Hilgers, Reinhard

[["dc.bibliographiccitation.firstpage","741"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","Neurourology and Urodynamics"],["dc.bibliographiccitation.lastpage","746"],["dc.bibliographiccitation.volume","34"],["dc.contributor.author","Viereck, Volker"],["dc.contributor.author","Kuszka, Andrzej"],["dc.contributor.author","Rautenberg, Oliver"],["dc.contributor.author","Wlazlak, Edyta"],["dc.contributor.author","Surkont, Grzegorz"],["dc.contributor.author","Hilgers, Reinhard"],["dc.contributor.author","Eberhard, Jakob"],["dc.contributor.author","Kociszewski, Jacek"],["dc.date.accessioned","2018-11-07T09:49:53Z"],["dc.date.available","2018-11-07T09:49:53Z"],["dc.date.issued","2015"],["dc.description.abstract","AimDespite a wide array of vaginal tapes to treat stress urinary incontinence (SUI), evidence suggesting that both patient characteristics and tape positioning influence outcomes, and differing tape insertion pathways (retropubic vs. transobturator), it remains unclear if the same incision location is effective for all tapes. The aim of the study was to compare outcomes using two different surgical incision locations when inserting a transobturator vaginal tape (TOT) to treat SUI. MethodsWe compared patient characteristics, tape positioning, and surgical outcomes in 123 women undergoing a TOT procedure who were randomly assigned to have the surgical incision begin at 1/3 of the sonographically-measured urethral length (similar to the traditional retropubic approach) or 1/2 of the urethral length. ResultsIt was feasible to place the tape according to intention in 99.2% of the study cohort. The overall cure rate was higher when the incision site began at 1/2 the urethral length (83.6%) than 1/3 (62.9%) (P=0.01). In the subgroup analyses, only patients with normal urethral mobility had significantly different cure rates (85.7% vs. 55.2%, P=0.02). No significant differences in cure rates were observed between the other mobility categories of the study groupshypermobility was consistently associated with high cure rates and hypomobility with low cure rates. ConclusionsWhen surgically treating SUI with a TOT, incision at the mid-urethra using the 1/2 rule is recommended as it leads to better outcomes for most patients, particularly those with normal urethral mobility. Neurourol. Urodynam. 34:741-746, 2015. (c) 2014 Wiley Periodicals, Inc."],["dc.identifier.doi","10.1002/nau.22658"],["dc.identifier.isi","000362963200007"],["dc.identifier.pmid","25176293"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/35591"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Wiley-blackwell"],["dc.relation.issn","1520-6777"],["dc.relation.issn","0733-2467"],["dc.title","Do different vaginal tapes need different suburethral incisions? The one-half rule"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","485"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","Neurourology and Urodynamics"],["dc.bibliographiccitation.lastpage","490"],["dc.bibliographiccitation.volume","27"],["dc.contributor.author","Kociszewski, Jacek"],["dc.contributor.author","Rautenberg, Oliver"],["dc.contributor.author","Perucchini, Daniele"],["dc.contributor.author","Eberhard, Jakob"],["dc.contributor.author","Geissbuehler, Verena"],["dc.contributor.author","Hilgers, Reinhard"],["dc.contributor.author","Viereck, Volker"],["dc.date.accessioned","2018-11-07T11:20:29Z"],["dc.date.available","2018-11-07T11:20:29Z"],["dc.date.issued","2008"],["dc.description.abstract","Aim: To investigate tension-free vaginal tape (TVT) position and shape using ultrasound (US) and correlate the findings to outcome. Material and Methods: The results of TVT surgery were investigated in 72 women with urodynamic stress urinary incontinence. The main outcome parameters were US tape position in relation to the urethra and dynamic changes in TVT shape at rest and during straining. Results: Sixty-two patients (86%) were continent, 6 (8%) significantly improved, and the operation failed in four cases (6%). The median tape position was at 66% of the urethral length measured by US. The median tape-urethra-lumen distance was 3.8 mm at rest. Tape placement in the upper or lower quarter of the urethra was associated with a higher failure rate. Tapes positioned less than 3 mm from the urethra significantly