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(searched for: doi:10.1080/0167482x.2017.1294155)
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, Zelalem Mengistu Gashaw, Zelalem Ayichew Workineh, Tamiru Minwuye Andargie, Tibeb Zena Debele, Solomon Gedlu Nigatu
Published: 17 June 2022
Abstract:
Purpose: Pelvic Floor Disorders (PFDs) affects many women and have a significant impact on their quality of life. Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20) help to assess PFDs; however, both are not culturally translated into the Amharic-language. Hence, we aimed to translate the English versions of short forms of the PFDI-20 and PFIQ-7 into Amharic-language and evaluate their psychometric properties in Amharic-speaking Ethiopian women with symptomatic PFDs.Methods: The PFDI-20 and PFIQ-7 were translated into Amharic language using standard procedures. The Amharic versions were completed by 197 patients (response rate 92%) with PFDs from University of Gondar specialized and comprehensive Hospital. Internal consistency and test-retest reliability were examined through Cronbach’s alpha and Intraclass correlation coefficients (ICC). A relative criterion standard, POP-SS-7 score, was correlated with total PFDI-20 and subscale POPDI-6 scores (spearman’s rank order correlation (SCC). Construct validity was evaluated by known group validity using the Mann–Whitney U test.Results: Both instruments were successfully translated and adapted with an excellent content validity (> 0.90). The Amharic versions of the PFDI-20 and PFIQ-7 showed excellent internal consistency and test-retest reliability in both summary and subscales (Cronbach’s alpha: 0.92 for PFDI-20 and 0.91 for PFIQ-7; and ICC: 0.97 for PFDI-20 and 0.86 for PFIQ-7). Criterion validity was good for POPDI-6 (SCC = 0.71; p < 0.001). Moreover, construct validity was acceptable, showing significant differences among groups of PFDs in the PFDI-20 and PFIQ-7 scores (Mann–Whitney U Test; p < 0.001).Conclusions: The Amharic versions of the PFDI-20 and PFIQ-7 are comprehensible, reliable, valid, and feasible in Ethiopian Amharic-speaking women with PFDs to evaluate symptoms and its impact during research and clinical practice. However, further studies are needed to evaluate the responsiveness.
Dylan Hutchison, Marwan Ali, Jacqueline Zillioux, Nicolas M. Ortiz, Ryan Smith,
Current Bladder Dysfunction Reports, Volume 17, pp 115-124; https://doi.org/10.1007/s11884-022-00653-8

The publisher has not yet granted permission to display this abstract.
, E.A. Avetisyan, O.V. Starkina, Yu.Yu. Babin, N.N. Nikishov, S.M. Avetisyan, D.N. Suchilin, V.K. Beloglazov
Rossiiskii vestnik akushera-ginekologa, Volume 22; https://doi.org/10.17116/rosakush20222204155

Giulia Keppe Pisani, Tatiana De Oliveira Sato, Danilo Henrique Trevisan de Carvalho,
European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 268, pp 56-61; https://doi.org/10.1016/j.ejogrb.2021.11.424

The publisher has not yet granted permission to display this abstract.
, Marco P. L. Parente, Renato M. Natal Jorge, John O. L. DeLancey, James A. Ashton-Miller
International Urogynecology Journal, Volume 33, pp 211-220; https://doi.org/10.1007/s00192-021-05012-5

The publisher has not yet granted permission to display this abstract.
Published: 8 November 2021
by MDPI
Journal of Clinical Medicine, Volume 10; https://doi.org/10.3390/jcm10215210

Abstract:
Urinary incontinence (UI) is becoming an increasingly common health problem. UI treatment can be conservative or surgical. This paper focuses on the effectiveness of magnetic stimulation (MS) in the treatment of UI. We performed a systematic review in order to combine and compare results with results from our clinical study. A clinical prospective non-randomized study was carried out at the Ljubljana University Medical Center’s Gynecology Division. It included 82 randomly selected female patients, irrespective of their UI type. The success rate of using MS in treating UI was based on standardized ICIQ-UI SF questionnaires. Patients completed 10 therapy sessions on MS, and follow-up was performed 3 months after the last therapy session. UI improved after treatment with MS. The ICIQ-UI SF score improved in patients regardless of the type of UI. However, the greatest decrease in post-treatment assessment ICIQ-UI SF scores was seen in patients with stress urinary incontinence (SUI). Based on the findings described above, it can be concluded that MS is a successful non-invasive conservative method for treating UI. Future studies are necessary, all of which should include a large sample size, a control group, an optimal research protocol, pre-treatment analyses, standardization, and longer follow-ups.
Marilyn Clarke, , Corey Williams, Stephen J. Robson
International Journal of Gynecology & Obstetrics, Volume 155, pp 268-274; https://doi.org/10.1002/ijgo.13920

