31 research outputs found
Sacrifice and Its Spiritualization In The Christian and Hindu Traditions: A Study In Comparative Theology
Ballons ACT chez la femme : évolution de l’efficacité au cours des 24 mois suivant l’implantation
International audienceTo analyze the functional outcomes over time of ACT balloon in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD).4
Muscarinic receptor expression in spinal cord transected rats with early anticholinergic treatment
Quality of life associated with orthotopic neobladder and ileal conduit in women: A multicentric cross-sectional study
FUNCTIONAL RESULTS OF 3.5 CM CUFFS COMPARED TO LARGER CUFFS IN MEN WITH AN ARTIFICIAL URINARY SPHINCTER
Vie r\ue9elle apr\ue8s l\u2019implantation d\u2019une neuromodulation sacr\ue9e : taux, raisons et facteurs de risque d\u2019interruption du suivi \ue0 mi-parcours
Abstract: Objectives. - To evaluate follow-up after implantation of a sacral nerve modulation implantable pulse generator (IPG) and to investigate the reasons and risk factors for follow-up discontinuation. Materials and methods. - All patients who underwent an IPG implantation to treat lower urinary tract symptoms between 2014-2019 within 6 hospital centers located in the district of "Hauts-de-France" (France) were systematically called during the year 2020 for a standardized (tele)consultation. Patients were divided into 3 distinct profiles according to the regularity of their 5-year postoperative follow-up: "Regular follow-up", "Irregular follow-up" and "Lost to follow-up". The primary outcome was the change in the annual proportion of the 3 follow-up profiles over the 5 years following IPG implantation. As secondary outcomes we described the reasons reported for follow-up discontinuation and looked for risk factors associated with. Results. - Overall, 259 patients were included. At the time of data collection, after a mean follow-up of 28.4 (+/- 19.8) months, 139 patients (53.7%) had a "Regular follow-up", 54 (20.8%) had an "Irregular follow-up" and 66 (25.5%) were "Lost to follow-up". The proportion of patients with a "Regular follow-up" decreased year by year, representing only 46.2% of patients at five-years. 175 patients (67.6%) underwent a standardized (tele)consultation. In multivariate analysis, only "lack of knowledge of the follow-up protocol" was statistically associated with follow-up discontinuation (OR = 5.16; 95% CI [2.12-13.57]). Conclusion. - The proportion of patients followed up after IPG implantation decreased steadily over the years, often related to a lack of therapeutic education. Level of evidence.- 4. (c) 2023 Elsevier Masson SAS. All rights reserved
Intérêt de la toxine botulinique A dans le traitement des troubles pelvi-périnéaux de la personne âgée
International audienceThe present article is the final report of a multi-disciplinary meeting supported by the GRAPPPA (group for research applied to pelvic floor dysfunctions in the elderly). The objective was to conduct a comprehensive review on the role of botulinum toxin A (BonTA) in the treatment of pelvic floor dysfunctions in the elderly.Methods: The present article, written as a comprehensive review of the literature, combines data issued from the scientific literature with expert's opinions. Review of the literature was performed using the online bibliographic database MedLine (National Library of Medicine). Regarding intra-detrusor BonTA injections, only articles focusing on elderly patients (>65 yo) were included. Regarding other localizations, given the limited number of data, all articles reporting outcomes of BonTA were included, regardless of studies population age. In case of missing or insufficient data, expert's opinions were formulated.Results: Although, available data are lacking in this specific population, it appears that BonTA could be used in the non-fraily elderly patients to treat overactive bladder or even neurogenic detrusor overactivity, with a success rate comparable to younger population at 3 months (88.9% vs. 91.2%), 6 months (49.4% vs. 52.1%) and 12 months (23.1% vs. 22.3%), as well as a significant decrease in number of voids per day (11.4 vs. 5.29 P<0.001) and in the number of pads per day (4.0 vs. 1.3, P<0.01). Furthermore, BonTA is likely to be offered in the future as a treatment of fecal incontinence and obstructed defecation syndrome symptoms. Concerning bladder outlet obstruction/voiding dysfunction symptoms, intra-urethral sphincter BonTA should not be recommended.Conclusion: BonTA injections are of interest in the management of various pelvic floor dysfunctions in the elderly, and its various applications should be better evaluated in this specific population in order to further determine its safety and efficacy
Implantation robot-assistée du sphincter artificiel urinaire AMS-800 chez la femme : une série multicentrique internationale de 125 patientes
International audienceObjectifsLa voie robot-assistée a récemment été décrite pour l’implantation du sphincter artificiel urinaire (SAU) chez la femme pour tenter de diminuer la morbidité périopératoire. L’objectif de cette étude était de rapporter les résultats périopératoires et fonctionnelles de la première série multicentrique internationale de sphincter artificiel urinaire robot-assistée.MéthodesToutes les patientes ayant eu une implantation robot-assistée d’un SAU en utilisant une technique standardisée (voie antérieure) entre 2013 et 2020 dans quinze institutions européennes ont été incluses dans une étude rétrospective. L’indication du SAU était une incontinence urinaire d’effort par insuffisance sphinctérienne définie comme la combinaison d’une faible pression de clôture urétrale et un urètre peu mobile/figé. Le principal critère d’évaluation était le résultat fonctionnel classé comme sec (aucune protection), amélioré ou inchangé.RésultatsCent vingt-cinq patientes ont été incluses. Les caractéristiques des patientes sont résumées dans le Tableau 1. Il y a eu 20 complications peropératoires (16 %) : 12 plaies du col vésical et huit plaie vaginales. Dans un cas de plaies multiples du col vésical, l’intervention a été interrompue mais elle a été poursuivie dans tous les autres cas. Vingt-deux patientes ont eu une complication postopératoire (17,6 %) mais seulement quatre étaient Clavien ≥ 3 (3,2 %) : trois explantations précoces (2 pour érosion vaginale et une pour infection) et une réintervention pour fistule vésicale. Après un suivi moyen de 13 mois, il y a eu 7 explantations (4,1 %) : les 3 précoces rapportées ci-dessus, une pour rétention chronique d’urine et trois pour érosions tardives (2 vaginales et une urétrale). Au dernier suivi, 101 patientes étaient sèches (80,8 %), 11 étaient améliorées (8,8 %) et 13 étaient inchangées (10,4 %).ConclusionCette série est la première série multicentrique internationale évaluant les Résultats de l’implantation du SAU chez la femme par voie robot-assistée selon une technique standardisée. Cette étude confirme les résultats périopératoires et fonctionnels prometteurs rapportés dans les précédentes séries