Urethral sphincter volume and urodynamic diagnosis
ConclusionThe urethral sphincter of women with PureDO is larger than in women with PureUSI. The value in women with MUDS was between the two. The size of the urethral sphincter appears to be related to the pathophysiology. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 20, 2020 Category: OBGYN Source Type: research

Validation of the UDI-6 and the ICIQ-UI SF – Croatian version
AbstractIntroduction and hypothesisDespite the widespread use of UDI-6 and ICIQ-UI SF in Croatia, it remains unknown whether a realiable and valid measure for the population of interest is used. Thus, the aim of this study was to translate, adapt and validate the UDI-6 and the ICIQ-UI SF in Croatia.MethodsThe study included a total of 232 consecutive patients with urinary incontinence symptoms. The translation to Croatian followed standardized procedure. All participants underwent urodynamic assesment and completed UDI-6 and ICIQ-UI SF questionnaires at inclusion and 2  weeks after to assess test-retest reliability. C...
Source: International Urogynecology Journal - November 20, 2020 Category: OBGYN Source Type: research

Content and functionality features of voiding diary applications for mobile devices in Brazil: a descriptive analysis
ConclusionThere is variation in the content of voiding topics among the apps. Patients and professionals should choose the app based on the topics of most or particular interest. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 20, 2020 Category: OBGYN Source Type: research

Percutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis
AbstractIntroduction and hypothesisThis systematic review and meta-analysis aimed to evaluate the efficacy and safety of percutaneous tibial nerve stimulation (PTNS) for the treatment of overactive bladder (OAB) syndrome.MethodsPubMed, Embase, Web of Science and Cochrane Library were searched systematically to identify all the relevant studies. Void frequency per day, nocturia frequency per day, urgency episodes per day, incontinence episodes per day, urodynamic values, success rate and side effects, etc., were extracted from the included studies and analyzed.ResultsTwenty-eight studies with 2461 patients in total were inc...
Source: International Urogynecology Journal - November 20, 2020 Category: OBGYN Source Type: research

Letter to the editor: “Update in native tissue vaginal vault prolapse repair”
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 20, 2020 Category: OBGYN Source Type: research

The impact of personality traits on pessary treatment outcomes in patients with pelvic organ prolapse
ConclusionsOur data indicate that neurotic and introverted women were more bothered by POP-related symptoms, although the improvement in symptoms was not significantly associated with personality traits after 3  months of pessary treatment. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 18, 2020 Category: OBGYN Source Type: research

The impact of the 2011 US Food and Drug Administration transvaginal mesh communication on utilization of synthetic mid-urethral sling procedures
AbstractIntroduction and hypothesisWe sought to examine the change in utilization of the midurethral sling (MUS) for the treatment of stress urinary incontinence (SUI) after the 2011 US FDA communication regarding transvaginal mesh.MethodsThis is a retrospective cohort study evaluating surgical utilization of MUS at a managed care organization of 4.5 million patients from 2008 to 2016. The primary outcome was the change in utilization of synthetic mesh MUS before and after the July 2011 FDA communication. Secondary outcomes were the changes in surgeon level MUS utilization.ResultsMUS procedures decreased from 131 to 116 pe...
Source: International Urogynecology Journal - November 18, 2020 Category: OBGYN Source Type: research

Physical performance measures in older women with urinary incontinence: pelvic floor disorder or geriatric syndrome?
AbstractIntroduction and hypothesisTo evaluate physical performance measures of mobility and functional impairments and assess their association with urinary incontinence (UI) severity and impact on quality of life among older women with UI.MethodsIn a cross-sectional pilot study, 20 women aged ≥ 70 years with UI completed UI questionnaires (Global Impression of Severity, Incontinence Impact Questionnaire [IIQ-7]) and functional status evaluation. Functional status evaluation included the Modified Physical Performance Test (MPPT; range 0–36), Short Physical Performance Battery (SPPB; range 0–12), and ot...
Source: International Urogynecology Journal - November 17, 2020 Category: OBGYN Source Type: research

