Base bibliographique

Autosondages urinaires et temps de vidange : étude expérimentale de la vitesse de drainage des différentes sondes d'autocathétérisme
2012
- Réf : Prog Urol, 2012, 8, 22, 482-486


Introduction



Objective

To assess the flow rate obtained by catheters used in self intermittent catheterization.


Material

In vitro comparative study designed to compare the average flow rate obtained by intravesical catheters, by repeated flowmetric measures. The catheters studied were the most used in France in Fr10, 12 and 14 for female catheters and in Fr12, 14 and 16 for male catheters.


Results

We observed a strict relationship between Charriere and flow rate, both in female and male catheters These results were statistically significant (P <0.05). For female catheters, the average flow rate varied from 2.83 to 3.7mL/s for Fr10 catheters, from 4.31 to 5.35mL/s for Fr12 catheters and from 7.00 to 7.85mL/s for Fr14 catheters (P <0.05). For male catheters, the average flow rate varied from 4.53 to 5.00mL/s for Fr12 catheters, from 6.95 to 8.17mL/s for Fr14 catheters and from 10.4 to 11.07mL/s for Fr16 catheters (P <0.05). In female and male population, despite the observed flow rate differences between catheters, there were no statistically significant differences.


Conclusion

This study demonstrated a better flow rate when Charriere increases. Thus, an objective adaptation of self catheterization’s materiel is possible when the patient wishes to improve flow rate in order to reduce self intermittent catheterization duration.

Mots clés:
Autosondage / Charrière / Sonde vésicale / Vitesse de vidange
Mots-clés:
Self catheterization / Charriere size / Urinary catheter / Flow rate
Continuous recording intrarectal pressures during the second phase of labor
2012
- Réf : Prog Urol, 2012, 8, 22, 487-494


Aim of the study


Mots clés:
Delivery / Intrapelvic pressures / Pelvic floor problems / Pelvi-perineology / Accouchement
Mots-clés:
S. / F. / H. / P. / C.
Incontinentation par vaporisation bipolaire du sphincter externe de l'urèthre. Premiers résultats
2012
- Réf : Prog Urol, 2012, 8, 22, 462-466


Introduction



Objectives

The aim of this study was to assess the feasibility, efficacy and tolerance of external urethral sphincter vaporization in saline for treating detrusor-sphincter dyssynergia.


Material

Between 2009 and 2011 a monocentric prospective study of ten men mean age 58±9 years with neurogenic detrusor-sphincter dyssynergia was carried out. Preoperative evaluation included kidney ultrasound scan, 24-hour creatinine clearance, urodynamics, retrograde and voiding urethrocystography and an at least 6 months temporary stent sphincterotomy. Postoperative assessment was composed of an ultrasound scan post-void residual volume measurement when the urethral catheter were removed and 1 year after the procedure, a retrograde and voiding urethrocystography at 3 months and a flexible cystoscopy at 1 year.


Results

At the catheter removal, eight patients emptied their bladder at completion, a supra-pubic catheter was temporary left in one case and a patient had a permanent urinary retention. For a mean follow-up of 22±11 months, eight patients emptied their bladder at completion and two had a complete urinary retention related to a detrusor underactivity. An orchitis occurred in one case 1 month after the procedure and an urethral stricture in four cases in 12.75±5.68 months on average.


Conclusion

External urethral sphincter vaporisation saline was feasible and efficient for treating detrusor-sphincter dyssynergia but was associated with a high risk of urethral stricture.

Mots clés:
vessie neurologique / Incontinentation / Dyssynergie vésicosphinctérienne / Vaporisation / sphincter
Mots-clés:
Neurologic disorders / External urethral sphincterotomy / Sphincter dyssynergia / Vaporization / Urethral
Intérêt des irrigations transanales dans la gestion des troubles intestinaux et ano-rectaux chez les blessés médullaires
2012
- Réf : Prog Urol, 2012, 8, 22, 467-474


Introduction



Objective

Bowel dysfunction and disordered defecation are very common after spinal cord injury (SCI) and can have a major impact on patients’ social life and quality of life. The aim of this study was to assess the safety and efficacy of transanal irrigations (TAI) in the management of Bowel dysfunction in SCI patients.


Methods

Forty-five consecutive SCI patients using TAI were retrospectively included. TAI efficacy was assessed through Neurogenic Bowel Dysfunction (NBD) score recorded before and after 8weeks of regular use. Possible side effects were assessed with a semi-structured questionnaire. Patients who started TAI use at least 6months previously were contacted to assess long-term compliance, efficacy and safety of TAI.


