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O504 TVT and TVT-O: A comparative randomized study of these operative procedures for the treatment of severe urinary stress incontinence
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Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
Conclusion: The MS based metabolomic profiling in combination with MDA allowed urinary steroid levels to be quantified and the metabolomic patterns to be characterized. The present study demonstrates that the described approaches are potentially useful diagnostic tools and provide an effective means of biomarker ‘mining’. O502 Strategic alliances in development assistance for health: Taiwan experience in Africa A. Lai1 , V. Koledoye2 , R. Huang3 . 1 Lee Kuan Yew School of Public Policy, National University of Singapore, 2 Our Lady of Apostles Hospital, Nigeria, 3 Institute of Molecular Cell Biology, Agency for Science, Technology and Research (A*STAR) Objectives: Development assistance for health (DAH) has been increasing in number of funds and in forms of delivery since early 1990s. DAH has played an important role to fulfill its goal of promoting economic development and welfare in the health sector in Africa. Since 1960s, Taiwan has accumulated and disseminated substantial economic development experience that has passed on to Africa. Amidst the developmental work, DAH has been the key task. This study aims to overview and analyze DAH in Africa in terms of skills training and technology transfer supported by Taiwan International Cooperation and Development Fund (Taiwan ICDF). Material and Methods: Four African countries (Burkina Faso, Sao Tome & Principe, Swaziland, and The Gambia) have been selected for our case studies. Ten DAH projects (2 projects in Burkina Faso, 4 projects in Sao Tome & Principe, 2 projects in Swaziland, and 2 projects in The Gambia) have been studied. Analytical time frame is from 1995 to 2008. The framework of alliance life cycle has been adopted. The criteria in the six stages (evaluating, forming, incubating, operating, transitioning, and retiring) are utilized to compare and contrast the potentials and pitfalls of the DAH programs in these four African countries. Among these 10 projects, malaria control project in Sao Tome & Principe is well received and recognized as the most successful projects in DAH, thus this case is served as a benchmark case. The study outlines the research into the nuances of DAH projects and compares them in terms of strategic alliances framework. We aim to find which projects work better in what way by using strategic alliances analysis. We also examine the way in which it has been undertaken. Results: In stretching DAH more for better outcomes, we find among our case studies that multi-faceted medical and health services based on the strategic alliances of mutual manpower allocation and institutional capacity building on the ground is the most important and significant mandate. Strategic alliances perfectly align problem definition and alternatives construction along with the course of case analysis. The study also depicts the historical trajectory of DAH contributed by Taiwan ICDF from holding clinics in partner countries, to projects expanded to the transfer of technology to reinforce the human resources of partner nations, and help them develop and enact sustainable systems for self-reliance in health system. Conclusion: To help African nations embark on the path of economic progress as quickly as possible, we have come up with a better analytical tool, strategic alliances framework, to formulate DAH polices in Africa. To effectively and successfully implement strategic alliances, using alliance life cycle to evaluate a strategy and potential partners on the ground has a great potential in the DAH policy process, especially at the stage of pre-decisional phase. Strategic alliances framework can be used as a form of applied research to acquire a deeper understanding of DAH policy issues in hope to bring out better solutions.
