Urogynecology (Hagerstown, Md.)最新文献

{"title":"Reduced-Dose OnabotulinumtoxinA for Urgency Incontinence in Older Women: Methods.","authors":"Anne C Cooper, Holly E Richter, Shawn A Menefee, David D Rahn, Sara Cichowski, Isuzu Meyer, Jonathan P Shepherd, Christopher Chermansky, E Ann Gormley","doi":"10.1097/SPV.0000000000001905","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001905","url":null,"abstract":"<p><strong>Importance: </strong>Older women have a high prevalence of and bother from overactive bladder (OAB) and urgency urinary incontinence (UUI), with unique treatment challenges. It is important to improve care for this long-overlooked and understudied group.</p><p><strong>Objective: </strong>The objective was to describe the design and rationale for a randomized controlled noninferiority trial of low-dose (50 unit) versus standard-dose (100 unit) onabotulinumtoxinA (OnabotA) for OAB symptoms in women 70 years or older with UUI.</p><p><strong>Study design: </strong>Study population, injection procedure, and conduct are described. The primary outcome is change in quality of life (QOL) between groups as measured by the OAB Questionnaire (OABq-SF) 3 months posttreatment, including confirmatory heterogeneity of treatment effect analysis by frailty status. Secondary outcomes include patient-reported symptom bother and distress, satisfaction, goal attainment, depression scores, adverse events (AEs), cost analysis, and qualitative interviews. Patients will be assessed monthly for safety and efficacy through 12 months and can receive up to 2 additional treatments.</p><p><strong>Results: </strong>A sample size of 278 is needed to achieve 90% power to detect noninferiority. Assuming a withdrawal of 26%, the target randomization is 376 participants. Adult females aged 70 years and older are recruited if they have urgency or urgency-predominant mixed urinary incontinence. Exclusion criteria include postvoid residual volume >150 mL, need for treatment under sedation, current other treatment for OAB, and conditions that affect bladder emptying.</p><p><strong>Conclusions: </strong>This trial will contribute important data on symptom-specific and health-related QOL, patient-reported and clinical outcomes, and AEs among older women with UUI being treated with the standard dose versus reduced dose of OnabotA.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633018","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":"Early Versus Delayed Laparoscopic Repair of Surgically Induced Vesicovaginal Fistula.","authors":"Mingrui Wang, Fen Yin, Xiaodong Guan, Qi Li","doi":"10.1097/SPV.0000000000001900","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001900","url":null,"abstract":"<p><strong>Importance: </strong>The optimal timing of surgical repair for vesicovaginal fistula (VVF) remains debated, with traditional recommendations favoring delayed intervention. Whether early laparoscopic repair can achieve comparable outcomes without increasing morbidity is clinically relevant.</p><p><strong>Objectives: </strong>This study aimed to compare the clinical efficacy and safety of early (within 3 weeks) versus delayed (≥3 months) laparoscopic VVF repair following surgical injury.</p><p><strong>Study design: </strong>A retrospective cohort study was conducted involving 23 patients with surgically induced VVF treated between January 2021 and December 2024. Patients were categorized into group A (early repair, n = 11) and group B (delayed repair, n = 12). The primary outcome was the surgical success rate, defined as complete resolution of vaginal leakage with cystoscopic confirmation of closure at 3-month follow-up. Secondary outcomes included operative time, estimated blood loss, length of hospital stay, and complication rates.</p><p><strong>Results: </strong>No significant differences were observed in baseline characteristics, including age, body mass index, or fistula location. The surgical success rates were 90.9% (10 of 11) in group A and 91.7% (11 of 12) in group B (P > 0.99). Operative time, intraoperative blood loss, length of hospital stay, and postoperative complication rates were comparable between the 2 groups. Correlation analysis revealed expected clinical relationships, with operative time and blood loss showing a strong positive association (r = 0.62).</p><p><strong>Conclusions: </strong>Early laparoscopic VVF repair (within 3 weeks) demonstrates comparable efficacy and safety to delayed repair (≥3 months). The superior visualization provided by laparoscopy is critical for successful early intervention. Early surgical management avoids prolonged patient suffering and represents a viable treatment option for surgically induced simple VVF.