Urogynecology (Hagerstown, Md.)最新文献

{"title":"Reasons for Missed Appointments.","authors":"Rachan Ghandour, Jeannine M Miranne, Julia Shen, Rachel Murphy, Mireya Taboada, Melissa Plummer, Steph Schatzman-Bone, Vatche A Minassian","doi":"10.1097/SPV.0000000000001646","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001646","url":null,"abstract":"<p><strong>Importance: </strong>Little is known about reasons behind missed appointments in subspecialty settings, particularly in urogynecology practices.</p><p><strong>Objective: </strong>The aim of the study was to understand patient-perceived barriers to appointment attendance at an academic urban multisite urogynecology practice.</p><p><strong>Study design: </strong>This was a prospective, qualitative study of patients who missed their appointments at a urogynecology practice from April to September 2023. Patients were invited to participate in semistructured interviews. Nonrandom, purposive sampling ensured a reflective sample. The interview guide addressed attendance barriers, reasons for missed appointments, and clinic accessibility. Inductive coding was applied to interview text fragments and a codebook was developed.</p><p><strong>Results: </strong>Of the 230 eligible patients, 110 (48%) were contacted and 26/110 (24%) consented and completed interviews. Patients identified the following 3 major barriers to appointment attendance: (1) community and environmental barriers, (2) patient-related factors, and (3) clinic-related factors. Community and environmental barriers (n = 20 [77%]) included unforeseen circumstances and transportation issues, with 52% citing transportation difficulties. Patient-related factors (n = 16 [62%]) included family obligations, personal illness, mental health concerns, confusion with appointments, or competing job responsibilities. Clinic-related factors (n = 9 [35%]) included scheduling and timing issues. Participants proposed changes to facilitate attendance, which included clinics offering transportation assistance, providing interpersonal support through support groups, and improving the internet-based portal to make patient communication easier.</p><p><strong>Conclusions: </strong>Identifying the reasons why patients miss appointments is pivotal to providing patient-centered care. Our findings provide a deeper understanding of issues underlying missed urogynecology appointments. Future research to develop an algorithm to identify barriers to attending appointments and provide interventions such as transportation support could result in more accessible, equitable care.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883794","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 Neuroexcitation Patterns Using fNIRS in Women With Overactive Bladder.","authors":"Linda S Burkett, Mina Ghatas, Helen Query, Peter Daniels, Gabrielle Grob, Ashley Matthew, Devin Rogers, Lynn Stothers, John E Speich, Adam P Klausner","doi":"10.1097/SPV.0000000000001625","DOIUrl":"10.1097/SPV.0000000000001625","url":null,"abstract":"<p><strong>Importance: </strong>Functional near-infrared spectroscopy (fNIRS) is a noninvasive technique used to quantify prefrontal cortex (PFC) neuroexcitation. The PFC is involved in the decision to void, and dysfunction in the region has been associated with overactive bladder (OAB). This study demonstrates neuroexcitation differences in the brain region associated with the decision to void (prefrontal cortex) using noninvasive fNIRS.</p><p><strong>Objective: </strong>The objective of this study was to compare PFC neuroexcitation during natural filling in female participants with and without OAB.</p><p><strong>Study design: </strong>Female participants with OAB were cross-sectionally compared with controls without urinary urgency. The fNIRS signals were continuously recorded during an oral hydration protocol. Simultaneously, recordings of real-time bladder sensation of fullness were completed. A period of \"high sensation\" was defined as the time from first desire to 100% sensation. Signal analysis included removal of motion artifact, low pass filtering, and interpolated to standardize reporting bladder filling time.</p><p><strong>Results: </strong>A total of 25 female participants were enrolled and had complete analyzable data, including 14 with OAB and 11 controls without OAB. Change in O2Hb during the high sensation period was significantly lower in all PFC regions in the OAB group compared with controls (P < 0.001). The majority of OAB participants had a constant or decreasing neuroexcitation pattern, which differenced in comparison to normal controls who displayed an increasing pattern.