International Urogynecology Journal最新文献

{"title":"Thrombospondin-1 as a Mechanosensitive Matrix Protein Driving Fibroblast Senescence: A Novel Pathogenic Target for Pelvic Organ Prolapse.","authors":"Yaqin Li, Fuqing Feng, Yue Zhang, Shujia Xu, Bing Xie, Xiuli Sun","doi":"10.1007/s00192-026-06878-z","DOIUrl":"https://doi.org/10.1007/s00192-026-06878-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Current pelvic organ prolapse (POP) management focuses on anatomical repair without addressing the underlying pathology. Fibroblast dysfunction underlies pelvic tissue degeneration, but its upstream regulation remains unclear. Here, we investigated whether a pro-senescent protein, thrombospondin-1 (THBS1), responds to stress injury and activates a cellular senescence-matrix degradation axis, offering a potential target for POP.</p><p><strong>Methods: </strong>Machine learning identified mechanosensitive senescence-associated markers from transcriptional profiles of uterosacral ligament (USL) tissues of POP patients. Histology assessed extracellular matrix (ECM) composition, senescence phenotypes, and THBS1 expression. Primary USL fibroblasts isolated from POP patients were transfected with THBS1-specific RNA interference fragments and then evaluated for proliferation, senescence, and ECM synthesis. Complementary gain- and loss-of-function assays in RAT1 fibroblasts using recombinant human THBS1 (rhTHBS1) or THBS1 knockdown further delineated the role of THBS1 in cellular senescence, matrix degradation, and recovery from damage induced by mechanical stress or chemical insults (H₂O₂, Etoposide).</p><p><strong>Results: </strong>THBS1 was identified as a mechanosensitive, senescence-associated matricellular protein in POP. Tissues and fibroblasts from POP patients showed increased expression of senescence markers and THBS1, accompanied by reduced expression of ECM components, compared to those of non-POP patients. Knockdown of THBS1 enhanced proliferative capacity and ameliorated senescent phenotypes in POP patient-derived fibroblasts. Moreover, exogenous rhTHBS1 promoted senescence and matrix degradation in RAT1 cells, whereas THBS1 knockdown rescued the cellular damage induced by mechanical or chemical stress.</p><p><strong>Conclusions: </strong>THBS1 mediates stress-induced pelvic floor degeneration by promoting fibroblast senescence and disrupting ECM homeostasis, highlighting its potential as a promising target for POP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968672","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":"Neuromuscular Function Patterns at 6 Weeks Postpartum Characterised Using Latent Profile Analysis: A Cross-Sectional Study of 525 Women.","authors":"Yun Liu, Chang Wang, Juan He, Miaomiao Qiu, Tian Li","doi":"10.1007/s00192-026-06844-9","DOIUrl":"https://doi.org/10.1007/s00192-026-06844-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Postpartum pelvic floor dysfunction is heterogeneous; routine assessment often uses single modalities that may miss neuromuscular variation. We explored whether multimodal pelvic-floor assessment at 6 weeks postpartum could identify exploratory neuromuscular clusters using latent profile analysis (LPA) in a single-centre retrospective cohort.</p><p><strong>Methods: </strong>Retrospective cross-sectional study of de-identified routine ≈6-week postpartum records from one Chinese public hospital (January 2024-December 2025; n = 525), with Glazer-protocol surface electromyography (sEMG), transperineal ultrasound, Oxford strength grading and patient-reported outcomes. After correlation-based variable reduction, LPA used Gaussian mixture models; models were selected using the Bayesian information criterion, entropy, minimum class proportion and bootstrap stability. Between-pattern differences were assessed with rank-based tests and Spearman correlations.</p><p><strong>Results: </strong>A two-class equal volume, equal shape and variable orientation solution was selected (Pattern 1, n = 60 [11.4%]; Pattern 2, n = 465 [88.6%]). Pattern 1 had lower resting sEMG and higher Oxford strength than Pattern 2 (e.g. pre-contraction mean 4.2 vs 7.8 µV). Fifteen of the 16 neuromuscular and strength indicators differed between patterns. Pelvic-floor pain differed (p < 0.001); Pelvic Floor Distress Inventory-20 (p = 0.129), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (p = 0.616) and stress urinary incontinence (18.3% vs 23.0%; p = 0.580) did not. Pain correlated with resting sEMG (Spearman ρ = 0.56, p < 0.001).</p><p><strong>Conclusions: </strong>At 6 weeks postpartum, exploratory clustering differed mainly in sEMG, strength and pelvic pain, not in distress or incontinence scores. Resting sEMG correlated with pain and should not be equated with hypertonicity without longitudinal validation. Prospective studies are needed before clinical implementation.