Evolving Enterococcus faecalis Biofilms and Urinary Tract Infection Relapse: Does Vaginal Estrogen Matter?

Importance: Enterococcus faecalis urinary tract infection (UTI) is common in postmenopausal females and these bacteria create biofilms that may reduce treatment efficacy. The role of local vaginal estrogen therapy in susceptibility to E. faecalis infection is unclear.

Uncovering Surface Penetration by Enterococci From Urinary Tract Infection Patients.

Importance: The relationship between Enterococcus faecalis vaginal colonization and urinary tract infections (UTIs) remains uncertain.

Objective: We aimed to evaluate the surface invasion capability of E faecalis isolates from patients with and without UTIs as a potential readout of pathogenicity.

Study Design: Participants were females from urogynecology clinics, comprising symptomatic UTI and asymptomatic non-UTI patients, categorized by the presence or absence of E faecalis-positive cultures identified via standard urine culture techniques.

Adverse Event Reporting of Commonly Used Gender-Specific Implantable Medical Devices in the United States.

Background: Evidence suggests that more women are harmed by implantable medical devices than men. It is unknown whether this difference includes gender-specific devices.

Methods: In this study, we examine the differences in reported adverse events between 6 female- and 5 male-specific implantable devices from the Manufacturer and User Facility Device Experience (MAUDE) database from 1993 to 2018.

A Community-Based Education Program for Overactive Bladder in a Predominantly Minority Older Female Population: A Pilot Study.

Introduction: Knowledge gaps regarding available treatment and social stigmatization are barriers to care in patients with overactive bladder (OAB). We assessed the feasibility of an OAB education program targeting older community-dwelling females.

Methods: Community-dwelling women over 55 years old were recruited.

No pelvic exam, no problem: patient satisfaction following the integration of comprehensive urogynecology telemedicine.

Introduction And Hypothesis: The COVID-19 pandemic revolutionized the practice of medicine, requiring rapid adoption of telemedicine. However, patient satisfaction has not been well characterized for telemedicine visits for a broad range of urogynecologic conditions.

Methods: We performed a cross-sectional survey study following a retrospective review of all urogynecologic telemedicine visits from March 1, 2020, to March 31, 2021, at a tertiary care center.

Characterizing Adverse Events Reporting for an Over-the-Counter Disposable Intravaginal Support Device for Stress Urinary Incontinence.

Objectives: In recent years, new intravaginal support devices for stress urinary incontinence have been introduced to the market. Although studies have demonstrated their safety and efficacy, few studies have examined adverse events attributed to their use. The objective of this study was to characterize reported adverse events for an over-the-counter intravaginal support device and determine whether further medical treatment was necessary to manage the adverse event.

Training the Next Generation of Obstetrics and Gynecology Leaders, A Multi-Institutional Needs Assessment.

Objective: To assess resident and faculty interest in, as well as content and preferred format for, a leadership curriculum during obstetrics and gynecology residency DESIGN: From June to July 2019, a needs assessment survey on leadership training was distributed to residents and academic faculty at 3 United States obstetrics and gynecology residency programs. Descriptive and bivariate analyses were performed. Open ended questions were analyzed for themes.

Long-term Device Outcomes of Mesh Implants in Pelvic Organ Prolapse Repairs.

Objective: To evaluate the longer-term safety and reintervention outcomes of mesh implants in pelvic organ prolapse (POP) repairs.

Methods: We conducted a population-based cohort study of women undergoing POP repairs in inpatient and outpatient surgical settings between 2008 and 2016 in New York State. Multivariable logistic regression was used based on patient and procedural characteristics and hospital volume between mesh and nonmesh groups to obtain propensity scores for each individual.

The Management and Efficacy of Surgical Techniques Used for Erosive Mesh in the Urethra and Bladder: A Systematic Review.

Background: This study reports the re-operation and symptom resolution rates of different techniques used in surgical excision of genitourinary mesh erosions.