increased postoperative complications (P < 0.0001). The tape was flat at rest and curved during straining in 44 (61%) patients; 98% (43/44) of these women were continent after surgery. An unchanged tape shape was associated with a poorer outcome (P = 0.00038). Patients with a flat tape at rest and during straining failed in 25% and patients with a permanent curved shape in 10%. Conclusions: TVT position relative to the patient's urethra seems to play a role in treatment outcome. Outcome was best in patients with dynamic change in tape shape during straining and location of the tape at the junction between the lower and middle urethra and at least 3 mm from the urethral lumen."],["dc.identifier.doi","10.1002/nau.20556"],["dc.identifier.isi","000258278500005"],["dc.identifier.pmid","18288705"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/55546"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Wiley-liss"],["dc.relation.issn","0733-2467"],["dc.title","Tape functionality: Sonographic tape characteristics and outcome after TVT incontinence surgery"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","586"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","International Urogynecology Journal"],["dc.bibliographiccitation.lastpage","592"],["dc.bibliographiccitation.volume","17"],["dc.contributor.author","Viereck, Volker"],["dc.contributor.author","Pauer, Hans-Ulrich"],["dc.contributor.author","Hesse, Oda"],["dc.contributor.author","Bader, Werner"],["dc.contributor.author","Tunn, Ralf"],["dc.contributor.author","Lange, Rainer"],["dc.contributor.author","Hilgers, Reinhard"],["dc.contributor.author","Emons, Guenter"],["dc.date.accessioned","2018-11-07T09:01:33Z"],["dc.date.available","2018-11-07T09:01:33Z"],["dc.date.issued","2006"],["dc.description.abstract","The aim of this study was to define the concept of hypermobility of the bladder neck and determine its effects on the cure rate and postoperative complications in patients undergoing colposuspension. In a retrospective study, 310 patients who underwent primary colposuspension for urodynamically proven genuine stress urinary incontinence were assessed by introital ultrasound before surgery and during follow-up for up to 48 months postoperatively. A total of 152 women completed 48 months of follow-up. Mobility of the bladder neck during straining was described as linear dorsocaudal movement (LDM) with LDM > 15 mm being defined as hypermobility. The overall objective cure rate was 90.0% at 6-month follow-up vs 76.8% at 48-month follow-up (Kaplan-Meier estimators). Urge symptoms occurred in 12.6% (39/310) of the women and de novo urge incontinence in 2.3% (7/310). Bladder neck hypermobility was significantly reduced after anti-incontinence surgery, from 67.1% (208/310) before surgery to 5.5% (17/310) immediately after surgery (P < 0.0001). Postoperative hypermobility was associated with a higher recurrence rate. In the hypermobility group, 52.9 and 34.0% of the patients were continent for up to 6 and 48 months, respectively, as opposed to 92.2 and 79.2% in the group without hypermobility (P < 0.0001). Women with postoperative hypermobility had a 3.2-fold higher risk of recurrence within 48 months. Bladder neck hypermobility after surgery was also associated with postoperative voiding difficulty (P=0.0278). Patients in whom hypermobility of the bladder neck diagnosed before surgery persists after colposuspension have a higher risk of recurrence and are more likely to develop postoperative complications than those without this hypermobility."],["dc.identifier.doi","10.1007/s00192-006-0071-4"],["dc.identifier.isi","000241259300009"],["dc.identifier.pmid","16538422"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/24457"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.publisher.place","London"],["dc.relation.issn","0937-3462"],["dc.title","Urethral hypermobility after anti-incontinence surgery - a prognostic indicator?"