Urogynecology (Hagerstown, Md.)最新文献

{"title":"Pessary Placement for Voiding Dysfunction Due to Prolapse Among Neurologically Intact Women.","authors":"Sarah Ashmore, Margaret G Mueller, Kimberly Kenton, C Emi Bretschneider","doi":"10.1097/SPV.0000000000001629","DOIUrl":"10.1097/SPV.0000000000001629","url":null,"abstract":"<p><strong>Importance: </strong>Literature surrounding conservative management of voiding dysfunction (VD) due to pelvic organ prolapse (POP) is limited.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the effect of pessaries on VD in women with symptomatic POP.</p><p><strong>Study design: </strong>This was a retrospective case series of adult women who underwent a pessary fitting for POP and VD between January 2010 to December 2022 at 2 tertiary care centers. Voiding dysfunction was defined as a composite outcome of participant report of obstructive voiding symptoms and postvoid residual volume (PVR) ≥150 mL prior to pessary fitting. Obstructive voiding symptoms were determined by positive response on the Pelvic Floor Distress Inventory-20 to items 5, 6, 19, and/or 20.</p><p><strong>Results: </strong>Sixty-one participants with POP and VD underwent successful pessary fitting at 2 large academic institutions. Median (range) age was 75 years (35-89) and body mass index of 26.5 (18.0-46.3). Participant reports of \"difficult bladder emptying\" and \"sensation of incomplete bladder emptying\" were the most reported symptoms of obstructive voiding. Advanced staged prolapse (prolapse ≥ stage 3) was documented for 84% of participants. Median point C, Ba, and genital hiatus were -2 cm, +3 cm, and 4 cm, respectively, on examination. Median PVR prior to pessary fitting was 263 mL (150-810). Voiding dysfunction resolved in 60 out of 61 participants (98%). Median repeat PVR after pessary placement was 50 mL (0-250).</p><p><strong>Conclusion: </strong>Pessary placement resolved VD due to POP in 98% of participants. Clinicians can offer pessary placement as nonsurgical management for participants with VD due to POP.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"384-389"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017815","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}

{"title":"Residents' Exposure to Obstetric Anal Sphincter Injury: A 16-Year Temporal Trend.","authors":"Courtney K Pfeuti, Lindsay Gugerty, John A Occhino, Suneet P Chauhan","doi":"10.1097/SPV.0000000000001618","DOIUrl":"10.1097/SPV.0000000000001618","url":null,"abstract":"<p><strong>Importance: </strong>Exposure to the surgical management of obstetric anal sphincter injuries (OASIS) is limited during obstetrics training.</p><p><strong>Objectives: </strong>The objective of this study was to quantify residents' exposure to OASI repair during 4-year obstetrics and gynecology (OBGYN) residency and examine temporal trends over a 16-year period.</p><p><strong>Study design: </strong>This was a retrospective cohort study of residents' exposure to OASIS at a community academic hospital from 2007 to 2022. Individuals with documented OASIS (third- or fourth-degree laceration) by International Classification of Diseases, Ninth and Tenth Revisions, codes during vaginal delivery (VD), spontaneous vaginal delivery (SVD), or operative vaginal delivery (OVD), were included. Delivery rates and OBGYN resident positions were examined. Temporal trends in OASIS were analyzed in 4-year epoch to determine average resident exposure during OBGYN residency.</p><p><strong>Results: </strong>During the 16-year study period, there were 103,234 deliveries (62% VD, 4% OVD, 34% cesarean delivery). Among VDs, there were 2,344 (3.4%) OASIS with 88.5% classified as third-degree and 11.5% as fourth degree. The OASI rate decreased from 4.2% (2007-2010) to 2.9% (2019-2022), whereas OBGYN residents increased by 49% (67 to 99; P < 0.001). Average resident exposure to OASIS decreased from 11 (2007-2010) to 5 (2019-2022; P = 0.55). Subclassification revealed that residents were exposed to 5 third-degree repairs and less than 1 fourth-degree repair, on average, during 2019-2022.</p><p><strong>Conclusions: </strong>During 4 years of training, average resident exposure was to 7 OASIS, 6 third degree, and 1 fourth degree. Limited exposure to OASIS during residency may be detrimental, as surgical treatment is a complicated yet essential obstetric procedure that carries significant risk of patient morbidity and potential long-term sequelae. Therefore, reliance on supplementation with simulation may improve surgeon competence in OASI management.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"436-443"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883798","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}

