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Zivanovic I, Gamper M, Fesslmeier D, Walser C, Regauer S, Viereck V. Nd:YAG/Er:YAG dual laser compared with topical steroid to treat vulvar lichen sclerosus: A randomised controlled trial. BJOG 2024; 131:740-749. [PMID: 38149520 DOI: 10.1111/1471-0528.17737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of a novel non-ablative Nd:YAG/Er:YAG dual laser treatment for vulvar lichen sclerosus (LS) in comparison with the recommended first-line therapy with topical steroid. DESIGN A randomised investigator-initiated active-controlled trial. SETTING Single tertiary referral centre. POPULATION Women with vulvar LS. METHODS Randomisation (2:1) to Nd:YAG/Er:YAG laser therapy or topical clobetasol proprionate therapy. Four laser treatments at 0, 1, 2 and 4 months or decreasing doses of steroid for 6 months. MAIN OUTCOME MEASURES The primary outcome was the change in objective validated clinical LS score in the laser arm between baseline and 6 months. Secondary outcomes were laser tolerability/safety, symptom scores and patient satisfaction. RESULTS Sixty-six women were included, 44 in the laser group and 22 in the steroid group. The total LS score decreased by -2.34 ± 1.20 (95% CI -2.71 to -1.98) in women treated with laser compared with a decrease of -0.95 ± 0.90 (95% CI -1.35 to -0.56) in those receiving steroid applications (p < 0.001). Laser treatment was safe and well tolerated. Subjective severity scores (on visual analogue scale) and vulvovaginal symptoms questionnaire scores improved similarly for the laser and steroid arms without significant differences between the two treatments. Patient satisfaction was higher in the laser arm than in the steroid arm (p = 0.035). CONCLUSIONS Non-ablative dual Nd:YAG/Er:YAG laser therapy was safe and significantly improved clinical outcome and subjective symptoms at the 6-month follow up. This suggests that laser may be a promising alternative to corticosteroid therapy. However, the authors caution regular follow ups because of the premalignant nature of the disease.
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Affiliation(s)
- Irena Zivanovic
- Department of Gynaecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Marianne Gamper
- Department of Gynaecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Debra Fesslmeier
- Department of Gynaecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Claudia Walser
- Department of Gynaecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Sigrid Regauer
- Diagnostic and Research Institute of Pathology, Medical University Graz, Graz, Austria
| | - Volker Viereck
- Department of Gynaecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
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Viereck V, Gamper M, Regauer S, Walser C, Zivanovic I. Correction: Nd:YAG/Er:YAG dual laser vs. topical steroid to treat vulvar lichen sclerosus: study protocol of a randomized controlled trial. Arch Gynecol Obstet 2024; 309:339-340. [PMID: 37874354 PMCID: PMC10769983 DOI: 10.1007/s00404-023-07162-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Affiliation(s)
- Volker Viereck
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland.
| | - Marianne Gamper
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland
| | - Sigrid Regauer
- Institute of Pathology, Medical University Graz, Graz, Austria
| | - Claudia Walser
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland
| | - Irena Zivanovic
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland
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Viereck V, Gamper M, Regauer S, Walser C, Zivanovic I. Nd:YAG/Er:YAG dual laser vs. topical steroid to treat vulvar lichen sclerosus: study protocol of a randomized controlled trial. Arch Gynecol Obstet 2023; 308:643-649. [PMID: 37145134 PMCID: PMC10293446 DOI: 10.1007/s00404-023-07055-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/24/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE Vulvar lichen sclerosus (LS) is a chronic debilitating inflammatory skin disease. Today, the gold standard is a life-long topical steroid treatment. Alternative options are highly desired. We present a study protocol of a prospective, randomized, active-controlled, investigator-initiated clinical trial comparing a novel non-invasive dual Nd:YAG/Er:YAG laser therapy with the gold standard for the management of LS. METHODS We recruited 66 patients, 44 in the laser arm and 22 in the steroid arm. Patients with a physician-administered clinical LS score ≥ 4 were included. Participants received either four laser treatments 1-2 months apart, or 6 months of topical steroid application. Follow-ups were planned at 6, 12, and 24 months. The primary outcome looks at the efficacy of the laser treatment at the 6-month follow-up. Secondary outcomes look at comparisons between baseline and follow-ups within the laser or the steroid arm, and comparisons between laser vs. steroid arm. Objective (LS score, histopathology, photo documentation) and subjective (Vulvovaginal Symptoms Questionnaire, symptom VAS score, patient satisfaction) measurements, tolerability, and adverse events are evaluated. CONCLUSION The findings of this trial have the potential to offer a novel treatment option for LS. The standardized Nd:YAG/Er:YAG laser settings and the treatment regime are presented in this paper. CLINICAL TRIAL IDENTIFICATION NUMBER NCT03926299.
