Sphincter System Research Articles

ОСОБЕННОСТИ СТРОЕНИЯ СЕМЯПРОВОДОВ У КРОЛИКОВ

The aim of the study is to investigate the anatomical and histological structure of the ductus deferens in representatives of the order Lagomorpha. The results of the micromorphology of the vas deferens in representatives of the order Lagomorpha are presented. Histological preparations were prepared and exami¬ned at the Omsk State Agrarian University (Department of Anatomy, Histology, Physiology and Pathological Anatomy). The objects of the study were material obtained from five sexually mature male Californian rabbits. For histological examination, pieces of organs were selected using the generally accepted method. Sections were stained with hematoxylin and eosin, as well as the Van Gieson method. Morphological, histological, morphometric and statistical methods were used in the study. The ductus deferens in rabbits is a paired tubular organ. The thickness of the mucous membrane of the left ductus deferens varies within 85.77 ± 3.13 μm, of the right ductus deferens was 136.14 ± 3.20 μm. The thickness of the muscular membrane of the left ductus deferens was 287.16 ± 3.48 μm, of the right ductus deferens was 333.79 ± 4.07 μm. The thickness of the adventitia of the left ductus deferens was 246.08 ± 4.75 μm, of the right ductus deferens was 258.56 ± 3.84 μm. During the study, special attention was paid to the adaptation of the muscular layer, which demonstrates a high degree of development and the ability to powerful peristaltic contractions, ensuring the movement of sex cells to the urethra. We can also assume the formation of sphincter systems of the ductus deferens in the indicated anatomical areas.

Our Experience of Distal and Total Urethrectomies in Post Irradiated Vulvar Malignancies in Low Resource Settings: A Single Centre Study.

At diagnosis, women with vulvar cancer often present in locally advanced stage especially in developing countries, owing to the associated ignorance and social stigma. Generally tumour is seen involving adjacent organs, like the vagina, anus, and urethra. Damage to the sphincter system leads to urinary incontinence. Available evidence regarding urethral resections, subsequent lower urinary tract dysfunction and neo-meatus reconstruction in radical vulvar surgeries is scarce and conflicting. Considering, the lack of literature on outcomes of partial and total urethrectomies post chemoradiation in advanced vulvar malignancies from India, in the current study, we analysed our experience of such cases that have been operated post chemoradiation over a span of 2years (from January 2019 to January 2021). DFS ( disease free survival) of more than 6months was seen in 5 of our patients, however in view of local wound complications after primary closure, we recommend reconstruction with myocutaneous flaps. Also in view of incontinence observed in two of our patients who had undergone more than 1⁄2 of urethral resection, as a result of failed suprapubic catheterisation, further plan of urethral reconstruction should be considered especially in patients who have received prior radiation. Our small group of patients represents a unique cohort of patients in whom surgery was attempted after radiation therapy. We have seen that surgery is a feasible option after radiotherapy in patients with advanced disease.

Robust voltage-controlled transcutaneous energy transfer system for artificial anal sphincter.

The artificial anal sphincter (AAS) system has gained significant attention as a solution for treating fecal incontinence (FI). It relies on transcutaneous energy transfer (TET) as its primary energy source. However, changes in posture or biological tissue can cause misalignment of the coil, resulting in unstable power reception. Inadequate power affects charging efficiency, while excessive power leads to excessive heating at the receiver side. Consequently, achieving safe and constant voltage charging for the AAS becomes a complex challenge. To maintain a consistent charging voltage and overcome the issue of variations in load and coil coupling strength, this article proposes a wireless charging control system that utilizes an LCC-S-type resonant network and phase shift to adjust the transmitting voltage based on feedback charging voltage in real time. In particular, the PI controller and neural network are introduced to change the phase-shift angle swiftly. The dynamic performance is then evaluated under different misalignments and presented with comparative results. The results indicate that the multilayer perceptron control system outperforms the PI. Under the complex misalignment disturbance, the average error of receiver side load voltage is only 0.007 V, with an average settling time of 960 ms. Additionally, the average temperature at the receiver side is 40.4°C. The experiments demonstrate that the proposed system effectively addresses the misalignment issue in TET during the charging, ensuring constant voltage charging at the receiver side and thermal safety.

