scholarly journals Long-Term Results after Suprapubic ARC Procedure for the Treatment of Stress Urinary Incontinence in Women: A Retrospective Data Analysis

2021 ◽  
pp. 1-9
Author(s):  
Samra Jasarevic ◽  
Doroteja Jankovic ◽  
Georg C. Hutterer ◽  
Regina Riedl ◽  
Georg P. Pichler ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Flow Rate ◽  
Maximal Flow ◽  
Cough Test ◽  
Cure Rates ◽  
Subjective Cure ◽  
Weight Number ◽  
Objective Cure

<b><i>Introduction:</i></b> The aim of this study was to evaluate long-term safety and efficacy of the suprapubic arc (SPARC) procedure for the surgical treatment of stress urinary incontinence (SUI). <b><i>Materials and Methods:</i></b> 139 female patients treated by SPARC were included in this retrospective analysis, whereby 126 patients were available for follow-up after 1 year, 70 after 6 years, and 41 after 9 years. The cough test, pad test, uroflowmetry, and post-void residual volume measurements were performed. Severity of bother (visual analogous scale [VAS] 0–10), continence, and the satisfaction rate were assessed. Objective cure was defined as a negative cough test and pad weight ≤1 g, subjective cure as no urine loss during daily activities and no usage of pads. The VAS, pad weight, number of pads per day, and maximal flow rate were compared preoperatively and postoperatively. <b><i>Results:</i></b> Objective cure rates at 1, 6, and 9 years were 78.6, 71.4, and 70.7% and subjective cure rates were 72.2, 55.7, and 65.8%, respectively. The VAS, pad weight, number of pads, and maximal flow rate decreased significantly. Study limitations include a relatively small sample size and the retrospective fashion of the analysis. <b><i>Conclusions:</i></b> In the long-term context, SPARC showed to represent an efficient and safe procedure for treatment of female SUI.

scholarly journals Patient satisfaction and objective outcome assessment following mid-urethral sling procedures in women with stress urinary incontinence: A prospective study

2019 ◽  
Author(s):  
Zinat Ghanbari ◽  
Seyedeh Belin Tavakoly Sany ◽  
Maryam Hajhashemi ◽  
Nahid Radnia ◽  
Arezoo Orooji ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Urinary Incontinence ◽  
Patient Satisfaction ◽  
Stress Urinary Incontinence ◽  
Prospective Study ◽  
A Prospective Study ◽  
Cure Rates ◽  
Effective Procedures ◽  
Objective Cure

Abstract Background Mid-urethral sling (MUS) operations are currently a recognized as the most popular and effective procedures for the surgical treatment of stress urinary incontinence (SUI) among women population. However, data reporting a long-term outcome is still equivocal, and thus, the data available are limited. This study aims to examine the efficacy of MUS operations after implantation for the treatment of women SUI during 3-years follow up. Method A prospective study was conducted in referral centers in the Tehran University of Medical Science, Emam Khomeini Hospital, Iran. 105 patients with urodynamically proven pure SUI or mix incontinence treated by MUS surgeries (TOT-TVT) were included. Patients with history of prior anti-incontinence surgery and abdominal radical pelvic surgery were excluded. Data regarding objective cure rates, subjective outcomes (Urogenital Distress Inventory Questionnaire–Short Form, Surgical Satisfaction Questionnaire) were collected during follow-up. We analyzed the preoperative parameters by univariate and multivariate analysis was conducted to investigate outcomes. Results One hundred five women had MUS implantation. At 4-years follow-up, 101 women (95%) were available for the assessment. We find evidence of significant improvement in urinary symptoms, objective cure rates and patient satisfaction after operation. At 3-years follow up, 80 of 101 women (82.17%) indicated themselves cured. Similarly, at 3-years evaluation, 83 of 101 women (82.17%) were satisfied or very satisfied, not showing visible urine leakage; and a state that did not need interval surgery. The multivariate analysis of the preoperative parameters revealed that age, VD, absences of urgency symptoms were the parameters related independently to the surgical success and patient’s satisfaction and Qmax was well associated with postoperative voiding dysfunction (PVD). Conclusion The 4-years findings of this study suggest that MUS surgeries are an effective procedures for the treatment of SUI.

scholarly journals Mid- to Long-Term Magnetic Resonance Imaging Results of Two Prolapse Surgeries for Apical Defect: A Secondary Analysis of a Randomized Controlled Trial

