The Urethral Motion Profile Before and After Suburethral Sling Placement
|
|
- Nathaniel Anderson
- 6 years ago
- Views:
Transcription
1 The Urethral Motion Profile Before and After Suburethral Sling Placement Ka Lai Shek,* Varisara Chantarasorn and Hans Peter Dietz From the Nepean Clinical School, University of Sydney, Sydney, Australia Abbreviations and Acronyms SUI stress urinary incontinence UMP urethral motion profile USI urodynamic stress incontinence Submitted for publication August 14, Study received human research ethics committee approval. * Correspondence: Nepean Clinical School, University of Sydney, Nepean Hospital, Penrith NSW 2750, Australia (telephone: ; FAX: ; shekkalai@yahoo.com.hk). Financial interest and/or other relationship with American Medical Systems, CCS, GE, Astellas, Bruel & Kjaer and Toshiba. Purpose: We examined the effect of the Monarc suburethral sling on urethral mobility. Materials and Methods: We retrospectively studied the records of 54 consecutive women who received a Monarc suburethral sling between July 2005 and November All patients were examined by volume ultrasound preoperatively and at followup (average 0.7 years). Volume data sets were analyzed using post-processing software. Urethral mobility was described by vectors of movement from rest to a maximum Valsalva maneuver of 6 equidistant points marked evenly along the urethra from bladder neck (point 1) to external urethral meatus (point 6), as identified in the mid sagittal view. Measurements were made of point coordinates relative to the pubic symphysis dorsocaudal margin at rest and during maximal Valsalva maneuver. To determine the urethral motion profile we calculated mobility vectors of the 6 points using the formula, square root [(x val x rest ) 2 (y val y rest ) 2 ], where val represents the value during the Valsalva maneuver and rest represents the value at rest. We compared values before and after sling placement. Results: The subjective cure rate for stress urinary incontinence was 78% (42 cases). There was a statistically significantly decreased mobility at points 2 to 4, corresponding to the urethral central aspect (p to 0.018). No significant change in mobility was noted at the bladder neck and distal urethra (p 0.39 to 0.89). Conclusions: Monarc suburethral sling placement decreases mid urethral mobility but does not seem to affect the bladder neck. Key Words: urethra; urinary incontinence, stress; suburethral slings; ultrasonography; process assessment (health care) THE prevalence of urinary incontinence in community dwelling women is 20% to 40% 1 3 with SUI the most common type. 2,4 Despite its high prevalence the exact etiology of SUI remains elusive. SUI may develop when urethral support is defective, impairing pressure transmission during periods of increased intra-abdominal pressure. 5 Burch colposuspension, the previous gold standard for SUI surgical treatment, aims to reposition the bladder neck in the abdominopelvic pressure zone to improve pressure transmission. While immobilizing and elevating the bladder neck is the primary aim of the procedure and successful colposuspension has been documented, 6,7 postoperative complications are not uncommon, including voiding difficulties in 3% to 32% of patients and urge symptoms or de novo urge incontinence in 4% to 41% The observation that voiding initiation is /10/ /0 Vol. 183, , April 2010 THE JOURNAL OF UROLOGY Printed in U.S.A by AMERICAN UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC. DOI: /j.juro
2 URETHRAL MOTION PROFILE BEFORE AND AFTER SUBURETHRAL SLING PLACEMENT 1451 preceded by bladder neck descent suggests that the procedure may not be physiological. The tension-free suburethral sling, a minimally invasive procedure with greater than 80% objective and subjective cure rates, and a low rate of de novo urge symptoms and voiding difficulty at 7-year followup, 12 has now become the gold standard for surgical treatment for SUI. Previous groups examined the effect of such slings on bladder neck mobility 13,14 and urethrovesical junction position, 13,15 and determined suburethral sling site and mobility but there is little information on changes in urethral mobility. Such information may enhance our understanding of the mechanism of action of suburethral slings and complications after such procedures. We examined the effect of Monarc suburethral sling placement on UMP, a recently developed method to study urethral mobility. 19 Figure 1. Bladder and urethra at rest (B r ) and during Valsalva maneuver (B v ) showing change in position of points 1 (bladder neck) to 6 (external urethral meatus) marked along urethra. SP, symphysis pubis. METHODS We retrospectively reviewed the records of 91 consecutive women who received a Monarc suburethral sling between July 2005 and November 2008 at a tertiary urogynecology unit. Preoperatively in all patients USI was diagnosed by multichannel urodynamic testing. The procedure was performed or supervised by one of us (HPD). The sling procedure was done using general anesthesia according to the manufacturer technique. All patients had undergone standardized interview, clinical examination, uroflowmetry and 4-dimensional transperineal ultrasound preoperatively and during followup a minimum of 4 weeks postoperatively. Voiding data obtained with a weight transducer flowmeter were converted to maximum flow rate centiles according to the Liverpool nomogram. 20 Transperineal ultrasound was done with the patient supine after bladder emptying using a Voluson 730 Expert system (GE Medical Ultrasound Kretz, Zipf, Austria) equipped with an 8 to 4 MHz curved array volume transducer with an 85-degree acquisition angle, as previously described. 21 Volume acquisition was done at rest and during the maximum Valsalva maneuver. At least 3 Valsalva maneuvers were done per patient. Data analysis was performed on a desktop personal computer using 4-dimensional SonoView, version 5.0 several months after ultrasound data acquisition while blinded to clinical data. Urethral mobility was described by vectors of movement from rest to a maximum Valsalva maneuver of 6 equidistant points marked along the length of the urethra from bladder neck (point 1) to external urethral meatus (point 6) in the mid sagittal plane, as previously described (fig. 1). 