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Gao Z, Lin H, Ke K, Yao T, Zhang Q, Li L, Wang X, Shen J. Surgical Effect Observation and Treatment Strategy Analysis of Pseudo Urgency Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111506. [PMID: 36363463 PMCID: PMC9693268 DOI: 10.3390/medicina58111506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Background and Objectives: pseudo urgency syndrome among patients with mixed incontinence (MUI) causes and the corresponding treatment strategies is explored. Materials and Methods: A total of 40 patients with MUI are treated with transobturator tape (TOT) and/or solifenacin succinate. Further, 30 patients with simple stress urinary incontinence (SUI) that were treated with transobturator tape (TOT) from the period of December 2018 to August 2020 are retrospectively analyzed; then, their clinical characteristics and therapeutic effects were summarized and analyzed. Results: The effective rates of SUI symptoms in MUI and simple SUI groups were 85% and 90%, respectively; further, the difference was noted as not statistically significant (P > 0.05). Among the 40 patients with MUI, 12 patients had unstable bladder contraction, and the other 28 patients showed normal bladder compliance. The treatment effectiveness rates of SUI symptoms in patients with unstable bladder contraction and normal bladder compliance were 83.3% and 85.7%, respectively; further, no significant difference was noted (P > 0.05). However, the effective rates of urge urinary incontinence (UUI) were 50% and 85.7%, respectively, however the difference was noted as statistically significant (P < 0.05). Conclusions: Most of the UUI symptoms in MUI patients may be “pseudo urgency syndrome” caused by the worry about the leakage of urine, rather than a real sense of UUI that is caused by excessive bladder excitement. Direct surgical treatment in patients with MUI can improve the symptoms of urinary incontinence, and the effect is more obvious in patients with urinary frequency who have normal bladder compliance according to urodynamics.
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Affiliation(s)
- Zhenhua Gao
- Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Han Lin
- Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Kunbin Ke
- Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Tingqiang Yao
- School of Mechanical and Electric Engineering, Kunming University of Science and Technology, Kunming 650093, China
| | - Quan Zhang
- Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Ling Li
- Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Xingqi Wang
- Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Jihong Shen
- Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Correspondence: ; Tel.: +86-135-7700-9705
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Cristina EG, Lorena SM, Rita PG, Santiago GME, Salvador JLJ. Construction of a Prognostic Score for Ultrasound Evaluation of the Transobturator Sling for Stress Urinary Incontinence. J Clin Med 2022; 11:jcm11051296. [PMID: 35268387 PMCID: PMC8910975 DOI: 10.3390/jcm11051296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
Currently, pelvic floor ultrasound allows us to correctly visualize the synthetic material used in stress urinary incontinence surgery. The objective of this study is the construction of a score and its correlation with the SUU clinic. During the study period, 81 patients with transobturator slings were studied using ultrasound. Through multivariate analysis, the statistically significant variables were the distance from the sling to the urethral wall (p = 0.004), the shape of the sling at rest (p = 0.003), and the symmetry of the mesh (p = 0.016). Through these variables, the construction of a score was carried out. Once the model was constructed, its internal validation was carried out to determine the discrimination capacity of patients who present clinical stress and those who do not, with an area under the curve of 0.848 (95% CI (0.72−0.97), p < 0.001). This simple score using three ultrasound variables serves to adequately and objectively discriminate patients who have successful surgery and absence of clinical effort.
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Affiliation(s)
- Espada-Gonzalez Cristina
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Málaga, 29010 Malaga, Spain; (E.-G.C.); (G.-M.E.S.); (J.-L.J.S.)
- Department of Gynecology and Obstetrics, Quiron Salud Hospital of Malaga, 29004 Malaga, Spain
| | - Sabonet-Morente Lorena
- Department of Gynecology and Obstetrics, Regional Universitary Hospital of Malaga, 29011 Malaga, Spain
- Correspondence:
| | - Perez-Gonzalez Rita
- Statistics Department, The Institute of Biomedical Research of Málaga (IBIMA), Regional Universitary Hospital of Malaga, 29011 Malaga, Spain;
| | - Gonzalez-Mesa Ernesto Santiago
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Málaga, 29010 Malaga, Spain; (E.-G.C.); (G.-M.E.S.); (J.-L.J.S.)
