Urogynecology (Hagerstown, Md.)最新文献

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Development and Validation of a Simulation Model for Ureteral Stent Placement. 输尿管支架植入模拟模型的开发与验证
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2024-11-11 DOI: 10.1097/SPV.0000000000001598
Nicole J Wood, Laura J Cheng, Dylan Buller, Dmitry Volkin, David M O'Sullivan, Elena Tunitsky-Bitton
{"title":"Development and Validation of a Simulation Model for Ureteral Stent Placement.","authors":"Nicole J Wood, Laura J Cheng, Dylan Buller, Dmitry Volkin, David M O'Sullivan, Elena Tunitsky-Bitton","doi":"10.1097/SPV.0000000000001598","DOIUrl":"10.1097/SPV.0000000000001598","url":null,"abstract":"<p><strong>Importance: </strong>Currently, there are no validated training models for cystoscopy with ureteral stent placement.</p><p><strong>Objectives: </strong>The objectives of this study were to develop and validate a novel endoscopic simulation model for training in ureteral stent placement.</p><p><strong>Study design: </strong>A low-cost, low-fidelity training model was developed to simulate ureteral stent placement. Recruited participants were divided into 3 groups: novices (postgraduate year 3/4 gynecology residents), advanced learners (urogynecology and reconstructive pelvic surgery fellows), and experts (urology residents, urogynecology faculty, and urology faculty). Construct validity was measured using de-identified video-recorded performances on the model, which were evaluated by 2 expert reviewers using validated scales (Global Operative Assessment of Laparoscopic Skills [GOALS], Global Rating Scale [GRS]) and procedure-specific metrics.</p><p><strong>Results: </strong>The model was created using a hollow Styrofoam sphere, plastic tubing from a retropubic sling, and a silicone pacifier. Thirty-six surgeons were assessed performing the procedure using the model with cystoscopic equipment. The experts (n = 12) performed significantly better than the advanced learners (n = 17) and novices (n = 7) in total scores (max 75, median [IQR]: 75 [75-75], 61 [56.5-68.5], 45 [43-46], respectively; P < 0.001) and within each individual scale domain. Increasing experience with ureteral stent placement had a significant correlation ( P < 0.001) with better performance on the model. A minimum total passing score of 63 was established. On post simulation assessment, most participants \"agreed\" or \"strongly agreed\" that the model closely approximates the feel of ureteral stent placement.</p><p><strong>Conclusion: </strong>This ureteral stenting simulation model is easy to construct, affordable, and reproducible. The model is valid and reliable for practicing the procedure in preparation for live surgery.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"201-209"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of ChatGPT to Generate Informed Consent for Surgery in Urogynecology. 使用ChatGPT生成泌尿妇科手术知情同意。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2025-01-17 DOI: 10.1097/SPV.0000000000001638
Emily S Johnson, Eva K Welch, Jacqueline Kikuchi, Heather Barbier, Christine M Vaccaro, Felicia Balzano, Katherine L Dengler
{"title":"Use of ChatGPT to Generate Informed Consent for Surgery in Urogynecology.","authors":"Emily S Johnson, Eva K Welch, Jacqueline Kikuchi, Heather Barbier, Christine M Vaccaro, Felicia Balzano, Katherine L Dengler","doi":"10.1097/SPV.0000000000001638","DOIUrl":"10.1097/SPV.0000000000001638","url":null,"abstract":"<p><strong>Importance: </strong>Use of the publicly available Large Language Model, Chat Generative Pre-trained Transformer (ChatGPT 3.5; OpenAI, 2022), is growing in health care despite varying accuracies.</p><p><strong>Objective: </strong>The aim of this study was to assess the accuracy and readability of ChatGPT's responses to questions encompassing surgical informed consent in urogynecology.