Transobturator slings for incontinence in rare cases can cause intractable groin or thigh pain in some women. Cleveland Clinic urologists evaluated thigh dissection with mesh removal and found it improved outcomes.
Both Botox and Interstim are good treatment options for patients with refractory UI, concludes a first-of-its-kind, multicenter clinical trial. The difference? It’s in the eye of the beholder.
Complications such as urethral obstruction, mesh extrusion and/or chronic pain can necessitate removal of synthetic midurethral slings originally placed to treat stress urinary incontinence. Surgeons at Cleveland Clinic’s Glickman Urological & Kidney Institute perform transvaginal sling excision to address these complications. This video presents three separate cases of synthetic mesh excision and offer tips to improve surgical outcomes.
If urethral perforation occurs after synthetic midurethral sling placement, transvaginal removal is an option. In this video, Cleveland Clinic urological surgeon Howard Goldman, MD, demonstrates the pre-procedure patient evaluation and surgical technique of transvaginal sling removal from the urethra of a 66-year old patient with a history of urinary retention and urinary tract infections.
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Surgery for stress urinary incontinence can reduce overactive bladder symptoms, but the level of improvement decreases over time and can be blunted by obesity, a recent analysis reports.
Regenerating the urinary sphincter’s functional capability may be an alternative to traditional methods to restore normal pelvic anatomy in women with stress urinary incontinence. Cleveland Clinic researchers are participating in a clinical trial evaluating autologous muscle-derived stem cells for urinary sphincter repair in SUI patients.
Pelvic organ prolapse treatment options for elderly women should not be based on chronological age alone. Patients’ symptom concerns, functional status, attitudes and preferences are all key factors in the treatment decision.
Overactive bladder guidelines call for following hierarchical treatment of patients, with correction of prolapse the next step for patients who fail modifiable and medical interventions.
Cleveland Clinic researchers have for the first time described the natural evolution of pelvic organ prolapse (POP) in patients seeking treatment. Almost half of women with symptomatic POP will have prolapse progression within a year. When the leading edge of prolapse is beyond the hymen, the chance of progression is doubled.