Urogynecology (Hagerstown, Md.)最新文献

{"title":"A Prediction Model for Pelvic Floor Recovery After Vaginal Birth With Risk Factors.","authors":"Pamela S Fairchild, Lisa Kane Low, Mary Duarte Thibault, Katherine M Kowalk, Giselle E Kolenic, Dee E Fenner","doi":"10.1097/SPV.0000000000001556","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001556","url":null,"abstract":"<p><strong>Importance: </strong>Although parturients report few postpartum symptoms, birth is clearly associated with future symptom development. The ability to identify asymptomatic at-risk women would facilitate prevention.</p><p><strong>Objective: </strong>The aim of the study was to develop a model predicting abnormal recovery in women at risk for childbirth-associated pelvic floor injury.</p><p><strong>Study design: </strong>Women undergoing first vaginal birth at high risk of pelvic floor injury underwent examinations and ultrasound imaging and completed 6-week and 6-month postpartum questionnaires. We defined \"abnormal\" recovery as having ≥1 of the following 3 findings: (1) levator ani injury, (2) decreased objective pelvic floor strength, and (3) Pelvic Organ Prolapse Quantification point Bp ≥0. Descriptive statistics and bivariate analyses compared \"normal\" and \"abnormal\" recovery. Birth characteristics, 6-week examinations, and questionnaires potentially predicted abnormal recovery at 6 months. Significant variables were included as candidates in the multivariable logistic regression predicting \"abnormal\" recovery after birth.</p><p><strong>Results: </strong>Fifty-four women (63.5%) had normal and 31 (36.5%) had abnormal recovery at 6 months. At 6 weeks, women with abnormal recovery had decreased pelvic floor strength by Oxford scores (3 [2-5], 6 [2-8]; P = 0.002), lower point Bp (-1 [-3 to 0], -2 [-3 to -1]; P = 0.02), larger genital hiatus (4 [3 to 4], 3 [3 to 3.5]; P = 0.02), and higher levator ani injury rate (76.7%, 22.4%; P < 0.001). Between-group questionnaire differences were not clinically significant. Our final model included postpartum examination findings or birth characteristics: Oxford Scale, 6-week Pelvic Organ Prolapse Quantification GH strain, infant head circumference, and second stage ≥120 minutes. The area under the curve for predicting abnormal recovery at 6 months was 0.84, indicating a good sensitivity and specificity balance.</p><p><strong>Conclusion: </strong>The model identifies women at risk for an abnormal recovery trajectory.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636070","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":"Factors Associated With Pelvic Organ Prolapse in Postmenopausal South Korean Women.","authors":"Tae-Ran Kim, Hee-Yeong Jung, Myoung-Hwan Kim, Jin-Sung Yuk","doi":"10.1097/SPV.0000000000001535","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001535","url":null,"abstract":"<p><strong>Importance: </strong>This study identifies key risk factors for pelvic organ prolapse (POP) in Korean women, providing valuable insights for prevention and personalized care.</p><p><strong>Objectives: </strong>The aim of this study was to identify risk factors for POP in Korean women.</p><p><strong>Study design: </strong>This retrospective case-control study analyzed 2003-2011 Korean health checkup data in postmenopausal women diagnosed with POP (cases) and age-matched controls without POP (1:4 ratio) to identify risk factors.</p><p><strong>Results: </strong>Of 2,506,271 participants, 34,648 patients were selected for the POP group and 138,592 patients were selected for the control group. The risk of POP was found to be increased with overweight (body mass index, 23-24.9: odds ratio [OR], 1.146; 95% confidence interval [CI], 1.1-1.196; body mass index, 25-29.9: OR, 1.142; 95% CI, 1.097-1.189) and multiple childbirths (2 times: OR, 1.52; 95% CI, 1.39-1.653; ≥3: OR, 1.639; 95% CI, 1.493-1.8). The risk of POP was found to be decreased with smoking (OR, 0.769; 95% CI, 0.688-0.861), alcohol drinking (3-6/week: OR, 0.65; 95% CI, 0.557-0.758), and exercise (1-2/week: OR, 0.904; 95% CI, 0.862-0.947; 3-4/week: OR, 0.896; 95% CI, 0.844-0.951; 5-6/week: OR, 0.87; 95% CI, 0.788-0.96).</p><p><strong>Conclusions: </strong>This study found that overweight and multiple childbirths were associated with an increased risk of POP. Smoking, alcohol drinking, and exercise reduced the risk of POP, but socioeconomic status, age at menarche, and age at menopause were not found to be associated with POP.