IntroductionThe aim of this study was to evaluate oral single/multiple doses of Fosfomycin Trometamol with clinical and microbiological efficacy in:Asymptomatic bacteriuria in pregnancy.Endourological procedures.Lower urinary tract infections. Material and methodsThis prospective, uncontrolled, open label study was conducted in two tertiary hospitals over a period of three years. A total of 400 patients were included in the study. Group A (200 patients) with asymptomatic bacteriuria in pregnancy and Group B (200 Patients) with symptomatic lower urinary tract infections and with any day care endourological procedures were enrolled in our study. Efficacy end points like post- antibiotic urinalysis, microbiological efficacy and clinical improvement with adverse effects of the drug were evaluated.ResultsOf the 400 patients studied, 98% returned for follow-up. Out of the 304 urinary isolates in Table 2 (ASB and symptomatic LUTS) grown on urinary culture, majority of the isolates were Gram-negative Enterobacteriacae family. After oral single/multiple doses of fosfomycin, bacterial eradication, bacterial persistence, bacterial reinfection were 96.3%, 3.9%, 3.9% respectively (Figure 2). No isolates were grown in 8 cases (Table 2). However, on administration of the drug 23.5% patients noticed diarrhea (loose stools) followed by itching (19.7%) in genital area (Figure 1).ConclusionsFosfomycin Trometamol is a bactericidal antibiotic with a broad spectrum activity against Gram-positive also Gram-negative bacteriae. It has an advantage of oral single /multiple doses, higher eradication rate of bacteria after 48 hours, excellent tolerability and safety in pregnancy and other female age groups. We recommend Fosfomycin Trometamol as the drug of choice particularly in patients with poor drug compliance and for minor day care endourological procedures.

Background: To assess the treatment outcome and overall efficacy of the novel technique of a transvaginal subfascial synthetic sling (TVSS) in comparison to the standard trans-obturator tape (TOT-O) mid-urethral sling for female stress urinary incontinence (SUI). Materials and methods: The study included 206 female SUI patients managed at our institution between March 2015 and December 2019. The patients were randomly distributed into 2 comparable groups (Group A as TOT-O and Group B as TVSS) with respect to age, trouble due to SUI assessed with respect to degree of incontinence (number of episodes and diapers used per day), and body mass index (≤40 kg/m 2 ), with 100 patients in the TOT-O group as group A and 106 patients in TVSS as group B. Preoperative variables related to the number of incontinent episodes and diapers usage were equal in both groups. The procedure was done under spinal anesthesia and results were assessed in terms of improvement in SUI as the primary outcome, any sexual dysfunction, complications, and overall satisfaction as secondary outcomes. Results: Symptomatic improvement after the procedure was seen in all patients with complete resolution of symptoms in 91 patients (91.%) in the TOT-O group (group A) versus 96 patients (90.56%) in the TVSS (group B). Postoperative complications included urinary retention in 6% versus 5.6%, increased day time urinary frequency in 8% versus 6.6%, urge incontinence in 4% versus 2.8%, and groin/thigh pain in 12% versus 0.9%, respectively. Mesh incision was done in 1 (1%) versus none (0%), and local mesh excision for mesh erosion in 2 (2%) versus 1 (0.9%) at 3 months after the procedure in the TOT-O group and the TVSS group, respectively. The p value and Chi-Square test with respect to the clinical profile and satisfaction with respect to complete resolution of symptoms was calculated using Open EPI software which were insignificant. Sexual function (SF) was assessed using the Brief Index of SF for Women questionnaire. All the patients were satisfied with respect to SF at 6 months of follow-up. Conclusions: The TVSS as a novel technique for female SUI is less invasive, simpler to learn, with less postoperative pain with resolution of SUI, rapid recovery, and good personal satisfaction compared to the standard TOT-O in procedure.