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This was a prospective, interventional, comparative study conducted on patients with congenital simple severe ptosis. A novel method of silicone rod fixation to the tarsus (tarsal tunnel technique, group 1) was done compared with a conventional technique of silicone rod fixation (suture fixation technique, group 2) in frontalis suspension surgery. A total of 30 patients were randomized into two groups of 15 patients each. Postoperatively, MRD1, vertical palpebral aperture, and eyelid fold height were comparable in both groups till the last follow-up with stability in eyelid position. Patient satisfaction scores showed similar results with good-fair satisfaction grading in 13 patients in group 1 and 11 patients in group 2 at 6 months follow-up. No significant complications occurred in either group. Tarsal tunnel fixation of silicone rods is a novel method in sling surgery with optimal cosmetic and function outcomes. Further long-term studies are needed to validate the results of the technique.

This was a prospective, interventional, comparative study conducted on patients with congenital simple severe ptosis. A novel method of silicone rod fixation to the tarsus (tarsal tunnel technique, group 1) was done compared with a conventional technique of silicone rod fixation (suture fixation technique, group 2) in frontalis suspension surgery. A total of 30 patients were randomized into two groups of 15 patients each. Postoperatively, MRD1, vertical palpebral aperture, and eyelid fold height were comparable in both groups till the last follow-up with stability in eyelid position. Patient satisfaction scores showed similar results with good-fair satisfaction grading in 13 patients in group 1 and 11 patients in group 2 at 6 months follow-up. No significant complications occurred in either group. Tarsal tunnel fixation of silicone rods is a novel method in sling surgery with optimal cosmetic and function outcomes. Further long-term studies are needed to validate the results of the technique. [ABSTRACT FROM AUTHOR]

Purpose: To explore the effectiveness of sling surgery followed by pelvic floor muscle exercises (PFME) or PFME alone for moderate stress urinary incontinence (SUI) in women and its influencing factors. Methods: This is a prospective observational cohort study investigating whether sling surgery or PFME is preferred for pre-menopause women with moderate uncomplicated SUI. Those who received PFME alone or sling surgery were divided to PT or TVT group, respectively. The primary outcome was objective cure at 12 months. The secondary outcomes included Incontinence Impact Questionnaire—Short Form (IIQ-7) scores and PFME adherence. Results: The study sample comprised 130 and 74 patients in the PT and TVT groups, respectively. There was 38.2% of patients adhered to PFME twice weekly or more often, and the compliance varied by education level. At 12 months, the objective cure rate was significantly higher in the TVT versus PT group (75.7% vs 47.7%; adjusted OR = 4.27; 95% CI, 2.05–8.87; P < 0.001). In addition, the mean reduction in IIQ-7 scores was greater in the TVT group (16.2 vs 10.0; adjusted OR = 3.38; 95% CI, 1.93–4.82; P < 0.001). However, among patients with lower education or those without adherence to PFME at 12 months, the TVT was also favorized, and the discrepancy in cure rates was greater between the two groups. Conclusion: Sling procedures followed by PFME demonstrate greater efficacy versus physiotherapy alone for moderate female SUI management. Continued adherence to PFME was important, even for patients undergoing sling procedures. Educational factors influenced patient PFME adherence and the advantage conferred by sling procedures. [ABSTRACT FROM AUTHOR]

Urinary incontinence (UI) as one of the manifestations of pelvic floor disorder (PFD) or pelvic floor dysfunction has been surgically managed for decades with reconstruction of weakened pelvic floor support based on integral theory (IT). This paper provides the holistic understanding of pelvic floor support system based on the concept of defecatory perineal disorder (DFD) that may pose challenges to IT which believe weakened “ligaments” is the main cause in PFD. [ABSTRACT FROM AUTHOR]

Introduction: Urinary incontinence is a socially significant disease affecting millions of women around the world. High efficiency of modern treatment methods and short hospital stay contribute to lower psychological discomfort of patients., Aim: To assess the psychological state of patients suffering from stress urinary incontinence before and after surgical treatment in a day patient department and while staying in the hospital for 3-4 days., Materials and Methods: A total of 133 patients aged from 34 to 69 years were included, who underwent surgical treatment in the City Clinical Hospital named after. S.I. Spasokukotsky from 2021 to 2022 in a day patient department and a standard hospital., Results: In homogeneous groups, there was a decrease in the level of anxiety and depression, as well as an increase quality of life after surgery, which was more pronounced in those treated in a day patient department.

