International journal of gynaecology and obstetrics, Dec 1, 2002
Objectives: To determine the efficacy of intravaginal maximal electrical stimulation for the trea... more Objectives: To determine the efficacy of intravaginal maximal electrical stimulation for the treatment of refractive detrusor instability. Methods: Thirty-five consecutive patients, treated by maximal electrical stimulation for pure refractive detrusor instability were evaluated subjectively by patient's questionnaires and 24-h urinary diary and objectively by 1-h standardized pad test and subtracted cystometry before and 1 week after the treatment. Paired-t and x-tests were used for the statistical analysis of the data. Results: Thirty-one (88.6%) of the 35 patients were 2 found to be either cured or improved, subjectively. The overall objective success rates based on the 1-h pad test and subtracted cystometry were 80.0% and 74.3%, respectively. The results of all subjective and objective assessment tests, except postvoiding residual urine volume, improved significantly after the treatment (P-0.01). No significant adverse effect related to the treatment was observed, except vaginal irritation noted only by 5 (14.3%) patients. Conclusion: Maximal electrical stimulation could offer a safe, non-invasive and effective treatment for patients with detrusor instability who respond poorly to other conservative therapies.
Aim: Aim of the study was to compare the effects of outpatient clinic-based versus home-based int... more Aim: Aim of the study was to compare the effects of outpatient clinic-based versus home-based intravaginal electrical stimulation (ES) for the treatment of urinary incontinence. Methods: Women applying with the complaint of urinary incontinence and offered ES treatment were divided into outpatient clinic-based or home-based ES. Patients were instructed about home-based ES at the outpatient clinic by certified physiotherapy nurses. Bladder diary, 1-hour pad test, and King's-Health-Questionnaire (KHQ) were performed before and after treatment. ES was applied for 20 minutes, 6-8 weeks with pulses of 10-50 Hz square waves at a 300 μs or 1 ms pulse duration and a maximal output current of 24 to 60 mA with 5-10 Hz frequency, three times/week. Results: Twenty-four patients received outpatient clinic-based, 22 patients received home-based ES. Pad test, bladder diary and pelvic floor muscle strength parameters in both groups improved significantly after treatment, with no significant difference between the two groups. Seven patients (31.8%) were cured, six patients (27.3%) were much improved, and seven patients (31.8%) were improved in the home-based ES group. Nine patients (37.5%) were cured, six patients (25%) were much improved, and six patients (25%) were improved and in the outpatient clinic-based ES group. There was an improvement in quality of life in all domains in both groups when the pretreatment and post-treatment KHQ results were compared, with no significant difference between the two groups. Conclusion: Home-based ES is as effective in the treatment of urinary incontinence as outpatient clinic-based ES with significant improvement in objective and subjective parameters.
Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesi... more Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesidir. Pelvik organ prolapsusu cerrahisinde çeşitli abdominal ve vaginal yöntemler tarif edilmiştir. Cerrahide doğal dokular veya meşler kullanılabilir. Doğal dokular ile plikasyon sonrasında rekürrensin arttığını gösteren yayınlar, vaginal meş cerrahisini popüler hale getirmiştir. Biyolojik veya sentetik materyaller ve meş kitleri geliştirilmiştir. Ancak halen meş kullanımının endikasyonları, kısa ve uzun dönem komplikasyonları ve başarı oranları hakkında tartışmalar mevcuttur.
