共查询到20条相似文献,搜索用时 15 毫秒
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Cystocele repair can lead to de novo stress urinary incontinence (SUI) or exacerbate pre-existing SUI. This study was designed
to determine the effect of cystocele repair by transobturator mesh on SUI. In a retrospective observational study, we saw
93 patients after a transobturator mesh procedure. Of those, 57 women had not undergone a concomitant anti-incontinence procedure.
We analyzed their clinical data and ultrasound datasets. At a median follow-up of 9 months, 21 of 24 preoperatively stress
incontinent women reported cure/improvement, one patient reported worsened SUI. Seven of 33 preoperatively continent women
complained of de novo SUI. There is a net positive effect on SUI (McNemar χ2 exact test p = 0.013) after transobturator mesh. A narrower gap between symphysis pubis and mesh was associated with a positive outcome
(p = 0.015 on ANOVA). Transobturator mesh for cystocele repair appears to have a net positive effect on SUI. 相似文献
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Predictors of successful voiding before hospital discharge after urinary stress incontinence surgery
Sallie Oliphant Ödül Aktan Amburgey AnnaMarie Connolly 《International urogynecology journal》2008,19(6):805-810
This study aims to identify variables associated with successful voiding before hospital discharge in women undergoing urinary
stress incontinence (USI) surgery. Medical records of women who underwent USI surgery between July 1997 and October 2005 were
reviewed. Demographic, urodynamic, and perioperative data were recorded. The primary outcome was successful voiding at hospital
discharge. Univariate, bivariate, and logistic regression analyses were performed (SPSS 12.0/SPSS, Chicago, IL, USA). The
two groups, successful vs unsuccessful voiders, were similar in age, postmenopausal status, and prior hysterectomy/incontinence/prolapse
surgery. Burch colposuspension was performed in 82% and pubovaginal sling in 18% of women. Multivariate logistic regression
analysis revealed that age < 45 years (OR 2.6), sustained detrusor contraction (OR 4.4), and Burch colposuspension (OR 2.9)
were positively associated with early successful voiding. Early successful voiding was associated with age < 45 years, sustained
detrusor contraction, and Burch colposuspension. These data may facilitate preoperative counseling in women undergoing USI
surgery. 相似文献
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Jae-Seung Paick Seung-June Oh Soo Woong Kim Ja Hyeon Ku 《International urogynecology journal》2008,19(1):123-129
We evaluated the outcome at least 6 months after tension-free vaginal tape (TVT), suprapubic arc (SPARC) sling, or transobturator
tape (TOT) procedure in women with mixed urinary incontinence and identified factors predicting the outcome in these patients.
A total of 144 women, 29 to 77 years old (mean age 57.3), were included in the study; TVT (n = 72), SPARC (n = 22), and TOT (n = 50). The mean follow-up time was 10.9 months (range 6 to 52). There were no significant differences in the three groups
in terms of the cure rate for stress urinary incontinence (SUI; TVT, 95.8%; SPARC, 90.0%; TOT, 94.0%; P = 0.625) and urinary incontinence (UUI; TVT, 81.9%; SPARC, 86.4%; TOT, 82.0%; P = 0.965). In the multivariate model, there is no influencing factor for treatment failure of SUI, while maximum urethral
closure pressure (MUCP) and the diagnosis of uninhibited detrusor contraction during cystometry were independent risk factors
for treatment failure of UUI. Decreasing MUCP was associated with an increased likelihood of treatment failure of UUI [odds
ratio (OR), 0.974; 95% confidence interval (CI), 0.950–0.998; P = 0.034]. In the same model, uninhibited detrusor contraction was associated with 3.4-fold risk of treatment failure of UUI
(OR, 3.351; 95% CI, 1.031–10.887; P = 0.044). Our findings suggest that low MUCP and the presence of uninhibited detrusor contraction during cystometry should
be considered to be at high risk of treatment failure of UUI after surgery in these patients. 相似文献
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Lorenzo-Gómez MF Gómez-García A Padilla-Fernández B García-Criado FJ Silva-Abuín JM Mirón-Canelo JA Urrutia-Avisrror M 《Actas urologicas espa?olas》2011,35(8):454-458
ObjectiveTo identify risk factors leading to treatment failure in a sample of 302 women with stress urinary incontinence (SUI) treated by transobturator vaginal tape (TOT) with a medium follow-up of 4 years (range 1-6).Material and MethodsA population based cohort study with prospectively data from 302 women, aged 41-81 years underwent TOT between April 2003-November 2010. Data were collected by validated questionnaire on urinary incontinence, the International Consultation on Incontinence Questionnaire — Short Form (ICIQ-SF), and clinical data-records. Continence was achieved in 262 (Group A) and 40 continued with incontinence (Group B). We investigated the relationship between age, SUI evolution time, type and number of childbirths (eutocic, dystocic, nulliparous, multiparous status) and medical and/or surgical backgrounds. The ICIQ-SF questionnaire was used to describe whether the surgery outcomes were successful or not.ResultsGroup A were younger (p = 0.0001), had less SUI evolution time (p = 0.017); more eutocic childbirths (p = 0.000018). Group B had more dystocic childbirth (p = 0.022), previous tension free vaginal tape (TVT) or TOT (p = 0.03.), antidepressant-anxiolytic drugs (p = 0.003), antihypertensive drugs (p = 0.0005), type 1 diabetes (p = 0.02), arterial hypertension (p = 0.0007), respiratory diseases (p = 0.025). Differences were not found with regard to nulliparous (p = 0.701), multiparous status (p = 0.42), obesity (p = 0.18), intestinal disorders (p = 0.59), oophorectomy (p = 0.19), caesarean (p = 0.17), prolapse surgery (p = 0.29), hysterectomy (p = 0.57), allergies (p = 0.48), arthritis (p = 0.22), arthrosis (p = 0.44), depression (p = 0.74), type 2 diabetes (p = 0.44), smoking patterns (p = 0.28), fibromyalgia (p = 0.47).ConclusionsElderly women, with long evolution SUI, dystocic delivery, previous TVT or TOT appear as independent risk factors associated to TOT failure. These factors may make the indication of another surgical approach recommendable. 相似文献
