INTRODUCTION AND HYPOTHESIS:We examined how preoperative urodynamic findings are related to the urinary problems following surgical repair of pelvic organ prolapse (POP).METHODS:The clinical records of 87 women who underwent surgery for POP were reviewed retrospectively. Preoperatively, cough stress test and urodynamic testing, including pressure-flow study, were performed with prolapse reduction. Postoperative evaluation included uroflowmetry, postvoid residuals, and symptom assessment using questionnaires.RESULTS:A cough stress test with simple filling was sufficient for diagnosis of occult stress urinary incontinence (SUI). The presence of detrusor overactivity was a good predictor of postoperative persistence of urgency and urge urinary incontinence. Postvoid residuals (PVR) largely increased immediately after surgery, but usually recovered within 1 month. Poor detrusor contractility was the best predictor of large PVR occurrence.CONCLUSIONS:Preoperative urodynamic evaluation of SUI and detrusor function was useful for predicting postoperative urinary conditions in POP patients. Its cost-effectiveness remains to be examined.
Objective The objective of this study was to validate the German version of the prolapse quality-of-life questionnaire (P-QOL). Methods The P-QOL questionnaire was translated into German and administered to women recruited from two gynecological outpatient clinics and seven gynecological practices. All women were examined in supine position using the Pelvic Organ Prolapse Quantification System of the International Continence Society. The validity was assessed by comparing symptom scores and quality-of-life scores between symptomatic and asymptomatic women. Results According to the English study, 140 symptomatic and 75 asymptomatic women were included. The total scores for each P-QOL domain were significantly different between symptomatic and asymptomatic women ( p < 0.001). Seven symptom regarding questions showed significant differences ( p < 0.05). Conclusion The German version of P-QOL is a valid, reliable, and easily comprehensible instrument to assess quality of life and symptoms in German-speaking patients with urogenital prolapse.
INTRODUCTION AND HYPOTHESIS:The purpose of this study is to evaluate women with urge syndrome following pubovaginal sling procedure for stress urinary incontinence using a polypropylene mesh.METHODS:A total of 292 cases were available to compare preoperative and postoperative videourodynamic parameters.RESULTS:There were 142 women (48.6%) with urge syndrome before operation and 92 (31.5%) with urge syndrome after pubovaginal sling procedure. Urge syndrome was persistent in 79 women, resolved in 63, and de novo urge syndrome was noted in 13. Urodynamic detrusor overactivity (DO) was present in 67 (22.9%) women before operation and in 47 (16.1%) after operation. DO was persistent in 29, resolved in 38, and de novo DO in 18 after operation. Among the 18 women with de novo DO, 15 (83.3%) had preoperative urge syndrome.CONCLUSIONS:Of patients with urge syndrome after pubovaginal sling procedure, 85.9% had a chronic condition, and 83.3% of patients with de novo DO had preoperative urge syndrome.
Urinary glycosaminoglycans (uGAG) have protective effects against urinary tract disorders. Here we investigated whether oral hormonal contraceptives (OC) affect uGAG excretion.
entry of the retro-pubic space and the proximity of the femoral vessels have been shown to be real serious risks. The trans-obturator technique is associated with a lower incidence of vascular as well as bladder and urethral injuries. The latter are reported to occur in less than 1% of patients and, as usual, occur more frequently during the learning curve of the procedure. However, the passage of the needles
Thousands of women undergo renal transplantation each year. Many develop pelvic floor conditions after transplantation requiring surgical correction. This study describes our experience with pelvic reconstructive surgery in renal transplant recipients.
INTRODUCTION AND HYPOTHESIS:We assessed whether urinary excretion of glycosaminoglycans (GAGs) may be affected by a condition of detrusor overactivity (DO).MATERIALS AND METHODS:We evaluated 24-h urinary excretion of GAGs in 25 patients (mean age 63.81 years) with DO and in 14 healthy controls (mean age 65.75 years). No patients or controls had urinary tract infection. The excretion of GAGs was measured on the basis of total urine volume and normalized to creatinine concentration. Student's test was employed to check between the urinary excretion of GAGs in the two groups.RESULTS:The urinary content of GAGs discovered in control group was significantly higher than that in pathological group for the ratio GAGs/creatinine concentration.CONCLUSIONS:The low content of GAGs might be due to relative ischemia of the bladder wall epithelial layer following a chronically increased contractile activity of the detrusor even if further studies are needed to confirm this finding.
The purpose of this study is to compare vaginal caldesmon expression in women with and without anterior vaginal wall prolapse.
