EAU Update SeriesPub Date : 2003-09-01Epub Date: 2003-08-05DOI: 10.1016/S1570-9124(03)00038-2
Lucia Dolan, Paul Hilton
{"title":"Surgical Management of Stress Incontinence: Which Technique When?","authors":"Lucia Dolan, Paul Hilton","doi":"10.1016/S1570-9124(03)00038-2","DOIUrl":"10.1016/S1570-9124(03)00038-2","url":null,"abstract":"<div><p>Since Baker Brown introduced suprapubic cystotomy in 1864, multiple surgical procedures and modifications have been described for stress urinary incontinence reflecting that none is optimal and no single procedure is ideal in all cases.</p><p>Stress urinary incontinence is predominantly a condition that affects females and discussion in this chapter is restricted to the surgical management in this group. The mechanisms proposed for surgical restoration of stress continence will be reviewed. Given that surgical success is dependent on effective case selection, issues surrounding pre-operative assessment will be included. Success rates, specific indications for each procedure, and special considerations for high-risk symptom groups will be outlined.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 3","pages":"Pages 154-165"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00038-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73727932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-09-01Epub Date: 2003-08-13DOI: 10.1016/S1570-9124(03)00041-2
Philippe Sèbe, Olivier Traxer, François Haab
{"title":"Pelvic Floor Imaging","authors":"Philippe Sèbe, Olivier Traxer, François Haab","doi":"10.1016/S1570-9124(03)00041-2","DOIUrl":"10.1016/S1570-9124(03)00041-2","url":null,"abstract":"<div><p>The purpose of this paper is to describe the current modalities of pelvic floor imaging: pelvic floor and endoanal ultrasonography, cystourethrography, evacuation proctography, dynamic colpocystoproctography, magnetic resonance imaging and endoanal magnetic resonance imaging.</p><p>As there are no set standards for prescribing imaging tests in pelvic floor disorders, we drew up a table of tests to be performed according to the anatomical abnormality observed on physical examination or functional sign reported by the patient.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 3","pages":"Pages 128-134"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00041-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88065633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-09-01Epub Date: 2003-08-12DOI: 10.1016/S1570-9124(03)00039-4
Jennifer R Berman, Laura A Berman, Kym A Kanaly
{"title":"Female Sexual Dysfunction: New Perspectives on Anatomy, Physiology, Evaluation and Treatment","authors":"Jennifer R Berman, Laura A Berman, Kym A Kanaly","doi":"10.1016/S1570-9124(03)00039-4","DOIUrl":"10.1016/S1570-9124(03)00039-4","url":null,"abstract":"<div><p>Female sexual dysfunction is age-related, progressive and highly prevalent, affecting 30–50% of American women. While there are emotional and relational elements to sexual function, it has become increasingly evident that female sexual dysfunction can occur secondary to medical problems and has an organic basis. A plethora of different female sexual dysfunctions exist and in order to obtain a greater understanding of the possible treatments for these problems, it is essential to have a strong knowledge base of female pelvic anatomy, the neurogenic mediators of female sexual response, the impact of hormones on female sexual function and the etiologies of female sexual dysfunction. Currently, there are potential therapeutic options for the treatment of female sexual dysfunction and these options include both hormonal and pharmacological therapy. However, therapeutic agents may not prove to be enough and the ideal approach to female sexual dysfunction is thus a collaborative effort between therapists and physicians, which should include a complete medical and psychosocial evaluation, as well as inclusion of the partner or spouse in the evaluation and treatment process.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 3","pages":"Pages 166-177"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00039-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73952383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-09-01Epub Date: 2003-08-25DOI: 10.1016/S1570-9124(03)00040-0
C.R. Chapple
{"title":"Urethral Diverticula, Urethro-Vaginal Fistulae, Vesico-Vaginal Fistulae","authors":"C.R. Chapple","doi":"10.1016/S1570-9124(03)00040-0","DOIUrl":"10.1016/S1570-9124(03)00040-0","url":null,"abstract":"<div><p>This review considers the management of urethral diverticula, urethro-vaginal fistulae, and vesico-vaginal fistulae. The aim of this is to provide the reader with an overview of the current management of these pathologies, with reference to pertinent literature.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 3","pages":"Pages 178-185"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00040-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73828576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-09-01Epub Date: 2003-08-05DOI: 10.1016/S1570-9124(03)00036-9
