Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Abdominovaginal sling surgery is performed in women with genuine stress incontinence. It is not usually a primary operation because of the higher morbidity compared to the colposuspension. Slings are indicated in incontinent women with previous failed surgery, urethral hypermobility, intrinsic sphincter weakness, significant anterior vaginal wall prolapse or those with restricted vaginal mobility. This study was undertaken to assess long-term patient perceived success of abdominovaginal sling surgery in women with genuine stress incontinence (GSI) in the presence of a cystocoele. The case notes were reviewed of all 37 women undergoing sling surgery for GSI in the presence of a significant cystocoele between 1988 and 1999. Patients were sent a questionnaire at a minimum follow-up of 12 months enquiring about urinary symptoms. The mean duration of follow-up was 49 months. Six weeks following surgery 33/37 (89%) were completely dry. Thirty-three women (89%) responded to the questionnaire. Of these 14/33 (42%) were totally dry, 10/33 (30%) had insignificant leakage and 9/33 required regular protection. The mean visual analogue score of improvement in incontinence was 75.3 (+/-30.1). The operation was deemed successful in 24/33 (72%) women. Voiding difficulty was reported in 12% and recurrent prolapse occurred in 15%. Of the failures 8/9 reported urge incontinence and 4/9 stress incontinence. Frequency, urgency and urge incontinence were significantly more common in the women in whom the operation failed. This study demonstrates a 72% long-term success of abdominovaginal sling operations in women with GSI and a significant cystocoele. Development of DI accounted for most of the operative failures.
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PMID:The long-term success of abdominovaginal sling operations for genuine stress incontinence and a cystocoele--a questionnaire-based study. 1252 88

Voiding difficulty has been relatively overlooked as a diagnosis. Previous estimates of its prevalence have generally been no more than 14% with one exception at 24%. The aim of this study is to determine the true prevalence and associations of voiding difficulty using a validated definition [urine flow rate under 10th centile of the Liverpool Nomograms and/or residual urine volume (by transvaginal ultrasound) more than 30 ml]. This study involved 592 women referred for an initial urogynecological assessment including urodynamics. Data were separated according to the presence or absence of voiding difficulty. The prevalence of voiding difficulty was 39%, far higher than previous estimates. It is the third most common urodynamic diagnosis behind urodynamic stress incontinence (USI-72%) and uterine/vaginal prolapse (61%) and ahead of the overactive bladder (13%). Voiding difficulty significantly increased in prevalence with age and increasing grades of all types of uterine/vaginal prolapse. Prolapse appeared to be the main factor in the age deterioration. Other significant positive relationships with voiding difficulty were prior hysterectomy and prior continence surgery, whilst USI and the symptom and sign of stress incontinence had significant inverse relationships.
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PMID:Has the true prevalence of voiding difficulty in urogynecology patients been underestimated? 1659 58