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Tega A, Yenealem F, Belay G, Asmare E, Getaneh T, Desalegn M, Dechasa N, Addis Z. Quality of life and its associated factors among women with pelvic organ prolapse who attend gynecology clinics Southern Ethiopia 2022. BMC Womens Health 2024; 24:398. [PMID: 38997642 PMCID: PMC11241974 DOI: 10.1186/s12905-024-03238-1] [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: 10/28/2023] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Pelvic organ prolapse is the implosion of one or more pelvic floor structures which affect womens quality of life by compromising overall health, physical, social, structural, functional and emotional well-being. OBJECTIVE To assess the quality of life and its associated factors among women with pelvic organ prolapse who attend gynecology clinics at Gurage zone hospitals, Southern Ethiopia 2022. METHODS Facility-based cross-sectional study was applied in gurage zone hospital from April, 30 to Jun 30, 2022. Systematic random sampling was employed to select 416 women. Interview based structured questionnaires were applied to collect the data. The collected data were analyzed using Statistical Produte and Service Solution. Binary and multivariable logistic regressions were fitted to assess the association between dependent and independent variables. P-value < 0.05 was used to declare the final statistical significance. RESULT The mean (SD) score of quality of life in this study was 53.57 (21.59). The most affected domains were general health perception and physical limitation (mean (SD) score 67.45 29.24) and (64.26 32.36)) respectively. Had no formal education (AOR = 1.50, 95% CI: 1.02, 3.12), stage III/IV POP (AOR = 2.02, 95% CI: 1.19, 3.60), constipation (AOR = 3.51, 95% CI: 2.12, 7.21), urge urinary incontinence (AOR = 3.89, 95% CI: 2.32, 6.95), and not did regular physical exercise (AOR = 2.18, 95% CI: 1.41, 3.37) were significantly associated with poor quality of life. CONCLUSION More than half of the participants in this study had impaired quality of life. The factor associated with quality of life was had no formal education, stage III/IV, constipation, urge urinary incontinence, and regular physical activity. It is recommended to have access education, counseling regular physical activity, detection, and management of its comorbidity.
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Affiliation(s)
- Ayenew Tega
- Department of Midwifery, Hosanna health science colleg, Hosanna, Ethiopia.
| | - Fentahun Yenealem
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getahun Belay
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eden Asmare
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Temesgen Getaneh
- Department of Midwifery, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Misgana Desalegn
- Department of Midwifery, Hossana College of Health Science, Hossana, Ethiopia
| | - Natnael Dechasa
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Zemenu Addis
- Department of Nursing, Hosanna health science colleg, Hosanna, Ethiopia
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AlSary S, Al-Zahrani EF, Al Baalharith M. Vesical Calculi and Female Pelvic Organ Prolapse: A Case Report and Literature Review. Cureus 2023; 15:e44578. [PMID: 37790022 PMCID: PMC10545005 DOI: 10.7759/cureus.44578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
This study presents a case report and reviews the literature on the simultaneous occurrence of advanced uterovaginal prolapse and urolithiasis, aiming to provide a comprehensive analysis of the reported cases. A thorough search was conducted in PubMed and Google Scholar; the search strategy included specific keywords and terms related to both conditions aiming to identify relevant case reports describing the association between advanced uterovaginal prolapse and urolithiasis; a total of 22 case reports were found in English literature. We present a case report of a 56-year-old woman, para 4, presenting with complaints of vaginal bulge and urinary symptoms. Upon examination, a complete procidentia with superficial ulceration was observed. During the reduction of the uterus, multiple small stones were noted coming through the urethral meatus. The patient underwent a vaginal hysterectomy, and the bladder stone was successfully extracted through vaginal cystotomy without complications. Our case report highlights the association between vesical calculi and female high-grade pelvic organ prolapse. Managing bladder stones in the context of pelvic organ prolapse can be challenging and vary significantly, reflecting the individual patient characteristics and surgeon preferences. The lack of standardized guidelines for managing bladder stones in the presence of pelvic organ prolapse highlights the need for further research.
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Affiliation(s)
- Saeed AlSary
- Urogynecology and Reconstructive Pelvic Surgery, King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU
- Obstetrics and Gynecology, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Eman F Al-Zahrani
- Urogynecology and Reconstructive Pelvic Surgery, King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU
- Obstetrics and Gynecology, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Maha Al Baalharith
- Urogynecology and Reconstructive Pelvic Surgery, King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU
- Obstetrics and Gynecology, King Abdullah International Medical Research Center, Riyadh, SAU
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Lv X, Yang H, Yan M, Jin X, Shen X, Li S, Zhang M, Su S, Liu X, Chen J. The mediating role of menstrual irregularity on obesity and sexual function in Chinese women with pelvic floor disorders: a cross-sectional study. BMC Womens Health 2023; 23:462. [PMID: 37653493 PMCID: PMC10472711 DOI: 10.1186/s12905-023-02594-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/09/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Sexual problems are common among women with pelvic floor disorders (PFD). Few studies have explored the relationship between obesity and sexual function in women with PFD. This study aimed to prove that obesity was a risk factor for worse sexual function in women with PFD, and to investigate the mediating role of menstrual irregularity. METHODS This was a cross-sectional study involving 783 women with PFD from Shandong Province, China between June 2020 and February 2021. Female sexual function was assessed using the Pelvic Organ Prolapse/UI Sexual Questionnaire-12 (PISQ-12). Obesity was defined as BMI ≥ 28.0. Menstrual irregularity was defined as menstrual cycles ≥ 35 or menstrual cycles < 25 days. Logistic regression and multiple linear regression were employed to explore the association among obesity, menstrual irregularity and sexual function. RESULTS Obesity was associated with worse PISQ-12 scores compared with normal- weight women (mean score 28.14 ± 7.03 versus 32.75 ± 5.66, p < 0.001). After adjusting for controlling variables, women with obesity (β= -3.74, p < 0.001) and menstrual irregularity (β= -3.41, p < 0.001) had a worse sexual function. Menstrual irregularity had a mediation effect on the association between obesity and sexual function. CONCLUSIONS This study provided evidence that obesity was associated with worse sexual function in women with PFDs, and the effect of obesity on sexual function was partially mediated by menstrual irregularity. Weight control may have potential benefits for improving sexual function and preventing female sexual dysfunction. It's also important to pay attention to the menstrual cycle.
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Affiliation(s)
- Xiaoyang Lv
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Huijun Yang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital, Jinan, Shandong, 250014, China
| | - Miaomiao Yan
- Yichang Hospital of Traditional Chinese Medicine, Yichang, Hubei, 443000, China
| | - Xuli Jin
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Xin Shen
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Shu Li
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Miqing Zhang
- Women's Pelvic Floor Functional Health Center, Yunshi Health Industry, Jinan, Shandong, 250000, China
| | - Sha Su
- Women's Pelvic Floor Functional Health Center, Yunshi Health Industry, Jinan, Shandong, 250000, China
| | - Xiaoyan Liu
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, Shandong, 250012, China.
| | - Jie Chen
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
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Siyoum M, Teklesilasie W, Alelgn Y, Astatkie A. Inequality in healthcare-seeking behavior among women with pelvic organ prolapse: a systematic review and narrative synthesis. BMC Womens Health 2023; 23:222. [PMID: 37138299 PMCID: PMC10157925 DOI: 10.1186/s12905-023-02367-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/16/2023] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Pelvic organ prolapse (POP) affects women's quality of life in various aspects. However, evidence on the healthcare-seeking behavior of women with POP is limited. Therefore, this review aimed to identify and synthesize the existing evidence on the healthcare-seeking behavior among women with POP. METHODS This systematic review and narrative synthesis of the literature on healthcare-seeking behavior among women with POP was conducted from 20 June to 07 July 2022. The electronic databases PubMed, African Journals Online, Cumulative Index to Nursing and Allied Health Literature, African Index Medicus and Directory of Open Access Journal, and Google Scholar were searched for relevant literature published from 1996 to April 2022. The retrieved evidence was synthesized using a narrative synthesis approach. The characteristics of included studies and the level of healthcare-seeking behavior were summarized in a table and texts. Error bar was used to show the variability across different studies. RESULTS A total of 966 articles were retrieved of which only eight studies with 23,501 women (2,683 women with pelvic organ prolapse) were included in the synthesis. The level of healthcare-seeking behavior ranges from 21.3% in Pakistan to 73.4% in California, USA. The studies were conducted in four different populations, used both secondary and primary data, and were conducted in six different countries. The error bar shows variation in healthcare-seeking behavior. CONCLUSIONS The level of health-care seeking behavior among women with POP is low in low-income countries. There is substantial variability in the characteristics of the reviewed studies. We recommend a large-scale and robust study which will help to better understand the healthcare-seeking behavior among women with POP.
