Changes in sexual function after treatment for prolapse are related to the improvement in body image perception.

Introduction: In a previous study, sexual function was related to a woman's self-perceived body image and degree of bother from pelvic organ prolapse (POP).

Aims: To evaluate sexual function, prolapse symptoms, and self-perceived body image 6 months following treatment for POP and to explore differences in body image perception and sexual function following conservative and surgical treatment for POP.

Methods: After institutional review board approval, consecutive women with > or = stage II POP were invited to participate.

Do the causes of psychotic symptoms matter?

There needs to be a better understanding of how psychoses and other serious mental illnesses develop. They do not develop in isolation but are connected with subsequent events that impose themselves on the individual. Predispositions, via heredity, starts the process, but it is what happens subsequently in the environment that leads to interactions that are dynamic.

[A surprise in the bladder: the case of the misplaced gortex].

A fifty-three-year-old vaginally primipara was evaluated for urinary mixed incontinence symptoms and POP-Q stage II pelvic organ prolapse. Her past medical history was significant for Burch colposuspension conducted six years prior to her referral. Review of the operative report indicated prior use of six peri-urethral gortex sutures attached to Cooper's ligament.

Tolterodine causes measurable restoration of urethral sensation in women with urge urinary incontinence.

Unlabelled: INTRODUCTION & HYPOTHESIS: Determine if treatment of urge incontinence with tolterodine results in changes in bladder and/or urethral sensation using Current Perception Threshold (CPT) testing.

Methods: Women with >or=1 incontinence episode on 7-day diary were treated with 4 mg of long-acting tolterodine for 2-months. At baseline and 2-months, participants had CPT testing of the urethral and bladder at 3 frequencies 2000, 250, and 5 Hz.

Sexual function is related to body image perception in women with pelvic organ prolapse.

Introduction: A previous study demonstrated that women seeking treatment for advanced pelvic organ prolapsed (POP) reported decreased self-perceived body image and decreased quality of life.

Aims: To determine the relationship between: (i) sexual function and POP, (ii) self-perceived body image and POP; and (iii) sexual function and self-perceived body image in women with prolapse.

Methods: After IRB approval, consecutive women with POP stage II or greater presenting for urogynecologic care at one of eight academic medical centers in the United States were invited to participate.

Transabdominal uterosacral suspension: outcomes and complications.

Objective: The objective of the study was to report outcomes and complications following abdominal uterosacral suspension (AUSS) for treatment of pelvic organ prolapse.

Study Design: This was a surgical case series of consecutive women who underwent AUSS between 2002 and 2005.

Results: One hundred seven women underwent AUSS using permanent suture (mean age, 55 years; range, 32-83; and mean follow-up, 21; range, 3-74 months).

Patients with painful bladder syndrome have altered response to thermal stimuli and catastrophic reaction to painful experiences.

Aims: To compare cutaneous sensory thresholds, habituation to somatic stimuli, and tendency towards catastrophic reaction to painful stimuli in patients with Painful Bladder Syndrome (PBS) to controls without PBS.

Method: Thermal and vibratory sensory thresholds were established in 11 PBS patients and 10 controls at C5, T1, T12, and S3 dermatomes. Supra-threshold thermal stimuli were then applied at T12 and S3 for 60 sec while patients periodically rated the intensity of stimuli using a visual analog scale.

Observations relating to urinary sensation during detrusor overactivity.

Aims: To describe the temporal relationship between increases in lower urinary tract (LUT) sensation and changes in detrusor and/or urethral pressures measured in real time.

Methods: We reviewed 33 multichannel urodynamic tracings that included a continuous recording of LUT sensation and that demonstrated detrusor overactivity incontinence (DOI) or detrusor overactivity (DO). Four physicians reviewed each urodynamic tracing and reached agreement about the temporal relationship between LUT sensation and detrusor contraction.

Evaluation of urgency in women, with a validated Urgency, Severity and Impact Questionnaire (USIQ).

The objective of this study is to develop a validated, patient-oriented questionnaire to assess urgency and associated life impact. We interviewed six urogynecologists and urologists and five patients with overactive bladder (OAB) symptoms about urinary urgency. Based on this data, we composed the first draft of our Urgency Severity and Impact Questionnaire (USIQ).

Urinary retention is uncommon after colpocleisis with concomitant mid-urethral sling.

The purpose of this study was to evaluate the effect of colpocleisis and concomitant mid-urethral sling on voiding function. This is an IRB-approved, retrospective case series of women who underwent a colpocleisis with concomitant synthetic mid-urethral sling for treatment of stress urinary incontinence (SUI) between January 2005 and September 2007. Thirty-eight women with pelvic organ prolapse and SUI symptoms were included.

Modulation of heart rate variability by estrogen in young women undergoing induction of ovulation.

