Modified pubovaginal sling technique in the surgical management of female stress urinary incontinence

Objective: To assess the application of aponeurotic sling by a modified technique with direct visualization of needles in patients with stress urinary incontinence. Methods: we applied the Kings Health Questionnaire (KHQ) for quality of life, gynecological examination, urinalysis I and urine culture approximately seven days prior to the urodynamic study (UDS) and the one-hour PAD test in patients undergoing making aponeurotic sling with its passing through the retropubic route with direct visualization of the needle, PAD test and King's Helth Questionnaire before and after surgery. Results: The mean age was 50.6 years, BMI of 28 and Leak Pressure (LP) 58,5cm H2O; 89% were Caucasian. Forty-six of them were monitored for three and six months, 43 for 12 months. The objective cure rate at 12 months postoperatively was approximately 93.5%. In evaluating quality of life, we observed a significant improvement in 12 months postoperatively compared with the preoperative period. There was no no urethral/bladder injury. As adverse results, we had one persistent urinary retention (2.3%), who was submitted to urethrolysis, currently without incontinence. Conclusion: The proposed procedure is safe as for the risk of bladder or urethral injuries, promoting significant improvement in quality of life and objective cure.

Download Full-text

Demirtaş Erciyes-Mid urethral fibrin fixation technique (DE-MUFFT) for female stress urinary incontinence: A case series

Journal of Experimental and Clinical Medicine ◽

10.52142/omujecm.38.4.53 ◽

2021 ◽

Vol 38 (4) ◽

pp. 696-699

Author(s):

Türev DEMİRTAŞ ◽

Gökhan SÖNMEZ ◽

Şevket Tolga TOMBUL ◽

Abdullah DEMİRTAŞ

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Clinical Outcomes ◽

Female Stress Urinary Incontinence ◽

Fixation Technique ◽

Pad Test ◽

Quality Of Life Scale ◽

Urine Leakage

Factors including suburethral blood flow impairment, collagen deficiency, and the lack of tissue healing factors are known to play a role in stress urinary incontinence (SUI). Autologous fibrin (AF) appears to be a viable material for the treatment of SUI. The aim of this study was to present the initial clinical outcomes of a novel technique named “Demirtaş Erciyes-Mid Urethral Fibrin Fixation Technique (DE-MUFFT)” that involved the placement of AF material in the suburethral space instead of sling material (mesh). In this study, the clinical outcomes of five women with pure SUI who underwent the placement of AF material in the suburethral space were examined retrospectively. The complaint of urine leakage during physical exertion and patients’ quality of life were assessed using Incontinence Quality of Life Scale (I-QoL), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), Incontinence Impact Questionnaire (IIQ-7), and 24-h pad test. Patient outcomes were evaluated preoperatively, at sixth week and third month postoperatively. Significant improvement was obtained in the quality-of-life tests and 24-h pad test. In all patients, the complaint of urine leakage disappeared almost completely. No adverse event or postoperative complication occurred in any of the patients. These results indicated that DE-MUFFT can be a promising procedure in the treatment of SUI due to its biocompatibility, minimally invasive nature, re-applicability, and cost-effectivity.

Download Full-text

Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence

Sao Paulo Medical Journal ◽

10.1590/s1516-31802007000500003 ◽

2007 ◽

Vol 125 (5) ◽

pp. 265-269 ◽

Cited By ~ 40

Author(s):

Míriam Raquel Diniz Zanetti ◽

Rodrigo de Aquino Castro ◽

Adriana Lyvio Rotta ◽

Patrícia Diniz dos Santos ◽

Marair Sartori ◽

...

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Subjective Evaluation ◽

Female Stress Urinary Incontinence ◽

Control Group ◽

Pelvic Floor Muscle Exercises ◽

Pad Test

CONTEXT AND OBJECTIVE: Urinary incontinence is a public health problem that affects more than 200 million people worldwide. Stress incontinence is the most prevalent type. Pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application. The aim of this study was to compare the results from treating female stress urinary incontinence with pelvic floor muscle exercises with or without physiotherapist supervision. DESIGN AND SETTING: This was a randomized, prospective, controlled trial in the Urogynecology and Vaginal Surgery Sector, Universidade Federal de São Paulo. METHODS: Forty-four women were randomized to be treated for stress urinary incontinence with pelvic floor exercises for three consecutive months, into two groups: one with and the other without physiotherapist supervision. They were evaluated before and after treatment using a quality-of-life questionnaire, pad test, micturition diary and subjective evaluation. Descriptive analysis was used to evaluate the population. The homogeneity of the two groups was evaluated using the Kruskal-Wallis and Chi-squared tests. The success of the two groups after treatment was evaluated using the Wilcoxon test. RESULTS: The supervised group showed statistically greater improvement in the pad test, micturition diary and quality of life than did the control group. In the subjective evaluation, only 23.8% of the control group patients were satised with their treatment. In the supervised group, 66.8% of patients did not want any other treatment. CONCLUSION: Supervised pelvic floor muscle exercises presented better results in objective and subjective evaluations than did unsupervised exercises.

