PURPOSE: The aim of this prospective 12-month follow-up study is to evaluate the persistence of the treatment effect achieved during the initial course of peroneal electrical Transcutaneous NeuroModulation (peroneal eTNM®) in patients with overactive bladder (OAB). METHODS: This study enrolled 21 female patients who participated in two previous clinical studies designed to assess the efficacy and safety of peroneal eTNM®. The patients were left without subsequent OAB treatment and were invited to attend regular follow-up visits every 3 months. The patient's request for additional treatment was considered an indicator of the withdrawal of the treatment effect of the initial course of peroneal eTNM®. The primary objective was the proportion of patients with persisting treatment effect at follow-up visit 12 months after initial course of peroneal eTNM®. Descriptive statistics are presented using median, correlation analyses were computed using a nonparametric Spearman correlation. RESULTS: The proportion of patients with persistent therapeutic effect of the initial course of peroneal eTNM® was 76%, 76%, 62% and 48% at 3, 6, 9 and 12 months, respectively. There was a significant correlation between patient reported outcomes and the number of severe urgency episodes with or without urgency incontinence as reported by patients at each follow-up visit (p = 0.0017). CONCLUSION: The treatment effect achieved during the initial phase of peroneal eTNM® persists for at least 12 months in 48% of patients. It is likely that the duration of effects is dependent on the length of the initial therapy.
Cíl práce: Přehled problematiky inkontinence moči v těhotenství. Typ práce: Přehledový článek. Název a sídlo pracoviště: Gynekologicko-porodnická klinika FN Ostrava Závěr: Mechanismy vedoucí ke vzniku stresové inkontinence jsou multifaktoriální. Těhotenství a porod mohou vést k poranění či denervaci svaloviny pánevního dna. Věk rodičky při prvním porodu a BMI mají na vzniku poruch pánevního dna podobný podíl jako vlastní způsob ukončení těhotenství.
Objective: An overview of urinary incontinence issues during pregnancy. Design: A review article. Setting: Department of Gynekology and Obstetrics, University Hospital Ostrava. Conclusion: Mechanisms leading to stress incontinence are multifactorial. Pregnancy and childbirth can lead to injuries or drowsiness of the pelvic floor muscles. The age of the firstborn and BMI in the pelvic floor disorders is similar to that of the end of pregnancy.
- MeSH
- inkontinence moči * etiologie terapie MeSH
- komplikace těhotenství * MeSH
- lidé MeSH
- pánevní dno patofyziologie zranění MeSH
- porod MeSH
- prevalence MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
Cíl studie: Popis případu vzácné komplikace dlouhodobého sestupu dělohy. Typ studie: Kazuistika. Název a sídlo pracoviště: Gynekologicko-porodnická klinika, Fakultní nemocnice Ostrava. Vlastní pozorování: Sedmdesátiletá pacientka s dlouhodobým kompletním urogenitálním prolapsem a poruchou mikce s významnou retencí moči, podstoupila v srpnu 2017 na Gynekologicko-porodnické klinice Fakultní nemocnice Ostrava vaginální hysterektomii s parciální kolpektomií a suturou velkých stydkých pysků. Operace byla původně plánovaná ještě v bezpříznakovém období, ale pro úraz pacientky musela být odložena o více než rok. Samotný operační zákrok byl komplikován lézí močového měchýře, který byl močovými kameny a infekcí výrazně změněn. Sanace cystolitiázy suprapubickou cystolitotomií byla provedena za 16 dní od primární operace. Dočasná derivace moči byla pooperačně zajištěna oboustrannou nefrostomií, epicystostomií a močovým katétrem vzhledem k nízké reziduální kapacitě močového měchýře. Závěr: Kameny močového měchýře jsou vzácnou komplikací jinak relativně častého kompletního urogenitálního sestupu u žen. Mezi hlavní příčiny patří porucha mikce a chronická infekce močových cest zapříčiněná právě sestupem pochvy a dělohy.
