Literature DB >> 29410910

Author's Reply.

Bernhard Liedl1.   

Abstract

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Year:  2017        PMID: 29410910      PMCID: PMC5791416          DOI: 10.5173/ceju.2017.1595

Source DB:  PubMed          Journal:  Cent European J Urol        ISSN: 2080-4806


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We were very pleased to receive endorsements of the main thrust of our paper by authors of the letter to the editor and that of the other authors quoted [1-4], that symptoms of overactive bladder (OAB), urgency, frequency, urgency incontinence, nocturia, are surgically curable in women with pelvic organ prolapse. As Professor Sivaslioglu states, the surgical cure of OAB symptoms flies in the face of statements by major incontinence societies that OAB symptoms in these women are not curable. We hope that our paper and those of the other authors [1-5] will in some way change this seemingly entrenched attitude by the ‘opinion leaders’ of OAB. We are also grateful to Professor Sivaslioglu for drawing attention to the use of ‘simulated operations’: mechanical support of the front or back ligaments of the vagina lessens the feeling of urgency by the patient. In our view, this is the ultimate proof of the Integral Theory which underlies these ‘simulated operations’. Mechanically supporting the ligament restores the bi-directional stretching of the vagina by the muscle vectors. This supports the bladder stretch receptors and reverses the afferent inflow of impulses, which are interpreted by the cortex as urgency. The tissue fixaton system (TFS) which we used permanently, restores this support mechanism. Longer-term data confirms the OAB cure in women with pelvic organ prolapse at 4 years [5]. In both additional letters, Peter Petros and Rotem Reut, Weintraub AY emphasized that shortening and reinforcing the loose pelvic floor ligaments can cure not only bladder dysfunctions and pelvic organ prolapse, but also bowel dysfunctions and pelvic pain. The mechanics of these dysfunctions have been detected in the last few decades. It is time to recognize and accept that symptoms of urgency, urinary frequency, urgency incontinence, nocturia and other symptoms can be induced by pelvic organ prolapse, by which reconstruction of the latter can cure these symptoms.
  2 in total

Review 1.  Current treatment of pelvic organ prolapse correlated with chronic pelvic pain, bladder and bowel dysfunction.

Authors:  Bernhard Liedl; Klaus Goeschen; Leopold Durner
Journal:  Curr Opin Urol       Date:  2017-05       Impact factor: 2.309

2.  Posterior intra-vaginal slingplasty for the treatment of vaginal apex prolapse: Medium-term results of 140 operations with a novel procedure.

Authors:  M Neuman; Y Lavy
Journal:  Eur J Obstet Gynecol Reprod Biol       Date:  2007-01-30       Impact factor: 2.435

  2 in total

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