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431743","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":"Chatbot Use by Patients Seeking Urogynecologic Consultation: A Randomized Trial.","authors":"Nicole J Wood, David M O'Sullivan, Elena Tunitsky-Bitton","doi":"10.1097/SPV.0000000000001906","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001906","url":null,"abstract":"<p><strong>Importance: </strong>Urogynecology patients increasingly investigate their problems using technology-based resources, yet the effect of artificial intelligence (AI) chatbots on patient decision making remains unclear.</p><p><strong>Objective: </strong>The objective of this study was to investigate the effect of the use of an AI chatbot platform on patient decisional conflict during an initial urogynecology visit.</p><p><strong>Study design: </strong>In this institutional review board-approved, single-center randomized trial, patients presenting with prolapse, incontinence, or lower urinary tract symptoms were assigned to 1 of 3 groups: (1) ChatGPT-4o (OpenAI) use before the visit, (2) after the visit, or (3) usual care without chatbot use. English- and Spanish-speaking participants used ChatGPT to ask questions about their primary concern. Demographics, prior information-seeking behavior, and visit details were collected. Surveys administered immediately and at 3 months assessed understanding of diagnosis and treatment, decisional conflict (Decisional Conflict Scale), visit satisfaction, and chatbot satisfaction. Chatbot transcripts were analyzed for readability.</p><p><strong>Results: </strong>Among 125 randomized patients (July 2024-December 2024), attrition at 3 months was 3.2%. Most participants were White (78.2%) with at least a high school education (92.8%), and 98.8% had no prior medical chatbot use. Demographics and diagnoses were similar across groups. Decisional conflict was low and did not differ immediately (P = 0.691) or at 3 months (P = 0.875). Understanding of diagnosis, visit satisfaction, and chatbot satisfaction were similar between groups. By 3 months, home chatbot use was more common in the intervention arms (P = 0.011). Chatbot responses averaged an 11th-12th grade reading level.</p><p><strong>Conclusions: </strong>Patient use of a chatbot peri-visit did not affect decisional conflict. While increasingly accepted, chatbots may not yet optimally support urogynecologic patient-centered decision making.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427154","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":"Cost-effectiveness of Total Versus Supracervical Hysterectomy at Sacrocolpopexy.","authors":"Lauren A Cadish, Shannon L Wallace, Roberto Vargas, Brad St Martin, Olivia H Chang, Eric R Sokol, Jonathan P Shepherd","doi":"10.1097/SPV.0000000000001886","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001886","url":null,"abstract":"<p><strong>Importance: </strong>Cervical preservation versus removal is commonly debated among urogynecologists performing sacrocolpopexy (SCP), the gold standard reconstructive procedure for prolapse. A randomized controlled trial is unlikely to ever be performed.</p><p><strong>Objective: </strong>The objective was to compare the cost-effectiveness of total (TLH) versus supracervical (SCH) hysterectomy at the time of SCP.</p><p><strong>Study design: </strong>Markov microsimulation evaluated 5-year outcomes after SCP with TLH or SCH. Route-specific complications included bladder/ureteral injury, cuff dehiscence, port-site hernia, mesh exposure, prolapse recurrence with or without retreatment, and occult uterine cancer. Quality-adjusted life years (QALYs) incorporated recovery, prolapse recurrence, and cancer treatment states with an annual 3% discount rate. Probabilistic sensitivity analysis (PSA, n=10,000) assessed model uncertainty.</p><p><strong>Results: </strong>Median costs were SCP/TLH=$16,117.50, SCP/SCH=$16,078.00 (Δ=$39.50, 0.2%). Median effectiveness was 4.65 QALYs for both. PSA showed TLH was more effective in 15.8%, SCH in 17.3%, with equal effectiveness in 67.0%. Net monetary benefit (NMB) favored SCH by $39.50 (<0.01% of total NMB).</p><p><strong>Conclusions: </strong>While risks vary between TLH and SCH, rare and mostly balanced complications, similar costs, and high efficacy regardless of route explain why both approaches perform equally overall.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427186","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":"Rate of IPG Placement for Sacral Neuromodulation in Patients With CNS Pathology.","authors":"Kunal Patel, Electra Korn, Michael Flynn, Cynthia Hall, Emily Wu","doi":"10.1097/SPV.0000000000001863","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001863","url":null,"abstract":"<p><strong>Importance: </strong>Little is known about the efficacy of sacral neuromodulation in patients with central nervous system (CNS) pathology.</p><p><strong>Objective: </strong>The objective of this study was to assess the rate of internal pulse generator (IPG) implantation for sacral neuromodulation (SNM) in patients with CNS pathology with overactive bladder (OAB) or urinary retention in women.