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M Halaska

Publications and source records attributed to M Halaska.

At least 19 recordsLinked to original sources
PubMed2006

Urinary incontinence in a group of primiparous women in the Czech Republic.

BACKGROUND/AIM: Not only the process of childbirth itself, but also processes during pregnancy seem to be strongly associated with urinary incontinence (UI). According to some epidemiological studies, UI during pregnancy occurs in 23-70% of the pregnant women. These studies also documented some risk factors (e.g., race, age, or body mass index). The aim of our study was to explore the prevalence of UI during pregnancy in the Czech Republic. METHODS: 474 primiparas who gave birth at our maternity ward from June 14, 2004, through January 31, 2005, received a questionnaire. The questionnaire concentrated on the occurrence and presentation of UI before and during pregnancy. RESULTS: 339 women (72%) completed the questionnaire. UI and the length of pregnancy are significantly related. We found a baseline UI prevalence before pregnancy of 17%, but before delivery one of 64%. We did not find any statistically significant relation between the prevalence of UI during pregnancy and body mass index before pregnancy as well as before delivery, weight gain during pregnancy, age, and birth weight. CONCLUSION: Our results show that pregnancy is a risk factor for the development of UI.

Cross-Sectional Studies↗
PubMed2006

Efficacy of solifenacin in patients with severe symptoms of overactive bladder: a pooled analysis.

BACKGROUND: The efficacy of antimuscarinic drug therapy in patients who have more severe symptoms of overactive bladder (OAB) at baseline has not been evaluated thoroughly. OBJECTIVE: This analysis determined the effects of solifenacin in patients with severe OAB symptoms at baseline. METHODS: All randomized, placebo-controlled phase III studies of solifenacin were pooled to determine the effects in patients with severe OAB symptoms at baseline. In these studies, patients were randomized to treatment with placebo or solifenacin 5 or 10 mg once daily. Baseline severity was defined according to the number of incontinence episodes/24 h, number of urgency episodes/24 h, and micturition frequency/24 h. The proportion of patients with restoration of continence, resolution of urgency, and normalization of micturition frequency at endpoint was determined. Mean change from baseline to endpoint in the number of episodes/24 h for incontinence, urgency, and micturition, and in the volume voided/micturition were assessed. Comparisons of change from baseline to endpoint were done with analysis of covariance (ANCOVA), and comparisons of percentage change from baseline to endpoint were based on van Elteren's test. RESULTS: Results from four multinational phase III studies of solifenacin with 2848 patients were pooled. The proportion of patients with restoration of continence, resolution of urgency, and normalization of micturition frequency at endpoint was significantly greater with solifenacin than with placebo among patients with severe OAB at baseline. Solifenacin 5 and 10 mg were significantly (p < 0.05) more effective than placebo for reductions in the number of episodes of incontinence, urgency, and micturition, and for the increase in volume voided/micturition among most subgroups of patients who were highly symptomatic at baseline (incontinence, urgency, or micturitions). CONCLUSION: Solifenacin was significantly more effective than placebo for patients with severe symptoms of OAB. The significant and consistent response was observed for all endpoints with solifenacin 10 mg and for most endpoints with solifenacin 5 mg using different definitions of baseline disease severity, and supports the overall effectiveness of solifenacin in highly symptomatic patients.

Adult↗
PubMed2006

[Deliveries out of medical facilities].

AIM OF STUDY: Analysis of reasons and risks of planned and unplanned deliveries out of medical facilities. TYPE OF STUDY: Review of literature and casuistry. NAME AND SITE OF DEPARTMENT: Department of Obstetrics and Gynaecology, Teaching Hospital Na Bulovce, 1st Faculty of Medicine, Charles University in Prague. MATERIAL AND METHOD: Authors of this paper are discussing published evidences concerning the reasons and the risks of planned and unplanned deliveries out of the medical facilities. They are pointing out at the activities of some independently practising midwives, who systematically encourage females against medically conducted deliveries during their prenatal courses, thus obtaining clients for home deliveries. At the end of the paper the authors present three casuistries from their own practice to document the outcomes of disinformation and prenatal courses guided in a wrong way. CONCLUSION: According to the results of foreign studies and own experience home deliveries are accompanied by senseless risks for mother and child. Dubitable benefits of the home surroundings cannot counterbalance these risks. Prenatally purposely misinformed woman and her partner often threaten themselves and their arriving child during labour with senseless risks.

Adult↗
PubMed2006

[Breast cancer cell populations and its changes relation to therapy].

