Learning curve for the single‐incision suburethral sling procedure for female stress urinary incontinence

Spelzini, Federico; Frigerio, Matteo; Regini, Cristina; Palmieri, Stefania; Manodoro, Stefano; Milani, Rodolfo

doi:10.1002/ijgo.12317

Cited by 19 publications

(15 citation statements)

References 18 publications

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“…Birth trauma and low estrogen level are the two major causes of the disease, but its pathogenesis is unknown so far [8][9][10] . At present, the common treatment methods are [11][12][13] .…”

Section: Resultsmentioning

confidence: 99%

The Improvement of Urethral Function in the Rat Stress Urinary Incontinence Model by Electrical Stimulation Combined With Pelvic Floor Muscle Training To Activate VEGF and ERK 1/2

Liu¹,

Li²,

Sun³

et al. 2021

ijps

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To explore the effect of electrical stimulation combined with pelvic floor muscle training on the improvement of urethral function in rats with stress urinary incontinence and to further study its possible mechanism. 48 rats were randomly divided into blank control group, model group, pelvic floor muscle training treatment group and electrical stimulation combined pelvic floor muscle training treatment group. The rehabilitation treatment group was treated with pelvic floor muscle training and combined electrical stimulation treatment after successful modeling. The sneeze test, urodynamics and pelvic floor muscle strength measurement were used to detect the rat urethra and pelvic floor muscle function. The expressions of vascular endothelial growth factor and extracellular-signal-regulated kinase 1/2 genes in urethral tissue cells were detected by reverse transcription-polymerase chain reaction. The rat sneeze test, urodynamics, pelvic floor muscle strength measurement, microvessel count and urethral histopathology results showed that the rat stress urinary incontinence model was successfully constructed and electrical stimulation combined with pelvic floor muscle training could significantly reduce the incidence of rate urinary incontinence and improve the pelvic floor muscle strength, the number of urethral capillaries and the repair of damaged vaginal nerves. Reverse transcription-polymerase chain reaction analysis showed that after rehabilitation treatment, the expressions of vascular endothelial growth factor and extracellularsignal-regulated kinase 1/2 were up-regulated and the up-regulation was more obvious in the combined electrical stimulation group. Electrical stimulation combined with pelvic floor muscle training could effectively improve the urethral function of rats and the action mechanism may be related to its activation of vascular endothelial growth factor and extracellular regulatory protein kinase extracellular-signalregulated kinase 1/2.

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Section: Resultsmentioning

confidence: 99%

The Improvement of Urethral Function in the Rat Stress Urinary Incontinence Model by Electrical Stimulation Combined With Pelvic Floor Muscle Training To Activate VEGF and ERK 1/2

Liu¹,

Li²,

Sun³

et al. 2021

ijps

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“…19 Interestingly, learning curves in urogynecology are often based on performances of a single operator, thus limiting the generalization of the data. 20,21 Moreover, often studies assessing the learning curve in cystoscopy are based on training on virtual simulators. 22,23 In our series, data were evaluated for three different residents, making our findings more reproducible.…”

Section: Discussionmentioning

confidence: 99%

Learning Curve of Botulinum Toxin Bladder Injection for the Treatment of Refractory Overactive Bladder

