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Gasmi A, Perrouin-Verbe MA, Hascoet J, Bey E, Jezequel M, Voiry C, Perrouin-Verbe B, Gamé X, Manunta A, Lenormand L, Capon G, Peyronnet B. Long-term outcomes of artificial urinary sphincter in female patients with spina bifida. Neurourol Urodyn 2020; 40:412-420. [PMID: 33197064 DOI: 10.1002/nau.24576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/21/2020] [Accepted: 10/31/2020] [Indexed: 02/04/2023]
Abstract
AIMS To report the long-term functional outcomes of artificial urinary sphincter (AUS) implantation in female patients with spinal dysraphism and stress urinary incontinence (SUI) related to intrinsic sphincter deficiency (ISD). METHODS The charts of all spina bifida female patients with SUI due to ISD who underwent AUS (AMS 800) implantation between 2005 and 2019 at three academic departments of urology were retrospectively reviewed. Reoperation was defined as either revision or explantation of the AUS device. Reoperation-free survival of the AUS device was estimated using the Kaplan-Meier method. Continence status as per patients' subjective assessment was categorized as follows: complete continence (no pads), improved continence, unchanged SUI or worsened SUI. RESULTS Twenty-three patients were included, 69.6% were self-catheterizing. The median follow-up was 14 years. Median time to first reoperation was 10 years. Survival rates without reoperation were 85.9%, 41.8%, 34.6%, and 20.9% at 5, 10, 15, 20 years, respectively. Survival rates without AUS explantation were 90.7%, 66.3%, 55.2%, and 41.4% at 5, 10, 15, 20 years, respectively. None of the patients who underwent device explantation had a new AUS implanted. The only predictive factor of reoperation-free survival was the type of spinal dysraphism (hazards ratio = 3.60 for closed vs. open dysraphism; p = .04). At last follow-up, 17 of the 23 patients were fully continent (73.9%). CONCLUSION AUS in female patients with spina bifida may be associated with satisfactory long-term functional outcomes and a high reoperation rate. The median time to first reoperation was similar to what is reported in the male AUS literature (10 years).
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Affiliation(s)
- Anis Gasmi
- Department of Urology, University of Rennes, Rennes, France
| | | | - Juliette Hascoet
- Department of Urology, University of Rennes, Rennes, France
- French referral network of Spina Bifida, Rennes University Hospital, Rennes, France
| | - Elsa Bey
- Department of Urology, University of Nantes, Nantes, France
| | - Magali Jezequel
- Department of Urology, University of Rennes, Rennes, France
- French referral network of Spina Bifida, Rennes University Hospital, Rennes, France
| | - Caroline Voiry
- Department of Urology, University of Rennes, Rennes, France
- French referral network of Spina Bifida, Rennes University Hospital, Rennes, France
| | | | - Xavier Gamé
- Department of Urology, University of Toulouse, Toulouse, France
| | - Andrea Manunta
- Department of Urology, University of Rennes, Rennes, France
- Department of Urology, University of Nantes, Nantes, France
| | - Loic Lenormand
- French referral network of Spina Bifida, Rennes University Hospital, Rennes, France
| | - Grégoire Capon
- Department of Urology, University of Bordeaux, Bordeaux, France
| | - Benoit Peyronnet
- Department of Urology, University of Rennes, Rennes, France
- Department of Urology, University of Nantes, Nantes, France
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Myers JB, Mayer EN, Lenherr S. Management options for sphincteric deficiency in adults with neurogenic bladder. Transl Androl Urol 2016; 5:145-57. [PMID: 26904420 PMCID: PMC4739985 DOI: 10.3978/j.issn.2223-4683.2015.12.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
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. Our goal, in this review, is to present some of the common surgical options for ISD [including artificial urinary sphincters, bladder slings, bladder neck reconstruction (BNR) and urethral bulking agents] and the evidence underlying these treatments in adults with neurogenic bladder.
