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Salagierski Maciej - One of the best experts on this subject based on the ideXlab platform.
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Transperineal ultrasound as a reliable tool in the assessment of Membranous Urethra length in radical prostatectomy patients.
Scientific reports, 2021Co-Authors: Kania Piotr, Mieleszko Rafał, Kuligowski Marcin, Dudka Karol, Kuca Monika, Biedrzycki Jakub, Zwolan Bartosz, Dmowski Tadeusz, Salagierski MaciejAbstract:To evaluate the usefulness of transperineal ultrasound (TPUS) as a method of Membranous Urethra length (MUL) measurement and investigate whether preoperative (MULpre) and postoperative (MULpost) would be associated with the degree and time of urinary continence recovery after laparoscopic radical prostatectomy (LRP). 84 patients who underwent LRP between January 2017 and December 2018 were selected for final analysis. All patients had preoperative and postoperative measurement of MUL in TPUS. Urinary continence was defined as no pad or a safety pad. Recovery of continence was assessed at 1, 3, 6 and 12 months after catheter removal. We prospectively analyzed correlation of MULpre, MULpost and a percent change in Membranous Urethral length (MULratio) with the urinary continence status. 69 (82%) patients regained continence in the follow-up of 12 months. MULpre, MULpost and MULratio assessed in TPUS were larger in subgroups of patients who regained continence earlier and in the entire continent group. Spearman rank test showed strong correlations between MULpost and MULratio (R-0.6 and R-0.56, respectively, p
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transperineal ultrasound as a reliable tool in the assessment of Membranous Urethra length in radical prostatectomy patients
Scientific Reports, 2021Co-Authors: Kania Piotr, Kuligowski Marcin, Dudka Karol, Kuca Monika, Biedrzycki Jakub, Zwolan Bartosz, Dmowski Tadeusz, Mieleszko Rafal, Salagierski MaciejAbstract:To evaluate the usefulness of transperineal ultrasound (TPUS) as a method of Membranous Urethra length (MUL) measurement and investigate whether preoperative (MULpre) and postoperative (MULpost) would be associated with the degree and time of urinary continence recovery after laparoscopic radical prostatectomy (LRP). 84 patients who underwent LRP between January 2017 and December 2018 were selected for final analysis. All patients had preoperative and postoperative measurement of MUL in TPUS. Urinary continence was defined as no pad or a safety pad. Recovery of continence was assessed at 1, 3, 6 and 12 months after catheter removal. We prospectively analyzed correlation of MULpre, MULpost and a percent change in Membranous Urethral length (MULratio) with the urinary continence status. 69 (82%) patients regained continence in the follow-up of 12 months. MULpre, MULpost and MULratio assessed in TPUS were larger in subgroups of patients who regained continence earlier and in the entire continent group. Spearman rank test showed strong correlations between MULpost and MULratio (R-0.6 and R-0.56, respectively, p < 0.0001) with the time to continence recovery in the cumulative 12 months follow-up. TPUS allowed a reliable measurement of MUL before and after LRP. MULpre, MULpost as well as MULratio are related with time to regain continence and recovery rate after LRP. Sparing longest possible sphincteric Urethra, with respect to oncological outcomes is a key factor in recovering continence after prostate cancer surgery.
Sonja M. Kirchhoff - One of the best experts on this subject based on the ideXlab platform.
