A safety and quality of life analysis of intravaginal slingplasty in female stress incontinence: a prospective, open label, multicenter, and observational study

Efficacy of Boswellia serrata L. and Cyperus scariosus L. plus pelvic floor muscle training in stress incontinence in women of reproductive age

INTRODUCTION

To determine the efficacy of combining of Boswellia serrata L. resin and the root of Cyperus scariosus L. plus PFMT in reproductive age women with stress urinary incontinence.

METHODS

A prospective, single-blind, placebo-controlled, randomized trial was conducted. The patients were randomized to receive orally either combination of equal quantity of B. serrata and C. scariosus (2g) (n = 30) or placebo (n = 30) respectively twice daily for 8 weeks in addition to pelvic floor muscle training in both groups. The outcome was one hour pad test. The results were analyzed using parametric and nonparametric test.

RESULTS

The improvement in the test and control group was 60% and 37% respectively. Between the group comparison was statistically significant (P = 0.035). The intra group comparison of one hour pad test was statistically significant in both groups (P < 0.001). No adverse effects were noted.

CONCLUSION

The test group was more effective than control group in women with SUI.

Urethral erosion and perineal cellulitis after midurethral sling procedure

Midurethral tension-free sling procedure has become one of the most popular techniques for the treatment of stress urinary incontinence. As the time elapsed, however, complications associated with a synthetic tape have been reported to occur. Recently, we experienced a rare case of urethral erosion with perineal cellulitis at anterior wall of vagina after midurethral sling procedure. So our experience was presented with a review of literature.

Impact of the midurethral sling procedure on quality of life in women with urinary incontinence

Purpose

This study was designed to objectively assess the impediment of incontinence to quality of life (QoL) in females and its improvement by the midurethral sling (MUS) procedure.

Materials and Methods

From June 2006 to June 2007, 93 female patients underwent the MUS procedure at our institute because of urinary incontinence. The incontinence quality of life (I-QoL) questionnaire was administered to measure the QoL of the incontinent patients before and 1 and 12 months after the MUS procedure. Preoperative data and urodynamic factors were analyzed retrospectively by I-QoL scores to identify factors that may affect the QoL of incontinent patients.

Results

The average preoperative I-QoL score of the 93 patients was 61.1±21.0 points. At 1 year after surgery, the average I-QoL score was found to have improved to 98.4±20.7 points. There were no significant differences between stress and mixed urinary incontinence in terms of cure and satisfaction (p>0.05). I-QoL scores of the cured and improved patients increased at 1 year after surgery (p<0.01). There were no statistically significant differences in the increment of I-QoL between cured and improved patients (p>0.05). Although urinary urgency and large urine leak amounts significantly reduced preoperative QoL in incontinent patients, the MUS procedure effectively improved the QoL regardless of these factors.

Conclusions

Preoperative I-QoL assessment revealed a significant impairment of QoL in incontinent women, but the MUS procedure effectively improved these women's QoL.

Gluteo-vaginal sinus formation complicating posterior intravaginal slingplasty followed by successful IVS removal. A case report and review of the literature

Posterior intravaginal slingplasty (IVS) is a technique used for the treatment of apical prolapse. Type III meshes have been mostly used with this technique. In this article, a case of bilateral gluteo-vaginal sinus tract formation that complicated a posterior vaginal slingplasty with a type III mesh is presented. At 3 months follow-up, the patient complained for bulking through the vagina, continuous offensive vaginal discharge, and constant pain at the buttocks. She had prolapse recurrence, and there was defective healing at the gluteal entry points of the posterior IVS. Ten months after the initial surgery, she underwent a laparotomic subtotal hysterectomy and sacrocervicopexy with prolene type I mesh. At the same time, the posterior mesh was removed allowing the surgeon to discover communication of the canal of the mesh extending from gluteal incisions to the vagina epithelium. The sinus tract was managed surgically with excision of the surrounding tissues. There was no recurrence or other complications at 2 months follow-up.