International Urogynecology Journal最新文献

{"title":"A Cross Sectional Study of Cytokines in Women with Refractory Detrusor Overactivity versus Controls.","authors":"Kylie J Mansfield, Zhuoran Chen, Samantha Ognenovska, Nancy Briggs, Ronald Sluyter, Kate H Moore","doi":"10.1007/s00192-024-05999-7","DOIUrl":"10.1007/s00192-024-05999-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Previous work has suggested that refractory detrusor overactivity (DO) was commonly associated with urinary tract infection (UTI), which can lead to inflammatory changes in the bladder. This study aimed to investigate the concentrations of urinary cytokines in a large sample of women with refractory detrusor overactivity (DO) and age matched controls.</p><p><strong>Methods: </strong>The urinary concentration of 27 cytokines in 140 women (95 with refractory DO and 45 age matched controls (women without urge incontinence)) was determined using the Human Cytokine 27-plex Assay. Cytokine concentrations were correlated with a \"UTI score\", the presence or absence of bacteriuria or pyuria on the day of sample collection and a previous history of UTI.</p><p><strong>Results: </strong>Pro-inflammatory cytokines were increased in refractory DO women compared to the controls. In women with refractory DO, the UTI score significantly correlated with urinary cytokine concentrations in 15 of the 22 cytokines detected. A previous history of UTI did not affect urinary cytokine concentrations in refractory DO women with no current UTI. Increasing pyuria was associated with increasing concentrations of urinary cytokines.</p><p><strong>Conclusion: </strong>Careful comparison of cytokine concentrations in women with refractory DO versus age matched controls has shown that changes in pro-inflammatory cytokines are related to the UTI disease burden, suggesting that an underlying inflammatory response, together with UTI, may be an aetiological contributor to the development of refractory DO.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667896","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":"Sleep Disorders and Childhood Enuresis in Women with Overactive Bladder Syndrome: Cross-Sectional Study.","authors":"Flora Maziero Parizotto, Tânia Aparecida Marchiori de Oliveira Cardoso, Luiz Gustavo Oliveira Brito, Cassia T Juliato","doi":"10.1007/s00192-024-05974-2","DOIUrl":"https://doi.org/10.1007/s00192-024-05974-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Childhood enuresis may be associated with overactive bladder syndrome (OAB) in adulthood, which may contribute to sleep disorders. The objective was to compare the prevalence of childhood enuresis and sleep quality among women with and without OAB.</p><p><strong>Methods: </strong>This mixed study included women with and without OAB, who completed an online questionnaire covering sociodemographic, urinary data, and five validated instruments in Portuguese: the Pittsburgh Sleep Quality Index (PSQI-BR), the Epworth Sleepiness Scale, the Berlin Questionnaire (QB-BR), the Modified Fatigue Impact Scale (MFIS-BR), and the Incontinence Questionnaire Overactive Bladder (ICIQ-OAB).</p><p><strong>Results: </strong>A total of 172 women were included, 86 in each group (OAB and non-OAB). The OAB group showed a higher prevalence of childhood enuresis (52.3% vs 25.6%, p < 0.001), poorer sleep quality on the PSQI-BR (9.6 ± 4.1 vs 5.7 ± 3.1, p < 0.001), more individuals classified as high risk of obstructive sleep apnea by the QB-BR (34.9% vs 15.1%, p < 0.001), higher impact on fatigue assessed by the MFIS-BR (39.3 ± 21.8 vs 17.8 ± 17.2, p < 0.001), and more daytime sleepiness according to the Epworth Sleepiness Scale (10.9 ± 6.1 vs 8.7 ± 4.8, p = 0.014). Women with OAB were associated with poor sleep quality, fatigue, obstructive sleep apnea, and daytime sleepiness. Childhood enuresis was associated with a 2.96 times higher chance of developing OAB (OR = 2.96; 95% CI: 1.41-6.19; p = 0.004).</p><p><strong>Conclusions: </strong>Overactive bladder was associated with a higher prevalence of childhood enuresis, diminished sleep quality, elevated risk of obstructive sleep apnea, heightened fatigue, and increased daytime sleepiness among women. OAB increases the risk of sleep disorders and childhood enuresis increases the chances of developing OAB.