Comparison of the determination of the local tumor extent of primary endometrial cancer using clinical examination and 3 Tesla magnetic resonance imaging compared to histopathology.

Purpose: The aim of this study is to analyze the correct staging of primary endometrial cancer (EC) using clinical examination and 3 Tesla (T) magnetic resonance imaging (MRI) results compared to histopathology.

Methods: In this prospective, non-randomized, single-center study, 26 women with biopsy-proven EC were evaluated. All women underwent clinical examination including transvaginal ultrasound (CE/US) and 3T MRI (T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences) prior to surgery.

Urethral length and bladder neck behavior: can dynamic magnetic resonance imaging give the same results as introital ultrasound?

Purpose: To compare dynamic magnetic resonance imaging (dMRI) and introital ultrasound results with regard to urethral length measurements and the evaluation of bladder neck changes.

Methods: Retrospective analyses of urethral length measurements and detection of bladder neck changes (rotated/vertical bladder neck descent, urethral funneling) were conducted in women-scheduled for surgical treatment with alloplastic material-who had undergone introital ultrasound and dMRI presurgery and 3 months postsurgery. Measurement differences between both imaging modalities were evaluated by assessing the confidence interval for the difference in means between the datasets using bootstrap analysis.

3D reconstruction of MR-visible Fe O -mesh implants: Pelvic mesh measurement techniques and preliminary findings.

Aims: To develop MR-based measurement technique to evaluate the postoperative dimension and location of implanted magnetic resonance (MR)-visible meshes.

Methods: This technique development study reports findings of six patients (A-F) with cystoceles treated with anterior vaginal MR-visible Fe O -polypropylene implants. Implanted meshes were reconstructed from 3 months and/or 1 year postsurgical MR-images using 3D Slicer®.

Pelvimetry in nulliparous and primiparous women using 3 Tesla magnetic resonance imaging.

Aims: To perform pelvimetry in nulliparous and primiparous women using 3 Tesla magnetic resonance imaging (3T MRI).

Methods: Twenty-five nulliparous volunteers and 25 primiparous women underwent pelvic 3T MRI within one week after vaginal childbirth in a prospective clinical single-center trial. The pelvimetric parameters interspinous distance (ISD), intertuberous distance (ITD), sagittal outlet (SO), obstetric conjugate (OC), and coccygeal curved length (CCL) were adapted from anthropometric measurements as well as from sonographic and computed tomography-based pelvimetry performed on high-resolution T2-weighted images.

Five-year outcome after pelvic floor reconstructive surgery: evaluation using dynamic magnetic resonance imaging compared to clinical examination and quality-of-life questionnaire.

Background Dynamic magnetic resonance imaging (dMRI) captures the entire pelvis during Valsalva maneuver and helps diagnosing pelvic floor changes after reconstructive surgery. Purpose To evaluate therapeutic outcome five years after reconstructive surgery using clinical examination, dMRI, and quality-of-life (QOL) questionnaire. Material and Methods Clinical examination, dMRI, and QOL questionnaire were conducted before surgery and in the follow-ups at 12 weeks, one year, and five years in women with pelvic organ prolapse (POP) stage ≥2.

In obesity even young women suffer from urogynecological symptoms.

Purpose: To evaluate the occurrence of urogynecological symptoms in obese women treated in a university outpatient clinic for obesity, setting a focus on younger women.

Methods: In this explorative, prospective, cross-sectional, single-center, multidisciplinary clinical trial, all consecutively recruited women received the Prolapse Quality of Life questionnaire (P-QOL) for data acquisition. The total study population (TSP) and a subgroup (SG) aged 18-49 years were evaluated descriptively regarding symptom demonstration.

MRI visible FeO polypropylene mesh: 3D reconstruction of spatial relation to bony pelvis and neurovascular structures.

Introduction And Hypothesis: To demonstrate mesh magnetic resonance imaging (MRI) visibility in living women, the feasibility of reconstructing the full mesh course in 3D, and to document its spatial relationship to pelvic anatomical structures.

Methods: This is a proof of concept study of three patients from a prospective multi-center trial evaluating women with anterior vaginal mesh repair using a MRI-visible FeO polypropylene implant for pelvic floor reconstruction. High-resolution sagittal T2-weighted (T2w) sequences, transverse T1-weighted (T1w) FLASH 2D, and transverse T1w FLASH 3D sequences were performed to evaluate FeO polypropylene mesh MRI visibility and overall post-surgical pelvic anatomy 3 months after reconstructive surgery.

