Evaluation of the outcome of transobturator vaginal tape in management of stress incontinence in women

To evaluate the therapeutic results of a minimally invasive anti-incontinence operative procedure-the tension free vaginal tape [TVT]-obturator. With this prospective, observational, and consecutive patient series, TVT-obturator surgery was performed, according to de Leval [2003], on 44 patients with urodynamically proven stress urinary incontinence. Follow-up lasted 3-24 month. The demographic and therapeutic aspects of the patient group data were evaluated. The TVT-obturator required neither bladder catheterization nor intraoperative diagnostic cystoscopy. 4 patients [9.09%] with postoperative voiding difficulties had urethral bladder catheterization for 1-4 d; there were 4 cases [9.09%] of early therapeutic failure rate for the TVT-catheterization for 1-4 d; there were 4 cases [9.09%] of early therapeutic failure rate for the TVT-obturator, no postoperative field infections were noted. Use of the TVT-obturator, a novel midurethral sling, seems to reduce the incidence of some of the operative complications novel midurethral sling, seems to reduce the incidence of some of the operative complications associated with the TVT, primarily bladder penetration and postoperative outlet obstruction. The early therapeutic results and the cost-effectiveness of the TVT-obturator appear similar to those reported for common TVT surgery

Evaluation de la consommation des antibiotiques dans un h“pital universitaire Tunisien

Purpose: To estimate the consumption of antibiotics in our hospital and to determine the points at which the recommendations of good practice of antibiotherapy will be targeted. Patients and methods: Our study is a one day prevalence study where antibiotic prescriptions are analyzed by a group of 6 doctors referents in antibiotherapy. During the study day, 443 patients were studied. Means age was 44.2 +/- 23.3 years [range: 1 and 102 years]. 101 infections were diagnosed in 48 patients [10.8%]. 192 patients [43.3%] received antibiotics. Antibiotherapy was curative in 44% of cases. The most prescribed antibiotics were gentamicin [85.2 DDD/1000 patients], metronidazole [79 DDD/1000 patients], and cefotaxime [73.9 DDD/1000 patients]. According to the evaluation group, 30.7% of the antibiotic prescription was considered unjustified. The antibioprophylaxis represents the category most often unjustified [49%]. The molecules in which prescription was frequently considered unjustified are the ciprofloxacin [67%], the amoxicillin-clavulonate [40%] and the cefotaxime [40%]. Our results suggest that an action of good practice should be targeted at the antibioprophylaxis and should concern especially molecules in which prescription was frequently unjustified