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Cure of Underactive and Overactive Bladder Symptoms in Women by 1,671 Apical Sling Operations Gives Fresh Insights into Pathogenesis and Need for Definition Change
- Source :
- Urologia Internationalis. 103:228-234
- Publication Year :
- 2019
- Publisher :
- S. Karger AG, 2019.
-
Abstract
- Introduction:To check evidence that symptoms identical with those constituting “underactive bladder” (UAB) and “overactive bladder” (OAB) are caused by apical prolapse and cured by repair thereof. Material and Methods: After repair of apical prolapse by mesh tape reinforcement of lax uterosacral ligaments (USL) data form 1,671 women were retrospectively examined to determine the presence of OAB and UAB symptoms and to check, how many were cured surgically. Thereby 3 different techniques were performed: elevate (n = 277), “Posterior IVS” (n = 1,049), and TFS cardinal (CL)/USL (n = 345). Results: Symptoms identical with those comprising UAB and OAB were cured in up to 80% of cases following surgical repair of the CL/USL complex. Conclusions: These symptoms may be consistent with symptoms of the posterior fornix syndrome, which comprises 4 main symptoms: micturition difficulties, urge/frequency, nocturia, chronic pelvic pain, all consequent on USL laxity. Surgical cure of OAB and UAB is inconsistent with existing definitions, which imply pathogenesis of the detrusor muscle itself. A reconsideration and reformulation of existing definitions may be required. Altering UAB definition to “bladder emptying difficulties” and return to former definitions for OAB such as “detrusor” or “bladder instability” may help to restore compatibility with surgical cure of these conditions.
- Subjects :
- Detrusor muscle
medicine.medical_specialty
Sling (implant)
Urology
030232 urology & nephrology
Underactive bladder
urologic and male genital diseases
Pathogenesis
03 medical and health sciences
0302 clinical medicine
Terminology as Topic
Urinary Bladder, Underactive
medicine
Humans
Nocturia
Retrospective Studies
Surgical repair
Suburethral Slings
Urinary Bladder, Overactive
business.industry
Pelvic pain
Remission Induction
medicine.disease
female genital diseases and pregnancy complications
Surgery
medicine.anatomical_structure
Overactive bladder
030220 oncology & carcinogenesis
Urologic Surgical Procedures
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 14230399 and 00421138
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- Urologia Internationalis
- Accession number :
- edsair.doi.dedup.....2c6c920d40357a062833675f3543adf6