International Urogynecology Journal最新文献

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Detection of Age-Related Pelvic Floor Fragility in Female Patients Using Magnetic Resonance Imaging. 磁共振成像检测女性患者年龄相关性盆底脆性。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-28 DOI: 10.1007/s00192-025-06200-3
Itsuko Okuda, Naoki Yoshioka, Keiichi Akita, Masahiro Jinzaki
{"title":"Detection of Age-Related Pelvic Floor Fragility in Female Patients Using Magnetic Resonance Imaging.","authors":"Itsuko Okuda, Naoki Yoshioka, Keiichi Akita, Masahiro Jinzaki","doi":"10.1007/s00192-025-06200-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06200-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>As aging societies become increasingly widespread worldwide, the prevalence of pelvic floor (PF) disorders is also increasing, particularly among older women. We hypothesized that PF fragility associated with aging could be detected by examining its configurations and the condition of the levator ani muscle. Therefore, in the present study, we aimed to establish a method for detecting age-related PF fragilities by analyzing PF configuration and levator ani muscle thickness using magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>In total, 328 healthy female participants aged 20-91 years were enrolled in this study. T2-weighted coronal MR images of the pelvis were used to classify PF configuration into four types: wing, shallow-V, deep-V, and cup. The correlation between age and levator ani muscle thickness was analyzed for each classification.</p><p><strong>Results: </strong>PF configuration was observed to transition from wing to shallow-V, deep-V, and finally to cup type with age. Additionally, a strong negative correlation was identified between age and levator ani muscle thickness (r = -0.75, P < 0.001). Levator ani muscle thickness decreased progressively in the following order: wing, shallow-V, deep-V, and cup.</p><p><strong>Conclusions: </strong>This MRI-based visual classification method provides a simple and practical approach to evaluate age-related PF changes. Visually assessing PF configuration facilitates the detection of structural decline associated with aging.</p>","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":"144527856","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}
引用次数: 0
A Complex Reconstructive Approach to Iatrogenic Vaginal Scarring and Resultant Urethral Intercourse. 医源性阴道瘢痕及由此引起的尿道性交的复杂重建方法。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-28 DOI: 10.1007/s00192-025-06214-x
Janice Wong, Alejandro Gomez-Viso, Cassandra Kisby
{"title":"A Complex Reconstructive Approach to Iatrogenic Vaginal Scarring and Resultant Urethral Intercourse.","authors":"Janice Wong, Alejandro Gomez-Viso, Cassandra Kisby","doi":"10.1007/s00192-025-06214-x","DOIUrl":"https://doi.org/10.1007/s00192-025-06214-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This video aims to: 1) Review vaginal septa; 2) Present a case of iatrogenic vaginal scarring leading to unknowing engagement in urethral intercourse; and 3) Demonstrate a multi-component reconstructive procedure to restore vaginal patency and urethral continence.</p><p><strong>Methods: </strong>This is a stepwise demonstration of surgical techniques with video narration. IRB approval was not required.</p><p><strong>Results: </strong>Vaginal septa are congenital anomalies that may present as transverse, longitudinal, and oblique septa Miller et al (Clin Obstet Gynecol 51:223-36, 1); Skinner and Quint (J Minim Invasive Gynecol 24: 909-14, 2). Concomitant anal, renal, or ureteral anatomic differences may be present, and additional imaging should be considered Lecka-Ambroziak et al (J Clin Med 12:7284, 3); Murphy et al (Curr Opin Obstet Gynecol 35: 328-36, 4); Kang et al (Medicine (Baltimore) 97:e12822, 5). This video presents the case of a 20-year-old female with a history of a vaginal septum resection followed by multiple surgeries resulting in a bladder injury and vaginal scarring. Subsequently, she developed chronic urinary leakage and dyspareunia. Examination revealed a urethra splayed from the meatus to the bladder trigone and vaginal obliteration. This video details an extensive reconstructive procedure, emphasizing the use of an autologous sling, Martius flap, and biologic graft. Ultimately, successful genitourinary reconstruction restored this patient's sexual function and urinary continence.</p><p><strong>Conclusions: </strong>Accurate diagnosis of congenital anomalies and referral to appropriate care are essential to ensure positive outcomes. Urogynecologists are well-equipped to perform these multi-component procedures.</p>","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":"144527852","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}
