Issue 1s: June 2008

UIJ Volume 1 Issue 1s June 2008

Urodynamic Results of Acute Urinary Retention after Trial without Catheter

 

Purpose

Acute urinary retention (AUR) is a serious complication of male with lower urinary tract symptoms (LUTS).

Does Urethral Function Affect Urodynamic Voiding Parameters in Women with Prolapse?

ABSTRACT

Introduction: We hypothesized that women with pelvic organ prolapse (POP) and overt stress urinary incontinence (SUI) would demonstrate less obstruction and retention because of the “release valve” effect of a less competent urethra. To evaluate this, we conducted a prospective supplementary study to the Colpopexy And Urinary Reduction Efforts (CARE) study. We compared voiding parameters and symptoms in 3 groups of women with POP: 1) women with no symptoms of SUI and no urodynamic stress incontinence (USI) during prolapse reduction , 2) women with no SUI symptoms but evidence of USI on reduction testing (occult USI) and 3) women with SUI symptoms (overt SUI).

The Correlation of Voiding Variables Between Non-Instrumented Uroflowmetery and Pressure-Flow Studies in Women with Pelvic Organ Prolapse

ABSTRACT

Introduction: To better understand the correlation between non-instrumented uroflowmetry (NIF) and pressure-flow studies (PFS) in women with pelvic organ prolapse (POP), we conducted a prospective supplementary study to the Colpopexy And Urinary Reduction Efforts (CARE) study.

The Impact of Anti-Incontinence Surgery on Sexual Satisfaction and Quality of Life

Department of Nursing and Midwifery, University of Southampton, UK.

 

To compare the performance and cost-effectiveness of the key absorbent product designs to provide a more solid basis for guiding selection and purchase. Also to carry out the first stage in the development of a quality of life (QoL) instrument for measuring the impact of absorbent product use on users' lives.

Indications for Anti-Incontinence Procedures in Women with Severe Anterior Prolapse

ABSTRACT

Introduction and Objectives: The aims of the present study were to determine the indications for anti-incontinence surgery and evaluate the efficacy of different methods (combination of anterior colporraphy with TVT, vaginal wall sling (VWS), Raz needle suspension) in preventing postoperative stress urinary incontinence (SUI) in women undergoing surgery for severe urogenital prolapse.

Lower Urinary Tract Symptoms (LUTS), Symptom Overlap, Psychosocial Impact, and Cardiovascular Disease in Men: Findings from the Boston Area Community Health Survey (BACH)

 ABSTRACT

Introduction and Objectives: Cluster analysis is a statistical method for categorizing groups of individuals with similar properties or characteristics. This method is useful for examining the relationship between complex urological problems and other health conditions or lifestyle factors. The method has previously been shown to differentiate men with mixed patterns of voiding and storage symptoms in a large Canadian sample [1]. Assessing symptom co-occurrence can increase understanding of the disease etiology and has patient management implications. We used this method to classify men with storage, voiding, and post-voiding symptoms in the Boston Area Community Health (BACH) Survey [2].

Correlation of Q-Tip Values and Point Aa in Stress Incontinent Women

Hypothesis/Aims of Study

To determine the relationship between POP-Q point Aa and maximum urethral straining angle (Q-tip strain) and if the relationship is affected by pelvic organ prolapse in a cohort of women with stress predominant urinary incontinence.

New Approach of Placing Polypropylene Mesh for Surgical Correction of Stress Urinary Incontinence and Severe Cyctocele with Uterine Preservation

ABSTRACT

Introduction: We hypothesized that women with pelvic organ prolapse (POP) and overt stress urinary incontinence (SUI) would demonstrate less obstruction and retention because of the “release valve” effect of a less competent urethra. To evaluate this, we conducted a prospective supplementary study to the Colpopexy And Urinary Reduction Efforts (CARE) study. We compared voiding parameters and symptoms in 3 groups of women with POP: 1) women with no symptoms of SUI and no urodynamic stress incontinence (USI) during prolapse reduction, 2) women with no SUI symptoms but evidence of USI on reduction testing (occult USI), and 3) women with SUI symptoms (overt SUI).

Interrater Reliability of Pressure Flow Study Interpretation in the SISTEr Trial

ABSTRACT

Introduction and Objectives: It is generally recognized that OAB symptoms significantly affect patient’s quality of life and spread their negative impact to all aspects of human life: social, family, professional and sexual relationship. Therefore, assessment of patient’s quality of life is one of the main aspects in examination OAB patient. During last few years a lot of studies were dedicated to this subject but unfortunately their results are contradictory. There is no universally accepted conception about which of OAB symptoms affect more patient’s quality of life and characteristics of impairment patient’s quality of life according to gender and age. To clarify these questions was primary goal of our research.

Transurethral Injection of Bulking Agent for the Treatment of Recurrent or Persistent Female Stress Urinary Incontinence after Mid-Urethral Sling

ABSTRACT

Introduction and Objective

Although mid-urethral sling (MUS) with synthetic materials is associated with high success rates in female stress urinary incontinence (SUI), its widespread use has led to a group of patients with failures, increasing the need for an appropriate salvage procedure. Current options for managing failed MUS are transurethral injection of bulking agent, pubovaginal sling, or repeat MUS. Transurethral injection (TUI) of bulking agent may be appealing in patients in whom was failed the MUS procedure for its minimal invasiveness. In this study we evaluated the efficacy of TUI of bulking agent for the treatment of recurrent or persistent SUI after MUS.

