scholarly journals Transobturator tape for female stress incontinence: follow-up after 24 months

2013 ◽  
Vol 4 (1) ◽  
pp. 33
Author(s):  
Waleed Al Taweel ◽  
Danny M. Rabah
Keyword(s):  
Transobturator Tape ◽  
Satisfaction Scale ◽  
Improvement Rate ◽  
Urogenital Distress Inventory ◽  
Global Satisfaction ◽  
Protection Contre ◽  
Point Pressure ◽  
Lost To Follow Up

Objective: The objective of this paper is to evaluate the effectivenessof transobturator vaginal tape (TOT) in the treatment of femalestress urinary incontinence (SUI) and to analyze functional resultsand quality of life after 24 months follow-up.Methods: The study included all women with SUI who underwenta TOT procedure in which the sling passes from the obturatorforamen from the outside to the inside, under general or regionalanesthesia from December 2004 to January 2006. All study patientsmust have had a minimal follow-up of 24 months. The patientswere prospectively evaluated, and the following factors wereassessed: number of pads used per day, physical examinationincluding pelvic examination, urinalysis, urogenital distress inventory(UDI-6), analog global satisfaction scale (GSS), pad weighttest, and urodynamic studies including filling cystometry andValsalva leak point pressure (VLPP) test.Results: Fifty-two consecutive patients who fulfilled the inclusioncriteria underwent TOT procedure by 1 surgeon. The mean agewas 50 ±9 (range 37-72) and minimal follow-up was 24 months(range 24-30 months). Two patients were lost to follow-up after12 months and 3 patients did not come for the 24-month evaluation.The mean operative time was 18 minutes ±4 (range 15-31),with an average amount of bleeding 57 cc ±22cc. Our resultsdemonstrate a 92% cure or improvement rate after 12 months,and an 85% after 24 months.Conclusion: The transobturator approach from outside to inside isa very effective treatment of SUI with low morbidity. However,longer follow-up in larger populations should assess the longtermreliability of this procedure.Objectif : L’objectif de notre étude est d’évaluer l’efficacité de labandelette transobturatrice mise en place par voie vaginale dans letraitement de l’incontinence urinaire d’effort (IUE) et d’analyser lesrésultats fonctionnels et la qualité de vie après un suivi de 24 mois.Méthodologie : Notre étude a inclus toutes les femmes atteintesd’IUE chez qui on avait posé une bandelette transobturatrice passantpar le trou obturateur de l’extérieur vers l’intérieur, sousanesthésie générale ou régionale entre décembre 2004 et janvier2006. Toutes les patientes devaient avoir été suivies pendant unminimum de 24 mois après l’intervention. Les patientes étaientévaluées de façon prospective, et les facteurs suivants ont étéévalués : nombre de culottes de protection contre les fuites urinairesutilisées chaque jour, examen physique comprenant unexamen pelvien, analyse d’urines, questionnaire UDI-6 (urogenitaldistress inventory), échelle analogique de satisfaction globale,test du poids de la culotte de protection, et études urodynamiquescomprenant une cystométrie de remplissage et une évaluation duseuil de pression de fuite de Valsalva (méthode VLPP).Résultats : Cinquante-deux patientes consécutives répondant auxcritères d’inclusion se sont vu poser une bandelette transobturatricepar le même chirurgien. L’âge moyen était de 50 ans ± 9 (de37 à 72 ans) et le suivi minimal était de 24 mois (de 24 à 30 mois).Deux patientes avaient été perdues de vue lors du suivi après12 mois et 3 patientes ne se sont pas présentées à l’évaluation au24e mois. La durée moyenne de l’intervention était de 18 minutes± 4 (de 15 à 31 minutes), et la quantité moyenne de sang perdude 57 mL ± 22. Nos résultats montrent un taux de guérison oud’amélioration de 92 % après 12 mois, et de 85 % après 24 mois.Conclusion : La technique de la bandelette transobturatrice poséede l’extérieur vers l’intérieur est un traitement très efficace del’IUE accompagnée d’un faible taux de morbidité. Cependant, unsuivi plus long avec des cohortes plus importantes est requis pourévaluer la fiabilité à long terme de cette intervention.

scholarly journals Tension free vaginal tape (TVT) vs transobturator tape(TOT) complications and outcomes