引用次数: 0
Automated Evaluation of Female Pelvic Organ Descent on Transperineal Ultrasound: Model Development and Validation. 经会阴超声对女性盆腔器官下降的自动评估:模型开发和验证。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-28 DOI: 10.1007/s00192-025-06211-0
Shuangyu Wu, Jiawei Wu, Yuteng Xu, Jiantao Tan, Ruixuan Wang, Xinling Zhang
{"title":"Automated Evaluation of Female Pelvic Organ Descent on Transperineal Ultrasound: Model Development and Validation.","authors":"Shuangyu Wu, Jiawei Wu, Yuteng Xu, Jiantao Tan, Ruixuan Wang, Xinling Zhang","doi":"10.1007/s00192-025-06211-0","DOIUrl":"https://doi.org/10.1007/s00192-025-06211-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Transperineal ultrasound (TPUS) is a widely used tool for evaluating female pelvic organ prolapse (POP), but its accurate interpretation relies on experience, causing diagnostic variability. This study aims to develop and validate a multi-task deep learning model to automate POP assessment using TPUS images.</p><p><strong>Methods: </strong>TPUS images from 1340 female patients (January-June 2023) were evaluated by two experienced physicians. The presence and severity of cystocele, uterine prolapse, rectocele, and excessive mobility of perineal body (EMoPB) were documented. After preprocessing, 1072 images were used for training and 268 for validation. The model used ResNet34 as the feature extractor and four parallel fully connected layers to predict the conditions. Model performance was assessed using confusion matrix and area under the curve (AUC). Gradient-weighted class activation mapping (Grad-CAM) visualized the model's focus areas.</p><p><strong>Results: </strong>The model demonstrated strong diagnostic performance, with accuracies and AUC values as follows: cystocele, 0.869 (95% CI, 0.824-0.905) and 0.947 (95% CI, 0.930-0.962); uterine prolapse, 0.799 (95% CI, 0.746-0.842) and 0.931 (95% CI, 0.911-0.948); rectocele, 0.978 (95% CI, 0.952-0.990) and 0.892 (95% CI, 0.849-0.927); and EMoPB, 0.869 (95% CI, 0.824-0.905) and 0.942 (95% CI, 0.907-0.967). Grad-CAM heatmaps revealed that the model's focus areas were consistent with those observed by human experts.</p><p><strong>Conclusions: </strong>This study presents a multi-task deep learning model for automated POP assessment using TPUS images, showing promising efficacy and potential to benefit a broader population of women.</p>","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":"144527853","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}
引用次数: 0
Comment on "Cause of Non‑specific Low Back Pain in Women: Pelvic Floor Muscle Weakness". 评论“女性非特异性腰痛的原因:盆底肌无力”。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-28 DOI: 10.1007/s00192-025-06220-z
Jie Hao
{"title":"Comment on \"Cause of Non‑specific Low Back Pain in Women: Pelvic Floor Muscle Weakness\".","authors":"Jie Hao","doi":"10.1007/s00192-025-06220-z","DOIUrl":"https://doi.org/10.1007/s00192-025-06220-z","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":"144527854","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}
引用次数: 0
Incidence of Surgical Treatments After Obstetric Anal Sphincter Injury. 产科肛门括约肌损伤后手术治疗的发生率。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-25 DOI: 10.1007/s00192-025-06201-2
Sara Rahman, Shannon L Wallace
{"title":"Incidence of Surgical Treatments After Obstetric Anal Sphincter Injury.","authors":"Sara Rahman, Shannon L Wallace","doi":"10.1007/s00192-025-06201-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06201-2","url":null,"abstract":"<p><strong>Importance: </strong>Patients with obstetric anal sphincter injury (OASI) are at increased risk for postpartum complications.</p><p><strong>Objective: </strong>To measure the incidence of surgical treatments within 1 year of delivery among patients with OASI. Secondary outcomes included identifying the indications for surgical retreatments of OASI complications and characterizing the procedures performed.</p><p><strong>Study design: </strong>This was a retrospective cohort study of patients with OASI seen at a tertiary referral center between October 2017 and February 2023.