Showing papers in "International Urogynecology Journal in 2010"
TL;DR: A consensus-based terminology report for female pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.
Abstract: Next to existing terminology of the lower urinary tract, due to its increasing complexity, the terminology for pelvic floor dysfunction in women may be better updated by a female-specific approach and clinically based consensus report. This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. Appropriate core clinical categories and a subclassification were developed to give an alphanumeric coding to each definition. An extensive process of 15 rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). A terminology report for female pelvic floor dysfunction, encompassing over 250 separate definitions, has been developed. It is clinically based with the six most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Female-specific imaging (ultrasound, radiology, and MRI) has been a major addition while appropriate figures have been included to supplement and help clarify the text. Ongoing review is not only anticipated but will be required to keep the document updated and as widely acceptable as possible. A consensus-based terminology report for female pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.
1,646 citations
TL;DR: This is the first study validating PGI-I as a global index of response to prolapse surgery and may be a valuable addition not only in clinical practice but also in trials comparing surgical interventions.
Abstract: Introduction and hypothesis
Currently, there is no global outcome assessment index in prolapse research. Patient Global Impression of Improvement (PGI-I) has only been validated in incontinence. Our aim was to validate its use following prolapse surgery.
316 citations
TL;DR: The sacrospinous hysteropexy for uterine descent is associated with an earlier recovery time, more recurrent apical prolapses but no differences in functional outcomes, and quality of life.
Abstract: Introduction and hypothesis
In a retrospective study, the sacrospinous hysteropexy was associated with a shorter recovery time compared to a vaginal hysterectomy with no differences in anatomical outcomes. No randomized trials are performed.
167 citations
TL;DR: Investigating the relationship between bladder neck displacement, electromyography (EMG) activity of the pelvic floor and abdominal muscles and intra-abdominal pressure (IAP) during different pelvicfloor and abdominal contractions found that bladder neck elevation only occurred during PFM and TrA contractions.
Abstract: Although the bladder neck is elevated during a pelvic floor muscle (PFM) contraction, it descends during straining. This study aimed to investigate the relationship between bladder neck displacement, electromyography (EMG) activity of the pelvic floor and abdominal muscles and intra-abdominal pressure (IAP) during different pelvic floor and abdominal contractions. Nine women without PFM dysfunction performed maximal, gentle and moderate PFM contractions, maximal and gentle transversus abdominis (TrA) contractions, bracing, Valsalva and head lift. Bladder neck position was assessed with perineal ultrasound. PFM and abdominal muscle activities were recorded with a vaginal probe and fine-wire electrodes, respectively. IAP was recorded with a rectal balloon. Bladder neck elevation only occurred during PFM and TrA contractions. PFM EMG and IAP increased during all tasks from 0.5 (gentle TrA) to 45.7 cmH2O (maximal Valsalva). Bladder neck elevation was only observed when the activity of PFM EMG was high relative to the IAP increase.
133 citations
TL;DR: No differences were found between the two treatment strategies, but almost one third of women were cured of SUI by prolapse surgery alone.
Abstract: This study aims to compare the result of an incontinence procedure performed at the time of prolapse repair or 3 months later in women with pelvic organ prolapse (POP) and stress urinary incontinence (SUI). In a multicenter prospective randomized trial, women with POP and SUI were randomized to have a tension-free vaginal tape (TVT) at the time of prolapse repair (n = 87; group I) or 3 months later (n = 94; group II). Women in group II were evaluated for SUI 3 months after the prolapse repair. Those with confirmed SUI had a TVT performed (n = 53). The main evaluation of all women was 1 year after the last surgery. On-treatment analysis resulted in 95% cure of SUI in group I and 89% in group II (p = 0.12). Twenty-seven percent were cured after prolapse surgery alone. No differences were found between the two treatment strategies, but almost one third of women were cured of SUI by prolapse surgery alone.
127 citations
TL;DR: The strongest predictor of incident UI in pregnancy was occasional leakage (less than once a month) before pregnancy, and the complex interplay of prepregnancy and pregnancy-related factors in the aetiology of UI in nulliparous women is needed.
