Vaginal Wall Sling for Female Stress Urinary Incontinence: Efficacy and Outcome Analysis

PURPOSE: The objective of this study was to assess the efficacy and clinical outcome of vaginal wall sling in the management of women with stress urinary incontinence. MATERIALS AND METHODS: A total of 37 patients with stress urinary incontinence underwent vaginal wall sling procedure by a single surgeon from January 1998 to December 2001. All patients were evaluated preoperatively with detailed history, physical examination, urinalysis, abdominal ultrasonography, Q-tip test and stress provocation test. The 4 sutures comprising vaginal wall sling (two at the level of mid-urethral complex and two at the level of bladder neck) provide a rectangle of support and compression from the bladder neck to the mid-urethra. The efficacy and clinical outcomes of this procedure were evaluated. RESULTS: With a mean follow-up of 19.2 months(5 to 46 months), 30 patients(81%) failed. Mean operation time was 63.3 minutes. Mean duration of indwelling catheter was 5.2 days and mean duration of hospitalization was 7.2 days. One patient(2.7%) suffered from prolonged voiding difficulty for 30 days. One patient(2.7%) had postoperative bleeding necessitating blood transfusion. De novo urge incontinence developed in 3 patients(8.1%). Other transient minor complications were urinary tract infection(13 cases), suprapubic discomfort(5 cases), and urgency(4 cases). CONCLUSIONS: We consider that vaginal wall sling is a simple and effective procedure for the treatment of stress urinary incontinence, though longer follow-up is necessary to assess the long term effect.

The Usefulness of Bladder Wall Thickness Measurement Using Ultrasound in Patients with Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Significant detrusor muscle hypertrophy is a well-recognized clinical finding observed benign prostate hyperplasia (BPH). This can be recognized as a bladder wall thickness (BWT) on transabdominal ultrasonography. The objective of this study was to assess the utility of a BWT measurement using ultrasound in patients with BPH. MATERIALS AND METHODS: A total of 197 men who underwent ultrasonic measurement of the BWT from August 1999 to August 2001 were enrolled in this study. Among them, 15 men comprised the normal control group, 145 men were in the symptomatic BPH group and 37 men were in the retention group. The BWT according to the clinical parameters (international prostate symptom score, peak flow rate, transverse diameter of prostate, age, duration of symptom, retention) was compared and analyzed. RESULTS: The mean BWT in the control group, BPH group and the retention group were 2.21+/-0.44mm, 3.39+/-0.87mm, 4.04+/-0.86mm, respectively. The BWT was well correlated with the international prostate symptom score (I-PSS), the peak flow rate (PFR), and age. The mean BWTs according to the I-PSS grouped into mild, moderate, and severe symptoms were 2.97 0.51mm, 3.12+/-0.68mm, 3.80+/-0.97mm, and the mean BWT according to PFR grouped into 15ml/sec were 3.65+/-0.93mm, 3.23+/-0.76mm, 2.91+/-0.58mm, respectively. The mean BWT according to age grouped into 50-59 years, 60-69 years 70-79 years, =80 years were 3.03+/-0.70, 3.47+/-0.68, 3.96+/-0.91, 4.60+/-1.25, respectively. Using the receiver operative characteristic curve (ROC curve), the cut-off BWT that can be used to distinguish the obstructive group was 3.60mm. CONCLUSIONS: The BWT can be measured noninvasively. From this study, the BWT can be a useful parameter for evaluating BPH.

A Case of Glandular Metaplasia and Primary Adenocarcinoma of the Female Urethral Diverticulum Associated with Stones / 대한비뇨기과학회지

No abstract available.