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Affiliation(s)
- Volker Viereck
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland.
| | - Marianne Gamper
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland
| | - Sigrid Regauer
- Institute of Pathology, Medical University Graz, Graz, Austria
| | - Claudia Walser
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland
| | - Irena Zivanovic
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld Postfach, 8501, Frauenfeld, Switzerland
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Viereck V, Gamper M, Walser C, Fesslmeier D, Münst J, Zivanovic I. Combination therapy with botulinum toxin and bulking agent-An efficient, sustainable, and safe method to treat elderly women with mixed urinary incontinence. Neurourol Urodyn 2021; 40:1820-1828. [PMID: 34342363 PMCID: PMC9292298 DOI: 10.1002/nau.24757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/10/2022]
Abstract
Aims To evaluate the efficacy, sustainability and safety of combined botulinum toxin and polyacrylamide hydrogel (PAHG) therapy to treat urgency and stress components of therapy‐refractory mixed urinary incontinence (MUI) in an elderly study population. Methods Fifty‐five women with therapy‐refractory MUI were treated with botulinum toxin and PAHG in one surgical procedure. Urgency urinary incontinence (UUI) and stress urinary incontinence (SUI) outcomes were separately assessed after 4 and 12 months by objective UUI episodes/24 h and cough test, subjective impact of UUI and SUI on quality of life, and subjective International Consultation on Incontinence Questionnaire‐Urinary Incontinence Short Form (ICIQ‐UI SF). MUI outcome was calculated by combining UUI and SUI outcomes. Complications were monitored throughout the study. Results At 4 months, objective cure rates were 73%, 53%, and 42%, and subjective cure rates were 71%, 52%, and 50% for SUI, UUI, and MUI. At 12 months, objective cure rates were 73%, 56%, 50% and subjective cure rates were 78%, 42%, and 40% for SUI, UUI, and MUI. The ICIQ‐UI SF score decreased by 9.0 and 8.7 points after 4 and 12 months. All complications were transient and included 22% clean intermittent catheterization immediately after surgery, 33% postvoid residual volumes >100 ml at 14 days, and 13% symptomatic urinary tract infection within the first postoperative month. Conclusions The combination of botulinum toxin and PAHG is effective, sustainable and safe to treat therapy‐refractory MUI, even in an elderly and frail study population. Patients benefit from the short surgical procedure without the need for general anaesthesia or discontinuation of anticoagulation.
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Affiliation(s)
- Volker Viereck
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Marianne Gamper
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Claudia Walser
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Debra Fesslmeier
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Julia Münst
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Irena Zivanovic
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
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Münst J, von Siebenthal M, Walser C, Gamper M, Viereck V. [Acute and recurrent urinary tract infections in women presenting in primary practice]. Ther Umsch 2019; 73:547-552. [PMID: 31113321 DOI: 10.1024/0040-5930/a001042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Acute and recurrent urinary tract infections in women presenting in primary practice Abstract. Acute and recurrent urinary tract infections in women of all age groups are becoming an increasing problem in primary care and medical practice. Symptoms can be relieved by a guideline-oriented acute therapy and a multimodal infection prophylaxis. The restoration of the body's natural defence mechanisms plays a central role. This article informs about the causes, the basic diagnostic examinations and the practical use of therapeutic and prophylactic measures.
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Kuszka A, Kociszewski J, Walser C, Gamper M, Viereck V. Erbium:YAG-Lasertherapie der weiblichen Belastungsinkontinenz – Outcome mit 2-Jahres Follow-up. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Kuszka
- Evangelisches Krankenhaus Hagen-Haspe, Frauenklinik, Hagen, Deutschland
| | - J Kociszewski
- Evangelisches Krankenhaus Hagen-Haspe, Frauenklinik, Hagen, Deutschland
| | - C Walser
- Kantonsspital Frauenfeld, Frauenklinik, Frauenfeld, Schweiz
| | - M Gamper
- Kantonsspital Frauenfeld, Frauenklinik, Frauenfeld, Schweiz
| | - V Viereck
- Kantonsspital Frauenfeld, Frauenklinik, Frauenfeld, Schweiz
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Gamper M, Walser C, Späth N, Moser R, Viereck V. Ist die Reizblase eine Frühform des Blasenschmerzsyndroms/der Interstitiellen Zystitis? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Gamper
- Kantonsspital Frauenfeld, Frauenklinik, Frauenfeld, Schweiz
| | - C Walser
- Kantonsspital Frauenfeld, Frauenklinik, Frauenfeld, Schweiz
| | - N Späth
- IBR Inc., Institute for Biopharmaceutical Research, Matzingen, Schweiz
| | - R Moser
- IBR Inc., Institute for Biopharmaceutical Research, Matzingen, Schweiz
| | - V Viereck
- Kantonsspital Frauenfeld, Frauenklinik, Frauenfeld, Schweiz
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Rautenberg O, Zivanovic I, Kociszewski J, Kuszka A, Münst J, Eisele L, Viereck N, Walser C, Gamper M, Viereck V. Current Treatment Concepts for Stress Urinary Incontinence. Praxis (Bern 1994) 2017; 106:829e-836e. [PMID: 29143573 DOI: 10.1024/1661-8157/a002843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Initially, stress urinary incontinence should be treated by conservative measures, such as weight reduction, hormonal substitution, physiotherapy, pelvic floor exercise and/or the use of pessaries. Incontinence surgeries are only recommended in case of unsuccessful conservative therapy. Today, tension-free suburethral sling insertions represent the gold standard of incontinence surgery yielding very good outcomes (cure rates of 80–90 %). Pelvic-floor sonography provides important information on decision of surgical methods and the management of complications. Furthermore, intra- or paraurethral injection of bulking agents is a promising, minimally invasive surgical alternative. This article discusses treatment concepts, pre-, intra- and post-operative examinations, decision on surgical methods, operational details for surgical success, and the prevention and management of complications.