The purpose of the review - presentation of clinical scientific data based on current evidence of information on the management of patients with stress urinary incontinence, the effectiveness and safety of periurethral injections of various bulking substances. Material and methods. А review of Russian and foreign sources on the prevalence, etiopathogenesis, diagnosis and treatment of stress urinary incontinence in women, in particular the injection method. Results. The review presents data of the etiopathogenesis, diagnosis and treatment of stress urinary incontinence in women, depending on the severity of the pathology. Analyzed the data of periurethral injection of various bulking materials, their effectiveness and safety.

He purpose of the review - presentation of basic clinical scientific data based on current evidence on the management of patients with mixed urinary incontinence. Material and methods. A review of Russian and foreign sources on the prevalence, etiopathogenesis, diagnosis and treatment of mixed urinary incontinence in women. Results. The review presents terminology, data on etiopathogenesis, clinic, diagnosis, phasing and treatment methods of mixed urinary incontinence in women at different age periods.

Purpose of Review: In this review, we present the current literature on the diagnosis and management of stress urinary incontinence induced by sphincter deficiency associated with neurogenic lower urinary tract dysfunction. Recent Findings: Because sphincter deficiency stress urinary incontinence is not a common condition, there are no guidelines or large-scale clinical studies that focus on the diagnosis and management of this condition. Although there is consensus that urodynamic investigation is the only method to assess the function of the lower urinary tract, there is no established urodynamic criteria to diagnose neurogenic sphincter deficiency. As for the treatment of sphincter deficiency stress urinary incontinence in neurogenic patients, artificial urinary sphincter has a better success rate and a higher complication and reoperation rate than other methods including sling surgery and injection of bulking agents. Summary: Although there is a progress in the evaluation and management of neurogenic patients with sphincter deficiency stress urinary incontinence, a prospective multicenter clinical study on this condition should be highly recommended. [ABSTRACT FROM AUTHOR]

