Botox® for idiopathic overactive bladder: efficacy, duration and safety. Effectiveness of subsequent injection

Purpose To test the efficacy, duration and safety of 100 U of botulinum toxin type A (BoNT/A) in women affected by idiopathic detrusor overactivity (IDO) and the effectiveness of subsequent injections. Methods In this double centre, prospective study con- ducted from March 2008 to March 2010, we selected women affected by IDO who failed to respond to various antimuscarinic agents, reported intolerable anticholinergic side-effects or contraindication to their use, also without any response to tibial stimulation. Medical history, physi- cal examination, standard urodynamic examination, uri- nalysis, urine culture, a 4-day voiding diary and a quality of life questionnaire were requested for al…

Spontaneous bilateral tubal pregnancy in a nulliparous woman. Laparoscopic diagnosis and treatment

A 34 year-old nulliparous woman was referred to our Department, complaining of vaginal bleeding and intermittent lower abdominal cramping. serum level of β-hCG was 4954 IU/L. Transvaginal ultrasound examination revealed no gestational sac in the uterine cavity and a right adnexal mass, suggestive of ectopic pregnancy; left adnexal area appeared regular. At laparoscopy, the presence of an ectopic pregnancy was confirmed in the right tube; on the left side, surprisingly, there was an intact infundibular ectopic pregnancy. Right tuba was removed; considering the condition of nulliparous of the patient, we decided to perform a linear salpingostomy. Histologic exam confirmed the diagnosis of spo…

Is intravesical instillation of hyaluronic acid and chondroitin sulfate useful in preventing recurrent bacterial cystitis? A multicenter case control analysis.

Abstract Objective Urinary tract infections (UTIs) are common in the female population and, over a lifetime, about half of women have at least one episode of UTI requiring antibiotic therapy. The aim of the current study was to compare two different strategies for preventing recurrent bacterial cystitis: intravesical instillation of hyaluronic acid (HA) plus chondroitin sulfate (CS), and antibiotic prophylaxis with sulfamethoxazole plus trimethoprim. Materials and methods This was a retrospective review of two different cohorts of women affected by recurrent bacterial cystitis. Cases (experimental group) were women who received intravesical instillations of a sterile solution of high concen…

Monoprosthesis for simultaneous correction of stress urinary incontinence and cystocele: a 3-year follow-up.

BACKGROUND Stress Urinary Incontinence (SUI) and cystocele can occur simultaneously because they have identical predisposing factors. This procedure reinforces pubourethral ligaments and the vesicovaginal fascia, solving SUI and Cystocele. METHODS 57 patients with grade III or higher cystocele were enrolled in this trial; SUI was present in 20% of patients (mean age: 57 years). NAZCA TC was used as monoprosthesis. Prolapse was evaluated using the POP-Q System, sexuality using the FSFI questionnaire, and LUTS using the OAB-SF questionnaire. RESULTS After surgery, there were positive changes, sustained during the follow-up: SUI was cured in 80% patients; there was only one patient with de nov…

Use of trans-labial ultrasound in the diagnosis of female urethral diverticula: A diagnostic option to be strongly considered.

AIM: To demonstrate effectiveness of trans-labial ultrasound (TL-US) in the evaluation of female urethral diverticula (UD). METHODS: In the study period, 20 UD were diagnosed and treated. All data on demographic characteristics, presenting symptoms, physical examination findings, diagnostic and operative procedures, were considered. Patients were referred to TL-US for diverticular evaluation, using a 2D 7.5-MHz endfire probe. For each UD, size, complexity, echogenicity content, and presence of diverticular neck were considered. Follow-up controls were carried out at 1, 6 and 12 months after surgery, to evaluate outcome and need for further intervention. RESULTS: Mean patient age was 46 year…

Robotic versus laparoscopic sacrocolpopexy for apical prolapse: a case-control study

The apical prolapse has always been considered the most complex of the defects of the pelvic floor, for both the difficulty of the surgical corrective technique and for the high post-surgical recurrence rate. Today, the laparoscopic sacrocolpopexy can be considered the standard treatment for apical prolapse. In the last years, several author performed robotic sacrocolpopexy, obtaining positive results. So, we developed a case-control study in order to compare the surgical outcome of robotic group with a control group of laparoscopic approach in patients with symptomatic apical pro-lapsed between January 2015 and December 2015 at University Hospital Policlinico “P. Giaccone” and Ospedali Riu…

Efficacy and acceptance of the sacral neuromodulation in the treatment of female lower urinary tract dysfunctions.