1
|
Fan YH, Shen YC, Hsu CC, Chow PM, Chang PC, Lin YH, Chang SJ, Jiang YH, Liao CH, Wang CC, Wu CT, Kuo HC. Current Surgical Treatment for Neurogenic Lower Urinary Tract Dysfunction in Patients with Chronic Spinal Cord Injury. J Clin Med 2023; 12:jcm12041400. [PMID: 36835937 PMCID: PMC9963408 DOI: 10.3390/jcm12041400] [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] [Received: 11/26/2022] [Revised: 01/16/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
This study aimed to present a comprehensive literature review of the efforts of a spinal cord injury workgroup in Taiwan regarding urologic surgery for neurogenic lower urinary tract dysfunction (NLUTD) in patients with chronic spinal cord injury (SCI). Surgical procedures should be viewed as a final option for managing patients with SCI who have persistent symptoms and complications that cannot be resolved by other means. Surgeries can be grouped according to their purpose: reducing bladder pressures, reducing urethra resistance, increasing urethra resistance, and urinary diversion. The choice of surgery depends on the type of LUTD based on urodynamic tests. Additionally, cognitive function, hand motility, comorbidities, efficacy of surgery, and related complications should be considered.
Collapse
Affiliation(s)
- Yu-Hua Fan
- Department of Urology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
| | - Yuan-Chi Shen
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Chih-Chen Hsu
- Department of Urology, Taipei Hospital, Ministry of Health and Welfare, Taipei 24233, Taiwan
| | - Po-Ming Chow
- Department of Urology, National Taiwan University Hospital and College of Medicine, Taipei 10002, Taiwan
| | - Po-Chih Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
| | - Yu-Hua Lin
- Department of Chemistry, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Shang-Jen Chang
- Department of Urology, National Taiwan University Hospital and College of Medicine, Taipei 10002, Taiwan
| | - Yuan-Hong Jiang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97004, Taiwan
| | - Chun-Hou Liao
- Divisions of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City 23148, Taiwan
| | - Chung-Cheng Wang
- Department of Urology, En Chu Kong Hospital, New Taipei City 23702, Taiwan
| | - Chun-Te Wu
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97004, Taiwan
- Correspondence: ; Tel.: +886-3-8561825 (ext. 2117)
| |
Collapse
|
2
|
Pannek J, Wöllner J. Management of stress urinary incontinence in female patients with spinal cord injury by autologous fascial sling: time for a revival? Spinal Cord Ser Cases 2022; 8:57. [PMID: 35610208 DOI: 10.1038/s41394-022-00524-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN This study is a retrospective chart analysis. OBJECTIVES Surgical treatment of stress urinary incontinence (SUI) in women with neurogenic lower urinary tract dysfunction (NLUTD) is a challenge, as minimally invasive procedures do not seem to be effective, whereas synthetic implants are associated with substantial risks. Thus, we evaluated the results of an autologous sling procedure in this group of patients SETTING: This study was performed at a spinal cord injury rehabilitation center in Switzerland. METHODS In this retrospective analysis, we evaluated the objective, subjective, and urodynamic results in women undergoing autologous sling insertion for SUI due to NLUTD at our institution. RESULTS The data of 17 women who underwent fascial sling surgery were analyzed. After a median follow-up of 40 months, 8 women (47%) were continent, and another 8 patients (47%) significantly improved (1 pad/day). Median video-urodynamic parameters remained unchanged after sling insertion, but two women developed de novo detrusor overactivity. Postoperative complications occurred in 6 of the 17 patients (35.3%), which required surgical interventions in 2 women (12%) (urethral erosion by the sling and complete occlusion of the urethra after removal of the catheter), which could be resolved without loss of continence. CONCLUSION In our case series, autologous fascial slings were effective in the treatment of SUI in women with NLUTD. As they are more effective than minimally invasive procedures, are associated with fewer complications than AUS, and seem to omit possible severe long-term consequences of synthetic slings, they are an excellent treatment option in this group of patients. Urodynamic controls are recommended, as de novo detrusor overactivity may occur after sling insertion.