{"title":"Tamsulosin to Prevent Urinary Retention After Vaginal Urogynecologic Surgery.","authors":"Jun Song, Luis Carrillo, Jasmine Tibon, Sylvia Botros-Brey, Elizabeth Evans, Alexandriah Alas","doi":"10.1097/SPV.0000000000001632","DOIUrl":"10.1097/SPV.0000000000001632","url":null,"abstract":"<p><strong>Importance: </strong>Postoperative urinary retention (POUR) affects up to 51% of women undergoing surgery for pelvic organ prolapse (POP). Effective prevention strategies remain elusive, although alpha receptor antagonists show promise in recent literature.</p><p><strong>Objectives: </strong>This study sought to evaluate the effect of preoperative tamsulosin on POUR after vaginal surgery for POP.</p><p><strong>Study design: </strong>We conducted a retrospective cohort study of female patients undergoing vaginal surgery for POP, with or without concomitant midurethral sling. Patients who received preoperative tamsulosin were compared with controls. All patients were discharged on the day of surgery after undergoing a standardized voiding trial. The primary outcome was the rate of POUR, defined by a failed voiding trial. Secondary outcomes included complication rates and risk factors for POUR.</p><p><strong>Results: </strong>A total of 195 patients were included for analysis, with 60 patients (30.8%) receiving tamsulosin and 135 (69.2%) not. Baseline demographics were similar between groups, except the tamsulosin group had lower parity and were less likely to splint to void. The tamsulosin group had similar rates of POUR compared with control (31.7% vs 34.8%, P = 0.67). Multivariate logistic regression controlling for confounders showed no significant effect of tamsulosin on POUR rates (odds ratio, 0.65; 95% confidence interval, 0.31-1.35; P = 0.24). Concomitant sling placement was identified as the only independent risk factor for POUR (odds ratio, 3.00; 95% confidence interval, 1.55-5.81; P = 0.001).</p><p><strong>Conclusions: </strong>Preoperative tamsulosin does not appear to be effective in preventing postoperative urinary retention in women undergoing vaginal surgery for POP, whereas concomitant sling placement appears to increase its risk.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"397-404"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412066","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}

{"title":"Prolonged Second Stage of Labor and Postpartum Pelvic Floor Dysfunction.","authors":"Andrea Marcheti Silveira, Glaucia Miranda Varella Pereira, Elaine Christine Dantas Moises, Cassia Raquel Teatin Juliato, Luiz Gustavo Oliveira Brito","doi":"10.1097/SPV.0000000000001687","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001687","url":null,"abstract":"<p><strong>Importance: </strong>Parity and mode of delivery are common risk factors for pelvic floor dysfunction. The prolonged second stage of labor, defined as the time between complete cervical dilation and the expulsion of the fetal head, may be related to these changes and no pooled evidence has been tabulated to seek this association.</p><p><strong>Objective: </strong>The aim of the study was to carry on a systematic review on the association between pelvic floor dysfunction symptoms and prolonged second stage of labor (PSSL).</p><p><strong>Study design: </strong>A systematic search was conducted in the databases PubMed, Cochrane Library, Embase, SCOPUS, Web of Science, and LILACS on July and December 2024. Studies involving populations of women who experienced PSSL and in which the analyzed outcomes were symptoms of pelvic floor dysfunction were included. The ROBINS-I scale was used to assess methodological quality for observational studies.</p><p><strong>Results: </strong>A total of 92 articles were fully analyzed, and 6 articles were selected. A meta-analysis could not be performed because of the heterogeneity of the primary outcome and the definition for PSSL. Two of 6 studies considered PSSL over 3 hours. Among the 6 studies, 3 showed no association between PSSL and pelvic floor dysfunction, 2 indicated an association with urinary incontinence, and one suggested a partial association. All studies presented a moderate overall risk of bias.</p><p><strong>Conclusions: </strong>Half of the studies did not demonstrate an association between PSSL and pelvic floor dysfunction and the other half suggested an association. Further studies with PSSL as primary outcomes with cohort design are needed to clarify this question.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766106","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}

