The effect of tension-free vaginal tape (TVT) procedure on sexual function in women with stress urinary incontinence

The aim of this study was to evaluate the effects of tension-free vaginal tape (TVT) on sexual function in women with stress urinary incontinence (SUI) by questionnaire. Thirty-two sexually active and married women who were planned for TVT to treat SUI constituted the patient group, and 25 women who were healthy, sexually active and married, were selected as the control group; the ages of both groups matched. Sexual functions (desire, arousal, orgasm, pain and satisfaction) were evaluated with the Index of Female Sexual Function (IFSF), and continence status during sexual intercourse was asked about both preoperatively and postoperatively in the 6th month. The mean domain scores of sexual functions such as desire, arousal, orgasm, pain and overall satisfaction preoperatively and postoperatively were 3.37±0.69, 3.82±0.62, 3.40±0.95, 3.41±0.98, 3.16±1.09 and 3.32±0.79, 3.71±0.53, 3.06±1.04, 2.75±1.29, 2.88±0.63, respectively, and postoperative scores insignificantly decreased. Also, these scores in the control group were 3.64±0.66, 3.96±0.73, 4.12±0.78, 3.96±1.14 and 3.68±0.92. In comparison with the control group, whereas all of the preoperative domain scores were found to be decreased but were statistically insignificant except orgasmic function, postoperative scores significantly worsened, except for desire and arousal. However, preoperatively nine patients explained that they had incontinence during sexual intercourse, and this problem persisted in twopostoperatively (p = 0.043). This study shows that both SUI and the TVT procedure negatively affect sexual function in women.Abbreviations FSD Female sexual dysfunction - SUI Stress urinary incontinence - TVT Tension-free vaginal tape Editorial Comment: This study examines female sexual function in relation to SUI and the TVT procedure. The conclusion is that as a rule SUI negatively affects female sexual function. A successful TVT procedure does not improve patients perception of sexual function. Counseling for sexual dysfunction should therefore be part of the preoperative investigation.     

Can conventional examinations contribute to the diagnostic power of unenhanced helical computed tomography in urolithiasis?

INTRODUCTION: To investigate whether ordinary tests used in urolithiasis can increase the diagnostic value of unenhanced helical computed tomography (HCT). MATERIALS AND METHODS: Of all patients admitted with acute flank pain, 137 without radiocontrast allergy, pregnancy and renal insufficiency were included in the study. After urinalysis (Ur) and ultrasonography (USG), HCT without a contrast agent was taken by 5-mm collimation, thereafter excretory urography (EU) was obtained. Confirmation of a stone was done by various tests and/or treatment methods. Statistically, the predictive values of HCT, USG, EU and Ur and their combinations were evaluated using the area under the receiver operating characteristic curve (AROC). RESULTS: The patients' mean age was 38 (range 4-72) years. Sensitivity values of HCT, USG, EU and Ur were 97, 69, 71 and 81%, respectively. Their specificity values were 96, 87, 91 and 65%, respectively. The widest AROC was found for HCT (97%). The best test combination was [HCT or USG] according to the AROC value (93%), but none of the AROC values of the test combinations was higher than that of HCT. However, 95% confidence intervals of the AROC values of these tests and their combinations overlapped. CONCLUSIONS: Because the HCT combinations with other tests improved the diagnostic value of HCT, they should be preferred in some individuals suspected of having urolithiasis. However, the most feasible single test meeting the all usage purposes was HCT in terms of the AROC value, and the combination was [HCT or USG] in which either HCT or USG was positive.     

Expeditious method of urethrovesical junction determination in retropubic colposuspension with intraballoon illumination of Foley catheter

OBJECTIVE: To investigate the efficiency and safety of Foley catheter intraballoon illumination in determining the urethrovesical junction (UVJ) in retropubic colposuspension. METHOD: Our accessory set for UVJ determination is composed of a 24-french Foley catheter and a 5-mm 0 degrees telescope. The telescope is inserted into the catheter from the urinary luminal side until the tip has reached the level of the catheter balloon. After dissection of the bladder, urethra, and paraurethral tissues to reveal the submucosal endopelvic fascia, the accessory set is inserted into the bladder and the balloon is inflated with 5 ml air and illuminated by a switch on the cold light source. To determine the right side of UVJ, the catheter is pulled slightly downward and to the right of the patient. The contralateral side of the UVJ is determined by pulling the catheter slightly downward and to the left of the patient. RESULT: Intraballoon illumination of the Foley catheter helps to ensure accurate placement of paraurethral sutures at UVJ. CONCLUSION: Intraballoon illumination for determination of UVJ is simple, safe, effective and precludes an invasive approach such as cystoscopy and cystotomy.     

