Are older patients with prolapse likely to continue pessary use? A retrospective observational study.

Introduction And Hypothesis: To review the outcomes and complications of vaginal prolapse management with pessaries in women aged 75 years or older, to ascertain whether pessaries are providing satisfactory long-term outcomes for older women.

Methods: A retrospective observational study was performed on women aged 75 years or older presenting to a tertiary Urogynaecology service with vaginal prolapse who opted for management with a vaginal pessary. Demographic and clinical data were collected by reviewing clinical files.

Evaluation of potential feedstock for biogas production via anaerobic digestion in Malaysia: kinetic studies and economics analysis.

As the population increases, energy demands continue to rise rapidly. In order to satisfy this increasing energy demand, biogas offers a potential alternative. Biogas is economically viable to be produced through anaerobic digestion (AD) from various biomass feedstocks that are readily available in Malaysia, such as food waste (FW), palm oil mill effluent (POME), garden waste (GW), landfill, sewage sludge (SS) and animal manure.

Efficacy of Clorpactin in refractory bladder pain syndrome/interstitial cystitis: a randomized controlled trial.

Introduction: Clorpactin is an antibacterial agent with limited evidence for its use as instillation therapy in patients with bladder pain syndrome/interstitial cystitis (BPS/IC). This was a multi-centre, single-blinded randomized controlled trial to investigate whether Clorpactin instillation results in symptom improvement in patients with refractory BPS/IC.

Methods: Fifty women with refractory BPS/IC were randomized to undergo cystoscopy/hydrodistension (25) or instillation of Clorpactin 0.

The Effect of 5-Minute Mindfulness of Peace on Suffering and Spiritual Well-Being Among Palliative Care Patients: A Randomized Controlled Study.

Background: Mindfulness practices may have a role in reducing suffering and improving spiritual well-being among patients with serious illness. The efficacy, feasibility and acceptability of such interventions warrant further exploration in the palliative care population.

Objective: To investigate the effect of a brief mindfulness practice, the 5-minute mindfulness of peace intervention, on suffering and spiritual well-being among palliative care patients.

RCT of vaginal extraperitoneal uterosacral ligament suspension (VEULS) with anterior mesh versus sacrocolpopexy: 4-year outcome.

Introduction And Hypothesis: This study assessed the safety and efficacy of vaginal extraperitoneal uterosacral ligament suspension (VEULS) with anterior overlay mesh versus sacrocolpopexy (SCP) for posthysterectomy vault prolapse.

Methods: This was a multicenter randomized trial of women with posthysterectomy vault prolapse stage >2 according to the Pelvic Organ Prolapse Quantification (POP-Q) system. Primary outcome was a composite of no vaginal bulge symptoms, no anatomical recurrence in the anterior or apical compartment at or beyond the hymenal ring, and no surgical retreatment for prolapse 12 months postsurgery.

Understanding and Challenges in Taking Tyrosine Kinase Inhibitors among Malaysian Chronic Myeloid Leukemia Patients: A Qualitative Study.

Background: In Malaysia, the treatment for chronic myeloid leukemia (CML) has long been delivered under the Malaysian Patient Assistance Program (MYPAP), but research on identifying factors contributing to non-adherence to tyrosine kinase inhibitors (TKIs) is still limited. The current study explored understanding and challenges of Malaysian CML patients in taking imatinib and nilotinib. Methods: Semi-structured, face-to-face interviews were conducted with 13 CML patients receiving treatment at a public tertiary care center, and were analyzed using the content analysis approach.

Cost Analysis of Using a Closed-System Transfer Device (CSTD) for Antineoplastic Drug preparation in a Malaysian Government-Funded Hospital.

Background: Apart from reducing occupational exposure to cytotoxic hazards, the PhaSeal® closed-system transfer device (CSTD) can extend the beyond-use dates (BUDs) of unfinished vials of antineoplastic drugs for up to 168 hours (seven days). In this study, the total material cost incurred by its use in a Malaysian government-funded hospital was calculated. Methods: A list of vial stability following initial needle punctures of 29 commonly-used antineoplastic drugs was compiled.

Long-term outcomes of intravesical dimethyl sulfoxide/heparin/hydrocortisone therapy for interstitial cystitis/bladder pain syndrome.