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968540","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":"Analysis of Clinical Characteristics of Partial Versus Total Colpocleisis for Pelvic Organ Prolapse: A Multicenter Retrospective Study in China.","authors":"Yiqi Guan, Kun Zhang, Jinsong Han, Lan Zhu, Ying Zhou, Xiaowei Li, Ling Zhang, Lili Li, Mei Jin, Xiaobin Huang, Shuai Tang, Hongying Mo, Yali Miao","doi":"10.1007/s00192-026-06847-6","DOIUrl":"https://doi.org/10.1007/s00192-026-06847-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Colpocleisis is an important procedure in elderly women with pelvic organ prolapse (POP) who have no desire for intercourse. The objective was to compare the clinical features of women who undergo partial colpocleisis with those of women who undergo total colpocleisis for POP in China.</p><p><strong>Methods: </strong>This is a multicenter retrospective cohort study investigating patients who underwent colpocleisis for moderate to severe POP across ten tertiary hospitals in China between 2015 and 2024. Epidemiological characteristics, perioperative indices, complications, and follow-up data were compared.</p><p><strong>Results: </strong>A total of 1,080 women were eligible for enrolment in the study. Among them, 696 patients underwent partial colpocleisis and 394 patients underwent total colpocleisis. The mean postoperative follow-up duration was 4.0 ± 2.6 years, with a median follow-up of 3 years. The subjective success rate was 98% and the anatomical cure rate was 99% in both groups. There was no statistically significant between-group difference in the postoperative satisfaction or regret rates. The anatomical recurrence rate at the final follow-up was lower in the total colpocleisis group. The total colpocleisis group had significantly greater intraoperative blood loss, a higher wound infection rate, a higher incidence of hematoma, and a longer hospital stay.</p><p><strong>Conclusions: </strong>Both procedures can achieve high subjective and objective cure rates. Total colpocleisis is associated with greater intraoperative blood loss and more cases of hematoma and wound infection but less likelihood of anatomical recurrence. Both procedures are suitable for elderly women with severe prolapse who have no wish for intercourse.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968524","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":"Educational Videos Were Not Superior to a Folder in Improving Urinary Incontinence Knowledge and Symptoms: A Randomized Controlled Trial.","authors":"Alana Mirelle Coelho Leite, Rodrigo Cappato de Araújo, Daniela Carvalho Santos, Letícia Bojikian Calixtre, Danielly Alves Amorim, Ana Carolina Rodarti Pitangui","doi":"10.1007/s00192-026-06898-9","DOIUrl":"https://doi.org/10.1007/s00192-026-06898-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic floor dysfunctions affect the physiology of continence and contribute to the onset of lower urinary tract symptoms. We aim to evaluate the effects of a video health education program Educa Mulher on knowledge, symptoms, and severity of urinary incontinence (UI) in incontinent women.</p><p><strong>Methods: </strong>A single-blinded, parallel-group randomized clinical trial with intention-to-treat analysis was conducted. Seventy-five incontinent women were randomly assigned to the experimental group (EG) or control group (CG). The Prolapse and Incontinence Knowledge Quiz (PIKQ-Br), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and Incontinence Severity Index (ISI) were used. Both groups received an educational folder about urinary incontinence and pelvic floor muscle training (PFMT). The EG additionally received educational videos via WhatsApp twice weekly for 1 month. Videos addressed IU knowledge, pelvic floor function, risk factors, quality-of-life impact, treatment options, and PFMT. Within- and between-group differences and 95% confidence intervals were analyzed using linear mixed models with group, time, and group-by-time interaction terms.</p><p><strong>Results: </strong>The mean age of the participants was 42.93 ± 10.33 years. At baseline, all participants presented with moderate UI, according to the ISI classification, as well as high levels of UI-related knowledge, as assessed by PIKQ-Br. No mean differences were observed in PIKQ-Br (95% CI -1.38 to 0.52), ICIQ-SF (95% CI -2.20 to 1.83), and ISI (95% CI -1.37; 0.89) scores.</p><p><strong>Conclusion: </strong>A remote health education program combining WhatsApp-delivered educational videos and an educational folder did not demonstrate superior effectiveness, compared to the folder alone, in improving knowledge, urinary symptoms or severity.