Treatment of Severe Urinary Incontinence following Radical Prostatectomy: Experience with Bioceram as a Bulking Agent

2019 ◽  
Author(s):  
Mohsen Ayati ◽  
Erfan Amini ◽  
Mohammad Reza Nowroozi ◽  
Seyed Ali Momeni ◽  
Solmaz Ohadian Moghadam ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Short Form ◽  
Bulking Agent ◽  
External Beam Radiation ◽  
Severe Stress ◽  
Beam Radiation ◽  
International Consultation ◽  
Before And After

Background: To evaluate the efficacy of Bioceram injection in men with severe stress urinary incontinence following radical prostatectomy. Methods: A total of 18 patients underwent retrograde injection of Bioceram for severe stress urinary incontinence following radical prostatectomy. Evaluation by pad test, international consultation on the Incontinence Questionnaire - Short Form (ICIQ-SF) and American Urology Association Symptom Score - Quality of Life (AUASS-QOL) was performed before and after injection therapy. Patients were considered cured if they were using no pads or only one safety pad per day. Results: Of 18 patients, 14 had received postoperative external beam radiation therapy. Furthermore, 5 patients required transurethral incision due to simultaneous stricture of the urethrovesical anastomosis. The baseline daily pad count changed from a mean of 6.1± 0.8 to 5.3 ± 1.7 (p = 0.010). None of the patients were cured and only 3 patients showed signs of improvement following injection. Conclusion: In patients with severe urinary incontinence, treatment with bulking agent injection is associated with modest efficacy.

scholarly journals Injectable Bulking Agent to Treat Postprostatectomy Urinary Incontinence: A Safety and Effectiveness Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Janneke I. M. van Uhm ◽  
Marloes Vermeer ◽  
Henk W. Elzevier ◽  
Joop W. Noordzij ◽  
Evert L. Koldewijn ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pilot Study ◽  
Radical Prostatectomy ◽  
Treatment Option ◽  
Short Form ◽  
Treatment Success ◽  
Bulking Agent ◽  
International Consultation ◽  
Weight Test ◽  
Urine Loss

Objectives. To evaluate the safety and effectiveness of the injectable bulking agent Opsys® (Promedon, Cordoba, Argentina) for treating minimal postprostatectomy stress urinary incontinence (SUI). Patients and Methods. Single-centre, pilot study on ten male patients with SUI, < 30 g urine loss/ 24 h, more than 1 year after radical prostatectomy. Patients were treated by endoscopic transurethral injections of bulking agent in the presphincteric zone of the urethral submucosa. The results were evaluated using a pad weight test to quantify the differences in urine loss at 1, 3, and 6 months after intervention. Subsequently, the results of treatment were also evaluated by International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory Short Form (UDI-6-SF), and the Patient Global Impression of Improvement (PGI-I) at 1, 3, and 6 months after intervention. Results. The primary outcome was the absolute result of the 24-hour pad weight test after treatment. Treatment success was defined as <3 g urine loss/24 h, improvement as ≥50% decrease in urine loss/ 24h, failure as <50% decrease in urine loss/24 h, or worsening of urine loss. Success was demonstrated in one, improvement in one, and failure in eight patients one month after treatment. One patient improved and 9 failed 3 and 6 months after treatment. The median 24-hour pad weight test was higher at all three moments of follow-up (1, 3, and 6 months after treatment). The median 24-hour pad weight test was before treatment 17.3g (6.4-20.9) and 1, 3, and 6 months after treatment, respectively, 40.3g (5.9-130.6) p= 0.038, 38.3g (18.3-202.1) p= 0.014, 55.0g (16.5-314.6) p= 0.028. The ICIQ-SF was significantly higher at 3 and 6 months, respectively 15.0 (12.0-18.5) p= 0.007 and 16.0 (12.5-17.5) p=0.012 versus 10.0 (9.0-12.0) before injection. No significant differences were found between IIQ-7, UDI-6-SF, and PGI-I before and after injection. Complications occurred in four patients: two patients reported spontaneously resolved haematuria and two patients reported urinary frequency. All complications were classified as Clavien–Dindo 1. Conclusion. Injection therapy with Opsys® bulking agent is not an effective treatment option for male SUI after radical prostatectomy. It is not a safe treatment option, due to worsening urine loss after treatment.