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Affiliation(s)
- Melese Siyoum
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
| | - Wondwosen Teklesilasie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yitateku Alelgn
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Kurniadi A, Dewi AK, Sasotya RMS, Purwara BH, Kireina J. Effect of Vitamin D analog supplementation on levator ani strength and plasma Vitamin D receptor expression in uterine prolapse patients. Sci Rep 2023; 13:3616. [PMID: 36869168 PMCID: PMC9984360 DOI: 10.1038/s41598-023-30842-2] [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: 08/25/2022] [Accepted: 03/02/2023] [Indexed: 03/05/2023] Open
Abstract
Uterine prolapse is a pathological condition that can negatively impact women's quality of life. It is caused by weakening of the pelvic floor muscles. Function of levator ani muscle and other striated muscles is thought to be influenced by Vitamin D levels. Vitamin D exerts its biological effects by adhering to Vitamin D receptors (VDRs) present in striated muscles. We aim to analyze the effect of Vitamin D analog supplementation on levator ani muscle strength in uterine prolapse patients. This was a quasi-experimental study with a pre-post design on 24 postmenopausal women diagnosed with grade III and IV uterine prolapse. Vitamin D levels, VDR, levator ani muscle, and hand grip muscle strength were measured before and after three months of Vitamin D analog supplementation. We found that Vitamin D level, VDR serum level, levator ani muscle strength, and hand grip muscle strength all significantly increase (p < 0.001) following Vitamin D analog supplementation. The correlation coefficient between levator ani muscle and handgrip muscle strength was 0.616 and with p value of 0.001. To conclude, Vitamin D analog supplementation can significantly increase levator ani muscle strength in uterine prolapse patients. We propose that determining Vitamin D level in postmenopausal women and replenishing its deficiency with Vitamin D analog supplementation might aid in preventing POP progression.
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Affiliation(s)
- Andi Kurniadi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia.
| | - Asri Kurnia Dewi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
| | - R M Sonny Sasotya
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
| | - Benny Hasan Purwara
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
| | - Jessica Kireina
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
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Dos Santos GB, Sato TDO, Miwa-Cerqueira T, Bifani BE, Rocha APR, Carvalho C. Pelvic floor dysfunctions in women with fibromyalgia: A cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2023; 282:1-6. [PMID: 36603313 DOI: 10.1016/j.ejogrb.2022.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/17/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Fibromyalgia (FM) is a rheumatic syndrome that causes musculoskeletal disorders and is associated with several problems that affect quality of life. As the musculoskeletal system is affected, it can have an impact on the pelvic floor muscles, leading to pelvic floor dysfunction (PFD). OBJECTIVE Investigate the occurrence of PFD, such as urinary incontinence (UI) and anal incontinence (AI), sexual problems, and pelvic organ prolapse (POP), in women with FM compared to a control group composed of women without FM; and investigate the association between FM and PFD. STUDY DESIGN This was an online cross-sectional survey. Demographic and anthropometric data, the description of PFD (UI, nocturia, AI, genital-pelvic pain/penetration disorder, and POP), and previous obstetric history were collected through a web-based questionnaire. The groups were compared using the independent t-test for quantitative variables and the chi-square test for categorical variables. The association between FM and PFD was tested using logistic regression analysis. RESULTS A total of 175 women answered the questionnaire (97 with FM and 78 healthy controls). The women with FM reported significantly more UI, mixed urinary incontinence, AI, POP, and vaginismus than the healthy controls (p ≤ 0.05). FM was associated with mixed urinary incontinence (OR: 2.6; 95 % CI: 1.1-6.4; p = 0.04), anal incontinence (OR: 2.9; 95 % CI: 1.3-6.1; p = 0.01), and flatus incontinence (OR: 2.6; 95 % CI: 1.2-5.4; p = 0.01). CONCLUSION The prevalence of PFD was significantly higher in women with FM compared to healthy women. Indeed, the women with FM were 2.6-fold to 2.9-fold more likely to report mixed urinary incontinence, anal and flatus incontinence than those in the control group. The present findings show possible impairment of the pelvic floor musculature in women with FM.
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Affiliation(s)
- Gabriel Bernardi Dos Santos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Tatiana de Oliveira Sato
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Tsugui Miwa-Cerqueira
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bianca Escuer Bifani
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Ana Paula Rodrigues Rocha
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Cristiano Carvalho
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil.
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Alizadeh A, Montazeri M, Shabani F, Bani S, Hassanpour S, Nabighadim M, Mirghafourvand M. Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study. BMC Urol 2023; 23:18. [PMID: 36782177 PMCID: PMC9924865 DOI: 10.1186/s12894-023-01186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Urinary incontinence (UI) is one of the most common symptoms during menopause, leading to a decreased quality of life and limited social activities. This study aimed to determine the prevalence and severity of urinary incontinence and associated risk factors in postmenopausal women. METHODS It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, Questionnaire for Urinary Incontinence Diagnosis (QUID), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF). Multivariate logistic regression was used to determine factors related to urinary incontinence. RESULTS The overall prevalence of urinary incontinence was 39.5%; 20.6% stress urinary incontinence (SUI), 10.4% urgency urinary incontinence (UUI), and 8.5% mixed urinary incontinence (MUI). Multivariate logistic regression analysis showed that the prevalence of SUI (aOR 0.38; 95% CI 0.18-0.77) and UUI (aOR 0.38; 95% CI 0.15-0.94) was significantly lower in women with three childbirths than the ones with fewer childbirths. Also, the odds of UUI increased significantly in women at the 50-55 age range (aOR 3.88; 95% CI 1.16-12.93) than those less than 50 years. CONCLUSION Due to the high prevalence of urinary incontinence in postmenopausal women, caregivers should screen for early diagnosis and appropriate treatment of urinary incontinence to prevent its destructive impact on the quality of life.
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Affiliation(s)
- Afsaneh Alizadeh
- grid.412888.f0000 0001 2174 8913Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- grid.412888.f0000 0001 2174 8913Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Shabani
- grid.412888.f0000 0001 2174 8913Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soheila Bani
- grid.412888.f0000 0001 2174 8913Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Hassanpour
- grid.412888.f0000 0001 2174 8913Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsan Nabighadim
- grid.411426.40000 0004 0611 7226Department of Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Managing Pelvic Organ Prolapse After Urinary Diversion or Neobladder. CURRENT BLADDER DYSFUNCTION REPORTS 2023. [DOI: 10.1007/s11884-023-00685-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Transvaginal natural orifice transluminal endoscopic surgery versus conventional vaginal surgery for sacrospinous ligament fixation of apical compartment prolapse: a retrospective analysis. BMC Surg 2023; 23:24. [PMID: 36707831 PMCID: PMC9883968 DOI: 10.1186/s12893-023-01921-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 01/18/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To objectively assess the safety, feasibility, advantages, and disadvantages of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) versus conventional vaginal (CV) surgery for sacrospinous ligament fixation (SSLF). METHODS We retrospectively analyzed the data of patients who underwent hysterectomy for SSLF via vNOTES or CV surgery due to apical compartment prolapse between April 2019 and April 2020 at our hospital. The patients were classified into the vNOTES group (n = 31) and CV surgery group (n = 51) based on surgical approach and their general characteristics and perioperative outcomes compared. RESULTS The two groups had similar general characteristics. The anatomical success and bilateral salpingo-oophorectomy rates were higher in the vNOTES than CV surgery group, while the postoperative stay was shorter in the vNOTES than CV surgery group. All differences were statistically significant. However, there were no statistically significant intergroup differences in operation time, bilateral salpingectomy rate, colporrhaphy rate, postoperative visual analog scale score, estimated blood loss, hemoglobin decrease at 72 h postoperative, maximum body temperature at 72 h postoperative, complication rate, buttock pain, or Pelvic Floor Impact Questionnaire-7 and Pelvic Floor Distress Inventory Questionnaire-20 scores at 1 year postoperative. CONCLUSIONS VNOTES for SSLF was safe and feasible and resulted in superior objective and subjective outcomes versus CV surgery for SSLF. These findings suggest that vNOTES could be an alternative to CV surgery for SSLF.
