The continence status and the most adequate form of delivery were assessed in pregnant women who had a suburethral band to treat stress urinary incontinence (SUI). A group of 57 women selected from different articles ...The continence status and the most adequate form of delivery were assessed in pregnant women who had a suburethral band to treat stress urinary incontinence (SUI). A group of 57 women selected from different articles published between 2000 and 2014 were reviewed. These women had become pregnant after having undergone a suburethral band procedure. Different aspects such as age, parity, type of band, time elapsed between the procedure and the pregnancy, SUI during pregnancy and after delivery, and the form of delivery were evaluated, as well as the possible relationship with the recurrence of SUI and the emergence of complications associated with the suburethral during pregnancy. A case of a complication related to a suburethral band was found in one patient who developed an episode of pyelonephritis and intermittent urethral obstruction which required a Foley catheter. Thirty patients had cesarean section while 27 had vaginal deliveries;12 patients had incontinence during pregnancy and 15 suffered from it after delivery. Postpartum SUI in relation with the delivery form did not show statistically relevant differences between the cesarean section group and the vaginal delivery group. It was observed that the emergence of SUI during pregnancy was a risk factor for the onset of postpartum SUI (OR = 6.47;p = 0.0137). The risk of developing postpartum SUI seems similar regardless the delivery form, thus it is plausible to recommend vaginal delivery to these patients. If there was a recurrence of SUI, a second suburethral band could be placed which would be as effective as the first one and would involve a lower risk surgery compared to a cesarean section.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
Stress urinary incontinence is not a deadly disease,but for the large population of women suffering from it,it is a very important issue.Especially in the continuously aging population all over the world,there is more...Stress urinary incontinence is not a deadly disease,but for the large population of women suffering from it,it is a very important issue.Especially in the continuously aging population all over the world,there is more and more need for treatment of this serious medical condition.Treatment of female stress urinary incontinence exists already for ages.In the 20th century invasive treatments like Burch colposuspension and pubovaginal slings were the mainstay of surgical treatments.The introduction of the midurethral sling made the procedure less invasive and accessible for more caregivers.Luckily there are many options available and the field is developing quickly.In recent years many new medical devices have been developed,that increase the number of treatment options available and make it possible to find a suitable solution for the individual patient based on subjective and objective results and the chances of complications.This manuscript provides an introduction to the therapeutical options that are available nowadays for female stress urinary incontinence.展开更多
Objective: To compare the long term efficacy of transobturator Tape (TOT) with tension free vaginal tape (TVT) at 24 months postoperatively. Patients & Methods: 160 women with stress urinary incontinence (SUI) wer...Objective: To compare the long term efficacy of transobturator Tape (TOT) with tension free vaginal tape (TVT) at 24 months postoperatively. Patients & Methods: 160 women with stress urinary incontinence (SUI) were randomly allocated to either TVT or TOT procedures and reviewed at 24 months after surgery. The primary outcomes were objective cure (a negative cough stress test, and a negative 1-hour pad test), and subjective cure (defined as “very much better” or “much better” improvement in the Patient Global Impression of Improvement scale). The secondary outcomes included incontinence related quality of life (using Urogenital Distress Inventory Questionnaire, and Incontinence Impact Questionnaire), and complications. Results: No statistical difference was reported in objective and subjective cure rates between both groups. Objective cure rate was 85.6% and 81.6% in the TOT and TVT groups respectively (P = 0.55). Subjective cure rate in the TOT and TVT groups were 87% and 83% respectively (P = 0.68). There were no significant differences in postoperative complications and incontinence related quality of life. However, the operating time was significantly shorter in the TOT group compared with the TVT group (22.6 ± 3.9, 27.1 ± 3;respectively, P < 0.001). Conclusion: TOT and TVT procedures were equally efficient and safe for treatment of SUI, with maintenance of high objective and subjective cure rates for 24 months. Longer follow-up is needed to confirm these results.展开更多
文摘The continence status and the most adequate form of delivery were assessed in pregnant women who had a suburethral band to treat stress urinary incontinence (SUI). A group of 57 women selected from different articles published between 2000 and 2014 were reviewed. These women had become pregnant after having undergone a suburethral band procedure. Different aspects such as age, parity, type of band, time elapsed between the procedure and the pregnancy, SUI during pregnancy and after delivery, and the form of delivery were evaluated, as well as the possible relationship with the recurrence of SUI and the emergence of complications associated with the suburethral during pregnancy. A case of a complication related to a suburethral band was found in one patient who developed an episode of pyelonephritis and intermittent urethral obstruction which required a Foley catheter. Thirty patients had cesarean section while 27 had vaginal deliveries;12 patients had incontinence during pregnancy and 15 suffered from it after delivery. Postpartum SUI in relation with the delivery form did not show statistically relevant differences between the cesarean section group and the vaginal delivery group. It was observed that the emergence of SUI during pregnancy was a risk factor for the onset of postpartum SUI (OR = 6.47;p = 0.0137). The risk of developing postpartum SUI seems similar regardless the delivery form, thus it is plausible to recommend vaginal delivery to these patients. If there was a recurrence of SUI, a second suburethral band could be placed which would be as effective as the first one and would involve a lower risk surgery compared to a cesarean section.
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.
基金supported by an unrestricted grant from Urogyn BV,Nijmegen,The Netherlands.
文摘Stress urinary incontinence is not a deadly disease,but for the large population of women suffering from it,it is a very important issue.Especially in the continuously aging population all over the world,there is more and more need for treatment of this serious medical condition.Treatment of female stress urinary incontinence exists already for ages.In the 20th century invasive treatments like Burch colposuspension and pubovaginal slings were the mainstay of surgical treatments.The introduction of the midurethral sling made the procedure less invasive and accessible for more caregivers.Luckily there are many options available and the field is developing quickly.In recent years many new medical devices have been developed,that increase the number of treatment options available and make it possible to find a suitable solution for the individual patient based on subjective and objective results and the chances of complications.This manuscript provides an introduction to the therapeutical options that are available nowadays for female stress urinary incontinence.
文摘Objective: To compare the long term efficacy of transobturator Tape (TOT) with tension free vaginal tape (TVT) at 24 months postoperatively. Patients & Methods: 160 women with stress urinary incontinence (SUI) were randomly allocated to either TVT or TOT procedures and reviewed at 24 months after surgery. The primary outcomes were objective cure (a negative cough stress test, and a negative 1-hour pad test), and subjective cure (defined as “very much better” or “much better” improvement in the Patient Global Impression of Improvement scale). The secondary outcomes included incontinence related quality of life (using Urogenital Distress Inventory Questionnaire, and Incontinence Impact Questionnaire), and complications. Results: No statistical difference was reported in objective and subjective cure rates between both groups. Objective cure rate was 85.6% and 81.6% in the TOT and TVT groups respectively (P = 0.55). Subjective cure rate in the TOT and TVT groups were 87% and 83% respectively (P = 0.68). There were no significant differences in postoperative complications and incontinence related quality of life. However, the operating time was significantly shorter in the TOT group compared with the TVT group (22.6 ± 3.9, 27.1 ± 3;respectively, P < 0.001). Conclusion: TOT and TVT procedures were equally efficient and safe for treatment of SUI, with maintenance of high objective and subjective cure rates for 24 months. Longer follow-up is needed to confirm these results.
