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Andrew C Peterson - One of the best experts on this subject based on the ideXlab platform.
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extirpative cultures reveal infectious Pubic Bone osteomyelitis in prostate cancer survivors with urinary Pubic symphysis fistulae upf
Urology, 2020Co-Authors: Brent D Nose, William C Eward, William R Boysen, Arman A Kahokehr, Brian M Inouye, Edward F Hendershot, Andrew C PetersonAbstract:Objective To examine the infectious features of patients with urinary Pubic symphysis fistula (UPF) and their association with osteomyelitis. Methods We conducted a review of our quality improvement database for 36 patients with UPF undergoing Bone resection and extirpative surgery from October 2012 to January 2019. An assessment of Bone and urine cultures was carried out along with surgical, radiologic and demographic data. We analyzed descriptive statistics and used Fisher Exact Tests and unpaired Welch t-tests to assess for associations with positive Bone cultures. Results In our cohort, 33 patients (91.7%) had positive Bone cultures with the three most common organisms being candida (22.0%), enterococcus (18.0%) and pseudomonas (10.0%). There was a correlation between positive pre-operative urine culture and positive Bone culture (p Conclusions In this series, 91.7% of patients undergoing extirpative surgery for UPF at our institution have positive Bone cultures at time of Pubic Bone debridement. Additionally, we demonstrate a statistically significant correlation between positive urine cultures and positive Bone cultures in these patients. This supports the need for a multidisciplinary approach including infectious disease, orthopedic surgery and reconstructive urology in order to address this complex clinical condition.
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extirpative cultures reveal infectious Pubic Bone osteomyelitis in prostate cancer survivors with urinary Pubic symphysis fistulae upf
Urology, 2020Co-Authors: Brent D Nose, William C Eward, William R Boysen, Arman A Kahokehr, Brian M Inouye, Edward F Hendershot, Andrew C PetersonAbstract:Abstract OBJECTIVE To examine the infectious features of patients with urinary Pubic symphysis fistula (UPF) and their association with osteomyelitis. METHODS We conducted a review of our quality improvement database for 36 patients with UPF undergoing Bone resection and extirpative surgery from October 2012 to January 2019. An assessment of Bone and urine cultures was carried out along with surgical, radiologic, and demographic data. We analyzed descriptive statistics and used Fisher Exact Tests and unpaired Welch t tests to assess for associations with positive Bone cultures. RESULTS In our cohort, 33 patients (91.7%) had positive Bone cultures with the 3 most common organisms being candida (22.0%), enterococcus (18.0%), and pseudomonas (10.0%). There was a correlation between positive preoperative urine culture and positive Bone culture (P CONCLUSION In this series, 91.7% of patients undergoing extirpative surgery for UPF at our institution have positive Bone cultures at time of Pubic Bone debridement. Additionally, we demonstrate a statistically significant correlation between positive urine cultures and positive Bone cultures in these patients. This supports the need for a multidisciplinary approach including infectious disease, orthopedic surgery and reconstructive urology in order to address this complex clinical condition.
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magnetic resonance imaging features of Pubic symphysis urinary fistula with Pubic Bone osteomyelitis in the treated prostate cancer patient
Abdominal Radiology, 2019Co-Authors: Stephanie J Sexton, Garjae Lavien, Andrew C Peterson, Nicholas Said, William C Eward, Rajan T GuptaAbstract:Introduction Pubic Bone osteomyelitis with Pubic symphysis urinary fistula represents a debilitating complication of radiation and ablative treatments for prostate cancer. The definitive radiographic diagnosis of this clinical entity is not described. In this study, we characterize the plain film and magnetic resonance imaging findings of Pubic osteomyelitis.
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Pubic Bone osteomyelitis and pubosymphyseal urinary fistula a poorly recognized complication in prostate cancer survivors
Oncology, 2017Co-Authors: Ramiro J Maddenfuentes, Andrew C PetersonAbstract:An uncommon but significantly burdensome sequela of therapy for prostate cancer is Pubic Bone osteomyelitis in association with a pubosymphyseal urinary fistula.