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Hambisa HD, Birku Z, Gedamu S. Magnitude of Symptomatic Pelvic Floor Dysfunction and Associated Factors Amongst Women in Western Ethiopia: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231171309. [PMID: 37203183 PMCID: PMC10201172 DOI: 10.1177/00469580231171309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/25/2023] [Accepted: 04/05/2023] [Indexed: 05/20/2023]
Abstract
The goal of this research was to determine the extent of pelvic floor dysfunction and the factors that contribute to it. The study design was community-focused and cross-sectional, and participants were chosen using a systematic random sampling technique. For data entry and cleansing, we used EPI data version 3.1 software, and for analysis, we used Statistical Package for the Social Sciences version 26. The 95% confidence interval was predicted, and the factor with a significant level less than 0.05 was chosen for multivariate logistic regression analysis. The overall Magnitude of pelvic floor dysfunction was 37.7% [(95% confidence interval (31.7-42.5)]. The most common type of pelvic floor dysfunction is overactive bladder, which was reported by 135 of all participants. Pelvic organ prolapse accounted for 92 (30.4%) of all cases, and 4 factors were found to be significantly associated with pelvic floor dysfunction. In this study, age 55 years [(AOR = 2.1; 95% CI: (1.52-6.42)], heavy labor work for more than 10 years [(AOR = 3.21; 95% CI: (1.86-5.72) grand-multipara, and being menopause [(AOR = 4.03; 95% CI: (2.20-8.27)] were linked to symptoms of pelvic floor dysfunction. The magnitude of pelvic floor dysfunction in this study was slightly higher than in Ethiopian studies. Pelvic floor dysfunction has been linked to heavy load lifting, low socioeconomic status, recurrent vaginal deliveries, chronic cough, and menopause. Screening and treatment of pelvic floor disorders should be prioritized in collaboration with regional and zonal health departments.
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Affiliation(s)
- Hunduma Dina Hambisa
- College of Health Science, Department
of Midwifery, Assosa University, Asosa, Ethiopia
| | - Zelalem Birku
- College of Health Science, Department
of Midwifery, Assosa University, Asosa, Ethiopia
| | - Samuel Gedamu
- College of Health Science, Department
of Midwifery, Assosa University, Asosa, Ethiopia
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Melkie TB, Gashaw ZM, Workineh ZA, Andargie TM, Debele TZ, Nigatu SG. Translation, reliability, and validity of Amharic versions of the Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). PLoS One 2022; 17:e0270434. [PMCID: PMC9671332 DOI: 10.1371/journal.pone.0270434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
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 using 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.
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Affiliation(s)
- Tadesse Belayneh Melkie
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gonda, Ethiopia
- * E-mail:
| | - Zelalem Mengistu Gashaw
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gonda, Ethiopia
| | - Zelalem Ayichew Workineh
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gonda, Ethiopia
| | - Tamiru Minwuye Andargie
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gonda, Ethiopia
| | - Tibeb Zena Debele
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gonda, Ethiopia
| | - Solomon Gedlu Nigatu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gonda, Ethiopia
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Sori DA, Bretones S, Mellier G, de Rochambeau B. Prevalence and surgical outcomes of stage 3 and 4 pelvic organs prolapse in Jimma university medical center, south west Ethiopia. BMC Womens Health 2022; 22:410. [PMID: 36207709 PMCID: PMC9540999 DOI: 10.1186/s12905-022-01992-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background Pelvic organ prolapse (POP) affects about half of the women and affects their quality of life. The current study is, therefore, aimed at determining the prevalence and surgical outcomes of severe stage POP at Jimma University medical center from November 2016 to May 2018.
Method A Hospital-based cross-sectional study was conducted on all patients with stage 3 and 4 POP, who were admitted, and had surgery. Data were collected from the patient’s chart, and logbooks, which were filled up from entry till her discharge. A Simplified POPQ(S-POPQ) was used to stage the prolapse at admission, at discharge, and three months follow-ups.
Results Among 92 patients who were analyzed, POP accounts for 10.6% of all gynecologic admissions, and 43.8% of all gynecologic surgeries. The mean age of patients is 46 (± 12) years, and nearly 34% of the patients had stage 3 and 66% had stage 4 POP. Based on the type of prolapse, 93.5% of patients had stage 3 and more anterior vaginal wall prolapse (AVWP) and apical prolapse, while 57.6% had stage 3 or more posterior vaginal wall prolapse. Out of 72 patients who had anterior colporrhaphy, 58.7% had anterior colporrhaphy with colposuspension. Out of 83 patients who had apical suspension, 48.2%, 39.8%, and 12% had uterosacral, sacrospinous, and Richardson respectively. Ninety-seven patients had stage 0 or 1 POP at discharge while 90% of 20 patients who returned for follow-up at three months had stage 0 or 1 POP. Eight patients had surgery-related complications; bladder injury, urinary retention, Hemorrhage during SSLF, and rectal injury. Conclusion The prevalence of pelvic organ prolapse is high and the majority of patients presented with advanced-stage pelvic organ prolapse, with a long duration of symptoms and associated problems. The surgical techniques used have resulted in a high immediate success rate of 97% and 90% at discharge and three months follow up respectively. Therefore, awareness creation activities are important to facilitate an early presentation for treatment to improve the quality of life and the current surgical technique; native tissue vaginal repair (NTVR), being practiced in the setup has had better success.
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Affiliation(s)
- Demisew Amenu Sori
- grid.411903.e0000 0001 2034 9160Jimma University Institute of Health, Department of Obstetrics and Gynecology, Jimma University, Jimma, Ethiopia
| | - Stephan Bretones
- Urogynecology and Reconstructive Pelvic Surgeon, Saint Joseph-Saint Luc Hospital, Lyon, France
| | - Georges Mellier
- grid.7849.20000 0001 2150 7757Department of Obstetrics and Gynecology, Lyon 1 University, Villeurbanne, France
| | - Bertrand de Rochambeau
- Urogynecology and Reconstructive Pelvic Surgeon, Saint Joseph-Saint Luc Hospital, Lyon, France
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Obsa MS, Worji TA, Kedir NA, Kute NG. Risk factors of pelvic organ prolapse at Asella Teaching and Referral Hospital: Unmatched case control study. Front Glob Womens Health 2022; 3:833823. [PMID: 36177338 PMCID: PMC9513197 DOI: 10.3389/fgwh.2022.833823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundProlapse is one of the sub-types of pelvic floor dysfunction (PFD) which occurs due to abnormal fall of the pelvic organs from their normal anatomic positions. Although the cause of prolapse is multifactorial, it primarily occurs due to pregnancy and vaginal delivery. Hence, the present study aimed to identify risk factors of prolapse among women who undergo gynecological surgery.Materials and methodsFacility-based-unmatched case–control design was employed. Cases were all gynecological women who were diagnosed with pelvic organ prolapse (POP) at Asella teaching referral hospital (ATRH) while controls were all charts of gynecological women who were diagnosed with other gynecological problems rather than POP at ATRH. For each case, two controls were selected using a simple random sampling technique. The data were entered into Epidata version 4.3.1 and finally exported to SPSS version 25 for further analysis. Then variables that had an association in the bivariate model (p < 0.25) were entered and analyzed by a multivariable conditional logistic regression model to identify the independent effect of different factors. Statistical significance was declared at p < 0.05.ResultsA total of 147 cases and 293 controls were included in this study. Women who had a history of chronic cough, previous pelvic floor surgery, constipation, and vaginal tear during delivery, history of pelvic trauma, age of the women, rural resident, and maternal gravidity were strongly associated with prolapse at p-value of < 0.05. Multigravida [adjusted odds ratio (AOR) 2.987 (95% CI 1.237–6.853), p = 0.014], age >50 years [AOR: 2.496 (95% CI 1.372–4.539), p = 0.003], women with a history of pelvic floor surgery [AOR: 0.3.666 (95% CI 1.328–10.124), p = 0.012], women who had diabetes mellitus [AOR: 4.676 (95% CI 0.908–24.075), p = 0.065], and resided in rural areas [AOR = 1.878; (95% CI: 0.984–3.585), I2 = 47.5%, p = 0.056] were the independent predictors were of prolapse.ConclusionsIn this study, women with diabetes mellitus, previous pelvic floor surgery, rural residents, being multigravida, and age >40 were independent predictors of prolapse. Therefore, delivering health education by focusing on the identified risk factors was strongly recommended.