Collapse
Affiliation(s)
- Jürgen Pannek
- Neuro-Urology, Schweizer Paraplegiker Zentrum, Nottwil, Switzerland. .,Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Jens Wöllner
- Neuro-Urology, Schweizer Paraplegiker Zentrum, Nottwil, Switzerland
| |
Collapse
|
3
|
Haudebert C, Richard C, Common H, Hascoet J, Bentellis I, Freton L, Voiry C, Samson E, Manunta A, Brucker B, Peyronnet B. Bandelette aponévrotique pubovaginale pour incontinence urinaire d’effort chez les femmes à risque de complications prothétiques. Prog Urol 2022; 32:500-508. [DOI: 10.1016/j.purol.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/26/2022]
|
4
|
Musco S, Ecclestone H, 't Hoen L, Blok BFM, Padilla-Fernández B, Del Popolo G, Groen J, Pannek J, Kessler TM, Karsenty G, Phé V, Sartori AM, Castro-Diaz D, Rizwan H. Efficacy and Safety of Surgical Treatments for Neurogenic Stress Urinary Incontinence in Adults: A Systematic Review. Eur Urol Focus 2021; 8:1090-1102. [PMID: 34509413 DOI: 10.1016/j.euf.2021.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/12/2021] [Accepted: 08/13/2021] [Indexed: 11/15/2022]
Abstract
CONTEXT Controversy still exists regarding the balance of benefits and harms for the different surgical options for neurogenic stress urinary incontinence (N-SUI). OBJECTIVE To identify which surgical option for N-SUI offers the highest cure rate and best safety without compromising urinary tract function and bladder management. EVIDENCE ACQUISITION A systematic review was performed under the auspices of the European Association of Urology Guidelines Office and the European Association of Urology Neuro-Urology Guidelines Panel according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. EVIDENCE SYNTHESIS A total of 32 studies were included. Overall, 852 neurourological patients were surgically treated for N-SUI. The treatment offered most often (13/32 studies) was an artificial urinary sphincter (AUS; 49%, 416/852) and was associated with a need for reintervention in one-third of patients. More than 200 surgical revisions were described. Overall, 146/852 patients (17%) received concomitant bladder augmentation, mainly during placement of an AUS (42%, 62/146) or autologous sling (34% of women and 14% of men). Following pubovaginal sling placement, dryness was achieved in 83% of cases. A significant improvement in N-SUI was observed in 87% (82/94) of women following placement of a synthetic midurethral sling. Efficacy after insertion of an adjustable continence therapy device (ACT 40%, proACT 60%) was reported for 38/128 cases (30%). The cure rate for bulking agents was 35% (9/25) according to 2/32 studies, mainly among men (90%). The risk of bias was highly relevant. Baseline and postoperative cystometry were missing in 13 and 28 studies, respectively. CONCLUSIONS The evidence is mainly reported in retrospective studies. More than one intervention is often required to achieve continence because of coexisting neurogenic detrusor overactivity, low compliance, or the onset of complications in the medium and long term. Urodynamic data are needed to better clarify the success of N-SUI treatment with the different techniques. PATIENT SUMMARY Our review shows that insertion of an artificial urinary sphincter for urinary incontinence is effective but is highly associated with a need for repeat surgery. Other surgical options may have lower continence rates or a risk of requiring intermittent catheterization, which patients should be informed about before deciding on surgery for their incontinence.
Collapse
Affiliation(s)
- Stefania Musco
- Department of Neuro-Urology, Careggi University Hospital, Florence, Italy.