Çalışmamızın amacı Türkiye'de üriner inkontinans ile ilgili düşünce ve tutumları ortaya koymaktır... more Çalışmamızın amacı Türkiye'de üriner inkontinans ile ilgili düşünce ve tutumları ortaya koymaktır. Gereç ve Yöntem: Çalışmaya, İstanbul Fatih ilçesinde rastgele seçilen, onay veren ve anket doldurtulan 150 kişi dahil edilmiştir. Katılımcılara Üriner İnkontinans Davranış Skalası (Urinary Incontinence Attitude Scale) doldurulmuştur. Üriner İnkontinans Davranış Skalası (Urinary Incontinence Attitude Scale), İngilizce'ye hakim 3 çevirmen tarafından Türkçe'ye çevrilerek geçerlik ve güvenirliği yapılmış, Cronbach alfa değeri 0.72 saptanmıştır. Bulgular: 122 kişi anketi tam olarak doldurmuştur. Yaş ortalaması 35.5 ± 10.8'dir. Katılımcıların 79'u (%64.8) kadın, 43'ü (%35.2) erkektir; 57'si (%46.7) evli, 65'i (%53.5) bekardır. 11 (%9.0) ilkokul, 4 (%3.3) ortaokul, 21 (%17.2) lise, 86 (%70.5) üniversite mezunu saptanmıştır. Katılımcıların %49.2'si ilk üriner inkontinans semptomlarının önemsenmeyebileceğini, %41.8'i idrar kaçırma üzerine konuşmanın utanç verici ve zor olduğunu, %88.5'i idrar kaçırmanın önlenebileceğini, %57'si sağlık sorunları arasında idrar sorunlarının sorgulanması ve bildirilmesi gerektiğini düşünmektedir. Ayrıca %86.8'i idrar kaçırmanın sosyal hayatı olumsuz yönde etkilediğini, %95.1'i idrar kaçırmanın üstesinden gelinebileceğini düşünmektedir. Kadın ve erkek katılımcıların verdikleri yanıtlar ayrı ayrı değerlendirildiğinde istatistiksel olarak anlamlı fark saptanmıştır. Soru 2'de kadınlar daha yüksek oranda idrar kaçırmanın utanç verici olmadığını düşünmektedir. Soru 10'da, erkekler daha yüksek oranda idrar kaçırmanın asap bozucu olduğunu düşünmektedir. Soru 11'de kadınlar daha yüksek oranda, sağlık sorunları değerlendirilirken idrar ile ilgili sıkıntıların bildirilmesi gerektiğini belirtmiştir. Sonuç: Çalışmamızda, katılımcıların çoğunluğu idrar kaçırmanın bir sorun olduğunu, tedavi edilebileceğini, önlenebileceğini; ancak idrar kaçırma üzerinde konuşmanın utanç verici olabileceğini ve sağlık sorunları sorgulanırken idrar kaçırma şikayetlerinin de sorgulanması gerektiğini düşünmektedir.
Journal of Wound Ostomy and Continence Nursing, Sep 1, 2016
4% over the next 2 decades. In a study published in 2010, the global prevalence of DM was reporte... more 4% over the next 2 decades. In a study published in 2010, the global prevalence of DM was reported to be 7.7% among individuals between 20 and 79 years of age, and is estimated to aff ect 439 million adults by 2030. 2 Diabetes is a growing health challenge in Turkey; its prevalence increased from 7.2% in 1998 3 to 13.8% in 2010. 4 Diabetes mellitus has been associated with alterations in lower urinary tract function, but studies examining its impact on lower urinary tract symptoms (LUTS) in women are limited. 5 Based on the criteria promulgated by the International Continence Society, we classifi ed LUTS into 7 categories: (1) storage symptoms, (2) voiding symptoms, (3) postmicturition symptoms, (4) symptoms associated with sexual intercourse, (5) symptoms associated with pelvic organ prolapse, (6) genital and lower urinary tract pain, and (7) genitourinary pain syndrome. 6 Lower urinary tract symptoms are more common in women than in men, but their prevalence increases in both women and men as they age. 7 , 8 Multiple other disorders have been associated with an increased risk for LUTS. 9 , 10 Lower urinary tract symptoms in women with DM may be overlooked by health care professionals, especially during the early stages of the condition. Polyuria is a common symptom in diabetic individuals, and health care providers may attribute LUTS such as complaints of urgency and frequency ABSTRACT PURPOSE: The aim of the study was to compare lower urinary tract symptoms (LUTS) in women with and without type 2 diabetes mellitus (DM). SUBJECTS AND SETTING: The sample was drawn from community-dwelling women in the province of Istanbul who were cared for in the diabetes outpatient clinic of Istanbul Medical School between January and June 2012. Two hundred forty-nine women with DM were compared to 255 women without DM cared for in the