International Urogynecology Journal最新文献

{"title":"Predictors of Lower Urinary Tract Symptoms Following Post-Acute Stroke: Analysis of Multiple Variables.","authors":"Özgü İnal Özün, Şahide Eda Artuç, Esra Üzelpasaci, Serdar Kesikburun","doi":"10.1007/s00192-025-06342-4","DOIUrl":"https://doi.org/10.1007/s00192-025-06342-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Lower urinary tract symptoms (LUTS) are associated with post-stroke recovery, and therefore identifying predictors of LUTS is important. This study was designed to determine predictors of LUTS following post-acute stroke.</p><p><strong>Methods: </strong>Brunnstrom Recovery Stages (BRS), Modified Ashworth Scale (MAS), Modified Rankin Scale (MRS), Functional Ambulation Scale (FAS), Berg Balance Scale (BBS), Functional Independence Measure (FIM), Core Lower Urinary Tract Symptom Score (CLSS), and Incontinence Quality of Life Scale (I-QOL) were used. The CLSS total and subdimensions were obtained by using multiple linear regression analysis using the stepwise selection method.</p><p><strong>Results: </strong>This study was completed with 93 participants. The stepwise selection method analysis found the regression model created with the variables age, gender, constipation, FAS, stroke type, and I-QOL total score predicting the CLSS total score to be significant (F_(6;87) = 168.035, p < 0.001). The contribution of the variables age, gender, constipation, FAS, stroke type, and I-QOL total score to the model was found to be statistically significant (p < 0.05). According to standardized regression coefficients, the greatest contribution to the model was made by age (0.961) and I-QOL total score (-0.890) variables. The established model explains 91.5% of the variation (R² = 0.915) in CLSS total score.</p><p><strong>Conclusions: </strong>This is the first study to examine predictors of LUTS following post-acute stroke in a broad context. Post-acute stroke patients with LUTS should be addressed multi-dimensionally, and the rehabilitation program should be planned to take these parameters into consideration.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212286","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 Empty Cough Stress Test with Midurethral Sling Outcomes and Intrinsic Sphincter Deficiency in Women with Stress Urinary Incontinence.","authors":"Emir Gurbuz, Esra Uyanik, Savci Bekir Telek, Oz Harmanli","doi":"10.1007/s00192-025-06309-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06309-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The evaluation of surgical outcomes for mid-urethral sling (MUS) procedures in treating stress urinary incontinence (SUI) is critical for optimizing patient care. This study is aimed at evaluating the association between empty cough stress test (CST) results and surgical outcomes in MUS procedures, and its role in detecting intrinsic sphincter deficiency (ISD).</p><p><strong>Methods: </strong>This was a retrospective cohort study of women who underwent MUS procedures at a single academic center between 2017 and 2023. Patient information including demographics, perioperative factors, urodynamic parameters, and postoperative outcomes were extracted from electronic medical records.</p><p><strong>Results: </strong>A total of 1215 women underwent MUS procedures, with 347 (28.6%) testing positive on the empty CST. The median follow-up period was 12 months (range 8 to 16). Empty CST-positive women were younger (median age 53 vs 57 years, p < 0.001) and more likely premenopausal. No significant differences were observed between the groups in SUI recurrence after MUS procedures (3.2% vs 4.8%, p = 0.477) or in reoperation rates for persistent SUI. The empty CST showed high specificity for leak point pressure ≤ 60 cm H₂0 (86.5%) and low maximum urethral closure pressure ≤ 20 cm H₂0 (85.3%), but limited sensitivity (17.7% and 3.7% respectively). CST positivity was initially associated with lower point Aa values (55.3% vs 74.0%, p < 0.001), but this lost significance after adjustment for confounders.</p><p><strong>Conclusions: </strong>Empty CST is not predictive of MUS success outcomes and shows high specificity with low sensitivity for detecting ISD, making it a useful yet limited diagnostic tool.