0000000000276007
AUTHOR
Gert Naumann
Changes in sexual function and quality of life after single-incision mid-urethral sling for treatment of female stress urinary incontinence.
Abstract Objectives To evaluate the effectiveness and assess the changes in sexual function and quality of life after placement of a single-incision sling for the treatment of female stress urinary incontinence. Study design A prospective study of women diagnosed with stress urinary incontinence. The single-incision sling was implanted and patients were followed postoperatively for 6 months. The postoperative rate of continence, complications, changes in sexual function, and patient-reported quality of life were evaluated. Female Sexual Function in sexually active patients was evaluated before and after the single-incision sling procedure using the Female Sexual Function Index. From January…
[Current developments and perspectives on the diagnosis and treatment of urinary incontinence and genital prolapse in women].
As a key area of gynaecology, urogynaecology has undergone impressive changes in the past few years. Together with the high prevalence of functional pelvic floor disorders, modern anaesthesia procedures and the introduction of new, innovative minimally invasive operation techniques have led to a dramatic increase in the number of operations for incontinence and prolapses. The increasingly subtle diagnostic options, such as, e. g., 2D and 3D sonography of the pelvic floor provide unambiguous findings and facilitate decision making. Tension-free vaginal slings in retro-pubic, trans-obturator or single-incision techniques show a high success rate with few complications and have almost complete…
Isolation of fibroblasts for coating of meshes for reconstructive surgery: differences between mesh types.
Aims: An extensive colonization of surgical meshes with autologous fibroblasts may reduce complications. Therefore, we aimed to establish a technique that allows isolation and propagation of fibroblasts from vaginal biopsies. Using these cells we tested the applicability of several clinically applied meshes for fibroblast coating. Materials & methods: Fibroblasts were isolated from vaginal tissue after digestion with collagenase. Characterization was performed by immunostaining for cytokeratin 5, 6 and 14, smooth muscle actin and vimentin. A semiquantitative technique was applied to determine the degree of mesh coating 5 h and 5 weeks after seeding of fibroblasts. Seven meshes of diffe…
Prognostic significance of the chemokine CXCL13 in node-negative breast cancer
615 Background: The chemokine CXCL13 is chemotactic for B cells. We examined the prognostic significance of CXCL13 mRNA expression in node-negative breast cancer. Methods: Microarray based gene-expression data for CXCL13 (205242_at) were analysed in four previously published cohorts (Mainz, Rotterdam, Transbig, Yu) of node-negative breast cancer patients not treated with adjuvant therapy (n=824). A meta-analysis of previously published cohorts was performed using a random effects model. Prognostic significance of CXCL13 on metastasis-free survival (MFS) was examined in the whole cohort and in different molecular subtypes (ER+/HER2-, ER-/HER2-, HER2+). Independent prognostic relevance was a…
Operative Therapie bei Genitaldeszensus der Frau: Pro und Kontra der Verwendung von Mesh-Materialien
Die gegenwärtige Entwicklung unterschiedlicher Mesh-Materialien hat zu einer Verbesserung der individuellen operativen Sanierung des Genitalprolapses geführt. Makroporöse monofilamentäre synthetische Netze scheinen geeignet zur Verwendung beim Rezidivprolaps oder bei ausgeprägten Beckenbodeninsuffizienzen zu sein. Die Verwendung von biologischen Netzen zeigt eine deutlich bessere Verträglichkeit mit weniger Infektionen oder Erosionen, bislang ist jedoch nicht das Problem der langfristigen Haltbarkeit geklärt. Die operative Korrektur des Genitalprolapses muss alle Risiken und Nutzen zur Verbesserung der Lebensqualität abwägen, hier können Mesh- Materialien deutliche Vorteile gerade in der Re…
Impact of mode of delivery on levator morphology: a prospective observational study with three-dimensional ultrasound early in the postpartum period
Please cite this paper as: Albrich S, Laterza R, Skala C, Salvatore S, Koelbl H, Naumann G. Impact of mode of delivery on levator morphology: a prospective observational study with three-dimensional ultrasound early in the postpartum period. BJOG 2012;119:51–61. Objective To evaluate morphology and integrity of the levator ani muscle (LAM) with three-dimensional ultrasound early in the postpartum period. Design Prospective cross-sectional observational study. Setting University hospital in Germany. Population Women after vaginal delivery and caesarean section with no previous vaginal delivery. Methods Three-dimensional perineal ultrasound was performed between 48 and 72 hours postpartu…
Pharmacotherapy of female urinary incontinence
Urinary incontinence is a major clinical problem and a significant cause of disability and dependency in older adults. Overall, the prevalence of urinary incontinence approaches 55% among women aged over 55 years. The past few years have seen significant advances in the pharmacotherapy of overactive bladder and stress incontinence. The review examines the evidence regarding their benefits and side-effects.
