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Khafagy W, ElBassioune W, Rady M, Farouk E, Elhelw E, Saeed A, Mahmoud A, Abuelmatti H, Elsheikh A, Mahmoud M, Hussein M, Zaky A, Abdeltawab A, Ali S, Altoraky M, Hegazy M, Almorsy A, Alghazaly M, Rehan M, Elnady E, Khater S, Mahmoud A, Elsayed A, Deif H. A new promising approach to urodynamic stress urinary incontinence care can help menopausal women. Prz Menopauzalny 2023; 22:121-125. [PMID: 37829269 PMCID: PMC10566331 DOI: 10.5114/pm.2023.131058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/15/2022] [Indexed: 10/14/2023]
Abstract
Introduction The goal of this study is to evaluate the effectiveness of single-incision mini-sling in the surgical treatment of postmenopausal urodynamic stress urinary incontinence (SUI) compared to the standard trans-obturator mid-urethral sling. Material and methods This prospective study was carried out in two tertiary centres; Al-Azhar University Maternity & Urology Hospitals. A total of 120 postmenopausal women with urodynamic SUI were randomized to undergo either single-incision mini-sling (n = 60) or standard trans-obturator mid-urethral sling procedure (n = 60) from May 2019 until Oct 2021. Main outcome measures: efficacy was evaluated utilizing objective cure rate (cough stress test) and subjective cure rate (Sandvik incontinence severity index and International Consultations on Incontinence Questionnaire - Short Form), intraoperative and postoperative complications, and postoperative pain (using a visual analogue scale). Results The single-incision mini-sling (SIMS) and transobturator tape (TOT) groups had no statistically significant difference in subjective and objective cure rates (p > 0.05). Compared with the transvaginal tape O group, patients in the SIMS group had significantly less postoperative pain, shorter operative duration, and less intraoperative blood loss (all p-values < 0.05). No significant difference in perioperative complications was observed between both groups. Conclusions Single-incision mini-sling was superior to TOT in postmenopausal as SIMS is of similar effectiveness, more safe and minimally invasive with earlier ambulance.
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Affiliation(s)
- Wael Khafagy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Walaa ElBassioune
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mahmoud Rady
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Elmetwally Farouk
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ehab Elhelw
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Saeed
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Mahmoud
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Hamada Abuelmatti
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Elsheikh
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mohamed Mahmoud
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mohammed Hussein
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Zaky
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Abdeltawab
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Soliman Ali
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Muhammad Altoraky
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mahmoud Hegazy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Almorsy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Moatazza Alghazaly
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mohamed Rehan
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Esam Elnady
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Saed Khater
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Alaa Mahmoud
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Elsayed
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Hazem Deif
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
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Elsayad A, Khafagy W, ElBassioune W, Rady M, Abdeltawab A, Altoraky M, Hegazy M, Ayad W, Alghazaly M, Elshorbagy A, Almorsy AS, Saeed A, Farouk E, Elhelw E, Abuelmatti H, Elkadosi MEH. A paradigm of higher success rate of intracytoplasmic sperm injection - preovulatory human chorionic gonadotropin-day serum oestradiol. Prz Menopauzalny 2023; 22:83-86. [PMID: 37674930 PMCID: PMC10477759 DOI: 10.5114/pm.2023.127964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 09/07/2022] [Indexed: 09/08/2023]
Abstract
Introduction The aim of the study is to evaluate the correlation between the level of serum oestradiol (E2) on the day of human chorionic gonadotropin (hCG-day) administration and successful intracytoplasmic sperm injection (ICSI) outcome. Material and methods This prospective study was performed during the period from January 2019 to September 2021, at Zagazig Obstetrics and Gynecology Department, and Al-Azhar Obstetrics and Gynecology Department, and private ART centers. One hundred and fifty women attending the infertility clinic for ICSI cycles. All women were divided into 5 groups according to the serum E2 level on the day of hCG administration: Group A - serum E2 < 1000 pg/ml; Group B - serum E2 1000 to < 2000 pg/ml; Group C - serum E2 2000 to < 3000 pg/ml;Group D - serum E2 3000 to < 4000 pg/ml; Group E - serum E2 ≥ 4000 pg/ml. Results The highest fertilization rate (58.1%) was among women with E2 ≥ 4000 pg/ml, while the lowest (37%) was in women with E2 1000 to < 2000 pg/ml. Also, the highest pregnancy rate (21.5%) was among women with E2 > 4000 pg/ml, while the lowest (5.3%) was in women with E2 < 1000 pg/ml. In the current study the median serum E2 level on the day of hCG administration was highly significant in women who became pregnant when compared to women who did not. The best cut-off value of serum E2 at hCG administration was ≥ 3682.3 pg/ml. Conclusions this study suggests that the optimal range of E2 level for achieving a successful pregnancy is > 4000 pg/ml.
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Affiliation(s)
- Ahmed Elsayad
- Department of Obstetrics and Gynaecology, Zagazig University, Egypt
| | - Wael Khafagy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Walaa ElBassioune
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Mahmoud Rady
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Ahmed Abdeltawab
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Muhammad Altoraky
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Mahmoud Hegazy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Waled Ayad
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | | | - Ahmed Elshorbagy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | | | - Ahmed Saeed
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Elmetwally Farouk
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Ehab Elhelw
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
| | - Hamada Abuelmatti
- Department of Obstetrics and Gynaecology, Al-Azhar University, Egypt
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Khafagy W, Elbassioune W, Ibrahim M, Rady M, Abdeltawab A, Altoraky M, Hegazy M, Ayad W, Alghazaly M, Elshorbagy A, Almorsy AS, Galal S, Alazazy H, Zaki A, Farouk E, Elhelw E, Abuelmatti H, Mahmoud M, Hussein M, Marai E, Sultan E, Deif O. A novel injection technique for ilioinguinal nerve block for post-operative pain relief in caesarean delivery - a randomized, double-blind, placebo-controlled trial. Ceska Gynekol 2023; 88:86-91. [PMID: 37130731 DOI: 10.48095/cccg202386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
AIM To determine whether the novel method is successful in blocking both ilioinguinal nerves to lessen postoperative pain following caesarean surgery. MATERIALS AND METHODS Between January 2022 and January 2023, 300 patients were enrolled in this study at the Obstetrics and Gynaecology Departments of the Faculty of Medicine at Al-Azhar University. About 150 of these patients received bupivacaine infiltration on both sides close to the anterior superior iliac spine, and 150 received a normal saline injection at the same locations. RESULTS The study compared the two groups and discovered significant differences in the timing of analgesic requests, interval before the patient's first ambulation, length of hospital stay, postoperative pain score, and incidence of postoperative nausea and vomiting, with group A performing better. CONCLUSION After a caesarean section, the local anaesthetic "bupivacaine" injection used to block the ilioinguinal nerves bilaterally is an efficient way to lessen postoperative discomfort and analgesic use.
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