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Safyre?: a readjustable minimally invasive sling for female urinary stress incontinence
Palma, Paulo C.R;Riccetto, Cassio L.Z;Dambros, Míriam;Thiel, Marcelo;Fraga, Rogério De;Netto Jr, Nelson R;
International braz j urol , 2003, DOI: 10.1590/S1677-55382003000400012
Abstract: introduction: safyre? is a readjustable and minimally invasive sling for the treatment of stress urinary incontinence (sui). it is as a pubovaginal sling placed in the medial third of the urethra. the initial experience is described. materials and methods: forty-five patients (mean age = 59 years) underwent a safyre? implant to treat sui. physical examination and urodynamic study were performed before surgery. all patients presented symptoms of sui and 20% also reported mild urgency. approximately 60% of this group had a previously failed anti-incontinence procedure. urethral hypermobility was diagnosed in 40% of the patients and intrinsic sphincter deficiency (isd) in 60% of the cases. results: the average follow up period was 10 months. the mean operative time was 20 minutes. dystopia repair was performed whenever necessary, during the same procedure. the average hospital stay was 24 hours. in 11% of the implants, bladder perforation occurred. during the postoperative period, 9 patients (20%) developed transient urgency symptoms. during the initial follow up period, 90% were found to be continent, 3% reported an improvement and 7% were unchanged. conclusion: safyre? is a safe and quick procedure that allows postoperative readjustment. this technique may be an attractive alternative in the management of sui, should the good result obtained so far prove to be long lasting.
Safyre : a readjustable minimally invasive sling for female urinary stress incontinence  [cached]
Palma Paulo C.R,Riccetto Cassio L.Z,Dambros Míriam,Thiel Marcelo
International braz j urol , 2003,
Abstract: INTRODUCTION: SAFYRE is a readjustable and minimally invasive sling for the treatment of stress urinary incontinence (SUI). It is as a pubovaginal sling placed in the medial third of the urethra. The initial experience is described. MATERIALS AND METHODS: Forty-five patients (mean age = 59 years) underwent a SAFYRE implant to treat SUI. Physical examination and urodynamic study were performed before surgery. All patients presented symptoms of SUI and 20% also reported mild urgency. Approximately 60% of this group had a previously failed anti-incontinence procedure. Urethral hypermobility was diagnosed in 40% of the patients and intrinsic sphincter deficiency (ISD) in 60% of the cases. RESULTS: The average follow up period was 10 months. The mean operative time was 20 minutes. Dystopia repair was performed whenever necessary, during the same procedure. The average hospital stay was 24 hours. In 11% of the implants, bladder perforation occurred. During the postoperative period, 9 patients (20%) developed transient urgency symptoms. During the initial follow up period, 90% were found to be continent, 3% reported an improvement and 7% were unchanged. CONCLUSION: SAFYRE is a safe and quick procedure that allows postoperative readjustment. This technique may be an attractive alternative in the management of SUI, should the good result obtained so far prove to be long lasting.
The Outpatient Burch-Sling Procedure: A Nerve-Sparing Method for Correcting Female Urinary Incontinence  [PDF]
Daryoosh Samimi, John S. Samimi
Open Journal of Urology (OJU) , 2017, DOI: 10.4236/oju.2017.712029
Abstract: Conventional methods to treat urinary stress incontinence, including the Sling, Burch, and Pereyra modification methods, are limited by several shortcomings due to disrupted nerve and vaginal wall integrity. The nerve-sparing Burch-Sling method represents a surgical advancement through the use of a nerve-sparing sling to treat genuine stress urinary incontinence. The procedure involves retropubic urethropexy using the FDA-approved Burch-Sling device. In this technique, the vagina is elevated bilaterally at the urethrovesical junction to the mid-urethra toward Cooper’s ligament above the base of the bladder. Then, the anterior vaginal wall and fascia are used as an endogenous suburethral sling without dissection. Two hundred twenty cases were included in this study; two hundred patients underwent the outpatient nerve-sparing sling method, and the other twenty underwent the novel abdominal Burch method. There were no major complications. The follow-up duration ranged from 6 months to eight years. All procedures were performed at the U.S. Women’s Institute at a 400-bed hospital in Fountain Valley, CA.
