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The aim of this study was to evaluate perioperative morbidity and shortterm efficacy of TVT-Secur in treating female stress urinary incontinence. Data from 147 patients with urodynamic and/or occult SUI who were treated with TVTsecur in each single centre between 1st March 2007 and 31st December 2007 were collected. In positioning the sling, 74.8% of the surgeons chose the transobturator approach (110/147) and the remaining 25.2% chose the retropubic one. In 64.6% of patients (95/147) with urethral hypermobility and cystocoele ==200ml. Post-operative morbidity was represented by 1 haematoma that disappeared spontaneously; 1 case of temporary pain that stopped within 7 days; 8 patients had urinating difficulties (RV>100ml), 5 of whom were in Group B. At the short-term follow up this technique’s success percentage with respect to the total population was 87.5% (119/136), 85.3% in Group A (81/95) and 90.3% (37/41) in Group B. The data collected show that when treating female stress urinary incontinence, TVTsecur represents an innovative, simpler and safer, therapeutic alternative, and its efficacy equals that of retropubic and/or transobturator traditional midurethral slings.

This paper presents the results of a broad, transversal, observational survey on the social cost of female urinary incontinence in the general female population, resident in the ASL3-Monza area. In this population, in an 18- 65 year old age group, the prevalence of U.I. observed is 28.5% (LIFE cases) and 18.6% (YEAR cases). The total number of incontinent women in the ASL3-Monza area and in the Lombardy Region can be estimated as follows: - ASL3-Monza 125,288 “LIFE” cases, 81,767 (18.6% of 439,609) “YEAR” cases. - Lombardy Region 1,119,480 “LIFE” cases, 730,608 (18.6% of 3,928,709) “YEAR” cases. In the light of the data collected, we can estimate that in the Lombardy Region and in the ASL3-Monza area, at least 379,600 (52% of 730,608) and 42,518 (52% of 81,767) incontinent women use protection and 175,200 (24% of 730,608) and 19,624 (24% of 81,767) consider using a pad to be the only useful solution to the problem. The “estimated” mean/annual cost per woman in an incontinent population with characteristics similar to those of the general female population of the ASL3-Monza is € 358,03, for a mean/life cost per woman of € 11.099,20.When there is no effective treatment of the symptom, we can estimate the following total cost/life in the ASL3-Monza area to be: 65,414 x 31 x € 358,03 = € 726.025.407. If the symptom disappears and the treatment is effective, this is also an advantage, apart from the obvious requirement for public health related to it, from a strictly pharmacological-economic point of view. The estimated total/life cost for the treatment (with the most effective medical, rehabilitative and/or surgical therapy available today) of a sample of 1,000 incontinent women of the ASL3- Monza area is significatively lower than the total cost/life expected in the case of persistence and “assistance” of the symptom: € 4.502.812,10 vs. € 23.451.270,02. Despite the methodological limits of a pilot study (single centre collection of data, limited samples, analysis of “theoretical” populations), from the data collected it appears clear that the more incisive and determined the strategy of information and education, and the fuller and earlier the diagnosis, the more significative the social- economic, as well as the psycho-social saving.

Sono state studiate 110 pazienti consecutive giunte per la prima volta all’Ambulatorio di Uro-ginecologia dell’Ospedale di Desio per una incontinenza urinaria da sforzo e sottoposte a trattamento uroriabilitativo presso la Divisione di Neuroriabilitazione dell’Ospedale di Seregno negli anni 1998- 2000.

The authors deal with “female diabetic cystopathy” with particular regard to the incidence of the most frequent disorders that characterise the syndrome. The study was carried out on 255 patients, in collaboration with outpatients’ surgeries specialised in diabetes. Other aspect s specially emphasized were the association of vesicourethral functional disorders with alterations of the pelvic statics and the severity of the symptoms in relation to the age of the patients and the duration of their diabetes.