International Urogynecology Journal最新文献

{"title":"Incorporating Perineorrhaphy into the LeFort Colpocleisis: A Modified Surgical Approach.","authors":"Savci Bekir Telek, Brad St Martin, Oz Harmanli","doi":"10.1007/s00192-025-06041-0","DOIUrl":"10.1007/s00192-025-06041-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Perineorrhaphy with levator myorrhaphy is considered a standard part of colpocleisis. Typically, this is done through a separate incision after colpocleisis is completed. We present a video to demonstrate a modified approach to LeFort colpocleisis incorporating perineorrhaphy into the procedure.</p><p><strong>Methods: </strong>A rectangular piece of anterior vaginal mucosa is dissected off the underlying fibromuscular tissue starting from 2-3 cm distal to the cervix and ending proximal to the urethrovesical junction. Similarly, a symmetrical posterior vaginal mucosa is dissected starting from the introitus and ending 2-3 cm distal to the cervix. The lateral edges of the rectangles between the anterior and posterior vaginal walls are sutured to create channels. The raw surfaces, including the fibromuscular tissue on the anterior and posterior vagina, are sutured to each other in three rows. Vaginal epithelium is closed continuously starting from the anterior wall and ending with posterior epithelium at the introitus.</p><p><strong>Results: </strong>Dissection of the anterior and posterior vaginal epithelium mimics standard colporrhaphy. The number of incisions and suturing is decreased by incorporating perineorrhaphy into colpocleisis. Sagittal closure with this technique restores the Aa point to a more anatomical position.</p><p><strong>Conclusion: </strong>These modifications may decrease operative time and de novo stress incontinence and allow less experienced surgeons to consider colpocleisis. Our surgical approach, which incorporates perineorrhaphy into colpocleisis, enables easier adaptation to the procedure and may decrease de novo stress incontinence.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1327-1331"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052512","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":"Analysis of Various Surgical Approaches to Supratrigonal Vesicovaginal Fistula Repair: A Tertiary Care Centre Experience.","authors":"Shivani Madhuchandra Iyer, Sanjeet Singh, Alok Srivastav","doi":"10.1007/s00192-025-06104-2","DOIUrl":"10.1007/s00192-025-06104-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Vesicovaginal fistula (VVF) is a devastating obstetric complication. Transvaginal, transabdominal, laparoscopic and robotic repairs have been proposed. This study was carried out to compare peri-operative and post-operative parameters of supratrigonal VVF repair to find out the best surgical approach among vaginal, abdominal and laparoscopic approaches.</p><p><strong>Methods: </strong>A quasi-experimental study was carried out from January 2015 to January 2021. A total of 175 women suffering from VVF were screened and 150 women with supratrigonal VVF were recruited. VVF repair was performed using transvaginal, transabdominal and laparoscopic approaches (50 repairs using each approach). Parameters such as success rate, operative time, blood loss, post-operative complications and hospital stay were recorded. Statistical analysis was carried out using SPSS Version 21. Written informed consent was taken before the recruitment of subjects.</p><p><strong>Results: </strong>Lower (uterine) segment Caesarean section, open or laparoscopic hysterectomy and obstructed labour were the common causes. Statistical analysis showed that mean operative time was significantly lower in vaginal repair, whereas analgesic requirement, hospital stay and blood loss were significantly lower in vaginal and laparoscopic repair. Urinary tract infection was seen in all three approaches, and was resolved by administration of antibiotics post-operatively. Minor wound infection was seen only in the transabdominal repair group, which resolved with the regular application of dressings. None of the patients developed recurrence during follow-up.</p><p><strong>Conclusions: </strong>Transvaginal and laparoscopic repairs are safe and effective approaches for VVF repair. However, laparoscopic repair requires a steep learning curve. Transvaginal repair has a significantly shorter operative time. Hence, in simple supratrigonal VVF, a transvaginal repair can be a preferred option.