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647689","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: Patient Impression of Improvement 1 Year After Sacrospinous Hysteropexy Versus Vaginal Hysterectomy in Women with Pelvic Organ Prolapse Stage 2 or Higher.","authors":"Yao-Yu Yang, Cheng-Yu Long","doi":"10.1007/s00192-024-05982-2","DOIUrl":"https://doi.org/10.1007/s00192-024-05982-2","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647688","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: The Outcomes of the Manchester Procedure Versus Sacrospinous Ligament Hysteropexy for Uterine Prolapse: A Study of the British Society of Urogynaecology Database.","authors":"Hsin-Pei Lee, Kun-Ling Lin, Cheng-Yu Long","doi":"10.1007/s00192-024-05976-0","DOIUrl":"https://doi.org/10.1007/s00192-024-05976-0","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638962","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":"Spanish-Speaking Latinas with Pelvic Floor Disorders: Understanding the Misunderstood.","authors":"Alexandra N Garcia, Katie Propst, Dina Martinez-Tyson","doi":"10.1007/s00192-024-05980-4","DOIUrl":"https://doi.org/10.1007/s00192-024-05980-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Challenges to providing care to Spanish-speaking Latinas with pelvic floor disorders (PFDs) are well studied. Limited data exist on patient and provider perspectives on the unique challenges in providing language-discordant care. Our study was aimed at highlighting these challenges and providing evidence-based recommendations on how to optimize the care of these women.</p><p><strong>Methods: </strong>Both Spanish-speaking patients with PFDs and non-Spanish speaking providers at the University of South Florida were recruited for this study. Interviews were conducted by a single bilingual interviewer. Topics included providers' experiences, specifically barriers, when caring for Spanish-speaking Latinas, and patients' experiences, focusing on differences between Spanish and non-Spanish speaking providers, while receiving care for PFDs. All interviews were analyzed using grounded theory qualitative methods.</p><p><strong>Results: </strong>Thirteen interviews were conducted, 7 Spanish-speaking Latinas with PFDs and 6 non-Spanish-speaking urogynecology providers. Qualitative analysis yielded three major themes noted by both patients and providers: cultural stigma, barriers influencing care, and behavioral adaptations to language discordance. Concepts identified from these themes included: generational shame and embarrassment, aversion to treatment, interpreter use barriers, lack of resources, accommodation between patient and provider, and time constraints. Culturally competent recommendations were made based on study findings and review of the literature to improve care of Spanish-speaking Latinas.</p><p><strong>Conclusions: </strong>This study highlights common themes experienced by both patients and their non-Spanish-speaking providers caring for Spanish-speaking Latinas. The study provides recommendations and implementable strategies that can improve care and help providers to build a stronger therapeutic relationship with Spanish-speaking Latinas.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619838","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":"Gestational Diabetes Mellitus Affects the Risk of Obstetric Anal Sphincter Injury: A Systematic Review and Meta-Analysis of Cohort Studies.","authors":"Ella Eg Fabricius, Thomas Bergholt, Louise Kelstrup, Hanna Jangö","doi":"10.1007/s00192-024-05989-9","DOIUrl":"https://doi.org/10.1007/s00192-024-05989-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>High birth weight increases the risk of obstetric anal sphincter injury. Macrosomia is a well-known complication in pregnancies complicated by gestational diabetes mellitus. The aim of this study was to investigate whether gestational diabetes is a risk factor for obstetric anal sphincter injury. We hypothesized that women with gestational diabetes have an increased risk of obstetric anal sphincter injury.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis using the PubMed and Embase databases. Studies including numbers on women with and without gestational diabetes and with and without obstetric anal sphincter injury were included. Studies were assessed using the SIGN-methodology checklist to evaluate the quality and risk of bias. Extracted data was analyzed using RevMan 5.4 and the statistical software R.