International Urogynecology Journal最新文献

{"title":"Factors Affecting Difficulties Faced by Women During their First Year of Clean Intermittent Self-Catheterization.","authors":"Hanan Ali Abdelmowla, Mahmoud F Abughanima, Ahmed Abdelhamid Shahat, Medhat Ahmed Abdalla, Rasha Ali Abdelmowla","doi":"10.1007/s00192-026-06846-7","DOIUrl":"https://doi.org/10.1007/s00192-026-06846-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Clean intermittent self-catheterization represents a cornerstone in the management of lower urinary tract dysfunction in women. Patients may be confronted with many difficulties during their early experience of self-catheterization, which may lead to discontinuation. The purpose was to identify the factors affecting difficulties that women with lower urinary tract dysfunction face during their first year of clean intermittent self-catheterization.</p><p><strong>Methods: </strong>Females older than 18 years who were on clean intermittent self-catheterization for less than 1 year responded to the Intermittent Catheterization Difficulty Questionnaire and Patient Clean Intermittent Catheterization-Quality of Life questionnaire. Statistical associations between their responses and factors expected to affect the difficulty of self-catheterization were tested.</p><p><strong>Results: </strong>The study included 42 patients with a median (range) age of 25 (18-51) years and median (range) duration of self-catheterization of 4 (3-10) months. The median (range) Intermittent Catheterization Difficulty Questionnaire score was 43 (26-59). For the Patient Clean Intermittent Catheterization-Quality of Life questionnaire, poor responses were reported regarding difficulty, pain and interest in continuing with self-catheterization for life in 20 (47.6%), 22 (52.4%), and 31 (73.8%) patients respectively. The factors that had statistically significant associations with Intermittent Catheterization Difficulty Questionnaire score were the occurrence of complications (p < 0.001), position during self-catheterization (p < 0.001), duration of self-catheterization (p = 0.007), and daily frequency of self-catheterization (p < 0.001). The previously mentioned four factors also had statistically significant associations with patients' responses to all domains of the Patient Clean Intermittent Catheterization-Quality of Life questionnaire.</p><p><strong>Conclusions: </strong>In women during their first year of clean intermittent self-catheterization, the factors associated with fewer difficulties are absence of complications, commode sitting position, longer duration, and increased daily frequency of self-catheterization.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016948","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":"Can Preadmission Inflammatory Markers Inform Episiotomy Wound Dehiscence Risk? A Case-Control Study in Primiparous Women.","authors":"Aybekcan Batman, Elif Özden Kural Taşsındıran, Enes Saraç, Yiğit Mert Bayrak, Ozan Karadeniz","doi":"10.1007/s00192-026-06911-1","DOIUrl":"https://doi.org/10.1007/s00192-026-06911-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>We hypothesized that routinely available preadmission inflammatory markers are associated with episiotomy wound dehiscence in primiparous women.</p><p><strong>Methods: </strong>In this retrospective case-control study at a single tertiary centre, we reviewed primiparous women who delivered vaginally with mediolateral episiotomy between January 2021 and June 2025. We compared 51 women who developed dehiscence with 54 women with uncomplicated healing. The absolute neutrophil count and four derived markers (neutrophil-to-lymphocyte ratio [NLR], systemic immune-inflammation index, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio) were measured on admission to the labour ward. We used logistic regression adjusted for body mass index, model comparison by the Akaike information criterion, ROC analysis with DeLong's test, bootstrap internal validation, and multinomial regression by wound culture status.</p><p><strong>Results: </strong>The preadmission neutrophil count was lower in women who developed dehiscence than in controls (median 5.53 vs 9.50 × 10⁹/L, p < 0.001). The neutrophil count and the NLR showed identical discrimination (AUC 0.815 each; DeLong p = 1.00), and no derived marker improved model fit beyond the neutrophil count alone. A higher neutrophil count was independently associated with lower odds of dehiscence (adjusted odds ratio 0.78, 95% CI 0.68-0.88). After bootstrapping, the optimism-corrected AUC was 0.795 with a calibration slope of 0.941. Lower neutrophil counts were associated with both culture-positive and culture-negative dehiscence.