Urogynecology (Hagerstown, Md.)最新文献

{"title":"A Multicenter Prospective Cohort Study of Antibiotics for OnabotulinumtoxinA.","authors":"Elise Morocco, Lannah Lua-Mailland, Adrienne Werth, Danielle Carr, Sarah Rabice, Sarah Ashmore, Vi Duong, Margaret Wilkes, Wesley Nilsson, Tanaz Ferzandi","doi":"10.1097/SPV.0000000000001621","DOIUrl":"10.1097/SPV.0000000000001621","url":null,"abstract":"<p><strong>Importance: </strong>Urinary tract infection (UTI) is the most common complication of intradetrusor onabotulinumtoxinA (BTX-A) injection. Despite this, there are no evidence-based guidelines on antibiotic prophylaxis.</p><p><strong>Objectives: </strong>Our primary aim was to determine whether antibiotic prophylaxis decreased symptomatic, culture-proven UTI rates within 6 weeks of intradetrusor BTX-A injection. Our secondary aims were to determine if there are differences between antibiotic regimens and to identify risk factors for developing a UTI.</p><p><strong>Study design: </strong>This was a prospective, observational multicenter cohort study of female patients receiving BTX-A for idiopathic overactive bladder. We compared patients who received antibiotics (nitrofurantoin or trimethoprim-sulfamethoxazole) to those who did not. To detect a 15% difference in UTI rates between groups (80% power, alpha = 0.05), 270 participants were needed.</p><p><strong>Results: </strong>A total of 282 participants ultimately received BTX-A and were included in the analysis. One hundred eighty-one (62.6%) were in the antibiotic cohort and 101 (35.8%) were in the no-antibiotic cohort. The overall rate of symptomatic, culture-proven UTI was 12.1%, and there was no difference between the antibiotic and no-antibiotic cohort (10.6% vs 14.9%, respectively; P = 0.29). On multivariable logistic regression, UTI was associated with older age (adjusted odds ratio [aOR], 1.07; 95% CI, 1.02-1.11), BTX-A dose of 200 units (aOR, 4.24; 95% CI, 1.45-12.35), and self-catheterization (aOR, 26.0; 95% CI, 3.62-186.5). The odds of symptomatic UTI were lower among postmenopausal participants (aOR, 0.13; 95% CI, 0.02-0.68) and participants in the Northeast United States (aOR, 0.23; 95% CI, 0.08-0.72).</p><p><strong>Conclusions: </strong>Our study did not find a lower rate of symptomatic, culture-proven UTI among participants who took antibiotics compared with those who did not.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"258-265"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848638","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":"Transcutaneous Tibial Nerve Stimulation for Urge Incontinence: A Randomized Clinical Trial.","authors":"Nemi M Shah, Emily S Lukacz, Kimberly L Ferrante, Shawn A Menefee","doi":"10.1097/SPV.0000000000001616","DOIUrl":"10.1097/SPV.0000000000001616","url":null,"abstract":"<p><strong>Importance: </strong>Overactive bladder is a distressing syndrome that significantly affects quality of life. Transcutaneous tibial nerve stimulation (TTNS) has been proposed as a home-based, patient-centered therapy that could improve access to treatment for this condition.</p><p><strong>Objective: </strong>We aimed to determine the efficacy of 12 weeks of TTNS versus sham therapy in reducing symptomatic bother in ambulatory women with urgency urinary incontinence.</p><p><strong>Study design: </strong>This was a double-masked, sham-controlled randomized trial. The primary outcome was the change in Overactive Bladder Questionnaire scores. Secondary outcomes included those with 50% or greater reduction in urgency incontinence episodes on 3-day voiding diaries and Patient Global Impression of Improvement.</p><p><strong>Results: </strong>One hundred women were randomized (65 intervention, 35 sham) and included in analysis. Both groups experienced clinically meaningful improvement in Overactive Bladder Questionnaire scores postintervention from baseline, which was not significant between groups (symptom severity: intervention -19.5 ± 20.2 vs sham -19.4 ± 20.4, P = 1.0; health-related quality of life -16.6 ± 18.5 vs -13.8 ± 16.8, P = 0.5). In the TTNS group, 58.8% of women achieved 50% or greater reduction in urgency incontinence episodes versus 41.7% of women in the sham group ( P = 0.2), and 25% versus 18% were \"much\" or \"very much improved\" ( P = 0.2). A sensitivity analysis confirmed these findings.</p><p><strong>Conclusions: </strong>Clinically meaningful reductions in overactive bladder symptoms were observed in both TTNS and sham therapy without significant differences between groups; however, a trend toward greater reduction in incontinence episodes and overall impression of improvement was noted in the active treatment. The therapeutic benefit from regularly connecting with a clinician should be considered when developing new therapies.