Effect of Supervised Pelvic Floor Biofeedback and Electrical Stimulation in Women With Mixed and Stress Urinary Incontinence.

Objective: The aim of this study was to compare the symptomatic change in urinary symptom distress before and after treatment with pelvic floor biofeedback and electrical stimulation in women with mixed urinary incontinence (MUI) and stress urinary incontinence (SUI).

Methods: We conducted a retrospective cohort study of women who underwent supervised pelvic floor biofeedback therapy and electrostimulation for the treatment of MUI and SUI. Our primary outcome was change in the Urinary Distress Inventory-6 (UDI-6) score before and after therapy.

Vulvovaginal symptoms prevalence in postmenopausal women and relationship to other menopausal symptoms and pelvic floor disorders.

Objective: The primary objective of this study was to use the Vulvovaginal Symptom Questionnaire (VSQ) to estimate the prevalence and examine the emotional, lifestyle, and sexual impact of vulvovaginal symptoms in postmenopausal women.

Methods: We administered the VSQ, a previous validated instrument to 358 postmenopausal women recruited from primary care physician offices and local senior centers. The first seven questions of the VSQ comprise the symptom subscale (itching, burning, hurting, irritation, dryness, discharge, and odor).

Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction.

Introduction And Hypothesis: There is a growing body of evidence demonstrating frailty as an important predictor of surgical outcomes in older adults undergoing major surgeries. The age-related onset of many symptoms of female pelvic floor dysfunction (PFD) in women suggests that many women seeking treatment for PFD may also have a high prevalence of frailty, which could potentially impact the risks and benefits of surgical treatment options. Our primary objective was to determine the prevalence of frailty, cognitive impairment, and functional disability in older women seeking treatment for PFD.

Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review.

Objectives: To summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community-dwelling persons.

Design: Systematic review of MEDLINE (OvidSP 1946 to May, Week 3, 2014).

Setting: Community.

The effects of comorbidity on the benefits and harms of treatment for chronic disease: a systematic review.

Background: There are concerns about the potential for unintentional harms when clinical practice guidelines are applied to patients with multimorbidity. The objective was to summarize the evidence regarding the effect(s) of comorbidity on the outcomes of medication for an index chronic condition.

Methods: A systematic review was conducted of studies published in MEDLINE and Cochrane Trials before May 2012.

Childbirth expectations and sources of information among low- and moderate-income nulliparous pregnant women.

This article explores the childbirth expectations and sources of information of first-time mothers using a qualitative descriptive method. A purposive sample of low- to moderate-income nulliparous women (N = 7) from an urban area in Connecticut were interviewed in their third trimester of pregnancy. The themes that emerged touched on mode of birth, supportive resources, emotional and physical expectations, control, and health of the baby.

Over-the-counter treatments and perineal hygiene in postmenopausal women.

Objective: The objective of this descriptive study was to quantify the personal hygiene habits/practices of, as well as the over-the-counter (OTC) products used by, postmenopausal women. Specifically, we were interested in any product that would contact the vulva or vagina.

Methods: We performed a cross-sectional study of postmenopausal women seeking routine gynecologic care.

Surgical site infection after hysterectomy.

Objective: Our objective was to estimate the occurrence of surgical site infections (SSI) after hysterectomy and the associated risk factors.

Study Design: We conducted a cross-sectional analysis of the 2005-2009 American College of Surgeons National Surgical Quality Improvement Program participant use data files to analyze hysterectomies. Different routes of hysterectomy were compared.

Cost-effectiveness of endometrial evaluation prior to morcellation in surgical procedures for prolapse.

Objective: The objective of the study was to compare the cost-effectiveness of 3 screening options for endometrial cancer in asymptomatic, postmenopausal women prior to undergoing morcellation in minimally invasive supracervical hysterectomy and minimally invasive sacral colpopexy for the treatment of pelvic organ prolapse.

Study Design: A decision tree model was constructed to compare no screening, endometrial biopsy, and transvaginal ultrasound for asymptomatic, postmenopausal women prior to surgery. Effectiveness was measured by life-years.

The Vulvovaginal Symptoms Questionnaire: a questionnaire for measuring vulvovaginal symptoms in postmenopausal women.

Objective: This study aims to develop a Vulvovaginal Symptoms Questionnaire (VSQ) to determine the symptoms, emotions, life impact, and sexual impact of vulvovaginal symptoms on postmenopausal women.

Methods: We developed a questionnaire that focuses on vulvovaginal symptoms based on modifications to Skindex-16, a validated questionnaire for measuring the impact of skin disease. We recruited postmenopausal women seeking routine gynecologic care to test the psychometric properties of the VSQ.

The association between urinary and fecal incontinence and social isolation in older women.

Objective: To describe the association between social isolation and urinary incontinence and fecal incontinence in older women.

Methods: We conducted a secondary database analysis of the National Social Life, Health and Aging Project for women aged 57 to 85 years old. Our primary outcome was self-report of often feeling isolated.

Sexual function in older women after oophorectomy.

Objective: To compare the sexual function of older women who had bilateral oophorectomy with that of older women who had retained their ovaries.

Methods: This cross-sectional study involved analysis of 1,352 women aged 57 to 85 years from the National Social Life, Health, and Aging Project. Women with previous bilateral oophorectomy were compared with women who retained their ovaries.

Major postoperative complications after benign gynecologic surgery: a clinical prediction tool.

Objective: The objective of this study was to create a clinical prediction tool to differentiate women at risk for postoperative complications after benign gynecologic surgery.

Methods: We utilized the 2005 to 2009 American College of Surgeons National Surgical Quality Improvement Program participant use data files to perform a secondary data-set analysis of women older than 16 years who underwent benign gynecologic procedures. We then temporally divided women into 2 similar cohorts.

Oophorectomy: the debate between ovarian conservation and elective oophorectomy.

Ovarian cancer remains the fifth deadliest cancer among women because of its early asymptomatic nature and lack of efficacious screening methods, leading to frequent late-stage diagnosis. Elective oophorectomy is an option for women undergoing benign hysterectomy as a means of reducing their ovarian cancer risk. Benefits also include reduced risk of repeat surgical operation due to adnexal masses and reduced anxiety related to perceived risk of ovarian and breast cancer.