Abstract: Few studies have examined associations of prepregnancy urinary incontinence (UI). Multicentre prospective pregnancy cohort study (n = 1,507) using standardised measures to assess frequency and severity of UI. Prevalence of UI increased from 10.8% in the 12 months before the index pregnancy to 55.9% in the third trimester. Stress incontinence (36.9%) and mixed incontinence (13.1%) were more common during pregnancy than urge incontinence alone (5.9%). UI before pregnancy was associated with childhood enuresis (adjusted odds ratio (AdjOR) = 2.4, 95% confidence interval (CI) 1.6–3.4), higher maternal body mass index (AdjOR = 2.3, 95% CI 1.4–3.8), and previous miscarriages or terminations (AdjOR = 1.6, 95% CI 1.1–2.3). The strongest predictor of incident UI in pregnancy was occasional leakage (less than once a month) before pregnancy (AdjOR = 3.6, 95% CI 2.8–4.7). Further research is needed to elucidate the complex interplay of prepregnancy and pregnancy-related factors in the aetiology of UI in nulliparous women.
123 citations
TL;DR: Multivariate analysis revealed that BMI >25, mixed incontinence, previous continence surgery, intrinsic sphincter deficiency, and diabetes mellitus are significant independent predictors for MUS failure.
Abstract: Midurethral sling (MUS) is now the first line surgical treatment for female stress urinary incontinence. Our aim was to identify predictors for MUS failure. A total of 1,225 consecutive women with urodynamic urinary stress incontinence had a synthetic MUS (955 retropubic and 270 transobturator) at our institution between 1999 and 2007. Multivariate analysis was performed in order to identify independent risk factors for failure. At a mean follow-up of 50 ± 24 months (range, 12–114), the subjective cure rate was 84.7%. Multivariate analysis revealed that BMI >25 (OR, 2.9), mixed incontinence (OR, 2.4), previous continence surgery (OR, 2.2), intrinsic sphincter deficiency (OR, 1.9), and diabetes mellitus (OR, 1.8) are significant independent predictors for MUS failure. Concomitant prolapse surgery decreased the likelihood of surgical failure after MUS (OR, 0.6). Patient’s age and the type of the sling were not found to be risk factors for surgical failure.
119 citations
TL;DR: Whether a Pilates exercise program and a pelvic floor muscle-training program could provide similar improvements in pelvic muscle strength is investigated to determine if Pilates can actually treat pelvic floor dysfunction.
Abstract: The purpose of this study is to determine whether a Pilates exercise program and a pelvic floor muscle-training (PFMT) program could provide similar improvements in pelvic muscle strength. Sixty-two women with little or no pelvic floor dysfunction were randomized to Pilates or PFMT. Each group had 24 biweekly 1-h sessions with either a physical therapist or Pilates instructor. Strength was measured via perineometry (cmH2O). Two questionnaires—pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7)—were also collected. At baseline, the Pilates and PFMT groups measured 14.9 ± 12.5 and 12.5 ± 10.4 cmH2O, respectively (p = 0.41). Both the Pilates and PFMT groups got stronger (6.2 ± 7.5 cmH2O, p = 0.0002 and 6.6 ± 7.4 cmH2O, p = 0.0002, respectively), with no difference between groups p = 0.85. PFIQ and PFDI scores improved from baseline but not between groups. Further study is required to determine if Pilates can actually treat pelvic floor dysfunction.
117 citations
TL;DR: In this article, a self-administered version of the already validated interviewer administered Australian pelvic floor questionnaire has been validated for routine clinical assessment and outcome research in a reproducible and valid fashion.