19 Measurements of point coordinates relative to the dorsocaudal margin of the pubic symphysis were made at rest and during the maximal Valsalva maneuver. Mobility vectors of the 6 points were calculated using the formula, square root [(x val x rest ) 2 (y val y rest ) 2 ]to determine UMP, where val represents the value during the Valsalva maneuver and rest represents the value at rest. Our method of determining UMP has good to excellent repeatability. 19 Since manually determining UMP coordinates is timeconsuming, a semi-automated program was developed using an Excel macro allowing automatic determination of x and y coordinates of the 6 points relative to the inferoposterior margin of the symphysis pubis on an image bitmap. Mobility vectors of the 6 points were calculated using the mentioned formula. Values before and after sling placement were compared to determine the change in UMP. A testretest series of 20 UMPs (120 mobility vectors) was done to test correlations between manual measurement and the semi-automated program, and between observers (KLS and VC) using the semi-automated program. ICC was 0.93 (95% CI ) and 0.95 (95% CI ), respectively, suggesting excellent repeatability. The study was done in the context of a human research ethics committee approved surgical audit (SWAHS HREC ref 09/03). The paired t and 2-sample t tests were used for statistical analysis with Minitab, version 13 for personal computers. The paired t test was used to compare the change in UMP after sling placement. The 2-sample t test was used to compare UMP in the cured group vs the group with persistent SUI and in women with vs without de novo voiding difficulty with p 0.05 considered statistically significant. RESULTS Of the 91 patients 31 were excluded from analysis due to previous or concomitant surgery that may interfere with urethral mobility, including a previously implanted sling in 5, anterior compartment Perigee mesh in 4, previous colposuspension in 8, of whom 1 also had a history of sling placement, and concomitant anterior compartment Perigee mesh implantation in 15. Six volumes could not be assessed due to corrupted files or incomplete data acquisition. All subsequent data refer to the remaining 54 data sets. Mean patient age was 55 years (range 33 to 87), median parity was 3 (range 1 to 8) and
3 1452 URETHRAL MOTION PROFILE BEFORE AND AFTER SUBURETHRAL SLING PLACEMENT median followup was 0.7 years (IQR ). At the preoperative assessment 52 (96%), 36 (67%) and 13 (24%) of the 54 patients complained of stress incontinence, urge incontinence and prolapse symptoms, respectively. Significant prolapse (International Continence Society Pelvic Organ Prolapse Quantification stage 2 or greater) noted in 31 patients was a stage 2 or greater cystocele in 16. All 54 patients had USI preoperatively and 11 (20%) also had detrusor overactivity. Concomitant prolapse repair was done in 22 patients (41%), including posterior repair in 16, anterior repair in 4 and sacrospinous colpopexy in 3. The subjective cure rate for SUI was 78% (42 of 54 patients). Five patients (9%) noted improvement, 5 remained the same and 2 felt worse after the sling procedure. Nine patients (17%) complained of de novo voiding dysfunction symptoms. Of 36 women with urge urinary incontinence preoperatively 31 (86%) noticed urge incontinence improvement/cure after sling placement. No sling erosion was identified. Before suburethral sling placement the mean mobility vector distances from points 1 (bladder neck) to 6 (external urethral meatus) were 2.92, 2.61, 2.31, 2.06, 1.88 and 1.80 cm, respectively. There was a decrease in mean mobility vector distance throughout the entire urethral length after sling placement. Corresponding values from points 1 to 6 were 2.86, 2.37, 1.99, 1.82, 1.8 and 1.81 cm (p 0.67, 0.039, 0.002, 0.018, 0.39 and 0.89), respectively. There was statistically significantly decreased mobility at points 2 to 4, corresponding to the central urethral aspect. No significant change in mobility was observed at the bladder neck or the external urethral meatus (see table and fig. 2). Comparing UMP in 12 women with persistent SUI and in 42 who were cured showed no significant difference in the change in mobility vectors of points 1 to 6 after sling placement (p 0.13 to 0.8). Maximum urethral closure pressure in the 2 groups was and 36.9 cm H 2 O, respectively (p 0.036), suggesting poorer urethral sphincter function in those with persistent SUI. There was a trend toward a greater decrease in mobility vectors of all 6 points in 9 patients with de novo symptoms of voiding Mobility vectors at maximal Valsalva maneuver before and after suburethral sling placement in 54 patients Point No. Preop Mean SD Mobility (cm) Postop Mean SD Mobility (cm) p Value 1 (bladder neck) (external urethral meatus) Figure 2. Mean UMP before (black curve) and after (gray curve) suburethral sling placement. Single asterisk indicates p Double asterisks indicate p Triple asterisks indicate p dysfunction but it did not attain statistical significance (p to 0.781). The maximum flow rate centile (35th vs 34th, p 0.94), post-void residual volume (15 vs 35 ml, p 0.23) and detrusor pressure at maximum flow on urodynamic testing before sling placement (25 vs 24 cm H 2 O, p 0.78) were not significantly different in women with vs without de novo voiding dysfunction. Similarly the maximum flow rate centile (28th vs 21st, p 0.51), change in maximum flow rate centile ( 4 vs 13, p 0.56) and post-void residual volume (11 vs 22 ml, p 0.052) after sling placement were also not significantly different between the 2 groups. There was no significant association between the mobility vector change and improvement/cure of urge urinary incontinence (p 0.16 to 0.29). Figure 3 shows ultrasound images in the mid sagittal plane before and after sling placement in a patient cured of SUI. DISCUSSION Urethral hypermobility is considered an important factor in USI pathophysiology. However, information on urethral mobility after incontinence surgery is lacking in the literature unless one considers bladder neck mobility, cotton swab angles, urethrovesical angle or bladder neck descent to indicate urethral mobility. These parameters at best focus on bladder neck mobility and give no information on the rest of the urethra. One could argue that the cotton swab test describes nothing more than an artifact since the urethra does not usually remain a straight tube upon the Valsalva maneuver.