obstetrics and gynecology department of the same university hospital. The mean ages of the groups were 55.1 and 53.7 years, respectively. METHODS: Participants completed a questionnaire that queried sociodemographic and clinical characteristics; the Bristol Female Lower Urinary Tract Symptoms-Short Form (BFLUTS-SF) was used to evaluate LUTS. The questionnaire required 10 to 15 minutes to complete; participants completed the questionnaire in a private room of each of the respective outpatient clinics. RESULTS: No statistically signifi cant differences were found when groups (women with and without DM) were compared based on age and cigarette smoking (P > .05). In contrast, BMI scores were signifi cantly higher in the women with DM (P < .001). The cumulative BFLUTS scores and the fi lling and incontinence symptoms subscale sores (P < .001) were signifi cantly higher in women with DM. No differences were observed in voiding symptoms (P = .347), sexual function (P = .380), and health-related quality of life (P = .142) subscale scores. The prevalence of storage symptoms nocturia, voiding frequency, urge incontinence, stress incontinence, frequency of incontinent episodes were higher among women with DM. In addition, women with DM were more likely to report the need to change clothing because of urinary leakage, effect of incontinence on daily tasks, and overall interference with daily activities of living. CONCLUSIONS: Women with type 2 DM are more likely to experience LUTS as compared to women without DM. Women with type 2 DM should routinely be assessed for LUTS.
Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesi... more Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesidir. Pelvik organ prolapsusu cerrahisinde çeşitli abdominal ve vaginal yöntemler tarif edilmiştir. Cerrahide doğal dokular veya meşler kullanılabilir. Doğal dokular ile plikasyon sonrasında rekürrensin arttığını gösteren yayınlar, vaginal meş cerrahisini popüler hale getirmiştir. Biyolojik veya sentetik materyaller ve meş kitleri geliştirilmiştir. Ancak halen meş kullanımının endikasyonları, kısa ve uzun dönem komplikasyonları ve başarı oranları hakkında tartışmalar mevcuttur.
Introduction: This study was conducted to evaluate the effectiveness and safety of adjustable sli... more Introduction: This study was conducted to evaluate the effectiveness and safety of adjustable slings in the treatment of recurrent stress urinary incontinence (SUI) after mid-urethral sling (MUS) failure. Materials and Methods: A prospective study was performed among women with recurrent SUI at the Urogynecology Division of Istanbul School of Medicine between February 2010 and March 2015. All women were preoperatively evaluated with detailed urogynecologic evaluations, which included pelvic examination, Q-tip test, pad test, urodynamic studies and a compilation of the Kings Health Questionnaire (KHQ). Postoperative follow-up was performed at 1, 6 and 12 months and annually thereafter. Our primary outcome was objective cure and patient's satisfaction with treatment. Secondary outcomes included perioperative complications and adverse events. Results: Nineteen women were included in the study. The patients' mean age was 55.3 ± 6.9 years (range 43-66 years). The median follow-up time was 20.7 ± 14.0 months (range 6-55 months). The overall cure and improvement rates were 84.2 and 10.5%, respectively. In the satisfaction questionnaire, 15 (79%) patients responded that they were very satisfied and 3 (15.7%) were moderately satisfied. Sling tension re-adjustment was needed during follow-up in 1 patient (5.3%), 13 months after the initial surgery. The preoperative mean KHQ score was 545.9 ± 243.0 and changed to 237.0 ± 217.5 (p &lt; 0.05). Postoperative complications were slight and easily manageable. Conclusions: Recurrent SUI is a challenging condition in urogynecology. The Regulation Mechanical External (Remeex) system has been found to be effective in the treatment of recurrent SUI after MUS failure with acceptable adverse effects. The Remeex system has the advantage of re-adjustment as a valuable option in the long-term management of patients.
