Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study
This study was aimed at determining the recurrence rate and risk factors for the recurrence of pelvic organ prolapse (POP), at 1 year post-vaginal reconstructive surgery in a resource-limited setting.MethodsWe enrolled women who underwent vaginal surgery for POP at the urogynecology unit of Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda between December 2018 and February 2020. The surgeries that were performed include anterior colporrhaphy for cystocele, posterior colporrhaphy for rectocele, vaginal hysterectomy with vault suspension for uterine prolapse, and cervicopexy in those with uterine prolapse whe...
Source: International Urogynecology Journal - July 28, 2021 Category: OBGYN Source Type: research

Effectiveness of physiotherapy for lower urinary tract symptoms in postpartum women: systematic review and meta-analysis
AbstractIntroduction and hypothesisThe efficacy of physiotherapy for postpartum lower urinary tract symptoms (LUTS) has attracted considerable research interest. In the current study we evaluated the efficacy and safety of pelvic floor muscle training (PFMT) combined with biofeedback (BF), electrical stimulation (ES) therapy, or both for postpartum LUTS.MethodsPUBMED, EMBASE, Web of Science, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science and Technique Journals Database, and Wanfang databases were searched from inception to December 2020. Eligible randomize...
Source: International Urogynecology Journal - July 24, 2021 Category: OBGYN Source Type: research

Is vaginal laxity an early symptom of pelvic organ prolapse?
ConclusionsWith increasing age the prevalence of VL decreases, whereas symptoms of POP increase. However, only very few women with objective POP perceive VL as their only symptom, independent of age at presentation. Therefore, vaginal laxity does not seem to be an early symptom of prolapse. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 24, 2021 Category: OBGYN Source Type: research

Pelvic floor architectural defects in female patients with urge fecal incontinence versus passive fecal leakage: a dynamic ultrasound study
ConclusionPatients with urge-predominant FI have increased frequency of bowel movements, looser stools, and increased rectal folding diagnosed via dynamic ultrasound as compared to patients with passive-dominant FI. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 22, 2021 Category: OBGYN Source Type: research

De novo detrusor overactivity and urgency after mid-urethral slings for urodynamic stress incontinence
The objective was to identify incidence and risk factors of de novo urgency and detrusor overactivity (DO) following mid-urethral slings (MUS) in patients with urodynamic stress incontinence (USI) without urgency.MethodsA total of 688 women between January 2004 and July 2017 were reviewed retrospectively. De novo urgency was established with a positive response to question 2 on the Urogenital Distress Inventory-6 questionnaire (UDI-6). Objective cure of USI is no involuntary urine leakage during filling cystometry and pad test
Source: International Urogynecology Journal - July 22, 2021 Category: OBGYN Source Type: research

Do patients discharged from the physiotherapy-led pelvic health clinic re-present to the urogynaecology service?
ConclusionThis study presents novel data on low re-presentation rates in the 12  months following discharge for patients with POP or UI managed in a PLPHC; and provides further support for advanced scope of practice physiotherapy gynaecological service models. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 21, 2021 Category: OBGYN Source Type: research

Unanticipated cystoscopic findings at the time of planned hydrodistension for bladder pain syndrome
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 21, 2021 Category: OBGYN Source Type: research

Can the mini-sling become the golden standard for treating stress urinary incontinence? Comment: The TFS retropubic tensioned minisling for SUI —a 14 year experience with high long-term RCT cure
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 21, 2021 Category: OBGYN Source Type: research

Postoperative prophylactic antibiotics for retropubic mid-urethral slings
ConclusionsThere was no significant difference in postoperative UTI rate in the group without postoperative prophylactic antibiotics compared to those who did receive it. Catheterization past postoperative day 1 was significantly associated with postoperative UTI. However, definitive conclusions are limited by a lack of power. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 15, 2021 Category: OBGYN Source Type: research

Modified autologous fascial sling technique ( ‘sling on a string’) for stress incontinence
ConclusionAutologous fascial slings can be used in the surgical management of urodynamic stress incontinence. The technique demonstrated in this video is the technique employed in the largest randomized controlled trial investigating the efficacy of autologous fascial slings to xenografts and tapes. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 14, 2021 Category: OBGYN Source Type: research

