The development of an effective and inexpensive device to restore and enhance the human musculoskeletal functions is of particular interest. Sling exercise therapy (SET) is one of the most effective developed tools in...The development of an effective and inexpensive device to restore and enhance the human musculoskeletal functions is of particular interest. Sling exercise therapy (SET) is one of the most effective developed tools in rehabilitation of musculoskeletal disorders, which has been successfully used in various applications ranging from diagnosis to treatment. To the best of our knowledge, SET has never been comprehended and reviewed previously. Therefore, it was highly required to further understand the role of SET in various therapeutic applications. Inspired by this herein, this study is dedicated to emphasize the advancement in utilization of the SET in both diagnosis and treatment as well as their related challenges. This would be concluded by future perspectives of the SET.展开更多
Conventional methods to treat urinary stress incontinence, including the Sling, Burch, and Pereyra modification methods, are limited by several shortcomings due to disrupted nerve and vaginal wall integrity. The nerve...Conventional methods to treat urinary stress incontinence, including the Sling, Burch, and Pereyra modification methods, are limited by several shortcomings due to disrupted nerve and vaginal wall integrity. The nerve-sparing Burch-Sling method represents a surgical advancement through the use of a nerve-sparing sling to treat genuine stress urinary incontinence. The procedure involves retropubic urethropexy using the FDA-approved Burch-Sling device. In this technique, the vagina is elevated bilaterally at the urethrovesical junction to the mid-urethra toward Cooper’s ligament above the base of the bladder. Then, the anterior vaginal wall and fascia are used as an endogenous suburethral sling without dissection. Two hundred twenty cases were included in this study;two hundred patients underwent the outpatient nerve-sparing sling method, and the other twenty underwent the novel abdominal Burch method. There were no major complications. The follow-up duration ranged from 6 months to eight years. All procedures were performed at the U.S. Women’s Institute at a 400-bed hospital in Fountain Valley, CA.展开更多
Pubovaginal slings have become the gold standard to treat stress urinary incontinence. Traditionally, the sling referred to a suspensory that was placed under the urethra and brought through the retropubic space and a...Pubovaginal slings have become the gold standard to treat stress urinary incontinence. Traditionally, the sling referred to a suspensory that was placed under the urethra and brought through the retropubic space and anchored on either side of the midline. Since this original concept, there have been many materials used for the sling, and there have been many different anchoring approaches. Most agree that one of the best materials is polypropylene mesh. However, the means of anchoring the device and where best to have this anchorage placed is debatable. The options for anchoring simply include using darts vs not to hold the sling in place. The location of this anchorage, on the other hand, is much more controversial. The main locations are retropubic, transobturator, and via a single incision. The obturator and retropubic slings have become the standard of care over time. The single incision sling, on the other hand, is starting to be more acceptable which has resulted in it being used more frequently. The single incision relies on mainly anchoring the sling through the obturator internus muscle with possible inclusion of the obturator membrane. The purpose of this review article is to present the data that exists for the use of the single incision sling.展开更多
Objectives: The Solyx System was developed to be easier and safer to use than other slings. It was the objective of this study to retrospectively assess the long-term safety and efficacy of the SolyxTM SIS Sling Syste...Objectives: The Solyx System was developed to be easier and safer to use than other slings. It was the objective of this study to retrospectively assess the long-term safety and efficacy of the SolyxTM SIS Sling System. Methods: After IRB approval and informed consent, chart reviews with follow up phone questionnaires of 69 subjects implanted with the Solyx Sling were collected at 2 sites. All of the patients had SUI and had urethral hypermobility with a q-tip test of >30 degrees. All subjects underwent surgery from 12/2008 to 01/2010 with a mean follow up of 43 months (range 39 -49). Subjects included in this data collection had a mean age of 67 years (range 30 -87). The dominant type of incontinence within the study patients was SUI while 17/69 (25%) of the subjects also had a component of urge incontinence. 38/69 (55%) of study patients had concomitant procedures. Results: Long-term Solyx results showed 64/69 (93%) of patients were subjectively dry by questionnaire and were satisfied with their outcome. 63/69 (91%) would have the procedure again. There were 4 cases of denovo urge incontinence and 2 reports of transient retention. There were no serious adverse events including no bladder, bowel, vessel or nerve perforations and no erosions or extrusions. No pain was reported that was attributed to the implant. Conclusions: Chart review with follow phone questionnaires indicated that the Solyx Sling was a safe, efficacious and less-invasive option for patients requiring SUI surgery and that these results were sustainable for an average of 43 months.展开更多
