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Lau HH, Su TH, Hwang JC. Impact of pelvic floor muscle training on sexual function in women affected by stress urinary incontinence. Sex Med 2024; 12:qfae040. [PMID: 38903774 PMCID: PMC11187770 DOI: 10.1093/sexmed/qfae040] [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: 02/01/2024] [Revised: 05/07/2024] [Accepted: 06/04/2024] [Indexed: 06/22/2024] Open
Abstract
Background Pelvic floor muscle training can effectively improve pelvic floor muscle strength and activities; however, its impact on sexual function in women with stress urinary incontinence remains unclear. Aim The study sought to investigate the impact of pelvic floor muscle training on pelvic floor muscle and sexual function in women with stress urinary incontinence. Methods This was a retrospective observational study involving women who visited a urogynecologic clinic at a tertiary medical center. Patients with stress urinary incontinence without pelvic organ prolapse underwent pelvic floor muscle training programs that included biofeedback and intravaginal electrostimulation. Other evaluations included pelvic floor manometry, electromyography, and quality-of-life questionnaires, including the short forms of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Outcomes Clinical characteristics, vaginal squeezing and resting pressure, maximal pelvic floor contraction, duration of sustained contraction, quality-of-life scores, and sexual function were compared between baseline and after the pelvic floor muscle training programs. Results There were 61 women included in the study. The mean number of treatment sessions was 12.9 ± 6.3, and the mean treatment duration was 66.7 ± 32.1 days. The short forms of the Urogenital Distress Inventory (7.7 ± 3.8 vs 1.8 ± 2.1; P < .001) and Incontinence Impact Questionnaire (5.9 ± 4.3 vs 1.8 ± 2.0; P < .001) scores significantly improved after the pelvic floor muscle training program. In addition, all pelvic floor muscle activities significantly improved, including maximal vaginal squeezing pressure (58.7 ± 20.1 cmH2O vs 66.0 ± 24.7 cmH2O; P = .022), difference in vaginal resting and maximal squeezing pressure (25.3 ± 14.6 cmH2O vs 35.5 ± 16.0 cmH2O; P < .001), maximal pelvic muscle voluntary contraction (24.9 ± 13.8 μV vs 44.5 ± 18.9 μV; P < .001), and duration of contraction (6.2 ± 5.7 s vs 24.9 ± 14.6 s; P < .001). Nevertheless, the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire score demonstrated no significant improvement (28.8 ± 9.7 vs 29.2 ± 12.3; P = .752). Clinical Implications Pelvic floor muscle training programs may not improve sexual function in women with stress urinary incontinence. Strengths and Limitations The strength of this study is that we evaluated sexual function with validated questionnaires. The small sample size and lack of long-term data are the major limitations. Conclusion Pelvic floor muscle training can improve pelvic floor muscle activities and effectively treat stress urinary incontinence; however, it may not improve sexual function.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College, Sanzhi District, New Taipei City 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Zhongshan District, Taipei City 104, Taiwan
- Mackay Medicine, Nursing and Management College, Beitou District, Taipei City 112, Taiwan
| | - Tsung-Hsien Su
- Department of Medicine, Mackay Medical College, Sanzhi District, New Taipei City 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Zhongshan District, Taipei City 104, Taiwan
- Mackay Medicine, Nursing and Management College, Beitou District, Taipei City 112, Taiwan
| | - Jiun-Chyi Hwang
- Department of Medicine, Mackay Medical College, Sanzhi District, New Taipei City 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Zhongshan District, Taipei City 104, Taiwan
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Lo TS, Rom E, Harun F, Jhang LS, Hsieh WC, Lin YH. Anterior-apical Transvaginal Mesh (Calistar-S) for Treatment of Advanced Urogenital Prolapse: Surgical and Functional Outcomes at 1 Year. Int Urogynecol J 2024; 35:1011-1019. [PMID: 38466345 DOI: 10.1007/s00192-024-05749-9] [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: 10/31/2023] [Accepted: 01/31/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Calistar-S is a single-incision synthetic mesh kit that addresses apical and anterior compartment prolapse. The aims of this study were to evaluate the short-term objective and subjective outcomes at the 1-year follow-up. The secondary objectives were to evaluate quality of life and lower urinary tract symptoms (LUTS) outcomes, as well as surgical complications. METHODS Records of 108 patients with symptomatic advanced pelvic organ prolapse (stages III and IV) who underwent prolapse surgery using the Calistar-S system from June 2018 to August 2022 were reviewed. The primary outcome was the objective cure of anterior and apical prolapse < stage 1, and the subjective cure was the negative response to questions 2 and 3 of the Pelvic Organ Prolapse Distress Inventory-6. Secondary outcomes measured quality of life, the presence of lower urinary tract symptoms, and complications. RESULTS A total of 101 patients were evaluated. The overall objective cure rate is 97% and the subjective cure rate is 92.1%. Good outcomes were seen in all three compartments. Secondary outcomes show significant improvement in all validated questionnaires. Persistence and de novo urinary incontinence were 15.2% and 18.2% post-operatively. There is one case of bladder injury and one case of vaginal mesh exposure. CONCLUSIONS The Calistar-S System is a safe and efficient method for treating advanced-stage POP. We observed good anatomical results and subjective relief with a minimal complication rate. LUTS have also been positively affected, showing a high success rate. Additional studies are needed to establish the long-term efficacy of this system.
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Affiliation(s)
- Tsia-Shu Lo
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-Shan, Linkou, Tao-Yuan City, 333, Taiwan.
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan.
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei Medical Center, Taipei, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Eyal Rom
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-Shan, Linkou, Tao-Yuan City, 333, Taiwan
| | - Fazlin Harun
- Department of Obstetrics and Gynecology, Women and Children Hospital (Hospital Tunku Azizah), Kuala Lumpur, Malaysia
| | - Lan-Sin Jhang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Tucheng Medical Center, New Taipei City, Taiwan
| | - Wu-Chiao Hsieh
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-Shan, Linkou, Tao-Yuan City, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-Shan, Linkou, Tao-Yuan City, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Lo TS, Harun F, Chua S, Shen YH, Tan YL, Hsieh WC. Polypropylene anterior-apical single-incision UPHOLD-LITE mesh surgery in women with severe pelvic organ prolapse: Outcome at 53 months follow up. J Formos Med Assoc 2024; 123:331-339. [PMID: 37996329 DOI: 10.1016/j.jfma.2023.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 10/07/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND AND PURPOSE We present this current study to complement with mesh inlays plausible benefits (UPHOLD-LITE System) on available long-term study amidst FDA's concern on mesh complications. This study aims to assess the medium-term outcomes of UPHOLD-LITE system for treatment of advanced pelvic organ prolapse (POP) and its complications, and lower urinary tract symptoms. METHODS This is a retrospective case series of 53 months follow-up of 123 consecutive patients who underwent UPHOLD-LITE system. Objective outcome measures the anatomical correction of prolapse with POP-Q ≤ Stage 1. Subjective outcome was patient's feedback to questions 2 and 3 of POPDI-6. Secondary outcome measures the quality of life, presence of lower urinary tract symptoms and complications. Quality of life is assessed by validated questionnaires on Urogenital Distress Inventory 6 (UDI-6), Incontinence Impact Questionnaire 7 (IIQ-7), Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 (PISQ-12) at 1 and 3 years post-operatively. RESULTS Objective outcome at 1 and 3 years was at 96.7 % and 95.4 % respectively. The subjective cure was 95.1 % and 91.6 %. Five-year cumulative cure rate maintained at 87.2 %. Secondary outcomes observed improvement on UDI-6, IIQ-7, POPDI-6 and PISQ-12 postoperatively. Bladder outlet obstruction improved while de novo urodynamic stress incontinence (USI) increased slightly post surgically. Mesh erosion rate was 0.8 %. CONCLUSION The UPHOLD-LITE system demonstrated good medium term anatomical correction of apical and anterior prolapse, with good subjective cure and improved quality of life. Whilst complication rate was low, slight increase in de novo USI was observed.