Single-Incision Mini-Slings: Obturator Complex Pull-Out-Force Measurements.

Aim: To evaluate the different pull-out-force out of the obturator membrane and the obturator internus muscle of 2 mini-sling systems for stress urinary incontinence (SUI) treatment.

Material And Methods: In a prospective study, the pull-out-force measurements were performed on 8 female cadaver pelvises, both on the obturator membrane and internal muscle, using the force measurement device PCE-FM50 (PCE Instruments). Tested were the hooks of 2 on the market available mini-sling kits (MiniArc by American Medical System; Ajust by BARD Inc.

[Imaging for urinary incontinence].

Background: Ultrasonography and functional cine magnetic resonance imaging (MRI) are noninvasive and x-ray free tools, which are currently widely used in clinical diagnostics and scientific research of male and female urinary incontinence. The increasing use and improving techniques of modern imaging tools are closely linked to rapid development of minimally invasive surgery in patients with urinary incontinence and insights gained in continence mechanisms.

Methods: Whereas ultrasonography is a cost-efficient and readily available diagnostic tool for a routine use, the more expensive functional MRI, as a tool with more precise visualization of functional interactions and spatial representation of anatomical structures of the pelvic floor, is suitable for complex diagnostic purposes and scientific research.

Magnetic resonance-visible polypropylene mesh for pelvic organ prolapse repair.

Aim: To develop a magnetic resonance (MR)-visible mesh using iron oxides and prove visibility.

Methods: In a phantom study, a suitable iron oxide, Fe3O4 [iron(II,III) oxide] and FeOOH [iron(III) oxide-hydroxide], concentration was determined using relaxometric MR measurements of the transverse relaxation rates R2 and R2*. Next, a nonabsorbable mesh was designed from the MR-visible threads woven into a polypropylene mesh.

3 T MRI-based measurements for the integrity of the female pelvic floor in 25 healthy nulliparous women.

Aims: Measurements indicating a loss of integrity of the levator ani muscle, which is an integral part of the pelvic floor, have been subject of recent studies using translabial ultrasound and 3D-MRI-models. We transferred these measurements into 2D-3 T-MR-images for clinical routine, as it is objective and does not need exhaustive post-processing.

Methods: The trial was accepted by the local ethics committee.

One-year dynamic MRI follow-up after vaginal mesh repair: evaluation of clinical, radiological, and quality-of-life results.

Background: Pelvic organ prolapse (POP) is a common disorder in elderly women often surgically repaired with alloplastic meshes; yet knowledge of the pelvic floor behavior and multi-compartment defects postoperatively is scarce.

Purpose: To evaluate the 1-year outcome after mesh repair in patients with POP using clinical examination (CE), dynamic magnetic resonance imaging (dMRI), and the prolapse quality-of-life (P-QOL) questionnaire.

Material And Methods: A prospective observational study was conducted of 69 women undergoing pelvic mesh surgery.

Magnetic resonance imaging of cervical carcinoma using an endorectal surface coil.

Introduction: The objective of this trial is to investigate the diagnostic value of magnetic resonance imaging (MRI) with an endorectal surface coil for precise local staging of patients with histologically proven cervical cancer by comparing the radiological, clinical, and histological results.

Materials And Methods: Women with cervical cancer were recruited for this trial between February 2007, and September 2010. All the patients were clinically staged according to the FIGO classification and underwent radiological staging by MRI that employed an endorectal surface coil.

Anatomical Position of Four Different Transobturator Mesh Implants for Female Anterior Prolapse Repair.

Polypropylene mesh implants are frequently used for pelvic floor reconstruction in women. Yet they vary in size and fixation. The purpose of this study is to compare four mesh products with regard to their anatomical positioning and functionality within the pelvic floor, to determine whether each mesh fits equally well in a female cadaver.

Is a wider angle of the membranous urethra associated with incontinence after radical prostatectomy?

Purpose: To investigate whether differences in the anatomy and dynamics of the pelvic floor (PF) in patients after radical prostatectomy (RP) depicted on magnetic resonance imaging (MRI) are associated with continence status.

Methods: In the prospective designed study, 24 patients with post-prostatectomy stress urinary incontinence were enrolled. Additionally, 10 continent patients after RP were matched for age, body mass index and perioperative parameters.

Endometrial cancer: results of clinical and histopathological staging compared to magnetic resonance imaging using an endorectal surface coil.