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Pubic Bone resection provides objective pain control in the prostate cancer survivor with Pubic Bone osteomyelitis with an associated urinary tract to Pubic symphysis fistula
Urology, 2017Co-Authors: Garjae Lavien, Godefroy Chery, Uwais B Zaid, Andrew C PetersonAbstract:Objective To investigate pain intensity perception in prostate cancer survivors with Pubic Bone osteomyelitis with an associated urinary tract to Pubic symphysis fistula before and after definitive surgical management. Materials and Methods We performed a review of an institutional review board-approved database of prostate cancer survivors with Pubic Bone osteomyelitis from 2010 to 2015. Demographic and clinical data were extracted. Pain scores were assessed in patients at varying points before and after definitive treatment using an 11-point numeric rating scale. Statistical analysis was performed using a Wilcoxon signed-rank test and NcNemar's test. Results We identified 16 patients with a median age of 72 who met inclusion criteria. Chronic narcotic use for pain management was noted in 6 of 16 (37.5%) patients preoperatively. No statistical difference was identified between the pain score at the time of diagnosis and after completion of conservative measures (5.5 vs 5.5, P = .76). A statistically significant decrease in median pain score at the first follow-up appointment was seen compared to the preoperative pain score (0 vs. 5.5, P = .0005). At a median follow-up of 9.4 months (interquartile range 3.7-16.5), a sustained decrease in the median pain intensity score was noted in our cohort compared to their preoperative baseline pain score (5.5 vs 0, P = .0005) and pain score at the time of diagnosis (5.5 vs 0, P = .004.) Conclusion Pubic Bone resection provides immediate and sustained improvement in pain intensity perception in the prostate cancer survivor with Pubic Bone osteomyelitis with an associated urinary tract to Pubic symphysis fistula.
Peter G Barnes - One of the best experts on this subject based on the ideXlab platform.
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outcome of conservative management of athletic chronic groin injury diagnosed as Pubic Bone stress injury
American Journal of Sports Medicine, 2007Co-Authors: Geoffrey M Verrall, John P Slavotinek, Peter G BarnesAbstract:Background: Little data exist on the results of treatment for sports-related chronic groin injury.Hypothesis: Sports-related chronic groin injury treated with a conservative (rest) program results in a satisfactory outcome.Study Design: Case series; Level of evidence, 4.Methods: Professional Australian male football players, at the end of the playing season, had their groin injury diagnosed using specific clinical and magnetic resonance imaging (MRI) criteria. Those assessed as having a non-hip-related cause for their chronic groin injury were treated principally by 12 weeks of complete rest from active weightbearing activities. Response to treatment was assessed at different stages of rehabilitation by recording the number of athletes who had returned to playing football and the number of athletes without symptoms.Results: Twenty-seven athletes were considered to have chronic groin injury. Clinical and MRI (Pubic Bone marrow edema N = 26 [96%]), hyperintense line N = 25 [93%]) criteria suggested a Pubic ...
