Periurethral collagen for urinary incontinence after gender reassignment surgery

Fitzpatrick, Christopher C.; Swierzewski, Stanley J.; McGuire, Edward J.

doi:10.1016/0090-4295(93)90388-q

Cited by 13 publications

(10 citation statements)

References 16 publications

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“…This subtype of SUI was later redefined as ISD in 1992 by the Agency for Health Care Policy and Research Clinical Practice Guideline Panel for Urinary Incontinence in Adults . Then, the VLPP was proposed as an objective parameter to substantiate ISD diagnosis when VLPP was 60 cm water or less . The pathophysiology of ISD corresponds to the inability of the intrinsic urethral sphincter mechanism to maintain mucosal coaptation either at rest or in the presence of a minimal increase in intra‐abdominal pressure .…”

Section: Discussionmentioning

confidence: 99%

“…One of the limitations of the present study was that we only analyzed the correlation between spontaneous urine leakage during posterior vaginal wall pressure using a split speculum and MUCP, but not VLPP. Regarding the literature, the correlation between VLPP and MUCP varied . Most of the time when VLPP is under 60 cm of water, MUCP is under 20 cm of water.…”

Section: Discussionmentioning

confidence: 99%

“…12 Then, the VLPP was proposed as an objective parameter to substantiate ISD diagnosis when VLPP was 60 cm water or less. 13 The pathophysiology of ISD corresponds to the inability of the intrinsic urethral sphincter mechanism to maintain mucosal coaptation either at rest or in the presence of a minimal increase in intra-abdominal pressure. 14 Currently, the ICS have not defined precisely ISD.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the literature, the correlation between VLPP and MUCP varied. 13,19 Most of the time when VLPP is under 60 cm of water, MUCP is under 20 cm of water. Even if sometimes MUCP is 20 cm of water or less and VLPP is more than 60 cm of water, we can note that studies that have analyzed the risk factor for the failure of continence surgery have only used MUCP of 20 cm water or less as the criterion to define ISD.…”

Section: Discussionmentioning

confidence: 99%

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Posterior vaginal wall pull down maneuver: A clinical test to diagnose intrinsic sphincter deficiency in women suffering from genuine urinary stress incontinence

et al. 2013

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Abbreviations & AcronymsObjectives: To assess the predictive value of a simple clinical test (posterior vaginal wall pull down maneuver) in the diagnosis of intrinsic sphincter deficiency. Methods: The present prospective study included 62 women suffering from stress urinary incontinence. Every patient underwent a urogynecological examination including multichannel urodynamic testing (cystometry, urethral pressure profile, Valsalva Leak Point Pressure measurement) and a clinical examination including posterior vaginal wall pull down maneuver. Posterior vaginal wall pull down maneuver was carried out with the bladder filled with 400 mL of saline in a supine position, and was obtained by means of a split speculum allowing gentle pull down traction of the posterior vaginal wall. Posterior vaginal wall pull down maneuver was considered as positive when a urine leak was observed during the manoeuvre. Intrinsic sphincter deficiency was urodynamically defined by maximum urethral closure pressure Յ20 cmH2O. Correlations between positive/negative posterior vaginal wall pull down maneuver and urodynamic intrinsic sphincter deficiency were calculated. Results: There was a statistical correlation between age and low maximum urethral closure pressure (P < 0.0001), and between low maximum urethral closure pressure and positive posterior vaginal wall pull down maneuver (P < 0.0001). Regarding the intrinsic sphincter deficiency diagnosis, the posterior vaginal wall pull down maneuver positive predictive value was 94.67% and the negative predictive value was 95.4%, with a specificity of 97.6% and sensitivity of 90%. Conclusion: Posterior vaginal wall pull down maneuver is a reliable clinical test, easy to carry out, inexpensive and without significant risk. This test allows the diagnosis of intrinsic sphincter deficiency in women suffering from stress urinary incontinence, thus avoiding further invasive urodynamic testing (urethral pressure profile, Valsalva Leak Point Pressure measurement) in women with genuine stress urinary incontinence. Furthermore, it is helpful when choosing the type of sling procedure (retropubic vs transobturator) when a surgery is planned.Key words: empty stress test, intrinsic sphincter deficiency, posterior vaginal wall pull down test, stress urinary incontinence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Posterior vaginal wall pull down maneuver: A clinical test to diagnose intrinsic sphincter deficiency in women suffering from genuine urinary stress incontinence

et al. 2013

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“…A case report on the use of intraurethral collagen injection suggests some degree of improvement in the incontinence. [1]…”

Section: Introductionmentioning

confidence: 99%

Stress urinary incontinence after male to female gender reassignment surgery: Successful use of a pubo-vaginal sling

Dangle¹,

Harrison

2007

Indian J Urol

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The case of a 50-year-old patient who had undergone male to female gender reassignment surgery is presented. She presented with mixed incontinence with symptoms of stress incontinence predominating. Initial conservative treatment was unsuccessful and subsequent videourodynamic assessment demonstrated urodynamic stress incontinence in association with a partially open bladder neck at rest. Also noted during the study was cough-induced detrusor overactivity. The option of inserting a pubo-vaginal sling using autologous rectus sheath was chosen. The procedure proved to be straightforward to perform and was uncomplicated. Subsequent follow-up demonstrated a resolution of her stress incontinence.

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Assessment of the strength and electrical activity of the pelvic floor muscles of male‐to‐female transgender patients submitted to gender‐affirming surgery: A case series

Hazin

Ferreira

Andrade

et al. 2021

Neurourology and Urodynamics

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To assess the strength and electrical activity of the pelvic floor muscles (PFMs) of male-to-female transgender individuals submitted to genderaffirming surgery (GAS).Methods: A case series study was conducted from October 2016 to August 2018. Transgender women, who were scheduled for GAS, participated in the study. The volunteers were submitted to a clinical evaluation of the PFM followed by digital palpation (PERFECT method) and electromyography in the preoperative, 15, and 30 days after GAS. They responded to the International Consultation on Incontinence Questionnaire-Urinary Incontinence (UI)-Short Form to evaluate the effect of UI on quality of life and to questions related to the urinary, anorectal, and sexual symptoms. Fifteen days after the GAS, patients were instructed to perform perineal exercises at home, twice a day. Results: The study sample consisted of 15 transgender women with an average age of 30.6 (SD = 6.7) years. There was a decline in median strength and sustained muscle contraction duration (PERFECT), in the electrical muscle activity (RMSmean and RMSmax) between pre-GAS and 15 days after GAS (p < 0.05). However, there was an increase in these parameters between 15 and 30 days after GAS (p < 0.05). Moreover, six patients exhibited pre-GAS UI, which continued after surgery, with a worsening of urgency symptoms and improvement in nocturia and postmicturition leakage. Conclusion:Strength, sustained muscle contraction duration, and PFM electrical activity may decline 15 days after GAS, returning to pre-GAS values in the first month after surgery.

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Periurethral collagen for urinary incontinence after gender reassignment surgery

Cited by 13 publications

References 16 publications

Posterior vaginal wall pull down maneuver: A clinical test to diagnose intrinsic sphincter deficiency in women suffering from genuine urinary stress incontinence

Posterior vaginal wall pull down maneuver: A clinical test to diagnose intrinsic sphincter deficiency in women suffering from genuine urinary stress incontinence

Stress urinary incontinence after male to female gender reassignment surgery: Successful use of a pubo-vaginal sling

Assessment of the strength and electrical activity of the pelvic floor muscles of male‐to‐female transgender patients submitted to gender‐affirming surgery: A case series

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