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Delorme E 《Annales d'Urologie》2005,39(1):10-15
The aim of suburethral transobturator suspension is to cure the women stress urinary incontinence. The concept underlying this apparatus is based on several points: it reproduces the urethral fascia; it complies with Delancey's concept; it consists of a tension-free band through the soft structures of the obturator fossa; it is a perineal surgery. This surgery needs specific devices: a synthetic tape and a specific tool to introduce it, the tunnelling device. Respecting some technical landmarks are mandatory to ensure successful intervention: the vaginal incision must include all the thickness of the vaginal wall; the trans-obturated endpoint must be located at the level of the mid urethra; the tunnelling device must have a close contact with the ischiopubic bone; the finger inside the incision protects the urethra and drives the tunnelling device inside the vaginal incision. 相似文献
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Louise Schreiber Pedersen Gunnar Lose Mette Terp Høybye Martina Jürgensen Annika Waldmann Martin Rudnicki 《International urogynecology journal》2018,29(4):521-530
Introduction and hypothesis
The aim of the study was to evaluate the predictors and reasons for help-seeking behavior among women with urinary incontinence (UI) in Germany and Denmark.Methods
This international postal survey was conducted in 2014. In each country, 4,000 women of at least 18 years of age were randomly selected. The questionnaires included validated items regarding help-seeking behavior and the ICIQ-UI SF. UI was defined as any involuntary loss of urine. Binary logistic regression analysis was used to assess factors predicting help-seeking behavior. Reasons for seeking or not seeking help were evaluated in terms of the severity of UI and as the most frequently reported.Results
Of 1,063 Danish women with UI, 25.3% had consulted a physician compared with 31.4% of 786 German women with UI (p = 0.004). The severity and duration of UI, and actively seeking information regarding UI, were significant independent predictors of help-seeking behavior. Women with slight/moderate UI did not seek help because they did not consider UI as a problem, whereas of women with severe/very severe UI, German women reported that other illnesses were more important and Danish women reported that they did not have enough resources to consult a physician.Conclusions
Only a small proportion of women with UI had consulted a physician, and the driving forces for help-seeking behavior were severity and duration of UI and actively seeking information regarding UI. Public information campaigns might enhance consultation rates providing that passively receiving and actively seeking information have the same effects on help-seeking behavior. We show for the first time that reasons for not consulting a physician for UI vary depending on the severity of the UI.19.
Alexandriah N. Alas Orawee Chinthakanan Luis Espaillat Leon Plowright G. Willy Davila Vivian C. Aguilar 《International urogynecology journal》2017,28(4):583-590
Introduction and hypothesis
There is a paucity of data evaluating the risk of de novo stress urinary incontinence (SUI) after surgery for pelvic organ prolapse (POP) in women with no preoperative occult SUI. We hypothesized that apical suspension procedures would have higher rates of de novo SUI.Methods
This was a retrospective database review of women who had surgery for POP from 2003 to 2013 and developed de novo SUI at ≥6 months postoperatively. Preoperatively, all patients had a negative stress test and no evidence of occult SUI on prolapse reduction urodynamics. The primary objective was to establish the incidence of de novo SUI in women with no objective evidence of preoperative occult SUI after POP surgeries at ≥6 months.Results
A total number of 274 patients underwent POP surgery. The overall incidence of de novo SUI was 9.9 % [95 % confidence interval (CI) 0.07–0.14]. However, the incidence of de novo SUI in those with no baseline complaint of SUI was 4.4 % (95 % CI 0.03–0.1). There was no difference in de novo SUI rates between apical [9.7 % (n?=?57)] and nonapical [10.5 %, (n?=?217] procedures (p?=?0.8482). Multivariate logistic regression identified sacrocolpopexy [adjusted odds ratio (OR) 4.54, 95 % CI 1.2–14.7] and those with a baseline complaint of SUI (adjusted OR 5.1; 95 % CI 2.2–12) as risk factors for de novo SUI.Conclusions
The incidence of de novo SUI after surgery for POP without occult SUI was 9.9 %. We recommend counseling patients about the risk of de novo SUI and offering a staged procedure.20.
Yuko M. Komesu Holly E. Richter Darrell L. Dinwiddie Nazema Y. Siddiqui Vivian W. Sung Emily S. Lukacz Beri Ridgeway Lily A. Arya Halina M. Zyczynski Rebecca G. Rogers Marie Gantz 《International urogynecology journal》2017,28(5):711-720