Variability in practice patterns in stress urinary incontinence and pelvic organ prolapse: results of an IUGA survey.

Introduction And Hypothesis: Members of the International Urogynecological Association (IUGA) come from different geographic locations and practice settings. A member survey regarding practice patterns provides valuable information for practitioners and researchers alike, and allows the IUGA to discover areas to focus on education and information dissemination.

Methods: A questionnaire was developed by the IUGA Research and Development committee and distributed electronically to IUGA surgeons.

Recurrent pelvic organ prolapse: International Urogynecological Association Research and Development Committee opinion.

Introduction And Hypothesis: This committee opinion paper summarizes available evidence about recurrent pelvic organ prolapse (POP) to provide guidance on management.

Method: A working subcommittee from the International Urogynecological Association (IUGA) Research and Development Committee was formed. The literature regarding recurrent POP was reviewed and summarized by individual members of the subcommittee.

Prevention of pelvic floor disorders: international urogynecological association research and development committee opinion.

Introduction And Hypothesis: Pelvic floor disorders (PFD), including urinary incontinence, anal incontinence, and pelvic organ prolapse, are common and have a negative effect on the quality of life of women. Treatment is associated with morbidity and may not be totally satisfactory. Prevention of PFDs, when possible, should be a primary goal.

A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders.

Introduction And Hypothesis: We evaluated the associations between pelvic floor muscle strength and tone with sexual activity and sexual function in women with pelvic floor disorders.

Methods: This was a secondary analysis of a multicenter study of women with pelvic floor disorders from the USA and UK performed to validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). Participants were surveyed about whether they were sexually active and completed the PISQ-IR and the Female Sexual Function Index (FSFI) questionnaires to assess sexual function.

Sexual function in women with anal incontinence using a new instrument: the PISQ-IR.

Introduction: Anal incontinence (AI) has been associated with sexual complaints. The Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA Revised (PISQ-IR) has been validated to measure sexual function in sexually active (SA) and non-SA (NSA) women with pelvic floor disorders (PFD) including AI. We describe symptoms in women with PFDs including AI using this instrument.

Mixed urinary incontinence: international urogynecological association research and development committee opinion.

Background And Aim: The definition as well as the treatment of women with mixed urinary incontinence (MUI) is controversial. Since women with MUI are a heterogeneous group, the treatment of MUI requires an individual assessment of the symptom components: stress urinary incontinence, urinary urgency, urgency urinary incontinence, urinary frequency, and nocturia. The purpose of this paper is to summarize the current literature and give an evidence-based review of the assessment and treatment of MUI.

The PISQ-IR: considerations in scale scoring and development.

Introduction: This paper provides a detailed discussion of the psychometric analysis and scoring of a revised measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR).

Methods: Standard tools for evaluating item distributions, relationships, and psychometric properties were used to identify sub-scales and determine how the sub-scales should be scored. The evaluation of items included a nonresponse analysis, the nature of missingness, and imputation methods.

A new measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR).

Introduction And Hypothesis: The objective of this study was to create a valid, reliable, and responsive sexual function measure in women with pelvic floor disorders (PFDs) for both sexually active (SA) and inactive (NSA) women.

Methods: Expert review identified concept gaps and generated items evaluated with cognitive interviews. Women underwent Pelvic Organ Prolapse Quantification (POPQ) exams and completed the Incontinence Severity Index (ISI), a prolapse question from the Epidemiology of Prolapse and Incontinence Questionnaire (ISI scores), the Pelvic Floor Distress Inventory-20 (PFDI-20), and the Female Sexual Function Index (FSFI).

Assessment of sexual function in women with pelvic floor dysfunction.

This article reviews sexual function questionnaires used in urogynecology, impact of pelvic floor dysfunction (PFD) on sexual function, and impact of surgical treatment of PFD on sexual function, with a focus on the experience and publications of validated sexual function questionnaires in the urogynecologic literature. A review of the literature was performed to obtain data on sexual function and PFD focusing on those studies that utilized validated sexual function questionnaires. Validated questionnaires assure data that are reliable, quantifiable, and reproducible.

Female sexual function and dysfunction.

This article identifies models of sexual function, defines and categorizes sexual dysfunction, and identifies therapeutic modalities for patients who have sexual dysfunction. Additionally, it discusses some of the questionnaires used to evaluate sexual function.

Clinical predictors of urinary retention after pelvic reconstructive and stress urinary incontinence surgery.

Objective: To evaluate the impact of perioperative variables on length of postoperative catheterization.

Study Design: A multicenter, prospective, cohort study of women undergoing pelvic reconstructive and/or incontinence surgery was performed. Perioperative variables associated with length of catheterization and prolonged catheterization (catheterization >30 days) were analyzed.

Posterior repair and sexual function.

Objective: The purpose of this study was to determine the effect of posterior repair (PR) on sexual function in patients who have undergone incontinence and/or pelvic reconstructive surgery.

Study Design: A cohort study of women who underwent incontinence and/or prolapse surgery was performed. Participants completed the pelvic organ prolapse urinary incontinence sexual questionnaire (PISQ) before and after the operation.

Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study.

Objective: The purpose of this study was to assess sexual function in women after surgery for stress urinary incontinence and/or pelvic organ prolapse (UI/POP) at 3 and 6 months with the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ).

Study Design: Of 269 eligible women participating in a trial of prophylactic antibiotic use with suprapubic catheters, 102 (37.9%) agreed to participate in a sexual function study.

Obesity and retropubic surgery for stress incontinence: is there really an increased risk of intraoperative complications?

Objective: The objective of the study was to evaluate the impact of obesity on length of surgery, blood loss, and intra- and postoperative complications in women who underwent retropubic surgery for stress urinary incontinence.

