International Urogynecology Journal最新文献

{"title":"Comment on \"Expressions of IGF-1, pAKT, and pS6 in Uterosacral Ligaments of Patients with Pelvic Organ Prolapse\".","authors":"Aravinth Annamalai","doi":"10.1007/s00192-025-06315-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06315-7","url":null,"abstract":"","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":"145148983","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":"Assessing Self-Management Coping in Urinary Incontinence: Psychometric Evaluation of the UI-SMCSI in Middle-Aged Women.","authors":"Marta G Porto, Filipa Pimenta, Inês Queiroz-Garcia, Marta Uva, Matilde Patrone, Teresa Mascarenhas, João Marôco","doi":"10.1007/s00192-025-06274-z","DOIUrl":"https://doi.org/10.1007/s00192-025-06274-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence (UI) significantly impairs women's quality of life and often leads to the adoption of self-management coping strategies. This study aimed to develop and validate the UI Self-Management Coping Strategies Instrument (UI-SMCSI) to assess coping strategies in women with UI.</p><p><strong>Method: </strong>A sample of 1538 Portuguese women aged 40-65 years with self-reported UI participated in the study. A quantitative design was employed to evaluate the instrument's factor structure, multigroup invariance, internal consistency, and validity evidence based on its internal structure and relations to other variables.</p><p><strong>Results: </strong>Confirmatory factor analysis supported a bidimensional first-order structure comprising defensive and hiding strategies, with excellent model fit indices (CFI = .989; TLI = .987; RMSEA = .072). Internal consistency was strong (α_defensive = .94; α_hiding = .80). Measurement invariance was confirmed across UI subtypes (stress, urge, and mixed). Convergent validity was supported by a moderately strong correlation (r = .615, p < .001) with the severity measures dimension of the King's Health Questionnaire.</p><p><strong>Discussion: </strong>The UI-SMCSI is a reliable and valid instrument for assessing UI self-management coping strategies among Portuguese women with UI. It offers a practical tool for healthcare professionals to identify behavioral patterns that may hinder effective UI management. Future research should explore the scale's sensitivity to intervention and its applicability to other demographic and cultural populations.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137748","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":"Evaluating Fundamentals of Vaginal Surgery for Use Among Obstetrics and Gynecology Residents in Accra, Ghana.","authors":"Marie Bangura, Gabriel Ganyaglo, David Kupualor, Alex Boateng, Perez Sepenu, Isaac Koranteng, Emma R Lawrence, Deborah Rooney, Payton Schmidt","doi":"10.1007/s00192-025-06343-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06343-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>We aimed to assess obstetrics and gynecology (Ob/Gyn) resident experience and confidence with vaginal surgery and ability to perform basic vaginal surgery skills using a vaginal surgery simulator at a teaching hospital in Ghana. We present validity evidence and a region-specific proficiency score that can be used for training.</p><p><strong>Methods: </strong>In this cross-sectional study at a teaching hospital in Accra, Ghana, Ob/Gyn residents in a 3-year training program completed a survey on demographics, vaginal surgery exposure, and surgical confidence. Using the Fundamentals of Vaginal Surgery (FVS) simulation system, participants performed five timed tasks twice each. A region-specific proficiency score of ≥ 266 was used to assess skill proficiency.</p><p><strong>Results: </strong>Thirty-four participants were enrolled. Of the 22 who provided details about types of vaginal surgery they had performed, only two (9.1%) had completed a vaginal hysterectomy in the past 12 months. All participants described being \"not at all confident\" in performing vaginal hysterectomy and other vaginal surgeries and \"somewhat or slightly confident\" in their surgical skills. The median (IQR) overall normalized score for the FVS hands-on skills assessment was 57.5 (6.3, 113.8) for novice and 160.0 (95.8, 312.0) for experienced participants (P = 0.005). Five percent of novice and 28.6% of experienced participants achieved the proficiency score of ≥ 266.</p><p><strong>Conclusions: </strong>We present validity evidence and a region-specific proficiency score supporting the use of FVS in a Ghanaian training program. Limited experience in vaginal surgery, low confidence and performance scores highlight an opportunity to utilize this training system.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137775","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 Handgrip Strength With Urinary Incontinence in Postmenopausal Korean Women: A Machine Learning Study.","authors":"Sung Jin Kim, Young Goo Lee, Ohseong Kwon, Sahyun Pak, Sung Gon Park, Sung Tae Cho","doi":"10.1007/s00192-025-06310-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06310-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence (UI) is a common condition in older women and is associated with frailty and functional decline. Handgrip strength is a simple, noninvasive marker of muscle function that may help identify women at risk for UI. This study aimed to examine the association between handgrip strength and UI in postmenopausal Korean women and evaluate its predictive utility using machine learning models.