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Female Urethral Prolapse Treated by Simple Ligation over a Foley Catheter: A Case Report.

Dong Hwan LEE ; Noh Sung SEOK ; Jae Suk YOO ; Hong Jin SUH

Journal of the Korean Continence Society.2004;8(1):48-50.

Urethral prolapse is rarely diagnosed. We have reported a case of urethral prolapse that was successfully managed by a simple ligation of prolapsed urethra over a Foley catheter in a postmenopausal woman who was suffering from advanced lung cancer.
Catheters* ; Female* ; Humans ; Ligation* ; Lung Neoplasms ; Prolapse* ; Urethra

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Surgical Treatment for Long Term Urethral Obstruction after Tension-Free Vaginal Tape Procedure.

Dae Sung CHO ; Yong Yeun WON ; Kyoung Sik SEO ; Min Kyu CHOI ; Jong Bo CHOI ; Young Soo KIM

Journal of the Korean Continence Society.2004;8(1):45-47.

Most of anti-incontinence surgeries bear the risk of postoperative complication such as voiding dysfunction due to urethral obstruction. Fortunately, Tension Free Vaginal Tape(TVT) procedure has much lower incidence of postoperative urethral obstruction than other surgical procedures for stress urinary incontinence. There are many reports about the surgical treatments for short-term urethral obstruction after TVT procedure. However, there are few reports on the effect of surgical releasing of the obstruction lasting for a long period. In our case, the patient had urethral obstruction for 32 months after TVT procedure and she was able to void well after surgical releasing of the tape. We suggest that releasing of the tape will be a treatment of choice for long-term urethral obstruction after TVT procedure.
Humans ; Incidence ; Postoperative Complications ; Suburethral Slings* ; Urethral Obstruction* ; Urinary Incontinence

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4 Cases with Complications Necessitating Surgical Correction of Tension- Free Vaginal Tape Procedure in Female Stress Urinary Incontinence.

Hwan KIM ; Yong Beom JEONG ; Young Kyung PARK

Journal of the Korean Continence Society.2004;8(1):42-44.

The tension-free vaginal tape procedure has become a state of the art operation for female urinary stress incontinence and is a simple surgical procedure with good postoperative outcomes. Cases of complication requiring surgical correction are reported to be rare. There are possibilities of major complications, which should be corrected with surgery, such as bowel perforation, obturator nerve injury, vascular injury, persistent urinary retention. We report on 4 patients with complications necessitating surgery, of which obturator nerve injury, vaginal erosion, cystocele, urinary retension.
Cystocele ; Female* ; Humans ; Obturator Nerve ; Polypropylenes ; Suburethral Slings ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Retention ; Vascular System Injuries

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The Temperature Differences among the Three Urethral Portions (Distal, Middle & Proximal) and Bladder in Incontinent Women.

Jun Sung KOH ; Ji Youl LEE ; Soon Young PAIK ; Soon Hong YUK ; Jin Ho LEE ; Sung Ho GHIL ; Sang Sub LEE

Journal of the Korean Continence Society.2004;8(1):38-41.

