Daniele Maglia

PD17-05 LAPAROSCOPIC VERSUS ROBOTIC ASSISTED SACROCOLPOPEXY: A RANDOMIZED, CONTROLLED TRIAL

RESULTS: Between 2011 and 2016, a total of 175 patients underwent robotic sacrocolpopexy for POP-Q Stage IV VVP. 50 patients undergoing repair with a heavy mesh weight (52 g/m2, 527 microns thick, and a suture pull out strength of 18.3 N) were matched to 50 patients undergoing repair with a lighter weight mesh ( 25 g/m2, 200 microns thick, and suture pull out strength of 23.3 N). At two year followup, anatomic success for apical prolapse was 100% and 2 patients (4%) in each group were found to have residual Grade 2 anterior prolapse and 2 patients (4%) in each group found to have Grade 2 posterior prolapse. De novo SUI was found in 5 patients (10%) in the heavy mesh group and 4 patients (8%) in the lighter mesh group. All de novo SUI patients did not have a mid urethral sling, MUS, placed at the time of the procedure. There was one mesh erosion in the light weight mesh group in a salvage patient that underwent concomitant pre-existing mesh removal at the time of surgery. CONCLUSIONS: Although the two Y-meshes are markedly different in their weight, surface area, thickness and suture pullout strength, there was no observed significant difference in the anatomic success of repair, the rate of de novo stress urinary incontinence or mesh erosion. The rates of de novo SUI seen in this study, have led us to perform a MUS procedure at the time of sacrocolpopexy for all Grade IV prolapse patients.

Role of phytotherapy associated with antibiotic prophylaxis in female patients with recurrent urinary tract infections

OBJECTIVE Aim of this study is to evaluate the efficacy of a phytotherapic which includes Solidago, Orthosiphon and Birch extract (Cistimev®) in association with antibiotic prophylaxis in female patients affected by recurrent urinary tract infections (UTIr). MATERIALS AND METHODS Patients affected by UTIr older than 18 years started a 3-months antibiotic prophylaxis (Prulifloxacin 600 mg, 1 cps/week or Phosphomicyn 1 cachet/week) according to antibiogram after urine culture. The patients were divided in 2 groups: Group A: antibiotic prophylaxis plus phytotherapy (1 cps/die for 3 months) and Group B: antibiotic prophylaxis alone. RESULTS 164 consecutive patients were studied: 107 were included in group A (mean age 59 ± 17.3 years) and 57 (mean age 61 ± 15.7) in group B. During the treatment period the relapse frequencies between the two groups were not significantly different (p = 0.854): 12/107 (11.21%) patients interrupted the treatment for UTIr in group A and 6/57 (10.52%) in group B. In the long term follow-up the relapse UTI risk was significant different in the two groups with a relapse risk 2.5 greater in group B than in group A (p < 0.0001). CONCLUSION Our study demonstrated that in female patients affected by recurrent UTI, the association between antibiotic prophylaxis and of a phytotherapic which includes Solidago, Orthosiphon and Birch extract reduced the number of UTI in the 12 months following the end of prophylaxis and obtained a longer relapsing time, greatly improving the quality of life of the patients.