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Cubuk A, Weinberger S, Moldovan ED, Schaeff V, Neymeyer J. Use of the Allium Round Posterior Stent for the Treatment of Recurrent Vesicourethral Anastomosis Stricture. Urology 2023; 179:118-125. [PMID: 37429546 DOI: 10.1016/j.urology.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE To compare outcomes of monopolar incision and Allium Round Posterior Stent (RPS) insertion for the treatment of recurrent vesicourethral anastomosis stricture. METHODS Having a suprapubic catheter and an obstructed pattern with a peak flow rate (PFR) ≤12 mL/s on uroflowmetry were the indications for the surgery. Once the fibrotic vesicourethral anastomosis was incised, RPS was inserted at the level of vesicourethral anastomosis under fluoroscopic guidance. All the stents were removed at postoperative first year. Patients were evaluated 3months after stent removal. Objective cure was defined as no need to further treatments and PFR ≥12 mL/s while subjective cure was defined as having points <4 on Patient Global Impression of Improvements scale. RESULTS Of the 30 patients with a median age 66 (52-74) enrolled in the study, 18 had a suprapubic catheter, remaining 12 had median PFR 5.2 (2-10) mL/s. Stent migration was noted in two patients, these stents were replaced by new ones. Stone formation was diagnosed in one patient, a pneumatic-lithotripsy was performed. The median follow-up time was 28 (4-60) months following stent removal. Six cases needed further treatment after removal. The median PFR of remaining 24 patients was 20 (16-30) mL/s (P = .001). The objective cure rate was 24/30(80%), the Patient Global Impression of Improvements scores varied from 1 to 2, meaning subjective cure rate was 24/30(80%). For the six failed cases, according to patient preferences a lifetime RPS insertion was planned. CONCLUSION With its minimally invasive nature, reversibility, and acceptable success and complication rates, incision of anastomosis and insertion of the RPS for a 1-year duration is a promising option for the treatment of recurrent vesicourethral anastomosis stricture.
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Affiliation(s)
- Alkan Cubuk
- Department of Urology, Kırklareli University, Kırklareli, Turkey.
| | | | | | | | - Joerg Neymeyer
- Department of Urology, Charite University, Berlin, Germany
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Neymeyer J, Weinberger S, Schlomm S, Cubuk A. Improved therapy of vesicourethral anastomosis stricture after radical prostatectomy through modified monopolar stricture opening and healing stent insertion. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01986-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Altmann J, Chekerov R, Fotopoulou C, Muallem MZ, du Bois A, Cliby W, Dowdy S, Podratz K, Lichtenegger W, Camara O, Tunn R, Cibula D, Kuemmel S, Scambia G, Vergote I, Chiantera V, Pietzner K, Inci MG, Chopra S, Biebl M, Neymeyer J, Blohmer JU, Sehouli J. Ten years of live surgical broadcast at Charité-MAYO conferences (2010–2019): a systematic evaluation of the surgical outcome. Int J Gynecol Cancer 2022; 32:746-752. [DOI: 10.1136/ijgc-2021-003173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
ObjectiveThe international Charité-MAYO Conference aims to promote international dialog on diagnostics, management, scientific breakthroughs, and state-of-the-art surgical procedures in gynecology and gynecologic oncology and senology. Live surgeries are a fundamental tool of interdisciplinary and international exchange of experts in their respective fields. Currently, there is a controversial and emotional debate about the true value, risks, and safety of live surgical broadcasts. The aim of the current study is to analyze peri-operative risks in patients who were operated live during the Charité-MAYO Conferences.MethodsLive surgeries were performed by the core Charité team consisting of gynecologic oncologic surgeons, breast and plastic surgeons, partly in collaboration with visiting gynecologic oncologic surgeons. We performed a retrospective analysis of live surgeries performed during seven Charité-MAYO Conferences from 2010 to 2019 held in Berlin, Germany. Patients’ files and tumor databases were analyzed as required and patients were contacted to update their long-term follow-up.ResultsSixty-nine patients who were operated live were included. The types of surgery were as follows: urogynecologic procedures (n=13), breast surgery (n=21), and gynecologic oncology surgery for ovarian, uterine, vulvar or cervical cancer (n=35). Peri-operative complications were assessed according to the Clavien–Dindo classification. Despite a high rate of complete resection and the high frequency of multivisceral procedures, the rate of peri-operative complications was within the range published in the literature. Time of surgery and length of intensive unit care and hospital stay did not differ from data acquired at the home institution.ConclusionsBased on our analysis, live surgeries appear to be safe when performed within a multidisciplinary setting without an increase in surgical morbidity and mortality compared with historical controls and without compromise of patients’ outcome. This is the first analysis of its kind to set the basis for patient information and consent for this type of surgeries.
