scholarly journals Bladder neck placement of a synthetic polypropylene sling for the treatment of stress urinary incontinence

2018 ◽  
Vol 12 (11) ◽  
Author(s):  
Louise C. McLoughlin ◽  
Mari Gleeson ◽  
Sami Francis ◽  
Colin O’Rourke ◽  
Hugh D. Flood
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Bladder Neck ◽  
Postoperative Recovery ◽  
Subjective Response ◽  
Improvement Rate ◽  
Initial Report ◽  
Maximum Score ◽  
Significant Difference ◽  
The Mean

Introduction: Pubo-vaginal sling placed at the bladder neck is the gold standard treatment for stress urinary incontinence (SUI). The synthetic mid-urethral sling (MUS) is now widely used, as morbidity rates with this technique are substantially reduced. This is an initial report on long-term outcomes of a polypropylene sling (PPS) placed in the traditional bladder neck location.Methods: A retrospective analysis of all patients who underwent PPS insertion at our institution between 2006 and 2014 was conducted. Patient and urodynamic demographics were recorded. Subjective and objective measures of success were determined by postoperative pad usage and validated incontinence questionnaires. Results: A total of 170 patients were followed for a median of four years (range 1–8). The mean age was 51 years (±10). Subjective response was assessed in 57% of patients; the overall subjective cure rate was 85.3% (n=145), subjective improvement rate was 4.1% (n=7), and the subjective failure rate was 10.6% (n=18). The mean Urogenital Distress Inventory (UDI)-6 score was 6.5 (±5.6) out of a maximum score of 24 and the Incontinence Impact Questionnaire (IIQ)-7 score was 5.5 (±6.3) out of a maximum score of 28. There was no significant difference in objective outcome measures in those with an abdominal leak-point pressure (ALPP) < or >60 cmH2O.Conclusions: Bladder neck placement of a PPS resulted in cure rates of 85% in this series. SUI secondary to intrinsic sphincter deficiency (ISD) and urethral hypermobility were treated with equal success. Bladder neck PPS placement has a role in the treatment of SUI. Our data may well reassure rectus fascia sling (RFS) surgeons who wish to take advantage of faster postoperative recovery using the less invasive PPS placed at the bladder neck.

scholarly journals Transperineal Ultrasound Assessment of a Cystocele’s Impact on the Bladder Neck Mobility in Women with Stress Urinary Incontinence

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 562
Author(s):  
Maria-Patricia Rada ◽  
Răzvan Ciortea ◽  
Andrei Măluțan ◽  
Doru Diculescu ◽  
Costin Berceanu ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Birth Weight ◽  
Stress Urinary Incontinence ◽  
Bladder Neck ◽  
Valsalva Maneuver ◽  
Transperineal Ultrasound ◽  
Inferior Margin ◽  
Significant Difference ◽  
Neck Mobility ◽  
Bladder Neck Mobility

Background and objectives: As pelvic floor disorders are often difficult to assess thoroughly based on clinical examination alone, the use of imaging as a complementary technique is helpful. This study’s aim was to investigate by transperineal ultrasound (US) if there was any significant difference in the mobility of the bladder neck in women with stress urinary incontinence (SUI) without a cystocele and in those with SUI and an associated cystocele. The study also investigated whether the number of vaginal births and/or the heaviest newborn’s birth weight was correlated with the bladder neck mobility. Materials and Methods: A total of 71 women suffering from SUI were included in the study and divided into two groups based on the presence of a cystocele. Their bladder neck mobility was evaluated by transperineal US, calculating the distance from the inferior margin of the symphysis pubis to the bladder neck (SPBN), and the dorsocaudal linear movement (DLM), term used to illustrate the displacement of the bladder neck by subtracting rest and Valsalva values. GraphPad Prism 8 was used for statistical analysis. Results: Within both study groups, the SPBN values were significantly higher and the DLM values were significantly lower at rest as compared to Valsalva maneuver (p < 0.05). No significant difference between the groups regarding SPBN and DLM values at rest, Valsalva, or subtraction was demonstrated. A significant positive correlation was found between the bladder neck mobility and the heaviest newborn’s birth weight, regardless of the presence of a cystocele (p = 0.042). Conclusions: The presence of a cystocele had no significant impact on the bladder neck mobility measurements in patients with SUI. The heaviest newborn’s birth weight positively correlated with bladder neck hypermobility, as quantified by SPBN.

Endoscopic transvaginal bladder neck suspension for stress urinary incontinence

1994 ◽  
Vol 26 (5) ◽  
pp. 513-518 ◽  
Author(s):  
A. Erol ◽  
S. Y. Sargin ◽  
I. Dalva ◽  
Z. E. Günes ◽  
E. Akbay ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Bladder Neck ◽  
Bladder Neck Suspension

scholarly journals Transobturator tension-free “inside-to-out” suburethral sling procedure for the treatment of stress urinary incontinence

2012 ◽  
Vol 140 (1-2) ◽  
pp. 47-50
Author(s):  
Darko Laketic ◽  
Andrej Veljkovic ◽  
Vesna Laketic
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Health Centre ◽  
Suburethral Sling ◽  
Abdominal Pressure ◽  
Sudden Increase ◽  
Voiding Function ◽  
Sling Procedure ◽  
Tension Free ◽  
Significant Difference