Current surgical management of postprostatectomy incontinence — Workup, options and decision making

This article gives a current overview of surgical options and limits of surgical post-prostatectomy incontinence (PPI) therapy and reflects the contents of workshop 6 at the ICS meeting in Vienna, Austria 2022.The decision-making process in PPI requires consideration of various dimensions from presentation to determination of treatment. Patient factors include the severity of symptoms, age and health condition, comorbidities, and patient’s expectations. Also important are the type of prior prostate surgery, radiation therapy, and status of cure.Only an accurate diagnosis will lead to the most effective management option being chosen. An accurate history, standardized questionnaires, physical examination, and 24-hour pad-weights are essential. Transperineal ultrasound, urethrocystoscopy with a urethral repositioning test, and multichannel urodynamics are useful in assessing sphincter and bladder function, as well as the anastomotic region after radical prostatectomy.The effect of various treatment options, such as slings, balloons, and artificial hydraulic sphincters can now be evaluated with long-term studies. The most widely used type of sling is the two-arm fixed sling with a dry rate of 58% and overall improvement rate of 83% at 5 years. Prior pelvic irradiation may reduce the long-term success rate. Adjustable devices offer the opportunity of adaptation to a potentially changing degree of incontinence to meet individual patients’ needs. Adjustable male slings support the bulbar urethra with a minimal increase of urethral resistanceThe artificial urinary sphincter (AUS) is the most predictably reliable treatment for men with moderate to severe stress incontinence with social continence rates of 79%. Device revision is required for recurrent incontinence with options including cuff repositioning, downsizing, or transcorporal cuff placement. Alternative hydraulic sphincter systems offer the possibility of postoperative adjustment by changing the intra-device pressure. Recent developments include electrical and remotely controlled devices not yet commercially available. Further factors of the decision-making process are the skills of the surgeon, individual preferences, and product availability.

Research on Biomechanical Compatibility for the Artificial Anal Sphincter Based on Improved Actuator

Abstract Anal incontinence, also known as fecal incontinence, refers to the loss of the body's ability to accumulate and control the liquid, solid, and gas contents in the rectum, increasing the frequency of bowel movements. It is a symptom of defecation disorders. The artificial anal sphincter provides a new solution for clinical treatment. In this paper, in order to solve the problem of biomechanical compatibility of the actuator of the artificial anal sphincter system, the original actuator was improved. The model of the rectum and the actuator was constructed by ANSYS. The mechanical finite element analysis of the clamping mechanism was carried out by simulating sphincter behavior, and the displacement cloud diagram and stress cloud diagram of the clamping rectum were obtained. in vitro experiments were carried out using pig intestine to simulate the rectum, which verified the effectiveness of the actuator. The results of the experiment show that the successful rate of holding the rectum reached 96% under the condition of ensuring the normal blood supply to the rectum. It fully proves that the actuator has good biomechanical compatibility.

Biliary slage as a stage of gallstone disease: the successes and difficulties of treatment

Introduction. The high prevalence rates of biliary sludge and its frequent development into the stone stage of cholelithiasis constitute grounds for studying this issue, as the effective action on biliary sludge can prevent overall disease progression.Purpose of the study. To determine the options for diagnosis of biliary sludge in the polyclinic settings. Objectives: 1) Estimate the frequency of diagnosis of biliary sludge. 2) Assess the features and dependence of treatment on the type of biliary sludge. 3) Assess the outcome of treatment depending on the follow-up managing of patients. 4) Propose an algorithm for managing patients after biliary sludge has been diagnosed.Materials and methods. In the work used data of the clinics of the President of the Russian Federation. The total number of people surveyed for 1 year was 1.117. These patients underwent an ultrasound examination (dispensation) and 218 were fitted with biliary sludge (BS), which was 19.4%. Of the 70 patients with BS, 4 groups were formed: 1st group (20 patients) with BS type, 2nd (20 patients) – with BS type, 3rd (20 patients) – with BS type, 4th (10 patients) – with BS-type (BSS) type.All patients received Exchhol therapy at the rate of 15 mg/kg of weight; patients with a pronounced spastic component in the sphincter system – myotropic spasmolytic Sparex (20 mg x 2 times a day); patients of the 4th group (with a near-located sediment indicating the presence of inflammation) – Adisord (derived nitrofuran) 200 mg x 4 times a day (5 days).Results. The type of precipitation was cupped in 4 weeks of treatment; Type – for 8–12 weeks of treatment, type V – for 13–14 weeks.Conclusions. The presented data allow us to hope that early diagnosis of biliary sludge and the factors of its development will help start timely treatment and prevention of the disease.

