International Urogynecology Journal最新文献

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A Novel Predictive Model of Detrusor Overactivity Based on Clinical Symptoms and Non-invasive Test Parameters in Female Patients with Lower Urinary Tract Symptoms 基于下尿路症状女性患者临床症状和非侵入性测试参数的新型逼尿肌过度活动预测模型
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-19 DOI: 10.1007/s00192-024-05896-z
Yu Cheng, Taicheng Li, Xiaoyu Wu, Guanghui Du, Shengfei Xu
{"title":"A Novel Predictive Model of Detrusor Overactivity Based on Clinical Symptoms and Non-invasive Test Parameters in Female Patients with Lower Urinary Tract Symptoms","authors":"Yu Cheng, Taicheng Li, Xiaoyu Wu, Guanghui Du, Shengfei Xu","doi":"10.1007/s00192-024-05896-z","DOIUrl":"https://doi.org/10.1007/s00192-024-05896-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>This study was aimed at investigating non-invasive indicators correlated with detrusor overactivity (DO) and at developing a prediction model for DO by reviewing clinical and urodynamic data of female patients.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We retrospectively enrolled 1,084 female patients who underwent a urodynamic study (UDS) at Tongji Hospital between September 2011 and April 2021. Associated factors and the independent prediction factors of DO were demonstrated by univariate and multivariate analysis. A non-invasive prediction model of DO was developed and validated by applying these data.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 194 patients (17.9%) were classified as having DO. A logistic regression of a multivariate nature showed that DO risk factors were independent of age, nocturia, urgency, urgency urinary incontinence (UUI), and the lack of stress urinary incontinence (SUI). The DO prediction model had good performance, with an area under the curve of 0.880 (95% CI 0.826–0.933), which was verified by urodynamic data of patients in Tongji Hospital to be 0.818 (95% CI 0.783–0.853). An outstanding correspondence between the anticipated probability and the observed frequency was revealed by the calibration curve. Decision curve analysis demonstrated that clinical net benefit can be obtained by applying the DO prediction model when the DO risk probability was between 8 and 97%.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>A non-invasive prediction model of DO was developed and validated using clinical and urodynamic data. Five independent factors associated with DO were identified: age, nocturia, urgency, UUI, and SUI. This prediction model can contribute to assessing the risk of female DO without the need for invasive urodynamic studies.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"22 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248525","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}
引用次数: 0
Letter to the Editor: Robotic-assisted Intravesical Mesh Excision following Retropubic Midurethral Sling. 致编辑的信:机器人辅助膀胱内网状物切除术(后尿道中段套扎术后)。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-18 DOI: 10.1007/s00192-024-05924-y
Liang-Ying Ke,Zi-Xi Loo,Cheng-Yu Long
{"title":"Letter to the Editor: Robotic-assisted Intravesical Mesh Excision following Retropubic Midurethral Sling.","authors":"Liang-Ying Ke,Zi-Xi Loo,Cheng-Yu Long","doi":"10.1007/s00192-024-05924-y","DOIUrl":"https://doi.org/10.1007/s00192-024-05924-y","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"38 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248523","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}
引用次数: 0
Incidence, Risk Factors, and Correlation with Caprini Score of Deep Vein Thrombosis After Colpocleisis with/without Concomitant Hysterectomy for Pelvic Organ Prolapse in Elderly Women 老年妇女因盆腔脏器脱垂而行耻骨联合切除术后/不同时行子宫切除术后深静脉血栓形成的发生率、风险因素以及与卡普里尼评分的相关性
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-17 DOI: 10.1007/s00192-024-05937-7
Qi Wang, Xiaoxiang Jiang, Chaoqin Lin
{"title":"Incidence, Risk Factors, and Correlation with Caprini Score of Deep Vein Thrombosis After Colpocleisis with/without Concomitant Hysterectomy for Pelvic Organ Prolapse in Elderly Women","authors":"Qi Wang, Xiaoxiang Jiang, Chaoqin Lin","doi":"10.1007/s00192-024-05937-7","DOIUrl":"https://doi.org/10.1007/s00192-024-05937-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>The objective was to investigate the incidence and risk factors of lower extremity deep vein thrombosis (DVT) in elderly women undergoing colpocleisis for pelvic organ prolapse and to evaluate the predictive efficacy of the Caprini scores.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Data from patients who underwent colpocleisis from August 2019 to April 2024 were retrospectively analyzed. The primary endpoint was DVT detected by ultrasonography within 7 days of surgery. Univariate and multivariate logistic regression analyses were applied to identify independent risk factors. Efficacy parameters of the Caprini scores were analyzed and optimal cut-off values were selected.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 262 patients were enrolled in the study, of whom 8.4% (22 out of 262) developed DVT postoperatively. After statistical analysis, the duration of menopause, history of inflammatory bowel disease, as well as higher levels of preoperative cholesterol and preoperative D-dimer, were identified as independent risk factors. There was a significant difference in the Caprini scores between the DVT and non-DVT groups (7.27 ± 1.28 vs 6.15 ± 0.80, <i>p</i> &lt; 0.001), and the risk of DVT tended to increase with higher Caprini scores. The best performance was achieved when the threshold for the Caprini score was set to 7, at which point the area under the receiver operating characteristic curve was 0.758, the sensitivity was 0.773, and the specificity was 0.662.