scholarly journals Male Urinary Incontinence

2016 ◽  
Vol 10 (6) ◽  
pp. NP127-NP135 ◽  
Author(s):  
Marcos E. Fernández-Cuadros ◽  
Javier Nieto-Blasco ◽  
Antonia Geanini-Yagüez ◽  
Daniel Ciprián-Nieto ◽  
Bárbara Padilla-Fernández ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Abdominal Surgery ◽  
Short Form ◽  
Life Measure ◽  
International Consultation ◽  
Before And After ◽  
Male Urinary Incontinence

The aim of the current study was to determine the demographic characteristics and risk factors associated with male urinary incontinence (UI) and to assess the effectiveness and the effect on the quality-of-life of a pelvic floor muscle training (PFMT) protocol with electromyography-biofeedback (EMG-BFB) with surface electrodes. A prospective, quasi-experimental before-and-after study with a sample of 61 men out of 372 patients referred to the Pelvic Floor Unit from October 2005 to June 2012 was performed. The protocol consisted of 20 sessions of EMG-BFB supervised by a physiotherapist twice a week. The session durations were 30 minutes (118 work/rest cycles of pelvic muscles). Work lasted 3 seconds and rest 7 seconds. Patients were given standards of conduct and questionnaires (International Consultation on Incontinence–Short Form and Incontinence Quality-of-Life Measure) at the beginning and at the end of the treatment. The average age was 64.85 ± 14.34 years; 44.3% ( n = 27) had benign prostatic hypertrophy, 41.9% ( n = 25) had prostate malignant neoplasm, 86.9% ( n = 53) had undergone prostatectomy, 16.4% ( n = 10) had undergone abdominal surgery. Abdominal surgery and radical prostatectomy were significantly associated with UI ( p < .05). Stress urinary incontinence was the most common type of UI (86.67%), followed by mixed urinary incontinence (8.33%) and urge urinary incontinence (5%). A significant improvement ( p < .05) in both International Consultation on Incontinence–Short Form and Incontinence Quality-of-Life Measure questionnaires was observed when making comparisons regarding the results before and after the EMG-BFB treatment protocol. These results support that male UI is significantly associated with urological and abdominal surgery (including radical prostatectomy) and that EMG-BFB for PFMT improves incontinence and quality of life (social embarrassment, limiting behavior, and psychosocial impact) in the three types of UI on an overall basis.

Evaluating urinary incontinence before and after radical prostatectomy using the international consultation on incontinence questionnaire‐short form

2018 ◽  
Vol 38 (2) ◽  
pp. 726-733 ◽  
Author(s):  
Kazuaki Machioka ◽  
Yoshifumi Kadono ◽  
Renato Naito ◽  
Kazufumi Nakashima ◽  
Masashi Iijima ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Short Form ◽  
International Consultation ◽  
Before And After

scholarly journals Do severe obese patients with stress urinary incontinence benefit from transobturator tape procedure? 3-year surgical outcome

2015 ◽  
Vol 9 (7-8) ◽  
pp. 546
Author(s):  
Tarik Yonguc ◽  
Ozgu Aydogdu ◽  
Ibrahim Halil Bozkurt ◽  
Tansu Degirmenci ◽  
Bulent Gunlusoy ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Patient Satisfaction ◽  
Stress Urinary Incontinence ◽  
Severe Obesity ◽  
Short Form ◽  
Transobturator Tape ◽  
Safe Procedure ◽  
Subjective Improvement ◽  
International Consultation ◽  
The Impact