AIM:To compare frontalis sling and tarsoconjunctival mullerectomy plus levator resection(TCMLR)in subjects with severe unilateral congenital ptosis with poor levator function(LF).METHODS:A prospective non-randomized n...AIM:To compare frontalis sling and tarsoconjunctival mullerectomy plus levator resection(TCMLR)in subjects with severe unilateral congenital ptosis with poor levator function(LF).METHODS:A prospective non-randomized nonblinded single center clinical trial.Fifty patients with severe unilateral congenital ptosis with poor LF were recruited.The frontalis sling and TCMLR were performed and the functional,cosmetic outcomes,complications,and success rate were evaluated at 1,3,and 6mo postoperatively.The t-test,Chi-square,Fishers exact,and nonparametric MannWhitney tests were used by SPSS software.RESULTS:Frontalis sling and TCMLR procedures were performed on 26 and 24 patients respectively.The mean age was 10.97±10.67y.LF was significantly better in the TCMLR group at months 1,3,and 6(P=0.002).Lagophthalmos was more common in the TCMLR group(no significant difference).At month 3,mild punctate epithelial erosions were observed more in the frontalis sling group(P=0.002).Significant complete success rate of 1st and 6th month for the frontalis sling vs TCMLR groups were 50%vs 20.8%(P=0.02),and 38.4%vs 50%(P=0.03)respectively.CONCLUSION:Complete success rate of TCMLR is higher in long-term follow-up in contrast with the frontalis sling in the short-term.Transient complications are more detected in mid-term follow-ups in both groups.展开更多
[Objectives]This paper aimed to investigate the effect of Tuina combined with sling exercise therapy(SET)and psoas&abdominal training on serum 5-hydroxytryptamine(5-HT)andβ-endorphin(β-EP)levels in patients with...[Objectives]This paper aimed to investigate the effect of Tuina combined with sling exercise therapy(SET)and psoas&abdominal training on serum 5-hydroxytryptamine(5-HT)andβ-endorphin(β-EP)levels in patients with nonspecific low back pain(NLBP).[Methods]Total 46 patients with NLBP who visited the Tuina Department of the First Affiliated Hospital of Hainan Medical University from August 2019 to May 2020 were randomly and evenly divided into control group and treatment group.On the basis of Tuina therapy,the patients in the control group and treatment group were treated with psoas&abdominal training and SET,respectively.After the treatment,the serum 5-HT andβ-EP levels of the patients were detected.[Results]The serum 5-HT andβ-EP levels in the treatment group were significantly improved compared with the control group(P<0.05).[Conclusions]The nerve&muscle reconstruction techniques of Tuina combined with SET or psoas&abdominal training can improve serum 5-HT andβ-EP levels in patients with NLBP.展开更多
Background: Patellofemoral Pain Syndrome (PFPS) is one of the most common conditions among athletes. Although there are various causes for this condition, reduced balance is the problem most frequently expressed by th...Background: Patellofemoral Pain Syndrome (PFPS) is one of the most common conditions among athletes. Although there are various causes for this condition, reduced balance is the problem most frequently expressed by these patients. The aim of the present study was to examine the effect of Extensor Muscle Sling Isometric and Isotonic (EMSII) exercises of lower limbs on female basketball players suffering from PFPS. Method: A total of 30 participants, all female basketball players suffering from PFPS, with an average age of 20 - 30 years, were divided into two isometric/isotonic and control experimental groups. Eight weeks of isometric and isotonic exercises were recommended to the participants with a focus on EMSII exercises of lower limbs in two four-week phases. The control group received no specific exercise program. Pre-test and post-test included the use of Stork balance test (SBT) and Y Balance tests (YBT) to assess the static and dynamic balance, respectively. Results: After eight weeks of performing separate isometric and isotonic exercises on the mentioned muscles, and according to the results of the pre-test, a significant increase was observed in the results of both static and dynamic balance tests (P Conclusion: EMSII exercises of lower limbs showed a significant effect on the increased balance. Recommended exercises can be suggested according to the type of exercises as a factor for increasing static and dynamic balance.展开更多
The authors, through a descriptive retrospective study have evaluated the results of surgical treatment, by Tension-Free Obturator tape (TOT) technique, of urinary incontinence in the first 68 patients operated in the...The authors, through a descriptive retrospective study have evaluated the results of surgical treatment, by Tension-Free Obturator tape (TOT) technique, of urinary incontinence in the first 68 patients operated in the Department “C” of Obstetrics and Gynecology of the Maternity and Neonatology Centre of Tunis (WTSC). The average age in those patients was 55.14 ± 8.47 years with extremes of 40 and 82 years. The majority of the patients (72%) were under the age of 60 years. In sixty-one patients (89%), no urine leak has been detected and they were healed. In three patients (4%) there was improvement with partial recovery. Three other (4%) did not notice any improvement after the surgery. No case of dysuria or rejection of the strip has been reported. It was concluded that the declared satisfaction rate is 93%.展开更多
A Retrospective Comparative Series Comparing Monarc and Sparc Suburethral Slings. Introduction and Hypothesis: There are a number of suburethral slings used in current practice to treat female urinary incontinence. To...A Retrospective Comparative Series Comparing Monarc and Sparc Suburethral Slings. Introduction and Hypothesis: There are a number of suburethral slings used in current practice to treat female urinary incontinence. To date there has been a lack of larger comparative series. This paper aims to evaluate the effectiveness and complications of two types of suburethral sling. Methods: A retrospective comparative series comparing 113 consecutive Sparcsuburethral slings with 112 consecutive Monarc slings. Results: The success rate of SparcvsMonarc was similar at 6 weeks (96.1% vs 94.2%, NS) and at 6 months (96.0% vs 92.6%, NS). The Monarc procedure had less intraoperative bladder fenestrations & less postoperative urgency. Conclusions: Both procedures had a similar success rate, while the Monarc had less complications. Brief Summary: Both procedures had a similar success rate, while the Monarc had less complications of intraoperative bladder fenestration & postoperative urgency.展开更多
