International Urogynecology Journal最新文献

{"title":"Robot-Assisted Laparoscopic Sacrohysteropexy with Autologous Fascia Lata.","authors":"David Hennes, Victoria Buckley, Anna Rosamilia","doi":"10.1007/s00192-024-06010-z","DOIUrl":"https://doi.org/10.1007/s00192-024-06010-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Autologous fascia lata has been increasingly utilised in pelvic floor reconstructive surgeries such as sacrocolpopexy and sacrohysteropexy. This case highlights sacrohysteropexy with autologous fascia lata as a promising option for women with advanced uterovaginal prolapse who wish to preserve their uterus and avoid synthetic mesh.</p><p><strong>Methods: </strong>We report the case of a 65-year-old woman with stage 3 pelvic organ prolapse following one forceps and one spontaneous vaginal delivery. She presented with cervical-dominant prolapse (6 cm beyond the hymen) and a widened genital hiatus. She was initially managed with a Gellhorn pessary for 7 months, which was removed before surgery. Preoperative findings included prolapse of the cervix, anterior, and posterior vaginal walls (+ 1 cm distal to the hymen). A robot-assisted laparoscopic sacrohysteropexy with autologous fascia lata was performed.</p><p><strong>Results: </strong>The 120-min procedure, conducted by a certified urogynaecologist, began with harvesting a 12 × 4 cm autologous fascia lata graft from the left thigh. The graft site was closed with 2-0 absorbable sutures and supported with a compression bandage for 4 weeks. The graft was secured to the cervix and anterior longitudinal ligament through laparoscopic dissection and robot-assisted suturing. No perioperative complications occurred, and the patient was discharged on postoperative day 2. At 1-year follow-up, there was no recurrence of prolapse.</p><p><strong>Conclusions: </strong>Sacrohysteropexy using autologous fascia lata is a feasible and effective alternative to synthetic mesh, providing an additional surgical treatment option for women in settings where synthetic polypropylene meshes are not approved, contraindicated, or an unacceptable option.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894334","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":"The Effect of Anterior Colporrhaphy: A Prospective Study Comparing POP-Q and Upright MRI.","authors":"Julia J Eijsink, Jaimy A Simmering, Manon Perik, Annemarie van der Steen, Anique T M Grob","doi":"10.1007/s00192-024-06006-9","DOIUrl":"https://doi.org/10.1007/s00192-024-06006-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The high recurrence rate (up to 40%) of native tissue surgery for pelvic organ prolapse (POP) is concerning and a better understanding of the effect of surgery is essential in optimizing treatment. As physical examination (Pelvic Organ Prolapse-Quantification, POP-Q) underestimates the degree of prolapse, upright assessment may provide new insights. Therefore, we compared supine POP-Q with upright magnetic resonance imaging (MRI) examination of the anatomical effect of native tissue POP surgery on the pelvic anatomy.</p><p><strong>Methods: </strong>This prospective study included 59 women with stage ≥ 2 anterior compartment prolapse undergoing solely anterior colporrhaphy (AC) or in combination with posterior colporrhaphy (PC), sacrospinous hysteropexy (SSH) or Manchester Fothergill (MF). Preoperatively and 6 weeks postoperatively, anatomical measurements were obtained: POP-Q and upright MRI. The Patient Global Impression of Improvement (PGI-I) questionnaire was completed 6 weeks postoperatively.</p><p><strong>Results: </strong>Significant lift of the lowest point of the bladder was observed on both POP-Q (37 ± 18 mm) and upright MRI (26 ± 22 mm), which was 10 ± 17 mm (p < 0.001) larger on POP-Q than on upright MRI. Symptomatic improvement (PGI-I) was reported by 93.2% of the patients, which showed a weak correlation with the bladder lift on upright MRI (Spearman's ρ -0.301, p = 0.021), but no correlation with the bladder lift on POP-Q (Spearman's ρ -0.078, p = 0.565).</p><p><strong>Conclusions: </strong>The POP-Q examination overestimates the anatomical result of native tissue POP repair on the anterior vaginal wall by 1 cm compared with upright MRI examination upon 6 weeks' follow-up. Upright MRI examination is suggested to relate better to symptomatic outcome than does POP-Q examination.