An exploration into patient preference for injectable therapy over surgery in the treatment of female urinary incontinence

Petrou, Steven; Lisson, Scott W.; Crook, Julia E.; Lightner, Deborah J.

doi:10.1590/s1677-55382006000500014

Cited by 12 publications

(13 citation statements)

References 3 publications

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“…The authors do clearly hi-light the safety and tolerability of this procedure and denote that radiofrequency micro remodeling clearly responds to the incontinent patients who will settle for improvement as opposed to cure in a trade-off for having a minimally invasive procedure. Similar patient desires with regards to injectable therapy have been noted in this journal (2).…”

Section: Editorial Commentsupporting

confidence: 74%

Neurourology & female urology

Petrou

2006

Int. braz j urol.

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Purpose: In a randomized study we compared the combination of orchiectomy and radiotherapy to radiotherapy alone as treatment for locally advanced prostate cancer. Patients who were treated only with radiotherapy initially underwent castration therapy at clinical progression, providing the opportunity to compare immediate vs deferred endocrine intervention. Materials And Methods: In this prospective study 91 patients with locally advanced prostate cancer were randomized to receive external beam radiotherapy (46) or combined orchiectomy and radiotherapy (45) after surgical lymph node staging. Survival rates were calculated. Results: During 14 to 19 years of followup 87% of the patients in the radiotherapy group and 76% in the combined orchiectomy and radiotherapy group died (log rank p = 0.03). Prostate cancer mortality was 57% and 36%, respectively (log rank p = 0.02). The difference in favor of combined treatment was mainly caused by lymph node positive tumors. For node negative tumors there was no significant difference in the survival rates.Conclusions: Immediate androgen deprivation should be considered instead of deferred endocrine treatment started at clinical progression for prostate cancer with spread to regional lymph nodes. While awaiting evidence from randomized trials, one should consider full dose radiotherapy for local control of locally advanced prostate cancer even when it is lymph node positive. Editorial CommentThis paper gives the long-term results of a simple but well-done trial: immediate or deferred hormone ablative treatment in patients undergoing external beam radiation therapy (ERBT) after surgical lymph node staging.The answer is clear-cut: immediate hormone ablative therapy is better than deferred therapy with regard to survival. This difference was most predominant in lymph node positive patients. In conclusion, these data and other papers strongly support the use adjuvant endocrine treatment in radiotherapy against prostate cancer. Aims: This prospective, randomized, controlled clinical trial was performed to demonstrate the 12 months safety and efficacy of transurethral radiofrequency energy (RF) collagen micro-remodeling in women with stress urinary incontinence (SUI). Dr. Andreas Bohle

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Section: Editorial Commentsupporting

confidence: 74%

Neurourology & female urology

Petrou

2006

Int. braz j urol.

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“…Basu et al reported that patients presenting with bothersome SUI were keen to receive the treatment with the highest chance of long‐term success, even if this implies they have to undergo an intervention that is more invasive. However, if the treatment‐related bother is considerably less, like a bulking agent or physiotherapy, patients seem to accept much higher trade‐offs . Our interpretation is that the perceived contrast between transobturator and single‐incision slings is present, but perhaps clinically of minor importance.…”

Section: Discussionmentioning

confidence: 79%

Are patients willing to trade cure rate against less pain? Patients’ preferences for single incision midurethral sling or transobturator standard midurethral sling

Schellart

Casteleijn

Dijkgraaf

et al. 2016

Neurourology and Urodynamics

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“…A meta-analysis by Leone Roberti Maggiore et al [18] showed that although the objective cure after MUS procedures is better, the subjective outcomes are not significantly different. Women are willing to sacrifice some efficacy in order to get a less invasive procedure [19] . Although good results can be achieved with a second sling procedure after failure of the first [20] , some patients do not wish to have this done or are simply not fit for (re-)surgery.…”

Section: Discussionmentioning

confidence: 99%

Para-Urethral Injections with Urolastic® for Treatment of Female Stress Urinary Incontinence: Subjective Improvement and Safety

Vries

Breda²,

Fernandes³

et al. 2017

Urol Int

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Introduction: Female stress urinary incontinence (SUI) is often treated surgically. Urethral bulking agents are a minimally invasive alternative, especially in patients suffering from intrinsic sphincter deficiency, but often with limited long-term efficacy. Urolastic® is a non-deformable, non-resorbable silicone elastomer that is used as an injectable. Its properties might result in a more durable response after injection. If this durability factor can be combined with a low complication rate, this can become a useful treatment option. We therefore assessed the subjective improvement and safety after treatment with Urolastic®. Materials and Methods: In 2 Dutch hospitals, 65 patients were treated with Urolastic®. The subjective improvement was assessed and the medical charts were reviewed for complications that appeared during the follow-up period. The complications were classified using the Clavien-Dindo classification. Results: We found that 76-88% of the patients showed subjective improvement at 12-25 months follow-up. The rate of improvement experienced was 50-70%. The rate of complications classified as Clavien-Dindo >II was 24-33%. The 12 patients with 75-100% subjective improvement after 2 months, showed 85% improvement after a median of 25 months. Conclusions: With careful patient selection, Urolastic® seems to be a safe, durable and effective treatment option for female SUI.

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An exploration into patient preference for injectable therapy over surgery in the treatment of female urinary incontinence

Abstract: Patients appear willing to accept a relatively low success rate for injectable therapy compared to open surgery.

Cited by 12 publications

References 3 publications

Neurourology & female urology

Neurourology & female urology

Are patients willing to trade cure rate against less pain? Patients’ preferences for single incision midurethral sling or transobturator standard midurethral sling

Para-Urethral Injections with Urolastic® for Treatment of Female Stress Urinary Incontinence: Subjective Improvement and Safety

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