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Affiliation(s)
- Jeremy B Myers
- The Center for Reconstructive Urology, Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Erik N Mayer
- The Center for Reconstructive Urology, Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Sara Lenherr
- The Center for Reconstructive Urology, Department of Surgery, University of Utah, Salt Lake City, Utah, USA
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Nakamura S, Hyuga T, Kawai S, Nakai H. Long-Term Outcome of the Pippi Salle Procedure for Intractable Urinary Incontinence in Patients with Severe Intrinsic Urethral Sphincter Deficiency. J Urol 2015; 194:1402-6. [DOI: 10.1016/j.juro.2015.05.095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Shigeru Nakamura
- Department of Pediatric Urology, Jichi Medical University, Children’s Medical Center Tochigi, Tochigi, Japan
| | - Taiju Hyuga
- Department of Pediatric Urology, Jichi Medical University, Children’s Medical Center Tochigi, Tochigi, Japan
| | - Shina Kawai
- Department of Pediatric Urology, Jichi Medical University, Children’s Medical Center Tochigi, Tochigi, Japan
| | - Hideo Nakai
- Department of Pediatric Urology, Jichi Medical University, Children’s Medical Center Tochigi, Tochigi, Japan
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El-Azab AS, El-Nashar SA. Midurethral slings versus the standard pubovaginal slings for women with neurogenic stress urinary incontinence. Int Urogynecol J 2014; 26:427-32. [DOI: 10.1007/s00192-014-2521-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/18/2014] [Indexed: 11/30/2022]
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Snodgrass W, Villanueva C, Gargollo P, Jacobs M. New hydronephrosis and/or vesicoureteral reflux after bladder outlet surgery without augmentation in 75 children with neurogenic bladder. J Pediatr Urol 2014; 10:906-10. [PMID: 24680474 DOI: 10.1016/j.jpurol.2014.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 02/20/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We report new upper tract changes in children after bladder neck (BN) surgery without augmentation for neurogenic incontinence. MATERIALS AND METHODS Consecutive children with neurogenic sphincteric incompetency had BN surgery without augmentation. Postoperative renal sonography and fluoroscopic urodynamics were done at 6 months, 12 months, and then annually. RESULTS There were 75 patients with mean follow-up of 48 months. Of these, 17 (23%) developed new hydronephrosis (HN) or vesicoureteral reflux (VUR). All HN resolved with medical management, as did 25% of VUR cases. Persistent VUR was treated by dextranomer/hyaluronic acid injection, or re-implantation in two patients undergoing re-operative BN surgery. There was no association between these upper tract changes and end filling pressures (<40 cm vs. >40 cm) or continence status (dry vs. wet). CONCLUSIONS Upper tract changes developed in 25% of patients with neurogenic bladders after BN surgery without augmentation during a follow-up of 48 months. All new HN and most new VUR resolved with medical management or minimally invasive intervention. No patient developed upper tract changes requiring augmentation.
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Affiliation(s)
- W Snodgrass
- UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9142, USA.
| | - C Villanueva
- University of Nebraska Medical Center, 988102 Nebraska Medical Center, Omaha, NE 68196-8102, USA.
| | - P Gargollo
- UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9142, USA.
| | - M Jacobs
- UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9142, USA.
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Haylen BT, Avery D, Chiu TL. Severe adolescent female stress urinary incontinence (SAFSUI): case report and literature review. Int Urogynecol J 2013; 25:393-6. [PMID: 24030217 DOI: 10.1007/s00192-013-2220-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/27/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Severe adolescent female stress urinary incontinence (SAFSUI) can be defined as female adolescents between the ages of 12 and 17 years complaining of involuntary loss of urine multiple times each day during normal activities or sneezing or coughing rather than during sporting activities. An updated review of its likely prevalence, etiology, and management is required. MATERIALS AND METHODS The case of a 15-year-old female adolescent presenting with a 7-year history of SUI resistant to antimuscarinic medications and 18 months of intensive physiotherapy prompted this review. Issues of performing physical and urodynamic assessment at this young age were overcome in order to achieve the diagnosis of urodynamic stress incontinence (USI). Failed use of tampons was followed by the insertion of (retropubic) suburethral synthetic tape (SUST) under assisted local anesthetic into tissues deemed softer than the equivalent for an adult female. RESULTS Whereas occasional urinary incontinence can occur in between 6 % and 45 % nulliparous adolescents, the prevalence of non-neurogenic SAFSUI is uncertain but more likely rare. Risk factors for the occurrence of more severe AFSUI include obesity, athletic activities or high-impact training, and lung diseases such as cystic fibrosis (CF). This first reported use of a SUST in a patient with SAFSUI proved safe and completely curative. Artificial urinary sphincters, periurethral injectables and pubovaginal slings have been tried previously in equivalent patients. CONCLUSIONS SAFSUI is a relatively rare but physically and emotionally disabling presentation. Multiple conservative options may fail, necessitating surgical management; SUST can prove safe and effective.
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Affiliation(s)
- Bernard T Haylen
- St Vincent's Clinic, Suite 904, 438 Victoria Street, Darlinghurst, 2010, NSW, Australia,
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de Kort L, Bower W, Swithinbank L, Marschall-Kehrel D, de Jong T, Bauer S. The management of adolescents with neurogenic urinary tract and bowel dysfunction. Neurourol Urodyn 2012; 31:1170-4. [DOI: 10.1002/nau.22206] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 01/10/2012] [Indexed: 11/11/2022]
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Abstract
Initial care of newborns with spina bifida centers on preventing bladder and upper tract damage from detrusor leak point pressure of greater than 40 cm H(2)O. The authors recommend using urodynamic-based management to select patients with elevated pressures for anticholinergic therapy and intermittent catheterization (CIC), using diapers and observation with biannual renal sonography for the remainder. At the age of toilet training, children who have urodynamic evidence of uninhibited contractions or rising pressure during filling are started on anticholinergics and CIC, or have their dosage increased until pressures less than 40 cm H(2)O and areflexia are achieved. Sphincter incompetency is diagnosed in incontinent children with pressures less than 40 cm H(2)O and areflexia or stress incontinence. Augmentation is indicated in patients with hydronephrosis or reflux and end-filling pressures or DLPP less than 40 cm H(2)O despite medical management to the point of patient tolerance. A minority of patients, not yet well-defined, will also need augmentation after bladder outlet surgery for similar postoperative indications.
