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Biomedical subjects

S K Yip

Publications and source records attributed to S K Yip.

At least 19 recordsLinked to original sources
PubMed2006

Tension-free vaginal tape sling procedure for the treatment of stress urinary incontinence in Hong Kong women with and without pelvic organ prolapse: 1-year outcome study.

OBJECTIVE: To assess the outcome of patients who underwent a tension-free vaginal tape sling procedure alone versus patients who underwent concomitant pelvic floor surgery. DESIGN: Retrospective cohort study. SETTING: Urogynaecology unit of a university teaching hospital, Hong Kong. PATIENTS: Patients diagnosed with moderate-to-severe urodynamic stress incontinence and underwent a tension-free vaginal tape sling procedure from September 1999 to August 2004. MAIN OUTCOME MEASURES: Objective cure rate of stress urinary incontinence 1 year following tension-free vaginal tape sling procedure was assessed. Patients were considered objectively cured if no stress urinary incontinence was evident on urodynamic studies at 1-year follow-up. Subjective cure rates at 4 months and 1 year after tension-free vaginal tape sling procedure were also assessed. Other outcome measures included intra-operative and perioperative complication rates, and the rate of de-novo detrusor overactivity at 1 year. RESULTS: Of 302 patients recruited, 250 (82.8%) completed 1-year follow-up. There were 157 (62.8%) patients who had a tension-free vaginal tape sling alone, and 93 (37.2%) had tension-free vaginal tape sling and concomitant pelvic floor surgery for pelvic organ prolapse. All patients had urodynamic studies before and 1 year following surgery. The objective cure rate was 87.3% for patients with tension-free vaginal tape sling alone, and 80.6% for tension-free vaginal tape sling with concomitant procedures (Chi squared test, P>0.05). The subjective cure rates for tension-free vaginal tape sling alone and tension-free vaginal tape sling plus concomitant procedures were 89.2% and 86.0% at 4 months, and 93.0% and 94.6% at 1 year, respectively (Chi squared test, P>0.05). The most common complication was postoperative urinary retention (15.2%), followed by de-novo detrusor overactivity at 1 year (10%), and bladder perforation (8%). CONCLUSION: The tension-free vaginal tape sling procedure alone or in combination with pelvic floor surgery are equally effective for the treatment of female stress urinary incontinence.

Aged↗
PubMed2005

17beta-estradiol suppresses proliferation of fibroblasts derived from cardinal ligaments in patients with or without pelvic organ prolapse.

BACKGROUND: Estrogen replacement therapy (ERT) has been used in the treatment of pelvic organ prolapse (POP) but clinical results are inconclusive. The purpose of this study was to investigate the effect of 17beta-estradiol (E(2)) on the proliferation of fibroblasts derived from cardinal ligaments in women with or without POP. METHODS: Fibroblasts were derived from seven patients with POP and seven age-matched controls. The growth rate of POP fibroblasts was compared with that of control by 3-(4,5,-dimethyl thiazolyl-2)-2,5-diphenyl tetrazolium bromide (MTT) assay. Four cell strains from each patient and control group were treated with different concentrations of E2 (10(-4), 10(-8), 10(-9) and 10(-10) mol/l). The effect of E2 on cell proliferation was then measured by MTT assay. RESULTS: The overall growth rate of POP fibroblasts was significantly slower than that of controls under normal culture conditions. Addition of E2 suppressed cell proliferation of all the fibroblasts, especially in POP fibroblasts. POP fibroblasts showed a significantly lower proliferative rate than that of controls at all E2 concentrations, with the most prominent inhibitory effect at physiological concentration (10.83 34.41% versus 81.56 48.10% at 10(-8) mol/l). CONCLUSIONS: Our results suggest that decreased fibroblast turnover may contribute to the development of POP; and ERT may not be an effective POP treatment.

Cell Proliferation↗
PubMed2005

Dysfunctional elimination symptoms in childhood and adulthood.

PURPOSE: The dysfunctional elimination syndrome (DES) is rare in adulthood. We evaluate the natural history of DES to identify aspects of the disorder that may be carried into adulthood. MATERIALS AND METHODS: A 2-part questionnaire was devised and self-administered to 191 consecutive women attending a urogynecological clinic (UG) and to 251 normal women. The first section asked for recall of childhood symptoms known to be associated with DES, while the lat-ter section explored current bladder and bowel problems. Data sets from the normal cohort (55) reporting current bladder problems were excluded. Descriptive statistics, chi-square and Mann-Whitney-U tests were used to compare variables. RESULTS: UG patients had significantly higher childhood DES scores than normal women. Overall 41.7% of UG patients could be labeled as having dysfunctional elimination as an adult. Symptoms reported significantly more often in childhood by UG patients than by control women were frequent urinary tract infection, vesicoureteral reflux, frequency, urge incontinence, slow and intermittent urine flow, small volume high urge voids, hospitalization for constipation, frequent fecal soiling and nocturnal enuresis. Higher DES scores correlated significantly with current adult urgency, urge leak, stress incontinence, incomplete emptying, post-void leak, hesitancy, nocturia and nocturnal enuresis. Constipation and fecal incontinence in adulthood also showed a significant association with high DES scores. Logistic regression revealed childhood urgency to be associated with adult DES. CONCLUSIONS: Childhood lower urinary tract dysfunction may have a negative impact on bladder and bowel function later life.

