1
|
Diamantidis D, Tsakaldimis G, Lailisidis S, Panagiotopoulos N, Kafalis C, Giannakopoulos S, Kalaitzis C. Severe Complications of Artificial Urinary Sphincter Placement in a Young Woman With Neurogenic Urinary Incontinence: A Case Report. Cureus 2023; 15:e41097. [PMID: 37519492 PMCID: PMC10381096 DOI: 10.7759/cureus.41097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
This article reports a case of a 40-year-old woman with a history of myelomeningocele and neurogenic urinary incontinence who developed erosion and fistula formation following the placement of an artificial urinary sphincter (AUS) when she was 18 years old. The patient had a long-standing history of urinary incontinence that was unresponsive to prior surgeries for meningomyelocele. She reported the loss of uro-fecal material from the vagina but did not seek further medical evaluation until the age of 40. Clinical examination revealed protruding tubes from the suprapubic region. The administration of a contrast agent through one of the two tubes led to the visualization of intestinal loops, and the administration of a contrast agent through the urethra confirmed the connection between the rectum, urinary bladder, and vagina. Due to the absence of reliable surgical history and in the absence of abdominal discomfort, bilateral nephrostomies were initially performed to prevent further uro-fecal material loss. The patient showed significant improvement, decided to not seek further evaluation and surgical treatment, and remained socially integrated during the follow-up period of 20 years. This case highlights the severe consequences of AUS placement in a young woman with neurogenic urinary incontinence and emphasizes the importance of proper patient selection and management in the presence of underlying neurological disorders.
Collapse
Affiliation(s)
- Dimitrios Diamantidis
- Department of Urology, University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Georgios Tsakaldimis
- Department of Urology, University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Stavros Lailisidis
- Department of Urology, University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| | | | - Charalampos Kafalis
- Department of Urology, University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| | | | - Christos Kalaitzis
- Department of Urology, University General Hospital of Alexandroupolis, Alexandroupolis, GRC
| |
Collapse
|
2
|
Reus CR, Phé V, Dechartres A, Grilo NR, Chartier-Kastler EJ, Mozer PC. Performance and Safety of the Artificial Urinary Sphincter (AMS 800) for Non-neurogenic Women with Urinary Incontinence Secondary to Intrinsic Sphincter Deficiency: A Systematic Review. Eur Urol Focus 2020; 6:327-338. [DOI: 10.1016/j.euf.2018.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/02/2018] [Accepted: 10/10/2018] [Indexed: 01/11/2023]
|
3
|
Joint Report on Terminology for Surgical Procedures to Treat Stress Urinary Incontinence in Women. Female Pelvic Med Reconstr Surg 2020; 26:162-172. [PMID: 32079836 DOI: 10.1097/spv.0000000000000831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Standardized terminology for surgical procedures commonly performed to treat stress urinary incontinence in women is needed to facilitate research, clinical care, and teaching in female pelvic medicine and reconstructive surgery. METHODS This report combines the input of members of the American Urogynecologic Society and the International Urogynecological Association, assisted by external referees. Extensive searches of the literature were performed, including Instructions for Use brochures and original source documents where possible. Historical context was considered along with procedural modifications, and expert opinion was included when appropriate. RESULTS A terminology report for the procedures commonly performed to treat stress urinary incontinence in women was produced. Included procedures are midurethral sling, retropubic colposuspension, pubovaginal sling, urethral bulking, and artificial urinary sphincter. Appropriate figures have been included to supplement and help clarify the text. Ongoing review will be performed periodically to keep the document updated and widely acceptable. CONCLUSIONS This document is a literature and consensus-based terminology report for surgical procedures to treat stress urinary incontinence in women. Future publications in female pelvic medicine and reconstructive surgery should use this standardized terminology whenever possible.