</p><p><strong>Results: </strong>Twelve cohort studies were included for the meta-analyses. Overall, we found a slightly increased prevalence of obstetric anal sphincter injury among the women with gestational diabetes of 2.40% (95% CI; 2.37-2.43) compared to 2.31% (95% CI; 2.30-2.32) in women without diabetes. The meta-analysis revealed increased risk of obstetric anal sphincter injury in the gestational diabetes-group (RR 1.24 [95% CI; 1.12-1.37]) with a high level of heterogeneity (I² = 94%). Primiparous women with gestational diabetes had an increased risk of obstetric anal sphincter injury 6.65% (95% CI; 6.18-7.14) compared to 4.98% (95% CI; 4.89-5.08) in the control group, whereas the risk was not significantly increased in multiparous women.</p><p><strong>Conclusions: </strong>The risk of obstetric anal sphincter injury is increased in primiparous women with gestational diabetes mellitus compared to women without gestational diabetes.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619398","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":"Effectiveness and Safety of Shorter Incontinence Slings.","authors":"Kjersti Rimstad, Sissel Hegdahl Oversand, Marie Ellström Engh, Rune Svenningsen","doi":"10.1007/s00192-024-05971-5","DOIUrl":"https://doi.org/10.1007/s00192-024-05971-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Traditional slings, tension-free vaginal tape obturator inside-out (TVT-O) and tension-free vaginal tape (TVT), have well-documented continence outcomes but can cause serious complications. This study was aimed at evaluating whether slings with less synthetic material, Ajust™ and TVT-O Abbrevo™ (TVT-A), have comparable 6- to 12-month failure and complication rates, including risk of prolonged postoperative pain, compared with traditional slings.</p><p><strong>Methods: </strong>A registry study from the Norwegian Female Incontinence Registry (NFIR) including 611 Ajust™, 2,772 TVT-A, and 18,612 traditional slings was carried out. Preoperative, surgical, and 6- to 12-month follow-up data from the period 2009-2021 were used. Objective failure was defined as ≥ 1-g leakage on standardized cough-jump stress test. Subjective failure was defined as stress index-score ≥ 3 on a validated questionnaire. Prolonged postoperative pain was defined as lasting > 3 months.</p><p><strong>Results: </strong>At first follow-up after 6-12 months, the groups differed significantly. Objective failure rates were as follows: Ajust™ 15.4%, TVT-A 13.5%, and traditional slings 7.3%, p < 0.01. Subjective failure rates were as follows: Ajust™ 23.4%, TVT-A 23.8%, and traditional slings 18.8%, p < 0.01. Shorter slings had fewer overall complications (Ajust™ 4.9% vs TVT-A 6.5% vs traditional slings 9.3%, p < 0.01), but did not have less prolonged postoperative pain (TVT-A: 1.4% vs Ajust™ 0.8% vs traditional slings 0.7%, p < 0.01 < 0.01). All presented outcomes remained significant after adjusting for differences at baseline.</p><p><strong>Conclusions: </strong>Shorter slings have inferior subjective and objective continence outcomes at 6-12 months, but fewer overall complications except for prolonged postoperative pain.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619397","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":"Implementation of Robotic-Assisted Sacrocervicopexy for Apical Organ Prolapse Using the Semitendinosus Tendon-Pilot Study and Analysis of Clinical Outcome.","authors":"Carolin Schröder, Charlotte Lukannek, Eva K Egger, Lucia A Otten, Alexander Mustea, Dominique Koensgen","doi":"10.1007/s00192-024-05975-1","DOIUrl":"https://doi.org/10.1007/s00192-024-05975-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This video demonstrates a robotic-assisted sacrocervicopexy using the semitendinosus tendon.</p><p><strong>Methods: </strong>Between June 2022 and February 2023, we performed the worldwide first Da Vinci robotic-assisted sacrocervicopexies (SCP) for apical organ prolapse using the semitendinosus tendon of the left knee. Analysis of safety, feasibility, and clinical outcome of the first ten patients operated on using this new surgical technique included the German pelvic floor questionnaire (GPFQ) as well as a clinical examination.</p><p><strong>Results: </strong>Ten patients with a follow-up of 12 months were included. There was a significant reduction of the patient's symptoms according to the GPFQ regarding the domain bladder (preoperatively versus 3 months postoperatively, mean 3.85 vs 1.61, p = 0.034), total score (preoperatively versus 3 months postoperatively, mean 12.79 vs 3.28, p = 0.034), and descensus symptoms (preoperatively versus 12 months postoperatively, mean 4.74 vs 0.67, p = 0.022). POP-Q stage (point C) was significantly reduced between the preoperative period and at the time of discharge (mean 2.2 vs 0, p = 0.004). No serious intra- and postoperative complications occurred.