{"title":"Response to Letter to the Editor \"Joint Terminology Report: Terminology Standardization for Female Bladder Pain Syndrome\".","authors":"Rhonda Kotarinos, Sarah Collins","doi":"10.1007/s00192-025-06221-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06221-y","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591225","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":"Turkish Adaptation and Psychometric Evaluation of the Barriers to Incontinence Care-Seeking Questionnaire.","authors":"Seda Yakit Yeşilyurt, Hanife Büşra Hekimoğlu, Merve Başol Göksülük, Patricia Brihuega González, Hatice Çankaya, Nuriye Özengin","doi":"10.1007/s00192-025-06199-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06199-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study was aimed at adapting, validating, and assessing the reliability of the Turkish version of the \"Barriers to Incontinence Care-Seeking Questionnaire\" (BICS-Q).</p><p><strong>Methods: </strong>One hundred and forty-eight Turkish women with mild to moderate urinary incontinence (UI) was assessed. The adaptation process was conducted in alignment with the COSMIN guidelines: forward-backward translation, expert review, cultural adaptation, and a pilot study. For construct validity, items from the study by El-Azab and Shaaban, which measure barriers to seeking care for incontinence, were adapted to this self-reported questionnaire (BICS-Q), and their associations with the total score as well as the subscale scores of the questionnaire were evaluated. Cronbach's alpha was used for internal consistency, and the intraclass correlation (ICC) coefficient was estimated for test-retest reliability.</p><p><strong>Results: </strong>The psychometric analyses indicated that the Turkish BICS-Q has high internal consistency (Cronbach's alpha = 0.846) and test-retest reliability (ICC = 0.854). Item analysis revealed that each item was significantly correlated with the total score, thereby confirming construct validity. It was also found that embarrassment, financial concerns, and low expectations from medical consultation were ranked as the most important barriers to treatment.</p><p><strong>Conclusions: </strong>This study demonstrated the applicability of the Turkish BICS-Q for both research and clinical purposes, emphasizing its role in identifying health care inequalities and guiding policy improvements for women with UI. The present validation study provides evidence that the Turkish BICS-Q is an appropriate tool for assessing barriers to incontinence care seeking that can be used to further research and interventions toward overcoming the barriers in Turkey.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575476","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}
Necmettin Yildiz, Saadet Nur Sena Oztekin, Yesim Akkoc
{"title":"Comparison of Magnetic and Transcutaenous Tibial Nerve Stimulation Added to Bladder Training for Overactive Bladder: A Randomized Controlled Trial.","authors":"Necmettin Yildiz, Saadet Nur Sena Oztekin, Yesim Akkoc","doi":"10.1007/s00192-025-06215-w","DOIUrl":"https://doi.org/10.1007/s00192-025-06215-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study aimed to compare the efficacy of magnetic stimulation (MStim) and transcutaneous tibial nerve stimulation (TTNS), both combined with bladder training (BT), in women with idiopathic overactive bladder (iOAB).</p><p><strong>Methods: </strong>Women with iOAB were randomized into three groups: group 1 received BT only; group 2 received MStim plus BT; and group 3 received TTNS plus BT. MStim and TTNS were administered twice weekly, 30 min per session, for a total of 12 sessions over 6 weeks. The primary outcome was the positive response rate, defined as ≥ 50% fewer incontinence episodes, measured via a 3-day bladder diary at 6 weeks. Seconder outcomes included incontinence severity (pad test), voiding frequency, incontinence episodes, nocturia, number of pads used, symptom severity (OAB-V8), QoL (IIQ-7).