2014 ◽  
Vol 61 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Milan Potic ◽  
Ivan Ignjatovic ◽  
Dragoslav Basic
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Test ◽  
Transobturator Tape ◽  
Urogenital Distress Inventory ◽  
Additional Surgery ◽  
Lower Complication ◽  
Cure Rates

Background: Stress urinary incontinence (SUI) is managed with both TVT and TOT. The TVT route of placement could result in a higher complication rate. The aim of this study is to analyze and compare outcomes and complications of TVT and TOT in SUI treatment. Methods: Prospective study in 64 women with isolated SUI was validated through Urogenital Distress Inventory (UDI-6), Incontinence Impact questionnaire (IIQ-7) and International Continence Impact Questionnaire (ICIQ5-SF). Intraoperative and postoperative complications were noted. Patients were considered cured when negative on stress test and with no need for additional surgery during follow up, after one and three months. Results: The cure rates for both TVT 26/30 (86,6%) and TOT 30/34 (88,2) were comparable. Higher rates of bleeding, bladder perforations, pain and dyspareunia are recorded in TVT group. Quality of life graded on the questionnaire basis proved significant improvement in both procedures. Conclusion: Both TVT and TOT have comparable cure results in the treatment of SUI. The TOT is equally effective in the SUI treatment with significantly lower complication incidence.

scholarly journals Efficacy of Combined Laparoscopic and Hysteroscopic Repair of Post-Cesarean Section Uterine Diverticulum: A Retrospective Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Cuilan Li ◽  
Shiyan Tang ◽  
Xingcheng Gao ◽  
Wanping Lin ◽  
Dong Han ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Combined Treatment ◽  
Clinical Manifestations ◽  
Abnormal Uterine Bleeding ◽  
Lower Uterine Segment ◽  
Improvement Rate ◽  
Uterine Scar ◽  
Lost To Follow Up

Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum.Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS), and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery.Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05), respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40). Three patients (3/40 = 7.5%) developed partial improvement, and 1/40 (2.5%) was lost to follow-up.Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.

scholarly journals Teledermatology in Times of COVID-19 Confinement: Comparing Patients’ and Physicians’ Satisfaction by the Standardized Brest Teledermatology Questionnaire

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Joachim W. Fluhr ◽  
Annie Gueguen ◽  
Delphine Legoupil ◽  
Emilie Brenaut ◽  
Claire Abasq ◽  
...  
Keyword(s):  
Main Question ◽  
Chronic Patients ◽  
Dermatology Department ◽  
Global Satisfaction ◽  
Technical Parameters ◽  
Face To Face ◽  
Almost All ◽  
Outpatient Settings

The French government imposed the first COVID-19 pandemic lockdown from March 17 until May 11, 2020. Only emergency cases and teledermatology (TD) were allowed in outpatient settings. A standardized questionnaire was developed to compare the satisfaction level of patients and their treating physicians. Our main question was whether the patients would perceive TD as a valid alternative for direct physical face-to-face consultation. Eighty-two patients and their 4 treating dermatologists from one dermatology department participated in the study (43 females, 39 males) with a mean age of 46.6 years (SD ±23.9). The reason for TD was a chronic disease in the majority (87.8%), and mainly as a follow-up (96.3%). Regarding satisfaction, almost all categories rated around 9 on a 0–10 verbal analogue scale. The same level of global satisfaction could be seen between the patients and the physicians as well as for the quality of the patient-physician relation and whether all questions could be addressed during the TC. Physicians showed significantly higher scores than patients only for the category of “length” of the consultation. Gender, age, as well as distance between the clinic and home of the patient were not influencing factors for satisfaction. Regarding the technical parameters, the evaluation was mostly comparable for patients and physicians, but overall lower than the relational satisfaction parameters, especially for image quality. Patients were significantly more motivated to continue the TD after the lockdown than their treating dermatologists. We see an interest for implementing TD in specialized centers with chronic patients coming from remote places for regular follow-ups. TD cannot replace in-person patient-physician interaction, but was helpful during the lockdown. As a result, TD might become part of dermatology training to prepare for future lockdown situations.