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Affiliation(s)
| | - Tahir A Worji
- Department of Anesthesia, Wolaita Sodo University, Sodo, Ethiopia
| | - Nemo A Kedir
- School of Medicine, Arsi University, Asella, Ethiopia
| | - Negeso G Kute
- Department of Anesthesia, Hawassa University, Hawassa, Ethiopia
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Hutchison D, Ali M, Zillioux J, Ortiz NM, Smith R, Rapp DE. Pelvic Floor Muscle Training in the Management of Female Pelvic Floor Disorders. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hadizadeh-Talasaz Z, Khadivzadeh T, Khadem ghaebi N, Ebrahimipour H. Exploration of sexual experience among women with pelvic organ prolapse: a qualitative study. SEXUAL AND RELATIONSHIP THERAPY 2022. [DOI: 10.1080/14681994.2019.1701187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Zahra Hadizadeh-Talasaz
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nayereh Khadem ghaebi
- Woman Health Research Center, Faculty of Medicine, Mashhad University Of Medical Sciences, Mashhad, Iran
| | - Hossein Ebrahimipour
- Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Pisani GK, Sato TDO, de Carvalho DHT, Carvalho C. Impact of urinary incontinence on quality of life in female CrossFit practitioners: A cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2021; 268:56-61. [PMID: 34861594 DOI: 10.1016/j.ejogrb.2021.11.424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/13/2021] [Accepted: 11/19/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Investigate the impact of urinary incontinence (UI) on quality of life (QoL) in female CrossFit practitioners and to verify the strategies used by them to minimize the occurrence of urine leakage. In addition, to verify whether anthropometric and clinical characteristics increase the UI impact on QoL of female CrossFit practitioners. STUDY DESIGN This was an online cross-sectional survey. The impact of UI on QoL was investigated by International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Associations between the impact of UI on QoL and the clinical (age, BMI, gestations, mode of delivery, practice of other physical activities) and the others pelvic floor dysfunctions (PFD) related independent variables were tested using logistic regression analysis. RESULTS A total of 828 female CrossFit practitioners answered the questionnaire and 36% reported UI symptoms. The women who obtained the highest score on the ICIQ-SF have high UI interference in QoL. Previous history of two or more gestations and sexual dysfunctions (dyspareunia or vaginismus) or pelvic organ prolapse increase 2.65 and 1.82 times the risk of female CrossFit practitioners with UI having a high impact of UI on their QoL, respectively (OR = 2.65 95% CI 1.30-5.40, p = 0.01; and OR = 1.82 95% CI 1.04-3.21, p = 0.04, respectively). The most strategies used by them to minimize the occurrence of urine leakage were emptying the bladder before training (77.5%) and use absorbent (17.8%). CONCLUSIONS Women who had higher scores on the ICIQ-SF reported greater impact on QoL, and the previous history of two or more gestations and sexual dysfunction/pelvic organ prolapse increase the risk of women with UI who practice CrossFit to have a greater impact on QoL. Multigravida and women with sexual dysfunction/pelvic organ prolapse who practice CrossFit could have more attention on the UI symptoms due to the high impact on their QoL.
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Affiliation(s)
- Giulia Keppe Pisani
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | | | - Cristiano Carvalho
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
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Pelvic floor muscle injury during a difficult labor. Can tissue fatigue damage play a role? Int Urogynecol J 2021; 33:211-220. [PMID: 34783861 DOI: 10.1007/s00192-021-05012-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
Pubovisceral muscle (PVM) injury during a difficult vaginal delivery leads to pelvic organ prolapse later in life. If one could address how and why the muscle injury originates, one might be able to better prevent these injuries in the future. In a recent review we concluded that many atraumatic injuries of the muscle-tendon unit are consistent with it being weakened by an accumulation of passive tissue damage during repetitive loading. While the PVM can tear due to a single overstretch at the end of the second stage of labor we hypothesize that it can also be weakened by an accumulation of microdamage and then tear after a series of submaximal loading cycles. We conclude that there is strong indirect evidence that low cycle fatigue of PVM passive tissue is a possible mechanism of its proximal failure. This has implications for finding new ways to better prevent PVM injury in the future.
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Lukanović D, Kunič T, Batkoska M, Matjašič M, Barbič M. Effectiveness of Magnetic Stimulation in the Treatment of Urinary Incontinence: A Systematic Review and Results of Our Study. J Clin Med 2021; 10:jcm10215210. [PMID: 34768730 PMCID: PMC8584787 DOI: 10.3390/jcm10215210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022] Open
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.
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Affiliation(s)
- David Lukanović
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, 1000 Ljubljana, Slovenia; (T.K.); (M.B.); (M.B.)
- Correspondence: ; Tel.: +386-1522-6005
| | - Tina Kunič
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, 1000 Ljubljana, Slovenia; (T.K.); (M.B.); (M.B.)
| | - Marija Batkoska
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, 1000 Ljubljana, Slovenia; (T.K.); (M.B.); (M.B.)
| | - Miha Matjašič
- Center for Social Informatics, Faculty of Social Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Matija Barbič
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, 1000 Ljubljana, Slovenia; (T.K.); (M.B.); (M.B.)
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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Clarke M, Whitson N, Williams C, Robson SJ. A silent burden-prolapse, incontinence, and infertility in Australian Aboriginal and Torres Strait Islander women: A systematic search and narrative review. Int J Gynaecol Obstet 2021; 155:268-274. [PMID: 34543443 DOI: 10.1002/ijgo.13920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/18/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pelvic organ prolapse (POP), urinary incontinence, and infertility are all prevalent conditions associated with considerable reduction in quality of life. As a group, Aboriginal and Torres Strait Islander women may be at higher risk of these conditions, but studies are scarce. OBJECTIVE To review the literature pertaining to the epidemiology, diagnosis, and management of these conditions in Indigenous Australian women. SEARCH STRATEGY Medline, Embase, and Scopus were searched for articles published between 1980 and 2021 pertaining to these conditions in Indigenous Australian women. SELECTION CRITERIA Studies that did not directly address the epidemiology, diagnosis, and management of these conditions were excluded. MAIN RESULTS It was possible to identify only 11 papers dealing with these conditions in Indigenous Australian women. Only one dealt with POP and was a retrospective audit of a health outreach program in the Northern Territory concluding that there was significant underreporting of the condition. Five papers dealt with urinary incontinence and, again, described significant underreporting and poor referral pathways. Five papers reported small studies about infertility, one reporting poor engagement from clinical directors. CONCLUSION It was concluded that despite the importance of these conditions, there is almost no body of research and this is an urgent national problem.
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Affiliation(s)
- Marilyn Clarke
- Department of Obstetrics and Gynaecology, Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia
| | - Nicole Whitson
- Department of Obstetrics and Gynaecology, John-Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Corey Williams
- Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Stephen J Robson
- Australian National University Medical School, Canberra, Australian Capital Territory, Australia
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Laparoscopic versus vaginal native tissue repair in combination with pectopexy. Sub-analysis from an international, prospective, and multi-centre study: short term results. MINIM INVASIV THER 2021; 31:782-788. [PMID: 34278938 DOI: 10.1080/13645706.2021.1941118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION 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.
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Kayondo M, Kaye DK, Migisha R, Tugume R, Kato PK, Lugobe HM, Geissbüehler V. Impact of surgery on quality of life of Ugandan women with symptomatic pelvic organ prolapse: a prospective cohort study. BMC WOMENS HEALTH 2021; 21:258. [PMID: 34172043 PMCID: PMC8228931 DOI: 10.1186/s12905-021-01397-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/16/2021] [Indexed: 12/04/2022]
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.
