Voiding dynamics of pelvic organ prolapse: Large scale comparative study

Çeti̇nel, Bülent; Kırlı, Elif A; Önal, Bülent; Kalender, Göktuğ; Demirbilek, Muhammet; Okur, Alper; Can, Günay

doi:10.1002/nau.25156

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…BOO was determined in 75.5% of these patients based on the urodynamic female BOO criteria. 20 BOO was not found in any patient with post‐operative urodynamic investigation (Table 2 ).…”

Section: Resultsmentioning

confidence: 93%

“…A formal multichannel urodynamic study was performed in 49 women (90.7%) before SRS. BOO was determined in 75.5% of these patients based on the urodynamic female BOO criteria 20 . BOO was not found in any patient with post‐operative urodynamic investigation (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…We defined MRUO as a persistently raised post‐void residual, troublesome voiding LUTS such as prolonged and positional voiding, hesitancy and straining, difficulty emptying to completion, the need for indwelling and clean intermittent self‐catheterization (CIC), as well as the urodynamic female bladder outlet obstruction (BOO) findings arising after mid‐urethral sling surgery (MSS). 20 De novo SUI was defined as the recurrence of the symptom and/or urodynamic finding of SUI after SRS.…”

Section: Methodsmentioning

confidence: 99%

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Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study

Çetinel,

Kalender,

Kırlı

et al. 2024

BJUI Compass

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ObjectiveTo compare the functional (obstruction relieving) outcomes and complications of unilateral J‐cut division, partial and subtotal vaginal removal techniques were performed for mesh‐related urethral obstruction (MRUO) in females.MethodsPatient review included demographics, a medical history and proforma with details of lower urinary tract symptoms (LUTS), physical and urodynamic findings, detailed surgical reports and follow‐up data. Variables were compared between the three groups.ResultsOut of 130 patients with sling revision surgery (SRS), 54 women underwent SRS for MRUO with a median follow‐up of 48 (17–96) months. Unilateral J‐cut division, partial and subtotal vaginal removal techniques were performed in 12, 31 and 11 patients with a median duration of surgery of 30 (25–34), 40 (35–56) and 60 (60–70) minutes, respectively (p = 0.001). Statistically significant increase in median maximum free urine flow rate and decrease in median post‐void residual urine volume were found after SRS in the three groups, while de novo stress urinary incontinence (SUI) developed in 10%, 44% and 60% of the patients in the unilateral J‐cut division, partial and subtotal removal groups, respectively (p = 0.007).ConclusionsThe unilateral J‐cut division technique was as effective as the partial and subtotal vaginal removal techniques in relieving MRUO with a shorter duration of surgery time (p = 0.001) and lower risk of de novo SUI (p = 0.007). Comparative studies with a larger number of patients are needed.

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“…BOO was determined in 75.5% of these patients based on the urodynamic female BOO criteria. 20 BOO was not found in any patient with post‐operative urodynamic investigation (Table 2 ).…”

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Unilateral J‐cut division versus partial and subtotal removal techniques in female patients with mesh‐related urethral obstruction: Multicentric comparative study

Çetinel,

Kalender,

Kırlı

et al. 2024

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Surgical management of bladder outlet obstruction due to functional and anatomical etiologies in women

Dequirez,

Wasserman,

Brucker

2024

Neurourology and Urodynamics

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IntroductionBladder outlet obstruction (BOO) in women includes functional and anatomic etiologies. Primary bladder neck obstruction (PBNO), Fowler's syndrome (FS), and dysfunctional voiding (DV) are some examples of functional obstructions, whereas pelvic organ prolapse (POP), periurethral masses, and intragenic causes are some of the anatomic causes.MethodsThis literature review describes the etiologies of female BOO, unique aspects of the workup and diagnosis, and the data for the standard surgical treatments and newer surgical techniques to treat women. Urethral stenosis and sling‐related obstruction are treated in the other articles of this series. Where possible the focus is the efficacy and outcomes.ResultsTreatment of PBNO using a transurethral incision of the bladder neck and injection of botulinum toxin in the bladder neck decreases the BOO. After the failure of conservative approaches, sacral neuromodulation (SNM) is effective for FS, while DV may benefit from SNM or botulinum toxin injections. Concerning POP, most surgeries have been reported to significantly improve a pre‐existent BOO but the level of evidence is low. Benign urethral and periurethral masses may provoke BOO, and surgical excision usually resolves this condition.ConclusionAlthough most surgical treatments of BOO for functional and benign anatomical etiologies in women seem to be effective, data are scarce even for more common conditions like POP. Further studies are required to give better advice on the choice of surgical technique for these patients.

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