scholarly journals Choosing the right sling for your patient

2017 ◽  
Vol 11 (6S2) ◽  
pp. 132 ◽  
Author(s):  
Stephen S. Steele ◽  
Gregory G. Bailly
Keyword(s):  
Urinary Incontinence ◽  
Gold Standard ◽  
Midurethral Sling ◽  
Synthetic Mesh ◽  
Published Data ◽  
Transvaginal Surgery ◽  
Incontinent Woman ◽  
The Right ◽  
Sui Surgery ◽  
Sphincter Deficiency

Recent data has demonstrated a one in five lifetime risk of a woman requiring stress urinary incontinence (SUI) surgery. Currently, most women opt for a synthetic midurethral sling (MUS), with over 3.6 million placed worldwide. This article attempts to identify whether a gold standard exists with regards to surgical correction of female SUI.When considering which sling type to use for which incontinent woman, the published data demonstrates excellent results for both synthetic mesh (retropubic or transobturator routes) and fascial pubovaginal slings for most patients. Intrinsic sphincter deficiency does appear to be better treated with the use of a retropubic approach, although still with less than stellar results. With little to differentiate, the treatment of most female SUI may be solely based on which sling the surgeon feels most comfortable performing. Currently, most urologists and gynecologists favour synthetic MUS over fascial slings in surgical-naïve patients; however, recent U.S Food and Drug Administration (FDA) warnings concerning the use of mesh in transvaginal surgery have patients questioning the safety of synthetic MUS for the treatment of SUI.

Long-term Risk of Reoperation After Synthetic Mesh Midurethral Sling Surgery for Stress Urinary Incontinence

2020 ◽  
Vol 75 (3) ◽  
pp. 163-164
Author(s):  
Alexander A. Berger ◽  
Jasmine Tan-Kim ◽  
Shawn A. Menefee
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Midurethral Sling ◽  
Synthetic Mesh ◽  
Sling Surgery ◽  
Midurethral Sling Surgery

scholarly journals Long-term Risk of Reoperation After Synthetic Mesh Midurethral Sling Surgery for Stress Urinary Incontinence

2019 ◽  
Vol 134 (5) ◽  
pp. 1047-1055 ◽  
Author(s):  
Alexander A. Berger ◽  
Jasmine Tan-Kim ◽  
Shawn A. Menefee
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Midurethral Sling ◽  
Synthetic Mesh ◽  
Sling Surgery ◽  
Midurethral Sling Surgery

Effect of Intrinsic Sphincter Deficiency on Midurethral Sling Outcomes in Women With Mixed Urinary Incontinence

2013 ◽  
Vol 19 (3) ◽  
pp. 132-136 ◽  
Author(s):  
Nadine C. Kassis ◽  
Blair B. Washington ◽  
Nicole B. Korbly ◽  
Vrishali V. Lopes ◽  
Vivian W. Sung
Keyword(s):  
Urinary Incontinence ◽  
Midurethral Sling ◽  
Intrinsic Sphincter Deficiency ◽  
Mixed Urinary Incontinence ◽  
Sphincter Deficiency

It is better an approximate answer to the right question than the exact answer to the wrong question : the case of the psychometric analysis of the ASQ:SE

2020 ◽  
Author(s):  
Luis Anunciacao ◽  
janet squires ◽  
J. Landeira-Fernandez
Keyword(s):  
Internal Structure ◽  
Statistical Methods ◽  
Principal Component ◽  
Psychological Theory ◽  
Published Data ◽  
Multivariate Statistical ◽  
Exact Answer ◽  
Wide Range ◽  
Ages And Stages Questionnaire ◽  
The Right

