Urethral Bulking for Stress Urinary Incontinence or Mixed Incontinence in Women Not Suitable for Treatment With a Midurethral Sling: 5-Year Follow-Up

2020 ◽  
Keyword(s):  
Urinary Incontinence ◽  
Treatment Group ◽  
Midurethral Sling ◽  
Treated Group ◽  
Patient Satisfaction Questionnaire ◽  
Urinary Tract Symptoms ◽  
Urethral Bulking ◽  
Group A

Aim: To compare outcome of injection with the bulking agent polyacrylamide hydrogel (PAHG) with no treatment in women with urinary incontinence who were not candidates for treatment with a midurethral sling. Methods: Women were randomized to treatment with PAHG or no treatment. After 2 months follow-up the women in the non-treatment group were also given PAHG treatment. All patients were then followed for 12 months. Patients were assessed with a patient satisfaction questionnaire, the UDI-6 (lower urinary tract symptoms) and IIQ-7 (quality of life). A new questioner was sent after 5 years. Results: At 2 months, IIQ-7 scores decreased by 55% and the UID-6 by 38% in women in the treated group compared with -4% and 2%, respectively in the non-treatment group. A total of 63% of patient were much satisfied/ satisfied in the treatment group compared with 19% in the non-treatment group. The 12-month follow-up showed a subjective satisfaction rate of 62%. The objective results show that women who were satisfied (n = 18) had a decrease in IIQ-7 of 61% and UID-6 of 41% compared with 20% and 10% in patients who were not satisfied (n = 11). At a mean (range) follow-up of 5 years (3–7), 44% of patients were still satisfied with treatment results. Conclusion: Bulking treatment with PAHG can be offered to patients not suited to treatment

scholarly journals Impact of Midurethral Sling Implantation on Sexual Function in Women with Stress Urinary Incontinence

2020 ◽  
Vol 9 (5) ◽  
pp. 1538
Author(s):  
Edyta Horosz ◽  
Aneta Zwierzchowska ◽  
Andrzej Pomian ◽  
Wojciech Majkusiak ◽  
Paweł Tomasik ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Sexual Function ◽  
Sexual Activity ◽  
Midurethral Sling ◽  
Sexual Life ◽  
Cough Test ◽  
The Impact

Stress urinary incontinence (SUI) negatively influences sexual functions. However, the available data on sexual activity of patients who underwent midurethral sling (MUS) implantation are inconsistent. Our aim was to evaluate the impact of MUS implantation on sexual functions of women with SUI. We enrolled 171 patients undergoing the MUS procedure. Preoperative examination included the cough test, 1 h pad test and the Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA Revised (PISQ-IR). All patients had the retropubic sling implanted. Follow-up visits were performed 6–12 months after surgery. Objective cure rate was obtained in 90.98% of patients. Coital incontinence was reported by 56% of women before the surgery, and 8.6% afterwards. Among women who gained continence, significant improvement in sexual function was observed in the majority of the domains. In women who were not objectively cured (9.02%), we did not observe improvement in sexual life. All these patients indicated fear of leaking urine during sexual activity as the main cause of avoiding sex, similarly as before operation. To conclude, successful treatment of SUI with MUS significantly improves the quality of sexual life. On the other hand, persistent incontinence appears to be the most probable cause of lack of improvement in the quality of sexual life.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

Efficacy of corticosteroid therapy in the treatment of long- lasting olfactory disorders in COVID-19 patients

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
L.A. Vaira ◽  
C. Hopkins ◽  
M. Petrocelli ◽  
J.R. Lechien ◽  
S. Cutrupi ◽  
...  
Keyword(s):  
Treatment Group ◽  
Case Control Study ◽  
Spontaneous Recovery ◽  
Olfactory Function ◽  
Control Group ◽  
Initial Control ◽  
Group A ◽  
Control Study

