International Urogynecology Journal最新文献

{"title":"Impact of Surgical Weight Loss Interventions on Urinary Incontinence in Obese Women: Systematic Review and Meta-Analysis.","authors":"Hanah Abdel-Fattah, Tooba Shaker, Naveena Sheikh, Alice Ambrose, Mohamed Abdel-Fattah, Alyaa Mostafa","doi":"10.1007/s00192-026-06701-9","DOIUrl":"https://doi.org/10.1007/s00192-026-06701-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Obesity is strongly associated with urinary incontinence (UI) in women, contributing to significant physical and psychological morbidity. Surgical weight loss interventions such as bariatric surgery are increasingly utilised to manage obesity and may offer therapeutic benefits for UI. This systematic review and meta-analysis aimed to evaluate the impact of bariatric surgery on urinary incontinence outcomes and related pelvic floor symptoms in obese women.</p><p><strong>Methods: </strong>Following PRISMA and Cochrane guidelines, a comprehensive literature search was performed across multiple databases (1998-2025). Eligible studies included obese adult women (BMI ≥30 kg/m²) undergoing bariatric surgery with reported urinary incontinence. Primary outcomes were subjective and objective measures of UI improvement; secondary outcomes included changes in body mass index (BMI), quality of life (QoL), sexual function, anal incontinence (AI), and pelvic organ prolapse (POP).</p><p><strong>Results: </strong>Thirty-nine studies encompassing 8960 women were included. Meta-analysis showed a significant improvement in UI incidence at 6, 12, and >12 months post-surgery. Pooled analysis from patient reported measures yielded RR 2.08, 95% CI 1.80-2.40, p = 0.00001, and objectively measured MD 3.62, 95% CI 2.57-4.67, all p = 0.00001. Mean BMI decreased significantly (MD 12.75, 95% CI 11.34-14.16, p = 0.00001) and QoL scores improved substantially (SMD 2.96, 95% CI 0.42-5.49, p = 0.001).</p><p><strong>Conclusion: </strong>Bariatric surgery is a highly effective intervention for improving urinary incontinence and related quality of life in obese women, with sustained benefits corresponding to significant reductions in BMI. Further long-term, standardised prospective studies are warranted to clarify the broader pelvic floor effects of surgical weight loss.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061258","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":"Management of Major Non-mesh Complications After Primary Uterovaginal Prolapse Surgery: A Systematic Review.","authors":"Fernanda Santis-Moya, Dylan T Wolff, Alexander Koven, Maria J D'Amico, Javier Pizarro-Berdichevsky, Iryna Schmeil, Danielle Antosh, Reut Rotem, Jan Deprest, Amy Sisson, Howard B Goldman, Jacqueline Zillioux","doi":"10.1007/s00192-026-06888-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06888-x","url":null,"abstract":"<p><strong>Introduction: </strong>Major complications following uterovaginal prolapse (UPOP) repair are rare but carry significant morbidity. High quality evidence regarding their management is scarce. Our objective was to perform a systematic review of available evidence and develop standardized consensus-based clinical principles and algorithms for these complications.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we retrieved studies from MEDLINE, EMBASE, and clinicaltrials.gov through 11/11/25 describing management of major complications following UPOP surgery. GRADE criteria were used to assess quality. Expert opinion and Delphi process were used to develop consensus-based management algorithms and clinical principles.</p><p><strong>Results: </strong>Of the 8890 abstracts screened, 24 studies met eligibility criteria. Most studies were retrospective and case reports with overall low to very low quality of evidence. Studies on management of complications such as bowel and ureteral injury, neuropathic pain, pyometra, and hemorrhage were retrieved.</p><p><strong>Conclusions: </strong>This systematic review and consensus document addresses a critical void in pelvic floor surgery by establishing the first structured management framework for bowel, ureteral, neuropathic, pyometra, and hemorrhagic complications following UPOP surgery.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061207","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":"Urinary Functional Outcomes and Prolapse Recurrence After Laparoscopic Sacrocolpopexy: A 400-Patient Single-Centre Study.","authors":"Ana Fernández-Mardomingo Díaz, Cesar Mínguez Ojeda, Almudena Coloma Del Peso, Jose Daniel Subiela Henríquez, Irene De La Parra, Sonia Vázquez Valdés, Luis Crespo Martínez, Francisco Javier Burgos Revilla","doi":"10.1007/s00192-026-06905-z","DOIUrl":"https://doi.org/10.1007/s00192-026-06905-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Laparoscopic sacrocolpopexy (LSC) is the reference surgical treatment for pelvic organ prolapse (POP), providing durable anatomical correction with a favourable safety profile. However, postoperative urinary symptom evolution remains incompletely characterized. We aimed to evaluate the surgical and functional outcomes of LSC and identify factors associated with postoperative urinary symptoms.