PURPOSE: We tried to find out an adequate sol-gel transition temperature of female urethra for the injection of thermosensitive polymer in incontinent patients. We measured the temperatures of three portions of female urethra and bladder. MATERIALS AND METHODS: Total of 53 female incontinent patients participated, excluding those with any kind of infection which could lead to an elevation of body temperature. The basal body temperatures were checked at the axilla, tympanic membrane and mouth. Temperatures of the proximal(U1), middle(U2), distal(U3) urethra and bladder(B) were measured by a digital thermometer under a lithotomy position. We divided our patients into 3 groups which were patients in follicular phase(F), luteal phase(L) and menopause(M). The temperature difference between the 4 portions of the urethra(D1; between U1 and U2, D2; between U2 and U3, D3: between U3 and B), was also analyzed. Statistics was done by the ANOVA of repeated measures, one-way ANOVA and Pearson correlation coefficient. RESULTS: The mean age of the patients was 48.1+/-10.7 years. The mean temperature of B, U1, U2, and U3 groups were 37.1+/-0.25 degreesC, 37.0+/-0.25 degreesC, 36.9+/-0.24 degreesC, and 36.7+/-0.25 degreesC. The mean temperature difference of D1, D2, and D3 were 0.2471+/-0.089 degreesC, 0.079+/-0.066 degreesC and 0.066+/-0.058 degreesC. The Pearson correlation coefficient of D1, D2 and D3 were 0.938, 0.965 and 0.970. This showed there was a constant temperature increase from distal urethra to bladder step by step. The number of patients in F, L and M groups were 25(47.2%), 10(18.9%) and 18(33.9%). There was no significant urethral temperature difference at each point(U1, U2, U3 and B) among these three groups. CONCLUSION: There was a constant temperature increase from distal urethra to bladder step by step. This is a baseline study for female urethra for future clinical study. We suggest that our data can be used as deciding the sol-gel transition temperature for thermosensitive polymer injection into incontinent female urethra.
Axilla ; Basal Bodies ; Body Temperature ; Female ; Humans ; Mouth ; Polymers ; Thermometers ; Transition Temperature ; Tympanic Membrane ; Urethra ; Urinary Bladder*

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Incidence of Concomitant Procedures for Pelvic Organ Prolapse and Reconstruction in Women Who Undergo Sling Operation for Stress Urinary Incontinence.

Jong Bouk LEE ; Woong NA ; Jong Ryul LIM ; Chong Won BAK ; Min Ho CHOI

Journal of the Korean Continence Society.2004;8(1):35-37.

PURPOSE: To determine the incidence of concomitant procedures performed for pelvic organ prolapse or vaginal reconstruction at the time of surgery for stress urinary incontinence in contemporary urologic practice. MATERIALS AND METHODS: We retrospectively examined all concomitant procedures for pelvic organ prolapse or vaginal reconstruction in 279 women who had underwent sling operation for stress urinary incontinence at our institution. The subjects presented with stress urinary incontinence underwent history taking, physical examination and urologic investigations such as standing cystourethrography and urodynamic study including Valsalva leak point pressure. RESULTS: Of 279 women, 64(22.9%) had at least one concomitant procedure performed for pelvic organ prolapse or vaginal reconstruction, including 43(15.4%) cystocele repairs, 24(8.6%) rectocele repairs, 6(2.2%) cystocele and rectocele repairs concurrently, 2(0.7%) vaginal hysterectomy and 1(0.4%) urethral diverticulectomy. CONCLUSION: We found that women who undergo surgery for stress urinary incontinence had a high incidence(22.2%) of associated pelvic organ prolapse requiring surgical repair. These additional maneuvers contributed to the overall success of surgery and should not be overlooked.
Cystocele ; Female ; Humans ; Hysterectomy, Vaginal ; Incidence* ; Pelvic Organ Prolapse* ; Physical Examination ; Rectocele ; Retrospective Studies ; Urinary Incontinence* ; Urodynamics

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Relationship between Parameters of Perineal Ultrasonography and Severity of Symptom in Genuine Stress Urinary Incontinence Patients.

Young Ha CHO ; Dae Gon KIM ; Young Jin SEO

Journal of the Korean Continence Society.2004;8(1):31-34.

