In vivo assessment of the levator ani muscles using shear wave elastography: a feasibility study in women
ConclusionsAn assessment of the elastic properties of the levator ani muscles is feasible for nonpregnant women. The reproducibility of the technique and its application in pregnant women and women with pelvic floor disorders must be investigated. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 20, 2019 Category: OBGYN Source Type: research

Perioperative hemorrhagic complications in pelvic floor reconstructive surgery
AbstractIntroduction and hypothesisWe sought to assess the incidence, symptoms, and risk factors of perioperative hemorrhagic complications in patients undergoing pelvic floor reconstructive surgery.MethodsThis is a retrospective study on 694 consecutive patients who underwent pelvic floor reconstructive surgery with or without using mesh in our hospital over a 3-year period.ResultsWe identified 694 pelvic floor reconstructive procedures from 2014 to 2016, including complete/incomplete colpocleisis (176, 25.4%), sacral colpopexy/hysteropexy with mesh (140, 20.1%), colporrhaphy (77, 11.1%) or vaginal mesh repair (99, 43.1%)...
Source: International Urogynecology Journal - June 20, 2019 Category: OBGYN Source Type: research

Effects of mesh-related complications in vaginal surgery on quality of life
ConclusionMesh surgery imposes specific complications. When counseling patients about the potential adverse events related to vaginal mesh surgery, it is important to inform them that mesh-related complications do not negatively affect QoL related to micturition, defecation, and sexual functioning. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 20, 2019 Category: OBGYN Source Type: research

Reintegration needs of young women following genitourinary fistula surgery in Uganda
ConclusionsYoung women recovering from genitourinary fistula surgery require individualized assessment of their social reintegration needs. Postoperative social reintegration services must be strengthened to do this effectively. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 20, 2019 Category: OBGYN Source Type: research

Letter to the editor: The negative predictive value of preoperative urodynamics for stress urinary incontinence following prolapse surgery
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 20, 2019 Category: OBGYN Source Type: research

Public toilets in parklands or open spaces in international cities using geographic information systems
ConclusionsAvailability of public toilets in parklands or open spaces varies among international cities. Toilet availability should be considered in urban planning and community healthcare programs to promote continence, health, and quality of life. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 18, 2019 Category: OBGYN Source Type: research

Post-hospital syndrome predicts poor postoperative outcomes and increased cost following transvaginal midurethral sling placement
AbstractIntroduction and hypothesisPost-hospital syndrome (PHS), a 90-day period of health vulnerability related to physiologic stressors following recent inpatient admission, has been observed in surgical and non-surgical patients. We aim to explore its effects on readmission and complication rates in patients undergoing elective female mid-urethral sling placement for the treatment of stress urinary incontinence.MethodsThe Healthcare Cost and Utilization Project State Inpatient Database, State Emergency Department Database, and State Ambulatory Surgery Database for Florida between 2009 and 2014 were linked and utilized. ...
Source: International Urogynecology Journal - June 13, 2019 Category: OBGYN Source Type: research

Does diastasis recti abdominis weaken pelvic floor function? A cross-sectional study
AbstractIntroduction and hypothesisThe aim of this study was to compare pelvic floor muscle strength (PFMS) and the prevalence of urinary incontinence (UI) and pelvic organ prolapse(POP) in women with and without diastasis recti abdominis (DRA) at 6 –8 weeks postpartum.MethodsThree hundred and ten women underwent routine examinations, including POP quantification (POP-Q), PFMS measurement, DRA evaluation, and UI determination. Chi-squared tests and independent samplet test were used to compare the differences between women with DRA and without DRA.ResultsWomen with DRA presented significantly lower prepregnancy ...
Source: International Urogynecology Journal - June 13, 2019 Category: OBGYN Source Type: research

Persistent occiput posterior position and stress distribution in levator ani muscle during vaginal delivery computed by a finite element model
ConclusionsThe fetal head position during vaginal delivery significantly affects the stress distribution in the levator muscle. Considering the persistent occiput posterior position, the stress increases evenly 3.6 times compared with the optimal head position. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 13, 2019 Category: OBGYN Source Type: research

Utilization of CT for InterStim sacral neuromodulation lead placement in a patient with morbid obesity
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 13, 2019 Category: OBGYN Source Type: research

Modified colpocleisis for repair of pelvic organ prolapse post-radical cystectomy
ConclusionsClosure of the vaginal canal successfully treated POP in our case series. There were no intra- or postoperative complications in any of the cases. Patients were discharged the following day and did not show any signs of recurrence at follow-up (3, 5, and 6  months post-surgery). (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 13, 2019 Category: OBGYN Source Type: research

