Development and validation of models predicting treatment patterns in women with urinary urgency and/or urgency incontinence: A Symptoms of Lower Urinary Tract Dysfunction Research Network observational cohort study.

Purpose: To develop a tool to predict a woman's treatment pattern for bothersome urinary urgency (UU) and/or UU incontinence over 1 year after presenting for care at urology or urogynecology clinics.

Methods: The Symptoms of Lower Urinary Tract Dysfunction Research Network observational cohort study enrolled adult women with bothersome UU and/or UU incontinence using the lower urinary tract symptoms (LUTS) Tool who were seeking care for LUTS. Treatments for UU and/or urgency incontinence were ordered from least to most invasive.

Risk of obstetric anal sphincter injuries at the time of admission for delivery: A clinical prediction model.

Objective: To develop and validate a model to predict obstetric anal sphincter injuries (OASIS) using only information available at the time of admission for labour.

Design: A clinical predictive model using a retrospective cohort.

Setting: A US health system containing one community and one tertiary hospital.

Clinical prediction is at the heart of preventing birth trauma and pelvic floor disorders for individual women.

Introduction And Hypothesis: The purpose of this article is to understand that the majority of studies investigating the role of risk factors for maternal birth trauma and pelvic floor disorders are designed using causal inferential statistical methods and have not been designed to investigate the more useful goal of clinical prediction.

Methods: A review of the literature was conducted to describe notable causal and predictive associations between risk factors and maternal birth trauma outcomes. Examples were obtained to illustrate and contrast differences in clinical usefulness between causal and predictive models.

Risk Factors for Surgical Failure and Worsening Pelvic Floor Symptoms Within 5 Years After Vaginal Prolapse Repair.

Objective: To assess independent risk factors for surgical failure and worsening pelvic floor symptoms within 5 years after vaginal prolapse surgery.

Methods: This secondary analysis includes OPTIMAL (Operations and Pelvic Muscle Training in the Management of Apical Support Loss) (n=374) and E-OPTIMAL (Extended) (n=285) trial participants. Surgical failure was defined as apical descent greater than one third of the total vaginal length, anterior or posterior vaginal wall past the hymen, subsequent surgery or bothersome vaginal bulge.

Automated problem list generation and physicians perspective from a pilot study.

Objective: An accurate, comprehensive and up-to-date problem list can help clinicians provide patient-centered care. Unfortunately, problem lists created and maintained in electronic health records by providers tend to be inaccurate, duplicative and out of date. With advances in machine learning and natural language processing, it is possible to automatically generate a problem list from the data in the EHR and keep it current.

Incidence and Predictors of Anal Incontinence After Obstetric Anal Sphincter Injury in Primiparous Women.

Objective: This study aimed to describe the incidence of fecal incontinence (FI) at 6, 12, and 24 weeks postpartum; anal incontinence (AI) and fecal urgency at 24 weeks; and identify predictors of AI in women with obstetric anal sphincter injury (OASI).

Methods: Primiparous women sustaining OASIs were identified at 8 clinical sites. Third-degree OASIs were characterized using World Health Organization criteria, 3a (<50%) or 3b (>50%) tear through the sphincter.

Minimum important differences for scales assessing symptom severity and quality of life in patients with fecal incontinence.

Objectives: The objective of this study was to estimate the minimum important difference (MID) for the Fecal Incontinence Severity Index (FISI), the Colorectal-Anal Distress Inventory (CRADI) scale of the Pelvic Floor Distress Inventory, the Colorectal-Anal Impact Questionnaire (CRAIQ) scale of the Pelvic Floor Impact Questionnaire, and the Modified Manchester Health Questionnaire (MMHQ).

Methods: We calculated the MIDs using anchor-based and distribution-based approaches from a multicenter prospective cohort study investigating adaptive behaviors among women receiving nonsurgical and surgical management for fecal incontinence (FI). Patient responses were primarily anchored using a Global Impression of Change scale.

Attitudes toward hysterectomy in women undergoing evaluation for uterovaginal prolapse.

Objectives: To investigate attitudes toward hysterectomy in women seeking care for pelvic organ prolapse.

Methods: Two hundred twenty women referred for evaluation of prolapse without evidence of previous hysterectomy were surveyed with the Pelvic Organ Prolapse Distress Inventory; the Control Preferences Scale; and questions regarding patients' perception of the impact of hysterectomy on health, social life, and emotional well-being. Additional items presented hypothetical scenarios.

Adherence to behavioral interventions for stress incontinence: rates, barriers, and predictors.

Background: First-line conservative treatment for stress urinary incontinence (SUI) in women is behavioral intervention, including pelvic-floor muscle (PFM) exercise and bladder control strategies.

Objective: The purposes of this study were: (1) to describe adherence and barriers to exercise and bladder control strategy adherence and (2) to identify predictors of exercise adherence.

Design: This study was a planned secondary analysis of data from a multisite, randomized trial comparing intravaginal continence pessary, multicomponent behavioral therapy, and combined therapy in women with stress-predominant urinary incontinence (UI).

Functional bowel disorders and pelvic organ prolapse: a case-control study.

Objectives: : To compare the relative frequencies of constipation and other functional bowel disorders between patients with and without pelvic organ prolapse (POP).

Methods: : This was a case-control study design. Cases were patients with stage 3-4 POP presenting to a urogynecology clinic and controls were patients presenting to a general gynecology or women's health clinic for annual examinations with stage 0-1 vaginal support.

Anatomic relationships of the tension-free vaginal mesh trocars.

Objective: The objective of the study was to describe the distances between the major anatomic structures to the path of the tension-free vaginal mesh (TVM) trocars.

Study Design: Four anterior transobturator and 2 posterior ischiorectal TVM trocars were inserted bilaterally into 8 fresh frozen cadavers. Dissections were performed and mean distances (95% confidence interval) were measured between the closest points along the trocar's path and significant anatomic structures.

Bowel symptoms 1 year after surgery for prolapse: further analysis of a randomized trial of rectocele repair.

Objective: The purpose of this study was to analyze change in bowel function and its relationship to vaginal anatomy 1 year after rectocele repair and pelvic reconstruction in a randomized trial of 3 techniques of rectocele repair.

Study Design: The study is an ancillary analysis of data from a randomized trial of 3 techniques of rectocele repair: posterior colporrhaphy, site-specific repair, and site-specific repair with Fortagen graft augmentation. Pelvic examination and validated questionnaires were obtained at baseline, 6 months, and 1 year after surgery.