Objectives: To elucidate the treatment results and predictors for successful outcome in women with detrusor underactivity (DU) and stress urinary incontinence (SUI) undergoing suburethral sling procedure. Methods: Medical records of women with coexistent SUI and DU treated with a suburethral sling were retrospectively reviewed and we analyzed the association between treatment outcome and baseline demographics including etiology of DU and urodynamic variables. Patients who were dry and could urinate spontaneously were considered successful. Treatment failure was considered in those who were dry but needing clean intermittent catheterization (CIC) and patients who were still wet. Urogenital Distress Inventory (UDI‐6) and Incontinence Impact Questionnaire (IIQ‐7) scores were used to assess the impact of surgery on the quality of life. Results: Among 71 patients, a successful outcome was noted in 39 (55%), failed outcome with CIC in 15 (21%), and totally treatment failure in 17 (24%). Treatment outcome did not differ among the etiology subgroups. Overall, UDI‐6 and IIQ‐7 scores significantly improved after surgery. Multivariable logistic regression analysis revealed that the IIQ‐7 and maximum flow rate (Qmax) were two independent predictors for improvement after surgery. An IIQ‐7 score ≤6, and Qmax ≥6 mL/s can predict improvement by receiver operating characteristic analysis. Qmax ≤6 mL/s can predict needing CIC after surgery. Conclusions: For women with SUI and coexistent DU who underwent suburethral sling procedure, low IIQ‐7 (≤6) scores and higher Qmax (≥6 mL/s) are predictors for improvement of surgical outcome. A Qmax of <6 mL/s was the only predictor for CIC after surgery. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the clinical and urodynamic parameters affecting the treatment outcomes of post‐prostatectomy incontinence (PPI) surgery. Patients and Methods: We reviewed the patients with PPI who received an artificial urinary sphincter (AUS) or adjustable male sling (MS) from 2001 to 2016. Results: A total of 103 patients (AUS, 53; adjustable MS, 50) with a mean age of 69.9 (±5.6, standard deviation) years were analyzed. The mean number of pads used daily was 4.8 (±3.4). The mean symptom duration and follow‐up duration were 46.9 (±31.1) and 31.0 (±21.4) months, respectively. The overall rate of treatment success (≤1 pad per day at last follow‐up) at 12 months postoperatively was 81.6%. Based on univariate analysis, previous pelvic irradiation (P = 0.013), prior PPI surgery (P = 0.017), and degree of incontinence (P = 0.010) were inversely associated with the success of PPI surgery. In patients who received AUS, history of neurologic disease (P = 0.038) was inversely associated with treatment success. However, in patients with an adjustable MS, previous pelvic irradiation (P = 0.001), prior PPI surgery (P = 0.022), and degree of incontinence (P = 0.008) were inversely associated with treatment success. Conclusions: Adjustable MS should be avoided in patients with previous pelvic irradiation, prior PPI surgery, or severe symptoms. Physicians should be aware that the treatment outcome of AUS might be compromised in patients with neurologic disease. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The objective was to evaluate the impact of body mass index (BMI) on the subjective improvement and risk of reoperation after first-time mid-urethral sling surgery.Methods: Data were retrieved from the national Danish Urogynaecological Database, including women with first-time surgery with mid-urethral polypropylene slings from 2011 to 2016. The subjective improvement was assessed by the difference in symptoms based on the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) completed pre- and 3 months postoperatively. A reoperation was defined as any new surgical procedure for stress urinary incontinence performed within the study period.Results: During the study period, 6,414 mid-urethral sling procedures were performed; 80.0% of these women filled out both pre- and post-surgical International Consultation on Incontinence Questionnaire (ICI-Q) forms. 42.4% had a BMI < 25, 34.6% had BMI 25-30, 16.9% had BMI 30-35, and 6.0% BMI >35. The subjective improvement after surgery was high in all BMI categories and there were no differences between the categories. The overall cumulative hazard proportion at 2 years of follow-up was 1.9% (CI 95%: 1.6-2.3) and after 5 years 2.4% (CI 95%: 2.0-2.9). Adjusted for age, smoking, and use of alcohol, the cumulative hazard proportion after 2 years of follow-up was 3.2% (CI 95%: 1.6-6.2) for women with BMI >35 and after 5 years 4.0% (CI 95%: 2.0-7.7), which was the highest proportion of reoperation in the study. The crude hazard ratio was 1.84 (CI 95%: 0.89-3.83) women with BMI >35 and the adjusted hazard ratio was 1.94 (CI 95%: 0.92-4.09).Conclusions: We found high subjective improvement after the first-time surgery unrelated to BMI. Women with a BMI over 35 had the highest proportion of reoperations, although this was not statistically significant. [ABSTRACT FROM AUTHOR]

