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Nobuo Okui
PURPOSE: Stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) lead to poor quality of life. In Japan, urinary incontinence is treated with tension-free vaginal tape (TVT) or transobturator tape (TOT) sling procedures, which involves inserting a synthetic material; however, problems arise with artificial mesh in some instances, requiring new treatment methods. Hence, laser therapy, whereby an erbium-doped yttrium aluminum garnet laser is directed into the vagina and urethra, may be useful...
August 16, 2018: World Journal of Urology
Marie-Pier Lirette, Benoit Bailey, Samuel Grant, Michael Jackson, Paul Leonard
Background: Paediatric clavicle fractures are commonly seen in the emergency department (ED), and the current standard of care is to obtain a radiograph for all suspected clavicle fractures. We are yet to determine whether radiographs add valuable information to clinicians' assessment and therefore if they are necessary in the management of paediatric clavicle fractures. Objective: To determine whether clinicians can manage paediatric clavicle fractures without radiographs, first by determining the accuracy of clinicians in identifying the presence of a clavicle fracture, and second by evaluating the level of agreement (kappa (κ)) between the ultimate management of children with suspected clavicle fractures and clinicians' blinded prediction prior to the radiograph...
2018: BMJ Paediatrics Open
Rosa Maria Laterza, Ksenia Halpern, Daniela Ulrich, Alexandra Graf, Karl Tamussino, Wolfgang Umek
AIMS: Our aim was to evaluate, in a second data analysis of the prospective randomized controlled trial conducted by Austrian Urogynaecology Working Group, the effect of age, BMI and parity at the time of surgery on short- and long-term outcomes of women primarily treated for SUI (stress urinary incontinence) with midurethral slings. METHODS: In the original study 554 patients received randomly a retropubic (TVT) or a transobturator midurethral (TVT-O) sling procedure...
2018: PloS One
Hkn Kankam, Gjm Hourston, P Forouhi, M Di Candia, G C Wishart, C M Malata
Introduction Patients with large ptotic breasts undergoing immediate implant-based reconstruction often require skin-reducing mastectomy to optimise the aesthetic outcome. However, healing complications, especially at the resulting inverted T-junction, leading to wound dehiscence, infection, skin necrosis, implant exposure and failed reconstruction have been widely reported. We present an innovative approach for immediate implant-based reconstruction combining porcine- or bovine-derived acellular dermal matrices with a de-epithelialised dermal sling to protect and support the implant, while improving clinical outcomes in this challenging group of patients...
August 16, 2018: Annals of the Royal College of Surgeons of England
Karoly A Viragh, Seth A Cohen, Luyao Shen, Nicole Kurzbard-Roach, Shlomo Raz, Steven S Raman
Purpose To evaluate the performance of translabial (TL) US in preoperative detection of sling erosion into pelvic organs with cystourethroscopic and surgical correlation. Materials and Methods The study cohort included women who underwent surgery at a subspecialty center (from 2008 to 2016) for suspected mesh complications in the setting of previous midurethral sling placement for stress urinary incontinence (from 1999 to 2012) with available preoperative TL US imaging. Clinical information, the finding of sling erosion identified intraoperatively and at cystourethroscopy, and blinded dual-reader radiologic analysis of the TL US studies for mesh location (intraluminal, mural, or extramural) relative to pelvic organs (bladder, urethra, vagina, or rectum) were evaluated...
August 14, 2018: Radiology
Carol B Benson, Catherine H Phillips
No abstract text is available yet for this article.
August 14, 2018: Radiology
Yuan Peng, Yuman Li, Haiyan Cao, Liu Hong, Yu Wang, Mingxing Xie
A pulmonary artery (PA) sling is a very rare congenital cardiovascular anomaly, and only a few studies have reported PA slings in fetuses. The relationship of the PA, aorta, ductus arteriosus, and trachea can be evaluated in the 3-vessel and 3-vessel and trachea views during fetal echocardiography. A PA sling can be detected by abnormal positioning of the left PA in relation to the trachea when sweeping from the 3-vessel view cranially to the 3-vessel and trachea view. Here we report 3 cases of fetal PA slings and their follow-ups...
