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midurethral slings

Julia Geynisman-Tan, Bhumy Dave-Heliker, Katarzyna Bochenska, Sarah Collins, Christina Lewicky-Gaupp, Margaret Mueller, Kimberly Kenton
OBJECTIVE: The objective of this study was to describe the expected duration of self-catheterization in women discharged home performing intermittent self-catheterization (ISC) after retropubic midurethral sling (RMUS). METHODS: We conducted a retrospective cohort analysis of women who underwent an isolated RMUS by 3 providers between 2009 and 2014 at a single institution. A 300 mL retrograde-fill voiding trial (VT) was performed before discharge. Those who failed their VT (postvoid residual [PVR] >1/3 total bladder volume [TBV]) and could perform ISC are included in this analysis...
March 5, 2018: Female Pelvic Medicine & Reconstructive Surgery
Marcella G Willis-Gray, Katherine E Husk, Taylor J Brueseke, Jennifer M Wu, Alexis A Dieter
OBJECTIVES: Our primary objective was to evaluate age as a predictor of postanesthesia care unit (PACU) opioid administration in women undergoing reconstructive pelvic surgery. Our secondary objective was to identify additional predictors of PACU opioid administration. METHODS: We conducted a retrospective cohort study of women undergoing outpatient urogynecologic surgery for pelvic organ prolapse and/or stress urinary incontinence between September 2015 to October 2016 at 1 academic medical center...
February 27, 2018: Female Pelvic Medicine & Reconstructive Surgery
Abigail Shatkin-Margolis, Catrina C Crisp, Christopher Morrison, Rachel N Pauls
OBJECTIVES: An ability to anticipate individuals at increased risk of postoperative pain would improve coordination of care and patient satisfaction. We sought to describe predictive factors of postoperative pain following vaginal reconstructive surgery. METHODS: This institutional review board-approved, retrospective study used previously collected data from research performed at 1 center from 2009 to 2015. Eligible trials enrolled subjects undergoing vaginal reconstructive surgery for pelvic organ prolapse...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Omar Felipe Dueñas-Garcia, Tania Sierra, Danielle Taylor, Katherine Leung, Cynthia D Hall, Michael K Flynn
OBJECTIVE: To determine the effect of preoperative oral phenazopyridine on postoperative voiding dysfunction in women undergoing a retropubic midurethral sling. METHODS: A single-institution randomized clinical trial was performed from September 2015 to March 2017, comparing 200 mg of oral phenazopyridine versus no phenazopyridine in patients undergoing a retropubic midurethral sling under general anesthesia with no concomitant procedures. A power calculation indicated that we required at least 40 subjects per arm...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Alex Fuselier, Jordan Hanberry, J Margaret Lovin, Alex Gomelsky
PURPOSE OF REVIEW: Obesity is highly prevalent and is associated with stress urinary incontinence (SUI). The purposes of this review are to assess the pathophysiology of SUI in the obese female and review the outcomes of weight loss and anti-incontinence surgery in this population. RECENT FINDINGS: While increased intra-abdominal pressure appears to be the common pathophysiologic link between obesity and SUI, neurogenic and metabolic pathways have been proposed...
February 22, 2018: Current Urology Reports
Erika J Wasenda, Anna C Kirby, Emily S Lukacz, Charles W Nager
AIMS: Traditional technology to characterize urethral pressure changes during dynamic conditions is limited by slow response times or artifact-inducing withdrawal maneuvers. The 8F high-resolution manometry (HRM) catheter (ManoScan™ ESO, Covidien) has advantages of fast response times and the ability to measure urethral pressures along the urethral length without withdrawal. Our objective was to determine static and dynamic maximum urethral closure pressures (MUCPs) and resting functional urethral length (FUL) in women using HRM before and after transurethral bulking and compare results to other women who underwent midurethral sling (MUS)...
