International Urogynecology Journal最新文献

{"title":"Risk Factors for Recurrence Following Surgery for Apical Prolapse: A Systematic Review and Meta-Analysis.","authors":"Agustina Vendramini, Ann-Sophie Page, Vinita Gottipati, Carolyn W Swenson, Ka Lai Shek, Marie E Sullivan, Kirsten Kluivers, Ankita Gupta, John O L DeLancey, Mackenzie Wood, Kaidi Kang, Catherine A Matthews, Cara L Grimes","doi":"10.1007/s00192-026-06910-2","DOIUrl":"https://doi.org/10.1007/s00192-026-06910-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Most of the existing literature focuses on patient-level risk factors for recurrence after prolapse surgery in general, rather than specifically for uterovaginal prolapse (U-POP). As uterine-preserving procedures are increasingly performed, understanding patient-level risk factors for recurrence after U-POP is essential.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched for studies including women undergoing U-POP surgery to evaluate risk factors for recurrence. Risk of bias was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Odds ratios were pooled using random-effects meta-analysis. Findings informed a Delphi process at the Global Consensus Conference on Controversies in Surgical Management of Primary U-POP (April 2026) resulting in consensus statements (≥80% agreement threshold).</p><p><strong>Results: </strong>Of the 4,149 abstracts screened, 25 studies (14,860 women; median follow-up 24 months) met the eligibility criteria. Meta-analyses were performed for 9 of the 16 risk factors identified. Advanced preoperative prolapse stage (OR 2.75; 95% CI 1.39-5.46), prior prolapse surgery (OR 2.09; 95% CI 1.16-3.75), and higher body mass index (BMI; OR 1.10 per unit increase; 95% CI 1.06-1.15) were each significantly associated with an increased risk of recurrence. No significant associations were identified for age, diabetes, smoking, parity, menopause, or preoperative estrogen use. Where there were insufficient data, expert consensus identified levator ani avulsion, enlarged genital hiatus, and connective-tissue disorders as additional risk factors.</p><p><strong>Conclusions: </strong>Advanced preoperative prolapse stage, prior prolapse surgery, and higher BMI were each significantly associated with U-POP recurrence. Together with expert consensus, these findings should inform preoperative counseling and individualized surgical planning to improve long-term outcomes.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Nitrofurantoin Versus Fosfomycin for Acute Uncomplicated Lower Urinary Tract Infection: A Systematic Review and Meta-Analysis.","authors":"Dipika Bansal, Mamidi Niveditha, Saroj Kundan Bharti, Hafsa Mohammad, Sudheer Kumar Devana","doi":"10.1007/s00192-026-06923-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06923-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Nitrofurantoin and fosfomycin are first-line oral agents for acute uncomplicated lower urinary tract infection (u-UTI) in women, yet direct comparative evidence remains limited. This study compared clinical and microbiological outcomes of multi-day nitrofurantoin versus single-dose fosfomycin trometamol for u-UTI, including pregnant and nonpregnant women.</p><p><strong>Methods: </strong>Databases were searched from inception through 9 May 2025, for RCTs comparing oral nitrofurantoin with single-dose fosfomycin trometamol (3g) for u-UTI. Primary outcomes were clinical and microbiological cure; secondary outcomes were 14-day relapse and adverse drug reactions (ADRs). Pooled risk ratios (RRs) with 95% CIs were calculated. Risk of bias was assessed using Cochrane RoB 2.0, and evidence certainty was graded using GRADE.</p><p><strong>Results: </strong>Six RCTs (n = 1762; mean age 36.49±15.29) were included. Clinical cure at ≤7, 7-10, 14, and ≥28 days was comparable (RR 0.98, 0.99, 1.05, 1.02). Nitrofurantoin 300 mg/day was associated with higher clinical cure at 14 and ≥28 days (RR 1.14 and 1.22), whereas no significant difference was observed with 200 mg/day. In pregnant women, fosfomycin was associated with higher clinical cure at ≤7 days (RR 0.87; 95% CI 0.76-0.98). Microbiological cure showed no significant overall difference between treatments (RR 0.99; 95% CI 0.92-1.08), including at 14 and ≥28 days. Nitrofurantoin was associated with higher 14-day relapse (RR 1.71; 95% CI 1.13-2.59). Overall ADR rates were not significantly different (RR 1.27; 95% CI 0.95-1.70), although ADRs were higher with nitrofurantoin 300 mg/day (RR 1.63; 95% CI 1.07-2.49).</p><p><strong>Conclusions: </strong>Nitrofurantoin and single-dose fosfomycin are both effective treatment options for uncomplicated cystitis. Treatment choice may be influenced by pregnancy, dosing regimen, and adherence considerations. Further well-designed trials are needed to clarify differences between treatment regimens.