Study Design: Of 449 women participating in a multicenter, randomized trial evaluating antibiotic prophylaxis in women with suprapubic catheters, 250 women underwent retropubic anti-incontinence procedures. This is a prospective nested cohort study of these women, 79 (32%) of whom were obese (body mass index 30 or greater) and 171 (68%) overweight or normal weight (body mass index less than 30).

Primary repair of obstetric anal sphincter laceration: a randomized trial of two surgical techniques.

Objective: This study was undertaken to compare surgical techniques for the primary repair of obstetric anal sphincter lacerations.

Study Design: Patients with complete third- or fourth-degree lacerations were recruited and randomly assigned to either an end-to-end or overlapping repair. Data collection included demographic data, obstetric history, and intrapartum events.

Sexual function after surgery for stress urinary incontinence and/or pelvic organ prolapse: a multicenter prospective study.

Objective: The purpose of this study was to assess sexual function in women after surgery for stress urinary incontinence and/or pelvic organ prolapse (UI/POP) at 3 and 6 months with the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ).

Study Design: Of 269 eligible women participating in a trial of prophylactic antibiotic use with suprapubic catheters, 102 (37.9%) agreed to participate in a sexual function study.

A randomized, double-blind, placebo-controlled comparison of the effect of nitrofurantoin monohydrate macrocrystals on the development of urinary tract infections after surgery for pelvic organ prolapse and/or stress urinary incontinence with suprapubic catheterization.

Objective: The purpose of this study was to determine if antibiotic prophylaxis with nitrofurantoin monohydrate macrocrystals (study drug) after pelvic organ prolapse and/or urinary incontinence surgery with suprapubic catheterization (SPC) decreases urinary tract infection (uti) compared with placebo in a randomized, double-blind, multicenter trial.

Study Design: Six centers participated in this study. After a negative preoperative urine culture, history, surgical and postoperative course, urine culture and symptoms at SPC removal, and at 6 to 8 weeks postoperative, any other UTI and adherence were recorded.

Abdominal hysterectomy for the enlarged myomatous uterus compared with vaginal hysterectomy with morcellation.

Objective: The purpose of this study was to compare intraoperative and postoperative complications of abdominal hysterectomy for the enlarged, myomatous uterus with vaginal hysterectomy with morcellation.

Study Design: Medical records of 139 patients who underwent vaginal hysterectomy with morcellation and 244 patients who underwent total abdominal hysterectomy for an enlarged, myomatous uterus between August 1990 and July 2001 were reviewed. Uterine weights of >982 g were excluded because this was the largest uterus removed vaginally, which left 208 evaluable cases of total abdominal hysterectomy.

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

The aim of this study was to develop the short form of a condition-specific, reliable, validated and self-administered instrument to evaluate sexual function in women with pelvic organ prolapse and/or urinary incontinence. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire -12 (PISQ-12) was developed from the data of 99 of 182 women surveyed to create the long form (PISQ-31). An additional 46 patients were recruited for further validation.

Vaginal erosion of cadaveric fascia lata following abdominal sacrocolpopexy and suburethral sling urethropexy.

The aim of this paper is to report vaginal erosion of cadaveric fascia lata used for abdominal sacrocolpopexy and suburethral sling urethropexy. The charts of patients who underwent abdominal sacrocolpopexy or suburethral sling urethropexy between March 1994 and February 1999 were reviewed for perioperative data. In 47 cases of abdominal sacrocolpopexy or suburethral sling, 32 utilized cadaveric fascia lata, with 11 for sacrocolpopexy and 22 for suburethral sling.

Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse.

The sexual function of women with and without urinary incontinence and/or pelvic organ prolapse (UI/POP) was compared using a condition-specific validated questionnaire, the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). Eighty-three women with UI/POP and 56 without agreed to participate. PISQ scores were significantly lower among women with UI/POP than in those without (P = 0.

Medical vs. Surgical treatment of ectopic pregnancy. The University of New Mexico's six-year experience.

Objective: To review and compare the treatments for ectopic pregnancy in a university setting serving an indigent population.

Study Design: Charts assigned an ICD-9 code for ectopic pregnancy from January 1, 1993, through December 31, 1998, were reviewed for presenting symptoms, hCG levels, ultrasound findings, treatment modality and need for subsequent treatment.

Results: Of 401 patients treated for ectopic pregnancy, 7 were managed expectantly.

Vasopressin as an etiologic factor for infection in gynecologic surgery: a randomized double-blind placebo-controlled trial.

Objective: The purpose of this study was to evaluate the risk of pelvic infection with the use of vasopressin at time of vaginal hysterectomy with a randomized controlled trial.

Study Design: Women who underwent vaginal hysterectomy and agreed to participate were randomly assigned to pericervical injections of vasopressin or normal saline solution. Surgeons and patients were blinded to the injected substance.

A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse.

Objective: Our aim was to develop a condition-specific, reliable, validated, and self-administered instrument to evaluate sexual function in women with pelvic organ prolapse or urinary incontinence.

Study Design: The questionnaire was designed after review of the literature and of nonspecific validated instruments. The study was completed in 2 phases.

Early feeding and the incidence of gastrointestinal symptoms after major gynecologic surgery.

Objective: To compare early feeding with traditional postoperative dietary management for development of postoperative gastrointestinal symptoms, including ileus after major gynecologic surgery for benign conditions.

Methods: Women who had major gynecologic surgery for benign conditions were randomly allocated to early feeding of low residue diets 6 hours postoperatively or traditional dietary management of clear liquids with normal bowel sounds, and regular diet with passage of flatus. Demographic and perioperative data were collected, and patients answered questionnaires on their perception of bowel function and pain using the McGill Pain Scale.