This review summarizes the data from published studies that dealt with observation of various bioparameters changes in cancer population dependant on used therapy. Critically evaluating these studies and looking for relations among separate results we are trying to estimate prognostic value of these parameters (likelihood of recurrence, overall survival, ...) and also their value for prediction of tumor response to cytostatic, hormonal or other treatment. The aim is selection of such tumor population characteristics the testing of them would enable better patient stratification in postoperative adjuvant systemic therapy.

Apoptosis↗
PubMed2006

[New method for detection of nonpalpable breast cancer].

OBJECTIVE: The objective of the study was to evaluate the feasibility of radio guided occult lesion localization (ROLL) in the cases of nonpalpable breast cancers with sentinel lymph node biopsy. DESIGN: Prospective clinical study SETTING: Department of Gynecology and Obstetrics, 2nd Medical Faculty and Teaching Hospital, Praha METHODS: Thirty-eight patients with nonpalpable breast cancer diagnosed by core cut biopsy underwent an injection of the radiopharmaceutical 18-20 hours before surgery. The dose of the radiopharmaceutical was 45 MBg into tumor and 15 MBg subdermaly. Surgical excision of radioactive breast tissue with nonpalpable tumor was carried out using the hand held gamma probe and the same technique was performed for biopsy of sentinel lymph node. Standard localization technique with hook-wire was performed in the control group of fifty-one patients. RESULTS: Radioguided surgery of nonpalpable tumor was successful in all cases. Surgical margins were clear in all cases, in four cases (10.5%) the margins were only 2 mm. The sentinel node was identified in all cases, in 3 patients (7.9%) the sentinel node was involved by tumor and axillary lymphadenectomy was performed. Infiltrating carcinomas were diagnosed in the "hook-wire" group in 21 cases (41.2%), all with clear margins over 3mm. Proportion of margins status between ROLL and hook-wire was the same. It seems that the health tissue loss around the tumor is in hook-wire technique bigger but it requires next study. CONCLUSION: Simultaneous performance of ROLL and sentinel node biopsy is useful and practicable methods in the management of nonpalpable breast cancer. In comparison to hook-wire, radioguided removal allows reduced excision volume and better lesion centering within the specimen.

Adult↗
PubMed2006

[Possibilities of using ultrasound in the diagnosis of descended posterior compartment of female pelvic floor].

OBJECTIVE: Find out the features of descending posterior vaginal wall using ultrasonography and set the objective diagnostic criteria. DESIGN: Prospective comparative study. SETTING: Department of Obstetrics and Gynaecology, Teaching Hospital Bulovka, First Medical Faculty, Charles University in Prague. METHODS: We included 39 attendants, 19 with clinicaly proven descent of posterior vaginal wall; 20 as a negative control group. We observed the ultrasonographical features of descending posterior vaginal wall according to the horisontal line crossing the inferior margin of pubic bone (PM) and central anorectal angle (PARA) at rest and during Valsalva manoevre with and without intrarectal application of sonographic yelly. Student's t-Test was used for statistical evaluation. RESULTS: We proved the statisticaly significant increase in the distances PM and PM' in the group of females suffering from the descent compared to the group of healthy women. Values of PARA were also signifinatly hightened in the group of patients with the descent compared to healthy females. CONCLUSIONS: The ultrasonographical evaluation of descending posterior vaginal wall appears to be promising chance in diagnostics of female's pelvic floor pathology.

Adult↗
PubMed2005

Treatment of autoimunne ovarian damage in adolescent girls.

INTRODUCTION: To investigate levels of antiovarian autoantibodies in girls and young women with disturbances of menstrual cycle before and during treatment with hormonal therapy. To explain morphological changes in ovarian structure in these patients. MATERIAL AND METHODS: Studied group included 39 patients. 18 patients were treated for primary amenorrhoea, 21 for menstrual cycle disorders. Patients included in the study were repeatedly examined at the beginning of the study and after six months during which they were treated by estrogen and gestagen. In all patients we have tested FSH, LH and FSH/LH ratio, presence of antiovarian antibodies. Results were compared with those obtained in control women. 21 antiovarian antibodies positive patients were indicated for laparoscopic biopsy. Bioptic sample was examined using light and electron microscopy. RESULTS: Our treatment with hormonal therapy lead to the reduction of ovarian antigens. In 85% of the cases marked decrease of antiovarian autoantibodies levels was observed, while in 28% of the cases the levels were undetectable. From morphological changes of the bioptic sample enhanced atresia of follicules at different developmental stages was frequently observed. It evoked marked reduction of follicular apparatus up to its complete disappearing. CONCLUSION: The results of our study and mapping of the antiovarian antibodies positivity support our hypothesis that the antiovarian antibodies positivity corresponds with the clinical symptoms. Appropriate treatment with hormonal replacement therapy minimizes ovarian destruction, preserves ovarian hormonal functions and saves healthy ovarian tissue necessary for future fertility.

