Outcomes of the Transobturator Tape Procedure for Elderly Women above 60 Years Old with Stress Urinary Incontinence

PUROPOSE: This study was aimed at evaluating the clinical efficacy, satisfaction and complication of patients with transobturator tape (TOT) operation for the elderly women suffering with stress urinary incontinence (SUI). MATERIAL AND METHODS: 58 women with stress urinary incontinence who underwent TOT procedure between March 2004 and June 2006 were included in this study. To assess whether outcome was influenced by the patient's age, the patients were divided into two age groups: women aged 60 years and older (n=22) and women aged less than 60 years (n=36). Preoperatively, the patients were evaluated with history taking, a physical examination, a one-hour pad test, uroflowmetry and urodynamic study. The procedure was carried out using a previously established method under local anesthesia. The post-operative symptoms and patient satisfaction were assessed by questionnaire. RESULTS: There was no significant difference between the 2 groups in terms of the success rate: cure (71.4% vs. 78.2%, p=0.746), improved (19.1% vs. 9.3%, p=0.415), and same as preoperation (9.5% vs. 12.5%, p=1.000) for above 60 years old women and less than 60 years old women, respectively. In addition, the patient satisfaction rate was not different significantly between 2 groups. De novo urge symptoms were observed in 2 women aged 60 years and older. The intraoperative complications were not found. CONCLUSIONS: TOT procedure in elderly women with SUI offers high success rate and satisfaction for operation. TOT should play a significant role in treating them, due to its safety and availability. However, we do not know how long the improvement of voiding symptoms will last, and so additional longer term follow-up should be done.

Case Review of Small Cell Carcinoma of the Urinary Bladder in Korea / 대한비뇨기과학회지

Although it is known that small cell carcinoma most commonly occurs in the lung, it may also originate outside the thorax. Primary extrapulmonary small cell carcinoma has been reported in various organs, including the pharynx, larynx, esophagus, stomach, small intestine, salivary glands, pancreas, skin, breast, cervix, vagina, kidneys, ureter, prostate and urinary bladder. Primary pure small cell neuroendocrine carcinoma of the bladder is a rare condition. It is an aggressive tumor with an average five-year survival rate of less than 10%, as cited by multiple case reports. The mean age of these patients is 67.8 years. The prognosis of small cell carcinoma of the urinary bladder is poor because its behavior is more aggressive than bladder transitional cell carcinoma. We review here 4 cases with small cell carcinoma of the urinary bladder, including our own patient who we treated.