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"225-233"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775523","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":"Surgical Site Infection After Sacral Neuromodulation: Impact of Postoperative Antibiotics.","authors":"Luke J King, Sarah L Ashmore, Hannah L Chapman, Collin M McKenzie, Bayley E Clarke, Sarah K Rozycki, Rodger W Rothenberger, Jared M Floch, Nageena R Khalid, Brittany L Roberts, Mildred N Bonglack, Charles R Rardin","doi":"10.1097/SPV.0000000000001627","DOIUrl":"10.1097/SPV.0000000000001627","url":null,"abstract":"<p><strong>Importance: </strong>There are limited data to guide practices to reduce surgical site infections following sacral neuromodulation; however, many surgeons prescribe prophylactic postoperative antibiotics after device implantation.</p><p><strong>Objective: </strong>The aim of the study was to compare the proportion of patients with sacral neuromodulation device-associated surgical site infections after use of prophylactic postoperative antibiotics versus none.</p><p><strong>Study design: </strong>This was a multicenter retrospective cohort study of patients undergoing sacral neuromodulation device implantation at 11 institutions from January 2014 to December 2023, comparing outcomes in patients who did versus did not receive prophylactic postoperative antibiotic treatment. The primary outcome was surgical site infection within 90 days. The proportions of surgical site infections were compared, and regression analyses were performed to identify variables associated with surgical site infection.</p><p><strong>Results: </strong>A total of 1,798 patients met inclusion criteria. Within this population, 67 surgical site infections (3.7%) were identified. Patients who received postoperative antibiotics (898/1798, 49.9%) were older (63.2 years vs 61.0 years, P < 0.001), and a greater proportion had staged procedures (57.9% vs 49.8%, P < 0.001). The proportion of surgical site infections and device explantations were not different between groups (3.6% vs 3.9%, P = 0.8) and (2.0% vs 2.8%, P = 0.2), respectively. After adjusting for age in a multivariate analysis, prophylactic postoperative antibiotic use was not associated with surgical site infections (0.98, 95% CI: 0.61-1.61, P = 0.94).</p><p><strong>Conclusions: </strong>Rates of surgical site infection following device implantation are low. Our findings suggest that the use of prophylactic postoperative antibiotics has minimal effect on reducing infection after device implantation. Further research is needed to explore underlying factors influencing this relationship.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"301-308"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959994","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":"Unequal Access and Overall Scarcity of Apical Suspension in Native Tissue Prolapse Repair.","authors":"Eleanor M Schmidt, Lauren Nicola-Ducey, Blake Osmundsen, Sara Cichowski","doi":"10.1097/SPV.0000000000001637","DOIUrl":"10.1097/SPV.0000000000001637","url":null,"abstract":"<p><strong>Importance: </strong>Evaluation of racial and ethnic differences in apical suspension during prolapse repair is crucial for equitable gynecological care.</p><p><strong>Objective: </strong>The objective was to assess racial and ethnic disparities in apical suspension during native tissue prolapse repair.</p><p><strong>Study design: </strong>We analyzed data from the 2019 Healthcare Cost and Utilization Project National Inpatient Sample and Nationwide Ambulatory Surgery Sample, using Current Procedural Terminology and International Classification of Diseases, Tenth Revision, codes. Bivariate analysis identified demographic and hospital-based differences between native tissue apical suspension procedures versus non-apical suspension during vaginal hysterectomy for prolapse, further analyzed with multivariable logistic regression. A separate analysis examined posthysterectomy prolapse surgical procedures.</p><p><strong>Results: </strong>Of the 62,553 vaginal hysterectomies, 26,094 (41%) were for prolapse. Among these, 14,027 (54%) included apical suspension. The cohort's racial and ethnic identity was 73% non-Hispanic White, 5% Black, 15% Hispanic, 3% Asian, 0% Native American, and 3% other. Multivariable analysis confirmed Black patients were more likely to receive apical suspension compared to non-Hispanic White patients (adjusted odds ratio [aOR] 1.26, 95% CI: 1.04-1.53, P = 0.02), and Hispanic patients were less likely to receive apical suspension (aOR 0.74, 95% CI: 0.63-0.87, P < 0.001). Among 60,074 posthysterectomy prolapse surgical procedures, only 18% included apical suspension. Compared to non-Hispanic Whites, Black, Hispanic, and Asian patients were less likely to receive apical suspension (Black: aOR 0.8, 95% CI: 0.68-0.95, P = 0.013; Hispanic: aOR 0.89, 95% CI: 0.77-1.04, P = 0.14; Asian: aOR 0.52, 95% CI: 0.41-0.66, P < 0.001).