A randomized, controlled trial comparing an innovative single incision sling with an established transobturator sling to treat female stress urinary incontinence.

Purpose: Mid urethral sling procedures have become the surgical treatment of choice for female stress urinary incontinence. Innovative modifications of mid urethral sling procedures were recently introduced with the claim of offering similar efficacy and decreased morbidity. We compared the efficacy and morbidity of an innovative single incision mid urethral tape and an established transobturator procedure.

Trocar-guided mesh compared with conventional vaginal repair in recurrent prolapse: a randomized controlled trial.

Objective: To compare efficacy and safety of trocar-guided tension-free vaginal mesh insertion with conventional vaginal prolapse repair in patients with recurrent pelvic organ prolapse.

Methods: Patients with recurrent pelvic organ prolapse stage II or higher were randomly assigned to either conventional vaginal prolapse surgery or polypropylene mesh insertion. Primary outcome was anatomic failure (pelvic organ prolapse stage II or higher) in the treated vaginal compartments.

Embolization of uterine leiomyomas with polyzene F-coated hydrogel microspheres: initial experience.

Purpose: To evaluate effectiveness and safety of Polyzene F-coated hydrogel microspheres for uterine artery embolization (UAE) in women with symptomatic uterine leiomyomas.

Materials And Methods: Between August 2006 and August 2008, 86 nonconsecutive premenopausal women (mean age, 43.9 years; median, 44 y; range, 28-54 y) were treated with UAE.

Uterine artery embolization in patients with a large fibroid burden: long-term clinical and MR follow-up.

Uterine artery embolization (UAE) in patients with a large fibroid burden is controversial. Anecdotal reports describe serious complications and limited clinical results. We report the long-term clinical and magnetic resonance (MR) results in a large series of women with a dominant fibroid of >10 cm and/or an uterine volume of >700 cm(3).

Is an intrauterine device a contraindication for uterine artery embolization? A study of 20 patients.

The presence of an intrauterine device (IUD) has been traditionally considered a risk factor for postprocedural infection in patients undergoing uterine artery embolization (UAE). The authors retrospectively evaluated the occurrence of infectious complications following embolization in 20 women with IUDs. After a mean follow-up of 20.

Perspectives by patients and physicians on outcomes of mid-urethral sling surgery.

Introduction And Hypothesis: The aim of this study is to determine patient expectations regarding wanted and unwanted sequels of mid-urethral sling (MUS) procedures and to identify mismatches during the physician-patient information exchange prior to MUS procedures.

Methods: A patient preference study (40 patients) and a questionnaire study with 20 experts as control group were conducted. Seventeen different sequels, defined by an expert team, were evaluated.

When to perform urodynamics before mid-urethral sling surgery for female stress urinary incontinence?

Introduction And Hypothesis: Development of a model that can predict in which group of women pre-operative urodynamics can be safely omitted.

Methods: Three hundred and eighty-one uncomplicated women who underwent pre-operative urodynamics were evaluated. A multivariate logistic regression model was developed based on medical history and physical examination predicting a high probability group of women with detrusor overactivity or a low (<20 cm H2O) mean urethral closure pressure and, therefore, are likely to benefit from urodynamics.

Outcome and complications of retropubic and transobturator midurethral slings translated into surgical therapeutic indices.

Objective: We sought to determine and compare surgical therapeutic indices (STIs) of the retropubic tension-free vaginal tape (TVT) and 2 kinds of transobturator tape (TOT), Monarc (American Medical Systems, Minneapolis, MN), and tension-free vaginal tape obturator.

Study Design: This was a retrospective cohort study. Patients with predominant stress urinary incontinence who underwent retropubic (TVT, n = 257) or TOT (n = 180) procedures were included.

Safety and effectiveness of uterine artery embolization in patients with pedunculated fibroids.

Purpose: To assess complications and outcomes of uterine artery embolization (UAE) in women with pedunculated fibroids in a large single-center patient cohort.

Materials And Methods: From a database with prospectively collected data from 716 women treated with UAE between 1996 and 2008, 29 women were identified with 31 pedunculated fibroids. Magnetic resonance images obtained before and 3 months after UAE were used to calculate stalk diameter change and volume reduction of both the pedunculated fibroid and uterus.

TVT-O versus Monarc after a 2-4-year follow-up: a prospective comparative study.

Introduction And Hypothesis: The aim of this study was to compare outcome and quality of life of tension-free vaginal tape "inside-out" (TVT-O) and Monarc transobturator tapes after 2-4 years.

Methods: The method used was a prospective comparative study. Participants (n = 191) were assigned to either a TVT-O (n = 93) or a Monarc (n = 98) procedure.

Risk factors for failure of retropubic and transobturator midurethral slings.

Objective: The aim of our study was to identify and compare risk factors for failure of retropubic and transobturator procedures.

Study Design: This was a retrospective cohort study. Women with predominant stress urinary incontinence who underwent a retropubic (n = 214) or transobturator tape procedure (n = 173) were included.

Predictive value of urodynamics on outcome after midurethral sling surgery for female stress urinary incontinence.

Objective: The aim of this study was to evaluate the value of urodynamic investigation in the preoperative workup of midurethral sling surgery and to identify risk factors for failure after 3 different midurethral sling procedures.

