Yves Gaspar

Inside out transobturator vaginal tape for the treatment of female stress urinary incontinence: Interim results of a prospective study after a 1-year minimum followup

PURPOSE We analyzed the results of a prospective, observational trial designed to assess the safety and efficacy of the TVT-O procedure for female SUI. MATERIALS AND METHODS Preoperative and postoperative evaluations included physical examination, and urinary symptom and quality of life scale questionnaires. RESULTS Between March 2003 and December 2004, 253 patients with clinical and urodynamic diagnoses of SUI who fulfilled inclusion and exclusion criteria were enrolled in the trial and underwent the TVT-O procedure. No significant intraoperative complications were observed. One-year minimum followup was available on 99 of the initial 102 patients, of whom 16 had undergone concomitant pelvic organ prolapse surgical treatment. The SUI complete cure rate was 91%. No patient had vaginal or urethral erosion. Four patients required tape release or section. Frequency and urge symptoms improved after the operation (p <0.001). The severity of obstructive symptoms slightly increased postoperatively in the group of patients who did not undergo associated pelvic organ prolapse treatment (p <0.05), while maximum flow rates somewhat decreased (p <0.001) and post-void residual urine volumes somewhat increased (p <0.005). Most patients reported a significant decrease in incontinence severity and improvement in quality of life (p <0.0001). CONCLUSIONS The results of this study, which suggest that the TVT-O procedure is a safe and efficient surgical treatment for female SUI, warrant further comparative evaluation of this procedure with retropubic and outside in transobturator approaches in appropriately designed, prospective, randomized trials.

Intracellular free iron content of rat liver tissue after cold ischemia

TRANSPLANTABLE ORGANS are usually stored in a preservation medium, such as University of Wisconsin (UW) solution, under hypothermic conditions due to the energy deficiency. During cold storage significant cellular alterations may occur. Rauen et al have described that the preservation injury to cultured liver endothelial cells and hepatocytes is mediated by the formation of reactive oxygen species (ROS) through energy-dependent mechanisms that occur independent of hypoxia and subsequent reoxygenation. Damage to cultured hepatocytes was prevented when the cells were preincubated with desferrioxamine, suggesting iron-dependent generation of ROS. Kozlov et al have provided evidence that intracellular free iron in the liver represents an intermediate step in the transport of iron from blood transferrin to the site of synthesis of iron-containing molecules such as ferritin. Detected by electron paramagnetic resonance (EPR) spectroscopy as paramagnetic complexes in presence of desferioxamine, this transit pool consists of low-molecular weight (LMW) iron compounds able to participate in ROS generation. In the present paper, we examine the effect of cold ischemia on the intracellular free iron content of rat liver tissue.