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Contains fulltext : 300102.pdf (Publisher’s version ) (Open Access), Surgery for male incontinence with artificial urinary sphincters and slings (SATURN) is a prospective, multicentre registry (observational cohort) for male stress urinary incontinence surgery to collect prospective data from multiple European centres and surgeons, to evaluate the short- and long-term success and the impact on quality of life., 01 november 2023

Contains fulltext : 225058.pdf (Publisher’s version ) (Closed access), CONTEXT: Coronavirus disease 19 (COVID-19) has changed standard urology practice around the world. The situation is affecting not only uro-oncological patients but also patients with benign and disabling conditions who are suffering delays in medical attention that impact their quality of life. OBJECTIVE: To propose, based on expert advice and current evidence where available, a strategy to reorganize female and functional urological (FFU) activity (diagnosis and treatment). EVIDENCE ACQUISITION: The present document is based on a narrative review of the limited data available in the urological literature on SARS-Cov-2 and the experience of FFU experts from several countries around the world. EVIDENCE SYNTHESIS: In all the treatment schemes proposed in the literature on the COVID-19 pandemic, FFU surgery is not adequately covered and usually grouped into the category that is not urgent or can be delayed, but in a sustained pandemic scenario there are cases that cannot be delayed that should be considered for surgery as a priority. The aim of this document is to provide a detailed management plan for noninvasive and invasive FFU consultations, investigations, and operations. A classification of FFU surgical activity by indication and urgency is proposed, as well as recommendations adopted from the literature for good surgical practice and by surgical approach in FFU in the COVID-19 era. CONCLUSIONS: Functional, benign, and pelvic floor conditions have often been considered suitable for delay in challenging times. The long-term implications of this reduction in functional urology clinical activity are currently unknown. This document will help functional urology departments to reorganize their activity to best serve their patients. PATIENT SUMMARY: Many patients will suffer delays in urology treatment because of COVID-19, with consequent impairment of their physical and psychological health and deterioration of their quality of life. Efforts should be made to minimize

Item does not contain fulltext, AIMS: To assess efficacy and safety as well as predictive factors of dry rate and freedom from surgical revision in patients underwent AUS placement. The artificial urinary sphincter (AUS) is still considered the standard for the treatment of moderate to severe post-prostatectomy stress urinary incontinence (SUI). However, data reporting efficacy and safety from large series are lacking. METHODS: A multicenter, retrospective study was conducted in 16 centers in Europe and USA. Only primary cases of AUS implantation in non-neurogenic SUI after prostate surgery, with a follow-up of at least 1 year were included. Efficacy data (continence rate, based on pad usage) and safety data (revision rate in case of infection and erosion, as well as atrophy or mechanical failure) were collected. Multivariable analyses were performed in order to investigate possible predictors of the aforementioned outcomes. RESULTS: Eight hundred ninety-two men had primary AUS implantation. At 32 months mean follow-up overall dry rate and surgical revision were 58% and 30.7%, respectively. Logistic regression analysis showed that patients without previous incontinence surgery had a higher probability to be dry after AUS implantation (OR: 0.51, P = 0.03). Moreover institutional case-load was positively associated with dry rate (OR: 1.18; P = 0.005) and freedom from revision (OR: 1.51; P = 0.00). CONCLUSIONS: The results of this study showed that AUS is an effective option for the treatment of SUI after prostate surgery. Moreover previous incontinence surgery and low institutional case-load are negatively associated to efficacy and safety outcomes.

Item does not contain fulltext, CONTEXT: Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae. Implantable materials have been adopted for the treatment of female and male stress urinary incontinence (SUI) and female pelvic organ prolapse (POP). OBJECTIVE: A consensus review of existing data based on published meta-analyses and reviews. EVIDENCE ACQUISITION: This document summarises the deliberations of a consensus group meeting convened by the European Association of Urology (EAU) and the European Urogynecological Association, to explore the current evidence relating to the use of polypropylene (PP) materials used for the treatment of SUI and POP, with reference to the 2016 EAU guidelines (European Association of Urology 2016), the European Commission's SCENIHR report on the use of surgical meshes (SCENIHR 2015), other available high-quality evidence, guidelines, and national recommendations. EVIDENCE SYNTHESIS: Current data suggest that the use of nonautologous durable materials in surgery has well-established benefits but significant risks, which are specific to the condition and location they are used for. Various graft-related complications have been described-such as infection, chronic pain including dyspareunia, exposure in the vagina, shrinkage, erosion into other organs of xenografts, synthetic PP tapes (used in SUI), and meshes (used in POP)-which differ from the complications seen with abdominal herniae. CONCLUSIONS: When considering surgery for SUI, it is essential to evaluate the available options, which may include synthetic midurethral slings (MUSs) using PP tapes, bulking agents, colposuspension, and autologous sling surgery. The use of synthetic MUSs for surgical treatment of SUI in both male and female patients has good efficacy and acceptable morbidity. Synthetic mesh for POP should be used only in complex cases with recurrent prolapse in the same compartment and restricted to those surgeons with appropriate training who are working i

Perennial herbs, undershrubs or lianas, mostly with milky or watery juice. Leaves opposite or whorled, membranaceous, coriaceous or fleshy. Stipules wanting, very small or rudimentary. Flowers actinomorphic, usually 5-merous, rarely very large. Inflorescence consisting of extra-axillary or terminal panicles, racemes, umbels or cymes or flowers solitary. Calyx persistent, 5-lobed, the segments imbricate or separate in the bud, the tube short. Corolla sympetalous, shortly or deeply 5-fid, rotate, campanulate, infundibuliform, hypocrateriform or tubular; the segments commonly reflexed; aestivation imbricate, contorted or rarely valvate. Corona usually present, taking various forms and formed either wholly or partly by appendages to the corolla or the staminal filaments, distinct or joined to each other, membranaceous or fleshy, sometimes also joined to the corolla. Stamens 5, distinct or more usually connate around the gynaecium and adherent to the stigma; filaments short and broad and connate at their bases or throughout into a staminal column; anthers 2- or rarely 4-celled, attached by their bases to the filaments, usually united with each other and with the style to form a complex organ, the gynostemium. Pollen in tetrads, associated with 5 spoon-shaped translators, or the grains of each anther cell united in one or two waxy masses (pollinia), the latter attached by means of arm like processes (caudicles) to 5 small various shaped bodies, inserted on the style top and alternating with the anthers: the corpuscles or pollen carriers; a corpuscle and the caudicles of the adjacent anthers forming together the translator, an apparatus for the removal of the pollinia. Ovaries 2, superior; styles 2, free below but linked above by a single massive 5-lobed stigma. Ovules numerous, mostly anatropous, pendulous. Fruit a pair of follicles, or sometimes only one developing, deshiscing adaxially, the placenta becoming free as a replum. Seeds ovate, oblong or elliptic, compressed