BACKGROUND: The growing number of COVID-19 patients with long-lasting olfactory disorders makes it necessary to identify effective treatments that enhance the spontaneous recovery of olfactory function. METHODS: Multicentre randomised case-control study that involved 18 patients with COVID-19 related anosmia or severe hyposmia for more than 30 days. Nine patients were prescribed systemic prednisone and nasal irrigation with betamethasone, ambroxol and rinazine for 15 days. The other 9, untreated, patients were used as controls. The olfactory function was evaluated with CCCRC test at 20 and 40 days from the first evaluation. RESULTS: In the control group, a median olfactory score of 20 (IQR 30) was detected at baseline. At the 20-day control there was no significant improvement in olfactory function. The improvement in olfactory performance became significant at the 40-day follow-up compared to baseline scores [60 (IQR 60) versus 20 (IQR 30)]. In the treatment group, patients had a mean olfactory score of 10 (IQR 15) at initial control. At the 20-day control, a significant im-provement in the olfactory scores, compared to the baseline, was detected [70 (IQR 40) versus 10 (IQR 15)]. Olfactory function further improved at 40 days [median score 90 (IQR 50)]. Patients in the treatment group reported significantly higher improvements of the olfactory scores than the controls at both the 20-day [40 (IQR 45) versus 10 (IQR 15)] and 40-day [60 (IQR 40) versus 30 (IQR 25)] evaluations. CONCLUSIONS: Based on the results of this study, the mix of drugs including steroids could represent a useful specific therapy to reduce the prevalence of this long-term morbidity.

scholarly journals A COMPARISON BETWEEN SYNTHETIC AND BIOSYNTHETIC MESHES IN THE SURGICAL TREATMENT OF SEVERE GENITAL PROLAPSE: RESULTS AND COMPLICATIONS

2010 ◽  
Vol 23 (3) ◽  
pp. 21
Author(s):  
S. Dati ◽  
V. De Lellis ◽  
P. Palermo ◽  
G. Carta
Keyword(s):  
Genital Prolapse ◽  
Pelvic Organ ◽  
Wilcoxon Test ◽  
Type I ◽  
Replacement Surgery ◽  
Group A ◽  
Group B ◽  
Work Up

The effectiveness, tolerability and complications of two surgical procedures using prosthetic materials with different physical and structural properties were assessed with a full Urogynecology work-up, through a retrospective study of 158 patients with severe genital prolapse (POP-Q staging III-IV) selected from November 2006 to April 2009. Eighty-six patients underwent fascial replacement surgery with ProliftTM System with a dual transobturator access in the anterior district and a transperineal posterior access with a synthetic polypropylene type I mesh (Group A). Seventy-two patients who underwent pelvic organ prolapse surgery with Avaulta/Avaulta PlusTM System with a dual transobturator access in the anterior district and a dual transperineal posterior access with a biosynthetic polypropylene type I mesh coated with a film of hydrophilic porcine collagen were placed in Group B. There were no intra and postoperative complications. Results of mean 20.8 month follow-up showed an effective anatomical cure rate of 89.5% in group A and 86.1% in group B and a low percentage of erosive complications, 8.1% and 5.6% respectively. Validated questionnaires for prolapse, the UDI 6 s.f., the IIQ7 s.f. and the PISQ-12 all showed a statistically significant improvement of quality of life in patients undergoing the two procedures (Wilcoxon test: P<0.001).

scholarly journals Burch Retropubic Urethropexy for Genuine Stress Urinary Incontinence: A Review of Eight Cases

2017 ◽  
Vol 5 (2) ◽  
pp. 129-132
Author(s):  
Disha A Rajput ◽  
Shalini M Valecha ◽  
Manisha Sarwade ◽  
Shrikant Dhumale
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Urinary Continence ◽  
Urgency Incontinence ◽  
Patient’S Satisfaction ◽  
Satisfaction Index ◽  
Genuine Stress Urinary Incontinence

ABSTRACT Introduction Urinary incontinence (UI) is more common than any other chronic disease with the prevalence of approximately 23 and 55%. Among the various forms of UI, stress incontinence (SUI) is the most common (49%), with urgency incontinence (UUI) representing 21% and mixed type (MUI) at 29%. As it affects the quality-of-life of women, the restoration of urinary continence is one of the greatest challenges. Aim To review the cases of genuine SUI treated surgically by Burch retropubic urethropexy. Results We have managed surgically eight cases of genuine SUI by Burch retropubic urethropexy. On 1-year follow-up, none of the patients had any urinary complaints. All had responded well to surgery and patient's satisfaction index was good. Conclusion Since SUI is the commonest among incontinences, it is a challenge to diagnose and treat to improve quality-of-life of patients. Burch retropubic urethropexy is the gold standard treatment for SUI, especially if other indications exist for abdominal surgery. Even in the present era of less invasive vaginal procedures, results are comparable. How to cite this article Rajput DA, Valecha SM, Sarwade M, Dhumale S. Burch Retropubic Urethropexy for Genuine Stress Urinary Incontinence: A Review of Eight Cases. J South Asian Feder Menopause Soc 2017;5(2):129-132.

