Search

Introduction and objectives. The aim of this study is to highlight predictors or predisposing factors of stress urinary incontinence (SUI) in order to help clinicians during their treatment decisions and establish a preventive strategy to decrease the incontinence rate among women. Materials and methods. We performed a retrospective study over a period of 3 years (January 2012-December 2014) in Mure? County Hospital, Clinic of Urology. We examined 113 women with urinary incontinence and we established the following diagnosis: stress urinary incontinence in 68 cases (60%), urge urinary incontinence in 26 cases (23%) and mixed urinary incontinence in 19 cases (17%). The selection criteria for this study were female patients diagnosed with stress urinary incontinence having indication of surgical treatment (transobturator tape-TOT). We included in this study 24 patients admitted in the hospital. Results. Regarding the distribution of the patients depending on age group we observed that SUI was predominant in the 60-69 years age group (12 cases), followed by 70-79 years (6 cases), 50-59 years (4 cases) and 40-49years (2 cases). The mean age was 64,25+/-8,25 (standard deviation) years old with extremities between 41 to 46 years old. For the statistical analysis we applied Fisher's test, Chi-square test and unpaired test and we compared the group having SIU with a group of 47 patients without the disease. We analyzed the data and we observed that increased age, pregnancies, vaginal delivery, menopause, body mass index (BMI), diabetes and hysterectomy represents risk factors for SUI and that there is a significant relation between SUI and those factors, p<0,05. Statisticaly, we found no relation between caesarian, urinary tract infections, genital prolapse, neurological diseases and SUI, p was insignificant. Conclusions. Stress urinary incontinence is frequent in middle age women. Multiple predictors like age, pregnancy, vaginal delivery, menopause, high body mass index, hysterectomy had been found to be associated with SUI. Recognizing these predisposing factors, we can develop in time prevention techniques which can reduce the development and progression of symptomatology in SUI. [ABSTRACT FROM AUTHOR]

Treatment of stress urinary incontinence consists of a wide range of options, from conservative therapies like lifestyle changes, medication, pelvic floor muscles exercises, electrostimulation, to minimally invasive proceduresinjection of collagen, suburethral slings TVT / TOT and last but not least, invasive surgical treatment reserved for recurrent and complex cases. Among the latest minimally invasive procedures reported in literature, the injection of intra-and perisfincterian of autologous stem cell (mioblasts and /or mature fibroblasts grown and multiplied in the laboratory from biopsy samples taken from the pectoralis muscles). The Clinical Institute of Uronephrology and Renal Transplantation Fundeni was performed the first stem cell implantation procedure in the urethral sphincter, in Romania. Assessment at 6 weeks, the quality of life questionnaires, micturition diary and clinical examination revealed a stunning decrease of urine loss from 6 pads / day at one per day, which significantly improved the patient's quality of life. Clinical and urodynamic evaluations will continue and will be future scientific topics. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to establish the importance of urodynamic investigations in women diagnosed with stress urinary incontinence (SUI) who have indication of surgical treatment. Methods: We performed a retrospective study over a period of 3 years (January 2012-December 2014) in Clinic of Urology from Tirgu Mures. The inclusion criteria were: female patients diagnosed with SUI having indication of surgical treatment and the existence of urodynamic investigations (uroflowmetry and pressure-flow study). We evaluated 118 patients with SUI. From this patients, 24 cases (20.3%) accomplished the criteria from above. Results: We included in this study 24 patients aged 64.25+/−8.25 (standard deviation). Pressure-flow study revealed an impaired detrusor contraction in 13 cases. Statistical anaysis pouved a relation between existence of post void residual urine (PVR) and underactive detrusor (UD) (p=0.01). There is no correlation between maximum flow rate (Qmax) and UD, r=0.18 (CI= −0.2-0.5), p=0.3 and between normal value of Qmax and normal detrusor pressure (Pdet), r= 0,28(CI=−0.6-0.8), p=0.58. Also there is no relation between a low Qmax and UD, p=0,5. There is a statistical relation between increased abdominal pressure (Pabd) and UD, p=0.02. Conclusions: Uroflowmetry has the role to guide us concerning the micturition process Pressure-flow study is indicated in management of SUI, in selected cases, in patients with voiding symptomatology, the suspicion of a detrusor contractility dysfunction, abnormal uroflowmetry results, existence of PVR, in prediction of the surgical treatment outcome or if we think that the findings can change the choice of treatment. [ABSTRACT FROM AUTHOR]