</p><p><strong>Conclusions: </strong>The study highlights persistent racial and ethnic disparities in apical suspension provision. There is a notable lack of apical suspension in native tissue repairs, especially after hysterectomy.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"322-332"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017823","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":"Outcomes at 12, 24, and 36 Months in Women Treated for Pelvic Organ Prolapse With Pessary or Surgery: Results From the Multicenter Pelvic Floor Disorders Registry.","authors":"Uduak U Andy, Leslie Meyn, Heidi W Brown, Pamela A Moalli, Cecile A Ferrando, Stuart Shippey, Ukpebo R Omosigho, Joseph T Kowalski, Noelani M Guaderrama, Jennifer T Anger, Raymond T Foster, Robert E Gutman, Ladin Yurteri-Kaplan","doi":"10.1097/SPV.0000000000001669","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001669","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe real-world outcomes in women treated for pelvic organ prolapse (POP) with pessary or surgery over 36 months.</p><p><strong>Study design: </strong>We report outcomes of patients in a multicenter, prospective registry who opted for treatment of POP with either pessary (discontinuation or retreatment with surgery rates and subjective improvement) or surgery (retreatment rates or subjective improvement).</p><p><strong>Results: </strong>Among 1,153 patients, follow-up was available for 248 (84%), 123 (42%), and 98 (33%) in the pessary group and 717 (93%), 407 (53%), and 331 (43%) in the surgery group at 12, 24, and 36 months, respectively. In the pessary group, rates of discontinuation and retreatment decreased over time with 82/248 patients (33%) discontinuing pessary use at 12 months, of whom 32 (39%) had surgery, 17/123 (14%) discontinuing at 24 months, of whom 7 had surgery, and 5/98 (5%) discontinuing at 36 months, of whom 2 had surgery. Subjective recurrence rates were 76/147 (52%), 4/99 (4%), and 11/87 (13%) at 12, 24, and 36 months, respectively. In the surgery group, the rate of retreatment was 15/717 (2%), 6/407 (1%), and 5/331 (2%) and the rate of subjective recurrence was 71/717 (10%), 8/407 (2%), and 13/331 (4%) at 12, 24, and 36 months.</p><p><strong>Conclusions: </strong>In this real-world registry, we observed that approximately one third of patients discontinued pessary use during the first 12 months, which decreased over time. There were low rates of reintervention following surgical management over the 36-month period. Our data provide valuable information that may be helpful for clinicians in counseling patients about management of their POP.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569178","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 Bowel Diary Completion and Education on Fecal Incontinence Severity.","authors":"Uduak U Andy, Benjamin Carper, Halina Zyczynski, Abhishek Sripad, Keisha Y Dyer, Joseph Schaffer, Donna Mazloomdoost, Marie G Gantz","doi":"10.1097/SPV.0000000000001660","DOIUrl":"10.1097/SPV.0000000000001660","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the effect of a run-in period on fecal incontinence (FI) symptom severity.</p><p><strong>Study design: </strong>This study conducted a planned secondary analysis of the run-in period to a study evaluating the effect of 12-week treatment with percutaneous tibial nerve stimulation versus sham in reducing FI severity in women. All participants completed a 4-week run-in period designed to exclude from randomization women whose symptoms reduced below the eligibility threshold after receiving education on FI and completing bowel diaries. Change in St Mark's (Vaizey) score and weekly FI episodes during the run-in period (week 1 vs week 4) was assessed.</p><p><strong>Results: </strong>One hundred and eighty-five women completed the run-in period. The mean St Mark's (Vaizey) score was 17.8 ± 2.6 and 16.9 ± 3.5 at week 1 and week 4, respectively. There was no significant change in the St Mark's (Vaizey) score from week 1 to week 4 (mean change, -0.93 [95% CI, -1.56 to -0.31]). The average number of FI episodes per week did not change significantly between week 1 and week 4, nor did other bowel diary measures. Only 11 (6%) women became ineligible for the trial following the run-in period, all of whom had baseline St Mark's (Vaizey) scores of 18 or lower.</p><p><strong>Conclusions: </strong>Completion of a bowel diary and receiving education on FI during the 4-week run-in period did not significantly affect symptom severity in women with FI. Only 6% of women became ineligible for participation following the run-in period, suggesting that, in a refractory population, a run-in period may have minimal effect.