Role of sex steroid hormones in pelvic organ prolapse.

Objective: Pelvic organ prolapse (POP) affects a significant percentage of women and contributes to major healthcare costs both in the United States and worldwide. This review examines the current understanding of the role of sex steroid hormones (estrogens, androgens, and progesterone) in POP in premenopausal, perimenopausal, and postmenopausal women.

Methods: We reviewed the relevant studies on POP related to estrogens, androgens, and progesterone in both animal models and humans.

Suppression of lysyl oxidase gene expression by methylation in pelvic organ prolapse.

Introduction And Hypothesis: We measured promoter methylation in the LOX gene in women with pelvic organ prolapse and in women without prolapse.

Methods: Genomic DNA was isolated from the uterosacral ligaments of eight women with prolapse and eight women without prolapse as controls. Genomic DNA was digested with BamHI and underwent sodium bisulfite modification.

Assessment of patient outcomes following submucosal injection of triamcinolone for treatment of Hunner's ulcer subtype interstitial cystitis.

Introduction And Objective: Hunner's ulcer subtype interstitial cystitis (IC) is characterized by the presence of circumscribed inflammatory ulcerations in the bladder wall identified during endoscopic examination of individuals with irritative voiding symptoms and pelvic pain. We present our experience with management of this subgroup with intralesional submucosal injection of corticosteroid.

Methods: Prospective analysis of patients presenting with Hunner's ulcer subtype IC was performed between November 2006 to April 2008.

Interstitial cystitis/painful bladder syndrome for the primary care physician.

Interstitial cystitis also known as painful bladder disorder refers to individuals with chronic bladder inflammation of unknown cause. The presentation of disabling symptoms of urgency, frequency, nocturia, and varying degrees of suprapubic discomfort, is one that the primary care physician will encounter frequently as the prevalence of interstitial cystitis ranges from 10.6 cases per 100,000 to as high as one in 4.

Decreased endopelvic fascia elastin content in uterine prolapse.

Background: Genital prolapse is a debilitating manifestation of pelvic floor dysfunction. The cause of this condition has not been elucidated. The purpose of this study was to determine elastin content and RNA expression of related enzymes of elastin synthesis in uterosacral ligament biopsies from women with severe prolapse, and controls with normal pelvic support.

Treatment of voiding dysfunction after transobturator tape procedure.

Voiding dysfunction after mid-urethral sling procedures is uncommon but not completely avoidable. We report on a method to adjust the transobturator mid-urethral sling under local anesthesia in the early postoperative period for postoperative voiding difficulty. At postoperative day 17 and 18, 2 women, who had undergone the transobturator tape procedure for stress incontinence, underwent successful loosening of the mesh through the previous vaginal incision, without the need to transect or remove the tape.

Bladder injury during transobturator sling.

The new minimally invasive transobturator sling for surgical treatment of female genuine stress urinary incontinence is designed to reproduce the natural suspension of the urethral fascia while eliminating the need for retropubic needle passage. We report 3 cases of bladder perforation during the transobturator sling procedure. All injuries were identified intraoperatively by cystoscopy, and successful reinsertion of the mesh was accomplished.