Urogynecology (Hagerstown, Md.)最新文献

{"title":"Prevalence of Urinary Incontinence in the United States 2015-2020.","authors":"Fatima Jibrel, Vivian Sung, Nageena Khalid, Julia Shinnick","doi":"10.1097/SPV.0000000000001913","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001913","url":null,"abstract":"<p><strong>Importance: </strong>Urinary incontinence (UI) affects quality of life and imposes substantial health care costs. Updated U.S. prevalence estimates are needed, as national data are more than a decade old.</p><p><strong>Objective: </strong>The objective of this study was to estimate the weighted prevalence of symptomatic UI among women in the United States from 2015 to 2020.</p><p><strong>Study design: </strong>This was a cross-sectional analysis of nonpregnant women aged 20 years or older in the 2015-March 2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of the U.S. population. Symptomatic UI was defined as an Incontinence Severity Index score ≥3. Subtypes were categorized as stress, urgency, or mixed. Weighted prevalence estimates were calculated and compared with previously published NHANES data. Associations with clinical and demographic factors were examined with multivariable logistic regression.</p><p><strong>Results: </strong>Among 6,446 participants, the weighted prevalence of UI was 22.3% (95% CI, 20.8-23.8), significantly higher than the 17.1% reported in 2005-2010 (P<0.001). Mixed UI was most common (46.6%), followed by stress (16.2%) and urgency (9.5%). In adjusted models, body mass index (BMI) ≥30 (odds ratio [OR], 2.74; 95% CI, 2.07-3.63), BMI 25.0-29.9 (OR, 1.78; 95% CI, 1.34-2.36), ≥3 comorbidities (OR, 2.12; 95% CI, 1.54-2.93), and increasing age (OR, 1.04 per year; 95% CI, 1.03-1.04) were significantly associated with UI.</p><p><strong>Conclusions: </strong>More than 1 in 5 U.S. women report symptomatic UI, a significant increase compared with prior estimates. Increasing prevalence may reflect population aging and increasing obesity rates.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802692","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":"Effect of Second Sling Type on the Success of Repeat Procedures.","authors":"Haydar Kaya, Mehmet Emre Peker, Can Ata, Ufuk Atlihan, Duygu Uçar Kartal, Duygu Lafci, Gökçe Yildirim, Tibet Koyuncu","doi":"10.1097/SPV.0000000000001917","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001917","url":null,"abstract":"<p><strong>Importance: </strong>The optimal surgical strategy after failed midurethral sling (MUS) surgery remains controversial, and robust comparative data are needed to guide the choice between repeating the same sling type and converting to an alternative approach.</p><p><strong>Objectives: </strong>The objectives of this study were to compare the effectiveness and safety of 4 redo MUS strategies and to assess whether sling-type conversion offers clinical advantages over same-type repetition.</p><p><strong>Study design: </strong>In this multicenter retrospective cohort study (2015-2025), 256 women undergoing redo MUS surgery for persistent or recurrent stress urinary incontinence (SUI) were included. Patients were categorized into 4 groups according to redo sling type: (1) tension-free vaginal tape-retropubic sling (RP)→transobturator sling (TO) (n=33), (2) RP→RP (n=38), (3) TO→ RP (n=92), and (4) TO→TO (n=93). The primary outcome was objective cure at final follow-up. Secondary outcomes included repeat failure, change in International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) severity category, and mesh-related complications. Inverse probability of treatment weighting (IPTW) was applied to adjust for baseline differences.</p><p><strong>Results: </strong>Baseline characteristics were comparable across groups. In IPTW-adjusted analyses, sling-type conversion was associated with significantly higher objective cure rates compared with same-type repetition (83.2% vs 61.8%; OR, 3.44; 95% CI, 1.86-6.37; P=0.001) and lower repeat failure (16.8% vs 38.2%; OR, 0.29; 95% CI, 0.16-0.54; P<0.001). Symptom improvement favored switch strategies, with mild postoperative ICIQ-SF scores observed in more than 80% of conversion groups. Mesh-related complications were also reduced with switching (OR, 0.63; 95% CI, 0.40-0.98), particularly in early redo procedures. In recurrent SUI, the switch strategy continued to show benefit in early recurrence, while in late recurrence (≥36 mo), no clear advantage was demonstrated.