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Arellano M, Santis-Moya F, Maluenda A, Pattillo A, Blümel B, Pohlhammer D, Gonzalez S, Pizarro-Berdichevsky J. Prevalence of colorectal symptoms and anal incontinence in patients with pelvic organ prolapse attended at an outpatient urogynecology service. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo10. [PMID: 38765524 PMCID: PMC11075412 DOI: 10.61622/rbgo/2024ao10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/10/2023] [Indexed: 05/22/2024] Open
Abstract
Objective To analyze data of patients with symptomatic pelvic organ prolapse evaluated with PFDI20 and its subscales to report the prevalence of lower gastrointestinal symptoms and anal incontinence in the population of a public hospital and analyze its impact on quality of life. Methods Cross-sectional study of patients with symptomatic POP. Patients were evaluated with demographic data, POP-Q, pelvic floor ultrasonography, urological parameters, and pelvic floor symptoms (PFDI-20), and quality of life (P-QoL) surveys. Patients were classified as CRADI-8 "positive" for colorectal symptoms, with responses "moderate" in at least 3 and/or "severe" in at least 2 of the items in the CRADI-8 questionnaires. Results One hundred thirteen patients were included. 42.5% (48) were considered positive for colorectal symptoms on CRADI-8. 53.4% presented anal incontinence. No significant differences were found in sociodemographic variables, POP-Q stage, ultrasound parameters, or urological parameters. Positive patients had a significantly worse result in PFDI-20, POPDI (48 vs 28; p<0.001), UDI6 (51 vs 24; p<0.001), and in the areas of social limitation (44.4 vs 22.2; p = 0.045), sleep- energy (61.5 vs 44.4; p = 0.08), and severity (56.8 vs 43.7, p=0.015) according to P-QoL. Conclusion Moderate or severe colorectal symptoms are seen in 40% of patients with symptomatic POP in our unit. Full evaluation of pelvic floor dysfunction symptoms should be performed routinely in urogynecology units.(FONIS SA12I2I53 - NCT02113969).
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Affiliation(s)
- Marco Arellano
- Corporación de Innovación en Piso PélvicoHospital Dr. Sótero del RíoSantiagoChileCorporación de Innovación en Piso Pélvico, Hospital Dr. Sótero del Río, Santiago, Chile.
- Clínica Puerto VarasPuerto VarasChileClínica Puerto Varas, Puerto Varas, Chile.
| | - Fernanda Santis-Moya
- Corporación de Innovación en Piso PélvicoHospital Dr. Sótero del RíoSantiagoChileCorporación de Innovación en Piso Pélvico, Hospital Dr. Sótero del Río, Santiago, Chile.
| | - Andrea Maluenda
- Corporación de Innovación en Piso PélvicoHospital Dr. Sótero del RíoSantiagoChileCorporación de Innovación en Piso Pélvico, Hospital Dr. Sótero del Río, Santiago, Chile.
- Clínica Santa MaríaSantiagoChileClínica Santa María, Santiago, Chile.
| | - Alejandro Pattillo
- Clínica Puerto VarasPuerto VarasChileClínica Puerto Varas, Puerto Varas, Chile.
| | - Bernardita Blümel
- Corporación de Innovación en Piso PélvicoHospital Dr. Sótero del RíoSantiagoChileCorporación de Innovación en Piso Pélvico, Hospital Dr. Sótero del Río, Santiago, Chile.
- Clínica Santa MaríaSantiagoChileClínica Santa María, Santiago, Chile.
| | - Dominga Pohlhammer
- Corporación de Innovación en Piso PélvicoHospital Dr. Sótero del RíoSantiagoChileCorporación de Innovación en Piso Pélvico, Hospital Dr. Sótero del Río, Santiago, Chile.
| | - Silvana Gonzalez
- Corporación de Innovación en Piso PélvicoHospital Dr. Sótero del RíoSantiagoChileCorporación de Innovación en Piso Pélvico, Hospital Dr. Sótero del Río, Santiago, Chile.
| | - Javier Pizarro-Berdichevsky
- Corporación de Innovación en Piso PélvicoHospital Dr. Sótero del RíoSantiagoChileCorporación de Innovación en Piso Pélvico, Hospital Dr. Sótero del Río, Santiago, Chile.