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Affiliation(s)
- Tsia-Shu Lo
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, ROC; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, ROC; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Medical Center, Taipei, Taiwan, ROC; Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC.
| | - Fazlin Harun
- Department of Obstetrics and Gynecology, Women and Children Hospital (Hospital Tunku Azizah), Kuala Lumpur, Malaysia
| | - Sandy Chua
- Department of Obstetrics and Gynecology, Cebu Institute of Medicine-Cebu Velez General Hospital, Cebu City, Philippines
| | - Yu-Hua Shen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, ROC
| | - Yiap Loong Tan
- Department of Obstetrics and Gynecology, Kuching Specialist Hospital, KPJ Healthcare Group, Sarawak, Malaysia
| | - Wu-Chiao Hsieh
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, ROC; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, ROC; Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC
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Lin YH, Lim CK, Chang SD, Chiang CC, Huang CH, Tseng LH. Tailor-made three-dimensional printing vaginal pessary to treat pelvic organ prolapse: a pilot study. Menopause 2023; 30:947-953. [PMID: 37625089 PMCID: PMC10487415 DOI: 10.1097/gme.0000000000002223] [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: 02/23/2023] [Accepted: 05/09/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVE This study aimed to apply three-dimensional (3D) printing technology to treat women with pelvic organ prolapse (POP) and to evaluate efficacy based on the improvement by quality of life (QOL) questionnaires. METHODS This was a pilot study at a tertiary urogynecology unit in Taiwan. Between January 2021 and June 6, 2021, participants who opted for self-management using Gellhorn pessaries to treat symptomatic POP were enrolled. For each woman, the original Gellhorn pessary was placed into the vagina to restore the prolapsed tissues and under transvaginal ultrasound guided to evaluate the gap which the Gellhorn pessary cannot cover. Otoform (an impression silicone) was used to make a model and have it hooked onto Gellhorn pessary (template). We collected templates and then applied 3D printing to customize the silicone vaginal pessary. All women completed multiple validated QOL questionnaires at baseline and at 3 and 6 months. RESULTS Six women completed the study. The QOL questionnaires revealed significant improvements across the board. CONCLUSIONS Our study demonstrates that a tailor made 3D pessary can be used for women with POP. A customized pessary can be made with the help of transvaginal ultrasound and 3D printing technology.
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Affiliation(s)
- Yi-Hao Lin
- From the Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chor-Kheng Lim
- Department of Art and Design, Yuan Ze University, Taoyuan, Taiwan
| | - Shuenn-Dyh Chang
- From the Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Chien Chiang
- Department of Obstetrics and Gynecology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Chun-Hung Huang
- From the Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ling-Hong Tseng
- Department of Obstetrics and Gynecology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
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Huang TX, Lo TS, Tseng HJ, Lin YH, Liang CC, Hsieh WC. Correlation between overactive bladder and detrusor overactivity: a retrospective study. Int Urogynecol J 2023; 34:867-875. [PMID: 35751673 DOI: 10.1007/s00192-022-05274-7] [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: 03/24/2022] [Accepted: 06/01/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The primary objective of this study is to determine the prevalence of overactive bladder (OAB) and detrusor overactivity (DO) in female patients who were referred for urodynamic study (UDS) because of lower urinary tract symptoms (LUTS). The secondary objective is to determine the subjective and objective differences between female OAB patients with and without DO. MATERIALS AND METHODS All female patients who underwent UDS for LUTS between June 2016 and September 2019 were retrospectively reviewed. Personal history, medical history, physical examination, and validated questionnaires were collected. One-hour pad test and multichannel urodynamic study was performed. All statistical analyses were conducted by SAS 9.4. P-value < 0.05 was considered statistically significant. RESULTS A total of 4184 female patients underwent UDS because of LUTS between June 2016 and September 2019; 1524 patients were analyzed for OAB or DO. The occurrence of OAB was 36.4%. The overall incidence of DO in OAB patients was 15.5%; 9.5% of all patients had DO findings on UDS, and 4.6% were incidental findings. There were significant differences among mean age, parity, ICIQ-UI SF, OABSS, POPDI-6, and all UDS parameters (except for maximal urethral pressure and pressure transmission ratio) between patients with and without DO. In patients with DO, there were no significant differences among age, parity, and BMI with or without OAB symptoms. However, there were significant differences among mean OABSS, ICIQ-UI SF, UDI-6, POPDI-6, IIQ-7, and pad test. CONCLUSIONS Patients with DO are associated with older age, increased parity, greater urine leakage, and worse storage and micturition functions on UDS. Combinations of subjective and objective measurements are better predictive models for OAB patients.
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Affiliation(s)
- Ting-Xuan Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China
| | - Tsia-Shu Lo
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China.
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China.
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei Medical Center, Taipei, Taiwan, Republic of China.
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
| | - Hsiao-Jung Tseng
- Biostatistics unit, Clinical Trial Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Ching-Chung Liang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Wu-Chiao Hsieh
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
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Huang S, Lv Q, Li Y, Meng Q, Li M. A modified technique for paravaginal repair of cystocele with paravaginal defect: A retrospective study. Eur J Obstet Gynecol Reprod Biol 2021; 269:108-113. [PMID: 34992032 DOI: 10.1016/j.ejogrb.2021.12.028] [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: 12/15/2020] [Revised: 10/27/2021] [Accepted: 12/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We aimed to determine the efficacy and safety of a modified protocol for paravaginal repair of symptomatic paravaginal defects and cystocele. METHODS This study was an observational case series of 98 consecutive female patients, referred to our hospital between June 2014 and May 2018, with symptomatic grade II to IV paravaginal defects and cystocele. Our modified technique for paravaginal repair is based on the conventional protocol but incorporates reverse bridge repair and the cross-stitching of bilateral sutures. The curative effect of this new technique was evaluated subjectively and objectively during postoperative follow-up. RESULTS All operations were successful. Patients were followed up for 12 to 48 months, until June 2019; the mean follow-up period was 32.4 months. Three months after surgery, the rate of success was 100% (98/98 cases); in each case, the top of the vagina lay above the level of the sciatic spine. The rate of success was 94.9% (93/98 cases) at 12 months after surgery, 91.0% (61/71 cases) at 24 months after surgery, and 76.2% (16/21 cases) at 48 months after surgery. Four cases required a second surgery; three of these cases were treated with sacrocolpopexy, and one case was treated with sacrospinous ligament fixation. CONCLUSION Our modified technique for paravaginal repair was safe and effective for anterior vaginal prolapse and cystocele, as confirmed by the results observed over a mean follow-up period of 32.4 months.
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Affiliation(s)
- Shuai Huang
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China.
| | - Qiubo Lv
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Ye Li
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Qingwei Meng
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Min Li
- Department of Gynecology and Obstetrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
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Yang E, Yang SH, Huang WC, Yeh SC, Yang JM. Association of Baseline Pelvic Floor Muscle Activities With Sexual and Urinary Functions In Female Stress Urinary Incontinence. J Sex Med 2021; 18:1698-1704. [PMID: 37057501 DOI: 10.1016/j.jsxm.2021.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/18/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The presence of reactive and strong pelvic floor muscle (PFM) activities is supposed to be associated with better urinary and sexual functions in female stress urinary incontinence (SUI). AIM This study was to explore the association of baseline PFM activities, both volitional and reflex, with urinary and sexual functions in women with SUI but who had no experience of PFM training programs before. METHODS Secondary analysis of a prospectively maintained database identified 125 sexually active women with SUI who had met the eligibility criteria. All patients had undergone intravaginal digital examination and pelvic ultrasound to detect volitional and reflex PFM activities, respectively, and responded to questionnaire surveys, including short forms of the urogenital distress inventory, incontinence impact questionnaire-7, and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. On pelvic ultrasound, an inward clitoral motion and an anorectal lift preceding or during coughing were regarded as the presence of reflex activities of the PFM. OUTCOMES The relationship of volitional and reflex PFM activities with pelvic floor dysfunction relating questionnaires and urethral function on urodynamic studies was analyzed. RESULT Of the 125 women studied, 30 (24.0%) had volitional PFM contraction strength less than grade 2, 74 (59.2%) grade 2 to 3, and 21 (16.8%) greater than grade 3 based on the modified Oxford grading scale. During or preceding coughing, an inward clitoral motion was not observed on ultrasound in 9 (7.2%) women and an anorectal lift was not observed in 8 (6.4%) women. The strength of volitional PFM contraction and the presence or absence of anorectal lift reflex was not associated with urethral and sexual function. In contrast, the absence of reflex inward clitoral motion was significantly associated with lower maximum urethral closure pressure (P = .042) and higher scores of urogenital distress inventory-6 (P = .006) and incontinence impact questionnaire-7 (P = .029). CLINICAL IMPLICATIONS Higher volitional PFM contraction strength was not associated with better sexual and urinary functions; however, loss of one reflex PFM activity was associated with poorer urinary function. STRENGTHS & LIMITATION To our knowledge, this is the first study that evaluates the association of baseline PFM activities with sexual and urinary functions in female SUI. Nevertheless, the cross-sectional design of this study cannot well support the cause-effect relationship CONCLUSION: Besides PFM physiotherapy for enhancing sexual and urinary functions in female SUI, additional treatment strategies such as neuromodulation should take into consideration for those who had absent reflex PFM activities. Yang E, Yang SH, Huang WC, et al. Association of Baseline Pelvic Floor Muscle Activities With Sexual and Urinary Functions In Female Stress Urinary Incontinence. J Sex Med 2021;18:1698-1704.
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Affiliation(s)
- Evelyn Yang
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan; Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, Taipei, Taiwan; Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wen-Chen Huang
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Su-Chen Yeh
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Jenn-Ming Yang
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.