Introduction. Stress urinary incontinence is an involuntary leakage of urine on a sudden increase of intra-abdominal pressure by physical activity, exercise, coughing, sneezing or laughing. Objective. To assess symptoms, functional and anatomical status of voiding function, complications and short term success of a novel procedure, tension-free vaginal tape obturator technique (TVT-O) in the treatment of stress urinary incontinence. Methods. A prospective study was performed on 40 female patients who underwent the TVT-O suburethral sling at the Urology Department of the Health Centre in Prokuplje and Urology Hospital in Nis between May 2009 and February 2010. The mean patients? age was 58 years (range 34-84 years). Preoperative evaluation included a detailed history and gynaecologic examination including urodynamic testing and voiding studies.UDI-6 and UIQ-7 score testing was performed before, and six months after surgery. All patients who demonstrated stress urinary incontinence with a Q-tip test-angle during maximal straining were included into the study. Postoperatively, outcomes evaluation included voiding function, anatomical parameters, complications, as well as subjective success rates. Results. In 30 patients surgery was performed under spinal and in ten under general anaesthesia. The average intraoperative blood loss during the TVT-O was minimal (<50 ml). There were no vascular, bladder, bowel, and neurological injuries. Thirty-eight patients (95%) were discharged voiding satisfactorily. There was a statistically significant difference in symptoms between UDI-6 and UIQ-7 before and after surgery. Conclusion. Initial experience with TVT-O suburethral sling is promising. The TVT-O differs from retropubic procedures by resulting in lower postoperative morbidity, intraoperative and postoperative complications.

scholarly journals Abdominal complex muscle in women with stress urinary incontinence – prospective case-control study

2021 ◽  
Author(s):  
Bartlomiej Burzynski ◽  
Tomasz Jurys ◽  
Michalina Knapik ◽  
Kamil Burzynski ◽  
Paweł Rzymski ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Muscle Thickness ◽  
Isometric Tension ◽  
Transversus Abdominis ◽  
Control Group ◽  
Abdominal Muscles ◽  
Study Group ◽  
Significant Difference ◽  
And Control

IntroductionThis study is designed to assess the percentage share of musculus obliquus externus abdominis, musculus obliquus internus abdominis and musculus transversus abdominis activity among women with stress urinary incontinence using ultrasonography.Material and methodsMaterial and methods: The study is a retrospective analysis of prospective collected data of 84 women aged 23-62 years old. In the study group are women suffering from grade 1 or 2 stress urinary incontinence according to the Stamey classification, the control group consists of women with no micturition disorders. The abdominal muscles activity was measured by using the ultrasound imaging with assessment of muscle thickness.ResultsThe analysis of musculus obliquus externus abdominis in anterolateral abdominal wall activity shows a statistically significant difference between study and control group concerning isometric tension of abdominal muscles (p=0,012) and lower part of abdomen tension (p=0,004). Women with stress urinary incontinence present a higher activity of the musculus obliquus externus abdominis than controls. In the case of the musculus obliquus internus abdominis, statistically significant differences were shown during tension of the lower part of the abdomen (p=0,024). Comparison of activity of the musculus transversus abdominis between study and control groups shows a statistically significant difference during isometric tension of abdominal muscles (p=0,018).ConclusionsThe pattern of activity of the assessed muscles differs between the study group and the control group. In the study group, the activity pattern is concerning the higher activity of the musculus obliquus externus abdominis and the lower activity of the musculus obliquus internus abdominis and musculus transversus abdominis.

Robot-assisted AMS-800 Artificial Urinary Sphincter Bladder Neck Implantation in Female Patients with Stress Urinary Incontinence

2019 ◽  
Vol 75 (1) ◽  
pp. 169-175 ◽  
Author(s):  
Benoit Peyronnet ◽  
Grégoire Capon ◽  
Olivier Belas ◽  
Andrea Manunta ◽  
Clément Allenet ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Bladder Neck ◽  
Artificial Urinary Sphincter ◽  
Robot Assisted ◽  
Female Patients ◽  
Urinary Sphincter

scholarly journals Stress Incontinence during Different High-Impact Exercises in Women: A Pilot Survey

2020 ◽  
Vol 17 (22) ◽  
pp. 8372
Author(s):  
Iman Akef Khowailed ◽  
Joelle Pinjuv-Turney ◽  
Cathy Lu ◽  
Haneul Lee
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Boot Camp ◽  
High Impact ◽  
Abdominal Pressure ◽  
Online Questionnaire ◽  
Pilot Survey ◽  
Urinary Leakage ◽  
Nulliparous Women ◽  
Significant Difference

The aim of this survey was to investigate the prevalence of stress urinary incontinence (SUI) among women (primigravida, multigravida, and nulligravida) in high-impact exercise groups—CrossFit, kickboxing, and boot camp. Incontinence Survey was modified to an anonymous online questionnaire. A total of 17 participants, 64.2% reported at least some urinary leakage during exercise. About 85.7% of participants in each of the 3 high-intensity exercise groups exercised >3 h/week. There was no significant difference in the likelihood of urinary leakage between participants who have had at least 1 pregnancy and those who had never been pregnant. CrossFit group were significantly more likely to report urinary leakage than those in the kickboxing and boot camp groups combined (p = 0.023). The participants did not exhibit typical risk factors, as they were premenopausal, active, and had an average body mass index within the normal range. This pilot survey indicates that all women those who do high-impact exercises are susceptible to stress urinary incontinence (SUI), and that CrossFit poses a greater risk for SUI in terms of more jumping resulting in increased intra-abdominal pressure and ground reaction forces compared to others. Our pilot study indicates that a higher risk of SUI during high impact exercises may exist associated with previous pregnancy but also in nulliparous women.

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