</p><p><strong>Results: </strong>According to the sample size calculation, 66 women were included in the study, with 22 assigned to each group. The three groups were comparable in terms of demographic and clinical characteristics. The positive response rate (primary outcome) was significantly higher in groups 2 and 3 compared to group 1 at week 6 (66.7% and 90.5% vs. 35.0%, p = 0.001), with no significant difference between groups 2 and 3 (p = 0.130). Both stimulation groups (each n = 21) demonstrated significant improvements in incontinence severity, incontinence episodes, number of pads used, symptom severity, QoL, and treatment satisfaction compared to the BT-only group (n = 20) (p < 0.0167). No significant differences were found between group 2 and group 3 for these parameters. Voiding frequency significantly improved in group 3 (med 11 to 6) compared to group 1 (med 11 to 8) and group 2 (med 12 to 8) (p < 0.0167).</p><p><strong>Conclusions: </strong>Both MStim plus BT and TTNS plus BT are more effective than BT alone in women with iOAB. These two stimulation methods have similar clinical efficacy, with TTNS demonstrating greater effectiveness in reducing voiding frequency.</p><p><strong>Clinical trial registration: </strong>This study was registered with ClinicalTrials.gov number, NCT05387824.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575463","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}
Bianca B Mengerink, Emma E Pluymen, Sanne A L van Leijsen, Esmee N de Jong, John P F A Heesakkers, Kirsten B Kluivers
{"title":"Persistent or Recurrent Urinary Incontinence 8 Years After Midurethral Sling Surgery: A Retrospective Cohort Study.","authors":"Bianca B Mengerink, Emma E Pluymen, Sanne A L van Leijsen, Esmee N de Jong, John P F A Heesakkers, Kirsten B Kluivers","doi":"10.1007/s00192-025-06183-1","DOIUrl":"https://doi.org/10.1007/s00192-025-06183-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Midurethral sling (MUS) surgery improves the quality of life of women with stress urinary incontinence (SUI). Nonetheless, treatment can fail leaving some women who still suffer from urinary incontinence post-surgery. This study determines the prevalence of persistent or recurrent urinary incontinence 8 years after MUS surgery and describes the type and effectiveness of additional treatments.</p><p><strong>Methods: </strong>This retrospective cohort study is a long-term follow-up study on women who participated in a randomized controlled trial (RCT) on the value of urodynamics and who underwent MUS surgery (VUSIS-2 study). Data were collected through medical file review in 12 of 30 recruiting hospitals, representing 68.2% of inclusions. Data on postoperative symptoms, additional diagnostics and treatments were collected.</p><p><strong>Results: </strong>Of 578 VUSIS-2 participants, 301 (52.1%) medical files were analysed. Urinary incontinence symptoms were reported in 71 cases (23.6% [95% CI 19.1-28.7]) over a median follow-up of 7.8 years. SUI symptoms were reported in 38 patients (12.6%), including 18 patients (6.0%) [95% CI 2.6-9.3]) with persistent and 20 patients (6.6%) [95% CI 3.1-10.1] with recurrent SUI. Urgency urinary incontinence was reported in 51 medical files (16.9%) [95% CI 11.9-21.6], whereof 18 patients had mixed urinary incontinence complaints. Additional treatment was received in 42 patients (59.2% of incontinent cases [95% CI 47.5-69.8]), of whom nine (3.0%) received additional surgery (3 excisions/removals (1.0%) and two additional MUS placements (0.7%)).</p><p><strong>Conclusions: </strong>In this retrospective long-term follow-up study among women receiving MUS surgery for predominant SUI, postoperative urinary incontinence symptoms were reported in nearly a quarter of cases. One-third of these women did not receive additional treatment. The prevalence of repeat surgery was 5.6%.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575464","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}
Rakel Gabrielsen, Kari Bø, Marie Ellström Engh, Merete Kolberg Tennfjord
{"title":"Is Pelvic Floor Muscle Resting Activity Associated with Pelvic and Genital Pain, Dyspareunia, and Pelvic Floor Muscle Contraction? A Cross-Sectional Study of Women with Endometriosis.","authors":"Rakel Gabrielsen, Kari Bø, Marie Ellström Engh, Merete Kolberg Tennfjord","doi":"10.1007/s00192-025-06190-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06190-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>A link between pelvic and genital pain, dyspareunia, and increased pelvic floor muscle (PFM) tone is an area of controversy. Additionally, it has been postulated that increased PFM tone can limit the ability to further activate the PFM. We aimed to investigate the association between PFM resting activity and pelvic and genital pain and dyspareunia, and whether there is an association between PFM resting activity and activation during attempts at PFM maximal voluntary contractions (MVCs) in women with endometriosis.