Inhibition of hyperplasia during the implantation of the puborectalis-like artificial anal sphincter.

This study aims to extend the implantation lifetime of the puborectalis-like artificial anal sphincter by inhibiting the occurrence of hyperplasia following the implantation process. A new transmission structure was designed inside the puborectalis-like artificial anal sphincter to generate an adequate torque to maintain the feces, even if hyperplasia developed around the prosthetic sphincter. An outer shell was added to the prosthetic sphincter to decelerate the occurrence of hyperplasia on the outer shell side. Medical titanium alloy was tested to replace the nylon-12 prosthetic sphincter, while polyetheretherketone was used for the construction of the power supply unit in the puborectalis-like artificial anal sphincter system instead of nylon-12. In vivo experiments were conducted to evaluate all the methods presented in this study with 10 Pa Ma piglets, 1 domestic pig, and 1 beagle dog during the past 2 years. Compared with the previous prosthetic sphincter that was equipped with a fixed-axle gear transmission, the new transmission structure is equipped with a planet-gear train managed to generate a prosthetic sphincter output with a 53% larger torque but with the same size and type of motor as that used previously and increase the implantation lifetime by 56%. After the replacement of the nylon-12, the new prosthetic sphincter made of medical titanium alloy succeeded in extending the implanted lifetime by 83%. In addition, the lifetime was increased by 143%, when an outer shell was added to the prosthetic sphincter. Polyetheretherketone significantly decreased the growth rate of hyperplasia around the power supply unit by 44% after the replacement of the power supply unit material. After the combination of all the improvements, the longest implantation lifetime of the puborectalis-like artificial anal sphincter during the in vivo experiments was 7 months and 10 days, which reflected an improvement of 249%. All methods posted in this study were evaluated to be effective to prolong the implantation lifetime of the puborectalis-like artificial anal sphincter. Among the methods proposed, the most effective was the addition of the outer shell to the puborectalis-like artificial anal sphincter. The least effective method was the improvement of the transmission structure. Medical titanium alloy and polyetheretherketone were good replacements for nylon-12 that managed to extend the implantation lifetime and yield a moderate improvement.

Research of improved fast independent component analysis algorithm in rectal diagnosis signal preprocessing.

With the maturity of artificial organ technology, the use of artificial anal sphincters was proposed to help patients who suffered anal incontinence for various causes reconstruct rectal perception, monitor rectal pressure and diagnose rectal lesion. Aimed at the lack of signal pretreatment in the artificial anal sphincter system, we find a way to solve it, that is, the multi-dimensional reconstruction of the intestinal one-dimensional pressure signal sequence by using phase space reconstruction, and the separation of the reconstructed signal by using the improved fast independent component analysis algorithm. We did some relevant experiments, further extracted the features of the isolated rectal signal, and used back propagation neural network to diagnose the rectal lesions. Experiments show that the method can pretreat the rectal signal, and further analyze the separated signal to diagnose of rectal function. The improved fast independent component analysis algorithm has few iterations, fast convergence, short run time, low requirements on initial weights and good diagnosis. This study lays a foundation for the diagnosis of rectal function by using artificial anal sphincters.