Collapse
|
4
|
Joint report on the terminology for surgical procedures to treat stress urinary incontinence in women. Int Urogynecol J 2020; 31:465-478. [DOI: 10.1007/s00192-020-04237-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
5
|
Gomes C, Doran I, Friend E, Tivers M, Chanoit G. Long-Term Outcome of Female Dogs Treated with Static Hydraulic Urethral Sphincter for Urethral Sphincter Mechanism Incompetence. J Am Anim Hosp Assoc 2018; 54:276-284. [DOI: 10.5326/jaaha-ms-6709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
The purpose of the study was to report the postoperative outcome, complications, and long-term follow-up of the use of a static hydraulic urethral sphincter for the management of urethral sphincter mechanism incompetence in female dogs. Medical records were reviewed to extract information on long-term (>365 days) outcome data. Telephone owner questionnaire was performed to assess postoperative urinary continence scores (scale 1–10, where 10 is complete continence) and the presence and frequency of complications. Twenty female dogs were included. Mean (±standard deviation) time to follow-up was 1,205.1 (±627.4) days. Median continence score/10 (range) was 3.5 (2–6) preoperatively, and 9.0 (7–10) at the last follow-up. Median continence score was significantly higher at all time points postoperatively compared with before surgery (P < .001). Complete continence was achieved in 90% of bitches. Minor complications occurred in 13 bitches and included dysuria (8), bacterial cystitis (8), longer urination time (10), incisional seroma (5), urinary retention (3), hematuria (2), and pain when urinating (2). Major complications occurred in one dog (static hydraulic urethral sphincter removed 28 mo after placement). Continence scores were sustainably improved in the long-term. Complications were mostly minor. Urinary tract infections were the most common but resolved with conventional antibiotic treatment.
Collapse
Affiliation(s)
- Cesar Gomes
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Ivan Doran
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Edward Friend
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Mickey Tivers
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| | - Guillaume Chanoit
- From the School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
| |
Collapse
|
6
|
Lalji S, Lozanova P. Evaluation of the safety and efficacy of a monopolar nonablative radiofrequency device for the improvement of vulvo-vaginal laxity and urinary incontinence. J Cosmet Dermatol 2017; 16:230-234. [PMID: 28556393 DOI: 10.1111/jocd.12348] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Vaginal childbirth, natural process of aging, congenital factors, and surgical interventions are considered the main causes of vulvo-vaginal laxity driven by changes in collagen and elastin fibers. This causes a loss of strength and flexibility within the vaginal wall. As a result, women may experience lack of sensation and stress urinary incontinence (SUI)-the condition of involuntary loss of urine associated with activities that cause an increase in intra-abdominal pressure (eg, sneezing, coughing, and lifting). Both vaginal laxity and urinary incontinence significantly affect patients' quality of life (QoL). The aim of this study was to evaluate efficacy and safety of a noninvasive radiofrequency device when used to treat SUI and vulvo-vaginal laxity through its heating effect which stimulates collagen and elastin fibers. METHODS Twenty-seven women (average age 44.78±10.04 years) with indications of mild/moderate SUI as well as vulvo-vaginal laxity were treated with a monopolar radiofrequency device. The treatment course consisted of three once-a-week sessions. Each session included intravaginal treatment followed by treatment of labia majora and the perineum. Improvement in the SUI condition was evaluated by applying the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF). Data were collected at the baseline, after the last treatment and at 1-month follow-up visit. Vaginal laxity was assessed by subjective vulvo-vaginal laxity questionnaire (VVLQ). Data were collected before the 1st treatment and during the 1-month follow-up visit. Patient's satisfaction was recorded using a satisfaction questionnaire. Data were collected after the last treatment and at the 1-month follow-up visit. Any adverse events related to the treatments were monitored. RESULTS On a scale of 0 to 5, the average frequency of urine leak improved from "2-3 times a week" (2.15±1.03 points prior to treatment) to "once a week" (1.00±0.78 points post-treatment), and on to "never" (0.44±0.51 points at the 1-month follow-up visit). Sixteen subjects (59.3%) reported decrease in the amount of leakage, with 15 women (55.6%) becoming completely leak-free at the 1-month follow-up. At the 1-month follow-up visit, 24 subjects (88.9%) expressed their condition's interference with everyday life decreased and 17 patients (62.9%) said the condition did not interfere with their everyday life at all as a result of the treatment. All results are statistically significant (P<.05). No adverse events were recorded. All subjects reported improvement in vaginal laxity, from average perception of "very loose" (2.19±1.08 points prior to treatment) to "moderately tight" (5.74±0.76 points at the 1-month follow-up visit). During the follow-up visit, 89% of the patients "agreed" or "strongly agreed" that their SUI condition improved, and 93% of the patients "agreed" or "strongly agreed" that their gratification during intercourse improved. None of the subjects reported dissatisfaction. CONCLUSION The study confirmed the monopolar radiofrequency method as an effective and safe treatment of SUI and vulvo-vaginal laxity. The treatments were well tolerated by all subjects with no adverse effects.
