Urogynecology (Hagerstown, Md.)最新文献

{"title":"Purported Bladder Irritant Intake in Women With Urgency Urinary Incontinence.","authors":"Barbara Ha, Lisa R Yanek, Bryna J Harrington, Joan L Blomquist, Chi Chiung Grace Chen, Danielle Patterson, Victoria L Handa","doi":"10.1097/SPV.0000000000001652","DOIUrl":"10.1097/SPV.0000000000001652","url":null,"abstract":"<p><strong>Importance: </strong>Patients with urgency urinary incontinence are often recommended to avoid bladder irritants, but there is a lack of evidence for this.</p><p><strong>Objective: </strong>The aim of the study was to compare consumption of purported bladder irritants between women with and without urgency urinary incontinence.</p><p><strong>Study design: </strong>We performed a case-control study of nonpregnant females aged ≥20 years using the National Health and Nutrition Examination Survey, 2007-2020. Cases were defined as participants with moderate, severe, or very severe urgency urinary incontinence without stress urinary incontinence, measured with the Sandvik Incontinence Severity Index. Controls were defined as those without urgency urinary incontinence. The exposures of interest were 6 bladder irritants listed by the National Institute of Diabetes and Digestive and Kidney Diseases: (1) alcohol; (2) spicy foods; (3) chocolate; (4) artificial sweeteners; (5) caffeinated, carbonated, and citrus beverages; and (6) high-acid foods. Weighted multivariable logistic regression analysis was used to determine independent associations between each irritant and urgency urinary incontinence.</p><p><strong>Results: </strong>Overall, this study included 651 cases with urgency urinary incontinence (6.8%) and 8,890 controls (93.2%). More cases reported consuming caffeinated, carbonated, and citrus beverages (53.8% vs 47.1%, P = 0.01) and high-acid foods (50.3% vs 44.3%, P = 0.02). In multivariable analysis, the odds of urgency urinary incontinence were increased significantly with intake of caffeinated, carbonated, and citrus beverages (odds ratio 1.37, 95% confidence interval 1.09-1.73) and high-acid foods (odds ratio 1.29, 95% confidence interval 1.03-1.62).</p><p><strong>Conclusions: </strong>In this case-control study of community-dwelling adult females, urgency urinary incontinence was associated with consumption of caffeinated, carbonated, and citrus beverages and high-acid foods. Adequately powered prospective trials are needed to further investigate the effects of these foods and beverages on urgency urinary incontinence to guide clinical practice.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"352-360"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017822","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":"Symptom Documentation Before Antibiotics for Recurrent Urinary Tract Infections.","authors":"Alexandra Kuzma, Elizabeth Critchlow, Nathanael Koelper, Surbhi Agrawal, Lauren Dutcher, Lily Arya","doi":"10.1097/SPV.0000000000001626","DOIUrl":"10.1097/SPV.0000000000001626","url":null,"abstract":"<p><strong>Importance: </strong>Documentation of symptoms in the medical record before prescribing antibiotics for urinary tract infection (UTI) could promote antibiotic stewardship.</p><p><strong>Objective: </strong>The aim of this study was to describe the number and type of symptoms documented across specialties during encounters where an antibiotic was prescribed to older women with recurrent UTI.</p><p><strong>Study design: </strong>We conducted a retrospective cohort study of women aged 65 years or older with a diagnosis of recurrent UTI. Patients were included if they had been prescribed an antibiotic for UTI at least twice in 6 months or 3 times in 1 year. Data on number and type of symptoms and urine culture results were extracted and compared across encounters and specialties.</p><p><strong>Results: </strong>A total of 454 encounters from 175 patients were analyzed. The majority of encounters were in primary care (61.8%), followed by urology/urogynecology (24%), obstetrics and gynecology (9.2%), and emergency department/urgent care (4.8%). The median number of UTI-specific symptoms recorded across specialties was 1 (interquartile range, 0-2) and declined in subsequent encounters. The number of UTI-specific symptoms documented was none in 25%, 1 in 26%, and 2 or more in 49% of encounters. Of the 337 encounters with positive cultures, 19% had no documented UTI-specific symptoms and 9% had no documented symptoms of any kind.