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955986","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 Floor Dysfunction After Obstetric Anal Sphincter Injuries: A Prospective Cohort Study.","authors":"Carolina de Alencar Ohi Garcia, José Ananias Vasconcelos Neto, Camila Teixeira Moreira Vasconcelos, Simony Lira do Nascimento","doi":"10.1007/s00192-026-06882-3","DOIUrl":"https://doi.org/10.1007/s00192-026-06882-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Obstetric anal sphincter injuries (OASIS) compromise pelvic floor function and quality of life; prospective evidence from low-resource settings remains scarce. We hypothesised that OASIS would be associated with worse sexual function and greater pelvic floor distress than controls over the first 6 months postpartum.</p><p><strong>Methods: </strong>Prospective cohort study conducted at a tertiary maternity unit in [Fortaleza, Ceará, northeastern Brazil] (2022-2024). Women with OASIS (n = 22) and controls without perineal injury (n = 69) were assessed using the PFDI-20, PFIQ-7, FSFI, and SF-36 at T0 (immediate postpartum), T1 (3 months), and T2 (6 months).</p><p><strong>Statistical analysis: </strong>Mann-Whitney and Friedman/Dunn tests (α = 0.05).</p><p><strong>Results: </strong>Ninety-one women were enrolled (OASIS incidence 1.2%); factors associated with OASIS were nulliparity, vacuum-assisted delivery, elevated neonatal birthweight, and epidural analgesia. Sexual dysfunction occurred in both groups throughout follow-up; the OASIS group had worse Arousal and Pain scores at T2 (p = 0.013; p = 0.037). On the PFDI-20, bowel and urinary symptoms were more severe in the OASIS group at T1 (p = 0.014; p = 0.005), with a difference in total score at T2 (p = 0.048). On the PFIQ-7, greater symptom impact was observed in the OASIS group at T1 (p = 0.035) and T2 (p = 0.017). Overall quality of life (SF-36) was similar between groups.</p><p><strong>Conclusions: </strong>OASIS were associated with worse sexual function and pelvic floor distress than controls from 3 months postpartum, confirming the study hypothesis; overall quality of life was similar between groups. Structured multidisciplinary postpartum follow-up addressing sexual function and pelvic floor rehabilitation is warranted for women with OASIS in low-resource settings.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955908","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":"Palliative Management of Inoperable Vesicovaginal Fistula in Cervical Cancer Patient Using Bilateral Single-J Stents and Bladder Stoma: A Pilot Study.","authors":"Yuqiang Shi, Sherryn Sherryn, Shenghan Wang, Zhentao Lei, Lin Yang, Qiang Gao, Qiangping Zheng, Bao Zhang","doi":"10.1007/s00192-026-06890-3","DOIUrl":"https://doi.org/10.1007/s00192-026-06890-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Vesicovaginal fistula (VVF) is characterized by the formation of an abnormal connection between the bladder and the vagina, leading to continuous, involuntary leakage of urine through the vaginal canal. For patients with inoperable fistulas, individualized urinary diversion becomes necessary to alleviate incontinence and pelvic pain, thereby enhancing the patient's quality of life. This pilot study aims to evaluate the feasibility and clinical benefits of an innovative use of single-J (SJ) stents in conjunction with bladder stomas for palliative management of VVF secondary to cervical cancer treatment. The primary objective of the study is to explore the safety and effectiveness of the urinary diversion in enhancing palliative care for individuals with inoperable VVF.</p><p><strong>Methods: </strong>This study evaluated 18 cervical cancer patients through purposive sampling. They were diagnosed with VVF at our center between January 2015 and October 2022. The effectiveness of the procedure was measured by comparing preoperative and postoperative data related to incontinence and quality of life, incontinence symptoms were assessed using translated versions of validated questionnaires, namely the Incontinence Quality of Life (I-QOL) questionnaire, Urogenital Distress Inventory-6 (UDI-6), and the Incontinence Impact Questionnaire-7 (IIQ-7). Safety was measured by documenting intraoperative and postoperative complications.</p><p><strong>Results: </strong>All procedures were successfully completed with minimal blood loss. The mean age was 70.8 ± 12.6 years, and mean fistula diameter was 2.0 ± 0.4 cm. Indications included failed prior repair (n = 10), local tumor recurrence (n = 3), poor surgical candidacy (n = 4), and patient refusal (n = 1). Post-procedurally, QoL scores significantly improved from 43 ± 8 to 72 ± 8. UDI-6 scores decreased from 72 ± 8 to 44 ±7, and IIQ-7 scores decreased from 76 ±6 to 46 ± 7. Daily urine pad usage was reduced to 0-2 pads per 24 h, and outpatient visits for urinary tract infections notably decreased. Complications were mostly grade I (fever, mild hematuria, UTI), with no stent dislodgement or serious adverse events reported during follow-up.