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Lo TS, Ng KL, Lin YH, Hsieh WC, Huang TX, Shen YH. De novo detrusor overactivity and urgency after mid-urethral slings for urodynamic stress incontinence. Int Urogynecol J 2021; 32:2737-2745. [PMID: 34292341 DOI: 10.1007/s00192-021-04911-x] [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: 04/13/2021] [Accepted: 05/29/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to identify incidence and risk factors of de novo urgency and detrusor overactivity (DO) following mid-urethral slings (MUS) in patients with urodynamic stress incontinence (USI) without urgency. METHODS A total of 688 women between January 2004 and July 2017 were reviewed retrospectively. De novo urgency was established with a positive response to question 2 on the Urogenital Distress Inventory-6 questionnaire (UDI-6). Objective cure of USI is no involuntary urine leakage during filling cystometry and pad test < 2 g. Subjective cure of stress urinary incontinence (SUI) is defined as a negative response to question 3 on UDI-6. Multivariate logistic regression was used to identify risk factors for failure. RESULTS Forty-four out of 688 women (6.4%) developed de novo urgency, with 16 out of 688 (2.3%) demonstrating de novo DO. Subjective cure for women with de novo urgency was significantly lower at 35 out of 44 (79.5%) compared with 556 out of 644 (86.3%) in those with no urgency (p < 0.001). Objective cure for women with de novo DO was significantly lower at 8 out of 16 (50%) compared with 599 out of 672 (89.1%) in those with detrusor stability (p < 0.001). Quality of life improved for all. Age ≥ 66 (OR, 1.23; 1.07), increased bladder sensation (OR, 4.18; 3.80), lower bladder capacity (OR, 5.28; 4.97), lower maximum urethral closure pressure (OR, 2.32; 5.20), and pad test > 100 g (OR, 1.08; 1.15) were independent risk factors for de novo urgency and DO. Diabetes (OR, 1.32) was an independent predictor of de novo urgency. CONCLUSION Cure is significantly reduced in women who report symptoms of de novo urgency or demonstrate DO after MUS at 1 year. Independent risk factors include age ≥ 66, increased bladder sensation, lower bladder capacity, lower maximum urethral closure pressure, greater pad loss, and diabetes.
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Affiliation(s)
- Tsia-Shu Lo
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China. .,Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China. .,Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Medical Center, Taipei, Taiwan, Republic of China. .,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
| | - Kai Lyn Ng
- Department of Obstetrics & Gynaecology, National University Hospital of Singapore, Singapore, Singapore
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Wu-Chiao Hsieh
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China.,Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Ting-Xuan Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China
| | - Yu-Hua Shen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China
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Tsai CP, Yang JM, Liang SJ, Lin YH, Huang WC, Lin TY, Hsu CS, Chuang FC, Hung MJ. Factors associated with treatment outcomes after intravesical hyaluronic acid therapy in women with refractory interstitial cystitis: A prospective, multicenter study. J Chin Med Assoc 2021; 84:418-422. [PMID: 33784267 DOI: 10.1097/jcma.0000000000000498] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Bladder instillation of hyaluronic acid (HA) is an acceptable treatment for bladder pain syndrome/interstitial cystitis (BPS/IC). The treatment is limited by a high proportion of non-responders (~30%-40%). Here, we aimed to evaluate predisposing factors associated with treatment outcomes. METHODS This is a prospective multicenter study. We enrolled a total of 137 (out of 140) women with refractory IC. They all underwent a standard protocol of 6-month intravesical HA therapy (initial 4 weeks, once weekly, followed by once monthly). To assess the outcomes, we used the pain Visual Analog Scale (Pain-VAS), Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI), and a scaled Global Response Assessment (GRA). RESULTS The age of patients was 47.6 ± 27.5 (range 24-77) years. We found statistically significant improvement (p < 0.001) in the Pain-VAS and the ICSI & ICPI scores both after the initial 4-weekly instillations and at the end of 6-month treatment. Those who reported moderate/marked improvement on GRA at the 2 follow-up visits were considered responders: 39.4% (n = 54) at the first follow-up, and 59.9% (n = 82) at the second follow-up. No remarkable side effect was noted. After statistical analyses, treatment outcomes on GRA were positively associated with baseline functional bladder capacity and with Pain-VAS scores. The initial treatment responses optimally (p < 0.001) predicted final treatment outcomes (McNemar). CONCLUSION Intravesical HA therapy is safe and effective for most (~60%) of our patients with refractory IC. Functional bladder capacity and Pain-VAS scores before treatment, and the early treatment responses are helpful predictors of treatment outcomes.
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Affiliation(s)
- Ching-Pei Tsai
- Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Jenn-Ming Yang
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei, Taiwan, ROC
| | - So-Jung Liang
- Department of Obstetrics and Gynecology, Wan Fang Hospital, Taipei Medical University, Taiwan, ROC
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
| | - Wen-Chu Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Mackay, Medicine, Nursing and Management College, Taipei, Taiwan, ROC
| | - Tzu-Yin Lin
- Department of Obstetrics and Gynecology, Taipei City Hospital, Branch for Women and Children, Taipei, Taiwan, ROC
| | - Chun-Shuo Hsu
- Department of Obstetrics and Gynecology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, ROC
| | - Fei-Chi Chuang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC
| | - Man-Jung Hung
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital; Department of Obstetrics and Gynecology, School of Medicine, Colleague of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
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Ouyang Y, Chen R, Chu L, Liang J, Zhang X, Li L, Gao T, Li H, Tong X. Safety and efficacy of a self-developed Chinese pelvic repair system and Avaulta repair system for the treatment of pelvic organ prolapse in women: A multicenter, prospective, randomized, parallel-group study. Medicine (Baltimore) 2020; 99:e22332. [PMID: 32957403 PMCID: PMC7505298 DOI: 10.1097/md.0000000000022332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The pelvic organ prolapse (POP) repair systems used in China are imported and expensive. Our aim was to compare the efficacy and safety of a self-developed pelvic floor repair system versus the Avaulta system.This was a multicenter, randomized, parallel-group, noninferiority trial of 132 patients with POP stage ≥II from the Tongji Hospital Affiliated to Tongji University and the General Hospital of Ningxia Medical University enrolled from 02/2014 to 03/2015. The patients were randomized 1:1 to POP repair using the self-developed system or the Avaulta system. Perioperative conditions, POP quantification, pelvic floor impact questionnaire-7, and prolapse quality of life questionnaires, gynecological ultrasound, and postoperative complications were compared. Patients were followed at 1.5, 3, and 6 months.According to the POP quantification scores obtained at 6 months after surgery, the cure rates of the self-developed and Avaulta groups were 98.3% and 100.0%, respectively (P > .999). At 6 months follow-up, the pelvic floor impact questionnaire-7 scores of the self-developed and Avaulta groups were both improved (P < .001 vs baseline), with no between-group difference observed (P = .488). There were no differences between the 2 groups for subjective symptoms of POP (all P > .05). There were no significant differences between the 2 groups regarding complications (all P > .05).The self-developed pelvic reconstruction system is safe and effective for the treatment of POP and improves the patients' quality of life, without difference compared to the Avaulta system.
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Affiliation(s)
- Yiqin Ouyang
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji University
| | - Rujun Chen
- The Fifth People's Hospital of Shanghai, Shanghai
| | - Lei Chu
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji University
| | - Junhua Liang
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji University
| | - Xueyu Zhang
- General Hospital of Ningxia Medical University, Yinchuan, China
| | - Li Li
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji University
| | - Tian Gao
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji University
| | - Huaifang Li
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji University
| | - Xiaowen Tong
- Department of Gynecology and Obstetrics, Tongji Hospital of Tongji University
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Lo TS, Ng KL, Huang TX, Chen YP, Lin YH, Hsieh WC. Anterior-Apical Transvaginal Mesh (Surelift) for Advanced Urogenital Prolapse: Surgical and Functional Outcomes at 1 Year. J Minim Invasive Gynecol 2020; 28:107-116. [PMID: 32416263 DOI: 10.1016/j.jmig.2020.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
STUDY OBJECTIVE To determine the objective and subjective outcomes of pelvic organ prolapse (POP) surgery using a modified Surelift system (Neomedic International, Barcelona, Spain) and to evaluate surgical complications and postoperative impact on quality of life (QOL) and lower urinary tract symptoms. DESIGN Retrospective cohort study. SETTING Tertiary-care university hospital. PATIENTS Patients with symptomatic anterior or apical POP stage III and above. INTERVENTIONS All patients underwent pelvic reconstructive surgery with a modified Surelift transvaginal mesh kit. MEASUREMENTS AND MAIN RESULTS Eighty-three women who underwent pelvic reconstructive surgery with a modified Surelift for symptomatic anterior or apical prolapse stage III and above from April 2018 to January 2019 were reviewed retrospectively. All completed a 72-hour voiding diary, urodynamic study, and multiple validated QOL questionnaires at baseline and at between 6 and 12 months postoperatively. Descriptive statistics were used for demographics and perioperative data. Paired-samples t test and the McNemar test were applied for comparison of pre- and postoperative continuous and categoric data, respectively. The primary outcomes were the objective cure of POP, defined as anterior and apical prolapse Pelvic Organ Prolapse Quantification System ≤ stage I, and subjective cure on the basis of negative answers to Pelvic Organ Prolapse Distress Inventory 6. The objective and subjective cure rates at 1 year were 97.6% and 92.8%, respectively. There were significant improvements in QOL scores postoperatively. Although bladder outlet obstruction improved, de novo urodynamic stress incontinence and stress urinary incontinence were increased at 18.9% and 21.6%, respectively, at 1-year follow-up. The mesh extrusion rate was 4.8%. CONCLUSION A modified Surelift has good objective and subjective cure rates at 1 year postoperatively with 4.8% mesh extrusion rate. There was significant improvement in lower urinary tract symptoms and QOL. De novo urodynamic stress incontinence at 6 months to 12 months was increased, but it was not sufficiently bothersome to warrant surgery.