</p><p><strong>Conclusions: </strong>Documentation of urinary symptoms during encounters where antibiotics are prescribed is sparse across specialties for older patients with recurrent UTI. The gap in care identifies an opportunity for improving antibiotic stewardship through improved documentation of urinary symptoms.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"369-376"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883769","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":"Sacral Neuromodulation Reprogramming Rates: Understanding Office-Based Requirement.","authors":"Helen Query, Tyler Morgan, Adam P Klausner, Linda S Burkett","doi":"10.1097/SPV.0000000000001635","DOIUrl":"10.1097/SPV.0000000000001635","url":null,"abstract":"<p><strong>Importance: </strong>Sacral neuromodulation (SNM) is a procedure with the advantage of reprogramming for discomfort or inadequate symptom control.</p><p><strong>Objectives: </strong>The aims of this study were to investigate the rates of office-based SNM programming in a large multisite cohort and to examine differences based on implantation indication.</p><p><strong>Study design: </strong>The TriNetX database was utilized for retrospective cohort comparison using International Classification of Diseases, Tenth Revision, and Current Procedural Terminology (CPT) codes. Cohort selection included female adults with a diagnosis of urinary retention, urgency urinary incontinence, and/or fecal incontinence (FI) at time of implantation. The primary outcome was the rate of SNM reprogramming CPT per individual from 6 weeks to 5 years postimplantation. Secondary outcomes included demographic comparisons, incidence, and survival curves for patients with SNM reprogramming identified with CPT codes. Further comparisons were completed between implantation diagnoses of grouped urinary (urgency and retention) versus fecal indications.</p><p><strong>Results: </strong>A total of 9,501 patients meet inclusion criteria with a mean of age 62.1 ± 14.9 years (range, 18-90). Office-based SNM reprogramming was identified in 31.5%. The probability of never having reprogramming at 5 years was 52.5%. The mean number of reprogramming sessions was 2.5 ± 2.1. Approximately half (48%) of the patients with FI also had a diagnosis of urgency urinary incontinence, and approximately 25% had urinary retention. The probability of never having reprogramming was 55% and higher in patients with a fecal incontinence indication than those with only urinary indications at 50%, P < 0.001.</p><p><strong>Conclusions: </strong>Office-based SNM reprogramming occurs in 31.5% of patients with implants, and rates are likely underreported. Patients with any FI diagnosis have a higher risk of requiring reprogramming.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"444-448"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959969","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":"Urogynecology Research Is Underrepresented in Top Obstetrics and Gynecology Journals.","authors":"Monica Saleeb, Sruthi Muluk, Nicole Wood, Elisabeth Sappenfield, Elena Tunitsky-Bitton","doi":"10.1097/SPV.0000000000001651","DOIUrl":"10.1097/SPV.0000000000001651","url":null,"abstract":"<p><strong>Importance: </strong>Patients with urogynecologic conditions commonly present to general gynecology practices. Consequently, it is imperative that journals for obstetrics and gynecology (OBGYN) represent topics pertinent to comprehensive women's health, including urogynecology topics.</p><p><strong>Objective: </strong>The aim of the study was to analyze the prevalence of urogynecology research compared to other topics in top OBGYN journals.</p><p><strong>Study design: </strong>This was a retrospective review of all papers published in top OBGYN-focused journals from 2000 to 2023. The publicly available PubMed package in R was used to extract papers. Stata, a statistical software package, was used to develop an algorithm searching for key words concerning urogynecology, obstetrics, benign gynecology, gynecologic oncology, and reproductive endocrinology and infertility. The algorithm was tested and cross-validated via manual review of papers published in 1999 to determine whether identified key words were accurate in determining paper content. The algorithm was modified with additional key words and revalidated based on this initial analysis.</p><p><strong>Results: </strong>Validation of the algorithm using all 1999 publications from several top OBGYN journals found a 93.48% accuracy for correct identification and classification of papers. Analysis was performed for 81,174 articles between 2000 and 2023. An average of 6.64% of publications focused on urogynecology topics. In contrast, 41.42% of publications concerned obstetrics, 33.9% on other benign gynecology, 41.9% on gynecologic oncology, and 24.7% on reproductive endocrinology and infertility.