Long-term effects of motherfit group therapy in pre-(MOTHERFIT1) and post-partum women (MOTHERFIT2) with stress urinary incontinence compared to care-as-usual: study protocol of two multi-centred, randomised controlled trials

BackgroundStress urinary incontinence (SUI) is highly prevalent during pregnancy and after delivery. It is often associated with a failing pelvic floor, sphincteric and/or supportive system. Pelvic-floor-muscle training (PFMT) peri-partum has been proven effective for up to 1 year post-partum; however, its long-term effects are unknown. Group PFMT, given by a physiotherapist, has been proven to be as equally effective as individual therapy. Motherfit is a group-PFMT therapy with an emphasis on pelvic floor exercises, adherence and general fitness. Care-as-usual (CAU), if guideline driven, should, as first treatment option, consist of PFMT. Cost-effective strategies are of relevance, given the rise of health care costs. Motherfit group therapy has the potential to be cost-effective in women with urinary incontinence. Therefore, the objectives of the two current studies are: (1) to investigate whether intensive, supervised, pre-partum (MOTHERFIT1) or post-partum (MOTHERFIT2) pelvic-floor-muscle group therapy reduces 18-month post-partum severity of SUI compared to CAU and (2) whether MOTHERFIT1 OR MOTHERFIT 2 is more (cost-)effective compared to CAU.MethodsTwo multi-centred, randomised controlled trials (MOTHERFIT1, n = 150, MOTHERFIT2, n = 90) will be performed. Participants will be recruited by their midwife or gynaecologist during their routine check. Participants with SUI will receive either motherfit group therapy or CAU. Motherfit group therapy consists of eight group sessions of 60 min each, instructed and supervised by a registered pelvic physiotherapist. Motherfit group therapy includes instructions on pelvic floor anatomy and how to contract, relax and train the pelvic-floor muscles correctly and is combined with general physical exercises. Adherence during and after motherfit will be stimulated by reinforcement techniques and a mobile app. The primary outcome measure is the absence of self-reported SUI based on the severity sum score of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF) at 18 months post-partum. Secondary outcomes evaluate quality of life, subjective improvement and health care costs.DiscussionThe motherfit studies are, to our knowledge, the first studies that evaluate both long-term results and health care costs compared to CAU in pregnant and post-partum women with SUI. If motherfit is shown to be (cost-)effective, implementation in peri-partum care should be considered.Trial registrationNetherlands Trial Register, ID: NL5816. Registered on 18 July 2016.

EDITORIAL COMMENT

The paper above adds to the growing body of evidence that the pressure regulating balloon (PRB) of the artificial urinary sphincter (AUS) system plays a critical role in controlling and effecting continence rates. Many urologists who perform AUS insertion feel that the pressure generated from the PRB can be inconsistent and there is a real need for future investigations to evaluate PRBs with a manometer to better analyze pressures. Perhaps these authors will prospectively assess this in future patients to better pinpoint revision approach. Also, there are many instances when performing an AUS revision that there is fluid loss in the PRB without any discernible evidence of leak from any of the components. This presents a conundrum to clinicians and frequently necessities compete revision with an entire new AUS system. Regardless, the results of this small series suggest that improved continence rates can be obtained by switching the 61-70 cm H2O pressure PRB to a 71-80 cm H2O pressure in select situations. The obvious advantage to this revision technique is it greatly simplifies the procedure by avoiding urethral dissection and allows patients to immediately reactivate the device, because there will be no scrotal swelling associated with the new placement of a pump. It would have been helpful if the authors had been able to identify those patients who had prior AUS with reasons for previous explant, but the retrospective nature of this series did not allow this. In addition, there is a clear distinction between patients with persistent vs recurrent incontinence which was not evaluated in this series. Persistent incontinence indicates a possible cuff sizing issue, while recurrent incontinence is more consistent with a device malfunction, eg, like a PRB losing pressure. In general, all surgeons in this arena could benefit from a better systematic way to trouble-shoot the AUS and especially assess for urethral atrophy. Cystoscopic inspection can be fraught with uncertainty in some cases and the premise of this manuscript is upregulating the PRB is effective when urethral atrophy has not occurred. Finally, some continued sobering reminders that irradiated patients have a higher risk of erosion and in fact constituted the 3 erosions seen in this cohort.

