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Giammò, Alessandro; Ammirati, Enrico; Geretto, Paolo; Manassero, Alberto; Squintone, Luisella; Falcone, Marco; Del Popolo, Giulio; Pistolesi, Donatella; Risi, Oreste; Costantini, Elisabetta; Giannantoni, Antonella; Mancini, Vito; Li Marzi, Vincenzo; Agrò, Enrico Finazzi; Pastorello, Mauro; Musco, Stefania; Gontero, Paolo

Can urethral re-bulking improve the outcomes of a prior urethral bulking?

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  • Medientyp: E-Artikel
  • Titel: Can urethral re-bulking improve the outcomes of a prior urethral bulking?
  • Beteiligte: Giammò, Alessandro; Ammirati, Enrico; Geretto, Paolo; Manassero, Alberto; Squintone, Luisella; Falcone, Marco; Del Popolo, Giulio; Pistolesi, Donatella; Risi, Oreste; Costantini, Elisabetta; Giannantoni, Antonella; Mancini, Vito; Li Marzi, Vincenzo; Agrò, Enrico Finazzi; Pastorello, Mauro; Musco, Stefania; Gontero, Paolo
  • Erschienen: SAGE Publications, 2022
  • Erschienen in: Therapeutic Advances in Urology
  • Sprache: Englisch
  • DOI: 10.1177/17562872211069265
  • ISSN: 1756-2872; 1756-2880
  • Schlagwörter: Urology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Aims:</jats:title><jats:p> To analyze the outcomes of urethral re-bulking in the treatment of female stress urinary incontinence. </jats:p></jats:sec><jats:sec><jats:title>Materials and Methods:</jats:title><jats:p> 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. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> 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. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> 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. </jats:p></jats:sec>
  • Zugangsstatus: Freier Zugang