Long-term results of prolapse recurrence and functional outcome after vaginal hysterectomy.

Objective: To evaluate the incidence of prolapse and prolapse-related symptoms following vaginal hysterectomy.

Methods: Data were reviewed from women who underwent vaginal hysterectomy between 1988, and 1995, at St George's Hospital, London, UK, and attended long-term follow-up. Outcome measures included a questionnaire for prolapse, urinary, bowel, and sexual symptoms; and a vaginal examination.

Significant improvement in the quality of life in women treated with a novel disposable intravaginal device for stress urinary incontinence.

Introduction And Hypothesis: The aim of the study was to assess the quality of life (QoL) in women with stress urinary incontinence (SUI) while using a novel disposable intravaginal device.

Methods: Fifty women with severe SUI who completed a 7-day control period followed by a 28-day device usage period underwent QoL assessments based on two validated questionnaires, the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6).

Results: Mean total score for the IIQ-7 decreased from 41.

Efficacy and safety of a novel disposable intravaginal device for treating stress urinary incontinence.

Objective: The purpose of this study was to evaluate the efficacy and safety of a novel disposable intravaginal device for treatment of stress urinary incontinence (SUI) in women.

Study Design: Sixty women with severe SUI were recruited from 2 sites in Israel to wear preweighed pads during a 7-day control period followed by a 28-day device usage period in which the device and preweighed pads were worn daily for 8 hours. The primary endpoint was the percentage of women who achieved a > or = 70% reduction in pad weight gain (PWG) from the control period to the last 14 days of device usage.

A comparative study of water perfusion catheters and microtip transducer catheters for urethral pressure measurements.

The aim of this study was to compare the maximum urethral closure pressure (MUCP) measures with two different techniques: water perfused catheter and microtip transducer catheters with respect to reproducibility and comparability for urethral pressure measurements. Eighteen women with stress urinary incontinence had repeat static urethral pressure profilometry on a different day using a dual microtip transducer and water perfused catheter (Brown and Wickham). The investigators were blinded to the results of the other.

Bilateral iliococcygeal fixation for vaginal vault prolapse and enterocele repair using a new suturing device--the digital needle driver.

The objective of our study was to evaluate the surgical feasibility, efficacy and safety of the digital needle driver (DND 202), a modified, flexible surgical device, during iliococcygeal fixation (ICF) for vaginal vault prolapse and enterocele repair. A prospective longitudinal study was carried out among 21 consecutive patients who underwent bilateral iliococcygeal fixation at St George's Hospital, London. All patients filled a comprehensive questionnaire for pre- and post-operative prolapse, urinary, bowel and sexual symptoms and underwent pre- and post-operative site-specific vaginal examination, following the standardized International Continence Society scoring for prolapse, pre-operative urodynamic studies and analysis of the surgical results.

Sacrocolpopexy for vault prolapse and rectocele: do concomitant Burch colposuspension and perineal mesh detachment affect the outcome?

Objective: This study compares the effect of abdominal sacrocolpopexy with posterior Teflon mesh interposition with and without concomitant Burch colposuspension on the posterior compartment.

Study Design: This retrospective review includes 49 consecutive women who underwent sacrocolpopexy for vault or uterine prolapse stage 2 or higher and rectocele; 25 of them had a concomitant Burch colposuspension for urodynamic stress incontinence. Postoperative bladder, bowel and sexual function and recurrent pelvic organ prolapse was assessed at > or =12 months.

Bulking agents for stress urinary incontinence: short-term results and complications in a randomized comparison of periurethral and transurethral injections.

The purpose of our study was to compare the two standard routes of urethral bulking injection in a prospective randomized trial. Forty women with genuine stress incontinence (n = 36), or mixed incontinence with a minor and controlled urge component (n = 4), participated in a urethral bulking agent trial. All patients had a standardized preoperative evaluation which included history, physical examination, assignment of incontinence status on a Stamey grading scale, postvoid residual (PVR) determination, Valsalva leak-point pressure, maximal urethral closure pressure, functional urethral length, Q-tip excursion angle, quantitative pad test, and completion of a quality of life questionnaire.

The tension-free vaginal tape in older women.

Objective: To evaluate peri-operative morbidity, continence outcome and patient satisfaction in older women (>/=65 years) compared with younger women undergoing tension-free vaginal tape.

Design: Case controlled study.

Setting: Tertiary Urogynaecology Unit.

Comparison of the ICIQ-SF and 24-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence.

This study compared the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the 24-h pad test with other measures that assess severity of urinary loss in women with urodynamic stress incontinence (USI). Ninety-five women with primary or recurrent (secondary) USI were recruited. Assessment of the severity of urinary loss was made using the ICIQ-SF, a 24-h pad test, continence questionnaire, Stamey grade, and 3-day frequency volume diary.

Incontinence and voiding difficulties associated with prolapse.

Purpose: Prolapse is the protrusion of a pelvic organ beyond its normal anatomical confines. It represents the failure of fibromuscular supports.

Materials And Methods: A MEDLINE search was done using the keywords cystocele, uterine prolapse, vault prolapse, enterocele or rectocele in combination with urinary incontinence.

Vaginal wind - a new pelvic symptom.

The aim of this study was to evaluate the risk factors, investigations and treatments for vaginal wind. A prospective longitudinal study was carried out at a tertiary care referral centre at St George's Hospital, London. Six consecutive women with symptomatic vaginal air were enrolled in the study, which used a comprehensive questionnaire for vaginal air, prolapse, urinary, bowel and sexual symptoms, vaginal examination following the Standardized ICS Scoring System for prolapse, physiotherapist evaluation, and analysis of the treatment.

MRI visualization of the female pelvis in the plane of the tension-free vaginal tape (TVT) procedure.

We evaluated the distances and angles of the major blood vessels from various pelvic structures in the plane of the tension-free vaginal tape (TVT) procedure in 19 pelvic MR imagies. The major blood vessels were the iliofemoral vessels. The mean distance of the left iliofemoral vessels from the midline was 5.

Triple compartment prolapse: sacrocolpopexy with anterior and posterior mesh extensions.

Post-hysterectomy vault prolapse may be accompanied by anterior (cystocele) and posterior (rectocele) pelvic compartment prolapse. We describe our results with sacrocolpopexy with anterior and posterior polytetrafluoroethylene mesh (SCAPM) extensions. A prospective on-going study is presented of 12 consecutive, complicated patients referred to our tertiary referral unit with a median age of 60 years (range 39-69) who underwent SCAPM between April 1997 and June 1999.

Urinary symptoms in pregnancy: are they useful for diagnosis?

This is the second part of a study assessing 161 women 12 weeks after their first delivery. The urodynamic data have previously been published [Br J Obstet Gynaecol 2000;107:1354]. The symptoms have been assessed using a (non-validated) urinary symptom questionnaire.

Efficacy, safety, and tolerability of extended-release once-daily tolterodine treatment for overactive bladder in older versus younger patients.

Objectives: To evaluate the efficacy, safety, and tolerability of a new, once-daily extended-release (ER) formulation of tolterodine in treating overactive bladder in older (> or =65) and younger (<65) patients.

Design: A 12-week double-blind, placebo-controlled clinical trial.

Setting: An international study conducted at 167 medical centers.