ABSTRACT
PURPOSE: We studied the voiding dysfunction after surgical treatment of female stress urinary incontinence and diagnosis and treatment. MATERIALS AND METHODS: Three hundred women with stress urinary incontinence underwent surgical procedure between January 1998 and December 2004. Ninety two patients(30.6%) experienced the postoperative voiding dysfunction. As the primary procedure for the management of postoperative voiding dysfunction alpha-blockers medication and clean intermittent catheterization(CIC) were performed. Then, hegar dilation and urethral pull-down procedure were performed as a secondary measure. For the patients who showed persistent obstructed symptoms, cutting of mesh or sling materials were performed. RESULTS: In 57 patients, symptoms improved by alpha-blockers medication and CIC. The others were received hegar dilation and urethral pull-down procedure, and 29 patients were improved. 6 patients were not controlled by conservative treatment, of which 3 patients underwent cutting of mesh or sling. De novo urgency was developed in 12 patients. Anticholinergics were taken, symptoms were diminished in 10 patients after 5 months of medication. CONCLUSION: Most voiding dysfunction after surgery may be effectively managed by conservative treatment. In cases of failure, hegar dilation and urethral pull-down procedure may be useful within postoperative first weak. Finally, cutting of mesh or sling must be considered in patient whose the secondary measure is failed.
Subject(s)
Female , Humans , Cholinergic Antagonists , Diagnosis , Urinary IncontinenceABSTRACT
PROPOSE: A specific criterion or comprehensive criteria for the condition of nocturnal erection, which can be considered as an abnormal erection mechanism or organic erectile dysfunction(ED), remain to be established. Thus, it was decided to verify the tenability of the currently referred criteria by performing nocturnal erection tests on volunteers with normal sexual cravings and erection capabilities. MATERIALS AND METHODS: This study was performed on 58 volunteers aged 20 years or older, with a normal sexual life and without past perversion. An IIEF questionnaire was used for verification of normalcy. Only the results from the volunteers who had had more than 4 sexual intercourses during the past 4 weeks, and had attained satisfaction, were reflected in the final report. All subjects completed three sessions of 3 nights of recording using the RigiScan device during the 3 day period. The volunteers were excluded if they woke due to the pressure of the ring or when they had less than 6 hours sleep during the test. RESULTS: The average number and period of erections were 3.7+/-1.7 times and 91+/-53.3 minutes and the average hardness of the distal part and base of the penis were 61+/-25.1 and 73.7+/-22.1% respectively. The average number of erections and maintained duration were 3.7 and 91 minutes, respectively. With more than 40% hardness, the distal part and base of the penis stayed erect for 62.3+/-37.0 and 74.1+/-46.5 minutes, while these figures for an erection were 57.7+/-35.7 and 72.8+/-46.3 minutes, respectively, as confirmed by greater than 60% hardness. Therefore, 56 of the 58(96.5%) failed to satisfy more than one of the criteria and 44(75.8%) did not meet the Brandley's nocturnal erection criterion standard. CONCLUSIONS: Our results were below the criteria for the existing erection test, which means there is the likelihood that these standards are overly high for Korean adult males. Apparently not all cases failing to reach the existing standard level of the nocturnal erection test should be considered as ED, with greater discretion required in the diagnosis for patients with ED.