</p><p><strong>Conclusions: </strong>In primiparous women, a lower preadmission neutrophil count was associated with episiotomy dehiscence, with the NLR acting as an equivalent proxy and no derived marker adding discriminative value. Whether this association reflects biology or the context of sampling relative to labour requires prospective confirmation.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017017","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":"Making What Is Old New Again: A Narrative Review Informing Expert Consensus on Obliterative Management of Primary Uterovaginal Prolapse.","authors":"Nicole P Jenkins, Peter L Rosenblatt, Katherine L Woodburn","doi":"10.1007/s00192-026-06858-3","DOIUrl":"https://doi.org/10.1007/s00192-026-06858-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Surgical management of uterovaginal prolapse using an obliterative vaginal approach is a safe and highly effective option for correction of pelvic organ prolapse. However, there is a lack of standardized procedural guidelines to optimize outcomes. As part of the Global Uterine Pelvic Organ Prolapse (U-POP) Consensus Conference held in Winston Salem, NC, USA, 20-21 April 2026, we aimed to compare specific techniques for colpocleisis in women undergoing surgery for primary uterovaginal prolapse.</p><p><strong>Methods: </strong>A large database systematic review was conducted on publications 31 December 2020 through 4 November 2025. Studies that described specific colpocleisis techniques were included. Primary outcomes were anatomical success, subjective improvement in bulge symptoms, and perioperative complications. Evidence quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Owing to the low quality of available evidence, a modified Delphi consensus process was used to develop consensus statements at the U-POP conference.</p><p><strong>Results: </strong>Of the 587 studies identified, 24 cohort and case series met the inclusion criteria. All studies were of low quality according to GRADE criteria. Two consensus statements were successfully agreed upon through the modified Delphi process.</p><p><strong>Conclusions: </strong>High-quality evidence supporting specific surgical techniques for obliterative repair of uterovaginal prolapse is limited, with most literature predating 2000. Significant variability exists in the operative techniques described, despite the established safety and efficacy of the procedure. Because meta-analysis was not possible owing to the absence of comparative trials, these consensus statements represent an important first step toward standardization. Further prospective and comparative research is needed to better define techniques and their impact on surgical outcomes in the modern age.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016418","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":"A Randomized Trial of Two Lightweight Polypropylene Meshes for Sacrocolpopexy.","authors":"Katie Propst, Marie Fidela R Paraiso, Cecile A Ferrando","doi":"10.1007/s00192-026-06903-1","DOIUrl":"https://doi.org/10.1007/s00192-026-06903-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Sacrocolpopexy is considered the most durable repair for apical pelvic organ prolapse. There are no data available to compare similar meshes used for sacrocolpopexy. The objective was to evaluate surgical success in women undergoing mesh sacrocolpopexy using two mesh grafts.</p><p><strong>Methods: </strong>This is a randomized single-blind trial evaluating two ultra-lightweight Y mesh grafts used in laparoscopic sacrocolpopexy. Participants were randomized to one of two meshes and were blinded to arm assignment. Participants were followed for 2 years postoperatively. The primary outcome was surgical success defined as prolapse retreatment or patient-reported vaginal bulge. Validated questionnaires were used to assess patient-reported outcomes. Power analysis indicated 90 participants were needed.</p><p><strong>Results: </strong>One hundred six patients underwent laparoscopic sacrocolpopexy: 54 in the Restorelle® arm and 52 in the Vertessa® Lite arm. Mean age and BMI for all participants were 60±9 years, 28.1±5.2 kg/m², respectively. Surgical success was similarly high in both study arms. At 6 months, two (2.1%) patients, one in each arm reported subjective bulge symptoms. At 12 months, there were no recurrences. At 24 months, three (3.3%) additional patients experienced recurrence, two in the Restorelle® arm and one in the Vertessa® Lite arm. Compared to baseline, validated questionnaires demonstrated improvement for all patients at 6, 12, and 24 months.</p><p><strong>Conclusions: </strong>In this randomized comparison of two lightweight meshes for sacrocolpopexy, we demonstrated similar surgical success and low reoperation rates for both meshes. Two years postoperatively, minimally invasive sacrocolpopexy is associated with significant improvement in pelvic floor symptoms regardless of mesh used.