Long-term Outcomes of Tension-free Vaginal Tape Procedure for Treatment of Female Stress Urinary Incontinence with Intrinsic Sphincter Deficiency

Purpose To assess the long-term outcomes of tension-free vaginal tape (TVT) for stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD) and to identify influencing factors for failure in these cases. Methods A total of 136 women who underwent TVT procedures with minimum follow-up duration of 3 years were included in the study. Patients were divided into two groups (non-ISD and ISD groups) based on preoperative urodynamic studies. Patient outcomes were assessed from retrospective chart review and telephone research. Cure was defined as the subjective resolution of SUI in any circumstances. Improvement was defined as the subjective improvement of SUI without complete resolution. Failure was defined as the subjective lack of improvement of SUI. Patients in ISD group were subdivided into two subgroups (cure and non-cure groups) and were compared to identify influencing factors for TVT procedure failure. Results Eighty-nine patients were in non-ISD group, and 47 in ISD group. The mean follow-up durations were 50.3±9.2 and 49.7±9.7 months, respectively. Subjective cure rate was 75.3% for non-ISD group, and 76.7% for ISD group (P>0.05). Improvement rate was 6.7% for non-ISD group, and 2.1% for ISD group (P>0.05). Satisfaction scores was 3.8±1.2 points in the non-ISD group, and 3.5±1.2 points in ISD group (P>0.05). In ISD subgroups, VLPP was 41.9±12.0 cmH2O for non-cure group, and 50.5±8.6 cmH2O for cure group, and was the only factor that showed significant statistical difference between the two subgroups (P=0.011). Conclusions With our long-term results, TVT is an effective treatment even in women with ISD. However, ISD patients with low VLPP should be counseled carefully about TVT outcome

The One Year Outcome after KTP Laser Vaporization of the Prostate According to the Calculated Vaporized Volume

The aim of this study was to develop a new simple method for measuring the vaporized volume and to evaluate the outcome of high-power potassium-titanyl-phosphate (KTP) photoselective laser vaporization. A total of 65 patients, with a mean age of 67.7 yr (range 53 to 85), were included in the primary analysis. The vaporized volume was calculated as the pre-operative volume minus the immediate post-operative volume plus the volume of the defect. For all patients, the subjective and objective parameters improved significantly after surgery. Six and 12 months after surgery, the group with a smaller vaporized volume (<15 g) had a lower reduction of the mean International Prostate Symptom Score (P=0.006 and P=0.004) and quality of life index (P=0.006 and P=0.004) when compared to the group with a greater vaporized volume (≥15 g). There were no differences in the change of the maximum flow rate and post-void residual based on the vaporized volume. Our findings suggest that the subjective improvement, after a high-power KTP laser vaporization, may be dependent on the vaporized volume obtained after the procedure

Impact of Prostate Volume on the Efficacy of High-Power Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate: A Retrospective, Short-Term Follow-Up Study on Evaluating Feasibility and Safety