Adolescent↗
PubMed2005

[Sentinel lymphatic node biopsy for breast cancer in practice].

OBJECTIVE: This paper reviewed the feasibility and accuracy of sentinel lymph node status in women with breast cancer. DESIGN: Clinical retrospective study. SETTING: Dept. of Obstetrics and Gynecology, 2nd Medical School, Teaching Hospital Motol, Praha. METHODS: Our trial involved 169 patients with breast cancer in the T1 and T2 stage without suspicion for axillary lymph node involvement. Lymphatic mapping was performed by sub dermal or subareolar injection of 99mTc labeled collodial human albumin (Senti-Scint) in the dose of 15 MBg one day before surgery. During the operation lymphatic mapping with vital blue dye (patent blau) was performed. Then the hand-held gamma-ray detector probe was used to locate the sentinel node. From a small axillary incision the blue-stained sentinel node was removed. Both methods of detection were compared, the sentinel lymph node has to be hot-radioactive and blue-stained. Complete axillary lymphadenectomy was then done. All removed lymph nodes were prepared for histopathological examination. RESULTS: Failures of sentinel lymph node detection were in 9 cases (5.3%) of the 169 patients. There was one case of false negative sentinel lymph node biopsy (0.6%). Most failures occurred during the learning phase of lymphatic mapping and were associated with excessive tumor involvement of axillary lymph nodes. Success of sentinel lymph node detection was in 160 cases (94.7%) and in our trial both methods of lymphatic mapping were equally effective. Tumor involvement of sentinel lymph nodes were in 43 patients (26.9%), in 19 (11.9%) of them, the sentinel nodes were the only metastasis nodes, whereas in the remaining 24 (15%) patients other axillary nodes were positive. The concordance between negative sentinel node and axillary lymph node status was in 117 (73.1%) cases. CONCLUSION: The introduction of sentinel lymph node biopsy allows directed and accurate assessment of axillary involvement with minimal morbidity. Sentinel node accurately predicts the status of all axillary nodes in more than 94.7% of cases.

Adult↗
PubMed2005

[Reimplantation of heart valve prosthesis at the 25th week of gestation].

OBJECTIVE: Pregnancy in a woman with thrombosis of heart valve prosthesis at the 25th week of gestation and fetal death during reimplantation of prosthesis with the use of extracorporeal circulation. SUBJECT: Case report. SETTING: Department of Gynecology and Obstetrics, 2nd Medical Faculty of Charles University, Motol Hospital, Prague. SUBJECT AND METHOD: Patient L. S., 24 years old, first pregnancy, admitted to coronary heart unit at the 25th week of gestation with a blocked heart valve prosthesis, NYHA IV, left heart failure, and pulmonary edema. There was an insufficient anticoagulation therapy during pregnancy and a thrombosis of the prosthetic heart valve was suspected from that reason. Reimplantation of a prosthetic heart valve with the use of extracorporeal circulation was indicated in spite of a possible risk for the fetus. The thrombosis was confirmed during cardio surgical operation and a change of the prosthesis was successfully performed. After the patient was converted to extracorporeal circulation, bradycardia and intrauterine fetal death occurred. With regard to the patient's coagulation and circulatory instability, further management was necessary because of fetal death--termination of pregnancy by minor caesarean section was the only alternative. Six hours later an 850 g weight dead fetus was delivered. There were no serious complications during the postoperative period. CONCLUSION: Reimplantation of a prosthetic heart valve from vital indication was performed at the 25th week of gestation. After conversion of mother to extracorporeal circulation, fetal death occurred. The patients was released with satisfactory cardiopulmonal compensation.

Adult↗
PubMed2005

Squamous intraepithelial lesion-microinvasive carcinoma of the cervix during pregnancy.