Barba¹,

Lazar²,

Cola³

et al. 2022

IJWH

Self Cite

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Intradetrusor botulinum toxin injections is an established second-line treatment for patients with refractory overactive bladder syndrome (OAB). We aimed to evaluate the learning curve of intradetrusor injections with botulinum toxin for the treatment of refractory OAB. Patients and Methods: This retrospective study analyzed all women with idiopathic and refractory OAB who underwent botulinum toxin bladder injections performed by residents with no previous experience with operative cystoscopy under consultant supervision. Baseline International Consultation on Incontinence Questionnaire-Short Form questionnaire (ICIQ-SF) and Euroqol (EQ-5D) questionnaires were collected. Procedural data (operative time, number of valid injections, complications, subjective easiness, perceived tolerability) and patients' outcomes (Patients Global Impression of Improvement (PGI-I), ΔICIQ-SF, ΔEQ-5D, need for self intermittent catheterization, duration of efficacy) were considered as markers to evaluate learning curves for each resident. Results: Twenty-seven patients underwent intravesical injection of botulinum toxin performed by residents. Only a grade 1 Clavien-Dindo complication occurred, and none of the patients had urinary retention. PGI-I was very satisfactory, scoring 1.4 ± 0.9. Both ICIQ-SF and EQ-5D 2-2 were statistically improved (p < 0.00001 and p = 0.04, respectively). The mean duration of efficacy resulted to be 8.0±4.3 months. A positive effect of the learning curve was observed only for operative time, subjective easiness, and perceived tolerability. Conclusion: Intradetrusor botulinum toxin injection for the treatment of refractory OAB is characterized by high efficacy and very low complications even at the very beginning of the learning curve when performed under proper mentorship.

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“…The following reasons may at least partially explain this finding. First, greater experience can improve clinical outcomes [18]. Most incontinence surgery in teaching hospitals in Korea is performed in the urology department.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Incontinence Surgery According to the Surgeon’s Specialty and Performance of a Preoperative Urodynamic Study

Choi

Han

et al. 2018

Int Neurourol J

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PurposeThe aim of this study was to analyze the efficacy and to estimate the complication rate of incontinence surgery according to the surgeon’s specialty and whether a preoperative urodynamic study (UDS) was performed, using a nationally representative dataset.MethodsWe enrolled 356,155 women over 20 years old who had undergone surgery for stress urinary incontinence between 2006 and 2015. Patients were followed for up to 3 years to analyze the reoperation and complication rates. Data were obtained from the National Health Claims Database of the National Health Insurance Service (NHIS) of Korea. Multiple Cox regression analysis was conducted to examine the efficacy and safety of incontinence surgery according to the surgeon’s specialty and whether a preoperative UDS was performed.ResultsThe hazard ratio (HR) for reoperation was significantly higher for procedures performed by nonurologists than for procedures performed by urologists (HR, 1.174; 95% confidence interval [CI], 1.103–1.249). Acute urinary retention, postoperative infections, procedure-associated pain, and other complications were also more common in procedures performed by nonurologists than in those performed by urologists. When stratified by whether a preoperative UDS was performed, the HR for reoperation according to the surgeon’s specialty varied by performance of a preoperative UDS. While the reoperation rate was significantly higher in procedures performed by non-urologists when a preoperative UDS was performed (HR, 1.208; 95% CI, 1.122–1.3), there was no significant difference in the HRs for reoperation according to specialty when a preoperative UDS was not performed.ConclusionsThis population-based study showed that the postoperative outcomes of incontinence surgery were dependent upon the surgeon’s specialty and that the reoperation rate according to the surgeon’s specialty varied based on whether a preoperative UDS was performed.

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Learning curve for the single‐incision suburethral sling procedure for female stress urinary incontinence

Abstract: SIS showed encouraging objective and subjective outcomes with a minimal complication rate even at the beginning of the learning curve. However, increasing experience reduced postoperative voiding symptoms and overactive bladder syndrome.

Cited by 19 publications

References 18 publications

The Improvement of Urethral Function in the Rat Stress Urinary Incontinence Model by Electrical Stimulation Combined With Pelvic Floor Muscle Training To Activate VEGF and ERK 1/2

The Improvement of Urethral Function in the Rat Stress Urinary Incontinence Model by Electrical Stimulation Combined With Pelvic Floor Muscle Training To Activate VEGF and ERK 1/2

Learning Curve of Botulinum Toxin Bladder Injection for the Treatment of Refractory Overactive Bladder

Efficacy and Safety of Incontinence Surgery According to the Surgeon’s Specialty and Performance of a Preoperative Urodynamic Study

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