International Urogynecology Journal最新文献

{"title":"Commentary on \"Autophagy Attenuates Oxidative Stress-Induced Collagen Degradation in Vaginal Fibroblasts: Implications for Pelvic Organ Prolapse\".","authors":"Ian Vasicka","doi":"10.1007/s00192-025-06063-8","DOIUrl":"https://doi.org/10.1007/s00192-025-06063-8","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074625","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":"Joint Terminology Report: Terminology Standardization for Female Bladder Pain Syndrome.","authors":"","doi":"10.1007/s00192-024-05923-z","DOIUrl":"10.1007/s00192-024-05923-z","url":null,"abstract":"<p><p>Female bladder pain syndrome (FBPS), previously known as interstitial cystitis/bladder pain syndrome, is a life-altering and morbid condition that occurs primarily in female patients and can be variable in presentation. Given the absence of pathognomonic symptoms and sensitive diagnostic tests, significant symptomatic overlap with numerous other pelvic conditions (such as pelvic floor tension myalgia or endometriosis) occurring in women makes diagnosis of FBPS challenging. The frequent co-occurrence of FBPS with other pain conditions and functional somatic syndromes further complicates diagnosis and management. The challenges have limited the progress made in understanding the pathophysiology of the condition and improving approaches to treatment and prevention. Improvement in standardization of the terminology used to describe this unique condition is needed to improve the accuracy of diagnosis and the clinical care for affected patients. Given the variability in presentation and the differing definitions for the condition world-wide, the American Urogynecologic Society and the International Urogynecologic Association convened a joint writing group to standardize terminology around common signs and symptoms of the condition and to clarify the diagnosis as it pertains to female patients with the condition. After careful consideration of a broad range of available data and clinical experiences, consensus opinion recommended adopting the term \"FBPS\" instead of the misleading \"interstitial cystitis\" to describe a chronic, intermittent condition of at least 3 months' duration affecting women involving symptoms of pain or discomfort localized to the bladder, often with bladder filling, which are not attributed to other pathology. This term will allow clinicians, researchers, and learners alike to standardize their understanding of FBPS.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"265-277"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921768","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":"New Rat Model Mimicking Sacrocolpopexy for POP Treatment and Biomaterials Testing via Unilateral Presacral Suspension.","authors":"Chenxi Lu, Jun Zhou, Qingyu Kong, Lulu Wang, Wei Ni, Zhen Xiao","doi":"10.1007/s00192-024-06019-4","DOIUrl":"10.1007/s00192-024-06019-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic organ prolapse (POP) impacts women's health and quality of life. Post-surgery complications can be severe. This study uses rat models to replicate sacrocolpopexy and test materials for pelvic support, verifying the 4-week postoperative mortality rate, the mechanical properties of the mesh tissue, and the collagen content.</p><p><strong>Methods: </strong>Twenty-one 12-week-old female Wistar rats were used. Eighteen rats were subjected to POP induction by cervical suction and constant traction. One week after prolapse modeling, 18 prolapsed rats underwent unilateral presacral suspension (UPS) surgery with polycaprolactone (PCL) scaffolds, decellularized porcine small intestinal submucosa (SIS) scaffolds, or polypropylene (PP) meshes (n = 6 each). UPS rats were compared with normal rats (n = 3). After 4 weeks, conditions and mortality were recorded. The rats were then euthanized for biomechanical testing and collagen analysis. Ultimate load (N) was defined as the highest load before the failure of the target sample.</p><p><strong>Results: </strong>The UPS procedure requires 42.9 ± 4.5 min with no complications or deaths over 4 weeks. SIS was the stiffest mesh (14.53 ± 0.86 N), followed by PP (8.43 ± 0.40 N), and PCL was the least stiff (0.66 ± 0.05 N). After 4 weeks, the ultimate load of the PCL complex increased to 1.71 ± 0.41 N (p = 0.0120), but showed no significant difference from parametrial fascia (1.25 ± 0.85 N) and uterosacral ligament (0.66 ± 0.41 N). The ultimate load of the SIS complex decreased to 5.99 ± 0.37 N, still higher than native tissue. The PP complex's ultimate load (10.02 ± 1.80 N) showed no significant difference from PP alone. The collagen ratio of the PCL complex (48.11 ± 9.88%) was closest to that of the uterosacral ligament (36.66 ± 11.64%), whereas SIS and PP complexes had significantly higher collagen ratios than USL.</p><p><strong>Conclusions: </strong>Unilateral presacral suspension mimics classical surgery for human POP in rats. First, this procedure can investigate the mechanical properties of pelvic floor tissues at the cellular level after correcting POP. Second, it can be used to validate new materials for the surgical treatment of POP, including but not limited to foreign body reactions with surrounding tissues, absorption time, etc. Third, it can be used to study the biological mechanisms of mesh exposure.