The urinary incontinence diagnostic process should include a medical history focused on ailments related to it and their impact on the quality of patient’s life. The lack of proper control over the function of the lower urinary tract creates a lot of troubles for sufferers and prevents them from living an active professional, social, and family life. The patient with a suspicion of urinary incontinence is recommended to record in a voiding diary the number of mictions per day, the volume of urine, and episodes of incontinence. The invasive test called urodynamics is based on cystometry, profilometry, and uroflowmetry. A urodynamic examination performed in patients with incontinence allows for correct diagnosis and proposal of specific surgical or pharmacological treatment.
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The paper presents the physicochemical and structural characteristics as well as the comparison of selected statins. Statins are relatively popular compounds used in modern medicine. They are increasingly often combined with other medications to improve the effectiveness of therapy. We analyzed the characteristics of pravastatin, simvastatin, atorvastatin, pitavastatin, lovastatin, mevastatin, fluvastatin, and rosuvastatin obtained from the PubChem Substance database. On the basis of data related to chemical structure and physicochemical properties, the statins were grouped into more and less similar ones. Statins are not homogeneous in terms of physicochemical properties and structure. Three groups of statins were identified. Mevastatin, lovastatin, and simvastatin are the most similar to each other, while pravastatin shows a slightly lower similarity to them. Pitavastatin and fluvastatin are also highly similar, while atorvastatin and rosuvastatin, because of their properties, are the most different from other statin groups.
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The paper presents an overview of the current studies attempting to determine the genetic background of urinary incontinence (UI) problems. The overview referred to the adaptations of biomedical literature from Medline, life science journals, and online books were searched from the earliest date possible to March 2015. Genetic variability studies (mostly with the use of single nucleotide polymorphism) in the context of UI are discussed. The authors indicate the variability of polymorphic forms of proteins, whose modified function may be related to the observed phenotypic symptoms: UI. The paper includes a discussion of the varied level of gene expression and the issue of defective process of the development of the urinary system in the context of UI disorders. The literature does not present any general, unequivocal description of the relationship between the genetic background and phenotype as UI. It is suggested that the methods of integration of data from various techniques (e.g. high throughputs) in reference to social, demographic, and other data may be the way of the approach used for the effective description of the relationship between genetic background and observed UI.
W referacie opisano koncepcję robota do wspomagania zabiegów chirurgicznych wykonywanych przez naturalne otwory ciała w obrębie miednicy mniejszej oraz wstępne badania zmierzające do opracowania konstrukcji i sterowania. Pierwszym zastosowaniem robota będzie wstrzykiwanie zawiesiny komórek macierzystych do zwieracza cewki moczowej w leczeniu wysiłkowego nietrzymania moczu u kobiet. Do lokalizowania właściwego miejsca podania zawiesiny wykorzystane zostanie obrazowanie multimodalne, integrujące dane z systemu wizyjnego, ultrasonografii oraz profilometrii cewkowej. Zastosowanie robota zwiększy dokładność podawania zawiesiny komórkowej, poprawiając skuteczność zabiegu i skracając czas jego trwania. Przy opracowywaniu robota wykorzystane zostanie w szerokim stopniu wirtualne prototypowanie, uwzględniające modele otoczenia (miednicy mniejszej) oraz systemów obrazowania (systemu wizyjnego i profilometrii cewkowej).
EN
The paper describes the concept of a robot for assisting in surgical procedures performed through pelvic natural orifices, and preliminary research to develop robot construction and control. The first application of the robot will be injection of stem cells suspension into urethral sphincter in the treatment of stress urinary incontinence in women. To locate the proper injection place, multimodal imaging, integrating data from vision system, ultrasound and urethral profilometry, will be used. Use of the robot will increase the accuracy of the administration of the cell : suspension, improving the effectiveness of treatment and shortening its duration. In the robot development, virtual prototyping will be widely used, taking into account models of the environment (pelvic) and imaging systems (vision system and urethral profilometry).
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The aim of the study was to present a case of virtual patient with urinary incontinence (UI), the treatment especially based on the new muscle-derived stem cell (MDSC) procedure. With the use of e-learning systems, the UI patient’s classical follow-up as well as MDSC sphincter injection therapy are shown. The “Virtual Patient” case allowed us to demonstrate the main results and the creation of a robotic system from the MDSC study. In this way, the authors will disseminate the new procedure developed in Collegium Medicum JU in UI patients. The “Virtual Patient” case may help students get involved in this new procedure along the main program.
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Minimally invasive surgery revolutionized operative procedures in the last 20 years. Much of the progress in minimally invasive surgery can be attributed to the development of robot-based systems. The most apparent changes are found in laparoscopy procedures. Procedures in which only small skin incisions are made have revolutionized operating theaters. The learning curve, although long in itself, allows for the development of procedures with reduced perioperative risk (i.e., bleeding, pain) or shorter postoperative period. Convalescence after endoscopy procedures is significantly shorter compared with classic laparotomy. However, certain limitations apply to laparoscopy. Apart from the long learning curve, movements executed with long and rigid tools cannot strictly translate the precision of an operator’s hand. The body position of the surgeon is often forced by the reach of the endoscope instrument. It is related to a significant physical load of personnel, especially during long operating procedures. For this reason, some therapeutic procedures are still executed using the laparotomy approach.
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Study objective: Our purpose was to assess a modification of laparoscopic colpopexy technique. Design: Retrospective case analysis. Setting: University teaching hospital. Patients: A total of 28 patients with stage I, II and III organ prolapse. Interventions: The rectovaginal space was dissected at the superior aspect of the posterior vaginal fascia and a mesh was sutured to this fascia. Measurements and Main Results: 28 patients completed a 36 months follow-up. No recurrences of the vagina vault prolapse was observed. Three cases of abdominal pain at the level of the trocars placing were recorded in a first week after surgery. Two of these were found in the group of LSH and one in the group of a hysterectomy history. There was no significant difference in blood loss, length of hospital stay and surgical or postoperative complications. Conclusion: The modification of laparoscopic colpopexy, although technically challenging, may be learned quickly. It shows rapid improvement in operative time without subjecting the patient to undue risk. Further studies are required to determine the long-term tolerance and outcome of the procedure.
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