</p><p><strong>Results: </strong>A total of 623 patients sustained an OASI during the study period. The mean age was 30.9 years (SD 4.5). Most patients were White non-Hispanic (n = 454, 72.8%), with a mean body mass index (BMI) of 30.6 (SD 5.5). The mean gestational age at delivery was 39.1 weeks (SD 1.4). Nearly half underwent operative deliveries (n = 287, 46.1%), and the majority had a third degree OASI (n = 526, 84.4%). Thirteen patients (2.1%) underwent surgical treatment within 1 year of delivery. Fourteen total procedures were performed, as one patient required two surgeries. The most common indication for surgery was persistent pain or tenderness followed by dyspareunia, wound breakdown, rectovaginal fistula, and post-coital bleeding. The most frequently performed procedures included revision or excision of scar tissue, perineorrhaphy, excision of granulation tissue, revision of perineal wound disruption/breakdown, and transvaginal rectovaginal fistula repair. Urogynecologists performed 11 of the 14 procedures.</p><p><strong>Conclusions: </strong>In this cohort, surgical intervention within 1 year of an OASI was uncommon. Postpartum patients with OASI should be screened for persistent pain and tenderness, dyspareunia, wound breakdown, rectovaginal fistula, and post-coital bleeding, as these symptoms may warrant surgical evaluation and treatment.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484343","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}
引用次数: 0
Detrusor Underactivity and Acontractile Bladder Patients Performing Clean Intermittent Catheterization in a Single Tertiary Referral Center: What is Happening in Real Life? 逼尿肌活动不足和膀胱收缩患者在单一三级转诊中心进行清洁间歇导尿:现实生活中发生了什么?
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-21 DOI: 10.1007/s00192-025-06181-3
Karel Dewulf, Alicia Meurice, Thibault Duvillier, Fons Van Isveldt, Wouter Everaerts, Maarten Albersen, Frank Van der Aa, Dirk De Ridder
{"title":"Detrusor Underactivity and Acontractile Bladder Patients Performing Clean Intermittent Catheterization in a Single Tertiary Referral Center: What is Happening in Real Life?","authors":"Karel Dewulf, Alicia Meurice, Thibault Duvillier, Fons Van Isveldt, Wouter Everaerts, Maarten Albersen, Frank Van der Aa, Dirk De Ridder","doi":"10.1007/s00192-025-06181-3","DOIUrl":"10.1007/s00192-025-06181-3","url":null,"abstract":"<p><strong>Objectives: </strong>Bladder emptying disorders, caused by detrusor underactivity (DU) and acontractile detrusor (ACD) are frequent conditions, where the focus of treatment is often targeted on minimizing secondary complications by bladder catheterization. If feasible, the preferred method is clean intermittent catheterization (CIC). In this study, we investigate underlying diseases, clinical and urodynamic parameters of a real-life cohort of DU and ACD patients requiring CIC.</p><p><strong>Methods: </strong>We performed a retrospective chart review of 133 patients performing CIC due to DU or ACD from 2015 to 2020. Demographic, clinical and urodynamic data were extracted for further analyses.</p><p><strong>Results: </strong>Of 133 patients included, 74% had ACD. Neurogenic diseases were present in 47% of patients, followed by pelvic surgery (23%) and pharmacotherapy (14%). Persistent need for bladder drainage on the long term was observed in 75% of patients. Of patients who discontinued CIC, 44% had a successful treatment. Sacral neuromodulation was the most frequent successful treatment in 56% of patients. Urine tract infections (UTIs) were present in one third of patients.</p><p><strong>Conclusions: </strong>In this patient cohort needing CIC, ACD was more frequent than DU. Most patients who need CIC for DU or ACD require bladder drainage on the long term. Underlying neurogenic diseases are the most frequent.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340110","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}
引用次数: 0
Comparison of Perioperative and Postoperative Outcomes between Single-Port Robotic Sacrocolpopexy and Multi-Port Approaches. 单孔机器人骶髋固定术与多孔机器人骶髋固定术围术期及术后疗效比较。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-20 DOI: 10.1007/s00192-025-06204-z
Erin Ferrigni, Sumin Oh, Kristina Butler, Jeffrey L Cornella, Aqsa Khan, Christopher E Wolter, Johnny Yi