Objective: Description of rare complication of long-term uterine prolaps. Desing: Case report. Setting: Department of Obstetric and Gynecology, University Hospital Ostrava. Case report: A seventy-years-old pacient with longterm complete uterine prolaps underwent vaginal hysterectomy with colpoclesis at department of Obstetric and Gynecology of university hospital Ostrava in August 2017. The surgery was planned more than year ago, when patient had no symptoms. But due to patient‘s injury, it was postponed and the condition was already complicated by urine incontinency. The surgery was complicated by bladder lesion, because it was suggested as a pelvis tumor. Correction of cystolithiasis was planned at a second time, when suprapubic cystolithotomy was performed after 16 days. Temporary urinary derivation was ensured by bilateral nephrostomy, epicystostomy and urinal catetrization for low residual bladder capacity after surgery. Conclusion: Bladder stones are a rare complication of otherwise relatively frequent complete urogenital prolaps in women. Major causes include micturition disorder and chronic urinary tract infection which is caused by vaginal and uterus descensus.
- Klíčová slova
- léze močového měchýře,
- MeSH
- inkontinence moči etiologie chirurgie MeSH
- kameny močového měchýře * MeSH
- lidé MeSH
- litiáza MeSH
- močové kameny MeSH
- močový měchýř * chirurgie patofyziologie MeSH
- prolaps pánevních orgánů * komplikace MeSH
- retence moči etiologie chirurgie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
OBJECTIVES: Sonouroflowmetry represents a novel method for estimating urinary flow parameters. The aim of this study was to compare the urinary flow parameters acquired using sonouroflowmetry with those of standard uroflowmetry in healthy female volunteers. METHODS: Thirty-six healthy female volunteers (aged 25-54 years) were subjected to standard uroflowmetry. Simultaneously, subjects dialed a dedicated number on a mobile phone and kept recording until urination was finished. Sound data were analyzed and compared to the uroflowmetry data. Of 218 recordings, 183 were included in the final analysis. Thirty-four measurements were excluded for voided volume <150 mL or technical problems during the recording. A linear model was fitted to calculate the urinary flow parameters and the voided volume from data obtained by sonouroflowmetry. Subsequently the matching datasets of UF and SUF were compared with respect to flow time, voided volume, maximum (Qmax ) and average (Qave ) flow rate. Pearson's correlation coefficient (PCC) was used to compare parameters recorded by uroflowmetry with those calculated based on sonouroflowmetry recordings. RESULTS: A strong correlation (PCC = 0.95) was noted between uroflowmetry recorded flow time and duration of the sonouroflowmetry sound signal. The voided volume measured by uroflowmetry showed a moderate correlation (PCC = 0.68) with the calculated area under the sonouroflowmetry curve. Qmax recorded using uroflowmetry and sonouroflowmetry recorded peak sound intensity showed a weak correlation (PCC = 0.38). CONCLUSIONS: This study validates the basic concept of using sound analysis to estimate urinary flow parameters and voided volume.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lineární modely MeSH
- moč MeSH
- močení * MeSH
- reologie metody MeSH
- reprodukovatelnost výsledků MeSH
- urodynamika * MeSH
- zdraví dobrovolníci pro lékařské studie MeSH
- zvuková spektrografie * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
AIMS: While the effect of different types of incontinence on the quality of life (QoL) has been clearly documented, the information about the impact of incontinence severity on QoL in women is lacking. Therefore, we investigated whether increasingly severe degrees of incontinence were linearly correlated with poorer QoL. METHODS: We included 391 incontinent women and 81 continent volunteers in the study and assessed them in accordance with routine clinical practice. A 24 h pad-weight test was used to objectively quantify the incontinence severity. We then stratified participants according to incontinence type and severity and assessed correlations between incontinence severity and Patient Perception of Bladder Condition (PPBC), International Consultation on Incontinence short-form questionnaire (ICIQ-SF), and King's Health Questionnaire (KHQ) quality of life scores in the entire study population and in individual groups according to incontinence type. RESULTS: Minimal incontinence was associated with significant negative impact on QoL, as measured by all quality of life assement tools. There were nonlinear correlations between scores on individual questionnaires and daily leakage volumes. Stress urinary incontinence had a weaker impact on quality of life than urge or mixed incontinence, as measured by PPBC (P < 0.0001), KHQ part 1 (P < 0.0001), and KHQ part 2 (P < 0.001). Stress urinary incontinence also had a weaker impact on QoL than mixed incontinence as measured by ICI-Q (P = 0.007). CONCLUSIONS: This study demonstrated that even mild urinary leakage significantly reduces the QoL, while subsequent increase in the degree of incontinence has only minimal additional effect. There was no linear correlation between incontinence severity and QoL.