European Journal of Physical and Rehabilitation Medicine, Dec 1, 2005
Urinary incontinence is one of the most common medical complaints in women. We here propose to ev... more Urinary incontinence is one of the most common medical complaints in women. We here propose to evaluate and compare the effects of 2 conservative treatment modalities, functional electrical stimulation (FES) and functional magnetic stimulation (FMS). We studied 22 female patients with urinary incontinence and divided them into 2 treatment groups (14 patients in the FES and 8 in the FMS group). The mean age of the patients in the FES group was 51.14+/-11.9 and in the FMS group 42.25+/-6.9 years. Functional electrical stimulation was applied continuously at 10 Hz and 30-50 Hz in urge and stress urinary incontinence respectively. In mixed urinary incontinence stimulation was applied at 10 Hz for 15 min and at 50 Hz for 15 min. The treatment sessions were for 20 min, 3 times a week for 6-8 weeks (12 with mixed, 2 with stress incontinence). FMS was applied by a magnetic chair, twice weekly for 6 weeks (6 with mixed, 1 with stress urinary and 1 with urge urinary incontinence). The efficacy of the treatment was judged from patient impressions, records in urinary diaries, results of 1 h pad test, perineometry value and digital palpation score. The perineometry value, digital palpation score increased significantly during stimulation compared with prestimulation levels in both groups (P&amp;amp;lt;0.05). For the pad test significant improvement was also noted in both groups (P&amp;amp;lt;0.05). The urinary diaries and frequency of micturition were significantly more cured or improved in the FES group (P&amp;amp;lt;0.05). However, reduction of the frequency of nocturnal micturition wasn&amp;amp;#39;t significant in either group (P&amp;amp;gt;0.05). Both FES and FMS treatments were effective. FMS does not involve intravaginal stimulation and it is twice a week. Although FMS is not often used it is more cost effective than FES. In order to have exact knowledge of this issue; more research than has been done in a greater number of subjects is required.
International journal of gynaecology and obstetrics, Dec 1, 2002
Objectives: To determine the efficacy of intravaginal maximal electrical stimulation for the trea... more Objectives: To determine the efficacy of intravaginal maximal electrical stimulation for the treatment of refractive detrusor instability. Methods: Thirty-five consecutive patients, treated by maximal electrical stimulation for pure refractive detrusor instability were evaluated subjectively by patient's questionnaires and 24-h urinary diary and objectively by 1-h standardized pad test and subtracted cystometry before and 1 week after the treatment. Paired-t and x-tests were used for the statistical analysis of the data. Results: Thirty-one (88.6%) of the 35 patients were 2 found to be either cured or improved, subjectively. The overall objective success rates based on the 1-h pad test and subtracted cystometry were 80.0% and 74.3%, respectively. The results of all subjective and objective assessment tests, except postvoiding residual urine volume, improved significantly after the treatment (P-0.01). No significant adverse effect related to the treatment was observed, except vaginal irritation noted only by 5 (14.3%) patients. Conclusion: Maximal electrical stimulation could offer a safe, non-invasive and effective treatment for patients with detrusor instability who respond poorly to other conservative therapies.
Aim: Aim of the study was to compare the effects of outpatient clinic-based versus home-based int... more Aim: Aim of the study was to compare the effects of outpatient clinic-based versus home-based intravaginal electrical stimulation (ES) for the treatment of urinary incontinence. Methods: Women applying with the complaint of urinary incontinence and offered ES treatment were divided into outpatient clinic-based or home-based ES. Patients were instructed about home-based ES at the outpatient clinic by certified physiotherapy nurses. Bladder diary, 1-hour pad test, and King's-Health-Questionnaire (KHQ) were performed before and after treatment. ES was applied for 20 minutes, 6-8 weeks with pulses of 10-50 Hz square waves at a 300 μs or 1 ms pulse duration and a maximal output current of 24 to 60 mA with 5-10 Hz frequency, three times/week. Results: Twenty-four patients received outpatient clinic-based, 22 patients received home-based ES. Pad test, bladder diary and pelvic floor muscle strength parameters in both groups improved significantly after treatment, with no significant difference between the two groups. Seven patients (31.8%) were cured, six patients (27.3%) were much improved, and seven patients (31.8%) were improved in the home-based ES group. Nine patients (37.5%) were cured, six patients (25%) were much improved, and six patients (25%) were improved and in the outpatient clinic-based ES group. There was an improvement in quality of life in all domains in both groups when the pretreatment and post-treatment KHQ results were compared, with no significant difference between the two groups. Conclusion: Home-based ES is as effective in the treatment of urinary incontinence as outpatient clinic-based ES with significant improvement in objective and subjective parameters.
Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesi... more Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesidir. Pelvik organ prolapsusu cerrahisinde çeşitli abdominal ve vaginal yöntemler tarif edilmiştir. Cerrahide doğal dokular veya meşler kullanılabilir. Doğal dokular ile plikasyon sonrasında rekürrensin arttığını gösteren yayınlar, vaginal meş cerrahisini popüler hale getirmiştir. Biyolojik veya sentetik materyaller ve meş kitleri geliştirilmiştir. Ancak halen meş kullanımının endikasyonları, kısa ve uzun dönem komplikasyonları ve başarı oranları hakkında tartışmalar mevcuttur.
Çalışmamızın amacı Türkiye'de üriner inkontinans ile ilgili düşünce ve tutumları ortaya koymaktır... more Çalışmamızın amacı Türkiye'de üriner inkontinans ile ilgili düşünce ve tutumları ortaya koymaktır. Gereç ve Yöntem: Çalışmaya, İstanbul Fatih ilçesinde rastgele seçilen, onay veren ve anket doldurtulan 150 kişi dahil edilmiştir. Katılımcılara Üriner İnkontinans Davranış Skalası (Urinary Incontinence Attitude Scale) doldurulmuştur. Üriner İnkontinans Davranış Skalası (Urinary Incontinence Attitude Scale), İngilizce'ye hakim 3 çevirmen tarafından Türkçe'ye çevrilerek geçerlik ve güvenirliği yapılmış, Cronbach alfa değeri 0.72 saptanmıştır. Bulgular: 122 kişi anketi tam olarak doldurmuştur. Yaş ortalaması 35.5 ± 10.8'dir. Katılımcıların 79'u (%64.8) kadın, 43'ü (%35.2) erkektir; 57'si (%46.7) evli, 65'i (%53.5) bekardır. 11 (%9.0) ilkokul, 4 (%3.3) ortaokul, 21 (%17.2) lise, 86 (%70.5) üniversite mezunu saptanmıştır. Katılımcıların %49.2'si ilk üriner inkontinans semptomlarının önemsenmeyebileceğini, %41.8'i idrar kaçırma üzerine konuşmanın utanç verici ve zor olduğunu, %88.5'i idrar kaçırmanın önlenebileceğini, %57'si sağlık sorunları arasında idrar sorunlarının sorgulanması ve bildirilmesi gerektiğini düşünmektedir. Ayrıca %86.8'i idrar kaçırmanın sosyal hayatı olumsuz yönde etkilediğini, %95.1'i idrar kaçırmanın üstesinden gelinebileceğini düşünmektedir. Kadın ve erkek katılımcıların verdikleri yanıtlar ayrı ayrı değerlendirildiğinde istatistiksel olarak anlamlı fark saptanmıştır. Soru 2'de kadınlar daha yüksek oranda idrar kaçırmanın utanç verici olmadığını düşünmektedir. Soru 10'da, erkekler daha yüksek oranda idrar kaçırmanın asap bozucu olduğunu düşünmektedir. Soru 11'de kadınlar daha yüksek oranda, sağlık sorunları değerlendirilirken idrar ile ilgili sıkıntıların bildirilmesi gerektiğini belirtmiştir. Sonuç: Çalışmamızda, katılımcıların çoğunluğu idrar kaçırmanın bir sorun olduğunu, tedavi edilebileceğini, önlenebileceğini; ancak idrar kaçırma üzerinde konuşmanın utanç verici olabileceğini ve sağlık sorunları sorgulanırken idrar kaçırma şikayetlerinin de sorgulanması gerektiğini düşünmektedir.
