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1.
Afr. j. urol. (Online) ; 17(1): 1-5, 2011.
Article in English | AIM | ID: biblio-1258100

ABSTRACT

Objectives: Anterior vaginal wall slings (AVWS) have been used for decades in the treatment of female stress urinary incontinence (SUI). The main drawback of using the vaginal wall as a sling is its tendency to weaken and stretch over the course of years. The use of synthetic tapes for the treatment of SUI is effective but costly. For patients who cannot afford synthetic tapes; we describe the preliminary results of a modified AVWS technique for the treatment of SUI types II and III. Patients and Methods: In this series; a modification of the AVWS was applied in 35 female patients with SUI. A fortified and rolled flap is used to provide compression and support of the urethra. The vaginal mucosal surface of the flap is cauterized and two diagonal sutures are placed across it. The flap is then rolled on itself with a running 2/0 vicryl suture. Two sutures attached to both ends are passed retropubically to the anterior abdominal wall and tied over the rectus sheath. Results: All 35 female patients had type II/III SUI. After a median follow up of 43 months; 91of the patients were dry or used 0-1 pad per day. Only one patient suffered from transient retention for one week post-operatively. Conclusion: This is a simple method to reinforce vaginal wall flaps. It could offer a durable and effective option for the treatment of SUI in patients who can not afford synthetic tapes. Long-term follow up is required to evaluate the durability of the procedure


Subject(s)
Stress, Physiological/therapy , Suburethral Slings , Urinary Incontinence
2.
Afr. j. urol. (Online) ; 16(1): 12-16, 2010.
Article in English | AIM | ID: biblio-1258080

ABSTRACT

The transobturator tape (TOT) is based on a similar principle as the tension-free vaginal tape (TVT); but introduced through the obturator foramen. The aim of this study was to compare these slings as surgical procedures for the treatment of stress urinary incontinence (SUI) in women. Patients and Methods This is a retrospective case-control study including female patients with SUI; either due to urethral hypermobility or intrinsic sphincter deficiency. Thirty patients were treated with TVT (group 1) and 30 were treated with TOT (group 2). The parameters studied were: pre-operative clinical data; operative data and surgical outcome. Results The post-operative complications in group 1 consisted of bladder perforation in one patient (3.3); urinary retention in 3 (10) and de novo urgency in 3 (10). The post-operative complications in group 2 consisted of vaginal xposure in 2 patients (6.7); de novo urgency in 2 (6.7) and transient urinary retention in one (3.3). In the TVT group; objective cure was achieved in 27/30 patients (90); while 3 patients (10) reported subjective cure; failure was not encountered. In the TOT group; objective cure was achieved in 24/30 patients (80) and subjective cure in 4 patients (13.3); and it failed in 2 patients (6.7). Conclusion TVT and TOT are effective procedures for the treatment of female SUI; with comparable results regarding operative time; hospital stay and the risk of complications


Subject(s)
Stress, Physiological/therapy , Suburethral Slings , Urinary Incontinence , Women
3.
Afr. j. urol. (Online) ; 7(2): 45-50, 2001.
Article in English | AIM | ID: biblio-1258128

ABSTRACT

Objectives To evaluate the role; safety and efficacy of endoscopic MacroplastiqueTM implants in the management of female stress incontinence. Material and Methods Between 1995 and 1999; transurethral submucosal injection of MacroplastiqueTM was performed in 68 women (mean age 58 years; range 32 - 85 years) for the treatment of genuine stress incontinence. Fourteen patients had undergone previous surgery for incontinence that had failed to correct the problem. Under general or regional anaesthesia; the Macroplastique was injected sub-mucosally 1 cm distal to the bladder neck at 3; 6 and 9 o' clock positions. In 26 cases the 12 o' clock position was chosen to ensure a good occlusion of the bladder neck. The mean volume of Macroplastique injected was 3 ml. Results At a mean follow-up of 19 months; 24 patients (35.3) were dry; 18 patients (26.5) were improved and 26 patients (38.2) were still wet. Complications were all minor. Conclusion Transurethral submucosal injection of MacroplastiqueTM should be used in women with mild to moderate stress incontinence who have failed to respond to physiotherapy. Being a minimally invasive day case procedure with low morbidity which can be repeated if necessary and has a satisfactory success rate; we believe Macroplastique implantation could be a good alternative line of treatment for stress incontinence


Subject(s)
Endoscopy , Stress, Physiological/therapy , Urinary Incontinence
4.
Article in English | AIM | ID: biblio-1264596

ABSTRACT

The main objective of the present investigation was to study the Samadhi tank; a technologically and controlled relaxation environment and its effects on the African blacks within the tropics. Other objectives were to investigate the effects of flotation in the Samadhi tank on the human of cardiovascular and cardiorespiratory systems; the body temperature; intellectual learning; relief of tension and the therapeutic response of some patients having hypertension and other painful conditions


Subject(s)
Africa , Physical Therapy Modalities , Relaxation Therapy , Stress, Physiological/therapy
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