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Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology, Division of Urogynecology, Chang Gung Memorial Hospital at Linkou, Taiwan (Drs. Lo, Huang, Lin, and Hsieh); Department of Obstetrics and Gynecology, School of Medicine, Chang Gung University, Taoyuan, Taiwan (Drs. Lo, Chen, and Lin); Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Keelung, Taiwan (Drs. Lo and Chen); Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Taipei (Dr. Lo), Taiwan.
| | - Kai Lyn Ng
- Department of Obstetrics and Gynaecology, National University Hospital of Singapore (Dr. Ng), Singapore
| | - Ting-Xuan Huang
- Department of Obstetrics and Gynecology, Division of Urogynecology, Chang Gung Memorial Hospital at Linkou, Taiwan (Drs. Lo, Huang, Lin, and Hsieh)
| | - Yi-Pin Chen
- Department of Obstetrics and Gynecology, School of Medicine, Chang Gung University, Taoyuan, Taiwan (Drs. Lo, Chen, and Lin); Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Keelung, Taiwan (Drs. Lo and Chen)
| | - Yi-Hao Lin
- Department of Obstetrics and Gynecology, Division of Urogynecology, Chang Gung Memorial Hospital at Linkou, Taiwan (Drs. Lo, Huang, Lin, and Hsieh); Department of Obstetrics and Gynecology, School of Medicine, Chang Gung University, Taoyuan, Taiwan (Drs. Lo, Chen, and Lin)
| | - Wu-Chiao Hsieh
- Department of Obstetrics and Gynecology, Division of Urogynecology, Chang Gung Memorial Hospital at Linkou, Taiwan (Drs. Lo, Huang, Lin, and Hsieh)
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Outcomes of urodynamic mixed urinary incontinence and urodynamic stress incontinence with urgency after mid-urethral sling surgery. Int Urogynecol J 2020; 31:1949-1957. [DOI: 10.1007/s00192-019-04213-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/12/2019] [Indexed: 12/01/2022]
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Lau HH, Enkhtaivan S, Su TH, Huang WC. The Outcome of a Single-Incision Sling versus Trans-Obturator Sling in Overweight and Obese Women with Stress Urinary Incontinence at 3-Year Follow-Up. J Clin Med 2019; 8:jcm8081099. [PMID: 31349577 PMCID: PMC6723533 DOI: 10.3390/jcm8081099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Being overweight or obese is a risk factor for incontinence and has negative impacts on the surgical outcomes. Compared with trans-obturator sling (TOS), single incision sling (SIS) is a new generation of anti-incontinence surgery. However, the data on SIS in overweight and obese women remains limited. Methods: This retrospective study analyzed the objective and subjective cure rate of overweight and obese women who underwent sling surgeries. Other evaluations included valid questionnaires to assess quality of life and 1-hour pad test to quantify urine leakage. Surgical characteristics and adverse events were also analyzed. Results: A total of 217 patients were analyzed with a median follow-up period of 37.3 months (range, 9–84 months). For overweight and obese patients, the objective and subjective cure rate were comparable (all p > 0.05). However, the SIS group had worse post-operative incontinence-related symptom distress (p < 0.001) and 1-hour pad test (p = 0.047). On the other hand, SIS had a shorter surgery time (p = 0.017) and lower pain score (p < 0.001). Conclusions: Compared with TOS, SIS had non-significant cure rates in the overweight and obese women. SIS had worse urine leakage and incontinence symptoms, but less surgical and wound pain in obese women. Thorough pre-operative counseling is necessary.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City 251, Taiwan
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu 300, Taiwan
| | | | - Tsung-Hsien Su
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City 251, Taiwan
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu 300, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan.
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan.
- Mackay Medicine, Nursing and Management College, New Taipei City 251, Taiwan.
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Lo TS, Chua S, Tan YL, Patrimonio MC, Pue LB. Ultrasonography and clinical outcomes following anti-incontinence procedures (Monarc vs MiniArc): A 3-year post-operative review. PLoS One 2018; 13:e0207375. [PMID: 30513097 PMCID: PMC6279016 DOI: 10.1371/journal.pone.0207375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/30/2018] [Indexed: 11/23/2022] Open
Abstract
Objective To compare the ultrasonographic positional changes of mid-urethral sling(MUS) tape in relation to symphysis pubis, and the different clinical outcomes among women who underwent MUS insertion with MiniArcTM or MonarcTM for the treatment of stress urinary incontinence 3 years after. Materials and methods A retrospective follow-up study on patients with clinically confirmed stress urodynamic incontinence and urodynamic stress incontinence who had undergone MiniArc or Monarc surgery. Data regarding preoperative evaluation, intraoperative complications and post-operative follow-ups were collated. Main outcome is to determine the change in position of the sling through measurement of the x- and y-axis at rest and during Valsalva maneuver using the 3D introital ultrasound. Results A total of 138 patients were evaluated, 82 belonged to Monarc and 56 to MiniArc. At 3years, objective and subjective cure rates for MiniArc and Monarc were comparable (88%, 91%; p>0.05; 83%, 89%, p>0.05 respectively). Ultrasonographic changes between MiniArc and Monarc from 6 months to 3 years, showed MiniArc to exhibit significant movement in both x- [3.0 ±0.4 mm vs. 2.2 ±0.3 mm (p = 0.02) at rest; 2.6 ±0.3 mm vs. 1.6 ±0.3 mm (p<0.001) during valsalva] and y-axis [3.5 ±0.5 mm vs. 2.0 ±0.3 mm (p<0.001) at rest; 3.3 ±0.5 mm vs. 2.9 ±0.3 mm (p = 0.037) during Valsalva]. The mobility of MiniArc was significantly more than Monarc from rest to Valsalva (1.1 ±0.4 mm vs. 0.3 ±0.3 mm, p = 0.001). Tightness of the sling assessed from the major and minor axis of the urethral core had no significant difference in both groups at rest and during Valsalva. Urethral kinking percentage and the location of the sling did not yield statistical difference. Conclusion Maintenance of continence rates of mid-urethral slings depends on the compressive effect of the sling on the urethra, urethral kinking, and sling fixation. From 6months to 3 years, MiniArc changed its position in both x- and y-axis over time, which the authors attribute to loosening of the anchoring mechanism since no clinical relevance could be sought.
