Experiences With Genitourinary Syndrome of Menopause and Barriers to Vaginal Estrogen Usage Reported by a National Sample of 1500 Women.

Objective: To investigate women's experiences with genitourinary syndrome of menopause (GSM) and vaginal estrogen therapy (VET), including barriers, awareness, and knowledge, and to report current trends and findings on GSM and VET to address barriers to care.

Methods: A survey on GSM and VET was posted on the ResearchMatch website. Eligible participants were women ≥ 40 years of age.

Oxybutynin-associated Cognitive Impairment: Evidence and Implications for Overactive Bladder Treatment.

Anticholinergic medications have long been a mainstay of overactive bladder (OAB) treatment. Oxybutynin, a first-generation anticholinergic, still accounts for more than half of all OAB medication prescriptions, despite associations with impaired memory and cognition, as well as mounting evidence that it may increase the risk of incident dementia. This review details the current literature regarding oxybutynin and cognition, including evidence from preclinical, clinical, and real-world studies that show that oxybutynin binds nonspecifically to muscarinic receptors in the brain and is associated with adverse cognitive outcomes.

Robotic-Assisted Laparoscopic Removal of Mid-Urethral Mesh Slings Eroded into the Bladder.

Introduction And Objectives: Depending on the indication, there are multiple surgical approaches for the removal of mid-urethral mesh slings (MUS): transvaginal, endoscopic, open abdominal, and robotic. We demonstrate the robotic approach to treat MUS that have eroded into the bladder. The robotic approach offers excellent exposure, visualization, and accessibility.

A Plain Language Summary on the Effect of the Medication Vibegron on Blood Pressure and Heart Rate in People With Overactive Bladder.

What Is This Summary About?: This is a plain language summary of an article originally published in the journal . Vibegron is a medicine that was approved by the US Food and Drug Administration (also called FDA) in 2020 for treatment of overactive bladder, a condition that causes a frequent and urgent need to urinate. This study took place before the medicine was approved to look at whether vibegron affects blood pressure or heart rate.

Opioid-Limiting Pain Control After Transurethral Resection of the Prostate: A Randomized Controlled Trial.

Objective: To assess whether a multimodal opioid-limiting protocol and patient education intervention can reduce postoperative opioid use following transurethral resection of the prostate.

Methods: This prospective, non-blinded, single-institution, randomized controlled trial (NCT04102566) assigned 50 patients undergoing a transurethral resection of the prostate to either a standard of care control (SOC) or multimodal experimental group (MMG). The intervention included adding ibuprofen to the postoperative pain regimen, promoting appropriate opioid use while hospitalized, an educational intervention, and discharging without opioid prescription.

Incomplete bladder emptying and urinary tract infections after botulinum toxin injection for overactive bladder: Multi-institutional collaboration from the SUFU research network.

Introduction: Onabotulinumtoxin A (BTX-A) is an effective therapy for overactive bladder (OAB), however, adverse events may prevent patients from initiating therapy. The study objective was to report real-world rates of incomplete emptying and urinary tract infection (UTI) in men and women undergoing BTX-A for OAB.

Methods: Eleven clinical sites performed a retrospective study of adults undergoing first-time BTX-A injection (100 units) for idiopathic OAB in 2016.

Listening to Learn: A Qualitative Analysis of Women's Experiences with Mesh Mid-urethral Sling Surgery.

Objective: To improve women's experiences with mesh mid-urethral sling (MUS) surgery for treatment of stress urinary incontinence (SUI), we sought to qualitatively examine patient perspectives of MUS surgery, organize resulting patient-derived themes, and present our findings as potential springboards for future research and quality improvement efforts.

Methods: We conducted semi-structured focus groups and interviews of patients who had undergone mesh MUS surgery at a single tertiary referral institution. Discussions were recorded, transcribed, de-identified, and analyzed using deductive and inductive content analysis.

The Evolving Story of Mesh Mid Urethral Slings: The Surgeon's Perspective.

Purpose: The objective of this study was to obtain the perspectives of surgeons who treat female stress urinary incontinence (SUI) and better understand their range of experiences with mesh mid urethral sling (MUS) surgery.

Materials And Methods: This qualitative study recruited gynecologic and urological surgeons who treat SUI. Surgeons were interviewed by phone and in person using a standardized interview guide.