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The extent of changes in the Membranous Urethra angle is associated with the outcome of retroUrethral transobturator sling procedure
International Urology and Nephrology, 2015Co-Authors: Irina Soljanik, Olga Solyanik, Christian G. Stief, Ricarda M. Bauer, Armin J. Becker, Christian Gozzi, Sonja M. KirchhoffAbstract:Purpose To evaluate the outcome of the retroUrethral transobturator sling (RTS) by functional magnetic resonance imaging (MRI) and to identify parameters associated with sling failure. Methods Of thirty recruited men with postprostatectomy stress urinary incontinence (SUI), 26 consecutively underwent functional MRI before sling procedure and 12 months thereafter in a prospective clinical cohort observational study. PeriUrethral/Urethral fibrosis and sling visualization were evaluated on static sequences. The angle of the Membranous Urethra, position of the bladder neck and external Urethral sphincter were assessed during Valsalva’s maneuver and voiding. Sling success was defined as no or one dry “security” pad. Results The success and failure rates were 58 % (15/26 patients) and 42 % (11/26 patients), respectively. The sling leads to reduction in the Membranous Urethra angle during Valsalva’s maneuver (39.55° vs. 36.82°, p = 0.025) and voiding (38.25° vs. 34.83°, p = 0.001) and elevation of the external Urethral sphincter (2.9 vs. 4.8 mm, p = 0.017). Preoperative wider angle of the Membranous Urethra was significantly correlated with severe preoperative incontinence. Sling failure ( p = 0.001) and severe preoperative incontinence ( p = 0.001) were significantly related to only small changes of the Membranous Urethra angle. The interrater and intrarater reliability for Membranous Urethra angle was excellent (intraclass correlation coefficient ≥0.75). Conclusions The RTS leads to reduction in the Membranous Urethra angle. The extent of the changes in the Membranous Urethra angle is associated with RTS outcome. Functional MRI is a reliable noninvasive visualization tool of interactions between the sling and pelvic floor for further research on the complex nature of postprostatectomy SUI.
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Is a wider angle of the Membranous Urethra associated with incontinence after radical prostatectomy?
World Journal of Urology, 2014Co-Authors: Irina Soljanik, Olga Solyanik, Christian G. Stief, Ricarda M. Bauer, Armin J. Becker, Christian Gozzi, Kerstin A. Brocker, Sonja M. KirchhoffAbstract:Purpose To investigate whether differences in the anatomy and dynamics of the pelvic floor (PF) in patients after radical prostatectomy (RP) depicted on magnetic resonance imaging (MRI) are associated with continence status. Methods In the prospective designed study, 24 patients with post-prostatectomy stress urinary incontinence were enrolled. Additionally, 10 continent patients after RP were matched for age, body mass index and perioperative parameters. All patients underwent continence assessment and MRI (TrueFISP sequence; TR 4.57 ms; TE 2.29 ms; slice thickness 7 mm; FOV 270 mm) 12 months after RP. Images were analyzed for Membranous Urethra length (MUL), angle of the Membranous Urethra (AMU), severity of periUrethral/Urethral fibrosis, lifting of the levator ani muscle, lowering of the posterior bladder wall (BPW), bladder neck (BN) and external urinary sphincter (EUS), and symphyseal rotation of these structures during the Valsalva maneuver and voiding. Results Compared to continent controls, incontinent patients showed a significant wider AMU during voiding ( p = 0.002) and more pronounced lowering of the BN and EUS ( p
Irina Soljanik - One of the best experts on this subject based on the ideXlab platform.
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The extent of changes in the Membranous Urethra angle is associated with the outcome of retroUrethral transobturator sling procedure
International Urology and Nephrology, 2015Co-Authors: Irina Soljanik, Olga Solyanik, Christian G. Stief, Ricarda M. Bauer, Armin J. Becker, Christian Gozzi, Sonja M. KirchhoffAbstract:Purpose To evaluate the outcome of the retroUrethral transobturator sling (RTS) by functional magnetic resonance imaging (MRI) and to identify parameters associated with sling failure. Methods Of thirty recruited men with postprostatectomy stress urinary incontinence (SUI), 26 consecutively underwent functional MRI before sling procedure and 12 months thereafter in a prospective clinical cohort observational study. PeriUrethral/Urethral fibrosis and sling visualization were evaluated on static sequences. The angle of the Membranous Urethra, position of the bladder neck and external Urethral sphincter were assessed during Valsalva’s maneuver and voiding. Sling success was defined as no or one dry “security” pad. Results The success and failure rates were 58 % (15/26 patients) and 42 % (11/26 patients), respectively. The sling leads to reduction in the Membranous Urethra angle during Valsalva’s maneuver (39.55° vs. 36.82°, p = 0.025) and voiding (38.25° vs. 34.83°, p = 0.001) and elevation of the external Urethral sphincter (2.9 vs. 4.8 mm, p = 0.017). Preoperative wider angle of the Membranous Urethra was significantly correlated with severe preoperative incontinence. Sling failure ( p = 0.001) and severe preoperative incontinence ( p = 0.001) were significantly related to only small changes of the Membranous Urethra angle. The interrater and intrarater reliability for Membranous Urethra angle was excellent (intraclass correlation coefficient ≥0.75). Conclusions The RTS leads to reduction in the Membranous Urethra angle. The extent of the changes in the Membranous Urethra angle is associated with RTS outcome. Functional MRI is a reliable noninvasive visualization tool of interactions between the sling and pelvic floor for further research on the complex nature of postprostatectomy SUI.