Translation and validation of the Persian ICIQ bladder diary
ConclusionThe Persian ICIQ bladder diary demonstrates good stability and strong content validity among the Iranian population with lower urinary tract symptoms. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 12, 2021 Category: OBGYN Source Type: research

Pelvic organ prolapse surgery and overactive bladder symptoms —a population-based cohort (FINPOP)
ConclusionsOAB symptoms are more strongly related to anterior and apical than to posterior compartment prolapse, but improvement is seen after surgery for any vaginal compartment. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 10, 2021 Category: OBGYN Source Type: research

Evaluation of mobile applications for patients with fecal incontinence using a modified APPLICATIONS scoring system
ConclusionsPatient-centered mobile apps that provide FI-specific educational information or allow for FI symptom tracking are scarce. While we did discover some accurate sources of information and means of tracking bowel habits, patients are likely to encounter inaccurate or irrelevant information even when searching for FI-related apps using appropriate terminology. Future app development should include FI-specific symptom tracking and educational information from reputable sources. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 10, 2021 Category: OBGYN Source Type: research

Acquired labial synechia in a virgin reproductive-aged woman: presentation and management
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 9, 2021 Category: OBGYN Source Type: research

Pessaries and rectovaginal fistulae: consequences of delayed clinical follow-up in the Covid-19 pandemic
ConclusionWe believe that delayed clinical follow-up of pessary management beyond 3 months due to the Covid-19 pandemic may lead to fistula complications in elderly women with Gellhorn pessaries. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 8, 2021 Category: OBGYN Source Type: research

Anal canal to pubis angle: a novel clinical ultrasound technique for the assessment of the anorectal region
AbstractIntroduction and hypothesisPosterior compartment prolapse is associated with severe morbidity including faecal incontinence and defaecation dysfunction. The aim of this study was to develop and validate a novel ultrasound marker (anal canal to pubis angle) for the assessment of the anal axis in the context of posterior compartment prolapse in women and in controls (healthy, nulliparous, non-pregnant volunteers).MethodsAnal canal to pubis (AC/Pubis) angle is measured with 2D transperineal ultrasound in precisely the midsagittal plane. The image was inverted and zoomed out and the angle opened to 107 ° (maximum)....
Source: International Urogynecology Journal - July 8, 2021 Category: OBGYN Source Type: research

Teaching the art of LeFort colpocleisis: a moderate-fidelity, low-cost simulation model
The objective was to demonstrate the build and use of a low-cost, moderate-fidelity simulation model for LeFort colpocleisis. We a present a video demonstrating the creation of a LeFort colpocleisis model, the mounting of this model to a pre-existing vaginal hysterectomy simulator (SimVaHT), and the use of the model to teach the steps of the LeFort colpocleisis procedure. This LeFort colpocleisis model is easy to make, from readily available materials, and is inexpensive. It can help trainees to enhance their intraoperative learning. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 8, 2021 Category: OBGYN Source Type: research

Modified vaginal hysterectomy for chronic non-puerperal complete uterine inversion: video presentation
ConclusionThis novel reverse vaginal hysterectomy combining the principles of both abdominal and vaginal hysterectomy can successfully manage chronic non-puerperal complete uterine inversion. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 8, 2021 Category: OBGYN Source Type: research

Response to commentary
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 8, 2021 Category: OBGYN Source Type: research

Re: The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis.  Int Urogynecol J 32, 501–552 (2021)
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 6, 2021 Category: OBGYN Source Type: research

Commentary on “Methenamine hippurate compared with trimethoprim for the prevention of recurrent urinary tract infections: a randomized clinical trial”
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 6, 2021 Category: OBGYN Source Type: research

Comparison of two laparoscopic vaginoplasties using a single peritoneal flap in patients with Mayer-Rokitansky-K üster-Hauser syndrome
ConclusionsBoth the Hebei I and Hebei II techniques are feasible approaches for creating a neovagina which can bring satisfactory anatomical and sexual outcomes in patients with MRKH syndrome. However, the Hebei II technique may be a good alternative to the Hebei I technique because of its relatively shorter operative time, fewer neovaginal secretions and fewer granulomatous polyps. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 2, 2021 Category: OBGYN Source Type: research