The publisher has not yet granted permission to display this abstract.
, Annelize Barnard, Carolin Spüntrup, Sven Schiermeier, Stephan Soltécz, Michael Anapolski, Ibrahim Alkatout
Minimally Invasive Therapy & Allied Technologies, Volume 31, pp 782-788; https://doi.org/10.1080/13645706.2021.1941118

Abstract:
The use of mesh for vaginal repairs is currently problematic and as a consequence, there is increased interest in native tissue repair. We describe the follow-up data of a sub-analysis of a prospective and multi-center study focusing on the combination of pectopexy and native tissue repair. Patients were followed up for 12–18 months after surgery (+ SD: 15). Two-hundred and sixty-four patients attended the clinics for physical examination and were integrated into the follow-up. Cystocele repair was performed laparoscopically in 84 patients and vaginally in 52 patients. Posterior repair was performed vaginally in 40 patients and laparoscopically in 53 patients. Results: Clinical success rate, patient recommendations and patient satisfaction rates were similar in both groups. The laparoscopic anterior repair resulted in an 89% cure or anatomical improvement rate; this compared to 94.2% for the vaginal approach. In the posterior group, laparoscopy resulted in a 94.3% cure or improvement rate compared to 97.5% in the second group. Conclusions: The outcomes of both strategies showed satisfactory results in our study. Consequently, surgeons may choose between the two strategies according to their preference and skill. The two approaches only differed with regard to vaginal scarring. We suggest future research investigating the long-term impact of scarring.
I. V. Gaivoronskii, G. V. Kovalev, D. D. Shkarupa, G. I. Nichiporuk
Journal of Anatomy and Histopathology, Volume 10; https://doi.org/10.18499/2225-7357-2021-10-2-23-29

Abstract:
The aimof this research was to study the variant anatomy of the obturator complex in terms of surgical treatment of stress urinary incontinence, as well as to determine the most atraumatic technique for conducting a surgical trocar for a transobturator suburethral sling. Material and methods.A suburethral sling was implanted on 40 sagittally dissected samples of the female pelvis with preserved soft tissues using two techniques: the conventional one based on the use of external landmarks and the technique of the trocar rotation around the lower branch of the pubic bone developed at the University Clinic of St. Petersburg. After implantation of a transobturator suburethral sling, the probability of injury to the branches of the obturator nerve was assessed by precision preparation for each of the presented techniques using 40 samples. It was also suggested to develop a protocol for atraumatic placement ofa sling for stress urinary incontinence. Results. Based on the results obtained and study of the topographic relationships of the trocar and branches of the obturator nerve, it is concluded that the obturator complex has significant anatomical variability. This relates to both the muscular component –the internal and external obturator muscles, and neurovascular structures. The obturator nerve has two types of branching: joint and separate. The latter is a risk factor for intraoperative nerve injury. The technique of suburethral sling implantation by rotating the surgical trocar around the inferior branch of the pubic bone is atraumatic and safe. Conclusions.Variant anatomy of the obturator complex influences the probability of trauma in a transobturator suburethral sling implantation. In particular, the separate branching of the obturator nerve is a risk factor for its intraoperative injury. Further clinical studies are required to assess the outcomes of surgical t reatment of stress urinary incontinence taking into account the variant anatomy of the true pelvis.
, Dan Kabonge Kaye, Richard Migisha, Rodgers Tugume, Paul Kalyebara Kato, Henry Mark Lugobe, Verena Geissbüehler
Published: 25 June 2021
BMC Women's Health, Volume 21, pp 1-7; https://doi.org/10.1186/s12905-021-01397-z

Abstract:
Background Pelvic organ prolapse (POP) is a significant public health issue that negatively affects the Quality of Life (QOL) of women in both low and high-income countries. About 20% of women will undergo surgery for POP over their lifetime. However, there is a paucity of information on the effect of surgery on QOL especially in resource-limited settings. We therefore assessed the QOL among women with symptomatic POP living in rural southwestern Uganda and the impact of surgery on their quality of life. Methods We conducted a prospective cohort study among 120 women with symptomatic POP scheduled for surgery at the urogynecology unit of Mbarara Regional Referral Hospital. The QOL at baseline and at 1 year after surgery in the domains of physical performance, social interaction, emotional state, sexual life, sleep quality, personal hygiene and urinary bladder function was determined using a King’s Quality of Life questionnaire. A paired t-test was used to compare the difference in mean scores at baseline and at 1-year post-surgery. Results Of the 120 participants that were enrolled at baseline, 117(98%) completed the follow-up period of 1 year. The baseline QOL was poor. The domains with the poorest QOL were physical, social, sexual, emotional and sleep quality. The mean QOL scores in all the domains and the overall QOL significantly improved 1 year after surgery (p < 0.001). The overall QOL improved by 38.9% after surgery (p < 0.001). Conclusions The QOL was poor among women with symptomatic POP and surgery improved the QOL in all the domains of life. We recommend that surgery as an option for treatment of symptomatic POP should be scaled up to improve on the QOL of these women.
Lisandra Da Silva Machado, , , Patrícia Viana da Rosa, Michele Fichera, Luís Henrique Telles da Rosa
Published: 16 May 2021
Women & Health, Volume 61, pp 490-499; https://doi.org/10.1080/03630242.2021.1927288

