Outcomes at 12, 24, and 36 Months in Women Treated for Pelvic Organ Prolapse With Pessary or Surgery: Results From the Multicenter Pelvic Floor Disorders Registry.

Objective: The aim of this study was to describe real-world outcomes in women treated for pelvic organ prolapse (POP) with pessary or surgery over 36 months.

Study Design: We report outcomes of patients in a multicenter, prospective registry who opted for treatment of POP with either pessary (discontinuation or retreatment with surgery rates and subjective improvement) or surgery (retreatment rates or subjective improvement).

Results: Among 1,153 patients, follow-up was available for 248 (84%), 123 (42%), and 98 (33%) in the pessary group and 717 (93%), 407 (53%), and 331 (43%) in the surgery group at 12, 24, and 36 months, respectively.

Impact of Bowel Diary Completion and Education on Fecal Incontinence Severity.

Objective: This study aimed to determine the effect of a run-in period on fecal incontinence (FI) symptom severity.

Study Design: This study conducted a planned secondary analysis of the run-in period to a study evaluating the effect of 12-week treatment with percutaneous tibial nerve stimulation versus sham in reducing FI severity in women. All participants completed a 4-week run-in period designed to exclude from randomization women whose symptoms reduced below the eligibility threshold after receiving education on FI and completing bowel diaries.

Postoperative Sexual Function After Vaginal Surgery and Clitoral Size, Position, and Shape.

Importance: Transvaginal surgery is commonly performed to treat pelvic organ prolapse. Little research focuses on how sexual function relates to clitoral anatomy after vaginal surgery despite the clitoris' role in the sexual response.

Objective: To determine how postoperative sexual function after vaginal surgery is associated with clitoral features (size, position, shape).

Body Image and sexual function improve following prolapse repair.

Objective: Body image (a woman's perceptions and attitudes about her body) likely plays a role in pelvic organ prolapse treatment satisfaction and post-operative sexual function. The primary aim of this study was to describe changes in body image after surgical repair of vaginal vault prolapse. The secondary aim was to evaluate whether changes in sexual function are correlated with changes in body image.

Variation in Overactive Bladder Treatment Type by Social Determinants of Health.

Importance: There is limited understanding of the relationship between social determinants of health (SDOH) and types of overactive bladder/urgency urinary incontinence (OAB/UUI) treatments.

Objectives: Our objective was to determine if OAB/UUI treatment type differs by SDOH, including insurance and estimated median household income (EMHI).

Study Design: This was a cross-sectional study of adult patients assigned female at birth with OAB/UUI, identified from 2017 to 2022 within a tertiary academic health system.

Validation of Lower Urinary Tract Symptom Questionnaire in the Transmasculine Population.

Introduction And Hypothesis: Transgender men and transmasculine individuals report a variety of lower urinary tract symptoms (LUTS), but little is known about LUTS in this population. One of the obstacles is the lack of validated questionnaires. This study was aimed at validating the International Consultation on Incontinence Questionnaire-Lower Urinary Tract Symptoms (ICIQ-LUTS), which measures filling, voiding, and incontinence symptoms, in transmasculine individuals.

Correlation of Digital Rectal Examination and Anorectal Manometry with Patient-Reported Outcomes Among Women with Fecal Incontinence.

Introduction And Hypothesis: Standardized digital rectal examination (DRE) correlates with anorectal manometry (ARM) measures. However, less is known about the relationship between DRE/ARM measures and patient-reported outcomes (PROs), especially among women with fecal incontinence (FI). Our aims were to evaluate associations between DRE and ARM measures and compare PROs with diagnostic evaluation measures for women with FI.

Patient perspectives in adverse event reporting after vaginal apical prolapse surgery.

Background: Many clinical trials use systematic methodology to monitor adverse events and determine grade (severity), expectedness, and relatedness to treatments as determined by clinicians. However, patient perspectives are often not included in this process.

Objective: This study aimed to compare clinician vs patient grading of adverse event severity in a urogynecologic surgical trial.

Dietary Intake and Symptom Severity in Women with Fecal Incontinence.

Introduction And Hypothesis: The goal of this study was to determine whether dietary fat/fiber intake was associated with fecal incontinence (FI) severity.

Methods: Planned supplemental analysis of a randomized clinical trial evaluating the impact of 12-week treatment with percutaneous tibial nerve stimulation versus sham in reducing FI severity in women. All subjects completed a food screener questionnaire at baseline.

Diet Intake After Diet Modification Intervention in Women With Fecal Incontinence.

Importance: Older women with fecal incontinence (FI) who underwent diet modification intervention (DMI) showed significant improvement in FI symptoms. It is unclear whether improvement in symptoms was associated with objective changes in dietary intake quality.