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Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, Keelung, Taiwan, Republic of China
- Division of Urogynecology, Department of Obstetrics and Gynecology, Linko, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
- Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China
- * E-mail:
| | - Sandy Chua
- Fellow, Division of Urogynecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
- Department of Obstetrics and Gynecology, Cebu Institute of Medicine- Cebu Velez General Hospital, Cebu City, Philippines
| | - Yiap Loong Tan
- Department of Obstetrics & Gynecology, Kuching Specialist Hospital, KPJ Healthcare, Kuching, Sarawak, Malaysia
| | - Ma. Clarissa Patrimonio
- Fellow, Division of Urogynecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
- Department of Obstetrics and Gynecology, Dr. Pablo O. Torre Memorial Hospital, Bacolod City, Philippine
| | - Leng Boi Pue
- Department of Obstetrics & Gynecology, Subang Jaya Medical Center, Ramsay Sime Darby Health Care, Selangor, Malaysia
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Lo TS, Pue LB, Tan YL, Hsieh WC, Kao CC, Uy-Patrimonio MC. Anterior-apical single-incision mesh surgery (uphold): 1-year outcomes on lower urinary tract symptoms, anatomy and ultrasonography. Int Urogynecol J 2018; 30:1163-1172. [DOI: 10.1007/s00192-018-3691-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/11/2018] [Indexed: 02/04/2023]
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Lo TS, Uy-Patrimonio MC, Hsieh WC, Yang JC, Huang SY, Chua S. Sacrospinous ligament fixation for hysteropexy: does concomitant anterior and posterior fixation improve surgical outcome? Int Urogynecol J 2018; 29:811-819. [PMID: 28971245 DOI: 10.1007/s00192-017-3487-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Uterine preservation in uterine prolapse is an option for young patients. We hypothesized that sacrospinous hysteropexy (SSH) with anchorage to both the anterior and posterior cervix (SSH-ap) would have a better outcome than SSH with anchorage to the posterior cervix only (SSH-p). METHODS This was a retrospective study including 75 patients who underwent SSH at Chang Gung Memorial Hospital between March 2008 and August 2013. Five were excluded due to incomplete data. Of the remaining 70 patients, 35 underwent SSH-p between March 2008 and June 2011, and 35 underwent SSH-ap between June 2010 and August 2013. The primary outcome was the objective anatomical result, and a successful outcome was considered anatomical correction (POP-Q stage 1 or less) of anterior and apical prolapse. Subjective outcome was evaluated using the POPDI-6 questionnaire, and a patient response of "No or mild abdominal organ falling out sensation" together with "No or mild heaviness" was considered to indicate a successful outcome. Anterior fornix and cervical diameter measurements were included. The secondary outcome was quality of life according to the UDI-6, IIQ-7, POPDI-6, and PISQ-12 questionnaires. The 3-year outcome was used for comparison. RESULTS The subjective overall cure rates were significantly different between the SSH-p and SSH-ap groups (74.3% and 94.3%, respectively; p = 0.023). However, the objective overall cure rates were not significantly different (74.3% and 82.9%, respectively). CONCLUSION Anchorage of the anterior cervix and vaginal wall together with the usual posterior anchorage yield better subjective outcomes and apical suspension at 3 years after surgery than anchorage of the posterior cervix and vaginal wall only. The cervix position affected the subjective outcome. Concurrent trachelectomy did not affect the outcome.
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Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Keelung Medical Center, 222, Maijin Road, Keelung, 204, Taiwan, Republic of China.
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.
- Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Xiamen Medical Center, Xiamen, People's Republic of China.
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
| | - Ma Clarissa Uy-Patrimonio
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
- Department of Obstetrics and Gynecology, Dr. Pablo O. Torre Memorial Hospital, Bacolod City, Philippines
| | - Wu-Chiao Hsieh
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
| | - Ju-Chun Yang
- Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Xiamen Medical Center, Xiamen, People's Republic of China
| | - Shih Yin Huang
- Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Keelung Medical Center, 222, Maijin Road, Keelung, 204, Taiwan, Republic of China
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
| | - Sandy Chua
- Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China
- Department of Obstetrics and Gynecology, Cebu Velez General Hospital, Cebu City, Philippines
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Lau HH, Huang WC, Su TH. Urinary leakage during sexual intercourse among women with incontinence: Incidence and risk factors. PLoS One 2017; 12:e0177075. [PMID: 28542221 PMCID: PMC5443475 DOI: 10.1371/journal.pone.0177075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 04/21/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Coital incontinence is an under-reported disorder among women with urinary incontinence. Women seldom voluntarily report this condition, and as such, related data remains limited and is at times conflicting. AIMS AND OBJECTIVES To investigate the incidence and quality of life in women with coital incontinence and to determine associated predictors. METHODS This observational study involved 505 sexually active women attending the urogynecologic clinic for symptomatic urinary incontinence at a tertiary medical center. All of the patients were consulted about the experience of coital incontinence and completed evaluations including urodynamics, and valid questionnaires including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, the Urogenital Distress Inventory and the Incontinence Impact Questionnaire. RESULTS Of these women, 281 (56%) had coital incontinence, while 224 (44%) did not. Among women with coital incontinence, 181 (64%) had urodynamic-proven stress incontinence, 29 (10%) had mixed incontinence, and 15 (5%) had detrusor overactivity. Only 25 (9%) sought consultation for this disorder before direct questioning. Fifty percent (84/281) of the women rarely or sometimes had incontinence during coitus, while 33% (92/281) often had incontinence, and 17% (48/281) always had incontinence. The frequency of coital incontinence was not different regarding the types of incontinence (p = 0.153). Women with mixed incontinence had the worst sexual quality of life and incontinence-related symptom distress. Based on univariate analysis, higher body mass index (OR 2.47, p = 0.027), and lower maximal urethral closure pressure (≤ 30 cmH2O) (OR 4.56, p = 0.007) were possible predictors for coital incontinence. Multivariate analysis showed lower MUCP was independently significant predictors (OR3.93, p = 0.042). CONCLUSIONS The prevalence of coital intercourse in urinary incontinence women was high. Coital incontinence in these women was associated with abnormal urodynamic diagnosis and urethral dysfunction.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College; Department of Obstetrics and Gynecology, Mackay Memorial Hospital; Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College; Department of Obstetrics and Gynecology, Mackay Memorial Hospital; Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Tsung-Hsien Su
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
- * E-mail:
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Asresie A, Admassu E, Setegn T. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case-control study. Int J Womens Health 2016; 8:713-719. [PMID: 28003773 PMCID: PMC5161336 DOI: 10.2147/ijwh.s122459] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Pelvic organ prolapse (POP) is a significant public health problem in developing countries including Ethiopia. However, less has been documented on risk factors of POP. Therefore, the aim of this study was to identify the determinants factors of POP. Methods An unmatched case–control study was conducted among gynecologic patients in Bahir Dar city, North West Ethiopia, from July to October 2014. A total of 370 women (selected from outpatient departments) were included in the study. Cases (clients with stage III or IV POP) and controls (who declared free of any stages of POP) were identified by physicians using the Pelvic Organ Prolapse Quantitative Examination tool. Data analysis was carried out by SPSS version 20.0. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Statistical differences were considered at P<0.05, and the strength of association was assessed by odds ratio (OR) and respective confidence intervals (CIs). Results This study revealed that determinants such as age of women (>40 years) (adjusted OR [AOR] =3.0 [95% CI: 1.59–5.89]), sphincter damage (AOR =8.1 [95% CI: 1.67–39.7]), family history of POP (AOR =4.9 [95% CI: 1.94–12.63]), parity (≥4) (AOR =4.5 [95% CI: 2.26–9.10]), nonattendance of formal education (AOR =4.3 [95% CI: 1.25–14.8]), carrying heavy objects (AOR =3.1 [95% CI: 1.56–6.30]), body mass index (BMI) <18.5 kg/m2 (AOR =3.1 [95% CI: 1.22–7.82]), and delivery assisted by nonhealth professionals (AOR =2.6 [95% CI: 1.24–5.56]) were significantly associated with POP. Conclusion In our study, sphincter damage, family history of POP, being uneducated, having ≥4 vaginal deliveries, carrying heavy objects, BMI <18.5 kg/m2, age ≥40 years, and having delivery assisted by nonhealth professional were the independent determinants of POP. Therefore, skilled delivery, further promoting family planning and girls’ education, early pelvic floor assessment, and counseling on avoidance of carrying heavy objects are recommended.
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Affiliation(s)
- Ayalnesh Asresie
- Hamlin Fistula Center, Amhara National Regional State, Bahir Dar, Ethiopia
| | - Eleni Admassu
- Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia
| | - Tesfaye Setegn
- Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia
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Ju R, Siddiqui N, Garrett J, Feng L, Heit M. A validated translation of a survey for measuring incontinence knowledge in Chinese-speaking American immigrants. Int Urogynecol J 2016; 28:851-856. [DOI: 10.1007/s00192-016-3215-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/14/2016] [Indexed: 12/22/2022]
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Five-year follow-up study of Monarc transobturator tape for surgical treatment of primary stress urinary incontinence. Int Urogynecol J 2016; 27:1653-1659. [PMID: 27085545 DOI: 10.1007/s00192-016-3019-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 03/24/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We hypothesized that transobturator tape (TOT) is safe and efficacious for the treatment of urodynamic stress incontinence in the long term. METHODS We conducted a prospective study of patients with confirmed urodynamic stress incontinence (USI) who underwent a MonarcTM TOT procedure in a tertiary center between February 2006 and March 2009 without other concurrent surgical procedures. Urodynamics were conducted at 1 and 3 years postoperatively. Subjective evaluation included Incontinence Impact Questionnaire (IIQ-7), Urinary Distress Inventory Questionnaire (UDI-6), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry and/ or 1-h pad test of <2 g. Subjective cure was based on a negative response to question 3 in UDI-6. Paired-samples t test, chi-square, and Fisher exact tests were applied; p < 0.05 was considered significant. The log-rank tests were used to compare event-free survival. RESULTS Sixty patients were enrolled, and 56 were evaluated at 5 years postoperatively. The majority were middle aged, postmenopausal, and overweight. Mean operating time was 31.1 ± 8.9 min, intraoperative complications were minor, and median period of follow-up was 80.3 ± 9.6 months. At 5 years of follow-up, objective and subjective cure rates were 89.3 % and 87.5 %, respectively. No mesh-related complications were seen. One patient needed a repeat midurethral sling procedure, and one patient each had bladder and bowel cancer. CONCLUSION Monarc TOT was safe and retained its high cure rate in the short- and long-term treatment of stress urinary incontinence.
