AIM:To analyze the clinical features,diagnostic modalities,and the surgical management of urethral complications after tension-free vaginal tape procedures.METHODS:This study encompasses a retrospective review of nine...AIM:To analyze the clinical features,diagnostic modalities,and the surgical management of urethral complications after tension-free vaginal tape procedures.METHODS:This study encompasses a retrospective review of nine patients presented with urethral complications after midurethral sling procedures.The patients underwent the procedures during a period from 1999 to 2012 in three different regional hospitals in the southwest part of Sweden.The time from sling placement to diagnosis,the risk factors,clinical features,diagnosis,surgical management,and functional outcome are presented.The presenting symptoms were described as either early onset(< 12 mo) or late onset(> 12 mo) according to when they were first reported.RESul TS:Eight cases of urethral erosion and one case of bladder-neck erosion were detected.The mean interval for diagnoses of the erosions ranged from 3 mo to 11 years.The most common presenting symptoms included de novo urgency with or without incontinence(7/9 patients),urinary retention/voiding dysfunction(4/9 patients),urethritis(4/9 patients),relapse of stress-incontinence(3/9 patients),recurrent urinary tract infections(5/9 patients),and hematuria(1/9 patient).In most cases,voiding dysfunction and urethritis occurred early after the operation.The surgical management applied in most cases was transurethral resection of the intraurethral part of the mesh.The removal of the intraurethral mesh resulted in improvement or complete cure of urgency symptomsin 5/7 patients with urgency.Four patients were reoperated with a new stress-incontinence surgery,one with laparoscopic Burch,and three with retropubic tension-free vaginal tape procedures.COn Clu SIOn:Urethral complications should be suspected in the case of de novo urgency and relapse of stressincontinence.Transurethral excision of the intraurethral mesh is the recommended treatment.展开更多
Objective To study the outcome of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with cystocele. Methods Forty-two patients with SUI confirmed by urodynamics underwent ...Objective To study the outcome of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with cystocele. Methods Forty-two patients with SUI confirmed by urodynamics underwent the TVT procedure under local anesthesia. A prolapse repair was done simultaneously. Results Mean TVT operation time was 26.29 minutes. Mean blood loss was 29.86 mL. Eighty-eight percent of the patients were able to micturate spontaneously within 12 hours and residual urine was less than 100 mL. And 12% of the patients had to use indwelling catheter for 3-11 days. Average hospital stay was 2.91 days. Eighty-eight percent of patients were discharged within 2 days. All patients were followed up (an average of 10.26 months). According to subjective and objective assessment of the outcome, 39 patients (93%) were cured, another 3 patients (7%) were significantly improved and none was failed. There were no major complications such as bladder injury occurred. Conclusion TVT procedure is a minimal invasive, effective, and safe surgery for treatment of SUI.展开更多
A single-phase lattice Boltzmann model with modified surface tension is developed in this paper to solve the problem of high-density-ratio free surface flow.The computational efficiency and accuracy are both enhanced....A single-phase lattice Boltzmann model with modified surface tension is developed in this paper to solve the problem of high-density-ratio free surface flow.The computational efficiency and accuracy are both enhanced.The restriction to the relaxation factor （which needs to be smaller than 1） is circumvented by the new surface tension algebra,due to its rational physical nature compared with the treatment of Xing,Buther and Yang in their paper （Comp.Mater.Sci.,2007,39（2）：282-290）.The proposed stable surface tension scheme is applied to simulate the free deformation of a square droplet with surface tension effect and the process of a droplet impinging on a liquid film.The numerical solution for free deformation of a droplet agrees well with thermodynamic principles,and also achieves high accuracy in comparison with Xing,et al.＇s model.Three typical impinging modes are successfully obtained with the new scheme,and another particular mode found by Wang and Chen is also successfully simulated.The evolutions of liquid crown agree well with the power law related to time.展开更多
文摘AIM:To analyze the clinical features,diagnostic modalities,and the surgical management of urethral complications after tension-free vaginal tape procedures.METHODS:This study encompasses a retrospective review of nine patients presented with urethral complications after midurethral sling procedures.The patients underwent the procedures during a period from 1999 to 2012 in three different regional hospitals in the southwest part of Sweden.The time from sling placement to diagnosis,the risk factors,clinical features,diagnosis,surgical management,and functional outcome are presented.The presenting symptoms were described as either early onset(< 12 mo) or late onset(> 12 mo) according to when they were first reported.RESul TS:Eight cases of urethral erosion and one case of bladder-neck erosion were detected.The mean interval for diagnoses of the erosions ranged from 3 mo to 11 years.The most common presenting symptoms included de novo urgency with or without incontinence(7/9 patients),urinary retention/voiding dysfunction(4/9 patients),urethritis(4/9 patients),relapse of stress-incontinence(3/9 patients),recurrent urinary tract infections(5/9 patients),and hematuria(1/9 patient).In most cases,voiding dysfunction and urethritis occurred early after the operation.The surgical management applied in most cases was transurethral resection of the intraurethral part of the mesh.The removal of the intraurethral mesh resulted in improvement or complete cure of urgency symptomsin 5/7 patients with urgency.Four patients were reoperated with a new stress-incontinence surgery,one with laparoscopic Burch,and three with retropubic tension-free vaginal tape procedures.COn Clu SIOn:Urethral complications should be suspected in the case of de novo urgency and relapse of stressincontinence.Transurethral excision of the intraurethral mesh is the recommended treatment.
文摘Objective To study the outcome of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with cystocele. Methods Forty-two patients with SUI confirmed by urodynamics underwent the TVT procedure under local anesthesia. A prolapse repair was done simultaneously. Results Mean TVT operation time was 26.29 minutes. Mean blood loss was 29.86 mL. Eighty-eight percent of the patients were able to micturate spontaneously within 12 hours and residual urine was less than 100 mL. And 12% of the patients had to use indwelling catheter for 3-11 days. Average hospital stay was 2.91 days. Eighty-eight percent of patients were discharged within 2 days. All patients were followed up (an average of 10.26 months). According to subjective and objective assessment of the outcome, 39 patients (93%) were cured, another 3 patients (7%) were significantly improved and none was failed. There were no major complications such as bladder injury occurred. Conclusion TVT procedure is a minimal invasive, effective, and safe surgery for treatment of SUI.
基金supported by the National Natural Science Foundation of China (Grant Nos.10625210,50609020 and 10902070)the Leading Academic Discipline Project of Shanghai Municipal Education Commission (Grant No.J50501)
文摘A single-phase lattice Boltzmann model with modified surface tension is developed in this paper to solve the problem of high-density-ratio free surface flow.The computational efficiency and accuracy are both enhanced.The restriction to the relaxation factor （which needs to be smaller than 1） is circumvented by the new surface tension algebra,due to its rational physical nature compared with the treatment of Xing,Buther and Yang in their paper （Comp.Mater.Sci.,2007,39（2）：282-290）.The proposed stable surface tension scheme is applied to simulate the free deformation of a square droplet with surface tension effect and the process of a droplet impinging on a liquid film.The numerical solution for free deformation of a droplet agrees well with thermodynamic principles,and also achieves high accuracy in comparison with Xing,et al.＇s model.Three typical impinging modes are successfully obtained with the new scheme,and another particular mode found by Wang and Chen is also successfully simulated.The evolutions of liquid crown agree well with the power law related to time.