Does the presence of a true radiological rectocele increase the likelihood of symptoms of prolapse?
ConclusionsThe presence of a true rectocele on TLUS does not seem to contribute substantially to the manifestation of clinical symptoms of prolapse. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 16, 2020 Category: OBGYN Source Type: research

Assessing vaginal pressure profiles before and after prolapse surgery using an intravaginal pressure sensor (femfit ®)
AbstractIntroduction and hypothesisThe impact of surgery on pelvic floor muscle (PFM) function remains uncertain. There is a pressure differential along the length of the vagina, influenced by surrounding active and passive tissue structures, giving rise to a pressure profile. The aim of this study is to determine if an intravaginal pressure sensor, femfit ®, can measure differences in pressure profiles before and after surgery for pelvic organ prolapse (POP).MethodsThis pilot study includes 22 women undergoing POP surgery. Intravaginal pressure profiles were measured with femfit ® pre- and post-surgery and differe...
Source: International Urogynecology Journal - November 16, 2020 Category: OBGYN Source Type: research

Commentary on “Do women runners report more pelvic floor symptoms than women in CrossFit? A cross-sectional survey” by Forner et al.
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 16, 2020 Category: OBGYN Source Type: research

Vaginal axis on MRI after laparoscopic lateral mesh suspension surgery: a controlled study
This study was aimed at investigating the level of anatomical correction following LLMS and comparing the vaginal axis on magnetic resonance imaging (MRI) in patients with apical genital prolapse.MethodsPatients who underwent LLMS and a nulliparous control group were included in this observational prospective case –control study. MRI was performed on the control group and the study group pre- and postoperatively. The angle between the pubococcygeal line and the lower vaginal segment, the angle between the levator plate and the pubococcygeal line, and the angle between the lower and upper vaginal segments we re measur...
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Early detection and endoscopic management of post cesarean section ureterovaginal fistula: a case series study
ConclusionIn cases of ureterovaginal fistula after cesarean section, ultrasonography and IVP with lateral view x-ray films may confirm the diagnosis. The traditional treatment for ureterovaginal fistula is ureteral reimplantation, but endoscopic management may be a viable technique with less invasiveness and faster results and recovery. Thus, retrograde stenting can be accomplished in selected patients with ureterovaginal fistula after cesarean section and may eliminate the need for reimplantation of the ureter. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Recovery expectancies impact postdischarge recovery 42 days after laparoscopic sacrocolpopexy
ConclusionsA low recovery expectancy has a negative impact on actual recovery 42  days after laparoscopic sacrocolpopexy. Our findings are important because preoperative recovery expectancies are modifiable predictors, making them a candidate for an expectancy manipulation intervention designed to optimize recovery after pelvic reconstructive surgery. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Telehealth in the rehabilitation of female pelvic floor dysfunction: a systematic literature review
ConclusionsTelehealth promoted a significant improvement in urinary symptoms, PFM function and quality of life. Telehealth is still emerging, and more studies are needed to draw more conclusions. The recommendations of the governmental authorities, physical therapy councils and corresponding associations of each country also need to be considered. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