Perioperative outcomes following pelvic floor reconstruction in women with hereditary disorders of connective tissue: a retrospective cohort study
ConclusionsPatients with HDCTs had more Clavien –Dindo grade I and II complications following pelvic floor reconstructive surgery and more readmissions. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 2, 2021 Category: OBGYN Source Type: research

A systematic review of neurocognitive dysfunction with overactive bladder medications
ConclusionIn this review, cognitive decline was reported with oxybutynin and tolterodine use and should be used with caution in adults over 65  years of age. Solifenacin, fesoterodine, and imidafenacin showed mixed results related to central nervous system effect. Trospium and darifenacin were not associated with cognitive decline among patients with and without baseline cognitive impairment. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 2, 2021 Category: OBGYN Source Type: research

Hysteropreservation versus hysterectomy in uterine prolapse surgery: a systematic review and meta-analysis
ConclusionThis study found that both hysteropreservation and hysterectomy have similar effects on recurrence and reoperation rates, while hysteropreservation was superior to hysterectomy in reducing intraoperative blood loss and shortening the duration of surgery and hospitalization. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 2, 2021 Category: OBGYN Source Type: research

Clinical presentation and treatment of Macroplastique ® urethral exposures: a retrospective case series
ConclusionUrethral bulking with Macroplastique ® can lead to symptomatic urethral exposures. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - July 2, 2021 Category: OBGYN Source Type: research

Translabial ultrasound: a non-invasive technique for assessing “technical errors” after TOT failure
The objective cure for SUI was defined as the absence of urine leakage during the stress test. We evaluated the bladder neck mobility at rest and during Valsalva; the position of the mesh along the urethra; the concordance of urethral movement with the sling during Valsalva; the symmetry of the lateral arms of the sling during straining; and the presence or absence of bladder neck funneling.ResultsFrom December 2012 to February 2016, 80 consecutive patients were included. Six months after surgery, incontinent women compared with continent women had the sling in a proximal or distal position, that moved discordantly with the urethra (p 
Source: International Urogynecology Journal - June 30, 2021 Category: OBGYN Source Type: research

International Urogynecological Consultation: clinical definition of pelvic organ prolapse
ConclusionsThe clinical definition of POP for this review of the literature is: “anatomical prolapse with descent of at least one of the vaginal walls to or beyond the vaginal hymen with maximal Valsalva effort WITH the presence either of bothersome characteristic symptoms, most commonly the sensation of vaginal bulge, or of functional or medical compromise due to prolapse wi thout symptom bother.” (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 30, 2021 Category: OBGYN Source Type: research

Letter to the editor: The extended pessary interval for care (EPIC) study: a failed randomized clinical trial
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 30, 2021 Category: OBGYN Source Type: research

Ultrasound evaluation of anterior transvaginal mesh for pelvic organ prolapse: correlation to 5-year clinical outcomes
AbstractIntroduction and hypothesisVaginal prolapse mesh may effectively restore vaginal anatomy. The aim of this study was to investigate how the in vivo mesh position correlates to clinical outcomes.MethodsSeventy-one women operated on using Uphold mesh for apical pelvic organ prolapse (POP-Q, C  ≥ stage II) were examined 5 years after surgery by introital-perineal 2D ultrasound in a midsagittal plane at rest and Valsalva. The horizontal line and pubis symphysis were considered the reference for all measures. Ultrasound measures were statistically compared to clinical outcomes: POP-Q, Pelvic Floor Distre...
Source: International Urogynecology Journal - June 29, 2021 Category: OBGYN Source Type: research

Surgical interventions in female urethral strictures: a comprehensive literature review
ConclusionIn practice, UD is tried first for FUS, at least once, before urethroplasty. In case of failure or short recurrence following UD, urethroplasty should not be delayed. In experienced hands, urethroplasty has a better outcome. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 29, 2021 Category: OBGYN Source Type: research

Fundal pressure in the second stage of labor (Kristeller maneuver) and levator ani avulsion
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 29, 2021 Category: OBGYN Source Type: research

The effectiveness of McCall culdoplasty following vaginal hysterectomy in advanced stages of uterine prolapse
ConclusionMcCall culdoplasty was found to have an equal subjective effectiveness following VH in both mild and advanced stages of uterine prolapse. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 28, 2021 Category: OBGYN Source Type: research

