A pilot study comparing anatomic failure after sacrocolpopexy with absorbable or permanent sutures for vaginal mesh attachment.

Objectives: To describe anatomic failure rates for sacrocolpopexy in groups receiving either delayed absorbable or permanent monofilament suture for mesh attachment to the vagina.

Methods: We reviewed the medical records of 193 women who underwent sacrocolpopexy with 2 different types of sutures attaching polypropylene mesh to the vagina: delayed absorbable sutures (median follow-up, 43 weeks) and permanent sutures (median follow-up, 106 weeks). Vaginal apical failure was defined as Point C greater than or equal to half of the total vaginal length.

A randomized trial of vaginal mesh attachment techniques for minimally invasive sacrocolpopexy.

Introduction And Hypothesis: We investigated the efficiency and efficacy of vaginal mesh attachment using interrupted, non-barbed, delayed absorbable sutures in comparison with a running, barbed, delayed absorbable suture during laparoscopic sacrocolpopexy (LSC) and robotic sacrocolpopexy (RSC).

Methods: Women undergoing LSC or RSC were recruited. Participants were randomized to at least six 0 PDS non-barbed interrupted sutures or at least six passes of a 1 PDS barbed suture (Quill™) on each anterior and posterior polypropylene mesh leaflet.

An update on the current and future demand for care of pelvic floor disorders in the United States.

Objective: In 2001, we predicted a 45% increase in the demand for care of women with pelvic floor disorders (PFDs) between 2000 and 2030. However, in 2010, we observed that in our clinic demand for care had increased substantially more than expected. Using updated data, we sought to provide more accurate projections of future demand for care of pelvic floor disorders in the United States.

Colporrhaphy compared with mesh or graft-reinforced vaginal paravaginal repair for anterior vaginal wall prolapse: a randomized controlled trial.

Objective: To report 2-year outcomes of a randomized controlled trial comparing standard anterior colporrhaphy with reinforced vaginal paravaginal repair using xenograft or synthetic mesh in women with symptomatic anterior vaginal wall prolapse.

Methods: Women with stage II or greater anterior prolapse were randomly assigned to three groups: anterior colporrhaphy, paravaginal repair with porcine dermis, or polypropylene mesh. Outcomes of prolapse stage, quality of life, degree of bother, and sexual symptoms were assessed by blinded examiners and validated measures at 2 years.

Robotic-assisted and laparoscopic sacrocolpopexy: comparing operative times, costs and outcomes.

Objectives: : To compare operative times, hospital costs, and surgical outcomes for robotic-assisted laparoscopic sacrocolpopexy (RALSC) and laparoscopic sacrocolpopexy (LSC).

Methods: : A retrospective cohort study of 104 subjects who underwent RALSC (n = 43) or LSC (n = 61) for vaginal vault prolapse was performed. The primary outcomes were operative time and hospital costs.

Prevalence and risk factors for mesh erosion after laparoscopic-assisted sacrocolpopexy.

Introduction And Hypothesis: The purpose of this study is to identify risk factors for mesh erosion in women undergoing minimally invasive sacrocolpopexy (MISC). We hypothesize that erosion is higher in subjects undergoing concomitant hysterectomy.

Methods: This is a retrospective cohort study of women who underwent MISC between November 2004 and January 2009.

Update of AUA guideline on the surgical management of female stress urinary incontinence.

Purpose: We updated the 1997 American Urological Association guideline on female stress incontinence.

Materials And Methods: MEDLINE searches of English language publications from 1994 and new searches of the literature published between December 2002 and June 2005 were performed using identified MeSH terms. Articles were selected for the index patient defined as the otherwise healthy woman who elected to undergo surgery to correct stress urinary incontinence or the otherwise healthy woman with incontinence and prolapse who elected to undergo treatment for both conditions.

Urinary frequency in community-dwelling women: what is normal?

Objective: The objective of the study was to assess urinary frequency in community-dwelling women.

Study Design: Voiding habits were assessed in 4061 women 25-84 years of age using survey responses from the Epidemiology of Prolapse and Incontinence Questionnaire. Bother related to daytime and nighttime frequency was assessed with 100-mm visual analog scales and compared using t tests and analysis of variance.

Prevalence and degree of bother from pelvic floor disorders in obese women.

We aimed to determine the prevalence and bother from pelvic floor disorders (PFD) by obesity severity, hypothesizing that both would increase with higher degrees of obesity. We performed a secondary analysis of 1,155 females enrolled in an epidemiologic study that used a validated questionnaire to identify PFD. Prevalence and degree of bother were compared across three obesity groups.

Prevalence and co-occurrence of pelvic floor disorders in community-dwelling women.

Objective: To assess the effect of age on prevalence of pelvic floor disorders and report the co-occurrence of these conditions in community-dwelling women.

Methods: Stress urinary incontinence (SUI), overactive bladder (OAB), pelvic organ prolapse (POP), and anal incontinence were assessed using a validated questionnaire among 25- to 84-year-old women. Women screened positive for each disorder based on reported symptoms and their degree of bother.

Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser Permanente Continence Associated Risk Epidemiology Study.

Objective: We examined associations between obesity and diabetes and female pelvic floor disorders (PFDs), stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI) in community-dwelling women.

Research Design And Methods: Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases, while other risk factors for PFDs were obtained through self-report.

Are sexual activity and satisfaction affected by pelvic floor disorders? Analysis of a community-based survey.