The use of vaginal lasers in the treatment of urinary incontinence and overactive bladder, systematic review
ConclusionBased on the available literature, lasers cannot be recommended as a treatment option at this time. Future better-quality studies are needed to document the exact mechanism of action, longevity, safety and its eventual place into the current treatment algorithms of SUI and OAB. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Prospective analysis of transvaginal mesh hysteropexy in the treatment of uterine prolapse
AbstractIntroduction and hypothesisThe aim of this study was to assess the efficacy of using transvaginal mesh to correct uterine prolapse by hysteropexy.MethodsThis was a single-center, prospective study of 40 subjects with bothersome uterine prolapse. Inclusion criteria were bothersome perception of a vaginal bulge on Pelvic Floor Distress Inventory short form (PFDI-20) and having a Pelvic Organ Prolapse Quantification System (POP-Q) point C of −2 or worse. Exclusionary criteria included inability to consent, history of pelvic malignancies, or any prior prolapse repair. Eligible subjects were treated with transvagi...
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Microbiome diversity predicts surgical success in patients with rectovaginal fistula
ConclusionsMicrobiome characteristics associated with fistula recurrence have been identified. The association of higher vaginal diversity with a favorable outcome has not been previously described. Expansion of this pilot project is needed to confirm findings. Taxa associated with successful repair could be targeted for subsequent therapeutic intervention. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Iatrogenic ureteral injuries: a case series analysis with an emphasis on the predictors of late ureteral strictures and unfavorable outcome in different surgical specialties
ConclusionIatrogenic ureteral injuries associated with ob/gyn surgeries involve the lower ureter, primarily with overall favorable outcomes (82%). Serious ureteroscopic IUIs affect men in the upper ureter with greater frequency. IUIs on the left side and colorectal cancer surgeries are the predictors for late strictures and secondary interventions. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Do you really want to deactivate your sacral neuromodulation device during pregnancy? A single center case series
ConclusionsThe use of SNM during pregnancy appears to be safe, without morbidity for the fetus. Moreover, risks associated with switching the device off may be greater than benefits and justify maintaining the electrical stimulation throughout pregnancy. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 11, 2020 Category: OBGYN Source Type: research

Pelvic organ prolapse after laparoscopic hysterectomy compared with vaginal hysterectomy: the POP-UP study
The objective was to review the long-term prevalence of pelvic organ prolapse (POP) after laparoscopic hysterectomy (LH) compared with vaginal hysterectomy (VH).MethodsAn observational cohort study was conducted amongst women who underwent an LH or a VH for benign indications during the period 1996 –2004: the POP-UP study. The prevalence of POP was inventoried by a questionnaire involving the Pelvic Floor Distress Inventory (PFDI-20) and a pelvic floor examination (POP-Q). Women were divided into groups based on route and indication of hysterectomy: LH, VH-1 (for nonprolapse), and VH-2 (prol apse).ResultsFour hundred...
Source: International Urogynecology Journal - November 10, 2020 Category: OBGYN Source Type: research

Financial conflicts of interest between pharmaceutical companies and the authors of urology clinical practice guidelines in Japan
ConclusionsWhile it remains unclear whether financial entanglements improperly influence the contents of UCPG, most Japanese authors received substantial payments from pharmaceutical companies with little or no disclosure. Because insufficient transparency in disclosure of these financial entanglements may compromise the integrity of UCPG, more rigorous regulation and greater disclosure of financial conflicts of interest are needed. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 5, 2020 Category: OBGYN Source Type: research

The effectiveness of surgical procedures to prevent post-hysterectomy pelvic organ prolapse: a systematic review of the literature
ConclusionA systematic review of published literature suggests that performing variations of McCall culdoplasty at the time of hysterectomy might be the most effective prophylactic surgical procedure for preventing post-hysterectomy pelvic organ prolapse. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 5, 2020 Category: OBGYN Source Type: research

Update in fertility-sparing native-tissue procedures for pelvic organ prolapse
AbstractUterine-sparing prolapse surgery has been gaining back popularity with clinicians and patients. Although both prosthetic and native-tissue surgery procedures are described, the latter is progressively regaining a central role in pelvic reconstructive surgery, owing to a lack of mesh-related complications. Available native-tissue procedures have different advantages and pitfalls, as well as different evidence profiles. Most of them offer anatomical and subjective outcomes comparable with those of hysterectomy-based procedures. Moreover, native-tissue procedures in young women desiring childbearing allow to avoid syn...
Source: International Urogynecology Journal - October 15, 2020 Category: OBGYN Source Type: research

Multidisciplinary approach between physicians and physiotherapists in urogynecology: how can we make it stronger?
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 15, 2020 Category: OBGYN Source Type: research

Urethral closure occurs by recoiling, pressure transmission, and a guarding reflex
AbstractEnh örning’s abdominal pressure transmission theory (ET) is built on Pascal’s law of fluid pressures. A theory that rejects ET also rejects this basic physical law and cannot be considered scientifically sound. The integral theory (IT) of female stress urinary incontinence rejects ET. This issue is discussed from the viewpoint of the urethral hanging theory of female stress urinary incontinence (UHT). (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 15, 2020 Category: OBGYN Source Type: research

