scholarly journals A comparative Histologic and Immunohistochemistry Evaluation Between Normal Aponeurotic Tissue, Fibrotic Aponeurotic Scars and Polypropylene Embedded Aponeurotic Scars

2017 ◽  
Vol 54 (3) ◽  
pp. 510-512
Author(s):  
Radu Chicea ◽  
Dan Bratu ◽  
Anca Lucia Chicea ◽  
Alin Mihetiu ◽  
Vlad Preluca ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Prognostic Marker ◽  
Genital Prolapse ◽  
Tissue Response ◽  
Surgical Interventions ◽  
Inflammatory Tissue

Synthetic polypropylene materials are increasingly being used in surgery to repair parietal defects in perineal floor curing surgery, in genital prolapse and stress urinary incontinence. The tissue response to contact with these materials varies, and the inflammatory tissue response may be a prognostic marker of success in surgical interventions that involve contact between tissues and polypropylene materials.

scholarly journals Surgical interventions for women with stress urinary incontinence: systematic review and network meta-analysis of randomised controlled trials

BMJ ◽  
2019 ◽  
pp. l1842 ◽  
Author(s):  
Mari Imamura ◽  
Jemma Hudson ◽  
Sheila A Wallace ◽  
Graeme MacLennan ◽  
Michal Shimonovich ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Adverse Events ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Surgical Interventions ◽  
Randomised Controlled ◽  
Meta Analyses

Abstract Objectives To compare the effectiveness and safety of surgical interventions for women with stress urinary incontinence. Design Systematic review and network meta-analysis. Eligibility criteria for selecting studies Randomised controlled trials evaluating surgical interventions for the treatment of stress urinary incontinence in women. Methods Identification of relevant randomised controlled trials from Cochrane reviews and the Cochrane Incontinence Specialised Register (searched May 2017), which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Medline In-Process, Medline Epub Ahead of Print, CINAHL, ClinicalTrials.gov, and WHO ICTRP. The reference lists of relevant articles were also searched. Primary outcomes were “cure” and “improvement” at 12 months, analysed by means of network meta-analyses, with results presented as the surface under the cumulative ranking curve (SUCRA). Adverse events were analysed using pairwise meta-analyses. Risk of bias was assessed using the Cochrane risk of bias tool. The quality of evidence for network meta-analysis was assessed using the GRADE approach. Results 175 randomised controlled trials assessing a total of 21 598 women were included. Most studies had high or unclear risk across all risk of bias domains. Network meta-analyses were based on data from 105 trials that reported cure and 120 trials that reported improvement of incontinence symptoms. Results showed that the interventions with highest cure rates were traditional sling, retropubic midurethral sling (MUS), open colposuspension, and transobturator MUS, with rankings of 89.4%, 89.1%, 76.7%, and 64.1%, respectively. Compared with retropubic MUS, the odds ratio of cure for traditional sling was 1.06 (95% credible interval 0.62 to 1.85), for open colposuspension was 0.85 (0.54 to 1.33), and for transobtrurator MUS was 0.74 (0.59 to 0.92). Women were also more likely to experience an improvement in their incontinence symptoms after receiving retropubic MUS or transobturator MUS compared with other surgical procedures. In particular, compared with retropubic MUS, the odds ratio of improvement for transobturator MUS was 0.76 (95% credible interval 0.59 to 0.98), for traditional sling was 0.69 (0.39 to 1.26), and for open colposuspension was 0.65 (0.41 to 1.02). Quality of evidence was moderate for retropubic MUS versus transobturator MUS and low or very low for retropubic MUS versus the other two interventions. Data on adverse events were available mainly for mesh procedures, indicating a higher rate of repeat surgery and groin pain but a lower rate of suprapubic pain, vascular complications, bladder or urethral perforation, and voiding difficulties after transobturator MUS compared with retropubic MUS. Data on adverse events for non-MUS procedures were sparse and showed wide confidence intervals. Long term data were limited. Conclusions Retropubic MUS, transobturator MUS, traditional sling, and open colposuspension are more effective than other procedures for stress urinary incontinence in the short to medium term. Data on long term effectiveness and adverse events are, however, limited, especially around the comparative adverse events profiles of MUS and non-MUS procedures. A better understanding of complications after surgery for stress urinary incontinence is imperative. Systematic review registration PROSPERO CRD42016049339.