Introduction: We evaluate the impact of severe obesity on surgical outcomes of the transobturator tape (TOT) procedure in patients with stress urinary incontinence (SUI).Methods: In total, 32 women with severe obesity (body mass index [BMI] >35 kg/m2) were included in the study. All patients were preoperatively evaluated with history, pelvic examination, ultrasonography, and cough stress test. All patients completed the International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) preoperatively and at the postoperative followup. Cure of incontinence was defined as being completely dry after surgery. Cure was assessed subjectively and objectively. Subjective improvement defined as an International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) score ≤12 and satisfaction with surgery. Failure was defined as having no change or worsening of urinary incontinence after surgery. Postoperative patient satisfaction was assessed using a visual analog scale.Results: The mean follow-up time and mean BMI were 40.9 ± 20.9 months and 38 ± 3 kg/m2, respectively. According to preoperative ICIQ-SF questionnaire scores, 20 patients (62.5%) had severe and 12 patients (37.5 %) had very severe urinary incontinence symptoms. No patient had slight or moderate symptoms. None of the patients experienced worsening symptoms after surgery. Objective cure, subjective cure, subjective improvement and patient satisfaction rates were 81.2%, 46.8%, 37.5%, and 84.3% respectively. Our overall complication rate was 9.3%. None of the patients experienced intraoperative complications.Conclusion: In experienced hands, TOT is an effective and safe procedure to treat SUI, with minimal complications in severe obese women.

Experience after 12 Cases with the Adjustable Transobturator Male Sling for Postprostatectomy Stress Urinary Incontinence

2017 ◽  
Vol 84 (4) ◽  
pp. 251-253
Author(s):  
Andrea Vismara Fugini ◽  
Luca Giovanessi ◽  
Michelangelo Tosana
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Short Form ◽  
Cure Rate ◽  
Invasive Treatment ◽  
International Consultation ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
The Mean

Objectives The aim of the study was the prospective evaluation of the efficacy of the adjustable transobturator male system (ArgusT®) for the treatment of postprostatectomy stress urinary incontinence (PPI). Methods Twelve consecutive patients were treated with ArgusT system for PPI. All patients were comprehensively evaluated preoperatively and after 3 and 6 months regarding daily pad use, residual urine, Incontinence Quality of Life Scale (I-QoL) score and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) score. Cure rate was defined as no pad use or one pad (used for security reasons). Results At 3 and 6 months, we achieved a cure rate of 91%. The mean number of pads per day decreased from 4 ± 1.3 to 0.7 ± 0.9 and 0.5 ± 0.9 after 3 and 6 months, respectively (p<0.001). Only one patient showed no significant improvement. Compared with baseline, the mean ICIQ-SF score dropped from 17.3 ± 2.8 to 2.7 ± 3.8 and 2.4 ± 3.8, at 3 and 6 months, respectively (p<0.001). The mean I-QoL score also improved significantly from 53.1 ± 20.3 to 99.5 ± 11 and 96.8 ± 12.5 after 3 and 6 months, respectively (p<0.001). Postoperative acute urinary retention was seen in one patient. Conclusions In our early experience, the ArgusT system offers effective, safe and minimally invasive treatment option for PPI.

scholarly journals Identification of peri-prostatic neurovascular fibers before and after radical prostatectomy by means of diffusion tensor imaging (DTI) with clinical correlations: initial experience

2019 ◽  
pp. 35-41
Author(s):  
SALVATORE SIRACUSANO ◽  
ANTONIO B. PORCARO ◽  
ALESSANDRO TAFURI ◽  
RENATO TALAMINI ◽  
ADAM J. CYBULSKI
Keyword(s):  
Diffusion Tensor Imaging ◽  
Radical Prostatectomy ◽  
Diffusion Tensor ◽  
Morphological Changes ◽  
Short Form ◽  
International Consultation ◽  
Significant Difference ◽  
Before And After ◽  
Spearman Test ◽  
Diffusion Tensor Imaging Dti

