The prostate in women: an updated histological and immunohistochemical profile of the female periurethral glands and their relationship to an implanted midurethral sling.

Background: There is evidence of glandular tissue in the region of the anterior vaginal wall-female periurethral tissue (AVW-FPT) that has similar morphology and immunohistochemistry to the prostate in men. Surgical injury to this tissue has been suggested as a potential cause of sexual dysfunction following midurethral sling (MUS) procedures. However, the anatomy and embryology of these glands have not been fully resolved.

International Urogynecology Consultation Chapter 1 Committee 5: relationship of pelvic organ prolapse to associated pelvic floor dysfunction symptoms: lower urinary tract, bowel, sexual dysfunction and abdominopelvic pain.

Introduction And Hypothesis: This article from Chapter 1 of the International Urogynecology Consultation (IUC) on Pelvic Organ Prolapse (POP) establishes the prevalence of lower urinary tract disorders, bowel symptoms, vulvo-vaginal/lower abdominal/back pain and sexual dysfunction in women with POP.

Methods: An international group of nine urogynecologists/urologists and one medical student performed a search of the literature using pre-specified search terms in Ovid, MEDLINE, Embase and CINAHL from January 2000 to March 2019. Publications were eliminated if not relevant or they did not include clear definitions of POP or the symptoms associated with POP.

Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial.

Introduction And Hypothesis: This single-blind, randomised controlled trial was aimed at determining whether peri-operative physiotherapist-supervised pelvic floor muscle (PFM) training was superior to standard care (handout) in terms of improvements in stress urinary incontinence (SUI) symptoms, cure rate, and/or post-operative filling or voiding symptoms among women undergoing surgical mid-urethral sling (MUS) insertion for SUI.

Methods: Women with SUI were recruited from surgical wait lists at four participating urogynecology clinics. Participants were assessed at baseline (V1) then randomised (1:1 allocation) to receive supervised PFM training or a handout.

Guideline No. 411: Vaginal Pessary Use.

Objective: To review the use, care, and fitting of pessaries.

Target Population: Women requiring the use of vaginal pessaries for pelvic organ prolapse and/or stress urinary incontinence. Use may also be indicated for women with certain pregnancy-related clinical scenarios, including incarcerated uterus.

Directive clinique n° 411 : Utilisation des pessaires.

Objectif: Passer en revue l'utilisation, l'entretien et l'ajustement des pessaires.

Population Cible: Les femmes qui ont besoin d'utiliser un pessaire en raison d'un prolapsus génital et/ou d'une incontinence urinaire d'effort. L'utilisation peut être indiquée chez les femmes enceintes dans certains scénarios cliniques liés à la grossesse, dont l'incarcération utérine et le risque de travail préterme liée à l'incompétence du col.

A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence.

Introduction And Hypothesis: The aim of this study was to prospectively identify aspects of baseline demographic, clinical, and pelvic morphology of women with stress urinary incontinence (SUI) that are predictive of cure with physiotherapist-supervised pelvic floor muscle training (PFMT).

Methods: Women ≥18 years old with SUI were recruited from urogynecology and pelvic health physiotherapy clinics. Participants completed a 3-day bladder diary, the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF), a standardized pad test, manual assessment of pelvic floor muscle (PFM) strength and tone, and transperineal ultrasound (TPUS) assessment of their urogenital structures at rest while in a supine position and standing, and during contraction, straining, and coughing.

Retrospective Comparison of PGE Vaginal Insert and Foley Catheter for Outpatient Cervical Ripening.

Objective: To compare the efficacy of two methods of outpatient cervical ripening (CR): an intracervical Foley catheter and a prostaglandin E (PGE) slow-release vaginal insert.

Methods: All records of women receiving outpatient CR at a tertiary care hospital from January 2017 to June 2018 were retrospectively reviewed. We compared time from insertion of first CR agent until delivery between groups using a Cox proportional hazards (CPH) model.

Testing for Occult Stress Urinary Incontinence in Patients With Pelvic Organ Prolapse? Results of a Pragmatic Approach.

Objective: Pelvic organ prolapse (POP) surgery may unmask occult stress urinary incontinence (OSUI) in otherwise asymptomatic patients. Preoperative urodynamic studies (UDSs) with prolapse reduction may, by potentially unmasking OSUI, assist surgical decision making. This study investigated the long-term objective postoperative rate of SUI, according to the presence of OSUI.

Urinary incontinence among competitive rope-skipping athletes: a cross-sectional study.

Introduction And Hypothesis: The purpose of this study was to determine the prevalence, impact and management of stress urinary incontinence (SUI) among rope-skipping (RS) athletes.

