Porcine small intestinal submucosa implant in pubovaginal sling procedure on 48 consecutive patients: long-term results.

OBJECTIVE: The long-term efficacy of pubovaginal sling (PVS) procedure with porcine small intestinal submucosa (SIS) implant was retrospectively assessed. STUDY DESIGN: Forty-eight patients with SUI underwent a pubovaginal sling with SIS. Patient evaluation included history, physical examination with stress test and prolapse assessment by Baden-Walker classification, routine laboratory tests, 24h-pad test, and multichannel urodynamic measurement. Postoperatively the patients were classified as cured, improved and unchanged or failed. A King's Health Questionnaire (KHQ) was performed to verify post-operatively the quality of life of these patients. RESULTS: At median follow-up of 76 months 33/48 (69%) were cured, 6/48 (12%) were improved while 9/48 (19%) were failed or unchanged. No urinary retention or dyspareunia was reported and no vaginal erosion or adverse tissue reaction was detected. The descriptive statistics of KHQ scores by dimensions was done in 32/48 patients (67%). Failed or unchanged patients showed worse scores than cured and improved patients in all KHQ dimensions showing an overall overlapping between objective and subjective results although these findings are weakened due to the lack of a preoperative evaluation of QoL. CONCLUSIONS: PVS procedure using SIS cannot offer a durable option for the treatment of SUI as reported by the current mininvasive techniques.

Urinary levels of glycosaminoglycans in patients with idiopathic detrusor overactivity.

INTRODUCTION AND HYPOTHESIS: We assessed whether urinary excretion of glycosaminoglycans (GAGs) may be affected by a condition of detrusor overactivity (DO). MATERIALS AND METHODS: We evaluated 24-h urinary excretion of GAGs in 25 patients (mean age 63.81 years) with DO and in 14 healthy controls (mean age 65.75 years). No patients or controls had urinary tract infection. The excretion of GAGs was measured on the basis of total urine volume and normalized to creatinine concentration. Student's test was employed to check between the urinary excretion of GAGs in the two groups. RESULTS: The urinary content of GAGs discovered in control group was significantly higher than that in pathological group for the ratio GAGs/creatinine concentration. CONCLUSIONS: The low content of GAGs might be due to relative ischemia of the bladder wall epithelial layer following a chronically increased contractile activity of the detrusor even if further studies are needed to confirm this finding.