</p><p><strong>Study design: </strong>Five fellowship-trained urogynecology attending physicians and 1 reconstructive female urologist evaluated ChatGPT's responses to questions about 4 surgical procedures: (1) retropubic midurethral sling, (2) total vaginal hysterectomy, (3) uterosacral ligament suspension, and (4) sacrocolpopexy. Questions involved procedure descriptions, risks/benefits/alternatives, and additional resources. Responses were rated using the DISCERN tool, a 4-point accuracy scale, and the Flesch-Kinkaid Grade Level score.</p><p><strong>Results: </strong>The median DISCERN tool overall rating was 3 (interquartile range [IQR], 3-4), indicating a moderate rating (\"potentially important but not serious shortcomings\"). Retropubic midurethral sling received the highest overall score (median, 4; IQR, 3-4), and uterosacral ligament suspension received the lowest (median, 3; IQR, 3-3). Using the 4-point accuracy scale, 44.0% of responses received a score of 4 (\"correct and adequate\"), 22.6% received a score of 3 (\"correct but insufficient\"), 29.8% received a score of 2 (\"accurate and misleading information together\"), and 3.6% received a score of 1 (\"wrong or irrelevant answer\"). ChatGPT performance was poor for discussion of benefits and alternatives for all surgical procedures, with some responses being inaccurate. The mean Flesch-Kinkaid Grade Level score for all responses was 17.5 (SD, 2.1), corresponding to a postgraduate reading level.</p><p><strong>Conclusions: </strong>Overall, ChatGPT generated accurate responses to questions about surgical informed consent. However, it produced clearly false portions of responses, highlighting the need for a careful review of responses by qualified health care professionals.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"285-291"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vaginal Orthosis After Native Tissue Reconstructive Surgery: Design and Phase 0. 原位组织重建手术后阴道矫形器:设计和0期。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2024-12-23 DOI: 10.1097/SPV.0000000000001628
Max C Cadena, Christopher X Hong, Alexandra Blokker, Derek Sham, Holly E Richter
{"title":"Vaginal Orthosis After Native Tissue Reconstructive Surgery: Design and Phase 0.","authors":"Max C Cadena, Christopher X Hong, Alexandra Blokker, Derek Sham, Holly E Richter","doi":"10.1097/SPV.0000000000001628","DOIUrl":"10.1097/SPV.0000000000001628","url":null,"abstract":"<p><strong>Importance: </strong>Pelvic organ prolapse recurrence following native tissue repair occurs with composite failure rates of 9-19% within 12 months, predominantly involving apical/anterior compartments. Objective The objective of this study was to develop a novel vaginal orthosis (NVO) device prototype through an iterative design process based on investigator and user feedback.</p><p><strong>Study design: </strong>The NVO was designed based on pelvic floor biomechanical principles to mitigate unopposed intra-abdominal pressure of the anterior vagina by absorbing and redirecting intra-abdominal forces to the levator ani and tailored to accommodate postoperative vaginal caliber and axis. Prototypes were fabricated by 3D-printing negative molds, cast, and cured with medical-grade biocompatible silicone. Ten healthy volunteers were recruited to provide qualitative feedback for iterative design refinement (phase 0).</p><p><strong>Results: </strong>Through an iterative engineering design process, initial concepts were refined to align with the natural, resting H-shape of the vagina. Key features included a distal self-retaining feature, posterior curvature, proximal taper, and apical/anterior contact areas for support. A more rigid material to withstand intra-abdominal forces without folding was required; therefore, Shore A60 (medium soft) instead of A40 (soft) silicone was used. Based on participant feedback, the NVO retaining feature width range was reduced (47.5-63 mm to 45-50 mm) to decrease pressure on lateral vaginal walls and levator ani distally maintaining self-retaining function. Updates to the fitting and education process also provided increased descriptive instructions for insertion and removal.</p><p><strong>Conclusions: </strong>A novel vaginal orthosis was designed specifically tailored to facilitate wound healing using an orthomedical model, improving the design through iterative feedback.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"309-314"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Operating on the Oldest-Old: Vaginal Prolapse Surgery Outcomes in Women Over 90. 高龄手术:90岁以上女性阴道脱垂手术的结果。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2025-01-17 DOI: 10.1097/SPV.0000000000001636
