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Intrinsic sphincter deficiency

Shirish Dattatraya Yande, Omkar Vinay Joglekar, Maya Joshi
INTRODUCTION: Role of urodynamics prior to surgery of stress urinary incontinence (SUI) is under constant debate. Demonstration of the presence of detrusor overactivity is the only aspect that has been emphasized in the literature so far. We believe that there are number of other factors which may influence the evaluation and in turn the choice of surgical management and prediction of outcome of treatment. They are as follows: (1) Presence of voiding inefficiency, (2) asymptomatic detrusor overactivity, (3) and severity of SUI...
July 2016: Journal of Mid-life Health
J Koudy Williams, Gopal Badlani, Ashley Dean, Shannon Lankford, Kimberly Poppante, Tracy Criswell, Karl-Erik Andersson
BACKGROUND: Many factors may influence the efficacy of cell therapy for intrinsic urinary sphincter deficiency (ISD), including the route of administration of the cells and the condition of the sphincter. The goal of this study was to compare local versus intravenous administration of autologous skeletal muscle precursor cells (skMPCs) when administered to nonhuman primates (NHPs) with either acute or chronic ISD. METHODS: Thirty-two adult female monkeys were divided into eight groups (n = 4/group): (1) control; (2) surgically induced ISD/no treatment; (3) acute ISD (6-week duration)/local vehicle only; (4) acute ISD/local skMPC injection; (5) acute ISD/systemic skMPC; (6) chronic ISD (6-month duration)/local vehicle; (7) chronic ISD/local skMPC; (8) chronic ISD/systemic skMPC...
October 7, 2016: Stem Cell Research & Therapy
Caroline Massot, Hichem Khenioui, Olivier Agnani, Marc-Alexandre Guyot, Patrick Hautecoeur, Cécile Donze
PURPOSE: To report the prevalence and risk factors of stress urinary incontinence (SUI) and the prevalence of intrinsic sphincter deficiency in women with multiple sclerosis (MS). METHODS: We conducted a retrospective study. Female patients with MS, followed for lower urinary tract symptoms (LUTS) during a 15-year period were included. Demographic data, MS history, expanded disability status scale (EDSS) score at the urodynamic visit, obstetrical past, birth weight, LUTS, and urodynamic findings were collected...
September 2016: International Neurourology Journal
Emanuel C Trabuco, Christopher J Klingele, Roberta E Blandon, John A Occhino, Amy L Weaver, Michaela E McGree, Maureen A Lemens, John B Gebhart
OBJECTIVE: To compare efficacy and safety of retropubic Burch urethropexy and a midurethral sling in women with stress urinary incontinence (SUI) undergoing concomitant pelvic floor repair with sacrocolpopexy. METHODS: Women were randomly assigned to Burch retropubic urethropexy (n=56) or retropubic midurethral sling (n=57) through dynamic allocation balancing age, body mass index, history of prior incontinence surgery, intrinsic sphincter deficiency, preoperative incontinence diagnosis, and prolapse stage...
October 2016: Obstetrics and Gynecology
Aparna Hegde, Vivian C Aguilar, G Willy Davila
INTRODUCTION AND HYPOTHESIS: To determine the prevalence of levator ani (LA) muscle subdivision defects in patients with SUI using three-dimensional endovaginal ultrasound (3D EVUS). METHODS: This is a prospective cohort study of 100 patients with pure or predominant urodynamic SUI who underwent 3D EVUS. The 3D cubes obtained were analyzed and the LA muscle was divided into three subgroups: the puboperinealis/puboanalis, the puborectalis, and the iliococcygeus/pubococcygeus...
July 8, 2016: International Urogynecology Journal
Eu Chang Hwang, Sun Ouck Kim, Dong Deuk Kwon
PURPOSE: To assess the reproducibility of the Valsalva leak point pressure (VLPP) based on urodynamics in females with stress urinary incontinence (SUI). MATERIALS AND METHODS: From October 2008 to December 2009, 65 consecutive women with urodynamically confirmed SUI underwent duplicate VLPP measurements. The intra-individual reproducibility of the VLPP recording obtained by one urologist was determined. The two observations were separated by a 10-min interval. RESULTS: The differences between the repeated measurements were not significant (initial vs...