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1273-1279"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648270","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 Machine Learning Models for Risk Prediction of Postpartum Stress Urinary Incontinence: A Prospective Observational Study.","authors":"Liyun Wang, Nana Wang, Minghui Zhang, Yujia Liu, Kaihui Sha","doi":"10.1007/s00192-025-06057-6","DOIUrl":"10.1007/s00192-025-06057-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study aims to develop a postpartum stress urinary incontinence (PPSUI) risk prediction model based on an updated definition of PPSUI, using machine learning algorithms. The goal is to identify the best model for early clinical screening to improve screening accuracy and optimize clinical management strategies.</p><p><strong>Methods: </strong>This prospective study collected data from 1208 postpartum women, with the dataset randomly divided into training and testing sets (8:2). Five machine learning algorithms-logistic regression, decision trees, random forests, support vector machines (SVM), and eXtreme gradient boosting (XGBoost)-were used to construct the PPSUI risk prediction model. Model performance was evaluated using multiple metrics, and the best-performing model was selected and validated for generalizability with the testing set.</p><p><strong>Results: </strong>The final model retained ten features: birth weight, weight gain during pregnancy, BMI before delivery, pre-pregnancy BMI, age of delivery, gestation, parity, pre-delivery uterine height, age of first delivery, and labor analgesia. Among the five algorithms, the random forest model performed best, with a test AUC of 0.995 (95% CI 0.990-0.999, P < 0.05), accuracy of 0.956, precision of 0.957, recall of 0.944, specificity of 0.966, and F1 score of 0.951. The model's high generalizability was confirmed with the testing set and further validated through bootstrapping and tenfold cross-validation.</p><p><strong>Conclusion: </strong>The random forest model shows strong clinical potential for PPSUI risk prediction and early screening. Future studies should expand the sample size and include multi-center data to further enhance the model's clinical applicability.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"1217-1228"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065598","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 Prospective Study of the Impact of Persistent Nocturnal Enuresis on Female Sexual Function.","authors":"Kubilay Sarıkaya, Adem Sancı, Serkan Akpınar, Emre Hepşen, Metin Yığman","doi":"10.1007/s00192-025-06172-4","DOIUrl":"https://doi.org/10.1007/s00192-025-06172-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The aim of this study is to examine the effects of persistent nocturnal enuresis on female sexual function.</p><p><strong>Methods: </strong>This prospective study included adult females with monosymptomatic nocturnal enuresis (group 1) and healthy controls (group 2), all of whom were sexually active and in a relationship, between March 2023 and April 2024. The comparative analysis of group 1 and group 2 was performed using individual items from the Female Sexual Function Index (FSFI), the total FSFI score, and the overall Rosenberg Self-Esteem Scale (SES) score. Additionally, the Incontinence Quality of Life Questionnaire (I-QOL) was employed to assess the patients' quality of life. The comparative statistical analyses were conducted using the Mann-Whitney U test and the independent samples t test. Statistical significance was considered to be p < 0.05.</p><p><strong>Results: </strong>A total of 60 patients were included, with 30 patients (age range 19-36) in group 1 and 30 healthy controls (age range 19-41) in group 2. Group 1 had a significantly higher I-QOL score (median 55, range 20-108) than group 2 (median 5, range 1-25; p < 0.001). FSFI score was significantly lower in group 1 across all domains: desire, arousal, lubrication, orgasm, satisfaction, and pain (p < 0.05 for all). The total FSFI score was also significantly lower in group 1 (16.21 ± 2.38) than in group 2 (24.50 ± 3.97; p < 0.001). Additionally, group 1 had a significantly lower median SES score (11, range 5-20) than group 2 (17, range 8-29; p < 0.001).