Urogynaecologia

Long-term efficacy and safety of a bioresorbable polycaprolactone-based injectable in female stress incontinence

Andelo Mojsović, Alexander J.W. Beulens, Evert L. Koldewijn — Thu, 04 Apr 2024 00:00:00 +0000

A fully bioresorbable polycaprolactone (PCL)-based bulking agent was evaluated for safety and efficacy in female patients with mild to moderate stress urinary incontinence (SUI) who attempted and failed prior pelvic floor muscle training. A total of 44 adult female subjects with mild or moderate SUI (median age 60 and 57, respectively) were treated by transurethral sub-mucosal injection. Safety was evaluated at 6-, 12-, and 24-month follow-up visits. Efficacy was assessed at the same intervals with the Stamey grading system (SGS). SGS improvement was shown in both the mild and moderate SUI groups. At 24 months, most participants were continent: 78.1% in the mild SUI group and 66.7% in the moderate SUI group. All participants in the moderate SUI group showed an improvement in the SGS grade, and most participants were continent. The study shows that the PCL-based bioresorbable bulking agent treatment seems to be a safe and effective treatment option for women with mild to moderate SUI who attempted and failed prior pelvic floor exercises.

Factors affecting the onset and the degree of post-hysterectomy vaginal vault prolapse

Thu, 29 Feb 2024 00:00:00 +0000

Post-hysterectomy vaginal vault prolapse can affect life quality, and its onset varies. Previous studies have discussed the causes of post-hysterectomy vaginal vault prolapse but have not discussed the causes of the degree. This study aims to explore factors affecting the onset and degree of post-hysterectomy vaginal vault prolapse. A case-control study was conducted for seven years (2015-2022) at a tertiary referral hospital in East Java, Indonesia. Patient medical record data was accessed to find a diagnosis of post-hysterectomy vaginal vault prolapse. The onset was divided into two categories: ≤1 year and >1 year. The pelvic organ prolapse quantification system measured the degree. The data were analyzed with the Chi-square test. A total of 34 patients were identified. Age influences the onset of post-hysterectomy vaginal vault prolapse (p<0.05). Number of living children, history of abortion, ethnic group, contraceptive use, number of marriages, body mass index (BMI), vaginal labor history, sexual status, and operation history did not influence the onset of complaints/appearance of post-hysterectomy vaginal vault prolapse (p≥0.05). Age, number of living children, history of abortion, ethnic group, contraceptive use, number of marriages, BMI, vaginal labor history, sexual status, operation history, and the onset did not differ between grade I-II and grade III-IV patients (p≥0.05). It is necessary to pay attention to the age factor to prevent and detect the emergence of post-hysterectomy vaginal vault prolapse.

Patients with transobturator tape: a retrospective observational study of ten-year follow-up

Vineet Mishra, Smit Solanki, Rohina Aggarwal, Athulya Shajan — Wed, 17 Jan 2024 00:00:00 +0000

Stress urinary incontinence (SUI) may result from intrinsic sphincter weakness or urethral hypermobility brought on by weakened muscles in the pelvic floor that sustain the urethra and bladder. The amount of mid-urethral support is increased by the mid-urethral tape's function to serve as an anchored pubo-urethral neo-ligament. This study's objective is to assess the safety and effectiveness of transobturator tape (TOT) for SUI after a 10-year follow-up period. There were 103 patients included in this retrospective observational single-arm research. Only 95 participants were included in the trial since 8 patients were lost to follow-up. Patients who had TOT between 2010 and 2013 were monitored until December 2022. The effectiveness of the tape was assessed at 10 years for both early and late surgical problems in the patients. Those diagnosed with SUI were 52.27 years old on average (standard deviation ±8.48). 24% of patients (n=21) experienced mixed urinary incontinence (MUI), compared to 79.61% (n=82) of patients who had just pure stress incontinence. At 10 years, the success rate in our research was 97.09%. Demand incontinence was healed in 57.14% (n=12) of the 21 MUI patients. 7.69% of de novo urgency was noted (n=7). There were no significant side effects including mesh erosion, bladder and intestine perforation, or vascular hemorrhage. Excellent patient satisfaction was rated in 43% of cases (n=44), good in 54% of cases (n=56), and low in 3% of cases (n=3). At 10 years, TOT for SUI shows an impressive cure rate and excellent effectiveness. When the treatment is carried out by experienced hands, there are no significant difficulties.

Non-pharmacological interventions and coping mechanisms during dysmenorrhea among female undergraduates in a tertiary institution in Nigeria

Wed, 17 Jan 2024 00:00:00 +0000

Dysmenorrhea can be a burden on individuals and families. Investigating dysmenorrhea has become important to further our understanding of this issue and to research the measures that have been effective in managing it in other populations. Hence, the study aimed to investigate non-pharmacological interventions and coping mechanisms for painful menstruation among female undergraduates. The survey was carried out among 358 female students, and data was obtained with a researcher-structured questionnaire from a sample size of 208 derived using multistage sampling. A descriptive method of analysis was used to analyze the responses. Results revealed a high incidence of dysmenorrhea since 175 (89.7%) respondents experienced dysmenorrhea. Data revealed that nonpharmacological measures and home remedies for self-care, such as exercise, heat therapy, and herbal remedies, were prevalent among respondents. However, some respondents consult friends, families, and doctors for help. In conclusion, pharmaceutical and non-pharmaceutical interventions were common, and some young women opted to normalize pain and were not utilizing the most effective alternatives for managing menstrual pain.