Lower urinary tract symptoms in female patients with pelvic organ prolapse: Efficacy of pelvic floor reconstruction
|
|
- Jessie Rafe Scott
- 5 years ago
- Views:
Transcription
1 bs_bs_banner International Journal of Urology (14) 1, doi:.1111/iju.181 Original Article: Clinical Investigation Lower urinary tract symptoms in female patients with pelvic organ prolapse: Efficacy of pelvic floor reconstruction Daisuke Obinata, Kenya Yamaguchi, Akiko Ito, Yasutaka Murata, Daisaku Ashikari, Tomohiro Igarashi, Katsuhiko Sato, Junichi Mochida, Yataro Yamanaka and Satoru Takahashi Department of Urology, Nihon University School of Medicine, Tokyo, Japan Abbreviations & Acronyms HRQL = health-related quality of life ICIQ-SF = International Consultation on Incontinence Questionnaires Short Form IPSS = International Prostate Symptom Score LUTS = lower urinary tract symptoms MFR = maximal flow rate OAB-Q = overactive bladder questionnaire POP = pelvic organ prolapse POP-Q = pelvic organ prolapse quantification PVR = postvoid residual QOL = quality of life SUI = stress urinary incontinence TOT = transobturator tape TVM = tension-free vaginal mesh Correspondence: Satoru Takahashi M.D., Ph.D., Department of Urology, Nihon University School of Medicine, 30-1 Ooyaguchikamicho, Itabashi, Tokyo , Japan. takahashi.satoru@nihon-u.ac.jp Received 14 March 13; accepted 14 August 13. Online publication 30 September 13 Objective: To evaluate the impact of pelvic floor reconstruction on lower urinary tract symptoms in patients with pelvic organ prolapse. Methods: We carried out a prospective study at a single institution. A total of 3 female patients who underwent tension-free vaginal mesh surgery for pelvic organ prolapse between January 06 and February were enrolled and prospectively evaluated. A total of 171 cases with concurrent stress urinary incontinence (76% of all cases) underwent concomitant transobturator tape sling. For evaluation of lower urinary tract symptoms, parameters included International Prostate Symptom Score, its quality of life score, International Consultation on Incontinence Questionnaires Short Form, overactive bladder questionnaire, maximal flow rate and postvoid residual. These parameters were evaluated at baseline, and at 3, 6 and 1 months after the surgery. Results: The severity of International Prostate Symptom Score total scores significantly correlated with preoperative pelvic organ prolapse quantification stages, overactive bladder questionnaire total scores and International Consultation on Incontinence Questionnaires Short Form scores. A total of 37% of stage 4 showed International Prostate Symptom Score (severe cases). Postvoid residual significantly increased in stage 4 compared with stage. Tension-free vaginal mesh improved International Prostate Symptom Score, overactive bladder questionnaire and International Consultation on Incontinence Questionnaires Short Form significantly, and also achieved grade 0 pelvic organ prolapse quantification in 91% of all cases at 1 year after surgery. Postvoid residual values significantly improved and remained stable for 1 year. Worse overactive bladder questionnaire score was a significant predictive factor for poor postoperative International Prostate Symptom Score. Conclusion: The tension-free vaginal mesh plus transobturator tape procedure improves lower urinary tract symptoms in the majority of patients presenting pelvic organ prolapse. Key words: lower urinary tract symptoms, pelvic organ prolapse, quality of life, tensionfree vaginal mesh. Introduction POP is a common problem in the aging female. It has been reported that 11% of women in the USA have surgery for POP and/or a related condition by the age of years. 1 Recent studies have shown that POP impacts health-related QOL, as well as lower urinary tract function. 4 Although LUTS are common in women of all ages, the prevalence rises with age. Reports show that many of the female patients with LUTS have associated POP. Therefore, the treatment of POP might be effective for the improvement of female LUTS that cause a negative effect on QOL. The surgical procedure, known as TVM surgery, involved the implantation of a synthetic mesh (polypropylene mesh) in areas of vesicovaginal and rectovaginal dissection spaces. Although conventional treatment strategies for POP repair have a recurrence rate of 30%, 1,6,7 TVM surgery has gained popularity in POP repair since the higher rates of successful treatment. Consistent with previous reports, we have reported 9.3% of anatomical cure rates at 1 year with low incidences of surgical complications. 8,9 Although several studies have shown a relationship of POP with LUTS,,11 or the anatomical efficacies of TVM for POP, 1,13 just a few papers have prospectively evaluated both issues in the same cases, and the efficacies of concomitant TOT sling for SUI. 14 In the present study, we prospectively evaluated LUTS in patients with POP, and 1-year clinical efficacies of the TVM ± TOT procedure. 13 The Japanese Urological Association 301
