Gary E. Lemack

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BACKGROUND Midurethral slings are increasingly used for the treatment of stress incontinence, but there are limited data comparing types of slings and associated complications. METHODS We performed a multicenter, randomized equivalence trial comparing outcomes with retropubic and transobturator midurethral slings in women with stress incontinence. The(More)
OBJECTIVE To describe surgical complications in 597 women over a 24-month period after randomization to retropubic or transobturator midurethral slings. STUDY DESIGN During the Trial of Midurethral Slings study, the Data Safety Monitoring Board regularly reviewed summary reports of all adverse events using the Dindo Surgical Complication Scale. Logistic(More)
BACKGROUND Many surgical procedures are available for women with urinary stress incontinence, yet few randomized clinical trials have been conducted to provide a basis for treatment recommendations. METHODS We performed a multicenter, randomized clinical trial comparing two procedures--the pubovaginal sling, using autologous rectus fascia, and the Burch(More)
PURPOSE We refined recently developed pressure flow cutoff values for female bladder outlet obstruction and applied these values in a consecutive group of women undergoing urodynamic testing for various lower urinary tract symptoms. MATERIALS AND METHODS A total of 87 women with clinical obstruction determined by history and presenting complaint were(More)
INTRODUCTION Overactive bladder (OAB) symptoms often accompany pelvic organ prolapse. While there seems to be a relationship between symptom resolution and anatomic repair, a subset of patients will not experience improvement in OAB symptoms. Our aim was to identify preoperative demographic and urodynamic (UD) parameters related to persistence of OAB(More)
OBJECTIVES To address the issue of sexual dysfunction after vaginal surgery for incontinence based on responses to a mailed questionnaire. METHODS A sexual function questionnaire was mailed to 93 women who underwent anterior vaginal wall suspension for stress urinary incontinence alone (group 1) or in conjunction with a concomitant posterior repair (group(More)
OBJECTIVES The Urogenital Distress Inventory (UDI-6) is a validated 6-item questionnaire that assesses lower urinary tract symptoms, including incontinence, in women. Similar indexes developed in men to evaluate symptoms of benign prostatic hyperplasia have failed to show a relationship with urodynamic (UD) parameters indicating bladder outlet obstruction(More)
PURPOSE The use of mesh bioprosthesis during inguinal herniorrhaphy is now considered routine. To our knowledge, no studies have examined the effects of mesh induced fibrosis on the structure and function of the adjacent spermatic cord. We present our experience in a canine model. MATERIALS AND METHODS Unilateral inguinal hernia defects were created in 12(More)
Due to their rarity, benign masses of the periurethral tissues and anterior vaginal wall are poorly understood. Arriving at the proper evaluation and treatment is challenging because many of these masses have similar presenting signs and symptoms, as well as overlapping differential diagnoses. The literature regarding these lesions mainly consists of level(More)
OBJECTIVES To examine the urodynamic (UDS) attributes of detrusor overactivity (DO) in patients with Parkinson's disease in comparison to DO in men without neurologic disease, in whom DO is presumably outlet obstruction induced. METHODS The UDS database was reviewed for three groups of patients: group 1, men with lower urinary tract symptoms (LUTS) and no(More)