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The extent of changes in the Membranous Urethra angle is associated with the outcome of retroUrethral transobturator sling procedure.
International urology and nephrology, 2014Co-Authors: Irina Soljanik, Olga Solyanik, Christian G. Stief, Ricarda M. Bauer, Armin J. Becker, Christian Gozzi, Sonja KirchhoffAbstract:To evaluate the outcome of the retroUrethral transobturator sling (RTS) by functional magnetic resonance imaging (MRI) and to identify parameters associated with sling failure. Of thirty recruited men with postprostatectomy stress urinary incontinence (SUI), 26 consecutively underwent functional MRI before sling procedure and 12 months thereafter in a prospective clinical cohort observational study. PeriUrethral/Urethral fibrosis and sling visualization were evaluated on static sequences. The angle of the Membranous Urethra, position of the bladder neck and external Urethral sphincter were assessed during Valsalva’s maneuver and voiding. Sling success was defined as no or one dry “security” pad. The success and failure rates were 58 % (15/26 patients) and 42 % (11/26 patients), respectively. The sling leads to reduction in the Membranous Urethra angle during Valsalva’s maneuver (39.55° vs. 36.82°, p = 0.025) and voiding (38.25° vs. 34.83°, p = 0.001) and elevation of the external Urethral sphincter (2.9 vs. 4.8 mm, p = 0.017). Preoperative wider angle of the Membranous Urethra was significantly correlated with severe preoperative incontinence. Sling failure (p = 0.001) and severe preoperative incontinence (p = 0.001) were significantly related to only small changes of the Membranous Urethra angle. The interrater and intrarater reliability for Membranous Urethra angle was excellent (intraclass correlation coefficient ≥0.75). The RTS leads to reduction in the Membranous Urethra angle. The extent of the changes in the Membranous Urethra angle is associated with RTS outcome. Functional MRI is a reliable noninvasive visualization tool of interactions between the sling and pelvic floor for further research on the complex nature of postprostatectomy SUI.
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Is a wider angle of the Membranous Urethra associated with incontinence after radical prostatectomy?
World Journal of Urology, 2014Co-Authors: Irina Soljanik, Olga Solyanik, Christian G. Stief, Ricarda M. Bauer, Armin J. Becker, Christian Gozzi, Kerstin A. Brocker, Sonja M. KirchhoffAbstract:Purpose To investigate whether differences in the anatomy and dynamics of the pelvic floor (PF) in patients after radical prostatectomy (RP) depicted on magnetic resonance imaging (MRI) are associated with continence status. Methods In the prospective designed study, 24 patients with post-prostatectomy stress urinary incontinence were enrolled. Additionally, 10 continent patients after RP were matched for age, body mass index and perioperative parameters. All patients underwent continence assessment and MRI (TrueFISP sequence; TR 4.57 ms; TE 2.29 ms; slice thickness 7 mm; FOV 270 mm) 12 months after RP. Images were analyzed for Membranous Urethra length (MUL), angle of the Membranous Urethra (AMU), severity of periUrethral/Urethral fibrosis, lifting of the levator ani muscle, lowering of the posterior bladder wall (BPW), bladder neck (BN) and external urinary sphincter (EUS), and symphyseal rotation of these structures during the Valsalva maneuver and voiding. Results Compared to continent controls, incontinent patients showed a significant wider AMU during voiding ( p = 0.002) and more pronounced lowering of the BN and EUS ( p
Kania Piotr - One of the best experts on this subject based on the ideXlab platform.
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Transperineal ultrasound as a reliable tool in the assessment of Membranous Urethra length in radical prostatectomy patients.