2021 ◽  
Vol 43 (01) ◽  
pp. 046-053 ◽  
Author(s):  
Luiz Carlos Santos Junior ◽  
Luiz Gustavo Oliveira Brito ◽  
Edilson Benedito de Castro ◽  
Sergio Dertkigil ◽  
Cassia Raquel Teatin Juliato
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Resonance Imaging ◽  
Surgical Failure ◽  
One Year ◽  
Cure Rates ◽  
Subjective Cure ◽  
Objective Cure

Abstract Objective Magnetic resonance imaging (MRI) has been considered another tool for use during the pre- and postoperative periods of the management of pelvic-organ prolapse (POP). However, there is little consensus regarding its practical use for POP and the association between MRI lines of reference and physical examination. We aimed to evaluate the mid- to long-term results of two surgical techniques for apical prolapse. Methods In total, 40 women with apical POP randomized from 2014 to 2016 underwent abdominal sacrocolpopexy (ASC group; n = 20) or bilateral vaginal sacrospinous fixation with an anterior mesh (VSF-AM group; n = 20). A physical examination using the POP Quantification System (POP-Q) for staging (objective cure) and the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS: subjective cure), were applied and analyzed before and one year after surgery respectively. All MRI variables (pubococcigeous line [PCL], bladder base [BB], anorectal junction [ARJ], and the estimated levator ani subtended volume [eLASV]) were investigated one year after surgery. Significance was established at p < 0.05. Results After a mean 27-month follow-up, according to the MRI criteria, 60% of the women were cured in the VSF-AM group versus 45% in ASC group (p = 0.52). The POP-Q and objective cure rates by MRI were correlated in the anterior vaginal wall (p = 0.007), but no correlation was found with the subjective cure. The eLASV was larger among the patients with surgical failure, and a cutoff of ≥ 33.5 mm3 was associated with postoperative failure (area under the receiver operating characteristic curve [ROC]: 0.813; p = 0.002). Conclusion Both surgeries for prolapse were similar regarding the objective variables (POP-Q measurements and MRI cure rates). Larger eLASV areas were associated with surgical failure.

scholarly journals Long term safety, efficacy and clinical outcomes of transobturator tension free tape (inside-out technique) in women with stress urinary incontinence

2018 ◽  
Vol 7 (2) ◽  
pp. 442
Author(s):  
Poornima Penmetsa ◽  
Indira Guntoory ◽  
Ravi K. Raju Namburi ◽  
Jayalaxmi M.
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Medical Sciences ◽  
Tension Free ◽  
Bladder Neck Suspension ◽  
Objective Outcomes ◽  
A Prospective Study ◽  
Cure Rates ◽  
Inside Out

Background: Stress urinary incontinence (SUI) is commonly encountered in Gynaecological practice. The management of stress urinary incontinence underwent a paradigm shift with focus changing from bladder neck suspension to support of mid urethra in the last two decades. The aim of our study is to know the safety, efficacy, subjective and objective outcomes of Transobturator Tension Free Tape (TOT) (in-out technique) in women with Stress urinary incontinence.Methods: This is a prospective study conducted in the departments of Gynaecology and Urology at Maharajah’s Institute of Medical Sciences, Nellimerla, Vizianagaram district, Andhra Pradesh, India. 62 patients were treated with Tension Free Trans-obturator tape with inside-out technique using polypropylene mesh. This study was conducted from June 2012 to May 2014. These women were followed up annually for a period of 3 years af-ter surgery. 3 year subjective and objective outcomes were assessed. Subjective outcome is defined as no loss or leak of urine on physical activity and objective outcome is defined as negative Pad test.Results: The subjective and objective cure rates were 91.93% and 95.16% respectively.Conclusions: Transobturator Tension free Tape is an effective treatment for Stress urinary in-continence in women providing high subjective and objective efficacy upto 3 years after surgery.

scholarly journals An Open Multicenter Study of Clinical Efficacy and Safety of Urolastic, an Injectable Implant for the Treatment of Stress Urinary Incontinence: One-Year Observation

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Konrad Futyma ◽  
Paweł Miotła ◽  
Krzysztof Gałczyński ◽  
Włodzimierz Baranowski ◽  
Jacek Doniec ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Clinical Efficacy ◽  
Bulking Agents ◽  
Invasive Treatment ◽  
Cough Test ◽  
Urethral Bulking ◽  
One Year ◽  
Cure Rates ◽  
Patients Experience