{"title":"Presacral Space Surgical Anatomy: Piriformis Fascia as Lateral Border.","authors":"Adam M Hare, Polina Sawyer, Samantha Hull, Marlene M Corton","doi":"10.1097/SPV.0000000000001681","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001681","url":null,"abstract":"<p><strong>Importance: </strong>Safe surgery requires an understanding of the anatomic boundaries and neurovascular structures of the presacral space.</p><p><strong>Objective: </strong>The aim of the study was to characterize anatomy of the presacral space applicable to sacrocolpopexy or rectopexy while highlighting cadaveric findings of the lateral border of the space.</p><p><strong>Study design: </strong>Structures and boundaries of the presacral space of 18 unembalmed female cadavers were studied. Anatomic relationships and distances to landmarks were established.</p><p><strong>Results: </strong>A dense connective tissue layer ≤1 mm thick on the piriformis muscle's medial surface attaches to the anterior sacrum just medial to the sacral foramina, separating the lateral sacral vein and sacral nerves laterally from the presacral space contents medially. Median transverse distance from midsacral promontory to right sympathetic trunk was 19.5 (range, 15-31) mm. Distances from right S1, S2, S3, and S4 foramina to midsacral promontory were 28.8 (22-47.5), 48.3 (38.5-72.5), 65.8 (54.5-89.5), and 80.8 (65-104.5) mm and to midline sacrum were 16.5 (14-22), 15.3 (13-20.5), 13.5 (10.5-19.5) and 13.3 (10.5-19.5) mm, respectively. Transverse communicating veins, measuring 3 (2-4) mm in width, penetrated the piriformis fascia, joining the lateral sacral vein to form the sacral venous plexus. Vertical distance from midsacral promontory to the most cephalad communicating vein was 38.3 (7.5-60.5) mm.</p><p><strong>Conclusions: </strong>During presacral space surgical procedures, avoiding suture placement and mesh fixation beyond 1.5 cm from the sacrum midline should prevent injury to the sacral sympathetic trunk, sacral nerves, and lateral sacral vein. Transverse communicating vessels of the sacral venous plexus are usually encountered below the S1 foramina level. The piriformis fascia is the lateral boundary of the presacral space over the greater sciatic foramen.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766103","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}

{"title":"Re. DeLancey, J., Is POP-Q II Now Overdue?","authors":"Hans Peter Dietz, Ka Lai Shek","doi":"10.1097/SPV.0000000000001690","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001690","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766124","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}