Long Term Follow up of the Solyx Single Incision Sling in the Treatment of Female Stress Urinary Incontinence (SUI)  [PDF]
Scott Serels, Michael Douso
Open Journal of Urology (OJU) , 2014, DOI: 10.4236/oju.2014.42003
Abstract:

Objectives: The Solyx System was developed to be easier and safer to use than other slings. It was the objective of this study to retrospectively assess the long-term safety and efficacy of the SolyxTM SIS Sling System. Methods: After IRB approval and informed consent, chart reviews with follow up phone questionnaires of 69 subjects implanted with the Solyx Sling were collected at 2 sites. All of the patients had SUI and had urethral hypermobility with a q-tip test of >30 degrees. All subjects underwent surgery from 12/2008 to 01/2010 with a mean follow up of 43 months (range 39 -49). Subjects included in this data collection had a mean age of 67 years (range 30 -87). The dominant type of incontinence within the study patients was SUI while 17/69 (25%) of the subjects also had a component of urge incontinence. 38/69 (55%) of study patients had concomitant procedures. Results: Long-term Solyx results showed 64/69 (93%) of patients were subjectively dry by questionnaire and were satisfied with their outcome. 63/69 (91%) would have the procedure again. There were 4 cases of denovo urge incontinence and 2 reports of transient retention. There were no serious adverse events including no bladder, bowel, vessel or nerve perforations and no erosions or extrusions. No pain was reported that was attributed to the implant. Conclusions: Chart review with follow phone questionnaires indicated that the Solyx Sling was a safe, efficacious and less-invasive option for patients requiring SUI surgery and that these results were sustainable for an average of 43 months.

Nuestra experiencia con minicintas MiniArc? en la cirugía de la incontinencia urinaria de esfuerzo: Our experience
Jiménez Calvo,J.; Hualde Alfaro,A.; Cebrian Lostal,J.L.; álvarez Bandres,S.; Jiménez Parra,J.; Montesino Semper,M.; Raigoso Ortega,O.; Lozano Uru?uela,F.; Pinos Paul,M.; González de Garibay,A.S.;
Actas Urológicas Espa?olas , 2010, DOI: 10.4321/S0210-48062010000400010
Abstract: objective: to describe the surgical technique of ams miniarc swing system for the teatment of female urinary incontinence, evaluate its results and complications. method: we performed a retrospective study of surgery with ams miniarc swing system. from august 2007 to march 2009, 135 patients with urinary incontinence (ui) underwent ams miniarc swing system surgery in hammock way. 110 patients (81.5%) suffered from stress urinary incontinence (sui) and 25 (18.5) from mixed (mui). the average age was 55 years-old. all these procedures were performed wigh local anesthesia and in ?out patient surgery?. we evaluate every patient a month later, between 3-6 months later, and a year after surgery. during the following up, clinical history was made in every women with iciq-sf questionnare, that included a fourth question to evaluate the degree of satisfaction after surgery, as well as physical examination. we considered objective cure when negative stress test with full bladder. we use the spss program (v 14.0) for statistical analysis of the results (student′s t-test). results: with a mean follow-up of 495 days (range from 181 to 777), early complications included: 2 bladder perforations during sling placement, inguinal pain in 4 patients and one obturator hematoma (resolved spontaneously). the long-term postoperative complications were: 4 tape exposures in vagina (2.9%), urethral obstruction in 3 patients (2.2%) that required urethrolysis and net section, and irritative symptoms of frequency and urgency reported in 9 patients (6.6%), 5 out of 9 were temporary (between 2 and 6 months) whereas the remaining 4 required anticholinergic agents due to persistent symtoms. when evaluating the success rates of anti-incontinence surgery, 91.9% of patients showed objective cure (88% with mui and 92.7% with sui) since we demonstrated no loss of urine by physical examination with full bladder. the iciq-sf score (fourth question included) decreased an average of 12.7 points. 90% of pati
Bulbourethral Sling in Men with Stress Urinary Incontinence
Mohsen Ayati,Peyman Hekmati,Abolghasem Nikfallah,Mohsen Varyanee
Journal of Family and Reproductive Health , 2007,
Abstract: Objective: This study evaluated the efficacy and safety of the bulbourethral sling in male urinary incontinence. Materials and methods: This case series was conducted in Imam Khomeini hospital-Tehran , between April 2001 to December 2006. Bulbourethral sling was implanted in 7 patients with stress urinary incontinence after prostate surgery. The patients were monitored and evaluated in a prospective manner. The average follow up period was 24 months. Treatment was considered to be successful if the patient stopped wearing any kind of pad and improved if the patient was wearing only one pad daily.Results: Five patients were completely dry. One patient weared one pad daily and the last patient suffered from treatment failure. All patients who were completely dry or had improvement were satisfied and presented no obstructive or irritative urinary symptoms. Urethral erosion was not reported. The overall success rate was 85%. Conclusion: The bulbourethral sling in men has satisfying results to treat urinary incontinence.