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592315","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":"Geographic Access to Urogynecology Care in the United States.","authors":"Eleanor M Schmidt, Lucy Ward, W Thomas Gregory, Sara B Cichowski","doi":"10.1097/SPV.0000000000001547","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001547","url":null,"abstract":"<p><strong>Importance: </strong>Although access to urogynecologic care is known to influence patient outcomes, less is known regarding geographic access to care and how it may vary by population characteristics.</p><p><strong>Objective: </strong>The primary objective of this study was to estimate geographic accessibility of urogynecologic services in terms of drive time and by population demographics.</p><p><strong>Study design: </strong>We performed a descriptive study using practice location data by zip code for all board-certified urogynecologists who are American Urogynecologic Society members (n = 497) and pelvic floor physical therapists (n = 985). Drive times from each zip code to the nearest health care professional zip code were calculated. These data were then overlaid onto a map of the continental United States. Race/ethnicity, age, education, poverty status, disability status, health insurance coverage, and rurality were compared across travel times.</p><p><strong>Results: </strong>Of the 31,754 zip codes of the continental United States, 389 (1.23%) had at least 1 urogynecologist, and 785 (2.47%) had at least 1 pelvic floor physical therapist; 92.29 million women older than 35 years were represented in the demographic analyses. Seventy-nine percent of the studied population live within 1 hour of a urogynecologist, and 85% live within 1 hour of a pelvic floor physical therapist. Seven percent and 3% live >2 hours from urogynecologic services, respectively. Values for drive times to all health care professionals indicate that American Indian/Alaska Native individuals have a much greater travel burden than other racial/ethnic groups.</p><p><strong>Conclusions: </strong>There are population groups with limited geographic access to urogynecologic services. Pelvic floor physical therapists are more geographically accessible to the population studied than urogynecologists.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636071","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":"Dynamic Changes of the Genital Hiatus at the Time of Prolapse Surgery: 1-Year Follow-Up Study.","authors":"Olivia H Chang, Cecile A Ferrando, Marie Fidela R Paraiso, Katie Propst","doi":"10.1097/SPV.0000000000001537","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001537","url":null,"abstract":"<p><strong>Importance: </strong>The genital hiatus (GH) has been identified as a predictor of pelvic organ prolapse. An enlarged preoperative GH is a risk factor for recurrent prolapse after surgery.</p><p><strong>Objective: </strong>The objective of this study was to determine the changes in preoperative and postoperative GH size compared with the intraoperative resting GH at 6 weeks and 12 months after native-tissue pelvic organ prolapse surgery.</p><p><strong>Study design: </strong>This was a descriptive analysis of a prospective cohort study of women undergoing native-tissue prolapse repair with apical suspension. Resting GH was obtained at the start and conclusion of surgery. Measurements were obtained preoperatively, and 6 weeks and 12 months postoperatively under Valsalva maneuver. Comparisons were made using paired t tests for the following time points: (1) preoperative measurements under Valsalva maneuver to resting presurgery measurements under anesthesia, and (2) resting postsurgery measurements under anesthesia to 6 weeks and 12 months postoperatively under Valsalva maneuver.</p><p><strong>Results: </strong>Sixty-seven patients were included, with a median age of 66 years and median body mass index (calculated as weight in kilograms divided by height in meters squared) of 29.1. There was no significant difference in GH when measured preoperatively to resting presurgical measurements under anesthesia (P = 0.60). For all, the median GH was 3.0 cm at the conclusion of surgery and remained at 3.0 cm at 6 weeks and 12 months postoperatively. In patients who had a concurrent posterior colporrhaphy, the median resting postsurgery GH was 3.0 cm, then decreased to 2.5 cm at 6 weeks then 3.5 cm at 12 months under Valsalva.</p><p><strong>Conclusions: </strong>Preoperative GH size under Valsalva maneuver and resting under anesthesia were comparable. For all patients undergoing native-tissue pelvic organ prolapse repair, the genital hiatus size remains the same from the intraoperative final resting measurements to the 6-week and 12-month measurements under Valsalva maneuver.