{"title":"Epidural Analgesia and the Risk of Obstetric Anal Sphincter Injury.","authors":"Do Hee Lee, Celia Kucera, Melissa Salinas, Charelle M Carter-Brooks","doi":"10.1097/SPV.0000000000001677","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001677","url":null,"abstract":"<p><strong>Importance: </strong>There are conflicting data regarding the association between epidural analgesia and obstetric anal sphincter injuries (OASIs). There are also few predictive models that document assessment for multicollinearity among risk factors or precisely identify effect modifiers and confounders.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the association between epidural analgesia and OASIs, using rigorous statistical methods to identify effect modifiers and confounders in a diverse, urban population.</p><p><strong>Study design: </strong>This was a secondary analysis of a retrospective case-control study of women with singleton vaginal deliveries. Our primary analysis was to assess the association between epidural analgesia and OASIs, adjusting for modifiable and nonmodifiable risk factors. These risk factors were additionally assessed for effect modification and confounding effect.</p><p><strong>Results: </strong>Our sample consisted of 1,326 women who had a vaginal delivery. Among the women with OASIs, 218 women (75.4%) had an epidural, and among those without OASIs, 620 women (59.8%) had an epidural (P < 0.001). Epidural analgesia increased the odds of OASIs by 107% (odds ratio 2.07, 95% confidence interval [1.54 to 2.77]). Through further examination of the relationship between OASIs and epidurals, while considering multiple risk factors and addressing multicollinearity, effect modification, and confounding, we identified operative delivery and labor induction as confounding variables. Accounting for these factors mitigated the association between epidural use and OASIs (adjusted odds ratio 1.38, 95% confidence interval [1.00 to 1.91]).</p><p><strong>Conclusions: </strong>Initially, we found epidural analgesia to be associated with OASIs; however, after performing additional statistical analysis and accounting for additional risk factors, this association was no longer statistically significant.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702248","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}

{"title":"YouTube and UTIs: What Is Online Video Content Teaching Our Patients?","authors":"Benjamin Worrall, Anthony-Joe Nassour, Kevin Zhuo, Maria Pilar Alvarado, Amanda Chung","doi":"10.1097/SPV.0000000000001672","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001672","url":null,"abstract":"<p><strong>Importance: </strong>YouTube is an important source of information about urinary tract infections (UTIs), which are the most common outpatient infections.</p><p><strong>Objective: </strong>This study aimed to assess the quality of YouTube videos about UTI prevention.</p><p><strong>Study design: </strong>Three doctors independently reviewed the first 50 YouTube search results for \"how to prevent UTIs,\" using the DISCERN and Patient Education Materials Assessment Tool (PEMAT); SPSSv28 was used for analysis with P < 0.05 considered significant.</p><p><strong>Results: </strong>Three non-English videos were excluded. Sixteen of 47 (34%) were produced by medical sources. Forty-three of 47 (91%) were targeted at patients, rather than clinicians. The median views per video was 24,110 (88-5,552,204). Nonmedical sources ranked higher in search results (rs = 0.41, P < 0.05). Nonmedical sources had more subscribers and views. Nonmedical sources were \"liked\" significantly more than nonmedical sources (U = 146, P < 0.05). The overall quality of evidence-based material was moderate (mean DISCERN, 3.1). Medical sources were significantly more accurate than nonmedical sources (DISCERN, 3.6 cf. 2.9; P = 0.03). The overall mean PEMAT understandability was 62.8%, and actionability was 65.7%, with no significant difference between medical and nonmedical sources. The video view count was not associated with significantly higher PEMAT or DISCERN scores.</p><p><strong>Conclusions: </strong>Videos by medical sources were more factually reliable, but there was no difference in delivery quality between medical and nonmedical sources. Patients may present with inaccurate preconceptions about UTI treatment from YouTube, which practitioners should be prepared to address. There is a role for medical institutions and all doctors who treat patients for UTIs to create YouTube content that is both factually accurate and accessible to patients.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659991","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}