</p><p><strong>Conclusions: </strong>This study demonstrates that fNIRS PFC excitation during a period of high sensation is consistently lower in women with OAB as compared with controls. These data support the hypothesis that the PFC plays an inhibitory role in voiding function and that there may be a lack of inhibitory control in women with OAB.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883780","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":"Pain Following Obstetric Anal Sphincter Injuries: A Prospective Cohort Study.","authors":"Yasamin Fazeli, Lannah L Lua-Mailland, Meng Yao, Shannon L Wallace","doi":"10.1097/SPV.0000000000001614","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001614","url":null,"abstract":"<p><strong>Importance: </strong>Studies characterizing pain and pain management following obstetric anal sphincter injury (OASI) are limited.</p><p><strong>Objectives: </strong>Our primary objective was to analyze time to pain resolution following OASI. Secondary objectives included analyzing pain severity, location, triggers, and patterns of pain medication use.</p><p><strong>Study design: </strong>This was a prospective cohort study of patients with OASIs seen in a postpartum care clinic at a tertiary referral center between 2017 and 2022. We analyzed data on pain resolution, visual analog scale pain scores, pain triggers, pain location, and pain medications.</p><p><strong>Results: </strong>A total of 362 patients were included in this study. In the Kaplan-Meier estimator, 58.5% of patients showed resolution of pain by 3 months following their initial postpartum care clinic visit, and 73.3% showed resolution of pain by 6 months. The median months to pain resolution was 2.2 (95% confidence interval: 1.6-3.0) for patients with third-degree lacerations and 2.3 (95% confidence interval: 1.6-6.8) for patients with fourth-degree lacerations. Visual analog scale scores showed the most improvement in the first 2 months. Common pain triggers included sitting and bowel movements in the first few months, as well as intercourse during later recovery. Pain location varied over time; bilateral pain in the levator ani muscles and obturator internus were most prevalent at each time point. Pain appeared to be predominantly managed by acetaminophen and ibuprofen.</p><p><strong>Conclusions: </strong>Half of patients who experience OASI will have pain resolution by 2-3 months postpartum. Most patients will have resolution of their pain by 6 months postpartum.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775511","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":"Comparison of Culturing Methods of Primary Vaginal Fibroblasts.","authors":"Olivia O Cardenas-Trowers, Tammee M Parsons, Jing Zhao, Ralph B Perkerson, Christopher C Glembotski, Frederic Zenhausern, Geoffrey C Gurtner, Marianna Alperin, Takahisa Kanekiyo","doi":"10.1097/SPV.0000000000001612","DOIUrl":"10.1097/SPV.0000000000001612","url":null,"abstract":"<p><strong>Importance: </strong>Vaginal fibroblast function is altered in people with pelvic organ prolapse. Thus, it is important to study vaginal fibroblasts to better understand the pathophysiology of prolapse.</p><p><strong>Objective: </strong>This study aimed to compare 3 culturing methods of primary vaginal fibroblasts.</p><p><strong>Study design: </strong>This was an in vitro study. Patients who were undergoing surgery for vaginal prolapse were recruited. Excess vaginal epithelial tissue that would have otherwise been discarded was collected. The vaginal fibroblasts from each participant were cultured via (1) 3-hour digest, (2) coverslip, and (3) gelatin-coat methods. Differences in the efficiency of cell isolation, expression of known fibroblast-associated genes, and cellular function were compared between the 3 methods using one-way analysis of variance and Tukey test for post hoc pairwise comparisons (P < 0.05).</p><p><strong>Results: </strong>Five patients with pelvic organ prolapse were recruited. Fibroblasts cultured via the 3-hour digest method became confluent within 3-5 days in a 100-mm dish compared to 2-3 weeks in a 6-well dish for the coverslip and gelatin-coat methods. Cells from all culture methods expressed similar amounts of vimentin and α smooth muscle actin. There were no significant differences in morphology; gene expression levels of MMP1, MMP2, ACTA2, COL1A1, COL3A1, and LOXL1 on qPCR; cell viability; proliferation; and migration between the 3 culturing methods.</p><p><strong>Conclusion: </strong>Culturing primary vaginal fibroblasts via the 3-hour digest, coverslip, and gelatin-coat methods similarly resulted in reliable primary vaginal fibroblast growth and function.