</p><p><strong>Conclusions: </strong>Nocturnal enuresis negatively affects sexual function and self-esteem in adult females. These findings emphasize the importance of addressing these aspects in the management of enuresis.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191811","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":"Same Day Discharge with Vaginal Packing Following Pelvic Floor Reconstruction: An Analysis of Safety and Healthcare Utilization.","authors":"Tyler Trump, Omer Anis, Howard B Goldman","doi":"10.1007/s00192-025-06186-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06186-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Vaginal packing is sometimes placed during pelvic floor reconstructive surgery to aid with hemostasis. Historically, these patients were admitted overnight. In the interest of moving patients safely and efficiently through the discharge process select patients are discharged home with vaginal packing. The objective of this study is to assess healthcare utilization and safety among patients discharged with packing.</p><p><strong>Methods: </strong>Retrospective review of patients undergoing pelvic organ prolapse (POP) surgery by a single surgeon between 2016 and 2023. Patients were identified before and after the 2020 COVID pandemic as this marked a transition point where same day discharge became heavily emphasized. The historic cohort (group 1) represents patients admitted overnight with vaginal packing compared to those discharged home same day to remove their own packing (group 2). Healthcare utilization and complications were recorded in the first 30 days postoperatively.</p><p><strong>Results: </strong>Thirty-eight patients were identified in group 1 and 39 in group 2. Age, BMI, and estimated blood loss was similar. There were 20 total unplanned encounters with 10 in each group (p = 0.95). Unplanned encounters in group 1 were seven phone calls/messages, one office visit, and two ED visits compared to three phone calls/messages, five office visits, and two ED visits in group 2. Overall complication rate was similar with six in group 1 and seven in group 2 (p = 0.80). There were zero cases of retained packing.</p><p><strong>Conclusion: </strong>Patients may safely be discharged home with vaginal packing in place with similar rate of complications and healthcare utilization when compared to hospital admission.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191813","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":"Physical Activity, Quality of Life, and Pelvic Floor Disorders Before and After Hysterectomy for Gynecological Cancer: A Prospective Cohort Study.","authors":"Robyn Brennen, Kuan Yin Lin, Linda Denehy, Sze-Ee Soh, Thomas Jobling, Orla M McNally, Simon Hyde, Helena Frawley","doi":"10.1007/s00192-025-06157-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06157-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study investigated physical activity (PA) levels and health-related quality-of-life (HRQoL) before and after, and associations between pelvic floor disorders (PFD) and PA/HRQoL after, hysterectomy for gynecological cancer.</p><p><strong>Methods: </strong>Secondary analysis of a longitudinal cohort study, with assessments before, 6 weeks, and 3 months after hysterectomy for gynecological cancer. The International Physical Activity Questionnaire-short form was used to assess PA and European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30 (QLQ-C30) to assess HRQoL. Changes over time were analyzed using generalized estimating equations or linear mixed models. Associations between PFD with PA and HRQoL were analyzed using logistic regressions and analyses of variance.</p><p><strong>Results: </strong>Of 126 participants, median age 63 years, most had endometrial (69%) and/or stage 1 cancer (72%) and underwent total hysterectomy (65%). Pre-surgery, 39% met PA guidelines, increasing to 53% 3 months post-surgery (+14%, 95% CI 2-25). Mean global health status/QoL domain scores from the QLQ-C30 did not change significantly (+4.4/100 points, 95% CI -0.8 to 9.6). Three months post-surgery, whether participants met PA guidelines was not associated with PFD. Participants with anal incontinence or double incontinence had lower global health status/QoL scores than participants without these symptoms (mean (SD) AI 61.4 (17.8) vs no AI 72.5 (18.7), p = 0.006; DI 61.5 (17.9) vs no DI 71.7 (18.8), p = 0.019).