Results of the SISTEr Randomized Surgical Trial Comparing the Autologous Rectus Fascia Sling to the Burch Colposuspension

 

Introduction and Objectives

Cluster analysis is a statistical method for categorizing groups of individuals with similar properties or characteristics.

Treatment of Stress Urinary Incontinence Via Transobturator Route

 

Introduction and Objectives

The aim of this study is to report the functional results, patient satisfaction, and morbidity of the Transobturator tape procedure (TOT) in the treatment of stress urinary incontinence (SUI).

Race/Ethnic Differences in Symptoms and Impacts of Urinary Incontinence in Women Undergoing Stress Incontinence Surgery

 

Hypothesis/Aims of Study

To determine the relationship between POP-Q point Aa and maximum urethral straining angle (Q-tip strain) and if the relationship is affected by pelvic organ prolapse in a cohort of women with stress predominant urinary incontinence.

Two-year Outcomes Following Sacrocolpopexy with and without Burch to Prevent Stress Urinary Incontinence

Reference Urodynamic Values for Stress Incontinent Women

 

Introduction and Objectives

Interrater reliability (IRR) of the pressure flow study (PFS) in multicenter trials is difficult to achieve.

Obesity and Outcomes after Sacrocolpopexy

ABSTRACT

Objective: To compare outcomes and complications after sacrocolpopexy (SC) performed with and without Burch colposuspension between obese and healthy-weight women.

Influence of Age on the Characterization of Elasticity of Prolapsed Vaginal Tissue on a Postmenopausal Women Group

ABSTRACT

Introduction and Objective: The objective of the current study is to evaluate the influence of age on the Elasticity of prolapsed vaginal tissue. Despite the recent efforts of several researchers [1,2], the mechanical properties of vaginal tissue are not fully understood. This information is important, for example, as an aid to evaluate the adequacy of urogynecologic implant materials [3], or it can be a contribution to the improvement of numerical simulations related with the pelvic cavity on women with pathologies like pelvic organ prolapse or urinary incontinence.


Methods: For the current study 28 post-menopausal patients were considered. Patient‚s age ranged from 49 to 84 years old. All patients were assisted on São João Hospital, and live on the North of Portugal. The tissue samples were collected between April of 2006 and October of 2007. Sample removal was performed during prolapse correction surgeries, according to a procedure approved by the Ethics Committee of S. João Hospital. Uniaxial tension tests were performed. The maximum time until testing was 6 hours and most of the specimens were tested no more than 4 hours after surgery. It was measured an elasticity parameter E describing the linear elastic portion of the stress/stretch curves [3]. The software package MATLAB® version 7 for windows was the platform used for statistics, data interpolation and graphical presentation of the results. The R-square value (complete miss? 0 = R-square = 1? complete match) was as a statistical measurement for the accuracy of the curve fittings presented.

Results: The experimental (average ± SD) value obtained for the elasticity parameter E was E = 12.34 ± 4.71 MPa. The results of the current study are a close match to those reported in [1], considering that they were achieved with a different experimental protocol [2,3]. A linear approximation of E (E˘-0.017*age+13; R-square = 0.001) shows a slight decreasing tendency of this property with age. However, a very small R-square coefficient indicates that the fitting does not describe the experimental results with accuracy.

Conclusion: It is known that biomechanical properties of living tissues are influenced by a multitude of patient dependent factors [4]. For the particular case of vaginal tissue, there have been recent works [1,2] debating the influence of patient dependent characteristics (such as age or parity) on the biomechanical properties. The present study, in agreement with the consulted literature, indicates that patient age does not influence the biomechanical properties of prolapsed vaginal tissue in any special way [1], but nevertheless does have some influence.

REFERENCES

  1. Lei, L., Y. Song, et al. (2007). "Biomechanical properties of prolapsed vaginal tissue in pre- and postmenopausal women." Int Urogynecol J 18: 603-607
  2. Epstein, L., M. Heit, et al. (2006). "Systemic and vaginal elasticity in women with and without pelvic organ prolapse." Int Urogynecol J 17(S2): S57
  3. Afonso, J., P. Martins, et al. (2008). "Mechanical properties of polypropylene mesh used in pelvic floor repair." Int Urogynecol J 19: 375-380
  4. Fung, Y. C. (1993). Biomechanics: Mechanical properties of living tissues, 2nd ed. Springer-Verlag. 

 

Preoperative Urodynamic Testing Does Not Predict Postoperative Voiding Dysfunction Among Women Undergoing Surgery for SUI: Results from a Prospective Randomized Trial Comparing Burch Versus Pubovaginal Sling

 

Introduction

Voiding dysfunction (VD) may occur in 2-20% of patients following surgery for stress urinary incontinence (SUI). Urodynamic studies (UDS) have been proposed as a means of identifying patients at risk for VD.

Changes in Physical Activity after Sacrocolpopexy for Advanced Pelvic Organ Prolapse

ABSTRACT

Introduction and Objectives: The aim of this study is to report the functional results, patient satisfaction, and morbidity of the Transobturator tape procedure (TOT) in the treatment of stress urinary incontinence (SUI). 204 patients with mean age of 58.8 years (range 31-72) who have completed a minimal follow-up of 12 months were enrolled in this study. 157 patients (77%) had history of stress incontinence and 47 patients (23%) had history of mixed incontinence. 153 patients had concomitant gynecological pathology (pelvic organ prolapse).

Urodynamic Changes Associated with Successful Stress Urinary Incontinence Surgery: A Little Tension is a Good Thing?

 

Introduction and Objectives

The aim of this study is to identify urodynamic changes that correlate with overall success after stress urinary incontinence surgery.