Efficacy and safety of the trans-obturator tape for female stress urinary incontinence

Background: To assess the safety and efficacy of Trans-obturator tape (TVT-O) for female stress urinary incontinence (SUI).Methods: A cohort of 35 cases of SUI and underwent TVT-O procedure over a period of 4 years. Pre-operative evaluation included pelvic examination, one hour pad test, urodynamic study, urinary diary and baseline haematological tests. Post-operatively all women had post-void residual volume and were followed up for 3 years.Results: The mean age of the patients was 47±9.5 years. TVT-O alone was done in 58.1% of cases. 41.9% of cases had TVT-O done as a concomitant procedure. The median duration of follow-up was 48 months. The overall objective and subjective cure rate was 92.3% with failure rate of 7.7%, 12.9% of women reported post-operative thigh pain and 6.5% patients had immediate post-operative urinary retention. 16.1% of the patients had post-operative voiding dysfunction. No major complications were encountered in these patients.Conclusions: TVT-O is a safe, easy and effective minimally invasive procedure for female SUI with minimal acceptable complications

Prosthetic strap system for simplified ventral hernia repair. Its results in a porcine experimental model.

Abstract: Introduction Aiming to achieve a simplified ventral hernia repair, a proprietary shaped mesh was experimentally tested in the porcine model. The mesh is structured with a large central body and radiating straps. The friction of the straps passing through the tissues are hypothesized to be adequate to maintain the mesh in place during tissue ingrowth, avoiding classic point fixation while ensuring a wide coverage of the abdomen. Methods The mesh, having 6 radial straps, was placed using a sublay preperitoneal technique in 4 pigs. All straps were passed laterally through the abdominal wall and exteriorized from the skin. The straps were trimmed at the level of the skin, allowing the stumps to recoil into the subcutaneous space. The animal were euthanized at 1 and 4 months to determine the integration of the straps. Results Macroscopically all 24 straps were firmly incorporated within the abdominal wall. The tension free placement of the mesh by using the straps was effective. The friction of the straps passing through the tissues was adequate to keep the mesh well orientated. No dislocation of the implants was observed. The strap system also allowed a broader coverage of the abdominal wall, far beyond the wound opening. Conclusions The described arm system of the described implant seems to be effective in eliminating point fixation of the mesh. The fixation arms seemed to have ensured the mesh stayed orientated in all animals. A very wide lateral mesh placement was accomplished, assuring sufficient defect overlap when shrinkage occurs

Сравнительный анализ послеоперационных осложнений свободной синтетической петли в лечении недержания мочи при напряжении у женщин

Резюме. Цель исследования: анализ интпраоперационных и послеоперационных осложнений использования свободной синтетической петли (TVT, TVT-О) при лечении недержания мочи у женщин в зависимости от хирургического доступа. Материалы и методы: в клинике кафедры урологии МГМСУ прооперировано 504 пациентки с использованием свободной синтетической петли, среди которых были выделены две группы. В первую группу вошли 207 больных, которым выполнялась операция TVT. Вторую группу составили 109 пациенток, которым выполнялась операция TVT-О. Результаты: частота перфорации мочевого пузыря составила 0.48% (1/207) для TVT и не наблюдалась во второй группе пациенток (р=0.467). Количество тазовых гематом при позадилонном доступе составило 2.9% (6/207), а при транс обтураторном - 0.92% (1/109, р=0,255). Вновь возникшие императивные симптомы: в группе 1 - 2.9% (6/207), в группе 2 - 1.83% (2/109, р=0,567). Заключение: Исследование показало: не существует статистически достоверной разницы в частоте осложнений операций TVT и TVT-0

Laparoskopska parcijalna adrenalektomija: serija slučajeva

The aim is to present our case series documenting indications, laparoscopic technique, surgical and endocrinologic outcomes of laparoscopic partial adrenalectomy. In the period from April 2011 until October 2021, we performed 39 procedures. The patients were divided into three groups: unilateral adrenal gland tumor with a normal contralateral gland (group 1), tumor of the solitary adrenal gland (group 2), and adrenal cysts (group 3). There were 20 patients in group 1, 6 patients in group 2, and 13 patients in group 3. The most common histology in group 1 was adenoma (40%), all tumors in group 2 were renal cell carcinoma metastases, and all cysts in group 3 were benign. There were no major complications (Clavien Dindo grade ≥2) in the whole cohort. All patients in groups 1 and 3 had favorable endocrinologic outcomes, and 50% of group 2 patients required lifelong hydrocortisone replacement therapy. The procedure is safe and feasible with favorable outcomes in the hands of a high volume adrenal surgeon.Cilj je predstaviti našu seriju slučajeva koja dokumentira indikacije, laparoskopsku tehniku, kirurške i endokrinološke ishode laparoskopske parcijalne adrenalektomije (LPA). U razdoblju od travnja 2011. do listopada 2021. godine učinili smo 39 zahvata. Bolesnici su podijeljeni u tri skupine: jednostrani tumor nadbubrežne žlijezde s normalnom kontralateralnom žlijezdom (skupina 1.), tumor solitarne nadbubrežne žlijezde (skupina 2.) i ciste nadbubrežne žlijezde (skupina 3.). U skupini 1. bilo je 20, u skupini 2. šest i u skupini 3. trinaest bolesnika. Najčešća patohistološka dijagnoza u skupini 1. bio je adenom (40%), svi tumori u skupini 2. bili su metastaze karcinoma bubrega, a sve ciste u skupini 3. su bile benigne. U cijeloj kohorti nije bilo značajnijih komplikacija (Clavien Dindov stupanj ≥2). Svi bolesnici u skupinama 1. i 3. imali su povoljan endokrinološki ishod, a 50% bolesnika u skupini 2. zahtijevalo je doživotnu nadomjesnu terapiju hidrokortizonom. LPA je učinkovit i siguran zahvat s povoljnim ishodima u rukama urologa s iskustvom u kirurgiji nadbubrežne žlijezde

Un polytechnicien et la belle époque de la carte postale

Depuis fort longtemps, les Grandes Ecoles françaises (et en particulier Polytechnique, Centrale, Saint-Cyr et les Arts et Métiers) ont été l’objet de l’attention de l’opinion et de la presse. S’agissant de la « Poule aux œufs d’or », comme disait Napoléon, on peut légitimement s’extasier de tout ce qu’un collectionneur de « vieux papiers » peut retrouver sur l’Ecole Polytechnique : livres, articles dans les journaux, plaquettes diverses, etc.. A toutes les époques, la presse a rédigé des text..

Neoajuvant Chemotherapy with Gemcitabine and Cisplatin Plus S-1 for Primary Female Urethral Adenocarcinoma

A 67-year-old female presented for evaluation of a left inguinal mass. Contrast-enhanced computed tomography revealed a tumor surrounding the urethra. Magnetic resonance imaging showed that the tumor had invaded the bladder neck on the anterior aspect of the urethra. The serum carbohydrate antigen 19-9 level was elevated. The clinical diagnosis was a primary adenocarcinoma of the female urethra (cT4N2M0). The initial treatment consisted of gemcitabine plus cisplatin (GC) and oral fluoropyrimidine (S-1). A total cysto-urethrectomy with anterior vaginal wall resection, pelvic and inguinal lymphadenectomy, and urinary diversion with ileal conduit formation were performed. The final diagnosis was urethral adenocarcinoma (ypT4ypN2, stage IV). Twelve months post-operatively, there was no evidence of recurrence or distant metastases