OBJECTIVE: The objective of this work was to assess proper management of squamous intraepithelial lesion (SIL) and microinvasive carcinoma during and after pregnancy, to assess risks of punch biopsy and conization in pregnancy and to assess regression, persistence and risk of progression with low-grade (L) and high-grade (H) SIL. METHODS: We carried out a prospective study of 167 pregnant women from our colposcopic unit who were referred to us for abnormal cytological findings between 1997 and 2002. The diagnosis of precancerosis was verified in all of the women by punch biopsy, suspect microinvasive carcinoma needle or LETZ conization up to the 20th week of pregnancy. All women were followed-up during the pregnancy and 24 months after their deliveries. RESULTS: In 23 women with suspect early invasion we performed conization during the pregnancy (weeks 13-23). There were six cases (26.1%) of microinvasive carcinoma and 17 cases (73.9%) of HSIL. One pregnancy aborted two days after the conization. No other obstetrical complications were recorded and there were no premature deliveries. Sixty-two women with HSIL were only followed-up during their pregnancy. We observed complete regression of HSIL during the study in 14 patients (22.6%), regression to LSIL in 17 patients (27.4%), persistence in 25 patients (40.3%) and progression to microcarcinoma in six cases (9.7%). Eighty-two patients were followed up for LSIL. Complete regression of LSIL was observed during the study in 40 cases (48.8%), persistence in 24 cases (29.2%) and progression to HSIL in 18 cases (22.0%). CONCLUSION: For LSIL and HSIL during pregnancy the above follow-up is a sufficient and safe protocol. Suspect microinvasive carcinoma should be treated by conization, which is a safe procedure until the 24th week of pregnancy.

Adult↗
PubMed2004

[The hiatus urogenitalis and its dorsal component--its importance in urinary and fecal continence in women].

OBJECTIVE: Numerous anatomical studies over the last years resulted in a principal shift in the view of the area of female pelvic floor. These studies also deal with the area of posterior compartment, i.e. a region which used to be of little interest to urogynecologists. This article presents a brief outline of anatomical and physiological knowledge as well as a brief survey of most important methods of examination and basic clinical symptoms associated with disorders of posterior part of hiatus urogenitalis. The presently accepted concept of a complex approach to disorders of female pelvic floor will probably require increased interest in this area among urogynecologists. The article is aimed at summarizing elementary knowledge necessary for adequate clinical care of patients suffering from disorder in posterior compartment function. SUBJECT: Review article. SETTING: Department of Gynecology and Obstetric, Faculty Hospital Na Bulovce, 1st Medical Faculty, Prague, Czech Republic.

Defecation↗
PubMed2004

[Correlation of maximum urethral closure pressure and Valsalva leak-point pressure in patients with genuine stress incontinence].

OBJECTIVE: The aim of our study was to find correlation between Valsalva leak-point pressure (VLPP) and cough leak-point pressure (CLPP) and to determine whether water perfusion maximum urethral closure pressure (MUCP) correlates with Valsalva leak-point pressure (VLPP). DESIGN: Cross-sectional clinical study. SETTINGS: Gynecological and Obstetric Clinic, 1st Medical Faculty, Charles University and General Faculty Hospital, Prague. MATERIAL AND METHODS: Thirty women with previously untreated GSI were recruited to participate in a clinical study. Their mean age was 56.9, mean body mass index (BMI) 27.6, and mean parity 1.8. As part of the urethral pressure profile we determined MUCP and functional length (FUL) of the urethra. VLPP and CLPP were assessed during US examination using an ultrasound contrast medium and the color Doppler velocity (CDV). Funneling was described as the increase in distance between the inner edges of proximal urethra during Valsalva maneuver. RESULTS: We did not find statistically significant differences in the mean value of VLPP and CLPP. The mean value of VLPP was 51.6 cm H2O (SD=26.5) and CLPP 53.1 cm H2O (SD=25.5). The mean values of MUCP were 39.7 cm H2O (SD=22.1) with 500 ml and 41.5 cm H2O (SD=22.7) with 300 ml of sterile saline; the difference between them is not statistically significant. In the study group (n=30), 22 patients had low VLPP (< or = 60 cm H2O). Only 8 patients had simultaneously MUCP < or = 30 cm H2O and of these patients only 2 had simultaneously MUCP < or = 20 cm H2O (the bladder volume 300 ml). Similar results were obtained with the bladder volume 500 ml. We did not find statistically significant differences in the funneling of proximal urethra between the groups of patients with low MUCP (< or = 30 cm H2O) and with higher MUCP (> 30 cm H2O) and between the groups of patients with low VLPP (< or = 60 cm H2O) and with higher VLPP (> 60 cm H2O). CONCLUSIONS: This study mainly compares two parameters--the MUCP and the VLPP. Based on our results we support the theory that ISD has a multifactorial basis, and a low MUCP or a low VLPP derives from two different pathogenic mechanisms. We support the Pajoncini hypothesis that low VLPP correlates with a deficiency in mucosal sealing and compromise of the intrinsic proximal component at the level of the bladder neck, and low MUCP correlates with a deficiency at the level of the rhabdosphincter in the middle urethra. In the future we must establish the prognostic value of the VLPP and the MUCP in the postoperative follow-up.

