Predictors of short and long term urinary incontinence after radical prostatectomy in prostate MRI: Significance and reliability of standardized measurements
Publication date: Available online 14 September 2019Source: European Journal of RadiologyAuthor(s): Markus Sauer, Pierre Tennstedt, Christoph Berliner, Lennart Well, Hartwig Huland, Lars Budäus, Gerhard Adam, Dirk BeyersdorffAbstractPurposeTo evaluate standardized measurements of the membranous urethra length (MUL), the membranous urethra angle (MUA) and the prostate’s apex type (AT) among further clinical parameters as potential preoperative risk factors of urinary incontinence (UI) after radical prostatectomy (RP).MethodOur institutional review board approved this retrospective single center study. 316 patients (mean age 65 years) underwent MRI at 3 T prior to prostatectomy. MUL, MUA and AT were measured according to a standardized approach on T2w- sagittal sequences. In a second reading the inter-rater agreement for the MUL was determined. Image findings and clinical data were correlated by logistic regression to UI as evaluated by a standardized questionnaire determining the number of necessary hygiene pads (HP) at three different time points with corresponding patient subsets (one week, six months and 12 months after RP).ResultsThere was a significant impact of the MUL on postoperative UI with odds ratios (OR) of 0.8 [p
CONCLUSIONS: Following sling implantation, modifications in UPPs were observed, with increases in MUCP and FUL but these increments were not statistically significant. Limitations to our study include biases inherent to the interpretation and reproducibility of urethral profilometry, the sample size, and the variable delay between sling implantation and postoperative urodynamic studies. LEVEL OF EVIDENCE: 4. PMID: 31587866 [PubMed - as supplied by publisher]
CONCLUSION: This multicentric retrospective series confirms that male slings are a usefull therapy for patients with mild or moderate urinary incontinence. LEVEL OF EVIDENCE: 4. PMID: 31587865 [PubMed - as supplied by publisher]
ConclusionAchievement of urinary continence and improvement of urinary quality of life are delayed in patients with preoperative urinary incontinence assessed by the 1-h pad test. The preoperative 1-h pad test could be a useful predictor of prolonged urinary incontinence and poor quality of life after robot-assisted radical prostatectomy.
AbstractRobotic-assisted simple prostatectomy (RASP) has emerged as a safe and effective treatment option for symptomatic patients with lower urinary tract symptoms related to significant benign prostatic enlargement (BPE) above 80 g. The recent release of the da Vinci SP robotic system (Intuitive, Sunnyvale, CA, USA) continues to advance the minimally invasive nature of robotic surgical technology. We now report our institution’s initial experience performing RASP using the da Vinci SP robotic system. An IRB-approved, ret rospective chart review was performed of all patients undergoing robotic-assisted simple ...
ConclusionsOur data demonstrate a promising new strategy to predict PPI through the perfusion quality of pelvic muscle structures with contrast media kinetics. This may facilitate preoperative patient consulting and decision-making.
Medical device companies attempting to market a new treatment in the U.S. often make the erroneous assumption that winning FDA approvalÂ is the final destination, and success is theirs. In fact, going through the regulatory process is only the halfway point. The grueling path from FDA approval to reimbursement is like a treacherous walk through Death Valley and many companies donât make it through. In this case study, I discussÂ the trials and triumphs of bringing robotic high intensity focused ultrasound (HIFU), a non-invasive procedure for localized prostate cancer, to the U.S.&Aci...
We present our findings in the form of evidence maps.ResultsWe included 16 good-quality systematic reviews examining biofeedback alone or as an adjunctive intervention. We found clear, consistent evidence across a large number of trials that biofeedback can reduce headache pain and can provide benefit as adjunctive therapy to men experiencing urinary incontinence after a prostatectomy. Consistent evidence across fewer trials suggests biofeedback may improve fecal incontinence and stroke recovery. There is insufficient evidence to draw conclusions about effects for most conditions including bruxism, labor pain, and Raynaud ...
CONCLUSION: The VIRTUE © sling seems to be an effective, safe tool treating SUI at short term. LEVEL OF EVIDENCE: 3. PMID: 31387835 [PubMed - as supplied by publisher]
Conditions: Prostatic Cancer; Surgical Procedure, Unspecified; Urinary Incontinence Intervention: Sponsor: Consorci Sanitari Integral Completed