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• W2389190680 abstract "Purpose: A prospective cohort study was done to determine the efficacy and clinical outcome of a new technique for anterior vaginal wall sling construction to treat urinary incontinence due to intrinsic sphincter dysfunction or anatomical incontinence. Materials and Methods: Preoperative evaluation included lateral cystography, video urodynamics, cystoscopy and incontinence staging. Postoperative subjective and objective staging outcome measures were prospectively assigned at predetermined regular intervals by a third party. Results: Of the patients 95 had intrinsic sphincter dysfunction and 65 had anatomical incontinence. The repair failed in 7% of the 160 patients who had recurrent incontinence during followup and 9% had de novo urgency incontinence. Time to failure comparing patients with intrinsic sphincter dysfunction and anatomical incontinence was modeled using &plan-Meier survival curves, and the log rank test showed no significant difference between the groups (p >0.05). Logistic regression covariates revealed no significant predictive factors for postoperative failures. Preoperative patient age was the only predictive factor for de novo instability (logistic regression model p <0.05). Conclusions: Our initial results indicate that the 2 groups are indistinguishable to date based on current clinical and experimental statistics except for time to full recovery of postoperative voiding and incidence of postoperative instability (regression model p <0.05). Before initiating therapy for patients with stress urinary incontinence several clinical, radiographic and urodynamic parameters are considered by the clinician, including the degree of prolapse of the anterior vaginal wall, type of incontinence (intrinsic sphincter dysfunction or anatomical incontinence), other abnormalities to be corrected at the same time (enterocele, rectocele or hysterectomy) and presence of instability. Following evaluation numerous alhormonal replacement and behavior modification, may be discussed as potential treatment options.'. Intrinsic sphincter dysfunction may occur following multiple operations, estrogen deficiency or trauma to the urethra, or it may be associated with neurogenic disease. Current surgical options for patients with intrinsic sphincter dysfunction include injectable agents (collagen or autologous fat), various sling techniques or insertion of an artificial urinary A sling for the correction of intrinsic sphincter dysfunction may be fashioned with autologous fascia1 strips (rectus fascia, fascia lata and SO forthA4 donor strips (dura), synthetic materials (PolYProPYlene, PolytetrafluoroethYlene [Gore-Texl or polyester fiber mesh graft)5.6 or by burying the vaginal These techniques involve hamesting of a graft material, use of synthetics or creation of a vaginal flap. A simplified technique using permanent sutures placed into the periurethral supporting structures was developed as a modification of the Raz bladder neck suspension. We report on the efficacy of this procedure in a prospective manner to establish clinical outcomes with time." @default.
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• W2389190680 title "Urological Neurology and Urodynamics VAGINAL WALL SLING FOR ANATOMICAL INCONTINENCE AND INTRINSIC SPHINCTER DYSFUNCTION: EFFICACY AND OUTCOME ANALYSIS" @default.
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