The use of botulinum toxin A to promote wound healing in a recurrent lip fissure

AbstractDuring the wound healing process there is an element of contraction and scarring. Lip wounds can be very noticeable to others, making patients self‐conscious. In the lower lip there is an added problem of significant muscular pull similar to a sphincteric system. We demonstrate excellent healing with the injection of Botulinum Toxin A (Botox®) as an adjunct to close surgical excision of a chronic, non‐healing lower lip fissure.

Collagen III (Reticulin) – A Location Marker of Pre-Sinusoid Arteriole Sphincters in the Villous System of Human Placenta

Blood micro-circulation within the placental villous system still raises a large number of problems of functional anatomy concerning the angio-structure of terminal villi, the communication between arterioles and venules of the umbilical vascular system, the spatial extension of the “extra-vascular contractile system” and, last but not least, the existence of the pre-sinusoid arteriole sphincters. The authors make a micro-anatomic analysis of the spatial distribution of the collagen fibres type III (reticulin) as markers of the pre-sinusoid arteriole sphincters. The study was performed on 20 human placentae of gestation age between 25 and 35 weeks. After paraffin embedding, 10 serial sections were obtained from each paraffin block. They were stained in Hematoxilin Eosin, or silver-impregnated according to Gomori method. We had two objectives: to evaluate the spatial distribution of post arteriole sinusoid blood vessels within the terminal villi in the placenta, on the one hand, and the visualization of the location of a presinusoid arteriole sphincter system, on the other. The authors believe that umbilical arterioles and venules are connected “serially” at the level of terminal villi through arteriole-venule sinusoid blood vessels. The location of the trajectory of collagen type III (reticulin) bundles enveloping pre-sinusoid arterioles are markers of the existence of a pre-sinusoid arteriole sphincter at this level.

A novel puborectalis muscle artificial anal sphincter system with the module of sensory perception

This article presents a novel puborectalis muscle artificial anal sphincter system (PM-AASS) with the module of sensory perception for treating severe faecal incontinence (FI). Due to the implantable feature of PM-AASS, this system applied low-power design and the total energy consumption could drop to 48.8 Ah/d. To reduce the injury of intestine and the pressure exerted on intestine, the actuator, including the structure of tings and the robot mechanism, of PM-AASS was presented and the middle ring was optimised. To realise the sensory perception, the intestinal flexible pressure sensors, comprising the radial sensors and the axial sensors, were designed. The sensors calibration showed the R-square of each fitting line were above 0.998, which presented a high goodness of fit and indicated we could figure out the pressure value with the analogue voltage captured by MCU. Through the in-vitro experiment, the results that the radial sensors were more relevant to the occlusion threshold while the axial sensors had more effect on the alarm threshold could be concluded. The practicability of the PM-AASS was verified by the results of the in-vivo experiment, which showed that the PM-AASS had the effect of improvement to the anorectal internal pressure.

Regeneration of degenerated urinary sphincter muscles: improved stem cell-based therapies and novel imaging technologies.

Stress urinary incontinence (SUI) is a largely ousted but significant medical, social, and economic problem. Surveys suggest that nowadays approximately 10% of the male and 15% of the female population suffer from urinary incontinence at some stage in their lifetime. In women, two major etiologies contribute to SUI: degeneration of the urethral sphincter muscle controlling the closing mechanism of the bladder outflow and changes in lower pelvic organ position associated with degeneration of connective tissue or with mechanical stress, including obesity and load and tissue injury during pregnancy and delivery. In males, the reduction of the sphincter muscle function is sometimes due to surgical interventions as a consequence of prostate cancer treatment, benign prostate hyperplasia, or of neuropathical origin. Accordingly, for women and men different therapies were developed. In some cases, SUI can be treated by physical exercise, electrophysiological stimulation, and pharmacological interventions. If this fails to improve the situation, surgical interventions are required. In standard procedures, endoprostheses for mechanical support of the weakened tissue or mechanical valves for a bladder outflow control are implanted. In 20% of cases treated, repeat procedures are required as implants yield all sorts of side effects in time. Based on preclinical studies, the application of an advanced therapy medicinal product (ATMP) such as implantation of autologous cells may be a curative and long-lasting therapy for SUI. Cellular therapy could also be an option for men suffering from incontinence caused by injury of the nerves controlling the muscular sphincter system. Here we briefly report on human progenitor cells, especially on mesenchymal stromal cells (MSCs), their expansion and differentiation to smooth muscle or striated muscle cells in vitro, labeling of cells for in vivo imaging, concepts of improved, precise, yet gentle application of cells in muscle tissue, and monitoring of injected cells in situ.