PURPOSE: The goal of this study is to know the relationship between the parameters of perineal ultrasonography and severity of symptom in stress urinary incontinence patients. MATERIALS AND METHODS: We retrospectively examined total 68 patients with stress urinary incontinence who were diagnosed by physical examination, history, urinalysis and urodynamic study. The patients were divided into three group, 1, 2, 3 by Stamey grade in order of each grade I, II, III. We measured the posterior urethrovesical angle(PUVA) at rest and during strain, descent and funneling of bladder neck using perineal ultrasonography. RESULTS: The mean PUVA at rest was 123.9+/-24.0degrees. In group 1, the angle was 124.6+/-20.6degrees, in group 2, 121.4+/-27.1degrees, in group 3, 138.6+/-4.9degrees(p=0.320). During strain state, the mean PUVA was 139.5+/-24.8degrees. In group 1, the angle was 140.6+/-23.7degrees, in group 2, the angle was 136.9+/-26.5degrees, in group 3, 154.0+/-10.8degrees(p=0.346). The mean descent of bladder neck was 10.8+/-4.4mm. In group 1, the descent was 9.9+/-5.8mm, in group 2, 11.3+/-3.5 mm, in group 3, 11.8+/-0.8 mm(p=0.455). The number of cases presenting funneling of bladder neck was 3, 4, 2 in each group(p=0.150). CONCLUSION: There was no relationship between the parameters of perineal ultrasonography and the severity of symptom in stress urinary incontinence patients.
Humans ; Neck ; Perineum ; Physical Examination ; Retrospective Studies ; Ultrasonography* ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

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Changes of Voiding Methods in Patients with Spinal Cord Injury.

Jeong Hwan SEO ; Kwan Min KIM ; Myoung Hwan KO ; Seung Yong NA

Journal of the Korean Continence Society.2004;8(1):26-30.

PURPOSE: To investigate the changes of voiding methods according to the time after discharge and to clarify the reason of changing voiding method. MATERIALS AND METHODS: One hundred and seventeen patients with spinal cord injury were enrolled. We classified these patients into five groups such as normal voiding, reflex voiding, intermittent catheterization, Foley catheter, and suprapubic cystostomy group. We interviewed the patients for necessary information including current voiding method and reason of changing voiding method. RESULTS: 50% of intermittent catheterization patients changed to reflex voiding method. 66% of these patients changed the voiding method without consult with their physician. Higher percentage of the paraplegic patients with intermittent catheterization changed to reflex voiding than the quadriplegic patients. Moreover, female patients indwelt the catheters due to absence of external collecting device than males. CONCLUSION: It is necessary to follow up the voiding methods of patients with spinal cord injury more closely to avoid the following inadvertent complications.
Catheterization ; Catheters ; Cystostomy ; Female ; Follow-Up Studies ; Humans ; Male ; Reflex ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Catheterization

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Urodynamic Analysis of Men with Normal Prostate Less Than 20 gm Combined with Lower Urinary Tract Symptoms.

Young Joo KIM ; Ji Hyun LEE ; Jung Sik HUH

Journal of the Korean Continence Society.2004;8(1):20-25.

PURPOSE: The cause of lower urinary tract symptoms(LUTS) without diseased causes of urodynamics in men is unclear. The aim of this study was to elucidate reliability of difference of LUTS and its treatment by urodynamic study. MATERIALS AND METHODS: Urodynamic study of 124 patients with LUTS were evaluated by age, international prostate symptom score(IPSS) and PSA. The group of patients were divided according to the chief complaint as irritative symptom group(n=72) and obstructive symptom group(n=42). RESULTS: In irritative symptoms group, 29 patients showed stable bladder which combined with bladder outlet obstruction(BOO)(n=11), detrusor underactivity(DU)(n=2) and normal finding(n=6). 43 patients showed unstable bladder which combined with BOO(n=11) and only detrusor overactivity(DO)(n=32). In obstructive symptoms group, 41 patients showed stable bladder that combined BOO(n=13), DU(n=17) and normal finding(n=11), 11 patients showed unstable bladder that BOO(n=1) and DO(n=10). CONCLUSION: LUTS in men are common and often misdiagnosed. Thus, We must treat the LUTS patients with individual therapy based on urodynamic findings.
Humans ; Lower Urinary Tract Symptoms* ; Male ; Multiple Endocrine Neoplasia Type 1 ; Prostate* ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Tract ; Urodynamics*

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Female Bladder Outlet Obstruction: Clinical Characteristics, Urodynamic Findings, and Treatment Responses.