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136497","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":"Nonabsorbable Versus Delayed-Absorbable Sutures in Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort Study.","authors":"Nahyun Judith Koh, Jihye Lim, Min Ju Kim, Myung Jae Jeon","doi":"10.1007/s00192-026-06925-9","DOIUrl":"https://doi.org/10.1007/s00192-026-06925-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The optimal suture material for uterosacral ligament suspension (USLS) remains uncertain. We compared surgical outcomes between nonabsorbable and delayed-absorbable sutures in vaginal USLS.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent vaginal hysterectomy with USLS for uterine prolapse and completed 1-year follow-up. The primary outcome was composite surgical failure at 1 year, defined as vaginal bulge symptoms, apical descent greater than half of the total vaginal length, anterior or posterior descent beyond the hymen, or retreatment for prolapse. Secondary outcomes included suture-related complications and need for intervention.</p><p><strong>Results: </strong>A total of 310 patients were included (205 nonabsorbable, 105 delayed-absorbable). Composite surgical failure was significantly higher in the delayed-absorbable group (38.1% vs 13.7%, p < 0.01). Overall suture-related complication rates did not differ significantly (p = 0.28), whereas complications requiring intervention were less frequent in the delayed-absorbable group (1.0% vs 5.9%, p = 0.04).</p><p><strong>Conclusions: </strong>Delayed-absorbable sutures were associated with higher surgical failure but fewer complications requiring intervention compared with nonabsorbable sutures.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127508","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":"Enhanced Recovery After Surgery Versus Conventional Care in Elderly Patients Undergoing Transvaginal Pelvic Floor Reconstruction: A Systematic Review and Meta-Analysis.","authors":"Aqsa Khanzada, Syeda Vilay Zehra Rizvi, Farah Hadi, Benish Khan, Fatima Sajjad, Fazia Khattak, F N U Fahad, Fatima Abid, Fatima Yousaf, Kainat Sheraz, F N U Laiba, Laila Mehsood, Maheen Mehsud, Minhal Nadeem, Sawera Gul, Talha Bin Tariq, Wahidullah Sheraz, Muhammad Waqar Shahid, Abdullah Afridi","doi":"10.1007/s00192-026-06883-2","DOIUrl":"https://doi.org/10.1007/s00192-026-06883-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic organ prolapse is a common condition in older women requiring surgical correction. The benefits of Enhanced Recovery After Surgery (ERAS) have been demonstrated in gynecological procedures, but there are still few data on its use in older patients (aged 60 years and above) undergoing transvaginal pelvic floor reconstruction. This study evaluates the effectiveness and safety of ERAS compared with conventional perioperative care, specifically in this older population.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Cochrane databases were searched for randomized and observational studies comparing ERAS with conventional care in older patients undergoing transvaginal pelvic floor reconstruction. Outcomes assessed were time to first intestinal exhaust, ambulation, urinary catheterization duration, hospital stay, operative time, bleeding volume, 30-day readmission, and reoperation rates. Data extraction and quality assessment were performed independently, and pooled analyses were conducted using a random-effects model.</p><p><strong>Results: </strong>Nine studies involving 1,585 patients were included. ERAS significantly reduced time to first intestinal exhaust, ambulation, urinary catheter removal, and postoperative length of stay compared with conventional care. No significant differences were observed in operative duration, intraoperative bleeding, 30-day readmission, or reoperation rates.</p><p><strong>Conclusions: </strong>For older patients undergoing transvaginal pelvic floor reconstruction, ERAS enhances postoperative recovery without sacrificing safety. The need for multicenter randomized studies and standardized protocols remains despite encouraging findings.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127486","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":"Small Bowel Obstruction Following Laparoscopic Sacrocervicopexy Involving Barbed Sutures: Case Report and Focused Review.","authors":"Tsunagu Ichikawa, Edward Marici","doi":"10.1007/s00192-026-06879-y","DOIUrl":"https://doi.org/10.1007/s00192-026-06879-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Barbed sutures are increasingly used in minimally invasive pelvic reconstructive surgery but have been associated with rare postoperative complications. We present a case of delayed small bowel obstruction (SBO) due to barbed-suture entrapment after laparoscopic sacrocervicopexy, and review the current literature to characterize the presentation, mechanisms, and management of this complication.