Objectives: The primary aim was to determine if improvement in overall dietary intake quality was associated with improvement in FI symptoms.

Dual Incontinence and Risk of Fall: A Retrospective Cohort Study.

Importance: Although there is a known association between urinary incontinence (UI) and fall risk, it is unclear if having both UI and fecal incontinence, or dual incontinence (DI), increases this risk.

Objective: The objective of our study was to elucidate a relationship between DI and falls.

Study Design: This was a retrospective cohort study at a tertiary academic health system of female patients 65 years and older presenting for a new patient visit to a urogynecology health care professional for UI from 2019 to 2021.

Patient perspectives on treatment and prevention of recurrent urinary tract infections: a focus group study.

Introduction And Hypothesis: We sought to understand factors that are important to patients for the management of recurrent urinary tract infections (UTI) during both an acute episode and for the prevention of future episodes.

Methods: This was a qualitative study with focus groups in women with recurrent UTIs. Participants filled out information about prior recurrent UTI treatment and the Belief about Medicines Questionnaire (BMQ).

Changing Practices in the Surgical Management of Adnexal Torsion: An Analysis of the National Surgical Quality Improvement Program Database.

Objective: To evaluate trends in the surgical management of adnexal torsion and to evaluate these trends with respect to the updated American College of Obstetricians and Gynecologists (ACOG) guidelines.

Methods: We performed a retrospective cohort study using the National Surgical Quality Improvement Program database. Women who underwent surgery for adnexal torsion between 2008 and 2020 were identified on the basis of International Classification of Diseases codes.

U.S.-Based Obstetrician/Gynecologists' Experiences with Delivering Care to Women with Female Genital Cutting.

There has been an increase of women living in the United States who have experienced female genital cutting (FGC). However, limited research exists evaluating the experiences of obstetrician/gynecologists delivering care to this patient population. This study aimed to assess the overall experiences, including barriers and facilitators, of U.

Characteristics associated with subjective and objective measures of treatment success in women undergoing percutaneous tibial nerve stimulation vs sham for accidental bowel leakage.

Introduction And Hypothesis: In randomized trials both percutaneous tibial nerve stimulation (PTNS) and sham result in clinically significant improvements in accidental bowel leakage (ABL). We aimed to identify subgroups who may preferentially benefit from PTNS in women enrolled in a multicenter randomized trial.

Methods: This planned secondary analysis explored factors associated with success for PTNS vs sham using various definitions: treatment responder using three cutoff points for St.

Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension.

Importance: The impact of a persistently enlarged genital hiatus (GH) after vaginal hysterectomy with uterosacral ligament suspension on prolapse outcomes is currently unclear.

Objectives: This secondary analysis of the Study of Uterine Prolapse Procedures Randomized trial was conducted among participants who underwent vaginal hysterectomy with uterosacral ligament suspension. We hypothesized that women with a persistently enlarged GH size would have a higher proportion of prolapse recurrence.

Reducing Falls in Older Women with Urinary Incontinence.

Urinary incontinence is common in older women and doubles the risk of falls in this population. The association between urinary incontinence, especially urgency urinary incontinence, and falls is multifactorial and likely the result of a complex interaction between physical, mental, social, and environmental factors. As a result of this multifactorial etiology and based on existing evidence, the integration of different fall prevention strategies including strength and resistance exercises, bladder training, and home hazard reduction have the potential to decrease the risk of falls in older women with urinary incontinence.

Development of a patient-centered text message-based platform for the self-management of interstitial cystitis/bladder pain syndrome symptoms.

Objective: To develop a patient-centered text message-based platform that promotes self-management of symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS).

Methods: Adult women with IC/BPS interested in initiating a first- or second-line treatments per American Urological Association guidelines (recategorized as "behavioral/non-pharmacologic treatments" and "oral medicines" in the 2022 version) participated in rapid cycle innovation consisting of iterative cycles of contextual inquiry, prototype design and development. We delivered treatment modules and supportive messages using an algorithm-driven interactive messaging prototype through a HIPAA-compliant texting platform.

Outcomes of Pessary Use at 1 Year in Women Treated for Pelvic Organ Prolapse in a Large Multicenter Registry: Developed by the Pelvic Floor Disorders Registry.

Importance: There is a lack of high-quality long-term follow-up regarding pessary treatment. Most studies are case series or retrospective with a small sample size and short-term follow-up.

Objectives: This study aimed to evaluate differences in women who continue versus discontinue pessary use and the effectiveness, quality of life, and safety associated with pessary management at 1 year.