Methods: A comprehensive systematic review was completed after searching electronic databases for studies involving outcomes of mesh erosion in humans that were managed surgically using a transvaginal, cystoscopic, or abdominal approach. Surgical outcomes were reported in percentages, ranges, and simple pooling to generate trends in management techniques.

Anticholinergic Burden in the Elderly Population: An Emerging Concern.

Antimuscarinics are commonly used to treat overactive bladder, but increase anticholinergic burden, which has been associated with multiple adverse outcomes in older patients. We advocate for standardization of anticholinergic risk assessment and reevaluation of anticholinergic prescribing practices for the elderly.

Pneumomediastinum from vaginal cuff dehiscence four months after laparoscopic-assisted vaginal hysterectomy: A case report.

Introduction: Vaginal cuff dehiscence (VCD) is a rare post-operative complication after hysterectomy in which the approximated edges of the vaginal cuff separate. Associated presentations range from simple separation with minimal bothersome symptoms to pain, infection, and surgical emergencies such as bowel evisceration. In this report we describe a rare and delayed presentation of VCD.

Is Something Missing From Antenatal Education? A Survey of Pregnant Women's Knowledge of Pelvic Floor Disorders.

Objective: This study aimed to describe the knowledge on pelvic floor disorders among a cross section of pregnant women.

Study Design: This was an institutional review board-approved cross-sectional survey study of pregnant women with a gestational age of more than 18 weeks at a single tertiary care institution. Participants completed the validated 24-item Prolapse and Incontinence Knowledge Questionnaire, and responses were graded to determine a raw accuracy score (0-100%).

Future Directions of Research and Care for Urinary Incontinence: Findings from the National Institute of Diabetes and Digestive and Kidney Diseases Summit on Urinary Incontinence Clinical Research in Women.

Purpose: Female urinary incontinence is prevalent, costly and morbid. Participants in a NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases) sponsored summit reviewed findings from NIH (National Institutes of Health) funded clinical research on urinary incontinence in women and discussed the future of urinary incontinence research.

Materials And Methods: The NIDDK convened the Summit on Urinary Incontinence Clinical Research in Women on March 14, 2014.

Trends and Reinterventions in the Surgical Management of Stress Urinary Incontinence among Female Medicare Beneficiaries.

Introduction: We compare the use of bulking agents and slings for the treatment of stress urinary incontinence among female Medicare beneficiaries.

Methods: We analyzed data from a 5% national random sample of Medicare claims from 2000 to 2011. Female beneficiaries who underwent a sling or bulking agent procedure were identified based on CPT-4 and ICD-9 procedure codes.

The concomitant use of fesoterodine and topical vaginal estrogen in the management of overactive bladder and sexual dysfunction in postmenopausal women.

Objective: The objective of this study is to investigate the combination effect of anti-muscarinic medication and topical vaginal estrogen in the treatment of overactive bladder (OAB) and female sexual dysfunction in postmenopausal women.

Study Design: After IRB approval, 23 female subjects who met the entry criteria were randomized into two groups: (1) fesoterodine (Toviaz®, Pfizer, NY) with topical vaginal estrogen (Premarin®, Pfizer, NY) once daily or (2) fesoterodine once daily alone. If 4 mg fesoterodine was tolerated at 1-week, the dose was increased to 8 mg.

Trends in surgical management and pre-operative urodynamics in female medicare beneficiaries with mixed incontinence.

Objective: We sought to examine the surgical trends and utilization of treatment for mixed urinary incontinence among female Medicare beneficiaries.

Methods: Data was obtained from a 5% national random sample of outpatient and carrier claims from 2000 to 2011. Included were female patients 65 and older, diagnosed with mixed urinary incontinence, who underwent surgical treatment identified by Current Procedural Terminology, Fourth Edition (CPT-4) codes.

Adjunctive social media for more effective contraceptive counseling: a randomized controlled trial.