Transobturator tape procedure outcome: a clinical and quality of life analysis of a 1-year follow-up

2006 ◽  
Vol 18 (8) ◽  
pp. 895-900 ◽  
Author(s):  
S. Domingo ◽  
P. Alamá ◽  
N. Ruiz ◽  
G. Lázaro ◽  
M. Morell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Transobturator Tape ◽  
Life Analysis

scholarly journals Predictors of Mortality among Patients Lost to Follow up Antiretroviral Therapy

Jurnal NERS ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 114 ◽  
Author(s):  
Putu Dian Prima Kusuma Dewi ◽  
Gede Budi Widiarta
Keyword(s):  
Incidence Rate ◽  
Median Time ◽  
Secondary Data ◽  
Primary Data ◽  
People Living With Hiv ◽  
Risk Of Death ◽  
Living With Hiv ◽  
Lost To Follow Up

Introduction: The death of HIV/AIDS patients after receiving therapy in Bali is the seventh highest percentage of deaths in Indonesia. LTFU increases the risk of death in PLHA, given the saturation of people with HIV taking medication. The level of consistency in the treatment is very important to maintain the resilience and quality of life of people living with HIV. This study aims to determine the incidence rate, median time and predictors of death occurring in LTFU patients as seen from their sociodemographic and clinical characteristics.Methods: This study used an analytical longitudinal approach with retrospective secondary data analysis in a cohort of HIV-positive patients receiving ARV therapy at the Buleleng District Hospital in the period 2006-2015. The study used the survival analysis available within the STATA SE 12 softwareResults: The result showed that the incidence rate of death in LTFU patients was 65.9 per 100 persons, with the median time occurrence of 0.2 years (2.53 months). The NNRTI-class antiretroviral evapirens agents were shown to increase the risk of incidence of death in LTFU patients 3.92 times greater than the nevirapine group (HR 3.92; p = 0.007 (CI 1.46-10.51). Each 1 kg increase in body weight decreased the risk of death in LTFU patients by 6% (HR 0.94; p = 0.035 (CI 0.89-0.99).Conclusion: An evaluation and the monitoring of patient tracking with LTFU should be undertaken to improve sustainability. Furthermore, an observation of the LTFU patient's final condition with primary data and qualitative research needs to be done so then it can explore more deeply the reasons behind LTFU.

scholarly journals The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years’ follow-up

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Bulat Aytek Şık ◽  
Hanife Copur ◽  
Yılda Arzu Aba
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Transobturator Tape ◽  
Mixed Urinary Incontinence ◽  
Perineal Pain ◽  
Cure Rate ◽  
Objective Cure

Objective: To evaluate the clinical outcomes and the effects on quality of life of transobturator tape surgery during a 2-year follow-up period in our clinics. Methods: Eighty-seven patients with stress or mixed urinary incontinence who underwent transobturator tape surgery were included in the study conducted in Istanbul. Taksim. Training. and Research Hospital Gynecology and Obstetrics Clinic, between 2011 and 2013. The patients’ demographic features, incontinence questionnaires, quality of life scores [Incontinence Impact Questionnaire (IIQ-7) and urinary distress inventories (UDI-6)], examination findings, urodynamic results, stress tests, Q tip tests, number of daily pads, ultrasonography, surgery, and cystoscopy results were recorded. Patients were evaluated 23-27 months (mean: 25.40±1.31 months) after their discharge in terms of symptoms, quality of life scores, urodynamic findings, complications, and stress test. Results: Sixty-three (72.4%) patients had stress incontinence and 24 (27.6%) patients had mixed urinary incontinence. No perioperative complications were observed in our study. After a follow-up period of two years, a significant improvement was detected in the IIQ-7 and UDI-6 questionnaires when compared with the preoperative period. Moreover, the objective cure rate was found as 88.5% (n=77). De novo urge incontinence was obtained in 5.7% (n=5) of patients and was treated with anticholinergics. Perineal pain was present in 3 (3.44%) patients and was treated with analgesics and cold packs. In 2 (2.29%) patients, vaginal mesh erosion was detected and full recovery was achieved with an excision. Urinary retention and bladder perforation was not seen in any patients. Conclusion: Our study revealed a high objective cure rate, and an improvement in symptoms and quality of life with the transobturator tape operation. How to cite this:Sik BA, Copur H, Yilda Arzu ABA. The outcomes of transobturator tape intervention in the treatment of stress urinary incontinence: Two years’ follow-up. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.603 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Transcranial Doppler Ultrasound Screening in Urban Pediatric Sickle Cell Center - Better Charting Improves Compliance over Published Rates