Adolescent↗
PubMed2005

The impact of urinary incontinence on quality of life among women in Hong Kong.

OBJECTIVE: To determine the prevalence of female urinary incontinence in Hong Kong and its impact on quality of life. DESIGN AND SETTING: Territory-wide telephone survey in Hong Kong. PARTICIPANTS: Hong Kong women aged 10 to 90 years accessed by fixed residential telephone lines between June 2001 and July 2002. MAIN OUTCOME MEASURES: The prevalence of urinary symptoms was assessed using telephone interview. The urinary symptoms investigated were as listed in a validated Chinese version of Urogenital Distress Inventory Short Form (UDI-6). The impact on quality of life was quantified using a validated Chinese version of Incontinence Impact Questionnaire Short Form (IIQ-7). RESULTS: There were 749 valid respondents (response rate, 24.4%). Urinary symptoms were reported by 52% of women (95% confidence interval, 48.9-56.0%), of whom 12% believed it impaired their quality of life. Stress urinary incontinence was reported by 34% (95% confidence interval, 28.7-38.9%). Social (5.1%; 95% confidence interval, 2.8-7.4%) and emotional (5.6%; 95% confidence interval, 3.3-7.9%) factors were the quality-of-life areas most impacted by urinary incontinence. CONCLUSIONS: Urinary symptoms are common among Hong Kong women. Quality of life is consequently impaired in 12% of affected women.

Adolescent↗
PubMed2003

One-year urodynamic outcome and quality of life in patients with concomitant tension-free vaginal tape during pelvic floor reconstruction surgery for genitourinary prolapse and urodynamic stress incontinence.

The aim of the study was to examine the 1-year urodynamic outcome and quality of life in patients who have had concomitant tension-free vaginal tape insertion during pelvic floor reconstruction surgery. The medical notes of a retrospective cohort of 45 patients who had undergone tension-free vaginal tape together with pelvic floor reconstruction surgery were reviewed. The operative information, the results of the urodynamic studies and the change in the quality-of-life scores 1 year after surgery were examined. The quality of life was assessed with both general and disease-specific quality-of-life questionnaires (General Health Questionnaire (GHQ-12), Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7)). Patient satisfaction was assessed with the validated Chinese version of the Client Satisfaction Questionnaire (CSQ). Forty-five patients underwent tension-free vaginal tape insertion together with pelvic floor reconstruction surgery. The overall objective cure rate was 43%. There was a significant improvement in the disease specific quality-of-life assessment (UDI-6 score 38.3-15.5; P<0.01) and (IIQ-7 score 15.0-4.0; P<0.01). The patients who had a concomitant cystocele repair had a worse objective cure rate than patients without concomitant cystocele repair (38% vs 67%; P=0.19).

Aged↗
PubMed2003

Dimer state of spin-1 bosons in an optical lattice.

We consider spin-1 bosons, such as 23Na, trapped in an optical lattice, in the regime of one particle per site. We argue that the ground state is expected to be the dimer phase in one, two, or three dimensions, thus realizing a state that has so far been studied only theoretically.

Journal Article↗
PubMed2003

Compliance with a pelvic muscle exercise program as a causal predictor of urinary stress incontinence amongst Chinese women.

AIM: To determine the importance and contribution of compliance in a pelvic muscle exercise program as a factor in reducing the severity of urinary stress incontinence amongst Chinese women. METHODS: Two hundred fourteen women presenting with urinary stress incontinence who agreed to undertake a program of pelvic muscle exercises were recruited into the study. Incontinence (wetting episodes), pelvic muscle strength, exercises compliance, correctness of pelvic muscle exercise technique, duration of stress incontinence, and previous history of pelvic surgery were recorded on four occasions: baseline (first clinic session) and second to fourth clinic sessions. Demographic data were also collected at baseline. Stepwise multiple regression analyses were used to determine the relative importance of compliance to exercise regime in predicting the severity of incontinence. Path analysis was used to provide a summary description of the influence of compliance on the outcomes over the four visits. RESULTS: The pelvic muscle training program appears to be able to reduce the overall urinary incontinence episodes by 85.2% and achieved a 73.1% increase in pelvic muscle strength. Although the number of wetting episodes in any visit are causally linked to that recorded in previous visit, those who were more compliant had a greater reduction. Age, mode of delivery, menopausal status, history of pelvic surgery, and duration of incontinence did not appear to contribute significantly to predicting incontinence. CONCLUSION: Compliance with pelvic muscle exercises significantly contributed to a reduction in urinary stress incontinence.