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Affiliation(s)
- Warren T Snodgrass
- Department of Urology, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX 75207, USA.
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Snodgrass W, Barber T, Cost N. Detrusor Compliance Changes After Bladder Neck Sling Without Augmentation in Children With Neurogenic Urinary Incontinence. J Urol 2010; 183:2361-6. [DOI: 10.1016/j.juro.2010.02.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Indexed: 10/19/2022]
Affiliation(s)
- Warren Snodgrass
- Pediatric Urology Section, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, Texas
| | - Theodore Barber
- Pediatric Urology Section, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, Texas
| | - Nicholas Cost
- Pediatric Urology Section, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, Texas
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Stress Urinary Incontinence in Women with Neurogenic Voiding Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2010. [DOI: 10.1007/s11884-010-0060-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Urologic care of adults with spina bifida. CURRENT BLADDER DYSFUNCTION REPORTS 2009. [DOI: 10.1007/s11884-009-0027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Canales BK, Fung LCT, Elliott SP. Miniature Intravesical Urethral Lengthening Procedure for Treatment of Pediatric Neurogenic Urinary Incontinence. J Urol 2006; 176:2663-6; discussion 2666-7. [PMID: 17085188 DOI: 10.1016/j.juro.2006.08.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Indexed: 11/25/2022]
Abstract
PURPOSE Resistance to flow in a fluid conduit is proportional to tube length divided by the radius to the fourth power (Poiseuille's law). We report the results of a miniature intravesical urethral lengthening procedure where outlet resistance is increased by minimizing the diameter of the intravesical urethral tube. MATERIALS AND METHODS Nine pediatric patients with preoperative intractable incontinence underwent the miniature intravesical urethral lengthening procedure along with continent catheterizable stoma (9 patients) and bladder augmentation (8). The intravesical portion of the urethral lengthening was 3 cm (traditionally 6 cm), and the urethra was tubularized around an 8Fr feeding tube (traditionally a 16Fr catheter). After the tubularized caudal portion was tunneled under the trigone the cephalad part of the urethra was placed as an onlay to the posterior bladder wall without ureteral reimplantation. RESULTS At a mean followup of 31 months (range 10 to 47) 8 patients reported dry intervals of 3 hours or more, with minor leak per urethra only if they were overdue on the catheterization schedule. Mean postoperative abdominal leak point pressure was 71 cm H(2)O (range 28 to 116). Upper tracts were well preserved in all patients. One patient required bladder neck closure for intractable incontinence. CONCLUSIONS The miniature intravesical urethral lengthening procedure requires minimal bladder tissue and is easy to perform. It appears to be an effective alternative in bladder neck reconstructive techniques, avoiding the need for ureteral reimplantation due to its small size, while functioning as a pop-off valve when the bladder is overly full. This procedure should be avoided in patients who lack a trigonal bar.
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Affiliation(s)
- Benjamin K Canales
- Department of Urologic Surgery, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
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Castellan M, Gosalbez R, Labbie A, Ibrahim E, Disandro M. BLADDER NECK SLING FOR TREATMENT OF NEUROGENIC INCONTINENCE IN CHILDREN WITH AUGMENTATION CYSTOPLASTY: LONG-TERM FOLLOWUP. J Urol 2005; 173:2128-31; discussion 2131. [PMID: 15879865 DOI: 10.1097/01.ju.0000157688.41223.d2] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE We retrospectively reviewed the outcome and long-term followup (mean 4.16 years) of bladder neck slings for the treatment of neurogenic urinary incontinence in 58 patients (15 males) who also underwent bladder augmentation. MATERIALS AND METHODS A total of 58 patients with neurogenic bladder (43 females and 15 males, median age 11.4 years) underwent a rectus fascial sling procedure as part of the reconstructive efforts for continence between July 1991 and July 2003. Criteria for enhancement of bladder outlet resistance included a detrusor leak point pressure of less than 45 cm H2O, an open bladder neck during bladder filling at low detrusor pressures and clinical evidence of stress incontinence. RESULTS Followup ranged from 1 year to 10 years, 3 months (mean 4.16 years). A total of 51 patients (88%) obtained good continence results. Five females and 2 males remained incontinent following the sling procedure. Four females underwent a secondary open bladder neck procedure at a mean of 18 months after the initial procedure (artificial urinary sphincter in 2, bladder neck closure in 2). Two male patients (5 and 17 years old) had daily underwear staining or dampness with exercise or transfer. CONCLUSIONS We consider bladder neck slings the procedure of choice for the enhancement of bladder outlet resistance in the majority of patients with neurogenic bladder who need augmentation cystoplasty and whom we do not expect will be capable of voiding spontaneously. In males and females satisfactory long-term continence can be expected with the use of the rectus fascial sling.