Study Design: Retrospective cohort study. 437 women who underwent a tension-free vaginal tape, Monarc, or tension-free vaginal tape-obturator procedure without other simultaneously performed urogynecological surgery were included.

Long-term outcome of uterine artery embolization for symptomatic uterine leiomyomas.

Purpose: To evaluate long-term outcomes and factors associated with treatment failure after uterine artery embolization (UAE) in women with symptomatic uterine leiomyomas.

Materials And Methods: One hundred consecutive women treated with UAE for symptomatic uterine leiomyomas participated. Clinical outcome data (ie, changes in symptoms, menstrual status, subsequent therapies) and satisfaction data were collected.

Pregnancy and delivery after mid-urethral sling procedures for stress urinary incontinence: case reports and a review of literature.

In this article, the effects of pregnancy and delivery on the development of stress urinary incontinence are described with special emphasis on the obstetrical management in women who wish to become pregnant or are pregnant after a preceding mid-urethral sling procedure. Three case histories and a review of literature are presented. Pregnancy after a preceding incontinence operation is rare and makes it quite difficult to formulate guidelines about delivery when a pregnancy occurs.

Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres: midterm clinical and MR imaging follow-up.

Purpose: To evaluate clinical and magnetic resonance (MR) imaging results after uterine artery embolization (UAE) in women with symptomatic adenomyosis with or without uterine leiomyomas.

Materials And Methods: Thirty-eight women with symptomatic adenomyosis with or without uterine leiomyomas were treated with UAE with calibrated tris-acryl gelatin microspheres. Based on MR findings, women were categorized as having pure adenomyosis (group A; n = 15), adenomyosis dominance with fibroid tumors (group B; n = 14), or fibroid tumor dominance with adenomyosis (group C; n = 9).

Result of the tension-free vaginal tape in patients with concomitant prolapse surgery: a 2-year follow-up study. An analysis from the Netherlands TVT database.

This study assessed the long-term outcome of tension-free vaginal tape (TVT) in women with concomitant pelvic surgery. A prospective cohort study of 746 patients in 41 hospitals was undertaken. The Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6) were used to measure the results of the TVT.

The effectiveness of tension-free vaginal tape (TVT) and quality of life measured in women with previous urogynecologic surgery: analysis from The Netherlands TVT database.

Objective: Long-term outcome of tension-free vaginal tape (TVT) in women with a history of surgery for urinary incontinence and/or prolapse.

Study Design: Prospective cohort study of 809 women. Twenty-eight teaching and 13 local hospitals, 54 gynecologists and urologists performed the TVTs.

Nerve injury: an exceptional cause of pain after TVT.

Persistent pain after a tension-free vaginal tape procedure is rare. Perforation or erosion of the tape into the bladder, urethra, or vagina; hematoma formation; and tape rejection are the most common causes. Less frequent causes are injury to the pelvic bone or to iliopectineal ligaments.

The prevalence of voiding difficulty after TVT, its impact on quality of life, and related risk factors.

Objective: To determine the prevalence of voiding difficulty (VD), quality of life, and related risk factors after tension-free vaginal tape (TVT).

Design: Prospective cohort study in 703 women with a TVT procedure for stress urinary incontinence.

Main Outcome Measures: VD stated by women, Urogenital Distress Inventory (UDI-6) question 5 (difficulty in emptying the bladder), maximum flow rate, postvoid residual urine, necessity of postoperative catheterization, tape division, and impact on quality of life (Incontinence Impact Questionnaire, IIQ-7).

Limited uterine artery embolization for leiomyomas with tris-acryl gelatin microspheres: 1-year follow-up.

Purpose: To assess the safety and efficacy of uterine artery embolization (UAE) using large calibrated tris-acryl gelatin microspheres.

Materials And Methods: One hundred fifty-eight women with symptomatic uterine fibroids underwent UAE. Embosphere was used in 105 women and Embogold microspheres in 53 women.

Quality of life before and after TVT, a prospective multicentre cohort study, results from the Netherlands TVT database.

Objective: To asses the long term outcome of tension-free vaginal tape procedure in women with isolated stress urinary incontinence (SUI).

Design: Prospective cohort study.

Setting: Twenty-eight teaching hospitals and 13 local hospitals, with 54 gynaecologists and urologists performing the surgery.

What determines a successful tension-free vaginal tape? A prospective multicenter cohort study: results from The Netherlands TVT database.

Objective: The objective of this study was to report which preoperative and intraoperative factors influence the success of the tension-free vaginal tape procedure for stress urinary incontinence.

Study Design: This was a prospective cohort study of 809 patients. In 28 teaching hospitals and 13 local hospitals, 54 gynecologists and urologists performed the tension-free vaginal tape procedure.

Mid-term clinical results and patient satisfaction after uterine artery embolization in women with symptomatic uterine fibroids.

Purpose: To evaluate the mid-term clinical results and patient satisfaction following uterine artery embolization (UAE) in women with symptomatic fibroids.

Methods: Between August 1998 and December 2002, 135 patients had UAE for symptomatic uterine fibroids. All patients were asked to fill in a questionnaire.

Prospective analysis of complications of tension-free vaginal tape from The Netherlands Tension-free Vaginal Tape study.

Objective: The intra- and postoperative anatomic complications, frequency, and influence of risk factors of the tension-free vaginal tape are described.

Study Design: This was a prospective cohort study of 809 patients.

Results: The total intraoperative complication rate was 6.