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864188","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":"Effectiveness of Biofeedback with Dilator Therapy for Sexual Function in Women with Primary Vaginismus: Randomized Controlled Trial Study.","authors":"Farnaz Jokar, Maedeh Fani, Najimeh Tarkesh Isfahani, Reihane Sabahi","doi":"10.1007/s00192-024-06011-y","DOIUrl":"https://doi.org/10.1007/s00192-024-06011-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Vaginismus is characterized by the involuntary spasm of the pelvic floor muscles (PFMs) around the outer third of the vagina, leading to difficulties in vaginal penetration. Physical therapists often use biofeedback to help individuals to gain better control over their muscles. This study was aimed at assessing the impact of biofeedback with dilator therapy on sexual function in women with primary vaginismus.</p><p><strong>Methods: </strong>In this randomized controlled trial study, 32 women with primary vaginismus, aged 18 to 45, were randomly assigned to either the experimental group (n = 16) or the control group (n = 16). The experimental group received both dilator therapy and biofeedback training, whereas the control group only received dilator therapy. Both groups followed a 6-week, twice-a-week session program. The Female Sexual Function Index (FSFI) questionnaire, which includes six dimensions (desire, arousal, lubrication, orgasm, satisfaction, and pain), was administered before and after the 6-week treatment, as well as 1 month after completion.</p><p><strong>Results: </strong>The analysis of variance test showed that the interaction effect of the group and time on the overall score of sexual function (p < 0.001) and the aspects of desire (p < 0.001), arousal (p < 0.001), orgasm (p = 0.028), satisfaction (p < 0.001), and pain (p = 0.003) were significant; however, the interaction between group and time (p = 0.182) was not observed for lubrication.</p><p><strong>Conclusion: </strong>Biofeedback therapy combined with dilator therapy and dilator therapy alone are both effective in improving sexual function in women with primary vaginismus. However, women undergoing biofeedback combined with dilator therapy seem to benefit more than those receiving dilators alone.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846556","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":"Relationship Between A Body Shape Index and Self-Reported Stress Urinary Incontinence Among US Women: A Cross-Sectional Analysis.","authors":"Xingyun He, Fenxiong Liang, Yuewen Guo, Guiyu Hou, Xiting Chen, Lixin Li","doi":"10.1007/s00192-024-06001-0","DOIUrl":"https://doi.org/10.1007/s00192-024-06001-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Stress urinary incontinence (SUI) is common among women, but its link with A Body Shape Index (ABSI) is not well understood. This study investigates the association between ABSI and SUI risk in women, exploring variations across different subgroups.</p><p><strong>Methods: </strong>Data from National Health and Nutrition Examination Survey (2001-2020) were analyzed. A weighted multivariable logistic regression was performed to examine the relationship between ABSI and SUI risk, calculating odds ratios and 95% confidence intervals. A restricted cubic spline (RCS) analysis was used to assess any nonlinear associations. Subgroup analyses and interaction tests were conducted to explore the influence of factors on the ABSI-SUI relationship. Sensitivity analyses were also performed to ensure the robustness of the findings.</p><p><strong>Results: </strong>The analysis, after adjusting for potential confounders, showed a significant association between ABSI and SUI risk (p < 0.001). The RCS analysis indicated a nonlinear relationship (p for nonlinear = 0.02) with a turning point at an ABSI of 0.081. Subgroup analyses revealed that the association between ABSI and SUI was stronger in women with lower BMI, non-Mexican ethnicity, and those without hypertension (p for interaction < 0.05). Sensitivity analyses confirmed the consistency of these findings, supporting their robustness.</p><p><strong>Conclusion: </strong>Higher ABSI is associated with an increased risk of SUI in US women, particularly in specific subgroups. This suggests that ABSI could be a valuable measure for identifying women at higher risk of SUI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846558","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":"Short-Term Complications of Concomitant Pelvic Organ Prolapse and Rectal Prolapse Repair: A Systematic Review and Meta-Analysis.","authors":"Alireza Hadizadeh, Henry H Chill, Angela Leffelman, Claudia Paya-Ten, Cecilia Chang, Roger P Goldberg, Steven D Abramowitch, Ghazaleh Rostaminia","doi":"10.1007/s00192-024-06007-8","DOIUrl":"https://doi.org/10.1007/s00192-024-06007-8","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to evaluate and compare the short-term postoperative complications of concomitant pelvic organ prolapse (POP) and rectal prolapse repair with isolated apical prolapse repair or rectopexy.