International Urogynecology Journal最新文献

{"title":"Laparoscopic Pudendal Nerve Release at the Level of Sacrospinous Ligament.","authors":"Baris Mulayim, Sema Mulayim","doi":"10.1007/s00192-025-06062-9","DOIUrl":"10.1007/s00192-025-06062-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pudendal nerve release can be managed by the laparoscopic approach for pudendal nerve entrapment.</p><p><strong>Methods: </strong>This is a case report of a stepwise demonstration of the technique with narrated video footage. A 71-year-old woman, gravid 7, parity 3, abortion 4, live births 3 vaginal delivery, complained of pain while sitting. She had been having vaginal and vulvar pain on the left side for 3 years. At vaginal examination, she had pain over the sacrospinous ligament with palpation. Tinel's sign (+) on the left side. Left side pudendal nerve block relieves pain for 1 h. Using a laparoscopic approach for a left pudendal nerve release at the level of sacrospinous ligament, the dissection started at the level of medial to the infundibulopelvic ligament, after visualization of obliterated umbilical artery and obturator nerve and vessels, dissection continued deeper to the pelvic floor visualizing the obturator internus muscle, then pudendal nerve and vessels are identified and the coccygeus muscle and sacrospinous ligament are observed. The sacrospinous ligament is cut all the way to the entrance of Alcock's canal.</p><p><strong>Results: </strong>The operation was finished without any complication and the patient was discharged after the operation day. Pain decreased on her postoperative examination. Follow-up visits will be continued at 3 and 6 months.</p><p><strong>Conclusions: </strong>Laparoscopic pudendal nerve release is reproducible, effective, safe, and has a steep learning curve method for the management of pudendal nerve entrapment.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1105-1107"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033126","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":"Short-Term Complications Following Transvaginal Sacrospinous Ligament Rectopexy: A Retrospective Cohort Study.","authors":"Alireza Hadizadeh, Henry H Chill, Angela Leffelman, Claudia Paya-Ten, Cecilia Chang, Jungeun Lee, Roger P Goldberg, Steven D Abramowitch, Ghazaleh Rostaminia","doi":"10.1007/s00192-025-06098-x","DOIUrl":"10.1007/s00192-025-06098-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Obstructed defecation syndrome (ODS) affects over 12% of middle-aged women, characterized by excessive straining, incomplete evacuation, and splinting. Current surgical options such as ventral mesh rectopexy, though effective, involve risks associated with mesh use and abdominal entry. This study evaluates the short-term complications of transvaginal sacrospinous ligament rectopexy.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a tertiary medical center, including patients over 21 years who underwent transvaginal sacrospinous ligament suture rectopexy for ODS from January 2018 to May 2024. Demographic, intraoperative, and 30-day postoperative complication data were collected.</p><p><strong>Results: </strong>A total of 190 patients with a mean age of 62.3 years underwent transvaginal sacrospinous ligament suture rectopexy. Intraoperative complications were rare, with four rectal injuries: two occurred during posterior dissection, one due to aggressive posterior repair, and another was discovered during exploration for postoperative pain. All rectal injuries were managed successfully. One patient experienced significant intraoperative bleeding, resulting in a hematoma that required evacuation 5 days later. Postoperative urinary retention was the most common complication, affecting 29.8% of patients. This was associated with concurrent procedures, such as mid-urethral sling placement and anterior colporrhaphy. Reoperation within 30 days was necessary for six patients (3.7%): two for urinary retention due to sling-related issues, two for sacrospinous pain necessitating suture removal, and two for vaginal bleeding related to hematoma formation. No cases of surgical site infection, sepsis, or mortality were observed.</p><p><strong>Conclusions: </strong>Transvaginal sacrospinous ligament suture rectopexy appears to be a safe alternative for ODS treatment, with low short-term complication rates.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1037-1044"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Gestational Diabetes Mellitus Affects the Risk of Obstetric Anal Sphincter Injury: A Systematic Review and Meta-Analysis of Cohort Studies\".","authors":"Lakshmi T","doi":"10.1007/s00192-025-06064-7","DOIUrl":"10.1007/s00192-025-06064-7","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1115-1116"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605104","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":"Fecal Incontinence Outcomes Following Transvaginal Posterior Vaginal Wall Repair.","authors":"Jersey B Burns, Amr El Haraki, Jesseca Crawford, Candace Y Parker-Autry","doi":"10.1007/s00192-025-06096-z","DOIUrl":"10.1007/s00192-025-06096-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Knowledge regarding rates of improvement of fecal incontinence (FI) after repair of posterior compartment prolapse is limited. We aimed to estimate the rate of resolution or improvement of fecal incontinence postoperatively following transvaginal posterior compartment repair.</p><p><strong>Methods: </strong>This was a retrospective cohort study including patients with diagnosis of fecal incontinence who underwent transvaginal posterior repair at a single academic institution between 1/2016 and 1/2022. Patients who underwent concomitant anal sphincteroplasty served as controls. The primary outcome was resolution of FI symptoms within 6-weeks postoperatively. Secondary outcomes included improvement of FI symptoms and preoperative anorectal manometry characteristics. Univariate and bivariate analysis were performed to describe and compare outcomes between groups with multivariable regression performed to address potential confounders.</p><p><strong>Results: </strong>Of 179 patients included, 91 had posterior repair alone, while 88 had concomitant anal sphincteroplasty. Demographic and clinical characteristics were similar between groups. Overall, 143 (80%) patients did not report any FI symptoms at their 6-week postoperative visit. An additional 28 (16%) reported improvement in FI symptoms. Among patients who underwent posterior repair alone, 76 (84%) had resolution of their FI compared to 67 (76%) in patients with concomitant anal sphincteroplasty (P = 0.6); 71 patients underwent anorectal manometry preoperatively. There were no significant differences in mean average resting pressures or mean maximum squeeze pressures between groups.</p><p><strong>Conclusions: </strong>Posterior compartment repair resulted in resolution or improvement of fecal incontinence symptoms within 6-weeks postoperatively. The mechanism for FI symptoms in women with rectoceles may be independent of the anal sphincter complex.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1061-1066"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prasterone and Overactive Bladder in Postmenopausal Women.","authors":"Alka Bhide, Steven Swift, G Alessandro Digesu","doi":"10.1007/s00192-025-06205-y","DOIUrl":"10.1007/s00192-025-06205-y","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"945-946"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274793","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":"Efficacy and Tolerance of the Tampsec Vaginal Tampon for Treating Stress Urinary Incontinence. A Randomized Controlled Trial.","authors":"Irene Diez-Itza, Jordi Cassadó, Alicia Martin, Eloy Muñoz, Elisa López-Herrero, Celia Bauset, Mikel Mancisidor, Cristina Sarasqueta","doi":"10.1007/s00192-025-06060-x","DOIUrl":"10.1007/s00192-025-06060-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Stress urinary incontinence (SUI) is a highly prevalent condition in women. We hypothesized that the Tampsec™ vaginal tampon will be efficacious and well tolerated in its treatment.</p><p><strong>Methods: </strong>This was a multicenter open-label parallel-group randomized control trial. All participants were recommended to make lifestyle modifications and perform pelvic floor muscle training for SUI treatment. Additionally, women in the tampon group were instructed to use a Tampsec™ throughout the day. The primary outcome measure was a ≥50% reduction in pad weight by the end of treatment. Secondary outcome measures were women's perception of improvement evaluated using the Patient Global Impression of Improvement (PGI-I) questionnaire, decrease in the mean number of SUI episodes/day, and improvement in the impact of urinary incontinence (UI) on everyday life. Tampon tolerance and usability were also evaluated.</p><p><strong>Results: </strong>Forty-six women with a positive urinary stress test were randomized 1:1 to tampon or control treatments. Regarding the primary outcome, a ≥50% reduction was achieved in 69.9% of patients in the tampon group and 26.1% in controls (RR 2.7; 95%CI 1.3-5.4). On the basis of PGI-I responses, the treatment was successful in 60.9% of women in the tampon group and 17.4% of controls (p = 0.003). The tampon group also reported greater decreases in SUI episodes/day (mean 2.0±2.2 vs 0.5±1.1; p = 0.007) and more improvement in the impact of UI on everyday life. Tolerance and usability were good in most women.</p><p><strong>Conclusion: </strong>The Tampsec™ tampon is efficacious and well tolerated in women with SUI. This treatment decreases the number of SUI episodes/day and improves UI-related quality of life.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1011-1018"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065602","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":"Symptomatic Pelvic Floor Disorders in Community-Dwelling Women in Central Gondar Zone, Northwest Ethiopia.","authors":"Zelalem Ayichew Workineh, Zelalem Mengistu Gashaw, Tamiru Minwuye Andargie, Tibeb Zena Debele, Solomon Gedlu Nigatu, Wagaye Fentahun Chanie, Tadesse Belayneh Melkie","doi":"10.1007/s00192-025-06053-w","DOIUrl":"10.1007/s00192-025-06053-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study was aimed at assessing the prevalence and factors contributing to pelvic floor disorder (PFD) symptoms.</p><p><strong>Methods: </strong>A community-based cross-sectional study was employed among 737 women in the central Gondar Zone of Northwest Ethiopia from September to December 2022. Participants were selected using a multi-stage cluster sampling. The Amharic version of the Pelvic Floor Disorder Inventory 20 (PFDI-20) tool was employed to evaluate the occurrence of PFDs. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of PFDs.</p><p><strong>Results: </strong>The prevalence of at least one form of PFD was 26.9% (95% CI 23.3 to 30.0%). Pelvic organ prolapse symptoms, urinary incontinence, and fecal incontinence were reported at rates of 19.9%, 19.7%, and 12.8% respectively. Factors associated with PFDs included increasing age (AOR = 3.61, 95% CI 1.01 to 6.91), residing in a rural area (AOR = 2.12, 95% CI 1.63 to 3.66), a history of difficult labor (AOR = 1.83, 95% CI 1.26 to 2.66), multiple vaginal deliveries (AOR = 2.41, 95% CI 2.18 to 3.92), home delivery (AOR = 1.29, 95% CI 1.86 to 2.93), and being postmenopausal (AOR = 1.62, 95% CI 1.55 to 2.89).</p><p><strong>Conclusions: </strong>Currently, more than 25% of women are experiencing distressing symptoms associated with PFDs. Contributing factors include older age, rural residence, having multiple vaginal deliveries, and postmenopausal status. Therefore, it is essential to focus on the early identification of PFD symptoms, raise awareness within the community and among women regarding the connections between advanced age, menopause, and multiparity, and advocate for family planning initiatives.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1019-1028"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189178","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 Single-Incision Sling Placement on Female Sexual Function in Women with Stress Urinary Incontinence.","authors":"Marie Van Isacker, Frank Van der Aa","doi":"10.1007/s00192-025-06058-5","DOIUrl":"10.1007/s00192-025-06058-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Stress urinary incontinence (SUI) is a common condition among women of childbearing age, often requiring surgical intervention. The midurethral sling (MUS), including first-generation tension-free vaginal tapes (TVT) and second-generation transobturator tapes (TOT, TVT-O), has long been the standard treatment. However, both approaches have associated risks, prompting the development of single-incision slings (SIS) as a third option. SIS have proven their efficacy in SUI treatment, but the impact of these slings on female sexual function specifically remains underexplored.</p><p><strong>Methods: </strong>A literature search was conducted using PubMed using the keywords \"stress urinary incontinence,\" \"midurethral slings,\" \"single-incision slings,\" \"female sexual function,\" and \"dyspareunia.\"</p><p><strong>Results: </strong>The reviewed studies demonstrated that SIS generally maintain or improve sexual function postoperatively, but with varying impact on specific aspects of sexual function. While coital urinary incontinence often improved or resolved, new or worsened dyspareunia was reported in a significant number of patients.</p><p><strong>Conclusion: </strong>SIS placement for SUI generally preserves or enhances sexual function, though individual aspects, such as dyspareunia, may worsen for some patients. Given that an important goal of SUI treatment is to improve quality of life, it is crucial to identify preoperative factors that will identify patients at risk of developing dyspareunia after surgery or are more likely to experience an improvement in sexual function. Further research is needed to better understand these predictors and optimize surgical outcomes for women undergoing SUI treatment with SIS.