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775509","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":"Complications in Pelvic Organ Prolapse With 3-Month Versus 6-Month Pessary Care: Pilot Study.","authors":"Geovana Volta Giorgenon, Letícia Martineli Galhardo, Camila Carvalho de Araujo, Edilson Benedito de Castro, Luiz Gustavo Oliveira Brito, Cássia Raquel Teatin Juliato","doi":"10.1097/SPV.0000000000001610","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001610","url":null,"abstract":"<p><strong>Importance: </strong>Despite evidence emphasizing the necessity of routine care for women with pelvic organ prolapse (POP) using pessaries, the frequency of follow-up is unclear.</p><p><strong>Objective: </strong>The aim of this study was to compare the presence of complications in women with POP using vaginal pessaries with cleaning and gynecological examination every 3 or 6 months.</p><p><strong>Study design: </strong>This pilot study was a randomized clinical trial of women with advanced POP using a ring pessary. The women were randomized into 2 groups (\"3-month group\" and a \"6-month group\") that returned for evaluation by a health care professional that monitored the vagina, removed the pessary, cleaned it, and reinserted it. Sociodemographic and clinical data were collected. During their follow-up, the women answered a questionnaire regarding the presence of vaginal symptoms and had a physical examination and vaginal sampling for microbiological analysis.</p><p><strong>Results: </strong>A total of 38 women were randomized into 2 groups: the 3-month group (n = 18) and the 6-month group (n = 20). Baseline characteristics of the groups were similar except for age, which was 70.7 (±7.4) years in the 3-month group and 74.7 (±6.6) years in the 6-month group (P = 0.022). Regarding physical examination, after 12 months of follow-up, 4 women in each group presented erosions or ulcers in each group, but without difference (P = 1). The presence of bacterial vaginosis was more frequent in the group with cleaning every 6 months (P = 0.026).</p><p><strong>Conclusions: </strong>The prevalence of ulcerations was similar in both groups with cleaning every 3 or 6 months, but the group with cleaning every 6 months showed a higher prevalence of bacterial vaginosis.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Recurrent Prolapse by Extent of Mesh Excision Procedures: A Multicenter Study.","authors":"Abhishek A Sripad, Kristen A Gerjevic, Vi Duong, Daisy Hassani, Amy Askew, Stephanie Glass Clark, Katherine L Woodburn, Erin Maetzold, Christina A Raker, Charles R Rardin","doi":"10.1097/SPV.0000000000001600","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001600","url":null,"abstract":"<p><strong>Importance: </strong>There is limited evidence guiding surgeons in how much mesh to resect when treating mesh complications.</p><p><strong>Objective: </strong>The aim of the study was to compare rates of recurrent prolapse after mesh excisional surgical procedures for prolapse mesh complications.</p><p><strong>Study design: </strong>This multicenter, retrospective cohort study included patients, identified by Current Procedural Terminology codes, who were treated surgically for prolapse mesh complications at 8 institutions between 2010 and 2019. Excisional surgical procedures were categorized as major (total vaginal, extravaginal, and total mesh excisions) or minor (partial vaginal excisions and mesh revisions). The primary outcome was prolapse recurrence 1 year after mesh excision surgery. Secondary outcomes included long-term prolapse recurrence. Prolapse recurrence was evaluated by Kaplan-Meier survival analysis and Cox proportional hazards regression.</p><p><strong>Results: </strong>Two hundred sixty-one patients met inclusion criteria with 188 (72%) undergoing minor and 73 (28%) major excisions, with a median follow-up time of 1.0 years. Groups differed in parity, location of implant surgery, and number of vaginal compartments involved in excision. Within the first year, major excisions had a higher prolapse recurrence rate (8.7%) than minor excisions (2.9%), P < 0.05. Adjusting for mesh implant type, the hazard ratio for pelvic organ prolapse was 6.1 in the major compared to minor excision. In the entire study period, prolapse recurrence was 33.8% and did not differ between groups.</p><p><strong>Conclusions: </strong>Patients undergoing major excision surgical procedures may have higher rates of prolapse at 1 year compared to those undergoing minor excisions. However, in long-term follow-up, recurrence rates were not different. Our findings may aid surgeons in expectation setting prior to excisional procedures.