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4749-4749
Author(s):  
Ariel Gliksberg ◽  
Christopher McCauley ◽  
Lewis L. Hsu
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Sickle Cell ◽  
Research Funding ◽  
Chart Review ◽  
Ultrasound Screening ◽  
Patients Âgés ◽  
Lost To Follow Up

Abstract Background: TranscranialDoppler ultrasound (TCD) screening for stroke risk is one of the major advances in pediatric sickle cell disease, since the landmark STOP study. TCD screening is among the measures for quality of pediatric sickle cell care proposed by expert consensus (Wang 2011, NHLBI guidelines 2014). Reeves et al 2016 shows that TCD screening rates are low but still improving (22% in 2006 -44% in 2010). To improve the quality-of-care provided to pediatric sickle cell patients at University of Illinois Hospital, we conducted chart review in 2014 to establish a baseline report of UI Hospitalsadherence to the expert care standards. At that time TCD screening rates were much lower than immunization rates. We then introduced a reminder table in the electronic medical record. 18 months since this change in EMR we re-evaluated our compliance with TCDs. Objectives: To evaluate the improvement atUIHealthpediatric sickle cell clinic compliance with annual TCD. Methods: A manual chart review of these pediatric sickle cell patients was employed to determine adherence to TCD screening standards. All patients ages 2-16yowith SCD-SS and SCD-S/Beta-0-thalassemia that were seen in pediatric sickle cell clinic and adolescent-adult transition clinics two times over 15 months from 2/1/15-5/1/16 were included in study. TCD compliance was determined if patient had TCD between 5/1/2015 through 5/31/16. 5-15 minutes per patient was spent evaluating EMR for TCD compliance Data from the 2014 previous study was also re-evaluated using the same criteria of 2 visits within 15 months of original study date and TCD within 1 year of study. Results: In this work, the charts of 91 pediatric SCD-SS and SCD-S/Beta0 patients were reviewed (ages 2-16 years; M: 34 F 28, 5 ineligible [2 on chronic transfusion, 1 high hemoglobin, 1 yearly MRI, 1 last visit before 2yo]. Lost to follow-up (Seen in clinic since 2014 but not 2 visits from 2/1/15-5/1/16): 24 The rate of TCD screening among these eligible children was 53 out of 62, or 85.5% in 2016. Comparable figures from the 2014 chart review were 17 out of 27, or 63% in 2014. Fishers exact test indicates that this was a significant improvement, p=0.05. Conclusions: We focused our quality-improvement efforts onTranscranialDoppler screening, adding a reminder table in the Electronic Medical Record then re-assessing 18 months later. The rate of TCD screening significantly improved from 63% to 85%. Although less than 100%, these compare favorably to other published TCD rates (Table). The next step is to improve clinic attendance and tracking, to reduce the rate of patients who are "lost to follow-up." To facilitate future chart reviews we have incorporated the key parameters into our "Screening & Management Table" as a component of the electronic medical record. Table Table. Disclosures Hsu: Purdue Pharma: Research Funding; Mast Therapeutics: Research Funding; Eli Lilly: Research Funding; Sancilio: Research Funding; Centers for Medicare and Medicaid Innovation: Research Funding; Pfizer: Consultancy, Research Funding; EMMI Solutions: Consultancy; Gerson Lehman Group: Consultancy; Astra Zeneca: Consultancy, Research Funding; Hilton Publishing: Consultancy, Research Funding.

Timing of adjuvant chemotherapy in stage III colon cancer as a measure of quality: Reasons for noncompliance.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 640-640
Author(s):  
Omar M. Rashid ◽  
Karen A. Coyne ◽  
Thomas W. Ross ◽  
David Shibata
Keyword(s):  
Colon Cancer ◽  
Cancer Care ◽  
Tertiary Care ◽  
Stage Iii ◽  
Cancer Center ◽  
Patient Centered ◽  
Stage Iii Colon Cancer ◽  
Lost To Follow Up

