RESUMO
INTRODUCTION: The primary aim of this study was to evaluate the results of midurethral sling (MUS) removal in women who have pain as their single complication of MUS. MATERIAL AND METHODS: We performed a retrospective chart study supplemented with a cross sectional questionnaire. Women who underwent MUS removal for pain as the solitary reason for removal between 2004 and 2018 were included. Primary outcome was change in pain levels assessed by the visual analogue scale (VAS) pain score (range 0-10). Secondary outcome was the recurrence of stress urinary incontinence (SUI). RESULTS: Twenty-six of 31 patients returned the questionnaire. Median medical file follow-up was 12 months (range 2-66) and 25 months (range 5-104) regarding questionnaires. VAS pain score dropped from 7.8 (SD 1.9) at baseline to 4.5 (SD 3.2) at follow-up (p <.00). Seven (23%) patients were pain-free. Patients undergoing partial vaginal resection (n = 6) had a VAS pain score decrease of 4.7 (p = .02) versus 2.7 (p = .02) for complete vaginal removal (n = 14). Twenty-three (89%) patients experienced SUI at follow-up, whereof 10 (45%) reported (almost) no incidents of SUI. CONCLUSIONS: MUS removal is a viable and safe option with a significant drop in VAS pain score in patients with chronic pain after MUS placement. A post-operative increase of SUI and a possible renewed wish for SUI treatment have to be considered. This should not be a reason to refrain from information and/or referral for surgical removal.
RESUMO
INTRODUCTION: Prostate growth and androgenic alopecia are both under the influence of dihydrotestosterone. Dihydrotestosterone can make prostates larger and men balder. Therefore, we assessed the association of men suffering from lower urinary tract symptoms and androgenic alopecia. MATERIAL AND METHODS: We enrolled 177 subjects which underwent a Green Light Laser Vaporization Procedure of the prostate between 2006 and 2017. We identified two groups of males with different levels of androgenic alopecia, classified according to the Norwood-Hamilton scale, which we compared in this study. lower urinary tract symptoms were evaluated using the International Prostate Symptom Score questionnaire. Other parameters included demographics, urodynamics, prostate volume and prostate-specific antigen. RESULTS: Mean patient age was 68 (47-87) years. Mean International Prostate Symptom Score was 20 (1-35). 59.3% of subjects were classified as bald using the Norwood-Hamilton scale (androgenic alopecia score). Mean prostate size (range) was 77.5 ml (21-245), mean Qmax was 9 ml/s (1-25), and mean PSA was 4.7 ng/ml (0.3-39). The androgenic alopecia score correlated with none of the other parameters. PSA and prostate volume correlated with the Schäfer obstruction classification. Qmax correlated with the Schäfer classification and International Prostate Symptom Score. International Prostate Symptom Score correlated with QoL. Schäfer classification correlated with PSA, prostate volume, Qmax and age. CONCLUSIONS: As expected, various lower urinary tract symptoms parameters in our study correlated with each other. However, no correlation was found between the androgenic alopecia score and LUTS or prostate volume. This score cannot be used to estimate prostate size.