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Affiliation(s)
- Musa Kayondo
- Faculty of Medicine, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda. .,Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, P.O.BOX 40, Mbarara, Uganda.
| | - Dan Kabonge Kaye
- Department of Obstetrics and Gynecology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Richard Migisha
- Department of Physiology, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda
| | - Rodgers Tugume
- Faculty of Medicine, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda.,Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, P.O.BOX 40, Mbarara, Uganda
| | - Paul Kalyebara Kato
- Faculty of Medicine, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda.,Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, P.O.BOX 40, Mbarara, Uganda
| | - Henry Mark Lugobe
- Faculty of Medicine, Mbarara University of Science and Technology, P.O.BOX 1410, Mbarara, Uganda.,Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, P.O.BOX 40, Mbarara, Uganda
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Machado LDS, Marques Cerentini T, Laganà AS, Viana da Rosa P, Fichera M, Telles da Rosa LH. Pelvic floor evaluation in CrossFit® athletes and urinary incontinence: a cross-sectional observational study. Women Health 2021; 61:490-499. [PMID: 33993850 DOI: 10.1080/03630242.2021.1927288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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.
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Affiliation(s)
- Lisandra da Silva Machado
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Taís Marques Cerentini
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Patrícia Viana da Rosa
- Physiotherapy Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Michele Fichera
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Luís Henrique Telles da Rosa
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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Gabriel I, Kalousdian A, Brito LG, Abdalian T, Vitonis AF, Minassian VA. Pelvic organ prolapse after 3 modes of hysterectomy: long-term follow-up. Am J Obstet Gynecol 2021; 224:496.e1-496.e10. [PMID: 33207236 DOI: 10.1016/j.ajog.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/01/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND There are various indications and approaches for hysterectomy; yet, the difference in long-term risk of subsequent prolapse after surgery is not well studied. OBJECTIVE To assess the risk of prolapse after abdominal, vaginal, and laparoscopic or robotic hysterectomy for up to 17 years from surgery. STUDY DESIGN A retrospective chart review study of women undergoing hysterectomy across all indications (benign and malignant) between 2001 and 2008 was conducted. An equivalent random sample of hysterectomy patients was selected each year. We compared demographic and other surgical characteristics data including age, race, parity, body mass index, indication and year of hysterectomy, blood loss, cervix removal, cuff suspension, and complications using chi-square, Kruskal-Wallis test, and Fisher's exact across the 3 groups. Presence and treatment of subsequent prolapse (based on patient symptoms, pelvic exam, International Classification of Diseases, Ninth Revision diagnosis, and current procedural terminology pessary or surgical codes) were compared with Kaplan-Meier survival analysis and Cox proportional hazards regression. RESULTS Of the 2158 patients, 1459, 375, and 324 underwent open, vaginal, and laparoscopic or robotic hysterectomy, respectively. The vaginal group (56) was older than the abdominal (52) or laparoscopic or robotic (49) groups, with a P value of <.05. Most patients were White with a mean body mass index of 30 kg/m2. The main indication was cancer for abdominal (33%) and laparoscopic or robotic hysterectomy (25%) and prolapse for vaginal hysterectomy (60%). Time to prolapse was shortest after vaginal surgery (27 months) and longest after laparoscopic or robotic surgery (71 months). After controlling for confounders, including surgery indication, the hazard ratio for subsequent prolapse was no different among vaginal (hazard ratio=1.36 [0.77-2.45]), laparoscopic or robotic (hazard ratio=1.47 [0.80-2.69]), or open (reference) hysterectomy. Prolapse grade was similar across the 3 groups. About 50% of women with recurrent prolapse received physical therapy, pessary, or surgical treatment. CONCLUSION At the 17-year follow-up, the route of hysterectomy is not associated with a difference in recurrence, grade, or subsequent treatment of prolapse when the indication for hysterectomy is considered. Prolapse, as an indication for hysterectomy, increases risk for recurrence. Women planning a hysterectomy should be counseled appropriately about the risk of subsequent prolapse.
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Functional and sexual outcome of laparoscopic ventral mesh rectopexy vs transperineal mesh repair in the treatment of rectocele: a retrospective analysis. Eur Surg 2021. [DOI: 10.1007/s10353-021-00695-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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25
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Brusciano L, Schiattarella A, De Franciscis P, Torella M, Gallo P, Gambardella C, del Genio G, Tolone S, Terracciano G, Gualtieri G, Colacurci N, Docimo L. Prevalence of Pelvic Floor Dysfunction and Impact on the Quality of Life in Epidemiological Evaluation of Bariatric Patients. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2020.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Luigi Brusciano
- Division of General, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Marco Torella
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Pasquale Gallo
- Obstetrics and Gynecology Unit, “Santa Maria Delle Grazie” Hospital, Naples, Italy
| | - Claudio Gambardella
- Division of General, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
- Department of Cardiothoracic Sciences, School of Medicine, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Gianmattia del Genio
- Division of General, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Salvatore Tolone
- Division of General, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Gianmattia Terracciano
- Division of General, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Giorgia Gualtieri
- Division of General, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Ludovico Docimo
- Division of General, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
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Vilos GA, Reyes-MuÑoz E, Riemma G, Kahramanoglu I, Lin LT, Chiofalo B, Lordelo P, Della Corte L, Vitagliano A, Valenti G. Gynecological cancers and urinary dysfunction: a comparison between endometrial cancer and other gynecological malignancies. Minerva Med 2021; 112:96-110. [PMID: 32700863 DOI: 10.23736/s0026-4806.20.06770-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The purpose of this paper is to provide a narrative overview of the available literature about voiding dysfunction in women with gynecological cancer before and after surgical, chemo- and radiotherapy treatments. Radical surgery, radiotherapy, and chemotherapy may cause lower urinary tract dysfunction such as stress and urge urinary incontinence, and voiding difficulties. However, nerve-sparing radical hysterectomy may be a valid surgical approach in order to reduce bladder innervation impairment and maintain normal urinary function. Also, newer radiotherapy techniques significantly reduce the number of adverse effects, including bladder dysfunction. Pelvic floor muscle physiotherapy and training with biofeedback and urethral bulking agents represent some additional therapies that can be used in oncologically treated patients with urinary symptoms in order to improve a significant aspect of their quality of life. Considering the important impact on the patients' quality of life, a full urogynecological evaluation should be considered as an important part of oncological treatment and follow-up.
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Affiliation(s)
- George A Vilos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada -
| | - Enrique Reyes-MuÑoz
- Department of Endocrinology, Isidro Espinosa de los Reyes National Institute of Perinatology, Mexico City, Mexico
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
- Division of Gynecologic Oncology, Department of Women's and Children's Health, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Ilker Kahramanoglu
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, University of Instanbul, Istanbul, Turkey
| | - Li-Te Lin
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Benito Chiofalo
- Unit of Gynecologic Oncology, Department of Experimental Clinical Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Patricia Lordelo
- Centro de Atenção ao Piso Pélvico (CAAP), Division of Physiotherapy, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University, Naples, Italy
| | - Amerigo Vitagliano
- Department of Women and Children's Health, University of Padua, Padua, Italy
| | - Gaetano Valenti
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Shi C, Zhao Y, Hu Q, Gong R, Yin Y, Xia Z. Clinical analysis of pain after transvaginal mesh surgery in patients with pelvic organ prolapse. BMC Womens Health 2021; 21:46. [PMID: 33516228 PMCID: PMC7847570 DOI: 10.1186/s12905-021-01192-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/21/2021] [Indexed: 12/28/2022] Open
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.
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Affiliation(s)
- Chang Shi
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Ying Zhao
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Qing Hu
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Runqi Gong
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Yitong Yin
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China
| | - Zhijun Xia
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China.
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Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Gjerde JL, Ayele TA. Pelvic organ prolapse surgery and health-related quality of life: a follow-up study. BMC WOMENS HEALTH 2021; 21:4. [PMID: 33388056 PMCID: PMC7778798 DOI: 10.1186/s12905-020-01146-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 12/08/2020] [Indexed: 11/10/2022]
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.
