International Urogynecology Journal最新文献

{"title":"Holistic Pelvic Floor: Pelvic Floor Stress Dysfunction Diseases.","authors":"Xingqi Wang, Zhenhua Gao, Ling Li, Daoming Tian, Yuan Li, Jihong Shen","doi":"10.1007/s00192-026-06667-8","DOIUrl":"https://doi.org/10.1007/s00192-026-06667-8","url":null,"abstract":"<p><p>Female pelvic floor dysfunction diseases (PFD) comprise pelvic floor stress dysfunction diseases (PFSD) and non-pelvic floor stress dysfunction diseases (non-PFSD), with PFSD accounting for the majority of pelvic floor issues. PFSD is a group of diseases caused by pelvic floor stress support function injury and stress imbalance, mainly associated with pelvic floor support structure defects, weaknesses, injuries, pregnancy, transvaginal delivery, age, etc. A key to resolving PFSD lies in establishing the concept of holistic pelvic floor and therapeutic strategies based on functional pelvic floor biomechanics, etiology, and a holistic view of the disease. This article presents our perspective on current advances, challenges, and future directions in understanding and treating PFSD, emphasizing the need for a paradigm shift from symptom-oriented to mechanism-based management.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dual-Task Deep-Learning Model with Fused Ultrasound Images for Simultaneous Typing and Grading of Cystocele.","authors":"Shiyi Ran, Rong Lu, Muchen Li, Can Qu","doi":"10.1007/s00192-026-06679-4","DOIUrl":"https://doi.org/10.1007/s00192-026-06679-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>We developed a dual-task deep-learning model, termed FD-Net, which utilizes fused two-dimensional (2D) and three-dimensional (3D) ultrasound images to simultaneously automate cystocele typing and grading, and evaluated its diagnostic performance.</p><p><strong>Methods: </strong>We retrospectively included 625 patients (467 cystocele, 158 normal). The model fused preprocessed two-dimensional (2D, resting and Valsalva) and three-dimensional (3D, levator hiatus) images as input. On the basis of a ResNet50 backbone, FD-Net performed both typing (normal, type I/II/III) and grading (normal, mild, significant) tasks. Its performance was compared against single-modal models using only 2D images (ST-Net for typing, SG-Net for grading). Evaluation metrics included accuracy, precision, recall, F1-score, and the area under the receiver operating characteristic curve (AUC), with model comparisons made using McNemar tests.</p><p><strong>Results: </strong>On the test set (n = 188), compared with single-modal models using only 2D images, FD-Net achieved higher accuracy in typing (79.68% vs. ST-Net's 70.05%, P = 0.023) and grading (81.38% vs. SG-Net's 71.28%, P = 0.006). The F1-score improved notably for normal cases (from 64.94% to 85.44%) and mild cystocele (from 57.94% to 69.47%). For other key categories, FD-Net also attained high F1-scores of 87.50% for significant prolapse and 77.08% for type III. All AUC values exceeded 0.92.</p><p><strong>Conclusions: </strong>The dual-task model with image fusion accomplishes simultaneous cystocele typing and grading, showing higher diagnostic performance than single-modal models, and holds potential for clinical application.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Tadalafil and Amitriptyline in Female Interstitial Cystitis/Bladder Pain Syndrome: Double-Blind Randomized Trial.","authors":"Noran N Makled, Mirhan N Makled, Tamer E Helmy, Mahmoud R El-Kenawy, Ahmed S El-Hefnawy","doi":"10.1007/s00192-026-06536-4","DOIUrl":"https://doi.org/10.1007/s00192-026-06536-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic debilitating disorder of unclear etiology that impairs quality of life; physically, emotionally, and sexually. Up till now, no standard effective therapy has existed. Phosphodiesterase-5 inhibitors are vasodilatory and anti-inflammatory. We studied the efficacy and safety of tadalafil, amitriptyline, and their combination in female IC/BPS patients.</p><p><strong>Methods: </strong>In this study, 132 female patients were randomized into three groups. Assessments were performed at baseline and at 4, 8, and 12 weeks using voiding diary, uroflowmetry, the visual analog scale (VAS), the Interstitial Cystitis Symptom Index (ICSI), and the Interstitial Cystitis Problem Index (ICPI). Global Response Assessment (GRA) and correlations between VAS and voided volume were analyzed at the end. Statistical analysis was performed using the Kruskal-Wallis test.