Linguistic and clinical validation of the acute cystitis symptom score in German-speaking Swiss women with acute cystitis
ConclusionsThe analysis showed that the German version of the ACSS is also suitable for use in the German-speaking female population of Switzerland. Minor differences in definitions of AC between German and Swiss guidelines explain the observed discrepancies in diagnostic values of the ACSS between cohorts. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 25, 2021 Category: OBGYN Source Type: research

Can the inability to contract the pelvic floor muscles influence the severity of urinary incontinence symptoms in females?
ConclusionsNo association was found between the inability to contract the PFMs and the severity of UI symptoms. Other studies should be developed to better understand why some women are incapable of performing a voluntary PFM contraction. Also, it would be relevant to compare women with PFM dysfunction who are not able to contract the PFMs with healthy women with the same PFM condition to analyze whether this muscle condition could be related to dysfunctions such as UI or pelvic organ prolapse. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 25, 2021 Category: OBGYN Source Type: research

The right of patients to make autonomous choices: Montgomery v Lanarkshire Health Board: a landmark decision on information disclosure to patients in the UK
This article aims to consider the impact of the decision of the Supreme Court in Montgomery on information disclosure to patients in the UK but the decision may also have ethical implications which will be relevant in other countries. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 25, 2021 Category: OBGYN Source Type: research

Intraoperative ultrasound assessment of ureteral patency during pelvic surgery
AbstractUreteral injuries probably represent the most feared complication of benign hysterectomies. Lack of proper intraoperative detection causes diagnostic delay, which results in additional hospitalization, prolonged catheterization, and multiple additional procedures. However, the policy of universal cystoscopy is still under debate, owing to costs, increased operative time, lack of proper training, and risk of trauma. Intraoperative ultrasound assessment can offer a valid alternative for evaluating ureteral patency. After intravenous administration of 300  ml of saline solution and 10 mg of furosemide, the b...
Source: International Urogynecology Journal - June 25, 2021 Category: OBGYN Source Type: research

Letter to the editor: Single-incision slings for the treatment of stress urinary incontinence: efficacy and adverse effects at 10-year follow-up
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 25, 2021 Category: OBGYN Source Type: research

Current situation of complications related to reconstructive surgery for pelvic organ prolapse: a multicenter study
This study aimed to investigate the evaluation and management of complications after pelvic floor reconstructive surgery for pelvic organ prolapse in China.MethodsComplications of pelvic floor reconstructive surgery for pelvic organ prolapses from 27 institutions were reported from November 2017 to October 2019. All complications were coded according to the category-time-site system proposed by the International Urogynecological Association (IUGA) and the International Continence Society (ICS). The severity of the complications was graded by the Clavien-Dindo grading system. Four scales were used to evaluate patient satisf...
Source: International Urogynecology Journal - June 24, 2021 Category: OBGYN Source Type: research

Robot-assisted sacrocolpopexy: not only for vaginal vault suspension? An observational cohort study
ConclusionsRobot-assisted sacrocolpopexy and RSHS show sustainable results in the treatment of prolapse. Symptoms of bulge, urinary symptoms, and quality of life improved substantially 50  months postoperatively. Patients should be counseled about the risk of anterior wall recurrence and the small chance of recurrent symptoms that need treatment. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 23, 2021 Category: OBGYN Source Type: research

Contemporary trends for urological training and management of stress urinary incontinence in Ireland
ConclusionsThis study has identified a downward trend in SUI surgery, which is concerning for the undertreatment of females with SUI. A decline in SUI surgery training has resulted in reduced trainee confidence and interest in this subspecialty. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 23, 2021 Category: OBGYN Source Type: research

Trigone as a diagnostic and therapeutic target for bladder-centric interstitial cystitis/bladder pain syndrome
AbstractThe pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS) may be bladder-centric, with afferent nerve hyperexcitability and/or due to neural central sensitization. In bladder-centric disease, the trigone ’s unmyelinated nociceptive C-fibers are thought to be upregulated, suggesting this as a potential target for diagnostic modalities and for treatment with local anesthetics and chemodenervation. We propose that the transvaginal trigone treatment (T3) route of administration of such treatments shou ld be considered in women with IC/BPS, as this approach is easier and less invasive than cystos...
Source: International Urogynecology Journal - June 22, 2021 Category: OBGYN Source Type: research