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Affiliation(s)
- M Castellan
- Division of Pediatric Urology, Miami Children's Hospital and Jackson Memorial Hospital, and Department of Urology, University of Miami, Miami, Florida, USA
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Siracusano S, Ciciliato S, Benedetto PD, Marega D, Tiberio A, Stacul F. An unusual use of AMS 800 artificial urinary sphincter cuff in the treatment of sphincteric neurogenic incontinence: case report. Spinal Cord 2004; 42:652-4. [PMID: 15249927 DOI: 10.1038/sj.sc.3101624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Case report of an unusual use of AMS 800 (American Medical Systems, Inc., Minnetonka, Minnesota) artificial urinary sphincter cuff in a female patient affected by neurogenic urinary incontinence. OBJECTIVE To describe this rare surgical solution. SETTING Department of Urology in Italy. METHODS A 43-year-old woman affected by flaccid paraplegia, acontractile bladder and incompetent bladder neck, underwent an implantation of an artificial urinary sphincter AMS 800. After 7 years, a mechanical failure of the device occurred and pubovaginal sling (PVS) utilizing the cuff of the sphincter was employed due to the poor quality of rectus fascia and the development of previous allergy for some heterologous materials. RESULTS At 17 months follow-up, the patient is content and able to empty the bladder by clean intermittent self-catheterization (CIC). CONCLUSION The risk of developing an allergy reaction due to the employment of heterologous materials and the impossibility to use the rectus fascia obliged us to adopt the pre-existent cuff of the artificial urinary sphincter AMS 800.
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Affiliation(s)
- S Siracusano
- Department of Urology, University of Trieste, Trieste, Italy
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Godbole P, Bryant R, MacKinnon AE, Roberts JP. Endourethral injection of bulking agents for urinary incontinence in children. BJU Int 2003; 91:536-9. [PMID: 12656911 DOI: 10.1046/j.1464-410x.2003.04127.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the early and late outcome of endourethral injection with bulking agents in children with urinary incontinence (a neuropathic bladder or exstrophy-epispadias complex), by reviewing our experience over a 5-year period. PATIENTS AND METHODS The records of 15 children (10 boys) were reviewed retrospectively; 10 had spina bifida and a neurogenic bladder, four had a neurogenic bladder from other causes and one had epispadias. All children had a stable low-pressure detrusor and a compliant bladder with sphincteric weakness on preoperative urodynamic testing. Four children had undergone previous enterocystoplasty with a Mitrofanoff stoma, with concomitant urethral lengthening in two and a Goretex trade mark bladder neck sling in two. Three children voided spontaneously while 12 depended on intermittent catheterization. The agent was injected under general anaesthesia in all patients but one, with an endourethral submucosal injection of the bulking agent into four or more points at the junction of the bladder neck and proximal urethra, aiming to obtain visual occlusion of the urethra. The median (range) number of injections was 2 (1-3); five children had one injection, seven had two and three had three. There were no procedure-related complications and most were day-case procedures. Initially PTFE paste was used as the bulking agent, being replaced by bovine collagen or polydimethylsiloxane in the latter half of the series. RESULTS At a median (range) follow-up of 28 (11-65) months three children were completely dry after a single injection; there was no change in four and a short-term improvement (median 25 months, range 4 days to 37 months) in eight. After this period all children deteriorated to their original incontinence grade; hence the overall cure rate was three of 15. CONCLUSION This experience with a long-term follow-up differs from previously reported high success rates for the endourethral injection of bulking agents for urinary incontinence in children. Despite a short-term benefit, in the long-term this technique was unreliable and often ineffective. Patients and their carers should be given a realistic and guarded prognosis.
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Affiliation(s)
- P Godbole
- Department of Paediatric Surgery, Sheffield Children's Hospital, Sheffield, UK.
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The Use of Small Intestinal Submucosa as an off-the-shelf Urethral Sling Material for Pediatric Urinary Incontinence. J Urol 2002. [DOI: 10.1097/00005392-200210020-00051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Colvert JR, Kropp BP, Cheng EY, Pope JC, Brock JW, Adams MC, Austin P, Furness PD, Koyle MA. The Use of Small Intestinal Submucosa as an off-the-shelf Urethral Sling Material for Pediatric Urinary Incontinence. J Urol 2002. [DOI: 10.1016/s0022-5347(05)64433-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- James R. Colvert
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - Bradley P. Kropp
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - Earl Y. Cheng
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - John C. Pope
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - John W. Brock
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - Mark C. Adams
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - Paul Austin
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - Peter D. Furness
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
| | - Martin A. Koyle
- From the Children’s Hospital of Oklahoma, Oklahoma City, Oklahoma, Vanderbilt Children’s Hospital, Nashville, Tennessee, St. Louis Children’s Hospital, St. Louis, Missouri, and Denver Children’s Hospital, Denver, Colorado
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Mingin GC, Youngren K, Stock JA, Hanna MK. The rectus myofascial wrap in the management of urethral sphincter incompetence. BJU Int 2002; 90:550-3. [PMID: 12230615 DOI: 10.1046/j.1464-410x.2002.02973.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To review our experience with a modified rectus/pyramidalis myofascial sling, described more than a century ago for treating refractory urinary incontinence in children with neurogenic sphincteric incompetence. PATIENTS AND METHODS Thirty-seven patients (23 females and 14 males, aged 8-21 years) presented with urinary incontinence which failed to respond to medical treatment. In 36 patients the cause of the incontinence was a neurogenic bladder; one patient had sustained a traumatic injury to the bladder neck and urethra. Patient selection was based on videocysto-urethrographic detection of an incompetent bladder neck, and a low maximum closure pressure during urethral pressure profilometry. The bladder was augmented in 33 of the 37 patients. RESULTS Of the 37 patients, 34 (92%) are dry between catheterizations; the follow-up was 0.5-10 years. Two of the male patients continued to have persistent incontinence requiring bladder neck closure and creation of a continent stoma. One of the female patients developed stress incontinence after 4 years of being dry, with a rectus sling. CONCLUSION The rectus myofascial sling provides long-term satisfactory dry intervals between catheterizations in patients with neurogenic sphincteric incompetence. The cinch-wrap modification appears to enhance the occlusive effect of the sling, particularly in males.