4 URETHRAL MOTION PROFILE BEFORE AND AFTER SUBURETHRAL SLING PLACEMENT 1453 Figure 3. Ultrasound in mid sagittal plane before (A) and after (B) sling placement in patient cured of SUI. PB, pubic bone. B, bladder. U, urethra. r, rectum. AC, anal canal. M, sling. Masata et al recently described an ultrasound method to assess changes in urethral mobility after a successful TVT procedure. 22 They assessed the urethrovesical junction and fixed urethral points 7, 17 and 27 mm below, representing different parts of the urethra in different individuals since urethral length can vary markedly among patients. We measured urethral length as a mean of 30.8 mm (range 22.9 to 40.1). Thus, the method of Masata et al may not be exact enough to serve as a research tool to study urethral support and mobility. In that study mobility was significantly decreased in all parts of the urethra upon the Valsalva maneuver after TVT placement. In contrast, we found significantly decreased urethral mobility only at the proximal and mid urethra (points 2 to 4). No significant change in mobility was noted at the bladder neck or the distal urethra. Differences in methodology may partly explain the discrepancies in findings and a transobturator tape cannot be considered fully equivalent to a TVT. We noted no significant changes in bladder neck mobility after suburethral sling placement. Other groups reported similar findings after TVT placement. 18,23,24 Unlike colposuspension, which supposedly works by immobilizing the bladder neck, 6,7 suburethral slings seem to exert a different effect. These procedures seem to be curative by limiting the mobility of the mid urethra rather than the internal meatus, likely leading to mid urethral compression. In a study of the correlation of UMP with SUI and USI an increased mobility vector distance of point 2 to 4, ie the proximal and mid urethra, significantly correlated with SUI and a USI diagnosis significantly correlated with the mobility vector distance of all 6 points with the correlation strongest for points 2to4. 25 Central urethral mobility rather than bladder neck mobility seems to be most strongly affected in SUI cases, suggesting possibly impaired urethral support/fixation of this part of the urethra. Thus, suburethral slings may be more physiological in their action than colposuspension procedures, as supported by urodynamic studies after TVT and colposuspension. No significant change in urodynamic parameters except positive pressure transmission in the mid portion of the urethra of those cured or improved was noted after TVT. 23 However, after colposuspension significantly increased voiding detrusor pressure and slowing of the maximum flow rate may suggest a degree of outlet obstruction as a result of bladder neck immobilization. 26 To our knowledge this is the first study using ultrasound to examine the effect of suburethral slings on mobility of the entire urethra. While currently available data mainly focus on bladder neck mobility after incontinence procedures, 13,14 this parameter cannot be considered to signify urethral mobility. The methodology described is a clear improvement on previously used methods and it may be useful in future studies, eg to investigate urethral trajectory during cough or the Valsalva maneuver. With current ultrasound technology the UMP methodology may become useful for this purpose. Instead of focusing on movement amplitudes we also plan to study the timing and direction of urethral segmental movement along the lines of the pioneering series by Lovegrove et al. 27 CONCLUSIONS There is a significant decrease in mobility of the central aspects of the urethra after Monarc suburethral sling placement. No significant changes in mobility were found for the bladder neck or the external meatus. Unlike colposuspension, this suburethral sling seems to limit central urethral rather than bladder neck mobility, a curative mechanism that may be more physiological. ACKNOWLEDGMENTS Wai Yee Kay assisted with semi-automated program development.
5 1454 URETHRAL MOTION PROFILE BEFORE AND AFTER SUBURETHRAL SLING PLACEMENT REFERENCES 1. Chiarelli P, Brown W and McElduff P: Leaking urine: prevalence and associated factors in Australian women. Neurourol Urodyn 1999; 18: Hunskaar S, Lose G, Sykes D et al: The prevalence of urinary incontinence in women in four European countries. BJU Int 2004; 93: Hannestad YS, Rortveit G, Sandvik H et al: A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence in the County of Nord-Trondelag. J Clin Epidemiol 2000; 53: Lee KS, Sung HH, Na S et al: Prevalence of urinary incontinence in Korean women: results of a National Health Interview survey. World J Urol 2008; 26: Enhorning GE: A concept of urinary continence. Urol Int 1976; 31: Vierhout ME and Hol M: Vaginal ultrasound studies before and after successful colposuspension and in continent controls. Acta Obstet Gynecol Scand 1998; 77: Viereck V, Pauer HU, Hesse O et al: Urethral hypermobility after anti-incontinence surgery a prognostic indicator? Int Urogynecol J 2006; 17: Dietz HP and Wilson PD: Colposuspension success and failure: a long-term objective follow-up study. Int Urogynecol J 2000; 11: Eriksen BC, Hagenn B, Eik-Nes SH et al: Longterm effectiveness of the Burch colposuspension in female urinary stress incontinence. Acta Obstet Gynecol Scand 1990; 69: Feyereisl J, Dreher E, Haenggi W et al: Long-term results after Burch colposuspension. Am J Obstet Gynecol 1994; 171: Alcalay M, Monga A and Stanton SL: Burch colposuspension: a year follow up. Br J Obstet Gynaecol 1995; 102: Nilsson C, Falconer C and Rezapour M: Sevenyear follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol 2004; 104: Atherton MJ and Stanton SL: A comparison of bladder neck movement and elevation after tension-free vaginal tape and colposuspension. Br J Obstet Gynaecol 2000; 107: Bakas P, Liapis A and Creatsas G: Q-tip test and tension-free vaginal tape in the management of female patients with genuine stress incontinence. Gynecol Obstet Invest 2002; 53: MeLennan MT, Melick CF and Cannon S: The position of the urethrovesical junction after incontinence surgery: early postoperative changes. Int Urogynecol J 2004; 15: Ng CCM, Lee LC and Han WHC: Use of threedimensional ultrasound scan to assess the clinical importance of midurethral placement of the tension-free vaginal tape. Int Urogynecol J 2005; 16: Lo TS, Horng SG, Liang CC et al: Ultrasound assessment of mid-urethra tape at three-year follow-up after tension-free vaginal tape procedure. J Urol 2004; 63: Dietz HP, Mouritsen L, Ellis G et al: Does the tension-free vaginal tape stay where you put it? Am J Obstet Gynecol 2003; 188: Shek KL and Dietz HP: The urethral motion profile: a novel method to evaluate urethral support and mobility. Aust N Z J Obstet Gynecol 2008; 48: Haylen BT, Ashby D, Sutherst JR et al: Maximum and average urine flow rates in normal male and female populations the Liverpool nomograms. Br J Urol 1989; 64: Dietz HP: Ultrasound imaging of the pelvic floor. Part II: three-dimensional or volume imaging. Ultrasound Obstet Gynecol 2004; 23: Masata J, Martan A, Svabik K et al: Ultrasound imaging of the lower urinary tract after successful tension-free vaginal tape (TVT) procedure. Ultrasound Obstet Gynecol 2006; 28: Lo TS, Wang AC, Horong SG et al: Ultrasonographic and urodynamic evaluation after tension free vaginal tape procedure (TVT). Acta Obstet Gynecol Scand 2001; 80: Sarlos D, Kuronen M and Schaer G: How does tension-free vaginal tape correct stress incontinence? Investigation by perineal ultrasound. Int Urogynecol J 2003; 14: Pipiris A, Shek KL, Kay P et al: Urethral mobility and its relationship with urodynamic diagnosis. Neurourol Urodyn 2009; 28: Lose G, Jorgensen L, Mortensen SO et al: Voiding difficulties after colposuspension. Obstet Gynecol 1987; 69: Lovegrove Jones RC, Peng Q, Stokes M et al: Mechanisms of pelvic floor muscle function and the effect on the urethra during a cough. Eur Urol, Epub before print June 21, 2009.