</p><p><strong>Conclusions: </strong>This study reveals consistent underrepresentation of urogynecology topics in leading OBGYN journals. Given that generalist gynecologists may not subscribe to subspecialty journals, this study underscores the need for the inclusion of urogynecologic research in OBGYN journals.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"428-435"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191593","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":"Acute Cortical Brain Neuroexcitation Can Be Detected With Sacral Neuromodulation.","authors":"Linda S Burkett, Alice Strawn, Mina P Ghatas, Luc Mortemousque, Justin Dare, Brendan J McCormack, Ryan Fogg, Brandon C Wilson, Adam P Klausner, John E Speich","doi":"10.1097/SPV.0000000000001657","DOIUrl":"10.1097/SPV.0000000000001657","url":null,"abstract":"<p><strong>Introduction: </strong>Functional near infrared spectroscopy (fNIRS) is a noninvasive technique for measuring cortical brain neuroexcitation.</p><p><strong>Objective: </strong>The objective of this study was to determine if fNIRS could detect differences in prefrontal cortex (PFC) neuroexcitation due to acute ON/OFF changes in sacral neuromodulation (SNM) during natural bladder filling.</p><p><strong>Study design: </strong>Female participants who had an SNM device implanted for ≥6 months underwent a 2-fill natural hydration protocol in this cross-sectional study. Continuous oxygenated hemoglobin (O2Hb) concentration was recorded using an fNIRS headcap as a measure of neuroexcitation. Sacral neuromodulation devices were acutely changed from ON to OFF and OFF to ON in 3-minute cycles. One-minute segments of fNIRS signals before and after acute modulation were selected and linear fitting was used to output slope. Two-minute control periods at a similar level of bladder sensation were used for comparison.</p><p><strong>Results: </strong>Twelve women completed the study and median time from SNM implant was 13 (6, 42) months. In the left and middle PFC regions, there was a significant alteration of fNIRS slope (∆O2Hb/time) from baseline to postactivation (OFF to ON) compared to control periods. The first deactivation (ON to OFF) showed continuation of the prior fNIRS slope. The control segments showed stability of averaged O2Hb signals regardless of sensation in all brain regions.</p><p><strong>Conclusions: </strong>This study indicates that fNIRS may be a useful tool to assess acute changes in neuroexcitation of the PFC in response to SNM device activation in female patients with overactive bladder. The results suggest that SNM may acutely affect the PFC during bladder filling.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 4","pages":"344-351"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Diversity, Equity and Inclusion Statements of Urogynecology Fellowships.","authors":"Nicole Jenkins, Qilin Cao, Gregory Vurture, Scott W Smilen","doi":"10.1097/SPV.0000000000001623","DOIUrl":"10.1097/SPV.0000000000001623","url":null,"abstract":"<p><strong>Importance: </strong>The Accreditation Council for Graduate Medical Education (ACGME) has aimed to increase diversity among the physician workforce. Prospective applicants utilize websites to identify programs that share a commitment to equity and inclusion. Published statements of Diversity, Equity, and Inclusion (DEI) demonstrate a fellowship program's recognition of the importance of improving diversity in health care and medical education.</p><p><strong>Objective: </strong>The aim of the study was to assess the utilization of DEI statements published on urogynecology and reconstructive pelvic surgery (URPS) fellowship program websites.</p><p><strong>Study design: </strong>All ACGME accredited URPS fellowship websites in July 2023 were reviewed for presence of a DEI statement as a primary outcome. Website content was then compared across geographical regions (Northeast, Mid-Atlantic, Midwest, South, and West).</p><p><strong>Results: </strong>Seventy-two URPS programs had a dedicated website for review. Nine (12.5%) URPS programs had a published diversity statement. There were no statistical differences in the presence of a statement in URPS fellowships based on core-surgical speciality or geographic region.