Collapse
Affiliation(s)
| | - Paula Lozanova
- Department of Dermatology and venerology, Medical University, Sofia, Bulgaria
| |
Collapse
|
7
|
Trolliet S, Mandron E, Lang H, Jacqmin D, Saussine C. Implantation de sphincter artificiel urinaire par voie laparoscopique chez des femmes avec incontinence urinaire d’effort sévère. Prog Urol 2013; 23:877-83. [DOI: 10.1016/j.purol.2013.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 03/21/2013] [Accepted: 03/21/2013] [Indexed: 10/26/2022]
|
8
|
Islah M, Cho SY, Son H. The current role of the artificial urinary sphincter in male and female urinary incontinence. World J Mens Health 2013; 31:21-30. [PMID: 23658862 PMCID: PMC3640149 DOI: 10.5534/wjmh.2013.31.1.21] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 12/20/2012] [Accepted: 01/03/2013] [Indexed: 01/27/2023] Open
Abstract
The evolution of the artificial urinary sphincter has affected the current surgical options for urinary incontinence. With its unique features, the artificial urinary sphincter (AUS) has been an attractive option for the treatment of urinary incontinence regardless of gender. The current paper discusses the indications, contraindications, types of devices, surgical approaches, outcomes, and complications of the AUS in the treatment of both male and female urinary incontinence. A PubMed review of the available literature was performed and articles reporting implantation of artificial urinary sphincters for urinary incontinence in both male and female patients were evaluated. There was a comparable satisfactory continence rate after the implantation of an AUS (59~97% in males vs. 60~92% in females). In comparison, there were some differences in the indications, contraindications, surgical approaches, outcomes, and complications of the AUS implanted for urinary incontinence in male and female patients. AUS implantation is a safe and effective surgical option for the treatment of urinary incontinence of various etiologies. Continuous evolution of the device has made it an attractive option for the treatment of both male and female urinary incontinence.
Collapse
Affiliation(s)
- Mar Islah
- Urology Unit, Department of Surgery, Kulliyyah of Medicine, Jalan Hospital, International Islamic University, Kuantan, Malaysia
| | | | | |
Collapse
|
9
|
Delisser PJ, Friend EJ, Chanoit GPA, Parsons KJ. Static hydraulic urethral sphincter for treatment of urethral sphincter mechanism incompetence in 11 dogs. J Small Anim Pract 2012; 53:338-43. [DOI: 10.1111/j.1748-5827.2012.01228.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
10
|
Mandron E, Bryckaert PE, Papatsoris AG. Laparoscopic artificial urinary sphincter implantation for female genuine stress urinary incontinence: technique and 4-year experience in 25 patients. BJU Int 2011; 106:1194-8; discussion 1198. [PMID: 20132197 DOI: 10.1111/j.1464-410x.2010.09206.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE to assess the safety, feasibility and efficacy of laparoscopic implantation of the artificial urinary sphincter (AUS) in women with genuine stress urinary incontinence (SUI). PATIENTS AND METHODS from April 2005 to July 2009, 25 women (mean age 66.8 years) with genuine SUI had a laparoscopic implantation of the AUS (AMS 800(TM) , American Medical Systems, Minnetonka, MN, USA). Patients had a negative Marshall test and urodynamic studies showed decreased closure pressure. All patients had a history of urogynaecological surgery. Transperitoneal laparoscopic access was created with two midline 10-mm and two lateral 5-mm trocars. One of the lateral port incisions was later extended to facilitate urethrovaginal dissection with scissors and dissector, and the insertion and assembly of the AUS. In six cases of concomitant genito-urinary prolapse, laparoscopic anterior and posterior mesh promontofixation was also performed. RESULTS the AUS was successfully implanted in all cases with no conversion to open surgery. There were no intra- or perioperative complications, except one vaginal perforation which was repaired during surgery. The mean operative duration was 92 min (71 min without and 123 min with simultaneous promontofixation). Five patients developed urinary retention, which was managed with re-insertion of the urethral catheter for 2 days in four and with insertion of a suprapubic catheter for 4 weeks in a patient with spina bifida. During the mean follow-up of 26.1 months, two treatment failures were diagnosed due to vaginal erosion and were managed with removal of the AUS. All the remaining 23 patients reported continence, either complete (in 19) or social (in four). However, this was not a randomized comparative study. CONCLUSION laparoscopic implantation of the AUS in women with genuine SUI is safe, feasible and efficient.
