International Urogynecology Journal最新文献

{"title":"Multi-parametric Quantitative MRI to Evaluate the Value of Pelvic Floor Muscle Dysfunction in POP Patients.","authors":"XiaoYing Wang, Wei Guo, Meng Wang, BaoGen Zhao, HongLiang Hu, Lu Zhang, Yong Wang, Li Zhang","doi":"10.1007/s00192-026-06652-1","DOIUrl":"10.1007/s00192-026-06652-1","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the application value of multiparameter quantitative MRI in evaluating pelvic floor muscle function in POP patients.</p><p><strong>Methods: </strong>Sixty-nine POP patients and 32 healthy controls (HC) were prospectively enrolled and categorized into POP _I-II (n = 32) and POP _III-IV (n = 37) groups based on POP-Q. All participants underwent conventional pelvic floor MRI, Q-Dixon, and T1-mapping. The PDFF and native T1 values of pelvic floor muscles were measured. Between-group differences in PDFF and T1 values were compared.</p><p><strong>Results: </strong>No significant differences were found in the PDFF and native T1 values of the bilateral OIM, OEM, PEC, and COC muscles (P > 0.05). The PDFF of the levator ani muscle (LAM) was significantly higher in the POP _III-IV group than in the POP _I-II and HC groups (P < 0.001). The PDFF of the coccygeus muscle (COC) was higher in both POP groups than in HCs (P < 0.001). Native T1 values of LAM and COC were lower in both POP groups compared to HCs (P < 0.001). Combined PDFF and T1 values of LAM and COC showed good diagnostic performance for POP severity (AUCs 0.826 and 0.841). Interobserver agreement was excellent (ICC 0.807-0.920).</p><p><strong>Conclusion: </strong>PDFF and native T1 values are valuable biomarkers for assessing pelvic floor muscle dysfunction and stratifying disease severity in patients with POP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"2869-2877"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Intensity Extracorporeal Shock Wave Therapy Restores Passive Urethral Closure Mechanism in Vaginal Distension Rat Model.","authors":"Takahiro Akimoto, Asuka Ashikari, Masahiro Kurobe, Gakuya Takamatsu, Yoshiyuki Akiyama, Haruki Kume, Minoru Miyazato","doi":"10.1007/s00192-026-06703-7","DOIUrl":"10.1007/s00192-026-06703-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Low-intensity extracorporeal shock wave therapy (LiESWT) is a promising noninvasive therapy for stress urinary incontinence (SUI). We assessed whether LiESWT restores urethral function in a vaginal distension (VD)-induced rat model of SUI, focusing on pelvic floor tissue remodeling and endoplasmic reticulum stress pathway as potential mechanisms.</p><p><strong>Methods: </strong>Eighty-one female Sprague-Dawley rats underwent functional and tissue analyses. Sneezing was induced to assess urethral pressure responses. Leak point pressure (LPP) was measured with or without hypogastric and pudendal nerve transections. Tissue remodeling and molecular pathways were assessed using histological and molecular expression analyses.</p><p><strong>Results: </strong>In VD rats, baseline urethral pressure (9.9 ± 4.3 vs 17.6 ± 3.1 cmH₂O) and LPP (27.4 ± 4.7 vs 37.0 ± 7.0 cmH₂O) were lower than in normal rats (both p < 0.05). LiESWT restored the baseline urethral pressure (16.3 ± 4.7 cmH₂O) and LPP (37.5 ± 4.9 cmH₂O) in VD rats (p < 0.05). Notably, LPP enhancement persisted after bilateral hypogastric and pudendal nerve transections. Additionally, LiESWT tended to reduce VD-induced vaginal smooth muscle fibrosis histologically, whereas collagen type I alpha and elastin mRNA expression remained elevated in both groups. Western blotting revealed no sustained activation of protein kinase R-like endoplasmic reticulum kinase (PERK) at 96 h after the final LiESWT.</p><p><strong>Conclusions: </strong>LiESWT enhanced urethral function in the VD-induced SUI model by potentially facilitating pelvic floor tissue remodeling, thereby restoring passive urethral closure. The absence of sustained PERK activation in the late phase indicates the safety of LiESWT for SUI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"3053-3062"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Radiofrequency Versus Myofascial Therapy in Women with Myofascial Chronic Pelvic Pain: A Randomized Clinical Trial.","authors":"Markus Huebner","doi":"10.1007/s00192-026-06755-9","DOIUrl":"10.1007/s00192-026-06755-9","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"3127"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"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":"2725-2733"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649944/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Bone-Targeted High-Intensity Training and Pelvic Floor Outcomes: Interpretation and Measurement Issues.","authors":"Efrem Kentiba, Victoria Drazdova","doi":"10.1007/s00192-026-06591-x","DOIUrl":"10.1007/s00192-026-06591-x","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"3129-3130"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485545","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":"Multicentric Preliminary Experience and Clinical Outcomes of Female Urethral Dilation Using a Paclitaxel-Coated Balloon.","authors":"David Carracedo, Ghali Belkahia, María D Sánchez-Gallego, Renán Otta, Esther García Rojo, Tamara Jerez, Guillermo Celada, Clara Sánchez-Guerrero, Lucía Estebán, César Minguez, José Manuel De la Morena, Javier Romero-Otero","doi":"10.1007/s00192-026-06693-6","DOIUrl":"10.1007/s00192-026-06693-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>To evaluate the feasibility, safety, and preliminary clinical outcomes of paclitaxel-coated balloon (Optilume®) dilation in women with urethral stricture disease, a condition with limited minimally invasive treatment options.