Optimal Pessary Care: A Modified Delphi Consensus Study.

Introduction: Support pessaries are an important, low-risk treatment option for women with vaginal prolapse but evidence to inform optimal practice is lacking. Currently, gynecologists, urologists, and urogynecologists recommend silicone vaginal support pessaries as first-line treatment for symptomatic vaginal prolapse in women of all ages. It is unknown how many providers who are not physicians prescribe and care for women using pessaries.

Pessary Practices of Nurse-Providers in the United States.

Objectives: Our purposes were to describe pessary-care practices and education of a sample of nurse providers in the United States and identify a cohort of high-volume providers.

Methods: An e-mail survey was sent to members of 3 related nursing professional organizations. Questions addressed general pessary care within the respondent's practice and specific pessary care choices of responding direct providers.

Pharmacological Agents to Decrease New Episodes of Recurrent Lower Urinary Tract Infections in Postmenopausal Women. A Systematic Review.

Objectives: The purpose of this systematic review was to evaluate and summarize pharmacological interventions evaluated in randomized clinical trials designed to prevent recurrent episodes of urinary tract infections (UTIs) in postmenopausal women.

Methods: Excerpta Medica dataBASE, Pubmed, Medline, and Cochrane Library were accessed to search for nonexperimental drugs evaluated in randomized clinical trials published in peer reviewed journals from January 1, 1970, to August 1, 2015, to reduce the number of recurrent UTIs in postmenopausal women.

Results: A systematic search yielded 9 articles that met eligibility criteria.

Patient-focused websites related to stress urinary incontinence and pelvic organ prolapse: a DISCERN quality analysis.

Introduction And Hypothesis: The quality of information related to pelvic floor disorders is varied and understudied. Using a validated instrument we evaluated the quality of selected websites addressing treatment options for pelvic organ prolapse (POP) and stress urinary incontinence (SUI).

Methods: English-language, patient-focused professional, governmental, and consumer websites related to POP and SUI were identified using the International Urogynecology Association (IUGA) list of continence societies worldwide, search terms, and provider nomination.

Urinary Retention After Hysterectomy and Postoperative Analgesic Use.

Objective: This study aimed to determine risk factors, including postoperative analgesic use, for the development of postoperative urinary retention (PUR) after hysterectomy for routine gynecologic indications using a case-control study design.

Methods: Cases of PUR after hysterectomy were identified from billing data. Cases were those patients requiring recatheterization for inability to void.

Correct performance of pelvic muscle exercises in women reporting prior knowledge.

Objectives: This study aimed to assess correct performance of pelvic muscle exercises (PMEs) in women presenting for urogynecologic care who express prior PME knowledge and to identify optimal instruction.

Methods: New patients referred to urogynecology clinic reporting knowledge of PME or Kegels were asked to complete a questionnaire concerning knowledge, prior instruction, and current use of PME. During examination, the participants were asked to perform their PME or Kegel.

Acute urinary retention after cesarean delivery: a case-control study.

Introduction: This study aimed to identify risk factors for postpartum urinary retention (PPUR) after cesarean delivery (CD).

Methods: A case-control study design was used. Cases of PPUR after CD were identified using billing codes for CD and "urinary retention" and confirmed by chart review.

Pharmacologic management of bladder dysfunction in adult women.

Women commonly experience lower urinary tract symptoms that can severely decrease quality of life. Symptoms are often associated with diagnoses such as urinary incontinence, overactive bladder, and bladder pain syndrome. Expanding evidence supports the effectiveness of many basic nursing interventions, including behavioral management education and optimal use of various pharmacologic agents.

Managing a pessary business.

In this final article in a series of three, components of pessary fitting, provision, and follow up are reviewed from a business perspective related to supplies, patient flow, billing, and coding.

Pessary care: follow up and management of complications.

Successful use of vaginal support pessaries requires provider and patient understanding of expected symptom-relief, potential complications, self-care options, and evaluation and treatment of pessary-related problems. This second article in a three-part series summarizes clinical recommendations and evidence related to pessary management.

Vaginal support pessaries: indications for use and fitting strategies.

Flexible silicone vaginal support pessaries offer a low-risk, effective option for treatment of symptoms of pelvic organ prolapse. This first article in a three-part series summarizes clinical recommendations and current evidence related to pessary indications, choice, and fitting.