The transition from resident to consultant
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 13, 2019 Category: OBGYN Source Type: research

A longitudinal qualitative evaluation of patient perspectives of adverse events after pelvic reconstructive surgery
AbstractIntroduction and hypothesisPatient perception of adverse events (AEs) after pelvic floor disorder surgery is incompletely understood and may differ from providers ’ views of AEs. Our objective is to describe patient perceptions of AEs related to pelvic floor disorder surgery and how perceptions change over time.MethodsMixed-method study of longitudinal patient interviews and surveys. Women planning pelvic floor disorder surgery completed three one-on-one interviews: preoperatively (
Source: International Urogynecology Journal - June 11, 2019 Category: OBGYN Source Type: research

Management of presacral bleeding
ConclusionFamiliarity with these techniques and product availability will aid in the management of acute presacral bleeding. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 11, 2019 Category: OBGYN Source Type: research

The resurrection of sacrospinous fixation: unilateral apical sling hysteropexy
ConclusionsA unilateral sacrospinous fixation with a synthetic mesh (apical sling) combined with anterior subfascial colporrhaphy enhances the anatomical efficacy of surgery. It also helps to avoid specific side effects of traditional sacrospinous fixation. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 10, 2019 Category: OBGYN Source Type: research

The underutilization of obliterative and constrictive surgery in the surgical treatment of pelvic organ prolapse
AbstractVaginal length and caliber are necessary for satisfactory vaginal coitus. Surgical treatment of pelvic organ prolapse (POP) can include preservation of vaginal length and caliber, or shortening and narrowing of the vagina (constrictive and obliterative surgery). The latter option is proven to have fewer complications and a lower risk of recurrence of POP. Women undergoing surgical intervention for POP who are not coitally active and choose not to be coitally active for the rest of their lives should be offered constrictive and obliterative surgery. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 10, 2019 Category: OBGYN Source Type: research

Pelvic floor muscle training adapted for urinary incontinence in multiple sclerosis: a randomized clinical trial
AbstractIntroduction and hypothesisLower urinary tract symptoms (LUTS) affect up to 80% of patients with multiple sclerosis (MS). The present randomized, open-label, clinical trial examines the effectiveness, as a conservative treatment for LUTS, of a physiotherapist-guided pelvic floor muscle training (PFMT) program adapted for patients with relapsing-remitting multiple sclerosis (RRMS) and urinary incontinence (UI).MethodsForty-eight patients with RRMS were randomly assigned to a 12-week PFMT program with or without physiotherapist guidance. The primary endpoint was the reduction in urinary leakages after 12  weeks ...
Source: International Urogynecology Journal - June 10, 2019 Category: OBGYN Source Type: research

Strong agreement between interview-obtained and self-administered Wexner and St. Mark ’s scores using a single questionnaire
ConclusionThe SMIS and Wexner scores can be completed by the patients using a single questionnaire, and the derived SMIS and Wexner scores are highly consistent with scores obtained by interview. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 6, 2019 Category: OBGYN Source Type: research

Teaching learners to raise the roof: a vaginal surgery simulator for apical suspension
ConclusionPelvic organ prolapse is common in women, although opportunities to teach apical suspension procedures may be limited. The proposed vaginal surgery simulator can be used to supplement the experience of gynecological surgery trainees with apical suspension procedures. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 6, 2019 Category: OBGYN Source Type: research

Prevalence of symptomatic pelvic floor disorders in community-dwelling women in low and middle-income countries: a systematic review and meta-analysis
ConclusionsPFDs affect a substantial proportion of women in LMICs. Since methodological heterogeneity was unexplained, this review suggests the need for large nationally representative population-based surveys to provide reliable estimates of the prevalence of PFDs in LMICs. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 4, 2019 Category: OBGYN Source Type: research

Somatic and psychological triggers for bladder storage symptoms among men and women
AbstractIntroduction and hypothesisTo determine the prevalence of somatic and psychological triggers for bladder storage symptoms among men and women who have not been diagnosed with overactive bladder (OAB) and to determine their impact on individuals ’ quality of life (QoL).MethodsRandomly selected male and female volunteers were screened for the presence of bladder storage symptoms and their impact on their QoL using the UDI-6 and IIQ-7 questionnaires. They were also asked about somatic and psychological triggers for these symptoms using the validated SOPSETO questionnaire. Individuals who had previously been diag...
Source: International Urogynecology Journal - June 4, 2019 Category: OBGYN Source Type: research