Adult↗
PubMed2003

Unsuspected pregnancy at hysterosalpingography: a report of three cases with different outcomes.

We report three cases of unsuspected pregnancy during hysterosalpingography (HSG) with different outcomes. In the first two cases, menstrual history was wrongly relied upon and no pregnancy tests had been performed. However, even with a negative pregnancy test carried out prior to the investigation, as in the third case, this was proven not to be foolproof. The outcome of our pregnancies involves one ectopic, one miscarriage and one normal term pregnancy. We advocate not relying solely on menstrual history and to be aware that even in cases where there is a negative pregnancy test before HSG, the patient can still be pregnant. Although the reporting of unsuspected pregnancy during HSG is rare, there is still a need to be alert, especially in high-risk patients with irregular, long menstrual cycles and unprotected intercourse prior to the investigation.

Abdominal Pain↗
PubMed2003

Spontaneous expulsion of a Filshie clip through the anterior abdominal wall.

Tubal occlusion using Filshie clip is one of the most commonly performed operations for female sterilization. It is usually a simple and safe procedure, and operative complications are uncommon. We report a rare case of spontaneous expulsion of a Filshie clip through the anterior abdominal wall 5 years after sterilization. The management and possible underlying mechanisms are discussed and the related literature is reviewed.

Abdominal Wall↗
PubMed2002

A randomized controlled trial of tolterodine and oxybutynin on tolerability and clinical efficacy for treating Chinese women with an overactive bladder.

Objective To compare the tolerability and clinical efficacy of tolterodine and oxybutynin in the treatment of Hong Kong Chinese women with an overactive bladder. Patients and methods A randomized controlled trial was conducted at two urogynaecology centres in Hong Kong. In all, 106 women with urodynamically confirmed detrusor instability were recruited. Baseline severity assessments included a visual analogue scale (VAS), urinary diary and urinary pad-test. The women were randomized to receive either oral tolterodine 2 mg or oxybutynin 5 mg twice daily for 10 weeks. Treatment responses were assessed at 4 and 10 weeks using the VAS and urinary diary. Treatment tolerability was assessed at baseline, 4 and 10 weeks using the Xerostomia Questionnaire. A urinary pad-test was repeated at 10 weeks. Results The perceived change from baseline VAS was better in the tolterodine than the oxybutynin group after 10 weeks of treatment (per-protocol analysis, P = 0.043). The two drugs were effective in reducing the symptoms of frequency (P < 0.001). Tolterodine was significantly better than oxybutynin in reducing urinary leakage (urinary pad-test; median change - 5.00 g vs 0 g, P = 0.019). Both drugs caused a significant worsening of dry mouth (overall dryness, P < 0.005; discomfort, P < 0.005; sleep, P = 0.021; speaking, P = 0.045; swallowing, P = 0.004; and liquid consumption, P = 0.017). Conclusions Both oxybutynin and tolterodine were effective in ameliorating the severity of the symptoms of detrusor instability. Tolterodine was better than oxybutynin in both subjective and objective outcome measures, but both drugs caused similar worsening of dry mouth that may limit the tolerability of these medications.

Administration, Oral↗
PubMed2002

Clinical experience and results of ESWL treatment for 3,093 urinary calculi with the Storz Modulith SL 20 lithotripter at the Singapore general hospital.

We study the outcome of 2,700 patients treated for 3,093 urinary calculi over a period of 60 months. All patients underwent Extracorporeal Shock Wave Lithotripsy (ESWL) treatment using the Storz Modulith SL20, predominantly on an outpatient basis (99.9% using intravenous pethidine for analgesia). The treatment outcome of 1,666 renal calculi and 1,427 ureteric calculi were analysed and stratified according to size and site. Follow-up status at 3 months was available for 91.8% of patients. For renal calculi, the overall success rate was 81% (re-treatment rate 29.7%). The majority of failures were stones larger than 2 cm and those situated in the lower pole of the renal calyces. The overall success rate for ureteric calculi is 85% with similar clearance rates throughout the ureter (re-treatment rate 22.8%). Failures were predominantly with stones larger than 2 cm. For the entire series, the morbidity rate requiring hospital admission was 2.9%, there was no mortality. The commonest cause for admission was for pain control (1.8%). To our knowledge, our experience with this lithotriptor is the largest to date. We have demonstrated that ESWL with Storz Modulith SL20 is safe, well tolerated and highly effective for the treatment of urolithiasis.

Adolescent↗
PubMed2002

An unusual case of a vesicovaginal stone.

We report a case of an unusual vesicovaginal stone. The dumb-bell-shaped stone created a ball valve effect in the fistula, therefore giving rise to only mild urinary leakage despite the large size of the fistula.

Calculi↗