International Urogynecology Journal最新文献

{"title":"Retrospective Cohort Study of Mesh-Related Complications of Minimally Invasive Sacrocervicopexy in 603 cases.","authors":"Vi Duong, Stephanie Schatzman-Bone, Joe Shi, Kaitlyn James, Milena M Weinstein","doi":"10.1007/s00192-025-06194-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06194-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Minimally invasive sacrocolpopexy (SCP) with concurrent supracervical hysterectomy (SCH) has become the preferred treatment for uterovaginal prolapse over traditional open surgery. However, there is a lack of standardization in surgical materials and techniques, leading to variations in outcomes. This study aims to examine mesh-related complications in women undergoing SCP with concurrent SCH.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted within a large academic hospital system between May 2007 and December 2021. Participants who underwent SCP with concurrent SCH were included. Demographics, perioperative characteristics, and postoperative data were collected. Mesh complications were identified using CPT codes and confirmed by chart review. Parametric and nonparametric tests were used to assess differences in participant and surgical factors, with significance set at p ≤ 0.05.</p><p><strong>Results: </strong>A total of 603 participants were analyzed with a mean follow-up of 55 months. Most underwent laparoscopic SCP (87%), with 53% performed by minimally invasive gynecologic surgery (MIGS) and 47% performed by urogynecology and reconstructive pelvic surgery (URPS). Mesh exposure occurred in 1.2% of cases and was significantly associated with permanent multifilament braided suture use for vaginal mesh attachment (p < 0.001). All exposures occurred in surgeries performed by MIGS surgeons. No significant associations were found with smoking, menopausal status, estrogen use, primary energy instrumentation, or mesh weight. Notably, no mesh erosions were observed.</p><p><strong>Conclusion: </strong>Mesh-related complications following SCP with concurrent SCH are rare. Permanent multifilament braided suture was the only factor associated with mesh exposure. Further research is needed to evaluate surgical factors and optimize techniques.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309886","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":"Buccal versus Vaginal Graft Urethroplasty in Female Urethral Stricture: A Systematic Review and Meta-Analysis.","authors":"Lalit Kumar, Anuja Thakur, Sakshi Agarwal, Mahesh Khairnar, Sameer Trivedi, Satya Narain Shankhwar","doi":"10.1007/s00192-025-06171-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06171-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study is aimed at comparing success rate, maximum flow rate (Q_max), and post-void residual volume (PVR) between the buccal mucosal graft (BMG) and vaginal wall graft (VWG) through a meta-analysis of studies commonly performed by urogynecologists.</p><p><strong>Methods: </strong>A systematic review was performed in April 2024, including retrospective, prospective, and comparative studies excluding duplicates, review, editorial comments, case reports, systematic reviews, meta-analyses, and therapeutic indications. Heterogeneity in the meta-analysis was assessed using I² statistics.</p><p><strong>Results: </strong>The meta-analysis incorporated a quantitative assessment of 18 original articles. The studies in meta-analysis evaluated various parameters, including Q_max, PVR, and success rates of surgical outcomes. The I² statistics indicated no heterogeneity in Q_max and success rates between BMG and VWG, both with I² = 0% and high heterogeneity for PVR values (I² > 50%). According to the results, Q_max values were 23.266 for BMG and 24.945 for VWG, PVR values were 14.651 for BMG and 23.009 for VWG, and success rates were 86.2% for BMG and 89.8% for VWG. A definition of success across the studies was established by achieving Q_max > 15 ml/s at 3 months, a PVR < 30 ml, and an improvement in the American Urological Association symptom scores.</p><p><strong>Conclusions: </strong>Meta-analysis indicates no significant differences between VWG and BMG regarding Q_max, PVR, and the overall success rate of surgical outcomes. Both BMG and VWG graft options demonstrate effectiveness in female urethroplasty. Graft choice should be based on graft availability and feasibility, patient characteristics, and the surgeon's preference and expertise.