</p><p><strong>Conclusion: </strong>PA levels were low pre- and post-surgery but worse preoperatively. This presents an opportunity for prehabilitation interventions to optimize physical function. There was no association between meeting PA guidelines and PFD. Global health status/QoL was slightly below population norms pre- and post-surgery. Lower HRQoL was associated with some symptoms of PFD.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191812","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":"Female Urinary Incontinence in Africa: Prevalence Estimates from a Systematic Review and Meta-Analysis.","authors":"Jeanne Bertuit, Andy-Muller Luzolo Nzinga, Véronique Feipel","doi":"10.1007/s00192-025-06146-6","DOIUrl":"https://doi.org/10.1007/s00192-025-06146-6","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis aimed to investigate the prevalence of urinary incontinence (UI) among women in African countries. Different types of UI, racial distributions, geographic locations, and methodological approaches were analyzed and compared.</p><p><strong>Methods: </strong>A systematic search was conducted using CINAHL, PubMed, Embase, and African Journals Online (AJOL). Studies published between 2000 and 2023 in French or English were included if they assessed the prevalence of UI among adult women (≥18 years) in Africa. A meta-analysis using a random-effects model was performed. The PRISMA checklist guided the reporting of this review.</p><p><strong>Results: </strong>A total of 22 studies were included. The pooled prevalence of UI was 24% (95% CI: 17-33%), with individual study estimates ranging from 2% to 80%. The pooled prevalence was 28% (95% CI: 19-38%) for urgency urinary incontinence (UUI), 35% (95% CI: 26-45%) for stress urinary incontinence (SUI), and 31% (95% CI: 18-45%) for mixed urinary incontinence (MUI). High heterogeneity was observed across studies (I² ranging from 72.6% to 99.8%; p 0.001 for Cochran's Q test in all UI subcategories).</p><p><strong>Conclusion: </strong>Urinary incontinence affects approximately one-quarter of adult women in Africa. However, the high heterogeneity in prevalence estimates-related to differences in methodology and UI definitions-limits the ability to draw firm conclusions.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186981","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":"Feasibility and Safety of Same-Day Discharge After a Manchester Procedure.","authors":"Jozefien Hamilton, Joggem Veen, Anne Damoiseaux, Viviane Dietz, Jaklien Leemans, Sanne van Leijsen","doi":"10.1007/s00192-025-06177-z","DOIUrl":"https://doi.org/10.1007/s00192-025-06177-z","url":null,"abstract":"<p><strong>Introduction: </strong>With the implementation of the Enhanced Recovery After Surgery (ERAS) approach, the duration of hospital admission after vaginal prolapse surgery is reduced. In this study, we determined the safety and feasibility of same-day discharge in patients undergoing a Manchester procedure by comparing same-day discharge to overnight admission.</p><p><strong>Methods: </strong>This retrospective cohort study was performed in a teaching hospital in the Netherlands. During the period 2019-2023, all patients undergoing a Manchester procedure planned with overnight admission (group A) were compared to patients undergoing this surgery which was planned with same-day discharge (group B). The need for readmission and rate of prolonged hospitalization and complications were compared.</p><p><strong>Results: </strong>This study included 213 patients; 103 in group A and 110 in group B. Baseline characteristics were comparable between the two groups. The rate of readmission in both groups was similar (10.7% vs 15.5%; p = 0.183). No differences were found regarding complications such as discharge with prolonged catheterization due to urinary retention (15.5% vs 11.8%; p = 0.483).</p><p><strong>Conclusion: </strong>Performing the Manchester procedure with same-day discharge is safe and should be implemented as an important element of the ERAS approach. Same-day discharge further reduces length of hospital stay and could reduce costs, while promoting early patient mobilization.