2 D OBINATA ET AL. Table 1 Methods Patient characteristics and preoperative assessments n (SD) Age (years) 67. (7.9) Parity.1 (0.6) Number of previous or occult SUI 171 History of POP surgery 1 Previous hysterectomy 8 Preoperative POP-Q stage Stage 9 Stage 3 11 Stage 4 73 Procedure A-TVM 1 AP-TVM 6 Total TVM 8 Concomitant TOT 171 LUTS evaluations IPSS total score 13. (9.0) IPSS QOL score 4. (1.) OAB-q total score 67.4 (3.) ICIQ-SF 7. (.7) n = 3. These studies were carried out at a single institution after approval of the ethics committee and institutional review board of Nihon University School of Medicine (approval number: 0903). All participants gave their written informed consent to participate in the present study and undergo the TVM ± TOT procedure. Patients who underwent TVM surgery with various types of POP were considered eligible. Exclusion criteria included: previous history of treatment of POP, presence of an apparent neurogenic bladder or urogenital malignancy. Between January 06 and February, 3 female patients of 4 recruited cases agreed to participate in the study and were eligible. A total of 3 individuals were qualified as stage in the POP-Q system, 1 A total of 118 and 73 were stage 3 and 4, respectively (Table 1). All cases had cystocele, including eight cases with vaginal vault prolapse, 1 with uterine prolapse and 36 with rectocele. After obtaining written informed consents, anterior TVM repair was carried out in 1 cases with cystocele, anterior/posterior TVM in 4 cases with prolapse of the apical compartment, and total TVM in eight cases with vaginal vault prolapse. A total of 171 cases with concurrent SUI (76% of all cases) underwent concomitant TOT sling because of concurrent SUI (Table 1). SUI was confirmed by a pad test or stress test. The degree of POP was evaluated by the POP-Q system. To evaluate LUTS and the related QOL, we used IPSS, IPSS-QOL score, OAB-Q, 16 and ICIQ-SF. 17 As objective parameters, we evaluated MFR (ml/s) and PVR (ml). The efficacies and complications of each patient were systematically assessed before, and 3, 6 and 1 months after surgery. During the assessments, four of 3 dropped out of the study (one case underwent additional posterior TVM 3 months after the, and three cases had additional prolapse surgery after 6 months). Data were analyzed with Spearman s correlation, Mann Whitney U-test, Wilcoxon signed rank test, one-way ANOVA and Bonferroni s multiple comparison tests or Dunnett tests compared with the control group. P-values <0.0 were considered statistically significant. Logistic regression was used for uniand multivariate analysis. Variables with a P < 0.03 in univariate analysis were included in the multivariate analysis. Analyses were carried out using JMP version 9 (SAS Institute Japan, Tokyo, Japan). Results Although % of cases with POP-Q stage showed less than 8 points of IPSS (mild cases), 37% of stage 4 showed equal to or more than points (severe cases) (Fig. 1). Interestingly, just 8% or 6% cases with stage, 3 and 4 showed mild cases in IPSS-QOL (Fig. 1). All subscores of IPSS, especially incomplete emptying (stage 1.36 ± 1.46, stage ± 1.74, stage 4.6 ±.03 points) and weak stream (stage 1.48 ± 1.3, stage 3.11 ± 1.84, stage 4.7 ± 1.99 points), tended to deteriorate in stage 4 (Table ). This tendency was also observed in OAB-Q total sores (stage 76.3 ± 1.0, stage ± 1.0, stage 4.0 ± 6.0 points) and ICIQ-SF scores (stage.9 ±.8, stage ±.4, stage ± 6.1 points; Table ). Regarding urinary function, MFR showed no difference among these stages (stage 6.0 ± 11.0, stage ± 8.1, stage 4 6. ± 6. ml/s); however, PVR significantly increased in stage 4 compared with stage (stage 7.9 ± 36.6, stage ± 71.7, stage ± 94.7 ml; Table ). Furthermore, the associations between type of prolapse, patient characteristics and LUTS were analyzed. There was a significant association between stage 4 cystocele (correlation coefficient 0.16, P = 0.08), uterine prolapse (correlation coefficient 0.19, P = ) and severe IPSS scores ( or more points). Regarding the efficacy of TVM surgery, anatomical cure rate (% grade 0 cases) was 91% at 1 year after surgery (Table 3). Although we found that seven cases remained in grade or 3 postoperatively, all of these cases were previously grade 4, and then they achieved a downgrade. After surgery, 76% and % of all cases were classified as mild in IPSS total scores, and also in IPSS-QOL (Fig. a). All subscores of IPSS, except nocturia, significantly improved 3 months after the surgery, which were maintained for 1 year (P < ; Fig. b). Like IPSS scores, all domains of OAB-Q and ICIQ-SF scores for all patients also significantly improved 3 months after surgery, which were maintained for 1 year (Fig. 3a,b). Various risk factors for postoperative severe IPSS scores were apparent in a univariate and multivariate logistic regression model. Among preoperative POP-Q, IPSS, OAB-Q, ICIQ-SF, MFR and PVR, worse OAB-Q score was the best predictor of postoperative severe IPSS (9% CI , P = 0.009). Although there was no change in MFR before and after surgery, PVR was significantly improved, and maintained for 1 year ( ml/s, P = 0.6; and ml, P < , respectively; Fig. 4a,b). There were no differences in voided volume among these time-points (pre ± 74.9, 3 months 17 ± 13.7, 6 months 1.6 ± 131.6, 1 months 19.6 ± 74.9 ml). To confirm the efficacy of LUTS by TOT, we The Japanese Urological Association
3 LUTS in POP patients and TVM ± TOT IPSS Total score IPSS QOL score Fig. 1 Evaluation of IPSS total and IPSS-QOL scores according to POP-Q stage (mild: 0 7, moderate: 8 19, severe: or more points in IPSS total scores; mild: 0 or 1, moderate: 4, severe: or 6 points in IPSS QOL scores.), Mild;, moderate;, severe. (%) Stage Stage 3 Stage 4 (%) Stage Stage 3 Stage 4 Table Correlations between LUTS parameters and POP-Q stage POP-Q stage (SD) 3 4 Subjective parameters IPSS (points) Voiding symptom Incomplete emptying* 1.36 (1.46) 1.87 (1.74).6 (.03)* Intermittency 1. (1.) 1. (1.70) 1.88 (1.90) Weak stream* 1.48 (1.3).11 (1.84).7 (1.99)* Straining 1.4 (1.6) 1.41 (1.6) 1.9 (1.86) Storage symptom Frequency.08 (1.68).41 (1.6).6 (1.96) Urgency 1.3 (1.49) 1.93 (1.81).4 (.01) Nocturia 1.36 (1.03) 1.6 (1.09) 1.89 (1.36) Total scores*.3 (7.61) 11.8 (8.) 