Implantable Systems for Stress Urinary Incontinence

Adem, Kenana Al; Bawazir, Sarah S.; Hassen, Waleed; Khandoker, Ahsan H.; Khalaf, Kinda; McGloughlin, Tim; Stefanini, Cesare

doi:10.1007/s10439-017-1939-9

Cited by 16 publications

(20 citation statements)

References 85 publications

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“…Despite the increase in alternative prosthetic devices, [10][11][12][13] AMS 800 still provides the highest long-term reference data and remains a fundamental device for surgical treatment of severe urinary incontinence. 3,4,14,15 Therefore, it is assumed as the main reference for the investigation within the present work. Cuffs were provided by Boston Scientific and represented the basis for the investigation.…”

Section: Experimental Testsmentioning

confidence: 99%

“…Artificial urinary sphincter (AUS) is considered an effective treatment for male stress urinary incontinence (SUI) resulting from various etiologies, including benign prostatic hyperplasia surgery, neurologic disease, radical cystectomy, congenital anomalies, or trauma . Long‐term outcomes of AUS implantation highlighted a satisfactory repair durability and an improvement of the quality of life . Nonetheless, the implantation of AUS has been associated with complications as tissue erosion and atrophy, which can lead to surgical revision or prosthesis explant in 25% of patients …”

Section: Introductionmentioning

confidence: 99%

“…1 Long-term outcomes of AUS implantation highlighted a satisfactory repair durability and an improvement of the quality of life. [2][3][4][5] Nonetheless, the implantation of AUS has been associated with complications as tissue erosion and atrophy, 6 which can lead to surgical revision or prosthesis explant in 25% of patients. 7 In general, AUS consists of an inflatable silicone cuff, a pressure-regulating balloon (PRB) and a deflating pump.…”

Section: Introductionmentioning

confidence: 99%

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Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

2019

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Male urinary incontinence is highly prevalent, leading to a miserable quality of life. The artificial urinary sphincter (AUS) is the device that closely simulates the function of the biological urinary sphincter. The precise evaluation of occlusion mechanisms and of interaction phenomena occurring between AUS cuff and urethral duct is fundamental for more reliable design. The action induced in the interaction with urethral duct under a specific pressure depends on its constitutive material and structural characteristics. The methods of experimental and computational bioengineering are exploited to investigate mechanical functionality of the coupled system, as AUS and urethral duct. Experimental tests are developed to investigate the response when the AUS is inflated around a urethral phantom. Numerical model of the cuff is developed mimicking the experimental tests for the validation. Subsequently, numerical models are exploited to interpret the interaction of the cuff with urethral phantoms considering the influence of urethral size and of tissues mechanical behavior, mimicking healthy and degraded configurations. The investigation provides useful information on the behavior of AUS cuff with urethral duct evaluating the action induced and represents a support for planning an extension of experimental tests on animal and human urethral samples.

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Section: Experimental Testsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

2019

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“…SUI is more prevalent in women than in men. In 2008, around 127 million women and 10 million men were affected [7]. Porous synthetic tapes (sling) have been globally used in such surgeries [8]; although this procedure has a high cure rate for SUI after 12 months, severe complications as erosion has been associated with the poor biocompatibility and inadequate biomechanical properties of polypropylene mesh-as lack of elasticity and high stiffness-when it is implanted into the pelvic floor [9,10].…”

Section: Introductionmentioning

confidence: 99%

Biocompatible Elastomer with Adjustable Mechanical Properties and Degradation Rate as a Midline Segment of Bipartite Sling

Oliveira¹,

Branciforti²

2021

Pharmacophore

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Surgeries for suspending the urethra with synthetic porous tapes (sling) use are effective for curing stress urinary incontinence (SUI). The shortening of the urethral canal and urinary retention are recurrent postoperative problems caused by the tension exerted by the sling on the urethra. This study evaluated the behavior of a biocompatible, bioresorbable, and biodegradable poly (glycerol sebacate) (PGS) elastomer applied as a middle connection of the bipartite sling, which, when degraded, relieves the tension on the organ. Bipartite slings (BS) were fabricated with PGS as a median portion to interconnect their parts. PGS elastomers were synthesized in the common microwave, cured at different curing times in a vacuum oven, and evaluated regarding adhesion strength and mechanical properties by tensile test after in vitro degradation. Bothprepolymer (pre-PGS) and PGS elastomers (E) were assessed by Fourier transform infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR). The analyses revealed a higher degree of esterification (DE) and crosslinking for samples prepared by curing for 72 h, as well as better performance of mechanical properties over 45 days of in vitro degradation incubation. PGS elastomer prepared at 48 to 72 h curing times has proven suitable as a median portion of the bipartite slings used in surgeries for suspending the urethra in the SUI treatment.

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“…For mild SUI (type I), single-incision sling or needle-free sling with minimal injury and pain can be used, while for severe SUI (type III), a small number of severe patients require artificial sphincter, 4 the standard transretropubic tension-free vaginal tape (TVT) is generally used. For moderate SUI (type II), transobturator tension-free tape (TVT-O or TOT) is mostly used.…”

Section: Introductionmentioning

confidence: 99%

Experience in application of modified sling in treatment of Moderate Stress Urinary Incontinence

Guo

et al. 2020

Pak J Med Sci

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Objective: To observe the clinical significance of modified sling in the treatment of moderate stress urinary incontinence (SUI). Methods: From January 2016 to January 2019, eighty patients with moderate urinary incontinence who were hospitalized in our hospital were randomly divided into two groups. 40 patients in the experimental group underwent modified sling transvaginal tension-free mid-urethral suspension. Modification method of the sling: cut the sling to a remaining length of about 6~7cm, properly connect the barbed sutures (V-LOCK) on both sides of the sling, and insert the urinary incontinence sling from the urethra to the obturator membrane, from the obturator membrane to the thigh. The inner skin area is replaced by the V-LOCK line. The 40 patients in the control group were unmodified ordinary slings. The operation time, the local pain of the inner thigh after the operation, and the improvement of postoperative urinary incontinence symptoms were compared and analyzed between the two groups. Results: Both groups of patients were successfully operated. The operation time was 16.36 minutes in the experimental group and 27.18 minutes in the control group. The difference in operation time between the two groups was statistically significant (p=0.00); the catheter was pulled out on the third day after the operation. One patient in the group had urinary effort, four patients still had urinary incontinence symptoms, the remaining 35 patients had good urinary control (effective rate 87.5%), five patients in the control group still had urinary incontinence, two patients had urinary effort, and the remaining 33 patients had urinary control Good, (effective rate 87.5%), there was no significant difference in surgical effectiveness between the two groups (p=0.53); follow-up for 12 to 36 months, no significant long-term complications occurred, the pain score of the inner thigh of the experimental group was significantly lower than that of the control group ,statistically significant (p=0.04). Conclusion: The efficacy of the modified sling in the treatment of moderate SUI is the same as that of the traditional sling, but the operation time is shorter, the operation is simpler, and the local pain is significantly reduced. doi: https://doi.org/10.12669/pjms.36.7.2619 How to cite this:Guo J, An F, Gu D, Yang W. Experience in application of modified sling in treatment of Moderate Stress Urinary Incontinence. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2619 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Implantable Systems for Stress Urinary Incontinence

Cited by 16 publications

References 85 publications

Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

Biocompatible Elastomer with Adjustable Mechanical Properties and Degradation Rate as a Midline Segment of Bipartite Sling

Experience in application of modified sling in treatment of Moderate Stress Urinary Incontinence

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