</p><p><strong>Conclusions: </strong>A majority of URPS programs lack a DEI statement (87.5%) demonstrating an area for improvement. With an increasingly diverse patient population, the recruitment of a diverse pool of physician applicants is more crucial than ever. By advocating for transparency, URPS fellowship programs can foster an environment that nurtures a physician workforce better equipped to provide culturally inclusive health care.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"449-453"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831168","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":"Optimizing the Laparoscopic Vecchietti Procedure: Tips and Tricks.","authors":"Annika Sinha, Abbigail Woll, Cassandra K Kisby","doi":"10.1097/SPV.0000000000001613","DOIUrl":"10.1097/SPV.0000000000001613","url":null,"abstract":"<p><strong>Background: </strong>The Vecchietti procedure is a staged procedure that, through use of an acrylic olive, allows for expedited traction and dilation to create a neovagina in patients with congenital vaginal agenesis. Although the steps are fairly standardized for the laparoscopic Vecchietti procedure, we have appreciated specific nuances in technique that have optimized our surgical approach and efficiency.</p><p><strong>Case: </strong>We present a case of congenital vaginal agenesis in a genetically female patient who completed neovaginal creation using the laparoscopic Vecchietti technique. During this case, we review each step of the procedure and offer technical strategies to enhance efficiency and effectiveness in the operating room. We also describe these specific preoperative, intraoperative, and postoperative considerations in a video.</p><p><strong>Conclusions: </strong>This optimized Vecchietti procedure, or traction vaginoplasty, is an excellent option for neovagina creation in those patients with vaginal agenesis. With the use of our techniques, we have had successful cosmetic and functional outcomes.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"465-468"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257495","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":"Potential Bladder Irritants and Overactive Bladder Symptoms: A Systematic Review.","authors":"Barbara Ha, Yoolim Seo, Ashlee M Weaver, Fouzia Zahid Ali Khan, Victoria L Handa","doi":"10.1097/SPV.0000000000001567","DOIUrl":"10.1097/SPV.0000000000001567","url":null,"abstract":"<p><strong>Importance: </strong>Initial management for overactive bladder includes behavioral modification with avoidance of bladder irritants. However, in 2017, the International Consultation on Incontinence concluded that more research is needed to determine the precise role of these irritants in the treatment of overactive bladder.</p><p><strong>Objectives: </strong>The objectives were to identify, evaluate, and summarize peer-reviewed literature examining associations between 6 potential bladder irritants as proposed by the National Institute of Diabetes and Digestive and Kidney Diseases (alcohol; spicy foods; chocolate; artificial sweeteners; caffeinated, carbonated, and citrus beverages; and high-acid foods such as citrus and tomatoes) and OAB symptoms.</p><p><strong>Study design: </strong>We performed a systematic literature search on MEDLINE, EMBASE, and SCOPUS. An adapted version of the patient-intervention-comparison-outcome framework was applied. The risk of bias was assessed using the Risk of Bias in Non-randomized Studies-of Exposures assessment tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023466251).</p><p><strong>Results: </strong>We reviewed 51 unique articles exploring the effect of alcohol (n = 34); spicy foods (n = 1); chocolate (n = 3); artificial sweeteners (n = 5); caffeinated, carbonated, and citrus beverages (n = 27); and high-acid foods (n = 2). The considered outcomes included overactive bladder (n = 16), urgency incontinence (n = 19), urinary urgency (n = 15), frequency (n = 17), and nocturia (n = 17). Overall, observed associations were mixed and inconsistent. The risk of bias was moderate in 23 publications and low for the remaining publications.</p><p><strong>Conclusions: </strong>This systematic review failed to identify consistent evidence of an association between any of these 6 potential bladder irritants and overactive bladder symptoms.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 4","pages":"454-464"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659993","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":"Risk Factors for Wound Complications After Obstetric Anal Sphincter Injury.","authors":"Nicole A Meckes, Coralee T Toal, Li Wang, Lauren E Giugale","doi":"10.1097/SPV.0000000000001642","DOIUrl":"10.1097/SPV.0000000000001642","url":null,"abstract":"<p><strong>Importance: </strong>Wound complications after obstetric anal sphincter injury (OASI) can amplify morbidity and affect quality of life.