Plasma growth hormone response to growth hormone-releasing hexapeptide (GH-RP-6) in children with short stature

Eighteen children with short stature were evaluated for growth hormone (GH) reserve after pharmacological tests and a single iv injection of GH-RP-6. These children were divided into two groups: 10 were diagnosed as having idiopathic GH deficiency by classical stimulation tests (group A) and the remaining 8 (group B) were considered growth-retarded children with normal GH secretion, following conventional stimulation, but reduced endogenous GH secretion. The results were compared with a group of 12 normal children. As a group, patients in group A showed a lower GH response to GH-RP-6, while patients in group B had a similar response as normal controls. However, on an individual basis, a considerable degree of overlapping in responses among the three groups was evident. These data indicate that, on an individual basis, GH-RP-6 testing is not of diagnostic value in children suspected of having idiopathic GH deficiency.GH deficiency, GH-RP-6, short stature C Dieguez, PO Box 563, 15705 Santiago de Compostela, Spain     

糖尿病大鼠卵巢组织中细胞色素C、线粒体Ca2+变化与灵芝孢子粉的干预

目的:以卵巢组织中细胞色素C、线粒体Ca2 和性激素水平为观察指标,观察灵芝孢子粉对2型糖尿病大鼠卵巢组织的保护作用。方法:实验于2006-06/08在佳木斯大学黑龙江省小儿神经康复重点实验室完成。①实验对象:Wistar雌性大鼠50只,随机分为对照组10只,2型糖尿病模型组20只,灵芝孢子粉组20只。②实验方法:大鼠禁食16～18h,自由饮水,模型组及灵芝孢子粉组大鼠经尾静脉一次性按25mg/kg注射2%链脲佐菌素,正常对照组尾静脉注射等量柠檬酸钠-柠檬酸缓冲液。正常饮食喂养2周后,进行糖耐量试验,模型组和灵芝组以糖耐量异常者保留,余去除,并改喂高脂高糖饮食,灵芝孢子粉组另加灵芝孢子粉[250mg/(kg·d)]持续10周,实验结束前一天再次做糖耐量试验。③实验评估:实验结束后,各组动物均禁食12h,乙醚吸入浅麻醉,内眦静脉取血待测血清胰岛素。解剖出卵巢,待测线粒体细胞色素C、线粒体Ca2 含量。结果:选用Wistar雌性大鼠50只,结果分析数量每组8只。①葡萄糖耐量试验:实验开始及实验12周时,模型组大鼠均表现出糖耐量异常的变化(P<0.05),1h血糖增高显著(P<0.05)达到高峰,2h血糖仍较高;对照组大鼠30min血糖达到峰值,2h血糖基本恢复正常。②血清胰岛素和卵巢性激素水平:模型组血清胰岛素明显升高(P<0.05)。而灵芝孢子粉组与对照组比较差异无显著性。模型组雌二醇含量明显降低(P<0.05),卵胞刺激素含量、睾酮含量明显升高(P<0.05),而灵芝孢子粉组与对照组比较差异无显著性。③胞浆细胞色素C、线粒体细胞色素C、线粒体钙变化:模型组卵巢组织胞浆细胞色素C含量明显升高(P<0.05),模型组卵巢组织线粒体细胞色素C含量明显降低(P<0.05),模型组卵巢组织线粒体钙含量明显降低(P<0.05);而灵芝孢子粉组与对照组比较差异均无显著性。结论:灵芝孢子粉可降低糖尿病大鼠血清胰岛素、卵巢组织卵胞刺激素、睾酮、胞浆细胞色素C含量,调节卵巢组织雌二醇、线粒体细胞色素C、钙含量,对糖尿病大鼠卵巢组织具有一定保护作用。     

高效液相色谱法测定人血中普鲁卡因酰胺及其代谢产物N-乙酰普鲁卡因酰胺

本文用高效液相色谱法测定人血中普鲁卡因酰胺(PA)及其代谢产物N-乙酰普鲁卡因酰胺(NAPA)。以正丙醇—氯仿(1:9)提取血清样品,蒸干,残渣用流动相溶解;色谱分析条件:NOVA-PAK 5μm ODS柱,醋酸(40 ml)—醋酸钠(4g)—水(1000ml)—乙腈(100ml)为流动相;定量分析以普鲁卡因为内标,样品的比率色谱图表明分离良好,PA和NAPA的线性测定范围分别为0.5～12.0μg/ml和0.5～6.0μg/ml,相关系数均优于0.99,平均回收率分别为99.4%和100.5%,平均变异系数分别为4.16%和4.36%。方法适用于血清样品分析和治疗药物监测,对病人血样的测定结果表明方法不受干扰。     

ARTIFICIAL VENTILATORY MANAGEMENT IN A SEVERE,PREGNANT ASTHMATIC — A CASE REPORT

A 33-year-old pregnant atopic woman, who had never suffered from asthma or atopic-related disorder, was admitted on three occasions during her fifth pregnancy with severe asthma. On her last admission she required more intensive monitoring and artificial ventilation. We report this patient and discuss the pathogenesis of asthma during pregnancy. Asthma in pregnancy is not uncommon and it may take a severe course in some pregnancies. In one prospective study 42% of the patients required aggressive management, but none required artificial ventilation. However, there was no difference in the outcome of pregnancies between asthmatic and control subjects.¹ Here we describe a patient with severe asthma who required artificial ventilation with a successful outcome.