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016877","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":"Decision Preparedness and User Experience with a Urinary Incontinence Patient Decision Aid in U.S. Primary Care.","authors":"Tsung Mou, Tiffany Brown, Ji Young Lee, Stephen D Persell, Kimberly Kenton, Sarah Collins","doi":"10.1007/s00192-026-06908-w","DOIUrl":"10.1007/s00192-026-06908-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Patient decision aid (PDA) use for urinary incontinence (UI) in primary care settings is understudied. We evaluated users' experiences with a specialty-developed UI PDA implemented in primary care. We also examined the association of decision preparedness, perceived usability, and time spent in the PDA with user experience and summarized user feedback.</p><p><strong>Methods: </strong>This concurrent mixed-methods secondary analysis included women aged ≥18 years with bothersome UI in primary care who accessed a computerized PDA. User experience was assessed using likelihood-to-recommend (LTR) ratings as a global user-experience measure, with ratings of 9-10 categorized as promoter status. Decision preparedness and perceived usability were assessed using validated questionnaire items reflecting decisional conflict and usability domains. Free-text feedback was summarized qualitatively to elaborate opportunities to improve user experience.</p><p><strong>Results: </strong>Of the 958 users who completed the PDA, 240 (25.1%) provided LTR ratings; the mean LTR was 6.0 (SD 3.5), and 31% were promoters. In multivariable logistic regression adjusting for decision preparedness, perceived usability, and time spent in the PDA, both decision preparedness (aOR 4.92; 95% CI 2.68-9.25) and perceived usability (aOR 1.75; 95% CI 1.22-2.60) were associated with promoter status. Time spent in PDA was not associated with promoter status. Qualitative findings complemented quantitative results by highlighting opportunities to improve clarity, accessibility, and personalization.</p><p><strong>Conclusions: </strong>Fewer than one-third of the respondents gave the highest likelihood-to-recommend ratings. Decision preparedness and perceived usability were associated with favorable user experience, suggesting that primary care implementation of UI PDAs may require greater attention to decisional readiness, personalization, and integration with clinician discussion.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016934","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":"Varying In-Person Coaching: Effects on Weight and Urinary Incontinence in Women with Obesity in a 20-Week Randomized Controlled Trial.","authors":"Lene Annette Hagen Haakstad, Kari Bø, John Magne Kalhovde, Elene Mauseth Tangen, Hege Clemm, Christina Gjestvang","doi":"10.1007/s00192-026-06862-7","DOIUrl":"https://doi.org/10.1007/s00192-026-06862-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence (UI) affects 25-45% of women and is more common in those with body mass index (BMI) ≥ 30 kg/m². UI may limit physical activity and quality of life, increasing weight gain and symptom severity. Although exercise may improve body composition and UI, adherence is low. We examined the effect of varying levels of in-person and online individualized exercise coaching on urinary incontinence and weight-related outcomes among low-active women with obesity.</p><p><strong>Methods: </strong>Low-active women with obesity (N = 188, 42.5 ± 10.4 years) participated in this 20-week randomized controlled trial, assigned to one of four groups: high-contact in-person coaching (once weekly, n = 47); medium-contact in-person (twice monthly, n = 47) with online support; low-contact in-person (once monthly, n = 47) with online support; and control group (CG, n = 47). UI was measured using the International Consultation on Incontinence Questionnaire (ICIQ) Short Form, alongside body weight and height at baseline (n = 155) and immediately following the 20-week intervention (n = 132). Additional questions regarding pelvic floor muscle training (PFMT) participation and supervision were collected as a part of a 1-year follow-up.</p><p><strong>Results: </strong>Post-intervention, no between-group differences were observed in UI prevalence or ICIQ scores (p = 0.38 and p = 0.20). All groups lost weight (p < 0.01), with greater reductions in the intervention groups (-4.3 to -5.2 kg) than in the CG (-2.9 kg), and between-group differences ranged from 1.4 to 2.3 kg (p = 0.06-0.19). BMI reductions showed a similar pattern. PFMT was reported by 14.7%, with limited correct technique and minimal supervision.</p><p><strong>Conclusions: </strong>The intervention did not improve UI symptoms. Low PFMT adherence and supervision, likely due to the absence of a standardized protocol, underscore the need for more structured interventions.