The objective of this study is to explore expectations and goals of women undergoing continence surgery using a combined quantitative and qualitative approach.
INTRODUCTION AND HYPOTHESIS:Our objective was to translate and validate a Portuguese version of the Urinary Incontinence-Specific Quality-of-Life Instrument (I-QOL), a questionnaire that is widely used in clinical trials.METHODS:Fifty patients completed the same questionnaire twice at a 2-week interval. During the first visit, we conducted a face-to-face interview and collected demographic data. The King's Health Questionnaire was completed during the same visit for comparisons.RESULTS:The results showed that the Portuguese version of the I-QOL has very good psychometrics properties. Reliability was assessed by Cronbach's alpha (0.93), reproducibility was calculated through the intraclass correlation coefficient (0.88), construct validity was determined by comparing the I-QOL scores and King's Health scores, and discriminant validity was calculated by comparing the total I-QOL scores with measures of gravity.CONCLUSIONS:We conclude that the Portuguese version of the I-QOL is a very good tool for the evaluation quality-of-life in women with urinary incontinence in Portuguese-speaking countries.
The aim of work is to study the natural progression of anal incontinence (AI) in women 10 years after their first delivery and to identify risk factors associated with persistent AI.
The levator ani muscle is generally thought to play a role in urinary continence, with incontinence assumed to be due to abnormal muscle function or morphology. This study examined whether avulsion of the puborectalis muscle is associated with symptoms or signs of bladder dysfunction.
INTRODUCTION AND HYPOTHESIS:Although polypropylene (PP) is the most common biomaterial used to repair genital prolapse via vaginal route, its mechanical properties however remain obscure.METHODS:An abdominal hernia rabbit model was used to evaluate retraction, solidity, and elasticity of the principal types of PP prostheses currently available, i.e., three large pore size monofilament prostheses, one heavy weight (HWPP), a second low weight (LWPP), and a third coated with atelocollagen (CPP). A small pore size multifilament PP (MPP) implant was also tested.RESULTS:In comparison with HWPP (12%), LWPP (15%), and MPP (30%), CPP had less retraction (8% of the original size). Unlike pore size, weight prosthesis is not an influencing factor for retraction. Atelocollagen coating reduced retraction. HWPP and MPP were the most solid prostheses. MPP supported the greatest elastic force.CONCLUSIONS:When the biomechanical parameters were comparatively assessed, HWPP was considered to have the most advantageous properties for prolapse surgery.
Introduction and hypothesis The use of vaginally implanted polypropylene meshes in the treatment of prolapse is becoming increasingly popular. We set out to detect how often bacterial colonisation of the mesh occurs and if the intraoperative sterility procedures that are applied matter. Methods In 64 consecutive women, bacterial colonisation was compared between two intraoperative sterility procedures. Culture swabs of the core mesh were taken during surgery, and the mesh arms removed at the end of surgery were cultured separately. Results Sixty-seven implants were cultured. In 56 (83.6%) implants, a positive culture with vaginal bacteria was found with very low bacterial density (<10 3 colony-forming units). No significant differences in bacterial species, density, clinical infection and erosion (two anterior and one posterior) were found between the two intraoperative sterility methods. Conclusions Colonisation of vaginally implanted mesh occurs frequently but in low bacterial densities, irrespective of the intraoperative sterility procedure used.
Nationwide use and costs of anticholinergic drug for overactive bladder are unknown.
Multichannel urodynamic testing is considered to be the gold standard for evaluation of lower urinary tracts symptoms in women. The objective of this study was to assess the level of pain associated with this test.
INTRODUCTION AND HYPOTHESIS:The aim of this study was to determine the effectiveness of pelvic floor muscle exercises on urinary incontinence during pregnancy and the postpartum period.METHODS:The study was carried out on 80 pregnant women (study group, 40 subjects; control group, 40 subjects).The study group was trained by the researcher on how to do the pelvic floor muscle exercises. Both groups were evaluated for pelvic floor muscle strength and urinary complaints in their 36th to 38th week of pregnancy and postpartum sixth to eighth week.RESULTS:The study group had a significant decrease in urinary incontinence episodes during pregnancy and in the postpartum period, and their pelvic floor muscle strength increased to a larger extent. Control group had an increase in the postpartum muscle strength and decrease in the incontinence episodes in the postpartum period.CONCLUSIONS:Pelvic floor muscle exercises are quite effective in the augmentation of the pelvic floor muscle strength and consequently in the treatment of urinary incontinence.