Collapse
Affiliation(s)
- Eric Mandron
- Department of Urology, Clinique Chirurgicale du Pre, Le Mans, France
| | | | | |
Collapse
|
11
|
Chung E, Cartmill RA. 25-year experience in the outcome of artificial urinary sphincter in the treatment of female urinary incontinence. BJU Int 2011; 106:1664-7. [PMID: 20500509 DOI: 10.1111/j.1464-410x.2010.09419.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report the outcome of artificial urinary sphincter (AUS) in female patients for the treatment of stress urinary incontinence (SUI). PATIENTS AND METHODS We retrospectively reviewed all female patients with AUS implanted over the last 25 years in one institution. Patient demographics, renal tract imaging and urodynamics assessment were documented. Outcomes measures included complications, duration and cause of AUS failure. Urinary continence was defined as no pad use after AUS insertion. AUS failure was defined as malfunction, infection or erosion. AUS malfunction included either mechanical (fluid leak) or non-mechanical (infection or surgical damage to AUS). A Kaplan-Meier analysis was used to determine device failure over time. RESULTS In all, 47 consecutive women with a mean (range) age of 51 (17-78) years received an AUS for the treatment of UI. Of these, 35 women had failed anti-incontinence surgery previously. There were two wound infections after AUS insertion but no mortality. Of the 47 AUS implanted, 39 (83%) AUS remained in situ. Eight (17%) AUS were removed due to AUS erosion or infection. There were 20 AUS revisions, 16 of which were primary AUS revisions. Most of the AUS revisions were related to mechanical malfunctions. Comparison of the proportion of AUS device survival over time using Kaplan-Meier analysis showed >80% of AUS remained functioning after 100 months. At the time of review, 83% of patients had a device in situ and the continence rate with no pads use was 59% with AUS only; this figure increased to 85% when concurrent clean intermittent self-catheterization was performed. CONCLUSIONS AUS is an effective and durable treatment option for female SUI. In properly selected women, high continence rates can be achieved. Most patients maintained satisfactory long-term continence rates despite revision surgery.
Collapse
Affiliation(s)
- Eric Chung
- Department of Urology, Princess Alexandra Hospital, Queensland, Australia.
| | | |
Collapse
|
12
|
Tape Shortening for Recurrent Stress Urinary Incontinence After Transobturator Tape Sling: 3-Year Follow-up Results. Int Neurourol J 2010; 14:164-9. [PMID: 21179334 DOI: 10.5213/inj.2010.14.3.164] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 10/27/2010] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Recently, as the number of transobturator tape (TOT) procedures has increased, recurrence after this procedure has been frequently reported. However, there are no standard guidelines for treatment. We describe our experience with shortening the previously implanted tape in patients with recurrent stress urinary incontinence after the TOT procedure. MATERIALS AND METHODS We enrolled 10 women who underwent shortening of the previously implanted tape and were followed up for 3 years. Shortening of the previously implanted tape was done by a figure-eight suture with 1-0 Prolene. One year after TOT shortening, we investigated continence status, patient satisfaction by means of a questionnaire, maximal flow rate (Qmax), and postvoid residual urine volume. Three years after TOT shortening, we evaluated continence status and patient satisfaction. RESULTS The mean period of TOT shortening was 4.2 months (range, 1-12 months) after the TOT procedure. One year after TOT shortening, 7 patients showed complete dryness, 2 patients showed improvement, and 1 patient reported failure. Eight patients were very satisfied or satisfied with the 1-year result after TOT shortening. The mean preoperative and postoperative Qmax were 23.8 and 26.7ml/s, respectively, and there was no significant difference. Three years after TOT shortening, 6 patients showed complete dryness, 2 patients showed improvement, and 2 patients reported failure. Among them,1 had failed from 1 year after TOT shortening and the other had shown 1 year of complete dryness. Eight patients were very satisfied or satisfied and 2 patients were dissatisfied with the 3-year result after TOT shortening. CONCLUSION Most of the patients who underwent TOT shortening reported satisfaction as well as improvement of incontinence after a 3-year follow up. Therefore, we suggest that TOT shortening may be recommended primarily in patients with recurrent stress urinary incontinence after the TOT sling procedure.