August 12, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Yoshiko Usui, Shigeru Ono, Katsuhisa Baba, Yuki Tsuji
PURPOSE: Congenital tracheal stenosis (CTS) is rare and challenging. Complete tracheal rings cause a wide spectrum of airway-obstructing lesions and varying degrees of respiratory distress. Although surgical reconstruction is the primary option for symptomatic CTS, sometimes an appropriate management strategy may be difficult due to other anomalies. We aimed to identify pitfalls in the management of CTS. METHODS: We retrospectively reviewed the records of patients with CTS during the last 10 years in our institution...
August 11, 2018: Pediatric Surgery International
Takashi Arai, Koji Yamaguchi, Tatsuya Ishikawa, Yoshikazu Okada, Go Matsuoka, Yoshihiro Omura, Takakazu Kawamata
Trigeminal neuralgia caused by vertebrobasilar dolichoectasia (VBD) is rare and challenging to treat. Some authors have reported techniques for treating trigeminal neuralgia caused by VBD using various kinds of objects, including clips, Proline slings, and titanium plates. Here, we report the effectiveness of cutting and splitting of the tentorium in three patients with trigeminal neuralgia. The clinical results were good, the pain disappeared in all patients without medication, and no complications occurred...
August 8, 2018: World Neurosurgery
Maximiliano Ranalletta, Agustin Bertona, Ignacio Tanoira, Gaston Maignon, Santiago Bongiovanni, Luciano A Rossi
The optimal management of recurrent anterior shoulder instability with significant glenoid bone loss continues to be a challenge. The high recurrence rates seen in arthroscopic Bankart repair in the presence of significant glenoid bone loss have led many surgeons to choose bony reconstructions to manage these injuries. The Latarjet procedure acts through the combination of 3 different mechanisms: the coracoid bone graft restores and extends the glenoid articular arc, the conjoint tendon acts as a dynamic sling on the inferior subscapularis and anteroinferior capsule when the arm is abducted and externally rotated, and the effect of repairing the capsule to the stump of the coracoacromial ligament...
July 2018: Arthroscopy Techniques
Ivan Ignjatovic, Dragoslav Basic, Milan Potic, Ljubomir Dinic, Aleksandar Skakic
INTRODUCTION: Distal urogenital fistulas (DUF) are usually iatrogenic and are uncommon in Europe. They occur in the urethra or near the bladder neck, and can be caused by vaginal hysterectomy, para-urethral cyst surgery, or erosion of the bladder or urethra from tension-free slings or meshes. The psychological and physical health consequences of DUF are devastating because most patients consider themselves "healthy" before surgery. Incontinence can appear after successful DUF closure due to previously occult incontinence or urethral incompetence...
August 1, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Ana L G Pascom, Lucyana M Djehdian, Maria A T Bortolini, Zsuzsanna I K Jarmy-Di Bella, Carlos A Delroy, Jose T N Tamanini, Rodrigo A Castro
BACKGROUND: The role of single-incision mini-slings (SIMS) in stress urinary incontinence (SUI) management is still not elucidated. OBJECTIVE: To compare efficacy and safety of SIMS and transobturator sling (TOT) for SUI after 36-month follow-up. METHODS: A randomized controlled clinical trial involving 130 women with SUI that had either SIMS or TOT. Primary outcomes: objective cure defined as negative cough stress and pad tests, and subjective cure reported as satisfaction and no desire for additional treatment...
August 8, 2018: Neurourology and Urodynamics
Alexander Kretschmer, Christian Gratzke
Persistent stress urinary incontinence following surgical treatment of bladder outlet obstruction based on benign prostate enlargement (BPE) occurs at an incidence of approximately 2.2 %, although incidence rates vary significantly between different surgical options. Current evidence on SUI treatment of BPE patients is usually based on postprostatectomy incontinence patient cohorts or small subgroup analyses of greater patient collectives. Studies that focus on SUI after surgical treatment of BPE are still rare...
August 2018: Aktuelle Urologie
Sarah Woltz, Pieta Krijnen, Inger B Schipper
OBJECTIVES: To evaluate mid-term patient-reported satisfaction and residual symptoms after plate fixation (PF) or nonoperative treatment (NOT) for displaced midshaft clavicular fractures. DESIGN: Follow-up survey of randomized controlled trial. SETTING: Sixteen teaching and nonteaching hospitals. PARTICIPANTS: All 160 patients with a fully displaced, midshaft clavicular fracture that had been randomized were approached by telephone...