1.0 (.) OAB-Q (points) Symptom severity.4 (4.1) 3.9 (3.9) 41.6 (7.) Coping 71.3 (.3) 64. (7.3) 4.8 (3.) Concern 71.3 (19.3) 6.9 (3.6).3 (8.) Sleep 79.1 (17.7) 7.7 (.0) 66.4 (.) Social 88.3 (11.6) 79.0 (1.0) 7.6 (.9) Total* 76.3 (1.0) 69.0 (1.0).0 (6.0)* ICIQ-SF (points).9 (.8) 6.8 (.4) 8.4 (6.1) Objective parameters MFR (ml/s) 6.0 (11.0) 1.8 (8.1) 6. (6.) PVR (ml)* 7.9 (36.6) 4.4 (71.7) 6.9 (94.7)* Voided volume (ml) 6. (114.6) 6.1 (117.8). (148) *ANOVA with post-hoc (Dunnett analysis) test, P < 0.0 versus stage. Table 3 Surgical outcomes of TVM procedures during 1-year follow up POP-Q stage Pre Years(n = 3) % Cure Anatomical cure rate (%) is a percentage of stage 0 cases in total 3 cases. compared cases with TVM and concurrent TOT (TVM/TOT group; n = 171), and TVM without TOT cases ( group; n = ). Although preoperative ICIQ-SF of the TVM/ TOT group was significantly higher than the group, a significant improvement was observed in IPSS, OAB-q, ICIQ-SF and PVR, except MFR, in both groups after surgery (Fig. ). In addition, postoperative de novo or worsened OAB occurred in three out of 171 (1.8%) in the TVM/TOT group; however, they occurred in two of (3.8%) in the group. One patient was prescribed anticholinergic drugs for SUI and OAB symptoms after TVM/TOT surgery. As for postoperative SUI, although 1.8% of cases with TVM/ TOT group had persistent SUI, 9.6% of cases with group experienced de novo SUI. Discussion A significant association of LUTS with POP stage and efficacy of pelvic floor reconstructive procedure for LUTS were apparent in the present study. We showed deteriorated IPSS score in POP stage 4, and the maintenance of improved LUTS for 1 year after TVM ± TOT. Although there are some reports about the anatomical success rate of mesh surgical repair of POP, 1,13,18 few were addressed on its efficacy in LUTS. 14 Compared with previous reports about conventional POP repair on LUTS, our 13 The Japanese Urological Association 303
4 D OBINATA ET AL. (%) IPSS total score Pre Months after the 1 Pre Incomplete emptying Pre Intermittency Pre Weak stream Pre (months) Straining (%) IPSS QOL score Pre Months after the Pre Frequency Pre Urgency Pre (months) Nocturia Fig. Changes in IPSS total and IPSS-QOL scores after the. A total of 67% of cases showed significant LUTS according to IPSS results, which reduced to 4% of cases postoperatively. Changes in IPSS domain after the. All domains of IPPS, except nocturia, were significantly improved. (P < vs preoperative score.), Mild;, moderate;, severe. 1 OAB-Q ICIQ-SF Points Points Pre 3 61 Pre 3 61 Pre 3 61 Pre 3 61 Pre 3 61 Pre 3 61(months) Symptom Coping Concern Sleep Social Total severity QOL Preoperatively 3 6 Months after the 1 Fig. 3 Changes in the OAB-Q and ICIQ-SF score 1 year after the. The domain of OAB-Q was significantly improved postoperatively. Only the symptom severity domain indicates that higher score values means greater symptom severity or bother, and lower scores indicate minimal symptom severity. (P < vs preoperative score) The preoperative ICIQ-SF score was high, and decreased after the. (P < vs preoperative score.) TVM ± TOT data seems to be favorable. Book et al. reported that approximately 3% of posterior colporrhaphy cases had postoperative transient urinary retention. 1 Costantini et al. reported that incontinence was successfully resolved in 8% cases, and instability persisted in 7% patients after four-corner colposuspension. Regarding two-corner bladder neck suspension, Hirata et al. reported that 3% patients with presurgical voiding difficulty had persistent symptoms, and 7% of cases had developed postoperative storage symptoms. 3 The IPSS, which was initially developed to assess LUTS in men with benign prostatic hyperplasia, has been recently reported to be relevant when used in women as well. 4 7 These The Japanese Urological Association
5 LUTS in POP patients and TVM ± TOT PVR (ml) MFR (ml/s) 1 Fig. 4 (a,b) The improvement of urinary function. Although there was no change in MFR before and after surgery, PVR significantly improved postoperatively (P < vs preoperative score). Pre (Months) Pre (Months) (c) * IPSS (points) OAB-Q (points) ICIQ-SF (points) (d) (e) PVR (ml) MFR (ml/s) 1 Fig. Comparison in efficacies of the TVM/TOT group and group (TVM/TOT; n = 171, ; n = ). In both groups, a significant improvement was observed in IPSS, OAB-Q, (c) ICIQ-SF and (d) PVR, except MFR (e), after the (P < vs each preoperative scores). Preoperative ICIQ-SF of the TVM/TOT group was significantly higher than the group (*P < 0.0).,Pre;, post. reports show that IPSS is neither sex specific nor disease (benign prostate hyperplasia) specific. Many urologists and researchers have already used IPSS for analysis of female LUTS. IPSS classifies LUTS to mild, moderate and severe by total scores; in addition, each symptom is classified into storage or voiding/postvoid symptoms. The present study showed that many patients with POP experience both symptoms severely, especially in high-stage cystocele or significant uterine prolapse. Among the questions of the IPSS regarding voiding symptoms, deteriorated scores of two questions (incomplete emptying and weak stream) were significantly associated with advanced POP-Q stages. Although increased PVR was observed in severe POP cases, there was no difference in MFR among POP stages. Some reports showed that POP, especially anterior vaginal wall prolapse, might affect the lower urinary tract by causing urethral obstruction, or attenuation of abdominal pressure during voiding, which leads to voiding difficulty As all of the voiding symptoms and PVR were significantly improved, and no MFR change was observed after surgery, voiding difficulty might be relieved by a resupported pelvic floor. In addition, no difference was observed in postoperative MFR between the TVM/TOT group (n = 171) and group (n = ; Fig. d,e). Therefore, TOT was not likely to induce urethral stricture or bladder outlet obstruction. Storage symptoms were evaluated by IPSS, OAB-Q and ICIQ-SF. OAB-Q is a multidimensional instrument designed to assess the symptom of bother and HRQL impact of overactive bladder. The higher score of HRQL total score indicates the better HRQL. Interestingly, recent studies have shown that POP plays a key role in the symptomatic OAB caused by urethral obstruction and neurogenic factors. 4,3 34 We showed TVM ± TOT improves OAB symptoms, and it is supportive for results of these studies of POP patients. The ICIQ-SF questionnaire is used for evaluation of clinical manifestations in patients with 13 The Japanese Urological Association 30
