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Bulent Cetinel

Publications and source records attributed to Bulent Cetinel.

3 recordsLinked to original sources
PubMed2005

Risk factors influencing the complication rates of tension-free vaginal tape-type procedures.

PURPOSE OF REVIEW: Tension-free vaginal tape (TVT)-type procedures are gradually becoming the new gold-standard treatment for female stress urinary incontinence. Studies trying to determine the influence of possible risk factors on complications of TVT surgery are needed in order to achieve more favorable results in the future. This review attempts to summarize the current studies which address the possible risk factors influencing the complication rates of TVT-type procedures. RECENT FINDINGS: Articles published in 2004 and 2005 were included and focused, while the older articles were used for historical purposes and achieving the integrity. Risk factors stated in the literature for immediate, infectious, vaginal and urethral erosion complications are found to be mostly on anectodal and speculative bases. The role of concomitant surgery as a risk factor for complications is conflicting, while preoperative low urine flow and low detrusor contractility for urinary retention, and previous anti-incontinence surgery and old age for de-novo urgency seem to appear as possible risk factors. SUMMARY: Most of the risk factors stated were anecdotal and speculative. No consensus exists on concomitant surgery's being a risk factor for postoperative urinary retention and bladder perforation, while prior anti-incontinence surgery and old age were found to be possible risk factors for postoperative overactive bladder symptoms. Multicentric data collection with well designed parameters under the surveillance of a well known organization is needed in order to identify the risk factors influencing the complications of TVT-type procedures.

Female↗
PubMed2004

Polypropylene mesh tape for male sphincteric incontinence.

OBJECTIVE: Management of male sphincteric incontinence is still challenging. We present our experience with a new male sling technique using polypropylene mesh tape (PMT). MATERIAL AND METHODS: A total of 12 patients (age range 17-75 years; median age 61 years) underwent the procedure. Sphincteric incontinence was due to radical prostatectomy in three patients, transurethral prostatectomy in four, open prostatectomy in two and neurologic etiologies in three. All patients had urodynamic stress incontinence with a mean Valsalva leak point pressure of 48.8 cmH2O (range 40-68 cmH2O). Through a midline incision the PMT sling was passed through the perineal membrane on each side and the limbs of the tape were withdrawn to a suprapubic incision with the help of trocars. The tension of the tape was adjusted during a retrograde sphincterometry until a retrograde leak point pressure of 30-50 cmH2O was achieved. RESULTS: The average operative time was 65 min (45-110 min). Follow-up was 12.1-46.4 months (median 31.6 months). Urinary incontinence was cured or improved in nine patients (75%) and there was no improvement in three (25%). Intermittent catheterization was initiated in three patients with impaired detrusor contractions due to neurologic etiology. One patient had intraoperative bladder perforation and one had perineal numbness lasting for 2 months. None of the patients had urethral erosion, wound infection or any other major complications. CONCLUSIONS: This procedure seems to be an effective and safe treatment for patients with sphincteric incontinence. Regarding the etiology of urinary incontinence, this technique seems to be more effective in transurethral prostatectomy-related sphincteric incontinence than in sphincteric incontinence of other etiologies. Further experience with more patients and a longer follow-up period is mandatory to determine the long-term effectiveness of the technique.

Adolescent↗