Purpose: The aim of this study was to evaluate the staging accuracy of magnetic resonance imaging (MRI) with an endorectal surface coil on patients with endometrial cancer compared to results obtained using the International Federation of Gynecology and Obstetrics (FIGO) classification and histopathology.

Methods: In this prospective study, patients with biopsy-proven endometrial cancer were staged clinically using the FIGO classification before undergoing 1.5 T MRI with an endorectal surface coil (eMRI).

MRI findings before and after prolapse surgery.

Background: Therapeutical outcome after prolapse surgery is evaluated using a standardized grading system based on maximum prolapse extent, which might not provide the full picture of the patient's subjective outcome. We therefore applied an evaluation method, which is detached from a grading system.

Purpose: To evaluate the impact of pelvic organ mobility in dynamic magnetic resonance imaging (MRI) before and after mesh-repair surgery in patients with symptomatic pelvic organ prolapse.

Successful therapy of vulvodynia with local anesthetics: a case report.

Background: Vulvodynia often occurs with unexplained vulvar pain and hyperesthesia, sexual dysfunction, and psychological disability, lacking an organic or microbiological substrate.

Case Report: A 25-year-old woman with generalized, unprovoked vulvodynia for 12 years was treated repeatedly with procaine 1% for 14 sessions after she had previously had numerous unsatisfying multidisciplinary treatments. We observed a decrease in pain scores on the visual analogue scale (VAS) from initially 8-9 to presently 0-2.

Accuracy of MRI with an endorectal coil for staging endometrial cancer.

Background: The very good results of magnetic resonance imaging (MRI) using an endorectal coil in staging prostate cancer at 1.5T suggested that this imaging technique might be able to be used to stage endometrial cancer, the most common tumor in postmenopausal women.

Purpose: To evaluate the accuracy of MRI with an endorectal surface coil for staging primary endometrial carcinoma.

Imaging of female pelvic malignancies regarding MRI, CT, and PET/CT: Part 2.

Purpose: To compose diagnostic standard operating procedures for both clinical and imaging assessment for vulvar and vaginal cancer, for vaginal sarcoma, and for ovarian cancer.

Methods: The literature was reviewed for diagnosing the above mentioned malignancies in the female pelvis. Special focus herein lies in tumor representation in MRI, followed by the evaluation of CT and PET/CT for this topic.

Imaging of female pelvic malignancies regarding MRI, CT, and PET/CT : part 1.

Aim: The goal of this article is to provide an overview of diagnostic standard operating procedures for both clinical and imaging assessment of cervical and endometrial carcinoma, sarcoma of the uterus, and primary pelvic non-Hodgkin's lymphoma.

Methods: The literature was reviewed for methods used to diagnose malignancies in the female pelvis with a special focus on the role of MRI as the imaging method of choice. Furthermore, CT findings and staging criteria for the mentioned malignancies are also provided.

Short-range clinical, dynamic magnetic resonance imaging and P-QOL questionnaire results after mesh repair in female pelvic organ prolapse.

Objective: To evaluate clinical, quality-of-life (QoL) and dynamic magnetic resonance imaging (dMRI) results in patients with pelvic organ prolapse (POP) preoperatively, and 4 and 12 weeks after anterior and/or posterior mesh repair.

Study Design: Thirty-six patients (mean age 65 years) with symptomatic pelvic floor descent underwent mesh repair. The prolapse was quantified using the POP-Q system.

Pelvic organ prolapse: does the postoperative course of mesh-repair surgery differ in elderly women when compared with younger patients?

Pelvic organ prolapse (POP) is a common disease in elderly women. Among a wide range of possibilities in POP surgery, the use of partially absorbable meshes appears to be very promising. The problem concerning POP therapy in elderly patients has not yet been not sufficiently investigated.

HER2 status of circulating tumor cells in patients with metastatic breast cancer: a prospective, multicenter trial.

There is a growing body of evidence that HER2 status can change during disease recurrence or progression in breast cancer patients. In this context, re-evaluation of HER2 status by assessment of HER2 expression on circulating tumor cells (CTCs) is a strategy with potential clinical application. The aim of this trial was to determine the HER2 status of CTCs in metastatic breast cancer patients comparing two CTC assays.

Validation of a German version of the P-QOL Questionnaire.

Objective: The objective of this study was to validate the German version of the prolapse quality-of-life questionnaire (P-QOL).

Methods: The P-QOL questionnaire was translated into German and administered to women recruited from two gynecological outpatient clinics and seven gynecological practices. All women were examined in supine position using the Pelvic Organ Prolapse Quantification System of the International Continence Society.