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Biomedical subjects

D Staskin

Publications and source records attributed to D Staskin.

11 recordsLinked to original sources
PubMed1999

Effect of a urinary control insert on quality of life in incontinent women.

The aim of the study was to evaluate the efficacy, safety and effect on quality of life of the Reliance urinary control insert (Uromed Corp., Needham, MA) in women with genuine stress incontinence. Efficacy was evaluated at baseline and at the end of the 12-month study period by standardized pad-weight studies and by rating scales measuring acceptability, incontinence symptom improvement, ease of learning, comfort and time to habituation, recorded in diaries at monthly intervals in 63 women. The SF-36 Health Survey questionnaire was used to assess quality of life status at baseline without the device and after 12 months of device use. A significant decrease in urine loss at 12 months compared with baseline was shown by standardized pad-weight studies, with and without the device in situ. Urine loss was reduced by more than 80% in 91% of the 63 patients, and 79% were completely dry. Patient diaries showed significant improvement in control of leakage, comfort, and ease of device use during the study period. Short-term-36 Health Status data also indicated significant improvement in the physical functioning score at 12 months. Urinary tract infection and hematuria were the most common adverse effects. The Reliance urinary control insert is an efficacious and safe means of controlling genuine stress incontinence in women. The device was perceived as easy to use and comfortable for these 63 women, and resulted in improved quality of life.

Adolescent↗
PubMed1998

Urinary Incontinence in Women.

Despite the prevalence of urinary incontinence, most affected women don't seek help, primarily because of embarrassment or because they are not aware that effective treatment is available. Failure to store urine may be caused by an abnormality in any component of the lower urinary tract. Common abnormalities are poor bladder compliance and bladder outlet failure. Patients who experience failure to empty can present with recurrent urinary tract infections, retention or incontinence. Using a symptom-based classification of incontinence, this would be referred to as overflow incontinence. Other possible categories of urinary incontinence are failure to store and empty and functional incontinence. A combination of a failure to store and empty is difficult to diagnose and treat clinically. Treatments are directed at the particular cause of incontinence and can include medical or surgical therapies.

Exercise Therapy↗
PubMed1996

Effectiveness of a urinary control insert in the management of stress urinary incontinence: early results of a multicenter study.

OBJECTIVES: The purpose of this study was to test the safety and effectiveness of a urethral insert for managing stress or mixed urinary incontinence. METHODS: We performed a prospective, multicenter study of 135 female patients who were treated for 4 months with the Reliance Urinary Control Insert. The effectiveness of the insert was measured objectively at the time of first use and after 4 months' use by standardized pad weight studies. Insert effectiveness was also measured by reports of symptom improvement during patient interviews and on patient diaries. Urine microscopy and culture were obtained monthly; cystoscopy and urodynamics were conducted at study entry and at 4 months. RESULTS: Significant improvement in involuntary urine loss was observed. Objective measurement of urine loss revealed that 80% of the patients were completely dry, and 95% of the patients achieved greater than an 80% decrease in urine loss. In addition, patients' perceptions of acceptability, incontinence symptom improvement, ease of learning, comfort, and time to habituation also showed improvements. Untoward events reported during the study included hematuria, bacteriuria, and bladder irritation. These events did not require significant medical intervention and did not result in any long-term clinical sequelae. CONCLUSIONS: These preliminary results indicate that the Reliance Urinary Control Insert may be a safe, effective, and well-tolerated alternative to other available methods for the management of stress or mixed incontinence in women. Additional long-term follow-up will be required to substantiate this conclusion.

Adolescent↗
PubMed1989

Prospective evaluation of an assessment strategy for geriatric urinary incontinence.

The objectives of this study were to design and prospectively evaluate a strategy to assess geriatric urinary incontinence in primary care settings. A management plan for urinary incontinence was determined for 264 elderly incontinent patients (205 females and 59 males) based on a clinical evaluation, simple tests of lower urinary tract function, and several criteria for referral for further evaluation derived from the literature on incontinence. Of the 264 patients, 168 (64%) also consented to undergo a urologic and formal urodynamic evaluation. Half of these 168 patients met at least one criterion for referral for further evaluation. At least one-quarter of the patients who met one or more of the criteria were found not to require surgical intervention, and probably did not benefit from the urologic and urodynamic evaluation. Among 84 patients who did not meet any of the criteria for referral, the urologic and urodynamic evaluation changed the initial treatment plan in only 10 (12%). The risks associated with the treatment plan based on the clinical assessment in these patients were, however, relatively small. While further refinement and testing in larger numbers of incontinent patients are needed, the data presented document that a substantial proportion of elderly patients with a treatable and often ignored problem can be appropriately managed based on a relatively simple and inexpensive assessment, which can easily be carried out in primary care settings.

Aged↗
PubMed1988

Simple versus multichannel cystometry in the evaluation of bladder function in an incontinent geriatric population.

Bladder capacity and stability were determined among 171 incontinent geriatric patients (mean age 80 years) with 2 techniques: a simple procedure for cystometry involving incremental bladder filling by gravity and a continuous water filling multichannel cystometrogram. Bladder capacities measured by both methods in 164 patients were correlated significantly by simple linear regression (r equals 0.75, p equals 0.0001) and they were not significantly different by paired t tests (t equals 1.20, p equals 0.23). Of the patients 110 (64 per cent) had detrusor motor instability or hyperreflexia on the multichannel cystometrogram, and simple cystometry had a sensitivity of 75 per cent, specificity of 79 per cent and positive predictive value of 85 per cent for this finding. The simple procedure was practical, well tolerated and helped to provide information for management decisions that would have been difficult to obtain from many of these geriatric patients without a formal and more complex urodynamic evaluation. When performed with other simple tests of lower urinary tract function and interpreted in conjunction with a few straightforward clinical criteria, simple cystometry can be helpful to assess bladder function among incontinent geriatric patients in settings in which formal urodynamics are either unavailable or impractical.

Aged↗
PubMed1987

Clinical versus urodynamic diagnosis in an incontinent geriatric female population.

The clinical presentation of incontinence was compared to diagnoses based on urological and urodynamic evaluation in 135 elderly women assessed consecutively in an outpatient clinic. Most patients (64 per cent) presented with mixed symptoms: 16 per cent presented with pure stress and 16 per cent with pure urge incontinence. After evaluation 46 per cent of the patients had stress incontinence with a stable bladder, 27 per cent had detrusor instability or hyperreflexia without sphincter weakness and 19 per cent had mixed urodynamic abnormalities. Presenting symptoms were predictive of urodynamic diagnosis in 64 per cent of the patients with pure stress incontinence and 55 per cent with pure urge incontinence. In general, symptoms in our patient population were less predictive of urodynamic findings than in previously reported series of younger incontinent women but they were more predictive than in other series of elderly women. Predictive values for some urodynamic findings were enhanced by combining a symptom with certain physical findings. Implications of these data for the evaluation and treatment of incontinence in the geriatric population are discussed.

Aged↗
PubMed1986

[Urethral replacement in women. Experimental works and clinical application].

Numerous operations have been previously described in view of replacing the urethra, but attempts to provide continence have rarely been satisfactorily achieved. Urethral replacement using ileum with an ileal intussuspected valve for continence has be39 successfully performed in ten dogs. This report details the experimental model with the results obtained in the long range. It is followed by the evaluation, surgical technique and postoperative results of the clinical application of this surgical alternative in three patients.

Adult↗