Submitted by Emanuel Varela Cardoso (emanuel.varela@ufcg.edu.br) on 2018-06-14T20:51:37Z No. of bitstreams: 1 CARMEM LÚCIA CAVALCANTI COUTINHO – DISSERTAÇÃO (PPG-CEMat) 2015.pdf: 1178536 bytes, checksum: 7b4bc6d75aa15e3438cedfa584239124 (MD5) / Made available in DSpace on 2018-06-14T20:51:37Z (GMT). No. of bitstreams: 1 CARMEM LÚCIA CAVALCANTI COUTINHO – DISSERTAÇÃO (PPG-CEMat) 2015.pdf: 1178536 bytes, checksum: 7b4bc6d75aa15e3438cedfa584239124 (MD5) Previous issue date: 2015-07-09 / A técnica sling pela via transobturadora é eficaz para o tratamento de mulheres com Incontinência Urinária de Esforço e apresenta elevada taxa de cura e melhora da qualidade de vida com baixos índices de complicações. Este trabalho teve como objetivo desenvolver e confeccionar, uma tela de policaprolactona, para uso na técnica de Sling e realizar análises comparativas deste material com a tela de polipropileno, utilizada comercialmente. A pesquisa foi desenvolvida no Laboratório de Avaliação e Desenvolvimento de Biomateriais do Nordeste – CERTBIO. Utilizouse duas amostras de tela, uma confeccionada no CERTBIO e outra de uso comercial. Foram avaliadas as composições químicas e físicas das telas de Policaprolactona (PCL) e Polipropile no (PP), através das técnicas de: Espectroscopia na Região de Infravermelho com Transformada de Fourier (FTIR), Difração de Raios X (DRX) e Microscopia Eletrônica de Varredura (MEV), Tensão superficial, Ensaios Mecânicos de Tração e Teste de Citotoxicidade. Pode-se comprovar pela análise de FTIR, que o material formador das telas era apenas de polipropileno e policaprolactona. A análise de DRX corroborou com os resultados obtidos na análise de FTIR, que indicavam que o material das telas tratava de PP e PCL, apresentando um espectograma característico d estes polímeros. Também, através da análise de DRX, foi possível observar o grau de cristalinidade indicando o PP que possui maior grau de cristalinidade que o PCL. Pode-se comprovar também, que o PP possui maior resistência mecânica que o PCL, verificando assim que o PP é mais frágil e quebradiço do que o PCL. A análise de tensão superficial mostrou que as duas telas possuem molhabilidade parcial devido as cavidade presentes na superfície das telas. A biocompatibilidade dos compostos foi confirmada com o teste de Citotoxicidade. / The sling technique by transobturator approach is effective for the treatment of women with Stress Urinary Incontinence and has a high cure rate and improved quality of life with low complication rates. This work aimed to develop and produce, polycaprolactone, screen for use in Sling surgery and to perform comparative analyses of this material with a polypropylene bladder, used commercially. The survey was developed in the laboratory of evaluation and development of Biomaterials in the Northeast-CERTBIO. Two samples were used to screen; a made in the laboratory and another used commercially. Been evaluated physical and chemical compositions of the Polycaprolactone (PCL) and Polypropylene (PP) screens, through the following techniques: infrared Spectroscopy in the region with a Fourier transform (FTIR), x-ray Diffraction (XRD) and scanning electron microscopy (SEM), surface tension, traction mechanical essays and Cytotoxicity test. You can check by the FTIR analysis, that the trainer material of fabrics was just poliproplieno and polycaprolactone, for examining the computer spectrogram. The XRD analysis corroborated with the results obtained in the FTIR analysis, which indicated that the material was PP screens and PCL, showing a characteristic you might like to look of these polymers. Also, through the analysis of DRX, it was possible to o bserve the degree of crystallinity indicating the PP has higher degree of crystallinity the PCL. One can prove that the PP has higher mechanical strength than the PCL, checking so that the PP is more brittle than the PCL. The analysis of surface tension showed that both screens have partial wettability due to cavity present on the surface of the canvas. The biocompatibility of the compounds has been confirmed with the Cytotoxicity test and it showed low cytotoxicity in two screens.

