This refined protocol reliably produced stable diuresis with a water load of 300 ml/15 min, excluding those with a difference in diuresis rate > 4.5 ml/min.
In some of the studies, the samples were too small to draw any significant conclusions. There were also conflicting data on which tool was the most accurate, especially as each method of evaluating bladder sensation may influence the way it is described by participants.
Introduction and hypothesisA significant proportion of patients develop voiding dysfunction after midurethral tape (MUT) insertion, which reduces patient satisfaction. The study’s purpose was to identify predictive factors of voiding dysfunction after a retropubic MUT procedure.MethodsThis was a retrospective study of 100 patients who underwent only a retropubic MUT procedure between January 2010 and December 2011. Early voiding dysfunction was defined when patients required a Foley catheter within 48 h. Data including demographic information, urogenital symptoms, previous surgery, preoperative uroflowmetry and urodynamic parameters were analysed using SPSS v22. Univariate analysis of all demographic variables was performed; those significant at 10 % were entered into a multivariate logistic regression.ResultsFourteen patients required Foley catheter insertion, with a median age of 58 years (26–83 years), median BMI 28 kg/m2 (20–48 kg/m2), and median parity 2 (0–4). Univariate analysis revealed peak flow rate <15 ml/s (OR 3.79; 1.07, 13.4; p = 0.046), bladder capacity (p = 0.044), stress incontinence versus mixed or urge incontinence (p = 0.064) and previous surgery (OR 4.39; 1.34, 14.41; p = 0.015) to be associated with voiding dysfunction. Multivariate analysis showed only previous pelvic floor surgery to be independently associated (OR 3.76; 1.14, 12.23, p = 0.029).ConclusionsOnly previous pelvic-floor surgery was found to be a strong predictive factor of voiding dysfunction. The rate of voiding dysfunction was similar to those of published data. Previous studies revealed different predictive factors. A larger cohort is needed to provide a definite answer. Those with previous surgery appear to be those most at risk and pre-surgical counselling for these women could be suggested.
Recruitment and randomisation were feasible and robust. This study demonstrates that a large-scale RCT is feasible and the IncoStress has potential value.
Introduction: COVID-19 pandemic led to changes in healthcare provision across the NHS with large-scale implementation of telemedicine. We aimed to evaluate the feasibility, acceptability, patients’ convenience and satisfaction of telephone clinics in urogynecology during the initial stages of the pandemic. Methods: All consented patients scheduled for phone clinics were included. Descriptive statistics were used to analyze quantitative data and inductive thematic analysis for free-text comments. Results: 101/109 (93%) patients completed the survey. Median age (interquartile, IQR) was 60 years (IQR 21.5) and median consultation duration was 16 minutes (IQR 8). 33/101 (32.7%) were new cases and 13/101(12.9%) were tertiary referrals. To facilitate face-to-face appointments, 100/101 (99%) patients required transport and 30/101 (29.7%) needed time off-work. 98/101 (97%) of the patients were happy or very happy with phone consultation, with 91/101(90.1%) scoring 8-10 on Visual Analogue Scale (VAS). Conclusion: Urogynecology phone clinics are feasible, acceptable and convenient with high level of patients’ satisfaction. Robust studies are required to evaluate the feasibility of integrating telemedicine into routine urogynecology practice.
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