Fluids affecting bladder urgency and lower urinary symptoms: results from a randomized controlled trial.

Introduction And Hypothesis: Caffeinated, alcoholic, artificially sweetened, carbonated, and acidic beverages are pervasive and consumed in large quantities. Reputedly, these beverages are "irritating to the bladder" and result in heightened void frequency, but prior studies lack control for intake volume. We tested the null hypothesis that women recruited from the community who demonstrate overactive bladder symptoms will show no difference by groups in void frequency when one group is instructed to replace listed beverages by substituting non-irritants (emphasis on water or milk) and the other group is instructed in healthy eating.

Stigma Associated With Pelvic Floor Disorders.

Objectives: Although the impact of stigma is known for women with urinary incontinence, it has not been well studied among the full spectrum of pelvic floor disorders. This study quantifies the level of stigma among women presenting for urogynecologic care and tests the hypothesis that stigma related to pelvic floor disorders results in a delay in care seeking for these problems.

Methods: Women presenting for new patient visits (N = 523) in university medical center-based urogynecology clinics completed 2 anonymous questionnaires (Stigma Scale for Chronic Illnesses 8-item version and Pelvic Floor Bother Questionnaire) before their visit.

Fluids affecting bladder urgency and lower urinary symptoms (FABULUS): methods and protocol for a randomized controlled trial.

Introduction And Hypothesis: We present the design of a randomized controlled trial, Fluids Affecting Bladder Urgency and Lower Urinary Symptoms (FABULUS), with the purpose of testing the common clinical advice of treating overactive bladder by eliminating potentially irritating beverages (PIBs) that are caffeinated, artificially sweetened, citric, or alcoholic. The primary hypothesis is that women taught to reduce PIBs will show less void frequency compared with a control group instructed in diet/exercise recommendations. Secondary outcomes include change in urgency symptoms and volume per void.

American Urogynecologic Society Systematic Review: The Impact of Weight Loss Intervention on Lower Urinary Tract Symptoms and Urinary Incontinence in Overweight and Obese Women.

Objective: Obesity can contribute to urinary symptoms such as urgency, frequency, and incontinence. In addition to classic treatments, weight loss interventions offer a unique clinical opportunity to improve these symptoms.

Study Design: The American Urogynecologic Society Systematic Review Group conducted a review of articles on the impact of surgical and behavioral weight loss (BWL) interventions on urinary symptoms in overweight and obese women.

Surgical interventions for posterior compartment prolapse and obstructed defecation symptoms: a systematic review with clinical practice recommendations.

Introduction And Hypothesis: Several posterior compartment surgical approaches are used to address posterior vaginal wall prolapse and obstructed defecation. We aimed to compare outcomes for both conditions among different surgical approaches.

Methods: A systematic review was performed comparing the impact of surgical interventions in the posterior compartment on prolapse and defecatory symptoms.

Microscopic Hematuria as a Screening Tool for Urologic Malignancies in Women.

Introduction: Most causes of microscopic hematuria (MH) are benign but may indicate an underlying malignancy. Current MH evaluation guidelines are reflective of male urologic malignancy risks. The objective of this systematic review was to evaluate whether the finding of MH predicts subsequent urologic malignancy in women.

Comparison of Serum Vitamin D Levels in Relation to Bowel and Bladder Symptoms in Women with Vulvar Diseases.

We sought to investigate associations between vitamin D levels and bowel and bladder disorders in women with vulvar diseases. This is a planned sub-analysis of a cross-sectional study comparing the prevalence of bowel and bladder symptoms in women with biopsy-proven vulvar lichen sclerosus (LS) to a control group of women with non-lichenoid vulvar diseases. All subjects were recruited from a tertiary referral vulvar care clinic in a university-based practice.

Completion of a validated pelvic floor symptom and bother instrument in real-life practice.

Introduction And Hypothesis: Validated questionnaires are commonly used in research, but successful completion rates in clinical settings are largely unknown. The primary goal of this study was to assess the frequency of appropriate completion of a validated research survey. We secondarily examined relationships between demographics and successful questionnaire completion.

Preemptive analgesia for postoperative hysterectomy pain control: systematic review and clinical practice guidelines.

Objective: The objective of the study was to investigate the effectiveness of preemptive analgesia at pain control in women undergoing total abdominal hysterectomy.

Data Sources: Eligible studies, published through May 31, 2016, were retrieved through Medline, Cochrane Central Register for Controlled Trials, and Cochrane Database of Systematic Reviews.

Study Eligibility: We included randomized controlled trials with the primary outcome of pain control in women receiving a preemptive medication prior to total abdominal hysterectomy.

Resident Education in Female Pelvic Medicine and Reconstructive Surgery.

Objective: The aim of this study was to evaluate whether obstetrics and gynecology trainees feel satisfied with the female pelvic medicine and reconstructive surgery (FPMRS) education received in residency.

Methods: This is a survey study of obstetrics and gynecology residents in the United States and Puerto Rico during the 2015-2016 academic year. The anonymous 29-question survey was approved by the Hartford HealthCare institutional review board.

