| Yang JM |
------>authors3_c=??? ------>paper_class1=1 ------>Impact_Factor=4.053 ------>paper_class3=2 ------>paper_class2=1 ------>vol=181 ------>confirm_bywho=tzengcr ------>insert_bywho=hwc0413 ------>Jurnal_Rank=14.5 ------>authors4_c= ------>comm_author=1 ------>patent_EDate=None ------>authors5_c= ------>publish_day=1 ------>paper_class2Letter=None ------>page2=218 ------>medlineContent= ------>unit=E0111 ------>insert_date=20090312 ------>iam=3 ------>update_date=None ------>author=??? ------>change_event=4 ------>ISSN= ------>authors_c=??? ------>score=500 ------>journal_name=J Urol 2009 ------>paper_name=Correlation of morphological alterations and functional impairment in the tension free vaginal tape obturator procedure ------>confirm_date=20090312 ------>tch_id=093176 ------>pmid=19013610 ------>page1=211 ------>fullAbstract=PURPOSE: We explored the morphological features associated with functional impairment in patients undergoing the tension-free vaginal tape obturator procedure. MATERIALS AND METHODS: We retrospectively reviewed the records of 98 women who underwent the tension-free vaginal tape obturator procedure alone or with concomitant pelvic surgery. Postoperative assessment included a symptom questionnaire, ultrasound cystourethrography and a cough stress test. During followup the measures of postoperative functional impairment included a positive cough stress test, new onset voiding dysfunction and the worsening or progression of urge symptoms. RESULTS: Median followup was 22 months. During followup 11 women had a positive cough stress test, 22 had voiding dysfunction and 12 had worsening or new onset urge symptoms. Failure was associated with 4 variables on multiple logistic regression analysis, including absent urethral encroachment at rest (OR 16.63, 95% CI 1.87-147.85, p = 0.01), bladder neck funneling (OR 8.27, 95% CI 1.99-34.26, p <0.01), a urethral location of less than the 50th percentile (OR 6.01, 95% CI 1.43-25.25, p = 0.01) and a resting tape angle of less than 165 degrees (OR 5.21, 95% CI 1.15-23.54, p = 0.03). A resting tape distance of less than 12.0 mm (OR 3.00, 95% CI 1.44-6.26, p <0.01) and urethral encroachment at rest (OR 2.86, 95% CI 1.30-6.30, p <0.01) were the variables predictive of postoperative voiding dysfunction. Bladder neck funneling was the only risk factor for postoperative urge symptoms (p <0.01). CONCLUSIONS: The tension-free vaginal tape obturator procedure achieves its effectiveness in a process of biological reaction and mechanical interaction between the tape and urethra. When this mechanical interaction is too great or too little, there is functional impairment after the procedure. ------>tmu_sno=None ------>sno=21358 ------>authors2=Yang SH ------>authors3=Huang WC ------>authors4= ------>authors5= ------>authors6= ------>authors6_c= ------>authors=Yang JM ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c=??? ------>publish_area=0 ------>updateTitle=Correlation of morphological alterations and functional impairment of the tension-free vaginal tape obturator procedure. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no= ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2009 ------>submit_flag=None ------>publish_month=1 |