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hip joint range of motion reduction in sports related chronic groin injury diagnosed as Pubic Bone stress injury
Journal of Science and Medicine in Sport, 2005Co-Authors: Geoffrey M Verrall, Ian A Hamilton, Roger D Oakeshott, A J Spriggins, John P Slavotinek, Peter G BarnesAbstract:Traumatic osteitis pubis is a non-specific entity that relates to chronic groin injury and has recently been described as being akin to a public Bone stress injury. It is uncertain whether or not reduction of hip joint range of motion occurs in traumatic osteitis pubis. The purpose of this study was to establish whether there is a reduction of hip range of motion in athletes who have chronic groin injury diagnosed as Pubic Bone stress injury. A case-control study was performed whereby 89 Australian Rules footballers underwent, with clinical history unknown, clinical and MRI examination of the groin region. Clinical criteria (pain with tenderness) and MR-criteria (Pubic Bone marrow oedema) were used for diagnosis of Pubic Bone stress injury. End-range internal and external rotation hip motion was measured using a goniometer. Athletes with and without symptoms were compared, as were athletes with current symptoms with athletes who had recovered from their groin pain episode. Chronic groin injury was diagnosed in 47 athletes with 37 having public Bone stress injury. Thirteen athletes had previous groin injury. A reduction of internal and external hip range of motion was demonstrated in athletes with public Bone stress injury (p
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description of pain provocation tests used for the diagnosis of sports related chronic groin pain relationship of tests to defined clinical pain and tenderness and mri Pubic Bone marrow oedema criteria
Scandinavian Journal of Medicine & Science in Sports, 2005Co-Authors: Geoffrey M Verrall, John P Slavotinek, Peter G BarnesAbstract:The clinical assessment of groin pain in athletes is difficult, with the lack of specific clinical tests being in part responsible. Three pain provocation tests used in the diagnosis of chronic groin pain are described and their relationship to defined clinical and MRI criteria has been assessed. Eighty-nine Australian Rules football players with and without groin symptoms underwent clinical examination followed by history. Three pain provocation tests were performed (named as the Single Adductor, Squeeze and Bilateral Adductor tests). All athletes subsequently underwent MRI of their groin region for the presence of significant Pubic Bone marrow oedema (BMO). Of the 89, 47 were defined as having chronic groin pain, and 46 had significant BMO with 37 having both chronic groin pain and BMO. The three pain provocation tests demonstrated only moderate sensitivity (range 30–65%). Positive predictive values were moderate to high (67–93%) depending upon the individual test. The Bilateral Adductor test was the most sensitive test with the highest positive predictive values. The high specificity (88–93%) demonstrated should be treated with caution due to the study methodology. Three pain provocation tests of potential value in assessing chronic groin pain in athletes are described. If positive, all three pain provocation tests demonstrated a high likelihood for the athlete having MR-detected parasymphyseal Pubic BMO. Further research is required on assessing the clinical usefulness of these tests.
Geoffrey M Verrall - One of the best experts on this subject based on the ideXlab platform.
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outcome of conservative management of athletic chronic groin injury diagnosed as Pubic Bone stress injury
American Journal of Sports Medicine, 2007Co-Authors: Geoffrey M Verrall, John P Slavotinek, Peter G BarnesAbstract:Background: Little data exist on the results of treatment for sports-related chronic groin injury.Hypothesis: Sports-related chronic groin injury treated with a conservative (rest) program results in a satisfactory outcome.Study Design: Case series; Level of evidence, 4.Methods: Professional Australian male football players, at the end of the playing season, had their groin injury diagnosed using specific clinical and magnetic resonance imaging (MRI) criteria. Those assessed as having a non-hip-related cause for their chronic groin injury were treated principally by 12 weeks of complete rest from active weightbearing activities. Response to treatment was assessed at different stages of rehabilitation by recording the number of athletes who had returned to playing football and the number of athletes without symptoms.Results: Twenty-seven athletes were considered to have chronic groin injury. Clinical and MRI (Pubic Bone marrow edema N = 26 [96%]), hyperintense line N = 25 [93%]) criteria suggested a Pubic ...
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groin pain in footballers the association between preseason clinical and Pubic Bone magnetic resonance imaging findings and athlete outcome
American Journal of Sports Medicine, 2005Co-Authors: John P Slavotinek, Geoffrey M Verrall, Michael R SageAbstract:BackgroundGroin pain and tenderness are common in athletes from a variety of codes of football, but little attention has been directed to the influence of magnetic resonance imaging and such clinical findings on athlete participation.HypothesisPreseason groin pain, tenderness, and magnetic resonance imaging findings such as Pubic Bone marrow edema are associated with restricted training capacity and missed games.Study DesignCohort study; Level of evidence, 2.MethodsFifty-two Australian footballers in the national competition were recruited. Preseason groin pain and focal tenderness were recorded, and magnetic resonance imaging of the groin was performed within 1 week of examination. Training restriction and games missed owing to groin pain were documented during the subsequent season.ResultsMagnetic resonance imaging showed Pubic Bone marrow edema in 19 of 52 (37%) footballers and linear parasymphyseal T2 hyperintensity in 16 of 52 (31%) footballers. Groin pain restricted training during the season in 22 ...
