Both the middle and distal sections of the urethra may be regarded as optimal targets for ‘outside-in’ transobturator tape placement

Bogusiewicz, Michał; Monist, Marta; Gałczyński, Krzysztof; Woźniak, Magdalena; Wieczorek, Paweł; Rechberger, Tomasz

doi:10.1007/s00345-014-1261-1

Cited by 23 publications

(26 citation statements)

References 24 publications

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“…Although abnormalities observed can be associated with urinary incontinence, such imaging is not predictive or diagnostic of the cause of the incontinence 87,88 . Ultrasonography might have a role in confirming the findings of the patient history and clinical examination, assessing postoperative complications 89 or as a means of providing biofeedback to help women to identify effective pelvic floor contraction during pelvic floor muscle training (PFMT) 90 .…”

Section: Diagnosis Screening and Preventionmentioning

confidence: 99%

Urinary incontinence in women

Aoki

Brown

Brubaker

et al. 2017

Nat Rev Dis Primers

362

317

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Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence.

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Section: Diagnosis Screening and Preventionmentioning

confidence: 99%

Urinary incontinence in women

Aoki

Brown

Brubaker

et al. 2017

Nat Rev Dis Primers

362

317

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“…There is a growing body of evidence that the position of the tape relative to the urethra is one of the most important factors determining sling outcome. Several studies have shown that optimally the tape should be placed between 50 and 75% of the urethral length, measured from the bladder neck to the external urethral meatus [49–52] (Figs. 2 and 6).…”

Section: Ultrasound In Management Of Treatment Failure and Complicationsmentioning

confidence: 99%

“…The worst results are obtained when a tape is placed under the proximal urethra, with the failure rate exceeding 50% [52, 54] (Fig. 7).…”

Section: Ultrasound In Management Of Treatment Failure and Complicationsmentioning

confidence: 99%

Ultrasound imaging in urogynecology – state of the art 2016

Bogusiewicz

2016

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The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue. However, in many instances, including planning and audit of surgical procedures, management of recurrences or complications, ultrasound may be proposed as the initial examination of choice. Ultrasound may be used for assessment of bladder neck mobility before anti-incontinence procedures. On rare occasions it is helpful in recognition of pathologies mimicking vaginal prolapse such as vaginal cyst, urethral diverticula or rectal intussusception. In patients subjected to suburethral slings, causes of surgery failure or postsurgical voiding dysfunctions can be revealed by imaging. Many reports link the location of a tape close to the bladder neck to unfavorable outcomes of sling surgery. Some postoperative complications, such as urinary retention, mesh malposition, hematoma, or urinary tract injury, can be diagnosed by ultrasound. On the other hand, the clinical value of some applications of ultrasound in urogynecology, for example measurement of the bladder wall thickness as a marker of detrusor overactivity, has not been proved.

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“…Recurrent SUI (RSUI) is defined as a failure of anti-incontinence surgery after a period of time or persistence of SUI after a procedure aimed at correcting it. Moreover, the complication of particular concern after primary or secondary sling is the incidence of voiding dysfunction resulting usually from improper tape positioning or its excessive tension [ 9 , 10 ]. One has to remember that repeating procedures performed on vaginal skin could cause scarred vagina syndrome.…”

Section: Introductionmentioning

confidence: 99%

An Open Multicenter Study of Clinical Efficacy and Safety of Urolastic, an Injectable Implant for the Treatment of Stress Urinary Incontinence: One-Year Observation

Futyma

Miotła

Gałczyński

et al. 2015

BioMed Research International

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The prevalence of stress urinary incontinence rises and affects up to 30% of women after 50 years of age. Midurethral slings are currently the mainstay of surgical anti-incontinence therapy. Some patients experience recurrent SUI (RSUI) which is defined as a failure of anti-incontinence surgery after a period of time or persistence of SUI after the procedure aimed at correcting it. The urethral bulking agent application decreases invasiveness of treatment and meets patients requirements. The objective of this study was to assess the safety and clinical efficacy of Urolastic injection. One hundred and five patients with SUI (including 91 patients with RSUI) were treated with Urolastic in three tertiary gynecological clinics. The efficacy of the procedure was assessed objectively at each follow-up visit by means of cough test and a standard 1-hour pad test. Objective success rate after 12 months after primary procedure in RSUI patients was found in 59.3% of patients. In 14 patients with primary SUI improvement after 1 year was found in 71.4% of patients. Although cure rates after MUS are up to 90% there is still place for less invasive treatment option like periurethral injection of bulking agents, especially in patients with previous SUI surgical management.

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Both the middle and distal sections of the urethra may be regarded as optimal targets for ‘outside-in’ transobturator tape placement

Cited by 23 publications

References 24 publications

Urinary incontinence in women

Urinary incontinence in women

Ultrasound imaging in urogynecology – state of the art 2016

An Open Multicenter Study of Clinical Efficacy and Safety of Urolastic, an Injectable Implant for the Treatment of Stress Urinary Incontinence: One-Year Observation

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