Impact of the type of vaginal assisted delivery on the pelvic floor and OASI - Ultrasound study.

Objective: To assess the prevalence of pelvic floor and anal sphincter trauma in women after assisted vaginal delivery.

Methods: Retrospective study on 201 primiparous women after assisted vaginal delivery, control group 43 women after normal vaginal delivery. 4D translabial ultrasound examination of the levator ani and the anal sphincter was performed according to standard methodology at least 3 months postpartum.

Effect of pelvic floor status on the outcome of pelvic organ prolapse surgery.

Pelvic organ prolapse (POP) is a common diagnosis with an incidence in the population of up to 50%. POP causes restrictions in everyday life and reduces patients' quality of life. Therapy is either conservative in the form of physiotherapy or the use of different types of pessaries, possibly.

Association between sonographic sling location and success of surgery for stress urinary incontinence.

Objective: To determine the relationship between the clinical outcome of suburethral sling surgery for stress urinary incontinence and sling location on ultrasound examination.

Methods: This was a retrospective study of patients diagnosed with stress urinary incontinence who were treated with a suburethral sling by a single surgeon between January 2009 and October 2016. Four-dimensional volumes acquired on transperineal ultrasound at least 3 months postoperatively were analyzed and the gap between the sling and symphysis pubis (sling-pubis gap (SPG)) on Valsalva maneuver was measured.

When to assess residual anal sphincter defect after OASI by ultrasound.

Objectives: Obstetrical anal sphincter injuries (OASIS) are complications of vaginal delivery. Unrepaired anal sphincter after delivery increases the risk of anal incontinence. The aim of our study is to search for residual defect after OASI repair by 4D introital ultrasound (US).

Impact of residual defect of anal sphincter on patients quality of life.

Aim: The aim of this retrospective study is to correlate the presence of residual anal sphincter defect with the quality of life of patients after vaginal delivery complicated with obstetrical anal sphincter injury.

Study Group And Methods: Patients diagnosed with obstetrical anal sphincter injury are dispensed at our urogynecological unit, with a mean follow-up period of 37 months. Two investigators blinded to the results of clinical symptoms evaluated archived ultrasound volumes taken for the presence of residual anal sphincter defects that were later correlated with the St.

Laparoscopic removal of intravesically inserted transobturator tape.

Introduction And Hypothesis: The aim of this video is to provide a step-by-step description of our approach to the surgical management of intravesically localized transobturator tape after previous failure of repeated cystoscopic tape resection.

Methods: This video presents a patient with tape erosion to the urinary bladder after repeated cystoscopic tape resection, recurrent stone formation, and repeated lithotripsy, with recurrent urinary tract infections and overactive bladder (OAB) with urgency incontinence.

Results: During the laparoscopy procedure tape was identified in the left obturator muscle, cut near the obturator muscle, and dissected up to the bladder wall.

Obstetric anal sphincter injury and anal incontinence.

Objective: The aim of our study is to clarify the problems of OASI (obstetric anal sphincter injuries) and anal incontinence and prevention of this injury.

Methods: Review of articles in peer reviewed journals with the usage of Google Scholar function and PubMed.

Conclusion: OASI is a severe injury which is more commonly associated with assisted vaginal delivery.

Is the fixation of single incision TVT-S tape as good as that of transobturator tape? An ultrasound study of randomized trial results.

Introduction: TVT-Secur (TVT-S) was the first single-incision sling available on the market and was soon found to have less efficacy than mid-urethral slings. Our aim was to assess the position and tape descent following TVT-O and TVT-S H in a U procedure and, based on this evaluation, to find the possible reason for lower TVT-S surgery efficacy.

Methods: We conducted an ultrasound study of a randomised trial with a 3-year follow-up that took place between 2007 and 2009 and included 197 women with urodynamic stress urinary incontinence.

Colpocleisis with a skin flap.