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hip joint range of motion reduction in sports related chronic groin injury diagnosed as Pubic Bone stress injury
Journal of Science and Medicine in Sport, 2005Co-Authors: Geoffrey M Verrall, Ian A Hamilton, Roger D Oakeshott, A J Spriggins, John P Slavotinek, Peter G BarnesAbstract:Traumatic osteitis pubis is a non-specific entity that relates to chronic groin injury and has recently been described as being akin to a public Bone stress injury. It is uncertain whether or not reduction of hip joint range of motion occurs in traumatic osteitis pubis. The purpose of this study was to establish whether there is a reduction of hip range of motion in athletes who have chronic groin injury diagnosed as Pubic Bone stress injury. A case-control study was performed whereby 89 Australian Rules footballers underwent, with clinical history unknown, clinical and MRI examination of the groin region. Clinical criteria (pain with tenderness) and MR-criteria (Pubic Bone marrow oedema) were used for diagnosis of Pubic Bone stress injury. End-range internal and external rotation hip motion was measured using a goniometer. Athletes with and without symptoms were compared, as were athletes with current symptoms with athletes who had recovered from their groin pain episode. Chronic groin injury was diagnosed in 47 athletes with 37 having public Bone stress injury. Thirteen athletes had previous groin injury. A reduction of internal and external hip range of motion was demonstrated in athletes with public Bone stress injury (p
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description of pain provocation tests used for the diagnosis of sports related chronic groin pain relationship of tests to defined clinical pain and tenderness and mri Pubic Bone marrow oedema criteria
Scandinavian Journal of Medicine & Science in Sports, 2005Co-Authors: Geoffrey M Verrall, John P Slavotinek, Peter G BarnesAbstract:The clinical assessment of groin pain in athletes is difficult, with the lack of specific clinical tests being in part responsible. Three pain provocation tests used in the diagnosis of chronic groin pain are described and their relationship to defined clinical and MRI criteria has been assessed. Eighty-nine Australian Rules football players with and without groin symptoms underwent clinical examination followed by history. Three pain provocation tests were performed (named as the Single Adductor, Squeeze and Bilateral Adductor tests). All athletes subsequently underwent MRI of their groin region for the presence of significant Pubic Bone marrow oedema (BMO). Of the 89, 47 were defined as having chronic groin pain, and 46 had significant BMO with 37 having both chronic groin pain and BMO. The three pain provocation tests demonstrated only moderate sensitivity (range 30–65%). Positive predictive values were moderate to high (67–93%) depending upon the individual test. The Bilateral Adductor test was the most sensitive test with the highest positive predictive values. The high specificity (88–93%) demonstrated should be treated with caution due to the study methodology. Three pain provocation tests of potential value in assessing chronic groin pain in athletes are described. If positive, all three pain provocation tests demonstrated a high likelihood for the athlete having MR-detected parasymphyseal Pubic BMO. Further research is required on assessing the clinical usefulness of these tests.