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>There was a strong correlation between the occurrence of DVT after colpocleisis and the Caprini score, with higher Caprini scores indicating a higher risk of postoperative DVT. A significantly increased risk was suggested when this score was ≥ 7.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"14 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248567","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}
引用次数: 0
Outcomes of Mid-Urethral Sling for Urodynamic Stress Incontinence Following Extensive Pelvic Reconstructive Surgery 尿道中段吊带治疗大范围骨盆重建手术后尿动力压力性尿失禁的效果
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-16 DOI: 10.1007/s00192-024-05918-w
Tsia-Shu Lo, Aisha Alzabedi, Lan-Sin Jhang, Wu-Chiao Hsieh, Maherah Kamarudin, Louiza Erika Rellora
{"title":"Outcomes of Mid-Urethral Sling for Urodynamic Stress Incontinence Following Extensive Pelvic Reconstructive Surgery","authors":"Tsia-Shu Lo, Aisha Alzabedi, Lan-Sin Jhang, Wu-Chiao Hsieh, Maherah Kamarudin, Louiza Erika Rellora","doi":"10.1007/s00192-024-05918-w","DOIUrl":"https://doi.org/10.1007/s00192-024-05918-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>To assess the outcomes of mid-urethral sling (MUS) procedures for urodynamic stress incontinence (USI) following extensive pelvic reconstructive surgery (PRS) and identify risk factors for persistent USI (P-USI).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This retrospective study analyzed 84 women who underwent a staged approach to MUS for USI after PRS for advanced pelvic organ prolapse (Pelvic Organ Prolapse Quantification III and IV). The primary outcome was objective cure rate, defined by negative urine leakage on urodynamic study and a 1-h pad test weight of &lt; 2 g. Subjective cure rate was through a negative response to question 3 of UDI-6.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The overall objective cure rate was 81.0%. The highest cure rate was observed in de novo USI (MUS-D; 89.7%) compared with women with persistent USD (MUS-P). Patients with overt SUI exhibited lower cure rates than those with occult SUI. Predictive factors for persistent USI were lower pre-operative maximum urethral closure pressure (MUCP; <i>p</i> = 0.031) and higher BMI in the MUS-P group than in the MUS-D group (<i>p</i> = 0.008). Subjective improvement was noted, especially in the MUS-D group, with a subjective cure rate of 78.6%. Those with MUS-D reported a higher impact on patient well-being post-surgery. No complications were observed after MUS surgery at follow-up.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Overt USI, low MUCP and high BMI are independent predictors of persistent USI after a staged MUS approach after pelvic reconstructive surgery.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"65 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248565","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}
引用次数: 0
Lumbosacral Discitis and Osteomyelitis after Sacrocolpopexy: A Case Series and Review of Management 骶椎间盘切除术后的腰骶椎间盘炎和骨髓炎:病例系列和处理回顾
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-16 DOI: 10.1007/s00192-024-05897-y
Danielle D. Antosh
{"title":"Lumbosacral Discitis and Osteomyelitis after Sacrocolpopexy: A Case Series and Review of Management","authors":"Danielle D. Antosh","doi":"10.1007/s00192-024-05897-y","DOIUrl":"https://doi.org/10.1007/s00192-024-05897-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>Lumbosacral discitis and osteomyelitis constitute a rare but devastating complication after mesh sacrocolpopexy for pelvic organ prolapse.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p> We present a case series of 3 patients at a single institution and a literature review of 30 patients suffering from this complication along with presenting symptoms, evaluation with laboratory and imaging findings, and management.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Lumbosacral discitis can present after sacrocolpopexy of any route (abdominal, laparoscopic, and robotic) and with various suture types and tacking devices. Patients presented with lower back pain at varying time frames and with elevated inflammatory markers, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). </p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The majority of cases required both excision of pelvic mesh via laparotomy or laparoscopy in combination with an extended course of intravenous (IV) antibiotics.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"186 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248568","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}
引用次数: 0
Obstetric Perineal Tears, Birth Characteristics and the Association with Urinary Incontinence Among Primiparous Women 12 Months Postpartum: A Prospective Cohort Study 初产妇产后 12 个月的产科会阴撕裂、分娩特征及与尿失禁的关系:一项前瞻性队列研究
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-16 DOI: 10.1007/s00192-024-05920-2
Ditte Gommesen, Sarah Hjorth, Ellen A. Nohr, Niels Qvist, Vibeke Rasch
