Post radical hysterectomy urinary incontinence: A prospective study of transurethral bulking agents injection

Plotti, Francesco; Zullo, Marzio Angelo; Sansone, Milena; Calcagno, Marco; Bellati, Filippo; Angioli, Roberto; Panici, Pierluigi Benedetti

doi:10.1016/j.ygyno.2008.09.022

Cited by 31 publications

(30 citation statements)

References 29 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Demographic data were equally distributed in all four groups: age (median 79 years, range 41-91), BMI (median 29 kg/m 2 , range 21-41 for polyacrylamide hydrogel and 19-41 for the other agents, respectively), previous incontinence operations (median 1, range 0-4), number of injections (median 1, range 1-3), hospital stay (median 2 days, range 1-3 except for one maximum stay of 34 days in a patient in whom complications occurred after a collagen injection), and operation time (median 10 min, range [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Eighty percent of patients answered the questionnaire in German, 18 % in French, and 2 % in English; 67 % had SUI and 33 % MUI.…”

Section: Resultsmentioning

confidence: 99%

“…As for surgery, suburethral slings are as effective as colposuspension, with lower perioperative morbidity, and are the gold standard in patients with SUI, displaying high and long-term cure rates [7,8]. However, there is a need for alternative therapeutic approaches in patients with significant comorbidities; in women who are unwilling to undergo surgery because of its associated risks, pain, and recovery; in patients with recurrent SUI; and in women in whom surgical options are limited (e.g., postoperatively or after irradiation) [9][10][11][12][13][14]. The study reported here focuses on injection therapy with bulking agents, as this technique may be considered as a first-line treatment option in selected patients [11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bulking agents: an analysis of 500 cases and review of the literature

et al. 2012

View full text Add to dashboard Cite

Introduction and hypothesis Stress urinary incontinence (SUI) is common, impacts women's quality of life, and generates high costs. Physiotherapy is the first-line therapy, and if it fails, suburethral slings are the gold standard in SUI surgery. Bulking agents injected periurethrally might be a beneficial alternative, but there is a paucity of data on bulking therapy. The aim of this study was to prospectively analyze the efficacy and safety of bulking agents in the setting of a tertiary referral center. Methods In the last 13 years, 514 elderly women with SUI were treated by injection therapy with either collagen (Contigen®), hyaluronic acid (Zuidex®), ethylene vinyl alcohol (Tegress®), or polyacrylamide hydrogel (Bulkamid®). Subjective and objective outcome was recorded at the 12-month postoperative appointment using the King's Health Questionnaire, visual analogue scale (VAS) describing their incontinence severity, standardized pad test, and urethral pressure profile.Results Demographic data were equally distributed in all four groups of agents used. Sixty-one patients were lost to follow-up (10.6 %). Statistically significant changes were found for maximum urethral closure pressure (MUCP), pad weight, and VAS before and after bulking for the four agents used. Pad test was negative in 73.2 % of patients after bulking therapy. Subjective assessment showed improvements in general health and role limitations. The overall complication rate was low for all agents. Conclusions This study shows improvement in incontinence after bulking therapy according to subjective and objective outcomes in an elderly population. In contrast to earlier reports, side effects due to injections were few and mild. We can advocate bulking therapy for treating SUI, as it is simple, safe, and shows both objective and subjective improvement and relief.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bulking agents: an analysis of 500 cases and review of the literature

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Plotti et al [34] investigated the effectiveness of PDMS injected at least 12 months after radical hysterectomy for the treatment of SUI. They demonstrated a success rate of 84% at 12 months follow-up.…”

Section: Polydimethylsiloxane Injectionmentioning

confidence: 99%

Urethral bulking agents: Techniques and outcomes

Kotb¹,

Campeau²,

Corcos

2009

Curr Urol Rep

View full text Add to dashboard Cite

Stress urinary incontinence is a common health problem affecting women and interfering with their quality of life. The use of bulking agents for urethral augmentation seems to be a beneficial way of restoring continence in these patients while avoiding the risk of surgical intervention. Many agents are available for injection, but the ideal choice should be durable, nonmigratory, and hypoallergenic, while evoking healing with minimal scarring. We reviewed the literature to provide an update on the best techniques of bulking agent injection, to describe the different available injectable agents, and to give their outcome and possible complications.