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Lo TS, Cortes EFM, Wu PY, Tan YL, Al-Kharabsheh A, Pue LB. Assessment of collagen versus non collagen coated anterior vaginal mesh in pelvic reconstructive surgery: prospective study. Eur J Obstet Gynecol Reprod Biol 2016; 198:138-144. [DOI: 10.1016/j.ejogrb.2016.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 11/25/2015] [Accepted: 01/01/2016] [Indexed: 11/26/2022]
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Lo TS, Pue LB, Tan YL, Wu PY. Risk factors for failure of repeat midurethral sling surgery for recurrent or persistent stress urinary incontinence. Int Urogynecol J 2015; 27:923-31. [PMID: 26700103 DOI: 10.1007/s00192-015-2912-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To study the outcomes following repeat midurethral sling (MUS) surgery in patients with persistent or recurrent stress urinary incontinence after failure of primary MUS surgery and risk factors for surgical failure. METHODS The medical records of 24 patients who underwent repeat MUS surgery at a single tertiary center from January 2004 to February 2014 were reviewed. The types of MUS used for the repeat surgey were transobturator, retropubic and single incision slings. Objective cure was defined as no demonstrable involuntary leakage of urine during increased abdominal pressure in the absence of a detrusor contraction observed during filling cystometry, and subjective cure was defined as a negative response to Urogenital Distress Inventory six (UDI-6) question 3 during follow-up between 6 months and 1 year postoperatively. The change in the inclination angle between the urethra and pubic axis was measured with introital ultrasonography and the cotton swab test performed. RESULTS The objective and subjective cure rates were 79.2 % and 75 %, respectively. There were no differences in demographics between the patients with failure of surgery and those with successful surgery. Significant independent risk factors for failure of repeat MUS surgery were a change in cotton swab angle at rest and straining of <30° (OR 4.6, 95 % CI 2.5 - 7.9°), a change in inclination angle of <30° (OR 4.6, 95 % CI 2.5 - 7.9°), intrinsic sphincter deficiency (OR 3.4, 95 % CI 1.8 - 6.1) and a mean urethral closure pressure of <60 cm H2O (OR 2.9, 95 % CI 1.5 - 4.5). In one patient the bladder was perforated. CONCLUSIONS Repeat MUS surgery is safe and has a good short-term success rate, both objectively and subjectively, with independent risk factors for failure related to bladder neck hypomobility and poor urethral function.
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Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology, Keelung Medical Center, Chang Gung Memorial Hospital, 222, Maijin Road, Keelung, Taiwan, 204, Republic of China. .,Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China. .,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
| | - Leng Boi Pue
- Department of Obstetrics and Gynecology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Yiap Loong Tan
- Department of Obstetrics and Gynecology, Kuching Specialist Hospital, Sarawak, Malaysia
| | - Pei-Ying Wu
- Department of Obstetrics and Gynecology, Keelung Medical Center, Chang Gung Memorial Hospital, 222, Maijin Road, Keelung, Taiwan, 204, Republic of China
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Validation of the Polish version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. Int Urogynecol J 2015; 27:781-6. [PMID: 26564223 DOI: 10.1007/s00192-015-2883-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of the study was to develop a Polish version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ) to evaluate sexual function in patients with stress urinary incontinence (SUI) and pelvic organ prolapse (POP) versus a control group. METHODS Before the validation study, a pilot study of the Polish version of the PISQ was performed in 22 women with pelvic floor dysfunctions. The respondents completed the questionnaire at recruitment and 2 weeks later. Test-retest reliability and internal consistency were determined. The validation study was performed in 249 sexually active women (123 with urodynamic SUI and POP; 126 healthy controls). The study group reported urinary incontinence (UI) at the urogynecological ambulatory clinic, where they underwent urogynecological and urodynamic examinations. All participants completed the questionnaire. PISQ results from both groups were compared and correlated with those of the King's Health Questionnaire (KHQ) and patient age. RESULTS Test-retest reliability was good according to Pearson's correlation coefficient (r = 0.89, p < 0.001). PISQ had high internal consistency (Cronbach's α = 0.878). The total PISQ score was significantly lower in the study group compared with the controls (83.6 ± 14.9 vs 95.7 ± 10.3, p < 0.001), as were scores for individual domains: Behavioral/Emotive, Physical, Partner-Related (33.9 ± 10.2 vs 39.8 ± 7.8, 31.7 ± 6.9 vs 37.1 ± 2.8, and 18.0 ± 3.1 vs 19.4 ± 2.6 respectively; p < 0.001), confirming the lower quality of sexual function in women with SUI and POP. A correlation between PISQ and KHQ scores and patient age was confirmed. CONCLUSIONS The Polish version of the PISQ is a reliable tool for evaluating sexual function in women with POP and UI.
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Lo TS, Tan YL, Cortes EFM, Lin YH, Wu PY, Pue LB. Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome. Aust N Z J Obstet Gynaecol 2015; 55:593-600. [PMID: 26299981 DOI: 10.1111/ajo.12397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/14/2015] [Indexed: 12/18/2022]
Abstract
INTRODUCTION To clinically and sonographically evaluate the influence of anterior vaginal mesh (AVM) surgery with concomitant mid-urethral sling surgery (MUS) for stress urinary incontinence (SUI). MATERIALS AND METHODS Women with severe symptomatic pelvic organ prolapse (POP) stage III or IV with concomitant SUI were divided into two groups: Group I had transobturator tape (TOT) and AVM surgery and Group II underwent TOT without AVM surgery. Clinical outcome was assessed pre-operatively and 1 year post-operatively, while ultrasound evaluations were performed after one year. Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry. Subjective SUI cure was a negative response to Urogenital Distress Inventory Six (UDI-6) (question 3). RESULTS A total of 97 women were recruited, 57 in Group I and 40 in Group II. Three women had symptomatic prolapse in Group I and 5 in Group II. There were no differences in the ultrasound and clinical outcomes between women who had mid-urethral slings with and without AVM. Successful SUI outcome was reported in 85 women. Urethral kinking was demonstrable in 50% of successful cases, but none with failed outcomes. Subanalysis among those with successful SUI outcome (n = 85) and failure (n = 12) revealed the tape, bladder neck and mesh mobility was significantly higher (P < 0.001) among those with SUI success. CONCLUSIONS Among women who had MUS, there were no differences in the ultrasound and clinical outcome between those who had AVM or otherwise.
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Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology, Keelung and Taipei, Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yiap Loong Tan
- Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.,Department of Obstetrics & Gynecology, Kuching Specialist Hospital, KPJ, Sarawak, Malaysia
| | - Eileen Feliz Mendoza Cortes
- Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.,Department of Obstetrics & Gynecology, De La Salle University Medical Center, Dasmariñas, Cavite, Philippines
| | - Yi-Hao Lin
- Linkou Medical Center, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Pei-Ying Wu
- Department of Obstetrics and Gynecology, Keelung and Taipei, Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,Linkou Medical Center, Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Leng Boi Pue
- Division of Urogynecology, Department of Obstetrics and Gynecology, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.,Department of Obstetrics & Gynecology, Hospital Serdang, Kajang, Selangor, Malaysia
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Validation of a Mandarin Chinese version of the pelvic organ prolapse/urinary incontinence sexual questionnaire IUGA–revised (PISQ-IR). Int Urogynecol J 2015; 26:1695-700. [DOI: 10.1007/s00192-015-2744-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/12/2015] [Indexed: 11/26/2022]
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Lo TS, Pue LB, Hung TH, Wu PY, Tan YL. Long-term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy. J Obstet Gynaecol Res 2015; 41:1099-107. [DOI: 10.1111/jog.12678] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/23/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Keelung/Taipei Medical Center; Keelung/Taipei Taiwan
- Division of Urogynecology; Department of Obstetrics and Gynecology; Linko, Chang Gung Memorial Hospital; Linkou Medical Center; Taoyuan Taiwan
- Chang Gung University, School of Medicine; Taoyuan Taiwan
| | - Leng Boi Pue
- Division of Urogynecology; Department of Obstetrics and Gynaecology; Chang Gung Memorial Hospital; Taoyuan Taiwan
- Department of Obstetrics and Gynecology; Serdang Hospital; Selangor Malaysia
| | - Tai-Ho Hung
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Keelung/Taipei Medical Center; Keelung/Taipei Taiwan
- Chang Gung University, School of Medicine; Taoyuan Taiwan
| | - Pei-Ying Wu
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Keelung/Taipei Medical Center; Keelung/Taipei Taiwan
- Division of Urogynecology; Department of Obstetrics and Gynaecology; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Yiap Loong Tan
- Division of Urogynecology; Department of Obstetrics and Gynaecology; Chang Gung Memorial Hospital; Taoyuan Taiwan
- Department of Obstetrics and Gynecology; Kuching General Hospital; Sarawak Malaysia
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Anterior-Apical Single-Incision Mesh Surgery (SIMS): Surgical and Functional Outcomes at 1 Year. J Minim Invasive Gynecol 2015; 22:50-6. [DOI: 10.1016/j.jmig.2014.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 06/28/2014] [Accepted: 07/02/2014] [Indexed: 11/24/2022]
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Lo TS, Bt Karim N, Cortes EFM, Wu PY, Lin YH, Tan YL. Comparison between Elevate anterior/apical system and Perigee system in pelvic organ prolapse surgery: clinical and sonographic outcomes. Int Urogynecol J 2014; 26:391-400. [PMID: 25257810 DOI: 10.1007/s00192-014-2492-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to assess the incidence of de novo stress urinary incontinence (SUI) and sonographic features of implanted transvaginal mesh in continent women treated with Elevate(™) anterior/apical [single-incision mesh (SIM-A)] or Perigee(™) [transvaginal mesh with sacrospinous fixation (TVM + SSF)] in extensive pelvic organ reconstruction surgery. METHODS This prospective observational study was done from May 2010 to January 2013. Patients were recruited from two tertiary centers, and the Elevate(™) and Perigee(™) systems were compared. Patients who had overt or occult SUI, previous prolapse or mesh insertion were excluded. RESULT Fifty-seven patients in the SIM-A group and sixty-one in the TVM + SSF group were analysed. All completed a minimum of 1-year follow-up. Groups were demographically and statistically similar. There was a significantly high incidence of de novo SUI postoperatively in the SIM-A group. The objective and subjective cure rate of pelvic organ prolapse (POP) were comparable between groups, with incidence of mesh erosion in the SIM-A group and three in the TVM + SSF group. Sonographic evaluation showed significant increase in mesh length in the SIM-A group. CONCLUSION Elevate(™) a offered lower incidence of mesh erosion and comparable results on anatomical POP correction; however, incidence of de novo SUI was high. There is an apparent lengthening of implanted Elevate® mesh sonographically.
