Stefan Heidler

The natural history of the overactive bladder syndrome in females: a long-term analysis of a health screening project.

To analyze the natural history of the overactive bladder (OAB) syndrome in women over a period of 6.5 years.

Impact of Overactive Bladder Symptoms on Sexuality in Both Sexes

Objectives: To define the epidemiological impact of the overactive bladder syndrome (OAB) on sexual life. We therefore analyzed this issue in a large cohort of individuals participating in a health screening project. Patients and Methods: A total of 2,365 men and women completed the Bristol Female Lower Urinary Tract Symptoms Questionnaire (BFLUTS). OAB was defined according to the International Continence Society (ICS). The impact of OAB on sexual life was assessed by a single question: ‘In general, how do your micturition problems affect your sexual life’. Results: A total of 1.199 men and 1.166 women with were analyzed. The overall prevalence of OAB was 13.9% (n = 329): 9.7% had OABdry and 4.2% OABwet. A total of 17.6% (n = 58) of individuals with OAB reported a negative impact of OAB on sexual life as compared to 4.7% of those without OAB (p < 0.001). One of 4 with OABwet reported a negative impact on sexual life (25%) as compared to 14.4% in those with OABdry (p < 0.005). Conclusion: Sexual dysfunction is frequently reported in individuals with OAB. Individuals with OABwet are experiencing a more profound impact on sexuality. Therefore, patients with OAB should be assessed regarding sexual dysfunction by the urologist.

The Suprapubic Arch Sling Procedure for Treatment of Stress Urinary Incontinence: A 5-Year Retrospective Study §

BACKGROUND Up to now, numerous similar products concerning the surgical treatment of female stress urinary incontinence (SUI) have been developed. OBJECTIVE To assess the long-term efficacy and safety of the suprapubic arch (SPARC) sling system in women with SUI. DESIGN, SETTING, AND PARTICIPANTS This was a long-term retrospective study. All patients underwent a comprehensive pre- and postoperative evaluation. Forty-six women were available for clinical follow-up investigation after SPARC sling placement. INTERVENTION Eighty-six women with SUI and a positive cough test underwent SPARC sling placement between June 2001 and January 2004. MEASUREMENTS At follow-up all 46 patients underwent a cough test, a pad test, uroflowmetry, and sonographic postvoid residual volume measurement. Women rated their subjective continence status (continent, slightly incontinent, incontinent) and were asked if they would undergo the procedure again and if they would recommend it to a friend. Objective cure was defined as a pad weight 0-1g and a negative cough test. Subjective cure was defined as no use of pads. RESULTS AND LIMITATIONS The median follow-up was 5.2 yr. The objective cure rate was 76%; the subjective cure rate was 52%. Sixty-three percent of the patients rated themselves as continent, 33% as slightly incontinent, and 4% as severely incontinent. Most of the women (98%) would recommend the SPARC procedure to a friend and would undergo the procedure again. CONCLUSIONS The SPARC sling system is an effective and safe procedure for the treatment of female SUI. Patient satisfaction is independent of complete dryness.

Diversity of Bacterial Urine and Prostate Gland Tissue Cultures in Patients Undergoing Transurethral Prostate Gland Resection.

Introduction: The objective of this study was to identify the types of bacterial colonization of the prostate gland tissue and urine pre- and postoperatively in patients undergoing a transurethral resection (TUR) of the prostate gland. In addition, clinical symptoms and histopathological findings were included. Material and Methods: Forty three patients were investigated. Urine test strips and urine cultures were taken pre- and postoperatively and intraoperatively prostate resection chips were taken for culture. Results: A positive bacterial culture was found in 20 of 43 (46.5%) patients. Preoperatively, a positive bacterial culture was found in 12 patients and postoperatively in 7 patients. Thirteen patients showed a positive culture of the prostate gland tissue. No patient showed the same bacterial isolates in all 3 samples. Postinterventionally, 6 patients of the group with positive bacterial cultures developed complications. From the group of patients without bacterial growth, only one patient developed a postoperative complication. Conclusion: The bacterial colonization in the 3 different cultures showed an inhomogeneous spectrum of bacteria without a reproducible pattern. Nevertheless, it clearly demonstrates that the group with a positive culture is at great risk to develop postoperative complications.

The Correlation of Prostate Volume and Prostate-specific Antigen Levels With Positive Bacterial Prostate Tissue Cultures

OBJECTIVE To compare prostate volume and prostate-specific antigen (PSA) levels with bacterial growth in prostate tissue cultures. MATERIALS AND METHODS Fifty male patients who underwent transurethral prostate resection were investigated prospectively. Resection chips from the prostate gland were added to brain-heart infusion medium and incubated. PSA levels were determined preoperatively at our urology ward. The prostate gland volume was estimated by transabdominal ultrasound examination preoperatively. RESULTS Persons with positive bacterial prostate tissue cultures have a greater prostate volume. This is significant in patients with and without histopathologic signs of prostatitis. Persons with positive bacterial prostate tissue cultures have higher PSA values. This is significant in patients without histopathologic signs of prostatitis. CONCLUSION People with positive bacterial prostatic tissue culture have a higher prostate volume in comparison with patients with negative culture findings and show a tendency toward increased PSA levels as well.

Quality of Life after SPARC Sling Procedure: A Long-Term Retrospective Analysis

Introduction: To asses the effects on quality of life (QoL) in women with stress urinary incontinence after a SPARC sling procedure. Methods: This is a long-term retrospective study. The study cohort consisted of 54 women: 46 were available for follow-up examination and 8 were contacted by telephone. Results: The median follow-up was 5.3 years. The QoL assessed by using a visual analogue scale improved significantly from 6.9 at baseline to 2.8. The IIQ-7 (Incontinence Impact Questionnaire-Short Form) general score decreased from an average of 56.7 at baseline to 17.5 at the follow-up investigation. Using the Patient Global Impression of Improvement questionnaire, 57.4% of women characterized themselves as very much better, 20.4% as much better and 11.1% as a little better. Eighty-seven percent of women regarded themselves as satisfied, but 13% were dissatisfied with the outcome of the SPARC sling procedure. Conclusion: In this study a significant and stable long-term improvement in QoL could be observed in women undergoing SPARC sling procedure.