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MZ M, Miranda A, Armbrust R, Neymeyer J, Sehouli J, Muallem J. Nerve sparing radical hysterectomy: Short-term oncologic, surgical, and functional outcome. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Muallem MZ
- Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum
| | - A Miranda
- Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum
| | - R Armbrust
- Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum
| | - J Neymeyer
- Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum
| | - J Sehouli
- Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum
| | - J Muallem
- Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum
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Neymeyer J, Moldovan DE, Weinberger S, Kranz J. [Old wine in new bottles-proven open-surgical procedures for the treatment of pelvic organ prolapse]. Urologe A 2019; 58:617-626. [PMID: 31209530 DOI: 10.1007/s00120-019-0940-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Urinary incontinence and pelvic organ prolapse (POP) are increasing due to demographic factors. Increasing life expectancy and sociocultural demands of women require successful treatments that also have low complication rates. Classic open procedures such as colposuspension or colposacropexy (native tissue repair as well as mesh procedures) are experiencing a renaissance due to the current critical view of mesh-repair pelvic floor surgery and continue to be of great importance. With suitable patient selection, long-term results of abdominal procedures are on a par with minimally invasive techniques. Cosmetically acceptable results can be achieved with optimized incisions. The therapeutically relevant target for apical fixation is the elevation angle of the vagina (EAV). Minimally invasive mesh-based primary reconstructions and interventions for POP recurrence proved to be superior to conventional procedures due to good long-term results, lower recurrence rates and reduced early and late complication rates when anatomically correct and gentle surgery is performed with a critical selection of textile implants. Abdominal procedures are not inferior to minimally invasive techniques when instrumental suturing techniques and modern instruments are used. Adequate and critical information about surgical options and possible risks of complications should be provided in a timely manner. Education and training in modern diagnostics as well as in abdominal and current minimally invasive techniques and complication management should be implemented according to the guidelines and recommendations of professional societies, the Food and Drug Administration and the European Network of Information Centres.
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Affiliation(s)
- J Neymeyer
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland.
| | - D E Moldovan
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland
| | - S Weinberger
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland
| | - J Kranz
- Klinik für Urologie und Kinderurologie, St.-Antonius-Hospital Eschweiler, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Straße 8, 52249, Eschweiler, Deutschland.
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.
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Abstract
Urogynaecology is a highly specialised interdisciplinary medical field. It aims to investigate and treat functional, static, endocrine and sexual disorders of the genitourinary system and pelvic area in a sustainable and holistic manner.The "Urological Functional Diagnostics and Female Urology" working group of the German Urologist Academy was founded in 1977. It focuses on developing and updating diagnostics and clinical therapy, contributing to urogynaecological guidelines as well as establishing programmes for further education.Urinary incontinence and other pelvic floor disorders are increasing for demographic reasons. Rising socio-cultural expectations of women require more effective treatments using methods that guarantee success and a low level of complications.Milestones in urogynaecology include the introduction and further development of minimally-invasive surgical procedures such as tension-free vaginal tape (TVT) systems, laparoscopic and robot-assisted techniques, the development of a modern complication management, more targeted drug therapies, and the possibilities of modern functional diagnostics including pelvic floor sonography and MRI examinations.Classic surgical techniques such as colposuspension or colposacropexy and vaginal native tissue repair continue to be very important. In special cases, e. g. recurrent pelvic organ prolapse, mesh-based repair has proven to be superior to conventional procedures because of good long-term success and low recurrence rates. However, this method requires an anatomically correct surgical technique, critical selection of textile implants, and adequate patient education. Suturing devices and robot-assisted surgery may be helpful due to the narrow access and limited surgical spaces. For apical direct fixations, the elevation angle of the vagina is the therapeutically relevant outcome. Tried-and-tested anatomical fixation points should be preferred.Education and training in the field of urogynaecology and harmonisation with European standards (European Board & College of Obstetrics and Gynaecology) should be implemented. Skills for highly specialised mesh-based surgery and effective techniques for managing complications should be taught in the same interdisciplinary manner as diagnostic procedures such as pelvic floor sonography, which are easy to learn and use.Only an interdisciplinary urogynecological sub-specialisation can guarantee the development of required professional competences. Interdisciplinary education should be organised by the participating societies (urology, surgery and gynaecology) together.
