Female Pelvic Medicine and Reconstructive Surgery最新文献

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Incidence of Sacral Osteomyelitis and Discitis After Minimally Invasive Sacrocolpopexy. 微创骶骶固定术后骶骨骨髓炎和椎间盘炎的发生率。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001033
Abby M Stork, Lauren E Giugale, Megan S Bradley, Halina M Zyczynski
{"title":"Incidence of Sacral Osteomyelitis and Discitis After Minimally Invasive Sacrocolpopexy.","authors":"Abby M Stork,&nbsp;Lauren E Giugale,&nbsp;Megan S Bradley,&nbsp;Halina M Zyczynski","doi":"10.1097/SPV.0000000000001033","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001033","url":null,"abstract":"<p><strong>Objective: </strong>The incidence and associated risk factors for sacral osteomyelitis and sacral discitis after sacrocolpopexy remain unknown. The aim of this study was to determine the incidence of sacral osteomyelitis and discitis after minimally invasive sacrocolpopexy and their association with the method of sacral mesh fixation.</p><p><strong>Methods: </strong>This is a retrospective cohort study of consecutive minimally invasive sacrocolpopexies performed by 11 female pelvic medicine and reconstructive surgery board-certified surgeons from January 2009 to August 2019 within a single health system. Sociodemographic, procedure, and clinical variables were abstracted from the electronic health record (EHR). We then performed a confirmatory EHR interrogation, cross-referencing procedural codes for laparoscopic and robot-assisted sacrocolpopexy and diagnostic codes for sacral osteomyelitis and sacral discitis.</p><p><strong>Results: </strong>The EHR chart review identified 1,189 women who underwent laparoscopic (55.2%) and robot-assisted (44.8%) minimally invasive sacrocolpopexy, all with polypropylene mesh. Median follow-up was 7.7 months (interquartile range, 0-49.8). Titanium helical tacks were used in 52.7% patients, sutures in 41.6%, and both in 5.6%. No cases (0%) of sacral osteomyelitis or discitis were identified by chart review. The system-wide EHR interrogation of procedural and diagnostic codes identified 421 additional procedures for a total of 1,610 minimally invasive sacrocolpopexies. Among these, there were no cases (0%) of osteomyelitis or discitis.</p><p><strong>Conclusions: </strong>Sacral osteomyelitis and discitis are rare early outcomes after minimally invasive sacrocolpopexy with an incidence of less than 1/1,000 cases. Given an absence of cases, we were unable to assess for an association between method of sacral attachment and sacral osteomyelitis and sacral discitis.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"672-675"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25326280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 1
Surgical Correction of Pelvic Organ Prolapse Has No Effect on Renal Function. 盆腔器官脱垂手术矫正对肾功能无影响。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001086
Samir Derisavifard, Olivia H Chang, Katie Propst, Howard B Goldman
{"title":"Surgical Correction of Pelvic Organ Prolapse Has No Effect on Renal Function.","authors":"Samir Derisavifard,&nbsp;Olivia H Chang,&nbsp;Katie Propst,&nbsp;Howard B Goldman","doi":"10.1097/SPV.0000000000001086","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001086","url":null,"abstract":"<p><strong>Objective: </strong>The aims of the study were to determine whether symptomatic pelvic organ prolapse (POP) is a cause of subclinical renal impairment by characterizing baseline renal function in women undergoing surgical correction for POP and to assess the effect of surgical POP repair on estimated glomerular filtration rate (eGFR) postoperatively.</p><p><strong>Methods: </strong>A prospective cohort study was designed to evaluate women undergoing surgical repair for at least stage II anterior or apical POP at a single institution. Data collected included preoperative serum creatinine values, patient demographics, and clinical risk factors for renal impairment. Postoperative serum creatinine values were obtained at routine 4- to 6-week follow-up. At that time, patients were evaluated for objective and subjective surgical success and surveyed on postoperative nonsteroidal anti-inflammatory drug use. Preoperative eGFRs were calculated and compared with postoperative values. Appropriate statistical tests were performed.</p><p><strong>Results: </strong>A total of 25 participants were recruited between August 2019 and March 2020. The median age was 70 years (interquartile range, 62-73 years). One participant (4%) reported a history of stage III chronic kidney disease preoperatively. At a median follow-up of 40 days (interquartile range, 34-49 days), no prolapse was recorded past the level of the hymen. There was no difference between preoperative and postoperative eGFR (median preoperative, 81 vs 76 mL/min per 1.73 m2, P = 0.3). Higher POP stage was not associated with significant changes in postoperative eGFR (P = 0.09).</p><p><strong>Conclusions: </strong>Surgical POP repair is not associated with any change in eGFR. It is unlikely that untreated POP causes subclinical renal impairment in the vast majority of women.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"e673-e676"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39570227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Percutaneous Tibial Nerve Stimulation in Diabetic and Nondiabetic Women With Overactive Bladder Syndrome: A Retrospective Cohort Study. 经皮胫神经刺激治疗糖尿病和非糖尿病女性膀胱过度活动综合征:一项回顾性队列研究