Abstract: Introduction and hypothesis The aim of this study was to validate a self-administered version of the already validated interviewer-administered Australian pelvic floor questionnaire. Methods The questionnaire was completed by 163 women attending an urogynecological clinic. Face and convergent validity was assessed. Reliability testing and comparison with the interviewer-administered version was performed in a subset of 105 patients. Responsiveness was evaluated in a subset of 73 women. Results Missing data did not exceed 4% for any question. Cronbach’s alpha coefficients were acceptable in all domains. Kappa coefficients for the test–retest analyses varied from 0.64–1.0. Prolapse symptoms correlated significantly with the pelvic organ prolapse quantification. Urodynamics confirmed the reported symptom stress incontinence in 70%. The self and intervieweradministered questionnaires demonstrated equivalence. Effect sizes ranged from 0.6 to 1.4. Conclusions This self-administered pelvic floor questionnaire assessed pelvic floor function in a reproducible and valid fashion and due to its responsiveness, can be used for routine clinical assessment and outcome research.
106 citations
TL;DR: TTNS showed significant improvement in most areas of QoL and in UUI parameters when compared with the control group, and is efficacious to treat UUI in older women.
Abstract: The aim of this study was to examine the efficacy of transcutaneous electrical tibial nerve stimulation (TTNS) to treat urge urinary incontinence (UUI) in older women. The study design was a randomized clinical trial conducted on 51 elderly women (>60 years) with UUI. All were treated with 12 weeks of bladder retraining and pelvic floor muscle exercises, and 25 were randomly selected to receive TTNS in addition to the standard therapy. The cases were evaluated at the baseline and after the end of therapy by 3-day bladder diary, quality of life questionnaires (QoL), and subjective response. Of the patients, 68.0% in TTNS group reported cure or improvement vs. 34.6% in the control group (P = 0.017). TTNS showed significant improvement in most areas of QoL and in UUI parameters when compared with the control group. TTNS is efficacious to treat UUI in older women.
99 citations
TL;DR: POP is significantly stiffer than nPOP tissue, both on anterior and posterior walls, which might explain the higher rate of relapse when repair is autologous, using already defective and more rigid vaginal tissue.
Abstract: Introduction and hypothesisOur aim is to characterize prolapsed and non-prolapsed vaginal tissue, and thus offer a better understanding of the genital prolapse physiopathology and an improvement of surgical treatments.MethodsVaginal tissue was collected in 30 patients with prolapse (POP) and ten fresh cadavers without prolapse (nPOP) with a favorable advice of Ethics Committee. Uniaxial tension tests were performed. Statistical comparisons of rigidity under moderate deformation and under large deformation have been performedResultsPOP is significantly stiffer than nPOP tissue, both on anterior and posterior walls. A significant difference between POP and nPOP tissues was highlighted when anterior or posterior vaginal walls were respectively compared.ConclusionsThese results might explain the higher rate of relapse when repair is autologous, using already defective and more rigid vaginal tissue. This study suggests that it might be interesting to adapt the characteristics of prosthetic implants to the vaginal face concerned by the prolapsus.
TL;DR: The study provides evidence contrary to published literature characterizing PP as inert in such applications and suggests the need for clinical trials comparatively investigating the performance of new types of monofilament prosthetics, such as those comprising PET.
Abstract: Introduction and hypothesis
Currently, most implants used for reinforcement in surgical treatment of pelvic floor disorders are knitted monofilament polypropylene (PP). While previously recognized as inert, PP is associated with high complication rates. Some recent literature suggests polyester prosthetics based on poly(ethylene terephthalate) (PET), which may be more inert in vivo.
TL;DR: Both intensive supervised PFMT and unsupervised PFMT are effective to treat female SUI if training session is provided.
Abstract: Pelvic floor muscle training (PFMT) is considered to be the first-line treatment for female stress urinary incontinence (SUI). There are few studies that have tested the efficacy of unsupervised PFMT. The aim of this study was to compare the effectiveness of intensive supervised PFMT to unsupervised PFMT in the treatment of female SUI. Sixty-two women with SUI were randomized to either supervised or unsupervised PFMT after undergoing supervised training sessions. They were evaluated before and after the treatment with the Oxford grading system, pad test, quality of life questionnaire, subjective evaluation, and exercise compliance. After treatment, there were no differences between the two groups regarding PFM strength (p = 0.20), International Consultation on Incontinence Questionnaire-Short Form score (p = 0.76), pad test (p = 0.78), weekly exercise compliance (p = 0.079), and subjective evaluation of urinary loss (p = 0.145). Both intensive supervised PFMT and unsupervised PFMT are effective to treat female SUI if training session is provided.