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Vicente-Campos V, Fuentes-Aparicio L, Rejano-Campo M. [Evaluation of the physical and psychosocial consequences of the diastasis of the rectus abdominis and its interference in health: A mixed study]. Rehabilitacion (Madr) 2023; 57:100744. [PMID: 35760642 DOI: 10.1016/j.rh.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Diastasis rectus abdominis (DRA) is defined as the separation of the rectus abdominis along the linea alba. This condition can occur in both sexes, being frequent in women during pregnancy and pospartum. There is little evidence on the consequences of DRA on the quality of life of women. OBJECTIVE The analysis of the perception of the symptoms of and its repercussion on a physical, psychological and social level in women affected by this condition. PATIENTS AND METHODS Observational study through a semi-structured online survey, composed of 30 closed questions and 2 open ones. The inclusion criteria were adult Spanish-speaking women who had given birth and who presented abdominal diástasis. The data were analyzed quantitatively and the qualitative information was obtained through a content analysis of the open questions. RESULTS 319 women with DRA were included. The results showed a negative effect of DRA on quality of life, functional capacities, and urogynecological and digestive health. Likewise, a negative impact was evidenced at an emotional level, on body image and poor self-perceived health. CONCLUSION DRA has a negative impact on women's health. Women with DRA present an impairment of the quality of life and functional capacities, an alteration in body image, feelings of abandonment by health institutions, shame, sadness, powerlessness, lack of self-esteem, resignation and social pressure.
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Affiliation(s)
| | - L Fuentes-Aparicio
- Grupo investigación Multiespecialidad (PTinMOTION), Departamento de Fisioterapia, Universidad de Valencia, Valencia, España.
| | - M Rejano-Campo
- Montse Rejano Fisioterapeuta, El Puertillo, Las Palmas, España
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Guallar-Bouloc M, Gómez-Bueno P, Gonzalez-Sanchez M, Molina-Torres G, Lomas-Vega R, Galán-Mercant A. Spanish Questionnaires for the Assessment of Pelvic Floor Dysfunctions in Women: A Systematic Review of the Structural Characteristics and Psychometric Properties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12858. [PMID: 34886580 PMCID: PMC8657821 DOI: 10.3390/ijerph182312858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pelvic floor dysfunctions affect a third of the adult female population, including a large number of clinical conditions, which can be evaluated through validated questionnaires that inform us of the status and perception of women both objectively and subjectively. The main objective of this study was to review and explain the topics of the validated questionnaires in Spanish on pelvic floor dysfunctions and to review their psychometric properties. METHODS A systematic review was carried out in the PUBMED and WOS databases. The keywords used were in PUBMED: (((((((("Fecal Incontinence" [Mesh]) OR "Urinary Incontinence" [Mesh]) OR "Pelvic Organ Prolapse" [Mesh]) OR "Pelvic Floor Disorders" [Mesh]) OR "Sexual Dysfunction, Physiological" [Mesh]) OR "Pelvic Girdle Pain" [Mesh]) OR "sexual function" [Title/Abstract]) OR "Prolapse" [Title/Abstract]) AND "Surveys and Questionnaires" [Mesh] AND "Validation" [Title/Abstract] combined with the Boolean operators "AND"/"OR". In contrast, in WOS, a segregated search was carried out with each of the terms of pelvic floor dysfunction together with "Validation" and "Surveys and Questionnaires". All articles published up to 19 November 2021 were considered. Methodological quality was assessed with the COSMIN scale. RESULTS A total of 687 articles were identified, of which 13 were included. The evaluated questionnaires and the structural characteristics and psychometric properties of each of them were collected. CONCLUSION The Spanish versions of the questionnaires show good basic structural and psychometric characteristics for the evaluation of patients with pelvic floor dysfunctions and that they resemble other versions of the same questionnaire published in other languages.