Journal of Wound Ostomy and Continence Nursing, Sep 1, 2016
4% over the next 2 decades. In a study published in 2010, the global prevalence of DM was reporte... more 4% over the next 2 decades. In a study published in 2010, the global prevalence of DM was reported to be 7.7% among individuals between 20 and 79 years of age, and is estimated to aff ect 439 million adults by 2030. 2 Diabetes is a growing health challenge in Turkey; its prevalence increased from 7.2% in 1998 3 to 13.8% in 2010. 4 Diabetes mellitus has been associated with alterations in lower urinary tract function, but studies examining its impact on lower urinary tract symptoms (LUTS) in women are limited. 5 Based on the criteria promulgated by the International Continence Society, we classifi ed LUTS into 7 categories: (1) storage symptoms, (2) voiding symptoms, (3) postmicturition symptoms, (4) symptoms associated with sexual intercourse, (5) symptoms associated with pelvic organ prolapse, (6) genital and lower urinary tract pain, and (7) genitourinary pain syndrome. 6 Lower urinary tract symptoms are more common in women than in men, but their prevalence increases in both women and men as they age. 7 , 8 Multiple other disorders have been associated with an increased risk for LUTS. 9 , 10 Lower urinary tract symptoms in women with DM may be overlooked by health care professionals, especially during the early stages of the condition. Polyuria is a common symptom in diabetic individuals, and health care providers may attribute LUTS such as complaints of urgency and frequency ABSTRACT PURPOSE: The aim of the study was to compare lower urinary tract symptoms (LUTS) in women with and without type 2 diabetes mellitus (DM). SUBJECTS AND SETTING: The sample was drawn from community-dwelling women in the province of Istanbul who were cared for in the diabetes outpatient clinic of Istanbul Medical School between January and June 2012. Two hundred forty-nine women with DM were compared to 255 women without DM cared for in the obstetrics and gynecology department of the same university hospital. The mean ages of the groups were 55.1 and 53.7 years, respectively. METHODS: Participants completed a questionnaire that queried sociodemographic and clinical characteristics; the Bristol Female Lower Urinary Tract Symptoms-Short Form (BFLUTS-SF) was used to evaluate LUTS. The questionnaire required 10 to 15 minutes to complete; participants completed the questionnaire in a private room of each of the respective outpatient clinics. RESULTS: No statistically signifi cant differences were found when groups (women with and without DM) were compared based on age and cigarette smoking (P > .05). In contrast, BMI scores were signifi cantly higher in the women with DM (P < .001). The cumulative BFLUTS scores and the fi lling and incontinence symptoms subscale sores (P < .001) were signifi cantly higher in women with DM. No differences were observed in voiding symptoms (P = .347), sexual function (P = .380), and health-related quality of life (P = .142) subscale scores. The prevalence of storage symptoms nocturia, voiding frequency, urge incontinence, stress incontinence, frequency of incontinent episodes were higher among women with DM. In addition, women with DM were more likely to report the need to change clothing because of urinary leakage, effect of incontinence on daily tasks, and overall interference with daily activities of living. CONCLUSIONS: Women with type 2 DM are more likely to experience LUTS as compared to women without DM. Women with type 2 DM should routinely be assessed for LUTS.
Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesi... more Pelvik organ prolapsusu, bir veya birkaç pelvik organın normal pozisyonundan aşağıya doğru inmesidir. Pelvik organ prolapsusu cerrahisinde çeşitli abdominal ve vaginal yöntemler tarif edilmiştir. Cerrahide doğal dokular veya meşler kullanılabilir. Doğal dokular ile plikasyon sonrasında rekürrensin arttığını gösteren yayınlar, vaginal meş cerrahisini popüler hale getirmiştir. Biyolojik veya sentetik materyaller ve meş kitleri geliştirilmiştir. Ancak halen meş kullanımının endikasyonları, kısa ve uzun dönem komplikasyonları ve başarı oranları hakkında tartışmalar mevcuttur.