TL;DR: Sacrocolpopexy was associated with a low risk of recurrence but with a relatively high risk of mesh erosion, and ranges of estimates for outcomes for other mesh techniques were wide.
Abstract: The aim of this study is to estimate efficacy and safety of mesh in surgery for uterine or vault prolapse. Seventeen electronic databases were searched for relevant studies that were published from 1980 onwards. Fifty-four studies involving 7,054 women were included. For sacrocolpopexy (average follow-up 23 months), the risk of clinical recurrence ranged from 0% to 6%, persistent symptoms ranged from 3% to 31% and mesh erosion from 0% to 12%. For infracoccygeal sacropexy (average follow-up 13 months), the risk of clinical recurrence ranged from 0% to 25%, persistent symptoms from 2% to 21% and mesh erosion 0% to 21%. Limited evidence was available for sacrocolpoperineopexy and uterine suspension sling to draw reliable estimates. Sacrocolpopexy was associated with a low risk of recurrence but with a relatively high risk of mesh erosion. Ranges of estimates for outcomes for other mesh techniques were wide.
TL;DR: The TVT procedure is effective and safe for more than 10 years and the subjective cure rate was 77%, while 18% had improved.
Abstract: Introduction and hypothesis
The aim was to evaluate the long-term cure rates and the late complications of the tension-free vaginal tape (TVT).
TL;DR: The findings suggest that both the orgasm and arousal function are related to better PFM function.
Abstract: This study aims to evaluate the association between pelvic floor muscle (PFM) strength and sexual functioning. Retrospective chart review of consecutive all women who were referred with a primary complaint of sexual dysfunction. Women underwent standardized clinical evaluation including pelvic muscle strength which was ranked from 0 (weak) to 2 (strong). The duration of pelvic muscle contraction was also recorded in seconds. Sexual function was evaluated by using a validated questionnaire, the Female Sexual Function Index (FSFI). One hundred seventy-six women with a mean age of 37 ± 11 years were included. Women with strong or moderate PFM scored significantly higher on the FSFI orgasmic and arousal domains than women with weak PFM (5.4 ± 0.8 vs. 2.8 ± 0.8, and 3.9 ± 0.5 vs. 1.7 ± 0.24, respectively; P < 0.001). The duration of PFM contraction was correlated with FSFI orgasmic domain and sexual arousal (r = 0.26, P < 0.001; r = 0.32, P < 0.0001, respectively). Our findings suggest that both the orgasm and arousal function are related to better PFM function.
TL;DR: In a trained center, mesh removal was found to be a quick and safe procedure and repeat was mostly associated with SUI and less with genital prolapse.
Abstract: Introduction and hypothesis
The objective of the study was to reveal the way we treat vaginal mesh complications in a trained referral center.
TL;DR: Medium-term results demonstrate that the TVM technique provides a durable prolapse repair, and is effective in patients with prolapse ≥stage II.
Abstract: Introduction and hypothesis
To evaluate clinical outcomes at 3 years following total transvaginal mesh (TVM) technique to treat vaginal prolapse.
TL;DR: Vaginal diazepam suppositories gave a clinically significant improvement in the treatment of HTPFD compared with the usual treatment regimen alone.
Abstract: To study intravaginal diazepam suppositories as adjunctive treatment for high-tone pelvic floor dysfunction (HTPFD) and sexual pain. A retrospective chart review was conducted on 26 patients who received diazepam suppositories as adjuvant therapy to pelvic physical therapy and intramuscular trigger point injections for bladder pain, sexual pain, and levator hypertonus. Pelvic floor muscular tone and pain were assessed by palpation and perineometry; sexual pain was objectively rated by Female Sexual Function Index (FSFI) and the Visual Analog Scale for Pain (VAS-P). Twenty-five out of 26 patients reported subjective improvement with suppository use; six out of seven sexually active patients resumed intercourse. Sexual pain as assessed on FSFI and serial VAS-P improved with diazepam (by 1.44 on 10-point scale, p = 0.14). PFM tone improved during resting (p < 0.001), squeezing (p = 0.014), and relaxation (p = 0.003) phases. Vaginal diazepam suppositories gave a clinically significant improvement in the treatment of HTPFD compared with the usual treatment regimen alone.