2016: Urology Journal
J Koudy Williams, Ashley Dean, Sherif Badra, Shannon Lankford, Kimberly Poppante, Gopal Badlani, Karl-Erik Andersson
PURPOSE: Mixed efficacy results of autologous skeletal muscle precursor cell (skMPC) therapy for women with chronic intrinsic urinary sphincter deficiency (ISD) has increased interest in the therapeutic value of alternative regenerative medicine approaches. The goal of this study was to compare the effects of the cell homing chemokine CXCL12 and skMPCs on chronic urinary sphincter regeneration in chronic ISD. MATERIALS AND METHODS: Five million autologous skMPCs, or 100 ng CXCL12, were injected into the urinary sphincter complex of adult female cynomolgus monkeys with chronic (6 months duration) ISD...
June 4, 2016: Journal of Urology
Romain Boissier, Jeremy Magalon, Florence Sabatier, Julie Veran, Laurent Giraudo, Sophie Giusiano, Stephane Garcia, Françoise Dignat-George, Laurent Arnaud, Guy Magalon, Eric Lechevallier, Stephane Berdah, Gilles Karsenty
PURPOSE: To evaluate the healing abilities of autologous stem cell therapy (stromal vascular fraction) prepared from adipose tissue we used an automated system without an ex vivo culture phase in a pig model of intrinsic sphincteric deficiency. MATERIALS AND METHODS: A total of 15 pigs underwent endoscopic section of the urethral sphincter. Animals were then randomly assigned to 3 groups, including 1) controls without stromal vascular fraction injection, 2) early injection with stromal vascular fraction 2 to 3 days after section and 3) late stromal vascular fraction injection delivery 30 days after injury...
September 2016: Journal of Urology
Hyeong Gon Kim, Hyoung Keun Park, Sung Hyun Paick, Woo Suk Choi
BACKGROUND: The aim of this study was to compare the two types of mid-urethral slings for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD). METHODS: This retrospective study included patients who underwent tension-free vaginal tape (TVT) procedure or transobturator tape (TOT) procedure by a single surgeon for SUI with ISD, defined as Valsalva leak point pressure (VLPP) < 60 cmH2O in a urodynamic study. Cases of neurogenic bladder, previous SUI surgery, and concomitant cystocele repair were excluded...
2016: PloS One
F A Valentini, P P Nelson, P E Zimmern, G Robain
AIMS: We assume that the voiding process in women is governed by the detrusor contractility and a "urethral resistance". The value of these 2 parameters, respectively named k and U in the VBN (Valentini-Besson-Nelson) mathematical model of micturition is deduced from the VBN analysis of pressure-flow recordings (PFs). Our objectives were to search for a correlation between these 2 parameters and clinically relevant variables such as chief complaint, urodynamic diagnosis (UD), and age by decades...
June 2016: Progrès en Urologie
Claudio Giberti, Fabrizio Gallo, Pierluigi Cortese, Francesco Visalli
AIMS: To retrospectively report our mid- to long-term results following suburethral tension adjustable sling (Remeex system) implantation for stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD). METHODS: Fifty female patients with severe SUI due to ISD underwent Remeex system positioning between May 2002 and March 2013 (mean follow-up 83.8 months, median follow-up 85.4 months). Before surgery, patients were evaluated by physical examination, translabial ultrasonography, cystoscopy, urodynamics, 1 hr pad test and compilation of quality-of-life questionnaire...
April 15, 2016: Neurourology and Urodynamics
Farzaneh Sharifiaghdas, Farzam Tajalli, Maryam Taheri, Mohammad Naji, Reza Moghadasali, Nasser Aghdami, Hossein Baharvand, Vajihe Azimian, Neda Jaroughi
OBJECTIVES: To evaluate the effect of autologous muscle-derived cells injection in the treatment of complicated stress urinary incontinence in female patients. METHODS: Female patients presenting with severe and complicated stress urinary incontinence secondary to the bladder neck and/or urethral trauma or congenital epispadias (with or without exstrophy) were enrolled in this prospective study. They underwent transurethral injection of autologous muscle-derived cells...
July 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Célia Amorim-Costa, Valentina Billone, Benoît Rabischong, Nicolas Bourdel, Gaspare Cucinella, Michel Canis, Revaz Botchorishvili
STUDY OBJECTIVE: To describe a technique for the safe placement of retropubic midurethral slings in patients undergoing concomitant laparoscopic surgery in order to avoid major complications associated with this procedure such as bladder perforation and retropubic hematomas. DESIGN: Step-by-step video demonstration of the technique. SETTING: A university tertiary care hospital. PATIENTS: Patients with an indication for retropubic midurethral sling placement because of recurrent stress urinary incontinence, intrinsic sphincter deficiency, or severe pelvic organ prolapse in whom a concomitant laparoscopic surgery has to be performed for other medical conditions...
