Urogynaecologia http://www.urogynaecologia.org/index.php/uij <p>The journal publishes original articles dealing with the latest advances in the field of Urogynecology, as infections of the genito-urinary system, endometriosis, genito-urinary alterations in menopause, diagnostic protocols and medical-surgical treatment of urinary incontinence, pelvic static disorders, perineology, uro-gynecologic rehabilitation therapy, etc. Urogynaecologia wide spreading allows a valid knowledge sharing mean among scientists and scholars all over the world. <strong>Urogynaecologia is the official journal of A.I.U.G., <em>Associazione Italiana di Urologia Ginecologica e del Pavimento Pelvico</em>.</strong></p> PAGEPress Scientific Publications, Pavia, Italy en-US Urogynaecologia 1121-3086 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="http://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> After Cesarean vesicouterine fistula (Youssef Syndrome) with successful conservative management http://www.urogynaecologia.org/index.php/uij/article/view/199 Vesicouterine fistula without vaginal leakage of urine, cyclic hematuria and amenorrhea is a rare condition, identified as Youssef’s syndrome. The most common cause of this syndrome is trauma during a cesarean section. Different therapeutical approaches that include conservative treatment, fulguration, hormonal therapy and open, laparoscopic or robotic surgeries have been mentioned in the literature. Herein a case in a 37-year-old patient is reported. Conservative treatment with urinary drainage was successful because the fistula was recognized in the immediate postoperative period. Julián Oñate Celdrán Francisco M. Gonzalez Valverde ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-10-16 2017-10-16 10.4081/uij.2017.199 Recurrent pelvic organ prolapse: a case report http://www.urogynaecologia.org/index.php/uij/article/view/194 Pelvic organ prolapse (POP) is a common female condition, which is seen as protrusion of pelvic organs into or beyond the vagina. Its incidence is increasing and every woman has an 11% lifetime risk of needing surgical treatment because of this condition. POP that is recurrent several times is a rare condition; however it can have major negative impact on quality of life. We present the case of a 77-year old Caucasian woman with repeated POP. She underwent six gynecologic operations for correction of recurrent POP. Presentation of this case clearly demonstrates dramatic recurrences of POP and how difficult its treatment and prevention can be. We do not know what the reason for multiple reoccurrence of this condition might be. We need to emphasize that there are no researches on specific risk for an individual patient, which may potentiate occurrence of POP and may affect decisions about surgical procedure. Kristina Drusany Starič Petra Bukovec Andrej Zore Adolf Lukanović ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-06-13 2017-06-13 10.4081/uij.2017.194 Time of symptom onset and histologic findings in bladder pain syndrome/interstitial cystitis: new findings on useful correlations http://www.urogynaecologia.org/index.php/uij/article/view/201 The aim was to find out whether a correlation exists between denudation of urothelium and time of symptom onset in patients with bladder pain syndrome/interstitial cystitis (BPS/IC), and to search a correlation between impact of symptoms evaluated with ICSI-ICPI and the presence of comorbid conditions associated with BPS/IC. Ninety-seven consecutive patients underwent cystoscopy under general anesthesia to classify those cases suspected of being affected from BPS/IC. Three cold bladder biopsies were taken including detrusor muscle. Statistical analysis showed significant correlation between IC/BPS duration and the presence of Hunner’s lesions (P&lt;0.023). Hunner’s lesion with cystoscopy and histological evidence of urothelial denudation with bladder biopsy appear to be items related to IC/BPS duration. Thus an early diagnosis allows to start an appropriate therapeutic approach and prevent a more severe evolution of this multifaceted painful syndrome. Our study shows a correlation between time of symptom onset and evidence of urothelial denudation and with detrusor mast cell count in the whole group of patients. IC/BPS duration seem to correlate with the presence of associated diseases. Daniele Porru Valentina Bobbi Carmelo Di Franco Alessandra Viglio Mattia Novario Carmine Tinelli Barbara Gardella Rossella Nappi Arsenio Spinillo Marco Paulli Bruno Rovereto ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-10-05 2017-10-05 10.4081/uij.2017.201 Efficacy of the inside-out tramsobturator tension-free vaginal tape (TVT-ABBREVO) for the treatment of stress urinary incontinence after a 12-month follow-up http://www.urogynaecologia.org/index.php/uij/article/view/177 The aim of this study was to evaluate the efficacy of the inside-out tension-free vaginal tape transobturator approach or TVT-Obturator system (TVT-ABBREVO) in women with stress urinary incontinence (SUI). This is a prospective single arm study of women with SUI who underwent a TVT-ABBREVO procedure. The inclusion criterion was a diagnosis of SUI urodynamically proven without detrusor over activity. SUI was defined as involuntary urine leakage with stress in the absence of detrusor over activity with or without intrinsic sphincter deficiency. Before, and 12 months after surgery women received urodynamic test, pelvic examination, and a personal interview using the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). The primary outcome was the incidence of incontinency through cough stress test during the urodynamic exam. A total of 90 women were included in the analysis. Our analysis showed that the incidence of incontinence through cough stress test during the urodynamic exam was significantly less 12 months after the intervention (100% vs 3%; P-value =0.001). Moreover, we found a significantly improvement of the quality of life measured by UDI score (13±4.5 <em>vs</em> 7.3±2.2 points; P-value 0.01) and IIQ score (14±5.7 <em>vs</em> 8.1 <em>vs</em> 3.1 points; P-value 0.02). No intraoperative complications were noticed. TVT-ABBREVO significantly reduced the incidence of stress urinary incontinence. In the authors’ experience, this technique resulted technically simple and provided high objective and subjective long-term efficacy, a clinically meaningful improvement in patient quality of life, and an excellent safety profile. Carlo Rappa Gabriele Saccone ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-10-02 2017-10-02 10.4081/uij.2017.177 Behaviour of urinary incontinence in the face of sacrocolpopexy http://www.urogynaecologia.org/index.php/uij/article/view/185 The aim of this study was to determine whether an association exists between the performance of a sacrocolpopexy for genital prolapse and the bladder function. A case series study was performed that includes all patients who received sacrocolpopexy in a tertiary Spanish hospital. An analysis was performed to study the association of some variables and the occurrence or persistence of urinary incontinence after the surgery. Forty patients with indication of sacrocolpopexy were included. A year after sacrocolpopexy, the outcomes showed 97.3% of prolapse healing. 