</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical course, imaging, operative findings, and outcomes of a patient who developed SBO following manual laparoscopic sacrocervicopexy. A focused literature review was performed using PubMed to identify reported cases of barbed-suture-related SBO following laparoscopic sacrocervicopexy or sacrocolpopexy.</p><p><strong>Results: </strong>The patient presented with characteristic symptoms of bowel obstruction. CT imaging revealed early SBO with a transition point in the anterior pelvis. Diagnostic laparoscopy identified distal small bowel mesentery entrapped beneath a barbed suture from the prior sacrocervicopexy. Simple removal of the entrapping suture resolved the obstruction without need for bowel resection. A literature review identified five reported cases of SBO secondary to barbed-suture use in sacrocervicopexy/sacrocolpopexy procedures. In the limited published cases, most patients were successfully managed laparoscopically.</p><p><strong>Conclusions: </strong>Small bowel obstruction secondary to barbed-suture entrapment is a rare but serious complication following sacrocervicopexy/sacrocolpopexy. Early recognition and prompt laparoscopic intervention are often associated with successful management without bowel compromise. Surgeons should employ a meticulous technique when using barbed sutures, including proper tail management and complete peritoneal coverage. Future efforts should be aimed at reducing this complication by way of materials innovation and clinical guideline development.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109643","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":"Urinary Biomarkers in Interstitial Cystitis and Bladder Pain Syndrome: A Narrative Review of Differential Diagnosis and Treatment Monitoring.","authors":"Margareta Moga, Bogdan Adrian Buhas, Răzvan-George Rahotă, Adriana Elena Bulboacă","doi":"10.1007/s00192-026-06894-z","DOIUrl":"https://doi.org/10.1007/s00192-026-06894-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction and hypothesis: &lt;/strong&gt;The objective was to narratively synthesize clinical studies of urinary biomarkers in interstitial cystitis/bladder pain syndrome (IC/BPS) and evaluate their utility for differential diagnosis versus overactive bladder (OAB), pre-cystoscopy biomarker enrichment for Hunner-lesion IC (HIC), and monitoring treatment response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a narrative review of MEDLINE/PubMed records available through June 2026, no start-date restriction, and screened reference lists of the articles included. Studies assessing urinary cytokines and chemokines, neurotrophins and growth factors, or oxidative-stress markers in IC/BPS against healthy or symptomatic comparators and across bladder-directed treatment cohorts were eligible. Thirty-five articles met the inclusion criteria; heterogeneity in biomarkers, assay platforms, normalization strategies, comparators, and outcomes precluded meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 35 articles included, the strongest single-marker performance for IC/BPS versus controls was urinary TNF-α (area under the curve [AUC] 0.92; sensitivity 99.0%; specificity 92.6%). Against overactive bladder, VEGF, CXCL10, and IL-8 gave AUCs of 0.87, 0.86, and 0.81, and a pilot algorithm used MIP-1β as an initial screen (sensitivity 92.2%) with eotaxin, CXCL10, and RANTES as confirmatory markers for IC/BPS. For pre-cystoscopic Hunner-lesion enrichment, urinary CXCL10 separated Hunner-type from non-Hunner-type disease (AUC 0.78, sensitivity 46.1%, specificity 93.7%, positive predictive value 97.7%); CXCL10 plus NGF reached an AUC of 0.81. Combining biomarkers with simple clinical variables outperformed biomarkers alone: 8-OHdG, TNF-α, and a bladder-pain visual analog scale score reached an AUC of 0.997 with 96% accuracy, and in an external validation the urinary biomarker cluster alone reached an AUC of 0.65, rising to 0.89 once age, bladder pain score, and the IC Problem Index were added, although those clinical variables alone performed comparably (AUC 0.89); thus, incremental value over routine clinical assessment was not demonstrated. Higher urinary CXCL10 correlated with O'Leary-Sant symptom and problem scores (both p = 0.02). In treatment-monitoring studies biomarker shifts accompanied rather than preceded clinical improvement: after sacral neuromodulation urinary MCP-1 fell from 448.3 to 176.9 pg/ml and sIL-1RA from 633.8 to 149.9 pg/ml at 24 weeks; after four monthly platelet-rich plasma injections, NGF, MMP-13, and VEGF fell whereas PDGF-AB rose; and extracorporeal shock wave therapy produced only transient 4-week changes, with none remaining at 12 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Current urinary biomarkers can assist, but not replace, standard clinical assessment and selective cystoscopy. At