| | - Hazel Ecclestone
- Department of Urology, Taranaki District Health Board, New Plymouth, New Zealand
| | - Lisette 't Hoen
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bertil F M Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Barbara Padilla-Fernández
- Department of Urology, Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Giulio Del Popolo
- Department of Neuro-Urology, Careggi University Hospital, Florence, Italy
| | - Jan Groen
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jürgen Pannek
- Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland
| | - Thomas M Kessler
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - Gilles Karsenty
- Department of Urology, Aix Marseille University, Marseille, France
| | - Véronique Phé
- Department of Urology, Sorbonne University, Pitié-Salpêtrière Academic Hospital, Assistance-Publique-Hôpitaux de Paris, Paris, France
| | - Andrea M Sartori
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - David Castro-Diaz
- Department of Urology, Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Hamid Rizwan
- Department of Urology, University College London and London Spinal Injuries Unit, London, UK
| |
Collapse
|
5
|
Synthetic mid-urethral slings for the treatment of stress urinary incontinence in women with neurogenic lower urinary tract dysfunction: a systematic review. Int Urogynecol J 2021; 33:767-776. [PMID: 34402935 DOI: 10.1007/s00192-021-04929-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of our study was to evaluate the efficiency and safety of synthetic mid-urethral slings (sMUS) for the treatment of stress urinary incontinence (SUI) in women with neurogenic lower urinary tract dysfunction (NLUTD). METHODS A systematic review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. MEDLINE, Embase and Cochrane controlled trials databases were systematically searched from January 1995 to April 2021. Studies including adult women with NLUTD who had a sMUS for SUI were considered for inclusion. Primary outcome was success of the surgery according to study criteria. Secondary outcomes were complications, especially de novo urgency, urinary retention, tape exposure and revision for complications. RESULTS A total of 752 abstracts were screened and 9 studies were included, representing 298 patients. The mean age was 52 years and median follow-up was 41.3 months. sMUS insertion was successful in 237 patients (79.5%). The median rate of de novo urgency was 15.7% (range 8.3-30%). In patients with spontaneous voiding, the median rate of retention was 19.3% (range 0-46.7%) and 21 out of 26 patients required intermittent self-catheterisation. Four cases of tape exposure were reported, and 8 patients underwent a revision for complications. CONCLUSIONS This review suggests that sMUS might offer interesting success rates and acceptable morbidity and could be considered for the treatment of SUI in women with NLUTD. Further studies are required to define which patients would be more likely to benefit from this intervention, as well as its place among the other surgical treatments for SUI.
Collapse
|
6
|
Hsiao SM, Kuo HC. Predictors of further anti-incontinence interventions or transvaginal urethrolysis after a pubovaginal sling procedure in women with and without neurologic disorders. J Formos Med Assoc 2021; 120:1464-1477. [PMID: 33468403 DOI: 10.1016/j.jfma.2020.12.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/13/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/PURPOSE The impact of neurologic disorders on the clinical outcome of suburethral sling procedures has seldom been studied. Our aim is to elucidate factors predicting further anti-incontinence interventions or transvaginal urethrolysis after a re-adjustable pubovaginal sling procedure (PVS), especially in patients with neurologic disorders. METHODS Medical records of all consecutive women who underwent re-adjustable PVS for stress urinary incontinence (SUI) were reviewed. RESULTS A total of 589 women were enrolled, 152 (25.8%) women were found to have persistent or recurrent SUI after surgery, and 39 (6.6%) women underwent further anti-incontinence interventions. Postoperative voiding dysfunction was found in 46 (7.8%) women, and 23 women (3.9%) underwent transvaginal urethrolysis. Low body mass index (hazard ratio = 0.92) and low functional bladder capacity (dL, hazard ratio = 0.83) were factors predicting the presence of persistent/recurrent SUI. However, the presence of spinal cord disorder (hazard ratio = 8.91) and a history of prior surgery for pelvic organ prolapse (hazard ratio = 2.51) were factors predicting further anti-incontinence interventions. A high post-void residual volume (PVR, dL, hazard ratio = 1.52) and preoperative bladder outlet obstruction (BOO, hazard ratio = 5.39) were factors predicting postoperative voiding dysfunction. Similarly, a high PVR (dL, hazard ratio = 1.50) and preoperative BOO (hazard ratio = 5.38) were factors predicting transvaginal urethrolysis. A PVR >1.51 dL was an optimal cut-off value for predicting transvaginal urethrolysis. CONCLUSION The presence of spinal cord disorder and prior surgery for pelvic organ prolapse were predictors of further anti-incontinence interventions after re-adjustable PVS. In addition, a large PVR and preoperative BOO were predictors of transvaginal urethrolysis after re-adjustable PVS.
