International Urogynecology Journal最新文献

{"title":"Commentary on Huang Y, Li HF, Yang Y. Genetically Predicted ESR1 Expression Protects Against POP: Complementary and Divergent Findings from Mendelian Randomization. Int Urogynecol J. 2025.","authors":"Daisuke Obinata","doi":"10.1007/s00192-025-06278-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06278-9","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954240","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 Commentary on the \"Detection of Age-Related Pelvic Floor Fragility in Female Patients Using Magnetic Resonance Imaging\".","authors":"Ian M Vasicka","doi":"10.1007/s00192-025-06263-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06263-2","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954149","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":"Clinical Characteristics and Influencing Factors of Pelvic Organ Prolapse Among Women in Fushun City: A Cross-Sectional Study.","authors":"BingJie Rui, GuangHai Rui, YanFeng Yang","doi":"10.1007/s00192-025-06284-x","DOIUrl":"https://doi.org/10.1007/s00192-025-06284-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study evaluates the prevalence of pelvic organ prolapse (POP) symptoms among women in Fushun and compares transperineal ultrasound (TPUS) and pelvic floor muscle (PFM) strength parameters across different symptom groups.</p><p><strong>Methods: </strong>A cross-sectional study recruited 237 participants aged ≥ 18 years. Data collection included the self-reported simple pelvic floor impact questionnaire (SPFIQ), three-dimensional TPUS, and PFM strength measurements. Among them, 196 participants underwent physician interviews and were divided into two groups based on International Continence Society (ICS) diagnostic criteria to compare TPUS and PFM parameters.</p><p><strong>Results: </strong>Higher body mass index (BMI) and alcohol consumption were associated with stress incontinence. Urinary retention correlated with self-reported conditions and higher dynamic vaginal pressure (DVP). A higher bladder neck position at rest (BNPR) reduced POP risk, while increased bladder neck mobility (BNM) elevated the risk of stress incontinence and POP. Levator hiatus area during Valsalva (LHA-Valsalva) was positively correlated with POP symptoms. Postmenopausal women showed more colorectal-anal symptoms, linked to type II pelvic floor muscle fatigue (PFMF-II). Clustering analysis identified two groups: one with mild symptoms and minimal quality-of-life impact, and another with significant urinary incontinence (UI) affecting daily activities, characterized by increased BNM and reduced PFM strength. In the physician-interviewed subset, bladder neck position during Valsalva (BNPV), BNM, and LHA-Valsalva showed varying predictive values for urinary incontinence.</p><p><strong>Conclusions: </strong>POP symptoms are significantly associated with higher BMI, alcohol consumption, self-reported conditions, postmenopause, and specific PFM and TPUS parameters. TPUS measurements, including BNPV, BNM, and LHA-Valsalva, offer predictive insights for clinical assessment and management of POP.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954166","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":"Bibliometric Mapping of Neovagina Creation Research: Trends, Themes, and Global Collaborations.","authors":"Melisa Golgelioglu, Gulcan Akverdi","doi":"10.1007/s00192-025-06287-8","DOIUrl":"https://doi.org/10.1007/s00192-025-06287-8","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Neovagina creation is an essential area of research in gynecological and reconstructive surgery, addressing congenital conditions like Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and transgender health needs. This study aims to provide a comprehensive bibliometric analysis of global research trends, influential contributors, and thematic developments in this evolving field.</p><p><strong>Methods: </strong>Data were retrieved from the Web of Science Core Collection, encompassing 357 publications from 56 countries. Bibliometric tools, including VOSviewer, were used to analyze publication trends, author and institutional contributions, and keyword co-occurrences. The study also visualized global collaborations and thematic patterns.