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Mid urethral sling

Lewis Chan, Vincent Tse
PURPOSE: The mid-urethral synthetic sling (MUS) procedure has become the standard of care for treatment of female stress urinary incontinence. However, a small number of patients will have complications following MUS including failure, obstructive voiding, sling erosion, or chronic pain. This paper discusses the role of 2D and 3D ultrasound imaging in the evaluation of the female patient with complications following placement of a synthetic mid-urethral sling. RESULTS: The MUS is easily visualized as an echogenic structure on ultrasound and can be imaged by transperineal, transvaginal and introital approaches...
March 12, 2018: World Journal of Urology
Connie Wang, Alana L Christie, Philippe E Zimmern
INTRODUCTION: To study the evolution of type of presenting symptoms after mid-urethral sling (MUS) placement relative to the interval between placement and subsequent synthetic sling removal (SSR) for complication(s). METHODS: An IRB-approved, prospectively maintained database of women who underwent SSR was retrospectively reviewed for demographics, interval between MUS placement and SSR, history of chronic pain syndromes and recurrent urinary tract infections (RUTI), anti-incontinence and prolapse repairs, and MUS-related symptoms at presentation, including storage dysfunction, voiding dysfunction, RUTI, vaginal pain, non-vaginal pain, mesh exposure, and urinary incontinence (UI)...
February 21, 2018: Neurourology and Urodynamics
Giampiero Capobianco, Massimo Madonia, Sonia Morelli, Francesco Dessole, Davide De Vita, Pier Luigi Cherchi, Salvatore Dessole
Stress urinary incontinence (SUI) is a condition characterized by an involuntary loss of urine occurring as result of an increase in intra-abdominal pressure due to effort or exertion or on sneezing or coughing. Estimates of its prevalence in the female population range from 10% to 40%. A literature search of the Medline, Cochrane library, EMBASE, NLH, and Google Scholar databases was done up to July 2017, restricted to English-language articles, using terms related to SUI, medical therapy, surgical therapy and treatment options...
March 2018: Maturitas
Vibeke Weltz, Rikke Guldberg, Michael D Larsen, Bjarne Magnussen, Gunnar Lose
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the impact of body mass index (BMI) on the subjective improvement and risk of reoperation after first-time mid-urethral sling surgery. METHODS: Data were retrieved from the national Danish Urogynaecological Database, including women with first-time surgery with mid-urethral polypropylene slings from 2011 to 2016. The subjective improvement was assessed by the difference in symptoms based on the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) completed pre- and 3 months postoperatively...
February 12, 2018: International Urogynecology Journal
Alexandra Mowat, Bernadette Brown, Anita Pelecanos, Victoria Mowat, Malcolm Frazer
OBJECTIVE: To establish whether the infusion method trial of void (TOV) after a mid-urethral sling procedure, in contrast to the standard auto-fill TOV, permits discharge home from recovery, as these procedures are eminently suited to same day discharge, and the delay in achieving a successful TOV often keeps the patient in hospital overnight. METHOD: A randomised controlled trial performed between December 2014 and April 2016 at the University Hospital, enrolling 40 women undergoing a mid-urethral sling procedure for stress urinary incontinence...
January 31, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Alan J Wein
No abstract text is available yet for this article.
February 2018: Journal of Urology
Osnat Elyashiv, Noa Mevorach Zussman, Masha Ben-Zvi, Jacob Bar, Ron Sagiv, Alexander Condrea, Shimon Ginath
STUDY OBJECTIVE: To compare the operative results of midurethral sling (MUS) surgeries for stress urinary incontinence (SUI) performed by residents under the guidance of an attending specialist in urogynecology, to those done by attendings. DESIGN: Retrospective chart review DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING: University hospital PATIENTS: A retrospective analysis of all MUS's performed between January 2009 to December 2013, in a single public tertiary medical center, was carried out...