The experience of genitourinary syndrome of menopause (GSM) among Thai postmenopausal women: the non-reporting issue
ConclusionsGSM is common among Thai postmenopausal women. The prevalence of non-reporting is high and underreported. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 4, 2019 Category: OBGYN Source Type: research

Ventral-onlay buccal mucosal graft urethroplasty for the treatment of female urethral stricture: a step-by-step video for Female Pelvic Reconstructive Surgeons
ConclusionPelvic surgeons should be familiar with the management of female urethral stricture, including surgical treatment options such as urethral reconstruction. This video may be used to facilitate the reproducibility and comprehension of the ventral urethroplasty procedure. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 4, 2019 Category: OBGYN Source Type: research

Authors ’ reply to comment by Tailor et. al on “Academic cosmetic gynecology and energy-based therapies: ambiguities, explorations, and FDA advisories”
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - June 4, 2019 Category: OBGYN Source Type: research

Motion of the vaginal apex during strain and defecation
This study was aimed at quantifying the motion of the non-prolapsed vaginal apex during strain and defecation maneuvers.MethodsThis study represents a sub-analysis of a parent study that was aimed at evaluating rectal mobility with regard to obstructed defecation symptoms. Patients with normal apical vaginal support who had undergone MR defecography were entered into the study. For each patient, midsagittal images at rest, maximum strain, and maximum evacuation were utilized. The location of the cervicovaginal junction, S4 –S5 intervertebral disc, sacral promontory, and hymen were identified. Vectors were calculated ...
Source: International Urogynecology Journal - June 3, 2019 Category: OBGYN Source Type: research

Utility of patient decision aids (PDA) in stress urinary incontinence surgery
AbstractIntroduction and hypothesisPatient decision aids (PDAs) facilitate shared decision making allowing patients to make decisions about their healthcare that take into account their personal values and preferences. The aim of this study was to establish whether a PDA used in women requiring stress incontinence surgery is helpful to women when making choices about the treatments they choose by using a Decision Conflict Scale (DCS).MethodsForty-five consecutive women were identified as having stress urinary incontinence and had completed all conservative treatments. All patients included in the study had stress urinary i...
Source: International Urogynecology Journal - June 1, 2019 Category: OBGYN Source Type: research

Effects of perineal preparation techniques on tissue extensibility and muscle strength: a pilot study
AbstractIntroduction and hypothesisPerineal preparation techniques for childbirth have been used with the aim of reducing perineal tears during the expulsive phase of labor. However, no studies were found to investigate the effects of instrument-assisted stretching versus perineal massage on pelvic floor muscle (PFM) variables. Therefore, the aim of this study was to evaluate the effect of instrument-assisted stretching versus perineal massage on the extensibility and strength of the PFMs.MethodsPrimiparous women were randomized to the instrument-assisted stretching (IStr) group (n = 13) and perineal massage ...
Source: International Urogynecology Journal - May 11, 2019 Category: OBGYN Source Type: research

Single prior caesarean section and risk of anal sphincter injury
ConclusionsVBAC does not confer an increased risk of OASI after a first delivery by caesarean section when compared with nulliparous women. The rate of successful VBAC may be contributory and suggests that the risk conferred by VBAC may be unit-specific. Unit and national-level audit is necessary to investigate this risk further. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - May 11, 2019 Category: OBGYN Source Type: research

Variations in bladder pain syndrome/interstitial cystitis (IC) definitions, pathogenesis, diagnostics and treatment: a systematic review and evaluation of national and international guidelines
ConclusionsThe guidelines are congruent in symptom reporting, quite congruent in diagnostics and vary to a high degree on treatment recommendations. The complexity of BPS and emerging evidence indicate the need for regular updating of the guidelines and a wider consensus. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - May 9, 2019 Category: OBGYN Source Type: research

Impairment of urethral coitus due to mid-urethral sling in a woman with vaginal agenesis
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - May 9, 2019 Category: OBGYN Source Type: research

LeFort colpocleisis for recurrent pelvic organ prolapse
This study evaluates the efficacy and safety of LeFort colpocleisis for recurrent POP.MethodsWe reviewed data from patients with recurrent POP who underwent LerFort colpocleisis at a center between March 2012 and April 2017. Quality of life was assessed using the Pelvic Floor Distress Inventory Questionnaire (PFDI-20) scores. The Patient Global Impression of Improvement scale (PGI-I) was used to assess self-perceived success and subjective measures of satisfaction. The Clavien-Dindo classification (CD) was used to assess the safety of the procedure. Chi-square and paired t-tests were used to compare the same patients befor...
Source: International Urogynecology Journal - May 8, 2019 Category: OBGYN Source Type: research