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Affiliation(s)
- Oliver Rautenberg
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
| | - Irena Zivanovic
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
| | - Jacek Kociszewski
- 2 Department of Gynecology and Obstetrics, Lutheran Hospital Hagen-Haspe, 58135 Hagen, Germany
| | - Andrzej Kuszka
- 2 Department of Gynecology and Obstetrics, Lutheran Hospital Hagen-Haspe, 58135 Hagen, Germany
| | - Julia Münst
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
| | - Lilly Eisele
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
| | - Nicole Viereck
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
| | - Claudia Walser
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
| | - Marianne Gamper
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
| | - Volker Viereck
- 1 Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, 8501 Frauenfeld, Switzerland
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Rautenberg O, Zivanovic I, Kociszewski J, Kuszka A, Münst J, Eisele L, Viereck N, Walser C, Gamper M, Viereck V. [Not Available]. Praxis (Bern 1994) 2017; 106:829-836. [PMID: 28745112 DOI: 10.1024/1661-8157/a002743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Zusammenfassung: Eine Belastungsinkontinenz sollte immer zuerst konservativ behandelt werden. Schon eine Gewichtsreduktion, Hormonpräparate, Physiotherapie, Beckenbodentraining und/oder die Anwendung von Pessaren können zum Erfolg führen. Nach Ausschöpfen dieser Therapien werden heute Inkontinenzoperationen mit meist sehr guten Heilungschancen (ca. 80–90 %) angeboten. Der operative Goldstandard ist die suburethrale Schlingeneinlage. Die Pelvic-Floor-Sonografie liefert dazu sehr wichtige Hinweise zur Wahl der Operationstechnik und zur Behebung von Komplikationen. Ferner bildet die intra- oder paraurethrale Injektion von Bulking Agents eine vielversprechende, wenig invasive operative Alternative. In diesem Artikel werden Behandlungskonzepte, prä-, intra- und postoperative Untersuchungen, Wahl der Operationsmethode, operationstechnische Details für den Operationserfolg sowie Vorbeugung und Behandlung von Komplikationen diskutiert.
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Affiliation(s)
- Oliver Rautenberg
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
| | - Irena Zivanovic
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
| | - Jacek Kociszewski
- 2 Abteilung für Gynäkologie und Geburtshilfe, Evangelisches Krankenhaus Hagen-Haspe, Hagen, Deutschland
| | - Andrzej Kuszka
- 2 Abteilung für Gynäkologie und Geburtshilfe, Evangelisches Krankenhaus Hagen-Haspe, Hagen, Deutschland
| | - Julia Münst
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
| | - Lilly Eisele
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
| | - Nicole Viereck
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
| | - Claudia Walser
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
| | - Marianne Gamper
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
| | - Volker Viereck
- 1 Blasen- und Beckenbodenzentrum, Frauenklinik, Kantonsspital Frauenfeld
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Wlaźlak E, Viereck V, Kociszewski J, Kuszka A, Rautenberg O, Walser C, Surkont G, Gamper M, Fehr MK. Role of intrinsic sphincter deficiency with and without urethral hypomobility on the outcome of tape insertion. Neurourol Urodyn 2017; 36:1910-1916. [PMID: 28139863 DOI: 10.1002/nau.23211] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/25/2016] [Accepted: 12/10/2016] [Indexed: 11/10/2022]
Abstract
AIMS Intrinsic sphincter deficiency (ISD) is a known risk factor for therapy failure after tension-free vaginal tape (TVT) insertion. The purpose of this study was to investigate if the severity of ISD alone or other factors such as urethral mobility and tape localization influence outcomes. METHODS One hundred and nine women with urodynamically determined ISD, a TVT insertion, and a 6-month follow-up visit were included. Urethral length, mobility, and tape localization were evaluated by pelvic floor sonography. Patients were classified into three urethral mobility groups (hypomobile, normomobile, hypermobile). Surgical outcome was assessed by a combination of objective and subjective criteria. RESULTS Therapeutic success rate after TVT insertion was 81.6%. The severity of ISD did not associate with therapy failure. But urethral mobility (P < 0.0001), relative tape position (P = 0.0003), and tape-urethra distance (P < 0.0001) differed between cured and not cured patient groups. Patients with a relative tape position toward 1/2 of urethral length had a higher cure rate. Significantly different cure rates (P = 0.0003) were found for hypomobile (67%), normomobile (76%), and hypermobile (100%) urethras. For ISD patients with a hypomobile urethra, highest cure rates were obtained for tape-urethra distances between 2.5 and 3.5 mm. CONCLUSIONS The reduced cure rate for ISD patients was due to the subgroup with a hypomobile urethra. A prospective study is needed to confirm that slightly shorter tape-urethra distances and a relative tape position more toward the mid-urethra will lead to better outcomes for this patient group.
