Suskhan Djusad, S. Hakim, T. Priyatini, F. Moegni, A. Meutia, Yudhistya Ksyatria, I. Gede Manu
Urinary incontinence is a health problem for women and the elderly, both physically and psychologically. To cure it, mid-urethral sling surgery is used. Moreover, the transobturator tape (TOT) appears to reduce the incidence of bladder injuries. This case series aims to assess the safety and efficacy of TOT at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. We present eleven female patients diagnosed with stress urinary incontinence (SUI) and complaints of involuntary leakage during sneezing, coughing, or laughing. All patients underwent a TOT operation, which included a coughing test, pad test, residual volume, and urinalysis to rule out the infection. Out of the eleven patients, eight showed the reported urinary leakage at the first follow-up, and three did not attend the follow-up. The pad test post-operative results from five patients were obtained: four patients revealed 0 g in their pad test, while one showed 3 g. No patient experienced sling erosion during control or follow-up management. The low erosion rate was due to the usage of type 1 polypropylene mashes (macropore, monofilament), and the procedure was done with the correct technique. The sling TOT procedure seems effective and has the potential to become the new gold standard in the management of true SUI with low morbidity.
尿失禁是困扰妇女和老年人身心健康的一个问题。为了治疗尿失禁，人们采用了尿道中段吊带手术。此外，经尿道胶带（TOT）似乎可以降低膀胱损伤的发生率。本病例系列旨在评估 TOT 在印度尼西亚雅加达 Cipto Mangunkusumo 医生医院的安全性和有效性。我们介绍了十一名被诊断为压力性尿失禁（SUI）并主诉在打喷嚏、咳嗽或大笑时出现不自主漏尿的女性患者。所有患者都接受了 TOT 手术，包括咳嗽测试、尿垫测试、残余尿量和尿液分析，以排除感染。在 11 名患者中，8 人在首次随访时出现漏尿，3 人未参加随访。5 名患者的术后尿垫测试结果显示：4 名患者的尿垫测试结果为 0 克，1 名患者的尿垫测试结果为 3 克。侵蚀率低的原因是使用了 1 型聚丙烯吊带（大孔、单丝），而且手术采用了正确的技术。吊带 TOT 术似乎很有效，有可能成为治疗真正 SUI 的新黄金标准，而且发病率较低。
{"title":"Management of stress urinary incontinence using transobturator tape: a case series","authors":"Suskhan Djusad, S. Hakim, T. Priyatini, F. Moegni, A. Meutia, Yudhistya Ksyatria, I. Gede Manu","doi":"10.4081/uij.2024.315","DOIUrl":"https://doi.org/10.4081/uij.2024.315","url":null,"abstract":"Urinary incontinence is a health problem for women and the elderly, both physically and psychologically. To cure it, mid-urethral sling surgery is used. Moreover, the transobturator tape (TOT) appears to reduce the incidence of bladder injuries. This case series aims to assess the safety and efficacy of TOT at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. We present eleven female patients diagnosed with stress urinary incontinence (SUI) and complaints of involuntary leakage during sneezing, coughing, or laughing. All patients underwent a TOT operation, which included a coughing test, pad test, residual volume, and urinalysis to rule out the infection. Out of the eleven patients, eight showed the reported urinary leakage at the first follow-up, and three did not attend the follow-up. The pad test post-operative results from five patients were obtained: four patients revealed 0 g in their pad test, while one showed 3 g. No patient experienced sling erosion during control or follow-up management. The low erosion rate was due to the usage of type 1 polypropylene mashes (macropore, monofilament), and the procedure was done with the correct technique. The sling TOT procedure seems effective and has the potential to become the new gold standard in the management of true SUI with low morbidity.","PeriodicalId":516576,"journal":{"name":"Urogynaecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A fully bioresorbable polycaprolactone (PCL)-based bulking agent was evaluated for safety and efficacy in female patients with mild to moderate stress urinary incontinence (SUI) who attempted and failed prior pelvic floor muscle training. A total of 44 adult female subjects with mild or moderate SUI (median age 60 and 57, respectively) were treated by transurethral sub-mucosal injection. Safety was evaluated at 6-, 12-, and 24-month follow-up visits. Efficacy was assessed at the same intervals with the Stamey grading system (SGS). SGS improvement was shown in both the mild and moderate SUI groups. At 24 months, most participants were continent: 78.1% in the mild SUI group and 66.7% in the moderate SUI group. All participants in the moderate SUI group showed an improvement in the SGS grade, and most participants were continent. The study shows that the PCL-based bioresorbable bulking agent treatment seems to be a safe and effective treatment option for women with mild to moderate SUI who attempted and failed prior pelvic floor exercises.