Abstract:
Athletic urinary incontinence is characterized by urinary loss during sports practice. This condition occurs in the case of CrossFit®, a modality based on high intensity training and functional movements, it can also be considered as having a high impact on the pelvic floor. This study aimed to compare the force and the contraction capacity of the pelvic floor musculature and urinary incontinence between female CrossFit® practitioners (AG) and non-practitioners (CG). We performed a cross-sectional observational study in the period from December 2018 and May 2019. Complaints of urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF); the functional evaluation of the pelvic floor was performed by digital palpation; resting tone, maximum voluntary contraction, fast contractions and sustained contraction of the pelvic floor muscles was tested by electromyography. The prevalence of urinary incontinence was significantly higher in AG compared with CG (p< .001). Nevertheless, we did not find significant differences between the two groups for functional assessment and electromyographic parameters. The AG presented a prevalence 60% of UI, while CG only 9,5 (p< 0,001). Considering this point, tailored prevention strategies seem mandatory in this population, in order to allow early identification and management of urinary incontinence.
Chang Shi, Ying Zhao, Qing Hu, Runqi Gong, Yitong Yin,
Published: 30 January 2021
BMC Women's Health, Volume 21, pp 1-9; https://doi.org/10.1186/s12905-021-01192-w

Abstract:
Background: The purpose of this study was to investigate the relevant factors of pain after transvaginal mesh (TVM) surgery for the treatment of pelvic organ prolapse and to analyse the management and relief of the pain. Methods: A multicentre retrospective study of a clinical database of patients who underwent TVM surgery was conducted, and pain related aspects were analysed. Results: A total of 1855 patients were included in the study. We divided the patients into two groups: pain-free (1805 patients) and pain (50 patients) group. The incidence of pain after TVM surgery was 2.70%, with a median occurrence time of 7.5 months. Pain mainly involved the vagina, perineum, buttocks, groin, inner thighs, and lower abdomen. Excessive intraoperative blood loss (OR = 1.284, 95% CI 0.868–2.401) and postoperative anatomic failure (OR = 1.577, 95% CI 0.952–3.104) were analysed as risk factors with statistical significance. Mesh exposure rate in the pain group was 38%, showing a significant difference between the groups (P< 0.01). Forty patients underwent non-surgical treatment, with a relief rate of 40.0%, 33 patients received surgical treatment, 15 underwent partial mesh removal, and 18 underwent complete mesh removal, with a relief rate of 84.8%. The total relief rate was 88% within all 50 patients suffering from pain. Conclusions: Excessive intraoperative bleeding and unsatisfactory postoperative anatomic outcomes can increase the risk of postoperative pain; mesh exposure is also associated with the pain. Most patients can get pain relief with proper management, more than half of whom may need mesh removal with differing approach.
, Abebaw Gebeyehu, Mulat Adefris, Guri Rortveit, Janne Lillelid Gjerde, Tadesse Awoke Ayele
Published: 2 January 2021
BMC Women's Health, Volume 21, pp 1-11; https://doi.org/10.1186/s12905-020-01146-8