January 12, 2018: Journal of Minimally Invasive Gynecology
David L Howard, Andrea McGlynn, Joy A Greer
BACKGROUND: Prior studies of complications after sling surgery excluded the large number of women in military treatment facilities (MTFs). OBJECTIVE: To characterize the postoperative complication rates after sling surgery for Stress urinary incontinence (SUI) within MTFs in the United States. MATERIALS AND METHODS: Retrospective cohort study of women aged 18 and older, with SUI, and who underwent either an outpatient or inpatient mid-urethral sling placement for SUI in any MTF in the United States between January 1, 2011 and December 31, 2012...
January 10, 2018: Journal of Women's Health
Andrew Doering, Ali Azadi, David Doering, Donald R Ostergard
We report a case of a mid-urethral sling (Advantage Fit™, Boston Scientific Corporation, Marlborough, Massachusetts) freshly removed from its original package. Upon removal from the packaging, the sling was noted to have a deformation in positioning at the midpoint, with curvature opposite the natural curve of the sling in the body. The images show the comparison to a sling with the desired positioning. Mid-urethral slings are commonly made from polypropylene mesh which has memory properties. It is important that manufacturers ensure that any steps in the processing or packaging of slings do not result in changes in the shape of the sling that may have unknown impacts on its clinical outcome...
December 22, 2017: Surgical Technology International
Maria Cláudia Bicudo-Fürst, Pedro Henrique Borba Leite, Felipe Placco Araújo Glina, Willy Baccaglini, Rafael Vilhena de Carvalho Fürst, Carlos Alberto Bezerra, Sidney Glina
INTRODUCTION: The impact of surgery for stress urinary incontinence (SUI) on female sexual function has received attention in the medical literature, but not in a structured manner. AIM: To assess the most recent evidence on the impact of surgical management for female SUI on female sexual function. METHODS: The review and meta-analysis of available articles published in Medline, Cochrane, LILACS, SCOPUS, Web of Science, CINHAL, and EMBASE included prospective randomized and non-randomized studies that assessed patients who underwent surgical treatment for UI through 2 validated questionnaires: the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Female Sexual Function Index (FSFI)...
December 27, 2017: Sexual Medicine Reviews
B André, O Jourdain, P Guerby, F Vidal, F Léonard
OBJECTIVES: To assess feasibility and postoperative outcomes associated with laparoscopic sacrocolpopexy in patients presenting with exteriorized pelvic organ prolapse (stage>3). METHODS: Prospective study involving patients undergoing laparoscopic sacrocolpopexy for advanced stage pelvic organ prolapse. Symptoms and quality of life were evaluated at baseline and at 1, 4 and 18 months after surgery using validated questionnaires (PFDI-20 and PFIQ-7). RESULTS: Sixty-three patients were included between September 2012 and January 2014...
December 27, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
Lieming Wen, Ka Lai Shek, Subramaniam Nishamini, Friedman Talia, Hans Peter Dietz
PURPOSE: To study correlations between sonographic and urodynamic findings after suburethral sling surgery. METHODS: This is a retrospective study on 141 women who had multichannel urodynamic testing and translabial 4D ultrasound after suburethral sling surgery between 2006 and 2016. The sling-pubis gap, i.e., the distance between sling and infero-posterior margin of the pubic symphysis on Valsalva, and urethral motion profile were determined. The urethral motion profile was assessed by calculating the mobility vectors of 6 equidistant points along the length of urethra from bladder neck to external urethral meatus, against the dorsocaudal margin of the symphysis pubis on Valsalva...
December 26, 2017: Journal of Urology
Franca Natale, Ester Illiano, Chiara La Penna, Raffaele Balsamo, Elisabetta Costantini
OBJECTIVES: It is hypothesized that urethral dysfunction is central in mixed urinary incontinence (MUI) in women, since urine entering the proximal urethra under increased intra-abdominal pressure provokes a urethro-detrusorial reflex and involuntary detrusor contraction. Mid-urethral slings have been proposed as a solution. Our primary objective was to evaluate the long-term subjective and objective outcomes on continence and other urinary symptoms of a trans-obturator mid-urethral sling (TOT) procedure...