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Affiliation(s)
- Tadesse Belayneh
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Abebaw Gebeyehu
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulat Adefris
- Department of Gynecology and Obstetrics, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Guri Rortveit
- Section for General Practice, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Research Unit for General Practice, NORCE Norwegian Research Center, Bergen, Norway
| | - Janne Lillelid Gjerde
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tadesse Awoke Ayele
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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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
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Keršič M, Keršič M, Kunič T, Garzon S, Laganà AS, Barbič M, Lukanović A, Lukanović D. Single-Incision Mini-Sling for the Treatment of Female Stress Urinary Incontinence: Is it Actually Inferior to Transobturator Vaginal Tape and Tension-Free Vaginal Tape? Gynecol Minim Invasive Ther 2020; 9:123-130. [PMID: 33101912 PMCID: PMC7545044 DOI: 10.4103/gmit.gmit_78_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/04/2020] [Accepted: 03/17/2020] [Indexed: 12/11/2022] Open
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.
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Affiliation(s)
- Matej Keršič
- Department of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Maruša Keršič
- Department of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Tina Kunič
- Department of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Matija Barbič
- Department of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Adolf Lukanović
- Department of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - David Lukanović
- Department of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia
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Zhao Y, Xia ZJ, Hu Q, Qin MY. Subjective and Objective Evaluation of Total Pelvic Floor Reconstruction with Six-Arm Mesh in Patients with Severe Pelvic Organ Prolapse: A 1-Year Retrospective Study. Ther Clin Risk Manag 2020; 16:861-870. [PMID: 32982258 PMCID: PMC7500836 DOI: 10.2147/tcrm.s267832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/31/2020] [Indexed: 11/23/2022] Open
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.
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Affiliation(s)
- Ying Zhao
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Zhi-Jun Xia
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Qing Hu
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Mei-Ying Qin
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
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Investigating the birth-related caudal maternal pelvic floor muscle injury: The consequences of low cycle fatigue damage. J Mech Behav Biomed Mater 2020; 110:103956. [PMID: 32957249 DOI: 10.1016/j.jmbbm.2020.103956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND One of the major causes of pelvic organ prolapse is pelvic muscle injury sustained during a vaginal delivery. The most common site of this injury is where the pubovisceral muscle takes origin from the pubic bone. We hypothesized that it is possible for low-cycle material fatigue to occur at the origin of the pubovisceral muscle under the large repetitive loads associated with pushing during the second stage of a difficult labor. PURPOSE The main goal was to test if the origin of the pubovisceral muscle accumulates material damage under sub-maximal cyclic tensile loading and identify any microscopic evidence of such damage. METHODS Twenty origins of the ishiococcygeous muscle (homologous to the pubovisceral muscle in women) were dissected from female sheep pelvises. Four specimens were stretched to failure to characterize the failure properties of the specimens. Thirteen specimens were then subjected to relaxation and subsequent fatigue tests, while three specimens remained as untested controls. Histology was performed to check for microscopic damage accumulation. RESULTS The fatigue stress-time curves showed continuous stress softening, a sign of material damage accumulation. Histology confirmed the presence of accumulated microdamage in the form of kinked muscle fibers and muscle fiber disruption in the areas with higher deformation, namely in the muscle near the musculotendinous junction. CONCLUSIONS The origin of ovine ishiococcygeous muscle can accumulate damage under sub-maximal repetitive loading. The damage appears in the muscle near the musculotendinous junction and was sufficient to negatively affect the macroscopic mechanical properties of the specimens.
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Long CY, Wang CL, Lin KL, Ker CR, Loo Z, Liu Y, Wu PC. Laparoscopic Long Mesh Surgery with Augmented Round Ligaments: A Novel Uterine Preservation Procedure For Apical Pelvic Organ Prolapse. Sci Rep 2020; 10:6615. [PMID: 32313187 PMCID: PMC7171133 DOI: 10.1038/s41598-020-63725-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/03/2020] [Indexed: 12/11/2022] Open
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.
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Affiliation(s)
- Cheng-Yu Long
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chiu-Lin Wang
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Ling Lin
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Ru Ker
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Zixi Loo
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yiyin Liu
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Chi Wu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
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Rada MP, Jones S, Falconi G, Milhem Haddad J, Betschart C, Pergialiotis V, Doumouchtsis SK. A systematic review and meta-synthesis of qualitative studies on pelvic organ prolapse for the development of core outcome sets. Neurourol Urodyn 2020; 39:880-889. [PMID: 32040864 DOI: 10.1002/nau.24297] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/23/2020] [Indexed: 01/08/2023]
Abstract
AIMS In the current climate of evidence-based health care, the aim of this meta-synthesis was to collect and systematically analyse data from primary qualitative studies on pelvic organ prolapse (POP), to identify patient-centered perspectives on the natural course of POP. Information acquired in this study may be useful for ongoing research towards the development of core outcome sets (COS) in pelvic floor disorders. METHODS A CHORUS Working Group performed a standardized search of three different databases (Medline, Embase, Scopus), from inception to October 2019. We selected qualitative studies on women's perspectives on POP that were published in the English language. Three reviewers independently evaluated the quality of eligible papers and highlighted recurrent themes based on patient perspectives. RESULTS Eighteen qualitative studies including a total of 497 patients were assessed in this analysis. Our study revealed five superordinate themes, recurrently encountered in qualitative studies on POP: awareness of POP (6 studies), communication (9 studies), treatments (10 studies), effects on quality of life (6 studies), and self-image (3 studies). Five out of 10 quality criteria were met by all the studies included, based on an assessment performed using the critical appraisal skills program. CONCLUSIONS This is the first synthesis of qualitative studies that address POP-related experiences of women, highlighting five superordinate themes, of which treatment was the most commonly reported one. This synthesis' findings may guide quantitative research priorities and will hopefully contribute to the development of a COS for POP.
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Affiliation(s)
- Maria Patricia Rada
- Department of Obstetrics and Gynaecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.,2nd Department of Obstetrics and Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Stephanie Jones
- Department of Obstetrics and Gynaecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.,2nd Department of Obstetrics and Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriele Falconi
- Department of Obstetrics and Gynaecology, San Bortolo Hospital, Vicenza, Italy
| | - Jorge Milhem Haddad
- Urogynaecology Division, Department of Obstetrics and Gynaecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Cornelia Betschart
- Department of Gynecology, University Hospital of Zurich, Zurich, Switzerland
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N. S. Christeas, Athens University Medical School, Athens, Greece
| | - Stergios K Doumouchtsis
- Department of Obstetrics and Gynaecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.,School of Medicine, American University of the Caribbean, Pembroke Pines, Florida.,Laboratory of Experimental Surgery and Surgical Research N. S. Christeas, Athens University Medical School, Athens, Greece.,Institute of Medical and Biomedical Education, St George's University of London, London, UK
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Nardos R, Ayenachew F, Roentgen R, Abreha M, Jacobson L, Haile A, Berhe Y, Gold K, Gregory WT, Spitznagle T, Payne CK, Wall LL. Capacity building in female pelvic medicine and reconstructive surgery: Global Health Partnership beyond fistula care in Ethiopia. Int Urogynecol J 2020; 31:227-235. [DOI: 10.1007/s00192-019-04197-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 11/19/2019] [Indexed: 01/01/2023]
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La Rosa VL, Ciebiera M, Lin LT, Sleiman Z, Cerentini TM, Lordelo P, Kahramanoglu I, Bruni S, Garzon S, Fichera M. Multidisciplinary management of women with pelvic organ prolapse, urinary incontinence and lower urinary tract symptoms.A clinical and psychological overview. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2019; 18:184-190. [PMID: 31975987 PMCID: PMC6970416 DOI: 10.5114/pm.2019.89496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 08/24/2019] [Indexed: 02/05/2023]
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 therapeutic approaches, which require the physicians to take into account not only the primary symptoms, but also all the associated factors negatively affected. It has been widely underlined that gynecological diseases are often associated with high stress and have a negative impact on quality of life and psychological well-being of women affected. For this reason, a multidisciplinary approach for the management of these diseases is highly recommended. Also in the case of urogynecological disorders, it is important to take into account psychological outcomes throughout the diagnostic and therapeutic process. In the light of these considerations, the aim of this short review is to evaluate the impact of the main urogynecological diseases and the currently available therapeutic options in order to improve quality of life and sexuality of these patients and to stress the need for a multidisciplinary approach in order to minimize the negative consequences of these diseases for the sexual well-being of women and their partners.