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517443","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":"Pelvic Floor Health Knowledge With Enhanced Education During Pregnancy.","authors":"Lauren Nicola-Ducey, Lucy Ward, Amanda Holland, Sara Cichowski, Emily Boniface, W Thomas Gregory","doi":"10.1097/SPV.0000000000001661","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001661","url":null,"abstract":"<p><strong>Importance: </strong>Prior to delivery, there are postpartum pelvic floor recovery topics to provide education on; however, because of a variety of factors, the majority of these are commonly unaddressed, leaving a patient unknowledgeable and unsatisfied.</p><p><strong>Objective: </strong>The primary aim of this study was to determine if providing tailored/targeted pelvic floor disorder education in the peripartum period will improve nulliparous patients' knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI). Our secondary aim was to evaluate if a difference exists in patient satisfaction and understanding.</p><p><strong>Study design: </strong>This was a single-site nonrandomized interventional study evaluating pregnant patients currently enrolled in an interactive electronic educational platform. We evaluated the change in Prolapse and Incontinence Knowledge Questionnaire (PIKQ) scores at 26-27 weeks antepartum and 6 weeks postpartum in 2 separate cohorts, before and after our education intervention was implemented. We also compared the magnitude of the change in PIKQ scores between the nonintervention and intervention postpartum cohorts as our primary outcome.</p><p><strong>Results: </strong>We compared the change in PIKQ mean scores between the control and intervention cohorts and found no statistical difference in change of UI (0.1 ± 1.8 vs 0.5 ± 1.9, P = 0.218) or POP knowledge (0.9 ± 2.5 vs 0.8 ± 2.4, P = 0.681). In addition, no significant change was detected in mean PIKQ UI scores for the control group between the antepartum and postpartum period (9.9 ± 2.4 vs 10.1 ± 2.1, P = 0.445), but there was a statistically significant change in POP knowledge scores (7.0 ± 3.3 vs 7.9 ± 3.1, P < 0.001). In the intervention cohort, there was a statistically significant change in both UI (9.3 ± 2.6 vs 9.8 ± 2.2, P = 0.012) and POP knowledge scores (6.7 ± 3.4 vs 7.5 ± 3.2, P = 0.001).</p><p><strong>Conclusions: </strong>We did not detect a significant difference in mean score change between our cohorts following implementation of a targeted educational intervention using an online educational platform. However, both cohorts had higher than anticipated baseline knowledge on pelvic floor disorders.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494870","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":"Barbed Suture Strength in Sacrocolpopexy: Does Pattern Matter?","authors":"José J Lázaro Weiss, Andrew A Tomaschke, Jennifer J Hamner, Douglass S Hale, Patrina O Agosta, Oluwakemi Ogunmuko, Olivia Reul, J Ryan Stewart","doi":"10.1097/SPV.0000000000001664","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001664","url":null,"abstract":"<p><strong>Importance: </strong>Although barbed suture in sacrocolpopexy is becoming increasingly common, an accepted vaginal attachment pattern for barbed suture has not been established.</p><p><strong>Objective: </strong>This study aimed to compare the structural properties of 3 different barbed suture attachment patterns used to fixate mesh to the vagina during sacrocolpopexy.</p><p><strong>Study design: </strong>Segments of type 1 polypropylene mesh (Restorelle; Coloplast, Humlebaek, Denmark) measuring 6 × 3 cm were affixed to rectus abdominis fascia from 5 fresh-frozen female cadavers. Barbed 6-inch 2-0 polydioxanone (Stratafix; Ethicon, Raritan, NJ) with 3 different attachment patterns and nonbarbed 2-0 polydioxanone were used for fixation. Barbed suture attachment patterns included circular, horizontal, and vertical patterns. Mechanical testing was carried out using a uniaxial tensile test to failure.</p><p><strong>Results: </strong>Tensile testing resulted in similar mechanical properties across all suture attachment pattern groups. Analyses found no significant effect of suture attachment pattern stiffness or the extension at failure. One-way ANOVAs revealed a global effect of suture attachment pattern on the load at failure (P = 0.0188) and energy at failure (P = 0.0435), but this significance was eliminated after controlling for multiple comparisons. A significant (P = 0.0459) increase in ultimate load was found when comparing the horizontal attachment pattern to the vertical attachment pattern.</p><p><strong>Conclusions: </strong>No difference was observed when comparing suture attachment patterns (circular, horizontal, and vertical). However, a statistically significant difference in ultimate load favored the horizontal attachment over the vertical attachment. Furthermore, there was no difference observed when comparing nonbarbed interrupted suture attachment to the 3 barbed suture attachment patterns.