Collapse
Affiliation(s)
- Sheng-Mou Hsiao
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
| |
Collapse
|
7
|
Shin JH, Park KW, Park J, Choo M. Treatment outcomes and overactive bladder symptoms after midurethral sling in female patients with or without various neurological diseases. Neurourol Urodyn 2020; 39:2379-2385. [DOI: 10.1002/nau.24498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Jung H. Shin
- Department of Urology, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| | - Kye W. Park
- Department of Neurology, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| | - Juhyun Park
- Department of Urology, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| | - Myung‐Soo Choo
- Department of Urology, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| |
Collapse
|
8
|
Santiago JE, Cameron AP, Navarrete RA. Addressing Sphincter Dysfunction in the Female with Neurogenic Lower Urinary Tract Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-020-00597-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
|
10
|
Teplitsky S, Murphy A, Shenot PJ. Knowledge Gaps in Urologic Care of Female Spinal Cord Injury Patients. Curr Urol Rep 2019; 20:21. [PMID: 30904966 DOI: 10.1007/s11934-019-0884-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW We highlight the substantial gaps in knowledge on urologic care of female spinal cord injury (SCI) patients. RECENT FINDINGS Males account for approximately 80% of people living with SCI in developed nations. Although there is a robust body of literature in some aspects of urologic care of individuals with SCI, such as treatments for neurogenic detrusor overactivity, there are relatively few studies focusing specifically on females. There are also few studies focusing on other aspects of urologic care of women with SCI such as sexual dysfunction, pelvic organ prolapse, and bladder cancer. Established guidelines for bladder management exist, generally recommending intermittent catheterization, but the fact remains that a substantial number of women with SCI utilize indwelling catheters for bladder management. There remains a paucity of literature using patient-reported measures regarding both outcomes and experiences of urologic management in the SCI population. Bladder management is challenging for many women with SCI. There are few studies on other urologic concerns in women with SCI.
Collapse
Affiliation(s)
- Seth Teplitsky
- Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Ste 1100, Philadelphia, PA, 19107, USA
| | - Alana Murphy
- Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Ste 1100, Philadelphia, PA, 19107, USA
| | - Patrick J Shenot
- Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Ste 1100, Philadelphia, PA, 19107, USA.
| |
Collapse
|
11
|
Sakalis VI, Floyd MS, Caygill P, Price C, Hartwell B, Guy PJ, Davies MC. Management of stress urinary incontinence in spinal cord injured female patients with a mid-urethral tape - a single center experience. J Spinal Cord Med 2018; 41:703-709. [PMID: 29076391 PMCID: PMC6217505 DOI: 10.1080/10790268.2017.1393190] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Context/Objective Stress urinary incontinence (SUI) affects the quality of life of females with spinal cord injury (SCI), has a negative impact on functional independence and disturbs their psychosocial interaction. Our aim was to assess the efficacy of mid-urethral tapes (MUT) in managing stress urinary incontinence in this population. Design Retrospective cohort study. Participants SCI females with upper motor neuron lesion and urodynamically proven stress or mixed urinary incontinence that was treated with a mid-urethral tape and followed up for at least 12 months. Interventions Mid-urethral tapes such TVT, TOT and mini-Arc. Patient reported outcomes based on the daily use of pads and ICIQ modular questionnaire scores. Outcome measures The primary endpoint was defined as the success rate of MUT surgery in managing stress incontinence at 12. The secondary endpoints included the improvement rate at 12 months, the complication rates and the need for additional treatments. Results 38 females were studied. At 12 months the overall patient reported success rate was 52.6%. 16% reported significant improvement. 68.4% felt the quality of life to improve. Nine patients develop tape related complications (five de novo urgency, one vaginal extrusion, one frequent dysreflexia and one worsening of incontinence). Conclusion Mid-urethral tapes are effective in the management of stress urinary incontinence in female patients with spinal cord injury. There are demonstrable improvements in both continence and quality of life.
Collapse
Affiliation(s)
- Vasileios I. Sakalis
- Department of Urology, Salisbury NHS Foundation Trust, Salisbury, UK,Correspondence to: Vasileios I. Sakalis MSc, FEBU, FRCS(Eng), Department of Urology, Salisbury NHS Foundation Trust, Salisbury, UK; Ph: +44 (0) 1722 336262 x2017, +44(0)7850931496.
