MicroRNA-30d and microRNA-181a regulate HOXA11 expression in the uterosacral ligaments and are overexpressed in pelvic organ prolapse.

The balanced turnover of collagen is necessary to maintain the mechanical strength of pelvic supportive connective tissues. Homeobox (HOX) A11 is a key transcriptional factor that controls collagen metabolism and homoeostasis in the uterosacral ligaments (USLs), and the deficient HOXA11 signalling may contribute to alterations in the biochemical strength of the USLs, leading to pelvic organ prolapse (POP). However, it is unknown how HOXA11 transcripts are regulated in the USLs.

NGF and HB-EGF: potential biomarkers that reflect the effects of fesoterodine in patients with overactive bladder syndrome.

Purpose: To determine whether levels of nerve growth factor (NGF) and heparin-binding epidermal growth factor-like growth factor (HB-EGF) can be used to objectively assess overactive bladder syndrome (OAB) treatment outcome and to evaluate the effects of fixed-dose fesoterodine on OAB symptoms.

Materials And Methods: This study included 124 participants (62 patients with OAB and 62 controls) in Severance Hospital between 2010 and 2012. In patients with OAB, 4 mg fesoterodine was administered once daily.

The significance and factors related to bladder outlet obstruction in pelvic floor dysfunction in preoperative urodynamic studies: A retrospective cohort study.

Objective: To demonstrate the significance of bladder outlet obstruction (BOO) in preoperative urodynamic studies (UDS) in women who have been diagnosed with pelvic floor dysfunction including pelvic organ prolapsed (POP) and stress urinary incontinence (SUI).

Methods: The medical records of 150 patients with pelvic floor dysfunction who underwent preoperative UDS at Yonsei University Health System from 2006 to 2012 were reviewed. Under the criteria of BOO, as a maximal flow rate in free-flow study (Qmax) less than 12 mL/sec and a detrusor pressure at Qmax in pressure-flow study (PdetQmax) higher than 20 cmH2O in UDS, they were divided into two groups: a group of 50 patients with BOO and a group of 100 patients without BOO.

Comparison of midurethral sling outcomes with and without concomitant prolapse repair.

Objective: We compared the outcomes of the midurethral sling (MUS) with and without concomitant prolapse repair.

Methods: We retrospectively reviewed the outcomes of 203 women who underwent MUS at Severance Hospital from January 2009 to April 2012 with and without concomitant prolapse repair. Patients completed the urogenital distress inventory questionnaire preoperatively and postoperatively.

Changes in sexual function and comparison of questionnaires following surgery for pelvic organ prolapse.

Purpose: The aim of this study was to evaluate the effect of surgical repair of pelvic organ prolapse on female sexual function and to assess correlations between the two using two current standardized questionnaires.

Materials And Methods: From October 2009 to September 2010, 143 patients with posterior compartment or combined vaginal prolapse were included. We assessed surgical outcomes according to anatomical change in the vagina and results of the Female Sexual Function Index (FSFI) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12) both pre- and postoperatively.

Alteration of elastin metabolism in women with pelvic organ prolapse.

Purpose: Although there are many studies about the effects of vaginal birth, the effects of menopause on pelvic floor support have not been identified. We compared elastin metabolism in the uterosacral ligament of women with and without pelvic organ prolapse, and defined the menopausal regulation of this process.

Materials And Methods: The study group consisted of 35 women who underwent hysterectomy for pelvic organ prolapse.

Comparison of Burch colposuspension and transobturator tape when combined with abdominal sacrocolpopexy.

Objective: To compare the treatment outcomes of Burch colposuspension and transobturator tape (TOT) when each is combined with abdominal sacrocolpopexy (ASC) to treat stress urinary incontinence (SUI) with pelvic organ prolapse (POP).

Methods: Consecutive cases of Burch colposuspension and TOT combined with ASC were retrospectively reviewed. Patients with SUI and POP beyond stage III--according to the POP-quantification system--were included.

Risk factors associated with voiding dysfunction after anti-incontinence surgery.

Introduction And Hypothesis: The aim of this study is to investigate the risk factors of voiding dysfunction occurring within 1 month after surgical treatment of urinary incontinence.

Methods: Medical records of 903 women who underwent anti-incontinence surgery at Yonsei Medical Health System from January 1999 to April 2007 were reviewed. The patient demographics, urodynamic parameters, pelvic organ prolapse stage, surgical procedures, and concomitant surgery were retrospectively evaluated.

A long-term treatment outcome of abdominal sacrocolpopexy.

