INTRODUCTION: Single-incision miduretral slings (SIMS) were withdrawn from the market in many countries due to lower efficacy. In some countries they are still in use, preferred primarily because it is possible to perform the procedure under local anesthesia. Based on our previous clinical experience we postulated that local anesthesia decreased primary anchor fixation in the obturator complex. The aim of the study is to assess how local infiltration anesthesia influences anchor fixation of the tape in porcine obturator complex. METHODS: The experiment was designed to determine the maximum force necessary to extract an implant anchor from a porcine obturator complex. The implant was extracted at a constant speed and data sampling frequency, and the data on displacement of the testing system, achieved force and time were recorded. The implant arms were divided into groups on the right and left sides. In the first group, the anchored arms were used for two implantations - primary and secondary without infiltration anesthesia - and in the second group they were used in the same way, using infiltration anesthesia. RESULTS: A total of 40 implanted anchors were tested in the experiment, totaling ten single-incision slings (each anchor was implanted twice). An average of 8.28 N (Newton) (SD 6.73, min. 2.11, max. 30.34 N) is required to remove the implant anchor from the obturator complex without infiltration by local anesthesia. An average force of 4.40 N (SD 2.99 min. 1.2, max. 9.48) is required to remove the anchor from the obturator complex after infiltration. Local anesthesia reduces anchor fixation in the obturator complex by 47%. CONCLUSIONS: The local infiltrative anesthesia decreases anchor fixation in the porcine obturator complex.

• Klíčová slova
• Midurethral sling (MUS), Obturator complex, Single-incision midurethral sling (SIMS), Stress urinary incontinence, Trans-obturator tape,
• Publikační typ
• časopisecké články MeSH

INTRODUCTION AND HYPOTHESIS: Information on urethral bulking therapy in women after previous pelvic radiotherapy is lacking. This study compared the safety and efficacy of polyacrylamide intraurethral injections in patients with and without previous radiotherapy. METHODS: A total of 46 patients with severe stress urinary incontinence (SUI) were enrolled in this multicenter prospective trial. Group A consisted of 24 patients with previous radiotherapy to the pelvis for the treatment of a gynaecological malignancy. Group B consisted of 22 patients without previous radiotherapy. All patients were treated with a transurethral injection of a bulking solution (Bulkamid). The average follow-up was 12.4 months. The paired Wilcoxon test was used to compare the results before and after the procedure within the groups, and the two-sample Wilcoxon test was used for comparisons between groups. RESULTS: Complete continence was achieved in 25 % of patients in group A and in 36.4 % of patients in group B. Significantly reduced urine leakage was observed in both groups (p = 0.0164 in group A and p = 0.0002 in group B). The total scores in the International Consultation on Incontinence Questionnaire decreased by 5.2 in group A (p = 0.0000) and 6.36 in group B (p = 0.0001). The scores for the Total Patient Perception of Bladder Condition decreased by 1.54 in group A (p = 0.0001) and 2.59 in group B (p = 0.0000), with a significant difference between groups (p = 0.0224). No clinically significant changes in urodynamic parameters were observed. No severe adverse events were noted. CONCLUSIONS: Based on our results, we conclude that urethral bulking therapy is a valuable treatment option in patients with severe SUI who have undergone pelvic radiotherapy for the treatment of gynaecological malignancy.

• Klíčová slova
• Pelvic radiotherapy, Polyacrylamide hydrogel, Stress urinary incontinence, Urethral bulking,
• MeSH
• akrylové pryskyřice aplikace a dávkování   škodlivé účinky   MeSH
• biokompatibilní materiály aplikace a dávkování   škodlivé účinky   MeSH
• dospělí MeSH
• hydrogely aplikace a dávkování   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory ženských pohlavních orgánů komplikace   radioterapie   MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stresová inkontinence moči komplikace   farmakoterapie   patofyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky kontrolované MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Názvy látek
• akrylové pryskyřice MeSH
• biokompatibilní materiály MeSH
• Bulkamid MeSH Prohlížeč
• hydrogely MeSH
• polyacrylamide MeSH Prohlížeč