我们对一种基于全生物可吸收聚己内酯（PCL）的膨大剂的安全性和有效性进行了评估，该膨大剂适用于患有轻度至中度压力性尿失禁（SUI）并尝试过盆底肌肉训练但失败的女性患者。共有 44 名患有轻度或中度 SUI 的成年女性受试者（中位年龄分别为 60 岁和 57 岁）接受了经尿道粘膜下注射治疗。在 6 个月、12 个月和 24 个月的随访中对安全性进行了评估。在相同的时间间隔内，采用斯塔米分级系统（SGS）对疗效进行了评估。轻度和中度 SUI 组的 SGS 均有改善。在 24 个月时，大多数参与者都能继续排尿：轻度 SUI 组为 78.1%，中度 SUI 组为 66.7%。中度 SUI 组的所有参与者的 SGS 分级都有所改善，大多数参与者都能保持大便通畅。研究结果表明，基于 PCL 的生物可吸收膨润剂疗法似乎是一种安全有效的治疗方案，适用于患有轻度至中度 SUI 并尝试过盆底锻炼但失败的妇女。
{"title":"Long-term efficacy and safety of a bioresorbable polycaprolactone-based injectable in female stress incontinence","authors":"Anđelo Mojsović, A. Beulens, Evert L. Koldewijn","doi":"10.4081/uij.2024.324","DOIUrl":"https://doi.org/10.4081/uij.2024.324","url":null,"abstract":"A fully bioresorbable polycaprolactone (PCL)-based bulking agent was evaluated for safety and efficacy in female patients with mild to moderate stress urinary incontinence (SUI) who attempted and failed prior pelvic floor muscle training. A total of 44 adult female subjects with mild or moderate SUI (median age 60 and 57, respectively) were treated by transurethral sub-mucosal injection. Safety was evaluated at 6-, 12-, and 24-month follow-up visits. Efficacy was assessed at the same intervals with the Stamey grading system (SGS). SGS improvement was shown in both the mild and moderate SUI groups. At 24 months, most participants were continent: 78.1% in the mild SUI group and 66.7% in the moderate SUI group. All participants in the moderate SUI group showed an improvement in the SGS grade, and most participants were continent. The study shows that the PCL-based bioresorbable bulking agent treatment seems to be a safe and effective treatment option for women with mild to moderate SUI who attempted and failed prior pelvic floor exercises.","PeriodicalId":516576,"journal":{"name":"Urogynaecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140743332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eunice Osuala, O. Udi, Glad Samchisadede, Florence Mandah
Dysmenorrhea can be a burden on individuals and families. Investigating dysmenorrhea has become important to further our understanding of this issue and to research the measures that have been effective in managing it in other populations. Hence, the study aimed to investigate non-pharmacological interventions and coping mechanisms for painful menstruation among female undergraduates. The survey was carried out among 358 female students, and data was obtained with a researcher-structured questionnaire from a sample size of 208 derived using multistage sampling. A descriptive method of analysis was used to analyze the responses. Results revealed a high incidence of dysmenorrhea since 175 (89.7%) respondents experienced dysmenorrhea. Data revealed that nonpharmacological measures and home remedies for self-care, such as exercise, heat therapy, and herbal remedies, were prevalent among respondents. However, some respondents consult friends, families, and doctors for help. In conclusion, pharmaceutical and non-pharmaceutical interventions were common, and some young women opted to normalize pain and were not utilizing the most effective alternatives for managing menstrual pain.
{"title":"Non-pharmacological interventions and coping mechanisms during dysmenorrhea among female undergraduates in a tertiary institution in Nigeria","authors":"Eunice Osuala, O. Udi, Glad Samchisadede, Florence Mandah","doi":"10.4081/uij.2024.310","DOIUrl":"https://doi.org/10.4081/uij.2024.310","url":null,"abstract":"Dysmenorrhea can be a burden on individuals and families. Investigating dysmenorrhea has become important to further our understanding of this issue and to research the measures that have been effective in managing it in other populations. Hence, the study aimed to investigate non-pharmacological interventions and coping mechanisms for painful menstruation among female undergraduates. The survey was carried out among 358 female students, and data was obtained with a researcher-structured questionnaire from a sample size of 208 derived using multistage sampling. A descriptive method of analysis was used to analyze the responses. Results revealed a high incidence of dysmenorrhea since 175 (89.7%) respondents experienced dysmenorrhea. Data revealed that nonpharmacological measures and home remedies for self-care, such as exercise, heat therapy, and herbal remedies, were prevalent among respondents. However, some respondents consult friends, families, and doctors for help. In conclusion, pharmaceutical and non-pharmaceutical interventions were common, and some young women opted to normalize pain and were not utilizing the most effective alternatives for managing menstrual pain.","PeriodicalId":516576,"journal":{"name":"Urogynaecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vineet V Mishra, Smit B. Solanki, R. Aggarwal, Athulya Shajan
Stress urinary incontinence (SUI) may result from intrinsic sphincter weakness or urethral hypermobility brought on by weakened muscles in the pelvic floor that sustain the urethra and bladder. The amount of mid-urethral support is increased by the mid-urethral tape's function to serve as an anchored pubo-urethral neo-ligament. This study's objective is to assess the safety and effectiveness of transobturator tape (TOT) for SUI after a 10-year follow-up period. There were 103 patients included in this retrospective observational single-arm research. Only 95 participants were included in the trial since 8 patients were lost to follow-up. Patients who had TOT between 2010 and 2013 were monitored until December 2022. The effectiveness of the tape was assessed at 10 years for both early and late surgical problems in the patients. Those diagnosed with SUI were 52.27 years old on average (standard deviation ±8.48). 24% of patients (n=21) experienced mixed urinary incontinence (MUI), compared to 79.61% (n=82) of patients who had just pure stress incontinence. At 10 years, the success rate in our research was 97.09%. Demand incontinence was healed in 57.14% (n=12) of the 21 MUI patients. 7.69% of de novo urgency was noted (n=7). There were no significant side effects including mesh erosion, bladder and intestine perforation, or vascular hemorrhage. Excellent patient satisfaction was rated in 43% of cases (n=44), good in 54% of cases (n=56), and low in 3% of cases (n=3). At 10 years, TOT for SUI shows an impressive cure rate and excellent effectiveness. When the treatment is carried out by experienced hands, there are no significant difficulties.