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Affiliation(s)
- Joerg Neymeyer
- Charité Universitätsmedizin Berlin, Urogynäkologie und Pelvic Floor Competence Center Charié (PF3C), Klinik für Urologie und Hochschulambulanz, Berlin
| | - Diana Moldovan
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin
| | - Kurt Miller
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin
| | - Sarah Weinberger
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin
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Neymeyer J, Weinberger S, Moldovan DE, Kornienko K, Salem F, Schlomm T. Modernes Komplikationsmanagement der kompletten Ureterdurchtrennung mittels minimalinvasiver, überbrückender, kontinuitätswiederherstellender, ummantelter Ureterschienung – Ureteric bridging with a fully coated stent. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - S Weinberger
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - DE Moldovan
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - K Kornienko
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - F Salem
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
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Neymeyer J, Weinberger S, Moldovan DE, Schlomm T. Vaginale anatomisch gerechte hohe mediale Rekonstruktion mit Lateraldefektbehebung der deszensusbedingten Blasenentleerungsstörung mittels Antegradem Nahtinstrument (ARSD-Ney). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - S Weinberger
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - DE Moldovan
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité Universitätsmedizin Berlin, Klinik und Poliklinik für Urologie, Berlin, Deutschland
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Neymeyer J, Weichert A, Weinberger S, Schlomm T. The „Pumping Probe Technique“ and complete sealing stent – a new simple method for the detection and treatment of ureteric fistulae. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Weichert
- Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Deutschland
| | - S Weinberger
- Charité Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
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Neymeyer J, Weintraub AY, Weinberger S, Moldovan DE, Kornienko K, Schlomm T. The elevation angle of the vagina (EAV) following different pelvic reconstructive procedures. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- J Neymeyer
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - AY Weintraub
- Soroka University Medical Center, Department of Obstetrics and Gynecology, Beer Sheva, Israel
| | - S Weinberger
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - DE Moldovan
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - K Kornienko
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
| | - T Schlomm
- Charité – Universitätsmedizin Berlin, Klinik für Urologie, Berlin, Deutschland
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Weintraub AY, Ben Zvi M, Yohay D, Neymeyer J, Reuven Y, Neuman M, Tsivian A. Safety and short term outcomes of a new truly minimallyinvasive mesh-less and dissection-less anchoring system for pelvic organ prolapse apical repair. Int Braz J Urol 2017; 43:533-539. [PMID: 28191790 PMCID: PMC5462146 DOI: 10.1590/s1677-5538.ibju.2016.0356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/20/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the safety and short term outcomes of a new, truly minimallyinvasive, mesh-less and dissection-less anchoring system for pelvic floor apical repair. METHODS A prospective study was conducted using the NeuGuide™ device system for pelvic floor apical repair. The primary effectiveness outcome was centro-apical pelvic floor prolapse by POP-Q after six months. The primary safety outcome was intra-operative, immediate (first 48 h) post-operative complications and adverse effects after six months. A standardized questionnaire (UDI-6) to assess quality of life at entry and during follow-up visits was used. Patients' six months-follow-up and evaluation are reported. RESULTS The mean age of the study population (n=10) was 63.8±12.0 years. All patients had a previous prolapse surgery. Five had a previous hysterectomy and two had stress urinary incontinence symptoms. During surgery six patients had a concurrent colporrhaphy. There was no injury to the bladder, rectum, pudendal nerves, or major pelvic vessels and no febrile morbidity was recorded. At six months, no cases of centro-apical recurrence were noted. Patients were satisfied with the procedure and had favorable quality of life scores. Using the UDI-6 questionnaire an improvement, in all domains was seen. Moreover, although the sample size was small, the improvement in urge and overflow incontinence related domains were demonstrated to be statistically significant. CONCLUSIONS This new NeuGuide™ device allows rapid and safe introduction of a suspending suture through the sacrospinous ligament and makes sacrospinous ligament fixation easy to perform, while avoiding dissection and mesh complications.
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Affiliation(s)
- Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Masha Ben Zvi
- Department of Urologic Surgery, Edith Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Yohay
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Joerg Neymeyer
- Department of Urology, Charitè University, Berlin, Germany
| | - Yonatan Reuven
- Siaal Research Center for Family Medicine and Primary Care, Division of Community Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Menahem Neuman
- Urogynecology, Department of Obstetrics and Gynecology, Galilee Hospital, and the Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel.,Assuta Medical Centers, Tel Aviv and Rishon Le-Zion, Israel
| | - Alex Tsivian
- Department of Urologic Surgery, Edith Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Weichert A, Braun T, Deutinger C, Henrich W, Kalache KD, Neymeyer J. Prenatal decision-making in the second and third trimester in trisomy 21-affected pregnancies. J Perinat Med 2017; 45:205-211. [PMID: 27442357 DOI: 10.1515/jpm-2016-0108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 06/10/2016] [Indexed: 11/15/2022]
Abstract
Down syndrome (DS) is the most common chromosome abnormality among live-born infants and the most frequent genetic cause of intellectual disability. The majority of pregnancies affected by DS are terminated. The decision concerning whether or not to continue a pregnancy following the prenatal diagnosis of DS is complex and amongst others, motivated by attitudes towards termination, socioeconomic factors, and ultrasound findings. In Germany, termination of pregnancy (TOP) is a legal option, even during the later stages of gestation. The aim of the present study was to evaluate the pregnancy outcomes as well as possible factors that influence the decisions made by women with trisomy 21-affected pregnancies. In our study 112 pregnancies affected by trisomy 21 were included. Our data confirm that most patients are more likely to terminate a trisomy 21-affected pregnancy [76 (67.9%) vs. 36 (32.1%) continued pregnancies]. Beyond that we found that women who continued their pregnancy tended to be at an advanced stage in their pregnancy at the time of karyotyping. With regards to factors from their medical history as well as sonographic findings there was no identifiable single factor that could distinguish between women that opted to continue or terminate their pregnancy.
