Management of mid-urethral tape complications: a retrospective study.

Background/purpose Of The Study: Following mid-urethral tape insertion, for stress urinary incontinence (SUI), a proportion of women experience complications such as voiding dysfunction or tape erosion which fail to respond to conservative management approaches. These women thus require further surgical treatment. Our objective was to describe the outcomes of the surgical management of complications in these women.

Management of complications arising from the use of mesh for stress urinary incontinence-International Urogynecology Association Research and Development Committee opinion.

Introduction And Hypothesis: Management of pain or mesh exposure complications after stress incontinence surgery has become a new issue over the last 20 years with the introduction of mesh techniques to treat stress incontinence. There is much debate regarding the incidence of complications and how best to treat them.

Methods: A working subcommittee from the International Urogynecology Association (IUGA) Research and Development (R&D) Committee was formed.

Interventions to reduce morbidity from vault hematoma following vaginal hysterectomy: a systematic review and meta-analysis.

Introduction And Hypothesis: A frequent complication following vaginal hysterectomy is the formation of vaginal vault hematoma. The objective of our systematic review was to assess the impact of various interventions in reducing the incidence of vault hematoma or postoperative febrile morbidity following vaginal hysterectomy.

Methods: We carried out a systematic search of Cochrane, MEDLINE, Embase, CINAHL, HTA database, PROSPERO, meta-Register of Controlled Trials (mRCT), PubMed, CENTRAL, Google Scholar, conference abstracts, and a hand search of journals from inception until September 2018.

Reproducibility of the transvaginal sonographic assessment of bladder wall thickness.

Objective: To assess whether transvaginal sonographic measurements of bladder wall thickness (BWT) have adequate reproducibility to detect differences in BWT potentially indicative of detrusor overactivity in women with overactive bladder.

Study Design: Three reproducibility studies were undertaken to assess (A) total measurement error, (B) intra-observer variability and (C) inter-observer measurement in the interpretation of scans. Women recruited to the Bladder Ultrasound Study underwent a transvaginal ultrasound scan to obtain a measurement of BWT.

Urodynamics Before Surgery for Stress Urinary Incontinence.

Following three noninferiority randomised controlled trials from different countries showing exactly the same results, it is time to translate this evidence into practice. In women undergoing primary surgery for pure stress urinary incontinence or stress-predominant mixed urinary incontinence without voiding difficulties, careful office evaluation including uroflowmetry and postvoid residual urine can replace invasive investigations such as cystometry, saving patients from embarrassment and a risk of urinary infection.

Digital rectal examination in the evaluation of rectovaginal septal defects.

Introduction And Hypothesis: The objective was to evaluate the diagnostic potential of digital rectal examination in the identification of a true rectocele.

Methods: This is a retrospective observational study utilising 187 archived data sets of women presenting with lower urinary tract symptoms and/or pelvic organ prolapse between August 2012 and November 2013. Evaluation included a standardised interview, ICS-POPQ, rectal examination and 4D translabial ultrasound.

Effectiveness of BTX-A and neuromodulation in treating OAB with or without detrusor overactivity: a systematic review.

Introduction And Hypothesis: Patients with refractory overactive bladder (OAB) pose a therapeutic challenge. Guidelines such as those from the National Institute for Health and Care Excellence recommend invasive treatments such as botulinum toxin-A ((BTX-A), sacral neural stimulation (SNS) etc. only if there is detrusor overactivity (DO) on urodynamics.

Testing and Treating Women after Unsuccessful Conservative Treatments for Overactive Bladder or Mixed Urinary Incontinence: A Model-Based Economic Evaluation Based on the BUS Study.

Objective: To compare the cost-effectiveness of bladder ultrasonography, clinical history, and urodynamic testing in guiding treatment decisions in a secondary care setting for women failing first line conservative treatment for overactive bladder or urgency-predominant mixed urinary incontinence.

Design: Model-based economic evaluation from a UK National Health Service (NHS) perspective using data from the Bladder Ultrasound Study (BUS) and secondary sources.

Methods: Cost-effectiveness analysis using a decision tree and a 5-year time horizon based on the outcomes of cost per woman successfully treated and cost per Quality-Adjusted Life-Year (QALY).

Bladder ultrasonography for diagnosing detrusor overactivity: test accuracy study and economic evaluation.

Background: Urodynamics (UDS) has been considered the gold standard test for detrusor overactivity (DO) in women with an overactive bladder (OAB). Bladder ultrasonography to measure bladder wall thickness (BWT) is less invasive and has been proposed as an alternative test.

Objectives: To estimate the reliability, reproducibility, accuracy and acceptability of BWT in women with OAB, measured by ultrasonography, in the diagnosis of DO; to explore the role of UDS and its impact on treatment outcomes; and to conduct an economic evaluation of alternative care pathways.