</p><p><strong>Results: </strong>The United States and Italy emerged as the leading contributors, reflecting their advanced research infrastructure and resources. Frequently occurring keywords, including \"neovagina,\" \"vaginal agenesis,\" and \"Mayer-Rokitansky-Küster-Hauser syndrome,\" highlighted the focus on congenital conditions and surgical reconstruction. Time-series analysis revealed increasing attention to uterus transplantation and transgender health since 2018. However, the study identified limited contributions from low-resource regions and insufficient international collaboration.</p><p><strong>Conclusions: </strong>This analysis highlights the evolving landscape of neovagina creation research, driven by multidisciplinary approaches and thematic diversity. While significant progress has been made, global disparities and research gaps remain. Addressing these issues through international collaborations and equitable research initiatives is critical to advancing clinical practices and improving outcomes for all patients requiring neovagina creation.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859111","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":"Hormonal Contraception Use and Risk of Lower Urinary Tract Symptoms and Conditions: Findings From the Boston Area Community Health Survey.","authors":"Emmanuel Afful, Emily S Barker, Tasneem Issa, Sarah Narcisse, Ratna Pakpahan, Chiara Ghetti, Bernard L Harlow, Ariana L Smith, Tessa Madden, Jerry L Lowder, Siobhan Sutcliffe","doi":"10.1007/s00192-025-06271-2","DOIUrl":"10.1007/s00192-025-06271-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between hormonal contraception (HC) and lower urinary tract symptoms (LUTS) and recurrent urinary tract infections (rUTIs) among premenopausal women in the Boston Area Community Health Survey.</p><p><strong>Methods: </strong>At baseline in 2002-2005 and 5 years later, participants provided information on contraception use, 14 LUTS, and rUTIs. We used this information to investigate HC use (ever, past, current, and ever systemic) in relation to the prevalence and risk of urinary incontinence, other storage symptoms, voiding/emptying symptoms, lower urinary tract pain, and rUTIs. Associations were estimated using Poisson regression with robust variance estimation, adjusting for age, race/ethnicity, vaginal parity, body mass index, waist circumference, cigarette smoking, diabetes, and sexual activity (rUTI analyses only).</p><p><strong>Results: </strong>In both prevalent (n = 881) and incident analyses (n = 608-867, depending on the LUTS), no associations were observed for HC use with urinary incontinence, other storage LUTS, voiding/emptying LUTS, or lower urinary tract pain. In contrast, positive associations were observed for rUTIs in prevalent analyses (ever [adjusted prevalence ratio (aPR) 6.4, 95% confidence interval (CI) 1.0-41.3] and current use [aPR 16.3, 95% CI 1.8-152.1] compared to never use), with similar suggestive positive associations in incident analyses (ever use [adjusted relative risk = 4.4, 95% CI 0.9-21.2] and current use [aPR 5.9, 95% CI 0.7-53.5]).</p><p><strong>Conclusions: </strong>Our prospective findings do not support associations between HC use and risk of most LUTS or conditions, except for rUTIs. Future studies should explore this association further to determine whether it is explained by residual confounding by sexual activity or the possible influence of HC use on the hormonal genitourinary tract milieu.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855186","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":"Rethinking Urethral Diverticulum: A Narrative Review of Clinical Outcomes and Cancer Associations.","authors":"Carolyn Daniels, Thomas R Wong, Ilaha Isali","doi":"10.1007/s00192-025-06244-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06244-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urethral diverticulum (UD) is a rare condition characterized by a pouch-like protrusion of the urethral mucosa into surrounding tissues. This review is aimed at synthesizing data on factors influencing surgical outcomes, postoperative complications, and the association between UD and malignancy.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted for studies published between 2014 and 2024. Inclusion criteria encompassed studies reporting patient outcomes post-UD repair, postoperative complications, or cases of UD-associated malignancy. Data were extracted and analyzed qualitatively owing to the heterogeneity of available studies.