Modification of bladder thermodynamics in stress urinary incontinence patients submitted to trans-obturator tape: A retrospective study based on urodynamic assessment
Importance: It needs to be clarified whether trans-obturator tape (TOT)-enhanced urethral resistance could impact the voiding function.Objective: Although TOT has been well-recognized for enhancing urethral resistance to restore continence in stress urinary incontinence (SUI) patients, whether the bladder’s voiding functions adapt to the TOT-enhanced resistance has not been adequately investigated. This study thereby aimed to investigate whether TOT impacts the bladder’s thermodynamic efficacy during the voiding phase.Design: A retrospective analysis of urodynamics performed before and after TOT was assessed.Setting: A tertiary referral hospital in Taiwan.Participants: A total of 26 female SUI patients who underwent urodynamic investigations before and after TOT.Main outcomes and measures: The area enclosed by the pressure-volume loop (Apv), which represents the work performed by the bladder during voiding, in a pressure-volume analysis established by plotting the detrusor pressure versus intra-vesical volume was retrospectively analyzed. Paired Student’s t-tests were employed to assess the difference in values before and after the operation. Significance in difference was set at p < 0.05.Results: TOT increased Apv in 20 of 26 (77%) patients and significantly increased the mean Apv compared to the preoperative control (2.17 ± 0.18 and 1.51 ± 0.13 × 103 cmH2O-ml, respectively p < 0.01). TOT also increased the mean urethral resistance (1.03 ± 0.30 vs. 0.29 ± 0.05 cmH2O-sec/ml, p < 0.01) and mean voiding pressure (25.87 ± 1.72 and 19.30 ± 1.98 cmH2O p < 0.01) but did not affect the voided volume and voiding time. Moreover, the TOT-induced Apv increment showed a moderate correlation with the changes in urethral resistance and voiding pressure (both r > 0.5) but no correlation with changes in voided volume or voiding time. It is remarkable that the TOT-induced urethral resistance increment showed a strong correlation with changes in voiding pressure (r > 0.7).Conclusion and Relevance: The bladder enhances thermodynamic efficacy by adapting the voiding mechanism to increased urethral resistance caused by TOT. Further studies with higher case series and longer follow-ups should assess whether this effect could be maintained over time or expire in a functional detrusor decompensation, to define diagnostic criteria that allow therapeutic interventions aimed at its prevention during the follow-up.Clinical Trial Registration: (clinicaltrials.gov), identifier (NCT05255289).
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
|---|---|
| Enthalten in: |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hui-Hsuan Lau [VerfasserIn] |
|---|
| Links: |
doi.org [kostenfrei] |
|---|
| Themen: |
Biotechnology |
|---|
| doi: |
10.3389/fbioe.2022.912602 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
DOAJ034448101 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | DOAJ034448101 | ||
| 003 | DE-627 | ||
| 005 | 20230307190607.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230227s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3389/fbioe.2022.912602 |2 doi | |
| 035 | |a (DE-627)DOAJ034448101 | ||
| 035 | |a (DE-599)DOAJaf9b6c201f7849ae8f2129a357a7cd0f | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 050 | 0 | |a TP248.13-248.65 | |
