Active clinical trials for "Urinary Incontinence"

Urinary continence recovery remains one of the most bothersome side effect of modern radical prostate surgery and several technical modifications, especially in Robotic assisted radical prostatectomy procedures, have been reported in order to improve early urinary continence recovery. With the aim to improve the urinary continence recovery after robotic prostatectomy, we evaluate the impact of the use of a 6-branch retropubic suburethral autologous sling, created and placed during the procedure, in association with intraoperative evaluation of the retrograde leak point pressure by means of retrograde perfusion sphincterometry for proper sling tensioning.

Transobturator tapes (TOT) are placed according to the surgical technique described by Delorme et al. in patients with a previous cervico-sacropexy (CESA) or vagino-sacropexy (VASA). Before final Fixation of the tapes and suturing the vaginal skin a Hegar dilator sound with either 8 mm or 6 mm diameter is placed in the urethra and a second Hegar dilator sound with either 4 mm or 3 mm diameter is placed between the tape and the urethra. After suturing the vaginal skin the Hegar sounds are removed.

The purpose of this study is to determine if addition of a handout to the standard consent process for the trans-obturator tape (TOT) mid-urethral sling procedure will improve patients' understanding, recall and satisfaction with their procedure. The information provided in the handout will include the procedure details, the accompanying risks and benefits, as well as the expectations and alternatives to the TOT procedure. The aim of the investigators is to improve and standardize the current process for surgical consent for patients undergoing a mid-urethral sling procedure, specifically the TOT. The investigators hypothesize that addition of a handout will improve patient's preoperative comprehension by an absolute value of 10% compared to the standard consent process. The investigators further hypothesize that the handout will improve patient satisfaction and recall of the surgical procedure details post operatively.

The aim of this study is to estimate the amount of extra urine produced by natural diuresis during 20-minute pad test, and assess the effect of diuresis on the accuracy of using 20-minute pad test to estimate the severity of SUI. Besides, the above results may be used for further refinement of the amount of water infusion used for the 20-minute pad test.

Urinary incontinence is well documented as a comorbidity of obesity. Studies demonstrate improvement of incontinency after weight loss. However, the mechanisms are still not clear. Aim of our study to analyze the effects of bariatric surgery on pelvic floor function in women.

This study is a randomized controlled trial designed to assess the rate of failure of voiding trials in the early and late post-operative period within patients who underwent outpatient pelvic floor surgery that failed initial same day voiding trials.

Prospective, single-arm, non-sponsored, observational single centre trial in a cohort of patients undergoing stress urinary incontinence surgery with ALTIS® procedure. All patients were diagnosed according to clinical reports, physical exploration and urodynamics. Body mass index(BMI) was categorized according to World Health Organization classification. Valsalva leak point pressure was categorized in three groups <60 cmH2O, 60-90 cmH2O and >90 cmH2O). Participants were evaluated post-operatively at 1, 6, 12 and 24 months with physical examination, ICIQ-SF, visual scale of satisfaction(SVS)(0-10). Adverse events were reported in each visit. Multivariate analysis for risk factors of surgery failure was performed.

Bariatric surgery of morbid obesity was first located at Førde Central Hospital, but it is now an established treatment at several other hospitals in the health region (Voss Hospital (Helse Bergen), Haugesund Hospital (Helse Fonna) Stavanger University Hospital ((SUS) Helse Stavanger). Surgical methods vary between hospitals: Voss: sleeve gastrectomy, Haugesund: gastric bypass (Roux-en Y),SUS: gastric bypass (Roux-en Y); Førde: biliopancreatic diversion with duodenal switch (BPD / DS) and sleeve gastrectomy . The investigators have then in Helse-Vest a unique opportunity to examine the various clinical and metabolic effects from different surgical methods. This project is part of the regional strategic research initiative in the Helse Vest

To determine if the T-PTNS is not inferior in the short term (3 months) to one of the usual pharmacological treatments (Solifenacin) in the treatment of hyperactive bladder syndrome and with respect to the percentage of patients that improve 50% any of the 3 signs (Urinary frequency, diurnal / nocturnal frequency, urgency and urinary incontinence). To determine prognostic factors associated with insufficient improvement (less than 50% in the 3 main signs of hyperactive bladder syndrome (urinary frequency, urgency and urinary incontinence frequency) after treatment with T-PTNS and Solifenacin.

Fundamentals of scientific research The "coital incontinence" (IC), defined as the "involuntary loss of urine in association with sexual intercourse." The incidence reported in the literature ranges from 10% to 27%, but is likely to be underestimated because of the embarrassment of the woman to report the disturbance. It was in fact estimated that only 3% of women speaks spontaneously to their doctor, and increases up to 20% only after a request by the medical staff. The CI is traditionally divided into two forms: incontinence at the time of penetration (60% of cases) incontinence during orgasm (40% of cases) Many theories have been proposed to justify this form of urinary incontinence, but none has been conclusively proved .Moreover, it has not been possible, to date, to identify risk factors, anatomical or urodynamics, for this condition. The IC is rarely a symptom isolated, but more frequently associated with other forms of urinary incontinence. In particular, the IC during penetration of associated with stress urinary incontinence (loss of urine that occurs due to coughing, sneezing and in general to all those activities that increase abdominal pressure); the IC during orgasm is associated more frequently to a condition of overactive bladder (presence of urgency, urge incontinence, increased urination day and night). The IC has a strong impact on female sexuality and can cause loss of libido, non orgasmic, decreased sexual satisfaction and, in some cases, termination of sexual activity. Research goals Evaluate a prospective investigation of health statistics, the incidence of coital incontinence into consideration that there are few data in the literature on this disorder and those who have reported a wide variance probably connected to how the data collection. The aim is to be able to identify a "threatening condition" which, if not evaluated, worsens the prognosis of the treatment of female urinary incontinence, a condition that has a negative impact on the quality of life of patients with significantly worse than that related to other recognized debilitating chronic diseases such as diabetes. And this individual psychosocial cost, hardly quantifiable, must be added the cost of significant socio-economic and welfare dependents of incontinent patients, the community and national health services. It is indeed evident from international and national literature that the more incisive and determined is the strategy of information, awareness and education, and adopted much wider and earlier the diagnosis, the more significant is the socio-economic savings, as well as psycho social, we get. Ultimate goal is to differentiate between them the two forms of incontinence coital (to penetration and during orgasm) because each of them is associated with pathogenesis and therefore to a separate treatment. And while the forms of IC penetration favorably affected the treatment of stress urinary incontinence, the forms of IC during orgasm, usually associated with a functional disorder of the detrusor (detrusor overactivity) show an inferior efficacy to treatment antimuscarinic traditionally reserved to the condition of overactive bladder and therefore need a more targeted diagnostic and individualized treatments. Materials and methods Self administered questionnaires will be dispensed to the patients The questionnaires,validated in Italian language, will be used, according to the guidelines of the International Consultation on Incontinence, : ICIQ-UI on urinary incontinence short-form: for the evaluation of symptoms and quality of life: Patient Perception of Bladder Condition (PPBC): to assess the impact of such a subjective condition; Urinary incontinence and quality of sexuality; Urinary incontinence and frequency of sexual activity; The questionnaire is anonymous in order to protect privacy. The patients will be recruited at the outpatient surgery and Urogynaecology urodynamics of Urology Clinic of the University of Perugia. The investigators defined that the statistically significant number of subjects can not be less than 200 units. The time duration of the collection of medical records was estimated at two years. There are no extremes of the conflict of interest, will not be tested or used drugs or medical equipment.