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Neymeyer J, Weichert B, Weinberger S, Weintraub A, Weichert A. Laparoskopische Sakropexie mit Retroperitonealsierung des Mesh-Interponats: Ergebnisse an 298 Patientinnen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Paz-Levy D, Yohay D, Neymeyer J, Hizkiyahu R, Weintraub AY. Native tissue repair for central compartment prolapse: a narrative review. Int Urogynecol J 2016; 28:181-189. [PMID: 27209309 DOI: 10.1007/s00192-016-3032-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 04/19/2016] [Indexed: 11/28/2022]
Abstract
Central descent due to a level 1 defect is a main component in pelvic organ prolapse (POP) reconstructive surgery, whether for symptomatic apical prolapse or for the prolapse repair of other compartments. A recent growth in the rate of native tissue repair procedures for POP, following the US Food and Drug Administration (FDA) warnings regarding the safety and efficacy of synthetic meshes, requires a re-evaluation of these procedures. The safety, efficacy, and determination of the optimal surgical approach should be the center of attention. Functional outcome measures and patient-centered results have lately gained importance and received focus. A comprehensive literature review was performed to evaluate objective and subjective outcomes of apical prolapse native tissue repair, with a special focus on studies reporting impact on patients' functional outcomes, quality of life, and satisfaction. We performed a MEDLINE search for articles in the English language by using the following key words: apical prolapse, sacrospinous ligament fixation, uterosacral ligament suspension, sacral colpopexy, McCall culdoplasty, iliococcygeus vaginal fixation, and functional outcomes. We reviewed references as well. Despite a prominent shortage of studies reporting standardized prospective outcomes for native tissue repair interventions, we noted a high rate of safety and efficacy, with a low complication rate for most procedures and low recurrence or re-treatment rates. The objective and subjective results of different procedures are reviewed. Functional outcomes of native tissue repair procedures have not been studied sufficiently, though existing data present those procedures as favorable and not categorically inferior to sacrocolpopexy. Apical compartment prolapse repair using native tissue is not a compromise. Functional outcomes of native tissue repair procedures are favorable, have a high rate of success, improve women's quality of life (QoL), and result in high rates of patient satisfaction. This subject requires further long-term, standardized prospective studies following the International Continence Society/International Urogynecologists Association guidelines for surgical outcomes report, with the focus on patient-centered functional outcomes.
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Affiliation(s)
- Dorit Paz-Levy
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - David Yohay
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Joerg Neymeyer
- Department of Urology, Charitè University, Berlin, Germany
| | - Ranit Hizkiyahu
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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Weintraub AY, Neuman M, Reuven Y, Neymeyer J, Marcus-Braun N. Efficacy and safety of skeletonized mesh implants for advanced pelvic organ prolapse: 12-month follow-up. World J Urol 2016; 34:1491-8. [DOI: 10.1007/s00345-016-1792-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/12/2016] [Indexed: 11/25/2022] Open
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Weichert A, Neymeyer J, Hinkson L, Weichert TM, Schmiedel D, Kalache KD. Semi-Automatic Identification of the Fetal Profile and Nasal Bone Measurement at the Time of the Routine Mid-Trimester Ultrasound Scan. Ultraschall Med 2015; 36:473-479. [PMID: 25072245 DOI: 10.1055/s-0034-1366880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE This study was designed to compare nasal bone length (NBL) measurements using a manual multiplanar mode with those made using a newer semi-automatic technique (Volume NT™) acquired by an experienced operator as well as measurements done by two independent observers with different levels of ultrasound experience (conventional 2 D vs. Volume NT™). MATERIALS AND METHODS Ultrasound examination was performed prospectively on 81 pregnant women with a singleton pregnancy at the time of their routine mid-trimester ultrasound scan. RESULTS The correct mid-sagittal plane of the fetal profile was successfully obtained using the semi-automatic technique in 53 of 81 cases. CONCLUSION NBL measurements using conventional two-dimensional techniques showed significantly higher inter-observer variability than the semi-automatic program. Our study shows the feasibility of using a semi-automatic technique, especially for less experienced operators. Measurements obtained with the semi-automatic technique produced much less variable results around a mean than those obtained with conventional two-dimensional ultrasound.
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Affiliation(s)
- A Weichert
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Germany
| | - J Neymeyer
- Department of Urology, Charité - Universitätsmedizin Berlin, Germany
| | - L Hinkson
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Germany
| | - T M Weichert
- Department of Pediatrics, Sana Klinikum Lichtenberg, Berlin, Germany
| | - D Schmiedel
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Germany
| | - K D Kalache
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Germany
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Weichert A, Weichert TM, Bergmann RL, Henrich W, Kalache KD, Richter R, Neymeyer J, Bergmann KE. Factors for Preterm Births in Germany - An Analysis of Representative German Data (KiGGS). Geburtshilfe Frauenheilkd 2015; 75:819-826. [PMID: 26366001 DOI: 10.1055/s-0035-1557817] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 06/03/2015] [Accepted: 06/11/2015] [Indexed: 10/23/2022] Open
Abstract
Introduction: Preterm birth is a global scourge, the leading cause of perinatal mortality and morbidity. This study set out to identify the principal risk factors for preterm birth, based on the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). A range of possible factors influencing preterm birth were selected for inclusion in the questionnaire, covering factors such as gender, national origin, immigrant background, demography, living standard, family structure, parental education and vocational training. Methods: All data were taken from the aforementioned KiGGS survey conducted between 2003 and 2006. A total of 17 641 children and adolescents (8656 girls and 8985 boys) drawn from 167 German towns and municipalities deemed to be representative of the Federal Republic of Germany were included in the study. Gestational age at birth was available for 14 234 datasets. The questionnaire included questions from the following areas as possible factors influencing preterm birth: gender, national origins, immigrant background, demography, living standard, family structure, parental education and vocational training. Results: The preterm birth rate was 11.6 %, higher than that of other national statistical evaluations. Around 57.4 % of multiple pregnancies and 10 % of singleton pregnancies resulted in preterm delivery. Multiple pregnancy was found to be the most important risk factor (OR 13.116). With regard to national origins and immigration background, mothers from Turkey, the Middle East, and North Africa had a higher incidence of preterm birth. Preterm birth was more prevalent in cities and large towns than in small towns and villages. Conclusion: Risk factors associated with preterm birth were identified. These should help with the early identification of pregnant women at risk. The preterm birth rate in our survey was higher than that found in other national statistical evaluations based on process data. More than half of all multiple pregnancies ended in preterm birth.