Purpose: To determine if 3 types of mid-urethral synthetic slings are visually the same. Materials and Methods: A retropubic, obturator, and single incision sling was individually placed in three cadavers. Tension was...Purpose: To determine if 3 types of mid-urethral synthetic slings are visually the same. Materials and Methods: A retropubic, obturator, and single incision sling was individually placed in three cadavers. Tension was set using a spacer (obturator and retropubic). Single incision sling (SIS) tension was set by visual inspection. Thirty physicians were asked to determine placement method, tension, and location of the 3 slings. Results: Physicians were composed of 5 urologists, 7 urogynecologist, and 18 general gynecologists, with an average of 53 slings performed per year. Conclusion: This study showed that after placement of a sling it is hard to tell how the sling was placed and that most physicians felt the SIS was tensioned the best and most likely at the mid-urethra.展开更多
BACKGROUND Stress urinary incontinence(SUI)is a common disease in women.The emergence of the needle-free sling has led to a new clinical treatment for SUI in women.AIM To explore the clinical value of the needleless s...BACKGROUND Stress urinary incontinence(SUI)is a common disease in women.The emergence of the needle-free sling has led to a new clinical treatment for SUI in women.AIM To explore the clinical value of the needleless sling without acupuncture in the treatment of SUI in women.METHODS From February 2017 to November 2018,according to the order of admission,44 patients(mid-suspension group)were treated by tension-free transobturator urethral suspension,and 44 patients(non-acupuncture group)were treated with a needleless non-acupuncture band.The clinical effects of the two treatments were evaluated.RESULTS There was no significant difference between the two groups in the total clinical effectiveness rate(P=0.374),but intraoperative blood loss and visual analogue scale score at postoperative day 1 were significantly lower in the non-acupuncture suspension group than in the middle urethral suspension group(P=0.396).The incidence of complications in the needle-free sling group was significantly lower than that in the middle urethral suspension group(P=0.025).CONCLUSION The clinical effectiveness of acupuncture-free suspension in treating SUI in female patients is better than that of traditional tension-free transobturator mid-urethral suspension.展开更多
We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the l...We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the left pulmonary artery, the relationship between pulmonary artery and airway, the diameter of the patent ductus artery and atrial septal defect. The information is helpful in diagnosis, pre-operative evaluation and post-operative follow-up of LPS.展开更多
AIM： To review of the efficacy and safety outcomes of different single incision slings （SIS） systems, also in comparison with traditional slings.METHODS： A literature search was conducted in PubMed/MEDLINE databas...AIM： To review of the efficacy and safety outcomes of different single incision slings （SIS） systems, also in comparison with traditional slings.METHODS： A literature search was conducted in PubMed/MEDLINE database. The research was re-stricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence （SUI）. The studies had to assess effcacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The fnal selection included 19 papers fulflling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS： Four different SIS systems were analysed： Ajust , Ophira , Altis and MiniArc . The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings （MUS） in terms of objective cure （all P 〉 0.005）. Only one paper showed a statistically lower success rate in MiniArc？ vs Advant-age？ slings （40% vs 90%） and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to com-pare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust？ and MiniArc？, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported long- term pain complains. CONCLUSION： SIS showed similar effcacy to that of traditional slings but lower short-term pain, complication and failure rates.展开更多
<strong>Objective</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>: </stron...<strong>Objective</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>: </strong>To evaluate the outcomes of transobturator mid-urethral sling (TO-MUS) with or without reconstructive pelvic floor surgery (RPFS) in Chinese women with stress urinary incontinence (SUI) after 10 years.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: This was a prospective observational study on Chinese women undergoing the insertion of</span><i> </i><span style="font-family:Verdana;">TO-MUS with or without RPFS. All patients were assessed at 1-year and 10-year by urodynamic study (UDS). Objective cure was defined as the absence of urine leakage during provocative maneuvers on filling cystometry. Data regarding subjective outcome (patient perception), quality of life changes (Urogenital Distress Inventory-short form (UDI-6), Incontinence Impact Questionnaire-short form</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">(IIQ-7)) and adverse events were also collected.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: Of 104 eligible patients, 99 patients completed the 10-year evaluation. 57 patients (57.6%) underwent TO-MUS only and 42 patients (42.4%) underwent TO-MUS with concomitant RPFS. At 10-year follow-up, the overall objective cure rate was 86.9% and overall subjective cure rate was 80.8%. In TO-MUS only group, the objective and subjective cure rates at 10-year were 84.2% and 78.9% respectively. In TO-MUS with RPFS group, the objective and subjective cure rates at 10-year were 90.5% and 83.3% respectively. Compared TO-MUS only group with TO-MUS with RPFS group, there were no statistically significant difference</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in objective cure rate (84.2% vs</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 90.5%, p = 0.55) and subjective cure rate (78.9% vs</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 83.3%, p = 0.58).</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: TO-MUS is an effective treatment for SUI in Hong Kong Chinese women. Concomitant RPFS during the procedure of TO-MUS does not affect the success.</span></span></span>展开更多