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Affiliation(s)
- G C Mingin
- Children's Hospital of New Jersey, St. Barnabas Health Care System, University of Medicine and Dentistry of New Jersey-New Jesrey Medical School, Newark, USA.
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Management of Intrinsic Sphincter Deficiency in Adolescent Females with Normal Bladder Emptying Function. J Urol 2002. [DOI: 10.1097/00005392-200209000-00077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Toh K, Diokno AC. Management of intrinsic sphincter deficiency in adolescent females with normal bladder emptying function. J Urol 2002; 168:1150-3. [PMID: 12187258 DOI: 10.1016/s0022-5347(05)64614-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Intrinsic sphincter deficiency is rare in adolescent females with normal bladder emptying function. Information regarding the long-term outcome of therapy in this group of patients is sparse. We report our long-term experience with 3 adolescent females with intrinsic sphincter deficiency and normal bladder function who were treated with an artificial urinary sphincter. We critically reviewed the literature regarding experience with anti-incontinence surgery in adolescent females, not only regarding the outcome of the surgical technique, but also issues not usually considered in older adults, including the impact of physical development and future childbearing. MATERIALS AND METHODS The charts of 3 adolescent females with intrinsic sphincter deficiency were reviewed. In addition, relevant peer reviewed articles were selected by a MEDLINE search. The results of the artificial urinary sphincter, pubovaginal sling and periurethral injection of bulking agents were reviewed. Long-term efficacy, the complication rate, impact of pregnancy and physical development were assessed. RESULTS The 3 patients had an excellent long-term outcome with the artificial urinary sphincter, including 1 with 2 pregnancies that ended in a normal vaginal delivery. The literature showed that a good long-term outcome was consistently achieved with the artificial urinary sphincter. An equally good outcome was achieved with the pubovaginal sling but long-term data are lacking. While periurethral injection of a bulking agent provides good initial results, they do not appear to be durable. In addition, the artificial urinary sphincter does not appear to impact pregnancy or physical development negatively. CONCLUSION Data support the artificial urinary sphincter and pubovaginal sling as effective therapies in adolescent females with intrinsic sphincter deficiency. However, long-term data on the pubovaginal sling are not available. When considering the impact on future childbearing and physical development, the artificial urinary sphincter is a favorable option.
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Affiliation(s)
- Khailee Toh
- Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA
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Niknejad K, Plzak LS, Staskin DR, Loughlin KR. Autologous and synthetic urethral slings for female incontinence. Urol Clin North Am 2002; 29:597-611. [PMID: 12476523 DOI: 10.1016/s0094-0143(02)00074-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Over the past decade, urethral slings have emerged as the procedure of choice for the surgical correction of most types of female urinary stress incontinence. A variety of materials, autologous, alloplastic, and synthetic, have been used successfully as urethral slings. In the next decade, it is hoped that a better understanding of the factors that influence surgical success will translate into continued refinement of surgical technique.