Letter to the editor: Is it time to abandon episiotomy use? A randomized controlled trial (EPITRIAL)
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 15, 2020 Category: OBGYN Source Type: research

In reply: Letter to the editor: Is it time to abandon episiotomy use? A randomized controlled trial (epitrial)
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 15, 2020 Category: OBGYN Source Type: research

Urethral closure is by a reflex musculoelastic mechanism not pressure transmission
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 15, 2020 Category: OBGYN Source Type: research

Pelvic organ prolapse surgical training program in Bangladesh and Nepal improves objective patient outcomes
AbstractIntroduction and hypothesisThe DAK Foundation (Sydney) has facilitated pelvic organ prolapse (POP) repairs performed by local gynecologists for underprivileged women in Bangladesh and Nepal since 2014. Initially, there was no long-term patient follow-up. When 156 patients were examined at least 6  months after their surgery, an unacceptably high rate of prolapse recurrence and shortened vaginas was identified. This demonstrated the need for surgical up-skilling in both countries. Our hypothesis is that the introduction of a surgical training program in low-resource countries can significant ly improve patient ...
Source: International Urogynecology Journal - October 14, 2020 Category: OBGYN Source Type: research

The impact of concomitant mid-urethral sling surgery on patients undergoing vaginal prolapse repair
ConclusionsCompared to prolapse repair alone, the addition of a sling did not increase hospital LOS, UTI, perioperative blood transfusions, readmission or postoperative wound infections. However, concomitant sling was found to be associated with a higher risk of reoperation and VTE. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 13, 2020 Category: OBGYN Source Type: research

Pilot study: pudendal neuromodulation combined with pudendal nerve release in case of chronic perineal pain syndrome. The ENTRAMI technique: early results
ConclusionPudendal nerve liberation by the ENTRAMI technique combined with short-term pudendal neuromodulation seems feasible and promising in treating patients with chronic perineal pain.Clinical trial number: NCT03880786. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 13, 2020 Category: OBGYN Source Type: research

Symptomatic and anatomic improvement of pelvic organ prolapse in vaginal pessary users
ConclusionThe ring pessary proved to be a good therapeutic option, with a reduction in POP-Q measurements and/or absence of POP progression in the short term and an improvement in women ’s QOL. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 13, 2020 Category: OBGYN Source Type: research

Ureteral exposures with stone formation after transvaginal mesh prolapse surgery
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 13, 2020 Category: OBGYN Source Type: research

Commentary on “Voided volume for postoperative voiding assessment following prolapse and urinary incontinence surgery”
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 13, 2020 Category: OBGYN Source Type: research

Musculoskeletal findings on MRI among postpartum women with persistent pelvic pain
ConclusionOf women with persistent postpartum pelvic pain, 94.4% had musculoskeletal abnormalities supporting their clinical symptoms. Pelvic floor imaging should be considered in women with unexplained persistent postpartum pelvic pain to accurately manage the source of their pain. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 10, 2020 Category: OBGYN Source Type: research

Effects of mode of delivery on sexual functions of parturients in Nigeria: a prospective cohort study
ConclusionMode of delivery does not affect time to resumption of coitus after childbirth, and FSF disorders by 3  months postpartum. Caesarean section should therefore not be recommended to women merely for early resumption of coital activity or preservation/maintenance of sexual function after childbirth. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 10, 2020 Category: OBGYN Source Type: research

Current trends in pessary management of vaginal prolapse: a multidisciplinary survey of UK practice
ConclusionsService provision, support and pessary training in the UK vary greatly. This calls for the standardisation of care, training and development of a national guideline. We present a clear rationale and need for a UK guideline on pessary management of vaginal prolapse and a standardised pessary training model for multi-professional use. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 9, 2020 Category: OBGYN Source Type: research

Efficacy of surgical revision of mesh complications in prolapse and urinary incontinence surgery
ConclusionsThis cross-sectional study shows that mesh revision surgery alleviates symptoms in 75% of women with mesh-related complications. Type of revision surgery and individual characteristics did not seem to matter to the individual chance of cure or complications. These data can facilitate the counseling of women considering mesh revision surgery. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 9, 2020 Category: OBGYN Source Type: research