Introduction And Hypothesis: For decades, intravesical dimethyl sulfoxide (DMSO) cocktail therapy has been used for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), but little is known about its long-term efficacy. We aimed to assess the long-term efficacy of intravesical DMSO/heparin/hydrocortisone/bupivacaine therapy in patients with IC/BPS.

Methods: Patients with IC/BPS from our institutions who underwent this therapy with >2 years follow-up were surveyed with O'Leary-Sant interstitial cystitis symptom and problem index questionnaires before and after therapy.

Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?

Introduction And Hypothesis: The objective of this study was to assess outcomes in native tissue (NT) and transvaginal mesh (TVM) repair in women with recurrent prolapse.

Methods: A retrospective two-group observational study of 237 women who underwent prolapse repair after failed NT repair in two tertiary hospitals. A primary outcome of "success" was defined using a composite outcome of no vaginal bulge symptoms, no anatomical recurrence in the same compartment beyond the hymen (0 cm on POPQ) and no surgical re-treatment for prolapse in the same compartment.

Randomized trial of a single incision versus an outside-in transobturator midurethral sling in women with stress urinary incontinence: 12 month results.

Objective: The objective of the study was to evaluate objective and subjective outcomes of MiniArc and Monarc (American Medical Systems, Minnetonka, MN) midurethral sling (MUS) in women with stress incontinence at 12 months.

Study Design: A total of 225 women were randomized to receive MiniArc or Monarc. Women with intrinsic sphincter deficiency, previous MUS, or untreated detrusor overactivity were excluded.

A prospective observational study of lower urinary tract symptoms before and after surgical removal of a large pelvic mass.

Introduction And Hypothesis: The aim of this study was to assess the impact of the surgical removal of a large pelvic mass on preexisting lower urinary tract symptoms (LUTS) and function.

Methods: This was a prospective study of planned surgical management of women with a large pelvic mass (uterine or ovarian mass ≥ 7 cm on pelvic ultrasound) who also reported bothersome LUTS (urinary frequency, urgency, incontinence and/or voiding dysfunction). Assessment included structured history and examination, completion of the short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), a 3-day bladder diary and multi-channel urodynamics (UDS) at baseline and 3 months postoperatively.

The effect of vaginal pelvic organ prolapse surgery on sexual function.

Aims: Data on female sexual function after prolapse surgery are conflicting. The aim of the study was to evaluate the change in sexual function and vaginal symptoms using patient reported outcomes following prolapse surgery in addition to the anatomical stage.

Methods: Prospective observational study of women undergoing pelvic organ prolapse (POP) surgery.

Functional outcomes following surgical management of pain, exposure or extrusion following a suburethral tape insertion for urinary stress incontinence.

Introduction And Hypothesis: Surgical revision of a tape inserted for urinary stress incontinence may be indicated for pain, or tape exposure or extrusion. This study assesses the clinical outcomes of revision surgery.

Methods: A retrospective review of 47 consecutive women who underwent surgical revision for the indications of pain, tape exposure or tape extrusion.

Training Self-Administered Acupressure Exercise among Postmenopausal Women with Osteoarthritic Knee Pain: A Feasibility Study and Lessons Learned.

Background. Osteoarthritis (OA) is more prevalent in women, particularly after menopausal age. Women are more likely to seek complementary and alternative medicine (CAM) approaches.

Which women develop urgency or urgency urinary incontinence following midurethral slings?

Introduction And Hypothesis: De novo urgency has a negative impact on women after midurethral sling (MUS). We aimed to identify risk factors for de novo urgency (dU) and urgency urinary incontinence (dUUI) following MUS, using multivariate analysis.

Methods: We investigated 358 consecutive women with only stress urinary incontinence (SUI) [or urodynamic stress incontinence (USI)] and 598 women with both SUI (or USI) and urgency (but not UUI) who underwent MUS with a mean follow-up of 50 months.

Sexual function following retropubic TVT and transobturator Monarc sling in women with intrinsic sphincter deficiency: a multicentre prospective study.

Introduction And Hypothesis: A prospective study comparing the effect of the tension-free vaginal tape (TVT) to the Monarc sling on sexual function in women with urodynamic stress incontinence (USI) and intrinsic sphincter deficiency (ISD) is presented.