{"title":"Comparison of Perioperative and Postoperative Outcomes between Single-Port Robotic Sacrocolpopexy and Multi-Port Approaches.","authors":"Erin Ferrigni, Sumin Oh, Kristina Butler, Jeffrey L Cornella, Aqsa Khan, Christopher E Wolter, Johnny Yi","doi":"10.1007/s00192-025-06204-z","DOIUrl":"10.1007/s00192-025-06204-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>To evaluate the feasibility and perioperative outcomes of single-port robotic (RSP) sacrocolpopexy (SCP) in comparison to the multi-port approach (RMP).</p><p><strong>Methods: </strong>This was a retrospective cohort study set at an academic, tertiary care center. The primary outcome was operative time (incision to closure) and the secondary outcomes included number and severity of complications. Medical charts were reviewed of patients who had undergone a robotic SCP between March 2018 and December 2024. Differences were tested using Mann-Whitney U tests, Fisher's exact tests, and multivariable regression models.</p><p><strong>Results: </strong>One hundred and eighty-one eligible cases were included. Among them, 109 patients underwent RMP, and 72 patients underwent the RSP approach. For operative time, RSP SCP was statistically significantly shorter than RMP SCP by 40 min (216 versus 176 min, p < .001). The hospital length of stay was shorter for the RSP group (11.0 versus 17.0 h, p < .001), while EBL showed no difference between groups (p = 0.18). No conversion to laparoscopy or laparotomy was found in both groups. Number and severity of adverse events assessed by Clavien-Dindo classification were similar and overall complication rates and complications requiring surgical correction under anesthesia did not show a difference (Clavien-Dindo Grade III, RMP 11.0% vs RSP 5.6%, p = 0.58). Median follow-up was 15.2 weeks postoperatively, and there were no significant differences in reoperation within 30 days, mesh erosion, prolapse recurrence and subsequent reoperations due to the recurrence.</p><p><strong>Conclusions: </strong>Single-port robotic sacrocolpopexy is a safe and feasible minimally invasive technique to address apical pelvic floor prolapse.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333045","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}
引用次数: 0
Fecal Incontinence Drives the Psychosocial Burden in Patients with Dual Incontinence. 大便失禁驱动双重失禁患者的心理社会负担。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-20 DOI: 10.1007/s00192-025-06192-0
Karla Rebullar, Delaney J Orcutt, Melissa R Kaufman, Roger R Dmochowski, Elisabeth M Sebesta
{"title":"Fecal Incontinence Drives the Psychosocial Burden in Patients with Dual Incontinence.","authors":"Karla Rebullar, Delaney J Orcutt, Melissa R Kaufman, Roger R Dmochowski, Elisabeth M Sebesta","doi":"10.1007/s00192-025-06192-0","DOIUrl":"10.1007/s00192-025-06192-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence (UI) and fecal incontinence (FI) are debilitating conditions affecting patients' quality of life (QOL). Dual incontinence (DI) of both urine and stool represents an additional burden. We compare the physical and mental health of patients with UI, FI, and DI. We hypothesize that DI might be associated with increased psychosocial burden.</p><p><strong>Methods: </strong>Patients completed online questionnaires on sociodemographics, urinary and bowel symptoms, and psychosocial comorbidity. The Patient-Reported Outcomes Measurement Information System (PROMIS) measures physical and mental health, anxiety, depression, stress, and instrumental support was used to assess psychosocial burden. Responses including PROMIS measures were compared between those with no incontinence (NI), those with UI, those with FI, and those with DI.</p><p><strong>Results: </strong>A total of 3620 respondents completed the study, the majority of whom were female (78%), and white (84%). Age and BMI were different among groups, with the DI group having the oldest mean age (54 years) and highest mean BMI (29 kg/m<sup>2</sup>). PROMIS scores were significantly different across groups, with DI having the lowest physical and mental health scores (i.e. poorest health), and highest stress and depression scores (i.e. greatest burden). This remains true when DI is compared only with NI or UI; however, results were similar for most measures between DI and FI, suggesting that the burden might largely be driven by FI.</p><p><strong>Conclusions: </strong>Dual incontinence results in worse patient-reported physical and mental health, and higher psychosocial burden. In our cohort, it appears that the psychosocial burden may be largely driven by the FI component of DI. Thus, addressing FI in our patients with DI may help improve QOL.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333046","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}
引用次数: 0
Risk Factors and Prediction Model for Preoperative Lower-Extremity Venous Thrombosis in Elderly Women Undergoing Colpocleisis. 老年女性阴道炎患者下肢静脉血栓形成的危险因素及预测模型。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-19 DOI: 10.1007/s00192-025-06196-w
Xiaoxiang Jiang, Stefano Manodoro, Chaoqin Lin, Qi Wang