Aim: To evaluate if Diffusion Tensor Imaging (DTI) is able to detect morphological changes of peri-prostatic neurovascular fibers (PNF) before and after robot-assisted radical prostatectomy (RARP) and if these changes are related to urinary incontinence (UI) and erectile dysfunction (ED). Materials and methods: From October 2014 and August 2017 26 patients with biopsy-proven prostate cancer underwent prostatic multi-parametric magnetic resonance imaging (mp-MRI) including DTI sequencing before and six months after, RARP. Images were analyzed by placing six regions of interest (ROI) respectively at the base, mid-gland and apex, one for each side, to obtain tractography reconstruction of the PNF. Patients were asked to complete an International Consultation Incontinence Questionnaire – Short Form (ICIQ-SF) and International Index of Erectile Function (IIEF-5) questionnaires before RARP and 6 months postoperatively. Fractional anisotropy (FA), number (N) and length (L) of PNF before and after RARP were compared by means of Student's t-test; Spearman test was used to evaluate the correlation between DTI parameters and questionnaires scores. We observed a significant difference in N values before and after RARP (p<0.001) and a negative correlation between IIEF-5 score and post-operative FA values at both the right (rho=-0.42; p= 0.0456) and left (rho=- 0.66; p=0.0006) base of the prostate. DTI with tractography of PNF is able to detect quantitative changes in N, L and FA values in PNF after RARP. In particular we observed an inverse correlation between FA of PNF and ED at 6 months after RARP. Further investigations are needed to confirm this trend.

scholarly journals Is electroacupuncture safe and effective for treatment of stress urinary incontinence in women? A systematic review and meta-analysis

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052094833
Author(s):  
Xiuhua Lai ◽  
Jiapeng Zhang ◽  
Jing Chen ◽  
Cuiwei Lai ◽  
Chunping Huang
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Elderly Women ◽  
Short Form ◽  
Systematic Evaluation ◽  
Pool Data ◽  
Efficacy And Safety ◽  
International Consultation ◽  
Standard Mean Difference ◽  
Urine Leakage

Objective Stress urinary incontinence (SUI) is prevalent worldwide, particularly among elderly women. Although electroacupuncture (EA) has been accepted by many patients and physicians in Asia, its efficacy for SUI has not been evaluated scientifically and systematically. We aimed to conduct a systematic evaluation of the efficacy and safety of EA treatment for women with SUI. Methods We retrieved publications up to February 2019 from seven databases. Randomized controlled trials for women with SUI treated by EA were included. Therapeutic effect, 1-hour urine leakage and International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) scores were the primary outcomes. The Cochrane Collection’s RevMan 5.3 software was used to pool data. Results The 15 included articles demonstrated that EA for SUI was effective (odds ratio [OR], confidence interval [CI] = 5.64, 4.19–7.59; Ι2 = 22%). ICIQ-SF scores increased (standard mean difference, CI = −0.48, −0.62 to −0.33; Ι2 = 32%) and 1-hour urine leakage decreased (OR, CI = −4.14, −4.96 to −3.33; Ι2 = 78%) in patients undergoing EA compared with those receiving sham EA, physical exercise or medication. Conclusion EA for women with SUI exhibited significant efficacy and safety for key outcomes.

scholarly journals The Effect of Selected Exercise Programs on the Quality of Life in Women with Grade 1 Stress Urinary Incontinence and Its Relationship with Various Body Mass Indices: A Randomized Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Magdalena Ptak ◽  
Sylwester Ciećwież ◽  
Agnieszka Brodowska ◽  
Aleksandra Szylińska ◽  
Andrzej Starczewski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Body Mass ◽  
Randomized Study ◽  
Abdominal Muscle ◽  
Body Type ◽  
International Consultation ◽  
Before And After

Aims. The aim of the study was to analyze the influence gymnastics has on the quality of life (QOL) in women with grade 1 stress urinary incontinence (SUI) and to determine the relationship between the outcome and selected body weight indices: body mass index (BMI) and waist-to-hip ratio (WHR). Methods. A randomized study of 140 women (45-60 years) with grade 1 SUI. The subjects were randomly assigned to a 3-month training for pelvic floor muscles and a transverse abdominal muscle (PFM + TrA, n=70) or PFM alone (n=70). The QOL was determined with the questionnaire International Consultation on Incontinence Modular Questionnaire–Lower Urinary Tract Symptoms Quality of Life (ICIQ LUTS QOL), before and after the program. Results. Women with BMI<30 kg/m2 benefited more from the PFM + TrA program with respect to physical limitations and embarrassment domains, whereas patients with a gynoid body type (WHR<0.8) benefited more in terms of physical and social limitations, SUI-evoked emotions, severity measures, and embarrassment domains. Conclusions. After the PFM + TrA training, women with WHR<0.8 had a better QOL than those with WHR>0.8.

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