scholarly journals URINARY INCONTINENCE;

2017 ◽  
Vol 24 (06) ◽  
pp. 824-827
Author(s):  
Ambreen Amna ◽  
Farkhunda Nadeem ◽  
Pushpa Srichand
Keyword(s):  
Urinary Incontinence ◽  
Stress Incontinence ◽  
Urinary Fistula ◽  
University Hospital ◽  
Persistent Symptoms ◽  
Grade 3 ◽  
Time Of Admission ◽  
Study Setting

Background: Genitourinary fistula remains a major cause of morbidity worldwide.Approximately 2 million of women suffer from urinary leakage. Since the establishment ofGenito urinary Fistula center at Isra University Hospital –Hyderabad Sindh. We are able to shareour experience of fistulous women at the time of admission and at follow up visit. Objectives:To determine the different types of urinary incontinence in a woman after genitourinary fistularepair. Study Design: A Follow-up Descriptive study. Study Setting: This Study was done atFistula center Isra University Hospital Hyderabad GU – 11 from January 2011 to December2013. All the women who were admitted with true incontinence followed by Obstetrical andmajor gynecological surgeries were included. However women with stress incontinence andurge incontinence and women who are not willing to include in the study were excluded.Result: Out of one hundred and ten (110) women included in this study, 59 (53.6%) were foundto have obstetrical fistula, while 43 (39%) were suffering from Iatrogenic fistula. Continencestatus were explored at follow up visit. Out of 110 women, 108 (98.18%) & 96 (87.27 %) werehaving no signs of incontinence on examination at first visit and after six week and secondvisit after three month respectively. Only 7 % women fell into incontinence grade 2 at six weekfollow up and only one percent had persistent symptoms of stress incontinence at 3 monthrespectively. Women fall on incontinence grade 3, 4 and 5 were completely cured at 3 month.Conclusion: Success rate of genitor- urinary fistula repair is 98 %. Majority of women (96 %)on short term follow up at 6 weeks showed improved urinary symptoms. Moreover on follow upvisit at 3 months, these women reported improved quality of life and social reintegration afterfistula closure.

Efficacy of Endoscopic Posterior Nasal Neurectomy in Treating Eosinophilic Chronic Rhinosinusitis

ORL ◽  
2021 ◽  
pp. 1-5
Author(s):  
Manman Chen ◽  
Ming Xu ◽  
Xuefeng Lei ◽  
Bin Zhang
Keyword(s):  
Chronic Rhinosinusitis ◽  
Surgical Recurrence ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Group A ◽  
Sinonasal Outcome Test ◽  
Random Number Table ◽  
Group B

<b><i>Objectives:</i></b> Recent guidelines have revealed that eosinophilic chronic rhinosinusitis (ECRS) exhibits a strong tendency for recurrence after surgery and impairs quality of life. Neuropeptides play an important neuroimmunological role. The aim of this study was to determine the efficacy of posterior nasal neurectomy (PNN) for the treatment of ECRS by inhibiting type 2 cytokine expression. <b><i>Methods:</i></b> Forty-six patients were divided into group A and group B according to a random number table. Group A underwent conventional functional endoscopic sinusitis surgery (FESS) combined with PNN, and group B underwent conventional FESS alone. The subjective and objective symptoms included a 10-cm visual analog scale (VAS), 22-item SinoNasal Outcome Test (SNOT-22) score, nasal speculum Lund-Kennedy score, and paranasal sinus computed tomography (CT) Lund-Mackay score at the 1-year postoperative follow-up. <b><i>Results:</i></b> Postoperative VAS (10.33 ± 2.18 vs. 8.38 ± 2.11, <i>p</i> &#x3c; 0.01) and Lund-Kennedy score (1.95 ± 1.32 vs. 3.14 ± 1.35, <i>p</i> &#x3c; 0.01) were significantly improved. The rhinorrhea score (1.76 ± 0.83 vs. 2.90 ± 1.14, <i>p</i> &#x3c; 0.001) in the VAS and the discharge (0.43 ± 0.51, vs. 0.95 ± 0.67, <i>p</i> &#x3c; 0.01) and edema (0.57 ± 0.60 vs. 0.95 ± 0.59, <i>p</i> &#x3c; 0.05) scores in the Lund-Kennedy score were observed to have improved significantly in group A compared with those in group B. <b><i>Conclusions:</i></b> FESS combined with PNN suppresses edema symptoms, which might significantly decrease the surgical recurrence rate of ECRS in the long term.

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