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274791","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 Safety of Robot-Assisted Sacrocolpopexy in Pelvic Organ Prolapse Treatment: Systematic Review and Meta-Analysis.","authors":"Bagrat Grigoryan, George Kasyan, Roman Shapovalenko, Alexander Popov, Dmitry Pushkar","doi":"10.1007/s00192-025-06158-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06158-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The aim of this study is to evaluate the safety of robot-assisted sacrocolpopexy (RSP) compared with other approaches of sacrocolpopexy and vaginal surgery in pelvic organ prolapse (POP).</p><p><strong>Methods: </strong>The search was performed on studies published prior to May 2024. The inclusion criteria were randomized and nonrandomized trials involving adult women with POP. Exclusion criteria comprised other forms of intervention treatments and articles lacking comparative analyses. This study adhered to the Population, Intervention, Comparison, and Outcome framework, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist, and was registered in the Prospective Register of Systematic Reviews.</p><p><strong>Results: </strong>The systematic review included 36 studies, whereas the meta-analysis included 30 studies. RSP demonstrated superior outcomes compared with laparoscopic (LSP), abdominal (ASP), and vaginal surgery (VS) approaches, with fewer perioperative complications (p < 0.00001 for RSP vs ASP; p = 0.01 for RSP vs VS), reduced blood loss (total p < 0.00001 for RSP vs LSP, ASP, and VS), and shorter hospital stays (p = 0.003 for RSP vs LSP; p = 0.27 for RSP vs VS). Additionally, RSP had fewer surgical conversions than LSP (p = 0.01). However, LSP and VS showed significantly shorter operation times than RSP (p < 0.00001).</p><p><strong>Conclusions: </strong>Robot-assisted sacrocolpopexy may offer advantages in reducing blood loss compared with VS and shortening hospital stays compared with LSP. Sensitivity analyses, however, revealed no significant differences in perioperative complications or blood loss compared with LSP and ASP. Further high-quality randomized studies are necessary to confirm the safety and efficacy of RSP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274794","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":"Five-Year Follow-up Study on Safety and Efficacy of Macroplastique® in Female Patients with Stress Urinary Incontinence (the ROSE Study).","authors":"Gamal Ghoniem, Felicia Lane, Bilal Farhan, Kelli Gilliam, S Abbas Shobeiri, Ahmed Salah","doi":"10.1007/s00192-025-06163-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06163-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study presents the 5-year study close-out results from the Real-Time Observation of Safety and Effectiveness (ROSE) study, evaluating the safety and efficacy of the Macroplastique® (MPQ) urethral bulking agent for the treatment of stress urinary incontinence (SUI) in women with intrinsic sphincter deficiency (ISD).</p><p><strong>Methods: </strong>The ROSE study was an observational prospective study conducted at 22 US centers that enrolled 274 adult women with ISD-confirmed SUI. Participants underwent MPQ treatment with an option for repeat injections. Follow-up assessments were conducted at 3 months and then annually for 5 years, evaluating SUI severity (Stamey grade), Incontinence Quality of Life (I-QoL), and Patient Global Impression of Satisfaction. Safety outcomes included treatment-related adverse events (AEs) and serious adverse events (SAEs).</p><p><strong>Results: </strong>Of 274 enrolled participants, 147 (54%) completed the 5-year follow-up. At 5 years, 47.6% 19 (70/147) of women showed improvement in SUI severity as measured by Stamey grade from 20 baseline after their last injection. I-QoL scores improved significantly, from 45 ± 23.9 to 70.9 ± 21 24.5 (1.1, 100). One device-related SAE of urinary retention (0.4%) resolved within 4 months; no 22 late-onset SAEs were reported. The most common minor treatment-related adverse events were 23 urinary tract infections (30.8%) and transient urinary retentions (7.2%). No late-onset SAEs were 24 reported during the 5-year period.</p><p><strong>Conclusions: </strong>Macroplastique® demonstrated sustained long-term efficacy and safety in managing SUI owing to 27 ISD. These findings reinforce its role as a minimally invasive treatment option with 28 durable outcomes over 5 years.