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016387","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":"Proposed Innovation Ecosystem for Prolapse Surgery: Delphi Consensus on Roles and Responsibilities Across Innovation Lifecycle.","authors":"Geoffrey W Cundiff, Alex Almendres, Mickey Karram, Okhumhekho Kassim, Karen Noblett, Cindy Mayer","doi":"10.1007/s00192-026-06897-w","DOIUrl":"10.1007/s00192-026-06897-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Surgical management of primary uterovaginal prolapse is undergoing rapid transformation, driven by novel devices, meshes, minimally invasive approaches, and digital tools. Yet the legacy of transvaginal mesh, device withdrawals, and litigation has exposed major gaps in how new prolapse technologies are conceived, evaluated, adopted, and monitored. We hypothesize an ecosystem that defines optimal roles and interactions among key parties in the innovation ecosystem for surgical management of primary uterovaginal POP.</p><p><strong>Methods: </strong>We conducted a Delphi consensus study with patients, clinicians, academics, and industry representatives to define optimal roles and interactions across the innovation continuum-from concept generation through post market surveillance. We identified seven separate domains of healthcare innovation and preformed literature searches for each based on a PICOTS framework. This informed an iterative process to develop the sequential rounds of the Delphi survey.</p><p><strong>Results: </strong>The panel achieved consensus on patient centered needs finding, staged and transparent evaluation aligned with the IDEAL framework, competency based training and credentialing, and continuous, socially responsible post market surveillance supported by high quality registries. There was also consensus on priorities for innovation, including identifying predictors of recurrent POP and developing training techniques to overcome perceived barriers to vaginal surgery.</p><p><strong>Conclusions: </strong>This commentary synthesizes the resulting concepts into a framework that could help rebuild trust and support safer, more effective innovation.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008546","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":"Comparative Effectiveness of Laparoscopic Lateral Suspension, Pectopexy and Sacrocolpopexy for Apical Pelvic Organ Prolapse: A Propensity-Weighted Retrospective Cohort Study.","authors":"Erhan Akturk, Yaşam Kemal Akpak, Sena Sayan, Neslihan Bademler, Murat İbrahim Toplu, Fatma Seda Öztürk","doi":"10.1007/s00192-026-06839-6","DOIUrl":"https://doi.org/10.1007/s00192-026-06839-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to compare anatomical and safety outcomes of laparoscopic lateral suspension (LS), pectopexy (PP), and sacrocolpopexy (SCP) for apical pelvic organ prolapse (POP) in a retrospective comparative cohort using propensity score weighting. The cohort consisted of consecutive women undergoing LS, PP or SCP at a tertiary referral centre between 2017 and 2023.</p><p><strong>Methods: </strong>Confounding by indication was addressed using a multinomial propensity score with inverse probability of treatment weighting; covariate balance was assessed by standardised mean differences. Weighted regression models with robust standard errors were used; primary-outcome pairwise comparisons were Holm corrected. Sensitivity analyses included overlap weighting, entropy balancing and doubly-robust estimation. The main outcome measures were 12-month apical anatomical success; perioperative outcomes; Clavien-Dindo complications; mesh-related events; reoperation; time to recurrence.</p><p><strong>Results: </strong>Of 188 women (58 with SCP, 63 with PP, 67 with LS), 12-month apical success was 74.1%, 73.0%, 80.6%, with no significant pairwise differences (PP vs SCP: aOR 0.80, 95% CI 0.33-1.93; LS vs SCP: aOR 1.42, 95% CI 0.56-3.60; global p = 0.437). Post hoc analysis indicated 80% power only for large effects (≈18 percentage points). LS required longer operative time (+44.2 min, p < 0.001); PP had modestly higher blood loss (+23.6 ml, p = 0.038). Complications, mesh exposure, reoperation and time-to-recurrence did not differ. Findings were robust across sensitivity analyses.</p><p><strong>Conclusions: </strong>No significant differences in 12-month apical success or safety were detected among women undergoing SCP, PP or LS after adjustment; LS required a longer operative time. Wide confidence intervals and absence of a prespecified non-inferiority margin preclude any equivalence claim; short-term findings cannot be extrapolated to long-term durability.