Sling Therapy Research Articles

Long-term outcomes of polyacrylamide hydrogel treatment in women with stress urinary incontinence.

Long-term outcomes of polyacrylamide hydrogel treatment in women with stress urinary incontinence.

ACUTE EFFECTS OF SLING EXERCISE RECOVERY WITH WHOLE-BODY VIBRATION RESTING MUSCLE FUNCTION AND BLOOD OF LACTATE

The purpose of this study was to investigate an effective recovery method on muscle function and blood of lactate level after maximal isotonic exercise. This study was conducted in 36 adult males. The group was divided into three groups. Sling therapy group (SG, [Formula: see text]), sling therapy group with whole body vibration continuous (SAVG, [Formula: see text]) and sling therapy group with whole body vibration in intermittent (SIVG, [Formula: see text]) were randomly composed. Sling exercise therapy using supine position and whole-body vibration of 10[Formula: see text]Hz, 5[Formula: see text]mm were performed. Lactate level and muscle function during the rest, fatigue and recovery period were measured and then maximal exercise using back extension was performed to induce fatigue. After 15[Formula: see text]min, sling with whole body vibration was conducted in two groups, respectively. Blood lactate was measured a few hours before and after of vibration. Also, muscle function between only sling exercise therapy condition, sling with whole body vibration condition in all time and sling with whole body vibration condition in intermittent time were analyzed. Lactate level was recorded by lactate measurement device. Isokinetic of lumber joint extension and flexion Peak torque/body weight, total work (J), average power (W) and acceleration time (m/s2) were measured using isokinetic dynamometer. The recovery method of sling with whole body vibration showed positive changes in physical characteristics. Isokinetic contraction of peak torque/body weight (N[Formula: see text]m), average power (Watts) and total work (J) were significantly increased in the recovery step for SIVG. Lactate level was significantly decreased for SIVG as compared with SG and SAVG. This study demonstrated that sling exercise therapy with intermittent time whole body vibration could provide a positive effect on the efficient recovery of muscle function and higher reduction of lactate after maximal isotonic exercise.

Injection of a bulking agent to combat urinary incontinence after unsuccessful sling therapy in a patient with post prostatectomy urinary incontinence

We report a case of a successful treatment of post prostatectomy urinary stress incontinence with bulk injections after failed primary treatment with a sling. Keywords: Incontinence; Sling; Bulking agent; Therapy; Post-prostatectomy Case presentation A 70 year-old man was referred to the Urologen Kliniek Vleuten, with complaints of persistent stress urinary incontinence (SUI). His past medical history includes an open radical prostatectomy for a pT2cNxMx Gleason 6 adenocarcinoma of the prostate, with an initial PSA of 6.6 July 2011. Two years after prostatectomy the patient still complained of mild SUI, despite extensive pelvic floor physiotherapy. To treat the incontinence, an Argus sling was implanted in 2013. Nevertheless, the patient still complained of stress urinary incontinence after this procedure.

Injection of a bulking agent to combat urinary incontinence after unsuccessful sling therapy in a patient with post prostatectomy urinary incontinence

We report a case of a successful treatment of post prostatectomy urinary stress incontinence with bulk injections after failed primary treatment with a sling. Keywords: Incontinence; Sling; Bulking agent; Therapy; Post-prostatectomy Case presentation A 70 year-old man was referred to the Urologen Kliniek Vleuten, with complaints of persistent stress urinary incontinence (SUI). His past medical history includes an open radical prostatectomy for a pT2cNxMx Gleason 6 adenocarcinoma of the prostate, with an initial PSA of 6.6 July 2011. Two years after prostatectomy the patient still complained of mild SUI, despite extensive pelvic floor physiotherapy. To treat the incontinence, an Argus sling was implanted in 2013. Nevertheless, the patient still complained of stress urinary incontinence after this procedure.