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Affiliation(s)
- Kathleen Niknejad
- Division of Urology, Brigham and Women's Hospital, Harvard Medical School, 45 Francis Street, Boston, MA 02115, USA
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NGUYEN HIEPT, BAUER STUARTB, DIAMOND DAVIDA, RETIK ALANB. RECTUS FASCIAL SLING FOR THE TREATMENT OF NEUROGENIC SPHINCTERIC INCONTINENCE IN BOYS: IS IT SAFE AND EFFECTIVE? J Urol 2001. [DOI: 10.1016/s0022-5347(05)66038-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- HIEP T. NGUYEN
- From the Department of Urology, Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - STUART B. BAUER
- From the Department of Urology, Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - DAVID A. DIAMOND
- From the Department of Urology, Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - ALAN B. RETIK
- From the Department of Urology, Children’s Hospital and Harvard Medical School, Boston, Massachusetts
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Abstract
PURPOSE We review our initial cases of continent cystostomy to assess long-term functional results and complications after a minimum of 15 years of followup. MATERIALS AND METHODS Between 1976 and 1984, 23 continent cystostomies were performed on 15 boys and 8 girls with neuropathic bladders. Mean patient age at surgery was 8 years and 4 months (range 3 to 16) and mean followup was 20 years (range 15 to 23). The neurological lesions were due to 21 myelomeningocele (2 associated with an imperforated anus in 21 cases), spinal neuroblastoma in 1 and complex genitourinary malformation associated with an imperforated anus in 1. Closure of the bladder neck was performed in 21 cases (16 during the same procedure, 5 secondarily) and 2 did not undergo this procedure. The appendix was used as the catheterizable conduit in 20 cases, 1 ureter in 2 and a bladder tube in 1. Bladder augmentation was performed during the same procedure in 2 cases and at a later stage in 8. Five patients presented with unilateral or bilateral secondary vesicoureteral reflux. RESULTS One death occurred after conversion to cutaneous diversion due to a postoperative infection leading to a ventriculoperitoneal valve infection. The remaining 22 patients were followed every 6 to 12 months. No metabolic disorder, secondary malignancy or spontaneous bladder perforation was noted. Bilateral upper tract deterioration was found in 10 cases leading to secondary bladder augmentation by enterocystoplasty in 6 and creation of noncontinent diversion in 4. Leakage occurred after bladder neck closure in 5 patients. Bladder stones were found in 5 patients (2 had prior bladder augmentation). Complications related to the conduit included stomal stenosis or persistent leakage in 11 cases, which required surgical revision and/or repeated dilations and 1 noncontinent diversion after revision failure. Five patients presented with intestinal occlusion due to volvulus in 3 and adhesion in 2. We noted that after 10 years of followup complications were rare and concerned mostly the catheterizable conduit. Therefore, 16 patients had a good and stable result while 6 have noncontinent diversion. CONCLUSIONS The rate of complications has a tendency to decrease with time. The results obtained in this series may appear less satisfactory than those of more recent series, which may be due to the fact that these oldest continent cystostomies correspond to acquisition of experience of this novel approach, and to a period when the concept of low pressure reservoir was not yet established and bladder augmentations were not routinely performed. Since 1984 no continent cystostomy performed at our institution was converted into a noncontinent diversion. This series with long followup demonstrates that continent cystostomy is a procedure with lasting efficiency.
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Affiliation(s)
- A Liard
- Department of Pediatric Surgery, University Hospital Charles Nicolle, Rouen, France
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Affiliation(s)
- J Bidmead
- Department of Urogynaecology, Kings College Hospital, London
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KRYGER JOHNV, GONZÁLEZ RICARDO, BARTHOLD JULIASPENCER. REVIEW ARTICLE: SURGICAL MANAGEMENT OF URINARY INCONTINENCE IN CHILDREN WITH NEUROGENIC SPHINCTERIC INCOMPETENCE. J Urol 2000. [DOI: 10.1016/s0022-5347(05)68031-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- JOHN V. KRYGER
- From the Division of Pediatric Urology, Children’s Hospital of Michigan, Wayne State University, Detroit, Michigan
| | - RICARDO GONZÁLEZ
- From the Division of Pediatric Urology, Children’s Hospital of Michigan, Wayne State University, Detroit, Michigan
| | - JULIA SPENCER BARTHOLD
- From the Division of Pediatric Urology, Children’s Hospital of Michigan, Wayne State University, Detroit, Michigan
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REVIEW ARTICLE: SURGICAL MANAGEMENT OF URINARY INCONTINENCE IN CHILDREN WITH NEUROGENIC SPHINCTERIC INCOMPETENCE. J Urol 2000. [DOI: 10.1097/00005392-200001000-00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Filipas D, Fisch M, Leissner J, Stein R, Hohenfellner R, Thüroff JW. Urinary diversion in childhood: indications for different techniques. BJU Int 1999; 84:897-904. [PMID: 10533000 DOI: 10.1046/j.1464-410x.1999.00394.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- D Filipas
- Department of Urology, University of Mainz School of Medicine, Mainz, Germany.
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RESULTS OF THE RECTUS FASCIAL SLING AND WRAP PROCEDURES FOR THE TREATMENT OF NEUROGENIC SPHINCTERIC INCONTINENCE. J Urol 1999. [DOI: 10.1097/00005392-199901000-00090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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BARTHOLD JULIASPENCER, RODRIGUEZ ELENA, FREEDMAN ANDREWL, FLEMING PATRICIAA, GONZALEZ RICARDO. RESULTS OF THE RECTUS FASCIAL SLING AND WRAP PROCEDURES FOR THE TREATMENT OF NEUROGENIC SPHINCTERIC INCONTINENCE. J Urol 1999. [DOI: 10.1016/s0022-5347(01)62131-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- JULIA SPENCER BARTHOLD
- Department of Urology, Children's Hospital of Michigan and Wayne State University School of Medicine, Detroit, Michigan
| | - ELENA RODRIGUEZ
- Department of Urology, Children's Hospital of Michigan and Wayne State University School of Medicine, Detroit, Michigan
| | - ANDREW L. FREEDMAN
- Department of Urology, Children's Hospital of Michigan and Wayne State University School of Medicine, Detroit, Michigan
| | - PATRICIA A. FLEMING
- Department of Urology, Children's Hospital of Michigan and Wayne State University School of Medicine, Detroit, Michigan
| | - RICARDO GONZALEZ
- Department of Urology, Children's Hospital of Michigan and Wayne State University School of Medicine, Detroit, Michigan
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Griebling TL, Berman CJ, Kreder KJ. Fascia lata sling cystourethropexy for the management of female urinary incontinence. Int Urogynecol J 1998; 9:165-73. [PMID: 9745977 DOI: 10.1007/bf02001087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pubovaginal sling cystourethropexy has rapidly become one of the primary surgical treatment options for women with urinary incontinence. The procedure has evolved over time with regard to clinical indications, patient selection criteria and surgical techniques. This article reviews the historical development of pubovaginal sling cystourethropexy, including recent technical advances. The selection of graft materials is considered and the utility of fascia lata emphasized. Clinical results and potential complications of the procedure are also reviewed.
