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  • 1
    Electronic Resource
    Electronic Resource
    A medium term analysis of the subjective efficacy of treatment for women with detrusor instability and low bladder compliance (1997)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective The aims of this study were to determine the medium term subjective outcome of treatment for women with a urodynamic diagnosis of detrusor instability and low bladder compliance.Setting A tertiary referral Urogynaecology clinic.Participants and methods One thousand one hundred and five women referred for the investigation of their urinary symptoms were entered into a prospective, long term, quality of life study. Of these, 348 had a videourodynamic diagnosis of detrusor instability or low bladder compliance and form the basis of this paper. Women were contacted by post at least six months following their urodynamic assessment and asked to complete a questionnaire detailing their treatment, its efficacy and side effects, and any residual urinary symptoms.Results Two hundred and fifty-six women (73.6%) responded to follow up; only 5.5% were cured of their urinary symptoms. The majority (90.2%) had received anticholinergic medication, although only 18.2% continued with this treatment in excess of six months. Many women had residual urinary symptoms following their investigation and treatment.Conclusion The medium term efficacy of the treatment of detrusor instability and low compliance is disappointing, and a large part of this failure may be attributable to poor treatment efficacy, side effects of medication, or inadequate follow up following the diagnosis and instigation of therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1997.tb12054.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Ultrasound: a noninvasive screening test for detrusor instability (1996)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 103 (1996), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine whether transvaginal ultrasound measurement of bladder wall thickness can be used as a screening test for detrusor instability in women with urinary symptoms.Design A blinded prospective study.Setting A London teaching hospital.Participants One hundred and eighty-four symptomatic women presenting to a urodynamic clinic.Main outcome measure The detection of detrusor instability by means of videocystourethrography (VCU) and ambulatory urodynamics in women with a mean bladder wall thickness of greater than 5 mm measured by transvaginal ultrasound.Results One hundred and eight women had a mean bladder wall thickness of greater than 5 mm. Ninety-four percent (102) of these women had detrusor instability either when undergoing VCU or ambulatory urodynamics. Seventeen women had a bladder wall thickness of less than 3.5 mm of whom three were found to have detrusor instability on VCU.Conclusion The measurement of a mean bladder wall thickness greater than 5 mm with transvaginal ultrasound is a sensitive screening method for diagnosing detrusor instability in symptomatic women without outflow obstruction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1996.tb09910.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Changes in the urethral sphincter in relation to child birth and the development of stress incontinence (1998)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1998.tb09981_4.x
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  • 4
    Electronic Resource
    Electronic Resource
    Author's Reply (2003)
    Oxford, UK : Blackwell Science Ltd
    BJOG 110 (2003), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1471-0528.2003.01011_2.x
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  • 5
    Electronic Resource
    Electronic Resource
    A new questionnaire to assess the quality of life of urinary incontinent women (1997)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives To design and validate a condition-specific quality of life questionnaire for the assessment of women with urinary incontinence, and to use the questionnaire to assess the quality of life of women with specific urodynamic diagnoses.Setting A tertiary referral Urogynaecology unit at King's College Hospital, LondonDesign The questionnaire was designed following six different pilot studies; in this study it was tested for validity and reliability using standard psychometric techniques. The questionnaire was used in 293 consecutive women referred for investigation of urinary incontinence.Results The questionnaire was shown to be reliable both by test-retest analysis and by measurement of its internal consistency. The construct of the questionnaire and the answers by respondents confirmed its face and content validity. Criterion validity was measured by correlation with scores obtained on a validated generic measure of quality of life, the Short Form 36. Women with detrusor instability had greater quality of life impairment than women with other urodynamic diagnoses.Conclusion The questionnaire was easy for the women to use and was a valid and reliable instrument for the assessment of quality of life in women with urinary incontinence. It will be useful for the rapid appraisal and follow up of women with urinary incontinence in many different clinical settings, including the evaluation of new treatments of urinary incontinence in controlled clinical trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1997.tb11006.x
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  • 6
    Electronic Resource
    Electronic Resource
    GAX collagen in the treatment of urinary incontinence in elderly women: a two year follow up (1997)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine the efficacy of GAX collagen in the treatment of elderly women with genuine stress incontinence.Design A single centre prospective study.Setting A London teaching hospital.Participants Thirty-four women older than 60 years of age with genuine stress incontinence diagnosed on videocystourethrography.Interventions Up to three paraurethral injections of GAX collagen.Main outcome measures Subjective and pad test assessments performed pre-operatively, after one month, one year and two years after the first injection of collagen. Videocystourethrography and urethral pressure profilometry were carried out pre-operatively, after three months and one year.Results There was a reduction in urinary leakage as measured on pad testing. After two years 77% of the surviving 26 women were symptomatically cured. Objectively after two years 48% of the women were cured and 9% were improved over their initial pre-treatment level of incontinence. The cure rate was the same whether or not the women had undergone previous vaginal surgery. The maximum urethral closure pressure was not increased with treatment indicating that collagen injections do not act by producing obstruction, but this should be interpreted with caution due to the small sample size.Conclusion GAX collagen is an effective method of treating urinary incontinence in the elderly and especially women who have undergone previous continence procedures. The technique is easy to perform and particularly suitable in those who are frail, but if failure occurs after two years consideration needs to be given to its cost effectiveness.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1997.tb10657.x
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  • 7
    Electronic Resource
    Electronic Resource
    Videocystourethrography with a ring pessary in situ. A clinically useful preoperative investigation for continent women with urogenital prolapse? (1998)
    Springer
    International urogynecology journal 9 (1998), S. 205-209 
    Details
    ISSN: 1433-3023
    Keywords: Female ; Incontinence ; Prolapse ; Ring pessary
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the study was to evaluate the use of a vaginal pessary in the detection of genuine stress incontinence (GSI) in women with urogenital prolapse undergoing urodynamic investigation. Continent women with urogenital prolapse, with or without associated urinary symptoms, were studied. All underwent video-cystourethrography using a standarized protocol. None had evidence of incontinence on provocative testing in the upright position. A well-fitting vaginal ring pessary was inserted to reduce the prolapse and mimic a vaginal repair. The provocative tests were then repeated while the bladder was screened. Seventy women with a mean age 59.0 years (range 34–83) were recruited over a 21-month period: 15 women complained of prolapse alone and 55 had concurrent urinary symptoms; 19 women (27%) developed GSI only following the insertion of a vaginal pessary. The women who became incontinent were significantly older (mean age 63.9 years) than those who remained continent (mean age 56.8 years) (P〈0.020). The use of a vaginal pessary increases the detection rate of GSI in continent women with urogenital prolapse undergoing videocystourethrography. These findings are important becasuse women with prolapse and coexisting incontinence should be offered a continence procedure rather than a simple vaginal repair.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01901605
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