{"title":"Activity Restrictions After Midurethral Sling: A Randomized Controlled Trial.","authors":"Pedro Alvarez, Cem Demirkiran, Leslie Rickey, Lisbet Lundsberg, Oz Harmanli","doi":"10.1097/SPV.0000000000001679","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001679","url":null,"abstract":"<p><strong>Importance: </strong>Postoperative activity restrictions can affect patient satisfaction after midurethral sling (MUS) surgery.</p><p><strong>Objective: </strong>The aim of the study was to assess the effect of a duration of postoperative activity restrictions on patient satisfaction and surgical outcomes after MUS surgery for stress urinary incontinence.</p><p><strong>Study design: </strong>Women undergoing MUS surgery alone for stress urinary incontinence were enrolled in this provider-blinded, randomized clinical trial. Randomization to either 3- or 6-weeks' duration of activity restrictions was assigned. Restrictions included abstaining from lifting greater than 20 pounds, high-impact activity, or strenuous exercise. Primary outcome was patient satisfaction with surgery, using a 5-point Likert patient satisfaction scale. Satisfaction scores were analyzed in a \"complete satisfaction\" (\"completely\" satisfied only) and a \"higher satisfaction\" approach (both \"completely\" and \"mostly\" satisfied). Secondary outcomes included objective and subjective assessment of incontinence symptoms and activity assessment.</p><p><strong>Results: </strong>Ninety-eight women underwent MUS surgery between July 2021 and September 2022, and 88 were randomized. Of them, 41 and 43 women with 3- and 6-week restrictions had patient satisfaction data, respectively. Baseline characteristics did not differ between groups. At the 6-month postoperative visit, overall patient satisfaction (\"completely\" and \"mostly\" satisfied) was very high at 92%. Complete satisfaction was significantly higher in the 3-week (73.2%) versus the 6-week restriction group (51.2%) (P = 0.04). \"Higher satisfaction\" did not reach a statically significant difference between groups (P = 0.11). Subjective urinary incontinence indices did not differ between groups.</p><p><strong>Conclusions: </strong>Return to normal activities 3 weeks after MUS surgery resulted in significantly higher satisfaction scores at 6 months compared to a 6-week restriction without compromising subjective and objective surgical success.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659982","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}

{"title":"Impact of a Digital Therapeutic Device on Pelvic Floor Symptoms.","authors":"Milena M Weinstein, Gena C Dunivan, Noelani M Guaderrama, Holly E Richter","doi":"10.1097/SPV.0000000000001674","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001674","url":null,"abstract":"<p><strong>Importance: </strong>Women undergoing treatment for urinary incontinence (UI) often have additional pelvic floor disorders (PFDs). It is important to understand the effect of UI-focused pelvic floor muscle training (PFMT) on other PFDs.</p><p><strong>Objective: </strong>The objective of this analysis was to evaluate the prevalence of symptoms of pelvic organ prolapse (POP) and fecal incontinence (FI) in women treated for UI, and symptom changes following pelvic floor muscle training (PFMT) with and without a motion-based biofeedback device (MBBD).</p><p><strong>Study design: </strong>This was a post-hoc analysis of a randomized controlled trial comparing PFMT with and without an MBBD in women with UI. Symptomatic PFDs were defined using Pelvic Floor Distress Inventory-20 (PFDI-20) subscales, the Urogenital Distress Inventory Short Form (UDI-6), Colorectal Anal Distress Inventory-8 (CRADI-8), and the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6). Outcomes included the prevalence of multiple PFDs and change in UDI-6, CRADI-8, and POPDI-6 scores among participants with and without concomitant PFDs.</p><p><strong>Results: </strong>A total of 299 women were analyzed. Of 299 women, 161 (57%) reported symptoms of more than 1 PFD. Age and body mass index did not differ. Baseline UDI-6 scores were higher in those with additional PFD symptoms versus UI alone (45.7 ± 15.8 vs 60.7 ± 19.4, P < 0.001). For participants with UI plus at least 1 additional PFD symptom, improvement in UDI-6 scores at 6 and 12 months was significantly greater in the intervention group. For participants with FI, the CRADI-8 was significantly improved from baseline to 8 weeks, 12 months, and 24 months. For participants with POP symptoms, the POPDI score was significantly improved at all time points.</p><p><strong>Conclusions: </strong>Pelvic floor muscle training is effective in treating UI in the context of additional PFDs, as well as in treating symptoms of FI and POP.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659986","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}