Diagnosis and Therapy of Female Urinary Incontinence. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/091, January 2022): Part 2 with Recommendations on Interventional/Surgical Therapy of Overactive Bladder, Surgical Treatment of Stress Urinary Incontinence and Diagnosis and Therapy of Iatrogenic Urogenital Fistula.

This completely revised interdisciplinary S2k-guideline on the diagnosis, therapy, and follow-up care of female patients with urinary incontinence (AWMF registry number: 015-091) was published in December 2021. This guideline combines and summarizes earlier guidelines such as "Female stress urinary incontinence," "Female urge incontinence" and "Use of Ultrasonography in Urogynecological Diagnostics" for the first time. The guideline was coordinated by the German Society for Gynecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG) and the Working Group for Urogynecology and Plastic Pelvic Floor Reconstruction (Arbeitsgemeinschaft für Urogynäkologie und plastische Beckenbodenrekonstruktion e.

The investigation and treatment of female pelvic floor dysfunction.

Background: 25% of all women report involuntary loss of urine, and 7% may require treatment.

Methods: This review is based on a selection of pertinent literature, including guidelines and Cochrane reviews.

Results: The assessment of pelvic floor dysfunction in women begins with a basic evaluation that is followed by special diagnostic tests if indicated.

Retropubic vs. transobturator tension-free vaginal tape for female stress urinary incontinence: 3-month results of a randomized controlled trial.

Background: We conducted a prospective randomized controlled noninferiority trial to compare objective and subjective outcomes of retropubic tension-free vaginal tape (TVT) with those of transobturator tape (TVT-O) as primary treatment for stress urinary incontinence (SUI) in women.

Study Design: The study was conducted at 25 gynecology units in Austria and Germany; regional and academic hospitals participated. A total of 569 patients were randomly assigned to undergo TVT or TVT-O.

Anticholinergic therapy: do the patients take the pills prescribed?

Purpose: To evaluate how many patients with overactive bladder still take their prescribed medication at least 12 months later and to find out the reasons for discontinuation of the therapy.

Methods: Two hundred and ten patients who had received a prescription for anticholinergic medication were contacted by telephone 12-46 months later.

Results: Out of 210 eligible patients 132 (63%) could be contacted and gave consent to participate in the study.

Is a dipstick test sufficient to exclude urinary tract infection in women with overactive bladder?

Introduction And Hypothesis: A dipstick test is recommended to screen for urinary tract infection in patients with overactive bladder (OAB). It was the aim of this study to test if a dipstick test is sufficient to identify patients with urinary tract infection attending a urological private practice because of OAB.

Methods: All patients who attended the practice because of OAB symptoms were routinely catheterized; a urine specimen was tested with dipstick, the spun sediment was examined microscopically, and the specimen was sent for microbiological examination.

Pregnant women after physical and sexual abuse in Germany.

Background/aims: The aim of our study was to evaluate the prevalence of abuse among pregnant women in Germany attending our antenatal outpatient clinic and to observe whether a history of abuse had consequences for women's feelings about their pregnancy.

Methods: 455 women between the 35th and 42nd weeks of gestational age were included and were asked to fill out an anonymous questionnaire concerning their pregnancy, their actual psychological state, and their history of physical/sexual abuse. 600 questionnaires were distributed (return rate 75.

Urogynecological training, testing and treatment among gynecologists in Germany.

Objective: A survey was conducted to evaluate the urogynecology training of German gynecologists and the diagnostic tests and therapeutic options offered to women with incontinence or prolapse in hospital departments and private practices.

Study Design: Questionnaires were mailed to 3000 gynecologists in private practice and to 500 consultants in gynecology departments. The questionnaire included items on urogynecological training, diagnostic workup as well as conservative and surgical treatment options.

Physical and sexual abuse in patients with overactive bladder: is there an association?

The known sequelae of sexual abuse include acute and chronic injury. The purpose of this study was to evaluate the association of overactive bladder symptoms (OABs) with a history of physical or sexual abuse. Two hundred and forty-three women who attended the gynaecological out-patient clinic or the urogynaecological clinic were recruited for our study.

Is the histomorphological concept of the female pelvic floor and its changes due to age and vaginal delivery correct?

Aims: To compare the histomorphology of pelvic floor specimens of 94 female cadavers, ten male cadavers, and 24 female symptomatic patients who underwent pelvic floor surgery, and to evaluate the association of age, parity, and sex to myogenic and/or neurogenic changes to the levator ani muscle (LAM).

Methods: The pelvic floor was biopsied at the pubococcygeus, the iliococcygeus and the coccygeus muscle. After staining, signs for myogenic/neurogenic changes to the muscle were evaluated (fibrosis, variation in fiber diameter, centralization of nuclei, small angulated fibers, and type grouping).

Urinary and anal incontinence after vacuum delivery.

Objectives: To evaluate urinary and fecal incontinence symptoms, and occult anal sphincter defects in women after vacuum and spontaneous vaginal delivery.

Study Design: In a case-control study, 50 primiparous women delivered by vacuum extraction were compared to 50 women delivered spontaneously. Urinary and anal incontinence symptoms, pelvic floor muscle strength and sphincter defects on endoanal ultrasound were evaluated 6-24 weeks postpartum.

Prevalence of sexual abuse among women seeking gynecologic care in Germany.

Objective: To estimate the prevalence of sexual abuse among patients seen for gynecologic care in Germany.

Methods: A short anonymous questionnaire was distributed to 1157 women attending a gynecologic outpatient clinic at a large urban teaching hospital. Data collected using the questionnaire included patient characteristics, sexual abuse history, and screening practices.

Long-term efficacy of pelvic floor re-education with EMG-controlled biofeedback.

Objective: To evaluate the long-term efficacy of pelvic floor re-education (PFR) with EMG-controlled biofeedback in the treatment of female genuine stress or mixed incontinence.

Study Design: Between 1995 and 1998, 36 women completed a pelvic floor muscle training with a biofeedback device for 3-6 months. A mean of 26 months later, a follow-up examination was performed.

The prognostic impact of a prolonged second stage of labor on maternal and fetal outcome.

Objective: While obstetrical management has changed significantly over years, the optimal duration of the second stage of labor still remains to be defined. The purpose of this study was to evaluate the effect of the duration of labor on fetal distress and maternal perinatal morbidity.

Methods: There were 1457 consecutive patients delivered of a singleton fetus in cephalic presentation beyond the 34th week of gestation at the I.

Age effects on urethral striated muscle. I. Changes in number and diameter of striated muscle fibers in the ventral urethra.

Objective: This study was undertaken to test the null hypothesis that the number of striated muscle fibers in the ventral wall of the female urethra remains constant with increasing age.

Study Design: The urethra and surrounding tissues from 25 female cadavers, mean age 52 years (+/-SD 18, range 15-80 years), were selected for this study. Each specimen was divided along the midsagittal plane, and a Masson trichrome histologic section was prepared.