Sling therapy as a means of improving the motor ability of children with spastic paraparesis

Sling therapy as a means of improving the motor ability of children with spastic paraparesis

Effectiveness of sling exercise for chronic low back pain: a systematic review.

[Purpose] This study investigated effects of sling exercise for patients with chronic low back pain. [Methods] We reviewed all relevant papers indexed in PubMed, SCOPUS, and the Cochrane Registered Trials. Eligible trials were randomized controlled trials that compared sling exercise with any type of treatment. We extracted data on muscle thickness, muscle activation, pain, and disability, and assessed the methodological quality of the data. Seven studies met our inclusion criteria. [Results] When sling exercise had an impact on activation of the trunk muscles, increasing the trunk muscle thickness, and the reduction in pain and disability had been assessed shortly after the final exercise session, it was more effective than general exercise at activating trunk muscles, but not more effective at increasing trunk muscle thickness and improving pain and disability than general exercise. [Conclusion] As sling therapy studies are based on a small number of trials, we cannot draw conclusions about the therapeutic effects of sling exercise. When segmental stabilizing exercise and individually designed programs are added to sling exercise, it increases the effectiveness of sling exercise at improving low back pain. This should be the focus of future studies.

MIDAZOLAM AS AN ADJUNCTIVE THERAPY FOR CAPTURE MYOPATHY IN BAR-TAILED GODWITS (LIMOSA LAPPONICA BAUERI) WITH PROGNOSTIC INDICATORS

Capture myopathy is a complication of capture and handling in many species of birds and mammals. Muscular necrosis leads to ataxia, paralysis, and pain, whereas metabolic disturbances can result in death. We conducted an opportunistic clinical trial on Bar-tailed Godwits (Limosa lapponica baueri) that developed capture myopathy after a cannon-net capture in New Zealand in October 2008. We assessed the beneficial effects of midazolam, a benzodiazepine with the effects of anxiolysis, muscle relaxation, and sedation, in the adjunctive treatment of capture myopathy. Physical and biochemical parameters were analyzed retrospectively for their potential as indicators for survival until release. Birds (n=16) were treated with subcutaneous fluid therapy, a nonsteroidal anti-inflammatory (meloxicam), gavage feeding, and sling therapy twice daily. The treatment group (n=8) was treated twice daily with intramuscular midazolam injections, 1.5 mg/kg. Surviving godwits were released over 1-9 days, with 6 of 8 treated birds (75%) surviving to release, compared with 3 of 8 controls (38%). Inability to counteract weight loss in captivity was the most significant problem for both groups. Lack of waterproofing and predation were contributing causes of death for at least two godwits after release. Birds treated with midazolam showed subjective benefits including improved tolerance of handling and sling therapy. Clinical parameters (change in body mass, packed cell volume [PCV], plasma creatine kinase [CK], aspartate aminotransferase [AST], total protein, and uric acid [UA] over time) were not statistically different between groups, although peak average values for CK, AST, and UA were lower in the treatment group. Decline in body mass (%), PCV, final plasma UA, and peak plasma CK were the most useful prognostic indicators. Midazolam shows potential as an ancillary treatment for capture myopathy in birds and is worthy of continued study and use.

FAST discharge without catheterization after sling therapy

Assessment of voiding function after female sling surgery varies and patients are often discharged with a catheter, which can cause discomfort and complications, including infection. Management protocols using force of stream measurements could reduce catheter use and enable rapid discharge of women from hospital after sling surgery.

