Increased fall risk is associated with elevated co-contraction about the ankle during static balance challenges in older adults.

Falls are a leading contributor to disability in older adults. Increased muscle co-contraction in the lower extremities during static and dynamic balance challenges has been associated with aging, and also with a history of falling. Co-contraction during static balance challenges has not been previously linked with performance on clinical tests designed to ascertain fall risk.

Urethral and bladder injections for incontinence including botox.

Stress urinary incontinence (SUI) and urge incontinence (UI) are increasingly significant health concerns for millions of women. Investigation continues into the use of different types of procedures for the surgical management of UI that can be done in the ambulatory office without the use of general or regional anesthesia. Injectable treatment for SUI and UI lend themselves to the ambulatory or office setting and mimic the efficacy and safety profiles of currently available procedures.

Solifenacin for overactive bladder: secondary analysis of data from VENUS based on baseline continence status.

Introduction And Hypothesis: VENUS evaluated the efficacy of solifenacin on urgency in patients with overactive bladder (OAB). We hypothesized that solifenacin would be comparably efficacious in continent and incontinent patients.

Methods: VENUS was a 12-week, placebo-controlled trial in patients with OAB.

Update of AUA guideline on the surgical management of female stress urinary incontinence.

Purpose: We updated the 1997 American Urological Association guideline on female stress incontinence.

Materials And Methods: MEDLINE searches of English language publications from 1994 and new searches of the literature published between December 2002 and June 2005 were performed using identified MeSH terms. Articles were selected for the index patient defined as the otherwise healthy woman who elected to undergo surgery to correct stress urinary incontinence or the otherwise healthy woman with incontinence and prolapse who elected to undergo treatment for both conditions.

Radiation treatment waiting times for breast cancer patients in Manitoba, 2001 and 2005.

Introduction: Our study examined the wait time from ready-to-treat to radiation therapy for cohorts of breast cancer patients requiring adjuvant radiation therapy in 2001 and in 2005 after the implementation of strategies to reduce wait times for radiation treatment. We also examined the overall time from diagnosis to radiation treatment and whether distance from the cancer treatment centre or month of referral had an effect on wait times.

Methods: This population-based retrospective study looked at representative samples of women newly diagnosed with breast cancer in 2001 and 2005.

Trospium chloride extended release is effective and well tolerated in women with overactive bladder syndrome.

Introduction And Hypothesis: To confirm the efficacy and tolerability of extended release (ER) trospium chloride in women with overactive bladder syndrome (OAB), data from two identical phase III studies were analyzed.

Methods: Adults (aged > or = 18 years) who had OAB with urinary urgency, frequency, and urge urinary incontinence (UUI) were randomized to trospium ER 60 mg or placebo once daily for 12 weeks. The analysis included 989 women (trospium ER, n = 484; placebo, n = 505).

Post hoc interpretation of urodynamic evaluation is qualitatively different than interpretation at the time of urodynamic study.

Objectives: Intraobserver reliability of post hoc urodynamic interpretation is greater than interobserver reliability, attributable to interpreter bias. If post hoc interpretation is qualitatively similar to interpretation at the time of study by a urodynamicist in attendance ("live" interpretation), a similar intraobserver bias should be observed. We therefore evaluated the intra- and interobserver reliability of post hoc versus "live" interpretation.

Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center's experience.

This case series' purpose is to review a referral center's experience with complications from mesh kits. A chart review of 12 patients who presented with complications associated with transvaginal mesh kit procedures was performed. All patients underwent complete surgical removal of the mesh to treat mesh exposure, pain, or vaginal bleeding/discharge followed by an anterior or posterior repair.

Transurethral collagen denaturation for women with stress urinary incontinence.

Transurethral collagen denaturation was approved by the US Food and Drug Administration in 2005 for the nonsurgical treatment of stress urinary incontinence in women. In this procedure, controlled, nonablative radiofrequency energy applied through a transurethral probe produces microscopic submucosal sites of collagen denaturation, resulting in reduced tissue compliance. Treatment is administered in about 30 minutes in an outpatient setting without incisions, general anesthesia, or use of cystoscopy or other visualization.

Large urethral prolapse formation after calcium hydroxylapatite (Coaptite) injection.

A 67-year-old woman who had failed two prior anti-incontinence surgeries presented with stress urinary incontinence and intrinsic sphincteric deficiency. Calcium hydroxylapatite (Coaptite(R)) was injected cystoscopically into the bladder neck and proximal urethra and resolved her incontinence. Seven months later, she presented with difficulty in voiding and a urethral mass.

Oxybutynin: an overview of the available formulations.

Overactive bladder (OAB) is a common problem presented to by physicians. Standard treatment with antimuscarinic medication is directed at suppressing involuntary detrusor contractions by blocking the binding of acetylcholine to muscarinic receptors in the bladder. Oxybutynin chloride is the first of several antimuscarinic medications to be marketed for OAB.