| 100 | 0 | |a Hui-Hsuan Lau |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Modification of bladder thermodynamics in stress urinary incontinence patients submitted to trans-obturator tape: A retrospective study based on urodynamic assessment |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Importance: It needs to be clarified whether trans-obturator tape (TOT)-enhanced urethral resistance could impact the voiding function.Objective: Although TOT has been well-recognized for enhancing urethral resistance to restore continence in stress urinary incontinence (SUI) patients, whether the bladder’s voiding functions adapt to the TOT-enhanced resistance has not been adequately investigated. This study thereby aimed to investigate whether TOT impacts the bladder’s thermodynamic efficacy during the voiding phase.Design: A retrospective analysis of urodynamics performed before and after TOT was assessed.Setting: A tertiary referral hospital in Taiwan.Participants: A total of 26 female SUI patients who underwent urodynamic investigations before and after TOT.Main outcomes and measures: The area enclosed by the pressure-volume loop (Apv), which represents the work performed by the bladder during voiding, in a pressure-volume analysis established by plotting the detrusor pressure versus intra-vesical volume was retrospectively analyzed. Paired Student’s t-tests were employed to assess the difference in values before and after the operation. Significance in difference was set at p < 0.05.Results: TOT increased Apv in 20 of 26 (77%) patients and significantly increased the mean Apv compared to the preoperative control (2.17 ± 0.18 and 1.51 ± 0.13 × 103 cmH2O-ml, respectively p < 0.01). TOT also increased the mean urethral resistance (1.03 ± 0.30 vs. 0.29 ± 0.05 cmH2O-sec/ml, p < 0.01) and mean voiding pressure (25.87 ± 1.72 and 19.30 ± 1.98 cmH2O p < 0.01) but did not affect the voided volume and voiding time. Moreover, the TOT-induced Apv increment showed a moderate correlation with the changes in urethral resistance and voiding pressure (both r > 0.5) but no correlation with changes in voided volume or voiding time. It is remarkable that the TOT-induced urethral resistance increment showed a strong correlation with changes in voiding pressure (r > 0.7).Conclusion and Relevance: The bladder enhances thermodynamic efficacy by adapting the voiding mechanism to increased urethral resistance caused by TOT. Further studies with higher case series and longer follow-ups should assess whether this effect could be maintained over time or expire in a functional detrusor decompensation, to define diagnostic criteria that allow therapeutic interventions aimed at its prevention during the follow-up.Clinical Trial Registration: (clinicaltrials.gov), identifier (NCT05255289) | ||
| 650 | 4 | |a trans-obturator tape (TOT) | |
| 650 | 4 | |a stress urinary incontinence (SUI) | |
| 650 | 4 | |a thermodynamics | |
| 650 | 4 | |a pressure-volume (P-V) loop | |
| 650 | 4 | |a urodynamics | |
| 653 | 0 | |a Biotechnology | |
| 700 | 0 | |a Hui-Hsuan Lau |e verfasserin |4 aut | |
| 700 | 0 | |a Hui-Hsuan Lau |e verfasserin |4 aut | |
| 700 | 0 | |a Cheng-Yuan Lai |e verfasserin |4 aut | |
| 700 | 0 | |a Hsien-Yu Peng |e verfasserin |4 aut | |
| 700 | 0 | |a Ming-Chun Hsieh |e verfasserin |4 aut | |
| 700 | 0 | |a Tsung-Hsien Su |e verfasserin |4 aut | |
| 700 | 0 | |a Tsung-Hsien Su |e verfasserin |4 aut | |
| 700 | 0 | |a Tsung-Hsien Su |e verfasserin |4 aut | |
| 700 | 0 | |a Jie-Jen Lee |e verfasserin |4 aut | |
| 700 | 0 | |a Jie-Jen Lee |e verfasserin |4 aut | |
| 700 | 0 | |a Tzer-Bin Lin |e verfasserin |4 aut | |
| 700 | 0 | |a Tzer-Bin Lin |e verfasserin |4 aut | |
| 700 | 0 | |a Tzer-Bin Lin |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i In |t Frontiers in Bioengineering and Biotechnology |d Frontiers Media S.A., 2014 |g 10(2022) |w (DE-627)DOAJ000031577 |x 22964185 |7 nnns |
| 773 | 1 | 8 | |g volume:10 |g year:2022 |
| 856 | 4 | 0 | |u https://doi.org/10.3389/fbioe.2022.912602 |z kostenfrei |
| 856 | 4 | 0 | |u https://doaj.org/article/af9b6c201f7849ae8f2129a357a7cd0f |z kostenfrei |
| 856 | 4 | 0 | |u https://www.frontiersin.org/articles/10.3389/fbioe.2022.912602/full |z kostenfrei |
| 856 | 4 | 2 | |u https://doaj.org/toc/2296-4185 |y Journal toc |z kostenfrei |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_DOAJ | ||
| 951 | |a AR | ||
| 952 | |d 10 |j 2022 | ||