{"title":"Obstetric Perineal Tears, Birth Characteristics and the Association with Urinary Incontinence Among Primiparous Women 12 Months Postpartum: A Prospective Cohort Study","authors":"Ditte Gommesen, Sarah Hjorth, Ellen A. Nohr, Niels Qvist, Vibeke Rasch","doi":"10.1007/s00192-024-05920-2","DOIUrl":"https://doi.org/10.1007/s00192-024-05920-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>Postpartum urinary incontinence (UI) is common and a concern for many women, as UI leads to a lower quality of life and self-esteem. Perineal tears may be a risk factor for UI, yet few studies have investigated the association between the degree of perineal tear and risk of developing UI postpartum. The objective was to examine how the degree of perineal tear and selected obstetric risk factors were associated with any UI and stress ultrasound (SUI) 12 months postpartum among primiparous women.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A prospective cohort study was conducted at four Danish hospitals. Baseline data were obtained at a clinical examination 2 weeks postpartum. Symptoms of UI were evaluated 12 months postpartum by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form questionnaire (web-based). Multivariate regression analyses were performed to investigate the risk factors for UI.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 603 primiparous women (203 with none/labia/first-degree tears, 200 with second-degree tears and 200 with third-/fourth-degree tears) were included between July 2015 and January 2018. Women with tears involving the perineal muscles reported any UI more often than women with no/labia or first-degree tears (spontaneous second-degree tear: RR 2.04, 95% CI 0.92–4.50; episiotomy: RR 2.22, 95% CI 0.99–4.96; third- or fourth-degree tear: RR 2.73, 95% CI 1.18–6.28). The same was found for SUI, but with wider confidence intervals.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>A higher prevalence of any UI and SUI was found among women with perineal tears involving any perineal muscles, compared with women with no, labia, or first-degree tears.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"46 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248526","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}
引用次数: 0
Effects of Inspiratory Muscle Training on Stress Urinary Incontinence in North African Women: A Randomized Controlled Trial 吸气肌训练对北非女性压力性尿失禁的影响:随机对照试验
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-14 DOI: 10.1007/s00192-024-05921-1
Sirine Abidi, Amine Ghram, Said Ahmaidi, Helmi Ben Saad, Mehdi Chlif
{"title":"Effects of Inspiratory Muscle Training on Stress Urinary Incontinence in North African Women: A Randomized Controlled Trial","authors":"Sirine Abidi, Amine Ghram, Said Ahmaidi, Helmi Ben Saad, Mehdi Chlif","doi":"10.1007/s00192-024-05921-1","DOIUrl":"https://doi.org/10.1007/s00192-024-05921-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>Pelvic floor muscles (PFMs) are involved in respiratory mechanisms. Additionally, stress urinary incontinence (SUI) can affect physical function. This randomized controlled trial was aimed at investigating the effects of inspiratory muscle training (IMT) on SUI severity, PFM function, and physical function in Tunisian women with SUI.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Twenty-seven incontinent women were randomly assigned to either the experimental group or the control group. The following parameters were assessed: respiratory muscle strength (RMS; maximal inspiratory and expiratory pressures), SUI severity (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; pad test), PFM function (Modified Oxford Scale, electromyography, and endurance), and physical function (Timed Up &amp; Go test; 6-min walk test; incremental shuttle walking test). IMT was conducted using threshold IMT.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The IMT program significantly reduced the severity of SUI (<i>p</i> &lt; 0.01), improved PFM function (<i>p</i> &lt; 0.001), enhanced physical function (<i>p</i> &lt; 0.01), and increased RMS (<i>p</i> &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Inspiratory muscle training could be an effective method for improving pelvic floor disorders and physical function in women with SUI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"194 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248621","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}
引用次数: 0
Effects of Mindfulness Meditation on Patient Experience During Urodynamics: A Prospective Study 正念冥想对泌尿动力学检查中患者体验的影响:前瞻性研究
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-14 DOI: 10.1007/s00192-024-05911-3
Ruby Kuang, Christina Moldovan, Sydney Drury, Hillary Wagner, Forrest Jellison, Andrea Staack