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"421-429"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948977","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":"Onabotulinum Toxin A-Led Urinary Tract Infections-Should we Safeguard? A Randomized Controlled Trial.","authors":"Anastasiya Holubyeva, Kaythi Khin, Tess Gao, Shaun Adair, Erika Wasenda, Laura Dhariwal, Ricardo Caraballo, Svjetlana Lozo, John Rutledge, Carolyn Botros","doi":"10.1007/s00192-024-06028-3","DOIUrl":"10.1007/s00192-024-06028-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective of our study was to evaluate the need for antibiotic prophylaxis for urinary tract infection (UTI) prevention before Onabotulinum toxin A injection for overactive bladder (OAB). We hypothesize that the lack of antibiotic prophylaxis might not be inferior to administering prophylaxis.</p><p><strong>Methods: </strong>This was a multi-centered, nonblinded, randomized controlled trial conducted between August 2022 and September 2024. Participants were randomized to either receive oral antibiotics or no treatment. Our primary outcome was to measure the rate of UTI at 2 weeks. Our secondary outcomes included post-void residuals, assessment for antibiotic compliance, and UTI rates at 6 weeks. Given a 20% UTI rate and a delta of 20%, 64 participants per study arm were necessary to achieve 80% power with an alpha value of 0.05.</p><p><strong>Results: </strong>Rates of UTI at 2 weeks post-procedure were 9.2% in the antibiotics group and 10.9% in the control group (p = 0.75). UTI rates 6 weeks post-procedure were 4.7% in the antibiotics group and 11.1% in the control group (p = 0.21). When analyzing variables such as age, race, body mass index, menopause status, vaginal estrogen use, or the rates of positive pre-procedure urine cultures, no factors proved to be predictors of developing a UTI at 2 weeks post-procedure. The urinary retention rate in our study was 0.8%.</p><p><strong>Conclusions: </strong>Rates of UTI were not significantly different between patients who obtained antibiotics prophylaxis and those who did not at 2 and 6 weeks following injection. Foregoing antibiotics prophylaxis in order to safeguard from the dangers of antimicrobial resistance may be considered in the treatment of OAB with Onabotulinum toxin A.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"469-474"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005324","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":"MRI-Based Structural Failure Comparison between Chinese and American White Women With Prolapse: A Case-Control Study.","authors":"Bing Xie, Lahari Nandikanti, Carolyn W Swenson, Jing Wu, Tianhang Liu, Xin Yang, Yi Li, Xiuli Sun, John O DeLancey, Luyun Chen, Jianliu Wang","doi":"10.1007/s00192-024-05945-7","DOIUrl":"10.1007/s00192-024-05945-7","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Although some evidence suggests that Chinese and white women might have different pelvic floor anatomy such as levator complex and connective tissue support for pelvic organs, it is unknown if these differences affect the mechanisms of pelvic organ prolapse. We sought to determine whether differences exist in MRI-based structural failure patterns between Chinese and American white women with prolapse.</p><p><strong>Methods: </strong>This is a case-control study in different racial cohorts recruited in China and the USA. The Chinese cohort included 19 women with anterior-predominant prolapse and 24 controls with normal pelvic support. The American white cohort included 30 women with anterior-predominant prolapse and 30 controls. Both cohorts underwent the same clinical evaluation and MRI protocol. Three structural support systems were quantified on stress 3D MRI at maximal Valsalva: vaginal factors (length, width); connective tissue attachment (cervix, lateral paravaginal height); and hiatus factors (urogenital hiatus size, major levator ani injury). Abnormal structural support was defined as any measurement outside the normal range defined as the 5th to 95th percentile in controls from the respective cohort. The percentages of the women with abnormal support in the two cohorts were compared.</p><p><strong>Results: </strong>Among those with prolapse, Chinese women were more likely than white women to have abnormally long vaginal length and width (90% vs 40%, p < 0.001; 53% vs 23%, p = 0.031 respectively). The occurrence of abnormal apical location, paravaginal location, and genital hiatus size ranged from 89 to 100% in Chinese women and from 63 to 80% in white women.</p><p><strong>Conclusions: </strong>Prolapse in American white women most commonly involves structural failure of connective tissue attachments and hiatus factors and less frequently involves vaginal wall factors, whereas prolapse in Chinese women frequently involves all support structures.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"363-371"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667906","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 New Combined Urogynecology and Colorectal Surgery Pelvic Floor Clinic-1 Year On.","authors":"Su-Wen Anne Mak, Sharmini Su Sivarajah, Simone Meiqi Ong, Cheryl Xi Zi Chong, Hong Liang Chua, Jill Cheng Sim Lee","doi":"10.1007/s00192-024-05968-0","DOIUrl":"10.1007/s00192-024-05968-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study is aimed at characterizing patients seen at a new combined pelvic floor clinic (CPFC) established at a tertiary women's hospital in Singapore. Study goals include identifying patterns of symptom clusters and reviewing management strategies compared with international care standards, improving understanding of complex female pelvic floor dysfunction, and guiding future development of clinical and ancillary support.