</p><p><strong>Methods: </strong>This cross-sectional study included 80 women with endometriosis and pelvic and genital pain. An electronic questionnaire included background information, pelvic and genital pain (numeric rating scale 0-10) and questions about location and concerns of dyspareunia. Associations between variables were analyzed using multiple linear regression. PFM resting activity was registered as the mean microvolt (μV) during rest before and between five voluntary MVCs of the PFM.</p><p><strong>Results: </strong>Mean age was 29 years (SD 6.2), and 9 (11%) were parous. No significant association between resting activity, pelvic and genital pain or location and concerns of dyspareunia was found. A significant positive association between PFM resting activity and activation during attempts at MVCs of the PFM (β = 0.130, p = 0.009, 95% CI = 0.034-0.229) was found.</p><p><strong>Conclusion: </strong>No association was found between PFM resting activity and pelvic and genital pain or location and concerns of dyspareunia. Contrary to the hypothesis, higher PFM resting activity resulted in more activation of the PFM during attempts at MVCs.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540199","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 Relationship Between the Distance of Common Iliac Artery Bifurcation to the Sacral Promontory and Sacropelvic Parameters: Implications for Sacropexy Operations.","authors":"Onur Bektaş, Kıvılcım Bektaş","doi":"10.1007/s00192-025-06176-0","DOIUrl":"https://doi.org/10.1007/s00192-025-06176-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study is aimed at assessing how sacropelvic parameters influence the spatial proximity between the sacral promontory and the aorta-common iliac artery bifurcation, which is of particular relevance in gynecological surgeries involving the presacral region.</p><p><strong>Methods: </strong>Abdominal computed tomography (CT) scans of 223 female patients, obtained for various unrelated clinical indications, were retrospectively evaluated. The distance between the aorta-common iliac artery bifurcation and the sacral promontory (aBPD), as well as sacropelvic parameters, were measured on these CT images. The relationship between aBPD and both demographic variables and sacropelvic parameters was analyzed.</p><p><strong>Results: </strong>The average distance (aBPD) was measured as 40.81 mm, with the bifurcation most frequently located at the L4 vertebral body level. Statistical analyses revealed that the aBPD had a negative correlation with age (p < 0.001) and hypertension (p = 0.026), while showing a positive correlation with BMI (p = 0.008), diagonal conjugate (DC) (p = 0.029), and pelvic thickness (PTH) (p = 0.031).</p><p><strong>Conclusions: </strong>A shorter aBPD was identified in patients with hypertension, low BMI, shorter PTH, shorter DC, and advanced age. These findings underscore the importance of considering individual anatomical variations during surgical risk assessment. Recognizing such factors may help to reduce the risk of vascular injury and enhance the safety and effectiveness of sacropexy procedures.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527939","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 \"Effect of Preoperative Tamsulosin on Postoperative Urinary Retention Prevention after Sling Placement: A Randomized Controlled Trial\".","authors":"Alexandre Fornari","doi":"10.1007/s00192-025-06218-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06218-7","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527855","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}
Christopher P Chung, Wilma I Larsen, Thomas J Kuehl