Robot-assisted re-do sacrohysteropexy after anterior abdominal wall hysteropexy
ConclusionWe demonstrated the feasibility of robot-assisted re-do sacrohysteropexy. In the surgical technique herein reported, we showed how we were able to partially re-use a previously implanted mesh together with a new one to ensure fixation of a multi-compartment pelvic organ prolapse. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 9, 2020 Category: OBGYN Source Type: research

Female pelvic medicine & amp; reconstructive surgery (FPMRS) challenges on behalf of the collaborative research in pelvic surgery consortium (CoRPS): managing complicated cases series 7: can fibroids worsen incontinence?
AbstractThis case presents the work-up and management of a patient with a fibroid uterus and urinary incontinence. Five international experts also provide their evaluation and approach to this case. According to the literature, there is uncertainty surrounding the relationship between fibroids and urinary incontinence. The experts emphasize patient counseling and a staged approach. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 8, 2020 Category: OBGYN Source Type: research

Results of bladder neck reconstruction using bladder flaps in complex female urethral defects
ConclusionsFemale urethral defects with bladder neck involvement are complex and challenging to manage. Bladder wall-based flaps offer a good chance of successful repair of these complex urethral defects. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 6, 2020 Category: OBGYN Source Type: research

Non-invasive massage technique to aid in removal of a tined sacral neuromodulation lead
ConclusionsLead removal is safely accomplished in a matter of a few minutes with the presented technique without the need for a cutdown. Lead breakage was 5% and similar to more invasive techniques. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 6, 2020 Category: OBGYN Source Type: research

Modified Lefort partial colpocleisis
ConclusionsOur modified technique used traditional suture methods to strengthen the bladder and rectum fascia, keeping most of the vaginal wall to create a solid longitudinal septum in the center of the vagina that supported the vaginal vault. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - September 30, 2020 Category: OBGYN Source Type: research

Specific Changes in Manometric Parameters are Associated with Non-improvement in Symptoms after Rectocele Repair
ConclusionPatients who showed clinical improvement showed insignificant increases in anal pressures and significant decreases in thresholds of first rectal sensation, first urge, intense urge, and MTV. Contrarily, patients who did not show clinical improvement showed significant increases in anal pressures and insignificant reduction in sensory thresholds. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - September 13, 2020 Category: OBGYN Source Type: research

Surgical approach, complications, and reoperation rates of combined rectal and pelvic organ prolapse surgery
AbstractObjectivesOur primary objective was to determine rectal prolapse (RP) and pelvic organ prolapse (POP) reoperation rates and postoperative
Source: International Urogynecology Journal - September 13, 2020 Category: OBGYN Source Type: research

Traditional McCall culdoplasty compared to a modified McCall technique with double ligament suspension: anatomical and clinical outcomes
This study compared anatomical and clinical outcomes of traditional McCall culdoplasty versus a modified McCall technique with double ligament suspension (DLS).MethodsThis retrospective study presents outcomes of 68 patients who underwent vaginal hysterectomy and vaginal suspension for apical prolapse ≥ stage II according to the POP-Q score system, at, between January 2016 and February 2018. In 34 women vaginal cuff suspension was obtained with traditional McCall culdoplasty (McCall group), while in 34 women we performed a modified McCall, which consists of a double ligament suspension (DLS gro up), suspending the vagin...
Source: International Urogynecology Journal - September 13, 2020 Category: OBGYN Source Type: research

Surgical removal of sacrocolpopexy mesh due to chronic inflammatory reaction
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - September 13, 2020 Category: OBGYN Source Type: research

Transobturator approach: a novel procedure for anterior vaginal wall prolapse avoiding the use of vaginal mesh
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - September 13, 2020 Category: OBGYN Source Type: research

The comeback of vaginal surgery during and after the COVID-19 pandemic: a new paradigm
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - September 13, 2020 Category: OBGYN Source Type: research