</p><p><strong>Conclusions: </strong>Sling-type conversion after failed MUS surgery is associated with superior efficacy and improved safety, supporting an individualized, strategy-driven approach to redo surgery.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765931","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":"Prolapse Education Video for Patient Satisfaction: A Randomized Clinical Trial.","authors":"Christine Santayana, Rachel M Smith, Perrin Downing, Andrew F Hundley, Lisa C Hickman","doi":"10.1097/SPV.0000000000001763","DOIUrl":"10.1097/SPV.0000000000001763","url":null,"abstract":"<p><strong>Importance: </strong>There are significant deficiencies in the general population's knowledge of pelvic floor disorders, including pelvic organ prolapse (POP). Educational videos can equip patients with a better understanding of POP.</p><p><strong>Objectives: </strong>The objectives of this study were to assess whether a previsit POP educational video improves patient satisfaction with their management decision. Secondary outcomes were POP knowledge, patient perception of knowledge, decision conflict, physician perception of patient comprehension, and counseling ease.</p><p><strong>Study design: </strong>This was a physician-blinded, randomized trial. Thirty-seven participants with POP symptoms were assigned to watch a previsit video (video group, n=18) or no video (control group, n=19). Eligibility included age 18 years or older, initial POP evaluation, English-speaking, internet access, and no prior POP treatment, pregnancy, or cognitive disability. Participants completed a baseline, postvisit, and postmanagement survey, which included the Prolapse and Incontinence Knowledge-POP Questionnaire (PIKQ-POP), a self-assessment of POP knowledge, the Satisfaction with Decision Scale for Pelvic Floor Disorders (SDS-PFD), and decision conflict questions. The counseling physicians were surveyed on their perceptions of patient comprehension and counseling ease.</p><p><strong>Results: </strong>After the initial visit, mean SDS-PFD scores were similar (4.89 vs. 4.78; P=0.44). However, the change in PIKQ-POP scores was greater in the video group (2.69 vs. 1.13; P=0.03). The change in self-perception of POP knowledge was also greater in the video group (1.72 vs. 1.05, P=0.02). There were no major differences in decision conflict, physician counseling ease, or perception of patient comprehension.</p><p><strong>Conclusions: </strong>POP video education as a supplemental resource to health care provider counseling did not improve patient decision satisfaction. It may improve POP knowledge from baseline though this study was not powered for this outcome.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"32 8","pages":"950-959"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581630","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":"Response to Letter to the Editor re: \"Nocturnal Polyuria and MACE: Neuroendocrine Links Explaining Sex Differences\" and \"Nocturia and Cardiovascular Events: Risk Factor or Clinical Marker?\"","authors":"Annika Sinha","doi":"10.1097/SPV.0000000000001896","DOIUrl":"10.1097/SPV.0000000000001896","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1018"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321167","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":"Laparoscopic Transvesical Versus Extravesical Uterovesical Fistula Repair.","authors":"Hisham Arafa, Waleed Mousa, Mahmoud Hossam, Mohammed Yassin, Ahmed Farouk","doi":"10.1097/SPV.0000000000001772","DOIUrl":"10.1097/SPV.0000000000001772","url":null,"abstract":"<p><strong>Importance: </strong>Due to the lack of data comparing transvesical (TV) and extravesical (EV) techniques for uterovesical fistulas (UVFs), specifically comparing surgical success rates, intraoperative complications, and postoperative effect on urinary bladder (UB) capacity, we designed our study.</p><p><strong>Objectives: </strong>This study compares laparoscopic TV versus EV repair of UVFs in terms of surgical success, intraoperative complications, postoperative UB capacity, and overactive bladder (OAB) symptoms.</p><p><strong>Study design: </strong>A retrospective observational cohort study was conducted from January 1, 2020 to January 1, 2025, upon patients aged 18 years and older who underwent laparoscopic UVF repair at Ain Shams University Hospital, Cairo, Egypt. Data were collected through a chart review of routinely administered perioperative assessments, including the Overactive Bladder 8-Question Awareness Tool (OAB-V8) and a 3-day voiding diary.