</p><p><strong>Results: </strong>Tadalafil and combination improved daytime voids more than amitriptyline (tadalafil vs amitriptyline p = 0.0005, amitriptyline vs combination p < 0.0001, tadalafil vs combination p = 0.0009). Night-time voids improved notably in tadalafil and combination vs amitriptyline (p < 0.0001). Maximum urinary flow rate (Qmax) increased in combination and tadalafil vs amitriptyline (p = 0.0004) and (p = 0.0294) respectively. Voided volume was higher in combination vs amitriptyline (p = 0.0041). ICSI, ICPI, and VAS scores decreased in all groups (p < 0.0001). Ninety-two patients achieved a GRA score of 7. VAS correlated with voided volume in the tadalafil group (r = -0.60). Amenorrhea was the most bothering adverse event among the patients in the tadalafil group.</p><p><strong>Conclusions: </strong>Tadalafil, alone or combined with low-dose amitriptyline, is a safe and effective treatment for female IC/BPS. The combination had comparable or superior efficacy to tadalafil using a lower amitriptyline dose while reducing adverse events.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Ultrasound in the Evaluation of Women with Obstetric Anal Sphincter Injuries: Narrative Review.","authors":"Cristina Ros, S Abbas Shobeiri, Montserrat Espuña-Pons","doi":"10.1007/s00192-026-06650-3","DOIUrl":"https://doi.org/10.1007/s00192-026-06650-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Obstetric anal sphincter injuries (OASI) are the main risk factor for postpartum anal incontinence (AI). All major scientific societies recommend follow-up in a perineal clinic to assess recovery and scarring, treat or prevent symptoms, and give advice about the subsequent mode of delivery.</p><p><strong>Methods: </strong>This narrative review was conducted through a systematic search of the relevant literature with the aim of exploring the role of ultrasound in the follow-up of patients with OASI. The databases searched included PubMed, Scopus, and Web of Science, using keywords such as \"obstetric anal sphincter injuries,\" \"anal incontinence,\" \"endoanal ultrasound,\" \"perineal pelvic floor ultrasound,\" \"perineal clinic,\" and \"mode of delivery.\" The search was limited to articles published in English up to December 2024, and included original research articles, reviews, and clinical guidelines. Data extraction was performed independently by two reviewers.</p><p><strong>Results: </strong>A pelvic floor ultrasound (PFUS), including the anal sphincter complex, should be performed after vaginal delivery in all women with OASI and those at high risk of obstetric pelvic floor trauma. PFUS plays a key role in assessing the success of primary intrapartum repair. Endoanal ultrasound (EAUS) is considered the gold standard; however, perineal or endovaginal approaches may be used as an alternative to identify sphincter complex abnormalities due to good testing accuracy and to determine which patients require further in-depth assessment with EAUS. The presence and severity of residual defects detected by PFUS are prognostic factors to determine optimal therapeutic management. PFUS is also useful in counseling patients regarding subsequent pregnancies, together with symptom assessment and patient preferences.</p><p><strong>Conclusions: </strong>In patients with OASI, PFUS is useful for evaluating primary repair of OASI and guiding therapeutic management and subsequent pregnancies.