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Affiliation(s)
- Valentina Lucia La Rosa
- Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy
- Corresponding author: Valentina Lucia La Rosa, Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy, e-mail:
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Li-Te Lin
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Zaki Sleiman
- Department of Obstetrics and Gynecology, Lebanese American University, Beirut, Lebanon
| | - Tais Marques Cerentini
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | | | - Ilker Kahramanoglu
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Simone Bruni
- Department of Molecular and Developmental Medicine, Division of Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Michele Fichera
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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La Rosa VL, De Franciscis P, Barra F, Schiattarella A, Török P, Shah M, Karaman E, Marques Cerentini T, Di Guardo F, Gullo G, Ponta M, Ferrero S. Quality of life in women with endometriosis: a narrative overview. Minerva Med 2019; 111:68-78. [PMID: 31755667 DOI: 10.23736/s0026-4806.19.06298-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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.
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Affiliation(s)
- Valentina L La Rosa
- Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy -
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Fabio Barra
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Academic Unit of Obstetrics and Gynecology, San Martino University Hospital IRCCS, Genoa, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Péter Török
- Faculty of Medicine, Institute of Obstetrics and Gynecology, University of Debrecen, Debrecen, Hungary
| | - Mohsin Shah
- Department of Physiology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Erbil Karaman
- Department of Obstetrics and Gynecology, Yuzuncu Yıl University, Van, Turkey
| | | | - Federica Di Guardo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Giuseppe Gullo
- AOOR Villa Sofia Cervello, IVF Public Center, Palermo, Italy
| | - Marco Ponta
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Academic Unit of Obstetrics and Gynecology, San Martino University Hospital IRCCS, Genoa, Italy
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Serati M, Laganà AS, Casarin J, Gisone B, Cantaluppi S, Ghezzi F. Laparoscopic duplication of the uterosacral ligaments following hysterectomy for stage III–IV apical pelvic organ prolapse. Updates Surg 2019; 72:199-204. [PMID: 31691118 DOI: 10.1007/s13304-019-00690-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 10/27/2019] [Indexed: 12/13/2022]
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Psychosocial Profile and Reproductive Decisions of Women Undergoing Pregnancy Termination for Medical Reasons-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183413. [PMID: 31540023 PMCID: PMC6765807 DOI: 10.3390/ijerph16183413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 01/05/2023]
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.
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Anglès-Acedo S, Ros-Cerro C, Espuña-Pons M, Valero-Fernandez EM. Sexual activity and function of women with severe pelvic organ prolapse subjected to a classical vaginal surgery. A Multicentre study. Actas Urol Esp 2019; 43:389-395. [PMID: 31202592 DOI: 10.1016/j.acuro.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/18/2019] [Accepted: 02/13/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVE Pelvic organ prolapse (POP) is related with female sexual dysfunction. The present study aimed to determine the impact of POP corrective surgery on the sexual life of women with advanced POP. MATERIALS AND METHODS A prospective, multicentre cohort study was designed, including patients with grade≥II, symptomatic POP, who underwent vaginal surgery with traditional procedures. Sexual activity and function were assessed by PISQ-IR before surgery and 12 months after. RESULTS We included 355 women; 322 had data from the follow-up visit. The mean (SD) age was 64.8 (9.9) years. At baseline, 170 women were sexually active and 185 were not. After surgery, 29 women (16.8%) became sexually active and 20 (12.8%) ceased sexual activity. Before surgery, 42.3% reported not having sexual intercourse due to bladder, bowel or POP problems; and 11.4% after surgery. At baseline visit, 25.3% had no sexual activity due to pain, however, at follow-up visits, this percentage was 8.5%. A statistically significant improvement was observed in 5 out of 6 scales of the PISQ-IR in sexually active women. CONCLUSIONS Symptomatic POP is associated with female sexual dysfunction. Surgical intervention seems to have a positive impact on sexual life among sexually inactive and active women.
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Affiliation(s)
- S Anglès-Acedo
- Unidad de Suelo Pélvico, ICGON, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España.
| | - C Ros-Cerro
- Unidad de Suelo Pélvico, ICGON, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
| | - M Espuña-Pons
- Unidad de Suelo Pélvico, ICGON, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
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Florian-Rodriguez M, Chin K, Hamner J, Acevedo J, Keller P, Word RA. Effect of Protease Inhibitors in Healing of the Vaginal Wall. Sci Rep 2019; 9:12354. [PMID: 31451729 PMCID: PMC6710245 DOI: 10.1038/s41598-019-48527-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 08/07/2019] [Indexed: 12/25/2022] Open
Abstract
Impaired elastogenesis and increased degradation of elastic fibers has been implicated in the pathogenesis of pelvic organ prolapse. Loss of the elastogenic organizer, fibulin-5 (FBLN5), leads to pelvic organ prolapse in mice. The objective of this study was to investigate the regulation of FBLN5 after surgical injury of the vaginal wall using the rat as a preclinical animal model. Both endogenous and recombinant FBLN5 were degraded after surgical injury. Estrogen did not alter the dramatic loss of vaginal FBLN5 in the acute phase after injury (12–48 h), but resulted in rescue of the poor recovery of FBLN5 levels in the late phase (7 d) of healing in ovariectomized animals. In contrast with estrogen, the general MMP inhibitor, actinonin, abrogated injury-induced degradation of FBLN5 significantly. Further, actinonin rescued the negative effects of injury on biomechanics, histomorphology, and elastic fibers. Control of excessive matrix degradation by local application of actinonin at the time of surgery may lead to improved elastic fiber regeneration and wound healing, thereby potentially enhancing pelvic floor recovery after reconstructive surgery for prolapse.
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Affiliation(s)
- Maria Florian-Rodriguez
- Department of Obstetrics and Gynecology Division of Female Pelvic Medicine and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
| | - Kathleen Chin
- Department of Obstetrics and Gynecology Division of Female Pelvic Medicine and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jennifer Hamner
- Department of Obstetrics and Gynecology Division of Female Pelvic Medicine and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jesus Acevedo
- Cecil H. and Ida Green Center for Reproductive Biology Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Patrick Keller
- Cecil H. and Ida Green Center for Reproductive Biology Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - R Ann Word
- Cecil H. and Ida Green Center for Reproductive Biology Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Quality of Life and Urinary Incontinence Symptoms in Women Undergoing Bariatric Surgery: A Combined Case-Cohort Study. Female Pelvic Med Reconstr Surg 2019; 26:e62-e67. [DOI: 10.1097/spv.0000000000000757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A comparison of sacral neuromodulation vs. transvaginal electrical stimulation for the treatment of refractory overactive bladder: the impact on quality of life, body image, sexual function, and emotional well-being. MENOPAUSE REVIEW 2019; 18:89-93. [PMID: 31485205 PMCID: PMC6719634 DOI: 10.5114/pm.2019.86834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 06/17/2019] [Indexed: 02/04/2023]
Abstract
Overactive bladder syndrome (OAB) is defined by the presence of urinary urgency, with or without urge incontinence, usually accompanied by an increase in urinary frequency and nocturia in the absence of urinary tract infections (UTI) or other diseases. The overall prevalence of OAB symptoms in the female population is reported to be 16.6% and increases with advancing age and menopause. The aetiology of OAB is not fully understood and is likely to affect a heterogeneous population of patients due to changes to their central and peripheral nervous systems. Although OAB is frequently associated with female sexual dysfunction (FSD), its real impact on sexual function in women has been evaluated only in a few studies. The first line of treatment for OAB includes behavioural modification and physical therapy, either as monotherapies or in combination. Many patients who have not had success in managing their symptoms with more conservative therapies may decide to resort to third-line treatments for refractory OAB. These treatments include neuromodulation therapies, particularly transvaginal electrical stimulation (TES) and sacral neuromodulation (SN). The aim of this short commentary is to provide an overview of the effectiveness of these treatments and of their impact on quality of life, body image, sexual function, and emotional well-being.