present, their clearest near-term roles are in research and selected specialist settings, including adjunctive differentiation of IC/BPS from ","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108744","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":"Facilitators and Barriers to Pelvic Floor Muscle Exercise Among Patients with Pelvic Floor Dysfunction: A Meta-Synthesis.","authors":"Miao Li, Xue Yang, Hangcheng Liu, Huan Wang, Haiyan Wang, Xixi Li","doi":"10.1007/s00192-026-06754-w","DOIUrl":"https://doi.org/10.1007/s00192-026-06754-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic floor muscle training (PFMT) is a first-line conservative therapy for Pelvic Floor Dysfunction (PFD), yet its effectiveness is often compromised by poor long-term adherence. From the patient's viewpoint, this study explores the facilitators and barriers to exercise compliance, seeking to guide the formulation of scientific and rational PFMT protocols.</p><p><strong>Methods: </strong>The literature search covered the period from database inception to May 20, 2025, and was performed across nine databases, including PubMed, Web of Science, Embase, CINAHL, the Cochrane Library, CNKI, Wanfang Database, VIP Database, and CBM. The methodological quality of the included studies was assessed with the Joanna Briggs Institute (JBI) checklist for qualitative research, and a thematic synthesis was conducted.</p><p><strong>Results: </strong>A total of 13 studies were included, yielding 66 research findings, which were categorized into 11 categories and consolidated into two outcomes. The promoting factors of PFMT in patients with PFD (perceived benefits of exercise, strong social support, flexible and diverse training strategies, awareness of the threat of the disease, and self-efficacy promoting internal drive) and hindering factors of PFMT in patients with PFD (doubts about exercise value, insufficient access to information, low exercise self-efficacy, lack of exercise conditions and enjoyment, weak social support systems, and the impact of the disease and low symptom perception).</p><p><strong>Conclusions: </strong>PFMT for women with PFD is influenced by multiple factors. Clinicians should address barriers, strengthen promoting factors, and actively optimize intervention strategies to provide patients with diverse, individualized pelvic floor muscle exercise (PFME) programs.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109640","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":"Ecological Momentary Assessment Reveals Greater Anxiety and Marked Instability of Urinary Urgency in Overactive Bladder.","authors":"Lindsey C McKernan, Benjamin N Johnson, Aaron X Lee, Tatsuki Koyama, A Grace Kelly, Stephen Bruehl, Roger R Dmochowski, Elisabeth M Sebesta","doi":"10.1007/s00192-026-06887-y","DOIUrl":"https://doi.org/10.1007/s00192-026-06887-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Overactive bladder (OAB) is highly prevalent and frequently co-occurs with anxiety. Although cross-sectional studies associate anxiety and OAB symptoms, anxiety and lower urinary tract symptoms (LUTS) vary in daily life. We applied ecological momentary assessment (EMA), consisting of four brief surveys administered via participants' smartphones over 7-14 days, to characterize severity and variability of anxiety and LUTS among individuals with and without OAB, and by sex among those with OAB.</p><p><strong>Methods: </strong>Three hundred thirty-one participants with active OAB symptoms and healthy controls (HC) (271 OAB, 60 HC) (M age = 47.0, 69% White) from two studies of OAB completed baseline measures and 322 completed EMA evaluating affective symptoms (e.g., anxiety) and LUTS (e.g., urgency, frequency). Analyses compared OAB to HC, and sexes within OAB on aggregated momentary affective and LUTS ratings reflecting symptom intensity, variability, and instability.</p><p><strong>Results: </strong>Despite equivalent cross-sectional anxiety ratings, OAB participants displayed significantly more severe, variable, and unstable anxiety than HC in EMA, with medium effects (p < 0.001, d = .48-.55). Urinary urgency was the most unstable LUTS in OAB, fluctuating roughly 7 points on an 11-point scale. While women reported more incontinence-related symptoms, men reported greater average frequency.</p><p><strong>Conclusions: </strong>Our findings confirm cross-sectional evidence for increased psychological and urinary burden and provide novel evidence of substantial fluctuations in distress and urinary symptoms in OAB patients. Findings suggest exploring mechanistic links between psychological and urinary symptoms and highlight the utility of EMA as an assessment tool in OAB.