</p><p><strong>Results: </strong>Patient demographic characteristics were similar in both groups. Success rates were similar between cohorts. One hysterectomy was performed in the EV group due to intraoperative bleeding. The EV approach had a higher complication rate than the TV group ( P =0.014). The TV approach was associated with a significantly greater reduction in UB capacity compared with the EV approach (97.73±15.39 mL vs. 37.50±22.39 mL, respectively, P =0.001). Concurrently, the TV group demonstrated a significantly higher increase in OAB-V8 scores than the EV group (6.70±0.82 vs. 1.36±0.50, respectively, P =0.001).</p><p><strong>Conclusion: </strong>Both techniques demonstrated efficacy in repairing fistulas. However, the EV approach offered superior functional outcomes, with significantly better preservation of UB capacity and a lower incidence of postoperative OAB symptoms. In contrast, the TV approach may remain preferable in younger patients or those seeking uterine preservation, as it enables precise dissection and repair while minimizing risk to uterine integrity.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"1005-1013"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566666","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 Self-reported Family History of Pelvic Floor Disorders.","authors":"Hannah A Zabriskie, Whitney K Hendrickson, Ingrid E Nygaard, Carolyn W Swenson","doi":"10.1097/SPV.0000000000001766","DOIUrl":"10.1097/SPV.0000000000001766","url":null,"abstract":"<p><strong>Importance: </strong>Although useful to drive prevention efforts, awareness of family history (FH) of pelvic organ prolapse (POP) or urinary incontinence (UI) may be influenced by factors other than the actual presence or absence of POP/UI in a family member. This analysis identifies demographic and clinical factors associated with positive self-reported family history (FH POP/UI +) during the first pregnancy and through 1-year postpartum (1-yr PP).</p><p><strong>Objectives: </strong>Based on self-reported FH during the third trimester, the objectives were to evaluate differences between nulliparous women with and without FH POP/UI +, identify factors associated with FH POP/UI +, and explore whether FH POP/UI + is associated with anatomic POP or moderate/severe UI at 1-yr PP.</p><p><strong>Study design: </strong>In this secondary analysis of a prospective cohort study, multiple logistic regression models tested associations between FH POP/UI + and data collected during the third trimester (n=962), following vaginal delivery at 8 weeks postpartum (8-wk PP, n=659), and 1-yr PP (n=543).</p><p><strong>Results: </strong>Adjusted odds of FH POP/UI + increased with higher education level and decreased if the participant's mother delivered via cesarean at all 3 time points, increased with moderate/severe UI symptoms during pregnancy and at 1-yr PP (not assessed at 8-wk PP), and increased with enlarged genital hiatus and prepregnancy body mass index during pregnancy and at 8-wk PP, but not 1-yr PP. In exploratory analysis, FH POP/UI + was associated with moderate/severe UI ( P <0.001) but not anatomic POP ( P =0.12) at 1-yr PP.</p><p><strong>Conclusions: </strong>FH POP/UI is multifactorial in nature, and future studies could investigate the relative contribution of genetics, cultural, and environmental factors to better characterize this as a risk factor for POP/UI.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"983-990"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12637010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330762","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":"Optimal Anesthesia for Polyacrylamide Hydrogel Injection: A Randomized Trial.","authors":"Neha G Gaddam, Joanna Marantidis, Noha T Ahmed, Rachael D Sussman, Elizabeth T Brown, Alexis A Dieter, Andrew I Sokol, Robert E Gutman, Lee A Richter","doi":"10.1097/SPV.0000000000001757","DOIUrl":"10.1097/SPV.0000000000001757","url":null,"abstract":"<p><strong>Importance: </strong>Despite the popularity of urethral bulking with polyacrylamide hydrogel (PAHG) for stress urinary incontinence (SUI)/intrinsic sphincter deficiency (ISD), no studies have assessed optimal anesthetic protocols.</p><p><strong>Objectives: </strong>To compare pain scores between 2 anesthetic protocols in women undergoing in-office PAHG injection: (1) combined anesthetic [external lidocaine-plus-prilocaine (EMLA) cream, intraurethral lidocaine gel, and lidocaine periurethral block] or (2) topical-only (external EMLA cream and intraurethral lidocaine gel).