Stephanie W Zuo, Kristina Warner, Halina Zyczynski, Mary F Ackenbom
{"title":"Operating on the Oldest-Old: Vaginal Prolapse Surgery Outcomes in Women Over 90.","authors":"Stephanie W Zuo, Kristina Warner, Halina Zyczynski, Mary F Ackenbom","doi":"10.1097/SPV.0000000000001636","DOIUrl":"10.1097/SPV.0000000000001636","url":null,"abstract":"<p><strong>Importance: </strong>Women aged 90 years and older (\"oldest-old\") represent a small but growing population who may experience bothersome pelvic organ prolapse and opt for surgical repair.</p><p><strong>Objective: </strong>This study aimed to compare perioperative adverse events (AEs) within 8 weeks of prolapse surgery between women ≥90 years and younger patients.</p><p><strong>Study design: </strong>We performed a secondary analysis of a dual-center retrospective cohort study of women ≥61 years old undergoing major prolapse surgery from January 2016 to May 2023. We identified all women ≥90 years and matched them to women <90 years in a 1:4 fashion based on Charlson Comorbidity Index score and surgery type. Matching was performed without replacement. The primary outcome was a composite AE outcome, defined as all intraoperative and postoperative complications within 8 weeks of surgery.</p><p><strong>Results: </strong>There were 24 oldest-old undergoing prolapse surgery who were matched to 96 women with mean ± standard deviation age of 77.2 ± 5.7 years. Women ≥90 years were more likely to have a lower body mass index ( P < 0.01), greater preoperative prolapse stage ( P = 0.049), and were less likely to have general anesthesia ( P < 0.01). Patients did not differ in medical comorbidities, frailty status, concomitant hysterectomy or incontinence procedure, or length of postoperative stay. The oldest-old did not experience any intraoperative complications and had low rates of readmission (8.3%) and discharge to skilled nursing facilities (4.2%). Age ≥90 was not associated with composite AEs on multivariable analysis (adjusted odds ratio 1.60, 95% confidence interval [0.39-6.55]).</p><p><strong>Conclusions: </strong>Age ≥90 years does not appear to increase the risk of perioperative AEs in women with similar comorbidities.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"315-321"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prophylactic Vancomycin Leads to Fewer Device Removals in Sacral Neuromodulation. 预防性万古霉素可减少骶神经调节中器械的移除。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2024-11-28 DOI: 10.1097/SPV.0000000000001606
Jada A Ohene-Agyei, Xi Wang, Suman Sahil, An-Lin Cheng, Jonathan P Shepherd, Gary Sutkin
{"title":"Prophylactic Vancomycin Leads to Fewer Device Removals in Sacral Neuromodulation.","authors":"Jada A Ohene-Agyei, Xi Wang, Suman Sahil, An-Lin Cheng, Jonathan P Shepherd, Gary Sutkin","doi":"10.1097/SPV.0000000000001606","DOIUrl":"10.1097/SPV.0000000000001606","url":null,"abstract":"<p><strong>Importance: </strong>Sacral neuromodulation (SNM) requires removal for infectious complications in 3-11%.</p><p><strong>Objective: </strong>The objective of this study was to examine the effect of preoperative antibiotic choice on all-cause SNM device removal rates.</p><p><strong>Study design: </strong>This was a retrospective cohort analysis, using the Health Facts Database, representing more than 750 hospitals. We included female patients undergoing SNM implantation from 2010 to 2018. Univariate and multivariate logistic regression identified factors associated with removal. Thirty-five comorbidities were evaluated. Those with P < 0.2 on univariate analysis were included in the multivariate analysis. We decided a priori to include prophylactic antibiotic choice in the final model.