The effect of hormonal status on the expression of estrogen and progesterone receptor in vaginal wall and periurethral tissue in urogynecological patients
Abstract Objective Our objective was to study the expression of estrogen receptor (ER) isoforms ER alpha (α) and ER beta (β) and of progesterone receptor (PR) in the vaginal wall and in periurethral tissue of women who underwent urogynecological surgical treatment with reference to estrogen status. Study design The study included 89 patients undergoing vaginal surgery for urogynecological conditions. Patients’ history and clinical data including estrogen status and body mass index (BMI) were evaluated. Biopsies from the vaginal wall and from periurethral tissue were obtained during surgery. The expression of ER α and β and of PR in vaginal wall and periurethral tissue was measured by RT-PCR…
Mesh complications following prolapse surgery: management and outcome.
Abstract Objective This is a description of complications following prolapse surgery with the use of alloplastic materials, the management and outcome. Study design 54 women have been referred to Mainz, urogynecology referral center due to complications following mesh-augmented prolapse surgery. Results The complaints who lead to the admission are expressed by the new terminology and standardized classification for complications arising directly from the insertion of prostheses and grafts in female pelvic floor surgery [1] . Pain (66.7%), mesh erosion (55.6%) and vaginal discharge (48.1%) were the most frequent complaints. Revision was performed after a median time of 27.2 months post mesh …
The extracorporeal perfusion of the female pig detrusor as an experimental model for the study of bladder contractility.
Aims The objective of the study was to establish an experimental model for the extracorporeal perfusion of the pig detrusor. In order to validate this model we examined some biochemical parameters and determined the effect of carbachol on the contractility of perfused female pig bladders. Methods Twenty-six pig bladders were perfused with Krebs–Ringer bicarbonate-glucose buffer for a period up to 5 hr with the aim to preserve a viable organ, which would be responsive to contraction-inducing agents. The intravesical pressure of the bladder as well as the intraarterial pressure of the vesical arteries were recorded before and after administration of carbachol. Results The perfusate pH, lactat…
Die Messung des infrapubischen Winkels in der 3-D-Perineal-Sonografie und seine Beziehung zu geburtshilflichen Parametern
Ziel: Die 3-D-Sonografie bietet einige Vorteile gegenuber der 2-D-Sonografie in der Urogynakologie. Neben den Weichteil-Strukturen ermoglicht die Darstellung der axialen Ebene die Identifikation des Levators und der Symphyse. Ziel dieser Arbeit war es, eine genaue Messung des infrapubischen Winkels sowie des Symphysenspalts durch Rotations-Anpassung zu beschreiben und die Inter-Observer-Variabilitat zu bestimmen. Zusatzlich wurden die Korrelationen des infrapubischen Winkels mit dem Auftreten von Levator-Defekten und der Dauer der Austreibungsperiode untersucht. Material und Methoden: Am 2. bis 3. Tag postpartal nach Vaginalgeburt wurde eine 3-D-Sonografie durchgefuhrt. Die Auswertung erfol…
Complications following the use of alloplastic materials in urogynecological surgery
Abstract Study design 118 patients, who were admitted from 2005 to 2008 to our department due to complications following mesh implantation, were included in a retrospective survey. We investigated patient symptoms, findings and subsequent patient management. There was a re-evaluation of symptoms in a follow-up eight weeks after the revision procedure. Data from our urogynecological file archive were used. Results The main complaints were de novo urgency, pain and recurrent urinary tract infections. The main findings were mesh erosion and infections including abscess formations and osteomyelitis. Before being admitted to our department, 42 patients (35.6%) had already undergone at least one …
Patient goals after incontinence procedures: does the single-incision sling satisfy them?
Abstract Objective This study was undertaken to describe short-term postoperative achievement of subjective preoperative goals for single-incision MiniArc slings, in comparison with tension-free vaginal tape (TVT). Method Patients submitted to mid-urethral sling (TVT and MiniArc) procedures for stress urinary incontinence (SUI) in two centers were included in this prospective study. Before surgery, the patients completed a preoperative open-ended questionnaire, in which they described their personal outcomes goals for SUI surgery and the degree of severity of their symptoms. At the first postoperative check, they were asked to assess the degree to which their goals had been met and the degr…