Biomedical subjects

F Bruyere

Publications and source records attributed to F Bruyere.

5 recordsLinked to original sources

PubMed2002

Prevalence and risk factors of urinary incontinence in young and middle-aged women.

Objective To assess the prevalence of and risk factors for urinary incontinence (UI) in young and middle-aged women. Subjects and methods During 1998 the prevalence of overall, stress, urge and mixed UI was assessed in women working in a French academic hospital. Women (2800) received a questionnaire at the same time as their yearly interview with a staff physician in occupational medicine. The usual risk factors for constitutional events, i.e. increasing age, obesity (defined as a body mass index of > or = 25), obstetric events (pregnancy, previous Caesarean delivery, previous vaginal delivery, postpartum incontinence) and gynaecological events (hysterectomy) were evaluated. Results Of the 1700 women (mean age 40.0 years) who returned the questionnaire, 467 (27.5%, 95% confidence interval, CI, 25.4-29.7) reported UI, comprising 210 (12.4%, 10.8-14.0) with stress UI, 28 (1.6%, 1.1-2.4) with urge UI and 229 (13.5%, 11.9-15.2) with mixed UI. Thirty-eight women (8.1%) had frequent urinary leakage, comprising one (0.5%), four (14.3%) and 33 (14.4%) with stress, urge and mixed UI. The prevalence of UI increased significantly with age > or = 40 years, with a relative risk (95% CI) of 2.16 (1.86-2.57), and with pregnancy (2.22, 1.71-2.87), previous vaginal delivery (2.15, 1.72-2.69), postpartum incontinence (2.57, 2.22-2.97), and hysterectomy (1.52, 1.11-2.08). Obesity (1.14, 0.99-1.32) and previous Caesarean delivery (2.15, 1.72-2.69) did not significantly increase the risk of UI. The risk factors for stress UI were age > or = 40 years, pregnancy, previous vaginal delivery, postpartum incontinence and hysterectomy, but there was no relationship between stress UI and obesity or previous Caesarean delivery. Conclusion There was a high prevalence of UI among young adult and middle-aged women hospital workers who had easy access to medical resources. Gynaecological and obstetric events (pregnancy, particularly previous vaginal delivery and hysterectomy) were the most prominent risk factors, especially for stress UI.

Adult↗

PubMed2001

Intestinal perforation as a complication of tension-free vaginal tape procedure for urinary incontinence.

OBJECTIVES: To report and prevent a serious complication of tension-free vaginal tape (TVT) procedure. CASE REPORT: One day after a TVT procedure, an emergency CT scan showed adhesion of intestinal loops with a pneumoperitoneum. The patient had previously had intra- and retroperitoneal surgery with a sacral cervicopexy and a Burch colposuspension. CONCLUSION: In such a case of previous surgery, a CT scan may be useful before a TVT procedure.

Aged↗

PubMed2001

[Laparoscopic sacral colpopexy: an attractive approach for prolapse repair].

OBJECTIVE: Evaluate laparoscopic sacral colpopexy. MATERIAL AND METHODS: 76 patients operated by laparoscopy between 1993 and 1999. The mean age of the patients was 59 years. 35 patients suffered from stress incontinence. A history of abdominal surgery was never a contraindication to laparoscopy. Hysterectomy was not systematically performed and the type of correction of urinary incontinence varied between suburethral sling, Burch procedure and TVT. The operating time ranged from 100 to 345 minutes with a mean of 199 minutes. Patients were discharged from hospital between the 2nd and the 10th postoperative day (mean: 4.9 days). Nine out of 10 patients operated (89.40%) were discharged before the 6th postoperative day. The results were satisfactory with correction of prolapse in 74 patients (96%). Only one intraoperative complication occurred in our series: a minimal injury of the colon complicated dissection of the posterior floor during resection of the pouch of Douglas. This wound was sutured during the same operating time. One conversion was required following sudden onset of oxygen desaturation during carbon monoxide insufflation. Laparoscopic prolapse surgery is used increasingly frequently and this study confirms that laparoscopic sacral colpopexy is effective, reliable and reproducible.

Adult↗

PubMed1999

[Transperitoneal laparoscopic nephrectomy].

OBJECTIVES: To evaluate the feasibility and complications of transperitoneal laparoscopic nephrectomy. MATERIAL AND METHODS: 30 transperitoneal laparoscopic nephrectomies were performed between November 1992 and October 1998: 17 for malignant lesions (10 renal cell carcinomas, 7 urothelial tumours) and 13 for benign lesions. RESULTS: The operation was performed entirely by laparoscopy in 25 cases, with 4 conversions: 3 for technical problems (difficulties of dissection: 1, haemorrhage: 2). One patient underwent laparotomy on the same day and three patients were transfused. The mean operating time was 116 minutes. No laparoscopy-specific complications were observed. CONCLUSION: A standard technique must be performed regardless of the disease: systematic open laparoscopy, wide colonic dissection, exposure of the vessels and resection in the plane of the radical nephrectomy. The risk of cancer dissemination with laparoscopy appears to be non-existent for renal cell carcinomas and controversial for urothelial tumours. Complications were always benign, although there is always a risk of bleeding, regardless of the operator's experience. The current technical conditions of laparoscopic surgery and its extension to all forms of visceral surgery should encourage the use of this technique by urologists, particularly for renal surgery.

Adult↗

PubMed1999

[Ureteral compression by mesenteric desmoid tumor. Report of 2 cases].

The authors report two cases of abdominal fibromatosis corresponding to Gardner's syndrome, causing hydronephrosis by extrinsic ureteric compression in young men in whom any form of surgical resection would have been in vain. These cases of ureteric compression were treated endoscopically by placement of a double J ureteric stent associated with treatment by tamoxifen in one case and sulindac in the other, with apparent stabilization of the disease. The two patients are regularly followed in the department with ureteric stent replacement two to three times a year.

Adult↗