Abstract:
Background: Symptomatic prolapse impairs quality of life. Health-related quality of life (HRQoL) is considered an important outcome of pelvic organ prolapse (POP) surgery. However, it is rarely reported, and measures are inadequately used. Thus, studies reporting patient-reported surgical outcomes in low-income contexts are needed. This study aims to evaluate the effect of prolapse surgery on patient HRQoL and determine the predictive factors for change in HRQoL. Methods: A total of 215 patients who had prolapse stage III or IV were enrolled. Patients underwent vaginal native tissue repair, and their HRQoL was evaluated at baseline, 3 and 6 months postoperatively. Effect of surgery on subjective outcomes were measured using validated Prolapse Quality of Life (P-QoL-20), Prolapse Symptom Score (POP-SS), Body Image in Prolapse (BIPOP), Patient Health Questionnaire (PHQ-9), and Patient Global Index of Improvement (PGI-I) tools. A linear mixed-effect model was used to compare pre- and postoperative P-QoL scores and investigate potential predictors of the changes in P-QoL scores. Results: In total, 193 (89.7%) patients were eligible for analysis at 3 months, and 185 (86.0%) at 6 months. Participant’s mean age was 49.3 ± 9.4 years. The majority of patients had prolapse stage III (81.9%) and underwent vaginal hysterectomy (55.3%). All domains of P-QoL improved significantly after surgery. Altogether more than 72% of patients reported clinically meaningful improvement in condition-specific quality of life measured with P-QoL-20 at 6 months. An improvement in POP-SS, BIPOP, and the PHQ-9 scores were also observed during both follow-up assessments. At 6 months after surgery, only 2.7% of patients reported the presence of bulge symptoms. A total of 97.8% of patients had reported improvement in comparison to the preoperative state, according to PGI-I. The change in P-QoL score after surgery was associated with the change in POP-SS, PHQ, BIPOP scores and marital status (p< 0.001). However, age, type of surgery, and prolapse stage were not associated with the improvement of P-QoL scores. Conclusions: Surgical repair for prolapse effectively improves patient’s HRQoL, and patient satisfaction is high. The result could be useful for patient counselling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for patients suffering from POP to improve HRQoL.
, T.V. Kotova, T.S. Kachalina, I.A. Kuznetsova, D.S. Krupinova, N.N. Nikishov, Kh.M. Klemente
Rossiiskii vestnik akushera-ginekologa, Volume 21; https://doi.org/10.17116/rosakush20212103146

, Anthony Kalousdian, Luiz Gustavo Brito, Talar Abdalian, Allison F. Vitonis ScM,
American Journal of Obstetrics and Gynecology, Volume 224, pp 496.e1-496.e10; https://doi.org/10.1016/j.ajog.2020.11.008

The publisher has not yet granted permission to display this abstract.
Ying Zhao, Zhi-Jun Xia, Qing Hu, Mei-Ying Qin
Therapeutics and Clinical Risk Management, pp 861-870; https://doi.org/10.2147/tcrm.s267832

Abstract:
Purpose: To investigate the effect of total pelvic floor reconstruction with a six-arm mesh in the treatment of pelvic organ prolapse. Patients and Methods: This is a retrospective observational cohort study. A total of 368 patients with pelvic organ prolapse underwent pelvic floor reconstruction surgery. Patients were categorized by the type of surgical mesh: 176 patients received a six-arm mesh and 192 patients received an anteroposterior approach mesh. The 1-year effect of the two groups was compared. The Pelvic Floor Distress Inventory Questionnaire (PFDI-20), Colorectal-Anal Distress Inventory (CRADI-8) and the Pelvic Organ Prolapse Quantitation (POP-Q) staging were used for evaluation. The incidence of complications was recorded. A cure standard was registered by a POP-Q score of grade I or below. A P value < 0.05 indicates the difference is statistically significant. Results: There was no recurrence documented in the patients; the cure rate was 100% in both groups. After surgery, the length of the vagina in the six-arm mesh group was longer than that of the control group at 6 months and 12 months, respectively (P< 0.05). The six-arm mesh group had lower PFDI-20 and CRADI-8 scores after surgery than those of the control group at 6 and 12 months, respectively (P< 0.05). Pelvic floor and rectal dysfunction symptom improvement were superior in the six-arm mesh group compared with the control group. After surgery, the Female Sexual Function Inventory (FSFI) score of the six-arm mesh group was superior to that of the control group at 6 and 12 months, respectively (P< 0.05). The incidence of complications in the six-arm mesh group was lower than that of the control group (P< 0.05). Conclusion: The total pelvic floor reconstruction using six-arm mesh has the same healing rate as anteroposterior approach mesh surgery, and it is better than traditional surgery in improving subjective symptoms and reducing postoperative complications.
, Chiu-Lin Wang, , Chin-Ru Ker, Zixi Loo, Yiyin Liu,
Published: 20 April 2020
Scientific Reports, Volume 10, pp 1-9; https://doi.org/10.1038/s41598-020-63725-x

Abstract:
We aim to assess the surgical outcomes of our novel hysteropexy procedure, laparoscopic long mesh surgery (LLMS) with augmented round ligaments. Twenty-five consecutive women with stage II or greater main uterine prolapse defined by the POP quantification staging system were referred for LLMS. Long mesh is a synthetic T-shaped mesh, with the body fixed at the uterine cervix and the two arms fixed along the bilateral round ligaments. The clinical evaluations performed before and 6 months after surgery included pelvic examinations, urodynamic studies, and questionnaires for urinary and sexual symptoms. After a follow-up time of 12 to 24 months, the anatomical reduction rate was 92% (23/25) for the apical compartment. The average operative time was 65.4 ± 28.8 minutes. No major complications were recognized during LLMS. The lower urinary tract symptoms and scores on the questionnaires improved significantly after the surgery, except urgency urinary incontinence and nocturia. Neither voiding nor storage dysfunction was observed after the operations. All of the domains and total Female Sexual Function Index (FSFI) scores of the 15 sexually active women did not differ significantly after LLMS. The results of our study suggest that LLMS is an effective, safe, and time-saving hysteropexy surgery for the treatment of apical prolapse.
, Pasquale De Franciscis, , Antonio Schiattarella, Péter Török, Mohsin Shah, Erbil Karaman, Tais Marques Cerentini, , Giuseppe Gullo, et al.
Published: 1 April 2020
by 10.23736
Minerva Medica, Volume 111, pp 68-78; https://doi.org/10.23736/S0026-4806.19.06298-0