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Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Keelung, Keelung Medical Center, Keelung, Taiwan, Republic of China,
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Wu SPY, Lo TS, Pue LB, Cortes EFM, Lu MH, Al-Kharabsheh AM, Lin YH. Outcome after conservative management for mixed urinary incontinence. J Obstet Gynaecol Res 2014; 41:269-76. [PMID: 25256568 DOI: 10.1111/jog.12526] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 06/24/2014] [Indexed: 11/29/2022]
Abstract
AIM Recommended initial treatment for mixed urinary incontinence involves behavioral therapy, and drug and pelvic floor muscle exercises. Our objective is to evaluate the outcome of these conservative treatments in our patients with mixed urinary incontinence. METHODS A retrospective review was conducted in patients with mixed urinary incontinence who were offered sequential conservative treatment modalities comprised of medication and physiotherapy. Outcome was defined as a score of 1 or less for questions 2 and 3 on the six-item Urodynamic Distress Inventory (UDI-6) and seven-item Incontinence Impact Questionnaire, in addition to clinical symptomatic improvement with no urgency, urge incontinence and voiding frequency of less than eight times per 24 h on a 3-day bladder diary after treatment. Treatment outcome of patients opting for medication plus physiotherapy (M + P) were analyzed against patients preferring medication only (M). RESULTS Sixty-two mixed urinary incontinent patients received an initial treatment with conservative measures with mean follow-up of 14 months. A total of 61.2% (30/49) and 56.3% (9/13) subjects had improved symptoms in the M + P and M group, respectively. There was significant improvement in UDI-6 total score in the M + P group after conservative treatment, despite no significant difference when compared to the M group. Only 6.45% required subsequent anti-incontinence surgery after conservative treatment, amongst whom only half showed improvement after the surgery. CONCLUSION Combined treatment with medication and physiotherapy is highly recommended for patients with mixed urinary incontinence. Conservative measures should still precede any surgical intervention. Further studies are needed to evaluate the long-term efficacy.
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Affiliation(s)
- Sandy Pei-Ying Wu
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China; Fellow of the Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China
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Lo TS, Tan YL, Wu PY, Cortes EFM, Pue LB, Al-Kharabsheh A. Ultrasonography and clinical outcomes following surgical anti-incontinence procedures (Monarc vs Miniarc). Eur J Obstet Gynecol Reprod Biol 2014; 182:91-7. [PMID: 25265496 DOI: 10.1016/j.ejogrb.2014.09.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 08/22/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the ultrasound morphology and its clinical outcome among women who had undergone Miniarc™ vs Monarc™ in the treatment of stress urinary incontinence (SUI). STUDY DESIGN This was a prospective study on 140 patients with USI and undergone either Miniarc or Monarc surgery. From March 2010 to December 2011, patients with clinically SUI and urodynamic stress incontinence (USI) were included in the study. Objective cure of SUI was defined as no urinary leakage on provocative filling cystometry and 1-h pad test of <2 g. Subjective cure of SUI was the negative response to UDI-6. Introital ultrasound at one-year explored the sling and bladder neck's position, mobility, sling tension, percentile of urethra where the sling was located and urethral kinking. RESULTS Postoperative data was available from 130 women. The ultrasound objective data for successful treatment post-operative follow-up was available from 119 women (46 Monarc, 73 Miniarc), the rest failed to follow-up. A bladder perforation was diagnosed in the Monarc group and 15 cases (7.1% of Monarc and 16.3% of Miniarc, p=0.082) of urinary retention was reported due to over-tensioning of the sling, majority of cases came from the Miniarc group. At rest and during Valsalva, analogous distances of the bladder neck and sling as well as the center of the urethral core were similar for both procedures. In both groups, shortest (Us) and longest diameters (Ul) of the urethral core were comparable at Valsalva which was significantly shorter and longer, respectively, compared to the values at rest. Sling position and percentage of urethral kinking were similar. Statistical analysis failed to detect any significant difference between the two groups with regards to the objective and subjective cure (p>0.05). CONCLUSIONS In conclusion, a Miniarc and Monarc exhibit similar mechanism of action with comparable subjective and objective clinical outcomes. Majority of urethral impingement was noted in the Miniarc group. A higher maximum urethral closure pressure (MUCP), longer resting Ul, and shorter resting Us suggested these observations. Postoperative ultrasonographic evaluation may give a promising future perspective for the evaluation of sling tension.
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Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung and Taipei, Medical Center, Keelung, Taiwan, ROC; Division of Urogynecology, Department of Obstetrics and Gynecology, Linko, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, ROC; Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC.
| | - Yiap Loong Tan
- Fellow of the Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC; Department of Obstetrics & Gynecology, Sarawak General Hospital & Kuching Specialist Hospital (KPJ), Kuching, Sarawak, Malaysia
| | - Pei-Ying Wu
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung and Taipei, Medical Center, Keelung, Taiwan, ROC; Division of Urogynecology, Department of Obstetrics and Gynecology, Linko, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, ROC
| | - Eileen Feliz M Cortes
- Fellow of the Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC; Department of Obstetrics & Gynecology, De La Salle University Medical Center, Dasmariñas, Cavite, Philippines
| | - Leng Boi Pue
- Fellow of the Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC; Department of Obstetrics & Gynecology, Hospital Serdang, Kajang, Selangor, Malaysia
| | - Ahlam Al-Kharabsheh
- Fellow of the Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC; Department of Obstetrics & Gynecology, King Abdullah University Hospital/University of Science & Technology, Irbid, Jordan
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Hung M, Su T, Lin Y, Huang W, Lin T, Hsu C, Chuang F, Tsai C, Shen P, Chen G. Changes in Sexual Function of Women with Refractory Interstitial Cystitis/Bladder Pain Syndrome after Intravesical Therapy with a Hyaluronic Acid Solution. J Sex Med 2014; 11:2256-63. [DOI: 10.1111/jsm.12507] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lo TS, Tan YL, Khanuengkitkong S, Dass AK, Cortes EFM, Wu PY. Assessment of collagen-coated anterior mesh through morphology and clinical outcomes in pelvic reconstructive surgery for pelvic organ prolapse. J Minim Invasive Gynecol 2014; 21:753-61. [PMID: 24607796 DOI: 10.1016/j.jmig.2014.02.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 02/25/2014] [Accepted: 02/27/2014] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVE To assess the morphologic features of anterior armed transobturator collagen-coated polypropylene mesh and its clinical outcomes in pelvic reconstructive surgery to treat pelvic organ prolapse. DESIGN Evidence obtained from several timed series with intervention (Canadian Task Force classification II-3). SETTING Chang Gung Memorial Hospital, Taoyuan, Taiwan, China. PATIENTS Between April 2010 and October 2012, 70 patients underwent surgery to treat symptomatic pelvic organ prolapse, stage III/IV according to the POP-Q (Pelvic Organ Quantification System). INTERVENTION Anterior armed transobturator collagen-coated mesh. MEASUREMENT AND MAIN RESULTS Morphologic findings and clinical outcome were measured. Morphologic features were assessed via 2-dimensional introital ultrasonography and Doppler studies. Clinical outcome was measured via subjective and objective outcome. Objective outcome was assessed via the 9-point site-specific staging method of the International Continence Society Pelvic Organ Prolapse Quantification before the operation and at 1-year postoperative follow-up. Subjective outcome was based on 4 validated questionnaires: the 6-item UDI-6 (Urogenital Distress Inventory), the 7-item IIQ-7 (Incontinence Impact Questionnaire), the 6-item POPDI-6 (Pelvic Organ Prolapse Distress Inventory 6), and the 12-item PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire), at baseline and at 12 months after the operation. Data were obtained for 65 patients who underwent the combined surgery and were able to comply with follow-up for >1 year. Ultrasound studies reveal that mesh length tends to shorten and decrease in thickness over the 1-year follow-up. Vagina thickness also was reduced. Neovascularization through the mesh was observed in <8.5% of patients in the first month and at 1 year, and was evident in approximately 83%. The mesh exposure rate was 6.4%. The recorded objective cure was 90.8% (59 of 65 patients), and subjective cure was 89.2% (58 of 65 patients) at mean (SD) follow-up of 19.40 (10.98) months. At 2 years, UDI-6, IIQ-7, and POPDI-6 scores were all significantly decreased (p < .001), whereas the PISQ-12 score was significantly increased (p = .01). CONCLUSIONS Ultrasound features suggest that the degeneration of collagen barrier may be longer than expected and that integration of collagen-coated mesh could occur up to 1 year. A substantially good clinical outcome was noted.