Results

After 8weeks of regular use of TAI, the average NBD scores decreased by four points (P <0.0001) with a specific improvement in the items related to stool frequency (P : 0.036), occurrence of malaise, headache, or sweating during defecation (P : 0.043), use of drugs against constipation (P : 0.007) and frequency of fecal incontinence (P : 0.001). The main side effects were bleeding (10%) and abdominal pain (8%). At 6months, 80% of the assessed patients had continued regular use of TAI with no particular problem.


Conclusion

This study showed good medium and long-term efficacy and safety of TAI in the management of bowel dysfunction and defecation disorders in spinal cord-injured patients.

Mots clés:
Irrigations transanales / Intestin neurogène / Blessés médullaires / Score NBD
Mots-clés:
Transanal irrigations / Neurogenic bowel / spinal cord injury / NBD score
La SIFUD PP vous offre un nouveau site Internet !
2012
- Réf : Prog Urol, 2012, 8, 22, 443-444


À l’époque où les nouvelles technologies de la communication se développent encore plus rapidement que les progrès de la médecine, le Président et les membres du conseil d’administration de la SIFUD PP ont décidé, à l’occasion du 35e anniversaire de votre Société, de vous offrir un site Internet résolument moderne.


Mots clés:
R.
Obésité et urogynécologie : revue de la littérature
2012
- Réf : Prog Urol, 2012, 8, 22, 445-453


Introduction



Objectives

To determine the specificity of the management of urogynecologic disorders in obese women.


Patients and methods

Review of the literature: obesity, genital prolapse, pelvic organ prolapse, urinary incontinence, anal incontinence.


Results

The relative risk of urinary incontinence (UI) for morbidly obese women (BMI>40kg/m2) is five times greater than a normal weight woman. A 10% weight loss reduced the frequency of urinary leakage by 50%. Beyond a BMI of 35kg/m2, the success rate of suburethral sling decreased to 50% with an increased risk of de novo urgenturies. Within this population of morbidly obese women, bariatric surgery was as successful as or more than surgery for incontinence. Patients with morbid obesity are three times as likely to experience anal incontinence, with a prevalence reaching 32%. The treatment of anal incontinence in obese patients is not clearly codified. The association between obesity and prolapse is very controversial according to the methodology used in the studies. Treatment of genital prolapse in obese women is little studied in the literature. Only sacrocolpopexy by laparotomy was studied. No more complications were found in this population.


Conclusion

Now we have specific data concerning urogynecology in obese women to better manage these patients.

Mots clés:
Urogynécologie / Obèse / Obésité / incontinence urinaire / Prolapsus génital
Mots-clés:
Urogynecology / Obèse / Obesity / Urinary incontinence / Genital prolapse
Stand up urgency: Is this symptom related to a urethral mechanism?
2012
- Réf : Prog Urol, 2012, 8, 22, 475-481


Introduction


Mots clés:
Female urinary incontinence / Overactive bladder / Urge urinary incontinence / Patient positioning / Stand up urgency
Mots-clés:
K. / X. / K. / D. / M.
Thérapie cellulaire et incontinence urinaire
2012
- Réf : Prog Urol, 2012, 8, 22, 454-461


Introduction



Aim

The objective of the current study was to perform a review of literature concerning stem cells therapy (preclinical and clinical studies) applied to the treatment of stress urinary incontinence (SUI).


Methods

Review of literature (Pubmed/Medline) using the following key words: stem cells, urinary incontinence, stress . Among 38 published articles (English or French language), 16 studies were selected (comparative preclinical and clinical studies).


Results

Multipotentes mesenchymal stem cells (MSC), present in the adults in most of the tissues derived from the mesoderm have been tested in the treatment of SUI. Three sources of MSC have been mainly used in urology: bone marrow, striated muscle and adipose tissue. The general principle consists in extracting the MSC from the source tissue and grafting these MSC in the injured urinary sphincter. The preclinical studies proved the capacity of these transplanted cells to differenciate into contractile myocytes and to reconstitute nerve junctions. Clinical studies are very different in terms of methodology, with sample size ranging from four to 123 subjects and a median follow-up of 1 year; these studies showed success rates (complete continence) ranging from 12 to 79 % and improvement rates (quality of life and/or pad test) from 13 to 66 %. Only one study reported two cases of worsening incontinence after cell therapy.


Conclusion

The few available clinical studies have reported that at short-term follow-up, cell therapy was associated with encouraging results with few side effects.

Mots clés:
incontinence urinaire / Moelle osseuse / Thérapie cellulaire
Mots-clés:
Urinary incontinence / Bone marrow / Cellular therapy