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Pre- and postoperative urodynamic findings in patients after a bulbourethral composite suspension with intraoperative urodynamically controlled sling tension adjustment for postprostatectomy incontinence.
Urology. 2012 Mar; 79(3):702-7.U

Abstract

OBJECTIVES

To compare pre- and postoperative urodynamic findings in patients with a bulbourethral composite suspension and intraoperative urodynamically controlled sling tension adjustment.

METHODS AND PATIENTS

All data were prospectively collected from 10 patients (mean age 66 years) who successfully underwent bulbourethral composite suspension for moderate to severe postprostatectomy incontinence. Patients were evaluated preoperatively and 3-6 months postoperatively by urodynamic measurements, including urethra pressure profiles (UPPs) and pressure flow studies (PFSs). Clinical outcome was evaluated by patient-reported pad use and questionnaires (ICIQ-UI SF and I-QOL). Intraoperatively sling tension was adjusted under repeated urodynamic measurements of abdominal leak point pressure. Data were evaluated using the Kruskal-Wallis Wilcoxon test.

RESULTS

Sling implantation was successful in all patients. Pre- to postoperative pad use decreased significantly (P < .005). Five patients were pad-free, 3 used 1 pad, and 2 used 2 pads per day. Continence and quality of life improved significantly (ICIQ-UI SF: pre-op 17 vs post-op 4.9; I-QOL: pre-op 66 vs post-op 91; P < .05 for both). Urodynamic parameters during the filling phase remained unchanged. UPPs revealed a significant increase of the maximal urethral closure pressure (pre-op 40 cm H(2)O vs post-op 58 cm H(2)O) and functional length (pre-op 31 mm vs post-op 40 mm; P < .05 for both). Postoperatively, urodynamic maximal flow rates were slightly reduced from 16 mL/s to 12 mL/s (P = .4). PFSs revealed an unobstructed voiding in all patients.

CONCLUSIONS

According to the present evaluation, a bulbourethral composite suspension with intraoperative urodynamically controlled sling tension adjustment improves continence without causing prolonged clinically or urodynamically significant voiding obstruction.

Authors+Show Affiliations

Department of Urology, Kantonsspital Winterthur, Brauerstrasse 15, Winterthur, Switzerland. marcushorstmann@gmx.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22245300

Citation

Horstmann, Marcus, et al. "Pre- and Postoperative Urodynamic Findings in Patients After a Bulbourethral Composite Suspension With Intraoperative Urodynamically Controlled Sling Tension Adjustment for Postprostatectomy Incontinence." Urology, vol. 79, no. 3, 2012, pp. 702-7.
Horstmann M, Fischer I, Vollmer C, et al. Pre- and postoperative urodynamic findings in patients after a bulbourethral composite suspension with intraoperative urodynamically controlled sling tension adjustment for postprostatectomy incontinence. Urology. 2012;79(3):702-7.
Horstmann, M., Fischer, I., Vollmer, C., Horton, K., Kurz, M., Padevit, C., & John, H. (2012). Pre- and postoperative urodynamic findings in patients after a bulbourethral composite suspension with intraoperative urodynamically controlled sling tension adjustment for postprostatectomy incontinence. Urology, 79(3), 702-7. https://doi.org/10.1016/j.urology.2011.11.012
Horstmann M, et al. Pre- and Postoperative Urodynamic Findings in Patients After a Bulbourethral Composite Suspension With Intraoperative Urodynamically Controlled Sling Tension Adjustment for Postprostatectomy Incontinence. Urology. 2012;79(3):702-7. PubMed PMID: 22245300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre- and postoperative urodynamic findings in patients after a bulbourethral composite suspension with intraoperative urodynamically controlled sling tension adjustment for postprostatectomy incontinence. AU - Horstmann,Marcus, AU - Fischer,Isabelle, AU - Vollmer,Christian, AU - Horton,Kevin, AU - Kurz,Michael, AU - Padevit,Christian, AU - John,Hubert, Y1 - 2012/01/13/ PY - 2011/08/16/received PY - 2011/11/10/revised PY - 2011/11/12/accepted PY - 2012/1/17/entrez PY - 2012/1/17/pubmed PY - 2012/5/19/medline SP - 702 EP - 7 JF - Urology JO - Urology VL - 79 IS - 3 N2 - OBJECTIVES: To compare pre- and postoperative urodynamic findings in patients with a bulbourethral composite suspension and intraoperative urodynamically controlled sling tension adjustment. METHODS AND PATIENTS: All data were prospectively collected from 10 patients (mean age 66 years) who successfully underwent bulbourethral composite suspension for moderate to severe postprostatectomy incontinence. Patients were evaluated preoperatively and 3-6 months postoperatively by urodynamic measurements, including urethra pressure profiles (UPPs) and pressure flow studies (PFSs). Clinical outcome was evaluated by patient-reported pad use and questionnaires (ICIQ-UI SF and I-QOL). Intraoperatively sling tension was adjusted under repeated urodynamic measurements of abdominal leak point pressure. Data were evaluated using the Kruskal-Wallis Wilcoxon test. RESULTS: Sling implantation was successful in all patients. Pre- to postoperative pad use decreased significantly (P < .005). Five patients were pad-free, 3 used 1 pad, and 2 used 2 pads per day. Continence and quality of life improved significantly (ICIQ-UI SF: pre-op 17 vs post-op 4.9; I-QOL: pre-op 66 vs post-op 91; P < .05 for both). Urodynamic parameters during the filling phase remained unchanged. UPPs revealed a significant increase of the maximal urethral closure pressure (pre-op 40 cm H(2)O vs post-op 58 cm H(2)O) and functional length (pre-op 31 mm vs post-op 40 mm; P < .05 for both). Postoperatively, urodynamic maximal flow rates were slightly reduced from 16 mL/s to 12 mL/s (P = .4). PFSs revealed an unobstructed voiding in all patients. CONCLUSIONS: According to the present evaluation, a bulbourethral composite suspension with intraoperative urodynamically controlled sling tension adjustment improves continence without causing prolonged clinically or urodynamically significant voiding obstruction. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/22245300/Pre__and_postoperative_urodynamic_findings_in_patients_after_a_bulbourethral_composite_suspension_with_intraoperative_urodynamically_controlled_sling_tension_adjustment_for_postprostatectomy_incontinence_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(11)02638-0 DB - PRIME DP - Unbound Medicine ER -