L'incontinenza urinaria della donna

L'incontinenza urinaria femminile rappresenta un problema socio assistenziale sottostimato e, per molti aspetti, irrisolto. Numerosi studi hanno messo in evidenza il notevole impatto negativo che essa ha su molti aspetti della vita della donna, tanto da condizionarne le attività quotidiane, le relazioni sociali e la vita privata, fino ad un intenso disagio psicologico ed a una profonda ripercussione sulla qualità di vit

Urinary Dysfunction Improvement after Treatment with Sativex® in a Multiple Sclerosis Patien

Nabiximols has been approved to treat multiple sclerosis-related spasticity symptoms; it also improves symptoms such as pain, urinary dysfunction and sleep disturbance. We report the case of a 43-year-old patient with multiple sclerosis who started add-on treatment with nabiximols for moderate spasticity (self-reported discomfort by the Numeric Rating Scale 6/10); she experienced a remarkable improvement in pre-existing urinary dysfunction. Nabiximols enables treatment of more spasticity-related symptoms, reducing the need for symptomatic medications and avoiding the unnecessary adverse effects produced by polytherapy

Neurologic Urinary Incontinence, Lower Urinary Tract Symptoms and Sexual Dysfunctions in Multiple Sclerosis: Expert Opinions Based on the Review of Current Evidences

Objective: To resume each specialist’s role in the management of neurologic urinary tract symptoms (nLUTS) and sexual dysfunctions (SD) in patients suffering from multiple sclerosis (MS). Material and Methods: We asked a neurologist, a urologist and a gynecologist, experts on neuro-urology and sexual dysfunction at our hospital, to resume their role in the management of nLUTS and SD in MS patients based on the review of current evidence. PubMed was used to review literature with a focus on nLUTS and SD in MS patients. Conclusions: The difference in symptomatology in MS patients is very wide. The more the CNS is involved, the more the variations and severity of nLUTS is present. SD have numerous causes and should always be assessed. Urologists play the director’s role in evaluating and treating these patients. Neurologist should play an important role, they must evaluate the potential mutual interactions between disease manifestations of MS and their treatments. Additionally, gynecologists play an important information sharing role in the management of patients with multiple sclerosis

Rectal mesh erosion after posterior vaginal kit repair

Introduction and hypothesis: The present video shows a rare case of erosion through the full rectal wall into the rectum after a transperineal implant of a double-arm polypropylene kit. Methods: A 70-year-old woman underwent a transperineal implant of a double-arm polypropylene kit. One year after surgery, she developed bothersome symptoms in the posterior perineum including heaviness, pain and rectal bleeding during defecation. A clinical examination showed the presence of a part of the prothesis traversing the rectal cavity. A minimally invasive transanal approach was performed to remove the mesh and restore the rectal integrity. Results: This surgical technique demonstrates rectal mesh removal with a transanal approach. Conclusions: To our knowledge, this is a rare complication of rectal erosion of a posterior transperineal mesh kit. The aim of this video is to show a complete transanal approach to treating this serious complication avoiding the more invasive and traumatic abdominal procedure

Is There a Role for Bladder Biopsy in the Diagnosis of Non-Hunner Lesions Interstitial Cystitis?

Introduction: Bladder pain syndrome/interstitial cystitis (BPS/IC) is either Hunner lesion interstitial cystitis (HL IC) or non-Hunner lesion interstitial cystitis (N-HL IC), differing in the presence of HLs on cystoscopy. Cystoscopy is essential in diagnosing HL but are bladder biopsies useful in N-HL IC patients? Our objective was to assess bladder biopsy in patients with N-HL IC, evaluating whether the count of mast cells (MCs) and percentage of activated MCs could measure severity. Materials and Methods: This is a single-centre retrospective study. Inclusion criteria: diagnosis of BPS/IC by ESSIC definition; absence of HLs. Each patient had three bladder biopsies. Statistical analysis: chi(2)/Fischer's exact test; Wilcoxon signed-ranks test/Mann-Whitney U test. Statistical significance: p < 0.05. Results: We separated 48 women into Group 1 with <50% of MCs activated and Group 2 with >50%. We compared the results of the O'Leary-Sant questionnaire between the two groups and did not find any correlation between the severity of the pathology and either the MC count in the detrusor or the percentage of activated MCs in the lamina propria or detrusor. Discussion/Conclusion: These findings cast doubt on the usefulness of bladder biopsy for the evaluation of severity in N-HL IC. (C) 2022 S. Karger AG, Base