International Urogynecology Journal最新文献

{"title":"TECAR Therapy in Pelvic Floor Rehabilitation for Women with Pelvic Pain: A Case-Control Study.","authors":"Daniela Caramazza, Monia Marturano, Vittoria Rizzitelli, Lediana Kamberaj, Lorenzo Vacca, Andrea Lombisani, Alfredo Ercoli, Giuseppe Campagna","doi":"10.1007/s00192-026-06537-3","DOIUrl":"https://doi.org/10.1007/s00192-026-06537-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Chronic pelvic pain (CPP) with pelvic floor muscle hypertonicity (PFMH) significantly impacts women's quality of life. The hypothesis is that TECAR therapy in standard pelvic floor rehabilitation would enhance pain reduction.</p><p><strong>Methods: </strong>This retrospective case-control study included 138 women with CPP and PFMH treated between January and December 2022. Cases (n = 72) received multimodal rehabilitation with bipolar radiofrequency TECAR therapy; controls (n = 66) received standard rehabilitation alone (Kegel exercises, myofascial stretching, low-frequency electrical stimulation). Pain was measured using the Visual Analogue Scale (VAS) at baseline and 1 month after completion of the rehabilitation program. Multivariable logistic regression and receiver operating characteristic (ROC) analyses identified predictors and optimal treatment thresholds for clinically relevant pain reduction (ΔVAS ≥ 2).</p><p><strong>Results: </strong>Both groups showed significant VAS reduction (p < 0.001), but the TECAR group achieved greater pain reduction (median VAS 8.0 → 3.0 vs 8.0 → 4.0; p < 0.001) and required fewer electrical stimulation sessions (7 vs 10, p < 0.001). In cases, the number of TECAR sessions was significantly associated with ΔVAS ≥ 2 in univariate (OR 1.36, 95%CI 1.01-1.83; p = 0.042) and multivariate models adjusted for baseline VAS, age, and BMI (OR 1.40, 95%CI 1.01-1.93; p = 0.041). No variables predicted response in controls. In cases, ROC analysis identified ≥ 6 TECAR sessions as the optimal threshold for meaningful improvement (AUC 0.80, sensitivity 66.7%, specificity 100%). No adverse events occurred.</p><p><strong>Conclusions: </strong>TECAR therapy enhances pelvic floor rehabilitation effectiveness in women with CPP and PFMH, providing superior pain relief with fewer invasive procedures. The six-session threshold may provide evidence-based guidance on treatment. These findings support the integration of TECAR into standard pelvic rehabilitation protocols.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771327","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":"Response to Letter to the Editor: \"Concerns Regarding Baseline Balance, Blinding Validity, and Clinical Relevance in Aktan et al.'s Study on Home-Based Inspiratory Muscle Training for Stress Urinary Incontinence\".","authors":"Rıdvan Aktan, Seda Yakıt Yeşilyurt, Sevgi Özalevli, Adil Emrah Sonbahar","doi":"10.1007/s00192-026-06622-7","DOIUrl":"https://doi.org/10.1007/s00192-026-06622-7","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intermittent Catheter Clamping Training on Postoperative Urinary Function Recovery in Patients Undergoing Pelvic-Floor Reconstruction: A Prospective Randomized Controlled Trial.","authors":"Liang Chen, Xiuwei Yi","doi":"10.1007/s00192-026-06610-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06610-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>To investigate the effect of intermittent urinary catheter clamping training on the recovery of urinary function in patients after pelvic-floor reconstruction surgery.</p><p><strong>Methods: </strong>A prospective randomized study enrolled patients who underwent pelvic-floor reconstruction at a tertiary hospital from November 2024 to March 2025, with randomization to continuous drainage (n = 90) or intermittent clamping (n = 90) groups (sample size based on pilot data). Outcome measures included 24-/48-h voiding success, 1st-, 3rd-, and 6th-week incidence of urinary retention and urinary tract infection (UTI), as well as postoperative maximum urinary flow rate (Qmax) and Quality of Recovery-15 (QoR-15) score.</p><p><strong>Results: </strong>Baseline characteristics were balanced (all p > 0.05). Intermittent clamping significantly improved 48-h voiding success (69.2% in the control group vs 86.4% in the intervention group, p = 0.047) and postoperative Qmax at all follow-up time points (all p < 0.001); UTI/urinary retention rates and hospital stay of the two groups were comparable. QoR-15 score was significantly higher in the clamping group at the 1st (absolute mean difference = 1.12 points), 3rd (absolute mean difference = 1.49 points), and 6th (absolute mean difference = 0.91 points) weeks (all p < 0.05), but did not meet the eight-point MCID. Subgroup analysis by surgical type showed that intermittent clamping improved Qmax in both the pelvic-floor repair with continence surgery and the repair alone subgroups (all p < 0.01). Subgroup analysis (preoperative PVR > 30 ml) showed that the clamping group had significantly reduced urinary retention (p = 0.031) and higher Qmax (p < 0.05).