Re-adjustable male slings are well established and should be offered to incontinent men with mild, moderate or severe incontinence. However, they should be able to interrupt their stream. Solely the slight increase of...Re-adjustable male slings are well established and should be offered to incontinent men with mild, moderate or severe incontinence. However, they should be able to interrupt their stream. Solely the slight increase of the urethral resistance (10 - 15 cmH20) supporting the smooth muscle component will provide continence for such patients. Argus, Remeex and Atoms allow exactly setting the urethral resistance to a level, which will provide continence thus avoiding obstructive voiding. Implantation may be carried out retropubically (Remeex), via a transobturator route (Atoms) or alternatively (Argus). The success rates after more than one-year follow-up come up to 84%. Intraoperative bladder perforations may occur in 6% - 11%, late complications are infections possibly leading to explantation in 8% - 12%. Postoperative perineal pain and/or numbness may be present.展开更多
Objectives:To compare the success rates of autologous fascial mesh(sling and transobturator tape[TOT])with midurethral syntheticmeshes(tension-free vaginal tape sling[TVT]and TOT)for stress urinary incontinence.Materi...Objectives:To compare the success rates of autologous fascial mesh(sling and transobturator tape[TOT])with midurethral syntheticmeshes(tension-free vaginal tape sling[TVT]and TOT)for stress urinary incontinence.Materials and methods:A literature search for studies published in English was conducted from May 10,2022,to June 1,2022.Thesearch included MEDLINE/PubMed,Cochrane Library,Scopus,Web of Science,Google Scholar,and ProQuest,using the terms{“Autologous fascial slings”}OR{“AFS”}AND{“TOT”}OR{“Transobturator tape”}OR{“TVT”}OR{“Transvaginal tape”}.A total of 20 studies,including 10 randomized controlled trials,were selected for the review.RevMan software(version 5.3)was used to calculate the pooledeffect estimates for operative and postoperative variables.Results:In the systemic review,20 studies,including 10 randomized controlled trials,were assessed.In the TVT versus autologouspubovaginal sling(A-PVS)groups,the effect estimates for the surgical duration,catheter duration,success,and complication rates weremore advantageous for TVT.However,in comparison to autologous transobturator tape groups,TOT provided better operative time and ashorter hospital stay.Moreover,in comparison to the A-PVS group,the TOT group was superior in terms of operating time,urethral catheterization,hospital stay,amount of residual urine,and wound complications.The A-PVS group had significantly more groin and thigh pain.Conclusions:During medium-and long-term follow-ups,the use of autologous rectus fascia grafts using a A-PVS or TOT providedsimilar complication rates and urinary continence results as using midurethral synthetic meshes(TVT and TOT).展开更多
Aims:To evaluate the medium term efficacy and safety of Altis and Solyx single incision slings(SIS)compared with tension-free vaginal tape(TVT)Abbrevo trans-obturator sling.We hypothesize that both SIS show little dif...Aims:To evaluate the medium term efficacy and safety of Altis and Solyx single incision slings(SIS)compared with tension-free vaginal tape(TVT)Abbrevo trans-obturator sling.We hypothesize that both SIS show little difference in efficacy and safety and perform similarly to TVT Abbrevo.Methods:We conducted an ambispective comparative cohort study of women with stress urinary incontinence who received a SIS in comparison to matched TVT Abbrevo subjects from a concurrent randomized controlled trial(RCT).Subjects were identified retrospectively,and prospectively invited for examination and questionnaires>12 months post-operatively.Exclusions included intrinsic sphincter deficiency,previous sling surgery,and others.Primary outcome was subjective cure[negative response to International Consultation Incontinence Questionnaire-Urinary Incontinence Short Form(ICIQ-UI SF)question 6,leakage during coughing/activity].Secondary outcomes include objective cure(negative cough stress test),functional outcomes,and adverse events.Results:Between 2012 and 2018,a total of 113 women received one of two SIS surgeries;Solyx(n=50)followed by the Altis(n=63);104 were available for final efficacy analysis.Mean follow-up was 21.7(Altis),46.0(Solyx),and 29.0(Abbrevo)months.Baseline characteristics were comparable between the groups.There was no significant differences in the subjective or objective cure rates between the groups,and no differences in functional outcomes such as patient global impression of improvement,and post-operative ICIQ-UI SF score.There was a low rate of mesh related complications and no differences seen between the groups.Conclusions:Despite being an underpowered study,Altis and Solyx SIS have favourable efficacy and safety profiles which are comparable to an established trans-obturator mid-urethral slings(MUS).展开更多