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Affiliation(s)
- Marina Guallar-Bouloc
- Department of Physiotherapy, Health Science Faculty, University of Jaén, 23071 Jaén, Spain; (M.G.-B.); (R.L.-V.)
| | - Paloma Gómez-Bueno
- Move-It Research Group, Department of Physical Education, Faculty of Education, Sciences University of Cádiz, 11002 Cádiz, Spain; (P.G.-B.); (A.G.-M.)
| | - Manuel Gonzalez-Sanchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain;
- Institute of Biomedicine of Málaga (IBIMA), 29010 Málaga, Spain
| | - Guadalupe Molina-Torres
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, 04120 Almería, Spain
| | - Rafael Lomas-Vega
- Department of Physiotherapy, Health Science Faculty, University of Jaén, 23071 Jaén, Spain; (M.G.-B.); (R.L.-V.)
| | - Alejandro Galán-Mercant
- Move-It Research Group, Department of Physical Education, Faculty of Education, Sciences University of Cádiz, 11002 Cádiz, Spain; (P.G.-B.); (A.G.-M.)
- Biomedical Research Unit, Innovation Institute of Cádiz (INiBICA), Puerta del Mar University Hospital, University of Cádiz, 11002 Cádiz, Spain
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Gurovich M, Aros S, Sepúlveda J, Rey R, Wainstein A, Sacomori C. Calidad de vida, complicaciones asociadas y satisfacción con el uso de pesarios para tratamiento conservador del prolapso de órganos pélvicos. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Vaginal Sacrospinous Ligament Fixation Using Tissue Anchoring System Versus a Traditional Technique for Women With Apical Vaginal Prolapse: A Randomized Controlled Trial. Female Pelvic Med Reconstr Surg 2021; 27:e215-e222. [PMID: 32541301 DOI: 10.1097/spv.0000000000000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to compare the efficacy and safety of the tissue anchoring system (TAS) kit versus the traditional technique for sacrospinous ligament fixation (SSLF) to treat apical vaginal wall prolapse. METHODS A prospective randomized controlled multicenter study of noninferiority involving women with apical prolapse (C-point≥+1). Primary outcome is surgical success as C-point≤-4 at the 1-year follow-up. Secondary outcomes are success according to the composite criteria as C-point≤-4, Ba-point ≤0, and Bp-point ≤0; POP-Q measures of the vaginal compartments; intraoperative findings, complications; reoperation rate; hospital stay; and quality of life and sexual functioning (PISQ-12). It was estimated that 50 individuals per group would yield an 80% power for a noninferiority margin of 15%. RESULTS Ninety-nine women were randomized: TAS (n = 55) and traditional SSLF (n = 44). The groups' preoperative data were similar. Drop-out rate was 11% for 12-month follow-up. Success rates were 90% for TAS and 80% for traditional SSLF (P = 0.0006; absolute difference, 9.8%; 90% confidence interval, -5.2 to 24.8) with the sensivity analyses per-protocol considering only the subjects that completed the 12-month follow-up and 80% versus 73%, respectively (P = 0.0048; absolute difference, 7.3%; 90% confidence interval, -9.6 to 24.2) by sensivity analyses considering the total number of participants randomized and treated with drop-out cases as failure. We detected shorter intraoperative time to dissect and reach the SSL, shorter length of hospitalization, lower rates of urinary tract infection, and lower pain scores in the first 30 days postoperative in the TAS compared with the traditional SSLF groups (P < 0.05). There was an improvement in women's quality of life that did not differ between groups. CONCLUSIONS The modified technique of SSLF using the TAS kit is noninferior to the traditional technique for the treatment of apical compartment in 12-month follow-up.