{"title":"Magnetic Resonance Imaging Evaluation of Pregnancy and Aging on External Anal Sphincter Volume in Squirrel Monkeys.","authors":"Christopher P Chung, Wilma I Larsen, Thomas J Kuehl","doi":"10.1007/s00192-025-06189-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06189-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Both humans and squirrel monkeys are susceptible to pelvic floor injury and prolapse from pregnancy, delivery, and aging. The mechanisms for external anal sphincter (EAS) injury in squirrel monkeys have not been evaluated in detail. This study evaluates a method for measuring EAS volume using magnetic resonance imaging (MRI) in squirrel monkeys and demonstrates the feasibility of serial measurements.</p><p><strong>Methods: </strong>Using a previously described procedure, MRI was performed on 10 squirrel monkeys prior to euthanasia. After euthanasia, tissue blocks of EAS were cryo-sectioned and stained with succinic dehydrogenase to identify EAS striated muscle fibers. EAS volumes from both MRI and histological measurements were calculated using image analysis software. MRI measurements were obtained by two independent investigators. A cohort of four monkeys, each having five pregnancies and 11 MRI studies over a 5-year span, was used to evaluate EAS volume changes serially within females.</p><p><strong>Results: </strong>Volumes measured by MRI for each squirrel monkey were similar for the two researchers (Cronbach alpha of 0.97 with 95% lower confidence limit of 0.92), and they were statistically consistent with the volumes obtained from analysis of histology (linear regression with R-squared of 0.97 and p < 0.0001). This validated technique was used to measure EAS volumes in four breeding females and demonstrated sufficient power to detect a decrease (p < 0.00001) from 32.1 ± 3.2 mm<sup>3</sup> (mean ± SE) prior to the first pregnancy to 10.7 ± 1.5 mm<sup>3</sup> after five pregnancies in 5 years.</p><p><strong>Conclusion: </strong>Magnetic resonance imaging is a valid technique for measuring EAS volume changes in squirrel monkeys with sufficient sensitivity to detect EAS volume changes such that effects of aging and serial pregnancies can be evaluated.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527879","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}
Qi Wang, Xiaoxiang Jiang, Stefano Manodoro, Chaoqin Lin
{"title":"Outcomes of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Uterosacral Ligament Suspension in Apical Compartment Prolapse: A Systematic Review.","authors":"Qi Wang, Xiaoxiang Jiang, Stefano Manodoro, Chaoqin Lin","doi":"10.1007/s00192-025-06195-x","DOIUrl":"https://doi.org/10.1007/s00192-025-06195-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This systematic review is aimed at assessing the efficacy and safety of transvaginal natural orifice transluminal endoscopic surgery-uterosacral ligament suspension (vNOTES-USLS) based on current evidence.</p><p><strong>Methods: </strong>A comprehensive search of PubMed and Web of Science was conducted for studies published up to 31 December 2024. Original studies on vNOTES-USLS were included, whereas reviews, abstracts, and publications not in the English language were excluded. No restrictions were placed on sample size or publication date.</p><p><strong>Results: </strong>Nine studies with 336 patients met the criteria, including 1 randomized controlled trial, 3 prospective, and 5 retrospective studies. Operative time ranged from 17.4 ± 6.4 to 29.7 ± 8.2 minutes. Hemoglobin reduction varied between 1.12 ± 0.83 and 1.80 ± 1.57 g/dl. Hospital stays ranged from 1.0 ± 0.5 to 3.7 ± 1.1 days. Intraoperative complications occurred in 2.1% (7 out of 336), with bladder injury being the most common (3 cases). One patient required conversion to vaginal USLS, but no laparotomy conversions were reported. Ureteral kinking occurred in 1 case (0.3%) and was resolved intraoperatively. Postoperative complications were reported in 7.4% (25 out of 336), with urinary tract infection being the most frequent (10 cases). Over 1-37 months of follow-up, 1 patient required reoperation for anterior prolapse recurrence.</p><p><strong>Conclusion: </strong>vNOTES-USLS appears to be a promising option for apical prolapse, with favorable short-term outcomes. However, small sample sizes, short follow-ups, and study design variations limit current evidence. Larger prospective studies with longer follow-ups and direct comparisons with established procedures are needed to assess long-term safety and effectiveness.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527938","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 Problem of Recurrent Anterior Wall Prolapse after Supracervical Hysterectomy with Sacrocolpopexy\".","authors":"Kaven Baessler","doi":"10.1007/s00192-025-06224-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06224-9","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527851","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}