Twelve years ’ experience with fascia lata autograft to replace complicated anterior vaginal mesh
AbstractObjectivesTo report 12-year experience with replacing transvaginal mesh (TVM) with fascia lata autograft.MethodsThis was a chart review of TVM removal and replacement with a fascia lata autograft placement by a single surgeon between 2005 and 2017. The Pelvic Organ Prolapse Quantification (POP-Q) system before and 1 year following the procedure, patient-reported recurrence of symptoms, changes in the POP-Q examination and complication rates are analyzed.ResultsTwenty-four patients were included. Mean age was 57.2 (95% CI 53.2 –61.2) years. Mean number of days to Foley catheter removal was 3.2 days (95% C...
Source: International Urogynecology Journal - May 8, 2019 Category: OBGYN Source Type: research

Risk factors and outcome of repair of obstetric anal sphincter injuries as followed up in a dedicated perineal clinic
AbstractIntroduction and hypothesisFaecal incontinence can be a devastating outcome with social, psychological and physical repercussions, and it occurs in 10 –61% following obstetric anal sphincter injury (OASIS). The aim of our study was to determine the contributing factors in the development of severity of OASIS and to correlate anal sphincter tone with the extent of anal sphincter injury.MethodsA prospective cohort study was performed of all patients attending the postnatal perineal clinic at 4 –12 months postpartum, from January 2016 until October 2017. Women were categorised into minor tears (3a and...
Source: International Urogynecology Journal - May 6, 2019 Category: OBGYN Source Type: research

Does estrogen deprivation affect pelvic floor muscle contractility?
ConclusionsEstrogen deprivation may not be an independent predictor of pelvic floor muscle contractility. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - May 4, 2019 Category: OBGYN Source Type: research

A live porcine model for robotic sacrocolpopexy training
ConclusionsThe porcine model provides a feasible tool for teaching robotic sacrocolpopexy to physicians. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - May 4, 2019 Category: OBGYN Source Type: research

Surgical treatment of primary uterine prolapse: a comparison of vaginal native tissue surgical techniques
ConclusionsSacrospinous hysteropexy has exceedingly high numbers of reoperations due to prolapse recurrence. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - May 3, 2019 Category: OBGYN Source Type: research

Pelvic floor dysfunction at transperineal ultrasound and voiding alteration in women with posterior deep endometriosis
AbstractIntroduction and hypothesisPosterior deep infiltrating endometriosis (DIE) has been associated with pelvic floor muscle (PFM) alteration and voiding dysfunction (VD). The aim of this study is to evaluate the correlation between the presence of VD and altered PFM morphometry, objectively evaluated using 3D/4D transperineal ultrasound at rest and during dynamic maneuvers, in patients with posterior DIE.MethodsA prospective study was conducted on 108 symptomatic women scheduled for surgical removal of posterior DIE. The study population was divided in two groups according to presence or absence of VD on the Bristol Fe...
Source: International Urogynecology Journal - May 2, 2019 Category: OBGYN Source Type: research

Risk factors for perineal trauma in the primiparous population during non-operative vaginal delivery
AbstractIntroduction and hypothesisObstetric anal sphincter injuries (OASIS) are more common in the primiparous population, especially during operative vaginal delivery (OVD). It would therefore be interesting to establish what factors influence the risk of OASIS when adjusting for the risk bias of OVD.MethodsRetrospective analysis of prospectively collected data from the maternity database at University of Southampton NHS Foundation Trust of primiparous women sustaining OASIS during a singleton, term, cephalic, non-operative vaginal delivery between 2004 and 2015. A control comparison was made of women with otherwise iden...
Source: International Urogynecology Journal - May 2, 2019 Category: OBGYN Source Type: research

Turkish translation of the Prolapse and Incontinence Knowledge Questionnaire: validity and reliability
AbstractIntroduction and hypothesisTo translate the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) into Turkish and test its validity and reliability.MethodsThe study included 341 women. The translation of the PIKQ, which comprised of the urinary incontinence (PIKQ-UI) and pelvic organ prolapse (PIKQ-POP) sections, was performed in accordance with international recommendations. The Incontinence Quiz (IQ) and the Visual Analog Scale (VAS) were applied to assess the level of knowledge about POP and UI. Psychometric analyses consisted of assessing the following: (1) construct validity by confirmatory factor analysis...
Source: International Urogynecology Journal - May 2, 2019 Category: OBGYN Source Type: research