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García-Segui A, Lorenzo Soriano L, Costa-Martínez MA, Amorós Torres A, Gilabert A, Oltra MF. The use of one-piece U-shaped mesh and barbed sutures in laparoscopic sacrocolpopexy. Actas Urol Esp 2020; 44:49-55. [PMID: 31806248 DOI: 10.1016/j.acuro.2019.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/27/2019] [Accepted: 09/16/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Laparoscopic sacrocolpopexy (LS) is considered a safe and effective surgery for the treatment of pelvic organ prolapse (POP), but it requires expertise in laparoscopic surgery. The complexity of the intervention is due to the requirements of intracorporeal sutures and the manipulation of the mesh inside the cavity, which may be cumbersome. The barbed sutures (BS) simplify intracorporeal suturing and do not require knotting. Additionally, one-piece U-mesh (OP-UM) may facilitate handling, stabilization and tension adjustment. We describe our LS surgical technique using both materials to assess its feasibility, safety and effectiveness in a prospective series of patients. MATERIALS AND METHODS A total of 7 patients with symptomatic pelvic organ prolapse were included. Urogynecological history, classification of the pelvic organ prolapse according to Baden-Walker and the application of the Prolapse Quality of Life questionnaire were performed in all cases. The non-absorbable polypropylene OP-UM (Uplift ™) was used. The posterior side of the single sling is sutured to the elevator anus muscles with two non-absorbable stitches. Two strands of BS (V-Loc™), tied at their ends, were used to attach the mesh to the vagina in two lines of continuous sutures in opposite directions. Self-anchoring tackers were used for promontofixation and BS for peritoneal closure. RESULTS The median age was 60 years, the median time of the anterior branch mesh BS fixation was 23minutes (range 21,30 - 26,40min), intraoperative bleeding was minimal, and the median hospital stay was 3 days. No intraoperative complications were recorded, and no mesh erosions or recurrences were observed at a median follow-up of 14 months (range 3-25 months). All patients presented clinical improvement of the prolapse and were satisfied with surgery. We observed that the OP-UM self-stabilizes when it extends longitudinally into the abdominal cavity, reducing the need of the surgical assistant. The independent promontofixation of each part of the mesh (posterior and anterior) allows a more anatomical tension adjustment. Fixing the mesh to the vagina is fast and simple with our BS technique. CONCLUSIONS The use of OP-UM and BS during LS is feasible, safe, effective and could simplify this surgical technique.
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Affiliation(s)
- A García-Segui
- Servicio de Urología, Hospital General Universitario de Elche, Elche, Alicante, España; Unidad de Uroginecología, Hospital General Universitario de Elche, Elche, Alicante, España.
| | - L Lorenzo Soriano
- Servicio de Urología, Hospital General Universitario de Elche, Elche, Alicante, España; Unidad de Uroginecología, Hospital General Universitario de Elche, Elche, Alicante, España
| | - M A Costa-Martínez
- Servicio de Urología, Hospital General Universitario de Elche, Elche, Alicante, España; Unidad de Uroginecología, Hospital General Universitario de Elche, Elche, Alicante, España
| | - A Amorós Torres
- Servicio de Urología, Hospital General Universitario de Elche, Elche, Alicante, España; Unidad de Uroginecología, Hospital General Universitario de Elche, Elche, Alicante, España
| | - A Gilabert
- Unidad de Uroginecología, Hospital General Universitario de Elche, Elche, Alicante, España; Servicio de Ginecología, Hospital Universitario de Elche, Elche, Alicante, España
| | - M F Oltra
- Unidad de Uroginecología, Hospital General Universitario de Elche, Elche, Alicante, España; Servicio de Ginecología, Hospital Universitario de Elche, Elche, Alicante, España
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A systematic review of the psychometric properties of the cross-cultural adaptations and translations of the Prolapse Quality of Life (P-QoL) questionnaire. Int Urogynecol J 2019; 30:1989-2000. [PMID: 31028420 DOI: 10.1007/s00192-019-03920-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/05/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Due to linguistic and cultural differences, there is a need to test the psychometrics of the translated versions of any patient-reported outcome measures. We investigated the psychometric properties of the Prolapse Quality of Life (P-QoL) questionnaire for non-English-speaking populations by conducting a systematic review of studies that examined the psychometric properties of non-English versions. METHODS We searched PubMed, Latin American and Caribbean Health Science Information Center (LILACS), and Science Direct databases for articles published in English up to February 2018. Methodological quality and quality of psychometric properties were assessed by two independent reviewers using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and validated quality assessment criteria. The two assessments were combined to produce the best level of evidence per language/translation. RESULTS Sixteen articles in 13 languages were retrieved. Most (n = 9; 56.3%) were not rigorously translated or reported, and there was poor evidence for structural validity. Internal consistency was reported in all studies, and all studies had good methodological quality. There was fair evidence for construct and good to fair for criterion validity. Evidence for responsiveness was good, although this was evaluated only in three studies. CONCLUSIONS There is limited evidence supporting the psychometric robustness of the original validation and translated versions of P-QoL. Cross-cultural adaptations are insufficient. Given this variability, the individual psychometrics of a translation must be considered prior to use. Responsiveness, measurement error, and cutoff values should also be assessed to increase the clinical utility and psychometric robustness of the translated versions.
