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Publications (4)6.33 Total impact

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    ABSTRACT: We report the results of the release and tape-shortening techniques in polypropylene pubovaginal slings. Of female patients who had undergone mid-urethral sling procedures [tension-free vaginal tape procedure and suburethral polypropylene (SPARC)], in cases in which postoperative retention occurred, the patients were offered release or tape cutting. Women reporting postoperative urinary incontinence underwent a tape-shortening procedure. In these patients, the tape was shortened by the use of clips. Mean follow-up time after the release and/or the shortening operations was 9.9 months (range 6-18). A total of 15 women, ranging from 41 to 75 years old (mean 58.3) were included in this study. Upon the latest follow-up, six women exhibited prolonged urinary retention and subsequently underwent a release procedure (n=5) or a tape-cutting procedure (n=1). After the release procedure, all patients remained continent, but one patient's urinary retention issues were not resolved, and she subsequently underwent a tape-cutting. Both of the patients who underwent the cutting procedure then developed recurrent stress urinary incontinence. The tape-shortening technique was conducted with nine patients. Seven of these patients recovered their continence, and no one patient experienced any urinary retention or other voiding difficulties. Two patients reported only minimal stress leakage and elected to undergo no further interventions. Our findings suggest that tension plays a substantial role in tension-free mid-urethral sling procedures.
    International Urogynecology Journal 03/2007; 18(2):153-8. · 2.17 Impact Factor
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    ABSTRACT: The object was to evaluate whether the degree of experience for the tension-free vaginal tape (TVT) procedures influenced the early results of the suprapubic arc (SPARC) sling procedure. We performed the TVT from March 1999 to May 2003 and SPARC from June to April 2004 by experienced surgeon (A) and inexperienced surgeon (B), respectively. Patients were divided as four subgroups: first 50 patients who underwent the TVT by surgeon A (TVT A); first 15 patients who underwent the TVT by surgeon B (TVT B); first 50 patients who underwent the SPARC by surgeon A (SPARC A); first 15 patients who underwent the SPARC by surgeon B (SPARC B). Bladder perforations were noted in 4 (8.5%) in the TVT A group and 2 (13.3%) in the TVT B group, respectively (P = 0.626). There was no bladder perforation occurred in the SPARC A and B groups. The rates of transient postoperative urinary retention were 6.4% in the TVT A group and 0.0% in the TVT B group, respectively (P = 1.000). No retention occurred in the SPARC A and B groups. Stress urinary incontinence was cured by 89.4% in the TVT A group and 80.0% in the TVT B group, respectively (P = 0.388). Similar success rates were found in the SPARC A (85.4%) and SPARC B (92.3%) group (P = 1.000). Our findings suggest that the degree of experience for the TVT procedure does not influence the results of the SPARC procedure during the learning phase.
    International Urology and Nephrology 02/2007; 39(4):1079-84. · 1.33 Impact Factor
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    ABSTRACT: The objective of this study was to determine whether the outcome of mid-urethral sling procedures is influenced by the body mass index of Korean women suffering from stress urinary incontinence (SUI). A total of 285 women, ranging in age from 28 to 80 years (mean 55.4), all of whom were followed up for at least 6 months, were ultimately included in this study. The patients were classified as follows: normal weight, 18.5-23 kg/m2; overweight, 23-27.5 kg/m2; obesity, 27.5 kg/m2 or higher. We noted bladder perforations in 11 cases (4.9%, 3.8% and 2.2% in the normal weight, overweight, and obesity groups, respectively; P = 0.449). We determined there to be no significant differences among the three groups with regard to cure rate (P = 0.173). The rates of postoperative urinary retention were 9.9% in the normal weight group, 10.1% in the overweight group, and 15.6% in the obesity group (P = 0.396). We determined there to be no significant differences among the three groups with regard to the persistence of urgency (P = 0.312). Seventy-nine patients (27.7%) exhibited symptoms indicative of voiding disorder (hesitancy, poor flow, or sensations of incomplete emptying). The postoperative development of these voiding symptoms was not significantly different among the three groups (P = 0.106). Our results demonstrate both the feasibility and the safety of mid-urethral sling procedures for obese Korean women who suffer from SUI. Additional studies, including prospective randomized trials with longer follow-up periods, will be required in order to confirm these findings.
    International Journal of Urology 05/2006; 13(4):379-84. · 1.73 Impact Factor
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    ABSTRACT: The object was to evaluate clinical outcome of the midurethral sling procedures in the elderly compared with middle-aged women. A total of 266 women who underwent midurethral sling procedures with at least follow-up greater than 6 months were included in the study. Patients were divided as the elderly group (65 years old or older, n = 60) and the middle-aged group (45-64 years old, n = 206). Although postoperative urge symptoms were more prevalent in the elderly group (25.0%) than in the middle-aged group (6.3%), there were no significant differences between the two groups for the rates of postoperative urge incontinence (p = 0.159). Stress incontinence was cured by 91.3% in the middle-aged group and 85.0% in the elderly group, respectively (p = 0.158). Age does not seem to be a significant risk factor for failure of midurethral sling procedures.
    Gynecologic and Obstetric Investigation 02/2006; 61(4):194-9. · 1.10 Impact Factor