A comparative evaluation of suburethral and transobturator sling in 209 cases with stress urinary incontinence in 8 years
Trivedi Prakash,D′Costa Sylvia,Shirkande Preeti,Kumar Shilpi
Journal of Gynecological Endoscopy and Surgery , 2009,
Abstract: Aims and Objectives: To evaluate the outcome of suburethral and transobturator sling in treatment of female stress urinary incontinence in 209 cases from 2002 to 2010. The criteria evaluated were success, failure, complications, operating time, ease of the procedure, availability and cost effectivity of the sling. Design and Setting: A retrospective comparative study was carried out at a tertiary referral centre for female urinary incontinence. Material and Methods: A total of 209 patients (females from 27 to 79 years of age) with proven stress urinary incontinence were treated by suburethral transvaginal tape (TVT) type of slings in 101 cases and transobturator Monarc type of sling in 108 cases at the National Institute of Endoscopic Surgery and Urinary Incontinence Center, Mumbai, India, from March 2002 to June 2010. The maximum follow up was for 8 years. Results: The TVT type of slings had higher complication rate like needle entering the bladder, retention of urine necessitating to cut the tape in the center and had a success rate of 94.5% compared to Monarc/Trivedi obturator tape (TrOT) type of sling with outside-in technique, which had a negligible complication (less than 1%), pain in groin or leg movement that reduced in 6 weeks and a success rate of 95%. Specially, the Indian design Trivedi′s stress urinary incontinence tape (TSUIT) and TrOT with reusable needles, the cost was only 15-20% of the international brands.
Pubovaginal sling in the treatment of stress urinary incontinence for urethral hypermobility and intrinsic sphincteric deficiency
Silva-Filho, Agnaldo L.;Triginelli, Sérgio A.;Noviello, Maurício B.;Santos-Filho, Admário S.;Pires, Cleidismar R.;Cunha-Melo, J. Renan;
International braz j urol , 2003, DOI: 10.1590/S1677-55382003000600012
Abstract: purpose: this study was undertaken to evaluate the use of pubovaginal sling for the treatment of female stress urinary incontinence in patients with intrinsic sphincteric deficiency and patients with urethral hypermobility. materials and methods: sixty-two patients aging 22 to 73 years-old (mean = 49.6) with a median parity of 4.1 (range 0 - 14) who underwent pubovaginal autologous fascial sling procedures for stress urinary incontinence from august/1999 to august/2002 were prospectively analyzed. objective pre and postoperative urodynamic evaluation was performed in all cases. the patients were divided into 2 groups: thirty-nine patients (62.9%) with urethral hypermobility (valsalva leak point pressure equal or superior to 60 cm of h2o) and twenty-three patients (37.1%) with intrinsic sphincteric insufficiency (valsalva leak point pressure below 60 cm of h2o). results: the average follow-up period was 24.8 months, ranging from 3 to 38 months. three patients (4.8%) had detrusor overactivity before the operation, and 36 patients (58.1%) had voiding dysfunction before surgery. the postoperative objective cure rate was 88.7% for stress urinary incontinence. the study also showed that 32.2% of the patients had voiding dysfunction and 11.3% had detrusor overactivity. the mean hospital stay was 3.1 days (range 2 - 4). no difference in the above parameters was noticed between patients with intrinsic sphincteric deficiency and those with urethral hypermobility. conclusion: construction of a pubovaginal sling is an effective technique for the relief of severe stress urinary incontinence, for both patients with urethral hipermobility and with intrinsic sphincteric deficiency, having a cure rate of 88.7%. the high frequency of postoperative voiding urgency was not related to the detrusor overactivity as evaluated by urodynamic studies.