Pharmacologic management of asymptomatic bacteriuria and urinary tract infections in women.

Many factors influence the decision to institute treatment for the common problems of urinary tract symptoms and/or the presence of microorganisms in the urine of women. This article summarizes current evidence related to treatment choice and compares selected treatment practice guidelines. Evidence related to prevention of recurrent infection without the use of antibiotics is included.

Long-term efficacy of the pubovaginal Mersilene mesh sling.

Objective: The objective of the study was to determine the efficacy of the pubovaginal Mersilene mesh sling (PVMMS) for complicated urodynamic stress incontinence (USI).

Study Design: Between 1990 and 2008, patients with USI plus an at-risk diagnosis underwent a PVMMS by a single surgeon. They were followed up with urodynamics (UDE) and Pelvic Floor Distress Inventory-short form 20 (PFDI-20).

'I'd rather just go on as I am'--pelvic floor care preferences of frail, elderly women in residential care.

Little is known about how frail, elderly women in assisted living and long-term care facilities view pelvic floor dysfunctions and treatments. Twenty-five residents reflect on these issues, and quality of life.

It's not all about birth: biomechanics applied to pelvic organ prolapse prevention.

Pelvic organ prolapse is a common and costly women's health problem. Prevention of prolapse continues to play a role in the debate about the risks and benefits of elective cesarean section, making this an important topic for midwives to understand. While some women appear to be at higher risk for prolapse because of intrinsic anatomic and physiologic factors, others have modifiable risk factors that can be addressed by health care providers.

Vaginal pressure during lifting, floor exercises, jogging, and use of hydraulic exercise machines.

We recorded vaginal pressure in 12 women without risk factors for prolapse during two activity and exercise sessions, compared exercise and cough pressure, and evaluated method reproducibility and patterns of relative pressure. Portable urodynamic equipment, repeated measures descriptive design, and purposeful sampling were used with nonparametric analysis and visual comparison of pressure graphs. Mean participant age was 31.

Age-related intraindividual performance variability with practice.

Fluctuations in cognitive task performance in older individuals have been reported. To examine intraindividual variability as a function of practice, 34 younger and 34 older female participants, aged 20-30 years and 70-82 years, respectively, performed a reading span task 16 times over four sessions. Each individual's recall accuracy was analyzed over the practice trials.

Midline anterior repair alone vs anterior repair plus vaginal paravaginal repair: a comparison of anatomic and quality of life outcomes.

Our aim was to study the anatomic recurrence rates and quality of life outcomes of patients who had undergone either anterior colporrhaphy (AC) or anterior colporrhaphy and vaginal paravaginal repair (AC + VPVR) as part of surgery for pelvic organ prolapse. Chart reviews were used to identify anatomic prolapse recurrence. Phone interviews assessed quality of life outcomes [Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ)] outcomes.

Speech, prosody, and voice characteristics of a mother and daughter with a 7;13 translocation affecting FOXP2.

Purpose: The primary goal of this case study was to describe the speech, prosody, and voice characteristics of a mother and daughter with a breakpoint in a balanced 7;13 chromosomal translocation that disrupted the transcription gene, FOXP2 (cf. J. B.

Common problems of urination in nonpregnant women: causes, current management, and prevention strategies.

This article uses a case-based approach to review common problems of urination in nonpregnant women, including overactive bladder; stress, urge, and mixed incontinence; and retention and prolapse. Up-to-date clinical issues related to assessment, diagnosis, treatment, and follow-up are reviewed, with a discussion of underlying pathophysiology and prevention strategies. Suggestions are made for relevant curriculum content at both the basic and advanced levels of advanced practice education.

Not the surgery for a young person: women's experience with vaginal closure surgery for severe prolapse.

Introduction: Vaginal prolapse can be debilitating, due to pelvic organ prolapse and herniation of the bladder, uterus, intestines and/or support tissues in the vaginal opening. However, there is little published information that documents women's experiences in the months and years after surgery to correct prolapse.

Objective: This phenomenologic study aimed to increase understanding of the specific experiences that patients report after vaginal closure surgery.

Analyzing qualitative data.

Data analysis in qualitative research is a creative process. As the instrument of data analysis, the researcher explores and reflects on the meaning of the data. In most qualitative traditions, the data analysis phase overlaps the data collection phase.