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592290","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":"A Randomized Controlled Trial of Consent for Patients Undergoing Transobturator Slings.","authors":"Veronica Demtchouk, William D Winkelman, Ronald M Cornely, Anna Modest, Michele R Hacker, Eman A Elkadry","doi":"10.1097/SPV.0000000000001543","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001543","url":null,"abstract":"<p><strong>Importance: </strong>Improving patients' recall and understanding of their planned surgery is essential for fully informed consent.</p><p><strong>Objective: </strong>The objective of this study was to assess if the addition of an information handout to the standard preoperative consent process for the transobturator midurethral sling procedure improved patient understanding, recall, and satisfaction.</p><p><strong>Study design: </strong>This is a randomized controlled trial of adult women undergoing a transobturator midurethral sling procedure for the treatment of stress urinary incontinence. After standard counseling, participants were randomly assigned to either the control or the intervention group, with the latter receiving an extra informational handout detailing surgical information. Before surgery, all participants filled out a questionnaire assessing key points discussed during the surgical consent, which was used to calculate a knowledge score, the primary endpoint. Secondary outcomes included perception of the consent process and patient satisfaction.</p><p><strong>Results: </strong>Of 98 randomized participants (50 control, 48 intervention), knowledge scores were 43% for controls and 57% for the intervention group (P = 0.015). Despite low scores, high self-rated understanding and satisfaction were noted across both groups (78% control, 71% intervention, P = 0.4). Notably, younger individuals, those with some college education, and patients undergoing additional prolapse surgery benefited most from the handout.</p><p><strong>Conclusions: </strong>The informational handout improved knowledge scores, though overall knowledge scores were low in both groups. High satisfaction and perceived understanding of the planned procedure persisted, but the addition of a handout was not associated with a significant difference in knowledge scores.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592289","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":"Obstetric Anal Sphincter Injury: Interpregnancy Interval and Route of Subsequent Delivery.","authors":"Alexandra C Nutaitis, Meng Yao, Lisa C Hickman, Swapna Kollikonda, Katie A Propst","doi":"10.1097/SPV.0000000000001551","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001551","url":null,"abstract":"<p><strong>Importance: </strong>Knowledge on the interpregnancy interval (IPI) among women with an obstetric anal sphincter injury (OASI) is both limited and not well understood.</p><p><strong>Objectives: </strong>The objectives of this study were to describe the IPI among women with OASI and to compare women with OASI based on the route of subsequent obstetric delivery and OASI recurrence.</p><p><strong>Study design: </strong>This was a retrospective single-cohort study of women who had an OASI between 2013 and 2015 at a tertiary academic medical center. Demographics, obstetric delivery data, postpartum sequelae, and subsequent pregnancy delivery data from 2013 to 2021 were collected. The IPI was defined as the time from date of first vaginal delivery to date of conception of the subsequent pregnancy. Women without a subsequent pregnancy were censored at the date of last contact. The IPI was evaluated using a survival analysis (Kaplan-Meier estimator).</p><p><strong>Results: </strong>A total of 287 women experienced an OASI, and subsequent pregnancy occurred for 178 (62.0%) women. The median IPI was 26.4 months (95% confidence interval: 23.7-29.9) for women with a prior OASI. Of the 97 women who did not have a subsequent pregnancy documented during the study, the median follow-up was 64.0 months (interquartile range: 5.7-80.0). Subsequent delivery route data were available for 171 women; of those, 127 (74.3%) experienced a subsequent vaginal delivery and 44 (25.7%) experienced a cesarean delivery. Of the 127 women who experienced a subsequent vaginal delivery, 3 (2.4%) experienced a recurrent OASI.</p><p><strong>Conclusion: </strong>The IPI among women with OASI is similar to the IPI for all women in Ohio and in the United States.