6 D OBINATA ET AL. urinary incontinence. 3 The higher score means severe symptoms of urinary incontinence. In the present study, ICIQ-SF tends to be worse in high-stage POP. Before surgery, ICIQ-SF scores of the group were significantly lower than the TVM/TOT group, because all of the TVM/TOT cases already had SUI or occult SUI (Fig. c). Although de novo irritative symptoms and OAB might arise secondary to placement of a mesh, we found just five of 3 cases with de novo OAB after the surgery. Furthermore, the number of patients with postoperative de novo SUI and OAB is fewer in cases with concomitant TOT than in. A previous report showed that abdominal sacrocolpopexy with Burch colposuspension for POP patients significantly reduced postoperative symptoms of SUI without increasing other LUTS. 36 In that report, 3.8% of the concomitant Burch group and 44.1% of the sacrocolpopexy alone group had de novo SUI (P < 0.001) 3 months after surgery. That result was similar to the present data regarding concomitant surgery for SUI. Furthermore, these data show that some cases of POP have a potential risk of de novo SUI and OAB. To date, no established tests can identify cases with the risk preoperatively. In addition to subsequent improvements of storage symptoms by the TVM surgery, TOT might consolidate the effectiveness of TVM by supporting pre-existing, preclinical damaged urethral ligaments. Regarding postoperative LUTS, we studied preoperative predictive factors by univariate and multivariate models. Patient characteristics, such as age, POP-Q stage, preoperative IPSS, MFR and PVR, did not appear to influence the risk of severe IPSS after surgery. Interestingly, severe OAB-Q total score was by far the best preoperative predictor for postoperative severe IPSS scores. As the precise significance of this fact still remains unclear, preoperative OAB might at least relate to postoperative LUTS in POP patients. On October 08, US Food and Drug Administration issued a warning position statement with regards to mesh materials in SUI and POP surgery. This warning shows over 0 reported complications of vaginal and urinary erosion, as well as bowel and vascular injuries. Although complications might occur that are unique to specific mesh materials, these complications appear to be rare under the adequate indication and procedure. Our previous report shows that there are few cases with perisurgical complications. 9 Our observation in a single institution has shown a significant correlation between POP and LUTS, and favorable results of pelvic floor reconstructive procedure for the improvement of LUTS. The present data strongly support the efficacy of TVM ± TOT for LUTS. Further studies are necessary for longterm efficacy of TVM and TVM with concomitant TOT procedures. Acknowledgment This study was supported by Society for Women s Health Science Research, and the 11 Research Grant of the th Anniversary Memorial Fund from Nihon University Medical Alumni Association. Conflict of interest None declared. References 1 Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet. Gynecol. 1997; 89: 1 6. Coates KW, Harris RL, Cundiff GW, Bump RC. Uroflowmetry in women with urinary incontinence and pelvic organ prolapse. Br. J. Urol. 1997; : Wren PA, Janz NK, Brubaker L et al. Reliability of health-related quality-of-life measures 1 year after surgical procedures for pelvic floor disorders. Am. J. Obstet. Gynecol. 0; 19: de Boer TA, Salvatore S, Cardozo L et al. Pelvic organ prolapse and overactive bladder. Neurourol. Urodyn. ; 9: Moller LA, Lose G, Jorgensen T. Incidence and remission rates of lower urinary tract symptoms at one year in women aged : longitudinal study. BMJ 00; 3: Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am. J. Obstet. Gynecol. 1996; 17: ; discussion Morley GW, DeLancey JO. Sacrospinous ligament fixation for eversion of the vagina. Am. J. Obstet. Gynecol. 1988; 18: Takahashi S, Obinata D, Sakuma T et al. Transvaginal mesh (TVM) reconstruction with TVT/TOT sling for vaginal prolapse concurrent with stress urinary incontinence. Aktuelle Urol. ; 41 (Suppl 1): S 3. 9 Takahashi S, Obinata D, Sakuma T et al. Tension-free vaginal mesh procedure for pelvic organ prolapse: a single-center experience of 3 cases with 1-year follow up. Int. J. Urol. ; 17: Elenskaia K, Thakar R, Sultan AH, Scheer I, Onwude J. Pelvic organ support, symptoms and quality of life during pregnancy: a prospective study. Int. Urogynecol. J. 13; 4: Lien YS, Chen GD, Ng SC. Prevalence of and risk factors for pelvic organ prolapse and lower urinary tract symptoms among women in rural Nepal. Int. J. Gynaecol. Obstet. 1; 119: Long CY, Hsu CS, Wu CH, Liu CM, Wang CL, Tsai EM. Three-year outcome of transvaginal mesh repair for the treatment of pelvic organ prolapse. Eur. J. Obstet. Gynecol. Reprod. Biol. 1; 161: Miller D, Lucente V, Babin E, Beach P, Jones P, Robinson D. Prospective clinical assessment of the transvaginal mesh technique for treatment of pelvic organ prolapse--year results. Female Pelvic Med. Reconstr. Surg. 11; 17: Kuribayashi M, Kitagawa Y, Narimoto K, Kawaguchi S, Konaka H, Namiki M. Postoperative voiding function in patients undergoing tension-free vaginal mesh procedure for pelvic organ prolapse. Int. Urogynecol. J. 11; : Bump RC, Mattiasson A, Bo K et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am. J. Obstet. Gynecol. 