</p><p><strong>Study design: </strong>This single-blinded trial randomized women to 1 of 2 anesthetic protocols. The primary outcome was pain reported via a 10-point visual analog scale (VAS). Secondary outcomes included International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) and Patient Global Impression of Improvement (PGI-I) scores. A safety endpoint of 3 subjects in the topical-only arm requiring unplanned periurethral block to complete the PAHG procedure, and an a priori sample size of 52 subjects was set.</p><p><strong>Results: </strong>Recruitment stopped at 23 subjects (N=11 combined anesthetic vs. N=12 topical-only) upon meeting the safety endpoint. Mean procedural VAS pain scores were lower with concomitant periurethral block (4.5±2.7 combined anesthetic vs. 7.4±2.3 topical-only; P <0.01). For 3 subjects in the topical-only arm requiring additional anesthesia, VAS pain scores were reduced following periurethral block (10.0±0.0 preblock to 4.0±2.6 postblock; P =0.04). There was no difference between arms in procedure duration, reinjection, or questionnaire scores. Subjects in the combined anesthetic arm were less likely to require post-procedure straight catheterization (0% vs. 33% topical-only; P =0.04).</p><p><strong>Conclusions: </strong>Use of a periurethral block with topical anesthetics reduced pain scores and improved postprocedure voiding. These findings support using a combined anesthetic protocol for women undergoing in-office PAHG injection.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"919-927"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133208","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":"BEST: Barbed-suture Efficiency Study for Sacrocolpopexy: A Randomized Clinical Trial.","authors":"Martina Gabra, Katherine L Woodburn, Amr El Haraki, Anna Zdroik, Marisa Duong, Christina Mezes, Maya Fisher, Lyle Paukner, Catherine A Matthews","doi":"10.1097/SPV.0000000000001768","DOIUrl":"10.1097/SPV.0000000000001768","url":null,"abstract":"<p><strong>Importance: </strong>Unidirectional barbed suture may decrease suture time for vaginal mesh attachment in robotic sacrocolpopexy.</p><p><strong>Objective: </strong>The objective of this study was to evaluate if absorbable unidirectional barbed suture decreases vaginal mesh attachment time compared with nonbarbed suture.</p><p><strong>Study design: </strong>This single-blind, randomized trial of women undergoing robotic sacrocolpopexy for ≥stage 2 symptomatic pelvic organ prolapse assessed if absorbable unidirectional barbed suture resulted in a 50% faster vaginal mesh attachment compared with interrupted nonbarbed suture. Surgeon-reported ease of mesh attachment, appearance of mesh, and global satisfaction with each suture type was assessed with a 10-point Likert scale (1 worst, 10 best). Six-month patient-centered outcomes were assessed.</p><p><strong>Results: </strong>In total, 52 participants were randomized, with 25 in the barbed suture group and 27 in the nonbarbed suture group. Vaginal mesh attachment was faster for barbed suture (13.2 vs. 19.7 min, P <0.01). However, this did not reach the primary outcome of a 50% decrease in suture time. When stratified by level of training, barbed suture remained significantly faster for resident and fellow surgeons but not for attending surgeons. Surgeons rated barbed suture higher than nonbarbed suture for ease of suture use and global satisfaction, with similar mesh appearance ratings. Total operative time was similar between groups (186.1 vs. 180.9 min, P =0.62). Six-month patient-centered outcomes were similar between groups.</p><p><strong>Conclusions: </strong>Unidirectional barbed suture decreased mesh attachment time compared with nonbarbed suture, especially for novice surgeons. Surgeon satisfaction was higher for barbed suture, and there was a similar improvement in all patient-centered outcomes at 6 months.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"996-1004"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544166","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":"Phenotype Variability in Interstitial Cystitis Clinical Trial Recruitment.","authors":"Ryan Wong, Emmaline Woodworth, Charles Wood, Sarah A Adelstein, Annah J Vollstedt","doi":"10.1097/SPV.0000000000001759","DOIUrl":"10.1097/SPV.0000000000001759","url":null,"abstract":"<p><strong>Importance: </strong>There is a need to understand phenotype-specific therapies for interstitial cystitis/bladder pain syndrome (IC/BPS) at the clinical trial level to move beyond trial-and-error treatment approaches.