[Predictive factors of immediate post-operative acute urinary retention or voiding dysfunction following mid-urethral sling surgery: A literature review]. / Facteurs prédictifs de rétention aiguë d'urine ou de dysurie en postopératoire immédiat après pose de bandelette sous urétrale : revue de la littérature.

OBJECTIVE: Immediate postoperative urinary retention (UR) and voiding dysfunction (VD) are some factors limiting outpatient procedure for mid-urethral sling (MUS) surgery in women presenting with stress urinary incontinence. The objective of the current review was to report the main predictive factors associated with immediate postoperative UR/VD following MUS surgery in women. METHODS: A systematic review was performed using Medline database, according to PRISMA methodology, using following keywords midurethral sling; tension-free vaginal tape; TVT; transobturator tape; TOT; predicting factor; voiding dysfunction; urinary retention; postvoid residual; postoperative residue of urine. RESULTS: Thirteen studies were included. Main clinical predictive factors associated with immediate postoperative urinary retention (UR) and voiding dysfunction (VD) were: previous pelvic surgery (hysterectomy, incontinence or pelvic organ prolapse surgery) [OR: from 3.7 ((CI95%: 1.14-12.33); P=0.029)] to 8.93 [(CI95%:1.17-61.1); P=0.035)], previous UR [OR: 415 (CI95%: 20-8619); P<0.001], age over 65 y/o [OR: 3,72 (CI95%:1.40-9.9); P<0.01], and general anesthesia [OR: 4.5 (CI95%:1.1-18.9); P=0.02]. Urodynamic predictive factors were underactive bladder at cystometry [OR: from 2.52 ([CI95%: 1.03-6.13]; P=0.042) to 5.6 ([IC95%: 1.6-19.2]; P=0.02] and preoperative maximum flow rate (Qmax) (the prevalence of UR was ranging from 12 to 35% when Qmax was under 15ml/s, versus 0% when Qmax was over 30ml/s). CONCLUSION: Predictive factors associated with immediate postoperative UR/VD following MUS surgery in women were age over 65 y/o, previous pelvic surgery or previous UR, underactive bladder and preoperative Qmax under 15ml/s.

[Lower urinary tracts symptoms after female genital mutilation: A review]. / Troubles fonctionnels du bas appareil urinaire après mutilation sexuelle féminine : revue de la littérature.

INTRODUCTION: The purpose of this article is to summarise the data available in literature on Lower Urinary Tract Symptoms [lower urinary tract symptoms (LUTS)] after female genital mutilation (MSF). METHODS: Our review identified 177 publications, 14 of which were included in the article. RESULTS: With regard to short-term complications, the prevalence of Acute Urinary Retention (RAU) after MSF is estimated between 3% and 12%. With respect to long-term complications, the data is discordant on repeat urinary tract infections (IUR) after MSF with an estimated prevalence between 9% and 39%. The prevalence of LUTS is significantly increased among women having suffered MSF. For example, mixed urinary incontinence is significantly higher in the MSF group with OR 5.17 CI 95% (2.34-12.97). And the more important the MSF is, the higher the LUTS prevalence is. Medical and surgical treatments are empirical and not evaluated. CONCLUSION: Further studies are needed to better characterize and evaluate the prevalence of LUTS after MSF as well as the interest and efficiency of different therapeutics.

Laser procedure for female urinary stress incontinence: A review of the literature.

INTRODUCTION: There is increasing interest in noninvasive treatment of female stress urinary incontinence (SUI), including a vaginal laser procedure. In view of a lack of data on this technique, we conducted a non-systematic review of the literature. METHODS: We reviewed studies concerning the laser treatment of SUI from PubMed, Medline, the Cochrane Library and Web of Science. Study design, outcome measure, number of participants, procedural complications and results were analyzed. RESULTS: The use of laser treatment of female SUI has been described in 7 prospective, single-center and non-comparative (no control group) studies, all of which used an erbium YAG or a CO2 laser in thermal non-ablative treatment. Primary outcome was ICIQ-UI-SF score in six studies, and pad tests in one study. Follow-up ranged from 5 to 36months. Improvement rates ranged from 62% to 78%. No major adverse events were noted. Minor side effects included sensation of warmth, increased vaginal discharge and transient urge urinary incontinence. CONCLUSION: The efficacy of vaginal laser treatment of SUI has not been assessed in comparative studies. More rigorous and adequately powered trials are required to assess the relative benefits and adverse event profile of laser treatment of SUI, as compared with other minimally invasive procedures.

[Predictive and prognostic factors of preeclampsia: Interest of PlGF and sFLT-1]. / Facteurs prédictifs et pronostiques de la prééclampsie : intérêt du dosage du PlGF et du sFLT-1.

Preeclampsia is characterized by the association of hypertension and a de novo proteinuria in the second half of pregnancy. Currently, obstetrical teams do not have any tool to detect during the first trimester of pregnancy, in low risk population, the patients likely to develop early and severe preeclampsia. On the other hand, there is no diagnostic/prognostic tool in case of strong suspicion of preeclampsia. The Placental Growth Factor (PIGF) and soluble receptor of the Vascular Endothelial Growth Factor (sFlt-1) are respectively two molecules pro- and anti-angiogenic released mainly by the placenta during pregnancy. Numerous experimental and clinical results suggest that an imbalance of pro/anti-angiogenic factors is involved in the pathophysiology of preeclampsia. We selected and analyzed the main studies that have evaluated the predictive, diagnostic and prognostic value of these two biomarkers for preeclampsia.