February 21, 2018: Neurourology and Urodynamics
Daniel Altman, Rebecca G Rogers, Li Yin, Karl Tamussino, Weimin Ye, Cheryl B Iglesia
OBJECTIVE: To assess whether there is any association between the implantation of synthetic polypropylene mesh slings for the treatment of stress urinary incontinence (SUI) and risk of cancer. METHODS: We performed a nationwide cohort study based on the general female population in Sweden. All women entered the observational period as unexposed on January 1, 1997, and contributed person-time as unexposed unless they underwent a midurethral sling procedure for SUI, after which they contributed person-time as exposed until first occurrence of any cancer, death, emigration, or end of the observational period (December 31, 2009)...
March 2018: Obstetrics and Gynecology
Adi Y Weintraub, Yonatan Reuven, Dorit Paz-Levy, Zehava Yohay, Inbal Idan, Debi Elharar, Hannah Glinter, Tamar Tzur, David Yohay
OBJECTIVE: To investigate the prevalence and risk factors of urinary tract infection (UTI) one year following sub-midurethral sling (SMUS) incontinence surgery in a university affiliated medical center in southern Israel. METHODS: A retrospective cohort study was conducted to identify and characterize patients who suffered UTI within a year following SMUS surgery. The study population comprised of all patients who underwent a SMUS surgery between the years 2014 and 2015...
January 30, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Qiang Niu, Jinping Zheng, Xiaohui Han
Midurethral mesh sling is the most performed incontinence procedure. This hypotheses propose knotless barbed suture could be positioned as a tension-free trans-vaginal sling under the mid-urethra without vaginal incision. Knotless suture sling support and stabilize mid-urethra when intraabdominal pressure increase. This procedure is designed to replace midurethral mesh sling operation, aiming at reducing complications. It is completed in a similar way with retropubic mesh sling procedure, and less invasive...
February 2018: Medical Hypotheses
Margrethe Foss Hansen
This PhD thesis is based on three original articles. The studies were performed at the Department of Obstetrics and Gynaecology, Herlev University Hospital and at the Center for Clinical Epidemiology, Odense University Hospital. 
Urinary incontinence (UI) is a frequent disorder among women, which for the individual can have physical, psychological and social consequences. The current standard of surgical treatment is the synthetic midurethral sling (MUS), which is a minimal invasive procedure.
As the synthetic MUSs (TVT,TVT-O,TOT) were introduced in the late 1990s, there are only a few studies at the long-term follow-up based on nationwide populations; only a few have reported on the risk of reoperation and there is sparse evidence on which treatment should be used subsequently to failure of synthetic MUSs...
February 2018: Danish Medical Journal
Bryan Hill, Sarah Fletcher, Jeffrey Blume, Rony Adam, Renée Ward
INTRODUCTION: Stress urinary incontinence at a low bladder volume is a clinically observed phenomenon that is not well studied with regard to treatment outcomes. The primary aim of our study was to determine if the volume at first leak is associated with sling outcome. METHODS: This is a retrospective cohort study evaluating whether urodynamic stress urinary incontinence observed at low volumes is associated with sling failure using the Synthetic Derivative database...
January 30, 2018: Female Pelvic Medicine & Reconstructive Surgery
Casey G Kowalik, Joshua A Cohn, Andrea Kakos, Patrick Lang, W Stuart Reynolds, Melissa R Kaufman, Mickey M Karram, Roger R Dmochowski
INTRODUCTION AND HYPOTHESIS: Urethral injury resulting from transvaginal mesh slings is a rare complication with an estimated incidence of <1%. Our objective was to review the surgical management and functional outcomes of women presenting with urethral mesh perforation following midurethral sling (MUS) placement. METHODS: This was a retrospective multicenter review of women who from January 2011 to March 2016 at two institutions underwent mesh sling excision for urethral perforation with Female Pelvic Medicine and Reconstructive Surgery fellowship-trained surgeons...