</p><p><strong>Objective: </strong>The objective of this study was to evaluate for characteristics associated with wound complications after OASI.</p><p><strong>Study design: </strong>This was a retrospective cohort study of patients with an OASI who were evaluated in a postpartum pelvic floor healing clinic between November 1, 2020, and May 16, 2023. Our primary outcome was to identify factors associated with wound complications (wound infection or breakdown, antibiotic treatment, or surgical intervention). We hypothesized that operative vaginal delivery would be associated with wound complications and that peripartum antibiotics would be protective. Statistical analyses included t tests, chi-square test, Fisher exact test, and multivariable logistic regression.</p><p><strong>Results: </strong>Of 332 patients with an OASI, 74 (22.3%) experienced a wound complication. There were 31 (9.3%) wound infections and 62 (18.7%) wound breakdowns; 50 (15.1%) patients received additional antibiotics, and 20 (6.0%) underwent additional surgical intervention. On univariate analysis, those with wound complications were older (31.9 vs 30.6 years, P = 0.01) and more likely to have had an episiotomy (23.0% vs 12.5%, P = 0.03). On multivariable logistic regression, older maternal age was associated with wound complication (odds ratio, 1.1, 95% CI, 1.01-1.13, P = 0.03), and peripartum antibiotics were associated with decreased odds of wound complication (odds ratio, 0.57, 95% CI, 0.33-0.97, P = 0.04). Patients with wound complications were more likely to undergo in-office procedures ( P < 0.001) and report postpartum pain ( P < 0.001), urinary incontinence ( P = 0.02), fecal urgency ( P = 0.02), and other symptoms ( P = 0.04).</p><p><strong>Conclusions: </strong>Older maternal age was associated with wound complications after OASI, while peripartum antibiotics were protective. Patients with wound complications were more likely to report symptoms of pelvic floor disorders.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"405-411"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916410","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":"Supplemental Lidocaine Patches Prior to Percutaneous Nerve Evaluation, a Randomized Trial.","authors":"Rodger W Rothenberger, Taylen Henry, Laurel Carbone, Jeremy T Gaskins, Ankita Gupta, Sean Francis, Stacy M Lenger","doi":"10.1097/SPV.0000000000001624","DOIUrl":"10.1097/SPV.0000000000001624","url":null,"abstract":"<p><strong>Importance: </strong>Improving patient comfort during percutaneous nerve evaluation (PNE), a trial procedure for sacral neuromodulation, is essential.</p><p><strong>Objective: </strong>The aim of the study was to determine whether the use of a lidocaine patch (LP) prior to PNE procedure improves the pain associated with PNE.</p><p><strong>Study design: </strong>This double-masked, randomized controlled trial compared a 4% LP to placebo patch (PP) immediately prior to PNE. Female patients ≥18 years of age were included if they were undergoing an office PNE, performed bilaterally and without fluoroscopy, for any indication. Either a lidocaine or placebo patch was placed over the sacrum 30 minutes prior to PNE. Additional local anesthesia with 2% lidocaine without epinephrine was administered per surgeon discretion. All patients received some volume of injectable lidocaine with their procedures. Secondary outcomes included volume of injectable lidocaine used, progression to a permanent implant, amplitude of perineal sensation, and patient satisfaction.</p><p><strong>Results: </strong>Thirty-nine women were enrolled, with 20 receiving LP and 19 patients receiving PP. Lower 100-mm visual analog scale pain score was seen in the LP group (45 ± 17 with LP vs 61 ± 21 with PP, P = 0.018). This difference was statistically and clinically significantly different between groups. The total injectable lidocaine, patient satisfaction, and progression to permanent implant were similar between groups.</p><p><strong>Conclusions: </strong>Patients experienced clinically and statistically significantly less pain at the time of PNE with a preprocedural LP when compared to placebo, despite similar use of local anesthetic. Satisfaction rates were high among all patients.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"377-383"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517448","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}