1996; 17: Coyne K, Revicki D, Hunt T et al. Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q. Qual. Life Res. 0; 11: Karantanis E, Fynes M, Moore KH, Stanton SL. Comparison of the ICIQ-SF and 4-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence. Int. Urogynecol. J. Pelvic Floor Dysfunct. 04; 1: ; discussion Nieminen K, Hiltunen R, Takala T et al. Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. Am. J. Obstet. Gynecol. ; 3: 3.e Nguyen JN, Burchette RJ. Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet. Gynecol. 08; 111: Sivaslioglu AA, Unlubilgin E, Dolen I. A randomized comparison of polypropylene mesh surgery with site-specific surgery in the treatment of cystocoele. Int. Urogynecol. J. Pelvic Floor Dysfunct. 08; 19: Book NM, Novi B, Novi JM, Pulvino JQ. Postoperative voiding dysfunction following posterior colporrhaphy. Female Pelvic Med. Reconstr. Surg. 1; 18: 3 4. Costantini E, Pajoncini C, Zucchi A et al. Four-corner colposuspension: clinical and functional results. Int. Urogynecol. J. Pelvic Floor Dysfunct. 03; 14: Hirata H, Matsuyama H, Yamakawa G et al. Does surgical repair of pelvic prolapse improve patients quality of life? Eur. Urol. 04; 4: The Japanese Urological Association
7 LUTS in POP patients and TVM ± TOT 4 Okamura K, Nojiri Y, Osuga Y, Tange C. Psychometric analysis of international prostate symptom score for female lower urinary tract symptoms. Urology 09; 73: Chai TC, Belville WD, McGuire EJ, Nyquist L. Specificity of the American Urological Association voiding symptom index: comparison of unselected and selected samples of both sexes. J. Urol. 1993; 1: Chancellor MB, Rivas DA. American Urological Association symptom index for women with voiding symptoms: lack of index specificity for benign prostate hyperplasia. J. Urol. 1993; 1: ; discussion Lepor H, Machi G. Comparison of AUA symptom index in unselected males and females between fifty-five and seventy-nine years of age. Urology 1993; 4: 36 ; discussion 1. 8 McCrery RJ, Appell RA. Bladder outlet obstruction in women: iatrogenic, anatomic, and neurogenic. Curr. Urol. Rep. 06; 7: Carr LK, Webster GD. Bladder outlet obstruction in women. Urol. Clin. North Am. 1996; 3: Lemack GE. Urodynamic assessment of bladder-outlet obstruction in women. Nat. Clin. Pract. Urol. 06; 3: Dancz CE, Ozel B. Is there a pelvic organ prolapse threshold that predicts bladder outflow obstruction? Int. Urogynecol. J. 11; : de Boer TA, Slieker-ten Hove MC, Burger CW, Vierhout ME. The prevalence and risk factors of overactive bladder symptoms and its relation to pelvic organ prolapse symptoms in a general female population. Int. Urogynecol. J. 11; : Rosenzweig BA, Pushkin S, Blumenfeld D, Bhatia NN. Prevalence of abnormal urodynamic test results in continent women with severe genitourinary prolapse. Obstet. Gynecol. 199; 79: Basu M, Duckett J. Effect of prolapse repair on voiding and the relationship to overactive bladder and detrusor overactivity. Int. Urogynecol. J. Pelvic Floor Dysfunct. 09; : Abrams P, Artibani W, Gajewski JB, Hussain I. Assessment of treatment outcomes in patients with overactive bladder: importance of objective and subjective measures. Urology 06; 68: Brubaker L, Cundiff GW, Fine P et al. Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N. Engl. J. Med. 06; 34: The Japanese Urological Association 307
Anatomical 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 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 informationPredictive factors for overactive bladder symptoms after pelvic organ prolapse surgery
Int Urogynecol J (2010) 21:1143 1149 DOI 10.1007/s00192-010-1152-y ORIGINAL ARTICLE Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery Tiny A. de Boer & Kirsten B. Kluivers
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 informationOriginal article J Bas Res Med Sci 2015; 2(2): The incidence of recurrent pelvic organ prolapse: A cross sectional study
The incidence of recurrent pelvic organ prolapse: A cross sectional study Ashraf Direkvand-Moghadam 1, Ali Delpisheh 2, Azadeh Direkvand-Moghadam 3* 1. Psychosocial Injuries Research Center, Faculty of
More informationBilateral sacrospinous fixation after second recurrence of vaginal vault prolapse:
Bilateral sacrospinous fixation after second recurrence of vaginal vault prolapse: efficacy and impact on quality of life and sexuality. Salvatore Giovanni Vitale 1, Diego Rossetti 2, Marco Noventa 3,
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 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 informationDiagnostic approach to LUTS in men. Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center
Diagnostic approach to LUTS in men Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center Classification of LUTS Storage symptoms Voiding symptoms Post micturition
More informationDoes trocar-guided tension-free vaginal mesh (Prolift ) repair provoke prolapse of the unaffected compartments?
Int Urogynecol J (2010) 21:271 278 DOI 10.1007/s00192-009-1028-1 ORIGINAL ARTICLE Does trocar-guided tension-free vaginal mesh (Prolift ) repair provoke prolapse of the unaffected compartments? Mariëlla
More informationOveractive bladder symptoms after midurethral sling surgery in women: Risk factors and management
Received: 4 January 2017 Accepted: 2 May 2017 DOI: 10.1002/nau.23328 REVIEW ARTICLE Overactive bladder symptoms after midurethral sling surgery in women: Risk factors and management Tom Marcelissen Philip
More informationProlapse & Stress Incontinence
Advanced Pelvic Floor Course Prolapse & Stress Incontinence OVERVIEW Day One and morning of Day Two- Pelvic Organ Prolapse The Prolapse component covers the detailed anatomy of POP including the DeLancey
More informationDoes Surgical Repair of Pelvic Prolapse Improve Patients Quality of Life?