</p><p><strong>Methods: </strong>This is a single-center, retrospective cohort study of medical case record review for all patients seen at the CPFC between 1 September 2020 and 31 August 2021. All patients seen at CPFC during this study period were included for analysis. Data were deidentified and aggregated, with analysis performed for descriptive and summary statistics. Institutional Review Board approval was obtained with waiver of informed consent.</p><p><strong>Results: </strong>Sixty-six referrals were made to the CPFC, with 57 patients seen in 11 clinic sessions across the 12-month period. The most common reasons for referral were fecal or flatus incontinence (30, 52.6%), severe constipation or defecatory dysfunction (21.1%), and rectal prolapse (17.5%). Most patients (78.9%) had multiple symptoms.</p><p><strong>Conclusions: </strong>Our patient demographic profile aligns with known risk factors for pelvic floor dysfunction, presenting with gastrointestinal symptoms-similar to PFCs worldwide. The new workflow and services were well positioned to address patients' needs, including those left previously untreated, or received uncoordinated care. Conservative approaches were first employed, like with other global PFCs. The combined multidisciplinary model of care resulted in good outcomes for patients managed both conservatively and surgically. Future studies to analyze patient satisfaction are planned.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"331-338"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620465","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":"Turkish Validation and Reliability Analysis of the International Female Coital Incontinence Questionnaire.","authors":"Mehmet Murat Seval, Şerife Esra Çetinkaya, Derya Gökmen, Kazibe Koyuncu Demir, Bulut Varlı, Fulya Dökmeci","doi":"10.1007/s00192-024-06039-0","DOIUrl":"10.1007/s00192-024-06039-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Coital incontinence (CI) is an important problem that negatively affects women's quality of life and is often underreported owing to embarrassment, indicating the importance of its assessment with validated questionnaires. The aim of this study was to validate the Turkish-translated version of the International Female Coital Incontinence Questionnaire (IFCI-Q) for the objective evaluation of women with CI in Turkish-speaking populations.</p><p><strong>Methods: </strong>Ninety women with CI filled out the Turkish-translated version of IFCI-Q. Confirmatory factor analysis (CFA), Cronbach's alpha, and intraclass correlation coefficients (ICCs) were evaluated for the construct validity, internal consistency, and test-retest reliability, respectively. Known group validity, which is the ability of the scale to reveal the expected difference according to patients' demographics and PISQ-12 scores, was evaluated.</p><p><strong>Results: </strong>The construct validity was confirmed after excluding the first and third items of the questionnaire (CFI 0.966, TLI 0.944). The first item was excluded from the CFA as all women who completed the IFCI-Q had CI and therefore answered this item questioning the existence of CI as \"yes.\" The third item was eliminated because its factor loading was below 0.20. Cronbach's alpha value for the scale was 0.67. ICC was calculated as 0.97 (0.95-0.98; p < 0.001), indicating a strong positive agreement between the test scores at two time points 2 weeks apart.</p><p><strong>Conclusions: </strong>The Turkish version of IFCI-Q seems to be a reliable, consistent, and valid instrument in the screening and assessment of CI in a gynecology outpatient clinic-based cohort of Turkish-speaking women.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"439-445"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970891","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":"Effects of Urinary Incontinence Subtypes on Quality of Life and Sexual Function among Women Seeking Weight Loss.","authors":"Zhao Tian, Linru Fu, Xiuqi Wang, Tangdi Lin, Wei Chen, Zhijing Sun","doi":"10.1007/s00192-024-05977-z","DOIUrl":"10.1007/s00192-024-05977-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to detect subtypes of urinary incontinence (UI) and their effects on quality of life (QoL) and sexual function among women seeking weight loss.</p><p><strong>Methods: </strong>A cross-sectional study focusing on women seeking weight loss with UI symptoms was carried out. Participants were stratified into three groups: stress UI, urgency UI, and mixed UI groups. The effects of the three groups on QoL and sexual function were compared.</p><p><strong>Results: </strong>A total of 564 individuals (46.8%) were reported to present with UI symptoms. Among these, 216 (38.3%), 71 (12.6%), and 277 (49.1%) had stress UI, urgency UI, and mixed UI respectively. The severity of UI was greater in the urgency UI and mixed UI groups than in the stress UI group, with varying ratios observed among patients with different severities of UI: stress UI was highest in mild cases, and the mixed UI was highest in moderate or severe cases. Mixed UI had the most detrimental effect on QoL and sexual function. However, after controlling for the severity of UI, mixed UI still had a greater detrimental effect on UI-specific QoL, and no differences were identified among the three groups regarding general QoL or sexual function.