scholarly journals RESULTS OF SIMULTANEOUS SURGICAL CORRECTION OF GENITAL PROLAPSE WITH STRESS URINARY INCONTINENCE

2017 ◽  
Vol 15 (5) ◽  
pp. 499-503
Author(s):  
A. N. Nechiporenko ◽  
◽  
N. A. Nechiporenko ◽  
A. V. Strotsky ◽  
◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Genital Prolapse ◽  
Surgical Correction

scholarly journals Economic evaluation of surgical treatments for women with stress urinary incontinence: a cost-utility and value of information analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035555
Author(s):  
Mehdi Javanbakht ◽  
Eoin Moloney ◽  
Miriam Brazzelli ◽  
Sheila Wallace ◽  
Laura Ternent ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Value Of Information ◽  
Time Horizon ◽  
Cost Effective ◽  
Incidence Rates ◽  
Information Analysis ◽  
Surgical Interventions ◽  
Value Of Information Analysis ◽  
Surgical Treatments

ObjectivesStress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (MUI) are common conditions that can have a negative impact on the quality of life of patients and serious cost implications for healthcare providers. The objective of this study was to assess the cost-effectiveness of nine different surgical interventions for treatment of SUI and stress-predominant MUI from a National Health Service and personal social services perspective in the UK.MethodsA Markov microsimulation model was developed to compare the costs and effectiveness of nine surgical interventions. The model was informed by undertaking a systematic review of clinical effectiveness and network meta-analysis. The main clinical parameters in the model were the cure and incidence rates of complications after different interventions. The outcomes from the model were expressed in terms of cost per quality-adjusted life-years (QALYs) gained. In addition, expected value of perfect information (EVPI) analyses were conducted to quantify the main uncertainties facing decision-makers.ResultsThe base-case results suggest that retropubic mid-urethral sling (retro-MUS) is the most cost-effective surgical intervention over a 10-year and lifetime time horizon. The probabilistic results show that retro-MUS and traditional sling are the interventions with the highest probability of being cost-effective across all willingness-to-pay thresholds over a lifetime time horizon. The value of information analysis results suggest that the largest value appears to be in removing uncertainty around the incidence rates of complications, the relative treatment effectiveness and health utility values.ConclusionsAlthough retro-MUS appears, at this stage, to be a cost-effective intervention, research is needed on possible long-term complications of all surgical treatments to provide reassurance of safety, or earlier warning of unanticipated adverse effects. The value of information analysis supports the need, as a first step, for further research to improve our knowledge of the actual incidence of complications.

De novo stress urinary incontinence in women after management of genital prolapse

2018 ◽  
Vol 17 (6) ◽  
pp. 26-32
Author(s):  
V.А. Krutova ◽  
◽  
О.V. Tarabanova ◽  
А.А. Khachetsukova ◽  
◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
De Novo ◽  
Genital Prolapse

scholarly journals Behaviour of urinary incontinence in the face of sacrocolpopexy

2017 ◽  
Vol 30 (1) ◽  
Author(s):  
Nuria L. Rodríguez-Mias ◽  
Jordi Sabadell-García ◽  
Elena Suárez-Salvador ◽  
Antonio Gil-Moreno ◽  
Jose Luis Poza-Barrasus
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
De Novo ◽  
Case Series ◽  
Genital Prolapse ◽  
Bladder Function ◽  
Urethral Hypermobility ◽  
Case Series Study ◽  
Increased Risk ◽  
The Face

The aim of this study was to determine whether an association exists between the performance of a sacrocolpopexy for genital prolapse and the bladder function. A case series study was performed that includes all patients who received sacrocolpopexy in a tertiary Spanish hospital. An analysis was performed to study the association of some variables and the occurrence or persistence of urinary incontinence after the surgery. Forty patients with indication of sacrocolpopexy were included. A year after sacrocolpopexy, the outcomes showed 97.3% of prolapse healing. 19.3% complained about de novo stress urinary incontinence, 33.3% recovered from it and another 66.7% remained the same. Only 10.8% asked for an anti-incontinence surgery after the sacrocolpopexy. The urethral hypermobility shows an increased risk of stress urinary incontinence after the sacrocolpopexy. Based on our results, we do not consider it necessary to perform a systematic antiincontinence procedure simultaneously with sacrocolpopexy unless a woman without urethral anti-incontinence surgical background shows a urethral hypermobility.

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