O503 The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China Z. Lan, L. Jinghe. Peking Union Medical College Hospital Objectives: To evaluate the prevalence and associated risk factors of urinary incontinence in Chinese women. Materials and Methods: In the cross-sectional survey, 20,000 Chinese women aged ≥20 years were randomly selected and interviewed with modified Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaires to estimate population prevalence rates and identify potential risk factors. Results 19,024 cases were included in the analysis with 976 excluded, qualified rate 95% (19024/20000). Of the Chinese women aged from 20 to 99 years old, (mean 45±16), the overall prevalence of urinary incontinence (UI) was 30.9%. Estimates of stress urinary incontinence (SUI), urge urinary incontinence (UUI) and mixed urinary incontinence (MUI) prevalence were 18.9%, 2.6% and 9.4%, with a correspanding proportional distribution of 61%, 8% and 31%, respectively. The prevalence of MUI increased with aging, while the prevalence of SUI peaked in 50 years group, and the UUI in 70 years group. Only 25% patients have consulted doctors on this issue. Through multivariable logistic regression analysis, we identified age, vaginal delivery, multiparity, alcohol consumption, central obesity (female waist circumference ≥80 cm), constipation, chronic pelvic pain (CPP), history of respiratory disease, gynecological events, pelvic surgery, peri-menopausal and postmenopausal status as potential risk factors for SUI, among which age, vaginal delivery, multiparity are three major risk factors. Conclusions Our findings suggest that the prevalence of UI is high in China, with SUI as the most common subtype. Age, vaginal delivery and so on are risk factors for SUI. O504 TVT and TVT-O: A comparative randomized study of these operative procedures for the treatment of severe urinary stress incontinence Z. Lan1 , L. Jinghe1 , W. Wenyan1 , W. Felix2 . 1 Peking Union Medical College Hospital, Beijing, P.R of China, 2 University of New South Wales, Sydney, NSW 2170, Australia Objectives: To compare the morbidity and short-term efficacy of the Tension-free vaginal tape (TVT) and Transobturator suburethral tape (TVT-O) procedures in the treatment of severe stress urinary incontinence (SUI). Patients and Methods: A total of 95 women with severe SUI were randomly allocated to undergo the TVT or the TVT-O procedure. Some patients had concomitant vaginal repair or vaginal hysterectomy as concomitant procedures as indicated. Results: The median follow up time was 20 months (range:12–48 months). The outcomes were subjectively assessed. The cure rate was 87.2% in the TVT group and 81.8% in the TVT-O group. Average operative time was significantly shorter in the TVT-O than in the TVT group (20±6 min vs 26±8 min; P < 0.001). No serious intra-operative complications occurred in either group. Both groups reported similar post-operative complications of thigh/groin pain, urinary retention, tape erosion and de novo urinary urgency. Two cases (4.3%) in TVT group were noted of haematoma. Conclusions: Both techniques appear to have low complication rates and equal efficacy in the surgical treatment of severe SUI in a short-term follow-up. O505 Promoting family planning education and training through international exchanges U. Landy, H. Steele, K. Miller. University of California San Francisco Objectives: As part of a two year post-graduate training program in the United States, Fellowship in Family Planning fellows (FPF)
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
Conclusion: The MS based metabolomic profiling in combination with MDA allowed urinary steroid levels to be quantified and the metabolomic patterns to be characterized. The present study demonstrates that the described approaches are potentially useful diagnostic tools and provide an effective means of biomarker ‘mining’. O502 Strategic alliances in development assistance for health: Taiwan experience in Africa A. Lai1 , V. Koledoye2 , R. Huang3 . 1 Lee Kuan Yew School of Public Policy, National University of Singapore, 2 Our Lady of Apostles Hospital, Nigeria, 3 Institute of Molecular Cell Biology, Agency for Science, Technology and Research (A*STAR) Objectives: Development assistance for health (DAH) has been increasing in number of funds and in forms of delivery since early 1990s. DAH has played an important role to fulfill its goal of promoting economic development and welfare in the health sector in Africa. Since 1960s, Taiwan has accumulated and disseminated substantial economic development experience that has passed on to Africa. Amidst the developmental work, DAH has been the key task. This study aims to overview and analyze DAH in Africa in terms of skills training and technology transfer supported by Taiwan International Cooperation and Development Fund (Taiwan ICDF). Material and Methods: Four African countries (Burkina Faso, Sao Tome & Principe, Swaziland, and The Gambia) have been selected for our case studies. Ten DAH projects (2 projects in Burkina Faso, 4 projects in Sao Tome & Principe, 2 projects in Swaziland, and 2 projects in The Gambia) have been studied. Analytical time frame is from 1995 to 2008. The framework of alliance life cycle has been adopted. The criteria in the six stages (evaluating, forming, incubating, operating, transitioning, and retiring) are utilized to compare and contrast the potentials and pitfalls of the DAH programs in these four African countries. Among these 10 projects, malaria control project in Sao Tome & Principe is well received and recognized as the most successful projects in DAH, thus this case is served as a benchmark case. The study outlines the research into the nuances of DAH projects and compares them in terms of strategic alliances framework. We aim to find which projects work better in what way by using strategic alliances analysis. We also examine the way in which it has been undertaken. Results: In stretching DAH more for better outcomes, we find among our case studies that multi-faceted medical and health services based on the strategic alliances of mutual manpower allocation and institutional capacity building on the ground is the most important and significant mandate. Strategic alliances perfectly align problem definition and alternatives construction along with the course of case analysis. The study also depicts the historical trajectory of DAH contributed by Taiwan ICDF from holding clinics in partner countries, to projects expanded to the transfer of technology to reinforce the human resources of partner nations, and help them develop and enact sustainable systems for self-reliance in health system. Conclusion: To help African nations embark on the path of economic progress as quickly as possible, we have come up with a better analytical tool, strategic alliances framework, to formulate DAH polices in Africa. To effectively and successfully implement strategic alliances, using alliance life cycle to evaluate a strategy and potential partners on the ground has a great potential in the DAH policy process, especially at the stage of pre-decisional phase. Strategic alliances framework can be used as a form of applied research to acquire a deeper understanding of DAH policy issues in hope to bring out better solutions.