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274792","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":"Correction to: Robot‑Assisted Laparoscopic Sacrohysteropexy with Autologous Fascia Lata.","authors":"David Hennes, Victoria Buckley, Anna Rosamilia","doi":"10.1007/s00192-025-06188-w","DOIUrl":"https://doi.org/10.1007/s00192-025-06188-w","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266151","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 Minimally Invasive Hysterectomy Route at the Time of Sacrocolpopexy with Postoperative Complications.","authors":"Selma Su, Sophia Neman, Naomi Fields, Douglas Luchristt, C Emi Bretschneider","doi":"10.1007/s00192-025-06175-1","DOIUrl":"https://doi.org/10.1007/s00192-025-06175-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Minimally invasive sacrocolpopexy (SCP) with concomitant minimally invasive hysterectomy (MIH) is a frequently employed reconstructive surgical treatment for pelvic organ prolapse; however, the literature is limited regarding how the route of MIH affects postoperative adverse events. This study was aimed at investigating the association of route of MIH at the time of minimally invasive SCP and 30-day postoperative adverse events.</p><p><strong>Methods: </strong>This was a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement database to compare perioperative adverse events for patients who underwent minimally invasive SCP with MIH for uterovaginal prolapse. MIH included total laparoscopic hysterectomy (TLH), laparoscopic supracervical hysterectomy (SCH), laparoscopy-assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). Perioperative adverse events of the four routes of MIH were compared.</p><p><strong>Results: </strong>During the study period, 7690 patients were identified. TLH was the most common route of MIH (56%), followed by laparoscopic SCH (39%), TVH (3%), and LAVH (2%). The rate of any 30-day adverse event was 10% and rates were similar between MIH groups. On multivariate logistic regression controlling for confounders, there were no significant differences in rates of postoperative adverse events between MIH groups.</p><p><strong>Conclusion: </strong>Adverse events following MIH at the time of SCP are not associated with the route of hysterectomy.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266150","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 Retroverted Uterus and Pelvic Floor Dysfunction: 400 BC to 2025 AD.","authors":"Bernard T Haylen, Dzung Vu","doi":"10.1007/s00192-025-06167-1","DOIUrl":"https://doi.org/10.1007/s00192-025-06167-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>In 2025, the retroverted uterus will be more formally recognized with a section in the Female Reproductive System Chapter of Gray's Anatomy. This study examines all available publications to develop a detailed history and associations with pelvic floor dysfunction.</p><p><strong>Methods: </strong>Medline and Embase databases extending back indefinitely were searched looking for references on the retroverted uterus or uterine retroversion. The limited number of articles relevant to any specific section prevented the development of specific selection criteria or the construction of tabulation.</p><p><strong>Results: </strong>From 400 BC to 2025 AD, a total of 308 publications were able to be sourced, of which 50 were pre-1900. Obstetric indications accounted for 116 (37.7%) publications, nearly all incarceration of a retroverted gravid uterus. Gynaecological indications, including conservative and surgical interventions, accounted from 107 (34.7%) publications. Factors relevant to pelvic floor dysfunction, including imaging, diagnosis and prevalence, were generally in the remaining 85 (27.6%) publications.</p><p><strong>Conclusions: </strong>The retroverted uterus has a long, rich and interesting history, with significant interruptions in reporting. The most relevant classification is anatomical according to the presence or absence of retroversion and whether retroflexion of the uterine fundus is additionally present. Its aetiology is more likely to be developmental, with a limited acquired component. Although there is a familial tendency, genetic studies have been inconclusive. Prevalence is 16-18% (1:6) women, increasing in the presence of pelvic floor dysfunction. The most significant gynaecological association is with uterine/pelvic organ prolapse and some types of vaginal prolapse. The literature has countless case reports of both obstetric (particularly incarceration) and gynaecological episodes of acute urinary retention. Less dramatic, chronic, sometimes cyclical symptoms of voiding and defecatory dysfunction, as well as pelvic pain, have also been recorded in publications. Uterine retroversion is most commonly asymptomatic, requiring no treatment. Symptomatic cases, including a prolapsed retroverted uterus, may, at times, require surgical relief.