Abstract:
Endometriosis is a very complex condition and has a significant impact on the quality of life, psychological wellbeing and interpersonal relationships of affected women. Endometriosis symptoms progressively impair the woman's ability to carry out some daily activities and result in a perception of worsening health status and overall well-being. The impact of these symptoms has been only partially investigated, and further studies and clinical insights are needed to fully understand the extent of this condition. It has been shown that endometriosis is associated with considerable direct and indirect costs, comparable to those of major worldwide chronic diseases such as diabetes. In addition, endometriosis-related symptoms substantially interfere with the employment of affected women, resulting in many cases in several working days missed. In this scenario, the aim of this narrative review is to provide a general overview of the psychological and social impact of this disease, as well as the effects of different therapeutic options, on quality of life and general well-being.
, Stephanie Jones, Gabriele Falconi Md, Jorge Milhem Haddad, , Vasilios Pergialiotis Md,
Published: 10 February 2020
Neurourology and Urodynamics, Volume 39, pp 880-889; https://doi.org/10.1002/nau.24297

The publisher has not yet granted permission to display this abstract.
, Fekade Ayenachew, Renate Roentgen, Melaku Abreha, Laura Jacobson, Amanuel Haile, Yibrah Berhe, Karen Gold, W. Thomas Gregory, Theresa Spitznagle, et al.
International Urogynecology Journal, Volume 31, pp 227-235; https://doi.org/10.1007/s00192-019-04197-0

Abstract:
Obstetric fistula is a devastating childbirth injury that leaves women incontinent, stigmatized and often isolated from their families and communities. In Ethiopia, although much attention has focused on treating and preventing obstetric fistula, other more prevalent childbirth-related pelvic floor disorders, such as pelvic organ prolapse, non-fistula-related incontinence and post-fistula residual incontinence, remain largely unattended. The lack of international and local attention to addressing devastating pelvic floor disorders is concerning for women in low- and middle-income countries. The objective of this article is to highlight the need for a more comprehsive approach to pelvic floor care and to share our experience in addressing it.
, Matej Keršič, Maruša Keršič, Tina Kunič, , Matija Barbič, Adolf Lukanović, David Lukanović
Gynecology and Minimally Invasive Therapy, Volume 9, pp 123-130; https://doi.org/10.4103/gmit.gmit_78_19

Abstract:
Objectives: The aim of the study was to report the extended long-term results of the use of single-incision mini-sling (SIMS), tension-free vaginal tape (TVT), and transobturator tape (TOT) for the treatment of female stress urinary incontinence (SUI) at the Department of Gynecology and Obstetrics of the University Medical Center Ljubljana. Materials and Methods: Enrolled women were evaluated by Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), Sandvik severity scale, Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) Short Form and data about diagnosis, procedures, complications, reoperations, postoperative results, and satisfaction with procedure were recorded. Results: In analyzed group of patients (n = 357), 116 (32%) underwent SIMS procedure, 189 (53%) TOT, and 52 (15%) TVT. The SIMS, TOT, and TVT groups did not differ significantly from each other in PGI-S, PGI-I, Sandvik severity scale, UDI-6, IIQ-7, and ICIQ-UI Short Form or in postoperative complication rate. Repeat surgery was needed in 9.5% after SIMS, in 13.2% of TOT patients and in 23.1% of TVT patients (P = 0.194). Urinary retention occurred in 9.5% of the SIMS patients, in 9.5% of the TOT patients, and in 13.5% of the TVT patients (P = 0.682). Mesh erosion/inflammation occurred in 3.4% of the SIMS patients, in 6.3% of the TOT patients, and in 3.8% of the TVT patients (P = 0.485). Conclusion: The efficacy and safety of SIMS, TOT, and TVT in the surgical treatment of SUI are comparable. The choice of the technique should be based on the relative pros and cons of techniques and the surgeon's experience.
, , , Aneta Słabuszewska-Jóźwiak
Videosurgery and Other Miniinvasive Techniques, Volume 15, pp 18-29; https://doi.org/10.5114/wiitm.2019.84702