Introduction And Hypothesis: Pelvic organ prolapse is a common problem affecting up to 50% of women over the age of 50. The various methods of reconstructive pelvic organ prolapse surgery have been reported to be associated with long-term recurrence rates of up to 50%.

Methods: Management of patients with repeated failure of different surgical procedures is often challenging.

Pilot study comparing tolerance of transperineal and endoanal ultrasound examination of anal sphincter.

Objective: To compare diagnostic possibilities of endoanal (EAUS) and transperineal (TPUS) ultrasound during anal sphincter examination and patients preferences.

Design: Prospective study.

Setting: Department of Obstetrics and Gynaecology, 1st Faculty of Medicine, Charles University and General University Hospital, Prague.

What is the optimal length for single-incision tape?

Introduction And Hypothesis: The aim of this study was to assess the length of adjustable single-incision midurethral tape (SIMS; Ajust), which is needed to fix this tape to the obturator membrane. From these data, we can deduce the optimal length of the SIMS.

Methods: For this study, we employed the intra-operative data of patients included in a single-center randomized trial comparing the efficacy of Tension free vaginal tape obturator (TVT-O) and Ajust.

Classification of descent and mobility of urethrovesic junction in women with stress urinary incontinence - an ultrasound study.

Objective: Detect urethrovesical junction descent and mobility values in women with stress incontinence prior to surgical treatment.

Design: Retrospective study.

Settings: Department of Gynecology and Obstetrics, First Medical Faculty, Charles University, General Teaching Hospital, Prague.

How durable is the effect of mirabegron in successfully-treated overactive bladder patients? Analysis of a multicentre study.

Objective: Many clinical studies indicate that pharmacologic treatment of overactive bladder (OAB) is considered effective and safe, but in real clinical practice a substantial proportion of patients discontinues the treatment. The reason for discontinuing the treatment most frequently reported is lack of efficacy and/or side effects. A further significant proportion of patients reports that they stopped the treatment because the symptoms disappeared or were resolved.

Surgical management of recurrent urethrovaginal fistula with a skin island flap.

Introduction And Hypothesis: A urethrovaginal fistula is a possible rare complication of tension-free vaginal tape procedures. Surgical management of these fistulas is sometimes complicated, and failure can occur. The operation is difficult when the defect between the urethra and the vagina is larger or scarred, so surgical intervention and the preferred technique are controversial.

How accurate are we in urethral mobility assessment? Comparison of subjective and objective assessment.

Objective: The knowledge of the mobility of urethra plays important role in patients with stress urinary incontinence and its assessment is a part of standard urogynecological examination. It has been assumed that increased mobility is associated with higher likelihood of successful treatment. There is arbitrary defined cut-off for hypermobile urethra - descend of more than 15 mm or 30-degree resp.

Effect of severity of urinary incontinence on quality of life in women.

Aims: While the effect of different types of incontinence on the quality of life (QoL) has been clearly documented, the information about the impact of incontinence severity on QoL in women is lacking. Therefore, we investigated whether increasingly severe degrees of incontinence were linearly correlated with poorer QoL.

Methods: We included 391 incontinent women and 81 continent volunteers in the study and assessed them in accordance with routine clinical practice.

Is it possible to cure the symptoms of the overactive bladder in women?

Purpose: To evaluate the feasibility of discontinuing treatment with mirabegron once symptoms have subsided in patients with overactive bladder (OAB).

Methods: The present study evaluated a total of 159 female OAB patients (age 62.9 ± 12.

[Cure effect and persistence of treatment with Mirabegron in patients with symptoms of overactive bladder: a multicentre clinical study].

Objective: The objective of this study was to monitor and evaluate the persistence and cure effect of Mirabegron in patients with overactive bladder syndrome after 18 months of treatment.

Design: Prospective clinical study.

Settings: 10 gynecological and urological departments in CZE.

Are the same tapes really the same? Ultrasound study of laser-cut and mechanically cut TVT-O post-operative behavior.