| | - Michael S. Floyd
- Department of Urology, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Philippa Caygill
- Department of Urology, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Chloe Price
- Duke of Cornwall Spinal treatment center, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Ben Hartwell
- Duke of Cornwall Spinal treatment center, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Peter J. Guy
- Department of Urology, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Melissa C. Davies
- Department of Urology, Salisbury NHS Foundation Trust, Salisbury, UK
| |
Collapse
|
12
|
Dray EV, Cameron AP, Bergman R. Stress Urinary Incontinence in Women with Neurogenic Lower Urinary Tract Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0471-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
13
|
Scott KA, Tonzi M, Nikolavsky D. Use of Artificial Urinary Sphincter and Slings to Manage Neurogenic Bladder Following Spinal Cord Injury—Is It Safe? CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Reuvers SHM, Groen J, Scheepe JR, 't Hoen LA, Castro-Diaz D, Padilla-Fernández B, Del Popolo G, Musco S, Pannek J, Kessler TM, Schneider MP, Karsenty G, Phé V, Hamid R, Ecclestone H, Blok BFM. Heterogeneity in reporting on urinary outcome and cure after surgical interventions for stress urinary incontinence in adult neuro-urological patients: A systematic review. Neurourol Urodyn 2017; 37:554-565. [PMID: 28792081 DOI: 10.1002/nau.23364] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/23/2017] [Indexed: 11/10/2022]
Abstract
AIMS To describe all outcome parameters and definitions of cure used to report on outcome of surgical interventions for stress urinary incontinence (SUI) in neuro-urological (NU) patients. METHODS This systematic review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The study protocol was registered and published (CRD42016033303; http://www.crd.york.ac.uk/PROSPERO). Medline, Embase, Cochrane controlled trials databases, and clinicaltrial.gov were systematically searched for relevant publications until February 2017. RESULTS A total of 3168 abstracts were screened. Seventeen studies reporting on SUI surgeries in NU patients were included. Sixteen different outcome parameters and nine definitions of cure were used. Six studies reported on objective outcome parameters mainly derived from urodynamic investigations. All studies reported on one or more subjective outcome parameters. Patient-reported pad use (reported during interview) was the most commonly used outcome parameter. Only three of 17 studies used standardized questionnaires (two on impact of incontinence and one on quality of life). Overall, a high risk of bias was found. CONCLUSIONS We found a considerable heterogeneity in outcome parameters and definitions of cure used to report on outcome of surgical interventions for SUI in NU patients. The results of this systematic review may begin the dialogue to a future consensus on this topic. Standardization of outcome parameters and definitions of cure would enable researchers and clinicians to consistently compare outcomes of different studies and therapies.
Collapse
Affiliation(s)
| | - Jan Groen
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - David Castro-Diaz
- Department of Urology, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain
| | - Bárbara Padilla-Fernández
- Department of Urology, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain
| | - Giulio Del Popolo
- Department of Neuro-Urology, Careggi University Hospital, Florence, Italy
| | - Stefania Musco
- Department of Neuro-Urology, Careggi University Hospital, Florence, Italy
| | - Jürgen Pannek
- Department of Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland
| | - Thomas M Kessler
- Department of Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Marc P Schneider
- Department of Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Gilles Karsenty
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Veronique Phé
- Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique- Hôpitaux de Paris, Paris 6 University, Paris, France
| | - Rizwan Hamid
- Department of Neuro-Urology, London Spinal Injuries Centre, Stanmore, United Kingdom
| | - Hazel Ecclestone
- Department of Neuro-Urology, London Spinal Injuries Centre, Stanmore, United Kingdom
| | - Bertil F M Blok
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
15
|
Phé V, Léon P, Granger B, Denys P, Bitker MO, Mozer P, Chartier-Kastler E. Stress urinary incontinence in female neurological patients: long-term functional outcomes after artificial urinary sphincter (AMS 800TM
) implantation. Neurourol Urodyn 2016; 36:764-769. [DOI: 10.1002/nau.23019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 03/30/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Véronique Phé
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Priscilla Léon
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Benjamin Granger
- Department of Statistics; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Pierre Denys
- Department of Physical Medicine and Rehabilitation; Raymond Poincaré Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
| | - Marc-Olivier Bitker
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Pierre Mozer
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Emmanuel Chartier-Kastler
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| |
Collapse
|
16
|
Losco GS, Burki JR, Omar YAI, Shah PJR, Hamid R. Long-term outcome of transobturator tape (TOT) for treatment of stress urinary incontinence in females with neuropathic bladders. Spinal Cord 2015; 53:544-6. [DOI: 10.1038/sc.2015.70] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 11/09/2022]
|
17
|
|
18
|