- Department of Gynecology and Obstetrics, Regional Universitary Hospital of Malaga, 29011 Malaga, Spain
| | - Jimenez-Lopez Jesus Salvador
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Málaga, 29010 Malaga, Spain; (E.-G.C.); (G.-M.E.S.); (J.-L.J.S.)
- Department of Gynecology and Obstetrics, Regional Universitary Hospital of Malaga, 29011 Malaga, Spain
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Verneker RA, Mishra V, Tutwala N, Lamba S. Five-Year Follow-up in Patients with Transobturator Tape - A Retrospective Observational Study. J Midlife Health 2022; 13:152-156. [PMID: 36276616 PMCID: PMC9583379 DOI: 10.4103/jmh.jmh_185_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/23/2022] [Accepted: 06/25/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Stress urinary incontinence (SUI) could be due to urethral hypermobility due to the weakening of the pelvic floor muscles which support the urethra and bladder or the intrinsic sphincter deficiency. The mid-urethral tape acts as an anchored pubo-urethral neo-ligament thus increasing the level of mid-urethral support. The purpose of this study is to evaluate the safety and efficacy of transobturator tape (TOT) for SUI at 5 years of follow-up. MATERIALS AND METHODS This was a retrospective observational single-arm study of 40 patients. Ten patients were lost to follow-up; hence, only 30 patients were included in the study. Patients who underwent TOT from 2010 to 2012 were followed up till December 2017. Patients were evaluated for early and late postoperative complications and efficacy of the tape at 5 years. RESULTS The mean age of the patients with SUI was 48.07 (standard deviation ± 9.38). About 76.66% (n = 23) of patients had only pure stress incontinence, whereas 23.3% of patients (n = 7) had mixed urinary incontinence (MUI). The cure rate in our study was 93.33% at 5 years. Out of the seven patients with MUI, urge incontinence was cured in 71.42% (n = 5). De novo urgency was observed in 6.6% (n = 2). No major complications such as bladder and bowel perforation, vascular hemorrhage, or mesh erosion were seen. Patient satisfaction was graded as excellent in 46.66% (n = 14), good in 30% (n = 9), and poor in 23% (n = 7). CONCLUSION TOT for stress incontinence has a high cure rate and very good efficacy at 5 years. No major complications are seen when the procedure is performed by expert hands.
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Affiliation(s)
- Ruchika A. Verneker
- Department of Obstetrics and Gynaecology, Grant Medical College, Mumbai, Maharashtra, India,Address for correspondence: Dr. Ruchika A. Verneker, Glory A 102, Vasant Marvel Complex, Borivali East Opposite Carnival Cinema, Mumbai - 400 066, Maharashtra, India. E-mail:
| | - Vineet Mishra
- Institute of Kidney Disease and Research Centre, Ahmedabad, Gujarat, India
| | - Nimish Tutwala
- Department of Obstetrics and Gynecology, Sai Sparsh Hospital, Mumbai, Maharashtra, India
| | - Sunita Lamba
- Department of Obstetrics and Gynecology, Spar Hospital, Jhunjhunu, Rajasthan, India
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Karakeçi A, Eftal TC, Keleş A, Gölbaşı C, Onur R. Single-incision midurethral sling shows less pain and similar success rate in a short-term follow-up compared to the transobturator tape method in the treatment of stress urinary incontinence. Turk J Urol 2019; 46:63-68. [PMID: 31658016 DOI: 10.5152/tud.2019.19105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 06/10/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To compare the efficacy, complications, quality of life, and patient satisfaction rates in women treated for stress urinary incontinence (SUI) using the adjustable anchored single-incision midurethral sling (SIMS) and standard midurethral sling (MUS) procedures. MATERIAL AND METHODS A total of 113 women between October 2012 and October 2016 underwent either the adjustable SIMS (n=54) or MUS (n=57) procedure. The postoperative pain profile was assessed using a 10-point visual analog scale at the fixed time-point quality of life and an additional postoperative 3rd week appointment. We asked our patients the following two questions to evaluate their satisfaction with surgery and their preference: "Would you have this kind of surgery again?" (Q1), and "Would you recommend this type of surgery to another patient with same symptoms?" (Q2). For the evaluation of patient complaints, the Incontinence Impact Questionnaire (IIQ-7) and Urinary Distress Inventory (UDI-6) were used before and after the procedure. RESULTS Women in the SIMS group had a significantly lower postoperative pain profile for up to 3 weeks (p<0.001). There was no significant difference in perioperative complications and postoperative continence rates between the groups. With regard to Q1 and Q2, a significant difference was found between the groups (p=0.003 and p=0.002, respectively). While the questionnaire scores of the IIQ-7 and UDI-6 were also significantly improved at postoperative evaluations (p<0.001), there was no significant difference between the two groups. CONCLUSION SIMS is associated with a significantly improved postoperative pain profile and earlier return to work when compared to MUS.