Optimal Design of Litz Wire Coils With Sandwich Structure Wirelessly Powering an Artificial Anal Sphincter System.

Transcutaneous energy transfer system (TETS) is widely used to energize implantable biomedical devices. As a key part of the TETS, a pair of applicable coils with low losses, high unloaded Q factor, and strong coupling is required to realize an efficient TETS. This article presents an optimal design methodology of planar litz wire coils sandwiched between two ferrite substrates wirelessly powering a novel mechanical artificial anal sphincter system for treating severe fecal incontinence, with focus on the main parameters of the coils such as the wire diameter, number of turns, geometry, and the properties of the ferrite substrate. The theoretical basis of optimal power transfer efficiency in an inductive link was analyzed. A set of analytical expressions are outlined to calculate the winding resistance of a litz wire coil on ferrite substrate, taking into account eddy-current losses, including conduction losses and induction losses. Expressions that describe the geometrical dimension dependence of self- and mutual inductance are derived. The influence of ferrite substrate relative permeability and dimensions is also considered. We have used this foundation to devise an applicable coil design method that starts with a set of realistic constraints and ends with the optimal coil pair geometries. All theoretical predictions are verified with measurements using different types of fabricated coils. The results indicate that the analysis is useful for optimizing the geometry design of windings and the ferrite substrate in a sandwich structure as part of which, in addition to providing design insight, allows speeding up the system efficiency-optimizing design process.

Design and evaluation of an intelligent artificial anal sphincter system powered by an adaptive transcutaneous energy transfer system.

The aim of this study was to optimize an intelligent artificial anal sphincter system (AASS) II for patients with severe fecal incontinence. Redesigning and integrating a pressure sensor into the sphincter prosthesis allows us to reduce the sensor volume and makes it suitable for a chronic, ambulatory application. Furthermore, a close-loop frequency control method was designed for the transcutaneous energy transfer system. Finally, a longer working time of the implanted device was obtained by the low-power design of the hardware and software. The new model was implanted in 2 dogs and studied for periods of up to 5 weeks. The output voltage induced on the load of 30 Ω, for a variation range in k of 0.12 ~ 0.42, was maintained at approximately 6.8 V with a frequency control range of the 270 ~ 320 kHz. The minimum and maximum output voltages of the pressure sensor were found to be 1.7 V and 2.34 V, respectively, which corresponded to a pressure range of 90 ~ 120 kPa with maximum change rate of approximately 3.7% caused by the temperature variations. Moreover, compared with AASS I, the low-power design resulting in 94% reduction in power consumption. The efficacy of the device in achieving continence and sensing the need to defecate was assessed in an animal model. The technical concept and the design of the AASS II turned out to be capable of fulfilling the medical requirements.

Prediction of Resiliency on the Basis of Social Support in Patients With Multiple Sclerosis