640 Background: The Institute of Medicine's report on improving cancer care, along with the evolution of ASCO's Quality Oncology Practice Initiative, has helped to develop process measures into critical quality of cancer care indicators. One such measure relates to "receipt of chemotherapy for stage III colon cancer (CC) within 120 days of diagnosis" and is now being incorporated into processes including hospital accreditation (American College of Surgeons; ACS), managed care contracts and Center for Medicare and Medicaid Services (CMS) quality monitoring. To better understand potential pitfalls related to the strict guidelines of this measure, we sought to evaluate institutional adherence at a tertiary care cancer center and to examine the reasons for non-compliance. Methods: A retrospective review was performed of all cases of stage III colon cancer reported at a single institution from 2008 – 2012. Coding for compliance was performed using standard ACS guidelines. Results: A total of 122 eligible cases were identified and consisted of 49 (40.2%) women and 73 (59.8%) men with a median age of 58 (range 32 - 77). Overall, 15 (12.3%) cases were non-compliant with 2 (1.6%) lost to follow up. Of the non-compliant cases, 14 (93.3%) cases did go on to receive chemotherapy while 1 (6.7%) never received adjuvant treatment. Of those receiving delayed treatment, 7 were due to patient-centered factors [e.g. patient timing preference (n=4), request for chemotherapy closer to home (n=2) and lost to follow up (n=1)]. Other reasons included delays at outside facilities (n=4), postoperative complications (n=1) and insurance approval (n=1). In 2 cases, designation of date of diagnosis based on suspicion rather than definitive biopsy contributed to non-compliant status. Conclusions: Our center averaged an annual compliance with the CC adjuvant therapy measure of approximately 90%. Larger scale studies are indicated to determine whether refinements in coding guides that account for patient preferences, clear diagnosis dates and cross-facility care could better reflect quality of care, and also promote improved patient-centered multidisciplinary management.

Health-Related Quality of Life in Lenalidomide and Bortezomib Treated Patients with Relapsed/Refractory Multiple Myeloma

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2085-2085
Author(s):  
Charalampia Kyriakou ◽  
Philip Murphy ◽  
Maria Teresa Petrucci ◽  
Pamela Bacon ◽  
Philip Lewis ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Disease Progression ◽  
Board Of Directors ◽  
Treatment Discontinuation ◽  
Advisory Committees ◽  
Third Line ◽  
Eortc Qlq ◽  
Lost To Follow Up