{"title":"Effects of Mindfulness Meditation on Patient Experience During Urodynamics: A Prospective Study","authors":"Ruby Kuang, Christina Moldovan, Sydney Drury, Hillary Wagner, Forrest Jellison, Andrea Staack","doi":"10.1007/s00192-024-05911-3","DOIUrl":"https://doi.org/10.1007/s00192-024-05911-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>Urodynamics (UDS) assesses voiding dysfunction using intravesical, vaginal, or rectal catheters, which can be distressing. This study was aimed at utilizing mindfulness to reduce anxiety and pain in patients undergoing UDS.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A single-institution randomized controlled trial was conducted on 60 patients who underwent UDS. Patients were assigned to a mindfulness group (<i>n</i> = 30) or a control group (<i>n</i> = 30). Before UDS testing, all patients completed validated questionnaires assessing lower urinary tract symptoms (Urogenital Distress Inventory 6, UDI-6), anxiety (State-Trait Anxiety Inventory 6, STAI-6), and pain (Visual Analog Scale, VAS). The mindfulness group listened to a mindfulness audio prompt before UDS. All patients received standardized UDS education before UDS testing in a calm environment. After UDS testing, all patients completed validated UDS-perception questionnaires, STAI-6, Likert scale, and VAS surveys. Statistical analysis was performed using paired <i>t</i> tests, independent <i>t</i> tests, Wilcoxon, and Chi-squared tests.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Both groups had similar demographics, history of prior UDS, anxiety, and baseline UDI-6 and STAI-6. Post-UDS, anxiety scores decreased in both groups, with the mindfulness group reporting significant improvement in “calmness” (mean 1.7, SD = 0.84) compared with the control group (mean 2.3, SD = 1.0, <i>p</i> &lt; 0.05). The mindfulness group reported increased relaxation whereas the control group reported decreased relaxation post-UDS. Patients in both groups without a history of UDS had a significant improvement in total anxiety compared with those with a history of UDS.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Mindfulness meditation may improve calmness and relaxation for patients undergoing UDS.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"194 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248569","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}
引用次数: 0
Overactive Bladder Syndrome: The Urgency of Integrating Emerging Methodologies to Improve Therapeutic Outcomes. 膀胱过度活动综合征:整合新方法以提高治疗效果的紧迫性。
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-14 DOI: 10.1007/s00192-024-05939-5
Rogério de Fraga,Maria Augusta Tezelli Bortolini
{"title":"Overactive Bladder Syndrome: The Urgency of Integrating Emerging Methodologies to Improve Therapeutic Outcomes.","authors":"Rogério de Fraga,Maria Augusta Tezelli Bortolini","doi":"10.1007/s00192-024-05939-5","DOIUrl":"https://doi.org/10.1007/s00192-024-05939-5","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"18 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248570","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}
引用次数: 0
Obstetric Anal Sphincter Injury After Episiometer-Guided Versus Conventional Episiotomy in Instrumental Deliveries: A Randomized Controlled Trial 器械助产中外阴切开术与传统外阴切开术后的产科肛门括约肌损伤:随机对照试验
IF 1.8 3区 医学
International Urogynecology Journal Pub Date : 2024-09-10 DOI: 10.1007/s00192-024-05917-x
Soundarya N. Sriram, Gowri Dorairajan, Ajay Rane
{"title":"Obstetric Anal Sphincter Injury After Episiometer-Guided Versus Conventional Episiotomy in Instrumental Deliveries: A Randomized Controlled Trial","authors":"Soundarya N. Sriram, Gowri Dorairajan, Ajay Rane","doi":"10.1007/s00192-024-05917-x","DOIUrl":"https://doi.org/10.1007/s00192-024-05917-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction and Hypothesis</h3><p>Guidelines recommend episiotomy for instrumental vaginal delivery with an optimal incision angle of 60° to protect the anal sphincter. The “Episiometer” is a new device promising a 60° incision angle. We compared the incidence of obstetric anal sphincter injury (OASI) and post-repair suture angle of episiotomies made with conventional “eyeballing” versus Episiometer guided during instrumental delivery.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted this randomized controlled trial in a tertiary care teaching institute in southern India after ethical committee approval, trial registration, and informed consent. We randomized (block) 328 pregnant women aged 18 years and above with term, singleton fetuses delivered by instruments into Episiometer-guided (164) or conventional episiotomy (164) groups (allocation concealed). We compared the OASI (identified clinically) and the suture angle measured from the midline (assessor blinded) in the two groups. We followed up on the subjects at 6 and 12 weeks to assess perineal pain and fecal/flatus incontinence.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The incidence of OASI of 0.61% in the Episiometer group was significantly lower compared with 4.88% in the eyeballing group (Chi-squared = 5.6; <i>p</i> = 0.02; adjusted risk ratio = 5.9; CI 0.7–46.1; <i>p</i> = 0.09). A significantly higher proportion of subjects (59.1%) in the Episometer group had a post-suture angle between 36 and 40° compared with 36.6% in the eyeballing group (Chi-squared = 21.8, <i>p</i> &lt; 0.001). We found no significant difference in the perineal pain or Wexner score during follow-up.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The Episiometer-guided episiotomy during instrumental delivery resulted in a significantly higher suture angle and lower obstetric anal sphincter injuries than with conventional eyeballing.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":"15 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142208221","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}
引用次数: 0
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