</p><p><strong>Results: </strong>Of 1,433 patients, 170 (11.9%) had device removal. Patients were 63.0 ± 14.9 years old, predominantly Caucasian (90.0%), treated in urban hospitals (94.1%), and married (54.2%). A total of 11.8% were obese, and 18.0% smoked. Those in the removal cohort were more likely from the Northeastern United States; 52.3% received first-gen cephalosporins (CPSN), 7.4% second- or third-generation CPSNs, 9.1% vancomycin, 13.4% aminoglycosides, 4.6% clindamycin, and 13.3% fluoroquinolones. Compared to vancomycin, more removals were associated with first-generation CPSNs (odds ratio [OR] = 3.1, 95% confidence interval [1.4, 6.8]); clindamycin (OR = 3.2, [1.2, 8.4]); second/third-generation CPSNs (OR = 3.1, [1.3, 7.6]); and aminoglycosides (OR = 3.1, [1.3, 7.4]). Additionally, patients treated in the Northeast were more likely to undergo removal (OR = 1.9, [1.0, 3.7]).</p><p><strong>Conclusions: </strong>Vancomycin as a prophylactic antibiotic was associated with fewer device removals compared to most antibiotics in this retrospective cohort analysis. While prospective trials could confirm this benefit, low removal rates may make this impractical.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"210-215"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Botox for Sleep Effectiveness. 提高睡眠效率的肉毒杆菌。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2024-11-14 DOI: 10.1097/SPV.0000000000001580
Feven W Getaneh, Lee Ann Richter, Mai Dabbas, Jiling Chou, Cheryl B Iglesia, Alexis A Dieter
{"title":"Botox for Sleep Effectiveness.","authors":"Feven W Getaneh, Lee Ann Richter, Mai Dabbas, Jiling Chou, Cheryl B Iglesia, Alexis A Dieter","doi":"10.1097/SPV.0000000000001580","DOIUrl":"10.1097/SPV.0000000000001580","url":null,"abstract":"<p><strong>Importance: </strong>Nocturia is one of the most bothersome complaints in women with overactive bladder syndrome (OAB). Although small preliminary studies have shown that intradetrusor onabotulinum toxin A (BTX) injections reduce nocturia episodes, it is not known how reduction in nighttime urination affects sleep quality and quality of life.</p><p><strong>Objectives: </strong>We aimed to assess the effect of BTX on nocturia frequency, sleep quality, and quality of life.</p><p><strong>Study design: </strong>This is a prospective observation study of adult women with ≥2 nocturia episodes and OAB planning to undergo treatment with BTX injections. Participants completed a 2-day bladder/sleep diary and sleep-related questionnaires at baseline and 5 weeks post-BTX.</p><p><strong>Results: </strong>A total of 40 participants were included with a mean age of 71 ± 12 years and most (90%) undergoing 100 units of BTX injection. At baseline, the median nocturia episodes were 3.5 (IQR, 2.5-5.0), and nearly half (43%) of participants reported mild to moderate sleep disturbance. At 5 weeks post-BTX, we found a significant decrease in nocturia episodes (-2/night) and a 59% decrease in mild to moderate sleep disturbance (P = 0.006). There were significant increases in longest sleep interval (+1.5 hours), time to first awakening (+1.6 hours) and average sleep interval (+1.3 hours), and a significant increase in nocturia-related quality of life scores (P < 0.001 for all). Sixteen (40%) of participants had nocturia resolution defined as ≤1 mean nocturia episode post-BTX.</p><p><strong>Conclusions: </strong>For women with OAB and >2 nocturia episodes/night, BTX injections reduce voids/night and improve sleep quality and nocturia-related quality of life.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 3","pages":"194-200"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postoperative Activity Restrictions After Reconstructive Pelvic Surgery. 骨盆重建手术后活动限制。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2024-12-18 DOI: 10.1097/SPV.0000000000001622
Alejandra Cacheiro Bofarull, Chris Elizabeth Philip, Gabriela Francis, Pedro Henrique Costa Matos da Silva, Chloe Koski, Linda Suk-Ling Murphy, Victoria Alzogaray, Olivia H Chang