- MeSH
- dospělí MeSH
- inkontinence moči psychologie MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nelineární dynamika MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- stresová inkontinence moči psychologie MeSH
- urgentní inkontinence psychologie MeSH
- vložky pro inkontinentní pacienty MeSH
- zdraví dobrovolníci pro lékařské studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the intra-individual variability of uroflowmetry (UFM) in healthy control subjects and women suffering from stress, urge, and mixed urinary incontinence. METHODS: A total of 35 healthy controls (group A) and 105 women suffering from urinary incontinence were enrolled in the study. Thirty-five women suffered from stress urinary incontinence (group B), 35 women suffered from mixed urinary incontinence (group C), and 35 women with overactive bladder both dry and wet (group D). All participants were asked to perform UFM measurement three times. The following parameters were analyzed: voided volume (VV), peak flow (Qmax), average flow (Qave), volume-corrected peak flow cQmax (cQmax = Qmax/2√ VV), volume-corrected average flow (cQave = Qave/2√ VV), and postvoid residual volume (PVR). Statistical analysis was performed using the analysis of variance on repeated measurements. Relative error was calculated using variation coefficients reported as a percentage of the average. All descriptive characteristics were reported as means ± standard deviation (SD). p values ≤0.05 were considered statistically significant. RESULTS: No statistically significant intra-individual difference in any of the recorded parameters was identified among the three UFM recordings in groups A, C, and D. The intra-individual variability of the following parameters reached statistical significance in patients suffering from stress urinary incontinence (group B): Qmax (p = 0.0016), Qave (p = 0.0005), and cQave (p = 0.0389). A significant difference was only observed in comparison between the first and second consecutive recordings. CONCLUSIONS: This study provides evidence supporting the high yield and good intra-individual reproducibility of UFM.
- MeSH
- dospělí MeSH
- hyperaktivní močový měchýř patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- reologie metody statistika a číselné údaje MeSH
- reprodukovatelnost výsledků MeSH
- stresová inkontinence moči patofyziologie MeSH
- studie případů a kontrol MeSH
- urgentní inkontinence patofyziologie MeSH
- urodynamika fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- Klíčová slova
- POP-Q, vaginální sítě,
- MeSH
- endosonografie MeSH
- lidé MeSH
- pánevní dno anatomie a histologie diagnostické zobrazování patologie MeSH
- pesary MeSH
- prolaps pánevních orgánů * diagnóza etiologie klasifikace terapie MeSH
- rizikové faktory MeSH
- zákroky plastické chirurgie škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
Cíl práce: Prezentovat kazuistiku s rozvojem rozsáhlého hematomu po implantaci tahuprosté vaginální pásky transobturátorovou technikou. Typ práce: Kazuistika. Název a sídlo pracoviště: Gynekologicko-porodnická klinika FN Ostrava. Závěr: Riziko poranění cév je při transobturátorové technice sice vzácné, ale možné. Operatér si této komplikace musí být vědom a musí znát varianty jejího řešení. Konzervativní postup řešení hematomu lze doporučit pouze v případě hemodynamické stability pacientky a pokud hematom nezpůsobuje sekundární komplikace.
Objective: To present a case report of the occurrence of large hematoma after the transobturator tape procedure. Design: Case report. Setting: Department of Obstetrics and Gynecology, University Hospital Ostrava. Conclusion: The risk of vessel injury during the transobturator procedure is rare, but it is possible. The surgeons should be aware of the possibility and know possible solution. Conservative management of hematomas has been recommended when the patient is hemodynamically stable only without other secondary complications.
- MeSH
- antibakteriální látky aplikace a dávkování terapeutické užití MeSH
- antikoagulancia MeSH
- dolní končetina patologie MeSH
- hematom * etiologie terapie MeSH
- iatrogenní nemoci MeSH
- krvácení etiologie terapie MeSH
- lidé středního věku MeSH
- nadroparin aplikace a dávkování terapeutické užití MeSH
- pooperační komplikace MeSH
- stresová inkontinence moči * chirurgie komplikace terapie MeSH
- suburetrální pásky * škodlivé účinky využití MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- Publikační typ
- abstrakt z konference MeSH