Objective: To determine whether social media, specifically Facebook, is an effective tool for improving contraceptive knowledge.

Methods: English-speaking women aged 18-45 years receiving care at an urban academic center obstetrics and gynecology clinic were included and randomized to a trial of standard contraceptive education and pamphlet (n=74) compared with standard contraceptive education and Facebook (n=69) information for contraception counseling. Contraceptive knowledge was evaluated preintervention and postintervention by the Contraceptive Knowledge Inventory.

Increased fluid intake is associated with bothersome bowel symptoms among women with urinary incontinence.

Objectives: To determine the association between the type and volume of fluid intake and bowel symptoms in women with urinary incontinence. We hypothesize that a lower volume of fluid intake would be associated with greater straining with bowel movements in women with urinary incontinence.

Methods: We performed a cross-sectional study of 256 women presenting with complaints of urinary incontinence from 2009 to 2010.

Lack of transient receptor potential vanilloid 1 channel modulates the development of neurogenic bladder dysfunction induced by cross-sensitization in afferent pathways.

Background: Bladder pain of unknown etiology has been associated with co-morbid conditions and functional abnormalities in neighboring pelvic organs. Mechanisms underlying pain co-morbidities include cross-sensitization, which occurs predominantly via convergent neural pathways connecting distinct pelvic organs. Our previous results showed that colonic inflammation caused detrusor instability via activation of transient receptor potential vanilloid 1 (TRPV1) signaling pathways, therefore, we aimed to determine whether neurogenic bladder dysfunction can develop in the absence of TRPV1 receptors.

Utility of preoperative examination and magnetic resonance imaging for diagnosis of anterior vaginal wall masses.

Introduction And Hypothesis: The clinical evaluation of anterior vaginal wall masses can present a dilemma, as there are no well-defined pathways for diagnosis and management. Our objective was to evaluate the role and accuracy of preoperative exam and magnetic resonance imaging (MRI) for these masses.

Methods: We identified women with a mass using billing codes for 10 years.

Evidence of bladder oversensitivity in the absence of an infection in premenopausal women with a history of recurrent urinary tract infections.

Unlabelled: Study Type - Prevalence (case control) Level of Evidence 4. What's known on the subject? and What does the study add? Urinary tract infections (UTIs) have been implicated in the aetiology of interstitial cystitis/painful bladder syndrome (IC/PBS). Prior studies have described symptoms and laboratory tests suggestive of UTI at the onset of IC/PBS as well as a significant history of childhood recurrent UTIs.

Acute colonic inflammation triggers detrusor instability via activation of TRPV1 receptors in a rat model of pelvic organ cross-sensitization.

Chronic pelvic pain of unknown etiology is a common clinical condition and may develop as a result of cross-sensitization in the pelvis when pathological changes in one of the pelvic organs result in functional alterations in an adjacent structure. The aim of the current study was to compare transient receptor potential vanilloid 1 (TRPV1) activated pathways on detrusor contractility in vivo and in vitro using a rat model of pelvic organ cross-sensitization. Four groups of male Sprague-Dawley rats (N = 56) were included in the study.

Is pelvic pain associated with defecatory symptoms in women with pelvic organ prolapse?

Objective: To investigate the significance of pelvic pain and its association with defecatory symptoms in women with pelvic organ prolapse (POP).

Study Design: This is a cross sectional study of 248 women with stage II POP or greater. Women were stratified into "pain" and "no-pain" groups based on their response to a question on the Pelvic Floor Distress Inventory short form.

Clinical significance of obstructive defecatory symptoms in women with pelvic organ prolapse.

Objective: To determine whether the presence of obstructive defecatory symptoms is associated with the site and severity of pelvic organ prolapse.

Methods: A cross-sectional study was performed of women with pelvic organ prolapse of grade 2 or greater who had completed a validated questionnaire that surveyed pelvic floor symptoms. Associations between patient characteristics, site and severity of prolapse, and obstructive bowel symptoms were investigated.