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451189","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":"Knowledge of Pelvic Floor Disorders in English- and Spanish-Speaking Postpartum Patients.","authors":"Moiuri Siddique, Emily Passarelli, Carol Shi, Deborah Myers","doi":"10.1097/SPV.0000000000001665","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001665","url":null,"abstract":"<p><strong>Importance: </strong>Postpartum patients generally have limited knowledge of urinary incontinence (UI) and pelvic organ prolapse (POP). However, it is unclear what differences exist in knowledge level between English- and Spanish-speaking postpartum patients for each condition.</p><p><strong>Objective: </strong>The objective of this study was to report rates of knowledge proficiency on UI and POP in English- and Spanish-speaking postpartum patients.</p><p><strong>Study design: </strong>In this cross-sectional study of postpartum patients at a tertiary care center, knowledge was assessed using the English and Spanish language-validated Prolapse and Incontinence Knowledge Questionnaire. Knowledge proficiency on UI was defined as answering correctly ≥80% of the questions and for POP as answering correctly ≥50% of the questions, based on cutoffs implemented by Geynisman-Tan et al previously. Pelvic floor disorder symptom severity was assessed using the Pelvic Floor Distress Inventory-20 and the Pelvic Floor Impact Questionnaire-7.</p><p><strong>Results: </strong>Fifty English- and 50 Spanish-speaking patients completed the survey questionnaires. Spanish-speaking patients had lower rates of UI proficiency compared to English-speaking patients (10.0% vs 40.0%, P < 0.001) and were less likely to identify childbirth to be a risk factor for UI compared to English-speaking patients. For POP, proficiency levels were low but similar between English and Spanish speakers. Pelvic floor disorder symptom severity and impact on quality of life were low, did not differ between the 2 groups, and did not correlate with knowledge scores.</p><p><strong>Conclusion: </strong>English- and Spanish-speaking postpartum patients have low knowledge of both UI and POP. Postpartum patients need educational resources to understand the risks and treatments for pelvic floor disorders.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494698","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":"Can Pharmacogenetics Be Used to Predict the Response to Fesoterodine Fumarate?","authors":"Jennifer M Wu, Nazema Y Siddiqui, Tim Wiltshire, Deepak Voora, Kenneth Schmader","doi":"10.1097/SPV.0000000000001668","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001668","url":null,"abstract":"<p><strong>Importance: </strong>Pharmacogenetics could address the challenge of predicting an individual's response to anticholinergic medications for urgency urinary incontinence (UUI).</p><p><strong>Objectives: </strong>Our objectives were to evaluate whether the metabolizer status of cytochrome p450 2D6 (CYP2D6), the drug metabolizing enzyme for fesoterodine, is associated with effectiveness or moderate/severe adverse events (AEs) from fesoterodine fumarate in women with UUI.</p><p><strong>Study design: </strong>In this pilot pharmacogenetics study, 58 women aged ≥50 with ≥3 UUI episodes on a 3-day bladder diary were treated with fesoterodine. Participants were categorized as normal metabolizers (NM), intermediate (IM), or poor metabolizers (PM) based on their genetic CYP2D6 sequence. Effectiveness was measured by Treatment Benefit Scale (responders were \"improved\" or \"greatly improved\" versus nonresponders were \"not changed\" or \"worsened\"). Moderate and severe AEs were defined by the National Cancer Institute Common Terminology Criteria for Adverse Events.</p><p><strong>Results: </strong>Among 58 women, 34 (58.6%) were NM, 22 (37.9%) were IM, and 2 (3.4%) were PM. Given the small proportion of PM, we compared the NM and IM groups. Regarding effectiveness for UUI, there was no significant difference between metabolizer cohorts at 4 weeks (82.8% vs 94.4%, P = 0.38 for NM vs IM, respectively). Metabolizer status was also not associated with moderate-severe AEs (14.7% vs 13.6% for NM vs IM, P = 1.0).</p><p><strong>Conclusions: </strong>In this pilot study with limited sample size, CYP2D6 normal and IM metabolizer status was not associated with effectiveness or moderate-severe AEs to fesoterodine fumarate. The proportion of poor metabolizers was low; thus, further investigation in this population is warranted.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659984","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}