Jin Ho CHOE ; Sang Jin KIM ; Kyu Sung LEE

Journal of the Korean Continence Society.2004;8(1):14-19.

PURPOSE: Bladder outlet obstruction(BOO) in women is an uncommon condition with an incidence range of 2.7~29%. It is difficult to predict because there is a result of the lack of standard diagnostic definition for the evaluation and no typical diagnostic symptoms. We analyzed the clinical manifestation, urodynamic findings, and response to treatment in female BOO. MATERIALS AND METHODS: 140 women with non-neuropathic voiding dysfunction were evaluated. In all, 27 women had bladder outlet obstruction as indicated by our diagnostic criteria: non-neuropathic voiding dysfunction, maximal flow rate(Q(max)) or =30 cmH2O. Using 16 Fr urethral metal soundation for urethral evaluation, we classified the patients into two groups, the anatomical BOO group in case of resistance to soundation or the functional BOO group, for cases without resistance. We managed these patients with urethral dilation of up to 28 Fr in combination with the administration of alpha 1-blocker. RESULTS: The etiology of BOO was anatomical(37%, n=10), and functional(63%, n=17). In patients with anatomical and functional BOO, urodynamic parameters were similar in each group. In women with BOO, the management with alpha 1-blocker and/or urethral dilation significantly reduced International Prostate Symptom Score(IPSS) and residual urine volume. CONCLUSION: In patients with P(det)Q(max)>or=30 cmH2O, Q(max) Female* ; Humans ; Incidence ; Prostate ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urodynamics*

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Holmium:YAG Laser Coagulation in the Female Patients of Voiding Symptom with Pseudomembranous Trigonitis.

Kun Chul LEE ; Joon Seong JEON ; In Rae CHO

Journal of the Korean Continence Society.2004;8(1):9-13.

PURPOSE: Pseudomembranous trigonitis is a common cystoscopic finding in the female patients with voiding symptoms. We evaluated the changes in voiding symptoms of the patients after coagulating this lesion with Holmium:YAG laser. MATERIALS AND METHODS: Six female patients with voiding symptoms including frequency, dysuria, lower abdominal pain who were refractory to the conservative treatment for more than 1 month were enrolled in this study. The mean age was 35(range: 26~43) years. The patients were treated with cystoscopic evaluation and Holmium:YAG laser with 365 and 500 micrometer probe fibers. Power setting was between 6 and 11 watts. Only the lesions at the trigone and bladder neck were coagulated. No indwelling urethral catheter was used postoperatively. We evaluated patient's symptoms with out-patient follow-up or telephone up to 16 months. RESULTS: The mean duration of symptoms were 3.8(range: 6 months~13 years) years, and the mean follow-up was 13.3(range: 8~16) months. In all cystoscopic evaluations, pseudomembranous trigonitis was seen. After treatment, 3 of the 6 patients showed symptomatic improvements within 3 months and retained the improved state up to the last follow-up period. However, in the other 3 patients, no change in symptoms or initial response with following recurrence was seen. In the 3 patients who showed good response, transient worsening period of 1~3 months preceded the improvement. Follow-up cystoscopy at 3 months showed complete regeneration of the trigone and bladder neck mucosa. CONCLUSION: In the patients of pseudomembranous trigonitis with voiding symptoms refractory to conservative therapy, laser coaulation of the trigonal lesion was not so satisfactory but may be one of therapeutic options. Further investigation is needed.
Abdominal Pain ; Cystoscopy ; Dysuria ; Female* ; Follow-Up Studies ; Humans ; Laser Coagulation* ; Laser Therapy ; Mucous Membrane ; Neck ; Outpatients ; Recurrence ; Regeneration ; Telephone ; Urinary Bladder ; Urinary Catheters

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