Vaginal pessary in advanced pelvic organ prolapse: impact on quality of life.

Introduction And Hypothesis: Pelvic organ prolapse (POP) is a highly prevalent dysfunction of the pelvic floor affecting up to 40% of women. The symptoms of POP have a major impact on quality of life. Pessary treatment is a therapy option associated with high levels of satisfaction and few complications.

Prevalence of urodynamic changes with risk for upper urinary tract damage in neuroschistosomiasis patients.

Introduction: This study aimed to identify the prevalence of urodynamic changes with an associated risk of developing upper urinary tract damage in neuroschistosomiasis patients.

Methods: A prospective study was conducted, wherein68 patients were admitted for analysis of urodynamics, urea and creatinine levels, and uroculture.

Results: Blood test results did not indicate kidney failure.

Is urodynamics necessary to identify occult stress urinary incontinence?

Purpose: To investigate Occult Stress Urinary Incontinence (OSUI) using physical exam (PE) and urodynamics (UDS) in women with advanced pelvic organ prolapse (POP), and compare the two methods.

Methods: This study comprised 105 women with POP stage-III and -IV, according to POP quantification (POP-Q) system, evaluated prospectively between January and December 2015. A standard history, an incontinence questionnaire and PE were completed before the investigation of the OSUI that was performed in the supine and standing positions, reducing the prolapse using gauze and Cheron dressing forceps.

Functional outcomes and quality of life after transobturatory slings: hand - made vs. commercial slings.

Surgical correction is the most efficient treatment for stress urinary incontinence (SUI), and transobturator sling (TO) has optimal results. The high cost of commercially available sling kits makes it difficult the access in most Brazilian public health services. Hand-made polypropylene slings, on the other hand, have been previously reported.

Modified pubovaginal sling technique in the surgical management of female stress urinary incontinence.

Objective: To assess the application of aponeurotic sling by a modified technique with direct visualization of needles in patients with stress urinary incontinence.

Methods: we applied the Kings Health Questionnaire (KHQ) for quality of life, gynecological examination, urinalysis I and urine culture approximately seven days prior to the urodynamic study (UDS) and the one-hour PAD test in patients undergoing making aponeurotic sling with its passing through the retropubic route with direct visualization of the needle, PAD test and King's Health Questionnaire before and after surgery.

Results: The mean age was 50.

Bacteriuria and urinary tract infection after female urodynamic studies: risk factors and microbiological analysis.

Background: This study was conducted to determine risk factors for infectious complications after urodynamic study (UDS) in women, which can assist clinicians in identifying high-risk subjects who would benefit from antibiotic prophylaxis before UDS.

Methods: In this prospective cohort study, we studied 232 women who underwent UDS at Santa Casa de São Paulo School of Medical Sciences between June 2013 and June 2014. Women ranging in age from 26 to 84 years who had urinary incontinence, pelvic organ prolapse, or voiding dysfunction were required to collect urine samples at 7 days before, on the day of, and 3-5 days after UDS.

Multicenter, randomized trial comparing native vaginal tissue repair and synthetic mesh repair for genital prolapse surgical treatment.

Introduction And Hypothesis: This trial aimed to compare the outcomes of native vaginal tissue repair versus polypropylene mesh repair for the treatment of severe genital prolapse.

Methods: This multicenter randomized trial included 184 women, with POP-Q stage 3 or 4. They were randomly assigned to undergo surgical treatment using native tissue repair (n = 90) or synthetic mesh repair (n = 94).

The Portuguese validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

Introduction And Hypothesis: Sexual well-being is an important aspect of women's life. The objective of this study was to validate the Portuguese-translated version of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire--PISQ-12.

Methods: Sixty-four women were enrolled to participate in the process of validating the PISQ-12 (study group).

Pubococcygeal activity on perineal ultrasound in incontinent women.

Introduction And Hypothesis: The aim of this study was to investigate the applicability and reproducibility of perineal ultrasound (US) in the evaluation of the pubococcygeal muscle (PCM) activity in urinary incontinent women.

Methods: Thirty women were assessed twice by two examiners who measured the angle between the lateral bundles of the PCM. The 2D US on coronal view evaluated the PCM performance during squeezing, straining, and resting.