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001036
Aldene Zeno, Stephanie J Handler, Sharon Jakus-Waldman, Tajnoos Yazdany, John N Nguyen
{"title":"Percutaneous Tibial Nerve Stimulation in Diabetic and Nondiabetic Women With Overactive Bladder Syndrome: A Retrospective Cohort Study.","authors":"Aldene Zeno,&nbsp;Stephanie J Handler,&nbsp;Sharon Jakus-Waldman,&nbsp;Tajnoos Yazdany,&nbsp;John N Nguyen","doi":"10.1097/SPV.0000000000001036","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001036","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this study was to compare optimal response (\"very much better\" or \"much better\" on the Patient Global Impression of Improvement [PGI-I] index) to posterior tibial nerve stimulation (PTNS) for overactive bladder (OAB) in patients with and without diabetes mellitus. Secondary outcomes included longitudinal data regarding PTNS use in patients with diabetes and controls.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis of women in our tertiary care center who completed at least 10 weekly and 1 maintenance PTNS treatments for OAB, excluding patients who were treated with PTNS for a non-OAB primary diagnosis. Participants were grouped into those with diabetes mellitus and those without. Previous research demonstrated a 20% difference in subjective response to anticholinergics in persons with diabetes versus persons without diabetes with OAB. To demonstrate a 20% difference in optimal PGI-I with 80% power, our analysis required 92 patients in each group.</p><p><strong>Results: </strong>We identified 356 patients: 96 with diabetes mellitus, and 260 controls. There was no statistically significant difference in the primary outcome, with 43 (44.8%) of 96 persons with diabetes versus 115 (44.2%) of 260 controls demonstrating optimal PGI-I response (P = 0.92). Among patients with diabetes, no baseline variables were found to predict treatment response, including hemoglobin A1c greater than 7%, diabetes with sequelae, or higher Charlson Comorbidity Index.</p><p><strong>Conclusions: </strong>In women undergoing PTNS for OAB, the optimal PGI-I response rate is similar in patients with and without diabetes.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"686-690"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39488201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 1
Bowel Obstruction After Sacrocolpopexy: A Case Series. 骶结肠固定术后肠梗阻:一个病例系列。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001095
Paul Wadensweiler, Emily L Whitcomb, Sarah E S Jeney, Daniel Meller, Katherine Moran, Noelani M Guaderrama, Taylor Brueseke
{"title":"Bowel Obstruction After Sacrocolpopexy: A Case Series.","authors":"Paul Wadensweiler,&nbsp;Emily L Whitcomb,&nbsp;Sarah E S Jeney,&nbsp;Daniel Meller,&nbsp;Katherine Moran,&nbsp;Noelani M Guaderrama,&nbsp;Taylor Brueseke","doi":"10.1097/SPV.0000000000001095","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001095","url":null,"abstract":"<p><strong>Objectives: </strong>Bowel obstruction after sacrocolpopexy (SC) can cause significant morbidity. The aim of this study was to delineate clinical and surgical factors associated with bowel obstruction after SC and to describe its presentation, management, and sequelae.</p><p><strong>Methods: </strong>We performed a retrospective case series of patients who underwent open, laparoscopic, or robotic SC within a large health maintenance organization and a single academic medical center between January 1, 2009, and December 31, 2019.</p><p><strong>Results: </strong>Of 3,231 patients who underwent SC, 32 (1.0%) experienced a bowel obstruction. Sacrocolpopexy was performed laparoscopically or robotically in 19 (59.4%) and abdominally in 13 (40.6%). The mean time to bowel obstruction was 1.9 years (SD, 2.5; range, 3 days to 8.8 years). In patients who experienced bowel obstruction, medical management was undertaken in 19 (61.3%) cases. Eight of the 13 (61.5%) surgically managed cases underwent bowel resection, and 3 cases (23.1%) reported partial mesh excision. Recurrent obstruction was seen in 2 (10.5%) of the medically managed and 2 (15.4%) of the surgically managed cases.</p><p><strong>Conclusions: </strong>Bowel obstruction is a rare complication of SC and our rate of at least 1.0% corroborates those in the literature. Obstruction occurs from days to years after SC. Nonsurgical management was effective in most cases, with low rates of recurrent obstruction. In surgically managed cases, the majority included bowel resection or mesh excision; however, mesh excision was not associated with a subsequent identifiable procedural intervention for recurrent prolapse. These data inform patient counseling and surgical planning before SC and aid in diagnosis and management of bowel obstruction after SC.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"e677-e680"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39570228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2
