Surgical Outcomes after Distal Suburethral Sling Procedures for Stress Urinary Incontinence in Aged Patients

PURPOSE: There are few reports describing objective and subjective outcomes in aged patients undergoing distal urethral polypropylene sling (DUPS) and canal transobturator tape (canal TOT) placement, which make the submucosal mesh 'tension-free' state in the operating room. We evaluated surgical outcomes and subjective satisfaction in patients over 70 years of age who underwent DUPS and canal TOT for the treatment of stress urinary incontinence (SUI). MATERIALS AND METHODS: We studied 29 consecutive patients over 70 years of age who underwent DUPS and canal TOT for genuine SUI between January 2006 and April 2008. Surgical outcomes were determined on the basis of hemoglobin change, operative time, hospital stay, and complications. Subjective satisfaction was determined on the basis of disease-specific quality of life, measured via the Incontinence Impact Questionnaire-short form (IIQ-7) and the Urogenital Distress Inventory-short form (UDI-6). RESULTS: No intraoperative or major postoperative complications were reported. No concomitant procedures were performed, including cystocele repair (n=0) or rectocele repair (n=0). The mean IIQ-7 and UDI-6 scores both decreased significantly after DUPS and canal TOT. Moreover, 82% of patients reported no SUI symptoms under any circumstances, and 91% of patients reported being rarely or never bothered by SUI symptoms. CONCLUSIONS: The surgical outcomes and subjective satisfaction seen with DUPS and canal TOT in this study were superior to those seen in other studies. However, it is possible that this study overestimated the effects of DUPS and canal TOT in aged women because of the small study sample. Therefore, additional studies are needed.

Postpartum Emphysematous Cystitis after Casarean Section

Emphysematous cystitis is a rare infectious condition of the urinary bladder. Underlying diabetes mellitus is present in over half of reported cases with women being affected twice as often as men. It also occurs in alcoholism, undernutrition, radiating and immunosuppressive treatments. We present a case of postpartum emphysematous cystitis after Casarean section (C-sec) in a young female without underlying disease.