Satyanarayan A, Gliga L, Lemack GE. Diagnosis and Management of Stress Urinary Incontinence in Females With Neurogenic Disease. CURRENT BLADDER DYSFUNCTION REPORTS 2015. [DOI: 10.1007/s11884-014-0276-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
19
|
Farag F, Koens M, Sievert KD, De Ridder D, Feitz W, Heesakkers J. Surgical treatment of neurogenic stress urinary incontinence: A systematic review of quality assessment and surgical outcomes. Neurourol Urodyn 2014; 35:21-5. [PMID: 25327633 DOI: 10.1002/nau.22682] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 09/03/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND There are many opinions but little firm knowledge about the optimal treatment of neurogenic stress urinary incontinence (NSUI). OBJECTIVE To scrutinize the quality and surgical outcomes of the available treatment modalities in the published literature. EVIDENCE ACQUISITION A systematic review of the published literature from Pub Med and Web of Science was undertaken for studies describing surgical treatment of NSUI between 1990 and 2013. A checklist of criteria of methodological and reporting quality of interventions in urological publications was applied to assess quality of the retrieved publications. Surgical outcomes of success, failure, and reoperation were calculated. Statistical analyses included one-way ANOVA and post-hoc tests to determine significant differences between groups. EVIDENCE SYNTHESIS Thirty studies were identified with Level 3 evidence. The quality of reporting was 43-81%, with significantly higher quality noted in studies published after 2002 (64% vs. 45%, P < 0.0001). None of the studies followed a randomized controlled trial (RCT) design. Three primary surgical procedures were used in 29 of 30 studies: artificial urinary sphincter (AUS), urethral slings, and urethral bulking agents. One study used a ProACT device. AUS was considered more successful than urethral bulking agents (77 ± 15% vs. 27 ± 20%, P = 0.002). Urethral bulking agents reported higher failures than urethral sling procedures (49 ± 16% vs. 21 ± 19%, P = 0.016) and AUS (21 ± 19% vs. 10 ± 11%, P < 0.002). CONCLUSIONS The quality of evidence obtained from non-RCTs is modest. Surgeries for NSUI have relatively high success rates but also high complication rates in this highly heterogeneous population. More studies using modern techniques are required to update our knowledge.
Collapse
Affiliation(s)
- Fawzy Farag
- Department of Urology, Radboud University Medical Centre Nijmegen, The Netherlands.,Department of Urology, Sohag University Hospital, Sohag, Egypt
| | - Martin Koens
- Department of Urology, Radboud University Medical Centre Nijmegen, The Netherlands
| | | | | | - Wout Feitz
- Department of Urology, Radboud University Medical Centre Nijmegen, The Netherlands
| | - John Heesakkers
- Department of Urology, Radboud University Medical Centre Nijmegen, The Netherlands
| |
Collapse
|
20
|
El-Azab AS, El-Nashar SA. Midurethral slings versus the standard pubovaginal slings for women with neurogenic stress urinary incontinence. Int Urogynecol J 2014; 26:427-32. [DOI: 10.1007/s00192-014-2521-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/18/2014] [Indexed: 11/30/2022]
|
21
|
|
22
|
Sadik CD, Ajay D, Le NBP. Evaluation and Management of Neurogenic Stress Urinary Incontinence. CURRENT BLADDER DYSFUNCTION REPORTS 2014. [DOI: 10.1007/s11884-014-0235-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
23
|
Update on Female Neurogenic Lower Urinary Tract Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2014. [DOI: 10.1007/s11884-013-0221-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
24
|
A retrospective study on female urological surgeries over the 10 years following spinal cord lesion. Spinal Cord 2013; 51:688-93. [PMID: 23836320 DOI: 10.1038/sc.2013.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 04/19/2013] [Accepted: 05/02/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To evaluate the efficacy and safety over a 10-year period of any urological operations required by female patients with spinal cord lesions (SCLs). METHODS Retrospective study of urological surgeries from our database performed on females with SCLs from 2001 to 2002. Surgery efficacy for neurogenic lower urinary tract dysfunctions (N-LUTDs) was evaluated by comparing 7-day voiding diaries pre- and post-surgeries, while individual investigations were done pre- and post-surgery to evaluate urological complications. Drawbacks were assessed. RESULTS Thirty-eight out of 69 patients underwent one or more urological procedures. Twenty-one out of 42 patients with suprasacral lesions underwent interventions for N-LUTD. The main surgical treatment was endoscopic detrusor infiltration of botulinum-A (Botox 300 UI or Dysport 750 UI) performed 107 times on 15 subjects using aseptic intermittent catheterizations for neurogenic overactive bladder. Mean efficacy duration was 9.2 months. Six females with infrasacral lesions underwent at least one intervention for N-LUTD. Two females in each group underwent tension-free vaginal tape for stress urinary incontinence (SUI), reducing episodes per week of SUI by >90% after 5 years. The most serious urological complication was active vesico-ureteral reflux (VUR) in three patients, treated endoscopically with submucosal injection of Macroplastique. No VUR recurrence was detected during a 6-year follow-up. All bladder stones (five cases) and renal calculi (five cases) were treated with endoscopic transurethrally electrohydraulic lithotripsy and extracorporeal shock-wave lithotripsy, respectively. Overall, no serious drawbacks were observed. CONCLUSIONS Mini-invasive surgeries were exclusively used to address urological issues in chronic SCL patients.