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607627","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":"The Impact of Smoking on Sacrocolpopexy Perioperative Outcomes: An Observational Study.","authors":"Monica S Saleeb, Rui Wang, Elisabeth C Sappenfield","doi":"10.1097/SPV.0000000000001603","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001603","url":null,"abstract":"<p><strong>Importance: </strong>Tobacco smoke is a modifiable risk factor that surgeons discuss with patients prior to undergoing sacrocolpopexy or mesh revision surgery.</p><p><strong>Objective: </strong>The aim of the study was to investigate the effect of smoking on perioperative outcomes after sacrocolpopexy for pelvic organ prolapse and mesh revision repair.</p><p><strong>Study design: </strong>This was a retrospective cohort study of data obtained from the National Surgical Quality Improvement Project's database. Women who underwent surgery for pelvic organ prolapse via abdominal sacrocolpopexy (ASCP) or minimally invasive sacrocolpopexy (MISCP) or prolapse mesh revision surgery from 2011 to 2021 were identified and compared based on current tobacco use. Demographic, medical, and surgical history, as well as intraoperative and 30-day perioperative outcomes, were compared. Multivariate analysis was performed.</p><p><strong>Results: </strong>Overall, 21,980 women underwent MISCP (8.60% smokers) and 3,775 underwent ASCP (8.74% smokers). Postoperative wound infections were more common after sacrocolpopexy in patients who smoked. Readmission after MISCP was more common in smokers. The composite perioperative morbidity score was different between smokers and nonsmokers for MISCP (P = 0.001) and ASCP (P = 0.002). Multivariate analyses of MISCP outcomes found an association between smoking and wound infection, readmission, and composite score. Multivariate analyses of ASCP outcomes found an association between smoking and wound infection. Overall 2,160 patients underwent mesh removal by any modality (16.57% smokers), and no difference in perioperative outcomes between smokers and nonsmokers for mesh removal was found.</p><p><strong>Conclusions: </strong>An association was found between tobacco smoking and wound infection as well as other postoperative complications. Tobacco use prior to a mesh excision procedure does not appear to increase perioperative outcomes.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607631","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":"Unexpected Pathology During Pelvic Organ Prolapse Repair in an Urban Population.","authors":"Johanna Gandelsman-Ginis, Stephanie Bentley, Fareesa Khan, Cynthia Brincat, Michele O'Shea","doi":"10.1097/SPV.0000000000001595","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001595","url":null,"abstract":"<p><strong>Importance: </strong>This study quantifies the occult pathology risk among our urogynecologic patient population and highlights the importance of preoperative counseling, particularly in patients who have been underrepresented in prior studies.</p><p><strong>Objective: </strong>The aim of the study was to estimate unexpected gynecologic pathology incidence among a low-risk, racially, and ethnically representative patient population undergoing surgery for symptomatic pelvic organ (POP) prolapse.</p><p><strong>Study design: </strong>This was a retrospective study of patients undergoing hysterectomy for POP at an urban academic medical center. Patients with abnormal preoperative pathologic evaluation were excluded. Data were abstracted from the electronic health record, including demographic and clinical history, preoperative laboratory evaluation, and clinical risk factors for gynecologic malignancy.</p><p><strong>Results: </strong>Two hundred ninety-nine nononcologic patients who underwent POP repair with hysterectomy were assessed. Thirty-six percent of patients identified as Hispanic, 17% as non-Hispanic Black, and 38% as non-Hispanic White. Twenty-three percent of patients reported abnormal uterine bleeding, 36% underwent a preoperative ultrasound examination, and 15% underwent endometrial biopsy. Two patients (0.9%) were diagnosed with endometrial carcinoma. Two patients (0.9%) were diagnosed with cervical dysplasia. No patients with concurrent oophorectomy or salpingectomy had ovarian or tubal pathology. The overall incidence of unexpected gynecologic pathology at the time of hysterectomy for prolapse was 1.7%.</p><p><strong>Conclusions: </strong>The rate of endometrial cancer in our cohort is on the higher end of previously published data, although absolute rates of unanticipated malignancy remain low. Future studies should examine the pathological findings of larger, racially, and ethnically diverse cohorts of patients undergoing POP surgery with hysterectomy, which can aid in providing relevant estimates for preoperative counseling.