International Urogynecology Journal最新文献

{"title":"From Roots to Canopy: Understanding Chronic Pelvic Pain Through a Tree-Inspired Model.","authors":"Magali Robert","doi":"10.1007/s00192-025-06151-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06151-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Chronic pelvic pain affects approximately 25% of women. Despite its prevalence, health care providers often find it challenging and may feel underprepared to offer effective care.</p><p><strong>Methods: </strong>Using the metaphor of a tree provides a simplified, systematic approach to better understanding and thus managing this condition. The tree model unites both the biopsychosocial and neuroinflammatory models of chronic pain. In this metaphor, the tree's roots represent nociceptive inputs, the trunk represents nociplastic changes, and the canopy signifies psychosocial factors. The bark symbolizes protective behaviors adopted by the individual, whereas the sap represents the bidirectional nature of pain messaging.</p><p><strong>Results: </strong>This metaphor provides a relatable visual framework for understanding chronic, persistent pelvic pain and serves as a foundation for history taking, physical examination, and care planning. The tree metaphor can help patients understand their pain and serve as a starting point for discussing treatment options.</p><p><strong>Conclusion: </strong>It helps to deconstruct the complexity of chronic, persistent pelvic pain into manageable components, offering a practical tool for both individuals with chronic pelvic pain and providers.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023750","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":"Phage Therapy for Urinary Tract Infections: Progress and Challenges Ahead.","authors":"Chase J Morgan, Haley Atkins, Alan J Wolfe, Linda Brubaker, Saima Aslam, Catherine Putonti, Michael B Doud, Lindsey A Burnett","doi":"10.1007/s00192-025-06136-8","DOIUrl":"https://doi.org/10.1007/s00192-025-06136-8","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary tract infection (UTI) treatment is a growing public health concern owing to increasing antimicrobial resistance. Phage therapy, an alternative or adjunctive treatment to antibiotics, has the potential to address this challenge. However, clinical use of phage therapy is hindered by knowledge gaps and inconsistent reporting. The objective was to review the current state of phage therapy for UTIs and highlight research priorities that can optimize phage clinical efficacy.</p><p><strong>Methods: </strong>Current literature on UTI phage therapy was examined, focusing on the lack of standardized phage susceptibility testing, phage characterization, and microbiological assessments during and after treatment.</p><p><strong>Results: </strong>Critical areas requiring further investigation include appropriate phage dosing, optimal routes of administration, and the dynamics of phage-host and phage-patient interactions. The influence of the urinary microbiome, including endogenous phages, on treatment outcomes also needs to be better understood. Suggested data collection and reporting standards should be developed and implemented to improve clinical impact of studies examining phage therapy for UTI. Randomized clinical trials are needed to establish efficacy and determine the best practices for clinical use.</p><p><strong>Conclusion: </strong>Phage therapy is a promising alternative to antibiotics for managing UTIs, especially in the face of rising antimicrobial resistance. To fully realize its potential, however, future research must focus on standardized protocols, dosing strategies, and the role of the urinary microbiome, with an emphasis on rigorously conducted clinical trials. These steps are essential for integrating phage therapy into mainstream UTI treatment regimens.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971113","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":"Prevalence of Urinary Incontinence Among University Students and Associated Factors.","authors":"Canan Birimoglu Okuyan, Oğuzhan Bahadır Demir, Esma Akgül","doi":"10.1007/s00192-025-06130-0","DOIUrl":"https://doi.org/10.1007/s00192-025-06130-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence can occur during university years, just as at other stages of life. The aim of this study was to determine the prevalence of urinary incontinence and related factors in university students.</p><p><strong>Methods: </strong>The cross-sectional research involved 293 students enrolled in the faculty of health sciences at a public institution. Data were collected using an information form, the International Consultation on Incontinence Questionnaire Short Form, the King's Health Survey, the Physical Activity Scale- 2, and the Childhood Trauma Scale. Descriptive statistics, the Mann-Whitney U test for pairwise group comparisons, the Kruskal-Wallis test for three or more group comparisons, and the Spearman correlation test were used to analyze data that did not follow a normal distribution.</p><p><strong>Results: </strong>The students' average age was 20.94 ± 1.70 years; 79.2% of them were female. It is observed that 98.6% of the students who were enrolled were single. 15.7% of the students reported that they frequently experienced urinary tract infections. 30% of the students had urinary incontinence problems; 21.1% were affected mildly, 8.2% moderately and 0.7% severely. It was found that the impact of urinary incontinence on quality of life varied based on students' personal characteristics and urinary problems. Various associations were identified between age, urinary incontinence symptoms, quality of life, physical activity levels, and childhood trauma.</p><p><strong>Conclusions: </strong>Preventive interventions should be implemented to address urinary incontinence among university students, as it is a public health concern. To avert the onset of urinary incontinence, it is advisable to identify students experiencing this condition, assist them in enhancing their quality of life by addressing relevant factors, promote and motivate them toward physical activity, and implement preventive measures such as exercise programs and counseling.