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494574","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":"Comparative Analysis of Performance of Large Language Models in Urogynecology.","authors":"Ghanshyam S Yadav, Kshitij Pandit, Phillip T Connell, Hadi Erfani, Charles W Nager","doi":"10.1097/SPV.0000000000001545","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001545","url":null,"abstract":"<p><strong>Importance: </strong>Despite growing popularity in medicine, data on large language models in urogynecology are lacking.</p><p><strong>Objective: </strong>The aim of this study was to compare the performance of ChatGPT-3.5, GPT-4, and Bard on the American Urogynecologic Society self-assessment examination.</p><p><strong>Study design: </strong>The examination features 185 questions with a passing score of 80. We tested 3 models-ChatGPT-3.5, GPT-4, and Bard on every question. Dedicated accounts enabled controlled comparisons. Questions with prompts were inputted into each model's interface, and responses were evaluated for correctness, logical reasoning behind answer choice, and sourcing. Data on subcategory, question type, correctness rate, question difficulty, and reference quality were noted. The Fisher exact or χ2 test was used for statistical analysis.</p><p><strong>Results: </strong>Out of 185 questions, GPT-4 answered 61.6% questions correctly compared with 54.6% for GPT-3.5 and 42.7% for Bard. GPT-4 answered all questions, whereas GPT-3.5 and Bard declined to answer 4 and 25 questions, respectively. All models demonstrated logical reasoning in their correct responses. Performance of all large language models was inversely proportional to the difficulty level of the questions. Bard referenced sources 97.5% of the time, more often than GPT-4 (83.3%) and GPT-3.5 (39%). GPT-3.5 cited books and websites, whereas GPT-4 and Bard additionally cited journal articles and society guidelines. Median journal impact factor and number of citations were 3.6 with 20 citations for GPT-4 and 2.6 with 25 citations for Bard.</p><p><strong>Conclusions: </strong>Although GPT-4 outperformed GPT-3.5 and Bard, none of the models achieved a passing score. Clinicians should use language models cautiously in patient care scenarios until more evidence emerges.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494570","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":"Measurement of Physical Activity Using Fitness Trackers Before and After Midurethral Sling.","authors":"Zebulun S Cope, J Ryan Stewart, Ankita Gupta, Deslyn T G Hobson, Jenna Warehime, Rehan Feroz, Sarah Scheidel, Kate V Meriwether, Stacy M Lenger, Jeremy T Gaskins, Sharmin Sumy, Sean Francis","doi":"10.1097/SPV.0000000000001549","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001549","url":null,"abstract":"<p><strong>Importance: </strong>Urinary incontinence can be a barrier to performing physical activities for many women. A midurethral sling (MUS) has shown symptom improvement for women experiencing stress urinary incontinence (SUI), suggesting the hypothesis that physical activity rates should increase after treatment.</p><p><strong>Objective: </strong>The aim of this study was to determine the change in objectively measured physical activity levels in women following placement of MUS for SUI.</p><p><strong>Study design: </strong>In this prospective cohort study, patients undergoing MUS placement, with or without concomitant pelvic reconstructive surgery, were provided a commercial activity tracker. Physical activity was tracked for at least 1 week preoperatively and up to 6 months postoperatively. Participants were required to wear the tracker for at least 2 weeks in the postoperative period. The primary outcome, mean caloric daily expenditure (MCDE), was compared preoperatively and postoperatively.</p><p><strong>Results: </strong>Seventy-two patients met criteria for data inclusion. The device was worn for a mean of 18.4 ± 12.1 days preoperatively and 91.7 ± 53.3 days postoperatively. Mean participant age was 51.9 ± 9.4 years. The MCDE was significantly higher postoperatively (preoperatively: 1,673 kcal/d vs postoperatively: 2,018 kcal/d; P < 0.01). There were no significant differences in postoperative MCDE in participants who had only MUS as the primary procedure versus participants who also had a concomitant procedure (2,020 ± 216 kcal/d vs 2,015 ± 431 kcal/d; P = 0.95). Of participants with class II/III obesity, 45% had at least a 500 kcal/d increase postoperatively.</p><p><strong>Conclusions: </strong>Treatment of SUI with MUS is associated with a significantly greater caloric expenditure in the postoperative period.