</p><p><strong>Conclusion: </strong>This study revealed variations in the constituent ratios of UI subtypes related to the severity of UI and the effects of various UI subtypes on QoL and sexual function among women seeking weight loss. Notably, the mixed UI demonstrated the most severe symptoms and the most detrimental impact, particularly as assessed by UI-specific QoL questionnaires.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"381-389"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681770","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":"Silicone Irregular Hexagon Pessary Versus Polyvinyl Chloride Ring Pessary for Pelvic Organ Prolapse: Randomised Controlled Trial.","authors":"Chin Yong, Tanaka Dune, Rebecca Shaya, Ann Cornish, Dean McKenzie, Marcus Carey","doi":"10.1007/s00192-024-05933-x","DOIUrl":"10.1007/s00192-024-05933-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Vaginal pessaries are the mainstay of the non-surgical management of pelvic organ prolapse (POP). A flexible silicone irregular hexagonal (SIH) pessary was developed based on the results of a prior vaginal case study. We hypothesised that the SIH pessary would have a higher rate of retention and self-management than the polyvinyl chloride (PVC) pessary.</p><p><strong>Methods: </strong>This was a prospective non-blinded, randomised controlled trial with institutional review board approval. Eligible participants were randomised and fitted with the assigned pessary. They were reviewed 1 week, 6 months and 1 year after the initial pessary fitting. Participants who returned for follow-up completed the study questionnaires. The primary outcome was success, defined as continued use of the allocated pessary at 6 months. Secondary outcomes included the ability to perform pessary self-care, treatment satisfaction and pessary-related complications. Statistical tests were performed with alpha or statistical significance defined as a p value of ≤ 0.05, two-tailed.</p><p><strong>Results: </strong>A total of 104 participants were randomised, with 52 subjects in each arm. Primary outcome data were analysed using per protocol analysis. Continuing pessary usage at 6 months was 68.1% for the PVC pessary group and 65.1% for the SIH group, with no statistically significant differences between the two groups (p = 0.765). Subjects with SIH were more likely to perform pessary self-care. There were no significant differences in subjects' satisfaction, quality-of-life scores or treatment complications between groups.</p><p><strong>Conclusions: </strong>The pessary continuation rate between the SIH and the PVC pessary groups was similar at 6 months. Participants with an SIH pessary were more likely to self-manage.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"289-298"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371828","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":"Management of Sacrocolpopexy Mesh Complications-A Narrative Review and Clinical Experience from a Large-Volume Center.","authors":"Chen Shenhar, Howard B Goldman","doi":"10.1007/s00192-024-05955-5","DOIUrl":"10.1007/s00192-024-05955-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Despite the reputation of sacrocolpopexy as a highly durable reconstructive surgery for pelvic organ prolapse, mesh-related complications remain a significant deterrent for patients. This review discusses the incidence, presentation, diagnosis, management and prevention of sacrocolpopexy mesh complications.</p><p><strong>Methods: </strong>We reviewed the literature on sacrocolpopexy focusing on long-term mesh complications and their management. As the literature is not specifically robust, we also give our recommendations based on experience from a large-volume center. Intraoperative videos and images are provided to illustrate findings and management techniques.</p><p><strong>Results: </strong>Sacrocolpopexy mesh complications include vaginal mesh exposure; bladder or bowel erosions; inflammatory and infectious conditions including spondylodiscitis; and mesh-related pain. Presentation ranges from overt symptoms such as mesh palpated in the vagina to insidious-like spondylodiscitis manifesting as back pain and malaise. Diagnosis relies on methodical history taking, review of operative reports, and a physical examination, with office-based endoscopy studies and imaging as indicated. Various management options have been described in the literature. We recommend an expectant approach for asymptomatic patients; For symptomatic vaginal exposure, we encourage removal of entire mesh arm(s) via an abdominal approach; however, many prefer to utilize a transvaginal or partial excisional approach first. Spondylodiscitis is managed with long-term antibiotics and often requires mesh removal. Prevention strategies include using a lightweight polypropylene mesh attached to well- vascularized vaginal walls, avoiding direct placement on any sutured vaginotomy or cystotomy. Delayed absorbable monofilament suture is non-inferior to permanent suture.</p><p><strong>Conclusions: </strong>Sacrocolpopexy mesh complications can be challenging to diagnose and manage. Symptomatic cases often require a proactive approach; listening to patients when they describe persistent symptoms with postoperative onset; a low threshold for further evaluation; and upfront discussion of management options.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"231-241"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619641","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}