</p><p><strong>Conclusion: </strong>The results suggest that the use of bilateral SJ stents and stoma bags for urinary diversion in patients with inoperable complex fistulas is a safe and effective approach. This method appears to positively impact the quality of life for selected patients with VVF, offering a viable palliative solution in cases where traditional surgical interventions are not feasible.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944772","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":"Development and Preliminary Evaluation of the Pelvic Dysfunction Composite Score (PDCS): A Pilot Study in Women with Endometriosis.","authors":"Davide Vinci, Florindo Mario Caniglia, Camilla Casolari, Fabiana Giordano, Gaetano Scalzone, Marco Torella","doi":"10.1007/s00192-026-06877-0","DOIUrl":"https://doi.org/10.1007/s00192-026-06877-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic floor dysfunctions are common in women with endometriosis. Currently available assessment tools are limited to isolated domains that do not allow for a comprehensive multidimensional evaluation. This study aimed to develop and perform a preliminary validation of a multidimensional composite index for pelvic floor dysfunction based on both subjective and objective measures in women with endometriosis.</p><p><strong>Methods: </strong>Data were retrospectively analyzed from a previously established cohort of patients who received either medical or medical-surgical treatment for endometriosis. The PDCS comprises three domains (each transformed to a 0-100 scale): subjective anorectal dysfunction (Wexner constipation and incontinence scores), pelvic floor symptoms (PFDI-20), and objective anorectal function (manometric parameters). The score was calculated as the mean of the available domains and stratified into mild (0-33), moderate (34-66), and severe (67-100) dysfunction. Internal structure assessment was based on principal component analysis and Spearman correlations. Clinical validation was assessed by correlating with pain (EHP-30) and sexual function (FSFI).</p><p><strong>Results: </strong>Twenty-nine patients with clinically relevant pelvic dysfunction were assessed [median PDCS 45.2 (IQR 33.3-60.6)]. Patients with a PDCS value of 0 were excluded from the validation analyses. There were no significant differences between treatment groups. PDCS correlated very well with PFDI-20, and moderately with the Wexner domain and manometric findings. The PDCS was significantly correlated with pain burden and sexual function.</p><p><strong>Conclusions: </strong>The PDCS is a preliminary, multidimensional composite index that integrates symptom burden and anorectal functional findings in women with endometriosis. In the clinical setting, the proposed severity categories should therefore be regarded as exploratory and require validation in larger prospective cohorts before translating the results into practice.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944578","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":"How is Subjective Surgical Success Defined Using the Pelvic Floor Distress Inventory (PFDI-20) After Primary Uterovaginal Prolapse Repair? A Systematic Review and Consensus Statements from the U-POP & LUTD 2026 Global Consensus Conference.","authors":"Alessandro Ferdinando Ruffolo, Marisa Nhat-Quynh Duong, Laura Cheng, Maurizio Serati, Alexis Anne Dieter, Amr Sherif El Haraki","doi":"10.1007/s00192-026-06896-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06896-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Anatomic success after pelvic organ prolapse (POP) surgery correlates poorly with symptom relief, prompting reliance on patient-reported outcomes (PROs). The Pelvic Floor Distress Inventory (PFDI-20) is widely used, yet how it is applied to define subjective surgical success is unclear. We aimed to evaluate how subjective success is defined using the PFDI-20 and its components after primary uterovaginal prolapse repair.</p><p><strong>Methods: </strong>As part of the U-POP & LUTD 2026 Global Consensus Conference, a systematic review (PRISMA; PROSPERO CRD420251171050) of MEDLINE, EMBASE, and ClinicalTrials.gov was conducted from inception to 8 December 2025. English-language studies of women undergoing primary uterovaginal prolapse repair that reported a PFDI-20- or POPDI-6-based definition of success were included. Screening and extraction were performed in duplicate, and the certainty of evidence was assessed using GRADE. Findings informed expert consensus statements.</p><p><strong>Results: </strong>Of 5379 records, 28 studies (4196 women) were included. Surgical success was most commonly defined as the absence of a vaginal bulge symptom-a negative response to question 3 of the PFDI-20-in 21 of 28 studies. Other definitions combined question 3 with additional items, required a negative POPDI-6 subscale, or used a statistically significant change in total PFDI-20 score. Only one study applied a minimal clinically important difference (MCID), and none applied a patient acceptable symptom state (PASS).