Force of Stream After Sling Therapy: Safety and Efficacy of Rapid Discharge Care Pathway Based on Subjective Patient Report

We evaluated the safety of a mid urethral sling postoperative care pathway using patient subjective reporting of force of stream to minimize length of stay and catheter placement. Women undergoing solitary mid urethral sling surgery were prospectively enrolled in our study. Force of stream after the sling therapy protocol consisted of retrograde bladder filling with 300 ml fluid within 1 hour after surgery. Patients rated force of stream compared to baseline on a visual analog scale. Those with a force of stream of 50% or greater were immediately discharged home regardless of post-void residual urine volume. Only those unable to void and those rating force of stream less than 50% with post-void residual urine volume greater than 500 ml were discharged home with a catheter. Patients were telephoned within 1 week of surgery and seen 4 to 6 weeks postoperatively. The primary outcome was unexpected visits to the emergency room or office for voiding dysfunction or urinary retention. A total of 114 women were prospectively enrolled in our study, of whom 105 (92.1%) passed the protocol and were discharged home without a catheter. Of the patients 14 were discharged home with increased post-void residual urine volume (range 152 to 427 ml) but no catheter, representing those who would have been discharged with a catheter by many traditional voiding protocols. According to protocol 9 patients were discharged with a catheter. No patient presented to the emergency room or office in urinary retention or with voiding dysfunction before the scheduled visit. Patients who report a force of stream of 50% or greater can be safely and rapidly discharged home after an uncomplicated mid urethral sling procedure regardless of post-void residual urine volume. Scanned post-void residual urine volume does not add much value in those who can void. By following the force of stream after sling therapy protocol patients can be discharged home less than 3 hours after mid urethral sling surgery.

MP-04.12: Force of stream after sling therapy (FAST): safety and efficacy of a rapid discharge pathway based on subjective report

MP-04.12: Force of stream after sling therapy (FAST): safety and efficacy of a rapid discharge pathway based on subjective report

Predictors of Success With Postoperative Voiding Trials After a Mid Urethral Sling Procedure

We identified predictors of passing a voiding trial after incontinence surgery with a mid urethral sling and examined if successful performance on a voiding trial was maintained. A total of 89 women scheduled for incontinence surgery were enrolled from July 2005 until April 2006. Voiding trials were performed the day of discharge from the hospital, with a two-thirds volume void after a 300 ml fill considered passing. Those who passed underwent a second voiding trial 3 hours later. Of the participants 60 (67.4%) underwent tension-free vaginal tape surgery, 29 underwent transobturator tape (32.6%) and 64 (71.9%) underwent concurrent vaginal repairs. A total of 59 (67.0%) participants passed the first voiding trial. Univariate analysis identified 12 potential predicting variables for passing the first voiding trial. From these 12, model building via backward stepwise logistic regression found maximum flow on preoperative uroflowmetry to be the only significant predictive variable (p = 0.0002). Of the 59 women who passed the initial voiding trial 9 (16.4%) failed the second voiding trial. None of the 11 participants who had maximal flow rates greater than 30 cc per second failed the first or second voiding trial, whereas 17 of 22 subjects (77.3%) who had maximal flow rates less than 15 cc per second failed either of these trials. Maximum flow rates on preoperative uroflowmetry were the best predictor of passing an initial voiding trial after undergoing a mid urethral sling procedure for incontinence. However, the ability to maintain performance on a second voiding trial, even only 3 hours after passing an initial trial, is not assured.

骨盤骨折の経験

From May, 1975 to April, 1982, fifty patients of pelvic fractures with, primarily pelvic ring disruptions were treated. These fractures were classified according to the direction of force by the method devised by Pennal et al. Five representative cases were described with special reference to their pathologic and therapeutic view points. There included one open-book fracture, one ipsilateral compression fracture, one contralateral compression fracture, and two four-rami fractures of lateral compression. Following results were obtained: 1) 86% of the patients (43) had lateral compression type fractures. 2) Of lateral compression type fractures, the most common pattern was the four-rami fracture with posterior disruption comprising 44% of all fifty patients. 3) Four patients (8% of the total) showed stable open-book fractures requiring pelvic sling therapy. This number was smaller than at first expected. This study suggested that pelvic ring disruptions should be accurately classified and the grade of injury accurately estimated so that an appropriate method of therapy can be determined promptly.