Transperineal ultrasound to assess the effect of tension-free vaginal tape position on flow rates
Ultrasound Obstet Gynecol 2010; 36: 379 383 Published online 3 August 2010 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.7640 Transperineal ultrasound to assess the effect of tension-free
More informationTwo-dimensional and three-dimensional ultrasound imaging of suburethral slings
Ultrasound Obstet Gynecol 0; : 000 000 Published online in Wiley InterScience (www.interscience.wiley.com). DOI:.0/uog. UOG Two-dimensional and three-dimensional ultrasound imaging of suburethral slings
More informationTreatment Outcomes of Tension-free Vaginal Tape Insertion
Are the Treatment Outcomes of Tension-free Vaginal Tape Insertion the Same for Patients with Stress Urinary Incontinence with or without Intrinsic Sphincter Deficiency? A Retrospective Study in Hong Kong
More informationDiagnosis of cystocele type by clinical examination and pelvic floor ultrasound
Ultrasound Obstet Gynecol 2012; 39: 710 714 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.10156 Diagnosis of cystocele type by clinical examination and pelvic floor
More informationOperative Approach to Stress Incontinence. Goals of presentation. Preoperative evaluation: Urodynamic Testing? Michelle Y. Morrill, M.D.
Operative Approach to Stress Incontinence Goals of presentation Michelle Y. Morrill, M.D. Director of Urogynecology The Permanente Medical Group Kaiser, San Francisco Review preoperative care & evaluation
More informationRole of bladder neck mobility and urethral closure pressure in predicting outcome of tension-free vaginal tape (TVT) procedure
Ultrasound Obstet Gynecol 2006; 28: 214 220 Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/uog.2834 Role of bladder neck mobility and urethral closure pressure in predicting
More informationTape functionality: position, change in shape, and outcome after TVT procedure mid-term results
Int Urogynecol J (2010) 21:795 800 DOI 10.1007/s00192-010-1119-z ORIGINAL ARTICLE Tape functionality: position, change in shape, and outcome after TVT procedure mid-term results Jacek Kociszewski & Oliver
More informationEfficacy and Adverse Effects of Monarc Versus Tension-free Vaginal Tape Obturator: a Retrospective One-year Follow-up Study
Efficacy and Adverse Effects of Monarc Versus Tension-free Vaginal Tape Obturator: a Retrospective One-year Follow-up Study Yvonne KY CHENG MBChB, MRCOG William WK TO MBBS, M Phil, FRCOG, FHKAM (O&G) HX
More informationUltrasound imaging of the lower urinary system in women after Burch colposuspension
Ultrasound Obstet Gynecol 2001; 17: 58 64 Ultrasound imaging of the lower urinary system in Blackwell Original Paper Science, Ltd women after Burch colposuspension A. MARTAN, J. MASATA, M. HALASKA and
More informationModern methods of imaging in urogynecology when do we really need them?
Archives of Perinatal Medicine 23(2), 77 81, 2017 ORIGINAL PAPER Modern methods of imaging in urogynecology when do we really need them? GRZEGORZ SURKONT, EDYTA WLAŹLAK Abstract Imaging is more often used
More informationResolution of urge urinary incontinence with midurethral sling surgery in patients with mixed incontinence and low-pressure urethra
Gynecol Surg (2012) 9:427 432 DOI 10.1007/s10397-012-0735-7 ORIGINAL ARTICLE Resolution of urge urinary incontinence with midurethral sling surgery in patients with mixed incontinence and low-pressure
More informationGuide to Pelvic Floor Multicompartment Scanning
Guide to Pelvic Floor Multicompartment Scanning These guidelines have been prepared by Giulio A. Santoro, MD, PhD, Head Pelvic Floor Unit, Section of Anal Physiology and Ultrasound, Coloproctology Service,
More informationCan we place tension-free vaginal tape where it should be? The one-third rule
Ultrasound Obstet Gynecol 2012; 39: 210 214 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.10050 Can we place tension-free vaginal tape where it should be? The one-third
More informationPelvic Floor Ultrasound Imaging. Prof HP Dietz (Sydney) A/Prof KL Shek (Sydney) Dr R Guzman Rojas (Santiago de Chile) Dr Kamil Svabik (Prague)
Pelvic Floor Ultrasound Imaging Workshop IUGA 2015 Nice Faculty: Prof HP Dietz (Sydney) A/Prof KL Shek (Sydney) Dr R Guzman Rojas (Santiago de Chile) Dr Kamil Svabik (Prague) The use of translabial ultrasound
More informationRisk Factors of Voiding Dysfunction and Patient Satisfaction After Tension-free Vaginal Tape Procedure
J Korean Med Sci 2005; 20: 1006-10 ISSN 1011-8934 Copyright The Korean Academy of Medical Sciences Risk Factors of Voiding Dysfunction and Patient Satisfaction After Tension-free Vaginal Tape Procedure
More informationBoth the middle and distal sections of the urethra may be regarded as optimal targets for outside in transobturator tape placement
DOI 10.1007/s00345-014-1261-1 Original Article Both the middle and distal sections of the urethra may be regarded as optimal targets for outside in transobturator tape placement Michał Bogusiewicz Marta
More informationAnatomical and Functional Results of Pelvic Organ Prolapse Mesh Repair: A Prospective Study of 105 Cases
International Journal of Clinical Urology 2018; 2(1): 20-24 http://www.sciencepublishinggroup.com/j/ijcu doi: 10.11648/j.ijcu.20180201.14 Anatomical and Functional Results of Pelvic Organ Prolapse Mesh
More informationUrethral pressure measurement in stress incontinence: does it help?
Int Urol Nephrol (2009) 41:491 495 DOI 10.1007/s11255-008-9506-9 UROLOGY - ORIGINAL PAPER Urethral pressure measurement in stress incontinence: does it help? Bassem S. Wadie Æ Ahmed S. El-Hefnawy Received:
More informationTension-free Vaginal Tape for Urodynamic Stress Incontinence
Long-term Results of Tension-free Vaginal Tape Insertion for Urodynamic Stress Incontinence in Chinese Women at Eight-year Follow-up: a Prospective Study YM CHAN MBBS, MRCOG, FHKAM (O&G), DCG, DCH, DFM,
More informationThe prevalence of major abnormalities of the levator ani in urogynaecological patients
DOI: 10.1111/j.1471-0528.2006.00819.x www.blackwellpublishing.com/bjog Urogynaecology The prevalence of major abnormalities of the levator ani in urogynaecological patients HP Dietz, a AB Steensma b a
More informationIntroital ultrasound in the diagnosis of lower urinary tract symptoms following anti-incontinence surgery using a synthetic midurethral tape
International Urogynecology Journal https://doi.org/10.1007/s00192-018-3837-6 ORIGINAL ARTICLE Introital ultrasound in the diagnosis of lower urinary tract symptoms following anti-incontinence surgery
More informationDoes levator ani injury affect cystocele type?