Methods: A cross-sectional observational study was employed. Survey #1 (current athletes): RS athletes aged ≥13 years attending a national RS competition (183) were invited to participate.

Obstetrical Anal Sphincter Injuries: Does Obstetrical Care Provider Matter? A Quality Assurance Study in Ontario.

Objectives: We sought to determine the rates of obstetrical anal sphincter tears (OASIS) between types of obstetrical care providers at Kingston General Hospital (KGH) and in Ontario via the Better Outcomes Registry Network (BORN).

Methods: This cross-sectional study collected patient, demographic, and delivery data from all vaginal deliveries at KGH from June 2011 to June 2014 and all vaginal deliveries through the BORN database from June 2012 to June 2014.

Results: During this period, 4.

Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair.

Objective: To review the evidence relating to obstetrical anal sphincter injuries (OASIS) with respect to diagnosis, repair techniques and outcomes. To formulate recommendations as to patient counselling regarding route of delivery for subsequent pregnancy after OASIS.

Options: Obstetrical care providers caring for women with OASIS have the option of repairing the anal sphincter using end-to-end or overlapping techniques.

RETIRED: Technical update on pessary use.

This document has been archived because it contains outdated information. It should not be consulted for clinical use, but for historical research only. Please visit the journal website for the most recent guidelines.

Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing.

Aims: The purpose of this study was to determine the effect of a 12-week pelvic floor muscle (PFM) training program on urethral morphology and mobility in women with stress urinary incontinence (SUI).

Methods: Forty women with SUI were randomly assigned to one of two groups: the treatment group received 12 weekly physiotherapy sessions during which they learned how to properly contract their pelvic floor muscles (PFMs) and a home exercise program was prescribed, reviewed, and progressed; the control group received no treatment. Before and after the 12-week study period, ultrasound imaging was used to evaluate bladder neck position and mobility during coughing and Valsalva maneuver in supine and in standing, as well as urethral morphology.

Postpartum maternal codeine therapy and the risk of adverse neonatal outcomes: a retrospective cohort study.

Objectives: To examine whether postpartum maternal prescription of codeine was associated with an increased risk of harm to newborns.

Design: Population-based retrospective cohort study.

Setting: Ontario, Canada, from April 1, 1998 to March 1, 2008.

Women with stress urinary incontinence demonstrate motor control differences during coughing.

Introduction: This study compared the patterns of pelvic floor muscle (PFM) activity during coughing between women with stress urinary incontinence (SUI) and continent women, using surface electromyography (EMG) and posterior vaginal wall (PVW) pressure.

Methods: Twenty-four women participated: eight continent, eight with mild SUI and eight with severe SUI. Volunteers performed three maximum coughs in supine and standing.

Confirmation of ureteric patency during cystoscopy using phenazopyridine HCl: a low-cost approach.

Objective: To describe the use of oral phenazopyridine (Pyridium) prior to pelvic surgery to facilitate intraoperative confirmation of ureteric patency.

Materials And Methods: We performed a chart review of women given phenazopyridine preoperatively prior to pelvic surgery in a tertiary care centre between July 2004 and June 2005. The primary outcome was the cystoscopic observation of bilateral ureteric urine efflux.

Procidentia-induced perinephric and subcutaneous abscesses.

Total uterine prolapse, or procidentia, rarely causes obstructive uropathy. Procidentia-induced perinephric abscess has not been reported to date. We present a case of perinephric and subcutaneous abscesses secondary to procidentia-induced hydronephrosis and forniceal rupture of Staphylococcus aureus-infected urine.

Women with SUI demonstrate motor control differences during voluntary pelvic floor muscle contractions.

Introduction And Hypothesis: To compare maximum abdominal and pelvic floor muscle (PFM) electromyographic (EMG) and intravaginal pressure (IVP) amplitudes and muscle activation patterns during voluntary PFM contractions between women with and without stress urinary incontinence (SUI).

Methods: Twenty-eight continent women and 44 women with SUI performed single and repeated PFM contractions in supine. Surface EMG data were recorded simultaneously with IVP.

Mid-trimester serum relaxin concentrations and post-partum pelvic floor dysfunction.

Objectives: To compare mid-trimester serum relaxin concentration (SRC) in primiparous women with or without pelvic floor dysfunction (PFD--stress urinary incontinence (SUI), genital prolapse).

Design: Nested observational cohort study.

Setting: Urogynecology clinic of affiliated University hospital.

Ethical issues associated with the introduction of new surgical devices, or just because we can, doesn't mean we should.

Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed.