Sarah Ashmore, Jinxuan Shi, Tara Samsel, Margaret G Mueller, Juraj Letko, Kimberly Kenton
{"title":"Rate of Urine Culture Contamination with Different Methods of Urine Specimen Collection.","authors":"Sarah Ashmore, Jinxuan Shi, Tara Samsel, Margaret G Mueller, Juraj Letko, Kimberly Kenton","doi":"10.1007/s00192-025-06068-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06068-3","url":null,"abstract":"<p><strong>Background: </strong>Midstream urine (MSU) samples are commonly collected at the time of patient evaluation despite known high rates of contamination.</p><p><strong>Objective: </strong>The primary objective of this study was to evaluate the rate of mixed flora results in urine specimens obtained by MSU compared to straight catheterization urine (SCU).</p><p><strong>Study design: </strong>This was a quality improvement project evaluating urine culture results of women who provided either an MSU or SCU sample for analysis. Adult women seen within urogynecology clinics at a tertiary care center between April and August 2023 who had urine cultures performed for any indication were included. Mixed flora was defined as the presence of ≥ 2 non-uropathogens or 1 uropathogen in low quantity (at least 10 times fewer) compared to the concentration of nonsignificant organisms.</p><p><strong>Results: </strong>Three hundred forty women provided a urine specimen during the study period. SCU collection was performed for 171 (50.3%) women while 169 (49.7%) provided an MSU sample. Overall, 18.8% of urine cultures were reported as mixed flora (33.1% in MSU and 4.7% in SCU, p < 0.001). Mixed flora was more common with MSU specimens (87.5%, p < 0.001) and associated with a higher BMI compared to positive or negative cultures (mixed flora 29.8 kg/m<sup>2</sup> ± 16.3, positive or negative cultures 27.8 kg/m<sup>2</sup> ± 7.0, p = 0.04). MSU samples had increased odds of urine contamination compared to SCU collection (7.40 aOR, 95% CI 3.01-18.24).</p><p><strong>Conclusion: </strong>The prevalence of mixed flora was reduced significantly when SCU samples were obtained. Clinicians should consider performing SCU collection when a urine specimen is required for patient evaluation.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189163","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}
Cristiano Carvalho, Ana Paula Rodrigues Rocha, Gabriel Bernardi Dos Santos, Júlia Barbosa Guimarães, Mariana Nobrega Amorim, Ana Carolina Sartorato Beleza, Daiana Priscila Rodrigues-de-Souza, Paula Regina Mendes da Silva Serrão, Tatiana de Oliveira Sato
{"title":"Pelvic Floor Dysfunction and Associated Factors in Women with Systemic Autoimmune Rheumatic Diseases: A Cross-Sectional Study.","authors":"Cristiano Carvalho, Ana Paula Rodrigues Rocha, Gabriel Bernardi Dos Santos, Júlia Barbosa Guimarães, Mariana Nobrega Amorim, Ana Carolina Sartorato Beleza, Daiana Priscila Rodrigues-de-Souza, Paula Regina Mendes da Silva Serrão, Tatiana de Oliveira Sato","doi":"10.1007/s00192-025-06071-8","DOIUrl":"https://doi.org/10.1007/s00192-025-06071-8","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Systemic autoimmune rheumatic diseases (SARDs) cause musculoskeletal disorders and are associated with various issues that affect the quality of life. Since the musculoskeletal system is affected, the pelvic floor muscles can also be impacted, leading to possible pelvic floor dysfunctions (PFDs). Thus, the purpose of this study was to investigate the presence of PFDs, such as urinary incontinence (UI), anal incontinence (AI), genital-pelvic pain/penetration disorder (GPPPD), and pelvic organ prolapse (POP) symptoms in women with SARDs compared to a control group composed of women without SARDs; and investigate the association between SARDs and PFDs.</p><p><strong>Methods: </strong>An online cross-sectional survey was carried out. Using a web-based questionnaire, data on demographic and anthropometric features, PFD (UI, nocturia, AI, GPPPD, and POP), and obstetric history were gathered. For quantitative variables, the Mann-Whitney U test was used, and for categorical variables, the chi-squared test was used for comparison between groups. The association between SARDs and PFD was investigated using logistic regression analysis.</p><p><strong>Results: </strong>The questionnaire was completed by 326 women (224 with SARDs and 102 healthy controls). Women with SARDs reported significantly more symptoms of PFD, UI, nocturia, AI (flatus and fecal incontinence), POP, and GPPPD than healthy controls. SARDs were associated with PFD, flatus incontinence, fecal incontinence, dyspareunia, and vaginismus.</p><p><strong>Conclusions: </strong>PFD was much more common in women with SARDs than in healthy women. Women with SARDs were 1.8 to 5.2 times more likely than the control group to report PFD symptoms than women without SARDs.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189101","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":"https://doi.org/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":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","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}
Maria Thereza Albuquerque Barbosa Cabral Micussi, Vatche Arakel Minassian, Rachan Mohamed Ghandour, Jeannine Marie Miranne
{"title":"The Interplay Between Chronic Pelvic Pain and Pelvic Organ Prolapse.","authors":"Maria Thereza Albuquerque Barbosa Cabral Micussi, Vatche Arakel Minassian, Rachan Mohamed Ghandour, Jeannine Marie Miranne","doi":"10.1007/s00192-024-06040-7","DOIUrl":"https://doi.org/10.1007/s00192-024-06040-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Chronic pelvic pain (CPP) affects approximately 26% of the world's female population and has various proposed etiologies. This manuscript aims to review concepts related to pelvic organ prolapse (POP) and CPP, encompassing its etiology, risk factors, clinical findings, and pain management.</p><p><strong>Methods: </strong>A narrative review was performed using MeSH terms and text words on PubMed, and the Cochrane Database of Systematic Reviews through May 2024. A total of 33 references were used to address the questions posed in this review.</p><p><strong>Results: </strong>Specific risk factors for CPP associated with POP include pain antedating POP onset, POP surgery duration, and extent of soft tissue trauma. Studies indicate that uterosacral ligament repair performed during surgical interventions for POP correction has alleviated CPP symptoms whether performed vaginally or laparoscopically. Women with preexisting CPP or central sensitization syndrome (CSS) undergoing pelvic reconstructive surgery for POP may experience less favorable postoperative outcomes compared to those without preexisting pain conditions. These outcomes include lower patient satisfaction, less resolution of discomfort, and poorer improvement in urinary symptoms.</p><p><strong>Conclusions: </strong>On the basis of current evidence, surgeries for POP correction, especially those involving the uterosacral ligament, have shown a positive impact on reducing pelvic pain. However, untreated CPP is associated with lower satisfaction and less improvement in outcomes after POP surgery regarding pelvic symptoms and quality of life. Screening for and treating CPP conditions prior to POP surgery should be prioritized. Pain management of CPP should be addressed preoperatively, perioperatively, and postoperatively.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189193","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 Validation of Risk Assessment Model for Pelvic Organ Prolapse Based on A Retrospective Study with Machine Learning Algorithms.","authors":"Ling Mei, Linbo Gao, Tao Wang, Dong Yang, Weixing Chen, Xiaoyu Niu","doi":"10.1007/s00192-025-06046-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06046-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>We aimed to develop and validate a clinically applicable risk assessment model for identifying women at a high risk of pelvic organ prolapse (POP) based on a retrospective practice.</p><p><strong>Methods: </strong>This study enrolled patients with and without POP between January 2019 and December 2021. Clinical data were collected and machine learning models were applied, such as multilayer perceptron, logistic regression, random forest (RF), light gradient boosting machine and extreme gradient boosting. Two datasets were constructed, one comprising all variables and the other excluding physical examination variables. Two versions of the machine learning model were developed. One was for professional doctors, and the other was for community-health providers. The area under the curve (AUC) and its confidence interval (CI), accuracy, F1 score, sensitivity, and specificity were calculated to evaluate the model's performance. The Shapley Additive Explanations method was used to visualize and interpret the model output.</p><p><strong>Results: </strong>A total of 16,416 women were recruited, with 8,314 and 8,102 in the POP and non-POP groups respectively. Eighty-seven variables were recorded. Among all candidate models, the RF model with 13 variables showed the best performance, with an AUC of 0.806 (95% CI 0.793-0.817), accuracy of 0.723, F1 of 0.731, sensitivity of 0.742, and specificity of 0.703. Excluding the physical examination variables, the RF model with 11 variables showed an AUC, accuracy, F1 score, sensitivity, and specificity of 0.716, 0.652, 0.688, 0.757, and 0.545 respectively.</p><p><strong>Conclusions: </strong>We constructed a clinically applicable risk warning system that will help clinicians to identify women at a high risk of POP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079978","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}
Sunny K Lee, Catherine Keller, Meng Yao, Katie Propst, Cecile A Ferrando
{"title":"Evaluation of Comprehensive Documentation After Obstetric Anal Sphincter Injury.","authors":"Sunny K Lee, Catherine Keller, Meng Yao, Katie Propst, Cecile A Ferrando","doi":"10.1007/s00192-024-05986-y","DOIUrl":"10.1007/s00192-024-05986-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The incidence of obstetric anal sphincter injuries (OASI) has increased in recent years, which may be due to improved recognition and documentation. There is limited evidence regarding the effects of thorough documentation of obstetric anal sphincter injury repairs on postpartum clinical outcomes. Our objectives were to (1) compare the incidence of perineal wound complications between documentation groups, (2) compare other adverse events, and (3) to describe factors associated with adequate documentation. We hypothesized that better documentation would be associated with improved clinical outcomes.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 599 patients with OASI at a tertiary care referral center between January 2015 and December 2020. A priori definitions of documentation adequacy were utilized to stratify delivery notes. On the basis of these criteria, there were preferred, adequate, and inadequate documentation groups. Maternal characteristics, outcomes, and peripartum factors were compared between the groups.</p><p><strong>Results: </strong>There were no significant differences in clinical outcomes between the groups. A higher degree of perineal laceration (p < 0.001), greater blood loss (p = 0.002), and the need for repairs in the operating room (p = 0.019) were significant factors associated with adequate documentation. Clinicians who were comprehensive in their documentation were more likely to refer patients to Urogynecology (p < 0.001) and to add OASI to the electronic medical record problem list (p = 0.005).</p><p><strong>Conclusions: </strong>While certain factors are associated with adequate documentation, this did not improve clinical outcomes for OASI and further research is warranted to explore the importance of medical documentation surrounding OASI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"307-316"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583020","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}
Tianyue Li, Xingpeng Di, Ya Li, Jingwen Wei, Banghua Liao, Kunjie Wang
{"title":"The Association between Depression and Overactive Bladder: A Cross-Sectional Study of NHANES 2011-2018.","authors":"Tianyue Li, Xingpeng Di, Ya Li, Jingwen Wei, Banghua Liao, Kunjie Wang","doi":"10.1007/s00192-024-05991-1","DOIUrl":"10.1007/s00192-024-05991-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The relationship between depression and overactive bladder (OAB) is unknown. This study aimed to explore the association between depression and OAB in the U.S.</p><p><strong>Population: </strong></p><p><strong>Methods: </strong>A cross-sectional study was performed utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Depression status and severity among participants were assessed via the Patient Health Questionnaire-9 (PHQ-9). The OAB symptoms of the participants were assessed via the OAB symptom score (OABSS) scale. Multivariate logistic regression was conducted to evaluate the association between depression and OAB.</p><p><strong>Results: </strong>A total of 19,359 participants were enrolled in the study, with 91.01% (N = 17618) exhibiting minimal or mild depression, 7.92% (N = 1533) presenting with moderate or moderately severe depression, and 1.07% (N = 208) identified as severe depression. The overall prevalence of OAB was 21.62%. We found that depression was positively associated with OAB before and after adjustments for all covariates. After adjusting for covariates, individuals with moderate or moderately severe depression presented an elevated risk of OAB (OR = 2.52, 95% CI 2.11-3.01, p < 0.01), while those with severe depression presented a greater risk (OR = 3.74 95% CI 2.37-5.90, p < 0.01) than did participants with minimal or mild depression. Age may modify the correlation between depression and OAB.</p><p><strong>Conclusions: </strong>Our study highlighted a positive association between depression and OAB in the U.S. population, and the association between depression and OAB was modified by age. However, more studies are needed in the future to verify the associations between depression and OAB and their underlying mechanisms.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"373-380"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681787","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":"Lower Urinary Tract Symptoms and Fall Risk: An Important Problem in Older Women with Cognitive Frailty.","authors":"Ulku Kezban Sahin, Hatice Calıskan","doi":"10.1007/s00192-024-06022-9","DOIUrl":"10.1007/s00192-024-06022-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective of our study is to investigate the presence of lower urinary tract symptoms (LUTS) and its correlation with the risk of falling in older women with cognitive frailty.</p><p><strong>Methods: </strong>The descriptive study was conducted on 102 female older adults, 60 women were classed as cognitively frail and 42 as healthy. Women were classified as having mild cognitive impairment based on the Clinical Dementia Rating Scale and as frail based on the Clinical Frailty Scale. The Bristol Female Lower Urinary Tract Symptoms questionnaire and Timed Up and Go test were applied to determine LUTS and fall risk respectively.</p><p><strong>Results: </strong>Cognitively frail women scored considerably higher for LUTS including quality of life, filling, incontinence, and voiding, than the healthy group (p < 0.001). Timed Up and Go test seconds were significantly longer in cognitively frail women (p < 0.001).</p><p><strong>Conclusions: </strong>These data suggest the notion that cognitive frailty might increase the risk of LUTS and falls. Older women at high fall risk are more likely to have LUTS. Thus, health practitioners must recognize that embarrassment may prevent individuals from seeking urinary care. Even in the absence of patient complaints, older women with cognitive frailty should have a comprehensive fall history and LUTS testing. Implementing LUTS and fall-risk measures may avoid future falls and serious complications such as fractures.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"413-420"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921772","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}
Stephen Rhodes, Amine Sahmoud, J Eric Jelovsek, C Emi Bretschneider, Ankita Gupta, Adonis K Hijaz, David Sheyn
{"title":"Validation and Recalibration of a Model for Predicting Surgical-Site Infection After Pelvic Organ Prolapse Surgery.","authors":"Stephen Rhodes, Amine Sahmoud, J Eric Jelovsek, C Emi Bretschneider, Ankita Gupta, Adonis K Hijaz, David Sheyn","doi":"10.1007/s00192-024-06025-6","DOIUrl":"10.1007/s00192-024-06025-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to externally validate and recalibrate a previously developed model for predicting postoperative surgical-site infection (SSI) after pelvic organ prolapse (POP) surgery.</p><p><strong>Methods: </strong>This study utilized a previously validated model for predicting post-POP surgery SSI within 90 days of surgery using a Medicare population. For this study, the model was externally validated and recalibrated using the Premier Healthcare Database (PHD) and the National Surgical Quality Improvement Project (NSQIP) database. Discriminatory performance was assessed via the c-statistic and calibration was assessed using calibration curves. Methods of recalibration in the large and logistic recalibration were used to update the models.</p><p><strong>Results: </strong>The PHD contained 420,277 POP procedures meeting the inclusion criteria and 1.6% resulted in SSI. The NSQIP dataset contained 62,553 POP surgeries and 1.4% resulted in SSI. Discrimination of the original model was comparable with that seen in the initial validation (c-statistic = 0.57 in PHD, 0.59 in NSQIP vs 0.60 in the original Medicare data). Recalibration greatly improved model calibration when evaluated in NSQIP data.</p><p><strong>Conclusion: </strong>A previously developed model for predicting SSI after POP surgery demonstrated stable discriminatory ability when externally validated on the PHD and NSQIP databases. Model recalibration was necessary to improve prediction. Prospective studies are needed to validate the clinical utility of such a model.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"431-438"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948060","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}
Erin A Brennand, Julia Chai, Shannon Cummings, Beili Huang, Taylor Hughes, Allison Edwards, Alison Carter Ramirez
{"title":"Babcock versus Scissor Tensioning for Retropubic Mid-Urethral Slings: Comparing Two Intra-Operative Techniques Through 5 Years of Follow-Up.","authors":"Erin A Brennand, Julia Chai, Shannon Cummings, Beili Huang, Taylor Hughes, Allison Edwards, Alison Carter Ramirez","doi":"10.1007/s00192-024-05916-y","DOIUrl":"10.1007/s00192-024-05916-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to determine if mid-urethral sling (MUS) tensioning with a Mayo Scissor as a sub-urethral spacer compared with a Babcock clamp holding a loop of tape under the urethra results in differences in patient-reported outcomes and rates of repeat surgery over a 5-year follow-up.</p><p><strong>Methods: </strong>Follow-up 5 years after a randomized clinical trial, utilizing primary data collection linked to administrative health data, was carried out to create a longitudinal cohort. The primary outcome was participant-reported bothersome SUI symptoms, as defined by the Urogenital Distress Inventory (UDI-6) questionnaire. Secondary outcomes included participant-reported bothersome overactive bladder (OAB) scores, median scores of three validated urinary symptom questionnaires, and rates of subsequent surgery determined through patient report and administrative data.</p><p><strong>Results: </strong>Two hundred and sixty (81.8%) of the original study participants provided participant-reported data at 5 years. Administrative data linkage was completed for all of the original participants (n = 318). Demographic characteristics remained similar in the two groups at the 5-year follow-up mark. No differences existed in the primary outcome of reported bothersome SUI symptoms (30.8% Scissors vs 26.8% Babcock, p = 0.559), proportion of participants with bothersome OAB, the median scores of three validated bladder questionnaires, or in rates and cumulative incidence of recurrent MUS surgery or surgical revision of mesh-related complications.</p><p><strong>Conclusion: </strong>Both the Scissor and Babcock tensioning techniques provided comparable outcomes at 5 years post-MUS surgery. The information from this study allows surgeons to better decide which technique to adopt in their practice, providing confidence in longer-term cure and safety.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"279-287"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346711","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}