</p><p><strong>Methods: </strong>This retrospective observational study included 400 consecutive women who underwent LSC for POP between 2011 and 2025. In accordance with our institutional staged continence-management strategy, no concomitant anti-incontinence procedures were performed. Surgical complications, prolapse recurrence, and urinary outcomes were evaluated. Persistent, resolved, and de novo stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) were assessed. Univariable logistic regression identified factors associated with postoperative urinary symptoms and prolapse recurrence.</p><p><strong>Results: </strong>Median follow-up was 30 months (interquartile range [IQR] 15-48). Intraoperative complications occurred in 7.8% of patients, mainly bladder (3.5%) and vaginal (2.0%) injuries. Overall prolapse recurrence was 7.8%. Preoperative SUI and UUI were present in 38% and 41% of patients, respectively. UUI prevalence decreased to approximately 15% postoperatively, whereas SUI remained close to 29%. Persistent SUI and UUI occurred in 38% and 23% of symptomatic patients, while de novo SUI and UUI developed in 23% and 9%, respectively. Preoperative urinary symptoms were the only significant predictors of postoperative urinary symptoms.</p><p><strong>Conclusions: </strong>LSC performed without concomitant anti-incontinence surgery was associated with favourable urinary outcomes, particularly for urgency symptoms. Preoperative urinary symptoms were the strongest predictors of postoperative urinary outcomes, emphasizing the importance of comprehensive preoperative assessment and individualized patient counselling.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038673","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":"Vaginal Natural Orifice Endoscopic Surgery for Primary Uterovaginal Prolapse: Evidence, Evolution, and Standardized Surgical Technique for Uterosacral Ligament Suspension.","authors":"Yasnaia Bruneel, Anna Zdroik, Catherine A Matthews, Jan Baekelandt","doi":"10.1007/s00192-026-06902-2","DOIUrl":"https://doi.org/10.1007/s00192-026-06902-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) has emerged as a minimally invasive approach for primary uterovaginal prolapse with increasing application in urogynecology. A systematic review published in 2025 supports vNOTES uterosacral ligament suspension (USLS) as an alternative mode of access with favorable perioperative anatomic and patient-centered outcomes compared to conventional transvaginal repair.</p><p><strong>Methods: </strong>In April 2026, a consensus conference on controversies in the surgical management of primary uterovaginal prolapse (U-POP) was conducted with the overarching goal of developing an evidence-based algorithm for surgical decision-making and standardizing best-practice surgical techniques for U-POP. For vNOTES USLS, a 2025 systematic review served as the primary evidence base for generation of consensus statements that were submitted for delphi voting. A recommendation for preferred surgical technique of vNOTES USLS was developed on the basis of expert opinion.</p><p><strong>Results: </strong>Current evidence suggests improved operative efficiency, low complication rates, and improved visualization of the ureters and pelvic sidewall anatomy compared to conventional vaginal uterosacral ligament suspension. This review describes the integration of vNOTES in urogynecology, reviews the current evidence regarding safety and outcomes, and provides stepwise surgical technique and best-practice considerations for vNOTES USLS for the surgical treatment of primary U-POP with accompanying videos.</p><p><strong>Conclusions: </strong>vNOTES provides improved visualization of the uterosacral ligaments and using a standardized technique, may offer advantages over laparoscopic and conventional transvaginal uterosacral ligament suspension for primary uterovaginal prolapse repair.