Objectives: To compare two different procedures, tension-free vaginal tape (TVT) and autologous rectus fascia sling, according to their medium-term subjective and objective outcomes and satisfaction rates in the treatment of urinary stress incontinence in women. Subjects and Methods: One hundred women with type II urinary stress incontinence were randomized to be treated with either TVT or autologous rectus fascia sling. They were evaluated by means of a cough-induced stress test, 1-hour pad test, Incontinence Impact Questionnaire (IIQ), and urodynamic study. They were reevaluated postoperatively every 6 months, and the collected data of more than 1 year’s follow-up were compared with preoperative assessments. Results: All patients completed the full 6-month postoperative assessment. However, of the 100 patients, only 61 (25 in the TVT and 36 in the sling group) were followed for more than 1 year. Mean follow-up time was 38.5 and 40 months in the TVT and sling group, respectively. Objective cure was achieved in 22 (88%) of the TVT group and in 30 (83%) of the sling group (p = 0.78) using a cough-induced stress test, and in 76 and 75% of the women in the TVT versus sling group (p = 0.83), respectively, using a 1-hour pad test. Postoperative mean IIQ scores were 44.3 (range 35.5–61.5) and 48.5 (range 38.5–69.7) in the TVT versus sling group (p = 0.46). Five (20%) and 11 (30%) of the TVT and sling group, respectively, reported some changes in the voiding pattern or posture at more than 1 year’s follow-up. Conclusion: There is no significant difference between the TVT and autologous rectus fascia sling procedures in the treatment of urinary stress incontinence at medium-term follow-up. There were changes in the voiding pattern for patients in both groups at more than 1 year postoperatively, which were not evident at early follow-up.
OBJECTIVE
To report and describe the diagnosis and treatment of female paraurethral cysts.
PATIENTS AND METHODS
Twenty‐five cases of cysts of the external female genitalia were diagnosed over a 7‐year period, using a physical examination, routine blood tests, urine analysis, abdominal ultrasonography and cysto‐urethroscopy in all. The cysts were incised, drained and marsupialized; no attempt was made to excise or remove the internal wall of the cyst and it remained in situ.
RESULTS
All patients responded to simple marsupialization, with no recurrence of the cyst.
CONCLUSION
Cysto‐urethroscopy and a limited laboratory and imaging evaluation were enough for the diagnosis.
Hem-o-lok and metallic vascular clips applied properly by trained surgeons according to published safety measures provide a safe and considerable cost-saving option for vascular control in laparoscopic nephrectomy.
Objectives: To evaluate the effect of autologous muscle-derived cells injection in the treatment of complicated stress urinary incontinence in female patients. Methods: Female patients presenting with severe and complicated stress urinary incontinence secondary to the bladder neck and/or urethral trauma or congenital epispadias (with or without exstrophy) were enrolled in this prospective study. They underwent transurethral injection of autologous muscle-derived cells. In selected cases, another injection was given after 6 months, as per the surgeon's assessment. All patients were monitored for 1 year, and the effect of autologous muscle-derived cells was evaluated by cough stress test, 1-h pad test and Incontinence Impact Questionnaireshort form score. A multichannel urodynamic study and maximum urethral closure pressure were carried out before and 12 months after the last treatment session. Cough stress test, 1-h pad test and uroflowmetry were repeated 36 months after the last injection. Severity and occurrence of complications were recorded at each visit. Results: All 10 patients who completed the study were monitored for 36 months. Three patients were cured, four had improved and three did not respond to the treatment. There was no major adverse effect related to the treatment. Conclusions: Muscle-derived cell therapy might represent a minimally-invasive and a safe procedure in the treatment of patients with severe and complicated stress urinary incontinence.
The association studies between miR-34b/c rs4938723 polymorphism and cancer risk showed conflicting results. This study aimed to assess the impact of rs4938723 polymorphism on prostate cancer risk. This case-control study was done on 151 prostate cancer (PCa) patients and 152 benign prostate hyperplasia to examine whether rs4938723 polymorphism in the promoter of pri-miR-34b/c was linked to the carcinogenesis of PCa in a sample of Iranian population. Genotyping of Pri-miR-34 b/c rs4938723 polymorphism was performed by using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method. The results showed that rs4938723 variant significantly increased the risk of PCa in codominant (OR = 1.92, 95% CI = 1.15 - 3.18, p= 0.012, TC vs TT), dominant (OR = 1.99, 95% CI = 1.23 - 3.24, p= 0.005, TC + CC vs TT), and allelic (OR = 1.79, 95% CI = 1.20 - 2.68, p= 0.005, C vs T) inheritance model. Our findings propose that Pri-miR-34 b/c rs4938723 variant may be a risk factor for the development of PCa in a sample of Iranian population. Larger sample sizes with different ethnicities are required to validate our findings.
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