Abstract:
The midurethral sling has become the current standard for the treatment of female stress urinary incontinence. To assess intraoperative complications, early post-operative complications as well as the efficacy of tension-free vaginal tape: retropubic and trans-obturator tape procedures. The analysis involved 91 tension-free vaginal tape (TVT) and 60 transobturator tape (TOT) procedures. Both groups were comparable in terms of patient characteristics, urodynamic results, and preoperative quality of life (QoL) assessment. The complications were registered, and the effectiveness of the procedures was assessed subjectively by the patients at 1-, 3-, 6- and 12-month follow-up. A significantly lower risk of intraoperative and early post-operative complications was noted in the case of TOT procedures (OR = 0.35%, 95% CI: 0.13-0.92). Moreover, regardless of the method used, patients with two or more vaginal deliveries in their history had a reduced risk of complications, as compared to nulliparas and uniparas (OR = 0.38%, 95% CI: 0.16-0.91). Previous gynaecological surgery and old age increase the risk of complications with borderline significance (OR = 2.5, 95% CI: 0.97-6.3; OR = 2.3, 95% CI: 0.95-5.5 respectively). The rates of cure, improvement and failure were similar in both groups, as was the significant positive change in post-operative life quality. TVT and TOT procedures are characterised by a high cure rate and improvement in the post-operative quality of life. However, it seems that the transobturator approach should be the preferred method of treatment of SUI due to the reduced risk of complications, shorter procedure time, and lower intraoperative blood loss.
Zahra Hadizadeh-Talasaz, , Nayereh Khadem Ghaebi, Hossein Ebrahimipour
Published: 23 December 2019
Sexual and Relationship Therapy, Volume 37, pp 238-252; https://doi.org/10.1080/14681994.2019.1701187

Abstract:
Pelvic organ prolapse (POP) is a common problem among women and can adversely affect sexual function. Therefore, designing a study to hear the sound of these women seems necessary. This study aimed to explore the sexual experience of women with POP. Based on a qualitative methodology, 20 untreated women with symptomatic POP were selected by purposive sampling and interviewed from March 2018 to December 2018. To achieve maximum diversity, different participants were selected based on age, education, occupation, type of delivery, type of prolapsed organ, and degree of prolapse. The data were analyzed using the MAXQDA software (Ver.10) and a qualitative content analysis approach. Ethical approval was obtained from Mashhad University of Medical Sciences, Mashhad, Iran. Mean (SD) age of women was 44.55 (10.22) years. Mean (SD) Duration of having prolapse was 6.05 (3.7). Qualitative analysis revealed the following five main themes: (I) Experiencing sexual discomfort; (II) damaged genital body image; (III) psychological problem, (IV) Husband's response to prolapse; (V) sexual problem management. These findings indicated that POP had disrupted women`s sexual life. An improved understanding of women's sexual experiences may help health provider better cover women`s unmet sexual needs.
Yuan Yuan, Lin Qiu, Zhi-Yi Li, Lei Zhang, Tao Xu, Jing-He Lang, Zhao-Ai Li, Jian Gong, Qing Liu, Xiao-Chun Liu, et al.
Chinese Medical Journal, Volume 133, pp 262-268; https://doi.org/10.1097/cm9.0000000000000552

Abstract:
Background: Fecal incontinence (FI) has been shown to be a common symptom in Western countries; however, there is few researches focusing on its epidemic condition in Chinese women. We conducted this national population-based epidemiology study to estimate the prevalence and risk factors of FI among adult Chinese women living in urban regions. Methods: This is a subgroup analysis of a national population-based epidemiology study of FI. Total 28,196 adult women from urban regions of six provinces and municipalities participated in this research from 2014 to 2015. They finished the questionnaire under the direction of trained interviewers. FI was defined as accidental leakage of flatus and/or liquid or solid stool at least once in the past. The FI prevalence trend and risk factors were identified by the Cochran-Armitage test, Chi-square test, and multivariable logistic regression. Results: The prevalence of FI in adult females in urban China was 0.43% (95% confidence interval: 0.35%–0.51%). Among women with FI, 42.96%, 82.96%, and 42.22% reported having leakage of solid, liquid stool, and gas, respectively. The overall FI prevalence and the incidence rate of solid stool/liquid stool/gas leakage increased with age. The mean Wexner score was 4.0% and 12.0% FI patients reported Wexner score ≥9. Body mass index ≥24 kg/m2, pelvic organ prolapses, chronic constipation, chronic cough, alcohol consumption, physical diseases including chronic bronchitis and cancer, gynecological diseases like gynecological inflammation are risk factors for FI. Vaginal delivery was the risk factor for FI in females with labor history. Conclusions: FI was not a common symptom in adult Chinese women living in urban areas and there were some potential modifiable risk factors. Trial Registration: Chinses Clinical Trial Registry: ChiCTR-OCS-14004675; http://www.chictr.org.cn/showproj.aspx?proj=4898
Maurizio Serati, , Jvan Casarin, Baldo Gisone, Simona Cantaluppi, Fabio Ghezzi
Published: 5 November 2019
Updates in Surgery, Volume 72, pp 199-204; https://doi.org/10.1007/s13304-019-00690-9

