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  • 1
    Electronic Resource
    Electronic Resource
    Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles (1998)
    Springer
    International urogynecology journal 9 (1998), S. 200-204 
    Details
    ISSN: 1433-3023
    Keywords: Anterior colporrhaphy ; Vaginal prolapse
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study assesses the use of Marlex mesh in conjunction with anterior colporrhaphy for the correction of cystocele with or without urinary stress incontinence. A retrospective review was carried out of 12 years' experience with 142 patients undergoing a modified anterior colporrhaphy reinforced with Marlex mesh. All patients had preoperative urodynamics. Pre- and post-operative symptoms were compared and patients were examined for recurrent prolapse and mesh complications. Mean follow-up time was 3.2 years. No patients experienced recurrent anterior vaginal wall prolapse. Three patients developed mesherosions into the vagina. There was a 74% success rate in the treatment of urinary stress incontinence. Marlex mesh used as a reinforcement for anterior colporrhaphy is effective in preventing recurrent anterior wall descent, with minimal complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01901604
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  • 2
    Electronic Resource
    Electronic Resource
    Unsuspected primary lymphomas of the female genital tract in patients presenting with urogynecological problems (1990)
    Springer
    International urogynecology journal 1 (1990), S. 168-171 
    Details
    ISSN: 1433-3023
    Keywords: Urogynecology ; Genital tract ; Lymphomas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A report of the presentation, diagnosis, and management of two patients presenting with urogynecological problems who ultimately were found to have a primary genital tract lymphoma, demonstrating the possibility of an occult presentation. A review of the literature is also discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00376609
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  • 3
    Electronic Resource
    Electronic Resource
    The Accuracy of Portable Abdominal Ultrasound Equipment in Measuring Postvoid Residual Volume (1999)
    Springer
    International urogynecology journal 10 (1999), S. 215-218 
    Details
    ISSN: 1433-3023
    Keywords: Key words:Bladder scan – Bladder volume – Catheterization – Portable abdominal ultrasound – Postvoid residual – Prospective study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: This study examines the accuracy of a new portable abdominal ultrasound machine (Bladder Scan, BVI 2500) used to measure postvoid urine residual (PVR). Using this machine, we started prospectively measuring residual urine in the first 80 women undergoing uroflowmetry in our urodynamic unit. Ultrasound PVR measurements were done immediately prior to catheterization while the patient was in the supine position. The catheterized postvoid residual was used as the gold standard. Eighty paired measurements were done on 78 women. Compared to catheterized PVR, ultrasound PVR measurements tend to underestimate and correlated poorly with the actual residual volume. The reading was considered accurate if it was within 25% of the catheterized PVR. The ultrasound PVR measurements were most accurate (60.6%) when the readings were below 50 ml and least accurate (10%) when readings were higher than 150 ml. Readings between 50 and 150 ml were 27% accurate. A measurement of zero ‘000’ was common (44%), usually reflecting volumes of less than 50 ml (84% of cases). However, it could indicate that the bladder had been missed altogether. Partial measurement of the bladder volume, where the lateral bladder borders are missing, produces readings much below the actual volume: a ‘tip of the iceberg’ phenomenon. We therefore advocate caution when interpreting PVR measurements from portable abdominal ultrasound machines, and if an accurate measurement of PVR is necessary, catheterization remains a more reliable method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001920050048
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  • 4
    Electronic Resource
    Electronic Resource
    Clinical Efficacy and Safety of Tolterodine Compared to Oxybutynin and Placebo in Patients with Overactive Bladder (1999)
    Springer
    International urogynecology journal 10 (1999), S. 283-289 
    Details
    ISSN: 1433-3023
    Keywords: Key words: Comparative study; Overactive bladder; Oxybutynin; Tolterodine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: This study compared the clinical efficacy (determined from micturition diaries) and safety of 12 weeks’ treatment with either tolterodine 2 mg twice daily, oxybutynin 5 mg three times daily or placebo in patients with an overactive bladder. A total of 277 patients were randomized and treated at 25 centers. Both tolterodine and oxybutynin significantly increased volume voided/micturition compared to placebo. Both treatment groups evoked greater decreases in micturitions per 24 hours and incontinence episodes per 24 hours compared to placebo; however, only tolterodine was significantly better than placebo in reducing micturition frequency. Tolterodine and oxybutynin were equivalent in their effectiveness. Tolterodine was significantly better tolerated than oxybutynin when adverse events (particularly frequency and intensity of dry mouth), dose reduction and patient withdrawals were considered. Oxybutynin is an effective drug whose frequent adverse effects limit its clinical usefulness. Tolterodine has equivalent efficacy to oxybutynin, but with less severe adverse effects. This will allow patients to receive more effective treatment for their condition, with better compliance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001929970003