{"title":"Postoperative Activity Restrictions After Reconstructive Pelvic Surgery.","authors":"Alejandra Cacheiro Bofarull, Chris Elizabeth Philip, Gabriela Francis, Pedro Henrique Costa Matos da Silva, Chloe Koski, Linda Suk-Ling Murphy, Victoria Alzogaray, Olivia H Chang","doi":"10.1097/SPV.0000000000001622","DOIUrl":"10.1097/SPV.0000000000001622","url":null,"abstract":"<p><strong>Importance: </strong>Restrictive physical activity after pelvic reconstructive surgery is recommended, although the optimal duration and intensity are not standardized.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the existing literature comparing clinical outcomes for liberal postoperative physical activity versus standard of care, defined as restricted postoperative physical activity, after pelvic reconstructive surgery.</p><p><strong>Study design: </strong>PubMed, CENTRAL, Scopus, Web of Science, and CINAHL databases were searched for observational and randomized studies comparing liberal postoperative physical activity and standard of care in women undergoing pelvic reconstructive surgery, reporting anatomic and functional outcomes. Statistical analysis was performed using RevMan software, presenting results as mean difference (MD) or odds ratio in a random-effects model, with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Five randomized trials, representing total n = 434, were included, with 2 studies on sling surgical procedures and 3 on prolapse surgical procedures. Data from 3 studies suggest no significant difference between liberal and standard postoperative instructions in surgical outcomes, measured by Point Ba from POP-Q assessment tool, up to 3 months follow-up (MD, -0.04; 95% CI, -0.16 to 0.07; P = 0.49). Disease-specific symptom distress, measured by Pelvic Floor Distress Inventory-20, favored the liberal approach (MD, -10.09; 95% CI, -18.33 to -1.86; P = 0.02). Other domains, including Urinary Distress Inventory-6, also showed significant improvements with liberal postoperative activities (MD, -4.29; 95% CI, -7.84 to -0.74; P = 0.02).</p><p><strong>Conclusions: </strong>Patients with liberal postoperative physical activity recommendations in prolapse repair surgical procedures had similar short-term anatomic outcomes compared with standard restrictions, with more favorable outcomes in disease-specific symptom relief and quality of life.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"266-275"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementing a Digital Platform for Recurrent Urinary Tract Infections. 实施复发性尿路感染数字平台。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2024-11-11 DOI: 10.1097/SPV.0000000000001604
Lily A Arya, Surbhi Agrawal, Ngozi Ikpeama, Heidi Harvie, Rebecca Hamm Feldman, Lauren Dutcher
{"title":"Implementing a Digital Platform for Recurrent Urinary Tract Infections.","authors":"Lily A Arya, Surbhi Agrawal, Ngozi Ikpeama, Heidi Harvie, Rebecca Hamm Feldman, Lauren Dutcher","doi":"10.1097/SPV.0000000000001604","DOIUrl":"10.1097/SPV.0000000000001604","url":null,"abstract":"<p><strong>Importance: </strong>A patient-centered care model is needed for recurrent urinary tract infection (UTI) management.</p><p><strong>Objective: </strong>The aim of this study was to develop a conceptual model for a digital platform to implement evidence-based guidelines for recurrent UTI management.</p><p><strong>Study design: </strong>This was a qualitative, 3-stage mixed methods study that included (1) developing an evidence-based prototype texting platform; (2) qualitative feedback from recurrent UTI patients using the platform; and (3) quantitative data on acceptability (proportion of patients engaging with the platform), accuracy (proportion of patient messages interpreted accurately by the platform), and usability (score 0-100).