Maturitas最新文献

{"title":"Correlation between anti-Müllerian hormone, hypertension and vascular age: the Generation R Study, a population-based prospective cohort study","authors":"R.H.M. Dykgraaf ,&nbsp;S. Schalekamp-Timmermans ,&nbsp;S.A.A. van den Berg ,&nbsp;E.J. Vinke ,&nbsp;E.A.P. Steegers ,&nbsp;J.S.E. Laven ,&nbsp;Y.V. Louwers","doi":"10.1016/j.maturitas.2025.108785","DOIUrl":"10.1016/j.maturitas.2025.108785","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to explore the relationship between levels of anti-Müllerian hormone (AMH) and the risk of hypertension and vascular ageing in a population-based cohort.</div></div><div><h3>Study design</h3><div>This study was embedded in the Generation R Study, a prospective population-based cohort study of children and their parents in the City of Rotterdam, the Netherlands. The present study included all women at the first recall visit with available data on AMH and blood pressure (<em>n</em> = 4883) and analysed the association between AMH and hypertension. AMH levels (first recall visit) and carotid artery intima-medial thickness (CIMT) measurements (second recall visit) were used to analyse the association between AMH serum levels and CIMT as a proxy for vascular age (<em>n</em> = 3508).</div></div><div><h3>Results</h3><div>A higher age and lower AMH percentiles (adjusted for age) were associated with an increased risk of hypertension. Women with AMH percentiles &lt;p10 had a 2.1 times higher risk of hypertension than women with AMH levels &gt;p90 (<em>P</em> &lt; .001). Vascular age, conducted from CIMT measurements (second recall visit), was on average 9.8 years older than chronological age in those with an AMH below p10 (first recall visit). This difference was 6.1 years in those with an AMH exceeding p90. Similarly, differences in medians between the groups were significant (<em>p</em> &lt; 0,008).</div></div><div><h3>Conclusions</h3><div>This large prospective cohort study shows that low AMH levels later in life, independent of age, are associated with hypertension. The results indicate that diminished ovarian reserve at a younger age is associated with indicators of vascular alterations. Women with low AMH levels should not only be counseled about potential fertility issues, but should also be informed about their increased risk of vascular damage in order to take appropriate preventive measures. In the future, AMH may serve as a prospective marker for the early detection of cardiovascular diseases.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"204 ","pages":"Article 108785"},"PeriodicalIF":3.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between social determinants of health and intrinsic capacity trajectories: A population-based longitudinal study","authors":"Ying Zhang ,&nbsp;Siyuan Wu ,&nbsp;Fuchao Xie ,&nbsp;Erxu Xue ,&nbsp;Lijuan Quan ,&nbsp;Binbin Zhu ,&nbsp;Ziyi Qi ,&nbsp;Keping Zhu ,&nbsp;Wei Wang","doi":"10.1016/j.maturitas.2025.108783","DOIUrl":"10.1016/j.maturitas.2025.108783","url":null,"abstract":"<div><h3>Background</h3><div>Global aging is a significant public health challenge. Social determinants of health are crucial in shaping healthy aging trajectories by influencing intrinsic capacity, a key indicator of functional ability and well-being in older adults. However, the association between social determinants of health and intrinsic capacity trajectories remains underexplored. This study examines the associations between social determinants of health and intrinsic capacity trajectories among Chinese community-dwelling older adults.</div></div><div><h3>Participants and setting</h3><div>Community-dwelling adults aged ≥60 years from the China Health and Retirement Longitudinal Study (2011–2015).</div></div><div><h3>Methods</h3><div>Bifactor models of intrinsic capacity were constructed. Multigroup confirmatory factor analysis was used to test the longitudinal measurement invariance of intrinsic capacity. Growth mixture modeling was performed to identify distinct intrinsic capacity trajectory classes, and multivariate logistic regression was employed to determine the social determinants of health associated with these classes.</div></div><div><h3>Results</h3><div>A total of 5798 community-dwelling older adults were included. Four distinct intrinsic capacity trajectory classes were identified: high-increasing (20.6 %), medium-maintaining (37.1 %), medium-decreasing (29.0 %), and low-decreasing (13.3 %). Compared with the high-increasing trajectory, illiteracy, low-middle income, no social activities, being separated/divorced/widowed/never married, smoking, non-drinking, low physical activity, rural residence, non-age-friendly home environment, and no health insurance were associated with a higher likelihood of belonging to the low-decreasing trajectory.