Multimodal therapy for painful bladder syndrome / interstitial cystitis: pilot study combining behavioral, pharmacologic, and endoscopic therapies.

Purpose: We evaluated the effectiveness of combining behavioral therapy, pharmacologic therapy and endoscopic hydrodistension for treating painful bladder syndrome / interstitial cystitis (PBS/IC).

Materials And Methods: Twenty-five patients with PBS/IC were prospectively enrolled in a pilot multimodal behavioral, pharmacologic and endoscopic treatment protocol. Behavioral modification included diet recommendations, fluid restriction to 64 oz.

Self-reported pad use per day reflects patient quality of life after pubovaginal sling surgery.

Introduction And Hypothesis: We hypothesized that self-reported pad use per day (PPD) after pubovaginal sling (PVS) correlated with postoperative quality of life (QOL) scores.

Methods: Two hundred fifteen women completed the incontinence impact questionnaire 7 (IIQ-7) and urogenital distress inventory 6 (UDI-6) before PVS and during follow-up. Starting 3 days before a visit, women recorded the number of protective urinary pad changes per day.

The adjustable continence therapy system for recurrent female stress urinary incontinence: 1-year results of the North America Clinical Study Group.

Purpose: We determined the efficacy, safety, adjustability and technical feasibility of the adjustable continence therapy device (Uromedica, Plymouth, Minnesota) for the treatment of recurrent female stress urinary incontinence.

Materials And Methods: Female patients with recurrent stress urinary incontinence were enrolled in the study and a defined set of exclusionary criteria were followed. Baseline and regular followup tests to determine eligibility, and to measure subjective and objective improvement were performed.

Correlation between urodynamic function and 3D cat scan anatomy in neobladders: does it exist?

Introduction: We compared the functional and anatomical differences among three different orthotopic neobladders, utilizing video urodynamics and 3D CT to determine what parameters, if any, correlate to function.

Materials And Methods: Thirty-four patients were able to participate in the evaluation of their neobladder by 3D CT and video urodynamics. Three different orthotopic neobladders were identified (12 ileal, 7 ileocecal, 15 sigmoid).

Mixed incontinence: does preoperative urodynamic detrusor overactivity affect postoperative quality of life after pubovaginal sling?

Objective: Our purpose was to determine if women with mixed urinary incontinence (MUI) and urodynamic detrusor overactivity (DO) have less improvement in urinary symptoms after pubovaginal sling surgery (PVS), compared to MUI without DO.

Materials And Methods: Women with preoperative MUI symptoms prior to PVS were identified through retrospective review. DO was defined as a symptomatic 5 cm H20 detrusor pressure or greater rise during urodynamics.

Statin use in American Indians and Alaska Natives with coronary artery disease.

Purpose: The use and adherence to statin therapy in American Indians and Alaska Natives with coronary artery disease (CAD) were studied.

Methods: A retrospective database analysis of the Phoenix Area of the Indian Health Service was conducted. For the cohort of patients with CAD, prescription data were obtained for all statins during calendar year 2003.

Transvaginal sling using acellular human dermal allograft: safety and efficacy in 253 patients.

Purpose: We evaluated the safety and efficacy of using human dermal allograft material for transvaginal slings to treat female stress urinary incontinence (SUI).

Materials And Methods: We present a prospective series of 253 patients with SUI treated with a transvaginal sling using a Repliform cadaveric human dermal allograft (LifeCell Corp., The Woodlands, Texas) and a bone anchor fixation kit.

Retropubic surgery for stress urinary incontinence.

More than 150 surgical techniques have been proposed in the literature for treating stress urinary incontinence. Many of the original published approaches were vaginal, but through the years the literature has expanded to include needle suspension, pubovaginal slings, and retropubic procedures. In this chapter, we focus on retropubic approaches for the treatment of SUI and discuss the physiology, indications, technical details and the complications of these procedures.

The relationship between fibromyalgia and interstitial cystitis.

Interstitial cystitis (IC) is a relatively uncommon and enigmatic disorder characterized by pain in the bladder and pelvic region, typically accompanied by urinary urgency and frequency. Fibromyalgia is a more common disorder, with the prominent symptoms being diffuse musculoskeletal pain and fatigue, and it has been well established that there is substantial clinical overlap between fibromyalgia and chronic fatigue syndrome (CFS). Although genitourinary and musculoskeletal symptoms predominate in IC and fibromyalgia respectively, both disorders share a number of features, including similar demographics, "allied conditions" (e.

Early surgical management of extensive gynecologic ureteral injuries.

Early ureteral reconstruction was performed during the immediate postoperative period upon 12 patients who sustained ureteral injuries secondary to gynecologic surgical procedures. The injuries occurred postoperatively for benign disease: endometriosis in one patient, fibrosis in eight patients and tubo-ovarian abscess in one patient. In three instances, portions of the ureter were noted in the pathologic specimen.

Cytologic diagnosis of prostatic carcinoma by fine-needle aspiration biopsy. Community hospital experience.

Transrectal fine-needle aspiration and transrectal or perineal core biopsies were simultaneously performed on 31 patients with suspected prostatic cancer over an eighteen-month period. Of the 29 aspirations that were adequate for cytologic diagnosis, there was histologic correlation in 24 (83%). The sensitivity of aspiration for the diagnosis for prostatic cancer was 92 per cent (11 of 12) compared with 85 per cent (11 of 13) for the core biopsy method.

Misconceptions about posterior approach for renoureteral surgery.

Misconceptions about the posterior approach for renal and ureteral surgery are dispelled. A review of the pertinent lumbar anatomy and a few fine points of technique are emphasized. The advantages of easy access to the kidney, minimal postoperative pain, and absence of the occurrence of postoperative hernia warrant more frequent use of this procedure.