Sex-Based Language Differences in Female Pelvic Medicine and Reconstructive Surgery Fellowship Recommendation Letters. 女性骨盆医学和重建外科奖学金推荐信中基于性别的语言差异。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001023
Samantha Freeman, Elishia McKay, Juan Lin, Ava Leegant, Nitya E Abraham
{"title":"Sex-Based Language Differences in Female Pelvic Medicine and Reconstructive Surgery Fellowship Recommendation Letters.","authors":"Samantha Freeman,&nbsp;Elishia McKay,&nbsp;Juan Lin,&nbsp;Ava Leegant,&nbsp;Nitya E Abraham","doi":"10.1097/SPV.0000000000001023","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001023","url":null,"abstract":"<p><strong>Introduction: </strong>Letters of recommendation (LORs) are a significant component of residency and fellowship applications. Applicant sex may play a role in the language used in letters, which could hinder progress in academic fields, particularly for women. Although differences in language based on applicant sex have been identified in other fields, no prior studies have evaluated LORs for female pelvic medicine and reconstructive surgery (FPMRS) fellowships.</p><p><strong>Methods: </strong>Letters of recommendations for applicants to an urban, tertiary care academic medical FPMRS fellowship from 2017 to 2019 were collected. Using the Linguistic Inquiry and Word Count program, a licensed text analysis software for academic purposes, we analyzed LORs based on 16 categories. The Wilcoxon rank sum test, Fisher exact test, and a generalized linear mixed model were used for statistical analyses.</p><p><strong>Results: </strong>A total of 97 fellowship applications were analyzed, yielding 354 LORs; 32 applicants were male, whereas 65 were female. Letters written for male applicants contained significantly more power words (P = 0.022) and significantly less affiliation words (P = 0.025) compared with female counterparts. Differences were maintained after adjusting for age, race/ethnicity, step 1 to step 3 scores, Phi Beta Kappa status, Alpha Omega Alpha status, and writer's sex.</p><p><strong>Conclusions: </strong>Significant linguistic differences based on applicant sex exist in FPMRS fellowship LORs. Differences are consistent with previous analyses within science and medical fields. These findings did not show a significant association with an applicant's ability to match; however, we did not analyze whether the matched institution was the preferred choice for each applicant.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"697-700"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25326650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 3
Factors Associated With Myofascial Dysfunction of the Pelvic Floor Muscles in Women With Urinary Incontinence: A Cross-Sectional Study. 尿失禁妇女盆底肌筋膜功能障碍相关因素:一项横断面研究。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001021
Amanda Martins Reis, Luiz Gustavo Oliveira Brito, Anna Lygia Barbosa Lunardi, Camila Carvalho de Araújo, Cássia Raquel Teatin Juliato
{"title":"Factors Associated With Myofascial Dysfunction of the Pelvic Floor Muscles in Women With Urinary Incontinence: A Cross-Sectional Study.","authors":"Amanda Martins Reis,&nbsp;Luiz Gustavo Oliveira Brito,&nbsp;Anna Lygia Barbosa Lunardi,&nbsp;Camila Carvalho de Araújo,&nbsp;Cássia Raquel Teatin Juliato","doi":"10.1097/SPV.0000000000001021","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001021","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the prevalence and associated factors of pelvic floor myofascial dysfunction (PFMD) in women with urinary incontinence (UI).</p><p><strong>Methods: </strong>A cross-sectional study was performed. Pelvic floor myofascial dysfunction was defined by pain of any intensity during palpation of the pelvic floor muscles and strength assessed by the modified Oxford scale, and was classified in grade I (mild pain), grade II (moderate), and grade III (severe). Univariate and multivariate analyses were calculated (5% significance level) to seek for the associated factors of PFMD.