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Affiliation(s)
- A Weichert
- Charité - Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin
| | - T M Weichert
- Bezirksamt Mitte von Berlin, Gesundheitsamt - Kinder- und Jugendgesundheitsdienst, Berlin
| | - R L Bergmann
- Charité - Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin
| | - W Henrich
- Charité - Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin
| | - K D Kalache
- Sidra Medical and Research Center, Obstetrics & Gynecology Department, Doha, Qatar
| | - R Richter
- Charité - Universitätsmedizin Berlin, Klinik für Gynäkologie, Berlin
| | - J Neymeyer
- Charité - Universitätsmedizin Berlin, Klinik für Urologie, Berlin
| | - K E Bergmann
- Charité - Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin
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Maxeiner A, Stephan C, Fischer T, Durmus T, Kilic E, Asbach P, Haas M, Günzel K, Neymeyer J, Miller K, Cash H. [Real-time MRI/US fusion-guided biopsy in biopsy-naïve and pre-biopsied patients with suspicion for prostate cancer]. Aktuelle Urol 2015; 46:34-8. [PMID: 25519051 DOI: 10.1055/s-0034-1395563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI)/ultrasound (US) fusion-guided biopsy detects more prostate cancer (PCa) than transrectal US (TRUS)-guided biopsy in patients with an indication for prostate re-biopsy. The aim of this study was a) to compare the detection rates of MRI/US fusion-guided biopsy with conventional TRUS in a double centre cohort and b) to investigate the influence of the number of pre-biopsies on the PCa detection rate. MATERIAL AND METHODS In the period from January 2012 to July 2014, 310 consecutive patients gave written informed consent and underwent 3 Tesla MRI scans of the prostate. All patients had at least one PCa suspicious lesion in the MRI and were biopsied by MRI/US fusion followed by a conventional 10-core biopsy of the prostate. Detection rates based on technique, Gleason score and number of pre-biopsies were calculated. RESULTS The overall detection rate of the study was 51% (158 patients). Among these 158 patients a histopathological Gleason score of 6 was detected in 60 patients (38%), a Gleason score of 7 in 54 patients (34%) and a Gleason score≥8 in 44 patients (28%). MRI/US fusion-guided biopsy detected 110 (69.7%) of the overall detected 158 PCa. TRUS-guided biopsy detected a higher rate of Gleason score 6 (54%) and a lower rate of Gleason score≥8 (15%) lesions in comparison to 38% Gleason 6 and 28% Gleason≥8 in the MRI/US fusion-guided biopsy, respectively. Furthermore, a lower Gleason score was observed in patients with more than one pre-biopsy. The detection rate in biopsy-naïve patients undergoing MRI/US fusion was 75% (40 patients) among 75% detected Gleason score≥7. CONCLUSION MRI/US fusion-guided biopsy detected more PCa and also more clinically significant cancer than conventional TRUS. In our cohort patients with more than one pre-biopsy showed lower Gleason scores. The included patients with an initial MRI/US fusion-guided biopsy should be further investigated.
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Affiliation(s)
- A. Maxeiner
- Klinik für Urologie, Charité – Universitätsmedizin Berlin, Berlin
| | - C. Stephan
- Klinik für Urologie, Charité – Universitätsmedizin Berlin, Berlin
| | - T. Fischer
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin
| | - T. Durmus
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin
| | - E. Kilic
- Klinik für Pathologie, Charité – Universitätsmedizin Berlin, CCM, Berlin
| | - P. Asbach
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin
| | - M. Haas
- Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin
| | - K. Günzel
- Klinik für Urologie, Charité – Universitätsmedizin Berlin, Berlin
| | - J. Neymeyer
- Klinik für Urologie, Charité – Universitätsmedizin Berlin, Berlin
| | - K. Miller
- Klinik für Urologie, Charité – Universitätsmedizin Berlin, Berlin
| | - H. Cash
- Klinik für Urologie, Charité – Universitätsmedizin Berlin, Berlin
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Weinberger S, Bäder M, Scheurig-Münkler C, Hinz S, Neymeyer J, Miller K, Kempkensteffen C. Optimizing evaluation of split renal function in a living kidney donor using scintigraphy and calculation of the geometric mean: a case report. Case Rep Nephrol Dial 2014; 4:1-4. [PMID: 24575115 PMCID: PMC3934684 DOI: 10.1159/000358007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Within the evaluation process of living kidney donors, split renal function is usually evaluated by renal scintigraphy. Since split renal function measured by conventional posterior scans depends on the position of the kidney, actual suitable donors may be rejected because of an inaccurate examination technique. We report the case of a 28-year-old male living kidney donor. Due to a complex vascular anatomy of the right kidney, only his left kidney was considered eligible for transplantation. In conventional posterior Tc99m-mercapto-acetyltriglycine scintigraphy, the left kidney had a relative function of 60%. A second scintigraphy using anterior and posterior dimercaptosuccinic acid scans with calculation of the geometric mean showed an adapted relative function of the left kidney of 53%, now meeting the inclusion criteria for living kidney donation. This case shows that the geometric mean method using simultaneous anterior and posterior views obtained with a dual-head gamma camera can be a very helpful approach to determine split renal function of potential living kidney donors. Further investigation is necessary to prove the benefit of a general bilateral scan before living kidney donation.