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Affiliation(s)
- Tsia-Shu Lo
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan, China.
| | - Yiap Loong Tan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan, China; Sarawak General Hospital, Kuching, Sarawak, Malaysia
| | - Siwatchaya Khanuengkitkong
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan, China; Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Anil Krishna Dass
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan, China; Penang Hospital, Penang, Malaysia
| | - Eileen Feliz M Cortes
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan, China; De La Salle University Medical Center, Dasmariñas Cavite, Philippines
| | - Pei-Ying Wu
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan, China
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Single-incision mesh repair versus traditional native tissue repair for pelvic organ prolapse: results of a cohort study. Int Urogynecol J 2014; 25:901-8. [DOI: 10.1007/s00192-013-2294-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 11/29/2013] [Indexed: 10/25/2022]
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Shaaban MM, Abdelwahab HA, Ahmed MR, Shalaby E. Assessment of female sexual function among women with pelvic organ prolapse or urinary incontinence via an Arabic validated short-form sexual questionnaire. Int J Gynaecol Obstet 2013; 124:24-6. [PMID: 24094997 DOI: 10.1016/j.ijgo.2013.06.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 05/31/2013] [Accepted: 08/29/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess female sexual function among women with pelvic organ prolapse or urinary incontinence via an Arabic, validated, short-form sexual questionnaire (PISQ-12). METHODS The present study was conducted among women attending Suez Canal University Hospital, Ismailia, Egypt, between September 2009 and August 2011. In the pilot study, 42 women completed the final version of the Arabic PISQ-12 at recruitment and then 2 weeks later, and the data were compared to evaluate reliability and internal consistency. The formal comparative study included 154 premenopausal sexually active women: 80 control women, and 74 women with some degree of pelvic prolapse with or without stress incontinence. All participants had a vaginal examination and completed the questionnaire. The main outcome measures were the mean questionnaire scores within its 3 domains (behavioral, physical, and partner-related). RESULTS The test-retest reliability and internal consistency of the Arabic PISQ-12 were excellent. Validity was approved by an expert panel. The case group had a significantly lower mean total questionnaire score (31.07 ± 4.2 vs 34.7 ± 6.2; P<0.05) but a higher partner-related score (9.0 ± 2.4 vs 8.4 ± 2.5; P<0.05). CONCLUSION The Arabic version of PISQ-12 was shown to be an effective and objective method of evaluating sexual function among patients with pelvic organ prolapse.
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Affiliation(s)
- Mohamed M Shaaban
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hassan A Abdelwahab
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Magdy R Ahmed
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Essam Shalaby
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Long-term outcomes of synthetic transobturator nonabsorbable anterior mesh versus anterior colporrhaphy in symptomatic, advanced pelvic organ prolapse surgery. Int Urogynecol J 2013; 25:257-64. [DOI: 10.1007/s00192-013-2200-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 07/23/2013] [Indexed: 10/26/2022]
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Lo TS, Tseng LH, Lin YH, Liang CC, Lu CY, Pue LB. Effect of extracorporeal magnetic energy stimulation on bothersome lower urinary tract symptoms and quality of life in female patients with stress urinary incontinence and overactive bladder. J Obstet Gynaecol Res 2013; 39:1526-32. [PMID: 23855601 DOI: 10.1111/jog.12090] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 12/12/2012] [Indexed: 11/28/2022]
Abstract
AIMS The aim of this study was to investigate the efficacy of extracorporeal magnetic stimulation (EMS) for the treatment of bothersome and severe symptoms of stress urinary incontinence (SUI) and overactive bladder syndrome (OAB) in female patients. MATERIAL AND METHODS A retrospective review was conducted on patients with SUI and OAB who were referred to EMS therapy. Successful treatment for the bothersome symptoms of OAB and SUI was defined as score ≤1 for questions 2 and 3 on the Urodynamic Distress Inventory-6. The objective cure of SUI and OAB was defined as no urinary leakage during the cough stress test and any urgency, urge incontinence and voiding frequency of less than eight times per 24 h based on the 3-day bladder diary, after the 9 weeks of treatment, respectively. RESULTS Ninety-three patients with SUI or OAB underwent a 9-week course of EMS at 20 min twice weekly. Seventy-two (77%) patients completed EMS treatment. Geographical factor and poor economic status were two main factors for dropout. A total of 94.1% (32 of 34) and 86.8% (33 of 38) of subjects had successful treatment for the bothersome symptoms of OAB and SUI, respectively. In contrast, the cure rate for OAB and SUI was only 61.7% and 42.1%, respectively. There was also a significant improvement in both Urogenital Distress Inventory Short Form (bothersome on lower urinary tract symptoms) and the Incontinence Impact Questionnaire Short Form (quality of life) total score in both groups after EMS. CONCLUSIONS EMS is a safe and effective alternative method for treating SUI and OAB. Further studies are needed to evaluate the long-term efficacy.
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Affiliation(s)
- Tsia-Shu Lo
- Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linko Medical Center, Chang Gung University, Taoyuan, Taiwan
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Celik DB, Beji NK, Yalcin O. Turkish adaptation of the short form of the pelvic organ prolapse/urinary incontinence sexual function questionnaire (PISQ-12): A validation and reliability study. Neurourol Urodyn 2013; 32:1068-73. [DOI: 10.1002/nau.22369] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 12/11/2012] [Indexed: 01/19/2023]
Affiliation(s)
- Dilek Bilgic Celik
- Department of Obstetric and Gynecologic Nursing; Istanbul University Florence Nightingale Faculty of Nursing; Istanbul Turkey
| | - Nezihe Kizilkaya Beji
- Department of Obstetric and Gynecologic Nursing; Istanbul University Florence Nightingale Faculty of Nursing; Istanbul Turkey
| | - Onay Yalcin
- Department of Obstetric and Gynecology, Division of Urogynecology; Istanbul University Istanbul Medical Faculty; Istanbul Turkey
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Lo TS, Tan YL, Khanuengkitkong S, Dass AK. Surgical outcomes of anterior trans-obturator mesh and vaginal sacrospinous ligament fixation for severe pelvic organ prolapse in overweight and obese Asian women. Int Urogynecol J 2012; 24:809-16. [DOI: 10.1007/s00192-012-1940-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 08/26/2012] [Indexed: 11/28/2022]
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Sexual function following outside-in transobturator midurethral sling procedures: a prospective study. Int Urogynecol J 2012; 23:1693-8. [DOI: 10.1007/s00192-012-1792-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 04/11/2012] [Indexed: 10/28/2022]
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Roy S, Mohandas A, Coyne K, Gelhorn H, Gauld J, Sikirica V, Milani AL. Assessment of the Psychometric Properties of the Short‐Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ‐12) following Surgical Placement of Prolift+M: A Transvaginal Partially Absorbable Mesh System for the Treatment of Pelvic Organ Prolapse. J Sex Med 2012; 9:1190-9. [PMID: 22353162 DOI: 10.1111/j.1743-6109.2011.02640.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sanjoy Roy
- Evidence Based Medicine, Ethicon Inc., Somerville, NJ 44125, USA.
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Sexual function in women following transvaginal mesh procedures for the treatment of pelvic organ prolapse. Int Urogynecol J 2012; 23:1455-60. [DOI: 10.1007/s00192-012-1713-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
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