Search results for "continence"
showing 10 items of 178 documents
Lower Urinary Tract Symptoms: What's New in Medical Treatment?
2018
Abstract Context Pharmacological treatment is a cornerstone in the management of patients with lower urinary tract symptoms (LUTS). Objective To review emerging evidence in the medical treatment of LUTS. Evidence acquisition An Embase/Pubmed-based literature search was conducted in December 2017, screening for randomized controlled trials (RCTs), prospective and retrospective series, animal model studies, and reviews on medical treatment of LUTS. Evidence synthesis The main medical innovation in recent years in overactive bladder (OAB) has been the approval of the first β 3 -adrenoceptor agonists (mirabegron) and intradetrusor onabotulinum toxin A, while several other drugs such as antiepil…
Artificial Urinary Sphincter Cuff Size Predicts Outcome in Male Patients Treated for Stress Incontinence: Results of a Large Central European Multice…
2019
Purpose The aim was to study the correlation between cuff size and outcome after implantation of an AMS 800 artificial urinary sphincter. Methods A total of 473 male patients with an AMS 800 sphincter implanted between 2012 and 2014 were analyzed in a retrospective multicenter cohort study performed as part of the Central European Debates on Male Incontinence (DOMINO) Project. Results Single cuffs were implanted in 54.5% and double cuffs in 45.5% of the patients. The cuffs used had a median circumference of 4.5 cm. Within a median follow of 18 months, urethral erosion occurred in 12.8% of the cases and was associated significantly more often with small cuff sizes (P<0.001). Multivariate ana…
Two-stage transperineal management of posterior urethral strictures or bladder neck contractures associated with urinary incontinence after prostate …
2007
Objectives: The treatment of posterior urethral strictures or bladder neck contracture associated with severe urinary incontinence after prostate surgery and failure of endoscopic treatments is controversial. We report our experience with a transperineal approach in two steps: end-to-end urethroplasty/anastomosis and subsequent artificial urinary sphincter implantation.Methods: Between September 2001 and January 2005, we observed six patients (58-68 yr old), with a combination of severe urinary incontinence and posterior urethral stricture with anastomotic bladder neck contracture after prostate surgery. In all cases, repeated endoscopic treatments of the strictures failed. The patients und…
Risk Factors for Failure of Male Slings and Artificial Urinary Sphincters: Results from a Large Middle European Cohort Study.
2016
<b><i>Introduction:</i></b> We analysed the impact of predefined risk factors: age, diabetes, history of pelvic irradiation, prior surgery for stress urinary incontinence (SUI), prior urethral stricture, additional procedure during SUI surgery, duration of incontinence, ASA-classification and cause for incontinence on failure and complications in male SUI surgery. <b><i>Materials and Methods:</i></b> We retrospectively identified 506 patients with an artificial urinary sphincter (AUS) and 513 patients with a male sling (MS) in a multicenter cohort study. Complication rates were correlated to the risk factors in univariate analysis. Subsequentl…
The TiLOOP® Male Sling: Did We Forejudge.
2017
<b><i>Introduction:</i></b> To evaluate the safety and efficacy of the TiLOOP® male sling (pfm medical, Cologne, Germany) used in the treatment for male stress urinary incontinence (SUI). <b><i>Material and Methods:</i></b> We retrospectively evaluated a total of 34 patients with a TiLOOP® male sling. Perioperative complication rates were assessed and validated questionnaires were prospectively evaluated to assess quality of life and satisfaction rate. Outcome and complication rates were analysed by using descriptive statistics. Correlation of continence outcome and risk factors was performed with the chi-square test. A <i>p</i> va…
Treatment of Severe Post-Prostatectomy Stress Urinary Incontinence Using Advance Sling
2010
Severe stress urinary incontinence (SUI) is usually treated by the implant of artificial sphincter positioned around bulbar urethra. AdVance sling is a functional, non-obstructive, anti-incontinence device that showed good results especially for mild and moderate SUI. We present our experience with AdVance sling in 7 patients with severe SUI unfit for artificial sphincter. Our results, after a follow-up of more than 6 months, showed a continence rate of 28% and an improvement rate of 43%, while 2 patients did not show any benefit. The success of AdVance sling depends on the integrity of urethral sphincter and can be applied also in selected cases for the treatment of severe post-prostatect…
Urethral fixation technique improves urinary continence recovery in men undergoing open radical cystectomy and ileal orthotopic neobladder
2021
Background We assessed urinary continence recovery and perioperative complications in patients operated on with the novel urethral fixation technique during open radical cystectomy (RC) with ileal orthotopic neobladder (IONB). Methods A retrospective cohort of 82 consecutive male patients undergoing open RC with IONB between 07/2013 and 06/2020 was analyzed. A study group of 48 patients operated on with the urethral fixation technique was compared with a control group of 34 patients receiving standard neovesico-urethral anastomosis. In the study group, the urethral stump was fixed to the dorsal median raphe posteriorly and to the medial portion of levator ani muscle postero-laterally in ord…
Urinary Incontinence in Chronic Obstructive Pulmonary Disease: A Common Co-morbidity or a Typical Adverse Effect?
2019
Urinary incontinence (UI) is defined as a loss of bladder control and is characterized by the complaint of any involuntary leakage of urine. Evidence suggests that the prevalence of UI is higher in subjects with chronic obstructive pulmonary disease (COPD) than in age-matched controls in both sexes. UI is classified as stress, urge, and mixed, and has a considerable impact on quality of life. However, the prevalence of UI in individuals with COPD is mostly unexplored in clinical research and often underestimated in clinical practice. Interestingly, although the involuntary leakage of a small amount of urine during coughing (e.g., stress UI) is among the most plausible causes of UI in patien…
Definition of overactive bladder and epidemiology of urinary incontinence
1998
Abstract Objectives To review the definition of the overactive bladder and to summarize the results of epidemiologic studies on this specific disorder as well as urinary incontinence (UI) in general. Methods From a literature search covering the time period from 1954 through 1995, 48 epidemiologic studies and several other publications dealing with the prevalence and natural history of UI were reviewed. A metaanalysis of reported data was performed with respect to incontinence definitions, investigation methods, home country of survey, sex, and age groups. Results Differences in definitions of incontinence, target populations, and study design in different investigations resulted in inhomog…
Pelvic floor stress response: reflex contraction with pressure transmission to the urethra.
1987
There is still controversy regarding the active role of striated intramural and periurethral muscles and their relative share of function for urinary continence under stress conditions. To evaluate the function of the periurethral muscles, we subjected a dog model to the physiologic stress condition created by sneezing. Simultaneous measurements of intravesical and three urethral pressures were obtained in the intact urinary tract and in a noncontractile substitute urethra, which was pulled through the pelvic floor and studied with and without additional pelvic floor suspension. The data clearly confirm the active role of striated sphincteric muscles for continence under stress conditions. …