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186980","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":"Regulation of Autophagy by the Cdk1/p53/p21 Feedback Loop in an Interstitial Cystitis/Bladder Pain Syndrome Cell Model: Implications for Inflammatory Response.","authors":"Kun Wang, Jian Shi, Zhen Chen, Yibo Zhuang, Dong Xue","doi":"10.1007/s00192-025-06169-z","DOIUrl":"https://doi.org/10.1007/s00192-025-06169-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The Cdk1/p53/p21 feedback loop could play an important role in maintaining a consistently high urinary tract epithelial permeability. This study is aimed at elucidating whether this feedback loop is associated with the inadequate autophagic response and the heightened inflammatory response in interstitial cystitis/bladder pain syndrome (IC/BPS).</p><p><strong>Methods: </strong>To construct the IC/BPS cell model, HTB4 cells were first treated with 1% H₂O₂ for 1 h, followed by a 24-h exposure to TNFα (10 ng/ml). The protein expression levels of LC3-I/II and Beclin 1 were assessed using Western blot analysis. Autophagosome formation was visualized using monodansylcadaverine (MDC) staining. The secretion levels of inflammatory cytokines, including IL-6, IL-8, and TNFα, were quantified using enzyme-linked immunosorbent assay. Additionally, malondialdehyde (MDA) levels and the activities of antioxidant enzymes (GSH and SOD2) were measured.</p><p><strong>Results: </strong>Compared with normal urothelial HTB4 cells, the number of autophagosomes and the levels of LC3-I/II and Beclin 1 are significantly increased in IC/BPS cells. These cells also exhibit markedly higher levels of inflammatory markers (TNFα, IL-6, IL-8) and MDA, alongside notably reduced levels of the antioxidants GSH and SOD2. Compared with IC/BPS cells or IC/BPS cells co-transfected with p21 siRNA and Cdk1 control, the IC/BPS cells co-transfected with p21 siRNA and Cdk1 inhibitor exhibit a significant increase in terms of autophagosome numbers and the LC3-I/II level. Additionally, the levels of inflammatory factors are significantly decreased in the IC/BPS cells co-transfected with p21 siRNA and Cdk1 inhibitor.</p><p><strong>Conclusion: </strong>In IC/BPS, the Cdk1/p53/p21 feedback loop could regulate the level of autophagy and inflammatory response. This discovery identifies promising new therapeutic targets for IC/BPS, which may pave the way for innovative clinical approaches to this complex disorder.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Mirabegron and Propiverine Combination in the Treatment of Refractory Overactive Bladder.","authors":"Mehmet Gokhan Culha, Mehmet Ali Sezgin, Mustafa Erkoc, Eyyup Danis, Emre Can Polat, Alper Otunctemur","doi":"10.1007/s00192-025-06178-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06178-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The aim of this study is to evaluate the effectiveness and safety of mirabegron + propiverine combination in the treatment of overactive bladder (OAB) resistant to anticholinergic agent or beta-3 agonist treatment.</p><p><strong>Method: </strong>Patients who presented with OAB symptoms between March 2019 and August 2023 and did not respond to anticholinergic or beta-3 agonist treatment were included in the study. All patients were recommended to use mirabegron 50 mg (Betmiga, Astellas Pharma, Japan) and propiverine 30 mg (Mictonorm SR, 30 mg, Recordati Pharmaceuticals, Italy) once a day. Patients' symptoms were evaluated with OABSS and bladder diary 3 months after treatment. Side effects and satisfaction rates were recorded.</p><p><strong>Results: </strong>A total of 320 patients were included in the study. One-year data of a total of 264 patients were examined. After 1 year of treatment, the patients' OABSS score, mean daily micturition frequency according to the bladder diary, frequency of urge incontinence, nocturia, and number of pads decreased compared to before treatment (p < 0.001 for each). After 1 year, 62.1% (164/264) of patients benefited from the mirabegron + propiverine combination. The most common side effects were dry mouth in 43 patients (16.3%) and constipation in 59 patients (22.3%).</p><p><strong>Conclusion: </strong>Mirabegron + propiverine treatment is an effective and reliable treatment option in the treatment of OAB resistant to medical monotherapy. With this combination treatment to be used before botulinum toxin application in the treatment of resistant OAB, the number of patients who will receive Botox may decrease.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142610","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}