December 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Patkawat Ramart
Stress urinary incontinence (SUI) is a common problem in women. Successful treatment is now mid urethral sling but it would be a cause of urethral obstruction. In this case report, a 50 years old woman presented with a huge introitus mass after 3 months of midurethral sling. The mass protruded from the urethra and could not be reduced. Emergency MRI of pelvis was demonstrated prolapsed ureterocele, single system of right ureter. Preoperative planning was cystoscopy and mass excision. The patient was preoperatively counseled that right ureteric reimplantation may be required...
January 2018: Urology Case Reports
Alan J Wein
No abstract text is available yet for this article.
December 2017: Journal of Urology
Abdulmuttalip Simsek, Sinan Levent Kirecci, Goksel Bayar, Kaya Horasanli, Faruk Ozgor, Zafer Gokhan Gurbuz
PURPOSE: Currently, it is unclear how the mesh tension should be adjusted on the transobturator tape surgery (TOT) for improving continence. The aim of this study was to evaluate the effects of per-operative cough stress test on TOT. MATERIALS AND METHODS: Between March 2007 and December 2011, 206 women with SUI were enrolled in this study. Patients were randomly categorized to treatment with TOT (96) or TOT with cough stress test (110). The IIQ-7 and the UDI-6 were used to identify satisfaction level...
October 3, 2017: Archivio Italiano di Urologia, Andrologia
Tomasz Kluz, Edyta Wlaźlak, Andrzej Wróbel, Wiktor Wlaźlak, Michał Pazdrak, Grzegorz Surkont
OBJECTIVE: The aim of this study is to evaluate using PFS-TV the mid-term results of our first operative experience with implanting a single incision sling - Ajust™. MATERIAL AND METHODS: One and the same surgeon has operated all the patients with symptoms of stress urinary incontinence. Ajust was the only performed procedure. Postoperative evaluation consisted of: a standardized interview and examination, a cough test and a PFS-TV for evaluation of urinary continence and tape location...
2017: Ginekologia Polska
Wojciech Majkusiak, Andrzej Pomian, Paweł Tomasik, Edyta Horosz, Aneta Zwierzchowska, Jacek Kociszewski, Ewa Barcz
OBJECTIVES: To ascertain whether a phenomenon of sling migration exists after suburethral sling placement, whether this might be responsible for suboptimal sling location and persistent incontinence, and whether a link exists between sling dislocation or migration and risk factors, such as obesity or age. METHODS: The present prospective cohort study was carried out in a group of 244 patients who underwent retropubic sling implantation. Sling location was determined by means of pelvic floor ultrasound, and calculated relative to the individual patient's urethral length measured before the procedure...
December 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
Charelle M Carter-Brooks, Angela L Du, Michael J Bonidie, Jonathan P Shepherd
INTRODUCTION AND HYPOTHESIS: Abdominal sacrocolpopexy is commonly performed for the surgical correction of pelvic organ prolapse (POP) in the USA. Over the last decade, fellowship programs have increased the number of these procedures performed robotically. Currently, there is a paucity of literature exploring the impact of fellowship training on outcomes of robotic-assisted sacrocolpopexy (RASC). We sought to explore the impact of an expert surgeon operating alone versus with a fellow on operative time and perioperative morbidity associated with RASC...
September 9, 2017: International Urogynecology Journal
Henry Tran, Matthew Rutman
Numerous surgical options are available for the management of stress urinary incontinence in women, including urethral bulking agents, pubovaginal slings, retropubic bladder neck suspensions, midurethral slings, and even artificial urinary sphincters. We discuss the incidence, etiology, diagnosis, evaluation, and management of bladder outlet obstruction after anti-incontinence surgery in women. This problem presents with a wide range of symptoms. Urodynamic evaluation is not always diagnostic but can be helpful...
September 6, 2017: Urology
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