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109635","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":"ChatGPT Health and ChatGPT Plus in Urogynecology: A Blinded Comparison of Response Quality, Guideline Concordance, and Safety.","authors":"Aybüke Tayarer","doi":"10.1007/s00192-026-06893-0","DOIUrl":"https://doi.org/10.1007/s00192-026-06893-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>ChatGPT Health is a health-focused conversational artificial intelligence (AI) environment, but its performance in patient-oriented urogynecology has not been directly compared with standard ChatGPT using both validated quality assessment and objective guideline-based criteria. We hypothesized that ChatGPT Health would provide higher patient-facing response quality while maintaining comparable guideline concordance and safety.</p><p><strong>Methods: </strong>Twenty-four guideline-informed patient queries covering common urogynecological and lower urinary tract concerns were submitted independently to ChatGPT Plus and ChatGPT Health on 14 August 2026. Forty-eight responses were anonymized and independently evaluated by five blinded clinicians using the validated Quality Analysis of Medical Artificial Intelligence (QAMAI) instrument, a prespecified five-element guideline-concordance checklist, and a safety scale. Blinded head-to-head preference was assessed secondarily. Prompt-level paired comparisons used Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Median guideline concordance was 100% for ChatGPT Health and 98% for ChatGPT Plus (p = 0.298). ChatGPT Health had a higher blinded five-domain QAMAI subtotal (25.0 vs 24.2; p = 0.026) and greater clarity (p = 0.020), completeness (p = 0.016), and usefulness (p = 0.033), with all three remaining significant after correction for false discovery rate. Accuracy did not differ (p = 0.453). No clinically meaningful safety concerns were identified in 240 ratings. ChatGPT Health was preferred in 47.5% of 120 assessments, ChatGPT Plus in 18.3%, and no meaningful difference was reported in 34.2%.</p><p><strong>Conclusions: </strong>Both platforms generated highly accurate, guideline-concordant, and safe responses. ChatGPT Health showed advantages primarily in clarity, completeness, usefulness, and overall quality of patient-facing communication rather than objective concordance of clinical content.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109658","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 Practice Patterns for Concomitant Anterior Colporrhaphy at the Time of Vaginal Apical Repair: An International Survey of FPMRS Specialists.","authors":"Fernanda Santis-Moya, Asnat Yuabov, Miguel Kreisberg, Howard B Goldman, Javier Pizarro-Berdichevsky","doi":"10.1007/s00192-026-06921-z","DOIUrl":"https://doi.org/10.1007/s00192-026-06921-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>There is a dearth of high-quality evidence to support concomitant anterior colporrhaphy (AC) during vaginal apical repair to reduce pelvic organ prolapse recurrence. This research aims to understand the practice of FPMRS surgeons regarding concomitant repair of anterior and apical compartments during a vaginal approach and explore new options to improve the current often suboptimal results for the anterior compartment. We hypothesized that significant variability in concomitant anterior colporrhaphy practice exists among Female Pelvic Medicine and Reconstructive Surgery (FPMRS) surgeons worldwide.</p><p><strong>Methods: </strong>An IRB-approved online survey was developed to evaluate surgical practices related to apical vaginal repair and the concurrent use of anterior colporrhaphy.</p><p><strong>Results: </strong>Eight hundred forty-five surgeons (77.0% gynecologists, 21.4% urologists, 1.4% other) from 59 countries responded. Seven hundred eighty (92.3%; 95% CI 90.3-93.9%) perform vaginal apical support surgeries, and only those are included in the following analysis: 93.2% (95% CI 91.2-94.8%) would change how they performed AC if there was guidance from a well-designed RCT, 82.3% (95% CI 79.5-84.8%) perform AC in all apical repairs, 16.7% (95% CI 14.2-19.4%) perform AC only if there are defects during apical vaginal suspension, depending on the individual case, and 1.0% (95% CI 0.5-2.0%) do not perform AC.</p><p><strong>Conclusions: </strong>There is high variability in how the anterior compartment is managed during apical suspension. Of note, 16.7% (95% CI 14.2-19.4%) of surgeons apply AC selectively based on individual case assessment, and 1.0% (95% CI 0.5-2.0%) do not perform AC regardless of the presence of an anterior defect. Surgeons are aware of the high anatomical/symptomatic failure for AC at the time of apical repair. Most surgeons would change their practice based on a well-designed RCT. Several strategies to improve the anterior results were proposed and these could be used to plan an RCT that would be well received by the FPMRS surgeons community.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108800","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}