The role of intrinsic sphincteric deficiency diagnosis in the era of midurethral sling.

The midurethral sling has gained popularity and is the most commonly used treatment of women with stress urinary incontinence (SUI). Whether intrinsic sphincteric deficiency (ISD) still should be used in the preoperative evaluation of patients with SUI and whether it should be considered as a predictor of success in patients undergoing a midurethral sling procedure and as a guide in the choice of surgical approach (retropubic vs transobturator) remain controversial. This article reviews and discusses the definitions of ISD and the latest research into the role of ISD determination in the era of the midurethral sling.

Periurethral mass formations following bulking agent injection for the treatment of urinary incontinence.

Purpose: Durasphere is gaining popularity as a bulking agent for treating women with stress urinary incontinence. We present a series of patients with periurethral mass formation following Durasphere injection.

Materials And Methods: The charts of 135 women with a mean age of 69.

Transitional cell carcinoma associated with marijuana: case report and review of the literature.

Transitional cell carcinoma of the bladder tends to occur in older patients with a history of tobacco use. We recently evaluated and treated a 45-year-old man with a history of heavy marijuana use. The patient's only risk factor for transitional cell carcinoma was the inhalation of up to five marijuana cigarettes daily for more than 30 years.

Bladder wall abscess following midurethral sling procedure.

Midurethal sling procedures are gaining popularity as the treatment of choice for stress urinary incontinence. Complications that were described include bladder perforation, urinary retention, pelvic hematoma and suprapubic wound infection. Sling erosion and pelvic abscess are rare complications of midurethral slings.

New periurethral bulking agent for stress urinary incontinence: modified technique and early results.

Purpose: Durasphere (Carbon Medical Technologies, St. Paul, Minnesota) is a newly approved injectable agent for stress urinary incontinence. Proven and potential advantages include nonimmunogenicity, tissue nonreactivity, efficacy at low injectable volume and durability.

Urethral reconstruction in spinal cord injury patients.

Purpose: Bladder management programs for patients with spinal cord injury and neurological disease (SCIND) include intermittent catheterization and sphincterotomy with external catheter drainage. These programs depend on maintaining a patent urethra. Once urethral stricture, erosion, diverticulum or urethrocutaneous fistula occurs, the only treatments available are urethral reconstruction and urinary diversion.

Baseline abdominal pressure and valsalva leak point pressures-correlation with clinical and urodynamic data.

Aims: To characterize the factors contributing to changes in baseline abdominal pressure (P(abd)) and the correlation between DeltaVLPP, VLPP(tot), and other clinical and urodynamic variables.

Methods: Two hundred sixty-four female patients who had undergone an anti-incontinence procedure between February 1994 and October 1999 were retrospectively reviewed. The urodynamics performed for each patient included abdominal and vesical pressures measured in a standardized manner with the patient sitting upright and the pressure sensors maintained at the level of the symphysis pubis.

Impaired detrusor contractility: anything new?

Impaired detrusor contractility (IDC) is a poorly defined entity that represents a treatment challenge for the urologist. The etiology of IDC is variable and may include neurologic disorders, inflammatory conditions, and pharmacologic and psychogenic causes. The gold standard for the treatment of IDC is clean intermittent catheterization (CIC).

Laparoscopic ileovesicostomy.

Purpose: We present our initial experience with laparoscopic ileovesicostomy for managing neurogenic bladder.

Materials And Methods: A 5 port transperitoneal approach was used for laparoscopic ileovesicostomy. After bladder preparation a 17 cm.

Urethral erosion of tension-free vaginal tape.

Tension-free vaginal tape (TVT) is gaining popularity as a treatment of choice for women with stress urinary incontinence. It is a minimally invasive procedure with reported short operative and postoperative hospitalization times and low complication rates. We describe urethral erosion of a TVT sling material in a 55-year-old woman who presented with immediate postoperative urinary retention.

Novel technique for combined repair of postirradiation vesicovaginal fistula and augmentation ileocystoplasty.

Concomitant vesicovaginal fistula and significant bladder contracture after radiation is an uncommon but complex urologic problem. We describe a surgical technique to address both issues and present our preliminary clinical data.

Bladder tumor antigen stat test in non-urothelial malignant urologic conditions.

Background: The bladder tumor antigen stat is a simple and fast one-step immunochromatographic assay for the detection of bladder tumor-associated antigen in urine.

Objectives: To evaluate the BTA stat in non-bladder cancer patients in order to identify the categories contributing to its low specificity.

Methods: A single voided urine sample was collected from 45 patients treated in the urology clinic for conditions not related to bladder cancer.