Purpose: To review cases of granuloma formation after sling surgery with a view to find out possible aetiological factors and propose a further plan of management Materials and methods: A retrospective analysis of 120 eyes of 108 patients who underwent frontalis sling surgery with silicone rod from Jan 2008 to Dec 2015 was conducted. All patients with severe ptosis and poor levator function who underwent frontalis sling surgery with silicone rod were included in the study irrespective of the cause of ptosis and method of passing the sling. A complete ophthalmic and ptosis examination was done. In all the cases, the prolene suture was tied over the sleeve to tighten it and it was buried along with the silicone rod in forehead pocket. All the cases with granuloma formation were first subjected to a microbiological examination including culture and sensitivity to antibiotics. All the patients were given a trial of antibiotics. Results: We encountered 10 cases of granuloma in 120 eyes of 108 patients operated during this period. The duration between time of surgery and presentation varied from 2 weeks to 4 months. The microbiological examination revealed positive culture in 5 cases. None of the cases responded to the course of antibiotics given for 10 days. The histopathological examination done in 5 cases (2 of them culture positive and 3 of them culture negative) revealed granulomatous inflammation of non-specific type. The sling was explanted in all cases which resulted in prompt resolution of granuloma in 7-10 days. Conclusions: The granuloma is primarily due to exposure of the sling itself or the sleeve enveloping the sling or the suture tied around the sleeve thereby. They do not respond to antibiotics but respond very well to explantation. These patients can be taken up for re-sling surgery after a waiting period of 3 months. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: To correlate dynamic assessment of sling function using 2D and 3D transperineal ultrasound with outcomes following transobturator sling surgery. Methods: This is an unmatched case-control study of 100 patients who underwent transobturator sling surgery at our center between 2009 and 2012. Group A ( n = 50) patients had successful outcomes and group B ( n = 50) patients had suboptimal outcomes 1 year following surgery. The patients underwent 2D dynamic and 3D transperineal ultrasound. The two groups were compared with regard to the deformability of the sling on Valsalva, the concordance of urethral movement with the sling, and location of the sling. Results: When compared with group B, group A had a significantly greater number of patients in whom the sling deformed at Valsalva (flat at rest, curving into a c-shape at Valsalva), the urethral movement was concordant with the sling and the sling had a midurethral location ( p < 0.0001). In all 17 patients in group B in whom the urethra moved in a concordant manner with the sling (34%), the sling did not deform on Valsalva maneuver and was located proximally. In all 15 patients in group A in whom the sling remained either flat or curved (30%), the urethra moved concordant with the sling and the sling was in midurethral location. Conclusions: On 2D and 3D transperineal ultrasound, the best outcomes following transobturator sling surgery are associated with concordance of urethral movement with the sling, midurethral location, and deformability of the sling on dynamic assessment. [ABSTRACT FROM AUTHOR]

Objective The primary objective of this study was to evaluate the feasibility of performing retropubic mid-urethral transvaginal tape (TVT) with self-tailored ordinary polypropylene mesh (STOM) under sedation and local anesthesia in female patients with stress urinary incontinence (SUI). The second objective was to evaluate perioperative and immediate postoperative complications, success rates, and cost-effectivity. Materials and methods Forty-two subjects treated for stress urinary incontinence using STOM under local anesthesia were reviewed. Pre- and postoperative evaluation included assessment of valid questionnaires such as the urogenital distress inventory (UDI) and medical, epidemiologic, and social aspects of aging incontinence questionnaire (MESA), uroflowmetry in all cases, and urodynamics in some instances. Success rates and complications were compared with published studies. Results The mean operating time was 27 mins, and the median visual analog scale (VAS) score at 12 hours was three. Postoperative MESA and UDI scores had significant improvement. The mean hospital stay was 18 hours. Mean preoperative and postoperative Q max had no significant difference. With a mean follow-up of 27.32±3.29 months, the cure was seen in 38 patients (90.4%), improvement in three patients (0.07%), and failure in one patient (0.02%). Mesh-related complications (extrusion) occurred in one patient. The sling cost was reduced from approximately $500 (Gynecare TVT sling; Ethicon Inc., Somerville, NJ, USA) to $12.44 (Ethicon 15 x 7.6 cm Prolene (polypropylene mesh); Ethicon Inc., Somerville, NJ, USA) in our study. Conclusion Performing TVT with STOM under sedation and local anesthesia as a daycare procedure was feasible and cost-effective, has a high success rate, and was associated with minimal complications. It should be considered in developing countries with vast patient burdens, such as India., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kalra et al.)