Scientific reports, 2021Co-Authors: Kania Piotr, Mieleszko Rafał, Kuligowski Marcin, Dudka Karol, Kuca Monika, Biedrzycki Jakub, Zwolan Bartosz, Dmowski Tadeusz, Salagierski MaciejAbstract:To evaluate the usefulness of transperineal ultrasound (TPUS) as a method of Membranous Urethra length (MUL) measurement and investigate whether preoperative (MULpre) and postoperative (MULpost) would be associated with the degree and time of urinary continence recovery after laparoscopic radical prostatectomy (LRP). 84 patients who underwent LRP between January 2017 and December 2018 were selected for final analysis. All patients had preoperative and postoperative measurement of MUL in TPUS. Urinary continence was defined as no pad or a safety pad. Recovery of continence was assessed at 1, 3, 6 and 12 months after catheter removal. We prospectively analyzed correlation of MULpre, MULpost and a percent change in Membranous Urethral length (MULratio) with the urinary continence status. 69 (82%) patients regained continence in the follow-up of 12 months. MULpre, MULpost and MULratio assessed in TPUS were larger in subgroups of patients who regained continence earlier and in the entire continent group. Spearman rank test showed strong correlations between MULpost and MULratio (R-0.6 and R-0.56, respectively, p
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transperineal ultrasound as a reliable tool in the assessment of Membranous Urethra length in radical prostatectomy patients
Scientific Reports, 2021Co-Authors: Kania Piotr, Kuligowski Marcin, Dudka Karol, Kuca Monika, Biedrzycki Jakub, Zwolan Bartosz, Dmowski Tadeusz, Mieleszko Rafal, Salagierski MaciejAbstract:To evaluate the usefulness of transperineal ultrasound (TPUS) as a method of Membranous Urethra length (MUL) measurement and investigate whether preoperative (MULpre) and postoperative (MULpost) would be associated with the degree and time of urinary continence recovery after laparoscopic radical prostatectomy (LRP). 84 patients who underwent LRP between January 2017 and December 2018 were selected for final analysis. All patients had preoperative and postoperative measurement of MUL in TPUS. Urinary continence was defined as no pad or a safety pad. Recovery of continence was assessed at 1, 3, 6 and 12 months after catheter removal. We prospectively analyzed correlation of MULpre, MULpost and a percent change in Membranous Urethral length (MULratio) with the urinary continence status. 69 (82%) patients regained continence in the follow-up of 12 months. MULpre, MULpost and MULratio assessed in TPUS were larger in subgroups of patients who regained continence earlier and in the entire continent group. Spearman rank test showed strong correlations between MULpost and MULratio (R-0.6 and R-0.56, respectively, p < 0.0001) with the time to continence recovery in the cumulative 12 months follow-up. TPUS allowed a reliable measurement of MUL before and after LRP. MULpre, MULpost as well as MULratio are related with time to regain continence and recovery rate after LRP. Sparing longest possible sphincteric Urethra, with respect to oncological outcomes is a key factor in recovering continence after prostate cancer surgery.
Urs E. Studer - One of the best experts on this subject based on the ideXlab platform.
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Reduction of sensitivity at the level of the Membranous Urethra after substitutive orthotopic ileal bladder
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie, 2001Co-Authors: Christophe L. Hugonnet, Hansjörg Danuser, Johannes Springer, Urs E. StuderAbstract:To determine whether the sensitivity of the Membranous Urethra is an important factor to obtain continence after ileal bladder replacement. The sensitivity threshold after electrical stimulation of the Membranous Urethra by a ring electrode placed on a Urethral catheter was measured in 47 men after ileal bladder replacement (postoperative group). The control group consisted of 35 men before radical prostatectomy or cystoprostatectomy. The mean sensitivity threshold of the Membranous Urethra was 9 +/- 2 mA in the control group and 27 +/- 11 mA in the postoperative group (p < 0.001). The sensitivity threshold of daytime continent and incontinent patients was 24 +/- 9 and 39 +/- 10 mA, respectively (p < 0.001). The sensitivity of the Membranous Urethra decreases in patients after cystoprostatectomy and ileal bladder replacement. The sensitivity of the Membranous Urethra is better in continent patients than in incontinent patients and therefore appears to be an important factor for continence after ileal bladder replacement.
