Impact of urinary incontinence on anxiety status during pregnancy: A prospective case-control study.

OBJECTIVES: To evaluate the impact of the presence and severity of urinary incontinence (UI) on pregnancy-related anxiety. STUDY DESIGN: This prospective case-control study included 160 pregnant women. Pregnant women with UI (n = 80) were compared with continent pregnant women (n = 80; control group) in terms of scores on the Incontinence Consultation Questionnaire-Short Form (ICIQ-SF) and the Pregnancy-related Anxiety Questionnaire-Revised 2 (PRAQ-R2) scale. Gynaecological examination was performed, and pelvic organ prolapse was diagnosed using the Pelvic Organ Prolapse Quantification system. UI was classified as stress UI (SUI), urge UI (UUI) or mixed UI (MUI). RESULTS: The total PRAQ-R2 score was significantly higher in all pregnant women with UI, as well as the UI subgroups, compared with the control group [mean ± standard deviation; 21.77 ± 8.1 (UI), 19.39 ± 6 (SUI), 20.13 ± 7.2 (UUI) and 28.1 ± 9.5 (MUI) vs 15.76 ± 5.9 (control group); p < 0.0001, p = 0.002, p = 0.012 and p < 0.0001, respectively). Significant positive correlation was found between the total ICIQ-SF and total PRAQ-R2 scores (r = 0.533; p < 0.0001). The score for the fear of giving birth domain in PRAQ-R2 was higher in women with SUI and MUI compared with the control group (9.5 ± 4 and 11.1 ± 2.6 vs 5.43 ± 2.4; p < 0.0001). Concern about own appearance was greater in the UUI and MUI groups compared with the control group (9.68 ± 4.5 and 7.8 ± 3.1 vs 4.85 ± 2.3; p < 0.0001). CONCLUSION: To the authors' knowledge, this is the first study to report the impact of the presence and severity of UI on pregnancy-related anxiety. The current findings show that anxiety may be an important psychosocial consequence of UI in pregnancy. This may lead to a clinical approach focusing on both the physical and psychological well-being of pregnant women with UI.

The effect of intraurethral hyaluronic acid on healing and fibrosis in rats with experimentally induced urethral trauma.

PURPOSE: To assess the efficacy of hyaluronic acid (HA) application after urethral trauma for preventing spongiofibrosis and inflammation in the early period. METHODS: A total of twenty-four rats were divided into 3 groups, with 8 rats in each. The urethra was traumatized with a 24 G needle sheath in all rats. Group 1 of rats were applied 0.9% saline solution twice a day, Group 2 were applied 0.9% saline solution and sodium HA 1% once a day, Group 3 were applied 1.0% HA twice a day. After 21 days, penectomy was performed in all rats. Inflammation, spongiofibrosis, hyperemia and edema in the urethra were investigated for each group. RESULTS: Histopathologic analysis revealed less fibrosis in both group 2 and group 3 compared to Group 1 (p = 0.004). There were no statistically significant differences among the groups in terms of inflammation, hyperemia, edema and congestion (p = 0.563, p = 0.069, p = 0.069, p = 0.068, respectively). Severe fibrosis was observed in 6 (75%) rats in Group 1, and in none of the rats of Group 2 or Group 3. With respect to spongiofibrosis compared to the control group, both Group 2 and Group 3 have statistically significant differences (p = 0.004). Moderate spongiofibrosis was observed in 5 (62.5%) rats in Group 2 and in 3 (37.5%) rats in Group 3. Statistically, there were no significant differences in respect of severity between Group 2 and Group 3 (p = 0.014). CONCLUSION: Intraurethral HA application after urethral trauma can decrease spongiofibrosis.

Efficacy of Obturator Nerve Block During Transurethral Resection on Non-muscle invasive Intermediate and High Risk Lateral Wall Bladder Tumours: A Prospective Randomized Controlled Study.

PURPOSE: We aimed to investigate the effects of obturator nerve block (ONB) on obturator reflex, incomplete resection, perforation, progression and recurrence of tumor, presence of muscle tissue in the specimen, need for a second transurethral resection (TURBT) of bladder tumors, and postoperative complications in patients who underwent TURBT for intermediate-high risk lateral wall non-muscle invasive bladder cancers (NMIBC). MATERIAL AND METHODS: Patients were assigned to one of two groups by drawing lots: ONB or none ONB. Early and late recurrence, tumor progression, obturator reflex beat, incomplete resection, perforation, presence of muscle layer in pathology, second TURBT application, operation time, postoperative hospital stay, and complications were compared between the two groups. RESULTS: The median follow-up time of the study was32 (23-41) months. Interquartile range (IQR) was 9. Tumor recurrence at the 3rd month cystoscopy controls was observed in 5 (9.8%) patients in the ONB group, while it was observed in 11 (20.8%) patients in the nONB group (p=0.01). Late tumor recurrence was observed in 10 patients (19.6%) in the ONB group, and in 20 patients (37.7%) in the nONB group (p=0.041). The RFS rate at 12th month was 84% in the ONB group, 69% in the nONB group, 79% in the ONB group at 36th month, and 58% in the nONB group at 36 months, the PFS rate was 94% in the ONB group, while it was 85% in the nONB group (p=0.041). CONCLUSION: Our study showed that ONB decrease the early and late recurrence and increase recurrence free survival in patients with intermediate-high risk lateral wall bladder cancer.