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212306","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":"Incidence and Risk Factors of Obstetric Anal Sphincter Injury at a Tertiary Care Hospital in Thailand: A 10-Year Retrospective Cohort Study.","authors":"Usana Unpikool, Apiwat Jongjakapun, Teerayut Temtanakitpaisan, Chompilas Chongsomchai","doi":"10.1007/s00192-025-06301-z","DOIUrl":"https://doi.org/10.1007/s00192-025-06301-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Obstetric anal sphincter injury (OASI) is a severe complication of vaginal delivery leading to short- and long-term consequences affecting women's physical and psychological health. This study is aimed at evaluating the incidence and risk factors of OASI at a tertiary care centre over the past decade.</p><p><strong>Methods: </strong>This retrospective cohort study included all singleton primiparous and multiparous women who delivered vaginally between 2014 and 2023. Women giving birth at < 24 weeks and whose child weighed < 500 g at birth, or with incomplete records, were excluded. Key maternal and obstetric factors were extracted and analysed using univariate and multivariate logistic regression.</p><p><strong>Results: </strong>Among 9956 women, the overall incidence of OASI was 9.4% (third-degree 8.7% and fourth-degree 0.7%). The incidence of OASI declined from 9.8% to 6.1% in the past decade, coinciding with a reduction in episiotomy rates. Multivariate analysis identified forceps extraction (aOR 6.15, 95% CI 3.66-10.33), prolonged second stage of labour (aOR 2.47, 95% CI 2.00-3.05), labour augmentation (aOR 1.62, 95% CI 1.38-1.89), deliveries performed by a faculty member (aOR 1.25, 95% CI 1.03-1.51) and every 100-g increase in neonatal birthweight (aOR 1.09, 95% CI 1.08-1.11) as significant risk factors. Delivery without an episiotomy was a protective factor (aOR 0.41, 95% CI 0.30-0.56).</p><p><strong>Conclusions: </strong>The high incidence of OASI at our institution highlights the impact of obstetric practices. The findings reinforce the need for restrictive episiotomy policies and targeted strategies to mitigate modifiable risk factors associated with OASI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199266","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":"Surgical Management of Pelvic Floor Disorders and the Utility of Preoperative Labs.","authors":"Tara Samsel, Sarah Ashmore, Jinxuan Shi, Kimberly Kenton, Margaret Mueller","doi":"10.1007/s00192-025-06307-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06307-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Current national guidelines advise against routine preoperative laboratory testing to assess risk of perioperative events prior to surgery for pelvic floor disorders (PFDs), yet many women undergo unnecessary testing. The primary objective was to determine the clinical utility of preoperative laboratory assessment prior to surgical management of PFDs. Secondary objectives include rates of case cancellation or postponement owing to laboratory abnormalities and factors associated with testing.</p><p><strong>Methods: </strong>A retrospective study was performed of all surgeries within the Division of Urogynecology and Reconstructive Pelvic Surgery at a single academic medical center between 1 January 2021 and 31 December 2024. Patient demographics, clinical characteristics, and preoperative laboratory assessments were abstracted from the medical record. Case cancellation or postponement was documented. Group comparisons were performed using Student's t test and Chi-squared and Fisher's exact test for continuous and categorical variables.</p><p><strong>Results: </strong>During the study period, 634 surgeries were performed for PFDs. Four hundred sixty-nine (74%) women had preoperative labs performed. Laboratory abnormalities were rare and did not result in any changes to surgical management. Patients with diabetes mellitus were more likely to have preoperative labs (p = 0.02); otherwise, medical co-morbidities were similar in the two cohorts. Patients who had preoperative labs were more likely to have a hysterectomy (p < 0.001), sacrocolpopexy (p = 0.004), uterosacral ligament suspension (p = 0.001), anterior repair (p < 0.001), and posterior repair (p < 0.001).</p><p><strong>Conclusions: </strong>Despite the majority of patients undergoing preoperative laboratory testing, clinically meaningful abnormalities were rare and did not change surgical management. Policies surrounding preoperative testing should be re-evaluated to reflect current national guidelines.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199353","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":"Transperineal Ultrasound Immediately After Birth to Predict Postpartum Anorectal Dysfunction: A Prospective Cohort Study.","authors":"Laura Cattani, Bram Packet, Adela Samešova, Helena Williams, Jan Y Verbakel, Dominique Van Schoubroeck, Jan Deprest","doi":"10.1007/s00192-025-06344-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06344-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>To study the correlation between transperineal ultrasound (TPUS) findings immediately after birth and postpartum anal incontinence (AI) and constipation.