show abstract

“…Our interviewees, however, suffered mostly from urinary incontinence for which good treatment options exist, as documented. 26,27 In addition, GPs could play a greater role by paying more attention to pelvic floor symptoms and making timely referrals as part of a 'shared-care model' for cancer survivors, as suggested by Oeffinger and McCabe. 40 …”

Section: Discussionmentioning

confidence: 99%

“…18,19 Seeking medical help for pelvic floor symptoms should be encouraged, as many conditions can be treated adequately, especially stress urinary incontinence and constipation and, to a lesser extent, radiation cystitis and proctitis, resulting in a better quality of life. [20][21][22][23][24][25][26][27] Insight into the personal factors that impede help-seeking behaviour in women with gynaecological cancer is therefore needed. 28 The primary objective of this qualitative study was to explore women's personal reasons for not seeking medical help for bothersome pelvic floor symptoms after treatment for gynaecological malignancy.…”

Section: Introductionmentioning

confidence: 99%

Reasons for not seeking medical help for severe pelvic floor symptoms: a qualitative study in survivors of gynaecological cancer

Hazewinkel¹,

Sprangers

Taminiau-Bloem

et al. 2009

BJOG

View full text Add to dashboard Cite

Objective (1) To explore the reasons for not seeking help for severe pelvic floor symptoms after gynaecological cancer treatment. (2) To determine the willingness to undergo treatment for these symptoms. (3) To invite suggestions to improve outpatient care.Design Qualitative study using semistructured interviews.Setting Vulvar, endometrial or cervical cancer survivors treated in the Academic Medical Centre, Amsterdam, the Netherlands between1997 and 2007.Population Purposively selected sample from 138 eligible respondents to pelvic floor-related questionnaires, who were severely bothered by their symptoms (>75th percentile of domain sum score of questionnaires) and had not sought medical help.Methods After each semistructured interview, a checklist with reasons for not seeking help was complemented with newly mentioned reasons. The interviews were stopped when data saturation was accomplished, i.e. three consecutive interviewees had not revealed new reasons. The interviews were analysed by two researchers independently.Main outcome measure Help-seeking behaviour for bothersome pelvic floor symptoms.Results Fifteen interviews were conducted. Most reported reasons for not seeking help were that women found their symptoms bearable in the light of their cancer diagnosis and lacked knowledge about possible treatments. Seven women were willing to undergo treatment. Eleven women stated that care should be improved, specifically by timely referral to pelvic floor specialists and additional care by oncology nurses.Conclusions There is a need for standardised attention to adverse effects on pelvic floor function after cancer treatment. This could be realised by quantifying symptoms using questionnaires, standardised attention for such symptoms by gynaecological oncologists or oncology nurses, and timely referral to pelvic floor specialists of women with bothersome pelvic floor symptoms.Keywords Cancer survivors, help-seeking behaviour, pelvic floor symptoms, post-treatment care, qualitative methods.Please cite this paper as: Hazewinkel M, Sprangers M, Taminiau-Bloem E, van der Velden J, Burger M, Roovers J. Reasons for not seeking medical help for severe pelvic floor symptoms: a qualitative study in survivors of gynaecological cancer.

show abstract

Post radical hysterectomy urinary incontinence: A prospective study of transurethral bulking agents injection

Cited by 31 publications

References 29 publications

Bulking agents: an analysis of 500 cases and review of the literature

Bulking agents: an analysis of 500 cases and review of the literature

Urethral bulking agents: Techniques and outcomes

Reasons for not seeking medical help for severe pelvic floor symptoms: a qualitative study in survivors of gynaecological cancer

Contact Info

Product

Resources

About