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012237","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":"Effect of Music Intervention on Pain and Anxiety During Urodynamic Testing: A Randomized Controlled Trial.","authors":"Athiwat Songsiriphan, Purim Ruanphoo, Suvit Bunyavejchevin, Keerati Chiengthong","doi":"10.1007/s00192-025-06161-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06161-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urodynamic testing is used to evaluate urinary tract function and often causes patients to experience pain, anxiety, and embarrassment. Music intervention has been proposed as a strategy to alleviate these discomforts. This research was conducted to investigate the effects of music intervention on pain and anxiety levels in women during urodynamic testing compared to the standard protocol.</p><p><strong>Methods: </strong>During December 2021 to October 2022, 50 patients attending the Female Pelvic Medicine and Reconstructive Surgery clinic at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, that required urodynamic tests were randomized into the music intervention group and the control group (non-music). All participants were given questionnaires including demographic characteristics, pain score (Visual Analog Scale (VAS)), Thai-version State-Trait Anxiety Inventory Form (STAI) X-q by Spielberger, the embarrassment level and satisfaction score.</p><p><strong>Results: </strong>The median pain level with IQR (interquartile range) demonstrated no statistically significant differences between the two groups (2.50 (4.55) in the music group vs. 0.15 (2.18) in the non-music group, p = 0.064). There were no statistically significant differences in the mean total STAI score (41.07 ± 9.16 in the music group vs. 43.08 ± 7.96 in the non-music group, p = 0.415) and the median VAS of embarrassment score (4.05 (7.32) in the music group vs. 5.00 (6.20) in the non-music group, p = 0.646). There were no statistically significant differences in the satisfaction of both groups.</p><p><strong>Conclusion: </strong>There is no difference in the pain and anxiety in patients undergoing multichannel urodynamic testing with or without music intervention.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009337","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":"About the Efficacy of Vaginal Erbium Laser Versus Pelvic Floor Muscle Training for Stress Urinary Incontinence.","authors":"Ali Furkan Batur, Elif Balevi Batur","doi":"10.1007/s00192-025-06166-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06166-2","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965982","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":"Comparing Post-Operative Pain Outcomes in Pelvic Organ Prolapse Surgery With and Without a Hysterectomy.","authors":"Wesley Nilsson, Elizabeth Narwold, Lindsay Turner, Jonathan Shepherd","doi":"10.1007/s00192-025-06162-6","DOIUrl":"https://doi.org/10.1007/s00192-025-06162-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Many surgeons perform hysterectomy at the time of pelvic organ prolapse (POP) surgery if the uterus is present, but it is unknown how this impacts patient pain. The objective of this study was to compare POP surgeries with and without a hysterectomy for differences in post-operative pain using a visual analog scale (VAS), and morphine milligram equivalents (MME) at 24 h.</p><p><strong>Methods: </strong>This was a secondary analysis of a randomized controlled trial comparing the impact of pre-operative intravenous acetaminophen with placebo on post-operative pain following POP surgery.</p><p><strong>Results: </strong>We included 202 subjects undergoing minimally invasive POP surgery. A concomitant hysterectomy was performed in 120 of the subjects (59.4%). Most were white (97.5%), had baseline POP-Q stage III prolapse (75%), and BMI 27.8 ± 4.3 kg/m², with no difference between groups. Those with concomitant hysterectomy were younger (64.2 ± 10.5 vs 67.5 ± 8.7 years, p = 0.02). Length of stay was 0.9 ± 0.5 days, and similar between groups (p = 0.24). Operative time was longer with concomitant hysterectomy (186.1 ± 52.7 vs 123.1 ± 47.2 min, p = 0.02). VAS scores 24 h post-operatively (hysterectomy = 3.0 ± 2.3, no hysterectomy = 2.7 ± 2.3, p = 0.49) and MMEs (51.4 ± 74.5 vs 37.1 ± 60.4, p = 0.15) were both similar. Patient-Reported Outcomes Measurement Information System scores measuring pain interference showed no difference between groups (22.9 ± 9.7 vs 20.9 ± 9.3, p = 0.21, possible range 8-40). Linear regression showed that concomitant hysterectomy did not impact 24-h VAS scores (adjusted beta = 0.113; p = 0.77) and showed no impact on 24-h MME (adjusted beta = 14.25; p = 0.15).</p><p><strong>Conclusion: </strong>Although procedures were longer and patients were younger, with concomitant hysterectomy, there was no difference in 24-h VAS pain scores, 24-h MME opioid usage, or other pain metrics in POP surgeries with and without hysterectomy. Overall, opioid use and pain scores were low.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989762","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":"Adaptations for Urogynecologic Surgery in Limited-Resource Settings: How to Do More with Less.","authors":"Hnin Yee Kyaw, Catherine Matthews, Hannah G Krause, Marvin Mwesigwa, Judith T W Goh","doi":"10.1007/s00192-025-06137-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06137-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic floor disorders affect up to 50% of women in limited-resource settings (LRS) but are severely under-treated. Historically, attention has focused on urogenital fistulae, but pelvic organ prolapse (POP) is emerging as a growing issue, especially for women engaged in manual labor. Women in these regions often endure their conditions in silence owing to social stigma and mental health impacts, compounded by health care access barriers. Delivery of urogynecological services in LRS requires adaptable surgical models and skills because of limited tools and equipment. Diagnostic treatment approaches must be tailored to the unique challenges of these settings.