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607552","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":"Green Cystoscopy: Does Minimizing the Use of Drapes Increase Infection Rates?","authors":"Alexandra I Melnyk, Erin E Mowers, Isabel Janmey, Leslie A Meyn, Noe Woods, Pamela Moalli","doi":"10.1097/SPV.0000000000001602","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001602","url":null,"abstract":"<p><strong>Importance: </strong>The U.S. health care system has an enormous carbon footprint made worse by the escalating use of single-use supplies. Emerging evidence suggests that smaller surgical fields (\"green\" draping) may represent a safe alternative to traditional draping.</p><p><strong>Objectives: </strong>The aim of the study was to determine if the proportion of cases treated for culture-proven urinary tract infection (UTI) within 2 weeks of operating room cystoscopy after the green draping protocol implementation is noninferior to preprotocol cases. Secondary objectives included risk factors for UTI and waste and cost savings.</p><p><strong>Study design: </strong>A pre-post implementation noninferiority study was performed from 2021 to 2023 in a urogynecology division at an academic medical center. The green draping protocol eliminated the use of top drapes, leg drapes, and gowns; blue towels were permitted per the surgeon's discretion. All minor cystoscopy cases were included.</p><p><strong>Results: </strong>The cohort included 240 patients. Treatment of culture-proven UTI in the green cohort was noninferior to the preprotocol group (9 [7.5%] vs 7 [5.8%], P < 0.05). The odds of a culture-proven UTI were higher with history of recurrent UTI (odds ratio = 7.02), interstitial cystitis/bladder pain syndrome (odds ratio = 4.33), and older age (odds ratio per 5-year increase = 1.21). Approximately $1,403.92 (2023 USD) was saved, and 165 pounds of waste was diverted from the landfill.</p><p><strong>Conclusions: </strong>A green draping protocol is noninferior to standard draping with respect to rates of postoperative culture-positive UTIs. Clinicians may use a smaller operating room field to decrease the carbon footprint without compromising quality of care.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607622","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":"Urinary Incontinence in Nulliparous Female Elite Athletes: A Mixed Methods Exploration.","authors":"Zoe S Gan, Andrea Bilger, Ariana L Smith","doi":"10.1097/SPV.0000000000001573","DOIUrl":"10.1097/SPV.0000000000001573","url":null,"abstract":"<p><strong>Importance: </strong>Urinary incontinence (UI) occurs in 40-50% of nulliparous female elite athletes. However, causative factors, management, and perceptions of UI in this population are suboptimally understood.</p><p><strong>Objectives: </strong>The objectives of this study were to (1) identify factors that precipitate UI in nulliparous female elite athletes and (2) explore management strategies for UI and its effect on sports performance and quality of life.</p><p><strong>Study design: </strong>This was a cross-sectional, mixed-methods study in Division 1, college-aged nulliparous female athletes. Surveys assessed demographics, sport characteristics, relevant medical history, bladder symptoms during exercise, and validated genitourinary symptom questionnaires (Lower Urinary Tract Dysfunction Network Symptom Index-29, Female Genitourinary Pain Index). Data were compared between symptomatic athletes (who had ever experienced urinary leakage during exercise) and asymptomatic athletes. Symptomatic athletes discussed their experiences with UI in focus groups.</p><p><strong>Results: </strong>Symptomatic athletes (33/67, 49%) had more asthma (21% vs. 2.9%, P = 0.027) and constipation (15% vs. 0%, P = 0.025), were more sexually active (76% vs. 44%, P = 0.008), and had worse overall urinary symptoms and genitourinary pain than asymptomatic athletes. They described both stress and urgency incontinence precipitated by various factors, including running, jumping, sustained efforts, and stressful situations. Many described voiding frequently before and during exercise. Despite increasing normalization of UI in the female athlete population since the onset of adolescence and variable degrees of bother, interest in improving symptom management was common.</p><p><strong>Conclusions: </strong>Urinary incontinence in nulliparous female elite athletes may be multifactorial given its association with medical, behavioral, exercise-specific, and environmental conditions, which may be explored longitudinally to inform prevention and treatment strategies.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"929-937"},"PeriodicalIF":0.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334098","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}