{"title":"Risk Factors and Prediction Model for Preoperative Lower-Extremity Venous Thrombosis in Elderly Women Undergoing Colpocleisis.","authors":"Xiaoxiang Jiang, Stefano Manodoro, Chaoqin Lin, Qi Wang","doi":"10.1007/s00192-025-06196-w","DOIUrl":"https://doi.org/10.1007/s00192-025-06196-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Preoperative lower-extremity venous thrombosis (LEVT) is a potential concern in elderly women undergoing colpocleisis for advanced pelvic organ prolapse (POP), given their increased risk owing to age, limited mobility, and comorbidities. This study is aimed at determining the prevalence of LEVT, identifying independent risk factors, and developing a predictive model to assist in risk stratification.</p><p><strong>Methods: </strong>A retrospective study was conducted on elderly women scheduled for colpocleisis owing to advanced POP between August 2019 and September 2024. Doppler ultrasonography was used to diagnose LEVT. Independent risk factors were identified using univariate and multivariate logistic regression. A nomogram-based predictive model was developed and validated using five-fold cross-validation.</p><p><strong>Results: </strong>Among 340 patients, 52 (15.3%) had preoperative LEVT. Advanced age, history of venous thromboembolism, current or past malignancies, elevated cholesterol levels, and high D-dimer levels were independently associated with LEVT. The predictive model showed good discrimination, with an area under the curve for the receiver operating characteristic of 0.824 in the training set and 0.806 in the validation set. At the optimal cutoff (Youden index = 0.121), the sensitivity was 80.8%, specificity was 69.1%, positive predictive value was 32.1%, and negative predictive value was 95.2%. Decision curve analysis confirmed the model's clinical utility.</p><p><strong>Conclusions: </strong>A substantial proportion of elderly women undergoing colpocleisis have preoperative LEVT. The developed predictive model provides a practical tool for early risk assessment, potentially improving perioperative management and patient outcomes.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325631","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}
引用次数: 0
Addressing Commonly Asked Questions in Urogynecology: Accuracy and Limitations of ChatGPT. 解决泌尿妇科常见问题:ChatGPT的准确性和局限性。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2025-06-18 DOI: 10.1007/s00192-025-06184-0
Gregory Vurture, Nicole Jenkins, James Ross, Stephanie Sansone, Ellen Conner, Nina Jacobson, Scott Smilen, Jonathan Baum
{"title":"Addressing Commonly Asked Questions in Urogynecology: Accuracy and Limitations of ChatGPT.","authors":"Gregory Vurture, Nicole Jenkins, James Ross, Stephanie Sansone, Ellen Conner, Nina Jacobson, Scott Smilen, Jonathan Baum","doi":"10.1007/s00192-025-06184-0","DOIUrl":"https://doi.org/10.1007/s00192-025-06184-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Existing literature suggests that large language models such as Chat Generative Pre-training Transformer (ChatGPT) might provide inaccurate and unreliable health care information. The literature regarding its performance in urogynecology is scarce. The aim of the present study is to assess ChatGPT's ability to accurately answer commonly asked urogynecology patient questions.</p><p><strong>Methods: </strong>An expert panel of five board certified urogynecologists and two fellows developed ten commonly asked patient questions in a urogynecology office. Questions were phrased using diction and verbiage that a patient may use when asking a question over the internet. ChatGPT responses were evaluated using the Brief DISCERN (BD) tool, a validated scoring system for online health care information. Scores ≥ 16 are consistent with good-quality content. Responses were graded based on their accuracy and consistency with expert opinion and published guidelines.</p><p><strong>Results: </strong>The average score across all ten questions was 18.9 ± 2.7. Nine out of ten (90%) questions had a response that was determined to be of good quality (BD ≥ 16). The lowest scoring topic was \"Pelvic Organ Prolapse\" (mean BD = 14.0 ± 2.0). The highest scoring topic was \"Interstitial Cystitis\" (mean BD = 22.0 ± 0). ChatGPT provided no references for its responses.</p><p><strong>Conclusions: </strong>ChatGPT provided high-quality responses to 90% of the questions based on an expert panel's review with the BD tool. Nonetheless, given the evolving nature of this technology, continued analysis is crucial before ChatGPT can be accepted as accurate and reliable.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325630","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}
引用次数: 0
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