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Affiliation(s)
| | - M Bäder
- Department of Nuclear Medicine, Berlin, Germany
| | | | - S Hinz
- Department of Urology, Berlin, Germany
| | | | - K Miller
- Department of Urology, Berlin, Germany
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Neymeyer J, Cash H, Roller C, Kontidou, Fuller T. MP-01.05 Vscan: A Pocket-Sized Ultrasound Device in Examination of the Genitourinary Tract. Urology 2011. [DOI: 10.1016/j.urology.2011.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Neymeyer J, Stier K, Roller C, Kassin S, Abdul-Wahab Al-Ansari W, Lisowski A, Miller K. UP-01.082 Single Incision Technique Using RSD-Ney for Insertion of Titanium Coated Extra-Light Mesh Yields More Favourable Clinical Outcomes in Patients Suffering from Vaginal Vault Prolapse Resulting from Previous Pelvic Tumor Surgery. Urology 2011. [DOI: 10.1016/j.urology.2011.07.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Neymeyer J, Cash H, Schmidt T, Abdul-Wahab W, Schostak M, Miller K. VID-05.08 Investigation of an Extended Set of Specialized Fiber Probes During the Application of Thermal Energy at Parenchymal Tissue. Urology 2011. [DOI: 10.1016/j.urology.2011.07.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Neymeyer J, Roller C, Stier K, Schlulzke B, Awadi E, Fuller T. UP-01.103 Urologists' Best Friend, the “Mobile Urological Bag” (MUB): A Lot of Technology in Little Space. Urology 2011. [DOI: 10.1016/j.urology.2011.07.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Abstract
The field of urogynaecology represents an interdisciplinary subspecialty which is dedicated to qualified diagnostics and effective treatment of functional, static, endocrine and urological pelvic floor disorders. Core areas of the surgical uro-gynaecology are pelvic floor reconstruction for the treatment of urinary and anal incontinence, descensus and prolapse including proctological surgery. Also included are the therapy and correction after trauma of the pelvic floor, as well as reconstruction after oncological interventions. In urogynaecological pelvic floor reconstruction, supporting tapes and mesh implants are usually implanted tension-free. The principle of the tension-free tape and mesh graft implantation is based on the induction of collagen regeneration as well as the development of scar tissue creating a tight, statically effective tissue within the pelvic floor. Surgical goal is the improvement of quality of life and the restitution of an appropriate coenaesthesia with preservation of a regular micturition and continence. Another important aspect is the restitution of a regular sexuality. Conservative urogynaecology represents the medicinal, physiotherapeutic or neuromodulatory treatment of mainly descensus disorders and urinary and anal incontinence. Other foci are urinary infections, chronic pelvic pain as well as postoperative and posttraumatic insufficiency of the pelvic floor.
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Neymeyer J, Abou-Dakn M, Kassin S, Greiner E, Beer M. Scheidenstumpffixation am Ligamentum sacrospinale nach Amreich-Richter mittels Nahtzange in 5 Minuten. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Niehues SM, Unger JK, Malinowski M, Neymeyer J, Hamm B, Stockmann M. Liver volume measurement: reason of the difference between in vivo CT-volumetry and intraoperative ex vivo determination and how to cope it. Eur J Med Res 2010; 15:345-50. [PMID: 20947471 PMCID: PMC3458704 DOI: 10.1186/2047-783x-15-8-345] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose Volumetric assessment of the liver regularly yields discrepant results between pre- and intraoperatively determined volumes. Nevertheless, the main factor responsible for this discrepancy remains still unclear. The aim of this study was to systematically determine the difference between in vivo CT-volumetry and ex vivo volumetry in a pig animal model. Material and Methods Eleven pigs were studied. Liver density assessment, CT-volumetry and water displacement volumetry was performed after surgical removal of the complete liver. Known possible errors of volume determination like resection or segmentation borders were eliminated in this model. Regression analysis was performed and differences between CT-volumetry and water displacement determined. Results Median liver density was 1.07 g/ml. Regression analysis showed a high correlation of r2 = 0.985 between CT-volumetry and water displacement. CTvolumetry was found to be 13% higher than water displacement volumetry (p < 0.0001). Conclusion In this study the only relevant factor leading to the difference between in vivo CT-volumetry and ex vivo water displacement volumetry seems to be blood perfusion of the liver. The systematic difference of 13 percent has to be taken in account when dealing with those measures.