Objetivo: analisar os resultados cirúrgicos após slings com mucosa vaginal, realizados pelo setor de Uroginecologia e Cirurgia Vaginal da UNIFESP/EPM, no tratamento de mulheres incontinentes com hipermobilidade do colo vesical, que apresentam alto risco de falha cirúrgica para outras técnicas ou naquelas com defeito esfincteriano intrínseco e, ainda, recidivas cirúrgicas. Métodos: foram avaliadas 21 pacientes submetidas à cirurgia para correção de incontinência urinária pela técnica de sling vaginal, no período de dezembro de 1997 a fevereiro de 1999, com seguimento pós-operatório que variou de 1 a 14 meses (média de 8,2). A média de idade das pacientes foi de 56 anos (39 a 77 anos), sendo que 15 (71,4%) encontravam-se na menopausa e 6 (28,6%) no menacme. Todas as pacientes foram avaliadas antes da cirurgia por meio de anamnese, exame clínico, estudo ultra-sonográfico e urodinâmico, sendo o grau de perda urinária acentuado em 66,7% e moderado em 33,3% das pacientes. Todas as pacientes apresentavam hipermobilidade da junção uretrovesical (superior a 10 mm) e 12 pacientes apresentavam cirurgia prévia para correção de incontinência urinária. Ao estudo urodinâmico, as pacientes apresentavam perda urinária com pressão máxima de fechamento uretral (PMFU) variando de 20 a 124 cmH2O (média de 55,2) e "Valsalva leak point pressure" (VLPP) variando de 18 a 128 cmH2O (média de 60,3). As indicações das cirurgias foram: defeito esfincteriano (11 pacientes - 52,4%), obesidade (5 pacientes - 23,8%), defeito esfincteriano e obesidade (2 pacientes - 9,5%), recidiva cirúrgica (2 pacientes - 9,5%) e defeito esfincteriano e prolapso uterino de 1º grau (1 paciente - 4,8%). Resultados: como complicações, 6 pacientes (28,6%) apresentaram retenção urinária temporária no pós-operatório, 1 (4,8%) infecção do trato urinário, 1 (4,8%) presença de fio de polipropileno na vagina, 1 (4,8%) infecção da ferida cirúrgica, 4 pacientes (19%) evoluíram com urgência/incontinência, 1 (4,8%) com urgência miccional e 1 (4,8%) com dificuldade para urinar (elevado resíduo pós-miccional). O grau de satisfação das pacientes foi satisfatório, com 15 pacientes (71,4%) referindo cura, 3 (14,3%) melhora, 2 (9,5%) quadro de perda urinária inalterado e 1 (4,8%) piora da perda urinária. Conclusões: a cirurgia de sling com mucosa vaginal é eficaz para o tratamento de casos específicos de incontinência urinária de esforço, destacando-se defeito esfincteriano, recidivas cirúrgicas e fatores predisponentes para falha de outras técnicas.Purpose: to analyze the surgical results after slings with vaginal wall, performed by the Urogynecology and Vaginal Surgery Sector of UNIFESP/EPM, for the treatment of incontinent women with hypermobility of the bladder neck, who show great risk of surgery failure with other techniques or in those with intrinsic sphincteric deficiency (ISD) and, also, surgery recurrence. Methods: we studied 21 patients submitted to surgery in order to correct urinary incontinence by the vaginal wall sling technique, in the period from December 1997 to February 1999, with postoperative follow-up which varied between 1 and 14 months (average 8.2). The mean age of patients was 56 years (39 to 77 years), 15 (71.4%) were in menopause and 6 (28.6%) in menacme. All patients were evaluated before the surgery through medical interview, physical examination, ultrasound and urodynamic study, the grade of urinary loss being high in 66.7% and moderate in 33.3% of the patients. All patients showed hypermobility of the bladder neck (more than 10 mm) and 12 patients had previous surgery to correct the urinary incontinence. Regarding the urodinamic study, the patients manifested urinary loss with maximum pressure of urethral closure (MPUC) varying from 20 to 124 cmH2O (average 55.2) and Valsalva leak point pressure (VLPP) varying from 18 to 128 cmH2O (average 60.3). The indications of surgery were: ISD (11 patients -- 52.4%), obesity (5 patients -- 23.8%), ISD and obesity (2 patients -- 9.5%), surgery recurrence (2 patients -- 9.5) and ISD and first grade womb prolapse (1 patient -- 4.8%). Results: as complications, 6 patients (28.6%) showed temporary urinary retention after surgery, 1 patient (4.8%) infection in the urinary tract, 1 patient (4.8%) presence of polypropylene suture in the vagina, 1 patient (4.8%) infection of the surgery wound, 4 patients (19%) developed urgency/incontinence, 1 (4.8%) urgency and 1 (4.8%) difficulty in urinating (high postvoiding residue). The grade of the patients' satisfaction was satisfactory, with 15 patients (71.4%) referring cure, 3 patients (14.3%) improvement, in 2 patients (9.5%) the urinary loss remained unchanged and in 1 patient (4.8%) the urinary loss got worse. Conclusions: the vaginal wall sling surgery is efficient for the treatment of specific cases of stress urinary incontinence, emphasizing intrinsic urethral sphincteric incompetence, surgery recurrence and predisposing factors to failure of other techniques.