Background: Multiple sclerosis (MS) is a chronic inflammatory disease that affects the nervous system and predominantly occurs in women between 20 to 40 years old. Various geographical, familial, genetic, environmental factors, and factors involved in the immune system and infections in childhood are involved in this disease. Motor, sensory, balance, vision, and sphincter systems are affected by MS; therefore, it is a major negative event in the life that will have adverse effects on health and social life. Social support is one of the factors involved in the resiliency of these patients. Objectives: The purpose of this study was to predict resiliency on the basis of social support in patients with MS. Patients and Methods: In this descriptive study, 108 patients with MS were selected in Farshchian Hospital of Hamadan. Data were collected by Connor-Davidson Resilience Scale (CD-RISC) and Social Support Appraisals (SS-A) questionnaire. Data analyses were conducted by SPSS in two descriptive and regression statistical levels. Results: There was a significant association between social support and resiliency. Moreover, there was a strong and positive association between social support and resiliency (r = 0.449, P < 0.01); therefore, the association was significant and the higher the total amount of social support of patients with MS is the higher the level their resiliency would be. Conclusions: Components of social support, totally account for 19% of resiliency variance value of patient; the components of social support, family, friends, and other people’s support at only had lower contribution in predicting resiliency. Support of this group of people to increase their resiliency seems necessary.

Design and assessment of novel artificial anal sphincter with adaptive transcutaneous energy transfer system

This paper presents the in vitro assessment of a novel elastic scaling artificial anal sphincter system (ES-AASS) with an adaptive transcutaneous energy transfer system (TETS) for treatment of severe faecal incontinence (FI). The proposed adaptive TETS has a phase control, which can maintain the output voltage at ∼ 7 V across the full range of the coupling coefficient variation (from 0.09–0.31) during the whole process of charging with a phase shift of 177.5° to 79.1°. A maximum surface temperature of 42.2 °C was measured above the secondary coil during an energy transmission of 3.5 W in air. The specific absorption rate (SAR) and current density analysis of the biological three-layers structure, including the skin, fat and muscle) surrounding the coil pair were analysed and the results of simulation analysis showed that the value of SAR and current density were very small at any given transmission condition compared with the basic restrictions of the International Commission on Non-Ionizing Radiation Protection (ICNIRP). In conclusion, in vitro experimental results showed that the ES-AASS can control simulated faecal behaviour effectively and the performance of TETS was validated.

Reconstructive surgery for male stress urinary incontinence: Experiences using the ATOMS(®) system at a single center.

Objective: To propose possible success-driven solutions for problem and complication rates encountered with the ATOMS® sling system, based on first-hand experience; and to provide possible actual alternative scenarios for the treatment of male stress urinary incontinence (SUI). Patients and methods: During the defined period (between 4/2010 and 04/2014), 36 patients received ATOMS® system implants at our clinic. We collected pre- and post-operative evaluation data using the International Consultation on Incontinence Questionnaire Short Form (ICIQ SF). As an expansion of the questionnaire, we added questions about post-operative perineal pain, the general satisfaction with the results of the intervention and willingness to recommend the operation to a best friend. Results: Our data shows a relatively high explantation rate, but a surprisingly high patient satisfaction rate. Explantation was required mainly due to late onset infections or other symptomatic factors. Compared to other studies early onset infections were rare. Conclusion: A non-invasive, uncomplicated adjustable system to alleviate male stress urinary incontinence remains a challenge. Although there are various systems available for the treatment of male stress urinary incontinence, it seems that despite the advantages of the ATOMS® system, an artificial sphincter system may pose more advantages based on our experience, understanding and knowledge of its well-documented long-term solutions and problems.

Coupling analysis of transcutaneous energy transfer coils with planar sandwich structure for a novel artificial anal sphincter

This paper presents a set of analytical expressions used to determine the coupling coefficient between primary and secondary Litz-wire planar coils used in a transcutaneous energy transfer (TET) system. A TET system has been designed to power a novel elastic scaling artificial anal sphincter system (ES-AASS) for treating severe fecal incontinence (FI), a condition that would benefit from an optimized TET. Expressions that describe the geometrical dimension dependence of self- and mutual inductances of planar coils on a ferrite substrate are provided. The effects of ferrite substrate conductivity, relative permeability, and geometrical dimensions are also considered. To verify these expressions, mutual coupling between planar coils is computed by 3D finite element analysis (FEA), and the proposed expressions show good agreement with numerical results. Different types of planar coils are fabricated with or without ferrite substrate. Measured results for each of the cases are compared with theoretical predictions and FEA solutions. The theoretical results and FEA results are in good agreement with the experimental data.