Narrow Vagina as a Predictor of Obstructive Voiding Dysfunction after Transobturator Sling Surgery

2021 ◽  
pp. 1-7
Author(s):  
Miklós Romics ◽  
Veronika Keszthelyi ◽  
Valentin Brodszky ◽  
Péter József Molnár ◽  
Attila Keszthelyi ◽  
...  
Keyword(s):  
Midurethral Sling ◽  
Voiding Dysfunction ◽  
Univariate Analysis ◽  
Pelvic Organ ◽  
Primary Objective ◽  
Older Age ◽  
Transobturator Sling ◽  
Significance Level ◽  
Voiding Difficulty ◽  
Sling Surgery

<b><i>Background:</i></b> Voiding dysfunction (VD) is a potential complication after female midurethral sling operations. <b><i>Objectives:</i></b> Our goal was to assess the rate of obstructive VD after ­transobturator tension-free tape (TOT) procedures and to find perioperative risk factors (RFs) predicting postoperative voiding problems. <b><i>Methods:</i></b> We have retrospectively evaluated the perioperative data of 397 women who underwent TOT operations. Significant post-void residual (PVR) (&#x3e;50 mL) was considered as the primary (objective) end point of the study, the voiding difficulty as the secondary (subjective) 1. First univariate analysis and then multivariate logistic regression were performed, with a 5% significance level. <b><i>Results:</i></b> Significant PVR was present in 51 (12.8%) women; catheterization was needed in 21 (5.3%) and reoperation in 3 (0.8%) cases. Seventy women (17.6%) experienced postoperative voiding difficulty. Narrow vagina (&#x3c;2 cm), older age &#x3e;70 years, and preoperative voiding difficulty were independent RFs for significant PVR (odds ratio: 5.07, 2.14, 5.38, respectively, <i>p</i> &#x3c; 0.05). Preoperative overactive bladder syndrome and previous pelvic organ prolapse surgery were considered independent RFs for postoperative voiding difficulty. <b><i>Conclusions:</i></b> Older age, narrow vagina, or preoperative voiding difficulty increases the chance for significant postoperative PVR. These patients should be chosen and counseled appropriately.

Unilateral sling transection for patients with postoperative voiding dysfunction after transobturator sling surgery

2015 ◽  
Vol 131 (3) ◽  
pp. 313-314
Author(s):  
Daniele Castellani ◽  
Vikiela Galica ◽  
Pietro Saldutto ◽  
Daniela Biferi ◽  
Giuseppe Paradiso Galatioto ◽  
...  
Keyword(s):  
Voiding Dysfunction ◽  
Transobturator Sling ◽  
Sling Surgery

scholarly journals Prevalence of voiding and defecatory dysfunction in postmenopausal women with pelvic organ prolapse: a prospective observational study

2018 ◽  
Vol 7 (6) ◽  
pp. 2230
Author(s):  
Nanthini Saravanan ◽  
Emily Divya Ebenezer ◽  
Vaibhav Londhe ◽  
Lilly Varghese ◽  
Aruna N. Kekre ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Vaginal Hysterectomy ◽  
Voiding Dysfunction ◽  
Short Form ◽  
Pelvic Organ ◽  
Primary Objective ◽  
P Value ◽  
Pelvic Floor Repair ◽  
Defecatory Dysfunction

Background: Primary objective of this work was to study the prevalence of voiding and defecatory dysfunction in women with pelvic organ prolapse and correlate the stage and compartment of prolapse with voiding and defecatory dysfunction. The secondary objective was to correlate stage of prolapse with flow rate and post void residue and to study the voiding dysfunction in pelvic organ prolapse.Methods: A prospective observational cohort study in 120 post-menopausal women scheduled for vaginal hysterectomy pelvic floor repair. Short form of pelvic floor distress inventory (PFDI-20) and International prostate symptom questionnaire I-PSS score for Lower urinary tract symptoms (LUTS)was employed.Results: The prevalence of voiding dysfunction in this study was 78% and defecatory dysfunction was 77%. Higher stage of prolapse had significant correlation with voiding dysfunction. (P value was 0.028). Women with posterior compartment defect had more voiding dysfunction with the significant P value (p value was 0.04). Pre-operative voiding dysfunction resolved post operatively in 86%, the p<0.000 which was highly significant.Conclusions: Women with pelvic organ prolapse had high prevalence of voiding and defecatory dysfunction. Stages of prolapse have positive correlation with voiding dysfunction. Pre-operative voiding dysfunction resolved after vaginal hysterectomy and pelvic floor repair.