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward a Future Where Diabetes No Longer Limits Mesh Surgery.","authors":"Rui Liang","doi":"10.1007/s00192-026-06675-8","DOIUrl":"https://doi.org/10.1007/s00192-026-06675-8","url":null,"abstract":"<p><p>The use of synthetic mesh in urogynecologic pelvic reconstructive surgery has evolved substantially over the past three decades. Although advances in biomaterials, textile design, and surgical techniques have improved mesh outcomes, patient-specific factors remain insufficiently addressed. Among these, diabetes is common in women undergoing pelvic floor surgery and is associated with an increased risk of mesh-related complications. This review summarizes current perioperative glucose management in surgical populations and discusses its relevance to mesh implantation. Despite widespread reliance on HbA1c for preoperative assessment, reliable markers for predicting mesh outcomes are lacking. Intra- and postoperative glucose control also affects outcomes; however, optimal targets and their relationship to long-term implant success remain to be better defined. Patient management is further complicated by altered immune function driven by glycemic variability and hyperglycemic memory, alongside diabetes-related declines in tissue quality. This editorial advocates for a shift toward an individualized, precision medicine framework that integrates patient-specific factors and emphasizes the need for mechanistic studies, biomarker discovery, and computational modeling.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond UTI: Chronic Lower Urinary Tract Symptoms as a Manifestation of Genitourinary Tuberculosis: Case Series with Review of Literature.","authors":"Nisha N, J B Sharma, Manasi Deoghare, Ashita Aggarwal, Muntaha Khan, Rajesh Kumari","doi":"10.1007/s00192-026-06674-9","DOIUrl":"https://doi.org/10.1007/s00192-026-06674-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Genitourinary tuberculosis (GUTB) is a significant cause of chronic lower urinary tract symptoms (LUTS) in endemic regions, yet it remains underdiagnosed owing to its nonspecific presentation and the frequent absence of bacteriuria. This case series highlights the clinical profile and diagnostic challenges of bladder tuberculosis (TB) in women presenting with chronic LUTS.</p><p><strong>Methods: </strong>A retrospective review of seven female patients diagnosed with GUTB based on urine acid-fast bacilli (AFB) positivity (6 out of 7) between Jan 2024 and Dec 2024 at a tertiary care urogynaecology centre in India. Demographic details, symptom duration, prior TB history, investigation findings, treatment, and follow-up were analysed.</p><p><strong>Results: </strong>All patients presented with LUTS, including dysuria, urgency, frequency, nocturia, and incomplete bladder evacuation, with a symptom duration ranging from 1 to 15 years. Urine cultures were sterile in all cases. Urine AFB was positive in six patients; one was diagnosed on clinical-radiological correlation. Imaging findings included cortical scarring, hydronephrosis, bladder wall thickening, and significant post-void residual urine. Two patients had a prior history of urethral dilatation or surgical interventions. All received anti-tubercular therapy (ATT) for 6 months. Five patients reported ≥ 80% symptomatic relief; two had persistent frequency and urgency due to established bladder dysfunction.</p><p><strong>Conclusions: </strong>Bladder TB should be considered in women with chronic LUTS, especially in TB-endemic areas and in cases unresponsive to antibiotics with sterile urine cultures. Urine AFB testing and early imaging are essential for timely diagnosis. Prompt ATT initiation may reverse symptoms and reduce the need for invasive procedures.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Impact of Vaginal Hysterectomy on Quality of Life, Body Image, and Sexual Function in Women with Pelvic Organ Prolapse: A Study of Rural Women in a Low-Resource Setting\".","authors":"Mujde Canday","doi":"10.1007/s00192-026-06677-6","DOIUrl":"https://doi.org/10.1007/s00192-026-06677-6","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of PFMT in Treating Postpartum Urinary 1 Incontinence: A Systematic Review and Meta-analysis.","authors":"Yunna Chen, Jinlin Zhang","doi":"10.1007/s00192-026-06656-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06656-x","url":null,"abstract":"<p><strong>Introduction: </strong>The efficacy of pelvic floor muscle training (PFMT) in preventing and treating postpartum urinary incontinence remains inconclusive. This systematic review aims to evaluate the efficacy of pelvic floor muscle training (PFMT) in treating postpartum urinary incontinence (PPUI).</p><p><strong>Method: </strong>We systematically searched Embase, PubMed, and Cochrane Library for randomized controlled trials (RCT) investigating PFMT for PPUI. Studies published before October 2024 were included. