TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study

Objectives: The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI)

Female pelvic organ prolapse (POP) surgery. Results at 24-month follow-up

Background: PROLIFT (anterior, posterior, total) is a type of the surgical procedure during which synthetic implants are used. PROLIFT procedure involves the use of porous, non-absorbable polypropylene mesh and fixation of the uterine fascia and its ligaments. The aim of this study: to evaluate the efficacy, outcomes and complications of the PROLIFT procedure and evaluate the changes in the patients sexual function (before and after surgery). Material and methods: a prospective study based on observation of clinical outcomes of the PROLIFT procedure performed by one surgeon during the period of 4 years (01/05/2008 -01/05/2012). Patients were observed and examined after 3, 6, 12 and 24 months. Our studied women responded to the FSFI questionnaire and special 4 questions before and after surgery about quality of their sexual life. Results: Analysis of 51 PROLIFT procedures was performed. Mean age of women – 52.19 years. All women reported having active sexual life. 70.6% of women were menopausal. The mean number of births – 2.21. The following factors for POP were distinguished: birth weight over 4kg in 37 cases (72.5%), BMI above 30kg/m2 (37.3%) in 19 women, and manual work was reported by 8 women (15.7%). Three types of the PROLIFT procedures were carried out: anterior – for 45 women (88.2%), posterior - 5 women (9.8%) and total - 1 woman (2%). PROLIFT procedure was combined with colpoperineoplasty in 45 cases (88.2%), with amputation of the uterine cervix in 5 cases (9.8%), and in 1 case (2%) with TVT operation. Spinal anesthesia was administered in 43 cases (84.3%), general anesthesia - in 6 cases, (11.8%) and in 2 cases (3.9%) - intravenous anesthesia. Mean PROLIFT procedure time – 43.2 minutes. Mean hospital stay – 2.7 days. Mean amount of blood loss during procedure - 131ml. Efficacy of the procedure was evaluated after 24 months and showed a 98.0% success rate. There was 1 case of recurrence (2%), thus the procedure was repeated. Conclusions: PROLIFT procedure as minimally invasive surgical treatment for POP is shown to be effective in 98.0 % of cases after 24 months. With aging and pelvic organ prolapse stage, a number of early complications increases. Women have significantly better sexual life after PROLIFT procedure

Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome

Prostatitis is the most commonly diagnosed disease in men younger than 50 years and accounts for about 8% of all urologists’ consultations

Surgical treatment of female pelvic organ prolapse at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine

Objective. To compare surgical methods, complications, and outcomes in the treatment of female pelvic organ prolapse at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine, and to disclose the risk factors that influence female pelvic organ prolapse. Material and methods. A retrospective analysis of surgeries for pelvic organ prolapse performed during the period of 2003–2007 was carried out. A total 823 women were operated on for pelvic organ prolapse. Results. During 2003–2007, 823 surgical procedures for the correction of female pelvic organ prolapse were performed at the Clinic of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine. Eighty (9.7%) patients underwent vaginal hysterectomy; 372 (45.3%), vaginal plastic operations (out of them, 23 were combined with TVT and 47 with TVT-O procedure); 360 (43.7%), vaginal hysterectomy with vaginal plastic surgeries; and 11 (1.3%), Prolift operations. The mean age of females was 62 years. Mean blood loss during operations was 162.1 mL. Patients undergoing vaginal plastic operations lost significantly less blood than those undergoing vaginal hysterectomy or combined operations (P<0.05). Mean time in surgery was 60.3 min. The duration of Prolift operations and vaginal plastic operations was significantly shorter than that of vaginal hysterectomy or combined procedures (vaginal hysterectomy + vaginal plastic surgery) (P<0.05). Mean hospital stay was 8.1 days. Hospital stay after vaginal plastic operations was significantly shorter than after vaginal hysterectomy or combined operations. The shortest hospital stay was after Prolift operation (P<0.05). Complications were related to the type of operation performed. Conclusions. The most common operations in the surgical treatment of female pelvic organ prolapse were vaginal plastic operations and combined operations. The shortest time in surgery and lowest blood loss was in case of vaginal plastic operations. The shortest hospital stay was after Prolift operations. The highest rate of complications was observed in patients who underwent vaginal hysterectomies, the lowest – after Prolift operations

Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome

Background Prostatitis is the most commonly diagnosed disease in men younger than 50 years and accounts for about 8% of all urologists’ consultations. Objective After evaluating clinical trials and demonstrating the efficacy of chronic non-bacterial prostatitis treatment, it remains of clinical importance to continue studies on the use of low-energy extracorporeal shock wave therapy (ESWT) in men. Materials and methods From May 2017 to April 2018, 40 patients with chronic prostatitis (CP) type IIIB/chronic pelvic pain syndrome (CPPS) were enrolled in the study. The patients underwent ESWT once a week for 4 weeks. Results The mean age of the patients was 47.8 years. A statistically significant improvement in all the parameters, i.e., the International Prostate Symptom Score (IPSS), the visual analogue scale (VAS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and the International Index of Erectile Function (IIEF), was observed at week 4. The effect of the treatment was maintained during the entire 12-week period. The NIH-CPSI total score showed the best improvement at week 4, but a slight deterioration without a statistically significant change was noticed at week 12. The greatest improvement at week 4 was documented for the NIH-CPSI and IPSS (43% and 37%, respectively). At week 12, an improvement of 52% and 39% was recorded for VAS and IPSS, respectively. Conclusions Our findings confirmed the effectiveness and safety of ESWT in resistant cases of CPPS in the short term. ESWT is cost-effective, which takes little time or requires a small amount of staff, and is easily conducted

Affective Symptoms and Health-Related Quality of Life Among Women with Stress Urinary Incontinence: Cross-Sectional Study

Purpose: To evaluate the relationship between affective symptoms, clinical variables of uro-gynaecological history and health-related quality of life (QoL) among women with stress urinary incontinence (SUI) in comparison to healthy controls