Ultrasound Obstet Gynecol 2010; 36: 618 623 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.7712 Does levator ani injury affect cystocele type? V. H. EISENBERG*, V.
More informationPrediction and prevention of stress urinary incontinence after prolapse surgery van der Ploeg, J.M.
UvA-DARE (Digital Academic Repository) Prediction and prevention of stress urinary incontinence after prolapse surgery van der Ploeg, J.M. Link to publication Citation for published version (APA): van
More informationInternational Federation of Gynecology and Obstetrics
International Federation of Gynecology and Obstetrics COMMITTEE FOR UROGYNAECOLOGY AND PELVIC FLOOR MEMBER: TSUNG-HSIEN (CHARLES) SU, CHAIR (TAIWAN) DAVID RICHMOND, CO-CHAIR (UK) CHITTARANJAN PURANDARE,
More informationIs levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement?
Ultrasound Obstet Gynecol 2013; 42: 230 234 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.12433 Is levator avulsion a predictor of cystocele recurrence following anterior
More informationBallooning of the levator hiatus
Ultrasound Obstet Gynecol 2008; 31: 676 680 Published online 12 May 2008 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/uog.5355 Ballooning of the levator hiatus H. P. DIETZ*, C. SHEK*,
More informationKEYWORDS: cystocele; laparoscopic Burch colposuspension; ultrasound cystourethrography; urodynamic stress incontinence; voiding function
Ultrasound Obstet Gynecol 2005; 25: 289 295 Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/uog.1838 Dynamic morphological changes in the anterior vaginal wall before
More informationPredictors of Postoperative Voiding Dysfunction following Transobsturator Sling Procedures in Patients with Stress Urinary Incontinence
Voiding Dysfunction INJ 2010;14:26-33 Predictors of Postoperative Voiding Dysfunction following Transobsturator Sling Procedures in Patients with Stress Urinary Incontinence Sung-Tae Cho, Hyeong-Cheol
More informationMinimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound
Int Urogynecol J (2011) 22:699 704 DOI 10.1007/s00192-010-1329-4 ORIGINAL ARTICLE Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound Hans Peter Dietz &
More informationLong-term follow-up of sacrocolpopexy mesh implants at two time intervals at least 1 year apart using 4D transperineal ultrasound
Ultrasound Obstet Gynecol 2017; 49: 398 403 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.15891 Long-term follow-up of sacrocolpopexy mesh implants at two time intervals
More informationOne Slim Needle One Incision. One Simple Solution for Stress Urinary Incontinence. The Difference is in the Data
CONTINENCE SOLUTIONS One Slim Needle One Incision ordering information Description US International Order Number Order Number One Simple Solution for Stress Urinary Incontinence MiniArc Single-Incision
More informationIntraoperative Observation of the Degree and Pattern of Urine Leakage before Adjustment of the Mesh during a Transobturator Tape Procedure
Original Article www.cmj.ac.kr Intraoperative Observation of the Degree and Pattern of Urine Leakage before Adjustment of the Mesh during a Transobturator Tape Procedure Jae-Joon Park, Hyung Ho Lee 1 and
More informationBrief involuntary urine loss associated with an increase in abdominal pressure. Pathophysiology of Stress Urinary Incontinence Edward J.
TREATMENT OF SUI Pathophysiology of Stress Urinary Incontinence Edward J. McGuire, MD Department of Urology, University of Michigan Medical Center, Ann Arbor, MI All cases of stress urinary incontinence
More informationKey Words: urinary incontinence, suburethral slings
Evaluation of Transobturator Tension-Free Vaginal Tapes in the Surgical Management of Mixed Urinary Incontinence: 3-Year Outcomes of a Randomized Controlled Trial Mohamed Abdel-Fattah,*, Laura R. Hopper
More informationUrodynamics in women. Aims of Urodynamics in women. Why do Urodynamics?
Urodynamics in women Chendrimada Madhu MD, MA, MRCOG Subspecialty Trainee in Urogynaecology Southmead Hospital 2013 Aims of Urodynamics in women n Confirmation of incontinence and its cause n Definition
More informationLong-Term Durability of the Distal Urethral Polypropylene Sling for the Treatment of Stress Urinary Incontinence: Minimum 11-Year Followup
Long-Term Durability of the Distal Urethral Polypropylene Sling for the Treatment of Stress Urinary Incontinence: Minimum 11-Year Followup Lisa Rogo-Gupta,*, Z. Chad Baxter, Ngoc-Bich Le, Shlomo Raz and
More informationAssociation between ICS POP-Q coordinates and translabial ultrasound findings: implications for definition of normal pelvic organ support
Ultrasound Obstet Gynecol 216; 47: 36368 Published online 29 January 216 in Wiley Online Library (wileyonlinelibrary.com). DOI: 1.12/uog.14872 Association between ICS POP-Q coordinates and translabial
More informationTVT-O versus Monarc after a 2 4-year follow-up: a prospective comparative study
Int Urogynecol J (2009) 20:1327 1333 DOI 10.1007/s00192-009-0943-5 ORIGINAL ARTICLE TVT-O versus Monarc after a 2 4-year follow-up: a prospective comparative study R. Marijn Houwert & Charlotte Renes-Zijl
More informationLong-Term Outcome of the Tension-Free Vaginal Tape Procedure in Female Urinary Incontinence: A 6-Year Follow-Up
www.kjurology.org DOI:10.4111/kju.2010.51.6.409 Voiding Dysfunction Long-Term Outcome of the Tension-Free Vaginal Tape Procedure in Female Urinary Incontinence: A 6-Year Follow-Up Jun Hyung Lee, Min Chul
More informationUrethral hypermobility after anti-incontinence surgery a prognostic indicator?