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"947-954"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255660","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":"What Pad Weight Gain During Treadmill Running Indicates Urine Leakage Among Females? An Observational Study.","authors":"Marina Petter Rodrigues, Marie-Eve Berube, Grace Collins, Linda McLean","doi":"10.1007/s00192-025-06122-0","DOIUrl":"10.1007/s00192-025-06122-0","url":null,"abstract":"<p><strong>Introduction: </strong>Pad tests have been used to assess urinary incontinence (UI) during exercise, but they do not account for confounding factors such as perspiration. The objectives of this study were to describe pad weight gain among runners with and without running-induced stress UI (RI-SUI), who complete a standardized treadmill-based pad test, and to investigate the sensitivity and specificity of pad weight gain as a measure of urine leakage.</p><p><strong>Methods: </strong>This was an observational cohort study. We recruited adult female runners with and without RI-SUI. Participants performed a 38-min treadmill-based running protocol while wearing a pre-weighted incontinence pad. Pad weight gain was described by group, then compared between groups using the Mann-Whitney U test. A receiver-operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of different cutoff values for pad weight gain.</p><p><strong>Results: </strong>Data from 74 runners (20 with and 54 without RI-SUI) were included. The median pad weight gain was significantly higher in the incontinent group (24.20 g; range 3.90-166.30 g) than in the continent group (3.80 g; range 0.20-19.96 g; p < 0.001). When using a 9.35 g cutoff, the ROC curve predicted urine leakage with 70% sensitivity and 88% specificity, while a 0.25 g cutoff would achieve 100% sensitivity and 19.98 g would achieve 100% specificity.</p><p><strong>Conclusion: </strong>Pad weight gain during a treadmill-based pad test should be interpreted cautiously, as values up to 19.96 g may result from perspiration or other fluids.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1053-1060"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673784","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 Comparison of Pelvic Floor Muscle Exercises and Spinal Stabilization Exercises in Women with Stress Urinary Incontinence.","authors":"Esra Bayramoğlu Demirdöğen, Tufan Ulcay, Muhammet Şahin Bağbanci, Şeyda Toprak Çelenay","doi":"10.1007/s00192-024-05978-y","DOIUrl":"10.1007/s00192-024-05978-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to compare the effects of pelvic floor muscle exercise (PFME) and spinal stabilization exercise (SSE) on urinary symptoms, pelvic floor muscle strength (PFMS), quality of life (QoL), core stability, balance, spinal posture, and perception of subjective improvement (PSI) in women with stress urinary incontinence (SUI).</p><p><strong>Methods: </strong>Patients were randomly divided into PFME (n = 25) and SSE (n = 25) groups. The exercises of both groups was applied 3 days a week for 8 weeks. Urinary symptoms, PFMS, QoL, core stability, balance, spinal posture, and PSI were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and pad test, the Modified Oxford Scale (MOS), the King's Health Questionnaire (KHQ), the Sahrmann test, the Biodex Balance System, a Spinal Mouse device, and a Likert-type scale respectively.</p><p><strong>Results: </strong>The ICIQ-SF, pad test, KHQ, and static balance scores of both groups decreased, whereas the MOS and Sahrmann scores increased (p < 0.05). All balance scores and sacral angles decreased in the SSE group (p < 0.05). The KHQ-Physical and KHQ-Emotional scores decreased more in the PFME group than in the SSE group, whereas core stability increased more and sacral angle decreased more in the SSE group than in the PFME group (p < 0.05). The PSI were similar (p > 0.05).</p><p><strong>Conclusion: </strong>Both PFME and SSE were effective in improving urinary symptoms, PFMS, QoL, and PSI in women with SUI. SSE was superior to PFME in improving core stability, balance, and sacral position. SSE may be an alternative method in the treatment of SUI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"969-979"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667888","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}