19.3% complained about <em>de novo</em> stress urinary incontinence, 33.3% recovered from it and another 66.7% remained the same. Only 10.8% asked for an anti-incontinence surgery after the sacrocolpopexy. The urethral hypermobility shows an increased risk of stress urinary incontinence after the sacrocolpopexy. Based on our results, we do not consider it necessary to perform a systematic antiincontinence procedure simultaneously with sacrocolpopexy unless a woman without urethral anti-incontinence surgical background shows a urethral hypermobility. Nuria L. Rodríguez-Mias Jordi Sabadell-García Elena Suárez-Salvador Antonio Gil-Moreno Jose Luis Poza-Barrasus ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-08-30 2017-08-30 10.4081/uij.2017.185 Prevalence of female urinary incontinence in the state of Roraima, Brazil http://www.urogynaecologia.org/index.php/uij/article/view/183 Urinary incontinence (UI) is a significant health problem leading to physical, psychological and social discomfort, especially in elderly women. A study of prevalence and classification of UI in the Roraima state was taken up to aid in formulation of healthcare policy and improvement of patient referral facilities. A retrospective study of 765 female patients who have undergone urodynamic examination between November 2013 and December 2014 has been conducted. Subjects were classified in to diagnostic classes: normal, stress incontinence, mixed incontinence, sensitive emergency, overactive bladder, and others. The overall prevalence of UI was 58.4%. The highest prevalence was observed in the menopausal age group (45- 49 years). Among the etiologies of UI, stress incontinence ranked highest at 30.9%, followed by overactive bladder at 6.9%. In the 25-55 years age group, stress incontinence was predominant (50-63%), while overactive bladder became significant (14-44%) in later years. The prevalence of UI in women in the state of Roraima, was high, in line with its prevalence in Brazil, as well as other western countries. Mário Maciel De Lima Junior Elizângela Castelo Branco ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-06-13 2017-06-13 10.4081/uij.2017.183 Outcome of using a modified surgical technique for the repair of complex vesicovaginal fistulas in Nigeria http://www.urogynaecologia.org/index.php/uij/article/view/196 The relatively low effectiveness of available surgical repair techniques for complex obstetric fistula has justified the need for continued exploration of more effective repair techniques. Subjects who presented at a vesicovaginal fistula referral centre in Nigeria were randomized into the study group (modified technique) and the control group (conventional technique). Success rates between the two groups were compared. The study comprised 29 patients in each arm of the study. The mean age of patients in the study group was 23.9 ± 9.6 years and 24.4 ± 2.1 years among patients in the control group with the vast majority of the patients in the both groups being married, 75.9% and 86.2% respectively. In both groups, the majority were secundipara, 55.2% in the study group and 44.8% in the control group. The majority (41.4% in the study group and 44.8% in the control group) of the patients in both groups had attained primary level of education. The mean duration of the fistulas among patients in the study population was 1.1 ± 0.3 years with over half (50.0% among patients in the study group and 53.5% of patients in the control group) of the patients had their fistula for less than one year. A highly statistically significant difference in success rate between patients in the study group and patients in the control group was obtained (p=0.0004). The modified repair technique presented by this study has proved to produce superior results when compared to the conventional repair technique in the management of complex obstetric fistulas in Nigeria. Aniefiok J. Umoiyoho Emmanuel C. Inyang-Etoh ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-06-08 2017-06-08 10.4081/uij.2017.196 Comparison of functional outcomes after robot-assisted laparoscopic sacrocolpopexy in women with a BMI below and above 30 http://www.urogynaecologia.org/index.php/uij/article/view/178 The aim of this study was to assess the impact of body-mass index on robot-assisted laparoscopic sacrocolpopexy (RALSCP). A retrospective study was conducted on women who underwent a RALSCP. Data were collected prospectively from 17 obese and 78 non-obese patients treated between January 2008 and January 2013. Obesity was defined as a body-mass index (BMI) of ≥30 kg/m<sup>2</sup>. Relationships with outcome analysed using Mann– Whitney U-test and Fisher’s exact test. The operating time was the same in both groups: 220 vs 200 min in the obese and non-obese groups, respectively (P=0.232). The median follow-up was 12 months in both non-obese and obese patients. Overall anatomic repair rate was 94.1% and 97.4% for obese and non-obese patients, respectively (P=0.95). The overall reoperation rate (including surgery for <em>de novo</em> urinary-stress incontinence) was 5.9% for obese <em>vs</em> 11.5% for non-obese patients (P=0.8). These findings suggest that RALSCP is a viable option for obese women. The complication rates and outcomes for obese women were similar to those for non-obese women. Thibault Thubert Yohann Dabi Anne Sophie Boudy Marion Joubert Christophe Vaessen Emmanuel Chartier-Kastler Jean-Pierre Lefranc Morgan Rouprêt ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2017-02-15 2017-02-15 10.4081/uij.2017.178