</p><p><strong>Methods: </strong>This is a prospective cohort study in pregnant patients who delivered vaginally at term. Participants filled in questionnaires, including the St. Mark's Incontinence Score and the Patient Assessment of Constipation Symptoms, at inclusion and at 6-weeks postpartum follow-up. TPUS acquisitions were performed immediately after birth to detect anal sphincter and levator defects, the dimensions of the genital hiatus as well as the dimensions of rectovaginal septum defects. We report on the prevalence and severity of AI and constipation at the postpartum follow-up and ran regression models to quantify the association between the former and TPUS findings immediately after birth. We calculated that a minimum of 156 patients were required to detect potential predictors for AI (power = 80%; alpha = 0.05; f² = 0.15).</p><p><strong>Results: </strong>Of 182 consecutive participants, 109 (60%) reported AI and 78 (43%) constipation. There were 37 (20.3%) women with a levator avulsion, 83 (46%) with an external anal sphincter defect in one or more TUI-sections and 29 (16%) with a rectovaginal septum defect. On univariate regression, sphincter defects were associated with AI [OR = 1.94(1.28-2.94)]. On multivariate regression, levator avulsion was the only independent sonographic predictor of AI [aOR = 2.57(1.03-7.44)], whereas sphincter defects, dimensions of the genital hiatus or rectovaginal defects were not correlated with AI. We identified no factors associated with constipation.</p><p><strong>Conclusions: </strong>The presence of levator avulsion immediately after vaginal delivery predicts postpartum AI. Ultrasound appearance of the anal sphincter, genital hiatus and rectovaginal septum was not informative.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199276","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":"Pyometra-An Atypical Complication Following LeFort Colpocleisis: Narrative Review.","authors":"Emilio Chala Saad, Mariana Abril Barreto, Camilo Fonseca Guzmán, Omar Leonardo Gómez Polania","doi":"10.1007/s00192-025-06335-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06335-3","url":null,"abstract":"<p><strong>Introduction: </strong>LeFort colpocleisis is a surgical alternative for women with pelvic organ prolapse (POP). Complications are rare and typically minor. The accumulation of purulence within the uterine cavity, or pyometra, after this procedure is exceptionally uncommon. To date, only a handful of cases have been reported. Hereby, we present a narrative review on the current knowledge regarding the diagnosis and treatment of this atypical complication.</p><p><strong>Methods: </strong>A literature search was conducted using five different databases to identify previously published articles on this subject. Relevant keywords included colpocleisis, LeFort colpocleisis, pyometra, and reoperation. Studies describing complications after colpocleisis with concurrent hysterectomy or colpocleisis of vaginal vault were excluded.</p><p><strong>Results: </strong>Six case reports were identified, all from English-language sources. Data form an additional case at our institution was included. Median age was 78 years, and most women had multiple comorbidities. All underwent LeFort colpocleisis, with varying additional procedures. Only one case had a successful conservative approach; hysterectomy via laparotomy was ultimately required in the remaining cases. No cases of underlying malignancy were reported.</p><p><strong>Conclusions: </strong>Pyometra is a rare but important differential diagnosis in patients with a history of LeFort colpocleisis presenting with fever, vaginal discharge, and abdominopelvic pain. A high index of clinical suspicion is paramount, since prompt diagnosis and appropriate surgical management are a standard of care.