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Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Genet T. Translation, transcultural adaptation, reliability and validation of the pelvic organ prolapse quality of life (P-QoL) in Amharic. Health Qual Life Outcomes 2019; 17:12. [PMID: 30642346 PMCID: PMC6332683 DOI: 10.1186/s12955-019-1079-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 01/03/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Prolapse Quality of Life (P-QoL) is a disease-specific instrument designed to measure the health-related quality of life in women with prolapse; however, there is no Amharic version of the instrument. The aim of this study were to translate the P-QoL into Amharic and evaluate its psychometric properties among adult women. METHODS We followed an intercultural adaptation procedure to translate and adapt the P-QoL. A forward-backward translation, face validity interviews with experts and cognitive debriefing of the translated version with ten adults from the target group were performed. The Amharic version was then completed by 230 adult women with and without POP symptoms. All women were examined using a simplified Pelvic Organ Prolapse Quantification (SPOP-Q) system. We examined internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficient = ICC). Confirmatory factor analysis (CFA) was conducted and model fit was discussed. We extracted a new factor structure by exploratory factor analysis (EFA). Criterion validity was also assessed against the SPOP-Q stage. RESULTS The translated measure was found acceptable by the experts and target group, with only minor adaptations required for the Amharic context. It had high internal consistency (α = 0.96) and test-retest reliability (ICC = 0.87; p < 0.001). In CFA results, the model fit indices were unacceptable (CFI = 0.69, RMSEA = 0.17, SRMR = 0.43, TLI = 0.65, and PCLOSE = 0.00). EFA extracted three-factor with satisfactory convergent and discriminant validity. The P-QoL median scores were significantly higher in symptomatic women (Mann-Whitney U Test; p < 0.001). The score was also significantly correlated with stage of prolapse (Spearman's correlation coefficient = 0.42 to 0.64, p < 0.001). CONCLUSIONS The P-QoL scale was successfully translated to Amharic and appears feasible, reliable and valid for Amharic-speaking women. Factor analysis confirmed a three-factor structure, inconsistent with the original English version. Further studies are needed to evaluate responsiveness of the Amharic P-QoL score.