</div></div><div><h3>Conclusions</h3><div>These findings provide evidence for the early identification of heterogeneous intrinsic capacity trajectories and support the implementation of stratified intervention strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"204 ","pages":"Article 108783"},"PeriodicalIF":3.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women using menopausal hormone therapy who suicide have multiple risk factors","authors":"Julia M Lappin ,&nbsp;Shane Darke ,&nbsp;Sarah Grattan ,&nbsp;Alys Havard","doi":"10.1016/j.maturitas.2025.108784","DOIUrl":"10.1016/j.maturitas.2025.108784","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the characteristics, clinical presentation, documented risk factors for suicide, circumstances of death and toxicology of deaths by suicide in Australia, 2000–2024, among people known to be receiving menopause hormonal therapy.</div></div><div><h3>Design</h3><div>A retrospective descriptive study.</div></div><div><h3>Setting</h3><div>National population-level data retrieved from the National Coronial Information System.</div></div><div><h3>Main outcome measures</h3><div>Characteristics, clinical presentation, circumstances of death, documented risk factors for suicide and toxicology in all cases of death by suicide among people known to be receiving menopause hormonal therapy at their time of death in Australia, 2000–2024.</div></div><div><h3>Results</h3><div>63 cases were identified with a mean age of 54 years (range 50–59). Mental health diagnoses were present in almost all cases (93.7 %), with a preponderance of anxiety and depression. Prior suicidal behaviours were present in over half (52.4 %) and chronic pain in one-third (30.2 %). Almost all of these women (96.8 %) had at least one risk factor for suicide and 79.3 % had two or more risk factors. The most common circumstances of death were drug toxicity (39.7 %) or hanging (36.5 %). Psychoactive drugs were present in blood in the majority (93.5 %), most commonly antidepressants (53.2 %), hypnosedatives (50.0 %) and opioids (29.0 %).</div></div><div><h3>Conclusions</h3><div>Menopause hormonal therapy remains the most effective treatment for management of vasomotor symptoms and this study does not demonstrate any causal risk for suicide. Rather, it highlights that women prescribed menopause hormonal therapy who suicide have multiple risk factors for suicide including psychiatric complexity, prior suicidal behaviours, physical health comorbidity and concomitant psychoactive substance use.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"204 ","pages":"Article 108784"},"PeriodicalIF":3.6,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estetrol for the treatment of moderate to severe vasomotor symptoms in postmenopausal women: The design of the E4COMFORT I and II trials","authors":"Nick Panay ,&nbsp;Tommaso Simoncini ,&nbsp;Mélanie Taziaux ,&nbsp;Céline Bouchard ,&nbsp;Amanda Black ,&nbsp;Ekta Kapoor ,&nbsp;Wulf Utian ,&nbsp;Jean-Michel Foidart ,&nbsp;Rogerio Arnaldo Lobo","doi":"10.1016/j.maturitas.2025.108781","DOIUrl":"10.1016/j.maturitas.2025.108781","url":null,"abstract":"<div><div>Estetrol is a natural estrogen with a favorable safety profile, showing minimal effects on liver proteins, blood clotting, and breast tissue, which may reduce the risks of blood clots and cardiovascular disease. This review presents the profile of estetrol in support of the rationale of two pivotal phase 3 clinical trials, E4COMFORT I and E4COMFORT II, as well as the design of those. E4COMFORT I and II are aimed at assessing the efficacy and safety of estetrol in the treatment of moderate to severe vasomotor symptoms in postmenopausal women.</div><div>The E4COMFORT I and II trials were divided into an efficacy part (arms 1–3) and a safety part (arm 4). Efficacy was evaluated through a randomized, double-blind, placebo-controlled study examining two doses of estetrol (15 mg and 20 mg) in postmenopausal participants, both hysterectomized and non-hysterectomized, who experienced 7 or more moderate to severe vasomotor symptoms per day (or 50 or more per week). To comply with Food and Drug Administration and European Medicines Agency guidelines for long-term safety assessments in both groups, these trials evaluated the overall and endometrial safety of unopposed estetrol and of estetrol combined with natural progesterone. The total enrolment across the E4COMFORT I and II trials was 2576 participants.