Methods: Eighty-seven sexually active women with USI and ISD were enrolled. Sexual function was assessed pre-operatively and at 6 and 12 months post-operatively by history, PISQ-12, UDI-6 and IIQ-7 questionnaires.

Midurethral sling procedures for stress urinary incontinence in women over 80 years.

Aims: To compare the safety and efficacy of midurethral sling surgery for management of urinary stress incontinence in women over 80 years versus younger women.

Methods: 1225 consecutive women with urodynamic stress incontinence had a synthetic midurethral sling (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Ninety one percent (n = 1112) of the patients were interviewed via phone call with a structured questionnaire and were included in the analysis.

Do the Advantage slings work as well as the tension-free vaginal tapes?

Introduction And Hypothesis: There is currently no data on the safety and efficacy of the Advantage sling despite its widespread use.

Methods: We compared the efficiency and safety outcome data of 556 tension-free vaginal tape (TVT) and 108 Advantage slings after assessing for potential confounding factors.

Results: The two groups proved comparable.

Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence.

Purpose: We reported and compared the outcomes of repeat mid urethral sling with primary mid urethral sling in women with stress urinary incontinence.

Materials And Methods: A total of 1,225 consecutive women with urodynamic stress incontinence underwent a synthetic mid urethral sling procedure (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Of the patients 91% (1,112) were interviewed via telephone call with a structured questionnaire and were included in the analysis.

Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence.

Introduction And Hypothesis: Midurethral sling (MUS) is now the first line surgical treatment for female stress urinary incontinence. Our aim was to identify predictors for MUS failure.

Methods: A total of 1,225 consecutive women with urodynamic urinary stress incontinence had a synthetic MUS (955 retropubic and 270 transobturator) at our institution between 1999 and 2007.

Effectiveness of midurethral slings in intrinsic sphincteric-related stress urinary incontinence.

Purpose Of Review: Previous literature has shown that urodynamic evidence of intrinsic sphincter deficiency (ISD) decreases the surgical success of traditional antistress incontinence surgeries. The aim of this review is to assess recent evidence on the effectiveness of the increasingly popular midurethral slings (MUS) in women with ISD and stress urinary incontinence.

Recent Findings: Using the ISD definition of maximum urethral closure pressure of 20 cm H2O or less and/or abdominal/valsalva leak point pressure of 60 cm H2O or less, current literature would suggest that the effectiveness of retropubic MUS is reduced but remained acceptable in women with stress urinary incontinence and ISD.

Risk factors for trocar injury to the bladder during mid urethral sling procedures.

Purpose: We determined the incidence of and risk factors for bladder injury during mid urethral sling procedures for stress urinary incontinence.

Materials And Methods: At our institution 1,136 consecutive women underwent a mid urethral sling procedure (retropubic in 874 and transobturator in 262) and routine intraoperative cystoscopy between 1999 and 2007, and were followed to determine the clinical outcome. Statistical analysis was performed using the chi-square and independent t tests, and ANOVA to compare patients with and without bladder perforation by baseline characteristics and major risk factors.

Transvaginal pelvic organ prolapse repair of anterior enterocele following cystectomy in females.

This study aims to highlight pelvic organ prolapse (POP) in females following radical cystectomy and to describe our experiences with their management. This is a retrospective case series of five women who had symptomatic POP following radical cystectomy and ileal conduit urinary diversion. All patients presented with a midline anterior enterocele with atrophic ulcerated vaginal skin.

Effectiveness of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency: a randomized controlled trial.

Objective: To compare efficacy of transobturator tape with tension-free vaginal tape (TVT) in the treatment of stress urinary incontinence in women with intrinsic sphincter deficiency.

Methods: One hundred sixty-four women diagnosed with urodynamic stress incontinence and intrinsic sphincter deficiency with or without concomitant pelvic organ prolapse repair were randomized to receive TVT or transobturator tape. The primary outcome was the presence or absence of urodynamic stress incontinence at 6 months postoperatively.

Prospective study of the Perigee system for the management of cystocoeles--medium-term follow up.

Objectives: The Perigee transobturator cystocoele repair system (AMS) was designed and first used in Townsville, Australia. This prospective study evaluates the efficacy and safety of this device for the management of cystocoeles.

Methods: Patients who underwent surgery with the Perigee system between March 2004 and December 2005 were reviewed.