Karin Glavind

A pooled analysis of three phase III studies to investigate the efficacy, tolerability and safety of darifenacin, a muscarinic M3 selective receptor antagonist, in the treatment of overactive bladder.

An international group of authors present a pooled analysis of data from their phase III multicentre double‐blind clinical trials in patients with overactive bladder, which evaluated the efficacy, tolerability and safety of darifenacin. They found the drug, a muscarinic M3 selective receptor antagonist, to be effective in the treatment of this condition, with excellent tolerability and safety.

Sexual function in women before and after suburethral sling operation for stress urinary incontinence: a retrospective questionnaire study

Background.  The aim of this questionnaire study dealing with women with stress urinary incontinence was to find out what influence incontinence and operation for incontinence in the form of tension‐free vaginal tape (TVT) or intravaginal slingplasty operation (IVS) had on the patients sexuality and if there were any adverse effects on sexuality after the operation.

A prospective study of the discrete fascial defect rectocele repair

Background. The aim of this study is to describe the results of the discrete fascial defect rectocele repair with special emphasis on dyspareunia after the operation.

Biofeedback and physiotherapy versus physiotherapy alone in the treatment of genuine stress urinary incontinence

Biofeedback is a method of pelvic floor rehabilitation using a surface electrode inserted into the vagina and a catheter in the rectum. Forty women with genuine urinary stress incontinence were randomized to compare the efficacy of physiotherapy and physiotherapy in combination with biofeedback. The effect of the treatment was determined by a standardized pad-weighing test. Long-term status was determined using a questionnaire after 2–3 years. Thirty-four women completed the treatment. The study showed a statistically significant better improvement in the biofeedback group. The long-term effect in the biofeedback group seemed better and the patients were more motivated for training afterwards.

Incidence and treatment of urinary retention postpartum

The aim of this clinical study was to examine the incidence of postpartum urinary retention, to investigate the relationship between different obstetric parameters, and to find out whether our proposed treatment program fulfilled our needs. The incidence of urinary retention postpartum was 0.7%. The incidence of instrumental delivery, sphincter rupture, and larger lacerations of the perineum was significantly increased in the group with urinary retention. Our program for detecting and treating patients with postpartum urinary retention seemed to work efficiently.

Long-term treatment with darifenacin for overactive bladder: results of a 2-year, open-label extension study.

To examine, in a 2‐year, non‐comparative, open‐label extension study, the safety, tolerability and efficacy of darifenacin controlled‐release (CR) 7.5/15 mg once daily in patients with overactive bladder (OAB) who completed two 12‐week randomized, double‐blind, placebo‐controlled ‘feeder’ studies.

Paternity in patients with testicular germ cell cancer: Pretreatment and post-treatment findings

Paternity before and after treatment was investigated in 177 patients with unilateral germ cell tumours of the testis. Before the cancer was diagnosed, 51% had fathered at least 1 child, 9% had a history of infertility and 40% had not wanted to have children. It was estimated that 72% of the patients would have fathered at least 1 child at the age of 40 years. After treatment 41 patients had wished to have children. Infertility was still a problem 5 years after the end of treatment in 53% of these men. No significant differences was observed between patients treated with orchiectomy alone and patients treated with cisplatin-based chemotherapy or subdiaphragmatic irradiation. In 8 patients, infertility was present in spite of an evident recovery of spermatogenesis. Congenital malformations were recorded in 3.8% of the live-born children conceived before the orchiectomy. This incidence did not exceed the Danish national rate, the relative risk being 2.5 (95% confidence limits, 0.9-5.5). No malformations were observed in the 22 children conceived after ending treatment.

Uterine Myoma in Pregnancy

A review was made of the medical records of 76 patients with uterine myomas during pregnancy with the aim of studying the time and method of diagnosis, symptomatology, treatment, and outcome of pregnancy. In 11 patients (15%) myomectomy was performed during pregnancy. The frequency of abortion was 18% in patients treated both conservatively and with myomectomy. Myomectomy during pregnancy is discouraged in the literature. In cases where conservative treatment cannot be practised it seeems that the risk of spontaneous abortion during pregnancy is not significantly increased when myomectomy is performed.

Results and complications of tension-free vaginal tape (TVT) for surgical treatment of female stress urinary incontinence.

Thirty-one patients with stress urinary incontinence were operated on using tension-free vaginal tape (TVT). All were evaluated preoperatively with urodynamics, pad test and stress test. Conservative treatment was without significant effect. Three months after the operation no patients had stress incontinence but 1 with mixed incontinence experienced deterioration of her urge incontinence and 2 experienced de novo urge incontinence. The de novo urge incontinence was significantly improved and the urodynamic investigation normal after approximately 5 months. One patient with a previous operation with Kelly sutures under the urethra developed a urethrovaginal fistula. Fifteen patients were observed for 1 year. One patient who was continent after 3 months developed slight stress incontinence.

Efficacy of biofeedback in the treatment of urinary stress incontinence

Thirty-seven women with stress incontinence were given biofeedback instruction on how to perform pelvic floor exercises correctly. After 3 months with home exercises 31 patients performed a new standardized pad-weighing test: 39% were objectively cured and 42% improved. After a mean of 2 years 15 patients were evaluated with another pad-weighing test: 27% were now objectively cured and 47% improved. A questionnaire showed that 78% had an exact knowledge about the location of the pelvic floor muscles and 47% were satisfied with their present situation, but only 58% performed daily exercises.