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  • 5
    Electronic Resource
    Electronic Resource
    Bacterial Vaginosis Increases in Pessary Users (2000)
    Springer
    International urogynecology journal 11 (2000), S. 219-223 
    Details
    ISSN: 1433-3023
    Keywords: Key words:Bacterial vaginosis – Historical cohort study – Pessary – Smoking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The purpose of this study was to examine the association between pessary use, smoking and changes in the vaginal flora. Patients using pessaries were age matched with non-pessary using controls. All candidates examined were women attending the Mount Sinai Hospital, Toronto, for genitourinary problems. Vaginal cultures were routinely performed on all women attending the unit, irrespective of symptoms. Forty-four pessary users were age matched with 176 controls (4 controls per case). The mean age was 60.1 ± 12.6 years, and 15% of these were premenopausal. The duration of pessary use ranged from 0.5 to 8 years (mean 3.3 ± 1.7). Weight, parity, smoking status, diabetes mellitus, thyroid disease, UTI and postvoid residual urine volume were not significantly different between pessary users and controls. Bacterial vaginosis (BV) was noted in 32% of pessary users, versus 10% of controls. The relative risk of developing BV in pessary users was 3.3 (OR, 4.37; 95% CI, 2.15–9.32), P= 0.0002. Smoking independently affected the vaginal flora, increasing the relative risk of developing BV to 2.9 (OR, 3.78; 95% CI, 2.05–8.25), P = 0.0013. It was concluded that pessary use is a very effective and conservative method for the treatment of genital prolapse. However, we found that the presence of a foreign body was associated with changes in the vaginal flora, thereby increasing the odds of developing bacterial vaginosis to 4.37; this was further compounded by smoking.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00004026
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  • 6
    Electronic Resource
    Electronic Resource
    Limited accuracy of vaginal probe ultrasound in measuring residual urine volumes (1993)
    Springer
    International urogynecology journal 4 (1993), S. 138-140 
    Details
    ISSN: 1433-3023
    Keywords: Accuracy ; Catheterization ; Residual urine volume ; Vaginal ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Each of 45 women underwent three separate vaginal ultrasonographic scans to assess bladder volumes. The calculated volumes, computed using three different formulae taken from the literature, were compared to the true volumes as determined by catheter. The accuracy and percentage error were determined for each of the three formulae. Although vaginal ultrasonography is sensitive, it was neither accurate nor reliable in measuring residual volumes. It was concluded that transvaginal ultrasound to measure residual urine should be avoided, especially in a setting where voiding dysfunction may be prevalent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00571619
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  • 7
    Electronic Resource
    Electronic Resource
    Modified urethral sling for the treatment of genuine stress incontinence and latent incontinence (1994)
    Springer
    International urogynecology journal 5 (1994), S. 69-75 
    Details
    ISSN: 1433-3023
    Keywords: Marlex mesh ; Suburethral sling ; Urinary incontinence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of 143 women who underwent a modified urethral sling using Marlex mesh for the correction of stress urinary incontinence and latent stress incontinence, as diagnosed by clinical and urodynamic testing, are examined. The overall success rate for the surgical correction of genuine stress urinary incontinence was 99% during a median follow-up time of 1 year (range 0.12–4 years). There was a 12% postoperative incidence of varying degrees of genital prolapse. Difficulty with voiding resulting in the need for self-catheterization occurred in 17% of patients in the first 6 weeks, but only 2.8% were needing self-catheterizing after 1 year. There was a difference in peak flow preoperatively compared with 1 year postoperatively (20.5 ml/s v 15.7 ml/s, P=0.0003). Patients with a normal peak flow preoperatively (〉20 ml/s) were more compromised at 1 year postoperatively (28 ml/s preoperatively, 18.4 ml/s postoperatively, P=0.00001), than women with an abnormal preoperative flow (〈20 ml/s), (13.2 ml/s preoperatively, 13.5 ml/s postoperatively). Whether the operation was done for overt or latent stress incontinence did not affect postoperative flow results. It was not possible to predict by preoperative uroflow testing which patients were likely to need intermittent self-catheterization postoperatively. One year after surgery there were no significant alterations in bladder capacity (CMG) or urethral pressure profile measurements. There were no statistically significant changes in uroflow patterns when comparing primary and secondary surgical groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00375813
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  • 8
    Electronic Resource
    Electronic Resource