Introduction: This study was conducted to evaluate the effectiveness and safety of adjustable sli... more Introduction: This study was conducted to evaluate the effectiveness and safety of adjustable slings in the treatment of recurrent stress urinary incontinence (SUI) after mid-urethral sling (MUS) failure. Materials and Methods: A prospective study was performed among women with recurrent SUI at the Urogynecology Division of Istanbul School of Medicine between February 2010 and March 2015. All women were preoperatively evaluated with detailed urogynecologic evaluations, which included pelvic examination, Q-tip test, pad test, urodynamic studies and a compilation of the Kings Health Questionnaire (KHQ). Postoperative follow-up was performed at 1, 6 and 12 months and annually thereafter. Our primary outcome was objective cure and patient's satisfaction with treatment. Secondary outcomes included perioperative complications and adverse events. Results: Nineteen women were included in the study. The patients' mean age was 55.3 ± 6.9 years (range 43-66 years). The median follow-up time was 20.7 ± 14.0 months (range 6-55 months). The overall cure and improvement rates were 84.2 and 10.5%, respectively. In the satisfaction questionnaire, 15 (79%) patients responded that they were very satisfied and 3 (15.7%) were moderately satisfied. Sling tension re-adjustment was needed during follow-up in 1 patient (5.3%), 13 months after the initial surgery. The preoperative mean KHQ score was 545.9 ± 243.0 and changed to 237.0 ± 217.5 (p &lt; 0.05). Postoperative complications were slight and easily manageable. Conclusions: Recurrent SUI is a challenging condition in urogynecology. The Regulation Mechanical External (Remeex) system has been found to be effective in the treatment of recurrent SUI after MUS failure with acceptable adverse effects. The Remeex system has the advantage of re-adjustment as a valuable option in the long-term management of patients.
European Journal of Physical and Rehabilitation Medicine, Dec 1, 2005
Urinary incontinence is one of the most common medical complaints in women. We here propose to ev... more Urinary incontinence is one of the most common medical complaints in women. We here propose to evaluate and compare the effects of 2 conservative treatment modalities, functional electrical stimulation (FES) and functional magnetic stimulation (FMS). We studied 22 female patients with urinary incontinence and divided them into 2 treatment groups (14 patients in the FES and 8 in the FMS group). The mean age of the patients in the FES group was 51.14+/-11.9 and in the FMS group 42.25+/-6.9 years. Functional electrical stimulation was applied continuously at 10 Hz and 30-50 Hz in urge and stress urinary incontinence respectively. In mixed urinary incontinence stimulation was applied at 10 Hz for 15 min and at 50 Hz for 15 min. The treatment sessions were for 20 min, 3 times a week for 6-8 weeks (12 with mixed, 2 with stress incontinence). FMS was applied by a magnetic chair, twice weekly for 6 weeks (6 with mixed, 1 with stress urinary and 1 with urge urinary incontinence). The efficacy of the treatment was judged from patient impressions, records in urinary diaries, results of 1 h pad test, perineometry value and digital palpation score. The perineometry value, digital palpation score increased significantly during stimulation compared with prestimulation levels in both groups (P&amp;amp;lt;0.05). For the pad test significant improvement was also noted in both groups (P&amp;amp;lt;0.05). The urinary diaries and frequency of micturition were significantly more cured or improved in the FES group (P&amp;amp;lt;0.05). However, reduction of the frequency of nocturnal micturition wasn&amp;amp;#39;t significant in either group (P&amp;amp;gt;0.05). Both FES and FMS treatments were effective. FMS does not involve intravaginal stimulation and it is twice a week. Although FMS is not often used it is more cost effective than FES. In order to have exact knowledge of this issue; more research than has been done in a greater number of subjects is required.
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