European Urology European Urology 45 (2004) 213 218 Does Surgical Repair of Pelvic Prolapse Improve Patients Quality of Life? Hiroshi Hirata a, Hideyasu Matsuyama a, Gen-ichiro Yamakawa b, Akinobu Suga
More informationKeywords De novo prolapse, mesh, surgery, untreated compartment,
DOI: 10.1111/j.1471-0528.2011.03231.x www.bjog.org Urogynaecology Development of de novo prolapse in untreated vaginal compartments after prolapse repair with and without mesh: a secondary analysis of
More informationKaranvir Virk M.D. Minimally Invasive & Pelvic Reconstructive Surgery 01/28/2015
Karanvir Virk M.D. Minimally Invasive & Pelvic Reconstructive Surgery 01/28/2015 Disclosures I have none Objectives Identify the basic Anatomy and causes of Pelvic Organ Prolapse Examine office diagnosis
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 informationInterventional procedures guidance Published: 28 June 2017 nice.org.uk/guidance/ipg583
Sacrocolpopexy using mesh to repair vaginal vault prolapse Interventional procedures guidance Published: 28 June 2017 nice.org.uk/guidance/ipg583 Your responsibility This guidance represents the view of
More informationISSN: (Print) (Online) Journal homepage:
Archives of Andrology Journal of Reproductive Systems ISSN: 0148-5016 (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/iaan19 CHANGE IN INTERNATIONAL PROSTATE SYMPTOM SCORE AFTER TRANSURETHRAL
More informationShort-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse
Original Article - Female Urology Investig Clin Urol 2018;59:133-140. pissn 2466-0493 eissn 2466-054X Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse Naoko Takazawa
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 informationGökmen Sukgen, 1 Esra SaygJlJ YJlmaz, 2 and Eralp BaGer Introduction. 2. Case Presentation
Case Reports in Obstetrics and Gynecology Volume 2016, Article ID 2906596, 4 pages http://dx.doi.org/10.1155/2016/2906596 Case Report Vaginal Hysterectomy with Anterior Four-Arm Mesh Implant Technique
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 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 informationWhat are we talking about? Symptoms. Prolapse Risk Factors. Vaginal bulge 1 Splinting. ?? Pelvic pressure Back pain 1 Urinary complaints 2
Options for Vaginal Prolapse What are we talking about? Michelle Y. Morrill, M.D. Director of Urogynecology The Permanente Medical Group Kaiser, San Francisco Assistant Professor, Volunteer Faculty Department
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 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 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 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 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 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 informationLower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist
Lower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist Lower Urinary Tract Symptoms Storage Symptoms Frequency, urgency, incontinence, Nocturia Voiding Symptoms Hesitancy, poor flow, intermittency,
More informationFemale Pelvic Prolapse: Considerations on Mesh Surgery and our Experience with Prolift Mesh in 84 Women with Complicated Pelvic Prolapses
Journal of Applied Medical Sciences, vol.5, no. 2, 2016, 19-30 ISSN: 2241-2328 (print version), 2241-2336 (online) Scienpress Ltd, 2016 Female Pelvic Prolapse: Considerations on Mesh Surgery and our Experience
More informationFemale Urology. Young-Suk Lee, Deok Hyun Han, Ji Youl Lee 1, Joon Chul Kim 2, Myung-Soo Choo 3, Kyu-Sung Lee
www.kjurology.org DOI:1.4111/kju.21.51.3.187 Female Urology Anatomical and Functional Outcomes of Posterior Intravaginal Slingplasty for the Treatment of Vaginal Vault or Uterine Prolapse: A Prospective,
More informationOveractive Bladder: Diagnosis and Approaches to Treatment
Overactive Bladder: Diagnosis and Approaches to Treatment A Hidden Condition* Many Many patients self-manage by voiding frequently, reducing fluid intake, and wearing pads Nearly Nearly two-thirds thirds
More informationCurrent Role of Urethrolysis and Partial Excision in Patients Seeking Revision of Anti-Incontinence Sling
ORIGINAL ARTICLE Current Role of Urethrolysis and Partial Excision in Patients Seeking Revision of Anti-Incontinence Sling Alice Drain, MD,* Ekene Enemchukwu, MD, MPH, Nihar Shah, BA,* Raveen Syan, MD,*
More informationBen Herbert Alex Wojtowicz
Ben Herbert Alex Wojtowicz 54 year old female presenting with: Dragging sensation Urinary incontinence Some faecal incontinence HPC Since May 14 had noticed a mass protruding from the vagina when going
More informationJohn Laughlin 4 th year Cardiff University Medical Student
John Laughlin 4 th year Cardiff University Medical Student Prolapse/incontinence You need to know: Pelvic floor anatomy in relation to uterovaginal support and continence The classification of uterovaginal
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 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 informationContent. Terminology Anatomy Aetiology Presentation Classification Management
Prolapse Content Terminology Anatomy Aetiology Presentation Classification Management Terminology Prolapse Descent of pelvic organs into the vagina Cystocele ant. vaginal wall involving bladder Uterine
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 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 information* 梁景忠醫師 所有發表期刊論文 Bibliography
* 梁景忠醫師 所有發表期刊論文 Bibliography A. First author and Corresponding author (2000- ) 1. Liang CC, Tseng CJ, Soong YK: The usefulness of cystoscopy in the staging of cervical cancer. Gynecol Oncol 76: 200-3,
More informationPRACTICE BULLETIN Female Pelvic Medicine & Reconstructive Surgery Volume 23, Number 4, July/August 2017
PRACTICE BULLETIN Number 176, April 2017 (Replaces Committee Opinion Number 513, December 2011) Pelvic Organ Prolapse Pelvic organ prolapse (POP) is a common, benign condition in women. For many women
More informationIntroduction. Regarding the Section of the UPDATE Entitled Purpose
Time to Rethink: an Evidence-Based Response from Pelvic Surgeons to the FDA Safety Communication: UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ
More informationOAB score: A clinical model that predicts the probability of presenting overactive detrusor in the urodynamic study
ORIGINAL ARTICLE Vol. 44 (2): 348-354, March - Abril, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0213 OAB score: A clinical model that predicts the probability of presenting overactive detrusor in the urodynamic
More informationComparison of midurethral sling outcomes with and without concomitant prolapse repair
Original Article Obstet Gynecol Sci 2014;57(1):50-58 http://dx.doi.org/10.5468/ogs.2014.57.1.50 pissn 2287-8572 eissn 2287-8580 Comparison of midurethral sling outcomes with and without concomitant prolapse
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 informationUnderstanding Pelvic Organ Prolapse. Stephanie Pickett, MD, MS Female Pelvic Medicine and Reconstructive Surgery
Understanding Pelvic Organ Prolapse Stephanie Pickett, MD, MS Female Pelvic Medicine and Reconstructive Surgery Disclosures None I am the daughter of a physician assistant. Objectives List types of pelvic
More informationThe UK National Prolapse Survey: 10 years on
Int Urogynecol J (2018) 29:795 801 DOI 10.1007/s00192-017-3476-3 ORIGINAL ARTICLE The UK National Prolapse Survey: 10 years on Swati Jha 1 & Alfred Cutner 2 & Paul Moran 3 Received: 28 June 2017 /Accepted:
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 informationINJ. Transvaginal Cystocele Repair by Purse-String Technique Reinforced with Three Simple Sutures: Surgical Technique and Results.