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266152","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":"Expressions of IGF-1, pAKT, and pS6 in Uterosacral Ligaments of Patients with Pelvic Organ Prolapse.","authors":"Hongling Xu, Gensheng Wang, Qing Li, Xuemei Wang, Dongdi Xu","doi":"10.1007/s00192-025-06174-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06174-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to investigate the expressions and significance of IGF-1, pAKT, pS6, and type I and type III collagens in uterosacral ligaments of patients with pelvic organ prolapse (POP).</p><p><strong>Methods: </strong>A total of 38 patients with POP who underwent hysterectomy or pelvic floor reconstruction were selected as the POP group. Another 38 patients who underwent hysterectomy owing to nonpelvic floor dysfunction were selected as the control group. The POP quantitative staging scores of the two groups were III-IV and 0-I respectively. The histological manifestations of the abandoned uterosacral ligament tissues near the cervix were evaluated using hematoxylin-eosin staining and Masson staining. The expressions of IGF-1, plGF-1R, pAKT, pS6, and type I and type III collagen fibers were detected using immunohistochemistry and Western blotting.</p><p><strong>Results: </strong>Hematoxylin-eosin and Masson staining showed that the number of POP constituent fibrocytes decreased, the arrangement was disordered, and the distribution of collagen fibers was sparse compared with the control group. Immunohistochemical analysis showed that the expressions of IGF-1, pIGF-1R, pAKT , pS6, and type I and type III collagen in uterosacral ligament tissues of the POP group significantly decreased. Western blotting demonstrated that the expressions of IGF-1, pIGF-1R, pAKT, pS6, and type I and type III collagen in the POP group significantly decreased.</p><p><strong>Conclusion: </strong>The expressions of IGF-1, pAKT, pS6, and type I and type III collagen decreased in the uterosacral ligament tissues of POP patients, and the IGF-1/AKT/mTORC1 signaling pathway regulated by IGF-1 may be related to the occurrence of POP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234050","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 \"Platelet-Rich Plasma and Fractional CO₂ Laser Therapy to Reduce Surgical Intervention for Symptomatic Vaginal Mesh-Related Complications\".","authors":"Kubilay Sarikaya","doi":"10.1007/s00192-025-06170-6","DOIUrl":"https://doi.org/10.1007/s00192-025-06170-6","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215792","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":"Pelvic Organ Prolapse Quantification After Pessary Removal: The Use of Upright MRI in POP Research.","authors":"Annemarie van der Steen, Frank F J Simonis, Anique T M Grob","doi":"10.1007/s00192-025-06182-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06182-2","url":null,"abstract":"<p><strong>Introduction: </strong>When pelvic organ prolapse (POP) patients change from pessary to surgical treatment, new POP quantification is often necessary. However, the time to maximal POP recurrence after pessary removal is unclear. This video-article illustrates the variation over time of POP extent after pessary removal.</p><p><strong>Methods: </strong>Upright MRI scans of 12 POP patients were used to measure the distances from the lowest points of bladder and cervix to the Pelvic Inclination Correction System (PICS)) line, with the pessary in situ, immediately, 4 and 8 h after pessary removal. Statistical differences between time points were determined.</p><p><strong>Results: </strong>The bladder descended immediately after pessary removal from a median of 0.1 cm above to 1.8 cm below the PICS line. In 58% of patients, the bladder then remained stable; in 33%, the bladder further descended up to 5.4 cm after 4 to 8 h. The cervix descended immediately after pessary removal from a median of 3.1 cm to 1.9 cm above the PICS line. In 17% of patients, a late cervix descent after 4-8 h was seen.</p><p><strong>Conclusion: </strong>POP quantification should be delayed at least 8 h after pessary removal to prevent underestimation of POP extent.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215793","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}