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199355","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":"Letter to the Editor: Comment on: \"Addressing Commonly Asked Questions in Urogynecology: Accuracy and Limitations of ChatGPT\".","authors":"Gregory Vurture, Jonathan Baum","doi":"10.1007/s00192-025-06308-6","DOIUrl":"https://doi.org/10.1007/s00192-025-06308-6","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191516","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":"Symptomatic Pelvic Organ Prolapse and Self-Rated Health, One Year After Childbirth: A Swedish Nationwide Register Study.","authors":"Maria Mirskaya, Anna Isaksson, Eva-Carin Lindgren, Ing-Marie Carlsson","doi":"10.1007/s00192-025-06322-8","DOIUrl":"https://doi.org/10.1007/s00192-025-06322-8","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic organ prolapse (POP) is a complication of childbirth that may impair the overall health of women. We hypothesized that women with symptomatic pelvic organ prolapse (sPOP) would rate their health lower than women without sPOP 1 year after childbirth.</p><p><strong>Methods: </strong>The Swedish National Pregnancy Register, and the Pregnancy Survey were merged and searched for women with data on self-rated health and POP 1 year after childbirth. The women (n = 43,082), who answered these validated questions in the Pregnancy Survey between December 2022 and October 2024 comprised our study population, of which 40,392 were included in the final analysis. Analysis was performed using descriptive statistics and a binary logistic regression model to estimate the associations between self-rated health and sPOP 1 year after childbirth.</p><p><strong>Results: </strong>In total, 5704 (13.2%) participants reported sPOP; 1617 (28.3%) women with sPOP and 6669 (17.8%) women without sPOP rated their health as poor. sPOP was associated with poor self-rated health 1 year after childbirth (OR 1.557, 95% CI 1.453-1.669). Additionally, the following covariates: low education, urinary incontinence, fecal incontinence, and poor self-rated health before pregnancy were also associated with poor self-rated health 1 year after childbirth.</p><p><strong>Conclusions: </strong>Women with sPOP had higher odds of reporting poor self-rated health 1 year after childbirth compared to women without sPOP. In Sweden, sPOP represents a public health concern affecting women in their prime years and may lead to poorer health outcomes throughout the rest of their lives.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191507","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 \"Rethinking Urethral Diverticulum\": Awareness, MRI, and the Data Gap on Malignancy.","authors":"Ali Furkan Batur","doi":"10.1007/s00192-025-06357-x","DOIUrl":"https://doi.org/10.1007/s00192-025-06357-x","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175312","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":"Resilience in Women with Stress Urinary Incontinence.","authors":"Chia-Chen Tsai, Ching-Hui Chien, Shu-Pen Hsu, Hun-Shan Pan","doi":"10.1007/s00192-025-06340-6","DOIUrl":"https://doi.org/10.1007/s00192-025-06340-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence (UI) is a common and complex health issue among women that can profoundly impact their quality of life. Resilience plays a crucial role in coping with UI. The purpose of this study is to investigate the factors associated with positive thinking and resilience among women with stress urinary incontinence (SUI).</p><p><strong>Methods: </strong>This cross-sectional study recruited women diagnosed with SUI through convenience sampling from an obstetrics and gynecology outpatient department and a urodynamics room. Data were collected via a structured questionnaire covering demographics, UI-related variables, self-efficacy, positive thinking, and resilience. Analyses included t-tests, ANOVA, Pearson correlations, and multiple linear regression.</p><p><strong>Results: </strong>A total of 107 women participated in this study, with a mean age of 54.7 years and an average urinary leakage duration of 53.9 months. The mean score on the Positive Thinking Scale was 68.13 (range 25-88), and the average Resilience Scale score was 27.94 (range 3-40). Regression analysis revealed that greater happiness, perceived economic sufficiency, and shorter UI duration were significantly associated with higher levels of positive thinking. Furthermore, higher levels of positive thinking, self-efficacy for UI, and happiness were significantly associated with greater resilience.</p><p><strong>Conclusion: </strong>The resilience of women with SUI is influenced by their psychological coping abilities (positive thinking and self-efficacy) and mental health status. This study provides a deeper understanding of the resilience of women with SUI and offers valuable insights for the design of future psychological interventions for SUI patients.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149002","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}