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Affiliation(s)
- Tadesse Belayneh
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box –196, Gondar, Ethiopia
| | - Abebaw Gebeyehu
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box –196, Gondar, Ethiopia
| | - Mulat Adefris
- Department of Obstetrics and Gynecology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Guri Rortveit
- Research Group for General Practice, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Research Unit for General Practice, Uni Research Health, Bergen, Norway
| | - Tinsae Genet
- Department of Obstetrics and Gynecology, School of Medicine, University of Gondar, Gondar, Ethiopia
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Pizarro-Berdichevsky J, Borazjani A, Pattillo A, Arellano M, Li J, Goldman HB. Natural history of pelvic organ prolapse in symptomatic patients actively seeking treatment. Int Urogynecol J 2017; 29:873-880. [PMID: 28840270 DOI: 10.1007/s00192-017-3450-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 08/03/2017] [Indexed: 12/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS At our institution many symptomatic patients must wait months or years for surgery. Our aim was to determine the rates of clinically significant pelvic organ prolapse (POP) progression and identify risk factors associated with POP progression. METHODS Data from a prospectively maintained database of POP patients evaluated between 2008 and 2013 were analyzed. Women with symptomatic POP and two or more POP-Q examinations prior to surgery were included. POP progression was defined as having any of the POP-Q points Aa, Ba, C, D, Ap or Bp above the hymen at the baseline examination and at or below the hymen at the follow-up examination. Multivariable logistic analysis was preformed and the results are presented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS Of consecutive patients evaluated between July 2008 and June 2013, 388 met the inclusion criteria and were included. The median time between the POP-Q examinations was 9.9 months (IQR 7.8 to 13.8 months). The POP progression rate was 29.1% (95% CI 24.6-33.6%). Predictors of progression included age (OR 1.7, 95% CI 1.01-2.87) and the baseline status of points Ba, C, Bp and gH (OR 1.91, 95% CI 1.01-3.62; OR 0.53, 95% CI 0.3-0.94; OR 0.54, 95% CI 0.32-0.93; OR 2.15, 95% CI 1.13-4.1; respectively). POP-Q point correlations showed that anterior and posterior compartment points evolve with apical compartment points and gH evolves with both the anterior compartment and the apex. CONCLUSIONS Up to 29.1% of symptomatic patients with POP showed clinically significant progression over a median follow-up of 9.9 months. The likelihood of progression was not significantly associated with time. Those ≥60 years of age as well as those with point Ba ≥4 cm or gH ≥5 cm at baseline were at increased risk of POP progression.
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Affiliation(s)
- Javier Pizarro-Berdichevsky
- Urogynecology Unit, H. Dr. Sotero del Rio, Santiago, Chile. .,Division Obstetricia y Ginecologia, Pontificia Universidad Católica de Chile, Lira 85, 5to piso, Santiago, Chile. .,Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Ali Borazjani
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.,Global Innovations for Reproductive Health & Life, Cleveland, OH, USA
| | - Alejandro Pattillo
- Urogynecology Unit, H. Dr. Sotero del Rio, Santiago, Chile.,Division Obstetricia y Ginecologia, Pontificia Universidad Católica de Chile, Lira 85, 5to piso, Santiago, Chile
| | - Marco Arellano
- Urogynecology Unit, H. Dr. Sotero del Rio, Santiago, Chile
| | - Jianbo Li
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Howard B Goldman
- Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
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Kallidonis P, Al-Aown A, Vasilas M, Kyriazis I, Panagopoulos V, Fligou F, Athanasopoulos A, Fariborz B, Liatsikos E, Özsoy M. Laparoscopic sacrocolpopexy using barbed sutures for mesh fixation and peritoneal closure: A safe option to reduce operational times. Urol Ann 2017; 9:159-165. [PMID: 28479768 PMCID: PMC5405660 DOI: 10.4103/ua.ua_161_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: Laparoscopic sacrocolpopexy (LSC) has established itself as a safe method for the management of pelvic organ prolapse (POP). Laparoscopic suturing is a time-consuming intraoperative task during LSC. Self-retaining barbed sutures (SBSs) are known to reduce the operative time in laparoscopic cases. The current study aimed to evaluate the efficacy and safety of SBS during the performance of LSC. Materials and Methods: Twenty female patients with symptomatic POP were treated with LSC by an expert surgeon. The preoperative evaluation included the International Continence Society POP-quantification (POP-Q) and the prolapse-specific quality-of-life questionnaire Mesh fixation was performed with SBS anteriorly on the anterior vaginal wall and posteriorly on the levator ani muscle. A 5-mm titanium tacking device was used for promontofixation. The peritoneum was also closed with an SBS. Results: Mean patient's age was 63 years (range: 50–79 years). According to POP-Q, system 3 patients (15%) had Stage I, 12 patients (60%) had Stage II, 3 patients (15%) had Stage III, and 2 patients (10%) had Stage IV prolapse. Concomitant hysterectomy was performed in 14 patients, respectively. Mean operative time was 99.75 (range: 65–140) min, mean blood loss was 57.75 (range: 30–120) ml. One patient had a bladder perforation intraoperatively, and three patients developed transient fever postoperatively. One patient had a recurrent cystocele and three patients recurrent rectocele. Conclusions: The current study renders the use of SBS during LSC to be safe and efficient. Further comparative studies would elucidate the impact of the use of SBS in LSC.