Purpose: The aim of this study was to evaluate the long-term treatment outcome and major complication rates of abdominal sacrocolpopexy (ASC).

Materials And Methods: This retrospective study included 57 Korean women who underwent ASC with mesh for symptomatic uterine or vault prolapse and attended follow-up visits for at least 5 years. Forty-seven women with urodynamic stress incontinence concomitantly received a modified Burch colposuspension.

Perioperative and long-term complications among obese women undergoing vaginal surgery.

Objective: To determine whether obesity influenced the risk of perioperative and long-term complications in patients undergoing vaginal surgery.

Methods: Women diagnosed with pelvic organ prolapse who underwent vaginal surgery between March 1999 and May 2007 were classified into 3 groups: normal weight (body mass index [BMI, calculated as weight in kilograms divided by the square of height in meters] 18.5-23.

Polymorphism of a COLIA1 gene Sp1 binding site in Korean women with pelvic organ prolapse.

Purpose: To evaluate the possible influence of G-->T substitution at the Sp1-binding site of the COLIA1 gene on the risk of pelvic organ prolapse (POP).

Materials And Methods: The study group consisted of 15 women with advanced stage POP. Fifteen control subjects with uterine myomas among the postmenopausal women were matched for age and parity.

Preoperative maximum urethral closure pressure and valsalva leak point pressure as predictive parameters for midurethral sling.

Objective: To evaluate the efficacy of tension-free vaginal tape (TVT) and transobturator tape (TOT) according to urethral function based on a preoperative urodynamic study (UDS).

Study Design: Preoperative Valsalva leak point pressure (VLPP) and maximum urethral closure pressure (MUCP) were compared with the actual surgical outcome, and patients were followed for > 1 year. Student's t test, chi2 test, multiple regression analysis and receiver operating character curve analysis were used for statistical analysis.

Changes in expression of fibulin-5 and lysyl oxidase-like 1 associated with pelvic organ prolapse.

Objectives: Pelvic organ prolapse is associated with defects in connective tissue including elastic fibers. The purpose of this study was to investigate expression of fibulin-5 and lysyl oxidase-like 1, which play an essential role in synthesis and assembly of elastic fibers in the uterosacral ligament, in samples taken from women with advanced pelvic organ prolapse compared with controls.

Study Design: Specimens were obtained prospectively during abdominal hysterectomy from 30 women with advanced pelvic organ prolapse and 30 controls matched to the study group for age and parity among postmenopausal women with benign gynecologic pathology.

The relationship between COL3A1 exon 31 polymorphism and pelvic organ prolapse.

Purpose: We investigated the role of COL3A1 exon 31 polymorphism (a single base substitution from guanine to adenine at +2092), resulting in the replacement of alanine with threonine at the 698th amino acid of COL3A1, in the pathogenesis of pelvic organ prolapse.

Materials And Methods: A total of 72 postmenopausal Korean women who were not on hormonal replacement therapy and who had a history of vaginal childbirth were enrolled in this study. The patient group consisted of 36 women diagnosed with stage II or greater pelvic organ prolapse irrespective of urodynamic stress incontinence.

Risk factors for the recurrence of pelvic organ prolapse.

Background/aims: To investigate the risk factors for the recurrence of prolapse after traditional pelvic reconstructive surgery.

Methods: The medical records of 212 patients who received traditional restorative reconstructive surgeries for symptomatic pelvic organ prolapse from March 1999 to April 2006 were retrospectively analyzed. Recurrence was defined as any prolapse of stage II or greater according to the Pelvic Organ Prolapse Quantification system.

Comparison of the treatment outcome of pubovaginal sling, tension-free vaginal tape, and transobturator tape for stress urinary incontinence with intrinsic sphincter deficiency.

Objective: The aim of this study was to compare the treatment outcome of 3 sling procedures for stress urinary incontinence with intrinsic sphincter deficiency.

Study Design: This retrospective study included 253 patients who underwent incontinence surgery (pubovaginal sling [PVS] = 87, tension-free vaginal tape [TVT] = 94, and transobturator tape [TOT] = 72) for urodynamic stress incontinence with intrinsic sphincter deficiency. Analysis of variance, chi(2) test, Fisher's exact test, Kaplan-Meier survival analysis, and Cox proportional hazard regression were used for statistical analysis.

Is hysterectomy or the use of graft necessary for the reconstructive surgery for uterine prolapse?