Original Article Int Neurourol J 2012;16:144-148 pissn 2093-4777 eissn 2093-6931 International Neurourology Journal Transvaginal Cystocele Repair by Purse-String Technique Reinforced with Three Simple
More information9/24/2015. Pelvic Floor Disorders. Agenda. What is the Pelvic Floor? Pelvic Floor Problems
Management of Pelvic Floor Disorders Doctor, I don t want THAT mesh! Agenda What are pelvic floor disorders (PFDs)? What are the treatment options? Expectant. Conservative. Surgical. How and when are grafts
More informationClinical Study Treatment Strategy According to Findings on Pressure-Flow Study for Women with Decreased Urinary Flow Rate
Advances in Urology Volume 2009, Article ID 782985, 5 pages doi:10.1155/2009/782985 Clinical Study Treatment Strategy According to Findings on Pressure-Flow Study for Women with Decreased Urinary Flow
More informationAdVance Male Sling System
AdVance Male Sling System Clinical study summary This document is a compilation and summary of several AdVance Male Sling System peer-reviewed journal articles. The information presented here is taken
More informationTian-Ni Kuo 1, Ming-Ping Wu 1,2 *
RESEARCH LETTER THE USE OF A CONCOMITANT TENSION-FREE VAGINAL MESH TECHNIQUE AND A TENSION-FREE MIDURETHRAL SLING IN TREATING PELVIC ORGAN PROLAPSE AND OCCULT STRESS URINARY INCONTINENCE Tian-Ni Kuo 1,
More informationChildbirth after pelvic floor surgery: analysis of Hospital Episode Statistics in England,
DOI: 10.1111/1471-0528.12076 www.bjog.org Urogynaecology Childbirth after pelvic floor surgery: analysis of Hospital Episode Statistics in England, 2002 2008 A Pradhan, a DG Tincello, b R Kearney a a Department
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 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 informationAnterior colporrhaphy does not induce bladder outlet obstruction
Int Urogynecol J (2012) 23:723 728 DOI 10.1007/s00192-012-1688-0 ORIGINAL ARTICLE Anterior colporrhaphy does not induce bladder outlet obstruction M. M. E. Lakeman & R. A. Hakvoort & E. P. Van de Weijer
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 informationTraditional Anterior, Posterior, and Apical Compartment Repairs A Technique Based Review
Traditional Anterior, Posterior, and Apical Compartment Repairs A Technique Based Review Sandip Vasavada, MD Center for Female Urology and Pelvic Reconstructive Surgery The Glickman Urological and Kidney
More informationImprovements in overactive bladder syndrome after polypropylene mesh surgery for cystocele
Australian and New Zealand Journal of Obstetrics and Gynaecology 29; 49: 226 231 DOI: 1.1111/j.1479-828X.29.965.x Blackwell Publishing Asia Original Article Improvements in overactive bladder syndrome
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 informationDiagnosis and Mangement of Nocturia in Adults
Diagnosis and Mangement of Nocturia in Adults Christopher Chapple Professor of Urology Sheffield Teaching Hospitals University of Sheffield Sheffield Hallam University UK 23 rd October 2015 Terminology
More informationStop Coping. Start Living. Talk to your doctor about pelvic organ prolapse and sacrocolpopexy
Stop Coping. Start Living Talk to your doctor about pelvic organ prolapse and sacrocolpopexy Did you know? One in three women will suffer from a pelvic health condition in her lifetime. Four of the most
More informationPredictors of improved overactive bladder symptoms after transvaginal mesh repair for the treatment of pelvic organ prolapse
DOI 10.1007/s00192-010-1312-0 ORIGINAL ARTICLE Predictors of improved overactive bladder symptoms after transvaginal mesh repair for the treatment of pelvic organ prolapse Predictors of Improved OAB after
More informationManagement of Female Stress Incontinence
Management of Female Stress Incontinence Dr. Arvind Goyal Associate Professor (Urology& Renal Transplant) Dayanand Medical College & Hospital, Ludhiana, Punjab, India Stress Incontinence Involuntary loss
More informationPelvic Prolapse. A Patient Guide to Pelvic Floor Reconstruction
Pelvic Prolapse A Patient Guide to Pelvic Floor Reconstruction Pelvic Prolapse When an organ becomes displaced, or slips down in the body, it is referred to as a prolapse. Your physician has diagnosed
More informationSilodosin versus naftopidil for the treatment of benign prostatic hyperplasia: A multicenter randomized trial
The study protocol was approved by the ethics committee and institutional review board of Nihon University School of Medicine. Written informed consent was obtained from all patients. From December 2007
More informationLong-Term Effectiveness of Uterosacral Colpopexy and Minimally Invasive Sacral Colpopexy for Treatment of Pelvic Organ Prolapse
ORIGINAL ARTICLE Long-Term Effectiveness of Uterosacral Colpopexy and Minimally Invasive Sacral Colpopexy for Treatment of Pelvic Organ Prolapse Cecile A. Unger, MD, MPH, Matthew D. Barber, MD, MHS, Mark
More informationSurgical repair of vaginal wall prolapse using mesh
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Surgical repair of vaginal wall prolapse using mesh Vaginal wall prolapse happens when the normal support
More informationTools for Evaluation. Urodynamics Case Studies. Case 1. Evaluation. Case 1. Bladder Diary SUI 19/01/2018
Urodynamics Case Studies Christopher K. Payne, MD Vista Urology & Pelvic Pain Partners Emeritus Professor of Urology, Stanford University Tools for Evaluation Ears, Eyes, and Brain Bladder diary Stress
More informationCurrent status in pelvic organ prolapse surgery: an evidence based review
Current status in pelvic organ prolapse surgery: an evidence based review Christian Falconer, MD, PhD Department of Obstetrics and Gynecology Danderyd University Hospital Stockholm, Sweden Finnish Society
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 informationThe Evidence for Antimuscarinic Agents in Female Mixed Urinary Incontinence
european urology supplements 5 (2006) 849 853 available at www.sciencedirect.com journal homepage: www.europeanurology.com The Evidence for Antimuscarinic Agents in Female Mixed Urinary Incontinence Stefano
More informationStudy of correlation between symptoms and signs in women with anterior vaginal wall prolapse
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Bijwe SA et al. Int J Reprod Contracept Obstet Gynecol. 2017 Jul;6(7):3155-3159 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172953
More informationLaparoscopic sacrocolpopexy: an observational study of functional and anatomical outcomes
DOI 10.1007/s00192-010-1241-y ORIGINAL ARTICLE Laparoscopic sacrocolpopexy: an observational study of functional and anatomical outcomes Natalia Price & Alex Slack & Simon R. Jackson Received: 26 April
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 informationProlapse and Urogynae Incontinence. Lucy Tiffin and Hannah Wheldon-Holmes
Prolapse and Urogynae Incontinence Lucy Tiffin and Hannah Wheldon-Holmes 66 year old woman with incontinence PC: 7 year Hx of urgency, frequency, nocturia (incl. incontinence at night), and stress incontinence
More informationAGENDA. 8:00 AM 8:30 AM Pelvic Anatomy of the Lower Urinary Tract and the Anatomy and Physiology of Continence/Incontinence Mickey M.