Gina Defreitas, Philippe Zimmern
{"title":"The Role of Urodynamics in Women with Stress Urinary Incontinence","authors":"Gina Defreitas, Philippe Zimmern","doi":"10.1016/S1570-9124(03)00036-9","DOIUrl":"10.1016/S1570-9124(03)00036-9","url":null,"abstract":"<div><p><strong><em>Objective:</em></strong> To examine the role of urodynamic (UDS) investigations in women with stress urinary incontinence (SUI).</p><p><strong><em>Methods:</em></strong> Emphasis will be placed on indications for UDS assessment as well as UDS techniques and findings which apply to women with this condition. Topics such as female bladder outlet obstruction (BOO), the utility of urethral pressure (<em>P</em><sub>ure</sub>) and valsalva leak point pressure (VLPP) measurements, and the prognostic value of UDS in this patient population will also be explored.</p><p><strong><em>Results:</em></strong> Noninvasive uroflowmetry (NIF), post-void residual (PVR) measurement, filling cystometrogram (CMG), valsalva leak point pressure (VLPP) and pressure-flow studies (PFS) can provide the urologist with a wealth of information which may be used to refine treatment decisions in complex cases of female urinary incontinence. The utility of <em>P</em><sub>ure</sub> measurements in the pre- and postoperative work-up of stress incontinent women does not appear to be supported by the majority of urologic and urogynecologic studies to date.</p><p><strong><em>Conclusion:</em></strong> Prospective randomized controlled trials to evaluate the clinical efficacy, cost-effectiveness and effect on quality of life of a full pre-operative UDS assessment compared to a less invasive, more accessible basic office evaluation in different populations of women with SUI need to be conducted before any firm conclusion can be drawn regarding the superiority of one of these clinical approaches over the other.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 3","pages":"Pages 135-144"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00036-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77916473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-06-01Epub Date: 2003-05-31DOI: 10.1016/S1570-9124(03)00022-9
Martina Tinzl, Michael Marberger
{"title":"Urinary Markers for Detecting Bladder Cancer","authors":"Martina Tinzl, Michael Marberger","doi":"10.1016/S1570-9124(03)00022-9","DOIUrl":"10.1016/S1570-9124(03)00022-9","url":null,"abstract":"<div><p>Cystoscopy and urinary cytology have been the cornerstone of superficial bladder cancer diagnosis and monitoring for decades. Replacing cystoscopies by simple urinary markers is an ideal scenario, but until now, despite extensive investigations, very few tests meet the standards in terms of sensitivity and specificity for replacing the combination cystoscopy + cytology.</p><p>The present article reviews the place and effectiveness of both cell-bound and urine-bound tests in the diagnosis and follow-up of bladder cancer. None of the currently available urinary markers can replace cystoscopy at present but these tests might be useful for follow-up of bladder tumor patients.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 2","pages":"Pages 64-70"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00022-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77834007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-06-01Epub Date: 2003-05-31DOI: 10.1016/S1570-9124(03)00019-9
Cora N Sternberg
{"title":"Metastatic Bladder Cancer: Role of Chemotherapy and New Agents","authors":"Cora N Sternberg","doi":"10.1016/S1570-9124(03)00019-9","DOIUrl":"10.1016/S1570-9124(03)00019-9","url":null,"abstract":"<div><p>The M-VAC chemotherapy regimen has been widely used in locally advanced as well as in metastatic disease. Since only a proportion of patients with advanced disease will survive, there is a dire need to identify patients who will respond to chemotherapy and to identify new agents, targets and strategies to improve treatment outcome. Approaches to the management of advanced urothelial cancer include: intensifying the dose intensity, doublet and triplet combination chemotherapy, sequential regimens, reducing toxicity in unfit or elderly patients, and the use of biologic targeted therapies and promising new chemotherapeutic agents. These include MTA, the epothilones, topoisomerase inhibitors and vinflunine which act upon folate metabolism or upon different phases of the cell cycle. New agents that are coming into clinical trials include farnesyl transferase inhibitors, several growth factors receptor inhibitors, anti-sense therapy and COX-2 inhibitors. Significant progress has been made in understanding the molecular biology of cancer. Numerous novel agents, many of which are in clinical trials, have been developed to target various processes of tumor progression. The rationale behind application of these molecularly targeted therapies is to overcome resistance to cytotoxic therapies. Bladder cancer represents a unique model for targeted therapy. As our understanding increases, integration of newer biologic agents will condition future trials, and our ability to target bladder and urothelial cancers will be enhanced.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 2","pages":"Pages 108-117"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00019-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86605667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-06-01Epub Date: 2003-05-29DOI: 10.1016/S1570-9124(03)00023-0