</p><p><strong>Conclusions: </strong>This pilot study showed satisfying clinical outcomes after a follow-up of 12 months, with a low mid-term complication rate.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619587","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 Making of Confident Surgeons: Why and How?","authors":"Roxana Geoffrion, Terry Lee","doi":"10.1007/s00192-024-05987-x","DOIUrl":"https://doi.org/10.1007/s00192-024-05987-x","url":null,"abstract":"<p><p>Low self-confidence in surgical residents can be associated with poor self-efficacy and perceptions of sub-optimal preparedness for practice at graduation. The influence of social and biologic determinants of confidence deserves further study. Through a randomized controlled trial of procedure-specific didactic and low fidelity simulation training for vaginal surgery, we showed positive correlations between self-confidence and objective performance in the real operating room for three different surgical procedures and through validated scales. This demonstrates an accurate ability of novice surgeons to self-monitor in a high-stakes environment. Our trial results (described in full elsewhere), combined with our multiple one-on-one teaching interactions with surgical trainees through the trial, incentivized us to evaluate self-confidence in view of optimizing it through directed training and feedback. The current opinion piece summarizes our main findings for surgical educators and emphasizes their role engaging with trainees at extremes of confidence.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619864","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":"Management of Sacrocolpopexy Mesh Complications-A Narrative Review and Clinical Experience from a Large-Volume Center.","authors":"Chen Shenhar, Howard B Goldman","doi":"10.1007/s00192-024-05955-5","DOIUrl":"https://doi.org/10.1007/s00192-024-05955-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Despite the reputation of sacrocolpopexy as a highly durable reconstructive surgery for pelvic organ prolapse, mesh-related complications remain a significant deterrent for patients. This review discusses the incidence, presentation, diagnosis, management and prevention of sacrocolpopexy mesh complications.</p><p><strong>Methods: </strong>We reviewed the literature on sacrocolpopexy focusing on long-term mesh complications and their management. As the literature is not specifically robust, we also give our recommendations based on experience from a large-volume center. Intraoperative videos and images are provided to illustrate findings and management techniques.</p><p><strong>Results: </strong>Sacrocolpopexy mesh complications include vaginal mesh exposure; bladder or bowel erosions; inflammatory and infectious conditions including spondylodiscitis; and mesh-related pain. Presentation ranges from overt symptoms such as mesh palpated in the vagina to insidious-like spondylodiscitis manifesting as back pain and malaise. Diagnosis relies on methodical history taking, review of operative reports, and a physical examination, with office-based endoscopy studies and imaging as indicated. Various management options have been described in the literature. We recommend an expectant approach for asymptomatic patients; For symptomatic vaginal exposure, we encourage removal of entire mesh arm(s) via an abdominal approach; however, many prefer to utilize a transvaginal or partial excisional approach first. Spondylodiscitis is managed with long-term antibiotics and often requires mesh removal. Prevention strategies include using a lightweight polypropylene mesh attached to well- vascularized vaginal walls, avoiding direct placement on any sutured vaginotomy or cystotomy. Delayed absorbable monofilament suture is non-inferior to permanent suture.</p><p><strong>Conclusions: </strong>Sacrocolpopexy mesh complications can be challenging to diagnose and manage. Symptomatic cases often require a proactive approach; listening to patients when they describe persistent symptoms with postoperative onset; a low threshold for further evaluation; and upfront discussion of management options.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619641","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}