Patient Satisfaction With Nurse-Led Telephone Follow-up in an Ambulatory Setting.

Objectives: We studied our practice of using nurse telephone follow-up under physician direction to assess symptom improvement and patient satisfaction.

Methods: Women were recruited when their clinical care merited nurse telephone follow-up in the opinion of the attending physician. Women specified a preferred telephone number and completed a symptom questionnaire at the time of enrollment.

Graft and Mesh Use in Transvaginal Prolapse Repair: A Systematic Review.

Objective: To update clinical practice guidelines on graft and mesh use in transvaginal pelvic organ prolapse repair based on systematic review.

Data Sources: Eligible studies, published through April 2015, were retrieved through ClinicalTrials.gov, MEDLINE, and Cochrane databases and bibliography searches.

Defining Patient Knowledge and Perceptions of Vaginal Pessaries for Prolapse and Incontinence.

Objective: The aim of this study was to define patient knowledge and perceptions of pessaries to identify barriers to care and inform physician counseling efforts.

Methods: An anonymous survey was distributed to a convenience sample of new patients presenting to the urogynecology clinic at a single academic medical center. Data analysis was performed using standard bivariate and logistic regression models.

Does Instruction to Eliminate Coffee, Tea, Alcohol, Carbonated, and Artificially Sweetened Beverages Improve Lower Urinary Tract Symptoms?: A Prospective Trial.

Purpose: Common advice for lower urinary tract symptoms (LUTS) such as frequency, urgency, and related bother includes elimination of potentially irritating beverages (coffee, tea, alcohol, and carbonated and/or artificially sweetened beverages). The purpose of this study was to determine compliance with standardized instruction to eliminate these potentially irritating beverages, whether LUTS improved after instruction, and whether symptoms worsened with partial reintroduction.

Design: The 3-phase fixed sequence design was (1) baseline, (2) eliminate potentially irritating beverages listed above, and (3) reintroduce at 50% of baseline volume, with a washout period between each 3-day phase.

Left-sided sacrospinous ligament suspension for treating recurrent sigmoid neovagina prolapse.

Numerous techniques for surgical creation of a neovagina have been described for treating Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Sigmoid vaginoplasty is one well-described technique with satisfactory long-term outcomes. However, there are several case reports of subsequent prolapse of the sigmoid neovagina, which presents a unique challenge for surgical repair, as the associated mesentery can also be involved and is at risk during repair.

Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis.

Objective: Understanding the long-term comparative effectiveness of competing surgical repairs is essential as failures after primary interventions for stress urinary incontinence (SUI) may result in a third of women requiring repeat surgery.

Study Design: We conducted a systematic review including English-language randomized controlled trials from 1990 through April 2013 with a minimum 12 months of follow-up comparing a sling procedure for SUI to another sling or Burch urethropexy. When at least 3 randomized controlled trials compared the same surgeries for the same outcome, we performed random effects model metaanalyses to estimate pooled odds ratios (ORs).

Defining patients' knowledge and perceptions of vaginal mesh surgery.

Objective: Given recent government investigations and media coverage of the controversy regarding mesh surgery, we sought to define patients' knowledge and perceptions of vaginal mesh surgery.

Study Design: An anonymous survey was distributed to a convenience sample of new patients at urogynecology and female urology clinics at a single medical center during April to June 2012. The survey assessed patients' demographics, information sources, and beliefs and concerns regarding mesh surgery.

Pathologic evaluation of explanted vaginal mesh: interdisciplinary experience from a referral center.

Objectives: In light of vaginal mesh safety concerns, we reviewed our institutional experience with analytic processes and pathologic findings of explanted vaginal mesh to identify problems and opportunities to facilitate improved documentation and research.

Methods: We reviewed gross and microscopic pathology reports and archival slides of explanted mesh specimens from January 2010 through February 2012. Specimen requisition clinical history, number of mesh specimens per case, and type of examination (gross or histologic) were abstracted from pathology records using the initial search word "mesh".

Pyogenic spondylodiscitis associated with sacral colpopexy and rectopexy: report of two cases and evaluation of the literature.

Pyogenic spondylodiscitis includes a spectrum of spinal infections such as discitis, osteomyelitis, epidural abscess, meningitis, subdural empyema, and spinal cord abscess. This is a rare complication of sacral colpopexy, but can lead to devastating consequences for the patient. We present two cases of pyogenic spondylodiscitis following sacral colpopexy.

Antibiotic prophylaxis for selected gynecologic surgeries.

Background: Antibiotic prophylaxis for surgery is commonly used and is recommended by multiple organizations.

Objective: To critically review gynecology-specific data regarding surgical antibiotic prophylaxis in selected benign gynecologic surgeries.

Search Strategy: MEDLINE and Cochrane databases were searched from inception to July 2010.

Surgeon practice patterns for antibiotic prophylaxis in gynecologic surgery.

Objective: To assess surgeon practice patterns for antibiotic prophylaxis in gynecologic surgery.

Methods: A survey was distributed at the 2011 annual scientific meeting of the Society of Gynecologic Surgeons regarding antibiotic prophylaxis practices.

Results: The response rate was 51%.