Documenting pessary offer prior to hysterectomy for management of pelvic organ prolapse
AbstractObjectivesTo (1) determine the proportion of hysterectomy cases with documentation of pessary counseling prior to prolapse surgery and (2) identify variables associated with women offered a pessary.Study designThe Michigan Surgical Quality Collaborative (MSQC) is a hysterectomy improvement initiative. Hysterectomies from 2013 to 2015 in which prolapse was the principal diagnosis were included. “Pessary offer” was defined as documentation showing the patient declined, could not tolerate, or failed a pessary trial. Bivariate analyses were used to compare demographics, medical history, surgical route, conc...
Source: International Urogynecology Journal - April 30, 2019 Category: OBGYN Source Type: research

Assessment of abdominal and pelvic floor muscle function among continent and incontinent athletes
ConclusionsWe found that incontinent athletes have greater PFM strength than continent athletes. This suggests that urinary incontinence in this population is not due to PFM weakness. The positive association between abdominal and PFM strengths in incontinent athletes may be due to frequent co-contraction between these muscle groups. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 30, 2019 Category: OBGYN Source Type: research

Computed-tomography image segmentation and 3D-reconstruction of the female pelvis for the preoperative planning of sacrocolpopexy: preliminary data
ConclusionsPre-surgical 3D reconstructions of the female pelvis using ITK-SNAP could help achieve widespread use of sacrocolpopexy: further comparative studies are needed to evaluate the outcomes with and without their use. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 30, 2019 Category: OBGYN Source Type: research

Accuracy of postvoid residual volumes after vaginal delivery: a prospective equivalence study to compare an automatic scanning device with transurethral catheterization
ConclusionsThe BladderScan ® (BVI 9400) measures PVRV precisely and reliably after vaginal delivery and should be preferred over catheterization. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 30, 2019 Category: OBGYN Source Type: research

Bladder wall injection of mesenchymal stem cells ameliorates bladder inflammation, overactivity and nociception in a chemically induced interstitial cystitis-like rat model
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 30, 2019 Category: OBGYN Source Type: research

Validation of the Turkish version of the International Consultation on Incontinence Questionnaire-vaginal symptoms (ICIQ-VS)
This study aimed to validate the Turkish version of ICIQ-VS.MethodsThe English version of the questionnaire was translated into Turkish. On the basis of the pelvic organ prolapse quantification (POP-Q) system, symptomatic women with ≥ 2 grade pelvic organ prolapse (POP) were included in the symptomatic (patient) group and asymptomatic women with ≤ 1 grade POP in the asymptomatic (control) group. The questionnaire was administered three times: after the first examination of the women (T1), 3 weeks after T1 (T2), and 3 mont hs after the POP surgery (T3).ResultsA total of 111 women were included in the study (...
Source: International Urogynecology Journal - April 29, 2019 Category: OBGYN Source Type: research

FPMRS challenges on behalf of the Collaborative Research in Pelvic Surgery Consortium (CoRPS): managing complicated cases
AbstractThis case presents the work-up and management of a spina bifida patient with recurrent prolapse. Four international experts also provide their evaluation of and approach to this complex case. According to the literature, little is known regarding the approach to the management of this specific patient population. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 29, 2019 Category: OBGYN Source Type: research

Academic cosmetic gynaecology and energy-based therapies: ambiguities, explorations, and FDA advisories
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 29, 2019 Category: OBGYN Source Type: research

Editorial: use of surgical databases in urogynaecology
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 29, 2019 Category: OBGYN Source Type: research

Letter to the editor: The negative predictive value of preoperative urodynamics for stress urinary incontinence following prolapse surgery
(Source: International Urogynecology Journal)
Source: International Urogynecology Journal - April 29, 2019 Category: OBGYN Source Type: research

Pelvic organ prolapse patients ’ attitudes and preferences regarding their uterus: comparing German- and Russian-speaking women
AbstractIntroduction and hypothesisThe aim of this study was to compare preferences of patients with pelvic organ prolapse (POP) regarding their uterus between German- and Russian-speaking areas.MethodsSix urogynecologic tertiary referral centers participated in this prospective study: three centers from German-speaking countries and three from different regions of Russia. To assess the uterus-related preferences as well as the attitude toward hysterectomy versus uterus-sparing prolapse surgery, we developed a structured questionnaire that included 5-point Likert scales related to benefit of uterus (BOU) and benefit of not...
Source: International Urogynecology Journal - April 26, 2019 Category: OBGYN Source Type: research