Introduction One of the methods to treat post radical prostatectomy stress urinary incontinence is the Ad Vance ™ (American Medical Systems®, Minnetonka, MN, USA) male sling procedure. During this procedure, the somatic innervation of the penis may be at risk for injury. Six Ad Vance ™ procedures were performed in six donated bodies at the Anatomy and Embryology Department of the Leiden University Medical Centre. The pelves were dissected and the shortest distance between the sling and the dorsal nerve of the penis ( DNP) was documented. Aim The aim of this study was to describe the anatomical relation between the AdVance ™ male sling and penile nerves based on the dissection of six adult male pelves. Methods The Ad Vance ™ male sling procedure was conducted in six donated male bodies. After placement, the pelves were dissected and the shortest distance between sling and the DNP was documented. Main Outcome Measure The main outcome measure was the distance between the Ad Vance ™ male sling and the DNP. Results The mean distance of the sling to the DNP was 4.1 mm and was found situated directly next to the nerve (distance 0 mm) in 4 out of 12 (33%) hemipelves. The distance of the sling to the obturator neurovascular bundle was 30 mm or more in all six bodies. Conclusions Damage to the DNP caused by the Ad Vance ™ male sling procedure appears to be an extremely rare complication, which has not been described in current literature. The proximity of the Ad Vance ™ to the DNP could, however, pose a risk that should be taken into consideration by physicians and patients when opting for surgery. Hogewoning CRC, Elzevier HW, Pelger RCM, Bekker MD, and DeRuiter MC. The risk of damage to the somatic innervation of the penis during the Ad Vance™ procedure; An anatomical study. J Sex Med 2015;12:1705-1710. [ABSTRACT FROM AUTHOR]

Stress urinary incontinence (SUI) is one of the most common diseases accompanied by loss of control over the activity of the bladder. Women are more susceptible to this pathology than men due to the peculiarities of the structure of the genitourinary system, as well as due to pregnancy, childbirth, gynecological operations, and age. Incontinence occurs when a woman coughs, sneezes, laughs, lifts weights, runs, etc. It leads to social isolation and significantly reduces the quality of life of patients. The article analyzes the case of a patient who was in the gynecological department of the Uzhhorod City Maternity Hospital of the Uzhhorod City Council and complained of urinary incontinence during coughing, sneezing, laughing, and physical exertion. A full clinical and laboratory examination, physical examination, and consultation with narrow specialists were conducted. According to the research data, a diagnosis of stress urinary incontinence was made. Urethropexy with a synthetic loop (TVT-O operation) was performed using the Gynecare TVT Obturator System Tension-free Support for Incontinence. The complex treatment included antibacterial, antithrombotic and infusion therapy. The effectiveness of the result of surgical treatment was evaluated taking into account subjective and objective criteria for the restoration of anatomical parameters and functional parameters, as well as the patient's quality of life during dynamic follow-up for 2 years. We noted the high efficiency of surgical treatment of stress urinary incontinence using synthetic material.