Int Urogynecol J (2006) 17: 586 592 DOI 10.1007/s00192-006-0071-4 ORIGINAL ARTICLE Volker Viereck. Hans-Ulrich Pauer. Oda Hesse. Werner Bader. Ralf Tunn. Rainer Lange. Reinhard Hilgers. Günter Emons Urethral
More informationI-STOP TOMS Transobturator Male Sling
I-STOP TOMS Transobturator Male Sling The CL Medical I-STOP TOMS sling for male stress urinary incontinence was developed in France where it is widely used and is the market leader. It is constructed with
More informationNew Insights in the Surgical Management of Stress Urinary Incontinence in Women
New Insights in the Surgical Management of Stress Urinary Incontinence in Women Gabriel Gillon MD Dept. of Urology Rabin Med. Cent. /Beilinson Incontinence and LUTS 25/6/2009 Symposium Ramat Aviv New Insights
More informationq7:480499_P0 6/5/09 10:23 AM Page 1 WHAT YOU SHOULD KNOW ABOUT YOUR DIAGNOSIS OF STRESS URINARY INCONTINENCE
493495.q7:480499_P0 6/5/09 10:23 AM Page 1 WHAT YOU SHOULD KNOW ABOUT YOUR DIAGNOSIS OF STRESS URINARY INCONTINENCE 493495.q7:480499_P0 6/5/09 10:23 AM Page 2 What is Stress Urinary Incontinence? Urinary
More informationSequential Assessment of Urodynamic Findings before and aftertension-free Vaginal Tape (TVT) Operation for Female Genuine Stress Incontinence
European Urology European Urology 45 (2004) 362 366 Sequential Assessment of Urodynamic Findings before and aftertension-free Vaginal Tape (TVT) Operation for Female Genuine Stress Incontinence Long-Yau
More informationUrodynamic findings in women with insensible incontinence
bs_bs_banner International Journal of Urology (2013) 20, 429 433 doi: 10.1111/j.1442-2042.2012.03146.x Original Article: Clinical Investigation Urodynamic findings in women with insensible Benjamin M Brucker,
More informationPUBOVAGINAL SLING IN THE TREATMENT OF STRESS URINARY INCONTINENCE FOR URETHRAL HYPERMOBILITY AND INTRINSIC SPHINCTERIC DEFICIENCY
Urological Neurology International Braz J Urol Official Journal of the Brazilian Society of Urology PUBOVAGINAL SLING IN SUI Vol. 29 (6): 540-544, November - December, 2003 PUBOVAGINAL SLING IN THE TREATMENT
More informationHow to Achieve Long-Term Success in the Treatment of Female Urinary Stress Incontinence? Novel Modification on Vaginal Sling
www.kjurology.org DOI:10.4111/kju.2011.52.3.184 Voiding Dysfunction How to Achieve Long-Term Success in the Treatment of Female Urinary Stress Incontinence? Novel Modification on Vaginal Sling Mahmoud
More informationFive-Year Outcomes of the Tension-Free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence
european urology 50 (2006) 333 338 available at www.sciencedirect.com journal homepage: www.europeanurology.com Female Urology Incontinence Five-Year Outcomes of the Tension-Free Vaginal Tape Procedure
More informationORIGINAL ARTICLE. Judith A. Thompson & Peter B. O Sullivan & N. Kathryn Briffa & Patricia Neumann
Int Urogynecol J (2007) 18:779 786 DOI 10.1007/s00192-006-0225-4 ORIGINAL ARTICLE Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions
More informationEffect of Anesthesia on Voiding Function After Tension-Free Vaginal Tape Procedure
Effect of Anesthesia on Voiding Function After Tension-Free Vaginal Tape Procedure M. Murphy, MD, M. H. Heit, MD, MSPH, L. Fouts, MD, C. A. Graham, MD, L. Blackwell, RN, and P. J. Culligan, MD OBJECTIVE:
More informationEfficacy and Safety of the TVT-SECUR R and Impact on Quality of Life in Women with Stress Urinary Incontinence: A 2-Year Follow-Up
www.kjurology.org DOI:10.4111/kju.2011.52.5.335 Voiding Dysfunction Efficacy and Safety of the TVT-SECUR R and Impact on Quality of Life in Women with Stress Urinary Incontinence: A 2-Year Follow-Up Yu
More informationWhy are some women with pelvic floor dysfunction unable to contract their pelvic floor muscles?
Australian and New Zealand Journal of Obstetrics and Gynaecology 2013; 53: 574 579 DOI: 10.1111/ajo.12133 Original Article Why are some women with pelvic floor dysfunction unable to contract their pelvic
More informationPRE-OPERATIVE URODYNAMIC
PRE-OPERATIVE URODYNAMIC STUDIES: IS THERE VALUE IN PREDICTING POST-OPERATIVE STRESS URINARY INCONTINENCE IN WOMEN UNDERGOING PROLAPSE SURGERY? Dr K Janse van Rensburg Dr JA van Rensburg INTRODUCTION POP
More informationImpact of the Midurethral Sling Procedure on Quality of Life in Women with Urinary Incontinence
www.kjurology.org DOI:10.4111/kju.2010.51.2.122 Voiding Dysfunction Impact of the Midurethral Sling Procedure on Quality of Life in Women with Urinary Incontinence Hwa Su Lim, Jong Min Kim, Phil Hyun Song,
More informationThis information is intended as an overview only
This information is intended as an overview only Please refer to the INSTRUCTIONS FOR USE included with this device for indications, contraindications, warnings, precautions and other important information
More informationIncidence and Risk Factors of Postoperative De Novo Voiding Dysfunction following Midurethral Sling Procedures
Incidence and Risk Factors of Postoperative De Novo Voiding Dysfunction following Midurethral Sling Procedures Hoon Ah Jang, Jae Hyun Bae, Jeong Gu Lee From the Department of Urology, College of Medicine,
More informationClinical Study Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator Tape in Female Urinary Stress Incontinence
BioMed Research International Volume 2016, Article ID 6495858, 6 pages http://dx.doi.org/10.1155/2016/6495858 Clinical Study Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator
More informationTension-Free Vaginal Taping in Pakistani Women with Stress Urinary Incontinence
ORIGINAL ARTICLE Tension-Free Vaginal Taping in Pakistani Women with Stress Urinary Incontinence Ayesha Saleem ABSTRACT Objective: To evaluate the effectiveness and determine the peroperative and postoperative
More informationValue of UVJ-M in the diagnosis of SUI in late pregnancy and postpartum
1772 Value of UVJ-M in the diagnosis of SUI in late pregnancy and postpartum GUIXIN ZHANG 1, WEI JIANG 1, QUANWEI GUO 2 and QUANRONG GUO 3 Departments of 1 Obstetrics and Gynecology, 2 Ultrasonography,
More informationDepartment of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
Original Article The role of trans-obturator vaginal tape (TVT-O) in the management of female stress urinary incontinence: 2 years follow up, Minia University Experience Ahmed M. Abdel ghany Department
More informationNATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SCOPE. Urinary incontinence: the management of urinary incontinence in women
NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE 1 Guideline title SCOPE Urinary incontinence: the management of urinary incontinence in women 1.1 Short title Urinary incontinence 2 Background a) The National
More informationFemale Urology Evaluation of Transobturator Tension-free Vaginal Tapes in Management of Women With Recurrent Stress Urinary Incontinence
Female Urology Evaluation of Transobturator Tension-free Vaginal Tapes in Management of Women With Recurrent Stress Urinary Incontinence Mohamed Abdel-Fattah, Ian Ramsay, Stewart Pringle, Chris Hardwick,
More informationLaparoscopic sacrocolpopexy: how low does the mesh go?