Objective: The purpose of this study was to assess the relationship between pelvic floor disorders and sexual activity and satisfaction.

Study Design: Information on pelvic floor disorders, sexual activity, and satisfaction as measured by 100-mm visual analog scale was obtained by questionnaire from 4106 women. Proportions of sexually active women were compared by the presence of each pelvic floor disorder with the use of chi-square tests.

Seeking healthcare for pelvic floor disorders: a population-based study.

Objective: The purpose of this study was to identify characteristics that are associated with seeking care for pelvic floor disorders (PFD).

Study Design: Strategies for seeking care for pelvic organ prolapse, urinary incontinence (UI), and anal incontinence (AI) were assessed in 4392 women. Women were dichotomized into women who had sought care and women with disorders who had not.

Determinants of vaginal length.

Objective: The purpose of this study was to describe quantitatively the associations between total vaginal length and demographic, historic, and physical characteristics.

Study Design: At 2 clinical sites, patients completed a standardized questionnaire and physical examination. Bivariate correlations explored relationships between total vaginal length and demographic, historic, and examination variables.

Vaginal paravaginal repair with porcine dermal reinforcement: correction of advanced anterior vaginal prolapse.

Objective: The objective of the study was to determine the efficacy of the vaginal paravaginal repair using porcine dermal graft reinforcement for the correction of advanced anterior vaginal prolapse.

Study Design: One hundred eleven women underwent reinforced vaginal paravaginal repair between September 2001 and January 2004 and met our inclusion criteria. Postoperatively patients were evaluated at 6 weeks, 6 months, and yearly thereafter.

The definition, prevalence, and risk factors for stress urinary incontinence.

Stress urinary incontinence (SUI) has an observed prevalence of between 4% and 35%. Whereas the clinical definition of SUI has been established by the International Continence Society, the epidemiologic definition has not been established, leading to a broad disparity in reported prevalence rates. Numerous risk factors for SUI have been identified.

Elevated postvoid residual in women with pelvic floor disorders: prevalence and associated risk factors.

A retrospective case-control study was designed to assess risks for elevated post void residual (PVR) in women with pelvic floor disorders. The 1,399 women underwent evaluation including standardized questionnaire, examination, and catheterized PVR. Elevated PVR was defined as > or =100 ml and anterior and apical prolapse was defined as at or beyond the hymen.

Parity, mode of delivery, and pelvic floor disorders.

Objective: This study aimed to assess the associations between parity, mode of delivery, and pelvic floor disorders.

Methods: The prevalence of pelvic organ prolapse, stress urinary incontinence, overactive bladder, and anal incontinence was assessed in a random sample of women aged 25-84 years by using the validated Epidemiology of Prolapse and Incontinence Questionnaire. Women were categorized as nulliparous, vaginally parous, or only delivered by cesarean.

Comparison of dry mouth in women treated with extended-release formulations of oxybutynin or tolterodine for overactive bladder.

The incidence, severity and tolerability of dry mouth was compared in 790 women with overactive bladder who were treated with extended-release oxybutynin chloride 10 mg/day or extended-release tolterodine tartrate 4 mg/day for 12 weeks in a multicenter, double-blind, parallel-group study. Dry mouth was the most common adverse event associated with treatment, with an incidence rate of 28.1% in the oxybutynin group and 21.

Epidemiology of prolapse and incontinence questionnaire: validation of a new epidemiologic survey.

The epidemiology of prolapse and incontinence questionnaire (EPIQ) was developed to screen for female pelvic floor disorders (PFD). Content and face validity, reliability, internal consistency and criterion validity of the EPIQ to detect the presence of pelvic organ prolapse (POP), stress urinary incontinence (SUI), overactive bladder (OAB) and anal incontinence (AI) is presented. Cronbach's alpha; Spearman's, kappa, intraclass correlations, factor analysis and Chi-Squared tests were used for analysis.

Determinants of patient satisfaction after the tension-free vaginal tape procedure.

Objective: This study was undertaken to compare patient satisfaction with subjective and objective measures of success.

Study Design: Satisfaction at 1-year was measured by using a self-administered written questionnaire. Success was assessed both subjectively and objectively by using the short form Urogenital Distress Inventory, stress testing, and multichannel urodynamics.

The use of Visual Analog Scale in urogynecologic research: a psychometric evaluation.

Objective: The purpose of this study was to assess the validity of Visual Analog Scales in urogynecologic research.

Study Design: In phase I, 35 women completed short forms of the urogenital distress inventory, incontinence impact questionnaire, and Beck depression inventory fast screen using the Likert-type scale and Visual Analog Scale formats. Reliability was estimated with Spearman's correlations and Cronbach's alpha; construct validity was assessed with the use of factor analyses.

The effects of the tension-free vaginal tape on voiding function: a prospective evaluation.

The impact of tension-free vaginal tape (TVT) on voiding function was studied in a cohort of 103 patients. Voiding was assessed with quality of life questionnaires, non-invasive urine flow and voiding pressure-flow studies both preoperatively and 1 year postoperatively. Paired t-tests and Wilcoxon's signed ranks tests were used for analysis.

The effects of the tension-free vaginal tape on proximal urethral position: a prospective, longitudinal evaluation.

This study was designed to determine the anatomic effects of the tension-free vaginal tape (TVT). A cohort of 94 patients was followed for 1 year. Urethral position was quantified using the Q-tip angle.