Audrey Corstiaans

Suburethral slingplasty evaluation study in North Queensland, Australia: The SUSPEND trial

Objective:  To compare the safety and efficacy of three types of suburethral slings for the treatment of urodynamic stress incontinence.

Prospective study of the Perigee system for the management of cystocoeles – Medium-term follow up

Objectives:  The Perigee transobturator cystocoele repair system (AMS) was designed and first used in Townsville, Australia. This prospective study evaluates the efficacy and safety of this device for the management of cystocoeles.

Transobturator tape for stress incontinence: The North Queensland experience

A prospective observational study of 96 patients undergoing insertion of the MONARC transobturator tape (American Medical Systems, Minnetonka, USA) for treatment of urodynamic stress incontinence was conducted to investigate its’ the safety and efficacy. Although there were no major intraoperative complications, sling protrusion was observed in 11/91 patients (12.1%) at early follow up visits. At these visits, 80 women (87.9%) were either completely or substantially continent and 74 women (81.3%) were satisfied with the operation. Objectively, 74 women (81.3%) were cured on urodynamic assessment and only one woman (1.1%) was found to have voiding dysfunction. As a conclusion, it would appear that this new technique is effective for the treatment of stress incontinence; but further studies are needed to investigate its long‐term results and complications.

Sling distress: a subanalysis of the IVS tapes from the SUSPEND trial

Aim:  To study the incidence of erosions and tape infections following the use of intravaginal slingplasty (IVS) treatment for stress urinary incontinence after the SUSPEND trial period of 30 months. This subanalysis was carried out because of concerns regarding high percentage of delayed sling erosions and infections during follow up of the patients who participated in the trial.

Prospective study of the Perigee™ system for treatment of cystocele – our five‐year experience

Objectives:  The Perigee™ transobturator cystocoele repair system (AMS) was designed and first used in Townsville, Australia. In this study, we are reporting our five‐year experience with the Perigee™ system in the management of cystocoele stage III and above.

Does micturition improve in the squatting position

Summary Posture on the toilet is an important consideration during micturition. The objective of this prospective study is to evaluate the effects of posture on micturition in the lean forward and squatting positions. The participants were 54 volunteers who acted as their own controls. Uroflowmetric parameters were studied in each position. The two issues that arose from the study were ‘squatability’ and the differences in uroflowmetric parameters. Essentially there were no statistically significant differences found in our study population but the ability to squat in our population of volunteers was quite poor.

Management of the very weak pelvic floor. Is there a point

Abstract: Conservative treatment in the form of pelvic muscle exercises is effective in the treatment of stress urinary incontinence. There are no studies specifically looking at women who have extremely weak pelvic muscles and their response to conservative treatment. This study looks at the effectiveness of pelvic muscle therapy in women with very weak pelvic muscles. Out of 965 women attending the bladder clinic at Kirwan Hospital, 219 were assessed to have weak pelvic muscles by digital palpation. All patients were subjected to a detailed urogynecological questionnaire, a frequency/volume chart, and clinical assessment. All patients were then given detailed verbal and written instructions on good bladder habits, including posture, dietetic habits and pelvic muscle exercises. Of the 219 women, 163 were able to complete their treatment and presented for review. Out of 163 women 118 (72%) reported a subjective improvement; 89 (54%) demonstrated an objective improvement in pelvic muscle strength.

Recurrent non-absorbable suture erosion into the bladder after a Pereyra bladder neck suspension.

Delayed migration of sutures into the bladder after colposuspension procedures have been well documented in the literature. Biyani and Upsdell (1998) published a case report of late migration of the suture occurring 7 years after a Stamey endoscopic bladder neck suspension. Mandikandan et al. (2004) presented a case of intravesical foreign body granuloma post-Burch colposuspension. There are other reports of similar complications after bladder or pelvic surgery for incontinence. Most patients presented with lower urinary tract infection-like symptoms. The suture erosion and calculi formation were diagnosed by endoscopic assessment of the bladder. However, recurrent suture erosion case reports over a period of time are rare. Literature search revealed only one particular case report by Cardozo (1997) describing recurrent suture erosion following a Stamey-type endoscopic bladder neck suspension. This patient presented over a period of 2 years following the procedure. We are presenting here a case of recurrent suture erosion over even a longer period of time, 3 years and 8 years after a Pereyra bladder neck suspension procedure.