The aim of this study was to evaluate whether hysterectomy or the use of graft is necessary for the reconstructive surgery for uterine prolapse. One hundred sixty-eight patients were categorized into the 3 groups: group I, abdominosacral colpopexy with mesh and hysterectomy (n=63); group II, abdominosacral uteropexy with mesh (n=35); group III, abdominal uterosacrocardinal colpopexy and hysterectomy (n=70). Perioperative and postoperative complications, functional outcomes, and anatomical recurrences were assessed.

Surgical therapeutic index of tension-free vaginal tape and transobturator tape for stress urinary incontinence.

Background/aims: The aim of this study was to obtain the surgical therapeutic index (STI) of tension-free vaginal tape (TVT) and transobturator tape (TOT) and compare it with the previously obtained result of Burch colposuspension.

Methods: The study population consisted of 121 patients who were diagnosed as having stress urinary incontinence, underwent TVT or TOT between January 1, 2000 and June 30, 2005 and were followed up for at least 1 year. Patients with detrusor overactivity, urinary tract infection, intrinsic sphincter deficiency and pelvic organ prolapse more than stage II according to the POP-Q system were excluded.

Treatment outcome of tension-free vaginal tape in stress urinary incontinence: comparison of intrinsic sphincter deficiency and nonintrinsic sphincter deficiency patients.

The object of this study was to compare the treatment outcomes of tension-free vaginal tape (TVT) for intrinsic sphincter deficiency (ISD) and nonintrinsic sphincter deficiency (NISD) patients in stress urinary incontinence (SUI) and to evaluate whether TVT can be effectively used in both groups of patients. 111 women with SUI treated by TVT procedure from June 2003 to June 2005 with follow-ups for at least 1 year postoperatively were included in this study. The patients were divided into two groups: 31 patients with ISD and 80 patients with NISD.

Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature.

Through the experience of five cases of leiomyoma developed in the female bladder and urethra with a review of the literature, we have made an effort to characterize the association of symptom with the size and location of the tumor and demonstrate an appropriate treatment. The study population was composed of patients who underwent surgery for bladder or urethral leiomyoma in our hospital from March 1990 to April 2005. Their medical records were reviewed retrospectively concerning the symptom, size and location of leiomyoma, the result of cystoscope and radiological examination, surgical method, pathologic report, complications, and recurrence.

Implication of ADAM-8, -9, -10, -12, -15, -17, and ADAMTS-1 in implantational remodeling of a mouse uterus.

In the present study, whether the ADAM-8, -9, -10, -12, -15, -17, and ADAMTS-1 proteins might play a role in mouse uterus during periimplantation period was investigated. Immunoblotting analyses demonstrated that all ADAM proteins consistently appeared throughout days 1 to 8 of pregnancy but with a variation depending on the species of ADAM gene, the progression of pregnancy, and the site of the uterus. Immunohistochemical analyses indicated that ADAM proteins were localized in the luminal or glandular epithelial layers with a varying intensity depending on the species of ADAM and the progression of pregnancy.

Clinical experiences of fetal ovarian cyst: diagnosis and consequence.

Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts. Fetal ovarian cyst often presents complication such as torsion and seems to be an indication for surgical intervention. In this study, we reviewed pre- and post-natal medical records and ultrasonography of 17 fetuses that were diagnosed with ovarian cysts.

Comparative proteomics of ovarian epithelial tumors.

We analyzed 12 ovarian epithelial tumors using 2D PAGE-based comparative proteomics to construct intra- and inter-tumoral distance map trees and to discover surrogate biomarkers indicative of an ovarian tumor. The analysis was performed after laser microdissection of 12 fresh-frozen tissue samples, including 4 serous, 5 mucinous, and 3 endometrioid tumors, with correlation with their histopathological characteristics. Ovarian epithelial tumors and normal tissues showed an apparent separation on the distance map tree.

Differences in urodynamic study, perineal sonography and treatment outcome according to urethrovesical junction hypermobility in stress urinary incontinence.

Aims: To evaluate the differences in urodynamic study (UDS) and the perineal ultrasonography parameters between stress urinary incontinence (SUI) patients with or without urethrovesical junction (UVJ) hypermobility. Treatment outcomes following a retropubic urethropexy were also compared.

Methods: The records of 164 SUI patients ( View Article and Find Full Text PDF

The significance of bladder trabeculation in the female lower urinary system: an objective evaluation by urodynamic studies.

This study aimed to investigate the relationship between bladder trabeculation, urinary function, and the stage of pelvic organ prolapse (POP). The medical records of 104 patients with POP who underwent cystoscopies and urodynamic studies were reviewed retrospectively. Age, incidence of detrusor instability, stage and site of POP, and the parameters of urodynamic studies of patients with and without bladder trabeculation were compared.