ABSTRACT
OBJECTIVES: To study the effects of mini-invasive surgery using the tension-free vaginal tape (TVT) procedure and the transobturator tape (TOT) procedure in modifying clitoral blood flow in women affected by stress urinary incontinence. METHODS: The setting of the prospective open clinical study was the Urogynecologic Service of the Department of Microbiological and Gynecological Science, University of Catania School of Medicine (Catania, Italy). A total of 105 women underwent surgery; 42 (mean age 52.8 years) and 63 (mean age 53.9 years) were treated with TVT and TOT, respectively. Each woman underwent translabial color Doppler ultrasonography to measure the resistance index, pulsatility index, peak systolic velocity, and end-diastolic velocity of the clitoral arteries, before and 6 months postoperatively. RESULTS: In the TVT group, the mean pulsatility index and mean peak systolic velocity were significantly lower and the mean resistance index was significantly greater compared with the pretreatment values (P <0.5). In the TOT group, each color Doppler measurement was similar to that obtained at baseline (P = NS). CONCLUSIONS: The different vaginal approach for these two surgical methods influenced clitoral blood flow. Our data could add new information about sexual behavior after incontinence treatment, particularly the impact of clitoral blood flow changes.
Subject(s)
Clitoris/blood supply , Suburethral Slings/classification , Urinary Incontinence, Stress/surgery , Adult , Aged , Blood Flow Velocity , Clitoris/diagnostic imaging , Diastole , Female , Humans , Middle Aged , Minimally Invasive Surgical Procedures , Peripheral Nerve Injuries , Peripheral Nerves/pathology , Pilot Projects , Prospective Studies , Pulsatile Flow , Rheology , Suburethral Slings/adverse effects , Systole , Ultrasonography, Doppler, Color , Urinary Incontinence, Stress/physiopathology , Vascular ResistanceABSTRACT
OBJECTIVES: To verify whether sildenafil is effective in modifying clitoral blood flow in premenopausal women affected by type 1 diabetes. METHODS: The setting was a diabetes outpatient clinic in which 30 premenopausal women affected by type 1 diabetes treated with insulin therapy and 39 healthy premenopausal women participated in our prospective open-label clinical study. Each diabetic woman received a single oral dose of 100 mg sildenafil. Translabial color Doppler ultrasonography was used to measure the resistance index, pulsatility index, peak systolic velocity, and end-diastolic velocity of the clitoral arteries 1 and 4 hours after sildenafil intake. RESULTS: One hour after the administration of sildenafil, the mean resistance index was significantly lower and the mean pulsatility index, mean peak systolic velocity, and mean end-diastolic velocity of the clitoral arteries were significantly greater compared with baseline and 4 hours after sildenafil (P <0.05). The baseline clitoral blood flow of the diabetic women was lower compared with that of the control group (P <0.001). CONCLUSIONS: Sildenafil seems to improve the clitoral blood flow of premenopausal women with type 1 diabetes.
Subject(s)
Clitoris/blood supply , Diabetes Mellitus, Type 1/complications , Phosphodiesterase Inhibitors/administration & dosage , Piperazines/administration & dosage , Premenopause , Sexual Dysfunction, Physiological/physiopathology , Vasodilator Agents/administration & dosage , Administration, Oral , Adult , Blood Flow Velocity/drug effects , Diabetes Mellitus, Type 1/physiopathology , Female , Humans , Purines , Sexual Behavior , Sexual Dysfunction, Physiological/etiology , Sildenafil Citrate , Sulfones , Ultrasonography, Doppler , Vascular ResistanceABSTRACT
A case of successful pregnancy in a patient with complete Wolfram's syndrome is described. The diagnosis of diabetes insipidus (DI) was made during the pregnancy. The patient was the product of a consanguineous marriage. Our case is the fifth report of successful pregnancy; we underlined the importance of DI for its involvement with pregnancy.