Ultrasound Obstet Gynecol 2017; 49: 404 408 Published online 7 February 2017 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.15882 Laparoscopic sacrocolpopexy: how low does the mesh
More informationChapter 5. Steven E. Schraffordt Koops MD * Tanya M. Bisseling MD, PhD ** A. Peter M. Heintz MD, PhD *** Harry A.M.
Chapter 5 The effectiveness of Tension-free Vaginal Tape (TVT) and quality of life measured in women with previous urogynecological surgery: Analysis from The Netherlands TVT database Steven E. Schraffordt
More informationA Simplified Urinary Incontinence Score for the Evaluation of Treatment Outcomes
Neurourology and Urodynamics 19:127 135 (2000) A Simplified Urinary Incontinence Score for the Evaluation of Treatment Outcomes Asnat Groutz, Jerry G. Blaivas,* and Jarrod E. Rosenthal Weill Medical College,
More informationInfluence of Obesity on Short-term Surgical Outcome of the Transobturator Tape Procedure in Patients with Stress Urinary Incontinence
Urinary Incontinence INJ 2010;14:13-19 Influence of Obesity on Short-term Surgical Outcome of the Transobturator Tape Procedure in Patients with Stress Urinary Incontinence Dong-Un Tchey, Won-Tae Kim,
More informationAn Introduction to 4D View TM (Version 5.0)
9 An Introduction to 4D View TM (Version 5.0) Hans Peter Dietz This book includes a DVD that contains a version of the software 4D View (version 5.0), courtesy of GE Medical, Kretz Ultrasound, Zipf, Austria.
More informationPELVIC FLOOR ULTRASOUND
PELVIC FLOOR ULTRASOUND How, When, Why Part 1: Phyllis Glanc MD Sunnybrook Health Science Center University of Toronto Phyllis.Glanc@sunnybrook.ca www.phyllisglanc.com (current exact handout) Disclosures
More informationNIH Public Access Author Manuscript Int Urogynecol J Pelvic Floor Dysfunct. Author manuscript; available in PMC 2010 January 1.
NIH Public Access Author Manuscript Published in final edited form as: Int Urogynecol J Pelvic Floor Dysfunct. 2009 February ; 20(2): 171 175. doi:10.1007/ s00192-008-0738-0. The Cough Game : Are there
More informationTo compare intermittent catheterization, sling mobilization and sling transection for treatment of
1 ABSTRACT: Objective: To compare intermittent catheterization, sling mobilization and sling transection for treatment of urinary retention after mid-urethral sling surgery. Methods: Data registered in
More informationTreatment of Female Stress Urinary Incontinence by Trans-Obturaror Tension-Free Vaginal Tape (TVT-O): A Prospecive Controlled Study
Med. J. Cairo Univ., Vol. 79, No. 1, June: 267-272, 2011 www.medicaljournalofcairouniversity.com Treatment of Female Stress Urinary Incontinence by Trans-Obturaror Tension-Free Vaginal Tape (TVT-O): A
More informationThree-dimensional transperineal ultrasound for imaging mesh implants following sacrocolpopexy
Ultrasound Obstet Gynecol 2014; 43: 459 465 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.13303 Three-dimensional transperineal ultrasound for imaging mesh implants
More informationPathophysiological Rationale for Surgical Treatments of Stress Urinary Incontinence
Pathophysiological Rationale for Surgical Treatments of Stress Urinary Incontinence Urology Grand Rounds April 6, 2005 Herman Christopher Kwan R4 A familiar case? 62 year old female initial presentation
More informationSpecial Thank You NO DISCLOSURES. Objectives. Pelvic Floor Dysfunction Role of Ultrasound Text
Special Thank You Pelvic Floor Dysfunction Role of Ultrasound Phyllis Glanc Sunnybrook Health Sciences Center Department Medical Imaging Associate Professor, University of Toronto phyllis.glanc@sunnybrook.ca
More informationAre complications of stress urinary incontinence surgery procedures associated with the position of the sling?