</p><p><strong>Results: </strong>Thirty-two studies met the inclusion criteria, totaling 1052 patients with a median age range of 35-62 years; 86% of the patients were female. Transvaginal surgical excision has demonstrated success rates of 83% to 97%. Recurrence rates varied, with primary diverticulectomy showing 2% to 22% and urethroplasty 17%. Larger diverticula (> 3 cm) were linked to increased intraoperative blood loss (mean 450 ml vs 200 ml, p < 0.001). Anatomical complexity, such as circumferential diverticula, was associated with higher postoperative urinary tract infection rates (15% vs 7%, p = 0.02) and reduced surgical success (83% vs 97%, p < 0.05). Postoperative stress urinary incontinence occurred in 4% to 21% of patients. Eighteen cases of UD-associated malignancy were identified, predominantly adenocarcinoma (44%), with a mean age at diagnosis of 51.6 years.</p><p><strong>Conclusions: </strong>Surgical outcomes for UD are influenced by factors such as diverticulum size and anatomical complexity. Postoperative complications are significant considerations. Further research with standardized reporting is essential to enhance understanding and management of UD.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855187","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":"Redefining Urogynaecology Services: The Impact of Nurse-Physiotherapist Triage Clinics on Reducing Delays and Improving Patient Care.","authors":"Indranil Banerjee, Yatin Anant Thakur, Emerald Win Oo, Abhyuday Chanda, Sarah Lawrence, Neha Shirsalkar","doi":"10.1007/s00192-025-06259-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06259-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This project aimed to evaluate the impact of a nurse-physiotherapist triage clinic (NPTC) on service delivery within a urogynaecology department. The NPTC model was designed to be the first point of contact for urogynaecology referrals to supplement a consultant-led model and was run by specialist nurses and pelvic floor physiotherapists. The project period spanned one year before and one year after the NPTC's introduction.</p><p><strong>Methods: </strong>This was a service evaluation project registered with the local clinical governance team (reference number GYNAE374). A retrospective review of 200 case notes compared patients referred before the NPTC's establishment, pre-NPTC or group 1 (100 new patients), with those referred afterwards, post-NPTC or group 2 (100 new patients), with ensured comparability of primary reasons for referral between both groups. The patient selection for group 1 was conducted using statistical software R version 4.4.2 (R Foundation for Statistical Computing, Vienna, Austria).</p><p><strong>Results: </strong>The process measure for the project was to determine whether implementation of the NPTC reduced time intervals between general practitioner (GP) referral to first appointment and from the first visit to treatment completion. In both analyses, the NPTC showed significant reduction in the time intervals. The time interval between GP referral and first appointment was significantly reduced in group 2, with a p value of < 0.001. Similarly, the time interval from the first visit to treatment completion was shorter for group 2, with a p value of < 0.001, demonstrating the NPTC's efficiency in accelerating the care process and reducing treatment timelines. The balance measure was to investigate patient satisfaction, using feedback forms, which was overwhelmingly positive; 95% of respondents rated the clinic's service as 'excellent', and 5% rated it as 'good'.</p><p><strong>Conclusions: </strong>The NPTC model provides an effective, resource-efficient solution to urogynaecological service delivery, demonstrating its potential as a benchmark for modern urogynaecological practice. This was a successful quality improvement journey that can lead the way for adaptation of the same approach by different units.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835080","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":"Quality-Adjusted Life-Years Outcome 1 Year After Surgery by Robotics-Assisted Sacral Hystero-Colpopexy Versus Vaginal Mesh for Pelvic Organ Prolapse Repair.","authors":"Georgios Poutakidis, Kirk Geale, Edward Morcos","doi":"10.1007/s00192-025-06242-7","DOIUrl":"https://doi.org/10.1007/s00192-025-06242-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The aim of this study was to compare the quality-adjusted life-years (QALYs) attained 1 year after robotics-assisted sacral hystero-colpopexy (RASC) versus Uphold™ vaginal mesh surgery for pelvic organ prolapse repair.