</p><p><strong>Objective: </strong>The objective of this study was to characterize IC/BPS clinical trials that incorporate patient phenotype into the eligibility criteria in accordance with the American Urological Association (AUA) guidelines.</p><p><strong>Study design: </strong>Registered IC/BPS clinical trials were identified from ClinicalTrials.gov. Trials were included if they enrolled patients with IC/BPS and addressed pain-related outcomes. Trials were assessed for phenotype recognition and categorized by intervention type, funding source, and registration date relative to the AUA's 2015 IC/BPS guidelines for initial phenotype recognition.</p><p><strong>Results: </strong>Out of 170 trials, 37 (21.8%) included phenotype stratification. The majority focused on bladder-centric presentations. Men were underrepresented in IC/BPS clinical trials. Phenotypic stratification was more frequently reported in industry-funded trials compared with those without industry support (40.5% vs 16.5%, P =0.0031). Trials registered after the 2015 AUA guideline update showed greater phenotype inclusion, though this was not statistically significant (26.6% vs 15.8%). Therapeutic trials comprised the majority of trials. Stratification appeared more often in physical therapy and psychosocial trials at 40% and in drug studies at 34.3%. Intravesical instillation and injection trials showed lower rates at 19.6% and 13.0%, respectively.</p><p><strong>Conclusions: </strong>Failure to incorporate IC/BPS phenotypes into trial design limits the ability to evaluate treatments within the context of real-world symptom variability. Bridging this methodological gap is essential to ensure that clinical research supports the development of more targeted and effective therapies.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"928-933"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202424","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":"Characteristics Associated With Abnormal Video Urodynamics.","authors":"Summer Hardy, John Hill, Gregory Vurture, Nitya Abraham","doi":"10.1097/SPV.0000000000001910","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001910","url":null,"abstract":"<p><strong>Importance: </strong>Urodynamics evaluates lower urinary tract function. Video urodynamics (VUDS) provides additional anatomic information with fluoroscopy. Fluoroscopy requires additional personnel, equipment, and radiation precautions. However, VUDS can be valuable in certain patients.</p><p><strong>Objective: </strong>The objective of this study was to identify patient characteristics associated with abnormal fluoroscopy findings to improve VUDS patient selection.</p><p><strong>Study design: </strong>A retrospective chart review of women 18 years or older undergoing urodynamic studies was conducted from January 2022 to September 2025 at an urban academic institution. Demographics, relevant medical history, fluoroscopy findings, evidence of neurogenic lower urinary tract dysfunction (NLUTD), and radiation time and exposure were collected. Statistical analyses used R version 4.4.2 (R Core Team, 2025) and JMP v.16.2 software (SAS Institute Inc, Cary, NC).</p><p><strong>Results: </strong>Of 223 patients, 148 (66.4%) had a normal bladder appearance, whereas 75 (33.6%) had abnormalities. Older age was associated with abnormal findings (P<0.001). Mixed urinary incontinence (MUI) was the primary VUDS indication in the normal group (36.9%), compared with urinary retention in the abnormal group (56.0%). The abnormal group experienced higher radiation time (0.22 vs 0.28 min, P<0.001) and exposure (4.22 vs 5.50 mGy, P=0.02). The most common NLUTD etiology was early-stage multiple sclerosis in the normal group (31.2%) and diabetic cystopathy in the abnormal group (19.0%).</p><p><strong>Conclusions: </strong>Abnormal VUDS findings were associated with diabetic cystopathy or urinary retention, whereas normal VUDS findings were associated with MUI or early-stage multiple sclerosis. Our findings highlight the potential opportunity to use VUDS judiciously based on individual clinical scenarios.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702710","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}