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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This is the first reported case of recurrent stress urinary incontinence secondary to dislodged bone-anchoring screws. A 71-year-old man who had undergone successful bone-anchored sling placement for post-prostatectomy incontinence, presented with recurrent stress urinary incontinence after a bout of coughing. Pelvic radiography revealed three screws had been dislodged. The mesh was left in place, with replacement of the dislodged screws and the addition of one extra screw. The findings of this case suggest that dislodged screws can be a possible cause of sling failure. Preoperative bone scanning and postoperative pelvic radiography should be a part of the routine workup for patients with bone-anchored slings.
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PMID:Recurrent stress urinary incontinence after dislodged screws in patient with bone-anchored suburethral sling. 1831 80

After transvaginal adjustable tape, approximately 15% of patients still suffer incontinence, and voiding dysfunction is present in a relatively important number of patients. Transvaginal adjustable tape (TVA) permits postoperative readjustment of tension, suggesting that better results could be obtained. Sixty-four incontinent women received TVA. Patients were monitored 1, 6, and 12 months post-surgery and annually thereafter by medical history, cough stress test, flowmetry and post-void residual test (PVR), incontinence quality of life, International Consultation on Incontinence Questionnaire-Short Form, and Patient Global Impressions of Improvement (PGI-I) questionnaires. After adjustment, all patients rendered continent, and none had PVR. On no occasion was vesical catheterization or uretholysis necessary. Mean follow-up was 40+/-12.9 months. Objective and subjective cure rate were 94% and 56%, respectively. Qmax was 22.3+/-9.9 ml/s. The PGI-I questionnaire showed 94% of patients to be better or very much better than before. Our data suggest that with TVA tape, better results can be obtained, furthermore, without increasing surgical complications.
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PMID:Transvaginal adjustable tape: an adjustable mesh for surgical treatment of female stress urinary incontinence. 1836 Jul 35

The aim of this study was to correlate the lowest Valsalva or cough leak point pressure (LPP) with clinical measures of incontinence severity and quality of life in women with pure urodynamic stress incontinence (SUI). This is an analysis of the baseline data from a prospective, multicenter, randomized trial comparing the Monarc transobturator sling to the tension-free vaginal tape. One hundred fifty-five women with SUI underwent urodynamic evaluations including abdominal or vesical LPP determinations, and each completed the Sandvik Incontinence Severity Index, a 3-day voiding diary, and quality-of-life questionnaires. In patients with a LPP, there were no significant correlations between LPP and the above clinical measures of incontinence severity or condition-specific quality-of-life questionnaire scores. In this patient population with pure urodynamic SUI, LPP is not a useful urodynamic predictor of baseline SUI severity and its effects on quality of life.
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PMID:Leak point pressure does not correlate with incontinence severity or bother in women undergoing surgery for urodynamic stress incontinence. 1841 65

Urinary incontinence (UI) is a common complication after radical hysterectomy, ranging between 21% and 53%. Two cases of postradical hysterectomy UI treated with transurethral macroplastique injection are reported here. At 1-year follow-up, 1 patient showed no episodes of incontinence in voiding diary. The second patient showed a positive cough stress test only in standing position at 400 mL of bladder emptying. The frequency of UI according to a 3-day voiding diary was 3 episodes. Preoperative and postoperative subjective patient perception of UI symptom severity (visual analog scale) was 7-0 and 8-2 for cases 1 and 2, respectively. Bulking agents urethral injection could be a minimally invasive option to improve well-being of patients with cervical cancer after radical surgery.
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PMID:Transurethral polydimethylsiloxane injection: a valid minimally invasive option for the treatment of postradical hysterectomy urinary incontinence. 1843 16

Stress urinary incontinence (SUI) is the involuntary leakage of urine associated with effort, exertion, sneezing or coughing (Abrams et al, 2002) and is the most common type of incontinence in women (Hampel et al, 2004). In 2005, NHS Greater Glasgow introduced a primary care management of SUI pathway. However, a high percentage of patients failed to complete their therapy.The aim of this study was to explore why some women with SUI dropped out of the pathway.
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PMID:Why women leave therapy for stress incontinence. 1897 61

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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PMID:Stress urinary incontinence after male to female gender reassignment surgery: Successful use of a pubo-vaginal sling. 1971 37

We evaluated the long-term efficacy of laparoscopic Burch colposuspension for stress urinary incontinence (SUI) in women. A total of 68 patients who underwent extraperitoneal laparoscopic Burch colposuspensions with more than a 3-yr follow-up were included. The colposuspension was performed by using two non-absorbable sutures on each side. The patients were considered to be cured of SUI if they had a negative result of cough stress test and there were no reports of urine leakage during physical stress. The mean follow-up period was 52 months (range, 36 to 83 months). The overall subjective cure rate was reported in 49 patients (72%). There was no significant difference between the cured and non-cured group in terms of clinical parameters. The cure rate tended to decline gradually over time and it was more deteriorated significantly after 4 yr of surgery. Based on these results, we recommend that long-term follow-up is needed when evaluating the clinical efficacy of anti-incontinence surgery.
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PMID:Long-term results of laparoscopic Burch colposuspension for stress urinary incontinence in women. 1994 79