</p><p><strong>Methods: </strong>This was a secondary analysis of a previously published cohort study. A total of 65 patients who underwent RASC and 71 who underwent the Uphold™ procedure completed the 15-dimensional (15D) and the EuroQol five-dimensional three-level (EQ-5D-3L) instruments measuring health-related quality of life (HR-QoL). All patients had symptomatic and anatomical apical prolapse (POP-Q C ≥ stage II) with or without other vaginal wall defects. Changes in HR-QoL instruments were calculated and compared with minimal important change (MIC) thresholds and QALYs gained were estimated for each intervention.</p><p><strong>Results: </strong>The 15D and EQ-5D-3L mean index scores were improved from preoperatively to 1 year after RASC ([0.88 ± 0.10 to 0.90 ± 0.01] and [0.85 ± 0.1 to 0.90 ± 0.1]) and after Uphold™= ([0.87 ± 0.1 to 0.89 ± 0.1] and [0.86 ± 0.1 to 0.93 ± 0.1], p 0.024 to p < 0.001) with no significant difference between cohorts. Prolapse-related 15D profile index measures, including discomfort, sexual activity, and distress were significantly improved after RASC (p = 0.039 to < 0.001), whereas excretion, discomfort, and sexual activity were significantly improved after the Uphold™ (p = 0.009 to < 0.001). The improvement in 15D scores from baseline to 1-year follow-up of + 0.026 for RASC and + 0.025 for Uphold™ exceeded the MIC, indicating meaningful improvements in patient quality of life. The overall 1-year QALY gain was estimated to be 0.90 ± 0.1 in the RASC and 0.88 ± 0.1 in the Uphold™ cohorts (p < 0.001), with no significant difference between the two interventions (p = 0.514).</p><p><strong>Conclusions: </strong>The RASC and Uphold™ are both meaningful surgical treatments for prolapse, with significant improvement in the HR-QoL and the 1-year QALY gain and with no significant difference between the two surgeries.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835079","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":"Factors Affecting Anal Sphincter Recruitment During Intraoperative Pudendal Nerve Stimulation: An Observational Study.","authors":"Amador C Lagunas, Po-Ju Chen, Luis Ruiz, Amolak S Jhand, Nystha Baishya, Scott F Lempka, Priyanka Gupta, Tim M Bruns","doi":"10.1007/s00192-025-06238-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06238-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The relationship between pudendal neuromodulation and patient factors is not well understood. This observational study was aimed at identifying and quantifying physiological, demographic, and stimulation factors that significantly affect external anal sphincter (EAS) recruitment and outcomes in participants receiving pudendal neuromodulation for treatment of lower urinary tract symptoms and pelvic pain.</p><p><strong>Methods: </strong>Participants (N = 16) provided demographic and diagnostic information upon entry to this observational study. EAS activation at different stimulation amplitudes and pulse widths was recorded during lead implantation. Magnetic resonance imaging and computed tomography were used to determine the distance of the electrodes on the implanted lead from the nerve. Linear mixed modeling was used to quantify the impact of each variable on EAS recruitment.</p><p><strong>Results: </strong>Participant sex, age, and body mass index did not significantly affect EAS recruitment. Participant diagnoses had significant relationships with EAS recruitment, likely because of unbalanced group sizes. A pulse width of 210 µs required less current than 60 µs (p = 0.005) and less charge than 450 µs (p = 0.02) to activate the EAS. Increased electrode-to-nerve distance decreased the magnitude of the EAS response (p = 0.0011), increased the EAS activation threshold (p < 0.001), and was related to reduced bladder symptom improvements.</p><p><strong>Conclusions: </strong>Of the three tested pulse widths, 210 µs best balances current and charge for EAS recruitment. Minimizing the distance between the electrode and pudendal nerve should be a priority during lead implantation. External sphincter activation threshold and response magnitude could be useful clinical indicators of electrode-to-nerve distance.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835078","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 \"Somatic and Autonomic Nerve Density of the Urethra, Periurethral Tissue, and Anterior Vaginal Wall: An Immunohistochemical Study in Adult Female Cadavers\".","authors":"A Özgür Yeniel","doi":"10.1007/s00192-025-06266-z","DOIUrl":"https://doi.org/10.1007/s00192-025-06266-z","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816586","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}