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Affiliation(s)
- T L Griebling
- Department of Urology, University of Iowa, Iowa City 52242-1089, USA
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Rovner ES, Ginsberg DA, Raz S. A method for intraoperative adjustment of sling tension: prevention of outlet obstruction during vaginal wall sling. Urology 1997; 50:273-6. [PMID: 9255301 DOI: 10.1016/s0090-4295(97)00268-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To describe a simple, yet effective method of adjusting intraoperative tension on the suspending sutures of a vaginal wall sling placed for treatment of stress urinary incontinence (SUI) in the female patient. METHODS A cystoscope sheath is placed per urethra and inclined to approximately 20 degrees to 30 degrees relative to horizontal. The suspension sutures are tied down directly onto the rectus fascia but do not indent it. The sheath should easily rotate in the vertical plane within the urethral lumen, maintaining elastic mobility as the sutures are tied. RESULTS On review of the first 160 patients who have undergone vaginal wall sling using this technique of tension adjustment, no patient has had unexpected permanent urinary retention. Preoperative urgency incontinence has remained in 10 patients (less than 7%) postoperatively; 11 patients (6.8%) have had recurrent SUI during follow-up. CONCLUSIONS Proper adjustment of suture tension during performance of a sling procedure for SUI is critical in preventing urethral obstruction. The technique described is simple, objective, reproducible, and highly effective.
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Affiliation(s)
- E S Rovner
- Department of Urology, University of California Los Angeles School of Medicine, USA
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Abstract
Renewed interest in the pubovaginal sling procedure for stress urinary incontinence has occurred in response to recent reports of poor durability and inconsistent efficacy associated with simple cystourethropexy. Many of the failures are felt to represent patients with an unrecognized component of intrinsic sphincteric deficiency. Historically slings have a favourable cure rate, but have been perceived as having unacceptably high rates of prolonged urinary retention and secondary detrusor instability. This article reviews the preoperative evaluation and indications for pubovaginal slings, describes the evolution of the current techniques, and discusses choice of sling material, surgical approach, results and complications. It is hoped that this review will stimulate interest in this versatile but technically challenging procedure.
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Affiliation(s)
- R Sarver
- Department of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, Washington 98111, USA
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Curtis MR, Gormley EA, Latini JM, Halsted AC, Heaney JA. Prospective development of a cost-efficient program for the pubovaginal sling. Urology 1997; 49:41-5. [PMID: 9000183 DOI: 10.1016/s0090-4295(96)00382-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES We designed and implemented a cost-containment program for patients undergoing a pubovaginal sling procedure. We sought to test the hypothesis that preoperative patient education could reduce the length of hospital stay in these patients. Our goal was to decrease hospital charges while maintaining quality of care. METHODS A multidisciplinary group of clinic and hospital staff identified factors that contribute to a patient's hospital charges for a pubovaginal sling procedure. A program of preoperative patient education to teach intermittent self-catheterization was combined with the elimination or control of items considered unnecessary to the delivery of safe, efficient care. Patient care was standardized from the preoperative visit to discharge planning. The difference in the mean values of 38 prestudy patients was compared with 15 study patients with a Wilcoxon rank sum test. RESULTS Length of hospital stay was reduced from a mean of 2.8 to 1.1 days after implementation of the program (P < 0.0001). This decreased length of stay, combined with a reduction in routine laboratory studies (97% decrease; P < 0.0001), operating room charges (11% decrease; P < 0.01), and medications (35% decrease; P < 0.01), led to significantly reduced hospital charges. Total hospital charges decreased by 35%, from a mean of $4862 to a mean of $3153 (P < 0.0001). There was no increase in morbidity. Patient satisfaction with length of hospital stay did not change significantly following implementation of the program. CONCLUSIONS With a program of preoperative patient education combined with a critical review of the factors contributing to a patient's hospital charges, it is possible to implement a cost-efficient program for a pubovaginal sling, leading to a 35% reduction in mean total hospital charges. This approach directed toward other incontinence procedures could be expected to yield comparative results.