One of the main activities in psychometrics is to analyze the internal structure of a test. Multivariate statistical methods, including Exploratory Factor analysis (EFA) and Principal Component Analysis (PCA) are frequently used to do this, but the growth of Network Analysis (NA) places this method as a promising candidate. The results obtained by these methods are of valuable interest, as they not only produce evidence to explore if the test is measuring its intended construct, but also to deal with the substantive theory that motivated the test development. However, these different statistical methods come up with different answers, providing the basis for different analytical and theoretical strategies when one needs to choose a solution. In this study, we took advantage of a large volume of published data (n = 22,331) obtained by the Ages and Stages Questionnaire Social-Emotional (ASQ:SE), and formed a subset of 500 children to present and discuss alternative psychometric solutions to its internal structure, and also to its subjacent theory. The analyses were based on a polychoric matrix, the number of factors to retain followed several well-known rules of thumb, and a wide range of exploratory methods was fitted to the data, including EFA, PCA, and NA. The statistical outcomes were divergent, varying from 1 to 6 domains, allowing a flexible interpretation of the results. We argue that the use of statistical methods in the absence of a well-grounded psychological theory has limited applications, despite its appeal. All data and codes are available at https://osf.io/z6gwv/.

Clinical Case: Complications after Endovascular Treatment of Intracranial Aneurysm in a Patient after Subarachnoid Hemorrhage

2020 ◽  
Vol 8 (1) ◽  
pp. 9-15
Author(s):  
Petrov Nikolay ◽  
◽  
Marinova R. ◽  
Odiseeva Ev.
Keyword(s):  
Intracranial Aneurysm ◽  
Endovascular Treatment ◽  
Clinical Case ◽  
Endovascular Coiling ◽  
Published Data ◽  
Military Medical Academy ◽  
Life Threatening ◽  
Arachnoid Hemorrhage ◽  
The Right ◽  
Brain Artery

Abstract: Intracranial aneurysm is one of the most common neurovascular complications. During the recent years the accepted treatment of enraptured cranial aneurysm is noninvasive endovascular coiling. This technique is modern but it is not without complications which can be serious and life-threatening. A clinical case of a patient admitted to the ICU of Military Medical Academy - Sofia with sub arachnoid hemorrhage is described. After a positive clinical course, the check-up magnetic resonance showed intracranial aneurism of the right carotid artery. The patient underwent angiographic endovascular treatment. Vasospasm of the middle and right brain artery and thrombosis were detected during the procedure. Attempt of thromboaspiration was made without success. This article reviews published data on broad-spectrum researches concerning complications of endovascular coiling of intracranial aneurysms and the ways to prevent and reduce them.

scholarly journals Contemporary trends for urological training and management of stress urinary incontinence in Ireland

2021 ◽  
Author(s):  
Eoin MacCraith ◽  
James C. Forde ◽  
Fergal J. O’Brien ◽  
Niall F. Davis
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Fold Increase ◽  
Incontinence Surgery ◽  
Stress Urinary Incontinence Surgery ◽  
Urethral Bulking ◽  
Urological Training ◽  
Sui Surgery ◽  
Urinary Incontinence Surgery ◽  
Urethral Bulking Agent

Abstract Introduction and hypothesis The aim of this study is to evaluate the trends in stress urinary incontinence (SUI) surgery since the 2018 pause on use of the polypropylene (PP) mid-urethral sling (MUS) and to quantify the effect this has had on surgical training. Methods Two anonymous surveys were sent to all current urology trainees and to all consultant surgeons who specialise in stress urinary incontinence surgery. Results Prior to the pause, 86% (6 out of 7) of consultant urologists and 73% (11 out of 15) of consultant gynaecologists would “always”/“often” perform MUS for SUI. After that, 100% (22 out of 22) of consultants reported that they “never” perform MUS. There has been a modest increase in the use of urethral bulking agent (UBA) procedures among urologists, with 43% (3 out of 7) now “often” performing this, compared with 71% (5 out of 7) “never” performing it pre-2018. Trainee exposure to SUI surgery reduced by 75% between 2016 and 2020. Despite a ten-fold increase in UBA procedures logged by trainees, the decline in MUS has resulted in a major reduction in total SUI surgeries. Coinciding with this decrease in surgeries, there was a 56% reduction in trainees’ self-assessed competence at SUI surgery. Thirteen percent of trainees are interested in specialising in Female Urology and those trainees had significantly greater exposure to SUI procedures during their training than those who did not (p = 0.0072). Conclusions This study has identified a downward trend in SUI surgery, which is concerning for the undertreatment of females with SUI. A decline in SUI surgery training has resulted in reduced trainee confidence and interest in this subspecialty.

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