</p><p><strong>Methods: </strong>This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. A comprehensive literature search was performed using Web of Science, PubMed, Embase, and Scopus for studies published up to April 2024. Studies included were retrospective case-control studies, clinical cohort studies, and randomized clinical trials comparing short-term complications between concomitant apical and rectal prolapse repairs versus isolated repairs.</p><p><strong>Results: </strong>A total of seven studies, encompassing 16,471 patients, met the inclusion criteria. Of these, 843 patients underwent concomitant surgery, 7,808 underwent apical prolapse repair alone, and 7,820 underwent rectopexy alone. The meta-analysis revealed no significant increase in the overall complication rate for the concomitant group compared with the apical prolapse alone (OR 0.78; 95% CI 0.56, 1.09; p = 0.14; I² = 0%) or rectopexy alone (OR 0.79; 95% CI 0.49, 1.25; p = 0.31; I² = 48%). Furthermore, serious complication rates were not significantly higher in the concomitant group compared with isolated apical prolapse repair (OR 0.70; 95% CI 0.43, 1.16; p = 0.16; I² = 0%) or rectopexy alone (OR 0.86; 95% CI 0.54, 1.35; p = 0.50; I² = 39%).</p><p><strong>Conclusion: </strong>Concomitant apical and rectal prolapse repair does not significantly increase the risk of short-term postoperative complications compared with isolated repairs. This approach appears safe and feasible, suggesting that combined surgeries might offer a comprehensive treatment for patients with multicompartmental prolapse without elevating operative risks.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824082","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":"The Effectiveness of Caffeine in Reducing Constipation in Adults: A Systematic Review.","authors":"Anya Latthe, Albert Tan, Pallavi Latthe","doi":"10.1007/s00192-024-06003-y","DOIUrl":"https://doi.org/10.1007/s00192-024-06003-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Constipation is defined as infrequent stools/difficultly passing stools, or the sensation of incomplete emptying. The prevalence of constipation is estimated at 14% worldwide. Caffeine is believed to increase gastric motility in the colon, causing a laxative effect. The results of the studies in the literature are conflicting. The aim of this review is to assess the effectiveness of caffeine in reducing constipation in adults.</p><p><strong>Methods: </strong>We searched the Cochrane Library, AMED, MEDLINE, EMBASE, Web of Science and CINAHL. Search terms included \"constipation\", \"faecal impaction\" and \"caffeine\" in different forms. The screening of the titles was carried out by two independent reviewers for trials that assessed the effect of caffeine on constipation. We assessed the quality of the studies included and the data collated. ROBINS-I and risk-of-bias tools were employed to assess for risk of bias in the studies included.</p><p><strong>Results: </strong>Eight studies were included in the final review. The studies assessed caffeine in the forms of coffee, tea, energy drinks, cocoa and kombucha with different doses. Three studies were at a low risk of bias, 3 were at a moderate risk of bias and the randomised controlled trial (RCT) had some concerns regarding blinding. Four studies concluded that caffeine may be effective in reducing constipation and 4 studies showed no improvement or an increase in constipation. Meta-analysis was not done as the studies were too dissimilar in interventions and outcome assessments.</p><p><strong>Conclusion: </strong>The results of the studies are conflicting. Further rigorously designed and conducted RCTs need to be carried out to substantiate the effectiveness of caffeine on reducing constipation in adults.