</p><p><strong>Study design: </strong>This was a retrospective study utilizing the TriNetX Research Network platform, using the years 2010 to 2025, collected on March 27, 2025. Two separate queries of the data set were performed to obtain our cohorts due to the differences in inclusion criteria and endpoints. For our OAB cohorts, adult (18 years or older) female participants were included in the study if they had OAB, urge incontinence, or urgency of urination via International Classification of Diseases (ICD) codes. We then developed 6 cohorts for (1) dementia, (2) Parkinson disease, (3) stroke, (4) multiple sclerosis (MS), (5) normal pressure hydrocephalus (NPH), and (6) an aggregate cohort. We utilized ICD codes and medication codes for the aforementioned diagnoses. Each cohort had either stage 1 SNM placement or peripheral nerve evaluation (PNE) via Current Procedural Terminology (CPT) codes after 2010. Control participants included all female adult participants without any of the aforementioned neurological diagnoses. The primary outcome was the rate of neurostimulator device IPG placement within 1 month of stage 1 or PNE. A second group of cohorts was developed for urinary retention. Adult female participants were included in the study if they had retention of urine. We developed 4 cohorts: (1) dementia, (2) Parkinson disease, (3) stroke, and (4) MS, utilizing the previous ICD codes and medications. Each cohort had either stage 1 SNM placement or PNE placed after 2010. The primary outcome was the rate of neurostimulator device IPG placement (CPT code 64590) within 3 months of stage 1 or PNE.</p><p><strong>Results: </strong>Compared with the control (4,337 of 7,805, 55.56%), there was a statistically significant reduction in the rates of SNM IPG implantation in patients with dementia (179 of 375, 47.73%) and the aggregate (483 of 984, 49.09%). There was no significant difference in SNM IPG implantation for the Parkinson disease, stroke, MS, and NPH cohorts. In the urinary retention group, compared with the control population, there were no statistically significant differences in the rate of SNM IPG implantation in the cohorts.</p><p><strong>Conclusions: </strong>Our study suggests that SNM has equal efficacy in patients with CNS pathology with OAB or urinary retention, similar to the nonneurogenic population, except in patients with dementia, who have lower rates of IPG implantation for OAB.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400137","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":"Indigo Carmine Visualization Duration in Urine: A Randomized Kinetics Study.","authors":"Lucas Wiegand, Maria A Giannopoulos, Michelle L Boytim, Pavel Svintozelskiy, Herbert Lepor","doi":"10.1097/SPV.0000000000001748","DOIUrl":"10.1097/SPV.0000000000001748","url":null,"abstract":"<p><strong>Importance: </strong>Despite its frequent use for visualization of ureteral efflux during pelvic/abdominal surgery, there are limited data on indigo carmine pharmacokinetics and duration of blue color in postdose urine. Understanding how long the blue color persists allows the clinician to make accurate assessments of the urinary system during complex surgical procedures.</p><p><strong>Objectives: </strong>This study observed the plasma and urinary pharmacokinetics of indigo carmine in healthy volunteers and the voided urine color.</p><p><strong>Study design: </strong>This study was an open-label, randomized clinical trial in 16 healthy participants who received either a 2.5-mL or a 5.0-mL intravenous injection of indigo carmine. Blood (pre, 2, 5, 7, 10, 15, 20, 30, 40 minutes and 1, 2, 3, 4, 6, 12 hours post) and urine (predose, 0-2, 2-6, 6-12 hours post) were collected. The first postdose stool was collected.</p><p><strong>Results: </strong>Plasma concentration peaked within 5 minutes, and all plasma concentrations were below the limit of quantification by 2 hours postdose. The estimated plasma half-life of indigo carmine was 12 minutes. Voided urine through 2 hours postdose was visibly discolored compared with the matched predose urine. In some cases, urine discoloration persisted through 6 hours (10/16) and 12 hours (1/16). Unchanged indigo carmine eliminated in stool was observed in 4 of 16 participants (25%).</p><p><strong>Conclusions: </strong>The short half-life and rapid urinary excretion of indigo carmine favor its clinical use for intraoperative cystoscopy and are consistent with the reported median time of 6 minutes postinjection to ureteral efflux in patients undergoing surgical procedures.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"856-863"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965909","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":"Postoperative Body Weight Changes and Effect on Midurethral Sling Failure.","authors":"Stephanie M Glass Clark, Isabel Janmey, Megan S Bradley, Li Wang, Mary F Ackenbom","doi":"10.1097/SPV.0000000000001743","DOIUrl":"10.1097/SPV.0000000000001743","url":null,"abstract":"<p><strong>Importance: </strong>Little is known about the effect of weight change following surgery on midurethral sling outcomes.