Pubovaginal sling in the treatment of stress urinary incontinence for urethral hypermobility and intrinsic sphincteric deficiency  [cached]
Silva-Filho Agnaldo L.,Triginelli Sérgio A.,Noviello Maurício B.,Santos-Filho Admário S.
International braz j urol , 2003,
Abstract: PURPOSE: This study was undertaken to evaluate the use of pubovaginal sling for the treatment of female stress urinary incontinence in patients with intrinsic sphincteric deficiency and patients with urethral hypermobility. MATERIALS AND METHODS: Sixty-two patients aging 22 to 73 years-old (mean = 49.6) with a median parity of 4.1 (range 0 - 14) who underwent pubovaginal autologous fascial sling procedures for stress urinary incontinence from August/1999 to August/2002 were prospectively analyzed. Objective pre and postoperative urodynamic evaluation was performed in all cases. The patients were divided into 2 groups: thirty-nine patients (62.9%) with urethral hypermobility (Valsalva leak point pressure equal or superior to 60 cm of H2O) and twenty-three patients (37.1%) with intrinsic sphincteric insufficiency (Valsalva leak point pressure below 60 cm of H2O). RESULTS: The average follow-up period was 24.8 months, ranging from 3 to 38 months. Three patients (4.8%) had detrusor overactivity before the operation, and 36 patients (58.1%) had voiding dysfunction before surgery. The postoperative objective cure rate was 88.7% for stress urinary incontinence. The study also showed that 32.2% of the patients had voiding dysfunction and 11.3% had detrusor overactivity. The mean hospital stay was 3.1 days (range 2 - 4). No difference in the above parameters was noticed between patients with intrinsic sphincteric deficiency and those with urethral hypermobility. CONCLUSION: Construction of a pubovaginal sling is an effective technique for the relief of severe stress urinary incontinence, for both patients with urethral hipermobility and with intrinsic sphincteric deficiency, having a cure rate of 88.7%. The high frequency of postoperative voiding urgency was not related to the detrusor overactivity as evaluated by urodynamic studies.
Transobturator tension-free “inside-to-out” suburethral sling procedure for the treatment of stress urinary incontinence  [PDF]
Laketi? Darko,Veljkovi? Andrej,Laketi? Vesna
Srpski Arhiv za Celokupno Lekarstvo , 2012, DOI: 10.2298/sarh1202047l
Abstract: Introduction. Stress urinary incontinence is an involuntary leakage of urine on a sudden increase of intra-abdominal pressure by physical activity, exercise, coughing, sneezing or laughing. Objective. To assess symptoms, functional and anatomical status of voiding function, complications and short term success of a novel procedure, tension-free vaginal tape obturator technique (TVT-O) in the treatment of stress urinary incontinence. Methods. A prospective study was performed on 40 female patients who underwent the TVT-O suburethral sling at the Urology Department of the Health Centre in Prokuplje and Urology Hospital in Ni between May 2009 and February 2010. The mean patients’ age was 58 years (range 34-84 years). Preoperative evaluation included a detailed history and gynaecologic examination including urodynamic testing and voiding studies.UDI-6 and UIQ-7 score testing was performed before, and six months after surgery. All patients who demonstrated stress urinary incontinence with a Q-tip test-angle during maximal straining were included into the study. Postoperatively, outcomes evaluation included voiding function, anatomical parameters, complications, as well as subjective success rates. Results. In 30 patients surgery was performed under spinal and in ten under general anaesthesia. The average intraoperative blood loss during the TVT-O was minimal (<50 ml). There were no vascular, bladder, bowel, and neurological injuries. Thirty-eight patients (95%) were discharged voiding satisfactorily. There was a statistically significant difference in symptoms between UDI-6 and UIQ-7 before and after surgery. Conclusion. Initial experience with TVT-O suburethral sling is promising. The TVT-O differs from retropubic procedures by resulting in lower postoperative morbidity, intraoperative and postoperative complications.
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