Long-term re-procedure rate after mid-urethral slings for stress urinary incontinence
We examined the long-term re-procedure rate after MUS operations. The main outcome was re-procedures for SUI. The secondary outcome was surgical interventions due to complications.MethodsWe analysed a retrospective population cohort of 3531 women with MUS operations in 2000 –2006 and followed them up until 31 December 2016. Data were collected from a national hospital register and from hospital patient records.ResultsThe median follow-up time was 13 years (IQR 11.6–14.8) for the 3280 women with a retropubic MUS (RP-MUS) and 11 years (IQR 10.3–11.9) for the 245 women with a transobturator MUS (TO-MUS). The cumulative number of re-procedures for SUI was 16 (0.5%) at 1 year, 66 (1.9%) at 5 years, 97 (2.8%) at 10 years and 112 (3.2%) at 17 years. This risk was higher after TO-MUS than after RP-MUS operations (OR 3.6, 95% CI 2.5–5.2,p
Post-traumatic hydrocephalus (PTH) or secondary normal pressure hydrocephalus (NPH) are common complications that follow traumatic brain injury (TBI). PTH clinical features are similar to NPH and can be characterized by a triad of gait apraxia, cognitive deficits, and urinary incontinence. Symptoms may progress to psychomotor slowing, dementia, and the need for institutionalized care. Additionally, patients with TBI often experience a loss of impulse control, aggressive behaviors, and personality changes.
Publication date: Available online 24 February 2020Source: Surgery (Oxford)Author(s): Michel Wyndaele, Hashim Hashim
ConclusionCombined approaches for complete excision of transobturator slings, including bilateral inguinal dissection, are relatively morbid with prolonged recovery time and in most centres will require involvement of plastic surgeons. The laparoscopic approach not only allows for the mesh to be removed in total (including the intramural portion of the mesh), but also provides magnified views compared with open surgery and thus allows for better identification of planes and dissection. It also has the added benefit of avoiding vaginal incisions and therefore reducing the risk of fistula formation between the urethra/bladder and vagina.
Urinary incontinence is a common presentation and can manifest either as stress, urge or mixed incontinence. Though primarily a condition affecting women, the increasing uptake of prostate surgery for benign disease and cancer, whereupon up to one in five patients end up experiencing stress incontinence, means the prevalence of incontinence in men is increasing. A thorough assessment is necessary to identify the underlying urological abnormality and to guide appropriate management. Conservative approaches consist of treating constipation, the use of containment devices, weight loss, bladder training and pelvic floor muscle training.
ConclusionThe incidence of defecation disorders in the geriatric population is high and, most notably, anal incontinence is not spontaneously reported by most patients.ResumoIntroduçãoOs distúrbios da evacuação, seja a incontinência anal ou a constipação intestinal crônica, representam alterações do assoalho pélvico bastante frequente na população em geral e mais comumente naqueles com fatores de risco, ou seja, em idosos, mulheres com passado obstétrico, comorbidades, antecedente de radioterapia pélvica, diab&eacu...
Overactive bladder syndrome (OAB) is defined by the International Continence Society (ICS) as a clinical syndrome characterized by urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology . Its prevalence is higher in women than in men and increases with advancing age . In Brazil, Moreira et al., in 2013, found a prevalence of OAB of 5.1% in males and 10% in females among adults, and in the elderly, a prevalence of 78% in males and 82% in females.
This study investigates the prevalence in women who had turned to eHealth for treatment of UI and identifies possible factors associated with depression.MethodsWe analyzed data from two randomized controlled trials evaluating eHealth treatment for UI, including 373 women with stress UI (SUI), urgency UI (UUI), or mixed UI (MUI). We used the Hospital Anxiety and Depression Scale (HADS) and defined a score of ≥8 as depression or anxiety. The ICIQ-UI-SF questionnaire was used to score incontinence severity. Logistic regression was used to determine factors associated with depression and anxiety.ResultsWomen with UUI or MUI...
ConclusionsUI in women aged 50 –70 years in Hunan was not as prevalent as reported in previous studies. Some possible reasons are addressed; for example, the primary survey in this study was not a UI-focused survey. Women who were older, lived in the countryside and had histories of gynaecological disease, hypertension or card iovascular disease were more likely to have UI. Health departments and medical staff should target patients with factors that potential contribute to UI development.
Urinary incontinence, or the complaint of involuntary loss of urine, is a debilitating condition of the lower urinary tract with a potentially significant impact on a patient ’s physical and mental wellbeing and on their functioning and place in society. Due to the high prevalence of this disorder, the economic burden on healthcare systems worldwide is enormous. Urinary incontinence has a high prevalence in women, but men can be affected as well after a radical prostat ectomy or when suffering from chronic urinary retention.