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Affiliation(s)
- Stefan M Niehues
- Klinik für Strahlenheilkunde, Charite Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
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Neymeyer J, Abou-Dakn M, Abdul-Wahab Al-Ansari W, Greiner E, Kassin S, Beer M. UP-2.20: Sacrospinous ligament fixation for vaginal vault prolapse with a reusable suturing device (RSD-Ney) in 5 minutes. Urology 2010. [DOI: 10.1016/j.urology.2010.07.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Neymeyer J, Al-Ansari WAW, Kassin S, Beer M. V37 Optimizing results of suburethral sling operations among females using suburethral hyaluronic acid injections. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61474-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neymeyer J, Abdul-Wahab Al-Ansari W, Wuelfing T, Behm A, Kassin S, Beer M. POD-01.01: The TiLOOP® Male Sling and ProAct™ Balloons: A New Adjustable Treatment Option To Improve Male Stress Urinary Incontinence Significantly. Urology 2009. [DOI: 10.1016/j.urology.2009.07.1206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neymeyer J, Abdul-Wahab Al-Ansari W, Kassin S, Dehner Y, Müller B, Abou-Dakn M, Beer M. UP-1.190: Complication Rates of Ultra-Light Titanium Coated TVT vs TVT-O Sub-Urethral Meshes: A Prospective Randomized Study among Women Operated on for Stress Urinary Continence. Urology 2009. [DOI: 10.1016/j.urology.2009.07.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neymeyer J, Al-Ansari WAW, Al-Yafaey A, Abou-Dakn M, Müller B, Mazhari S, Beer M. O671 Complication rates of ultra-light titanium coated TVT vs TVT-O sub-urethral meshes - A prospective randomized study among women operarted on for stress urinary continence. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61044-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Neymeyer J, Abdul-Wahab Al-Ansari W, Apostolidis A, Kassin S, Laux T, Beer M. Diagnostik und Therapie der symptomatischen Harnstauungsniere in der Schwangerschaft. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Neymeyer J, Abdul-Wahab Al-Ansari W, Apostolidis A, Kassin S, Laux T, Beer M. Therapie der symptomatischen Harnstauungsniere in der Schwangerschaft – Harnableitung bei symptomatischer Harnstauung in der Schwangerschaft. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Neymeyer J, Abdul-Wahab Al-Ansari W, Kassin S, Behm A, Beer M. Komplikationsmanagement nach Fremdmaterialerosionen im kleinen Becken – Vorgehen nach Netzmaterialerosionen in die Urethra, Blase, Scheide und Darm. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Neymeyer J, Abdul-Wahab Al-Ansari W, Kassin S, Laux T, Beer M. Berücksichtigung onkologischer, urologischer und gynäkologischer Aspekte bei Anlage einer Neoblase mit Beckenbodenrekonstruktion – Kontinenzerhaltende Rekonstruktion nach Evisceration des kleinen Beckens. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Neymeyer J, Abdul-Wahab Al-Ansari W, Kassin S, Müller B, Abou-Dakn M, Beer M. TVT / TVTO mit titanisiertem extraleichten Schlingen–Eine prospektive randomisierte Studie zur Therapie der Stressinkontinenz – Titanisierte extraleichte suburethrale Schlingen zur Therapie der Stressinkontinenz. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Neymeyer J, Abdul-Wahab Al-Ansari W, Große-Siestrup C, Börger J, Groneberg D, Beer M. Tierexperimenteller Nachweis für die Beckenbodenplastik relevanter Eigenschaften titanisierter Netzimplantate (TiLoop) – Tierexperimenteller Nachweis von Eigenschaften titanisierter Netzimplantate an 2o Schweinen. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Sousa-Escandón A, Cabrera J, Mantovani F, Moretti M, Ioanidis E, Kondelidis N, Neymeyer J, Noguera R. Adjustable suburethral sling (male remeex system) in the treatment of male stress urinary incontinence: a multicentric European study. Eur Urol 2007; 52:1473-9. [PMID: 17560016 DOI: 10.1016/j.eururo.2007.05.017] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2007] [Accepted: 05/21/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a readjustable sling for the treatment of male stress urinary incontinence (SUI). MATERIALS AND METHODS Between October 2002 and August 2005, 51 male patients with mild to severe SUI were prospectively operated with the use of a readjustable sling (MRS) at seven different European hospitals: Spain (2), Italy (2), Greece (1), Germany (1), and Portugal (1). The origin of incontinence was radical prostatectomy in 43 cases, TUR in 4, and open prostatectomy in another 4. Duration of incontinence ranged from 1 to 10 yr with an average of 3.5 yr. RESULTS All patients but 5 were regulated during the early postoperative period; 44 patients (including all 5 not regulated during the early period) required a second regulation under local anaesthesia between 1 to 4 mo after surgery, and 17 other patients required more than one delayed regulation. After that, 33 patients (64.7%) were considered cured (25 of them wore no pads at all, and 8 used small pads or sanitary napkins for security but normally remained dry); another 10 cases showed important improvement (19.6%); and only 8 patients remain unchanged (15.7%). The average follow-up time was 32 mo (range: 16-50). The mesh was removed in 1 case owing to urethral erosion and the varitensor in 2 cases owing to infection. There were five (9.8%) uneventful intraoperative bladder perforations at the postoperative period, and there were three mild perineal haematomas (5.9%). Most patients felt perineal discomfort or pain, which was easily treated with oral medications. CONCLUSIONS The MRS((R)) allowed postoperative readjustment of the suburethral sling pressure at the immediate or midterm postoperative period, which allowed the achievement of good midterm results in almost 85% of patients without significant postoperative complications.