Collapse
|
13
|
Chung E, Navaratnam A, Cartmill RA. Can artificial urinary sphincter be an effective salvage option in women following failed anti-incontinence surgery? Int Urogynecol J 2010; 22:363-6. [PMID: 20878518 DOI: 10.1007/s00192-010-1268-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Accepted: 09/05/2010] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The role of artificial urinary sphincter (AUS) as salvage option following failed anti-incontinence surgery is unclear. METHODS Database review and telephone survey were conducted to review patient satisfaction, surgical outcomes, device failure and revision rates. RESULTS A total of 29 female patients received AUS following failed anti-incontinence surgeries. Five (17%) AUS devices were explanted due to AUS erosion or infection. Thirteen AUS revisions were made and device malfunction accounted for 95% of the cases. Kaplan-Meier analysis showed more than 90% of AUS malfunction occurred less than 100 months from the time of implant. There was a significant decrease in pad use (3.6 to 0.2 pads per day; p < 0.01). The continence rate with no pad use was 70% and this increases to 83% in patients wearing one precautionary pad. CONCLUSION AUS is a safe, durable and effective salvage option for females with previous failed anti-incontinent surgeries.
Collapse
Affiliation(s)
- Eric Chung
- Department of Urology, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Queensland 4102, Australia.
| | | | | |
Collapse
|
14
|
Recommandations pour le traitement de l’incontinence urinaire féminine non neurologique par le sphincter artificiel urinaire. Prog Urol 2010; 20 Suppl 2:S155-60. [DOI: 10.1016/s1166-7087(10)70011-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
15
|
Delorme E, Hermieu JF. Recommandations concernant la prise en charge des complications des bandelettes sous-urétrales. Prog Urol 2010; 20 Suppl 2:S132-42. [DOI: 10.1016/s1166-7087(10)70007-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Eandi JA, Tanaka ST, Hellenthal NJ, O'Connor RC, Stone AR. Self-reported urinary continence outcomes for repeat midurethral synthetic sling placement. Int Braz J Urol 2008; 34:336-42; discussion 343-4. [DOI: 10.1590/s1677-55382008000300011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2008] [Indexed: 11/22/2022] Open
|
17
|
Abstract
Urinary incontinence (UI) is regarded as a major health issue affecting a large sector of the population. The International Continence Society defines UI as the complaint of involuntary leakage of urine that is objectively demonstrated and is a social and hygienic problem. It is caused by a wide range of factors and it has a great negative impact on the lifestyle of patients, as well as a burden on the healthcare system, since it affects an estimated 10 million patients in the USA. Approximately 50% of all nursing home residents and between 15 and 30% of women over the age of 65 years have UI. The treatment modalities vary according to the underlying causes and the results are often unsatisfactory. With the introduction of the artificial urinary sphincter there has been a dramatic change in the management of refractory cases of UI. The artificial urinary sphincter is a device, usually in the form of an inflatable silicone cuff, inserted around the bladder neck or around the bulbous urethra in adult males. It mimics the biological urinary sphincter by providing a competent bladder outlet during urinary storage and an open outlet to permit voluntary voiding. In this review we give an overview of UI and the artificial urinary sphincter as a method of treatment.
Collapse
Affiliation(s)
- Aza Mohammed
- King George Hospital, Barley Lane, Ilford IG3 8YB, UK.
| | | | | | | | | |
Collapse
|
18
|
Chartier-Kastler E, Ayoub N, Mozer P, Richard F, Ruffion A. Chapitre H - Les conséquences neuro-urologiques de la chirurgie de l’incontinence urinaire d’effort et de la statique pelvienne. Prog Urol 2007; 17:385-92. [PMID: 17622064 DOI: 10.1016/s1166-7087(07)92335-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is difficult to prove the neurourological origin of a voiding disorder, pain or postoperative functional disorders after stress urinary incontinence and pelvic repair surgery and their incidence is difficult to evaluate. The purpose of this chapter is to review the data of the literature concerning complications of this type of surgery, possibly related to a neurological injury, regardless of the site. The most frequently encountered postoperative problem is acute urinary retention. Prevention of acute urinary retention must be based on preoperative assessment looking for risk factors and the quality of postoperative resumption of voiding after removal of the bladder catheter Medium-term and long-term de novo dysuria and/or urgency must be analysed according to a neurourological approach, looking for obstruction (that must be removed) and complications related to the implanted prosthetic material or to the operative technique. The most difficult symptom to assess is postoperative pelvic pain "induced" by surgery. It can be accentuated by a previously undiagnosed concomitant spinal or regional lesion (hip) and the diagnostic assessment must be based on a multidisciplinary approach. This review emphasizes the low level of proof of data of the literature in this field and supports the impression that prospective data from homogeneous cohorts must be recorded in registries, for example, despite the difficulty of long-term evaluation (> 5 years). In the future, patients in whom prosthetic material is implanted should probably be encouraged to more readily cooperate in this field to ensure continuing improvement of the quality of surgical care.