Collapse
|
25
|
Treatment of Neurogenic Stress Urinary Incontinence Using an Adjustable Continence Device: 4-Year Followup. J Urol 2012; 188:2274-80. [DOI: 10.1016/j.juro.2012.07.131] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Indexed: 11/18/2022]
|
26
|
Treating stress urinary incontinence in female patients with neuropathic bladder: the value of the autologous fascia rectus sling. Int Urol Nephrol 2012; 44:1363-7. [DOI: 10.1007/s11255-012-0247-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 06/26/2012] [Indexed: 10/28/2022]
|
27
|
|
28
|
Pannek J, Bartel P, Gocking K. Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion. J Spinal Cord Med 2012; 35:102-6. [PMID: 22525323 PMCID: PMC3304553 DOI: 10.1179/2045772312y.0000000008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES To evaluate the clinical usefulness of transobturator sub-urethral tapes for the treatment of stress urinary incontinence in women with spinal cord injury. METHOD AND SUBJECTS Chart review for all female patients with spinal cord injury who underwent implantation of a transobturator sub-urethral tape for treatment of stress urinary incontinence at our institution. RESULTS Nine women, median age 45.1 years, received a sub-urethral transobturator tape in the period November 2007 to September 2010. Four patients had paraplegia and five had tetraplegia. Seven women performed intermittent catheterization. At follow up, three of the nine patients were either cured or vastly improved. One major late complication (urethral erosion) occurred. Five of the six patients without treatment success underwent second-line treatment (artificial sphincter or urinary diversion). CONCLUSION In our case series, implantation of transobturator sub-urethral tapes in women with stress urinary continence due to intrinsic sphincter deficiency and a low leak point pressure led to unfavorable results.
Collapse
Affiliation(s)
- Juergen Pannek
- Schweizer Paraplegiker-Zentrum, Neuro-Urologie, Nottwil, Switzerland.
| | | | | |
Collapse
|
29
|
Mehnert U, Nehiba M. [Neuro-urological dysfunction of the lower urinary tract in CNS diseases: pathophysiology, epidemiology, and treatment options]. Urologe A 2012; 51:189-97. [PMID: 22331072 DOI: 10.1007/s00120-011-2796-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The lower urinary tract (LUT) is regulated by a complex neural network that is subject to supraspinal control. Neurological disorders, especially of the central nervous system (CNS), can rapidly lead to disruption of this control. Multiple sclerosis, Parkinson's disease, multiple system atrophy, and stroke are neurological disorders which quite frequently cause dysfunction of the LUT. With respect to the pathophysiology of bladder dysfunction in CNS diseases there are various hypotheses regarding the individual disorders: disturbances of neural communication between the frontal cortex and pontine micturition center, between the pontine micturition center and the lumbosacral parts of the spinal cord, and between the basal ganglia, thalamus, and anterior cingulate gyrus appear to play a pivotal role in the development of bladder dysfunction. The symptoms and urodynamic presentation of LUT dysfunction can vary considerably depending on the disease and disease progression and can change in the course of the disease. The incidence and prevalence of LUT dysfunctions rise with increasing progression of the underlying neurological disease.Various conservative, minimally invasive, and open surgical procedures are available to prevent harmful sequelae and to improve the quality of life of these patients. As yet, however, few data exist on most of the treatment options in cases of the above-mentioned CNS diseases. Intermittent self-catheterization and antimuscarinic medications are among the most important conservative treatment options. Injection of botulinum neurotoxin type A into the detrusor muscle and increasingly sacral or pudendal neuromodulation are among the most important minimally invasive treatment options. Surgical methods include reconstructive continent or incontinent urinary diversion.When planning therapy the patient's current needs and neurological limitations as well as possible disease progression must be taken into consideration. It is often advisable to consult with and enlist the cooperation of the attending neurologist when planning treatment.
Collapse
Affiliation(s)
- U Mehnert
- Urologische Klinik, Marienhospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Widumer Straße 8, 44627 Herne, Deutschland.
| | | |
Collapse
|