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1439"],["dc.bibliographiccitation.issue","11"],["dc.bibliographiccitation.journal","International Urogynecology Journal"],["dc.bibliographiccitation.lastpage","1441"],["dc.bibliographiccitation.volume","21"],["dc.contributor.author","Kociszewski, Jacek"],["dc.contributor.author","Rautenbcrg, Oliver"],["dc.contributor.author","Kolben, Sebastian"],["dc.contributor.author","Eberhard, Jakob"],["dc.contributor.author","Hilgers, Reinhard"],["dc.contributor.author","Viereck, Volker"],["dc.date.accessioned","2018-11-07T08:37:34Z"],["dc.date.available","2018-11-07T08:37:34Z"],["dc.date.issued","2010"],["dc.identifier.doi","10.1007/s00192-010-1256-4"],["dc.identifier.isi","000283335300018"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/18567"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.publisher.place","London"],["dc.relation.issn","0937-3462"],["dc.title","Tape functionality: position, change in shape, and outcome after TVT procedure-mid-term results (vol 21, pg 795, 2010)"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","289"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","International Urogynecology Journal"],["dc.bibliographiccitation.lastpage","294"],["dc.bibliographiccitation.volume","18"],["dc.contributor.author","Harms, Lena"],["dc.contributor.author","Emons, Guenther"],["dc.contributor.author","Bader, Werner"],["dc.contributor.author","Lange, Rainer"],["dc.contributor.author","Hilgers, Reinhard"],["dc.contributor.author","Viereck, Volker"],["dc.date.accessioned","2018-11-07T11:04:31Z"],["dc.date.available","2018-11-07T11:04:31Z"],["dc.date.issued","2007"],["dc.description.abstract","Does the presence of pre- and postoperative funneling of the proximal urethra affect the outcome of tension-free vaginal tape (TVT)? This prospective study of 191 women with proven primary genuine stress urinary incontinence treated by TVT insertion and assessed by pre- and postoperative introital ultrasound aims to answer that question. At 36-month follow-up, the cure rate was 89.5% (Kaplan-Meier estimator). At 6-month follow-up, 6.3% of the women had urge symptoms and 0.5% de novo urge incontinence. The cure rate in preoperative funneling was 77.5% as opposed to 96.6% in the group without funneling (P < 0.0001). The funneling rate significantly decreased from 37.2% preoperatively to 17.3% immediately postoperatively (P < 0.0001). The continence rate was 57.5% in persistent postoperative funneling vs 96.2% in the group without postoperative funneling (P < 0.0001). The complication rate was not higher in the group with persistent postoperative funneling. The TVT procedure significantly reduces bladder neck funneling. Both preoperative and persistent postoperative funneling are associated with an increased probability of therapeutic failure or recurrence."],["dc.identifier.doi","10.1007/s00192-006-0147-1"],["dc.identifier.isi","000243970700011"],["dc.identifier.pmid","16847585"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/51860"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.publisher.place","London"],["dc.relation.issn","0937-3462"],["dc.title","Funneling before and after anti-incontinence surgery - a prognostic indicator? Part 2: tension-free vaginal tape"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","795"],["dc.bibliographiccitation.issue","7"],["dc.bibliographiccitation.journal","International Urogynecology Journal"],["dc.bibliographiccitation.lastpage","800"],["dc.bibliographiccitation.volume","21"],["dc.contributor.author","Kociszewski, Jacek"],["dc.contributor.author","Rautenberg, Oliver"],["dc.contributor.author","Kolben, Sebastian"],["dc.contributor.author","Eberhard, Jakob"],["dc.contributor.author","Hilgers, Reinhard"],["dc.contributor.author","Viereck, Volker"],["dc.date.accessioned","2018-11-07T08:41:45Z"],["dc.date.available","2018-11-07T08:41:45Z"],["dc.date.issued","2010"],["dc.description.abstract","This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape-urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape-urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success."],["dc.identifier.doi","10.1007/s00192-010-1119-z"],["dc.identifier.isi","000278094200007"],["dc.identifier.pmid","20204326"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/4233"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/19537"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.publisher.place","London"],["dc.relation.issn","0937-3462"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Tape functionality: position, change in shape, and outcome after TVT procedure-mid-term results"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]