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Cochrane Risk of Bias Tool (ROB 2.0). Meta-analyses were performed using random-effects models, with effect sizes reported as risk ratios (RR) or standardized mean differences (SMD) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 19 RCTs were included in the analysis. Statistically significant improvements were observed in pelvic floor muscle strength (SMD 0.61, 95% CI [0.10, 1.12], P = 0.02) and endurance (SMD 0.68, 95% CI [0.06, 1.30], P = 0.03). However, no significant differences were found in quality of life (SMD -0.46, 95% CI [-1.18, 0.27], P = 0.22) or urinary incontinence incidence (RR 0.87, 95% CI [0.73, 1.04], P = 0.12). The subgroup analysis demonstrated that supervised PFMT interventions lasting more than 8 weeks were the most effective approach for improving pelvic floor muscle strength.</p><p><strong>Conclusion: </strong>Pelvic floor muscle training (PFMT) demonstrates significant efficacy in improving pelvic floor muscle function (strength and endurance) in postpartum women with urinary incontinence (UI), supporting its physiological mechanism of action. However, owing to limitations in the available data and substantial heterogeneity across studies, the direct impact of PFMT on symptom resolution-specifically UI incidence and quality of life-remains less certain and should be interpreted with caution.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Patient Education: A Clinical Reflection : (Comment on \"Development and Evaluation of an Augmented Artificial Intelligence Model for Urogynecology Queries\").","authors":"Shigeki Matsubara","doi":"10.1007/s00192-026-06648-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06648-x","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Cystoscopic Bladder Conditions on the Therapeutic Outcomes of Intravesical Platelet-Rich Plasma Injections in Patients with Interstitial Cystitis/Bladder Pain Syndrome.","authors":"Wan-Ru Yu, Jia-Fong Jhang, Yuan-Hong Jiang, Hann-Chorng Kuo","doi":"10.1007/s00192-026-06651-2","DOIUrl":"https://doi.org/10.1007/s00192-026-06651-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) may present with different cystoscopic bladder conditions. The current study investigated the treatment outcomes of repeated intravesical platelet-rich plasma (PRP) injections for various bladder conditions.</p><p><strong>Methods: </strong>This study included 66 patients with IC/BPS, including five with Hunner's IC and 61 with non-Hunner's IC, who were not successfully managed with conventional treatments. The eligible patients underwent videourodynamic studies, completed voiding diaries, and received intravesical PRP injections once a month for a total of four treatments. Cystoscopic hydrodistention was performed, and the maximal bladder capacity and glomerulation grade were recorded. Treatment outcomes were examined using the global response assessment (GRA), and patients with a GRA score of 2 or 3 were considered to have achieved treatment success.</p><p><strong>Results: </strong>In total, 33 (50%) patients, including 20 (30.3%) who had an excellent outcome (GRA score of 3) and 13 (19.7%) who had moderate improvement (GRA score of 2), reported a successful outcome. The bladder pain visual analog score of 23 (34.8%) patients reduced by ≥ 3, and the functional bladder capacity of 15 (25.9%) patients increased to ≥ 350 mL. The glomerulation grade of 20 (32.8%) patients decreased by ≥ 1. All patients did not report adverse events such as urinary tract infection and urination difficulty. Patients with a baseline MBC of ≥ 760 mL and glomerulation grade of 0 or 1 had relatively higher success rates.</p><p><strong>Conclusions: </strong>In 50% of patients with IC/BPS, including the non-Hunner's and Hunner's IC subtypes, intravesical PRP injections were effective in reducing bladder pain, increasing bladder capacity, and improving glomerulation grade after cystoscopic hydrodistention. Moreover, patients with reduced bladder inflammation who exhibited a low glomerulation grade and a larger maximal bladder capacity at baseline had a relatively higher treatment success rate.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}