</p><p><strong>Methods: </strong>This article presents a practical guide to managing vesicovaginal fistulae, chronic fourth-degree tears, and POP based on limited evidence and expert experience in LRS. Key diagnostic tools, surgical techniques, and case management strategies are outlined, addressing challenges such as resource scarcity and patient follow-up in LRS.</p><p><strong>Results: </strong>The article emphasizes the importance of precise diagnosis with limited access to diagnostic testing, adaptable surgical interventions, and postoperative care, offering sustainable solutions that maximize patient outcomes despite restrictions in equipment availability. Cases are presented to illustrate practical diagnostic and surgical approaches to urinary leakage, fecal incontinence, and POP.</p><p><strong>Conclusions: </strong>The article underscores the need for an adaptable care model that prioritizes cost-effective, reproducible methods while considering patients' long-term health and social well-being.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995984","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":"Association of Bladder Pain Syndrome/Interstitial Cystitis with Hyperlipidemia: A Case‒Control Study.","authors":"Zhong-Yun Zhang, Zhao Zhang, Ming Ling, Bo-Wen Shi, Zheng-Wang Zhang","doi":"10.1007/s00192-025-06149-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06149-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Metabolic factors have been proposed to be related to the bladder pain syndrome/interstitial cystitis (BPS/IC) pathogenesis. Herein, we investigated the association between metabolic factors, especially blood lipids, and BPS/IC.</p><p><strong>Methods: </strong>The present study adopted a case‒control design, comparing several metabolic indicators in 106 women with BPS/IC versus 164 women without BPS/IC, all of whom were diagnosed at the Hospital between January 2013 and December 2022. The case-control odds ratio (OR) and 95% confidence interval (CI) for metabolic indicators were estimated using logistic regression. The associations between indicators and BPS/IC classifications were assessed using ordinal multinominal logistic regression.</p><p><strong>Results: </strong>The propensity score-matching method was used to eliminate bias from age and body mass index (BMI), and the BPS/IC group had a greater hypercholesterolemia prevalence than the control group (16.3% vs 7.1%, p = 0.046), with an OR > 2.4 (p < 0.05). Ordinal multinomial logistic regression between indicators and BPS/IC classifications showed that age and triglycerides correlated with the BPS/IC lesion grade. However, when the data were corrected for age and BMI, triglycerides still correlated with lesion grade.</p><p><strong>Conclusions: </strong>The BPS/IC group had a greater hypercholesterolemia prevalence than the control group. Hypercholesterolemia may be a risk factor. Cystoscopic lesion grade correlated with age and triglyceride level. These results indicate a potential association between hyperlipidemia and the BPS/IC pathogenesis.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966020","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":"Urogenital Hiatus Closure: Facts, Fallacies, and Why a Unified Theory of Hiatal Failure is Needed.","authors":"John O L DeLancey, James A Ashton-Miller, Jennifer LaCross, Fernanda Pipitone, Payton Schmidt, Luyun Chen","doi":"10.1007/s00192-025-06153-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06153-7","url":null,"abstract":"<p><p>An enlarged urogenital hiatus is as important as apical support or fascial attachment failures in the development of prolapse and is strongly related to operative failure, yet we lack a conceptual model for factors responsible for hiatal failure. For a conceptual model to be valid, it cannot be proven false by empirical observation. We present six clinical observations with which future model development must be consistent. (1) Perineal body damage alone does not explain an enlarged urogenital hiatus. Three women have complete 4th degree lacerations but small hiatuses. (2) Levator damage is not a sole causal factor. One woman has bilateral levator avulsion but a normal hiatus, while another has intact muscles and an enlarged hiatus. (3) Hiatal assessment during straining is incomplete. Two women with similar straining urogenital hiatuses of 6-7 cm have respective 1.5 cm and 7 cm resting hiatuses. (4) Urogenital hiatus measurements during straining are confounded by Valsalva effort strength. Urogenital hiatus size increases by 30%, 51%, and 181% in one woman depending on straining strength. (5) Hiatal closure during pelvic muscle contraction differs widely. One woman can close her hiatus from 3.5 cm to 1.5 cm, while another shows no reduction despite evidence of contraction. (6) Prolapse/hiatus interactions occur with advancing age. One woman experiences progressive hiatal enlargement over 31 years. Our clinical observations reveal the complexity of the multiple factors involved in hiatal failure and support the need for a unified disease model consistent with these factors on which to base future research.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994929","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":"Comment on \"Development and Validation of Risk Assessment Model for Pelvic Organ Prolapse Based on a Retrospective Study with Machine Learning Algorithms\".","authors":"Triwiyanto Triwiyanto","doi":"10.1007/s00192-025-06164-4","DOIUrl":"https://doi.org/10.1007/s00192-025-06164-4","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010298","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}