Objective.The aim of this study was to determine the surgical success and complication rates of mixed type of mesh materials compared with Prolene mesh in sling surgery over a 4-year follow-up period. Material and methods .Between 2005 and 2007 broad-based double-forced sling operations were performed in 144 women with stress incontinence using three different types of mesh material. Group I consisted of 48 patients in whom Vypro® mesh (Ethicon, USA) was used; group II of 48 patients in whom Ultrapro ® mesh (Ethicon) and group III of 48 patients in whom Prolene ®light mesh (Ethicon) was used. The patients' data and the success of the operation were evaluated based on the 24 h pad test, International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) scoring and Korman questionnaire analysis. Results. The ICIQ-SF score, the number of pads used and the results of 24 h pad test were statistically lower in group II at postoperative month 48 (p < 0.05). The rate of postoperative complications was lower in Group II than in the other groups (p < 0.05). The continence rates of groups I, II and III were 84.7%, 91.6% and 85.1%, respectively, in the 48th postoperative month. Conclusions. Ultrapro mesh can be used in sling surgery owing to its higher success rates, and lower vaginal and urethral extrusion and de novo urgency rates, which have also been shown in clinical studies. [ABSTRACT FROM AUTHOR]

Aim: To examine the time-dependent biomechanical properties of four different implanted synthetic materials. Materials and Methods: 18 New Zealand rabbits were randomly categorized into three groups: group 1 to be evaluated at the 2nd week, group 2 at the 8th week, and group 3 at the 12th week. Before the implantation, baseline values were obtained. Each of the 2 × 5 cm sized materials of mersilene, prolene, ultrapro and vypro mesh were placed in the anterior abdominal fascia. The mesh materials were removed, tensile strength (N/mm2) and ultimate strain (%) were measured by tensinometry and surface area losses (cm2) were calculated. Results: Tensile strength values (mean ± SD) were 9.2 ± 1.5, 8.5 ± 1.2 for mersilene, 25.2 ± 7.3, 14.0 ± 2.9 for prolene, 2.2 ± 0.6, 12.5 ± 1.4 for ultrapro and 8.1 ± 1.6, 7.0 ± 1.8 for vypro at baseline and the 12th week. Ultimate strain values (mean ± SD) were 131.2 ± 46.1, 110.4 ± 98.6 for mersilene, 181.0 ± 26.4, 78.5 ± 14.4 for prolene, 91.5 ± 8.2, 89.6 ± 20.5 for ultrapro and 84.3 ± 8.9, 55.0 ± 13.2 for vypro at baseline and the 12th week. Surface areas (mean ± SD) were 8.87 ± 0.14, 9.38 ± 0.17, 8.4 ± 0.32 and 8.76 ± 0.16 for mersilene, prolene, ultrapro and vypro at the 12th week respectively. Conclusions: Although prolene mesh demonstrated a decrease in its tensile strength it still remains the highest at the 12th week. Considering the significant time-dependent increase in its tensile strength, ultrapro mesh should be studied in humans. A final decision on the preference of ultrapro mesh in sling surgery could be reached after such studies. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Eight older women with stress incontinence caused by intrinsic urethral weakness underwent sling surgery with allogenic fascia lata. The tolerance of the material was excellent. In 1 case a secondary release of the fixation on the pecten was necessary because of too much tension; in the other cases the evolution was uneventful and resulted in perfect continence lasting for at least 2 years of follow-up.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Urinary stress incontinence considerably decreases the life quality of women, which makes search for effective methods of treatment essential. The research presents results of surgical treatment of 230 patients with stress urinary incontinence between 2011 and 2014., Materials and Methods: Efficiency of treatment of urinary incontinence in women, using Tension-free Vaginal Tape (TVT-O) and mini-sling Ophira was presented. The evaluation was made out of complaints and physical examination in target groups, including patients with concurrent genital prolapse and mixed urinary incontinence. For correct diagnosis all patients were submitted to urodynamic and ultrasound tests. In case of need M-cholinomimetic drugs were applied. To evaluate different complaints 5-graded visual analogue scale was worked out. Results of cough stress test were taken as main objective way to estimate effectiveness of the treatment., Results: The research showed that application of TVT-O mesh and mini-sling Ophira turned out to be highly effective in treatment of urine stress incontinence in women. Among short-term complications urinary retention was most common (3,5 percent). To correct those complications alfa-adrenergic agonists, physiotherapy, and acupuncture were applied. Erosions of vaginal mucous had developed at the place where meshes were planted in 1,3 percent of cases. Only once it required mesh excision.