Biomedical subjects

T Bavendam

Publications and source records attributed to T Bavendam.

5 recordsLinked to original sources

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↗

PubMed1996

Treatment with the Reliance urinary control insert: one-year experience.

The 1-year experience of 63 women using an intraurethral insert for the management of stress or mild mixed urinary incontinence is presented, emphasizing safety and efficacy. Objective criteria, including standardized pad weight tests and patient diaries, were employed to evaluate the device's effectiveness. At study outset, 82% of the patients were completely dry with the device in situ, with an additional 16% of patients significantly improved. At 12 months, 79% of the patients were completely dry, and 16% were significantly improved. This result is consistent with the significant improvement (P < 0.0001) in the number of urinary incontinence episodes reported in patient diaries. Women reported that the device significantly improved their ability to stay dry over a number of routine and physically demanding daily activities. The device was increasingly easy to use and more comfortable over time (P < 0.0001). The latter finding was confirmed by a decline in patient reports of "sensation of device presence" over the duration of the study (35% at 1 week v 7% at 12 months). Untoward events included gross hematuria (24%), device-related bladder mucosal irritation (9%), and symptomatic bacteriuria (30%). Such side effects were expected for this type of device, were easily managed without significant medical intervention, and did not result in any long-term clinical sequelae. The great reduction in the number of episodes of urinary incontinence, the low rate of significant problems associated with device use, and ease of use make the intraurethral insert a useful management alternative for women with stress urinary incontinence.

Adolescent↗

PubMed1993

Bladder neck closure with continent augmentation or suprapubic catheter in patients with neurogenic bladders.

Twenty-four patients, with various combinations of non-healing decubitus ulcers, urethral fistulae, incontinence, and penile skin breakdown were candidates for proximal urinary diversion, having failed intermittent, external, and indwelling catheterization combined with pharmacologic therapy. Seventeen patients underwent bladder neck closure, including seven with multiple sclerosis and ten with spinal cord injury, and because they were unable or unwilling to do catheterization, had their urine diverted by suprapubic catheter. Seven patients, including four with spinal cord injury, underwent bladder neck closure and continent augmentation with formation of a catheterizable cutaneous stoma on the anterior abdominal wall, using right colon and right colon/ileum configurations. When ureteral reflux and obstruction are absent, the patient's bladder was used which spared the added risk of ureteral implantation and possible ureteral stricture while increasing total bladder capacity. In a select group of patients with intractable incontinence, perineal and penile skin breakdown, or urethral fistulae, bladder neck closure and urinary diversion by suprapubic catheter or continent augmentation has proven to be a reliable and effective alternative to an ileal conduit.

Catheterization↗

PubMed1992

Ectopically draining dysplastic kidney associated with genuine stress urinary incontinence: unusual combined cause of incontinence.

A thirty-two-year-old Samoan woman was referred for evaluation of "unstable bladder" and a history of continuous life-long urinary incontinence. A comprehensive radiographic and urodynamic evaluation demonstrated the unusual combination of a vaginal ectopic ureter draining a dysplastic kidney and genuine stress urinary incontinence. Appropriate treatment based on the recognition of both abnormalities resulted in restoration of continence.

Adult↗

PubMed1989

Bladder leiomyoma.

We herein present a case of leiomyoma of the urinary bladder discovered during evaluation for stress urinary incontinence. The histologic findings of this benign tumor and its urologic implications are reviewed.

Adult↗