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La Rosa VL, Ciebiera M, Lin LT, Fan S, Butticè S, Sathyapalan T, Jędra R, Lordelo P, Favilli A. Treatment of genitourinary syndrome of menopause: the potential effects of intravaginal ultralow-concentration oestriol and intravaginal dehydroepiandrosterone on quality of life and sexual function. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2019; 18:116-122. [PMID: 31488961 PMCID: PMC6719636 DOI: 10.5114/pm.2019.86836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/23/2019] [Indexed: 02/05/2023]
Abstract
The climacteric is considered a natural phase in a woman's aging process and is defined as the period starting from the decline in ovarian activity until after the end of ovarian function. Genitourinary syndrome of menopause (GSM) is commonly observed in menopausal women and is characterised by a collection of symptoms resulting from changes to the internal and external genitalia as well as the lower urinary tract. Several studies have demonstrated the close association between sexual dysfunction and symptoms related to GSM. Many medications, at different doses, have been studied over the years for the treatment of the symptoms of GSM. More specifically, ultralow-dose intravaginal oestriol and intravaginal dehydroepiandrosterone (DHEA) are reported to improve symptoms, signs, and quality of life of women with GSM, and they are safe owing to their specific local effect. While the dosage and the administration of intravaginal DHEA are well defined, the literature on intravaginal oestriol is less uniform: different doses and times of administration are proposed with different possible combinations with other non-pharmacological therapies, although a more standardised treatment may be necessary. The aim of this review is to summarise the available data about the effects of ultralow-concentration oestriol and intravaginal DHEA on the menopause-related symptoms, quality of life, and sexual function of women affected by GSM.
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Affiliation(s)
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynaecology, The Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Li-Te Lin
- Department of Obstetrics and Gynaecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shangrong Fan
- Department of Obstetrics and Gynaecology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Salvatore Butticè
- Department of Urology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Thozhukat Sathyapalan
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Robert Jędra
- Second Department of Obstetrics and Gynaecology, The Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Alessandro Favilli
- Section of Obstetrics and Gynaecology, Department of Surgical and Biomedical Sciences, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy
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Intraoperative and early postoperative complications in women with stress urinary incontinence treated with suburethral slings: a randomised trial. Wideochir Inne Tech Maloinwazyjne 2019; 15:18-29. [PMID: 32117482 PMCID: PMC7020724 DOI: 10.5114/wiitm.2019.84702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 02/16/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction The midurethral sling has become the current standard for the treatment of female stress urinary incontinence. Aim To assess intraoperative complications, early post-operative complications as well as the efficacy of tension-free vaginal tape: retropubic and trans-obturator tape procedures. Material and methods 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. Results 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. Conclusions 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.
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Wagner L, Chevrot A, Llinares E, Costa P, Droupy S. Long-term anatomic and functional results of laparoscopic sacrocolpopexy: a prospective study. Int Urol Nephrol 2019; 51:795-802. [PMID: 30875028 DOI: 10.1007/s11255-019-02124-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/05/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE 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. METHODS This is a prospective, single-center study that included 82 patients between 2009 and 2016. A clinical evaluation took place before surgery, and was repeated at 3, 12, 36 and 60 months postoperatively. Patients routinely received an anterior prosthesis, associated with a posterior prosthesis in case of symptomatic rectocele. Patients included self-administered questionnaires for functional pelvic problems (PFDI-20), quality of life (PFIQ-7), and sexual function (PISQ-12), and a clinical examination with POP-Q staging, at each medical visit. RESULTS Functional pelvic problems derived from prolapse (PFDI-20 scores) and their impact on patients' quality of life (PFIQ-7 score) significantly improved at 3, 12, 36 and 60 months postoperatively. Improvement on sexual activity was significant at 3 and 60 months postoperatively. Effective prolapse anatomical correction (POP-Q score < 2) was found in 94.4% and 97.2% of patients at the anterior and middle stages, respectively, at the end of follow-up, but only in 80.3% at the posterior stage. Symptomatic recurrence required surgical intervention in 4 patients (5.3%). CONCLUSIONS This long-term follow-up prospective analysis confirms the good functional and anatomical results of laparoscopic sacrocolpopexy for pelvic organ prolapse.
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Affiliation(s)
- Laurent Wagner
- Urology Department, University Hospital of Nîmes, 4 Rue du Professeur Robert Debré, 30029, Nîmes, France
| | - Armand Chevrot
- Urology Department, University Hospital of Nîmes, 4 Rue du Professeur Robert Debré, 30029, Nîmes, France.
| | - Elisabeth Llinares
- Urology Department, University Hospital of Nîmes, 4 Rue du Professeur Robert Debré, 30029, Nîmes, France
| | - Pierre Costa
- Urology Department, University Hospital of Nîmes, 4 Rue du Professeur Robert Debré, 30029, Nîmes, France
| | - Stéphane Droupy
- Urology Department, University Hospital of Nîmes, 4 Rue du Professeur Robert Debré, 30029, Nîmes, France
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Li C, Shu H, Dai Z. Do Pelvic Organ Prolapse Quantification Examination Ba and D Guide the Selection of Operation for Severe Pelvic Organ Prolapse? J INVEST SURG 2018; 33:438-445. [PMID: 30574821 DOI: 10.1080/08941939.2018.1533055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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.
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Affiliation(s)
- Chunbo Li
- Department of Gynaecology and Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai Shi, China
| | - Huimin Shu
- Department of Gynaecology and Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai Shi, China
| | - Zhiyuan Dai
- Department of Gynaecology and Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai Shi, China
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Tahaoglu AE, Bakir MS, Peker N, Bagli İ, Tayyar AT. Modified laparoscopic pectopexy: short-term follow-up and its effects on sexual function and quality of life. Int Urogynecol J 2018; 29:1155-1160. [PMID: 29500516 DOI: 10.1007/s00192-018-3565-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 01/13/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS This study examined the early outcomes of laparoscopic (LS) pectopexy and evaluated its effects on female sexual function and quality of life (QoL). METHODS Twenty-two patients with apical prolapse who underwent LS pectopexy were included. Outcomes of the procedure were noted; the Female Sexual Function (FSFI) and Prolapse Quality of Life (P-QOL) questionnaires were completed preoperatively and 6 months postoperatively. RESULTS There was no evidence of recurrent prolapse or constipation; the percentages of exacerbation of cystocele, rectocele, de novo stress urinary incontinence (SUI), and de novo urgency (UUI) were 4.5%, 9.0%, 4.5%, and 4.5%, respectively (mean follow-up 10.41 months). FSFI and P-QOL scores improved significantly (p < 0.05) postoperatively. CONCLUSIONS LS pectopexy shows promising results for pelvic organ prolapse (POP) surgery with comparable outcomes. It also improved the FSFI and P-QOL scores in POP patients.
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Affiliation(s)
- Ali Emre Tahaoglu
- Obstetrics and Gynecology Department, Health Sciences University Gazi Yasargil Research and Training Hospital, Talaytepe Mahallesi, Urfa Yolu, 21090 Merkez, Baglar, Diyarbakır, Turkey.
| | - Mehmet Sait Bakir
- Obstetrics and Gynecology Department, Health Sciences University Gazi Yasargil Research and Training Hospital, Talaytepe Mahallesi, Urfa Yolu, 21090 Merkez, Baglar, Diyarbakır, Turkey
| | - Nurullah Peker
- Obstetrics and Gynecology Department, Health Sciences University Gazi Yasargil Research and Training Hospital, Talaytepe Mahallesi, Urfa Yolu, 21090 Merkez, Baglar, Diyarbakır, Turkey
| | - İhsan Bagli
- Obstetrics and Gynecology Department, Health Sciences University Gazi Yasargil Research and Training Hospital, Talaytepe Mahallesi, Urfa Yolu, 21090 Merkez, Baglar, Diyarbakır, Turkey
| | - Ahter Tanay Tayyar
- Obstetrics and Gynecology Department, Zeynep Kamil Research and Training Hospital, Istanbul, Turkey
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Wenzler DL, Gulli F, Cooney M, Chancellor MB, Gilleran J, Peters KM. Treatment of ulcerative compared to non-ulcerative interstitial cystitis with hyperbaric oxygen: a pilot study. Ther Adv Urol 2017; 9:263-270. [PMID: 29383031 DOI: 10.1177/1756287217731009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 08/20/2017] [Indexed: 12/14/2022] Open
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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Affiliation(s)
- David L Wenzler
- Beaumont Health System, 3601 W 13 Mile Rd., St. 438, Royal Oak, MI 48073-6769, USA
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