No abstract

The male perineal sling can be an effective surgical treatment for stress incontinence in the appropriate patient. The procedure is most successful in patients with lesser objective degrees of incontinence. The Patient Global Impression of Improvement is an effective tool for assessing outcome for this population.

Aims:We assessed the utility of three self-assessment instruments: the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the post-operative Patient Global Impression of Improvement (PGI-I) score, and the International Prostate Symptom Score (IPSS) by correlating them with an objective outcome, the change in 24-hr pad weight, after a male perineal sling. Methods: Twenty-six men with urodynamically con¢rmed stress incontinence underwent a male perineal sling. Patients were evaluated pre-operatively and post-operatively with a 24-hr pad test, IPSS and ICIQ-SF. Patients also completed the PGI-I post-operatively. Changes in study parameters were compared via the paired t-test, and correlations were performed using Spearman's rho. Results: There were signi¢cant reductions in 24-hr pad weight (À274 g, P < 0.001), percentage 24-hr pad weight (54.2%), ICIQ-SF score (À6.3, P < 0.001), and the three ICIQ-SF subscores (À1.2, À1.7, À3.4 for Questions 3, 4, and 5, respectively, P < 0.001 for all). The change in total ICIQ-SF score and the post-operative PGI-I score correlated strongly with percentage reduction in 24-hr pad weight (r ¼ À0.68, P < 0.001; r ¼ À0.81, P < 0.001, respectively) and with each other (r ¼ 0.79, P < 0.001). The change in all three ICIQ-SF subscores correlated signi¢cantly with percentage reduction in 24-hr pad weight and with post-operative PGI-I score. There was no signi¢cant change in the IPSS or the voiding or storage subscores, and none correlated with any other study parameter. Conclusions: This study validates the construct validity of the ICIQ-SF and PGI-I in the assessment of treatment for male stress incontinence and should make clinicians con¢dent in comparing studies of incontinence treatment utilizing the change ICIQ-SF score, the post-operative PGI-I score, and percentage reduction in 24-hr pad weight as outcome measures.

Marine alginate fibre dressings are well established in wound management. Alginate fibres can absorb plenty of wound exudate due to their gel forming abilities and ion exchange. Alginates from bacteria have never been studied for medical applications so far, although the microbial polymer raises expectations for improved gelling capacity due to its unique O-acetylation. To prove the gelling capacity of bacterial alginate, we extracted the co-polymer from fermentation of the soil bacterium Azotobacter vinelandii ATCC 9046, cultivated on crude glycerol as an alternative carbon source. Bacterial alginate was isolated in high purity and extruded by a wet spinning method. Fibre structure and properties were characterised by infrared spectroscopy, NMR, GPC, scanning electron microscopy and tensile testing. The fibres could be processed into biocompatible needle web dressings, which showed more than twice the gel formation in saline compared to commercial dressings made of marine alginates. Gelled dressings of bacterial alginate formed stable hydrogels of sufficient shape and strength for wound healing applications. This work suggests that the increased gel formation of bacterial alginate from A. vinelandii may be optimal for the preparation of novel wound dressings.

No abstract