Abstract Introduction: Novel treatments have significantly improved outcomes for multiple myeloma (MM) patients, and HRQoL is an increasingly important endpoint to measure outcomes. This study explores patients' HRQoL in Relapsed/Refractory MM (RRMM) patients receiving second or third line lenalidomide or bortezomib treatment and assesses HRQoL changes from baseline for patients completing the study and those discontinuing. Methods: A multicenter, observational 6-month study was conducted in Italy, Germany, France, UK, Ireland, and Belgium in RRMM patients starting second- or third-line treatment with bortezomib or lenalidomide. HRQoL/functioning and symptoms of patients were measured via 3 EORTC patient questionnaires and changes from baseline were assessed at month 6 and study discontinuation. Clinical significance in HRQoL score changes was assessed against distribution-based minimal important differences (MID; Table). HRQoL domains considered included 15 domains from EORTC Quality of Life Core Questionnaire (QLQ-C30), 4 from EORTC QLQ-Multiple Myeloma (QLQ-MY20), and 3 from EORTC QLQ-Chemotherapy-Induced Neuropathy (CIPN20). Domain scores ranged from 0 to 100. For functional domains, higher HRQoL/functioning scores indicated better HRQoL/functioning; for symptom domains, higher symptom scores indicated greater symptom burden. Results: A total of 258 patients (mean age, 70 yrs; 54% male) were included in the study by 33 sites from Dec 2010 to July 2014. At baseline, the median time since diagnosis was 2.8 years for lenalidomide and 3.9 years for bortezomib; an ECOG performance status >2 was reported in 6.2% of lenalidomide patients (n=10) vs 3.1% of bortezomib (n=3); 8.9% (n=23) reported starting third line treatment (lenalidomide: 6.2% (n=10); bortezomib: 13.5% (n=13)). Whereas 5.6% (n = 9) of patients had received dialysis prior to entering the lenalidomide cohort, none had received dialysis in the bortezomib cohort. Chronic heart failure at baseline was more often observed for lenalidomide (14.8%, n=24) vs bortezomib (8.3%, n=8). EORTC questionnaires were completed by 251 (97.3%), 137 (53.1%), and 56 (21.7%) of patients at baseline, month 6, and study discontinuation, respectively. Out of 162 pts receiving LEN, 64 (39.5%) discontinued the study before 6 months, 6.2% (n=10) due to disease progression, 16.0% (n=26) due to treatment discontinuation, and 17.3% (n=28) due to other reasons (including death, lost to follow-up, withdrawn consent). Out of 96 patients receiving bortezomib, 53 (55.2%) discontinued the study: 10.4% (n=10) due to disease progression, 27.1% (n=26) due to treatment discontinuation, and 17.7% (n=17) due to other reasons (including death, lost to follow-up, withdrawn consent). At study completion (month 6), HRQoL reductions from baseline were observed for only 1 of 22 domains in each cohort: mean change (SEM) of 10.9 (2.8) for Diarrhoea domain in the lenalidomide cohort and -8.5 (3.5) for Global Health Status/QoL domain in the bortezomib cohort, indicating relative stability of HRQoL in patients on continued treatment within the 2 cohorts. For patients who discontinued the study prior to 6 months due to disease progression or treatment discontinuation, clinically meaningful declines in HRQoL exceeding the MID were more often observed in the bortezomib cohort (8 of 22 domains), than in the lenalidomide cohort (1 of 22 domains) (Table 1). Conclusions: This observational study showed that HRQoL could be maintained under continued treatment in both the lenalidomide and bortezomib cohorts. However, higher progression and treatment discontinuation rates were observed in the bortezomib cohort and study discontinuation was often associated with clinically meaningful deteriorations in HRQoL for bortezomib-treated patients, but not for lenalidomide-treated patients. The findings of this study are of potential relevance to future MM studies, both in the relapsed/ refractory and newly diagnosed setting. HRQoL of patients with early discontinuation has not always been reported separately from patients who discontinued fixed duration treatment in MM studies. Future studies should address the question of HRQoL separately at early discontinuation, for all current and future treatment alternatives approved in MM. Disclosures Kyriakou: Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees. Murphy:Celgene: Honoraria. Petrucci:Celgene: Honoraria; Janssen-Cilag: Honoraria; Amgen: Honoraria; Mundipharma: Honoraria; BMS: Honoraria. Bacon:Celgene Corporation: Employment, Equity Ownership. Lewis:Celgene Corporation: Employment, Equity Ownership. Gilet:Celgene: Consultancy. Arnould:Celgene: Consultancy. Vande Broek:Celgene: Consultancy; Roche: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees. Leleu:Janssen: Honoraria; Novartis: Honoraria; Celgene: Honoraria; BMS: Honoraria; Amgen: Honoraria.

scholarly journals The autologous fascia pubovaginal sling for complicated female

2013 ◽  
Vol 6 (1) ◽  
pp. 36 ◽  
Author(s):  
Blayne K. Welk ◽  
Sender Herschorn
Keyword(s):  
Quality Of Life ◽  
Retrospective Review ◽  
Midurethral Sling ◽  
Mesh Erosion ◽  
Intermittent Catheterization ◽  
Treatment Modalities ◽  
Mesh Removal ◽  
Urogenital Distress Inventory

Introduction: The purpose of this study is to review our contemporary experience with autologous fascia pubovaginal slings (AF-PVS) in the era of the midurethral sling.Methods: A retrospective review was completed to identify allpatients who underwent an AF-PVS between 2002 and 2009. Across-sectional questionnaire was used to assess postoperative urinary- specific quality of life (consisting of the Urogenital Distress Inventory [UDI-6] and the Incontinence Impact Questionnaires [IIQ-7]).Results: We identified 33 patients. They had failed a median oftwo previous incontinence treatments. Of these patients, 16 (48%) had failed a previous midurethral sling, and of these half had experienced a significant mesh erosion necessitating mesh removal. Preoperative median incontinence pad usage was 5/day. After a median follow-up of 16 months from the time of AF-PVS, the median pad usage had decreased to 1/day (p = 0.003). A third of the patients had postoperative urgency, and only 1 patient continues to use intermittent catheterization. The median IIQ-7 score was 19/100, and the median UDI-6 score was 44/100. Overall quality of life was mixed-to-delighted in 62% of patients.Conclusions: The AF-PVS has reasonable outcomes in a diversepopulation of patients, despite failure of other treatment modalities.

Sign in / Sign up

Export Citation Format

Share Document