Purpose Percutaneous vertebroplasty (PV) is a minimally invasive procedure involving the injection of bone cement within a collapsed vertebral body. Although this procedure was demonstrated to be effective in osteoporosis and metastases, few studies have been reported in cases of multiple myeloma (MM). We prospectively evaluated the safety and efficacy of PV in the treatment of vertebral compression fractures (VCFs) resulting from MM. Materials and Methods PV was performed in 106 consecutive MM patients who had back pain due to VCFs, the treatment of which had failed conservative therapies. Follow-up (28.2 ± 12.1 months) was evaluated at 7 and 15 days as well as at 1, 3, 6, 12, 18, and every 6 months after PV. Visual analog scale (VAS) pain score, opioid use, external brace support, and Oswestry Disability Index (ODI) score were recorded. Results The median pretreatment VAS score of 9 (range 4-10) significantly (P \ 0.001) decreased to 1 (range 0-9) after PV. Median pre-ODI values of 82% (range 36-89%) significantly improved to 7% (range 0-82%) (P \ 0.001). Differences in pretreatment and posttreatment use of analgesic drug were statistically significant (P \ 0.001). The majority of patients (70 of 81; 86%) did not use an external brace after PV (P \ 0.001).
The available data about the hypothesis that psychological conditions cause urinary incontinence are contradictory. This study was based on a group of patients undergoing urodynamic investigation to define the type of incontinence. Patients were submitted to a battery of psychological tests, including STAXI, CES-D and IBQ (in their Italian version). Patients suffering from urge incontinence showed higher degrees of inner anger and anger trait than those suffering from stress or mixed incontinence. Neither group showed signs of depression. The conviction of illness was greatest in patients suffering from stress or mixed incontinence, whereas irritability and general hypochondria prevailed in patients suffering from urge incontinence. Such patients tend to develop psychosomatic reactions that may contribute to the severity of their symptoms.
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