Management of Lower Urinary Tract Symptoms after Prostate Radiation.

Purpose Of Review: To present urologists with guidance on how to approach and manage lower urinary tract symptoms (LUTS) in patients who have undergone radiation therapy (RT) for prostate cancer.

Recent Findings: There are few studies that specifically examine treatment approaches for LUTS in patients who have undergone prostate cancer RT. LUTS after prostate RT are unique when compared to de novo LUTS.

Listening to Women: A Qualitative Analysis of Experiences after Complications from Mesh Mid-urethral Sling Surgery.

Objective: To gain a detailed understanding of women's experiences after undergoing revision surgery for mesh mid-urethral sling (MUS) complications, qualitatively organize those experiences, and present insights as potential springboards for future research.

Methods: We conducted a series of semistructured focus groups and interviews of patients who had undergone mesh MUS revision surgery at a single tertiary referral institution. Discussions were recorded, transcribed, de-identified, and analyzed using deductive and inductive content analysis.

Treatment of urethral stricture disease in women: A multi-institutional collaborative project from the SUFU research network.

Aim: Female urethral stricture disease is rare and has several surgical approaches including endoscopic dilations (ENDO), urethroplasty with local vaginal tissue flap (ULT) or urethroplasty with free graft (UFG). This study aims to describe the contemporary management of female urethral stricture disease and to evaluate the outcomes of these three surgical approaches.

Methods: This is a multi-institutional, retrospective cohort study evaluating operative treatment for female urethral stricture.

"Beyond the Bump" - Insight Into the Postpartum Women's Experience of Pelvic Organ Prolapse as Expressed on Reddit.

Objective: To qualitatively analyze the biopsychological experiences of postpartum women regarding pelvic organ prolapse (POP) as expressed on Reddit, a widely used internet platform for anonymous discussion and information sharing. POP is a prevalent condition in postpartum women, yet personal experiences are often not discussed due to social stigma.

Methods: "Beyondthebump," a Subreddit forum for postpartum mothers with >57,000 subscribers, was queried for "prolapse" to collect postings on POP in August 2018.

Do Patient Education Materials on Female Pelvic Floor Disorders Meet Readability Standards? Putting Them to the Test.

Introduction: Patient education materials are widely used vehicles to provide patients with health education. While the Joint Commission recommends patient education materials not exceed the 5th grade level and the National Institutes of Health the 7th grade level, studies show that patient education materials are routinely written above the 8th grade level. We assessed the readability of patient education materials available from national and international organizations on the topics of pelvic organ prolapse, overactive bladder and stress urinary incontinence.

Beyond Data Capture: A Single Institutional Experience with Establishing a Pelvic Floor Surgery Web Based Database.

Introduction: The American Urological Association has highlighted the need for complete and long-term data collection in female pelvic medicine and reconstructive surgery. We describe our institution's experience with transitioning our pelvic floor surgery database to a secure web based platform. In this article we share this experience and its challenges to help facilitate the process for other institutions.

Tobacco use, immunosuppressive, chronic pain, and psychiatric conditions are prevalent in women with symptomatic mesh complications undergoing mesh removal surgery.

Purpose: To identify demographic and clinical characteristics of patients with symptomatic pelvic floor mesh complications who underwent mesh removal at our academic medical center. The secondary goal was to determine patient-reported outcomes after mesh removal.

Materials And Methods: We conducted a retrospective review of consecutive patients from 2011-2016 undergoing removal of mesh graft for treatment of symptomatic mesh-related complications.

A Rapid Method to Preoperatively Assess Frailty for Older Patients with Pelvic Floor Conditions.

Purpose: Assessment of frailty can help surgeons predict perioperative risk and guide preoperative counseling. However, current methods are often cumbersome in the clinical setting. We prospectively compared the effectiveness of a rapid picture based Clinical Frailty Scale (CFS-9) assessed by patient and surgeon against reference standard Fried Frailty Index in older patients with pelvic floor conditions.

I leaked, then I Reddit: experiences and insight shared on urinary incontinence by Reddit users.