</p><p><strong>Results: </strong>Thirty-one women with recurrent UTI (median age, 71 years; range, 60-74 years) participated in testing over 4 months. The prototype platform was modified through iterative rounds of qualitative and quantitative analysis until engagement ≥85%, accuracy ≥90%, and usability score of ≥80 were achieved in 10 patients. Qualitative feedback indicated that patients valued rapid access to treatment through fewest possible health encounters during an acute episode, evidence-based education about prevention, and ability to participate in self-management with support from health care providers. Based on this feedback, a conceptual model consisting of 3 main components was developed: (1) an algorithm to triage acute symptoms, (2) educational videos emphasizing prevention strategies, and (3) supportive messages. Patient feedback identified 4 key implementation outcomes-usability, acceptability (engagement), fidelity (accuracy), and cost-and 3 clinical outcomes-self-efficacy, health care utilization, and rate of unnecessary antibiotics for testing the model.</p><p><strong>Conclusion: </strong>The proposed model can be used to implement and test a patient-centered evidence-based digital platform for the management of recurrent UTI.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"183-193"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Silver-Coated Foley Catheters to Reduce UTIs: A Randomized Clinical Trial. 镀银Foley导管减少尿路感染:一项随机临床试验。
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2025-01-02 DOI: 10.1097/SPV.0000000000001634
Kelsey Lewis, Catrina Crisp, Marlana Ray, Mildrede Bonglack, Meredith Carrel-Lammert, Emily Aldrich, Rachel Pauls, Jonathan Hoehn, Jennifer Yeung
{"title":"Silver-Coated Foley Catheters to Reduce UTIs: A Randomized Clinical Trial.","authors":"Kelsey Lewis, Catrina Crisp, Marlana Ray, Mildrede Bonglack, Meredith Carrel-Lammert, Emily Aldrich, Rachel Pauls, Jonathan Hoehn, Jennifer Yeung","doi":"10.1097/SPV.0000000000001634","DOIUrl":"10.1097/SPV.0000000000001634","url":null,"abstract":"<p><strong>Importance: </strong>This study is important as it challenges the effectiveness of silver-coated catheters in reducing urinary tract infections (UTIs) after pelvic floor surgery (PFS).</p><p><strong>Objective: </strong>The aim of this study was to investigate the incidence of UTIs in patients using silver-coated silicone transurethral indwelling catheters (TICs) compared with standard silicone TICs among women with postoperative urinary retention following PFS.</p><p><strong>Study design: </strong>This was a double-blind, randomized controlled trial of women undergoing PFS between June 2022 and February 2024 with postoperative urinary retention. Participants were randomized to a silver-coated silicone TIC or a standard silicone TIC. The primary outcome was the incidence of symptomatic, culture-proven UTI within 30 days of surgery. Secondary outcomes included the categorization of uropathogens as well as adverse symptoms potentially related to the catheter. A sample size of 155 participants per arm was calculated to find a relative decrease of 47%, from 30% to 16%.</p><p><strong>Results: </strong>Of 310 participants randomized, 303 were included in the analysis: 154 controls and 149 silver catheter. Demographics were similar for both groups. For our primary outcome, 56 patients in the control group and 52 patients in the silver catheter group were diagnosed with a UTI (36.4% vs 34.9%; P = 0.81). No adverse reactions to the silver catheter were noted. Analysis of the urinary microbiomes demonstrated Escherichia coli was the most represented uropathogen, found in 43% of the urine cultures overall.</p><p><strong>Conclusion: </strong>There was no difference in incidence of symptomatic, culture-confirmed UTIs in patients who received silver-coated silicone TICs compared with standard silicone TICs in women undergoing PFS.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"276-284"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gender-Affirming Vaginoplasty in a Patient With Inflammatory Bowel Disease. 炎性肠病患者的性别确认阴道成形术
IF 0.8
Urogynecology (Hagerstown, Md.) Pub Date : 2025-03-01 Epub Date: 2025-01-06 DOI: 10.1097/SPV.0000000000001644
Stanley E Rozentsvit, Erika Thys, Loren S Schechter, Kristin M Jacobs
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