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Niehues SM, Stockmann M, Unger J, Neymeyer J, Hamm B, Lemke AJ. Evaluation der Störgrößen CT-gestützter Lebervolumetrie am Tiermodell bei Hausschweinen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kröncke TJ, Gauruder-Burmester A, Gronewold M, Lembcke A, Fischer T, Puls R, Juran R, Scheurig C, Neymeyer J, Hamm B. Technische Erfolgsrate, peri-interventionelle Komplikationen und Strahlenexposition der transarteriellen Embolisation bei Uterus myomatosus. ROFO-FORTSCHR RONTG 2004; 176:580-9. [PMID: 15088185 DOI: 10.1055/s-2004-812748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To analyze the technical success rate, incidence and type of peri-interventional complications, and radiation exposure of uterine artery embolization (UAE) in symptomatic leiomyomas of the uterus. MATERIALS AND METHODS This prospective study includes 75 patients consecutively treated with UAE from October 2000 through August 2002, with all interventions performed by the same radiologist. Technical success rate, interventional material, and incidence and type of peri-interventional complications (length of hospitalization) were recorded and categorized according to the definitions of the Society of Interventional Radiology (SIR). Fluoroscopy time (FT), dose-area product (DAP), and effective dose (ED) were determined for each intervention and the influence of the radiologist's experience on the radiation exposure analyzed. RESULTS UAE was technically successful in 97.3 % of the cases. Peri-interventional complications occurred in 14.7 %. Four complications (5.3 %) were classified as major class C according to the SIR (post-embolization syndrome requiring prolonged drug treatment and hospitalization [n = 3] perforation of the uterine artery [n = 1]). None of the complications led to discontinuation of the intervention, subsequent surgical intervention, or permanent sequelae. FT decreased significantly (p < 0.05) until the 35th intervention. The median FT decreased from 18.8 min (13.4 - 28 min [25th to 75th percentile]) to 11.8 min (9.7 - 13.3 min [25th to 75th percentile]). The DAP decreased by 25.3 % to a median of 8.547 (6.527 - 11.590 cGy*cm (2) [25th to 75th percentile]). The median ED was 31.5 mSv from the 36th intervention onward. CONCLUSION UAE has a high technical success rate with a low rate of peri-interventional complications. The study showed a statistically significant learning effect with a decrease in radiation exposure for the first 35 interventions. The effective dose of UAE is comparable to that of 1 to 2 small bowel enema.
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Affiliation(s)
- T J Kröncke
- Institut für Radiologie, Universitätsklinikum Charité (Campus Mitte), Humboldt-Universität zu Berlin.
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Tunn R, Beyersdorff D, Neymeyer J, Goldammer K, Gauruder-Burmester A, Hamm B, Lichtenegger W. MRT-Morphologie des Stressharnkontinenz-Kontrollsystems bei Frauen mit Stressharninkontinenz. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Neymeyer J, Tunn R. Computergestützte Dokumentation und Auswertung medizinischer Leistungen - ein Beitrag zur medizinischen Qualitätssicherung. Geburtshilfe Frauenheilkd 2001. [DOI: 10.1055/s-2001-15971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Neymeyer J, Tunn R. [Efficient multicentric data acquisition via internet - a method evaluation]. Zentralbl Gynakol 2001; 123:438-40. [PMID: 11562805 DOI: 10.1055/s-2001-17239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Data input in web-htm-forms with a browser is much more efficient in comparison with write in paper mask documents. The specification-compliant forms for data entry as htm-forms are downloaded from the homepage of the project manager by the participants of the study. The transformation of content of different formatted htm-forms is made by the program "security-based form converter (SFC)", which is located on a web server respectively a proxy server. From there the transformed data are returned the project manager via e-mail. Those incoming data are imported into databases by means of ODBC-data source. The data are pivoted from sequential format to table format. The data entry principle presented here is a client-server-structured, web based intranet program. For this purpose only standard software and relational databases with ODBC-interfaces are used; no further registered commercial programs are needed. General data protection is ensured by encrypted data transmission.
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Affiliation(s)
- J Neymeyer
- Humboldt-Universität zu Berlin, Klinik für Frauenheilkunde und Geburtshilfe der Charité, Abteilung für Urogynäkologie, Berlin, Germany.
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