Polypropylene mesh vs. site-specific repair in the treatment of anterior vaginal wall prolapse: preliminary results of a randomized clinical trial.

Objective: Pelvic organ prolapse is a disorder caused by the imbalance between the forces responsible for supporting the pelvic organs in their normal position and those that tend to expel them from the pelvis. Anterior vaginal wall prolapse, known as cystocele, is the most common form of prolapse and can result from lesions in different topographies of the endopelvic fascia. Currently, a woman has an 11% risk of being submitted to a surgical procedure to correct pelvic floor disorder, and a 29% chance of being reoperated due to failure in the first surgery.

[A randomized comparison of two vaginal procedures for the treatment of uterine prolapse using polypropylene mesh: hysteropexy versus hysterectomy].

Objectives: To compare surgical morbidity and time, as well as anatomical outcomes between vaginal histerectomy and uterine preservation in the treatment of uterine prolapse using a mesh kit (Nazca).

Methods: Randomized controled trial with 31 women with uterine prolapse POP-Q stage 3 or 4 pelvic organ prolapse who underwent vaginal surgery using tipe I polypropilene mesh (Nazca). They were randomized in two groups: group HV: hysterectomy and pelvic reconstruction floor with mesh (n=15); group HP: hysteropexy and pelvic reconstruction floor with mesh (n=16).

Transvaginal polypropylene mesh versus sacrospinous ligament fixation for the treatment of uterine prolapse: 1-year follow-up of a randomized controlled trial.

Introduction And Hypothesis: The objective of this study was to compare the anatomical and quality of life outcomes of a posterior polypropylene mesh kit versus sacrospinous ligament fixation at the time of hysterectomy for the treatment of uterine prolapse.

Methods: Thirty-two women aged 50 to 75 years with stage III or IV (pelvic organ prolapse quantification system/International Continence Society) uterine prolapse were randomized into two groups (group 1: polypropylene mesh, Nazca R, Promedon, Cordoba, Argentina; group 2: sacrospinous ligament fixation).

Results: At 12-month follow-ups, we observed the same anatomical results in both groups.

Small intestinal submucosa patch for extensive vaginal endometriosis resection.

This case report describes use of a porcine small intestinal submucosa patch to prevent vaginal stiffness and retraction after extensive vaginal resection of an endometriosis nodule. A 32-year-old nulliparous woman was referred for surgical treatment of a large rectovaginal nodule that extended from the vaginal to the rectal mucosa. Surgical treatment was performed in 2 steps.

[Double-contrast barium enema in the diagnosis of intestinal deeply infiltrating endometriosis].

Purpose: to evaluate the sensitivity, specificity, positive and negative predictive value of double contrast barium enema (DCBE) for the diagnoses of rectum and sigmoid endometriosis.

Methods: prospective transversal study including 37 patients with suspicion of deep endometriosis. Patients were submitted to DCBE, according to the standard technique described in the literature, and then, to laparoscopy.

Validation of the Pelvic Organ Prolapse Quantification Index (POP-Q-I): a novel interpretation of the POP-Q system for optimization of POP research.

Even though very precise at describing pelvic organ position, our criticism to the Pelvic Organ Prolapse Quantification (POP-Q) system is its limited ability to quantify the prolapse itself, since it still classifies prolapse into four stages, almost the same way as Baden and Walker (Clin Obstet Gynecol 15(4):1070-1072, 1972) did in 1972. As a result, the same grade can include a wide prolapse intensity range. The objective of this study was to assess inter-observer reliability in the Pelvic Organ Prolapse Quantification Index (POP-Q-I; Lemos et al.

Optimizing pelvic organ prolapse research.

For many years, researchers on this field have suffered from the lack of an efficient method for describing pelvic organ prolapse. Struggling to solve this problem, the International Continence Society has proposed a pelvic organ prolapse quantification (POP-Q) system [Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull B, Smith ARB, Am J Obstet Gynecol, 175(1):1956-1962, 1996], which was validated as a precise and reproducible technique for describing pelvic organ position. However, even though very precise at describing pelvic organ position, our critic to this system is its limited ability to quantify the prolapse itself, since it still classifies prolapse into four grades, almost the same way as Baden and Walker did in 1972.