    Retropubic colpourethropexy: Clinical and urodynamic evaluation of 289 cases (1991)
    Springer
    International urogynecology journal 2 (1991), S. 196-200 
    Details
    ISSN: 1433-3023
    Keywords: Genuine stress urinary incontinence ; Retropublic ; colpourethropexy ; Urodynamic testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two hundred and eighty-nine (289) women who underwent a retropublic colpourethropexy, modified by the senior author (H.P.D.), using non-absorbable suture material, for the correction of stress urinary incontinence as diagnosed by clinical and urodynamic testing are examined. The overall operative success rate of the surgical correction was 95.5% during a mean follow-up time of 2.1 years (range: 0.13–12 years). Risk factors for recurrent stress urinary incontinence include previous incontinence surgery and initial low closure pressure on complex urodynamic testing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01923384
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  • 9
    Electronic Resource
    Electronic Resource
    Retropublic colpourethropexy with transabdominal anterior and/or posterior repair for the treatment of genuine stress urinary incontinence and genital prolapse (1991)
    Springer
    International urogynecology journal 2 (1991), S. 201-207 
    Details
    ISSN: 1433-3023
    Keywords: Genuine stress urinary incontinence ; Genital prolapse ; Low closure pressures ; Retropubic colpourethropexy ; Transabdominal internal anterior and/or internal posterior repair ; Urodynamic testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A new operative technique combining retropublic colpourethropexy with transabdominal internal anterior and/or internal posterior repair for the treatment of genuine stress incontinence (GSI) and genital prolapse is described in 75 cases. The overall success rate in correcting GSI was 92.0%, with a 94.8% success rate in the primary surgical group (n=58) and an 82.4% in the secondary group (n=17). Average follow-up has been 1.31 years (range 6 weeks–6 years). There was a 3.4% incidence of residual prolapse. Nine patients also underwent concomitant colpourethropexy. Overall surgical complications include febrile morbidity 4/75 (5.3%), wound infection 1/75 (1.3%), deep vein thrombosis 1/75 (1.3%) and partial ureteric obstruction 1/75 (1.3%). There were no statistically significant changes in multichannel urodynamic studies preoperatively and at 1 year following surgery. Onethird (2/6) of the GSI failures had low MUCP (〈20 cm H2O) prior to surgery and continued so at 1 year follow-up.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01923385
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  • 10
    Electronic Resource
    Electronic Resource
    Detrusor sphincter dyssynergia, detrusor instability, and urethral sphincter spasticity as the urodynamic findings in the urethral syndrome: Role of treatment with a combined anticholinergic and alpha blocking agent, bladder drill, and antibiotics (1991)
    Springer
    International urogynecology journal 2 (1991), S. 10-15 
    Details
    ISSN: 1433-3023
    Keywords: Detrusor instability ; Detrusor sphincter dyssynergia ; Isopropamide and trifluoperazine ; Urethral spasticity ; Urethral syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The combined effect of isopropamide 5 mg plus trifluoperazine 1 mg (a combined anticholinergic and alpha-adrenergic antagonist) (Smith, Kline and French Canada Ltd, Ontario, Canada), antibiotics, and bladder drill was retrospectively assessed on 100 consecutive women, aged 16 to 47 years, presenting with the signs and symptoms of the urethral syndrome. Assessment included history, physical examination, routine bacterial and chlamydial cultures (cervical, urethral, vaginal, and urine), cystourethroscopy, and urodynamics. Urodynamic diagnoses included detrusor sphincter dyssynergia (n=84), detrusor instability (n =8), external urethral sphincter spasticity (n=4), and sensory urgency (n=1). Three patients with positive urine cultures were excluded. Urethrotrigonitis was visualized at cystourethroscopy in all patients. Only one case of chlamydial urethritis-cervicitis was identified by culture: 82% of patients had a history of prior antibiotic therapy for lower urinary tract symptoms and 21% were being treated with antibiotics at the time of their initial assessment. Following 1 month of treatment, 44 (45%) patients were cured of all symptoms, 49 (51%) were improved, 3 (3%) were unchanged and 1 (1%) was worse. Significant changes in uroflowmetry included a reduction in postvoid residual urine volume from 49 ± 28 ml to 14 ±21 ml (P=0.029) in the unstable bladder group and a conversion from intermittent to continuous uroflow patterns in the detrusor sphincter dyssynergia group (P 〈0.005, χ2) and overall (P 〈0.005, χ2). A statistically significant number of patients (P 〈0.025, χ2) converted from increased to normal tracings on repeat perianal electromyography, suggesting that the pathophysiology of the urethral syndrome is urethral spasticity related to urethral inflammation rather than actual infection. We conclude that detrusor sphincter dyssynergia, bladder instability, and urethral sphincter spasticity are the common urodynamic findings in the urethral syndrome. A combination of anticholinergic and alpha blocking agent, antibiotics, and a bladder drill markedly improved (96%) symptoms in women with the urethral syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400034
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