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494573","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":"Experiences of Black Women With Pelvic Floor Disorders-A Qualitative Analysis Study.","authors":"Jennifer Chyu, Oriyomi Alimi, Shreeya Popat, Gjanje Smith-Mathus, Una J Lee","doi":"10.1097/SPV.0000000000001542","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001542","url":null,"abstract":"<p><strong>Importance: </strong>Disparities research in Black women with pelvic floor disorders (PFDs) has primarily focused on epidemiology or surgical outcomes, but little is known about the patient perspective on seeking PFD care.</p><p><strong>Objective: </strong>To provide quality and equitable care to Black women with PFDs, we conducted a qualitative study to hear their perspectives and lived health care experiences.</p><p><strong>Study design: </strong>Black women seeking care for PFDs at a tertiary care institution were invited to participate in qualitative interviews. Open-ended questions explored participants' knowledge, attitudes, and health care experiences. Interviews were transcribed verbatim and coded line-by-line. Inductive content analysis was performed to identify key themes, and consensus was achieved among the research team.</p><p><strong>Results: </strong>Eight Black women aged 21-83 years consented to participate. Patients noted a stigma surrounding PFDs, both among health care professionals and their community. They noted several barriers to care: financial, logistical, and racial bias. They cited difficulties in patient-health care professional communication, including not feeling heard or treated as an individual. They preferred gender and racial concordance with their physicians. These women expressed both a desire for more knowledge and to share this knowledge and advocate for other women.</p><p><strong>Conclusions: </strong>Black women expressed distinct obstacles in their PFD health care. They reported not feeling heard or treated as a unique individual. The themes derived from this study identify complex patient-centered needs that can serve as the basis for future quality improvement work and/or hypothesis-driven research. By grounding health disparities research in patient perspectives, we can improve the health care experiences of Black women.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494571","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":"Symptomatic Autonomic Dysfunction in Interstitial Cystitis/Bladder Pain Syndrome.","authors":"Rory Ritts, Dylan Wolff, Mary Namugosa, Fang-Chi Hsu, Kaylee Ferrara, Robert Evans, Stephen J Walker","doi":"10.1097/SPV.0000000000001536","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001536","url":null,"abstract":"<p><strong>Importance: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) is a highly prevalent condition with incompletely understood pathophysiology, especially in relation to the systemic symptoms experienced. The role of autonomic nervous system dysfunction in IC/BPS remains poorly understood.</p><p><strong>Objective: </strong>The purpose of this study was to assess the relationship between autonomic symptom severity and clinical characteristics of patients with IC/BPS.</p><p><strong>Study design: </strong>This is a retrospective cohort study of 122 IC/BPS patients who completed the Composite Autonomic Symptoms Score (COMPASS-31) questionnaire. Data were collected on anesthetic bladder capacity (BC), Hunner lesion (HL) status, results for validated IC/BPS symptom questionnaires (O'Leary Sant Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index (ICSI/ICPI) and the Pelvic Pain and Urgency/Frequency (PUF) scale), and comorbid nonurologic associated syndromes. Using the first quartile of COMPASS-31 scores as the cutoff, we compared patients within the first quartile (low symptom load; n = 30), to the remainder of the patients (high symptom load; n = 92).</p><p><strong>Results: </strong>Patients scoring ≥20.36 were significantly less likely to be HL positive (10.9% vs 26.7%; P = 0.043) and had a significantly higher BC (823.10 ± 396.07 vs 635.00 ± 335.06; P = 0.027), higher scores on the PUF questionnaire (23.80 ± 4.98 vs; 19.61 ± 5.22 P < 0.001), and a higher number of nonurologic associated syndromes (5.65 ± 2.90 vs 2.60 ± 1.89; P < 0.001).</p><p><strong>Conclusions: </strong>Patients with IC/BPS experience widespread symptoms associated with autonomic nervous system dysfunction. A higher symptom load strongly correlates with a nonbladder-centric phenotype. These findings provide further evidence that total body nervous system dysfunction is present in patients with nonbladder centric IC/BPS.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494575","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}