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Affiliation(s)
- Ahmet Karakeçi
- Department of Urology, Fırat University School of Medicine, Elazığ, Turkey
| | - Taner Cüneyt Eftal
- Department of Obstetric and Gynecology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ahmet Keleş
- Department of Urology, Esenyurt State Hospital, İstanbul, Turkey
| | - Ceren Gölbaşı
- Department of Obstetric and Gynecology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Rahmi Onur
- Department of Urology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
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Dur R, Akkurt İ, Coşkun B, Dur G, Çoşkun B, Ünsal M, Sivaslıoğlu AA. The impact of vaginal cone therapy on stress urinary incontinence compared with transobturator tape. Turk J Obstet Gynecol 2019; 16:169-173. [PMID: 31673469 PMCID: PMC6792060 DOI: 10.4274/tjod.galenos.2019.89137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/22/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To emphasize the efficiency of vaginal cone (VC) therapy in stress urinary incontinence (SUI) through a comparison with transobturator tape (TOT). MATERIALS AND METHODS A prospective randomized controlled study was conducted at the Etlik Zübeyde Hanım Maternity and Women Hospital during a one year study period. Forty women were allocated into two equal groups; those treated with VCs for a 3 month period, and women who underwent TOT procedures. These women were followed up at 6 weeks and 6 months after the treatments. Subjective cure was assessed using Wagner's Quality of Life Questionnaire. Objective cure was evaluated through a cough stress and pad test results. RESULTS Maternal demographic features were comparable among groups. We observed improvement in pad weight test among groups when compared with the pretreatment state (p=0.015, p=0.005). Although the subjective cure rate was similar in both groups at the 6th week and 6th month follow up (65% vs. 75%; 75% vs. 80%) (p>0.05), the objective cure rate was significantly higher in the TOT group than in the VC group, as expected (10% vs. 80%; 30% vs. 75%) (p<0.05). CONCLUSION The main treatment of SUI is surgery; however, VC could be offered as an alternative treatment for women who refuse surgery, those at high risk for surgery or it could be used temporarily before surgery.
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Affiliation(s)
- Rıza Dur
- University of Health Siences, Etlik Zübeyde Hanım Maternity and Women Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - İltaç Akkurt
- Bursa Anadolu Hospital, Clinic of Obstetrics and Gynecology, Bursa, Turkey
| | - Bora Coşkun
- Liv Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Gamze Dur
- Çifteler Stale Hospital, Clinic of Obstetrics and Gynecology, Eskişehir, Turkey
| | - Buğra Çoşkun
- Liv Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Mehmet Ünsal
- University of Health Siences, Etlik Zübeyde Hanım Maternity and Women Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Ahmet Akın Sivaslıoğlu
- Muğla Sıtkı Koçman University Faculty of Medicine, Department of Obstetrics and Gynecology, Muğla, Turkey
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