Background Pulmonary artery sling （PAS） is a rare congenital heart anomaly and may cause unexplained respiratory symptoms in infants. Since the non-specific respiratory symptoms of PAS may lead to misdiagnosis, the ...Background Pulmonary artery sling （PAS） is a rare congenital heart anomaly and may cause unexplained respiratory symptoms in infants. Since the non-specific respiratory symptoms of PAS may lead to misdiagnosis, the aim of this study was to clarify the clinical and imaging features of this disease for timely diagnosis and treatment. Methods Clinical histories, physical examinations and imaging studies were retrospectively evaluated in nine infants with PAS. Chest X-ray, echocardiography and contrast-enhanced computed tomography （CT） with 3-dimensional reconstructions were performed in all patients and three of them received surgical treatment. Results Nine cases included six males and three females with a mean age of （4.3_＋_2.8） months ranging from 2 to 11 months old. All patients had respiratory symptoms including recurrent cough, stridor and wheezing. The onset of symptoms was within 3 months in all cases and three children had symptoms only a few days after birth. The chest X-ray showed pneumonia in all cases. Contrast-enhanced CT showed the tracheal compression at different lengths in every case. The echocardiograph findings of PAS were anomalous origins of the left pulmonary artery from the posterior aspect of the right pulmonary artery. Of the 9 cases, 8 cases were diagnosed correctly by echocardiography. Of the complicated abnormalities, there were one with secundum atrial septal defect, one with patent foramen ovale and three with persistent left superior vena cava. None of them were complicated with significant blood dynamic changes. Conclusions Infants with recurrent respiratory symptoms such as chronic cough, stridor and wheezing, should be examined for the possible presence of congenital pulmonary artery sling. As a noninvasive technique, echocardiography is very helpful and should be the first-choice modality for the diagnosis of pulmonary artery sling. Contrast-enhanced CT, clearly demonstrating the anatomy of pulmonary artery sling and the position and extent of trachea compression, is necessary for the final diaqnosis and pre-operation evaluation.展开更多
文摘The development of an effective and inexpensive device to restore and enhance the human musculoskeletal functions is of particular interest. Sling exercise therapy (SET) is one of the most effective developed tools in rehabilitation of musculoskeletal disorders, which has been successfully used in various applications ranging from diagnosis to treatment. To the best of our knowledge, SET has never been comprehended and reviewed previously. Therefore, it was highly required to further understand the role of SET in various therapeutic applications. Inspired by this herein, this study is dedicated to emphasize the advancement in utilization of the SET in both diagnosis and treatment as well as their related challenges. This would be concluded by future perspectives of the SET.
文摘Conventional methods to treat urinary stress incontinence, including the Sling, Burch, and Pereyra modification methods, are limited by several shortcomings due to disrupted nerve and vaginal wall integrity. The nerve-sparing Burch-Sling method represents a surgical advancement through the use of a nerve-sparing sling to treat genuine stress urinary incontinence. The procedure involves retropubic urethropexy using the FDA-approved Burch-Sling device. In this technique, the vagina is elevated bilaterally at the urethrovesical junction to the mid-urethra toward Cooper’s ligament above the base of the bladder. Then, the anterior vaginal wall and fascia are used as an endogenous suburethral sling without dissection. Two hundred twenty cases were included in this study;two hundred patients underwent the outpatient nerve-sparing sling method, and the other twenty underwent the novel abdominal Burch method. There were no major complications. The follow-up duration ranged from 6 months to eight years. All procedures were performed at the U.S. Women’s Institute at a 400-bed hospital in Fountain Valley, CA.
文摘Pubovaginal slings have become the gold standard to treat stress urinary incontinence. Traditionally, the sling referred to a suspensory that was placed under the urethra and brought through the retropubic space and anchored on either side of the midline. Since this original concept, there have been many materials used for the sling, and there have been many different anchoring approaches. Most agree that one of the best materials is polypropylene mesh. However, the means of anchoring the device and where best to have this anchorage placed is debatable. The options for anchoring simply include using darts vs not to hold the sling in place. The location of this anchorage, on the other hand, is much more controversial. The main locations are retropubic, transobturator, and via a single incision. The obturator and retropubic slings have become the standard of care over time. The single incision sling, on the other hand, is starting to be more acceptable which has resulted in it being used more frequently. The single incision relies on mainly anchoring the sling through the obturator internus muscle with possible inclusion of the obturator membrane. The purpose of this review article is to present the data that exists for the use of the single incision sling.
文摘Objectives: The Solyx System was developed to be easier and safer to use than other slings. It was the objective of this study to retrospectively assess the long-term safety and efficacy of the SolyxTM SIS Sling System. Methods: After IRB approval and informed consent, chart reviews with follow up phone questionnaires of 69 subjects implanted with the Solyx Sling were collected at 2 sites. All of the patients had SUI and had urethral hypermobility with a q-tip test of >30 degrees. All subjects underwent surgery from 12/2008 to 01/2010 with a mean follow up of 43 months (range 39 -49). Subjects included in this data collection had a mean age of 67 years (range 30 -87). The dominant type of incontinence within the study patients was SUI while 17/69 (25%) of the subjects also had a component of urge incontinence. 38/69 (55%) of study patients had concomitant procedures. Results: Long-term Solyx results showed 64/69 (93%) of patients were subjectively dry by questionnaire and were satisfied with their outcome. 63/69 (91%) would have the procedure again. There were 4 cases of denovo urge incontinence and 2 reports of transient retention. There were no serious adverse events including no bladder, bowel, vessel or nerve perforations and no erosions or extrusions. No pain was reported that was attributed to the implant. Conclusions: Chart review with follow phone questionnaires indicated that the Solyx Sling was a safe, efficacious and less-invasive option for patients requiring SUI surgery and that these results were sustainable for an average of 43 months.