压力性尿失禁（SUI）可能是由于支撑尿道和膀胱的骨盆底肌肉力量减弱导致的内在括约肌无力或尿道过度活动造成的。尿道中段胶带具有固定耻骨尿道新韧带的功能，可增加尿道中段的支撑力。本研究的目的是评估经尿道胶带（TOT）治疗 SUI 的安全性和有效性。这项回顾性观察单臂研究共纳入了 103 名患者。由于有 8 名患者失去了随访，因此只有 95 名参与者被纳入试验。对 2010 年至 2013 年期间接受过 TOT 治疗的患者进行了监测，直至 2022 年 12 月。10年后，针对患者的早期和晚期手术问题，对胶带的有效性进行了评估。被诊断为 SUI 的患者平均年龄为 52.27 岁（标准偏差 ±8.48）。24%的患者（n=21）出现混合性尿失禁（MUI），而单纯压力性尿失禁患者的比例为 79.61%（n=82）。10 年后，我们研究的成功率为 97.09%。在 21 名 MUI 患者中，57.14%（12 人）的需求性尿失禁患者痊愈。7.69%的患者（7 人）出现了新的尿急症状。没有出现网片侵蚀、膀胱和肠穿孔或血管出血等重大副作用。43%的病例（44 例）患者满意度极佳，54%的病例（56 例）患者满意度良好，3%的病例（3 例）患者满意度较低。10 年后，TOT 治疗 SUI 的治愈率和疗效令人印象深刻。如果由经验丰富的医生进行治疗，不会出现明显的困难。
{"title":"Patients with transobturator tape: a retrospective observational study of ten-year follow-up","authors":"Vineet V Mishra, Smit B. Solanki, R. Aggarwal, Athulya Shajan","doi":"10.4081/uij.2024.318","DOIUrl":"https://doi.org/10.4081/uij.2024.318","url":null,"abstract":"Stress urinary incontinence (SUI) may result from intrinsic sphincter weakness or urethral hypermobility brought on by weakened muscles in the pelvic floor that sustain the urethra and bladder. The amount of mid-urethral support is increased by the mid-urethral tape's function to serve as an anchored pubo-urethral neo-ligament. This study's objective is to assess the safety and effectiveness of transobturator tape (TOT) for SUI after a 10-year follow-up period. There were 103 patients included in this retrospective observational single-arm research. Only 95 participants were included in the trial since 8 patients were lost to follow-up. Patients who had TOT between 2010 and 2013 were monitored until December 2022. The effectiveness of the tape was assessed at 10 years for both early and late surgical problems in the patients. Those diagnosed with SUI were 52.27 years old on average (standard deviation ±8.48). 24% of patients (n=21) experienced mixed urinary incontinence (MUI), compared to 79.61% (n=82) of patients who had just pure stress incontinence. At 10 years, the success rate in our research was 97.09%. Demand incontinence was healed in 57.14% (n=12) of the 21 MUI patients. 7.69% of de novo urgency was noted (n=7). There were no significant side effects including mesh erosion, bladder and intestine perforation, or vascular hemorrhage. Excellent patient satisfaction was rated in 43% of cases (n=44), good in 54% of cases (n=56), and low in 3% of cases (n=3). At 10 years, TOT for SUI shows an impressive cure rate and excellent effectiveness. When the treatment is carried out by experienced hands, there are no significant difficulties.","PeriodicalId":516576,"journal":{"name":"Urogynaecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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