Complications of ethylene vinyl alcohol copolymer as an intraurethral bulking agent in men with stress urinary incontinence.

Objectives: To report the short-term safety and efficacy of ethylene vinyl alcohol (EVA) copolymer (Tegress; C.R. Bard, Inc.

Nocturia: etiology, diagnosis, and treatment.

Voiding at night, or nocturia, is a common reason for interrupted sleep in the adult population. The condition affects both men and women, with an incidence that increases dramatically with age. Nocturia has a negative impact on quality of life, affecting both morbidity and mortality.

Male lower urinary tract symptoms: treatment with a-blockers, 5-a-reductase inhibitors, antimuscarinics, or a combination.

Pharmacological therapy is now considered a first-line treatment for men with moderate to severe lower urinary tract symptoms. Given the success of antimuscarinic agents, a-sympathetic blockers, and 5-a-reductase inhibitors in treating symptoms, the interest in combination therapy has grown. Despite this, large-scale trials to test the efficacy of such combination therapy are still lacking.

Nonsurgical, radiofrequency collagen denaturation for stress urinary incontinence: retrospective 3-year evaluation.

Transurethral radiofrequency collagen denaturation, a nonsurgical treatment for stress urinary incontinence, reduces regional dynamic tissue compliance without causing tissue necrosis or gross tissue shrinkage, unlike transvaginal radiofrequency tissue ablation. This retrospective study evaluated long-term safety and efficacy in 21 patients from a 12-month, randomized controlled trial utilizing 3-day diaries and the Incontinence Quality of Life (I-QOL) survey. Significant increases in overall I-QOL scores 3 years or more post treatment was the primary end point.

Does uroflow predict ISD?

Aim: The term superflow has been given to abnormally high flow rates in women, and has been thought to be indicative of intrinsic sphincteric deficiency (ISD), as ISD is associated with low urethral pressure. Pelvic organ prolapse (POP) damages the sphincteric mechanism extrinsic to the urethra. The aim of this study was to determine if ISD can be predicted from voiding flow rates in women with symptomatic POP.

Multicenter prospective randomized 52-week trial of calcium hydroxylapatite versus bovine dermal collagen for treatment of stress urinary incontinence.

Objectives: To evaluate the safety and effectiveness of soft-tissue augmentation of the urethral sphincter with calcium hydroxylapatite (CaHA; Coaptite) compared with glutaraldehyde cross-linked bovine collagen (Contigen) in female patients with stress urinary incontinence due to intrinsic sphincter deficiency and without associated urethral hypermobility.

Methods: This 12-month prospective, randomized, comparative, multicenter, single-blind, parallel, clinical trial of CaHA and collagen for soft-tissue augmentation of the urethral sphincter in the treatment of stress urinary incontinence enrolled 296 women. Up to five injections were performed in the first 6 months of the trial.

Nonsurgical transurethral radiofrequency treatment of stress urinary incontinence in women.

A transurethral radiofrequency collagen denaturation system was recently approved by the US FDA for nonsurgical, outpatient treatment of women with stress urinary incontinence associated with urethral hypermobility. Controlled radiofrequency energy applied through a transurethral probe heats submucosal tissue to produce collagen denaturation, resulting in reduced tissue compliance without necrosis, thus distinguishing this procedure from transvaginal radiofrequency tissue ablation. Treatment can be administered in 30 min under local anesthesia, without incisions, use of cystoscopy or other visualization of the treatment site.

Treatment options for patients with suboptimal response to surgery for stress urinary incontinence.

Background: Many women with stress urinary incontinence (SUI) undergo surgery to relieve their symptoms. Currently, tension-free vaginal tape or transobturator tape sling procedures are the surgical treatments of choice. Although these procedures are often successful, a growing number of women experience suboptimal results ranging from improvement without cure to postoperative failure.

The safety and efficacy of ethylene vinyl alcohol copolymer as an intra-urethral bulking agent in women with intrinsic urethral deficiency.

The purpose of this post-marketing case-series is to report the short-term safety and effectiveness of ethylene vinyl alcohol (EVA) copolymer (Tegress; C.R. Bard, Covington, GA, USA) in the treatment of intrinsic sphincter deficiency (ISD).

Current trends in the evaluation and management of female urinary incontinence.

Despite its common occurrence and often seemingly obvious causes, female urinary incontinence requires a thorough and thoughtful evaluation for its proper diagnosis and treatment. With rare exceptions, urinary incontinence is the result of failure of the sphincter mechanism to resist bladder pressures encountered during daily activities. This may be the result of sphincter failure, overactivity of the bladder detrusor muscle or both.

Transvaginal urethrolysis for obstruction after antiincontinence surgery.

Our objective was to determine our success in relieving bladder outlet obstruction (BOO) with a transvaginal urethrolysis (TVU). This was a chart review that included 55 patients who underwent 61 TVU procedures between 2001 and 2005. Twenty-three patients had at least one prior TVU.