TL;DR: These results suggest that MiniArc sling and Monarc sling are equally effective in the treatment of stress incontinence at 1 year follow-up.
Abstract: A retrospective, dual-center, cohort study on the single incision MiniArc sling and the transobturator Monarc sling in the treatment of stress urinary incontinence is presented. We hypothesized that both systems would perform equally well. One hundred thirty-one (MiniArc n = 75, Monarc n = 56) consecutive patients were evaluated. Evaluation was performed by cough stress test (CST), daily pad use, IIQ-7, UDI-6, and a 0–5 visual analog scale for quality of life. The 1-year data are presented. Six weeks after surgery, 91% of the patients in both populations had a negative CST. At 1 year, 85% of the MiniArc group and 89% of the Monarc group (p = 0.60) maintained a negative CST. QoL, symptom scores, and number of pads improved significantly and were comparable in both groups. Complication rates were similar. These results suggest that MiniArc sling and Monarc sling are equally effective in the treatment of stress incontinence at 1 year follow-up.
TL;DR: UTI is an important postoperative morbidity after urogynecologic surgery and is common in catheterizing women despite antibiotic prophylaxis, according to this case-control study.
Abstract: The purpose of our study was to estimate the frequency and risk factors for symptomatic urinary tract infection (UTI) after surgery for stress urinary incontinence (SUI) and/or pelvic organ prolapse (POP). Case-control study of 389 consecutive women who underwent surgery for POP and/or SUI. Cases were defined as a symptomatic, culture-confirmed UTI within 6 weeks of surgery. Multivariable logistic regression was used to determine independent risk factors. Thirty five (9%) women developed a UTI. The risk of UTI was significantly increased by previous history of multiple UTIs (adjusted OR: 3.7, CI 1.4–10.1), increased distance between the urethra and the anus (adjusted OR: 1.4, CI 1.1–1.9), and prolonged duration of catheterization (adjusted odds ratio (OR) for ≥10 days: 4.2, 95% CI 1.5–11.6); 94.6% of catheterizing women were prescribed daily nitrofurantoin. UTI is an important postoperative morbidity after urogynecologic surgery and is common in catheterizing women despite antibiotic prophylaxis.
TL;DR: CS provides incomplete or poorly sustained pelvic floor protection by middle age, and obese women were at highest risk and had the most severe symptoms.
Abstract: Intrapartum events at first delivery and subsequent childbearing are associated with long-term pelvic floor dysfunction (PFD). Primigravidae delivered between 1983–1986 were identified; current addresses traced through the UK National Health Service database (N = 3002). Women completed screening and Sheffield Pelvic Floor Questionnaires (Sheffield-PAQ ©). Maternity data were obtained from Standard Maternity Information System. Primary outcomes were urinary incontinence (UI), anal incontinence (AI), and prolapse (POP). Primary response was 62.1%; 53.8% (n = 985) had ≥1 PFD symptom and in 71.5% symptoms were bothersome. UI (OR 0.47 95% CI 0.28, 0.81) and fecal incontinence (FI; OR 0.32 95% CI 0.13, 0.77) risks were lower after first delivery by cesarean section (CS). However, 25% had UI and 12% had FI after delivering exclusively by CS. Obesity was a risk factor independent of obstetric history. CS provides incomplete or poorly sustained pelvic floor protection by middle age. Obese women were at highest risk and had the most severe symptoms.
TL;DR: Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds, and patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.
Abstract: This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape–urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape–urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.
TL;DR: Bulkamid®, is an effective and safe bulking agent in women with stress or mixed incontinence in a multicenter study carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incentinence.