Collapse
|
19
|
Koh JS, Kim HS, Kim HW, Lee YS, Kim SI, Lee KS, Choo MS, Lee JY. Comparison of Secondary Procedures for Recurrent Stress Urinary Incontinence after a Transobturator Tape Procedure: Shortening of the Tape versus Tension-free Vaginal Tape Redo. Korean J Urol 2007. [DOI: 10.4111/kju.2007.48.11.1149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jun Sung Koh
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyo Sin Kim
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Woo Kim
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yong Seok Lee
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Suk Il Kim
- Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyu Sung Lee
- Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung Soo Choo
- Department of Urology, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
20
|
Tsivian A, Neuman M, Yulish E, Shtricker A, Levin S, Cytron S, Sidi AA. Redo midurethral synthetic sling for female stress urinary incontinence. Int Urogynecol J 2006; 18:23-6. [PMID: 16583181 DOI: 10.1007/s00192-006-0113-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2005] [Accepted: 03/08/2006] [Indexed: 11/27/2022]
Abstract
Tension-free transvaginal tape (TVT) placement has recently become the preferred therapeutic approach for female stress urinary incontinence (SUI) in some centers. There are, however, no clearcut guidelines of how to treat patients in whom the procedure has failed. We describe our experience with repeat midurethral synthetic sling (MUS) implantation after a failed similar procedure. Twelve women (mean age 64.3 years) who had undergone a MUS procedure [TVT-9, intravaginal sling (IVS)-2, transobturator tape (TOT)-1] for SUI underwent a repeat MUS (TVT-5, IVS-4, TOT-3) due to persistent or recurrent SUI. The time from the first to the second procedure was 1-48 months. Eleven out of 12 patients (91.7%) achieved full continence (mean follow-up of 23.2 months, range 14-44). We conclude that a repeat MUS for persistent or recurrent SUI is a viable option for patients after an unsuccessful MUS procedure.
Collapse
Affiliation(s)
- Alexander Tsivian
- Department of Urologic Surgery, The Edith Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | | | | | | |
Collapse
|
21
|
Schick V. [Implantation of the AMS 800 artificial sphincter system in a woman via a paraurethral access]. Urologe A 2005; 44:794-7. [PMID: 15827711 DOI: 10.1007/s00120-005-0808-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The procedure described demonstrates the feasibility of reliable implantation of an artificial sphincter system in female patients via a paraurethral access between the urethral orifice and the clitoris following radical cystectomy with continent, orthotopic urinary diversion and postoperatively developed urinary stress-incontinence. The technique presented avoids the more invasive transperitoneal or transvaginal approaches which jeopardize the neobladder-neck and increase the risk for infections or fistulas.
Collapse
Affiliation(s)
- V Schick
- Robert-Koch-Krankenhaus, Gehrden.
| |
Collapse
|
22
|
Thakar R, Stanton S. Regular review: management of urinary incontinence in women. BMJ (CLINICAL RESEARCH ED.) 2000; 321:1326-31. [PMID: 11090517 PMCID: PMC1119067 DOI: 10.1136/bmj.321.7272.1326] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- R Thakar
- Urogynaecology and Pelvic Floor Reconstruction, St George's Hospital, London SW17 0QT.
| | | |
Collapse
|
23
|
Abstract
Recurrent stress urinary incontinence is a distressing problem. Its causes are multifactorial and the literature continually provides suggestions for changes to the surgical approach. Over 200 surgical procedures exist for the treatment of stress urinary incontinence, and this leaves the practising surgeon with an overwhelming range of choice. This article will review current available techniques for the surgical treatment of recurrent stress urinary incontinence.
Collapse
Affiliation(s)
- J A Schulz
- Department of Obstetrics and Gynecology, University of Toronto, Canada
| | | |
Collapse
|