January 29, 2018: International Urogynecology Journal
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
Erik D Hokenstad, Amy E Glasgow, Elizabeth B Habermann, John A Occhino
INTRODUCTION AND HYPOTHESIS: We aimed to determine the rate of readmission and reoperation for patients undergoing midurethral sling (MUS) placement for stress urinary incontinence (SUI). METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify all isolated MUS placed from 2012 through 2015 using the Current Procedural Terminology 4 (CPT-4) code for MUS with or without cystoscopy (57,288 ± 52,000)...
January 11, 2018: International Urogynecology Journal
Ida Bergman, Marie Westergren Söderberg, Andrea Lundqvist, Marion Ek
OBJECTIVE: To assess whether subsequent childbirths affect the outcomes of midurethral sling surgery with regard to stress urinary incontinence (SUI). METHODS: In this population-based cohort study, we used the validated Swedish nationwide health care registers (the Patient Register and the Medical Birth Register) to identify women with a delivery after midurethral sling surgery (n=207, study group). From the same registers we then randomly identified a control group who had no deliveries after their midurethral sling procedure (n=521, control group)...
February 2018: Obstetrics and Gynecology
Nabeel A Shakir, Connie Wang, Nirmish Singla, Feras Alhalabi, Alana Christie, Gary E Lemack, Philippe E Zimmern
PURPOSE: To determine the types and frequency of presenting symptoms in women undergoing sub-urethral mid-urethral sling removal (SSR) towards improving outcome reporting post-SSR. METHODS: Following IRB approval, women who underwent SSR of one MUS were evaluated for their presenting symptoms and correlation with the Urogenital Distress Inventory-Short form (UDI-6) questionnaire. Demographic data was recorded and patient-reported presenting symptoms were categorized into 5 domains: storage symptoms, voiding symptoms, pain, recurrent UTIs, or urinary incontinence (UI)...
January 4, 2018: Journal of Urology
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
Jinyang Chen, Chunlin Chen, Yige Li, Lan Chen, Juan Xu, Ping Liu
INTRODUCTION AND HYPOTHESIS: Morphological and functional anomalies of the urethra may cause stress urinary incontinence after radical hysterectomy (RH). We introduce a novel three-dimensional (3D) magnetic resonance imaging (MRI) technique to assess the impact of RH on the transobturator sling pathway. METHODS: 3D-MRI reconstruction models were retrospectively developed for the measurement of various parameters before and after RH, including puncture angle, orientation and distance from the midurethral puncture site to the obturator membrane (DUO), in 31 patients with cervical cancer...
December 14, 2017: International Urogynecology Journal
Päivi Rahkola-Soisalo, Tomi S Mikkola, Daniel Altman, Christian Falconer
OBJECTIVE: This study aimed to assess the long-term (5 years) outcomes of the Uphold Vaginal Support System for symptomatic vaginal apical prolapse with or without anterior colporraphy. METHODS: In total, 164 (81.2%) of 202 women operated on in 24 centers were reached for follow-up. Outcomes were assessed by using the Pelvic Organ Prolapse Quantification, the Pelvic Floor Distress Inventory 20, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire questionnaires...
December 11, 2017: Female Pelvic Medicine & Reconstructive Surgery
Emanuel C Trabuco, Brian J Linder, Christopher J Klingele, Roberta E Blandon, John A Occhino, Amy L Weaver, Michaela E McGree, John B Gebhart
OBJECTIVE: To evaluate 1- and 2-year urinary continence rates after Burch retropubic urethropexy compared with a retropubic midurethral sling for women with urinary incontinence undergoing sacrocolpopexy. METHODS: We conducted a planned secondary analysis of a multicenter, randomized, single-blind trial comparing Burch with a sling that enrolled participants from June 2009 to August 2013. Objective outcome measures of continence were assessed at 1- and 2-year follow-up through office visits and validated questionnaires...
January 2018: Obstetrics and Gynecology
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