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Affiliation(s)
- M R Curtis
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanan, New Hampshire 03756-0001, USA
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Perez LM, Smith EA, Broecker BH, Massad CA, Parrott TS, Woodard JR. Outcome of Sling Cystourethropexy in the Pediatric Population: A Critical Review. J Urol 1996. [DOI: 10.1016/s0022-5347(01)65773-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Luis M. Perez
- From the Division of Urology, Emory University, Egleston Children's Hospital and Scottish Rite Medical Center, Atlanta, Georgia
| | - Edwin A. Smith
- From the Division of Urology, Emory University, Egleston Children's Hospital and Scottish Rite Medical Center, Atlanta, Georgia
| | - Bruce H. Broecker
- From the Division of Urology, Emory University, Egleston Children's Hospital and Scottish Rite Medical Center, Atlanta, Georgia
| | - Charlotte A. Massad
- From the Division of Urology, Emory University, Egleston Children's Hospital and Scottish Rite Medical Center, Atlanta, Georgia
| | - Thomas S. Parrott
- From the Division of Urology, Emory University, Egleston Children's Hospital and Scottish Rite Medical Center, Atlanta, Georgia
| | - John R. Woodard
- From the Division of Urology, Emory University, Egleston Children's Hospital and Scottish Rite Medical Center, Atlanta, Georgia
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36
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Raz S, Stothers L, Young GP, Short J, Marks B, Chopra A, Wahle GR. Vaginal Wall Sling for Anatomical Incontinence and Intrinsic Sphincter Dysfunction: Efficacy and Outcome Analysis. J Urol 1996. [DOI: 10.1016/s0022-5347(01)65976-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Shlomo Raz
- Division of Urology and Department of Radiology, University of California Los Angeles, Los Angeles, California, Department of Urology, New York Hospital-Cornell University Medical Center, New York, New York, and Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lynn Stothers
- Division of Urology and Department of Radiology, University of California Los Angeles, Los Angeles, California, Department of Urology, New York Hospital-Cornell University Medical Center, New York, New York, and Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada
| | - George P.H. Young
- Division of Urology and Department of Radiology, University of California Los Angeles, Los Angeles, California, Department of Urology, New York Hospital-Cornell University Medical Center, New York, New York, and Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie Short
- Division of Urology and Department of Radiology, University of California Los Angeles, Los Angeles, California, Department of Urology, New York Hospital-Cornell University Medical Center, New York, New York, and Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Barbara Marks
- Division of Urology and Department of Radiology, University of California Los Angeles, Los Angeles, California, Department of Urology, New York Hospital-Cornell University Medical Center, New York, New York, and Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ashok Chopra
- Division of Urology and Department of Radiology, University of California Los Angeles, Los Angeles, California, Department of Urology, New York Hospital-Cornell University Medical Center, New York, New York, and Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gregory R. Wahle
- Division of Urology and Department of Radiology, University of California Los Angeles, Los Angeles, California, Department of Urology, New York Hospital-Cornell University Medical Center, New York, New York, and Division of Urology, University of British Columbia, Vancouver, British Columbia, Canada
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Haab F, Zimmern PE, Leach GE. Female Stress Urinary Incontinence Due to Intrinsic Sphincteric Deficiency: Recognition and Management. J Urol 1996. [DOI: 10.1016/s0022-5347(01)65925-1] [Citation(s) in RCA: 129] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Francois Haab
- Department of Urology, Kaiser Permanente Medical Center, Los Angeles, California
| | - Philippe E. Zimmern
- Department of Urology, Kaiser Permanente Medical Center, Los Angeles, California
| | - Gary E. Leach
- Department of Urology, Kaiser Permanente Medical Center, Los Angeles, California
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38
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39
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Bomalaski MD, Bloom DA, McGuire EJ, Panzl A. Glutaraldehyde Cross-Linked Collagen in the Treatment of Urinary Incontinence in Children. J Urol 1996. [DOI: 10.1016/s0022-5347(01)66503-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. David Bomalaski
- Section of Urology, University of Michigan, Ann Arbor, Michigan, and Department of Urology, University of Texas, Houston, Texas
| | - David A. Bloom
- Section of Urology, University of Michigan, Ann Arbor, Michigan, and Department of Urology, University of Texas, Houston, Texas
| | - Edward J. McGuire
- Section of Urology, University of Michigan, Ann Arbor, Michigan, and Department of Urology, University of Texas, Houston, Texas
| | - Anne Panzl
- Section of Urology, University of Michigan, Ann Arbor, Michigan, and Department of Urology, University of Texas, Houston, Texas
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41
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Walker DR, Flack CE, Hawkins-Lee B, Lim DJ, Parramore H, Hackett RL. Rectus Fascial Wrap: Early Results of a Modification of the Rectus Fascial Sling. J Urol 1995. [DOI: 10.1016/s0022-5347(01)67159-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Dixon R. Walker
- Division of Urology and Department of Pathology, University of Florida College of Medicine, Gainesville, Florida
| | - Charles E. Flack
- Division of Urology and Department of Pathology, University of Florida College of Medicine, Gainesville, Florida
| | - Bobbilynn Hawkins-Lee
- Division of Urology and Department of Pathology, University of Florida College of Medicine, Gainesville, Florida
| | - David J. Lim
- Division of Urology and Department of Pathology, University of Florida College of Medicine, Gainesville, Florida
| | - Herman Parramore
- Division of Urology and Department of Pathology, University of Florida College of Medicine, Gainesville, Florida
| | - Raymond L. Hackett
- Division of Urology and Department of Pathology, University of Florida College of Medicine, Gainesville, Florida
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