</p><p><strong>Methods: </strong>We analyzed data from 4213 postmenopausal women aged ≥45 years who participated in the Korean Longitudinal Study of Aging (2006 -2022). UI was defined as reporting urine leakage on ≥5 days during the past month. Handgrip strength was measured using a standardized digital dynamometer protocol. Five machine learning models-logistic regression, random forest (RF), support vector machine, extreme gradient boosting (XGB), and deep neural network-were used to predict UI. Model performance was evaluated using fivefold cross-validation. Logistic regression and generalized additive models were used to validate findings.</p><p><strong>Results: </strong>Among postmenopausal women, the prevalence of UI was 26.0%. Compared to the continent group, individuals with UI were older (73.5 ± 6.7 vs. 68.3 ± 6.1 years, p < 0.001), exhibited lower handgrip strength (20.4 ± 4.8 vs. 22.5 ± 4.9 kg, p < 0.001), and had a higher burden of comorbidities and functional impairments. In multivariable logistic regression models adjusting for age, BMI, and other demographic, clinical, lifestyle, and frailty-related symptom variables, lower handgrip strength remained independently associated with UI (adjusted OR 0.971, 95% CI 0.951-0.992 per 1 kg decrease). RF and XGB models demonstrated robust predictive performance, with AUCs of 0.887 and 0.860, respectively. A handgrip strength threshold of 15.75 kg was identified as a clinically relevant cutoff below which UI risk increased.</p><p><strong>Conclusion: </strong>Handgrip strength is independently associated with UI in postmenopausal women. As a practical and noninvasive measure, it may be useful in identifying individuals at increased risk of incontinence and guiding early interventions.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137786","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":"Comparison of Abdominal Muscle Thickness and Lumbopelvic Control Among Women With and Without Different Severity of Stress Urinary Incontinence.","authors":"Ui-Jae Hwang, Oh-Yun Kwon, Minju Kim","doi":"10.1007/s00192-025-06286-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06286-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Stress urinary incontinence (SUI) may be related to dysfunction of the core stabilizing system. We hypothesized that women with more severe SUI would demonstrate reduced abdominal-muscle thickness and decreased lumbopelvic control. This study investigated differences in abdominal-muscle thickness and lumbopelvic control among women with different SUI severities compared with continent women.</p><p><strong>Methods: </strong>This cross-sectional study included 54 women: 21 women with mild SUI, 12 women with moderate SUI, and 21 healthy controls. Abdominal-muscle thickness was measured using ultrasonography. Lumbopelvic control was assessed using one- and double-leg-lowering tests. One-way analysis of variance and post hoc tests were used for data analysis.</p><p><strong>Results: </strong>Women with both mild and moderate SUI demonstrated significantly reduced thickness of the transversus abdominis (p < 0.01), internal oblique (p < 0.01), and external oblique muscles (p < 0.01). The SUI groups also exhibited lower angles in the one-leg-lowering test (control = 67.04 ± 20.78°; mild SUI = 46.25 ± 31.43°; moderate SUI = 34.31 ± 32.10°; p < 0.01) and the double-leg-lowering test (control = 45.19 ± 24.56°; mild SUI = 28.96 ± 23.90°; moderate SUI = 24.38 ± 26.17°; p = 0.04).</p><p><strong>Conclusions: </strong>Women with SUI demonstrated significantly reduced abdominal-muscle thickness and lower performance on lumbopelvic control tests than continent women, with more pronounced deficits in moderate SUI. These findings highlight alterations in the core stabilizing system associated with SUI severity. Comprehensive rehabilitation approaches addressing both pelvic-floor and core-muscle function may be beneficial.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130857","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":"Treatment Choice in Stress Urinary Incontinence Should be Guided By Severity.","authors":"Nicole Claudia Keller, David Amos Scheiner, Cornelia Betschart","doi":"10.1007/s00192-025-06328-2","DOIUrl":"10.1007/s00192-025-06328-2","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130824","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":"Does Pre-Operative Grade of Stress Urinary Incontinence Severity Affect the Post-Operative Outcome? A Systematic Review.","authors":"Themistoklis Mikos, Nikolaos Roussos, Iakovos Theodoulidis, Christos Anthoulakis, Grigoris F Grimbizis","doi":"10.1007/s00192-025-06275-y","DOIUrl":"10.1007/s00192-025-06275-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>It is not known whether assessment of severity of stress urinary incontinence (SUI) is important before any attempt at the correction of it. The aim of this study is to identify the success rates and/or dry rates following interventional treatment in patients with mild, moderate, and severe SUI, and compare the results among the various treatments.</p><p><strong>Methods: </strong>This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the Prospective Register of Systematic Reviews System (ID: CRD420251017900), by searching PubMed, Scopus, and Cochrane Library Database from inception to December 2024. The Population, Intervention, Comparison, Outcomes, and Study design criteria were as follows: the 'Population' were adult women who underwent an interventional procedure for SUI and had pre- and post-interventional classification of SUI severity. As 'Intervention' was considered any type of interventional procedure: colposuspensions, mid-urethral slings (MUS), pubo-vaginal slings, energy-based devices (EBD), and injectables. 'Comparison' was considered between either single or comparative interventions according to the pre- and post-operative grade of SUI severity. 