Adult↗
PubMed2003

Controlled, double-blind, multicentre clinical trial to investigate long-term tolerability and efficacy of trospium chloride in patients with detrusor instability.

Our objectives were to ascertain the tolerability and efficacy of trospium chloride in doses of 20 mg twice daily for long-term therapy (52 weeks) in patients with urge syndrome. The trial comprised a total of 358 patients with urge syndrome or urge incontinence. After randomisation in the ratio of 3:1, participants were treated continuously for 52 weeks with either trospium chloride (20 mg twice daily) or oxybutynin (5 mg twice daily). At intervals of 4-8 weeks, patients were physically examined with measurements of blood pressure and pulse rate, were questioned about any adverse events, checked for compliance and underwent relevant laboratory tests. As an additional safety measure, an ECG was made at 26 and 52 weeks. Urodynamic measurements were performed at the beginning, and at 26 and 52 weeks to determine the maximal cystometric bladder capacity. Among others things, the frequencies of micturition, incontinence and number of urgency events were recorded in patient diary protocols in weeks 0, 2, 26 and 52. The evaluation of vital parameters, laboratory results and ECGs did not show any relevant changes attributable to the action of the anticholinergics. Analysis of the micturition diary clearly indicated a reduction of the micturition frequency, incontinence frequency, and a reduction of the number of urgencies in both treatment groups. Mean maximum cystometric bladder capacity increased during treatment with trospium chloride by 92 ml after 26 weeks and 115 ml after 52 weeks (P=0.001). Further comparison with oxybutynin did not reveal any statistically significant differences in urodynamic variables between the drugs. Adverse events occurred in 64.8% of the patients treated with trospium chloride and 76.7% of those treated with oxybutynin. The main symptom encountered in both treatment group was dryness of the mouth. For patients on trospium chloride, the estimated risk of an unexpected adverse event was 0.027 per patient per week for all adverse events and 0.009 for dryness of the mouth, resulting in a considerably lower risk during treatment given with trospium chloride than with oxybutynin (0.045 and 0.021, respectively). An overall assessment for each of the drugs reveals a comparable efficacy level and a better benefit-risk ratio for trospium chloride than for oxybutynin due to better tolerability.

Adult↗
PubMed2003

[The elderly patient with urge incontinence or urge-stress incontinence - efficacy and cardiac safety of propiverine].

PURPOSE: The efficacy of propiverine in elderly patients suffering from urge incontinence or urge-stress incontinence was intended to be investigated. Especially in elderly patients a cardiac influence of propiverine is possible due to its dual mode of action. That is why besides the efficacy especially the cardiac safety was intended to be investigated. MATERIAL AND METHODS: Ninety-eight patients (21 male, 77 female; 67.7 +/- 6.3 years of age) suffering from urgency, urge incontinence or mixed urge-stress incontinence were included in the double-blind, multicentre, placebo-controlled, randomized study. After a two-week placebo run-in period, the patients received propiverine (15 mg t. i. d.) or placebo (t. i. d.) for four weeks. Before (U 1, U 2) and during the treatment period (U 3, U 4), standard ECG's and 24 h long-term ECG's were recorded. RESULTS: Propiverine caused a significant reduction in the micturition frequency (U 2 : 8.7 +/- 4.2, U 4 : 6.5 +/- 3.2 ml; p < 0.01) reflected in a significant increase in the average micturition volume (U 2 : 163.5 +/- 65.9, U 4 : 216.3 +/- 101.5 ml; p < 0.01) and a significant reduction in the episodes of incontinence (- 54 %; p < or = 0.05). These findings were confirmed by the overall assessment after four weeks in which approximately 90 % of patients under propiverine were either free from urge incontinence and urge symptoms or improved. The efficacy parameters demonstrated a better efficacy for urge incontinence than for mixed urge-stress incontinence. Resting and ambulatory electrocardiograms evidenced no significant changes. Neither QTc interval nor other cardiac parameters were relevantly altered. The frequency of cardiac events (Lown classes IV a/b) was fortuitous, revealing no difference between placebo and propiverine. The incidence of adverse events was very low (2 % dryness of the mouth under propiverine) and confirmed by the findings from the quality of life questionnaires. CONCLUSIONS: A favourable benefit-risk ratio in the treatment of elderly patients suffering from urgency, urge incontinence or combined urge-stress incontinence is therefore proven for propiverine. Cardiac arrhythmia were not induced.