Introduction And Hypothesis: TVT-O production has been modified to laser cutting from mechanical cutting. We compared the behavior of laser and mechanically cut tension-free vaginal tape-obturator (TVT-O) using ultrasound at various time points after surgery.

Methods: This is a retrospective analysis of clinical and ultrasound data from two previously reported randomized controlled trials with TVT-O.

[Management of recurrent stress urinary incontinence after anti-incontinence surgery].

Objective: The review article describes the possibilities of procedures for failed anti-incontinence surgery - sling procedure or "bulking agent"?

Design: Review article.

Setting: Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Medical Faculty, Charles University, Prague.

Materials And Methods: The correct choice of procedure type to treat persistent SUI (Stress Urinary Incontinence) which persists or soon reoccurs after anti-incontinence surgery is often problematic.

[Degree of satisfaction of patients continuing overactive bladder treatment with mirabegron].

Objective: Overactive bladder syndrome is chronic disease with high prevalence rate (9-42%). This syndrome requires long term therapy, but the treatment persistence is after 3 months over all 26% with further decline in one-year period as low as 18.5%.

Persistence in the treatment of overactive bladder syndrome (OAB) with mirabegron in a multicenter clinical study.

Objective: The objective of this project was to evaluate treatment persistence in patients being treated for overactive bladder syndrome (OAB) with mirabegron, employing clinical follow-up in a prospective, multicenter study.

Study Design: This is an analysis of patients who started treatment with mirabegron between May and September 2014 and were evaluated 1year after treatment commenced. During this evaluation we determined how many patients stopped treatment and established their reasons for discontinuation.

[Ultrasound comparison of adjustable single-incision (Ajust) and transobturator tapes to assess post-operative fixation and function and clinical efficacy].

Objective: The aim of this study was to compare fixation and mobility of adjustable single-incision (Ajust) and standard transobturator midurethral sling (TVT-O) tapes based on postoperative ultrasound monitoring of the position of the tape at rest and at maximal Valsava (tape descent). The hypothesis was that fixation of SIMS Ajust is comparable to that achieved by the standard transobturator midurethral sling.

Setting: Gynecology and Obstetrics Department, GUH and 1st Charles University Prague; Gynecology and Obstetrics Department Masarykova nemocnice Ústí nad Labem.

Combination treatment with mirabegron and solifenacin in patients with overactive bladder: exploratory responder analyses of efficacy and evaluation of patient-reported outcomes from a randomized, double-blind, factorial, dose-ranging, Phase II study (SYMPHONY).

Purpose: This large dose-ranging study explored the benefits of different combinations of mirabegron and solifenacin on health-related quality of life (HRQoL), based on patient-reported outcomes (PROs), and patients ('responders') achieving clinically meaningful improvements in efficacy and HRQoL.

Methods: SYMPHONY (NCT01340027) was a Phase II, placebo- and monotherapy-controlled, dose-ranging, 12-week trial. Adult patients with overactive bladder (OAB) for ≥3 months were randomized to 1 of 12 groups: 6 combination (solifenacin 2.

Comparison of the efficacy of tension-free vaginal tape obturator (TVT-O) and single-incision tension-free vaginal tape (Ajust™) in the treatment of female stress urinary incontinence: a 1-year follow-up randomized trial.

Introduction And Hypothesis: The aim of this study was to compare the efficacy of the tension-free vaginal tape obturator (TVT-O) and single-incision tension-free vaginal tape (Ajust™) in the treatment of stress urinary incontinence in a randomized two-arm study with a 1-year follow-up.

Methods: This single-centre randomized trial compared the objective and subjective cure rates of TVT-O and Ajust using objective criteria (cough test) and subjective criteria (International Consultation on Incontinence Questionnaire short form, ICIQ-UI SF). The objective cure rate was defined as the number of patients with a negative cough stress test.