Introduction And Hypothesis: Urinary incontinence (UI) is a highly prevalent condition, but is often not discussed owing to social stigma. Reddit is an internet platform for anonymous information sharing, expression, and discussion. We sought to qualitatively analyze people's behavioral, psychological, and illness experiences with UI expressed on Reddit to improve our understanding of patients' perceptions and ultimately the care we provide.

Single Institutional Experience with Single Stage Sacral Neuromodulation: Cost Savings and Outcomes in a Contemporary Case Series.

Purpose: Sacral neuromodulation is traditionally performed in 2 stages. Studies have projected that 1-stage sacral neuromodulation is cost-effective if the conversion rate is 61.3% or greater.

Incontinence after Prostate Treatment: AUA/SUFU Guideline.

Purpose: Urinary incontinence after prostate treatment (IPT) is one of the few urologic diseases that is iatrogenic, and, therefore, predictable and perhaps preventable. Evaluation of the incontinent patient, risk factors for IPT, the assessment of the patient prior to intervention, and a stepwise approach to management are covered in this guideline. Algorithms for patient evaluation, surgical management, and device failure are also provided.

Outcomes in a contemporary cohort undergoing sacral neuromodulation using optimized lead placement technique.

Aims: To evaluate factors associated with progression to stage 2 sacral neuromodulation (SNM) for refractory overactive bladder, urinary retention, or fecal incontinence using optimal lead placement techniques with curved stylet.

Methods: This is a retrospective analysis of a prospectively collected database of all consecutive stage 1 SNM lead placements at our institution between August 2014 and May 2017 using optimal lead placement technique with curved stylet. Patients with refractory overactive bladder, urinary retention, or fecal incontinence were enrolled.

Do Patients Discontinue Overactive Bladder Medications after Sacral Neuromodulation?

Purpose: Overactive bladder medications often have poor tolerability or lack of efficacy with many patients progressing to third line therapy such as sacral neuromodulation. Those treated with sacral neuromodulation may avoid the potential side effects of overactive bladder medications while achieving symptom improvement. We evaluated the postoperative rate of discontinuing overactive bladder medications in patients who underwent sacral neuromodulation of refractory overactive bladder.

Opioid Prescription and Use in Sacral Neuromodulation, Mid Urethral Sling and Pelvic Organ Prolapse Surgery: An Educational Intervention to Avoid Over Prescribing.

Purpose: The opioid problem has reached epidemic proportions and the prescription of opioids after surgery can lead to chronic use. We explored prescribing patterns and opioid use after 3 pelvic floor surgeries (sacral neuromodulation, prolapse repair and mid urethral sling) before and after an educational intervention to reduce opioid prescriptions.

Materials And Methods: We retrospectively reviewed the amount of opioid medication prescribed to patients who underwent these 3 types of surgeries at our institution from June 2016 to May 2017.

Practice patterns in the diagnosis and treatment of fecal incontinence with sacral neuromodulation: Can urologists impact this gap in care?

Objective: The prevalence of fecal incontinence (FI) is 8% in the United States. Many patients will not seek treatment and the condition is underdiagnosed. Sacral neuromodulation (SNM) is effective in treating FI, and so urologists can play a key role in its treatment.

Analysis of the Completely Dry Rate Over Time After Mid-urethral Sling in a Real-world Clinical Setting.

Objective: To improve patient counseling regarding mid-urethral slings (MUS), we performed an analysis of MUS patients dry at initial follow-up to evaluate probability of remaining dry over time, and analyzed clinical factors potentially influencing the probability of remaining dry.

Methods: A retrospective review of our prospectively-collected institutional database identified patients who underwent retropubic MUS (RMUS) or transobturator MUS (TMUS) between January 2001 and March 2016 and were completely dry, defined as an answer of "not at all" to UDI-6 question 3, at first follow-up within 1.5 years of surgery.

Inconsistency in the Definition of Urinary Tract Infection after Intravesical Botulinum Toxin A Injection: A Systematic Review.

Purpose: To more accurately examine the rate of urinary tract infection following onabotulinumtoxinA injection of the bladder we systematically reviewed the literature for definitions of urinary tract infection in studies of onabotulinumtoxinA injections. We assessed the studies for consistency with guideline statements defining urinary tract infections.

Materials And Methods: We systematically reviewed the literature by querying MEDLINE® and Embase®.