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001867","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":"A Systematic Review (and Meta-Analysis) and Global Expert Consensus Statements (U-POP): The Manchester Procedure.","authors":"Lisa M Stoter, Mette H Bing, Mackenzie Wood, Kaidi Kang, Catherine A Matthews, Hugo W F van Eijndhoven","doi":"10.1007/s00192-026-06895-y","DOIUrl":"10.1007/s00192-026-06895-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The Manchester procedure (MP) is the oldest uterus-sparing technique for uterine prolapse and has traditionally been used to treat cervical elongation (CE). However, its optimal application remains unclear. This review aimed to evaluate the best management of CE during primary uterovaginal prolapse repair, and to assess whether MP technique variations influence outcomes.</p><p><strong>Methods: </strong>Following PRISMA guidelines, studies were retrieved from MEDLINE, Embase, and Pubmed through November 3, 2025. Evidence quality was assessed using GRADE criteria. Eligible studies included women undergoing surgery for primary uterovaginal prolapse. Outcomes included anatomic recurrence, patient-reported symptoms of vaginal bulge, and retreatment at ≥ 12 months. Random-effects meta-analyses were performed when ≥ 2 studies reported the same intervention and outcome. Evidence-based clinical statements were developed and evaluated through a consensus conference.</p><p><strong>Results: </strong>Of 456 screened abstracts, 12 studies met inclusion criteria (one RCT, one prospective cohort, ten retrospective cohorts). Overall study quality was low (grade C). Only one study clearly defined and measured CE, preventing determination of the most effective surgical approach for women with CE. MP techniques incorporating cardinal-ligament suspension showed lower anatomic failure rates than those without (9.16% vs 30.22; p = 0.024). Patient-reported bulge symptoms were similar (17.59% vs 17.32%; p = 0.969), as were retreatment rates (3.91% vs 9.45%; p = 0.136).</p><p><strong>Conclusions: </strong>Current evidence does not identify an optimal surgical strategy for CE due to inconsistent definitions and limited reporting of CE measurement. MP techniques incorporating cardinal-ligament suspension may reduce anatomic recurrence, although data remain limited and heterogeneous. Standardized CE definitions and improved reporting are needed to strengthen the evidence base.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982244","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 Mesh-Related Complications Following Uterovaginal Prolapse Repair: A Systematic Review.","authors":"Dylan T Wolff, Danielle Antosh, Maria J D'Amico, Fernanda Santis-Moya, Alexander Koven, Iryna Schmeil, Javier Pizarro-Berdichevsky, Jan Deprest, Amy Sisson, Howard B Goldman, Jacqueline Zillioux, Reut Rotem","doi":"10.1007/s00192-026-06886-z","DOIUrl":"10.1007/s00192-026-06886-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Mesh-based repairs for uterovaginal prolapse are associated with rare and potentially severe complications for which evidence-based management guidance remains limited. Our goal was to perform a systematic review of the literature and develop pragmatic management principles for mesh-related complications following uterovaginal prolapse repair.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE and EMBASE through 11/11/25 for studies describing management of severe mesh-related complications following surgical repair of uterovaginal prolapse. Data collected included management strategies and clinical outcomes. Expert opinion and a modified Delphi process were used to develop consensus-based management algorithms and best practice statements.</p><p><strong>Results: </strong>Of the 8890 abstracts screened, 56 studies met the inclusion criteria. The majority were small retrospective case series with overall low quality evidence. Vaginal mesh exposure was the most commonly reported complication, and management ranged from conservative to mesh excision. Mesh exposure involving visceral organs or fistula formation was associated with substantial morbidity, often presenting years after surgery, and frequently required multidisciplinary surgical management with mesh excision and repair of involved organs. Post-sacrocolpopexy lumbosacral discitis most commonly presented with lower back pain and elevated inflammatory markers. Selected patients were successfully managed with prolonged antibiotics alone, while most cases ultimately underwent surgical mesh excision.</p><p><strong>Conclusions: </strong>Management of mesh-related complications following uterovaginal prolapse repair varies according to the location, severity, and extent of disease. Although the available evidence is limited, this review provides pragmatic management principles and treatment algorithms to support clinical decision-making in uncommon but potentially morbid complications.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976849","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}