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incidence of Pubic Bone marrow oedema in australian rules football players relation to groin pain
British Journal of Sports Medicine, 2001Co-Authors: Geoffrey M Verrall, John P SlavotinekAbstract:Objectives —To examine the relation between the clinical features of groin pain and groin magnetic resonance imaging (MRI) appearances in a group largely comprising elite Australian Rules football players. The incidence of Bone marrow oedema and other MRI findings in the Pubic symphysis region was noted. The relation between a past history of groin pain and these other MRI findings was also examined. Method —In a prospective study, 116 male subjects (89 footballers, 17 umpires, 10 sedentary men) were examined before history taking and groin MRI. The clinical history was not known to the examiner (GMV) and radiologists (JPS, GTF). Clinical evidence of groin pain and examination findings were correlated with the presence of increased signal intensity within the Pubic Bone marrow. A past history of groin pain was correlated with the presence of other MRI findings such as cyst formation, fluid signal within the Pubic symphysis disc, and irregularity of the Pubic symphysis. Results —Fifty two athletes (47 footballers, five umpires) had clinical features of groin pain with Pubic symphysis and/or superior Pubic ramus tenderness. A high incidence of increased signal intensity (77%) within the Pubic Bone marrow was identified in this group. There was an association between this group of athletes and the MRI finding of increased signal intensity (p Conclusions —Athletes with groin pain and tenderness of the Pubic symphysis and/or superior Pubic ramus have clinical features consistent with the diagnosis of osteitis pubis. The increased signal intensity seen on MRI is due to Pubic Bone marrow oedema. An association exists between the clinical features of osteitis pubis and the MRI finding of Pubic Bone marrow oedema. A high incidence of Pubic Bone marrow oedema was also noted. Degenerative features visualised by MRI, such as subchondral cyst formation, were associated with a past history of groin pain. A stress injury to the Pubic Bone is the most likely explanation for these MRI findings and may be the cause of the clinical entity osteitis pubis.
John P Slavotinek - One of the best experts on this subject based on the ideXlab platform.
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outcome of conservative management of athletic chronic groin injury diagnosed as Pubic Bone stress injury
American Journal of Sports Medicine, 2007Co-Authors: Geoffrey M Verrall, John P Slavotinek, Peter G BarnesAbstract:Background: Little data exist on the results of treatment for sports-related chronic groin injury.Hypothesis: Sports-related chronic groin injury treated with a conservative (rest) program results in a satisfactory outcome.Study Design: Case series; Level of evidence, 4.Methods: Professional Australian male football players, at the end of the playing season, had their groin injury diagnosed using specific clinical and magnetic resonance imaging (MRI) criteria. Those assessed as having a non-hip-related cause for their chronic groin injury were treated principally by 12 weeks of complete rest from active weightbearing activities. Response to treatment was assessed at different stages of rehabilitation by recording the number of athletes who had returned to playing football and the number of athletes without symptoms.Results: Twenty-seven athletes were considered to have chronic groin injury. Clinical and MRI (Pubic Bone marrow edema N = 26 [96%]), hyperintense line N = 25 [93%]) criteria suggested a Pubic ...
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groin pain in footballers the association between preseason clinical and Pubic Bone magnetic resonance imaging findings and athlete outcome
American Journal of Sports Medicine, 2005Co-Authors: John P Slavotinek, Geoffrey M Verrall, Michael R SageAbstract:BackgroundGroin pain and tenderness are common in athletes from a variety of codes of football, but little attention has been directed to the influence of magnetic resonance imaging and such clinical findings on athlete participation.HypothesisPreseason groin pain, tenderness, and magnetic resonance imaging findings such as Pubic Bone marrow edema are associated with restricted training capacity and missed games.Study DesignCohort study; Level of evidence, 2.MethodsFifty-two Australian footballers in the national competition were recruited. Preseason groin pain and focal tenderness were recorded, and magnetic resonance imaging of the groin was performed within 1 week of examination. Training restriction and games missed owing to groin pain were documented during the subsequent season.ResultsMagnetic resonance imaging showed Pubic Bone marrow edema in 19 of 52 (37%) footballers and linear parasymphyseal T2 hyperintensity in 16 of 52 (31%) footballers. Groin pain restricted training during the season in 22 ...