基金Supported by Tehran University of Medical Sciences(No.9511257008)。
文摘AIM:To compare frontalis sling and tarsoconjunctival mullerectomy plus levator resection(TCMLR)in subjects with severe unilateral congenital ptosis with poor levator function(LF).METHODS:A prospective non-randomized nonblinded single center clinical trial.Fifty patients with severe unilateral congenital ptosis with poor LF were recruited.The frontalis sling and TCMLR were performed and the functional,cosmetic outcomes,complications,and success rate were evaluated at 1,3,and 6mo postoperatively.The t-test,Chi-square,Fishers exact,and nonparametric MannWhitney tests were used by SPSS software.RESULTS:Frontalis sling and TCMLR procedures were performed on 26 and 24 patients respectively.The mean age was 10.97±10.67y.LF was significantly better in the TCMLR group at months 1,3,and 6(P=0.002).Lagophthalmos was more common in the TCMLR group(no significant difference).At month 3,mild punctate epithelial erosions were observed more in the frontalis sling group(P=0.002).Significant complete success rate of 1st and 6th month for the frontalis sling vs TCMLR groups were 50%vs 20.8%(P=0.02),and 38.4%vs 50%(P=0.03)respectively.CONCLUSION:Complete success rate of TCMLR is higher in long-term follow-up in contrast with the frontalis sling in the short-term.Transient complications are more detected in mid-term follow-ups in both groups.
基金Natural Science Foundation of Hainan Province(No.818QN248,No.818MS061)。
文摘[Objectives]This paper aimed to investigate the effect of Tuina combined with sling exercise therapy(SET)and psoas&abdominal training on serum 5-hydroxytryptamine(5-HT)andβ-endorphin(β-EP)levels in patients with nonspecific low back pain(NLBP).[Methods]Total 46 patients with NLBP who visited the Tuina Department of the First Affiliated Hospital of Hainan Medical University from August 2019 to May 2020 were randomly and evenly divided into control group and treatment group.On the basis of Tuina therapy,the patients in the control group and treatment group were treated with psoas&abdominal training and SET,respectively.After the treatment,the serum 5-HT andβ-EP levels of the patients were detected.[Results]The serum 5-HT andβ-EP levels in the treatment group were significantly improved compared with the control group(P<0.05).[Conclusions]The nerve&muscle reconstruction techniques of Tuina combined with SET or psoas&abdominal training can improve serum 5-HT andβ-EP levels in patients with NLBP.
文摘Background: Patellofemoral Pain Syndrome (PFPS) is one of the most common conditions among athletes. Although there are various causes for this condition, reduced balance is the problem most frequently expressed by these patients. The aim of the present study was to examine the effect of Extensor Muscle Sling Isometric and Isotonic (EMSII) exercises of lower limbs on female basketball players suffering from PFPS. Method: A total of 30 participants, all female basketball players suffering from PFPS, with an average age of 20 - 30 years, were divided into two isometric/isotonic and control experimental groups. Eight weeks of isometric and isotonic exercises were recommended to the participants with a focus on EMSII exercises of lower limbs in two four-week phases. The control group received no specific exercise program. Pre-test and post-test included the use of Stork balance test (SBT) and Y Balance tests (YBT) to assess the static and dynamic balance, respectively. Results: After eight weeks of performing separate isometric and isotonic exercises on the mentioned muscles, and according to the results of the pre-test, a significant increase was observed in the results of both static and dynamic balance tests (P Conclusion: EMSII exercises of lower limbs showed a significant effect on the increased balance. Recommended exercises can be suggested according to the type of exercises as a factor for increasing static and dynamic balance.
文摘The authors, through a descriptive retrospective study have evaluated the results of surgical treatment, by Tension-Free Obturator tape (TOT) technique, of urinary incontinence in the first 68 patients operated in the Department “C” of Obstetrics and Gynecology of the Maternity and Neonatology Centre of Tunis (WTSC). The average age in those patients was 55.14 ± 8.47 years with extremes of 40 and 82 years. The majority of the patients (72%) were under the age of 60 years. In sixty-one patients (89%), no urine leak has been detected and they were healed. In three patients (4%) there was improvement with partial recovery. Three other (4%) did not notice any improvement after the surgery. No case of dysuria or rejection of the strip has been reported. It was concluded that the declared satisfaction rate is 93%.
文摘A Retrospective Comparative Series Comparing Monarc and Sparc Suburethral Slings. Introduction and Hypothesis: There are a number of suburethral slings used in current practice to treat female urinary incontinence. To date there has been a lack of larger comparative series. This paper aims to evaluate the effectiveness and complications of two types of suburethral sling. Methods: A retrospective comparative series comparing 113 consecutive Sparcsuburethral slings with 112 consecutive Monarc slings. Results: The success rate of SparcvsMonarc was similar at 6 weeks (96.1% vs 94.2%, NS) and at 6 months (96.0% vs 92.6%, NS). The Monarc procedure had less intraoperative bladder fenestrations & less postoperative urgency. Conclusions: Both procedures had a similar success rate, while the Monarc had less complications. Brief Summary: Both procedures had a similar success rate, while the Monarc had less complications of intraoperative bladder fenestration & postoperative urgency.