Thursday, June 12, 2014 Juniper Ballroom 1: Exhibits AGENDA 6:30 AM 8:00 AM Breakfast and Exhibits EVALUATION AND MANAGEMENT OF LOWER URINARY TRACT SYMPTOMS 8:00 AM 8:30 AM Pelvic Anatomy of the Lower
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 informationAmerican Journal of Obstetrics and Gynecology
American Journal of Obstetrics and Gynecology 1 2 3 Recurrence of vaginal prolapse after total vaginal hysterectomy with concurrent vaginal uterosacral ligament suspension: comparison between normal-weight
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of infracoccygeal sacropexy using mesh to repair vaginal vault prolapse The vaginal
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 informationRetrospective study of transobturator polypropylene mesh kit for the management of pelvic organ prolapse
Singapore Med J 212; 53(1) : 664 Retrospective study of transobturator polypropylene mesh kit for the management of pelvic organ prolapse Ganesh Raj Vaiyapuri 1, MBBS, MOG, How Chuan Han 2, MBBS, FRCOG,
More informationThe relationship between urinary symptom questionnaires and urodynamic diagnoses: an analysis of two methods of questionnaire administration
BJOG: an International Journal of Obstetrics and Gynaecology May 2004, Vol. 111, pp. 468 474 DOI: 1 0. 1111/j.1471-0528.2004.00126.x The relationship between urinary symptom questionnaires and urodynamic
More informationIndex. Cyclical pelvic pain, 37 Cystocele, 22, 23, 25, 48, 51, 52, 54, 56, 124, 148, 160
A Abdominal approach, 141 Abdominal hernia s surgery, 123, 124 Abdominal sacrocolpopexy (ASC), 116, 117 Abnormal uterine bleeding, 96 Anterior compartment repair, 101, 102 Apical compartment repair, 96
More informationUrogynecology: Evidence-Based Clinical Practice
Urogynecology: Evidence-Based Clinical Practice Kate H. Moore Urogynecology: Evidence-Based Clinical Practice Second Edition Kate H. Moore, MBBS, FRCOG, FRANZCOG, MD, CU Department Obstetrics & Gynaecology
More informationOptions for Vaginal Prolapse. What is prolapse? What is prolapse? Disclosures 10/23/2013. Michelle Y. Morrill, M.D. None
Options for Vaginal Prolapse Disclosures None Michelle Y. Morrill, M.D. Director of Urogynecology Kaiser, San Francisco Assistant Professor, Volunteer Faculty Department of Ob/Gyn, UCSF What is prolapse?
More informationMust Colposuspension be Associated with Sacropexy to Prevent Postoperative Urinary Incontinence?
european urology 51 (2007) 788 794 available at www.sciencedirect.com journal homepage: www.europeanurology.com Female Urology Incontinence Must Colposuspension be Associated with Sacropexy to Prevent
More informationMidterm Prospective Evaluation of TVT-Secur Reveals High Failure Rate
EUROPEAN UROLOGY 58 (2010) 157 161 available at www.sciencedirect.com journal homepage: www.europeanurology.com Female Urology Incontinence Midterm Prospective Evaluation of TVT-Secur Reveals High Failure
More informationIs the role of Burch colposuspension fading away in this epoch for treating female urinary incontinence?
Int Urogynecol J (2007) 18:937 942 DOI 10.1007/s00192-006-0264-x ORIGINAL ARTICLE Is the role of Burch colposuspension fading away in this epoch for treating female urinary incontinence? SooCheen Ng &
More informationSep \8958 Appell Dmochowski.ppt LMF 1
Surgical Outcomes (How did we get ourselves into this mess?) Roger R. Dmochowski, MD, FACS Department of Urologic Surgery Vanderbilt University School of Medicine Nashville, Tennessee Considerations Evaluation
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 informationFemale Urology. The Results of Grade IV Cystocele Repair Using Mesh. Introduction ZARGAR MA, EMAMI M*, ZARGAR K, JAMSHIDI M
Urology Journal UNRC/IUA Vol. 1, No. 4, 263-267 Autumn 2004 Printed in IRAN Female Urology The Results of Grade IV Cystocele Repair Using Mesh ZARGAR MA, EMAMI M*, ZARGAR K, JAMSHIDI M Department of Urology,
More informationPosterior intravaginal slingplasty for vault and uterovaginal prolapse: an initial experience
Gynecol Surg (2006) 3: 88 92 DOI 10.1007/s10397-005-0168-7 ORIGINAL ARTICLE R. Oliver. C. Dasgupta. A. Coker Posterior intravaginal slingplasty for vault and uterovaginal prolapse: an initial experience
More informationImaging of Pelvic Floor Weakness. Dr Susan Kouloyan-Ilic Radiologist Epworth Medical Imaging The Women s, Melbourne
Imaging of Pelvic Floor Weakness Dr Susan Kouloyan-Ilic Radiologist Epworth Medical Imaging The Women s, Melbourne Outline Overview and Epidemiology Risk Factors, Causes and Results Review of Relevant
More informationPractical urodynamics What PA s need to know. Gary E. Lemack, MD Professor of Urology and Neurology
Practical urodynamics What PA s need to know Gary E. Lemack, MD Professor of Urology and Neurology Urodynamics essential elements Urethral catheter Fill rate Catheter size Intravesical pressure measurements
More information