Abstract:
Different techniques have been proposed over the last decades to avoid the vaginal vault prolapse following hysterectomy for severe (stage III–IV) apical pelvic organ prolapse. In this scenario, the laparoscopic duplication of the uterosacral ligaments to the vaginal apex might represent a simple alternative procedure, associated with low morbidity and optimal surgical outcomes. In this paper, we present the preliminary results of 25 consecutive patients, who underwent total laparoscopic hysterectomy followed by uterosacral ligament duplication for stage III–IV apical pelvic organ prolapse. A detailed description of the surgical procedure is also provided.
International Journal of Environmental Research and Public Health, Volume 16; https://doi.org/10.3390/ijerph16183413

Abstract:
Background: The study aims to define the profile of women who decide to exercise their right to terminate a pregnancy and their future reproductive plans. Methods: Patients found eligible for termination for medical reasons between 2014 and 2016 were asked to complete an anonymous survey consisting of sixty questions examining the determinants of the decision to terminate a pregnancy. In total, 150 completed surveys were returned (62.5%). Results: Environmental factors, such as age, education, place of residence, marital status and financial status did not affect the decision-making process. The majority of the respondents were females under 35 years of age (71.3%). In most cases, the pregnancies had been planned and long-awaited (62.7%). The study also indicated that 22.6% of the patients who had been against abortion changed their mind when they encountered problems themselves. In addition, 20% of them changed their views on the acceptability of abortion. Termination had an impact on the participants future reproductive plans. Eighteen percent of the patients said they were definitely not planning more pregnancies. The majority (84.09%) of these women said that the reason was the traumatic experiences related to their pregnancy. Conclusions: The personal experience of a pregnancy termination procedure changed women’s opinions about pregnancy termination and modified further reproductive plans.
, Kathleen Chin, Jennifer Hamner, Jesus Acevedo, Patrick Keller, R. Ann Word
Published: 26 August 2019
Scientific Reports, Volume 9, pp 12354-10; https://doi.org/10.1038/s41598-019-48527-0

The publisher has not yet granted permission to display this abstract.
Kalina Durigon Keller, , Taís Marques Cerentini, Cislaine Machado de Souza, Filipe Langlois Costa, Patricia Viana da Rosa, Patrícia Da Silva Klahr, Elvio De Almeida Pereira, Luis Henrique Telles da Rosa
Female Pelvic Medicine & Reconstructive Surgery, Volume 26; https://doi.org/10.1097/spv.0000000000000757

Abstract:
Objective Obese women with large abdominal volume may present with elevated intra-abdominal and intravesical pressure due to their high body mass index (BMI), which leads to an imbalance in the mechanism responsible for urinary continence. Thus, these women have a 2-fold chance of developing urinary incontinence (UI) than nonobese women. Because increased BMI represents a risk factor for UI development, we hypothesize that its reduction could alleviate or decrease the symptoms of this condition in obese women. Therefore, the aim of this study was to describe the impact of weight loss on the severity of UI symptoms and quality of life (QoL) in women undergoing bariatric surgery. Methods This was a combined case-cohort study lasting 1 year, with 26 obese women aged 18 to 59 years who underwent bariatric surgery and presented preoperative UI. The participants’ BMI was calculated, their UI was assessed through the International Consultation on Incontinence Questionnaire–Short Form, and QoL by the King’s Health Questionnaire. Reassessments were performed at 3, 6, 9, and 12 postoperative months. Results We found no significant association between BMI reduction and prevalence and severity of UI. However, the 8-point reduction in BMI was sufficient to decrease the severity of UI. Quality of life improved significantly in 7 of the 9 domains evaluated. Conclusions According to the results of our study, we can conclude that the reduction in the prevalence and severity of UI together with weight loss induced by bariatric surgery was more evident in the first 3 months postoperatively, impacting positively the QoL of these women.
, C. Ros-Cerro, M. Espuña-Pons, E.M. Valero-Fernandez
Published: 13 June 2019
Actas Urológicas Españolas, Volume 43, pp 389-395; https://doi.org/10.1016/j.acuro.2019.02.003

The publisher has not yet granted permission to display this abstract.
Laurent Wagner, , Elisabeth Llinares, Pierre Costa, Stéphane Droupy
International Urology and Nephrology, Volume 51, pp 795-802; https://doi.org/10.1007/s11255-019-02124-2