</p><p><strong>Methods: </strong>Multicenter, retrospective case series, including nine consecutive female patients treated with Optilume® between May 2023 and November 2025. Clinical characteristics, uroflowmetry, post-void residual (PVR), and patient-reported outcomes were collected. A uroflowmetric response was defined as a ≥ 50% increase in maximum flow rate (Qmax). Symptomatic improvement was assessed using the Patient Global Impression of Improvement (PGI-I) scale. Pre- and postoperative Qmax and PVR were compared using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Nine women were included (mean age 63.2 years; SD 15.6). Median Qmax improved from 8.6 to 13.6 mL/s (p = 0.012). Median PVR decreased from 56 to 0 mL (p = 0.043). A uroflowmetric response was achieved in 66.7% (6/9). All procedures were outpatient, with no intra- or postoperative complications and no de novo stress urinary incontinence. One patient (11.1%) required reintervention for recurrence at 5 months, successfully managed with internal urethrotomy. All patients reported improvement on PGI-I: 66.7% (6/9) \"very much better\" and 33.3% (3/9) \"better.\" At short-term follow-up (mean 11 months; variable), 88.9% (8/9) remained free of reintervention.</p><p><strong>Conclusions: </strong>In this small, retrospective multicenter cohort, paclitaxel-coated balloon dilation appeared feasible and was not associated with major procedure-related complications in the short term, with encouraging functional and patient-reported improvements. These findings are preliminary and hypothesis-generating; prospective controlled studies with larger samples and longer, standardized follow-up are needed to better define effectiveness and durability.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"3075-3084"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972545","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":"Enhancing Recruitment in Urinary Incontinence Care: Insights from the EvidenceNOW Managing Urinary Incontinence Initiative.","authors":"Rachel M Burns, Nipher Malika, Shona Olalere Oluwatola, Gabriela Alvarado, Martha Timmer, Sangeeta Ahluwalia","doi":"10.1007/s00192-026-06658-9","DOIUrl":"10.1007/s00192-026-06658-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence (UI) affects over half of adult women but is widely underdiagnosed and undertreated in primary care due to stigma, normalization, and limited routine screening. Identifying effective recruitment strategies is essential to improving UI care in these settings.</p><p><strong>Methods: </strong>We conducted semi-structured interviews and focus groups with grantee leaders and practice facilitators (n = 32), site visits and virtual interviews with providers and staff (n = 47) and collected quarterly quantitative recruitment and retention data from five grantees participating in a nationwide UI initiative. Qualitative data were analyzed thematically using the Consolidated Framework for Implementation Research. Quantitative data, including 1950 enrolled practices and 134,852 screened patients, were summarized with descriptive statistics.</p><p><strong>Results: </strong>No single recruitment strategy was universally effective. All grantees utilized approaches such as leveraging professional relationships, engaging practice facilitators, and conducting in-person meetings, which were consistently linked to higher practice and provider recruitment. Leadership engagement facilitated recruitment success, while use of incentives and broad outreach alone were insufficient. Patient recruitment was most successful when UI screening was embedded in routine intake workflows. Across all grantees, 21% of screened patients tested positive for UI. Recruitment challenges included approval delays in large systems and increased workload related to integrating screening into routine care.</p><p><strong>Conclusions: </strong>Successful UI intervention recruitment in primary care requires combining leadership support, workflow integration, and tailored approaches. Limitations include reliance on aggregate data and absence of patient-reported perspectives or subgroup analyses. Future research should further investigate strategies to advance equitable UI care delivery.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"2967-2975"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter \"High-Intensity Resistance Training and Pelvic Floor Safety: Interpreting Null Findings in the Absence of a Non-inferiority Design\".","authors":"Belinda R Beck, Melanie Kistler-Fischbacher, Benjamin K Weeks","doi":"10.1007/s00192-026-06832-z","DOIUrl":"10.1007/s00192-026-06832-z","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"3139-3140"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535958","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":"Digital Therapeutic FEMANEA® for Women with Stress and Mixed Urinary Incontinence: A Randomized Controlled Pilot Study.","authors":"Anna Schneiderbanger, Katharina Arndt, Hannah Arnold, Matthias W Beckmann, Vesna Bjelic-Radisic, Hendrik Borgmann, Stefanie Burghaus, Emilia Fieseler, Thomas Fink, Michael Gedamke, Matthias Goetze, Anna-Lena Nachtigal, Maja Vorwerk, Bernd Wullich, Verena Lieb","doi":"10.1007/s00192-026-06670-z","DOIUrl":"10.1007/s00192-026-06670-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This exploratory pilot study provided initial evidence of the effectiveness of the digital therapeutic (DTx) FEMANEA® for the conservative treatment of stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) with a predominant stress component in women and is intended to prepare a further, more in-depth subsequent randomized controlled trial (RCT).