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038681","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 Use of Preoperative Defecography and Magnetic Resonance Imaging in Patients Undergoing Surgery for Primary Uterovaginal Prolapse: A Systematic Review.","authors":"Ankita Gupta, Emilia Alcoba, Steven Abramowitch, Annika Sinha, Fernanda Pipitone, Julia Geynisman-Tan, Catherine A Matthews, Ghazaleh Rostaminia, Amy Sisson, Lieschen Quiroz","doi":"10.1007/s00192-026-06869-0","DOIUrl":"https://doi.org/10.1007/s00192-026-06869-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The role of preoperative diagnostic testing, including preoperative defecography and magnetic resonance imaging (MRI) for women undergoing primary uterovaginal pelvic organ prolapse (U-POP) repair is not well described. Our primary objective was to evaluate the role of preoperative defecography and MRI for women undergoing surgery for U-POP.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we retrieved studies from MEDLINE and EMBASE in November 2025. Our population included women undergoing surgery for U-POP who underwent defecography or MRI as part of preoperative work-up. We evaluated indications for imaging, clinical utility of imaging in predicting surgical outcomes, and change in surgical planning based on imaging. Studies of all designs and in all languages were included if they had at least 30 patients with U-POP. Conference and video abstracts were excluded. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were used to assess the quality of the articles included. These data were used to create consensus guidelines, which were presented in-person at the U-POP consensus conference in Winston Salem, NC, USA on 20-21 April 2026.</p><p><strong>Results: </strong>For the systematic review regarding the use of preoperative defecography, 174 abstracts were identified and 135 abstracts were screened yielding 3 studies that met the eligibility criteria and had Grade C to D level of evidence. There was no evidence for routine preoperative defecography in patients undergoing primary U-POP repair. For MRI, 576 abstracts were screened with 29 full-text results reviewed, 2 of which met Population, Intervention, Comparison, Outcomes and Study criteria. Results presented here are therefore summarized from the papers included and extrapolated from a broader urogynecology population.</p><p><strong>Conclusions: </strong>Based on limited existing evidence, the global consensus concluded that \"clinicians should only consider defecography in the evaluation of patients with U-POP with symptoms of obstructed defecation.\" No consensus was reached on the optimal use of MRI in the preoperative evaluation of patients with U-POP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038655","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":"Reframing Chronic Pelvic Pain in Women: Central Sensitization, Psychosocial Burden, and Mechanism-Based Multidisciplinary Care.","authors":"Yael Sela, Keren Grinberg, Rachel Nissanholtz-Gannot","doi":"10.1007/s00192-026-06899-8","DOIUrl":"https://doi.org/10.1007/s00192-026-06899-8","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Chronic pelvic pain (CPP) often persists despite repeated organ-directed evaluation and treatment. We proposed that integrating disease-specific diagnosis with pain-mechanism phenotyping would provide a more clinically useful framework for explaining symptom persistence and selecting care.</p><p><strong>Methods: </strong>A structured narrative review was conducted using PubMed/MEDLINE, PubMed Central, the Cochrane Library, professional guidelines, journal websites, and reference lists. English-language literature published from January 2020 to May 2026 was prioritized, with earlier seminal sources included for foundational concepts.</p><p><strong>Results: </strong>Evidence indicates that CPP commonly reflects interacting nociceptive, neuropathic, nociplastic, musculoskeletal, psychological, sexual, and social contributors. Central sensitization and nociplastic pain may help explain disproportionate, widespread, or persistent pain, while pelvic floor dysfunction, distress, catastrophizing, fear-avoidance, sleep disturbance, and sexual pain can intensify disability. Current guidelines and reviews support comprehensive assessment, pelvic floor physical therapy when indicated, pain neuroscience education, psychological pain interventions, sexual counseling, disease-specific treatment, and coordinated multidisciplinary follow-up. Treatment matching should be based on dominant mechanisms and patient-prioritized outcomes rather than diagnosis or pain intensity alone.</p><p><strong>Conclusions: </strong>A mechanism-based biopsychosocial approach validates CPP as real while broadening therapeutic targets. Combining rigorous disease evaluation with pain phenotyping may reduce fragmented care and improve function, intimacy, quality of life, and patient-clinician communication.