</p><p><strong>Objective: </strong>The objective of this study was to determine the effect of body weight change after midurethral sling on the 24-month subjective outcome. We hypothesized that body weight gain would increase the chance of subjective failure.</p><p><strong>Study design: </strong>This was a secondary analysis of the Trial of Mid-Urethral Slings. The primary outcome was subjective failure at 24 months postoperatively. Secondary outcomes include objective failure and combined (objective/subjective) failure at 24 months. Weight change was categorized as no change (if ±5 lb of baseline), gain (>5 lb above), and loss (>5 lb below) at baseline. In addition, we categorized for percentage weight change of baseline body weight (±5%, 5-10%, and >10%). The association between weight change and outcomes was evaluated using logistic regression.</p><p><strong>Results: </strong>Four hundred thirty-two participants were included. Weight loss or gain of >5 lb was not significantly associated with 24-month subjective failure (weight loss odds ratio [OR]: 1.54, 95% CI: 0.96-2.49; weight gain OR: 1.51, 95% CI: 0.96-2.36). In addition, no significant association was observed with 24-month objective or combined failure (Objective: weight loss OR: 1.23, 95% CI: 0.73-2.08; weight gain OR: 1.11, 95% CI: 0.67-1.82; Combined failure: weight loss OR: 1.32, 95% CI: 0.82-2.13, weight gain OR: 1.47, 95% CI: 0.94-2.31). Participants with weight gain >10% baseline body weight had significantly increased odds of combined failure at 24 months (OR: 2.75, 95% CI: 1.13-6.69).</p><p><strong>Conclusions: </strong>Significant body weight gain (>10%) following midurethral sling placement is associated with increased odds of combined failure of the surgery at 24 months.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"833-839"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183780","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 Knowledge and Urinary Incontinence in Pregnancy: Clinical Trial.","authors":"Necmettin Yildiz, Yeşim Akkoç, Saadet Nur Sena Öztekin, Şenay Özdolap Çoban, Nalan Çapan, Belgin Erhan, Eylem Ünlübilgin, Selcen Kanyilmaz, Aysun Özlü, Gökay Özçeltik, Elif Nurdan Güneş, Tuğba Saraç Sivrikoz, Yasemin Yumuşakhuylu, İbrahim Gündoğdu, Orhan Şahin, Özlem Ulaş, Derya Kiliç, Müge Harma, Ayşe Karan, Canan Satir Özel, Tunahan Akduğan, Mert Açar, Özgür Yeniel","doi":"10.1097/SPV.0000000000001745","DOIUrl":"10.1097/SPV.0000000000001745","url":null,"abstract":"<p><strong>Importance: </strong>Knowledge of pelvic floor muscle (PFM) location, function, and antepartum exercises may prevent urinary incontinence (UI) symptoms.</p><p><strong>Objectives: </strong>The objectives of this study were to evaluate the awareness of PFMs and PFM exercises, including knowledge, training, and experience, among pregnant women and to investigate the relationship between PFM awareness and UI.</p><p><strong>Study design: </strong>This cross-sectional study involved 522 pregnant women aged 18 years and older recruited from 8 centers. A questionnaire was used to assess PFM awareness; knowledge of PFM exercises; training and experience with these exercises; and the presence of UI, pelvic organ prolapse (POP), and fecal incontinence (FI). PFM knowledge and awareness were compared between pregnant women with and without UI.</p><p><strong>Results: </strong>Of the 522 participants, 134 (25.7%) reported UI, 10 (1.9%) had POP, and 5 (1%) had FI. Among those with UI, 94 (70.1%) reported that their symptoms began during pregnancy. A significant proportion of women demonstrated limited PFM knowledge: 379 (72.6%) were unaware of PFM location, 385(73.8%) did not know PFM function, and 380 (72.8%) had not heard of PFM exercises. Pregnant women without UI were more likely to report performing PFM exercises than those with UI (66.7% vs 37.5%, respectively, P=0.002). Furthermore, women without UI were more likely to have performed PFM exercises for 8 weeks or more compared with those with UI (71.6% vs 40.0%, respectively, P=0.019).</p><p><strong>Conclusions: </strong>This study highlights a concerning lack of knowledge and awareness regarding PFMs and PFM exercises among pregnant women. Educational programs are needed to improve understanding of PFM function and to provide instruction on correct PFM exercise techniques.