</p><p><strong>Results: </strong>A total of 234 women with UI were included, 121 women in the PFMD group and 113 in the control group. The mean ages were 52.1 ± 10.2 and 53 ± 8.1 years, respectively. Pelvic floor myofascial dysfunction was more frequent among non-White women, and women with PFMD presented more dyspareunia and recurrent urinary tract infection. There was a higher frequency of mixed UI (MUI; 89.2%) in the PFMD group and stress UI (31.9%) in the control group. The prevalence of PFMD was 51.7%, with 10.6% of patients categorized into grade I, 18.8% in grade II, and 22.2% in grade III. In women with PFMD, there is an inverse relation between pain and muscle strength, with the highest strength values (3, 4, and 5) being in grade I (P = 0.028). The multivariate analysis has shown that women with MUI had a risk 4.9 times greater (adjusted odds ratio, 4.93 [2.34-10.42]; P < 0.001) of having PFMD, and non-White women had a 2.1-fold increased risk (adjusted odds ratio, 2.07 [1.10-3.91]; P = 0.024) of presenting with PFMD.</p><p><strong>Conclusions: </strong>A high prevalence of PFMD was found among women with UI. Mixed UI and non-White race were the associated factors of PFMD.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"691-696"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25533639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 1
Enhanced Recovery Protocol Enhances Postdischarge Recovery After Laparoscopic Sacrocolpopexy. 增强恢复方案提高腹腔镜骶骶固定术后出院后的恢复。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001042
Christine Pan, Douglass Hale, Michael Heit
{"title":"Enhanced Recovery Protocol Enhances Postdischarge Recovery After Laparoscopic Sacrocolpopexy.","authors":"Christine Pan,&nbsp;Douglass Hale,&nbsp;Michael Heit","doi":"10.1097/SPV.0000000000001042","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001042","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to determine if an ERAS (enhanced recovery after surgery) protocol enhanced the patient-perceived postdischarge recovery after laparoscopic sacrocolpopexy.</p><p><strong>Methods: </strong>In this prospective cohort study, patients exposed to an ERAS protocol completed a preoperative survey that included established predictors of postdischarge recovery. Postoperatively, they completed the validated Postdischarge Surgical Recovery 13 (PSR-13) scale at 7, 14, and 42 days. A historical cohort of non-ERAS patients who completed similar surveys were included for comparisons. Characteristics between the 2 cohorts were analyzed using the χ2 test, Student t tests, and Mann-Whitney U tests where appropriate. A mixed-design analysis of variance model was constructed to determine if our ERAS protocol affected recovery as measured by the PSR-13 scale.</p><p><strong>Results: </strong>Eighty-nine ERAS patients were compared with 169 non-ERAS controls. There were no differences in established predictors of recovery between the groups. Length of hospital stay was shorter in the ERAS cohort (33±13.1 hours vs 44.2±25.9 hours; mean difference, 11.2; 95% confidence interval [CI], 6.44-16.0). Postdischarge recovery significantly improved with time (7 days: 52.7; 95% CI, 50.1-55.2; 14 days: 63.4; 95% CI, 60.9-65.8; 42 days: 80.1, 95% CI, 78.1-82.1). The ERAS cohort reported greater postdischarge recovery than the non-ERAS cohort (as measured by the PSR-13 scale) at postoperative days 7, 14, and 42 days (68.4 vs 62.3; mean difference, 6.1; 95% CI, 2.04-10.16).</p><p><strong>Conclusions: </strong>Enhanced recovery after surgery protocols reduce length of hospital stay and enhance patient-perceived postdischarge recovery.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"667-671"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39108740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 5
The Effect of Symptomatic Stress Urinary Incontinence on Catheterization Rates After Intradetrusor OnabotulinumtoxinA Injections. 症状性应激性尿失禁对肌内注射肉毒杆菌毒素后置管率的影响。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001040
Caroline Brandon, Dominique Malacarne Pape, Cheongeun Oh, Fabiana M Kreines, Sameer S Thakker, Nirit Rosenblum, Victor W Nitti, Benjamin M Brucker, Dianne Glass
{"title":"The Effect of Symptomatic Stress Urinary Incontinence on Catheterization Rates After Intradetrusor OnabotulinumtoxinA Injections.","authors":"Caroline Brandon,&nbsp;Dominique Malacarne Pape,&nbsp;Cheongeun Oh,&nbsp;Fabiana M Kreines,&nbsp;Sameer S Thakker,&nbsp;Nirit Rosenblum,&nbsp;Victor W Nitti,&nbsp;Benjamin M Brucker,&nbsp;Dianne Glass","doi":"10.1097/SPV.0000000000001040","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001040","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether catheterization rates after intradetrusor onabotulinumtoxinA injection for nonneurogenic overactive bladder and urgency incontinence differ between women with urgency urinary incontinence only and women with urgency-predominant mixed urinary incontinence.