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813035","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":"Systematic Review of Evidence for Conservative Management of Pelvic Organ Prolapse in Younger Women.","authors":"Claire A Brown, Ping Jing Toong, Rohna Kearney, Suzanne Hagen, Joanne McPeake","doi":"10.1007/s00192-024-05995-x","DOIUrl":"https://doi.org/10.1007/s00192-024-05995-x","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of pelvic organ prolapse (POP) is poorly understood in younger women as the majority of prolapse research is conducted in the older population. There is an urgent need to evaluate conservative POP treatments for management in younger women due to high surgical complications and reoperation rates.</p><p><strong>Methods: </strong>Systematic review of the literature following PRISMA guidelines and registered in PROSPERO. Included studies were of conservative treatments in women younger than 51 years old.</p><p><strong>Results: </strong>From 416 retrieved studies, nine were included in the analysis. Two of three studies found pelvic floor muscle training (PFMT) significantly benefited patient reported outcome measures (PROM) compared to educational material. One of three studies found significant improvement in PROM using biofeedback in addition to PFMT versus PFMT alone. Electrical stimulation with PFMT versus PFMT alone (one study) showed significant additional benefit of the combined treatment. Biofeedback and electrical stimulation in combination with PFMT versus PFMT alone (one study) was found to provide significant additional benefits. One compared pessary use to no intervention but stopped early due to slow recruitment.</p><p><strong>Conclusion: </strong>PFMT improves patient reported outcomes in younger women with POP. Electrical stimulation and biofeedback are useful adjuncts to PFMT. The gap in research investigating the effect of pessaries in younger women warrants further study.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813028","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 \"Effect of Vaginal Microecological Alterations on Female Pelvic Organ Prolapse\".","authors":"Chunrong Liu, Long Chen, Yuan Yuan, Qinglin Tan, Yun Liang","doi":"10.1007/s00192-024-06013-w","DOIUrl":"https://doi.org/10.1007/s00192-024-06013-w","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791720","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":"Intrafascial Colpotomy, Edge-to-Edge Closure, and Peritoneal Graft Technique for Minimizing Mesh Erosion in Concurrent Robotic Hysterectomy and Sacrocolpopexy.","authors":"Yael Yagur, Assem Kalantan, Mujahid Bukhari, Orla Donohoe, Mohammed Almoqren, Jessica Robertson, Sarah Choi, David Rosen, Zhuoran Chen, Kate Moore, Danny Chou","doi":"10.1007/s00192-024-06012-x","DOIUrl":"https://doi.org/10.1007/s00192-024-06012-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Sacrocolpopexy (SCP) is a recognized treatment for apical pelvic organ prolapse (POP). However, mesh erosion remains a concern, particularly when performed with concomitant hysterectomy. This video presents data on one case of a modified technique aimed at potentially minimizing mesh erosion in robotic SCP.</p><p><strong>Methods: </strong>This technique focuses on reinforcing the vaginal cuff and using a pedicled peritoneal graft to create a tissue barrier between the mesh and the vaginal vault. Procedural steps include intrafascial colpotomy, edge-to-edge cuff closure using barbed sutures, and joining anterior and posterior meshes away from the vaginal cuff.</p><p><strong>Results: </strong>The surgical technique was successfully implemented in this single patient presented in the video and was performed in ten more patients with no intraoperative or postoperative complications. During the follow-up period, there were no signs of mesh erosion or exposure.</p><p><strong>Conclusions: </strong>This approach emphasizing vaginal cuff strengthening and mesh separation using a pedicled peritoneal graft can be an option for reducing mesh erosion risk. This report does not provide definitive evidence that this approach reduces mesh erosion risk and further research and long-term follow-up are required to validate these findings and integrate this technique into standard management practices.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785415","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 \"Type III Collagen RNA Level Expression in Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis\".","authors":"Rachana Mehta, Ashok Kumar Balaraman, Muhammed Shabil, Sanjit Sah","doi":"10.1007/s00192-024-06015-8","DOIUrl":"https://doi.org/10.1007/s00192-024-06015-8","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768722","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}