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"32 7","pages":"840-847"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280398","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":"Culture-confirmed Bacterial Species Causing Recurrent Urinary Tract Infection Among Adult Women.","authors":"Susan Tuddenham, Rebecca M Brotman, Victoria L Handa","doi":"10.1097/SPV.0000000000001740","DOIUrl":"10.1097/SPV.0000000000001740","url":null,"abstract":"<p><strong>Importance: </strong>Approximately 60% of adult women experience at least 1 urinary tract infection, and more than 25% experience multiple recurrences. If persistent bacterial reservoirs in the urinary tract contribute to the high incidence of recurrent infections, then repeated episodes should be disproportionately caused by the same bacterial species.</p><p><strong>Objectives: </strong>The obectives of this study were to estimate, among women with recurrent urinary tract infection, the proportion of recurrences due to the same bacterial species and to identify host characteristics associated with species consistency across episodes.</p><p><strong>Study design: </strong>This study was a retrospective observational study of adult women with recurrent urinary tract infections. Urinary tract infection was defined as a urine culture positive for ≥10,000 colony-forming units of a single bacterial species, plus a diagnosis related to relevant signs or symptoms. We calculated the proportion of infection pairs due to the same bacterial species. To identify host characteristics associated with species consistency across episodes and to account for repeated pairs, we used logistic regression with generalized estimated equations.</p><p><strong>Results: </strong>One hundred eighty-one women experienced 496 urinary tract infection episodes. The median age was 49 years, and the median interval between infections was 88 days. Among 315 episode pairs, the same bacterial species was identified in 239 pairs (75.9%). Women over age 65 years were significantly less likely to have the same bacterial species across episode pairs (relative odds 0.35, 95% CI: 0.17, 0.70). Race, ethnicity, body mass index, menopause status, diabetes, and time between infections were not significantly associated with species consistency.</p><p><strong>Conclusions: </strong>Consistent bacterial species cause most sequential infections among women with recurrent urinary tract infections, especially in younger women. This observation would be consistent with the hypothesis that bacterial reservoirs may contribute to recurrent urinary tract infections.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"812-818"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965863","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":"Preoperative Gabapentin for Vaginal Prolapse Procedures: A Randomized Trial.","authors":"Colin M Johnson, Kimberly A Kenne, Catherine S Bradley, Linder H Wendt, Joseph T Kowalski","doi":"10.1097/SPV.0000000000001746","DOIUrl":"10.1097/SPV.0000000000001746","url":null,"abstract":"<p><strong>Importance: </strong>Perioperative gabapentin is widely used in gynecology ERAS protocols, but evidence for its use for vaginal prolapse procedures is very limited.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the effect of preoperative gabapentin on postoperative opioid use in patients undergoing vaginal apical suspension procedures for pelvic organ prolapse.</p><p><strong>Study design: </strong>This was a double-blind, randomized, placebo-controlled clinical trial conducted at a tertiary care center. Participants received either 300 mg of gabapentin or placebo 1 hour before surgery, along with 975 mg of acetaminophen and 400 mg of celecoxib. The primary outcome was total opioid consumption in the first 24 hours postoperatively in morphine milligram equivalents. Secondary outcomes included pain scores, time to discharge, adverse events, and adequacy of pain control. Statistical analysis included the Wilcoxon rank sum and Fisher exact tests. A sample size of 46 per group was planned to achieve 80% power.</p><p><strong>Results: </strong>From January 2023 through October 2024, 110 participants were enrolled, and 100 were randomized and received the intervention (50 per group). Demographics and patient characteristics were similar between groups except for preoperative/intraoperative opioids. There were no significant differences between the placebo and gabapentin groups in postoperative 24-hour opioid use ( P =0.15) or any secondary outcomes. After correcting for the difference in preoperative/intraoperative opioid use with regression models, there were still no significant differences in the primary or secondary outcomes. The same results held true for a per-protocol analysis, which excluded 5 participants.</p><p><strong>Conclusions: </strong>A single 300-mg preoperative dose of gabapentin did not significantly reduce opioid use or improve pain control in patients undergoing vaginal apical suspension. These findings suggest limited utility for the routine use of gabapentin in this clinical context.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"848-855"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277922","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}