[Postpartum pelvic floor muscle training and abdominal rehabilitation: Guidelines]. / Rééducation périnéale et abdominale dans le post-partum: recommandations.

OBJECTIVE: Provide guidelines for clinical practice concerning postpartum rehabilitation. METHODS: Systematically review of the literature concerning postpartum pelvic floor muscle training and abdominal rehabilitation. RESULTS: Pelvic-floor rehabilitation using pelvic floor muscle contraction exercises is recommended to treat persistent urinary incontinence at 3 months postpartum (grade A), regardless of the type of incontinence. At least 3 guided sessions with a therapist is recommended, associated with pelvic floor muscle exercises at home. This postpartum rehabilitation improves short-term urinary incontinence (1 year) but not long-term (6-12 years). Early pelvic-floor rehabilitation (within 2 months following childbirth) is not recommended (grade C). Postpartum pelvic-floor rehabilitation in women presenting with anal incontinence, is associated with a lower prevalence of anal incontinence symptoms in short-term (1 year) (EL3) but not long-term (6 and 12) (EL3). Postpartum pelvic-floor rehabilitation is recommended to treat anal incontinence (grade C) but results are not maintained in medium or long term. No randomized trials have evaluated the pelvic-floor rehabilitation in asymptomatic women in order to prevent urinary or anal incontinence in medium or long term. It is therefore not recommended (expert consensus). Rehabilitation supervised by a therapist (physiotherapist or midwife) is not associated with better results than simple advice for voluntary contraction of the pelvic floor muscles to prevent/correct, in short term (6 months), a persistent prolapse 6 weeks postpartum (EL2), whether or not with a levator ani avulsion (EL3). Postpartum pelvic-floor rehabilitation is not associated with a decrease in the prevalence of dyspareunia at 1-year follow-up (EL3). Postpartum pelvic-floor rehabilitation guided by a therapist is therefore not recommended to treat or prevent prolapse (grade C) or dyspareunia (grade C). No randomized trials have evaluated the effect of pelvic floor muscle training after an episode of postpartum urinary retention or bladder outlet obstruction symptoms, or for the primary prevention of anal incontinence following third-degree anal sphincter tear or in patients presenting with anal incontinence after third-degree anal sphincter tear. The electrostimulation devices used alone were not assessed in this postpartum context (regardless of symptoms); therefore, isolated pelvic floor electrostimulation is not recommended (expert consensus). CONCLUSION: Pelvic floor muscle therapy is recommended for persistent postpartum urinary (grade A) or anal (grade C) incontinence (3 months after delivery).

[Miduretral sling and sexuality: a systematic review]. / Impact des bandelettes sous-urétrales sur la sexualité : revue de la littérature.

PURPOSE: To assess influence of miduretral sling (MUS) on patient's sexuality. METHODS: A comprehensive literature review using Pubmed, Medline, Embase and Cochrane: "stress urinary incontinence", "sexual function", "anti-incontinence surgery", "minimaly invasive slings", "mid-urethral slings", "tension-free vaginal tape", "transobturator vaginal tape". Sixty-nine articles really dealt with the impact of MUS on sexuality. RESULTS: The data were expressed as the median and interquartile range (IQR; 25th-75th percentile). After MUS surgery, 30% (21-37) patients had sexuality improvement, 8.5% (4.7-14) had sexuality impairment and 60% (53-73) didn't report change on their sexuality. CONCLUSION: MUS surgery didn't seem to impair significantly patient's sexuality.

[Appraisal of snakebite incidence in Senegal, West Africa]. / Evaluation de l'incidence des morsures de serpent au Sénégal.

Surveys were carried out in four savannah areas of Senegal. The studied zones had different climatic, economic and demographic characteristics. Two types of studies were performed: on the one hand, a retrospective survey carried out in health centres and, on the other, household surveys in the corresponding areas; all households were questioned in Niakhar, but only selected households in other areas following WHO method of cluster survey for vaccine coverage. Questions involved the circumstances of the bite, symptoms and treatment. The retrospective survey reported very few cases of snakebites over the prospected period. In addition, two zones of surveys were population study areas under observation since more than 20 years and, it has been possible to check certain information in the data base. In the first zone, Thies, a sub-urban area (population density higher than 150 inhabitants per km2), primarily occupied by fruit plantations (mangos, oranges, lemons) and gardens, the annual incidence of snakebites (i.e. all snakebites including those without any symptoms) reached 43 bites per 100,000 and mortality was 1.8 deaths per 100,000. In the study zone of Niakhar, located in the groundnut culture area of Senegal which is also highly populated (130 inhabitants per km2), the incidence of snakebites was 23 bites per 100,000 and mortality was close to 1.8 deaths per 100,000 a year. The area of Nioro du Rip is a mixed agricultural area (food producing and revenue agriculture) and less populated (100 inhabitants per km2). The annual incidence was roughly of 304 per 100,000 and the mortality 3.6 per 100,000. Finally, the fourth area, Bandafassi in the extreme South-East of Senegal is a mountainous zone exclusively occupied by bush and food producing agriculture, and sparsely populated (20 inhabitants per km2). The incidence was 915 per 100,000 and the mortality 11 deaths per 100,000. The population at risk involved males from 15 to 45 years. Pastoral work (agriculture and breeding) was at the origin of the majority of the accidents. The recourse to traditional practitioners was systematic, which explained why the data from the health centers were not relevant enough to evaluate the importance of the envenoming.