O503 The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China Z. Lan, L. Jinghe. Peking Union Medical College Hospital Objectives: To evaluate the prevalence and associated risk factors of urinary incontinence in Chinese women. Materials and Methods: In the cross-sectional survey, 20,000 Chinese women aged ≥20 years were randomly selected and interviewed with modified Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaires to estimate population prevalence rates and identify potential risk factors. Results 19,024 cases were included in the analysis with 976 excluded, qualified rate 95% (19024/20000). Of the Chinese women aged from 20 to 99 years old, (mean 45±16), the overall prevalence of urinary incontinence (UI) was 30.9%. Estimates of stress urinary incontinence (SUI), urge urinary incontinence (UUI) and mixed urinary incontinence (MUI) prevalence were 18.9%, 2.6% and 9.4%, with a correspanding proportional distribution of 61%, 8% and 31%, respectively. The prevalence of MUI increased with aging, while the prevalence of SUI peaked in 50 years group, and the UUI in 70 years group. Only 25% patients have consulted doctors on this issue. Through multivariable logistic regression analysis, we identified age, vaginal delivery, multiparity, alcohol consumption, central obesity (female waist circumference ≥80 cm), constipation, chronic pelvic pain (CPP), history of respiratory disease, gynecological events, pelvic surgery, peri-menopausal and postmenopausal status as potential risk factors for SUI, among which age, vaginal delivery, multiparity are three major risk factors. Conclusions Our findings suggest that the prevalence of UI is high in China, with SUI as the most common subtype. Age, vaginal delivery and so on are risk factors for SUI. O504 TVT and TVT-O: A comparative randomized study of these operative procedures for the treatment of severe urinary stress incontinence Z. Lan1 , L. Jinghe1 , W. Wenyan1 , W. Felix2 . 1 Peking Union Medical College Hospital, Beijing, P.R of China, 2 University of New South Wales, Sydney, NSW 2170, Australia Objectives: To compare the morbidity and short-term efficacy of the Tension-free vaginal tape (TVT) and Transobturator suburethral tape (TVT-O) procedures in the treatment of severe stress urinary incontinence (SUI). Patients and Methods: A total of 95 women with severe SUI were randomly allocated to undergo the TVT or the TVT-O procedure. Some patients had concomitant vaginal repair or vaginal hysterectomy as concomitant procedures as indicated. Results: The median follow up time was 20 months (range:12–48 months). The outcomes were subjectively assessed. The cure rate was 87.2% in the TVT group and 81.8% in the TVT-O group. Average operative time was significantly shorter in the TVT-O than in the TVT group (20±6 min vs 26±8 min; P < 0.001). No serious intra-operative complications occurred in either group. Both groups reported similar post-operative complications of thigh/groin pain, urinary retention, tape erosion and de novo urinary urgency. Two cases (4.3%) in TVT group were noted of haematoma. Conclusions: Both techniques appear to have low complication rates and equal efficacy in the surgical treatment of severe SUI in a short-term follow-up. O505 Promoting family planning education and training through international exchanges U. Landy, H. Steele, K. Miller. University of California San Francisco Objectives: As part of a two year post-graduate training program in the United States, Fellowship in Family Planning fellows (FPF)