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038726","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":"Surgical Strategies for Apical Pelvic Organ Prolapse: A Systematic Review and Network Meta-Analysis.","authors":"Tran T T Nguyen, Pouria Aryan, Mahshid Taheri, Ben Willem Mol, Marie Fidela R Paraiso, Jennifer Phung, Nadia Willison, Derek Abbott, Fariba Behnia-Willison","doi":"10.1007/s00192-026-06857-4","DOIUrl":"https://doi.org/10.1007/s00192-026-06857-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Comparative effectiveness of surgical approaches to apical pelvic organ prolapse (POP) remains uncertain, particularly regarding recurrence, reoperation and mesh-related outcomes over the available follow-up. The objective was to compare the effectiveness and safety of surgical treatments for primary apical pelvic organ prolapse (POP) using a systematic review and network meta-analysis of randomised controlled trials (RCTs).</p><p><strong>Methods: </strong>Comprehensive searches were conducted in Web of Science, Scopus, Embase, Medline, Cochrane Library, WHO, and ICTRP databases from inception to 30 June 2025. English-language RCTs comparing surgical interventions for apical POP, alone or with other compartment repairs, were included if they reported anatomical recurrence after ≥ 1-year follow-up. Studies on non-surgical interventions were excluded. The primary outcome was anatomical recurrence; secondary outcomes included subjective recurrence, reoperation rates and mesh complications. Risk of bias was assessed using the Cochrane tool, and study integrity was evaluated with the Trustworthiness in Randomised Controlled Trials checklist. A random-effects network meta-analysis (NMA; NMAstudio 2.0) was performed, grouping interventions by clinical similarity. Native tissue repair (NTR) served as the reference.</p><p><strong>Results: </strong>Fifty-eight RCTs (6,846 participants) were included. Vaginal, abdominal and laparoscopic mesh repairs significantly reduced anatomical recurrence versus NTR (relative risk 0.59-0.66). Vaginal mesh and laparoscopic sacrocolpopexy with posterior plication lowered subjective recurrence (relative risk 0.22-0.51). Abdominal sacrocolpopexy was associated with fewer recurrence-related reoperations (relative risk 0.40), whereas vaginal mesh had higher mesh-related reoperations (relative risk 5.19).</p><p><strong>Conclusions: </strong>Mesh-augmented vaginal, laparoscopic and abdominal repairs reduce prolapse recurrence compared with NTR but carry increased mesh-related risks. Sacrocolpopexy was associated with favourable anatomical durability for apical POP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030191","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 Postoperative Functional Recovery and Anatomical Restoration in Patients with Pelvic Organ Prolapse Undergoing Three Types of Apical Suspension Techniques: A Retrospective Study.","authors":"Jiaoyang Song, Yuexin Zhao, Haipeng He, Shiyan Wang, Xiuli Sun","doi":"10.1007/s00192-026-06875-2","DOIUrl":"https://doi.org/10.1007/s00192-026-06875-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Surgery is a key treatment for pelvic organ prolapse (POP). This study was aimed at comparing the effects of sacrospinous ligament fixation (SSLF), laparoscopic lateral suspension (LLS), and extraperitoneal high uterosacral ligament suspension (EHUS) on anatomical restoration and functional recovery in patients with POP.</p><p><strong>Methods: </strong>This retrospective cohort study included 188 patients with POP who underwent SSLF, LLS, or EHUS between 2020 and 2023. Baseline characteristics, Pelvic Organ Prolapse Quantification (POP-Q), lower urinary tract symptoms, and questionnaire scores were collected preoperatively, and at 1 and 12 months postoperatively. The primary outcome was surgical success; secondary outcomes included POP-Q scores and patient-reported symptom improvement.</p><p><strong>Results: </strong>Preoperative data were comparable among the three groups (p > 0.05). The surgical success rates were 84.93% (62 out of 73) for SSLF, 85.00% (34 out of 40) for LLS, and 77.78% (35 out of 45) for EHUS, with no significant difference. Anatomical success rates were 95.89% for SSLF, 95.00% for LLS, and 84.44% for EHUS. SSLF demonstrated a significantly higher anatomical success rate than EHUS (p = 0.012). Subjective cure rates were 84.93%, 90.00%, and 84.00%, and satisfaction rates were 94.52%, 95.0%, and 93.33% for SSLF, LLS, and EHUS groups respectively. All groups showed significant postoperative improvements in POP-Q and questionnaire scores. The SSLF group exhibited a significantly greater reduction in questionnaire scores from baseline to 12 months than the EHUS group (p < 0.05).</p><p><strong>Conclusion: </strong>At 12 months postoperatively, no single technique (SSLF, LLS, or EHUS) demonstrated overall superiority in surgical success. SSLF was associated with superior anatomical outcomes and greater symptom improvement than EHUS.