</p><p><strong>Conclusions: </strong>Intermittent catheter clamping after pelvic-floor reconstructive surgery enhances postoperative bladder function (higher Qmax) without increasing UTI risk or compromising recovery experience. It notably reduces urinary retention in patients with preoperative postvoid residual > 30 ml, serving as a valuable targeted perioperative strategy.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771232","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 Association Between Social Determinants of Health and Overactive Bladder in US Adults: Depression as a Potential Explanatory Factor.","authors":"Renjie Huang, Miao Huang, Rui Zhang","doi":"10.1007/s00192-026-06665-w","DOIUrl":"https://doi.org/10.1007/s00192-026-06665-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>To investigate the association between a composite measure of adverse social determinants of health (SDOH) and overactive bladder (OAB) among US adults, and to assess the potential role of depression in this relationship.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of adult participants (≥ 18 years) from the 2005-2016 National Health and Nutrition Examination Survey (NHANES). A composite SDOH score (range 0-8) was derived from eight adverse conditions across economic, educational, healthcare, housing, and social domains. OAB was defined using the Overactive Bladder Symptom Score (OABSS ≥ 3). Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9 ≥ 10). Survey-weighted multivariable logistic regression models were used to examine associations, adjusting for covariates. Mediation analysis quantified the proportion of the SDOH-OAB association explained by depression.</p><p><strong>Results: </strong>Among 27,429 participants (weighted n = 191.7 million), the prevalence of OAB was 19.3%. In the fully adjusted model, each 1-unit increase in the SDOH score was associated with 16% higher odds of OAB (OR 1.16; 95% CI 1.14-1.18). A clear dose-response relationship was observed across SDOH categories (P for trend < 0.01). Key individual SDOH components, including unemployment, poverty, and food insecurity, were independently associated with OAB. Depression accounted for a substantial proportion of the total association between SDOH and OAB. The positive SDOH-OAB association was consistent across most subgroups, and findings were robust in sensitivity analyses.</p><p><strong>Conclusions: </strong>A greater burden of adverse social determinants of health is associated with an increased prevalence of OAB in US adults. This relationship may be partially explained by depression.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771275","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":"Mesh Exposure After Laparoscopic Sacrocolpopexy: Caution in Attributing Risk to Concomitant Hysterectomy.","authors":"Ömer Faruk Öz, Can Dinç","doi":"10.1007/s00192-026-06671-y","DOIUrl":"https://doi.org/10.1007/s00192-026-06671-y","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771183","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":"Interpreting the Association Between Obstructive Sleep Apnea Severity and Overactive Bladder.","authors":"Elif Balevi Batur, Ali Furkan Batur","doi":"10.1007/s00192-026-06631-6","DOIUrl":"https://doi.org/10.1007/s00192-026-06631-6","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771179","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 \"Impact of Vaginal Hysterectomy on Quality of Life, Body Image, and Sexual Function in Women with Pelvic Organ Prolapse: A Study of Rural Women in a Low-Resource Setting\".","authors":"Yu-Hsuan Chung, Cheng-Yu Long","doi":"10.1007/s00192-026-06628-1","DOIUrl":"10.1007/s00192-026-06628-1","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771188","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":"Can Low Dose Tadalafil Improve the Sexual Functions in Women with Genital Mutilation?","authors":"Ahmed M Rammah, Samer Morsy, Hussein Ali Hussein, Sara M Hassan, Dalia Farouk, Karem M Daw","doi":"10.1007/s00192-026-06643-2","DOIUrl":"https://doi.org/10.1007/s00192-026-06643-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Female genital mutilation (FGM) is associated with female sexual dysfunction (FSD) through anatomical disruption and impaired genital vascular function. Phosphodiesterase-5 inhibition may enhance genital perfusion via nitric oxide-mediated pathways. We hypothesized that tadalafil improves sexual function and clitoral vascular parameters in women with FGM-related FSD.</p><p><strong>Methods: </strong>In this randomized, single-blind, placebo-controlled trial, 66 women with FGM-related FSD were randomized; 52 completed follow-up and were included in a modified intention-to-treat analysis (tadalafil 5 mg once daily, n = 25; placebo, n = 27) for 8 weeks. Sexual function was assessed using the Female Sexual Function Index (FSFI). Their FGM type was classified on the basis of WHO criteria. Clitoral color Doppler ultrasonography measured peak systolic velocity (PSV), resistance index (RI), and pulsatility index (PI). The primary endpoint was the between-group difference in change in total FSFI score from baseline to 8 weeks.