'Outcomes' were the success rates and/or dry rates according to pre- and post-operative grade of SUI severity.</p><p><strong>Results: </strong>From a total of 11,535 studies, 24 (4380 patients) were included for further analysis: in 13 studies (n = 3599) a graft was used and in 11 studies (n = 781) other interventions. Successful treatment of mild incontinence was achieved in 84.7% (MUS = 89.6%, EBD = 66.7%, p < 0.001), of moderate incontinence in 88.3% (MUS = 92.0%, EBD = 52.5%, p < 0.001), and of severe/very severe incontinence in 75.7% (MUS = 83.9%, EBD = 44.3%, p < 0.001).</p><p><strong>Conclusions: </strong>The success rates of any incontinence procedure depend largely on the pre-operative severity of SUI, and they are significantly lower with increasing severity of the SUI. MUS appear to have improved treatment rates compared with EBD, independently of the severity of SUI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130852","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":"Perineoplasty, Pain, and Urinary Retention Following Native Tissue Vaginal Prolapse Surgery.","authors":"Isabella Cervantes, Rachel A Kracaw, Gracen Moran, Spoorthi Kamepalli, Belia Camarena, Mark Turrentine, Mary Duarte Thibault, Francisco J Orejuela, Charles C Kilpatrick","doi":"10.1007/s00192-025-06318-4","DOIUrl":"https://doi.org/10.1007/s00192-025-06318-4","url":null,"abstract":"<p><strong>Introduction: </strong>Perineoplasty is commonly performed at the time of pelvic reconstructive surgery. Data on the immediate postoperative complications from perineoplasty are sparse.</p><p><strong>Objective: </strong>Perineoplasty performed at the time of vaginal prolapse surgery increases postoperative urinary retention and pain.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study on patients undergoing vaginal prolapse surgery with or without perineoplasty from 2014-2023 at an academic institution. Demographics, intra and postoperative characteristics, including pain scores, medical comorbidities, and surgical procedures performed, were compared. Postoperative urinary retention was defined as failing a retrograde voiding trial necessitating discharge home with a catheter. Acute postoperative pain in the postanesthesia care unit was assessed using a visual analogue scale. Multivariate and univariate analyses were completed.</p><p><strong>Results: </strong>Seven hundred fifteen patients underwent vaginal native tissue repair surgery for pelvic organ prolapse. Two hundred eighty-one (39%) eligible patients underwent perineoplasty. Patients who had a perineoplasty were more likely to have urinary retention when compared to those without perineoplasty (30.2% vs 19.1%, p < 0.01). There was no statistically significant difference in immediate postoperative pain in patients that underwent perineoplasty.</p><p><strong>Conclusions: </strong>We found a significant association between perineoplasty and postoperative urinary retention. Surgeons should discuss with their patients the risks and benefits of perineoplasty.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112918","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 Impact of Treatment Setting on Periurethral Bulking.","authors":"Erin E Mowers, Mary F Ackenbom, Lauren E Giugale, Amanda M Artsen","doi":"10.1007/s00192-025-06236-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06236-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Whether treatment setting impacts periurethral bulking efficacy is unknown. We hypothesized that periurethral bulking treatment failure rates would be greater for office versus operating room procedures.</p><p><strong>Methods: </strong>A retrospective cohort study including 113 patients undergoing polyacrylamide hydrogel periurethral bulking at a single academic medical center between 1 September 2022 and 30 March 2024 was carried out. Demographic and clinical variables, procedural details, patient satisfaction, and retreatment rates were abstracted. Primary outcomes included 6-month treatment failure, defined as no improvement following treatment, decision for additional therapy, or aborted procedure. Secondary outcomes included 12-month treatment failure and 6- and 12-month retreatment rates. Chi-squared, Fisher's exact, Mann-Whitney U, and t tests were applied, and logistic regression was used to identify factors associated with treatment failure.</p><p><strong>Results: </strong>The 6- and 12-month treatment failure rates in the operating room versus office cohorts were 32.4% vs 51.3% (p = 0.05) and 48.1% vs 50.0% (p = 0.87) respectively. Retreatment rates and modality did not differ. Approximately 15% of office cases but no operating room cases were unable to be completed as planned (p < 0.01). Office setting was associated with 3.23 increased odds of 6-month treatment failure (p < 0.05).</p><p><strong>Conclusions: </strong>Periurethral bulking in the office may be more likely to result in early treatment failure than bulking performed in the operating room, but any benefit appears short lived, with similar 12-month treatment failure and retreatment rates. Our findings, together with consideration of individual patient characteristics and resource optimization, can guide decisions regarding the appropriate treatment setting for periurethral bulking.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091645","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":"Commentary on \"Complication Rates are Low for Women Aged 70 and Older Undergoing Sacrocolpopexy\".","authors":"Zdenek Rusavy","doi":"10.1007/s00192-025-06337-1","DOIUrl":"https://doi.org/10.1007/s00192-025-06337-1","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080610","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}