September 2016: Journal of Minimally Invasive Gynecology
J V Baldissera-Aradas, L Rodríguez-Villamil, I González-Rodríguez, R Gil-Ugarteburu, S Fernández-Pello-Montes, J Mosquera-Madera
INTRODUCTION: The failure rate for anti-incontinence surgery ranges from 5% to 80%. There is not actual consensus on the use of artificial urinary sphincter (AUS) as treatment for recurrent urinary incontinence in women. Several authors have shown that AUS can be useful, if the intrinsic sphincteric deficiency is checked. We present the first case in Spain, to our knowledge, of laparoscopic implantation of AUS as treatment for female recurrent urinary incontinence. MATERIAL AND METHODS: Under general anaesthesia, patient was placed in supine decubitus with slight Trendelenburg, access to the vagina was verified...
July 2016: Actas Urologicas Españolas
Jeremy B Myers, Erik N Mayer, Sara Lenherr
Neurogenic bladder is a very broad disease definition that encompasses varied disease and injury states affecting the bladder. The majority of patients with neurogenic bladder dysfunction do not have concomitant intrinsic sphincteric deficiency (ISD), but when this occurs the challenges of management of urinary incontinence from neurogenic bladder are compounded. There are no guidelines for surgical correction of ISD in adults and most of the literature on treatment of the problem comes from treatment of children with congenital diseases, such as myelomeningocele...
February 2016: Translational Andrology and Urology
I-Shen Huang, Yu-Hua Fan, Alex T L Lin, Kuang-Kuo Chen
OBJECTIVE: The correlation between bladder neck mobility (BNM) and voiding function in females has not been examined before. This study investigated the correlation between BNM and voiding phase urodynamic parameters in female patients with stress urinary incontinence (SUI). METHODS: We recruited female patients with SUI between January 2005 and 2010. All patients underwent video urodynamic study (VUDS) including measurement of the bladder neck descent using the Valsalva maneuver and leak point pressure...
January 2016: Lower Urinary Tract Symptoms
Tsia-Shu Lo, Leng Boi Pue, Yiap Loong Tan, Pei-Ying Wu
INTRODUCTION AND HYPOTHESIS: To study the outcomes following repeat midurethral sling (MUS) surgery in patients with persistent or recurrent stress urinary incontinence after failure of primary MUS surgery and risk factors for surgical failure. METHODS: The medical records of 24 patients who underwent repeat MUS surgery at a single tertiary center from January 2004 to February 2014 were reviewed. The types of MUS used for the repeat surgey were transobturator, retropubic and single incision slings...
June 2016: International Urogynecology Journal
Katarzyna Jadwiga Macura, Richard Eugene Thompson, David Alan Bluemke, Rene Genadry
AIM: To define the magnetic resonance imaging (MRI) parameters differentiating urethral hypermobility (UH) and intrinsic sphincter deficiency (ISD) in women with stress urinary incontinence (SUI). METHODS: The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic (UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the high-resolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI...
November 28, 2015: World Journal of Radiology
Mohammed S ElSheemy, Hisham Ghamrawy, Hesham Fathy, Hussein A Hussein, Eman A Hussein, Ahmed Aly, Sherif Abdel Rahman
OBJECTIVE: To evaluate the safety and efficacy of a procedure using surgeon-tailored polypropylene mesh (STM) through a needle-less single-incision technique for treating stress urinary incontinence (SUI), aiming to decrease the cost of treatment, which is important in developing countries. PATIENTS AND METHODS: In all, 43 women diagnosed using a cough stress test were treated from January 2011 to June 2013 at the Urology and Gynaecology Departments (dual-centre), Cairo University Hospitals...
September 2015: Arab Journal of Urology
Abigail A Ford, Joseph A Ogah
INTRODUCTION AND HYPOTHESIS: Stress urinary incontinence is a common problem affecting 12-46% of women. A cohort of women have a more severe form of stress urinary incontinence usually due to intrinsic urethral sphincter deficiency that has traditionally resulted in lower success rates with standard treatment modalities. We aim to address the question of whether transobturator sling insertion is more effective than retropubic sling insertion in the treatment of intrinsic sphincter deficiency-related stress urinary incontinence in women...
January 2016: International Urogynecology Journal
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