文摘Purpose: To determine if 3 types of mid-urethral synthetic slings are visually the same. Materials and Methods: A retropubic, obturator, and single incision sling was individually placed in three cadavers. Tension was set using a spacer (obturator and retropubic). Single incision sling (SIS) tension was set by visual inspection. Thirty physicians were asked to determine placement method, tension, and location of the 3 slings. Results: Physicians were composed of 5 urologists, 7 urogynecologist, and 18 general gynecologists, with an average of 53 slings performed per year. Conclusion: This study showed that after placement of a sling it is hard to tell how the sling was placed and that most physicians felt the SIS was tensioned the best and most likely at the mid-urethra.
文摘BACKGROUND Stress urinary incontinence(SUI)is a common disease in women.The emergence of the needle-free sling has led to a new clinical treatment for SUI in women.AIM To explore the clinical value of the needleless sling without acupuncture in the treatment of SUI in women.METHODS From February 2017 to November 2018,according to the order of admission,44 patients(mid-suspension group)were treated by tension-free transobturator urethral suspension,and 44 patients(non-acupuncture group)were treated with a needleless non-acupuncture band.The clinical effects of the two treatments were evaluated.RESULTS There was no significant difference between the two groups in the total clinical effectiveness rate(P=0.374),but intraoperative blood loss and visual analogue scale score at postoperative day 1 were significantly lower in the non-acupuncture suspension group than in the middle urethral suspension group(P=0.396).The incidence of complications in the needle-free sling group was significantly lower than that in the middle urethral suspension group(P=0.025).CONCLUSION The clinical effectiveness of acupuncture-free suspension in treating SUI in female patients is better than that of traditional tension-free transobturator mid-urethral suspension.
文摘We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the left pulmonary artery, the relationship between pulmonary artery and airway, the diameter of the patent ductus artery and atrial septal defect. The information is helpful in diagnosis, pre-operative evaluation and post-operative follow-up of LPS.
文摘AIM： To review of the efficacy and safety outcomes of different single incision slings （SIS） systems, also in comparison with traditional slings.METHODS： A literature search was conducted in PubMed/MEDLINE database. The research was re-stricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence （SUI）. The studies had to assess effcacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The fnal selection included 19 papers fulflling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS： Four different SIS systems were analysed： Ajust , Ophira , Altis and MiniArc . The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings （MUS） in terms of objective cure （all P 〉 0.005）. Only one paper showed a statistically lower success rate in MiniArc？ vs Advant-age？ slings （40% vs 90%） and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to com-pare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust？ and MiniArc？, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported long- term pain complains. CONCLUSION： SIS showed similar effcacy to that of traditional slings but lower short-term pain, complication and failure rates.
文摘<strong>Objective</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>: </strong>To evaluate the outcomes of transobturator mid-urethral sling (TO-MUS) with or without reconstructive pelvic floor surgery (RPFS) in Chinese women with stress urinary incontinence (SUI) after 10 years.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: This was a prospective observational study on Chinese women undergoing the insertion of</span><i> </i><span style="font-family:Verdana;">TO-MUS with or without RPFS. All patients were assessed at 1-year and 10-year by urodynamic study (UDS). Objective cure was defined as the absence of urine leakage during provocative maneuvers on filling cystometry. Data regarding subjective outcome (patient perception), quality of life changes (Urogenital Distress Inventory-short form (UDI-6), Incontinence Impact Questionnaire-short form</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">(IIQ-7)) and adverse events were also collected.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: Of 104 eligible patients, 99 patients completed the 10-year evaluation. 57 patients (57.6%) underwent TO-MUS only and 42 patients (42.4%) underwent TO-MUS with concomitant RPFS. At 10-year follow-up, the overall objective cure rate was 86.9% and overall subjective cure rate was 80.8%. In TO-MUS only group, the objective and subjective cure rates at 10-year were 84.2% and 78.9% respectively. In TO-MUS with RPFS group, the objective and subjective cure rates at 10-year were 90.5% and 83.3% respectively. Compared TO-MUS only group with TO-MUS with RPFS group, there were no statistically significant difference</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in objective cure rate (84.2% vs</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 90.5%, p = 0.55) and subjective cure rate (78.9% vs</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 83.3%, p = 0.58).</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: TO-MUS is an effective treatment for SUI in Hong Kong Chinese women. Concomitant RPFS during the procedure of TO-MUS does not affect the success.</span></span></span>
文摘Re-adjustable male slings are well established and should be offered to incontinent men with mild, moderate or severe incontinence. However, they should be able to interrupt their stream. Solely the slight increase of the urethral resistance (10 - 15 cmH20) supporting the smooth muscle component will provide continence for such patients. Argus, Remeex and Atoms allow exactly setting the urethral resistance to a level, which will provide continence thus avoiding obstructive voiding. Implantation may be carried out retropubically (Remeex), via a transobturator route (Atoms) or alternatively (Argus). The success rates after more than one-year follow-up come up to 84%. Intraoperative bladder perforations may occur in 6% - 11%, late complications are infections possibly leading to explantation in 8% - 12%. Postoperative perineal pain and/or numbness may be present.