Rodolfo Montironi, Roberta Mazzucchelli
{"title":"Preneoplastic Lesions and Conditions of the Urinary Bladder","authors":"Rodolfo Montironi, Roberta Mazzucchelli","doi":"10.1016/S1570-9124(03)00023-0","DOIUrl":"10.1016/S1570-9124(03)00023-0","url":null,"abstract":"<div><p><strong><em>Background and Methods:</em></strong> Early clinical observations regarding the biology of the “at risk” field suggested that sites of urothelial preneoplastic changes could follow several distinct clinical courses. It is possible that areas of dysplasia remain simply dysplastic. Alternatively, the urinary epithelium can progress either to superficial bladder neoplasms, characterized by recurrence but rare life threatening progression, or along the path towards invasion with its well recognised risk of mortality. Evidence in support of these disparate pathways comes from the low progression rate of the majority of superficial bladder tumours, coupled with that fact that many invasive neoplasms present as such initially.</p><p><strong><em>Results and Discussion:</em></strong> From the morphological point of view, two basic pathways are identified on the basis of the pattern of growth of the intraepithelial lesions (flat and papillary), the behaviour of these lesions being related to the degree of architectural and cytological alteration of the urothelium. Several classification and grading schemes (including revisions and refinements) of the urothelial non-invasive or intraepithelial lesions have been reported in the literature. However, some controversies on the precise criteria and terminology, especially when the papillary lesions are concerned, are still present.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 2","pages":"Pages 53-63"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00023-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80578401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-06-01Epub Date: 2003-05-27DOI: 10.1016/S1570-9124(03)00020-5
A.G van der Heijden, J.A Witjes
{"title":"Intravesical Chemotherapy: An Update—New Trends and Perspectives","authors":"A.G van der Heijden, J.A Witjes","doi":"10.1016/S1570-9124(03)00020-5","DOIUrl":"10.1016/S1570-9124(03)00020-5","url":null,"abstract":"<div><p>More than 90% of all malignant bladder tumours are transitional cell carcinomas (TCC). Superficial TCC of the bladder is characterized by a high risk of recurrence (30–85%) after transurethral resection (TUR) of the initial tumour. Despite this high risk of recurrence, the 5-year survival rate is 85% to 90%. Unfortunately 10% to 30% of the superficial tumours will progress to a muscle invasive tumour, which has a poorer prognosis. The greatest concern in patients with superficial TCC is therefore twofold: to lower the number of recurrences and to prevent progression.</p><p>In an attempt to prevent or delay tumour recurrence or progression, adjuvant therapy after TUR has become common practice. The different chemotherapeutical modalities currently used and investigated for the treatment of TCC of the bladder are reviewed, starting with the first drug shown to be effective for treatment of superficial bladder cancer and chronologically leading to the latest treatment options.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 2","pages":"Pages 71-79"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00020-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86246826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EAU Update SeriesPub Date : 2003-06-01Epub Date: 2003-06-04DOI: 10.1016/S1570-9124(03)00018-7
Arnulf Stenzl
{"title":"Current Concepts for Urinary Diversion in Women","authors":"Arnulf Stenzl","doi":"10.1016/S1570-9124(03)00018-7","DOIUrl":"10.1016/S1570-9124(03)00018-7","url":null,"abstract":"<div><p>Intestinal continent diversions in women, although widely used in males, have been the subject of recent refinements. Potential associated problems are related to the functional aspects of these diversions and the possibility of secondary urethral tumors.</p><p>The present paper reviews the basic anatomical components of the urethral sphincter in women and discusses the indication and surgical techniques of this approach in women.</p><p>Postoperative results may be improved by performing a nerve-sparing procedure and by using low-pressure reservoirs.</p></div>","PeriodicalId":100385,"journal":{"name":"EAU Update Series","volume":"1 2","pages":"Pages 91-99"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1570-9124(03)00018-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78900133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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