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hip joint range of motion reduction in sports related chronic groin injury diagnosed as Pubic Bone stress injury
Journal of Science and Medicine in Sport, 2005Co-Authors: Geoffrey M Verrall, Ian A Hamilton, Roger D Oakeshott, A J Spriggins, John P Slavotinek, Peter G BarnesAbstract:Traumatic osteitis pubis is a non-specific entity that relates to chronic groin injury and has recently been described as being akin to a public Bone stress injury. It is uncertain whether or not reduction of hip joint range of motion occurs in traumatic osteitis pubis. The purpose of this study was to establish whether there is a reduction of hip range of motion in athletes who have chronic groin injury diagnosed as Pubic Bone stress injury. A case-control study was performed whereby 89 Australian Rules footballers underwent, with clinical history unknown, clinical and MRI examination of the groin region. Clinical criteria (pain with tenderness) and MR-criteria (Pubic Bone marrow oedema) were used for diagnosis of Pubic Bone stress injury. End-range internal and external rotation hip motion was measured using a goniometer. Athletes with and without symptoms were compared, as were athletes with current symptoms with athletes who had recovered from their groin pain episode. Chronic groin injury was diagnosed in 47 athletes with 37 having public Bone stress injury. Thirteen athletes had previous groin injury. A reduction of internal and external hip range of motion was demonstrated in athletes with public Bone stress injury (p
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description of pain provocation tests used for the diagnosis of sports related chronic groin pain relationship of tests to defined clinical pain and tenderness and mri Pubic Bone marrow oedema criteria
Scandinavian Journal of Medicine & Science in Sports, 2005Co-Authors: Geoffrey M Verrall, John P Slavotinek, Peter G BarnesAbstract:The clinical assessment of groin pain in athletes is difficult, with the lack of specific clinical tests being in part responsible. Three pain provocation tests used in the diagnosis of chronic groin pain are described and their relationship to defined clinical and MRI criteria has been assessed. Eighty-nine Australian Rules football players with and without groin symptoms underwent clinical examination followed by history. Three pain provocation tests were performed (named as the Single Adductor, Squeeze and Bilateral Adductor tests). All athletes subsequently underwent MRI of their groin region for the presence of significant Pubic Bone marrow oedema (BMO). Of the 89, 47 were defined as having chronic groin pain, and 46 had significant BMO with 37 having both chronic groin pain and BMO. The three pain provocation tests demonstrated only moderate sensitivity (range 30–65%). Positive predictive values were moderate to high (67–93%) depending upon the individual test. The Bilateral Adductor test was the most sensitive test with the highest positive predictive values. The high specificity (88–93%) demonstrated should be treated with caution due to the study methodology. Three pain provocation tests of potential value in assessing chronic groin pain in athletes are described. If positive, all three pain provocation tests demonstrated a high likelihood for the athlete having MR-detected parasymphyseal Pubic BMO. Further research is required on assessing the clinical usefulness of these tests.
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incidence of Pubic Bone marrow oedema in australian rules football players relation to groin pain
British Journal of Sports Medicine, 2001Co-Authors: Geoffrey M Verrall, John P SlavotinekAbstract:Objectives —To examine the relation between the clinical features of groin pain and groin magnetic resonance imaging (MRI) appearances in a group largely comprising elite Australian Rules football players. The incidence of Bone marrow oedema and other MRI findings in the Pubic symphysis region was noted. The relation between a past history of groin pain and these other MRI findings was also examined. Method —In a prospective study, 116 male subjects (89 footballers, 17 umpires, 10 sedentary men) were examined before history taking and groin MRI. The clinical history was not known to the examiner (GMV) and radiologists (JPS, GTF). Clinical evidence of groin pain and examination findings were correlated with the presence of increased signal intensity within the Pubic Bone marrow. A past history of groin pain was correlated with the presence of other MRI findings such as cyst formation, fluid signal within the Pubic symphysis disc, and irregularity of the Pubic symphysis. Results —Fifty two athletes (47 footballers, five umpires) had clinical features of groin pain with Pubic symphysis and/or superior Pubic ramus tenderness. A high incidence of increased signal intensity (77%) within the Pubic Bone marrow was identified in this group. There was an association between this group of athletes and the MRI finding of increased signal intensity (p Conclusions —Athletes with groin pain and tenderness of the Pubic symphysis and/or superior Pubic ramus have clinical features consistent with the diagnosis of osteitis pubis. The increased signal intensity seen on MRI is due to Pubic Bone marrow oedema. An association exists between the clinical features of osteitis pubis and the MRI finding of Pubic Bone marrow oedema. A high incidence of Pubic Bone marrow oedema was also noted. Degenerative features visualised by MRI, such as subchondral cyst formation, were associated with a past history of groin pain. A stress injury to the Pubic Bone is the most likely explanation for these MRI findings and may be the cause of the clinical entity osteitis pubis.