The prevalence of stress urinary incontinence rises and affects up to 30% of women after 50 years of age. Midurethral slings are currently the mainstay of surgical anti-incontinence therapy. Some patients experience recurrent SUI (RSUI) which is defined as a failure of anti-incontinence surgery after a period of time or persistence of SUI after the procedure aimed at correcting it. The urethral bulking agent application decreases invasiveness of treatment and meets patients requirements. The objective of this study was to assess the safety and clinical efficacy of Urolastic injection. One hundred and five patients with SUI (including 91 patients with RSUI) were treated with Urolastic in three tertiary gynecological clinics. The efficacy of the procedure was assessed objectively at each follow-up visit by means of cough test and a standard 1-hour pad test. Objective success rate after 12 months after primary procedure in RSUI patients was found in 59.3% of patients. In 14 patients with primary SUI improvement after 1 year was found in 71.4% of patients. Although cure rates after MUS are up to 90% there is still place for less invasive treatment option like periurethral injection of bulking agents, especially in patients with previous SUI surgical management.

scholarly journals Six-year follow-up in patients with urinary stress incontinence treated with Altis® single-incision sling: a prospective single-center study

2021 ◽  
Vol 12 (2) ◽  
pp. 72-76
Author(s):  
Dakota Viruega-Cuaresma ◽  
Sonia De-Miguel-Manso ◽  
Elena García-García ◽  
Carmen E Badillo-Bercebal ◽  
Julio A Gobernado-Tejedor ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
De Novo ◽  
Single Incision ◽  
Categorical Variables ◽  
Medium Term ◽  
Single Incision Sling ◽  
Objective Cure

Objetives: Single incision slings are the latest generation of suburethral bands that seek to minimize morbidity and major complications of transobturator bands. In short and medium term, their results in terms of success and safety are similar to transobturator and retropubic bands. Nevertheless, there is little data on their long-term outcomes. Our objective was to evaluate safety and efficacy of Altis® mini-sling during the short, medium and long-term follow-up. Methods: Prospective observational study in 67 women who underwent surgery with Altis® for a period of 6 years (2013-2019). The main variables evaluated were: total continence, objective cure and subjective cure (satisfaction). The secondary variables studied were: complications and number of pads used per day after surgery. Statistics: Student t-test or U-Mann-Whitney for quantitative variables, Chi-Square for categorical variables. Results: Objective cure rates were: 96.77%, 87.04%, 87.50%, 85.71%, 76.92% and 50% (from 1 to 6years), and total continence: 85.48%, 72.22%, 64.88%, 50%, 46.15% and 50% (from 1 to 6years). Degree of satisfaction was: 9, 8.2, 8.3, 7.7, 7.6 and 6.5 points (from 1 to 6years). 30 patients (44.78%) had some type of complication and the most common were: “de novo” urinary urgency (20.90%), recurrence of stress urinary incontinence (14.93%) and pain (5.97%). Conclusion: Altis® presents high rates of objective and subjective continence in short and medium-term (1-5years), during 6-year follow-up. It is safe and does not associate severe complications. We found a high percentage of “de novo” urgency and recurrence of stress urinary incontinence, especially after the fifth year.

scholarly journals “I just wear it and I become normal”: a qualitative study of Tanzanian women’s experiences with long-term vaginal pessary use for stress urinary incontinence

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040009
Author(s):  
Karina Holm Nissen ◽  
Benjamin C Shayo ◽  
Vibeke Rasch ◽  
Gileard G Masenga ◽  
Ditte Søndergaard Linde
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Vaginal Pessary ◽  
Cost Effective Treatment ◽  
Long Term Treatment

IntroductionPrevious research has shown that vaginal pessaries are a cost-effective treatment for women worldwide suffering from stress urinary incontinence. However, little is known about African women’s experiences with vaginal pessary use. The aim of this study was to understand the experiences of vaginal pessary use among Tanzanian women who had received long-term pessary treatment for stress urinary incontinence.Methods15 semi-structured, individual interviews were conducted over a 2-month period in 2019 with Tanzanian women living in the Kilimanjaro Region who suffered from stress urinary incontinence and who had been using a pessary for at least 18 months. The interview transcripts were analysed using qualitative content analysis.ResultsThe primary motivation for seeking treatment were discomfort from symptoms, social consequences and low quality of life. Perceived benefits from pessary use included improved quality of life with reacquired abilities to perform daily activities, participate in social gatherings, feeling symptom relief and improved sexual relations. Further, some women saw pessary treatment as superior to other locally available treatment options. Perceived barriers for pessary use included shame, husband’s disapproval, limited access to treatment and lack of knowledge among the women as well as healthcare personnel.ConclusionVaginal pessaries are well-perceived as a long-term treatment method among Tanzanian women suffering from stress urinary incontinence. This method may have potential to be implemented large scale in Tanzania if combined with basic health education.

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