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients that underwent intradetrusor onabotulinumtoxinA injection of 100 U for nonneurogenic urgency urinary incontinence. The primary outcome was the difference in catheterization rates between women with urgency urinary incontinence alone compared with women with urgency-predominant mixed urinary incontinence. Descriptive statistics and multivariate logistic regression analysis were performed.</p><p><strong>Results: </strong>Of the 177 women included in the final analysis, 105 had urgency urinary incontinence and 72 had urgency-predominant mixed urinary incontinence. The overall catheterization rate after onabotulinumtoxinA injection was 11.3%, with significantly fewer women with mixed urinary incontinence requiring catheterization when compared with women with urgency urinary incontinence alone (4.2% vs 16.2%; P = 0.03), despite an older population (P = 0.02). Patient-reported improvement (P = 0.37) and decision to continue onabotulinumtoxinA treatments (P = 0.89) were similar between groups. Multivariate logistic regression analysis revealed that women with mixed urinary incontinence had significantly lower odds of requiring catheterization after onabotulinumtoxinA injections than women with urgency urinary incontinence alone (odds ratio, 0.16; 95% confidence interval, 0.04-0.67; P = 0.01).</p><p><strong>Conclusions: </strong>Findings suggest that the presence of symptomatic stress urinary incontinence is associated with lower rates of catheterization after intradetrusor onabotulinumtoxinA, but does not compromise efficacy of treatment for urgency-predominant mixed urinary incontinence.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"676-680"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39010405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
The Use of Platelet-rich Plasma as a Novel Nonsurgical Treatment of the Female Stress Urinary Incontinence: A Prospective Pilot Study. 富血小板血浆作为一种新的非手术治疗女性压力性尿失禁的方法:一项前瞻性试点研究。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001100
Stavros Athanasiou, Christos Kalantzis, Dimitrios Zacharakis, Nikolaos Kathopoulis, Artemis Pontikaki, Themistoklis Grigoriadis
{"title":"The Use of Platelet-rich Plasma as a Novel Nonsurgical Treatment of the Female Stress Urinary Incontinence: A Prospective Pilot Study.","authors":"Stavros Athanasiou,&nbsp;Christos Kalantzis,&nbsp;Dimitrios Zacharakis,&nbsp;Nikolaos Kathopoulis,&nbsp;Artemis Pontikaki,&nbsp;Themistoklis Grigoriadis","doi":"10.1097/SPV.0000000000001100","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001100","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to evaluate the efficacy and safety of platelet-rich plasma (PRP) for the treatment of stress urinary incontinence (SUI).</p><p><strong>Methods: </strong>This was a prospective observational pilot study conducted in a tertiary referral unit, enrolling women with SUI booked for SUI surgery. A total of 20 consecutive women met the inclusion criteria and attended all follow-ups. All participants underwent 2 PRP injections into the lower one third of the anterior vaginal wall at 4- to 6-week intervals. At baseline, they underwent urodynamic studies, a 1-hour pad test, and completed the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms and King's Health Questionnaire. At follow-up visits (1, 3, and 6 months), patients underwent the 1-hour pad test and completed the King's Health Questionnaire, International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms, and Patient Global Impression Scale of Improvement. Primary outcome was to evaluate posttreatment SUI. Secondary outcomes included assessment of patient-reported questionnaires, assessment of urine loss (1-hour pad test), and the level of discomfort during injections (visual analog scale score). Statistical analysis was performed before PRP and 1, 3, and 6 months after the last treatment.</p><p><strong>Results: </strong>A significant improvement in SUI symptoms was observed 3 months after treatment with a further improvement at 6 months. A mean reduction of 50.2% in urine loss was observed in the 1-hour pad test. At the 6-month follow-up, 80.0% of women reported to be at least improved. No adverse effects were observed.</p><p><strong>Conclusions: </strong>Platelet-rich plasma injections were both effective and safe at least in the short term and could be offered as an alternative outpatient procedure for the treatment of SUI. However, these encouraging findings warrant further investigation with randomized controlled trials.</p>","PeriodicalId":48831,"journal":{"name":"Female Pelvic Medicine and Reconstructive Surgery","volume":"27 11","pages":"e668-e672"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39425345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 6
Minimally Invasive Repair of a Posterior Perineal Hernia With Mesh: A Case Report. 微创补片修复会阴后疝1例。
IF 1.6 4区 医学
Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI: 10.1097/SPV.0000000000001106
Michael Shu, Daniel Nassar, Abeer Eddib
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