Abstract: Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This multicenter study was carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incontinence. Submucosal injection of Bulkamid® was performed in 135 women with urinary incontinence (stress, 67; mixed, 68) followed for 12 months. Forty-seven had a reinjection (35%). At 12 months, the subjective response rate was 66%. Incontinence episodes/24 h and urine leakage g/24 h decreased significantly (from 3.0 to 0.7 and 29 g to 4 g, respectively). Additionally, the median International Consultation on Incontinence Questionnaire score was reduced to approximately 50%, and the overall quality of life visual analogue scale score was decreased significantly (from 72 to 20). Efficacy was very similar between patients with stress and mixed incontinence. Thirty treatment-related adverse events were registered. The most frequent was urinary tract infection (n = 10). No polyacrylamide hydrogel-specific adverse events were seen. Bulkamid® is an effective and safe bulking agent in women with stress or mixed incontinence.
TL;DR: Lower urinary tract symptoms are less common among women with prolapse and major levator ani defects and more common among those with minor defects.
Abstract: Among women with pelvic organ prolapse, compare rates of lower urinary tract symptoms by levator ani defect (LAD) status. Urinary incontinence and obstructive voiding are analyzed among 151 women with prolapse whose LAD status was determined with magnetic resonance imaging. Women with major LAD are less likely to experience stress incontinence when “coughing, laughing, or sneezing” (odds ratio (OR) 0.27) and when “twisting, reaching, lifting, or bending over” (OR 0.26) than women with normal muscles. They are less likely to have obstructive symptoms characterized by assuming an “unusual toileting position” or “changing positions…to start or complete urination” (OR 0.27). Women with minor LAD are more likely to experience stress incontinence with exercise (OR 3.1) and urge incontinence (OR 4.0) than those with normal muscles. Lower urinary tract symptoms are less common among women with prolapse and major levator ani defects and more common among those with minor defects.
TL;DR: An estimation of the frequency of surgery for posthysterectomy vault prolapse requiring surgical repair between 6% and 8%.
Abstract: We tried to estimate the frequency of surgery for posthysterectomy vault prolapse. We contacted all 86 departments of gynecology in Austria and asked them about total number of hysterectomies and total number of operations for vault prolapse. We then calculated a percentage of patients undergoing surgery for posthysterectomy vault prolapse. Sixty-five of 86 public hospitals replied (response rate 76%) and reported a total of 7,645 hysterectomies and 577 operations for vault prolapse for the year 2005, giving a percentage of 7.16 for surgery for posthysterectomy vault prolapse. On the assumption that vault prolapse takes on the average 10 years to develop and that the number of hysterectomies decreased by 10% over 10 years, we calculated a modified frequency of 6.52%. We were able to calculate an estimation of the frequency for posthysterectomy vault prolapse requiring surgical repair between 6% and 8%.
TL;DR: TVT and TVT-O procedures both have an outcome associated with an increase in quality of life with no significant differences in satisfaction rates at 2 years follow-up.
Abstract: Introduction and hypothesis
The purpose of this study is to compare the retropubic tension-free vaginal tape (TVT) procedure with the inside-out transobturator approach (TVT-O).
TL;DR: It is found that BMI does not influence the clinical effectiveness of SUI treatment, whereas both menopause and ageing had a detrimental influence on the final outcome of the surgery.
Abstract: Introduction and hypothesis
A few series comparing the clinical efficacy of midurethral slings in obese and postmenopausal patients are available. The aim of the study was to assess clinical efficacy of suburethral tape operations for the surgical treatment of female stress urinary incontinence (SUI) stratified by obesity, menopause and ageing.
TL;DR: TUI for failed MUS demonstrated a low cure rate but high patient satisfaction, and the procedure was minimally invasive with no significant complications.
Abstract: Introduction and hypothesis
We evaluated the efficacy of transurethral injection (TUI) for the treatment of recurrent or persistent stress urinary incontinence after mid-urethral sling (MUS) procedures.
TL;DR: The new onset of SUI during pregnancy is an independent risk factor for SUI in the postpartum period and the only factor independently associated with SUI after delivery was the development of Sui during pregnancy.
Abstract: Introduction and hypothesis
The aim of the study was to investigate the risk factors involved in stress urinary incontinence (SUI) 1 year after first delivery.