</div><div>The results of these trials are expected to give a thorough understanding of estetrol ‘s potential as a new, distinctive treatment option for women with postmenopausal symptoms.</div></div><div><h3>ClinicalTrials registration</h3><div><span><span>NCT04209543</span><svg><path></path></svg></span> and <span><span>NCT04090957</span><svg><path></path></svg></span></div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"204 ","pages":"Article 108781"},"PeriodicalIF":3.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-efficacy, quality of life, physical activity and educational interventions in menopausal women: A cross-sectional and pre–post study using Bayesian structural equation modelling","authors":"Daniele Magistro ,&nbsp;Roberto Vagnetti ,&nbsp;Paul Ansdell ,&nbsp;Jessica Piasecki","doi":"10.1016/j.maturitas.2025.108774","DOIUrl":"10.1016/j.maturitas.2025.108774","url":null,"abstract":"<div><h3>Objectives</h3><div>This two-part study aimed to confirm a theoretical model that integrates self-efficacy with menopause symptoms, quality of life and physical activity; and to determine the associations between self-efficacy and menopause knowledge following an education intervention.</div></div><div><h3>Study design</h3><div>The cross-sectional study involved 86 menopausal women (mean age = 55.57, SD = 7.44). Additionally, a pre–post design was employed after a half-day educational intervention (presentations, interactive polls and open discussions) with 51 women (mean age = 52.81, SD = 4.62).</div></div><div><h3>Main outcome measures</h3><div>The impact of menopausal symptoms on quality of life (QoL) was assessed via the Peri-menopausal Depression Scale and the Utian Quality of Life Scale. Physical activity was measured with the International Physical Activity Questionnaire. Self-efficacy was assessed with the General Self-Efficacy Scale. An ad hoc questionnaire pre- and post-events determined level of knowledge regarding menopause.</div></div><div><h3>Results</h3><div>Bayesian structural equation modelling confirmed the model. Physical activity exhibited a negative association with menopause symptoms (mean estimate = −1.69, 95 % CI [−3.08, −0.28]), and its relationship with quality of life (mean estimate = 1.35, 95 % CI [−0.24, 2.93]) was mediated by symptoms (mean estimate = 0.75, 95 % CIs [0.12, 1.51]). The detrimental impact of symptoms on quality of life (mean estimate = 4.42, 95 % CIs [2.22, 6.59]) was partially mediated by self-efficacy (mean estimate = −0.24, 95 % CIs [−0.38, −0.11]). Self-efficacy (<em>r</em> = 0.47, <em>p</em> &lt; .001) was significantly correlated with improvements in knowledge.</div></div><div><h3>Conclusions</h3><div>Increased physical activity could reduce menopausal symptoms and thereby enhance quality of life during the menopause. Higher levels of self-efficacy support better symptom management via improvements in menopause-related knowledge.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"203 ","pages":"Article 108774"},"PeriodicalIF":3.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal symptoms and sexual function in climacteric women experiencing stress urinary incontinence: a secondary analysis from a six-month follow-up of a randomised trial comparing microablative radiofrequency, pelvic floor muscle training, and combination treatments","authors":"Anna Lygia B. Lunardi ,&nbsp;Cassia R.T. Juliato ,&nbsp;Helena Slongo ,&nbsp;Cassio L.Z. Riccetto","doi":"10.1016/j.maturitas.2025.108777","DOIUrl":"10.1016/j.maturitas.2025.108777","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare microablative fractional radiofrequency (FMRF), pelvic floor muscle training (PFMT), and their combination (PFMT+FMRF) on vaginal symptoms, quality of life, and sexual function in incontinent climacteric women.</div></div><div><h3>Methods</h3><div>Secondary outcomes from a prospective, blinded, three-arm randomised controlled trial with 117 women (39 per group), assessed at pre-treatment, one month, and six months using: International Consultation on Incontinence Questionnaire–Vaginal Symptoms (ICIQ-VS), Female Sexual Function Index (FSFI), cytology, Vaginal Health Index (VHI), and transabdominal ultrasound to measure vaginal wall thickness.