Can urethral re-bulking improve the outcomes of a prior urethral bulking?
| Autor: | Alessandro Giammò, Enrico Ammirati, Paolo Geretto, Alberto Manassero, Luisella Squintone, Marco Falcone, Giulio Del Popolo, Donatella Pistolesi, Oreste Risi, Elisabetta Costantini, Antonella Giannantoni, Vito Mancini, Vincenzo Li Marzi, Enrico Finazzi Agrò, Mauro Pastorello, Stefania Musco, Paolo Gontero |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Therapeutic Advances in Urology, Vol 14 (2022) |
| Druh dokumentu: | article |
| ISSN: | 1756-2880 17562872 |
| DOI: | 10.1177/17562872211069265 |
| Popis: | Aims: To analyze the outcomes of urethral re-bulking in the treatment of female stress urinary incontinence. Materials and Methods: We performed a multicenter observational retrospective study, which included all consecutive patients treated with urethral re-bulking for the treatment of persistent stress or mixed urinary incontinence after a previous urethral bulking. Objective outcomes were evaluated with the 24 h pad-test, while PGI-I questionnaires were administered to evaluate subjective outcomes. Clinical outcomes were assessed before re-bulking procedure and at last follow-up. Mann–Whitney’s U test was used for subgroup analysis. Shapiro-Wilk’s tests were used as normality tests. Results: In total, 62 patients who underwent urethral re-bulking between 2013 and 2020 in a multicenter setting were included. Most patients did not reach complete continence after the first procedure (n = 56) while the remainder reported recurrence of urinary incontinence after initial benefit. Median age at surgery was 66 (IQR: 55-73). Median overall follow-up was 30 months (IQR: 24-41). Median time occurred between the first procedure and reintervention was 12 months (IQR: 7-27). Bulking agents for the re-bulking procedures were bulkamid(n = 56), macroplastique(n = 4), and Prolastic(n = 2). A statistically significant reduction of median 24 h pad test from 100 g(IQR: 40-200) to 35 g(IQR: 0-120) was observed (p = 0.003). Dry rate after rebulking was 36.6%, while 85.4% patients declared themselves ‘very much improved’ or ‘much improved’ (PGI-I 1-2). Very few low-grade complications were observed (n = 4). A single case of major complication occurred. Conclusions: Urethral re-bulking can be an effective technique for the treatment of stress urinary incontinence refractory to a previous urethral bulking and can determine a cumulative benefit after the first procedure. |
| Databáze: | Directory of Open Access Journals |
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