July 16, 2018: Journal of Orthopaedic Trauma
Shu-Yu Wu, Hann-Chorng Kuo
INTRODUCTION AND HYPOTHESIS: The suburethral sling procedure has been widely used as the first-line treatment for stress urinary incontinence (SUI) in women. Although the success rate is high, difficult urination and urine retention can occur in a small portion of patients. A transvaginal sling incision can solve this problem but recurrent SUI may occur. This study investigated the long-term outcomes of women who underwent the pubovaginal sling (PVS) procedure and subsequent transvaginal sling incision for urethral obstruction...
August 6, 2018: International Urogynecology Journal
Margrethe Foss Hansen, Gunnar Lose, Hrefna Bóel Sigurdardòttir, Kim Oren Gradel
INTRODUCTION AND HYPOTHESIS: Synthetic midurethral slings (MUSs) have shown similar cure rates in several short- and medium-term follow-up studies. Recently, long-term follow-up studies have indicated that the cure rate is higher following the retropubic midurethral sling (RPMUS) compared with the transobturator midurethral sling (TOMUS) procedure. The aim was to evaluate the efficacy of synthetic MUSs and to examine the influence of department and surgeon volume and patient-related factors on the cure rate of synthetic MUSs...
August 2, 2018: International Urogynecology Journal
Sameh Fayek GamalEl Din, Ahmed Fathy Abo Sief, Emad Awny Fawzy, Mohamed Abd El Fatah, Wessam Gamal Abo Senna
A 46 year-old male presented suffering from refractory erectile dysfunction. The patient had a past history of pelvic chondro-sarcoma. This case was a challenge for us; the surgery performed for excision of the sarcoma has resulted in the elimination of both pubic ramia together with excision of part of both corpora and left hemiscrotum. The procedure included a sling application on one side with a mesh sock wrapped around the rear part of the extendor cylinder. Another sling was applied on the contra lateral side without a mesh sock...
January 2018: Revista Internacional de Andrología
David Alao, Suzy Emily Connor
A 40-year-old woman presented to the emergency department with a painful left shoulder following a fall from a mountain bike. A radiograph of the clavicle and shoulder was carried out. A diagnosis of fractured left clavicle was made, which was treated conservatively in a sling. On day 3, she was reviewed in the fracture clinic and was found to still be in pain with reduced movement of the shoulder joint. A repeat radiograph of the shoulder joint showed a posterior dislocation. This required a closed reduction under general anaesthesia...
July 30, 2018: BMJ Case Reports
Nemi M Shah, Lindsey A Jackson, John N Phelan, Marlene M Corton
BACKGROUND: Mesh resection for refractory pain after transobturator midurethral sling may require exploration of structures different than those involved in insertion. Our objective was to describe the muscular and neurovascular anatomy of the medial thigh compartment. METHODS: Dissections were performed in unembalmed female cadavers. Relationships of medial thigh structures were evaluated relative to the midpubic arch and obturator nerve. An out-to-in transobturator tape was passed in a subset of cadavers, and its relationships to the obturator nerve and adductor muscles were examined...
July 24, 2018: Female Pelvic Medicine & Reconstructive Surgery
Tsia-Shu Lo, Nagashu Shailaja, Sandy Chua, Ling-Hong Tseng, Chuan-Chi Kao, Ming-Ping Wu
STUDY OBJECTIVE: To evaluate the clinical outcome and identify risk factors for failure of Solyx™ single-incision sling (SIS) in the treatment of urodynamic stress incontinence (USI). DESIGN: Retrospective observational study (Canadian Task Force classification II-2) SETTING: Tertiary referral center PATIENTS: Patients diagnosed with USI without needing concurrent procedures that underwent continence surgery using the Solyx SIS from February 2015 to May 2017. INTERVENTIONS: Anti-incontinence surgery MEASUREMENTS AND MAIN RESULTS: The primary outcome of this study is the rate of objective cure defined as the absence of demonstrable leakage of urine on the cough stress test and a 1-hour pad test weight of less than two grams...
July 21, 2018: Journal of Minimally Invasive Gynecology
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