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Affiliation(s)
| | - Abdulrahman Al-Aown
- Department of Urology, Armed Forces Hospital Southern Region, Khamis Mushait, Kingdom of Saudi Arabia
| | | | - Iason Kyriazis
- Department of Urology, University of Patras, Patras, Greece
| | | | - Fotini Fligou
- Department of Anesthesiology, University of Patras, Patras, Greece
| | | | | | | | - Mehmet Özsoy
- Department of Urology, University of Patras, Patras, Greece
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Pizarro-Berdichevsky J, Hitschfeld MJ, Pattillo A, Blumel B, Gonzalez S, Arellano M, Cuevas R, Alvo J, Gorodischer A, Flores-Espinoza C, Goldman HB. Association between pelvic floor disorder symptoms and QoL scores with depressive symptoms among pelvic organ prolapse patients. Aust N Z J Obstet Gynaecol 2016; 56:391-7. [PMID: 27135639 DOI: 10.1111/ajo.12467] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 03/17/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is no consensus on the relationship between depressive symptoms (DS) and pelvic organ prolapse (POP) symptoms and quality of life (QoL). Our hypothesis was that women with DS and POP have worse symptoms and QoL than those without DS and POP. AIM Our aim was to compare two groups of POP patients, those with depressive symptoms and those without, and evaluate the association of symptoms and QoL. MATERIALS AND METHODS This planned report is part of a prospective study evaluating the impact of pessary use among symptomatic POP patients. Patients were evaluated by POP quantification (POP-Q), pelvic ultrasound (US), voiding diaries, stress test, pad test, Pelvic Floor Distress Inventory (PFDI-20), Prolapse QoL (P-QoL) and the Goldberg Health Questionnaire (GHQ-12) (psychological health screening for DS when score ≥5). A sample size of 78 patients was required to demonstrate a 50-point difference in the global PFDI-20 score with 80% power and 95% probability. RESULTS Ninety-one women with POP were included. GHQ-12 was positive in 47 (51.6%) patients. No differences were found in POP-Q, pad and stress test between those with a positive GHQ-12 and those without. However, GHQ-12 was associated with higher PFDI-20 scores and higher scores in seven of nine P-QoL domains. GHQ-12 persisted as an independent risk factor for worse P-QoL scores after multivariable analysis. CONCLUSION A 'positive' screening for DS was associated with worse PFDI-20 and P-QoL scores despite no difference in objective measurements. It may be that depressed patients interpret their symptoms differently.
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Affiliation(s)
- Javier Pizarro-Berdichevsky
- Urogynecology Unit, H. Dr. Sotero del Rio, Santiago, Chile.,Division Obstetricia y Ginecologia, Pontificia Universidad Católica de Chile, Santiago, Chile.,Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Alejandro Pattillo
- Urogynecology Unit, H. Dr. Sotero del Rio, Santiago, Chile.,Division Obstetricia y Ginecologia, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Marco Arellano
- Urogynecology Unit, H. Dr. Sotero del Rio, Santiago, Chile
| | - Rodrigo Cuevas
- Urogynecology Unit, H. Dr. Sotero del Rio, Santiago, Chile.,Division Obstetricia y Ginecologia, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jacobo Alvo
- Medical School, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Ariel Gorodischer
- Medical School, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | | | - Howard B Goldman
- Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
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