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UrethraL SENSITIVITY AND THE IMPACT ON URINARY CONTINENCE IN PATIENTS WITH AN ILEAL BLADDER SUBSTITUTE AFTER CYSTECTOMY
The Journal of urology, 2001Co-Authors: Christophe L. Hugonnet, Hansjörg Danuser, Johannes P. Springer, Urs E. StuderAbstract:Purpose: After cystectomy and ileal bladder substitution, sensitivity in the Membranous Urethra correlates with postoperative urinary continence. We determine whether sensitivity is decreased only in the most proximal part of the Urethra or also more distally in the bulbar Urethra, which would give some indication as to which nerves may be injured during radical cystoprostatectomy.Materials and Methods: The sensory threshold for electrical stimulation was measured with double ring electrodes in the Membranous Urethra, and 2.5 cm. distally to it in 41 men after cystectomy and ileal bladder substitution, and in a control group of 29 men.Results: The mean sensory threshold plus or minus standard deviation of the Membranous Urethra was 9 ± 2 mA. in the control group compared to 26 ± 11 mA. in the postoperative group (p
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Inefficient Urethral milking secondary to Urethral dysfunction as an additional risk factor for incontinence after radical prostatectomy.
The Journal of urology, 2001Co-Authors: Pia Bader, Christophe L. Hugonnet, Fiona C. Burkhard, Urs E. StuderAbstract:Purpose: Continence after radical prostatectomy is thought to depend completely on the striated Urethral sphincter. However, some patients complain only of occasional post-void dribbling. Therefore, we determined whether Urethral dysfunction may be another cause of incontinence.Materials and Methods: The sensory threshold of electric stimulation was measured by double ring electrodes in the Membranous Urethra and 2.5 cm. distal in 29 men before and in 29 after radical retropubic prostatectomy. In addition, voiding cystourethrography was performed in 66 patients before and in 49 after surgery to determine complete post-void Urethral emptying or milking.Results: The mean sensory threshold of the Membranous Urethra was 15 ± 3 mA. preoperatively versus 38 ± 17 postoperatively (p
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decreased sensitivity in the Membranous Urethra after orthotopic ileal bladder substitute
The Journal of Urology, 1999Co-Authors: Christophe L. Hugonnet, Hansjörg Danuser, Johannes Springer, Urs E. StuderAbstract:AbstractPurpose: The effect of cystoprostatectomy with orthotopic substitution on Membranous Urethral sensation and subsequent urinary continence is unknown. We determined the sensory threshold for electrical stimulation of the Membranous Urethra and correlated it with continence, nerve sparing surgical technique and potency.Materials and Methods: The sensory threshold was measured in a control group of 35 men before radical prostatectomy or cystoprostatectomy and in 47 men after cystoprostatectomy and ileal bladder substitution.Results: The sensory threshold of the Membranous Urethra was 9 +/− 2 in the control group compared to 27 +/− 11 mA. in the postoperative group (p <0.001). Patients with daytime continence had a threshold of 24 +/− 9 compared to 39 +/− 10 mA. in incontinent patients (p <0.001). We were unable to show any correlation between the sensory threshold in patients with (25 +/− 10 mA.) and without (31 +/− 11 mA.) attempted nerve sparing surgery (p = 0.1) nor between potent (25 +/− 12 mA.) ...
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DECREASED SENSITIVITY IN THE Membranous Urethra AFTER ORTHOTOPIC ILEAL BLADDER SUBSTITUTE
The Journal of urology, 1999Co-Authors: Christophe L. Hugonnet, Hansjörg Danuser, Johannes P. Springer, Urs E. StuderAbstract:AbstractPurpose: The effect of cystoprostatectomy with orthotopic substitution on Membranous Urethral sensation and subsequent urinary continence is unknown. We determined the sensory threshold for electrical stimulation of the Membranous Urethra and correlated it with continence, nerve sparing surgical technique and potency.Materials and Methods: The sensory threshold was measured in a control group of 35 men before radical prostatectomy or cystoprostatectomy and in 47 men after cystoprostatectomy and ileal bladder substitution.Results: The sensory threshold of the Membranous Urethra was 9 +/− 2 in the control group compared to 27 +/− 11 mA. in the postoperative group (p