O Nativ - One of the best experts on this subject based on the ideXlab platform.
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Transvaginal Bone anchored sling
Urology, 2000Co-Authors: Shahar Madjar, M Beyar, O NativAbstract:Abstract Introduction. To describe a new technique for the treatment of stress urinary incontinence by the transvaginal creation of a sling anchored to the Pubic Bone. This technique is minimally invasive and easy to learn, with minimal morbidity and complications. Technical Considerations. Miniature Bone screws with No. 1 polypropylene sutures attached to them and a battery–operated screw inserter are used for the fixation of a biocompatible fabric sling to the Pubic Bone. The procedure is performed transvaginally with no abdominal or supraPubic incisions. One screw is inserted on each side of the urethra into the Pubic Bone below the bladder neck. A tunnel is made submucosally between these two holes just below the bladder neck, and the sling is passed through it. Using the sutures on each side of the urethra, the sling edges are tied and pulled toward the Pubic Bone. The openings made in the vaginal mucosa are closed with absorbable sutures. Conclusions. This sling procedure is minimally invasive, safe, and effective. Further experience and longer follow-up are necessary to establish its role in the treatment of women with stress urinary incontinence.
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minimally invasive pervaginam procedures for the treatment of female stress incontinence using a new Pubic Bone anchoring system
Artificial Organs, 1998Co-Authors: Shahar Madjar, M Beyar, Moshe Wald, Sarel Halachmi, Elias Issaq, Boaz Moskovitz, O NativAbstract:The purpose of this ongoing study is to evaluate the safety and efficacy of new minimally invasive pervaginam cystourethropexy and sling procedures for the treatment of female genuine stress urinary incontinence. A total of 75 women (mean age, 52.8 years) underwent either a cystourethropexy or a sling procedure. A miniature Bone anchor and a staple-like Bone anchor driver were used for the fixation of periurethral tissue or a xenogenic sling to the Pubic Bone. With a mean follow-up of eight months, 61 patients (82%) were completely cured of stress incontinence, 10 (14%) reported a more than 50% decrease in pad usage, and 4 patients showed failure early following surgery. The exclusively pervaginam cystourethropexy and sling procedures are minimally invasive, safe, and effective. Further experience and longer follow-up are necessary to establish their role in the treatment of women with stress urinary incontinence.
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Pubic Bone anchoring in the treatment of women with stress urinary incontinence new applications to an old concept
International Urogynecology Journal, 1998Co-Authors: Shahar Madjar, M Beyar, O NativAbstract:The concept of using the Pubic Bone as a support for the bladder neck and urethra in the treatment of women with genuine stress urinary incontinence is well established, and is applied in traditional procedures such as Marshall-Marchetti-Krantz and the Burch colposuspensions. Recently, minimally invasive techniques, including the use of laparoscopic surgery and Pubic Bone anchoring systems, have been introduced. These new techniques, attempt to combine the advantages of retroPubic procedures while remaining minimally invasive. A search of the English literature was carried out, traditional and new procedures using the Pubic Bone as a support for the bladder neck and urethra are described, and their efficacy and complications are reviewed and discussed. Traditional procedures have proved to be highly effective and well tolerated, with good long-term outcomes. The early results of innovative minimally invasive techniques are promising, but further experience and longer follow-up is needed to establish their role in the treatment of female stress urinary incontinence.