Urinary incontinence is a frequent affliction in women and may be disabling and costly {LE1}. When consulting for urinary incontinence, it is recommended that circumstances, frequency and severity of leaks be specified {Grade B}. The cough test is recommended prior to surgery {Grade C}. Urodynamic investigations are not needed before lower urinary tract rehabilitation {Grade B}. A complete urodynamic investigation is recommended prior to surgery for urinary incontinence {Grade C}. In cases of pure stress urinary incontinence, urodynamic investigations are not essential prior to surgery provided the clinical assessment is fully comprehensive (standardised questionnaire, cough test, bladder diary, post-void residual volume) with concordant results {PC}. It is recommended to start treatment for stress incontinence with pelvic floor muscle training {Grade C}. Bladder training is recommended at first intention in cases with overactive bladder syndrome {Grade C}. For overweight patients, loss of weight improves stress incontinence {LE1}. For surgery, sub-urethral tape (retropubic or transobturator route) is the first-line recommended technique {Grade B}. Sub-urethral tape surgery involves intraoperative risks, postoperative risks and a risk of failure which must be the subject of prior information {Grade A}. Elective caesarean section and systematic episiotomy are not recommended methods of prevention for urinary incontinence {Grade B}. Pelvic floor muscle training is the treatment of first intention for pre- and postnatal urinary incontinence {Grade A}. Prior to any treatment for an elderly woman, it is recommended to screen for urinary infection using a test strip, ask for a bladder diary and measure post-void residual volume {Grade C}. It is recommended to carry out a cough test and look for occult incontinence prior to surgery for pelvic organ prolapse {Grade C}. It is recommended to carry out urodynamic investigations prior to pelvic organ prolapse surgery when there are urinary symptoms or occult urinary incontinence {Grade C}.
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PMID:Diagnosis and management of adult female stress urinary incontinence: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. 2023 51

Out of 21 female patients who had undergone TVT operation for stress urinary incontinence from March 2000 to February 2001, 15 females responded to the interview in the telephone survey conducted in 2009. A Russian version of the King's Health Questionnaire was used. Seven (46.8%) patients assessed the effect of the operation as good, 4 (26.6%) patients--as satisfactory, 2 (13.3%) and 2 (13.3%) as bad and poor, respectively. Thus, a positive effect was achieved in 11 (73.4%) responders, while a negative effect was seen in 4 (26.6%) patients. Nine (60%) patients experienced no effect of urination problem on quality of life, 3 (20%) and 3(20%) patients experienced moderate and strong effect, respectively. Frequent voiding, urgencies at night, imperative voiding and urgent urinary incontinence were recorded in 3 (20%), 4 (26.7%), 2 (13.3%) and 2 (13.3%) patients, respectively. All 15 (100%) responders stated no incontinence in cough, sneezing and physical activity. Thus, our 8-year follow-up confirms that TVT operation is highly effective in stress urinary incontinence in women.
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PMID:[Remote results of using synthetic loop in the treatment of urinary incontinence in females (8-year study results)]. 2097 39

The expert panel recommendations are issued in order to increase the number of patients with urinary incontinence and overactive bladder receiving appropriate care. The expert panel recommends that urologists, gynecologists and other physicians interested in the field of incontinence should Incontinence question should be actively asked during each physician visit and if the answer is positive it should be followed by detailed questionnaire aiming at disclosing at which occasion patient is loosing urine. The next step should be urogynecological examination and cough stress test. The panel recommends urine dipstick in all women and post void residual urine measurement only in women with voiding difficulties. Other tests, such as ultrasound, cystoscopy urodynamics are not recommended during initial diagnostic procedure. The indications for referral are significant pelvic organ prolapse, haematuria, pain during micturition, recurrent incontinence and infections, suspicion of fistula. The initial management of stress urinary incontinence should include lifestyle interventions, and physiotherapy Use of pessaries is acceptable in women who are not fit or do not want surgical therapy Local estrogen therapy should only be used in women with urogenital atrophy Duloxetin is an option in the pharmacological therapy of stress incontinence, but it doesn't cure the disease. The ineffectiveness of initial procedure should be indication to surgery Alphaadrenomimetic drugs are not recommended in the therapy of urinary incontinence. The initial management of overactive bladder and urgency incontinence should include lifestyle interventions, however fluid restrictions (if fluid load is less than 3000 ml) are not recommended. The cornerstone of overactive bladder and urgency incontinence therapy remains the treatment with anticholinergic drugs. Drugs are only effective when used accordingly to the registered doses. The new generation anticholinergics are recommended over the old ones, especially in frail elderly patients and in patients with concomitant diseases, due to their better safety profile. The evaluation of anticholinergics efficacy should be performed after 2-3 months, then after 6 months.
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PMID:[Expert panel recommendations on therapeutic and diagnostic management of urinary incontinence and overactive bladder in women]. 2111 10


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