Abstract:
The aim of our study was to assess the impact of laparoscopic sacrocolpopexy on pelvic symptoms, quality of life and sexual function in patients with symptomatic pelvic organ prolapse. Secondary goals included the assessment of anatomical correction, recurrence and complication rates.
, Michał Ciebiera, Li-Te Lin, Zaki Sleiman, Taís Marques Cerentini, , Ilker Kahramanoglu, Simone Bruni, , Michele Fichera
Published: 1 January 2019
Menopausal Review, Volume 18, pp 184-190; https://doi.org/10.5114/pm.2019.89496

Abstract:
Although female sexual dysfunctions are common among women with urogynecological conditions, they have not been thoroughly studied and there are still many questions without an answer. The recent evidence on sexual disorders in women with urogynecological diseases shows a quite wide spectrum of...
, Huimin Shu,
Journal of Investigative Surgery, Volume 33, pp 438-445; https://doi.org/10.1080/08941939.2018.1533055

Abstract:
Purpose: To determine whether the preoperative Ba and D point could help to guide the choice of surgical procedure for POP. Materials and Methods: This prospective cohort study included 250 subjects with anterior/apical defect from January 2012 to June 2015. All subjects underwent a complete preoperative evaluation and completed 12 months of follow-up. Based on the connection of preoperative Ba and D point of Pelvic Organ Prolapse Quantification (POP-Q), patients were assigned two groups: 137 patients who underwent anterior vaginal repair with mesh (AVM) and 113 patients who underwent AVM combined with sacrospinous ligament fixation (SSLF). The primary outcomes were anatomical cure and recurrence rate of both procedures. Secondary outcomes were prolapse symptom, quality of life and sexual function based upon validated questionnaires. The complications were also recorded in both groups. Results: Both groups were homogeneous preoperatively. The anatomical success rates for the anterior, apical and posterior vaginal compartments were 99.2%, 97.0% and 97.7% in the AVM group, respectively. For patients who underwent AVM-SSLF, the anatomical success rates for the anterior, apical and posterior compartments were 96.1%, 98.1% and 98.1%, respectively. The recurrence for both techniques was low. Both procedures presented a significant improvement with regard to postoperative quality of life (QOL), prolapse symptoms, and sexual function after 1-year follow-up. Conclusion: The preoperative Ba and D point correlated with surgical choice for the treatment of anterior/apical prolapse, which further decided the surgical outcomes for prolapse support.
, Mehmet Sait Bakir, Nurullah Peker, Ihsan Bagli,
International Urogynecology Journal, Volume 29, pp 1155-1160; https://doi.org/10.1007/s00192-018-3565-y

Abstract:
This study examined the early outcomes of laparoscopic (LS) pectopexy and evaluated its effects on female sexual function and quality of life (QoL).
, Farris Gulli, Maureen Cooney, Michael B. Chancellor, Jason Gilleran, Kenneth M. Peters
Published: 29 September 2017
Therapeutic Advances in Urology, Volume 9, pp 263-270; https://doi.org/10.1177/1756287217731009

Abstract:
Background: The etiology of interstitial cystitis (IC) is often idiopathic but can be due to Hunner’s ulcers. Hyperbaric oxygen (HBO) is used to treat ulcerative disease of the superficial skin. We hypothesized that HBO can treat ulcerative IC (UIC) but would be less efficacious for non-ulcerative IC (NIC).Methods: Patients with NIC and UIC enrolled in this study. Following informed consent, demographic information was collected. A visual analog pain scale and validated questionnaires were collected; each patient underwent cystoscopy prior to treatment. Each subject met with a hyperbaric specialist and after clearance underwent 30 treatments over 6 weeks. Adverse events were monitored. Patients repeated questionnaires, visual analog pain scale and global response assessment (GRA) immediately, 2 weeks, 3, 6 and 12 months after treatment. Patients also underwent cystoscopy 6 months after treatment. Differences before and after treatment were compared.Results: Nine patients were recruited to this study. One was unable to participate, leaving two subjects with NIC and six with UIC. All patients completed HBO without adverse events. Three patients completed HBO but pursued other therapies 7, 8.5 and 11 months after treatment. On GRA, 83% of patients with UIC were improved. This treatment effect persisted, as 66% of UIC patients remained better at 6 months. In contrast, only one patient in the NIC group improved. Questionnaire scores improved in both groups. Pain scores improved by 2 points in the UIC group but worsened by 1.5 points in the NIC group. Two patients with ulcers resolved at 6-month cystoscopy.Conclusion: HBO appeared beneficial for both UIC and NIC. Data shows slightly better benefit in patients with UIC compared to NIC; both groups showed improvement. Given the small sample size, it is difficult to draw definitive conclusions from these data. Larger studies with randomization would be beneficial to show treatment effect.
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