</p><p><strong>Conclusions: </strong>Subjective success after primary uterovaginal prolapse repair is most often defined by a single PFDI-20 item, with MCID and PASS thresholds rarely applied. Consistent, validated definitions are needed to improve comparability across trials.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944733","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":"Impact of Fecal Diversion on Outcomes Following Martius Flap Repair for Rectovaginal Fistula.","authors":"Emre Teke, Afag Aghayeva, Mehmet Eşref Ulutaş, Sibel Yaman, Burcu Gümüştekin, Bilgi Baca","doi":"10.1007/s00192-026-06891-2","DOIUrl":"https://doi.org/10.1007/s00192-026-06891-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Rectovaginal fistula (RVF) repair remains surgically demanding, and whether a diverting stoma genuinely improves outcomes after Martius flap interposition is still unclear. Although diversion is traditionally advocated to minimize contamination and enhance healing, emerging evidence challenges its routine use. This study evaluated the impact of stoma diversion on recurrence, postoperative complications, and quality-of-life outcomes following Martius flap repair.</p><p><strong>Methods: </strong>This retrospective two-center cohort included women undergoing Martius flap repair for RVF between 2015 and 2025. Patients were grouped on the basis of whether a diverting stoma was present or created at surgery. Demographics, fistula characteristics, complications, recurrence, and Cleveland Global Quality of Life (CGQL) scores were compared.</p><p><strong>Results: </strong>Seventeen patients were included (ten with diversion, seven without). Baseline characteristics were similar between groups. Recurrence was markedly lower in the diversion group (10.0%) compared with the non-diversion group (42.9%). The overall recurrence rate was 23.5%. Reoperation was required in 42.9% of the non-diversion patients but in none of the diversion patients. CGQL scores were comparable between groups.</p><p><strong>Conclusions: </strong>The rate of unplanned fistula-related reoperation was lower in the stoma group following Martius flap repair for rectovaginal fistula. Recurrence also showed a trend toward a lower rate in the stoma group, although the difference was not statistically significant. Larger multicenter prospective studies are needed to confirm these findings and determine which patients may benefit most from diversion.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944782","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":"Ten-Year Outcomes After Nerve-Preserving Sacrocolpopexy for Vaginal Vault Suspension Using Resorbable Versus Nonresorbable Sutures.","authors":"Christl Reisenauer, Birgitt Schoenfisch, Jürgen Andress, Sara Y Brucker, Andrea Lippkowski, Kathrin Beilecke, Juliane Marschke, Ralf Tunn","doi":"10.1007/s00192-026-06850-x","DOIUrl":"https://doi.org/10.1007/s00192-026-06850-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Sacrocolpopexy (SCP) is the preferred treatment for vaginal vault prolapse. Long-term evidence comparing absorbable versus non-absorbable sutures for vaginal mesh fixation and functional outcomes after nerve-preserving SCP is lacking.</p><p><strong>Methods: </strong>In this bicentric, prospective, randomized trial, women with vaginal vault prolapse (Pelvic Organ Prolapse Quantification [POP-Q] stage II-III) underwent laparoscopic nerve-preserving SCP with either resorbable (VIC) or nonresorbable (ETH) sutures for vaginal mesh fixation. Concomitant surgeries were not permitted. Whereas the previous report focused on 6-month outcomes, the current analysis extends follow-up to 10 years. Primary outcome was anatomical success (POP-Q); secondary outcomes were functional outcomes assessed with validated questionnaires. Suture or mesh erosion and late adverse events were recorded.</p><p><strong>Results: </strong>Ten-year data were available for 104 of the 195 women. After a median of 10.2 years (range, 9.2-12.8), 102 women had POP-Q stage 0 and 2 had stage I in the apical compartment, with no difference between the groups. Two women were excluded owing to surgery for recurrence. Functional outcomes improved postoperatively and remained improved 10 years later. Three vaginal suture penetrations and one vaginal mesh erosion in the ETH group were asymptomatic; two vaginal mesh erosions in the VIC group required excision. Four anterior (1 ETH, 3 VIC) and six posterior colporrhaphies (3 ETH, 3 VIC) were performed. Nine women received a TVT and 1 a retropubic colposuspension; 1 small vesico-vaginal fistula was detected (ETH).</p><p><strong>Conclusions: </strong>Resorbable sutures were not observed to be inferior to nonresorbable sutures for vaginal mesh fixation during SCP. Nerve-preserving SCP was associated with a reduction in defecation disorders.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929943","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}