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030617","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":"Alpha-Linolenic Acid and Tarantula Cubensis Extract Attenuate Bladder Inflammation in Cyclophosphamide-Induced Cystitis: A Comparative Experimental Study.","authors":"Mehmet Yıldız, Ali Furkan Batur, Mehmet Burak Ateş, Ayşegül Bulut, Emre Altintaş, Murat Gül, Mehmet Kaynar, Özcan Kiliç, Serdar Göktaş","doi":"10.1007/s00192-026-06915-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06915-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Primary bladder pain syndrome (PBPS) is a chronic inflammatory bladder disorder characterized by pelvic pain, urinary urgency, and frequency. Current intravesical therapies such as hyaluronic acid (HA) mainly restore the urothelial barrier but may not adequately address inflammatory and oxidative mechanisms underlying bladder injury. We investigated whether alpha-linolenic acid (ALA) and Tarantula cubensis extract (TCAE) provide greater protection than intravesical HA in an experimental cystitis model.</p><p><strong>Methods: </strong>Forty female Wistar rats were randomly assigned to five groups: control, cyclophosphamide (CYP)-induced cystitis, CYP + HA, CYP + TCAE, and CYP + ALA. Chemical cystitis was induced with intraperitoneal CYP (75 mg/kg). HA was administered intravesically, TCAE intraperitoneally, and ALA orally. Bladder tissues were evaluated using histopathological scoring and biochemical analyses measuring IL-6, TNF-α, SOD1, malondialdehyde [MDA]), and nerve growth factor-β (NGF-β).</p><p><strong>Results: </strong>CYP administration produced marked bladder injury characterized by epithelial degeneration, submucosal edema, inflammatory infiltration, fibrosis, and increased mast cell density. Both ALA and TCAE improved these histopathological alterations compared with untreated cystitis. The greatest recovery was observed in the ALA group. Tissue MDA levels differed significantly among groups, with the lowest values observed in the ALA group. In contrast, IL-6, TNF-α, SOD1, and NGF-β levels showed group-related trends but did not reach statistical significance.</p><p><strong>Conclusions: </strong>ALA and TCAE attenuated bladder injury in this experimental cystitis model, with ALA demonstrating the most pronounced histological and antioxidative effects. These findings support further investigation of ALA as a potential therapeutic strategy in experimental bladder inflammation.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030612","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 Surgical Challenge of the Repeat Sacrocolpopexy.","authors":"Nishita Patel, Mushka Kaye, Mireya Taboada, K Marie Douglass, Tajnoos Yazdany","doi":"10.1007/s00192-026-06889-w","DOIUrl":"https://doi.org/10.1007/s00192-026-06889-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Sacrocolpopexy (SCP) is considered the \"gold standard\" of pelvic organ prolapse (POP) repair. There are no clear guidelines on the ideal mode of surgical retreatment when SCP fails. We aimed to summarize the existing literature regarding the performance of repeat SCP.</p><p><strong>Methods: </strong>We reviewed existing literature regarding surgical retreatment after SCP failure. Four hundred twenty-seven unique abstracts were identified, and two authors independently assessed eligibility and abstracted data from each study. Thirty-two full-text articles were reviewed, and 15 specifically concerning repeat SCP were included in the analysis.</p><p><strong>Results: </strong>The 15 articles included information on 116 patients. The majority (62.1%) underwent laparoscopic sacrocolpopexy (LSCP) as their index surgery, with a median time to recurrence of 24.0 months. Median prolapse stage at time of recurrence was stage 3. Repeat LSCP was the most common surgical technique (80.2%) after SCP failure. Mesh detachment was noted from the vagina (51.7%) and from the sacrum (9.5%). Only 23.3% of cases reported excising prior mesh. The median follow-up time after repeat surgery was 6.0 months. Mean subjective success rates were 89.7%, objective success rates (with varying definitions) were 85.2%, and the reoperation rate was 6.6%.</p><p><strong>Conclusions: </strong>SCP failure, though rare, presents a surgical challenge due to the procedural complexity and the limited information regarding the optimal mode of management. In this review, LSCP was the preferred method of reoperation. Short-term objective and subjective success rates after repeat SCP were high, and reoperation rates were low. Additional studies with longer-term follow-up are needed.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030314","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}