</p><p><strong>Methods: </strong>Between May and October 2024, 81 patients (women at least 18 years old; SUI or MUI) were enrolled at five centers and randomized into an intervention group (IG, n = 34) or a control group (CG, n = 40). Both groups received standard conservative treatments (i.e., reality of care), the IG additionally had immediate access to the DTx FEMANEA®. Outcome parameters were assessed at baseline, mid-treatment (45 days), and post-treatment (90 days) using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), King's Health Questionnaire (KHQ), bladder diary, 24-h pad test, Patient Activation Measure (PAM-13), and app usage metrics. Data collection was carried out electronically with eCRFs (electronic case report forms) and ePROs (electronic patient reported outcomes).</p><p><strong>Results: </strong>The final analysis included 74 patients (dropout rate 6.2%). At baseline, symptom burden was slightly higher in the IG than in the CG (ICIQ-UI SF: T0 IG 10.7 ± 4.3, CG 9.2 ± 3.0; p = 0.09). The CG showed no significant improvement in symptoms (T2 8.3 ± 2.7; Δ = -0.9, p = 0.051), whereas the IG demonstrated a significant and clinically relevant reduction in symptoms (T2 8.2 ± 4.7; Δ = -2.2; p = 0.001), exceeding the minimal important difference (MID) of 1.46 points. Additionally, the KHQ subscale 2 \"incontinence impact on life\" observed a significant improvement (IG -19.8 ± 18.7 vs. CG -5.3 ± 19.8; p = 0.002), with IG improvements also being clinically relevant and surpassing the MID by a factor of four. Daily incontinence episodes decreased by 79.7% in the IG versus 48.3% in the CG (each group p < 0.01). Urinary loss volume revealed a 44.0% reduction in the IG, whereas CG values slightly increased. The mean app use in the IG was 2.6 ± 1.9 days per week per patient.</p><p><strong>Conclusions: </strong>Use of the DTx FEMANEA® resulted in clinically and statistically significant improvements in UI symptom burden (ICIQ-UI SF) and quality of life (KHQ subscale 2). These initial clinical data are intended to provide preliminary indications and prepare for the subsequent trial to be conducted.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"2941-2951"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Pelvic Floor Dysfunction in Women After Pelvic Radiotherapy: Systematic Review and Meta-Analysis.","authors":"Constanza Deyanu Alvear Pérez, Anna Karoline Lopes Rocha, Maria Palharini Volpato, Cassia Raquel Teatin Juliato, Simone Botelho Pereira, Cassio Luis Zanettini Riccetto","doi":"10.1007/s00192-026-06557-z","DOIUrl":"10.1007/s00192-026-06557-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Survivors of pelvic cancer are at risk for pelvic floor dysfunction (PFD). This review is aimed at determining the pooled prevalence of PFD after pelvic radiotherapy and explore associations with treatment modalities.</p><p><strong>Methods: </strong>We included observational studies of women with urogynecological or anorectal cancer treated with radiotherapy, brachytherapy, or chemoradiotherapy, assessing PFD. Exclusion criteria were previous pelvic surgery or rehabilitation, reviews, case reports, conference abstracts, comments, letters, or inaccessible full texts. We searched PubMed, PubMed PMC, Cochrane library, EMBASE, Web of Science, and Scopus to 6 August 2024. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Meta-analyses were conducted in R software. Meta-regression explored potential covariates. A 5% level of statistical significance was established.</p><p><strong>Results: </strong>Fifteen studies involving 1667 women were included. Pooled prevalence estimates were urinary incontinence (UI, 37%), stress UI (34%) and urgency UI (47%), overactive bladder (42%), anal incontinence (24%), defecatory urgency (20%), pelvic pain (30%), and sexual dysfunction (19%). Longer follow-up time was associated with increased defecatory urgency (p = 0.0054). Certainty of evidence was moderate for urgency urinary incontinence and overactive bladder, and low for the other outcomes. No publication bias was detected (Egger's test, p = 0.17).</p><p><strong>Conclusions: </strong>Radiotherapy for pelvic malignancies is associated with UI and overactive bladder symptoms. Bowel and sexual dysfunction were heterogeneous, but defecatory urgency increased over time. Limitations include heterogeneity in follow-up and study methods. Routine assessment and proactive multidisciplinary care are needed to mitigate morbidity and improve quality of life.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"2755-2763"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147457328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}