Prevalence of urinary incontinence in pregnant and postpartum women in the Democratic Republic of Congo
The objective was to describe the prevalence of urinary incontinence in pregnant and postpartum women in the Democratic Republic of Congo and to identify factors associated with urinary incontinence (UI) in these populations.MethodsWe interviewed eligible women who sought prenatal or postnatal reproductive health clinic consultations over a 2-year period. Interviews collected information about demographics, obstetric history, and urinary incontinence symptoms, as well as the impact on the quality of life, via a validated questionnaire. Descriptive analyses compared women with and without urinary incontinence and compared c...
Source: International Urogynecology Journal - June 21, 2021 Category: OBGYN Source Type: research

Evaluation of clinical practice guidelines (CPG) on the management of female chronic pelvic pain (CPP) using the AGREE II instrument
ConclusionMajority of guidelines were of moderate quality with significant variation in recommendations and quality of guideline development. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 19, 2021 Category: OBGYN Source Type: research

Patient-reported outcomes and outcome measures in childbirth perineal trauma research: a systematic review
ConclusionsSignificant heterogeneity in PROs and PROMs was observed among RCTs. Despite inconsistency, PROs are the most prevalent outcome in perineal trauma research. Patient-reported adverse events are underreported. Their use in determining the effectiveness and safety of interventions makes their integration important in perineal trauma core outcome sets. Identification and grouping of outcomes will assist future core outcome consensus studies. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 18, 2021 Category: OBGYN Source Type: research

Prevalence, incidence and bothersomeness of urinary incontinence between 6  weeks and 1 year post-partum: a systematic review and meta-analysis
ConclusionsPost-partum UI is highly prevalent in women in the Western world. After an initial drop it rises again at 1  year post-partum. Experienced bother is mild to moderate. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 17, 2021 Category: OBGYN Source Type: research

Reliability, validity and responsiveness of pelvic floor muscle surface electromyography and manometry
AbstractIntroduction and hypothesisVaginal surface electromyography (sEMG) is commonly used to assess pelvic floor muscle (PFM) function and dysfunction but there is a lack of studies regarding the assessment properties. The aim of the study was to test the hypotheses that sEMG has good test-retest intratester reliability, good criterion validity and is responsive to changes compared to manometry.MethodsPFM resting tone, maximum voluntary contraction (MVC) and endurance were measured in 66 women with pelvic floor dysfunction. One assessment by manometry was followed by two testing sessions with sEMG at baseline. After 4 to...
Source: International Urogynecology Journal - June 17, 2021 Category: OBGYN Source Type: research

Determinants of uterovaginal prolapse in Western Ethiopia
AbstractIntroduction and hypothesisUterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited. It significantly affects women ’s health and productivity. Thus, it is very important to identify determinant factors and take preventive actions.MethodsA hospital-based unmatched case-control study was conducted on 86 cases and 258 controls who attended gynecologic outpatient departments in Nekemte town from May 1 to July 30, 2019. Cases were women with grade II, III and IV uterovaginal prolapse while controls were women free from uterovaginal p...
Source: International Urogynecology Journal - June 17, 2021 Category: OBGYN Source Type: research

Maternal birth trauma and its consequences: time to raise awareness
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 17, 2021 Category: OBGYN Source Type: research

Healthcare utilization following minimally invasive apical prolapse repair in a large integrated healthcare system
AbstractIntroduction and hypothesisWe sought to describe healthcare utilization (HU) following minimally invasive apical prolapse repair (MIAR) and its association with duration of hospital stay, patient characteristics, and perioperative factors.MethodsThis retrospective study included women undergoing MIAR within a large managed care organization between January 1, 2011, and June 30, 2018, and aimed to quantify HU within 30  days of surgery. HU was dichotomized into two groups: normal and high, based on typical postoperative utilization of healthcare resources. The primary outcome was the rate of normal versus high ...
Source: International Urogynecology Journal - June 16, 2021 Category: OBGYN Source Type: research