文摘Objectives:To compare the success rates of autologous fascial mesh(sling and transobturator tape[TOT])with midurethral syntheticmeshes(tension-free vaginal tape sling[TVT]and TOT)for stress urinary incontinence.Materials and methods:A literature search for studies published in English was conducted from May 10,2022,to June 1,2022.Thesearch included MEDLINE/PubMed,Cochrane Library,Scopus,Web of Science,Google Scholar,and ProQuest,using the terms{“Autologous fascial slings”}OR{“AFS”}AND{“TOT”}OR{“Transobturator tape”}OR{“TVT”}OR{“Transvaginal tape”}.A total of 20 studies,including 10 randomized controlled trials,were selected for the review.RevMan software(version 5.3)was used to calculate the pooledeffect estimates for operative and postoperative variables.Results:In the systemic review,20 studies,including 10 randomized controlled trials,were assessed.In the TVT versus autologouspubovaginal sling(A-PVS)groups,the effect estimates for the surgical duration,catheter duration,success,and complication rates weremore advantageous for TVT.However,in comparison to autologous transobturator tape groups,TOT provided better operative time and ashorter hospital stay.Moreover,in comparison to the A-PVS group,the TOT group was superior in terms of operating time,urethral catheterization,hospital stay,amount of residual urine,and wound complications.The A-PVS group had significantly more groin and thigh pain.Conclusions:During medium-and long-term follow-ups,the use of autologous rectus fascia grafts using a A-PVS or TOT providedsimilar complication rates and urinary continence results as using midurethral synthetic meshes(TVT and TOT).
文摘Aims:To evaluate the medium term efficacy and safety of Altis and Solyx single incision slings(SIS)compared with tension-free vaginal tape(TVT)Abbrevo trans-obturator sling.We hypothesize that both SIS show little difference in efficacy and safety and perform similarly to TVT Abbrevo.Methods:We conducted an ambispective comparative cohort study of women with stress urinary incontinence who received a SIS in comparison to matched TVT Abbrevo subjects from a concurrent randomized controlled trial(RCT).Subjects were identified retrospectively,and prospectively invited for examination and questionnaires>12 months post-operatively.Exclusions included intrinsic sphincter deficiency,previous sling surgery,and others.Primary outcome was subjective cure[negative response to International Consultation Incontinence Questionnaire-Urinary Incontinence Short Form(ICIQ-UI SF)question 6,leakage during coughing/activity].Secondary outcomes include objective cure(negative cough stress test),functional outcomes,and adverse events.Results:Between 2012 and 2018,a total of 113 women received one of two SIS surgeries;Solyx(n=50)followed by the Altis(n=63);104 were available for final efficacy analysis.Mean follow-up was 21.7(Altis),46.0(Solyx),and 29.0(Abbrevo)months.Baseline characteristics were comparable between the groups.There was no significant differences in the subjective or objective cure rates between the groups,and no differences in functional outcomes such as patient global impression of improvement,and post-operative ICIQ-UI SF score.There was a low rate of mesh related complications and no differences seen between the groups.Conclusions:Despite being an underpowered study,Altis and Solyx SIS have favourable efficacy and safety profiles which are comparable to an established trans-obturator mid-urethral slings(MUS).
文摘Background Pulmonary artery sling （PAS） is a rare congenital heart anomaly and may cause unexplained respiratory symptoms in infants. Since the non-specific respiratory symptoms of PAS may lead to misdiagnosis, the aim of this study was to clarify the clinical and imaging features of this disease for timely diagnosis and treatment. Methods Clinical histories, physical examinations and imaging studies were retrospectively evaluated in nine infants with PAS. Chest X-ray, echocardiography and contrast-enhanced computed tomography （CT） with 3-dimensional reconstructions were performed in all patients and three of them received surgical treatment. Results Nine cases included six males and three females with a mean age of （4.3_＋_2.8） months ranging from 2 to 11 months old. All patients had respiratory symptoms including recurrent cough, stridor and wheezing. The onset of symptoms was within 3 months in all cases and three children had symptoms only a few days after birth. The chest X-ray showed pneumonia in all cases. Contrast-enhanced CT showed the tracheal compression at different lengths in every case. The echocardiograph findings of PAS were anomalous origins of the left pulmonary artery from the posterior aspect of the right pulmonary artery. Of the 9 cases, 8 cases were diagnosed correctly by echocardiography. Of the complicated abnormalities, there were one with secundum atrial septal defect, one with patent foramen ovale and three with persistent left superior vena cava. None of them were complicated with significant blood dynamic changes. Conclusions Infants with recurrent respiratory symptoms such as chronic cough, stridor and wheezing, should be examined for the possible presence of congenital pulmonary artery sling. As a noninvasive technique, echocardiography is very helpful and should be the first-choice modality for the diagnosis of pulmonary artery sling. Contrast-enhanced CT, clearly demonstrating the anatomy of pulmonary artery sling and the position and extent of trachea compression, is necessary for the final diaqnosis and pre-operation evaluation.