Early voiding dysfunction after midurethral sling surgery: comparison of two management approaches

2017 ◽  
Vol 28 (10) ◽  
pp. 1515-1526 ◽  
Author(s):  
Erin A. Brennand ◽  
Selphee Tang ◽  
Colin Birch ◽  
Magali Robert ◽  
Shunaha Kim-Fine
Keyword(s):  
Midurethral Sling ◽  
Voiding Dysfunction ◽  
Sling Surgery ◽  
Management Approaches ◽  
Midurethral Sling Surgery

Abstract 3729: Delayed Hematoma Expansion Occurs After ICH: Observations from the Safety of Pioglitazone for Hematoma Resolution in INtraCerebral Hemorrhage (SHRINC) trial

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Navdeep S Sangha ◽  
Farhaan Vahidy ◽  
Mallikarjunarao Kasam ◽  
Mohammed Rahbar ◽  
Bursaw Andrew ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Prospective Study ◽  
Univariate Analysis ◽  
Primary Objective ◽  
Hematoma Expansion ◽  
Hematoma Growth ◽  
Secondary Objective ◽  
Magnetic Resonance Imaging Mri ◽  
Associated Risk Factors

Background and Purpose Early hematoma expansion (EHE) has been described in the first 48 hours. SHRINC is a phase 2 prospective safety trial whose primary objective is to assess the safety of pioglitazone (PIO) when administered to patients with spontaneous intracerebral hemorrhage (SICH) compared to standard care. A secondary objective is to characterize the changes in hematoma resolution and expansion over time. This prospective study addresses the natural history, clinical impact, and associated risk factors of late hematoma expansion (LEX) by serial magnetic resonance imaging (MRI) after SICH. Methods SHRINC aims to enroll 78 subjects between the ages of 18-80 with a SICH of ≥ 5 ml. This analysis includes the first 42 patients enrolled. Four subjects were excluded because they did not have an MRI after day 2. A baseline CTH was performed followed by an MRI within 24 hours of symptom onset. Hematoma volume (Hv) was measured on FLAIR sequences using a previously published semi-automated range of interest method. LEX was defined as an increase in Hv > 0.5 ml after the 48 hour MRI. Factors associated with LEX were evaluated with logistic regression. Longitudinal analyses were used for measurements taken over the follow up period. Results: Ten (26.3%) of 38 subjects displayed LEX. Eight subjects had LEX between day 2 to 14, and 4 between days 14 to 28. The median initial Hv was 16.1cc in LEX patients and 24.1cc in those without expansion (NEX) (p=0.23). Lower platelet counts (p=0.04) and BUN levels (p=0.03) were associated with LEX in univariate analysis. Multivariate analysis suggested that those with higher BUN levels were less likely to have LEX (OR=0.81; 95%CI 0.65-0.99). Blood pressure and EHE (13.2%) were not associated with LEX. There was no difference in neurological worsening (NIHSS increase ≥ 4), 6 month mRS or death between LEX and NEX. Conclusion: This is the first prospective study to address LEX with serial MRIs. LEX occurs between day 2 to 14 and day 14 to 28. Elevated BUN levels may decrease the likelihood of LEX. A limitation of our study is that the effect of PIO on LEX could not be evaluated because SHRINC is a blinded trial. Further studies will assess the pathophysiology of LEX and its potential implications in clinical trials evaluating hematoma growth and resolution.

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