Age Factors↗
PubMed2002

Changes of the electrical heart field and hemodynamic parameters in the 34th to 40th weeks of pregnancy and after delivery.

We have studied changes of the electrical heart field resulting from the changed spatial position of the heart during the last period of pregnancy in healthy women. This was suggested to be a good model of electrocardiographic changes that could be found on patients suffering from obesity. The measured parameters of the electrical heart field were compared with hemodynamic parameters before and after delivery in the group of non-obese women with physiological pregnancy and in a group of healthy non-obese and non-pregnant women. Several significant changes of the electrical heart field were detected in the late pregnancy: increased heart rate, shortening of A-V conductance, prolongation of QT interval normalised for the heart rate and changes in the ventricular depolarisation and repolarisation patterns. Some of these changes are not fully restored in 4 days after delivery. Moreover, we have found an increased pump function of the left ventricle accompanied by decreased peripheral resistance in the group of pregnant women. Increased pump function was partially restored after delivery, peripheral resistance was not only restored, but it overshot to increased values. Persisting elevated heart rate with increased peripheral resistance suggested increased sympathetic activity after birth. Only some changes of electrical heart field could be explained by changed spatial arrangement of the chest organs during pregnancy and they must be considered in a complex consequence with changes in regulatory mechanisms.

Adult↗
PubMed2002

Development of hydrogel implants for urinary incontinence treatment.

Hydrogel implants for urinary incontinence treatment based on HEMA supplemented with 10% methacrylic acid have been developed. The swelling properties of implants were tested in vitro and in vivo after implantation to laboratory mice. Biocompatibility has been determined by incubation of implants in tissue culture, by histological examination of adjacent tissues after subcutaneous application of implants to laboratory mouse in a long-term experiment, and by flow cytometry examination of blood cells. The swelling of hydrogel implants was completed in 6-24 h. There was no effect on in vitro growth of cells incubated with implants. In mice, implants were well tolerated without any sign of inflammatory reaction. The material allows an elastic compression of urethra compensating a damaged sphincter after trans-urethral sub-mucosal implantation of hydrogel cylinders.

Animals↗
PubMed2002

Ultrasound imaging of paravaginal defects in women with stress incontinence before and after paravaginal defect repair.

OBJECTIVE: The aim of our study was to analyze whether transabdominal and introital sonography can identify paravaginal defects and to determine changes that occur following paravaginal defect repair and Burch colposuspension. METHODS: Twenty women with genuine stress incontinence took part in this prospective study. The mobility of the bladder neck was assessed transperineally with a curved array probe following instillation of 300 mL saline. The same probe was used transabdominally to determine the presence of paravaginal defects. Introital examination using a transvaginal probe was then performed to determine the presence of paravaginal defects. The same measurements were performed following Burch colposuspension and paravaginal defect repair. RESULTS: There were significant differences in bladder neck position and mobility before and after surgical intervention. In 18 women before surgery, transabdominal ultrasound identified unilateral or bilateral paravaginal defects. Eight unilateral defects were found on the right side but only two were found on the left side. In eight women, the defect was bilateral. The introital approach obtained similar results apart from in two patients with a bilateral defect in whom it indicated a unilateral right defect. Between the first and second weeks following the operation transabdominal ultrasound found no paravaginal defects in 16 women and introital ultrasound found no paravaginal defects in 18 women. We were unable to visualize the region of the paravaginal defect in two women using transabdominal ultrasound because the abdominal wall was edematous after surgery. Five to 6 weeks after the operation, our results were confirmed by abdominal and introital ultrasound in all cases. No paravaginal defects were found in any of the patients after paravaginal defect repair. CONCLUSION: Our clinical study suggests that ultrasound scanning should be performed to confirm the presence of paravaginal defects and that paravaginal defect repair may be added to Burch colposuspension for the treatment of genuine stress incontinence, as an operation to correct cystourethrocele and the posterior urethrovesical angle.

Female↗