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Tadalafil significantly improved total FSFI score compared with placebo (mean change +5.47 vs -0.41; p < 0.001). Improvements were observed across all FSFI domains except lubrication. Significant increases in clitoral PSV, RI, and PI were detected in the tadalafil group, whereas no significant changes occurred in the placebo group. Greater benefit was observed in women with type I FGM.</p><p><strong>Conclusions: </strong>Once-daily tadalafil 5 mg for 8 weeks significantly improves sexual function and genital vascular parameters in women with FGM-related FSD, supporting its potential therapeutic role in this population.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728893","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":"Compartment-Specific Associations Between Perineal Body Length and Pelvic Organ Prolapse in Postpartum Women.","authors":"Yun Liu, Juan He, Hui Fei, Tian Li","doi":"10.1007/s00192-026-06563-1","DOIUrl":"https://doi.org/10.1007/s00192-026-06563-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic floor dysfunction (PFD) is common after childbirth, but the role of perineal body dimensions in compartment-specific prolapse remains unclear. To investigate the association between perineal body length and various types of pelvic floor dysfunction in postpartum women, with emphasis on compartment-specific effects.</p><p><strong>Methods: </strong>This cross-sectional study included 182 women assessed 30-90 days postpartum at a specialized pelvic floor clinic. Trained examiners measured perineal body length; outcomes assessed were anterior/posterior wall prolapse, uterine prolapse, stress urinary incontinence (SUI), and pelvic floor muscle weakness. Multivariable logistic regression (adjusted for age, pre-pregnancy BMI, delivery mode, postpartum days) was performed. Examiners were partially blinded.</p><p><strong>Results: </strong>Perineal body length showed compartment-specific prolapse associations: longer length was inversely associated with posterior wall prolapse (OR 0.544, 95% CI 0.313-0.943, P = 0.030) but positively associated with anterior wall prolapse (OR 3.558, 95% CI 1.133-11.167, P = 0.030; exploratory due to a few non-cases and wide CIs). No significant associations were observed with SUI, muscle weakness, or uterine prolapse. Sensitivity analysis including 16 additional women assessed after 90 days (total n = 198) showed consistent results.</p><p><strong>Conclusions: </strong>Perineal body length is differentially associated with anterior and posterior prolapse, reflecting compartment-specific pelvic floor support. The cross-sectional design and lack of pre-delivery measurements mean findings are associative (not causal) and should be validated in larger prospective studies.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728906","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":"Is There a Difference in Hiatal Area on Straining Between Type I and II Levator Avulsions?","authors":"Ka-Wing Lau, Hans Peter Dietz, Ka Lai Shek","doi":"10.1007/s00192-026-06637-0","DOIUrl":"https://doi.org/10.1007/s00192-026-06637-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>A distinction can be made between levator avulsions that preserve the appearance of a connection to the pelvic sidewall (type I), and those that do not (type II). We evaluated whether avulsion type affects hiatal area on straining.</p><p><strong>Methods: </strong>This retrospective observational study used archived patient data from a tertiary urogynaecological service between 2/2019 and 12/2020. All patients underwent a standardized interview, POP-Q examination, and 4D pelvic floor ultrasound. On analysing the archived volume data, the first author assessed hiatal area on maximum straining, the second author determined avulsion type, blinded to all other data. The primary outcome was hiatal area on straining, with avulsion type as the explanatory variable.</p><p><strong>Results: </strong>Inter-rater reliability for hiatal area on straining showed an intraclass correlation coefficient (ICC) of 0.872. Five hundred and twenty-four archived volume data were available. Mean age was 58 years (range 20-95), mean body mass index (BMI) was 29.1 kg/m² (range 16.9-56.8), and mean parity was 3 (range 0-8). Stress and urgency urinary incontinence were reported in 387 (73.9%) women, prolapse symptoms in 267 (51%). Mean POP-Q points were Ba = -1 cm (-3 to +5), C = -5 cm (-10 to +9), and Bp = -1 cm (-3 to +3). Mean hiatal area on straining was 26.9 cm² (8.1-60 cm²). A full/complete avulsion defined as detachment of the pubococcygeous/puborectalis or 'pubovisceralis' muscle from its insertion on the inferior pubic ramus was diagnosed in 124 women (24%), with 43 (8%) bilateral. Avulsion type classification was impossible in 10 due to suboptimal image quality; in 80, we found a type I avulsion (15.3%), and in 34, a type II (6.5%). No significant difference was observed in hiatal area on straining between type I and type II avulsions (32.6 cm² [SD 8.39] vs. 33.48 cm² [SD 11.29]; P = 0.6).</p><p><strong>Conclusions: </strong>Levator avulsion type does not seem to significantly affect hiatal area.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728877","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}