(1) Background: This study examined outcomes of second-line ATOMS implantation after failure of the fixed male sling (FMS) AdVance/AdVance XP. (2) Methods: A retrospective multicenter cohort analysis was carried out in men implanted with an ATOMS between 2011 and 2020 after failure of an AdVance/AdVance XP. Success was assessed on the basis of objective (dryness, 0–1 pad/24 h or >20 g/24 h pad test) and subjective results (PGI-I). We performed the Wilcoxon rank sum test, Fisher’s exact test, logistic regression, and multivariate analysis. (3) Results: The study included 88 patients from 9 centers with a mean age of 71.3 years. No Clavien–Dindo > II complications occurred within the first 3 months after ATOMS implantation. A total of 10 cases (9%) required revision in the ensuing clinical course. After a mean follow-up of 42.5 months, 76.1% achieved social continence, and 56.8% used no pads at all. Mean urine leakage/24 h dropped from 422 g (3.9 pads) to 38 g (0.69 pads) and the mean ICIQ-SF decreased from 16.25 to 5.3 (p < 0.0001). PROMs (patient-reported outcome measures) showed improvement in 98.9% of cases, and 63.6% gave a “very much better” PGI-I rating. Multivariate analysis identified a lower probability of achieving maximum satisfaction for the following factors: the AdVance XP as first-line therapy (OR 0.35), a lower ICIQ-SF question 1 (OR 0.26), status post-irradiation (OR 0.14), and more severe pain prior to ATOMS implantation (OR 0.51). (4) Conclusions: Implantation of an ATOMS is an effective and safe second-line treatment option for recurrent urinary incontinence after implantation of an AdVance/AdVance XP sling. High patient satisfaction was demonstrated in a long-term follow-up.

Knowledge of the course of the pudendal nerve (PN) is important when performing perineal surgery. Distances between landmarks were measured after PN dissections in 71 cadavers and after perineal procedures on 30 cadavers. Separate inferior rectal nerve (IRN) entry and medial position of the PN/IRN with shortened sacrospinous ligaments were often seen in black individuals. A PN block should therefore be placed more proximally and medially. The Richter’s stitch should be placed further from the ischial spine. During ischioanal procedures the IRN is at risk in white females, as it was more superficial. The dorsal nerve of the clitoris/penis (DNC/DNP) is in danger during the outside-in procedures in white or obese individuals, as it was closer to the inferior pubic ramus. The dorsal penile nerve block should be administered deeper in white and obese individuals, as the DNP was deeper. The above-mentioned findings should be verified in a clinical setting. / Dissertation (MSc)--University of Pretoria, 2013. / gm2014 / Anatomy / Unrestricted

Title: Quality of life of women with urinary stress incontinence Objectives: The aim of this thesis was to assess quality of life of women after conservative therapy and chirurgic therapy of urinary stress incontinence in Brno-město and Brno- venkov district. Methods: We did a questionnaire survey on quality of life by using a standardized questionnaire I-QoL (Urinary Incontinence Quality-of-life questionnaire). The questionnaire survey was conducted in patients after conservative or surgical therapy by TVT or TOT tape. Subjectively perceived quality of life of these patients after completion of the therapy was observed. The results were compared between the groups undergoing conservative and surgical therapy by TVT or TOT tape. Results: After the output assessment of quality of life of patients after the treatment, we found that there is a difference in the quality of life of patients treated conservatively and surgically by TVT or TOT tape. Patients treated surgically had higher quality of life than patients treated conservatively by 9%. We also found that there is a difference in the physical, mental and social scores of the groups. The respondents who were treated conservatively had lower score in all evaluated areas with the greatest difference in the physical area and the smallest difference...