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Affiliation(s)
- Edyta Wlaźlak
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland
| | - Volker Viereck
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Jacek Kociszewski
- Department of Gynecology and Obstetrics, Lutheran Hospital Hagen-Haspe, Hagen, Germany
| | - Andrzej Kuszka
- Department of Gynecology and Obstetrics, Lutheran Hospital Hagen-Haspe, Hagen, Germany
| | - Oliver Rautenberg
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Claudia Walser
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Grzegorz Surkont
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland
| | - Marianne Gamper
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Mathias K Fehr
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
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Zivanovic I, Rautenberg O, Lobodasch K, Bünau GV, Walser C, Viereck V. Urethral bulking for recurrent stress urinary incontinence after previous midurethral sling. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Zivanovic I, Rautenberg O, Lobodasch K, von Bünau G, Walser C, Viereck V. Urethral bulking for recurrent stress urinary incontinence after midurethral sling failure. Neurourol Urodyn 2016; 36:722-726. [DOI: 10.1002/nau.23007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/09/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Irena Zivanovic
- Department of Gynecology and Obstetrics; Cantonal Hospital; Frauenfeld Switzerland
| | - Oliver Rautenberg
- Department of Gynecology and Obstetrics; Cantonal Hospital; Frauenfeld Switzerland
| | - Kurt Lobodasch
- Department of Gynecology; German Red Cross Hospital Chemnitz-Rabenstein; Chemnitz Germany
| | | | - Claudia Walser
- Department of Gynecology and Obstetrics; Cantonal Hospital; Frauenfeld Switzerland
| | - Volker Viereck
- Department of Gynecology and Obstetrics; Cantonal Hospital; Frauenfeld Switzerland
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Nielsen D, Walser C, Kodan G, Chaney RD, Yonkers T, VerSteeg JD, Elfring G, Slots J. Effects of treatment with clindamycin hydrochloride on progression of canine periodontal disease after ultrasonic scaling. Vet Ther 2000; 1:150-158. [PMID: 19757577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study was conducted to determine the benefit, if any, of combining antibiotic therapy with ultrasonic scaling, root planing, and polishing (USRP) over USRP alone as determined by improvements in plaque index, gingival index, and pocket depth measurements. Thirty dogs with signs of periodontal disease were randomly assigned to the USRP-only treatment group or to the USRP-antibiotic treatment group. USRP was performed on all dogs on study day 0. In addition, dogs in the USRP-antibiotic treatment group received clindamycin hydrochloride (Antirobe, Pharmacia & Upjohn, Kalamazoo, MI) dosed at 2.5 mg/lb body weight (BW) twice a day beginning on day 0 and continuing 8 days. Followup visits occurred 2, 6, 13, and 25 weeks after the start of the study. Treatment differences were compared using a mixed model analysis for repeated measures. This analysis indicated that the clindamycin regimen, after USRP, had a significant effect on plaque and pocket depth measures of periodontal disease but not on gingivitis. For plaque, average index scores for the treatment group were lower at all follow-up visits with significant differences at 2 and 6 weeks after cleaning. The antibiotic treatment group also maintained a significantly smaller average pocket depth, representing a 15% postcleaning reduction for the clindamycin group versus a 3% reduction in the control group.
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Affiliation(s)
- D Nielsen
- Animal Medical Group, 1401 North Sepulveda Boulevard, Manhattan Beach, CA 90266, USA
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