Download Full-text

Outcome of Trans-obturator Tape Procedure in the treatment of Stress Urinary Incontinence at Kathmandu Model Hospital

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v15i1.29335 ◽

2020 ◽

Vol 15 (1) ◽

pp. 24-27

Author(s):

Ranjana Shrestha ◽

Ganesh Dangal ◽

Sonu Bharati ◽

Aruna Karki ◽

Hema Kumari Pradhan ◽

...

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Life Stress ◽

Cross Sectional Study ◽

High Rate ◽

Bladder Injury ◽

Cross Sectional ◽

Key Words Complications

Aims: To evaluate the improvement in the quality of life of women with stress urinary incontinence who were treated with trans-obturator tape procedure. Methods: This is a cross-sectional study of treatment of stress urinary incontinence using trans-obturator tape at Kathmandu Model Hospital from February 2018 to December 2019. The outcome of the procedure in terms of improvement in quality of life and surgical complications were assessed. Results: Out of 16 cases of stress urinary incontinence half of them were post-menopausal. One each had intra-operative bladder injury, urinary retention and urinary tract infection; 14 cases improved completely by a week, one had some improvement and one didn’t improve. At six months follow-up one case had no improvement and one developed urge incontinence. Conclusions: Trans-obturator tape has been found a good procedure for the treatment of stress urinary incontinence in our setting and hence led to high rate of improvement in quality of life with minimal and minor complications. Key words: Complications; quality of life; stress urinary incontinence; trans-obturator tape

Download Full-text

A 12-month feasibility study to investigate the effectiveness of cryogen-cooled monopolar radiofrequency treatment for female stress urinary incontinence

Canadian Urological Association Journal ◽

10.5489/cuaj.6145 ◽

2020 ◽

Vol 14 (7) ◽

Author(s):

Bruce B. Allan ◽

Stacie Bell ◽

Kathryn Husarek

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Outcome Measures ◽

Feasibility Study ◽

Patient Reported Outcome Measures ◽

Female Stress Urinary Incontinence ◽

Patient Reported ◽

Weight Test

Introduction: The purpose of this early feasibility study was to evaluate the safety and efficacy of a non-ablative, cryogen-cooled, monopolar radiofrequency (CMRF) treatment for female stress urinary incontinence (SUI). Methods: Subjects meeting all the inclusion and exclusion criteria were enrolled and randomized into two groups. Subjects in Group 1 received one CMRF treatment and subjects in Group 2 received two CMRF treatments six weeks apart. Followup visits were performed at one, four, six, and 12 months post-treatment. At each study visit, subjects performed an objective, standardized one-hour pad weight test and completed several patient-reported outcome measures, a seven-day bladder voiding diary, and safety assessments. Results: Data indicate an improvement in SUI symptoms and quality of life for subjects, as determined by validated SUI-related patient-reported outcomes and the objective one-hour pad weight test, with a >50% reduction in pad weight from baseline for 52% of the subjects at 12 months. In addition to efficacy, the CMRF treatment was well-tolerated and safe. Conclusions: The outcome measures evaluated indicate an improvement in SUI symptoms and quality of life. The sustained benefit of the CMRF vaginal treatment at 12 months suggests potential use as an office-based, non-surgical approach to treat mild to moderate SUI.

Download Full-text

The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years’ follow-up

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.2.603 ◽

2019 ◽

Vol 35 (2) ◽

Author(s):

Bulat Aytek Şık ◽

Hanife Copur ◽

Yılda Arzu Aba

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Transobturator Tape ◽

Mixed Urinary Incontinence ◽

Perineal Pain ◽

Cure Rate ◽

Objective Cure

Objective: To evaluate the clinical outcomes and the effects on quality of life of transobturator tape surgery during a 2-year follow-up period in our clinics. Methods: Eighty-seven patients with stress or mixed urinary incontinence who underwent transobturator tape surgery were included in the study conducted in Istanbul. Taksim. Training. and Research Hospital Gynecology and Obstetrics Clinic, between 2011 and 2013. The patients’ demographic features, incontinence questionnaires, quality of life scores [Incontinence Impact Questionnaire (IIQ-7) and urinary distress inventories (UDI-6)], examination findings, urodynamic results, stress tests, Q tip tests, number of daily pads, ultrasonography, surgery, and cystoscopy results were recorded. Patients were evaluated 23-27 months (mean: 25.40±1.31 months) after their discharge in terms of symptoms, quality of life scores, urodynamic findings, complications, and stress test. Results: Sixty-three (72.4%) patients had stress incontinence and 24 (27.6%) patients had mixed urinary incontinence. No perioperative complications were observed in our study. After a follow-up period of two years, a significant improvement was detected in the IIQ-7 and UDI-6 questionnaires when compared with the preoperative period. Moreover, the objective cure rate was found as 88.5% (n=77). De novo urge incontinence was obtained in 5.7% (n=5) of patients and was treated with anticholinergics. Perineal pain was present in 3 (3.44%) patients and was treated with analgesics and cold packs. In 2 (2.29%) patients, vaginal mesh erosion was detected and full recovery was achieved with an excision. Urinary retention and bladder perforation was not seen in any patients. Conclusion: Our study revealed a high objective cure rate, and an improvement in symptoms and quality of life with the transobturator tape operation. How to cite this:Sik BA, Copur H, Yilda Arzu ABA. The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years’ follow-up. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.603 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text