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- 검색키워드
- 저자 : Tufan Tarcan (검색결과 3 건)
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Tufan Tarcan,Cem Akbal,Çağrı A. Şekerci,Tuncay Top,Ferruh Şimşek 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.4
Purpose: This was a prospective single-arm study to assess the efficacy and safety ofintradetrusor injections of onabotulinum toxin-A in children with urinary incontinenceassociated with neurogenic detrusor overactivity due to myelomeningocele. All patientshad failed the first-line treatment of a combination of oral antimuscarinics andintermittent catheterization. Materials and Methods: The study group consisted of 31 children with myelomeningocelewith a mean age of 7.95 years (range, 5–13 years) who were followed up for a meanof 29 weeks. The amount of onabotulinum toxin A injected was 10 U/kg with a maximaldose of 300 U. There were 20 to 30 injection sites with rigid cystoscopic guidance undergeneral anesthesia. Results: Thirty of 31 patients reported dryness between intermittent catheterizationintervals. The mean reduction in maximum detrusor pressure and the mean increasein maximum cystometric capacity from baseline were 53% and 51.5%, respectively, 6weeks after injection. We found a 324% increase in mean bladder compliance and a 57%increase in mean intermittent catheterization volumes. The mean duration of efficacywas 28 weeks with a single injection and 36 weeks for repeated injections (minimum,16 weeks; maximum, 52 weeks). The mean time interval between repeated onabotulinumtoxin-A injections was 7 months (maximum, 13 months). Intradetrusor injectionsof onabotulinum toxin-A were well tolerated. Conclusions: Onabotulinum toxin-A injections into the bladder wall provide a significantsymptomatic and urodynamic improvement in children with neurogenic detrusoroveractivity due to myelomeningocele who are on intermittent catheterization. The treatment seems to be safe and very well tolerated.
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Management of Complications After Tension-Free Midurethral Slings
Bülent Çetinel,Tufan Tarcan 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.10
Since their introduction in 1996, tension-free midurethral slings (MUS) have been proven to have long-term efficacy and safety. They are considered the gold standard treatment of female stress urinary incontinence, especially in cases that are associated with urethral hypermobility. However, they are not free of complications and, although rare, some of these complications can be challenging for both patients and physicians. Some complications occur intraoperatively, whereas others appear in the early or late postoperative period. There is less controversy in the diagnosis and treatment of complications such as vaginal extrusion or urinary system erosion, whereas de novo voiding problems are at best not completely understood. Voiding dysfunction after MUS placement may vary in a wide range from urinary frequency or urgency to retention and is usually attributed to the obstructive or irritative effect of the sling. However, present urodynamic criteria for the diagnosis of female infravesical obstruction are not satisfactory, and the best management policy for de novo voiding dysfunction remains controversial. In the majority of cases, the diagnosis of obstruction leading to a urethral release surgery depends on a combination of several clinical findings. The timing of urethral release surgery varies depending on the preferences of the surgeon, and the outcome of this surgery is not always predictable. The purpose of this review was to assess the diagnosis and management of the immediate, short-term, and long-term complications of MUS in light of the current literature in an attempt to determine the best management policy.
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The Effect of Asymptomatic Urethral Caruncle on Micturition in Women with Urinary Incontinence
Cuneyd Ozkurkcugil,Levend Ozkan,Tufan Tarcan 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.4
Purpose: The aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence. Materials and Methods: A total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards. Results: Both groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference. Conclusions: Our results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon’s decision whether to treat asymptomatic UC. Purpose: The aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence. Materials and Methods: A total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards. Results: Both groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference. Conclusions: Our results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon’s decision whether to treat asymptomatic UC.
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