Does trocar puncture of the bladder during midurethral sling impact postoperative urinary storage and voiding symptoms?

Introduction And Hypothesis: The incidence of trocar bladder puncture during midurethral sling (MUS) surgery varies widely. We aim to further characterize risk factors for bladder puncture and examine its long-term impact on storage and emptying.

Methods: This is an Institutional Review Board-approved, retrospective chart review of women who underwent MUS surgery at our institution from 2004 to 2018 with ≥12 months of follow-up.

Urgency and urgency incontinence following stress urinary incontinence surgery: A review of evaluation and management.

The presence of urgency urinary incontinence (U/UUI) after sling surgery is a common reason for dissatisfaction and imposition on quality of life. We aimed to evaluate and analyze the pathophysiology, evaluation, and treatment of U/UUI after sling surgery. A MEDLINE review was performed for relevant, English-language articles relating to storage and emptying symptoms after sling surgery.

Abdominal versus robotic sacral colpopexy: A detailed analysis of outcomes.

Aims: Although abdominal sacrocolpopexy (ASC) is considered the gold standard for surgical repair of vaginal vault prolapse, the open surgical approach has significant morbidity. We aim to compare anatomic and functional outcomes in women receiving either robotic-assisted sacral colpopexy (RSC) or ASC for post-hysterectomy prolapse.

Methods: We present a retrospective chart review of all women who underwent ASC and RSC at our institution and had 12-month follow-up (FU).

Impact of preoperative pelvic floor muscle training (pretraining) on urinary storage and emptying symptoms in women undergoing sling surgery.

Introduction And Hypothesis: Although pelvic floor muscle training (PFMT) is an option for female mixed incontinence (MUI), the role of PFMT prior to midurethral sling (MUS) surgery is not well defined. We hypothesize that preoperative PFMT (pretraining) positively impacts urinary storage and voiding symptoms prior to retropubic MUS.

Methods: We carried out an institutional review board-approved, retrospective chart review of women with stress-predominant MUI undergoing a retropubic MUS.

Long-term outcomes of transobturator midurethral slings: A critical evaluation of a real-world population.

Aims: The American Urological Association/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction stress urinary incontinence (SUI) guidelines strongly recommend the midurethral sling (MUS) for the index female patient with SUI. While numerous studies report long-term outcomes and complications for the retropubic MUS, these are largely absent for the transobturator MUS and are assessed in this study.

Methods: This is an Institutional Review Board approved retrospective chart review of all women who underwent a transobturator MUS at a single institution from 2004 to 2010.

Surgery for urinary incontinence in women: Report from the 6th international consultation on incontinence.

Urinary incontinence is a prevalent condition worldwide and causes a tremendous impact on a woman's quality of life. While conservative and non-surgical therapies are options for treatment, surgery for stress urinary incontinence (SUI) is common. Options include colposuspension, slings (pubovaginal and midurethral), and periurethral bulking.

Obesity and Stress Urinary Incontinence: Impact on Pathophysiology and Treatment.

Purpose Of Review: Obesity is highly prevalent and is associated with stress urinary incontinence (SUI). The purposes of this review are to assess the pathophysiology of SUI in the obese female and review the outcomes of weight loss and anti-incontinence surgery in this population.

Recent Findings: While increased intra-abdominal pressure appears to be the common pathophysiologic link between obesity and SUI, neurogenic and metabolic pathways have been proposed.

Combination treatment for male lower urinary tract symptoms with anticholinergic and alpha-blockers.

Purpose Of Review: Although alpha-adrenergic antagonists (α-blockers) are effective for relieving voiding lower urinary tract symptoms (LUTS) in men, storage symptoms often persist. The aim of this manuscript is to evaluate the efficacy and safety of combination therapy with α-blockers and muscarinic receptor antagonists (anticholinergics).

Recent Findings: High-quality evidence confirms that the addition of an anticholinergic improves micturition diary parameters, such as daytime and nocturnal frequency and urgency incontinence episodes, as well as total and storage subset scores on the International Prostate Symptom Score.

Urinary incontinence in women: non pharmacologic approaches and newer pharmacotherapies. An update.

Urinary incontinence is a widespread problem for women, with stress urinary incontinence (SUI) being the most common type. An updated review of PubMed literature using the following keywords was performed: "stress urinary incontinence", "women", "midurethral slings", "bulking agents", "pubovaginal slings", "retropubic suspension", "postoperative complications", and "treatment outcome". More recent publications, systematic reviews, and meta-analyses were given preference.

Treatment of Concomitant OAB and BPH.

The etiology of men's lower urinary tract storage and voiding symptoms involves a contribution from both detrusor and outlet. As such, treatment of benign prostatic enlargement (BPE) ± benign prostatic obstruction (BPO) with standard alpha-adrenergic blockade and 5-alpha reductase inhibitor therapy may leave a population of men with persistent and bothersome urinary storage symptoms. An abundance of adequately powered, randomized, placebo-controlled trials indicate that the use of antimuscarinics and beta-3 adrenergic agonists, either alone or in combination with standard BPE/BPO therapy, leads to improvement in storage symptoms.

The impact of obesity on outcomes and complications after top-down retropubic midurethral sling.

Aims: Obese women (BMI ≥ 30 kg/m ) have been considered at higher risk for postoperative complications and failure in efficacy after SUI surgery. We compare the outcomes in this population with non-obese women (BMI < 30 kg/m ) undergoing top-down retropubic polypropylene midurethral sling (RPM).

Methods: We retrospectively identified 328 non-obese women and 294 obese women who underwent RPM.