Estrogens are involved in the modulation of the cardiovascular system, yet their effects in young women remains largely unknown. Women who undergo ovulation induction treatments attain extremely high estrogen concentrations during a very short time period. The aim of the present study was to evaluate the effects of an acute increase in estrogens on the autonomic nervous system modulation of heart rate variability (HRV).

Graft use in transvaginal pelvic organ prolapse repair: a systematic review.

Objective: To estimate the anatomic and symptomatic efficacy of graft use in transvaginal prolapse repair and to estimate the rates and describe the spectrum of adverse events associated with graft use.

Data Sources: Eligible studies, published between 1950 and November 27, 2007, were retrieved through Medline and bibliography searches.

Methods Of Study Selection: To assess anatomic and symptomatic efficacy of graft use, we used transvaginal prolapse repair studies that compared graft use with either native tissue repair or repair with a different graft.

Comparison between sensory testing modalities for the evaluation of afferent nerve functioning in the genital area.

Determine the reproducibility and relationship between current perception threshold testing (CPT) and quantitative sensory testing (QST) in the genital area. Sixteen women underwent CPT and QST of the vagina. CPT was done at 2,000, 250, and 5 Hz (corresponding to A-beta, A-delta, and C fibers, respectively), and QST testing was done using thermal (C fibers), vibratory (A-beta fibers), and cold (A-delta and C fibers) sensation.

Urogynecology and sexual function research. How are we doing?

Introduction: Urinary incontinence (UI) and pelvic organ prolapse (POP) negatively impact health-related quality of life by affecting daily activities, body image, and sexual relationships.

Aim: To evaluate interest in sexual function (SF) research among urogynecologists.

Main Outcome Measures: The rate of abstracts presented at national meetings that dealt with SF over a 5-year period.

Clinically useful measures in women with mixed urinary incontinence.

Objective: The purposes of this study were to assess: 1) clinically relevant relationships between urinary diary and quality of life, and 2) reproducibility of validated questionnaires and urinary diaries in women with mixed urinary incontinence symptoms (MUI).

Study Design: Forty-seven women with MUI completed 7-day diaries, the Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire, and Medical, Epidemiological, and Social Aspects of Aging questionnaire 2 weeks apart.

Results: The number of urge incontinence episodes predicted incontinence severity on UDI-6 (R(2) = .

Mixed incontinence is more bothersome than pure incontinence subtypes.

The purpose of the study was to compare incontinence bother in women with mixed incontinence versus pure incontinence subtypes. This is an institutional review board-approved study comparing physical exam findings and responses to the Medical Epidemiologic and Social Aspects of Aging (MESA) questionnaire and the Urinary Distress Inventory (UDI-6). The MESA responses were used to classify women as mixed, pure stress, or pure urge incontinence.

The relationship between obstructive sleep apnea, nocturia, and daytime overactive bladder syndrome in women.

Objective: The purpose of this study was to corroborate the association between obstructive sleep apnea (OSA) and nocturia in a clinical sample of urogynecologic patients and to explore whether night-time urine concentration predicts the presence of OSA.

Study Design: Patients with nocturia and control subjects underwent a home sleep study, completed validated nocturia questionnaires, and provided evening and morning urine specimens that were analyzed for osmolarity.

Results: Twenty-one patients with nocturia (16 of whom also had daytime overactive bladder [OAB] symptoms) and 10 control subjects were studied.

Validation of a real-time urodynamic measure of urinary sensation.

Objective: The purpose of this study was to test the feasibility and validity of a continuous measurement of urinary sensation during cystometry.

Study Design: Subjects continuously recorded their level of urinary sensation during cystometry with the use of urodynamic diagnoses and responses to the Medical Epidemiologic and Social Aspects of Aging (MESA) and Urinary Distress Inventory (UDI) scales. Trends in urinary sensation recordings by increasing percentage of maximum cystometric capacity (MCC) were captured and compared with the use of growth curves.

Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA.

A diet high in fruits and vegetables (F&V) has been associated with a decreased risk of certain cancers, reduced morbidity and mortality from heart disease, and enhanced weight management. Yet to date, most of the US population does not consume the recommended amount of F&V despite numerous interventions and government guidelines to promote consumption. Research has found various impediments to F&V consumption, such as high costs, an obesogenic environment and low socio-economic status.

Obstructive voiding symptoms are not predictive of elevated postvoid residual urine volumes.

The aim of this study is to explore the relationship between measured postvoid residual urine volumes (PVR) and self-reported bother from obstructive voiding symptoms (OS) using a retrospective chart review of patients presenting to our clinic from 2004 to 2005. Demographic, primary clinical diagnoses, PVR, and responses to the short form of the Pelvic Floor Distress Inventory (PFDI-20) were recorded. We considered a PVR > 150 ml to be elevated or consistent with urinary retention.