Non-surgical, transurethral RF micro-remodeling is a safe treatment for women with SUI. In women with moderate to severe SUI, this novel therapy resulted in statistically significant improvement in quality of life of a magnitude associated with patient satisfaction with the treatment. Women who underwent RF micro-remodeling demonstrated a statistically significant elevation in mean LPP at 12 months.
For 92 patients who had undergone transurethral and open urologic surgery a prospective, randomized, double-blind study was done that compared the effects of ceftriaxone, a third generation cephalosporin, to placebo. The 2 groups were similar in respect to demographic characteristics. Ceftriaxone reduced significantly the incidence of postoperative infection (p less than 0.01). Of 43 patients who received ceftriaxone 2 (5 per cent) became infected compared to 15 of 49 (30 per cent) who received placebo. Patients in the placebo group who had positive postoperative urine cultures did so approximately 2 days earlier than those in the ceftriaxone group, even though the day of catheter removal averaged about 1 1/2 days later in the ceftriaxone group. There was no correlation between the incidence of fever and infection, and there was no difference between groups with regard to postoperative bleeding, or the incidence of recatheterization or rehospitalization. Average operating time, highest temperature postoperatively and number of hospital days were approximately the same in both groups. Two patients in the placebo group had serious complications and incurred approximately $11,600 in additional expenses as a result of those complications. Of these patients 1 became septic, and 1 had urinary tract and wound infections postoperatively. These data suggest that this method of antibiotic prophylaxis will not only reduce the incidence of postoperative infection in such patients, thereby reducing morbidity, mortality and hospital costs, but also may provide an additional 1 to 2 days of protection from infection for patients who require postoperative catheterization.
Transurethral radiofrequency collagen denaturation, a nonsurgical treatment for stress urinary incontinence, reduces regional dynamic tissue compliance without causing tissue necrosis or gross tissue shrinkage, unlike transvaginal radiofrequency tissue ablation. This retrospective study evaluated long-term safety and efficacy in 21 patients from a 12-month, randomized controlled trial utilizing 3-day diaries and the Incontinence Quality of Life (I-QOL) survey. Significant increases in overall I-QOL scores 3 years or more post treatment was the primary end point. Secondary end points were reductions in frequency and severity of incontinence episodes. After 3 years, mean overall I-QOL score improvement was 12.7 (+/-26); 56% of patients achieved 50% or more reduction in frequency. No new adverse events occurred. These results indicate that radiofrequency collagen denaturation is safe and provides durable efficacy.
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