Purpose: We determined the impact of prostate volume on the efficacy of the high-power (80 W) potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate in men with lower urinary tract symptoms (LUTS). Materials and Methods: Patients were stratified into 3 groups according to prostate volume: `<40 g` (n = 49) and `40-59 g` (n = 49) and 60 g` (n = 22). Median follow-up was 9 months (range 6 to 21). Results: No differences in age and follow-up duration were observed in the three groups. At baseline, no significant differences were noted in the three groups in terms of the International Prostate Symptom Score (IPSS) (21.4, 19.4 and 19.1; p = 0.412) as well as the maximum flow rate (Qmax) (10.2, 9.2, and 8.6 mL/s; p = 0.291) and post-void residual (PVR) (66.2, 80.4, and 71.5 mL; p = 0.856). The mean operative times were 30.9, 46.9, and 58.6 minutes (p < 0.001) and total median energy deliveries for each group were 62.3, 97.6, and 135.9 kJ, respectively (p < 0.001). No severe intraoperative complication was observed. At the last follow-up, these parameters improved significantly regardless of prostate volume, and the IPSS (11.1, 9.4, and 12.3; p = 0.286) as well as Qmax (15.9, 15.9, and 14.2 mL/s; p = 0.690) and PVR (33.7, 28.4, and 14.2 mL; p = 0.395) were not significantly different among the groups. Conclusion: Although a larger prostate requires more time and energy delivery, photoselective laser vaporization of the prostate is safe and efficacious for patients with LUTS regardless of prostate volume.Spaliviero M, 2008, J ENDOUROL, V22, P2341, DOI 10.1089/end.2008.9708Rieken M, 2010, WORLD J UROL, V28, P53, DOI 10.1007/s00345-009-0504-zNaspro R, 2009, EUR UROL, V55, P1345, DOI 10.1016/j.eururo.2009.03.070Lee R, 2008, J UROLOGY, V180, P1551, DOI 10.1016/j.juro.2008.06.002Du CJ, 2008, J ENDOUROL, V22, P1031, DOI 10.1089/end.2007.0262Paick JS, 2007, J SEX MED, V4, P1701, DOI 10.1111/j.1743-6109.2007.00574.xMonoski MA, 2006, UROLOGY, V68, P312, DOI 10.1016/j.urology.2006.02.020Bouchier-Hayes DM, 2006, J ENDOUROL, V20, P580Te AE, 2006, BJU INT, V97, P1229, DOI 10.1111/j.1464-410X.2006.06197.xKrambeck AE, 2010, J ENDOUROL, V24, P433, DOI 10.1089/end.2009.0147Fu WJ, 2006, ASIAN J ANDROL, V8, P367, DOI 10.1111/j.1745-7262.2006.00134.xBarber NJ, 2006, UROLOGY, V67, P80, DOI 10.1016/j.urology.2005.07.028Bachmann A, 2005, EUR UROL, V48, P965, DOI 10.1016/j.eururo.2005.07.001Sandhu JS, 2005, J ENDOUROL, V19, P1196Sarica K, 2005, J ENDOUROL, V19, P1199Malek RS, 2005, J UROLOGY, V174, P1344, DOI 10.1097/01.ju.0000173913.41401.67Volkan T, 2005, EUR UROL, V48, P608, DOI 10.1016/j.eururo.2005.07.013Bachmann A, 2005, EUR UROL, V47, P798, DOI 10.1016/j.eururo.2005.02.003Kumar SM, 2005, J UROLOGY, V173, P511, DOI 10.1097/01.ju.0000150099.31289.d7Reich O, 2005, J UROLOGY, V173, P158, DOI 10.1097/01.ju.0000146631.14200.d4Sandhu JS, 2004, UROLOGY, V64, P1155Sulser T, 2004, J ENDOUROL, V18, P976Te AE, 2004, J UROLOGY, V172, P1404, DOI 10.1097/01.ju.0000139541.68542.f6Reich O, 2004, J UROLOGY, V171, P2502, DOI 10.1097/01.ju.0000128803.04158.76Hai MA, 2003, J ENDOUROL, V17, P93Shingleton WB, 1999, UROLOGY, V54, P1017Shingleton WB, 1998, SCAND J UROL NEPHROL, V32, P266Kuntzman RS, 1997, UROLOGY, V49, P703Kuntzman RS, 1996, UROLOGY, V48, P575

Segmental resection of distal ureter with termino-terminal ureteral anastomosis vs bladder cuff removal and ureteral re-implantation for upper tract urothelial carcinoma: results of a multicentre study

22To compare overall (OS), cancer-specific (CSS), recurrence free survival (RFS) and post-operative renal function among patients affected by upper tract urothelial carcinoma (UTUC) of the distal (lower lumbar and pelvic) ureter, electively treated with segmental resection and termino-terminal anastomosis (TT) vs bladder cuff removal and ureteral re-implantation (RR).partially_openembargoed_20200203Abrate, Alberto; Sessa, Francesco; Sebastianelli, Arcangelo; Preto, Mirko; Olivero, Alberto; Varca, Virginia; Benelli, Andrea; Campi, Riccardo; Sessa, Maurizio; Pavone, Carlo; Serretta, Vincenzo; Vella, Marco; Brunocilla, Eugenio; Serni, Sergio; Trombetta, Carlo; Terrone, Carlo; Gregori, Andrea; Lissiani, Andrea; Gontero, Paolo; Schiavina, Riccardo; Gacci, Mauro; Simonato, AlchiedeAbrate, Alberto; Sessa, Francesco; Sebastianelli, Arcangelo; Preto, Mirko; Olivero, Alberto; Varca, Virginia; Benelli, Andrea; Campi, Riccardo; Sessa, Maurizio; Pavone, Carlo; Serretta, Vincenzo; Vella, Marco; Brunocilla, Eugenio; Serni, Sergio; Trombetta, Carlo; Terrone, Carlo; Gregori, Andrea; Lissiani, Andrea; Gontero, Paolo; Schiavina, Riccardo; Gacci, Mauro; Simonato, Alchied