International Journal of Urology (2016) doi: 10.1111/iju.13262 Original Article Are complications of stress urinary incontinence surgery procedures associated with the position of the sling? Jacek Kociszewski,
More informationRepeat midurethral sling treatment for prior midurethral sling failure
Gynecol Surg (2012) 9:17 21 DOI 10.1007/s10397-011-0675-7 REVIEW ARTICLE Repeat midurethral sling treatment for prior midurethral sling failure Chi-Feng Su & Kwong-Pang Tsui & Horng-Jyh Tsai & Gin-Den
More informationClinical Study Cough Test during Tension-Free Vaginal Tape Procedure in Preventing Postoperative Urinary Retention
Advances in Urology Volume 2013, Article ID 797854, 4 pages http://dx.doi.org/10.1155/2013/797854 Clinical Study Cough Test during Tension-Free Vaginal Tape Procedure in Preventing Postoperative Urinary
More informationFACTORS AFFECTING VOIDING FUNCTION IN UROGYNECOLOGY PATIENTS
ORIGINAL ARTICLE FACTORS AFFECTING VOIDING FUNCTION IN UROGYNECOLOGY PATIENTS Ling-Hong Tseng*, Ching-Chung Liang, Pei-Kwei Tsay 1, Alex C. Wang, Tsia-Shu Lo, Yi-Hao Lin Department of Obstetrics and Gynecology,
More informationManagement of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women
UROLOGY doi 10.1308/003588412X13373405385610 Management of recurrent stress urinary incontinence and urinary retention following midurethral sling H Hashim 1, TR Terry 2 1 North Bristol NHS Trust, UK 2
More informationINJ. Original Article INTRODUCTION. Int Neurourol J 2010;14: doi: /inj pissn eissn
Original Article Int Neurourol J 21;14:267-271 pissn 293-4777 eissn 293-6931 International Neurourology Journal The Influence of Preoperative Bladder Outlet Obstruction on Continence and Satisfaction in
More informationKathleen C. Kobashi, MD, FACS Head, Section of Urology and Renal Transplantation Virginia Mason Medical Center, Seattle, WA
Kathleen C. Kobashi, MD, FACS Head, Section of Urology and Renal Transplantation Virginia Mason Medical Center, Seattle, WA Disclosures Advisory Board and/or Speaker Allergan Medtronic Astellas AUA Guidelines
More informationA PATIENT GUIDE TO Understanding Stress Urinary Incontinence
A PATIENT GUIDE TO Understanding Stress Urinary Incontinence Q: What is SUI? A: Stress urinary incontinence is defined as the involuntary leakage of urine. The problem afflicts approximately 18 million
More informationThe Suprapubic Arch Sling Procedure for Treatment of Stress Urinary Incontinence: A 5-Year Retrospective Study
EUROPEAN UROLOGY 57 (2010) 897 901 available at www.sciencedirect.com journal homepage: www.europeanurology.com Female Urology Incontinence The Suprapubic Arch Sling Procedure for Treatment of Stress Urinary
More informationUltrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse
www.kjurology.org http://dx.doi.org/10.4111/kju.2012.53.10.691 Voiding Dysfunction Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse Vesna S. Antovska
More informationBurch Colposuspension and Tension-Free Vaginal Tape in the Management of Stress Urinary Incontinence in Women
European Urology European Urology 41 2002) 469±473 Colposuspension and Tension-Free Vaginal Tape in the Management of Stress Urinary Incontinence in Women A. Liapis *, P. Bakas, G. Creatsas 2nd Department
More informationSPARC Sling System for Treatment of Female Stress Urinary Incontinence in the Elderly
european urology 50 (2006) 826 831 available at www.sciencedirect.com journal homepage: www.europeanurology.com Female Urology Incontinence SPARC Sling System for Treatment of Female Stress Urinary Incontinence
More informationReview Article Complications following Tension-Free Vaginal Tapes: Accurate Diagnosis and Complications Management
BioMed Research International Volume 2015, Article ID 538391, 5 pages http://dx.doi.org/10.1155/2015/538391 Review Article Complications following Tension-Free Vaginal Tapes: Accurate Diagnosis and Complications
More informationUroToday International Journal. Volume 3 - October 2010
UroToday International Journal Osama Abdelwahab, Hammouda Sherif Department of Urology, Faculty of Medicine, Benha University, Benha, Egypt Submitted August 18, 2010 - Accepted for Publication September
More informationIraqi JMS. Perineal Ultrasound for Evaluating Bladder Neck and Urethra in Stress Urinary Incontinence
Iraqi JMS Published by Al-Nahrain College of Medicine ISSN 1681-6579 Email: iraqi_jms_alnahrain @yahoo.com http://www.colmed-nahrain.edu.iq/ Perineal Ultrasound for Evaluating Bladder Neck and Urethra
More informationPrognostic value of urethral mobility and valsalva leak point pressure for female transobturator sling procedure
original Article Vol. 38 (5): 667-673, September - October, 2012 Prognostic value of urethral mobility and valsalva leak point pressure for female transobturator sling procedure Luis Gustavo Morato de
More informationOutcomes of Midurethral Slings in Women with Concomitant Preoperative Severe Lower Urinary Tract Voiding Symptoms
ORIGINAL RESEARCH The Ochsner Journal 15:223 227, 2015 Ó Academic Division of Ochsner Clinic Foundation Outcomes of Midurethral Slings in Women with Concomitant Preoperative Severe Lower Urinary Tract
More informationHow can we measure bladder volumes in women with advanced pelvic organ prolapse?
Ultrasound Obstet Gynecol 215; 46: 233 238 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 1.12/uog.14678 How can we measure bladder volumes in women with advanced pelvic organ
More informationClinical Curriculum: Urogynecology
Updated July 201 Clinical Curriculum: Urogynecology GOAL: The primary goal of the Urogynecology rotation at the University of Alabama at Birmingham (UAB) is to train physicians to have a broad knowledge
More informationNIH Public Access Author Manuscript Int Urogynecol J. Author manuscript; available in PMC 2012 December 06.
NIH Public Access Author Manuscript Published in final edited form as: Int Urogynecol J. 2011 December ; 22(12): 1491 1495. doi:10.1007/s00192-011-1458-4. URETHRAL CLOSURE PRESSURES AMONG PRIMIPAROUS WOMEN
More informationNew imaging method for assessing pelvic floor biomechanics
Ultrasound Obstet Gynecol 2008; 31: 201 205 Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/uog.5219 New imaging method for assessing pelvic floor biomechanics I. THYER*,
More informationABSTRACT R.D. MOORE, D.O., F.A.C.O.G., F.A.C.S. DIRECTOR, ADVANCED PELVIC SURGERY DIRECTOR, UROGYNECOLOGY ATLANTA UROGYNECOLOGY ASSOCIATES ATLANTA, GA
Single-Center Retrospective Study of the Technique, Safety, and 12-Month Efficacy of the MiniArc Single-Incision Sling: A New Minimally Invasive Procedure for Treatment of Female SUI R.D. MOORE, D.O.,
More informationMedical Policy Title: Radiofrequency ARBenefits Approval: 10/19/2011
Medical Policy Title: Radiofrequency ARBenefits Approval: 10/19/2011 Treatment, Urinary Stress Incontinence, Transurethral Effective Date: 01/01/2012 Document: ARB0359 Revision Date: Code(s): 53860 Transurethral
More informationIs pelvic organ support different between young nulliparous African and Caucasian women?
Ultrasound Obstet Gynecol 2016; 47: 774 778 Published online 2 May 2016 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.15811 Is pelvic organ support different between young nulliparous
More informationBiometry of the pubovisceral muscle and levator hiatus by three-dimensional pelvic floor ultrasound
Ultrasound Obstet Gynecol 2005; 25: 580 585 Published online 10 May 2005 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/uog.1899 Biometry of the pubovisceral muscle and levator hiatus
More informationWhat you should know about your diagnosis of incontinence
What you should know about your diagnosis of incontinence What is Stress Urinary Incontinence? WHAT IS NORMAL URINARY FUNCTION? Urine is a normal waste product of the body that is manufactured by the kidneys
More information