</div></div><div><h3>Results</h3><div>All groups showed significant improvement over time in ICIQ-VS total score, laxity, dryness, impact on sex life, abdominal pain, vaginal soreness (<em>p</em> &lt; 0.0001 for all questions), reduced sensation (<em>p</em> = 0.0004), and impairment of sex life (<em>p</em> = 0.0005). Only the FMRF group had sustained improvement in daily life interference at six months (<em>p</em> = 0.0419; CL pre vs post: −63.2 [−94.7;-31.8], pre vs 6 months: −45.7 [−79.4;-12.0]). FSFI improvements (total and domains) were not sustained at six months: total score (0.0102), desire (0.0134), lubrication (0.0093), satisfaction (0.0239), pain (0.0430). VHI showed significant, treatment-dependent differences: for moisture, FMRF improved pre- vs post-treatment (<em>p</em> = 0.0209; CL: 4.5 [2.4;26.6]), FMRF+PFMT improved over time (p = 0.0209; CL: 24.3 [10.6;38.0], 18.6 [4.2;32.9]); for fluid volume, FMRF+PFMT improved (<em>p</em> = 0.0004; CL: 27.6 [12.2;43], 24.7 [8.5;40.8]); for total score, FMRF improved pre- vs post-treatment (<em>p</em> = 0.0028; CL: 13.2 [4.4;22.1]), and FMRF+PFMT improved over time (p = 0.0028; CL: 21.6 [11.7;31.5], 18.9 [8.5;29.3]). All groups improved in pH (<em>p</em> &lt; 0.0001) and epithelial integrity (p &lt; 0.0001); however, the improvement in elasticity (<em>p</em> = 0.0001) was not sustained at six months. Vaginal wall thickness increased similarly across groups.</div></div><div><h3>Conclusion</h3><div>At six-month follow-up, all groups had similar improvements in quality of life, vaginal health, and sexual function.</div></div><div><h3>Trial registration</h3><div>This trial is registered on REBEC (Registro Brasileiro de Ensaios Clínicos; Brazilian Registry of Clinical Trials) under number RBR-9v3q33.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"204 ","pages":"Article 108777"},"PeriodicalIF":3.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intra-articular hyaluronic acid injections on pain and function in patients with knee osteoarthritis: An umbrella review of systematic reviews and meta-analyses of randomized placebo-controlled trials","authors":"Olivier Bruyère ,&nbsp;Majed Alokail ,&nbsp;Nasser Al-Daghri ,&nbsp;Jean-Yves Reginster ,&nbsp;Shaun Sabico","doi":"10.1016/j.maturitas.2025.108779","DOIUrl":"10.1016/j.maturitas.2025.108779","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Knee osteoarthritis is a prevalent and disabling condition characterized by pain and functional impairment. Intra-articular hyaluronic acid injections are widely used for symptom relief, but their efficacy remains debated due to conflicting conclusions across systematic reviews and meta-analyses. This umbrella review assesses the symptomatic efficacy of intra-articular hyaluronic acid based on evidence reported by previously conducted systematic reviews and meta-analyses, identifies factors contributing to discrepancies in findings, and summarizes consistent outcome trends.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This umbrella review followed the Cochrane guidelines for overviews of reviews and adhered to the PRIOR reporting checklist. A systematic search was conducted in Medline (Ovid), the Cochrane Database of Systematic Reviews (Ovid CDSR), and Embase, using a predefined Population/Intervention/Comparator/Outcome/Study design (PICOS) framework. Systematic reviews of randomized controlled trials evaluating the efficacy of intra-articular hyaluronic acid on pain and/or function compared with placebo were included. Exclusion criteria were systematic reviews that included both randomized controlled trials and non-randomized controlled trials without separate synthesis of data from the former, scoping reviews, abstracts, commentaries, or narrative reviews. Two independent reviewers screened titles/abstracts, and full texts, resolving disagreements by consensus. Risk of bias was assessed using the AMSTAR-2 checklist, classifying systematic reviews as high, moderate, low, or critically low quality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-two systematic reviews were included, with AMSTAR-2 quality ratings as follows: four high, one moderate, three low, and fourteen critically low. The majority (20/22) reported statistically significant beneficial effects of intra-articular hyaluronic acid injections on pain and function. However, according to the interpretation of their authors, fifteen systematic reviews concluded positively, three provided mixed interpretations, and four concluded negatively. All five of the reviews of high or moderate quality reported statistically significant beneficial effects, but with three concluding positively and two negatively. Negative or mixed conclusions were primarily attributed to restrictive inclusion criteria (e.g., analyses only of large trials, minimum patient numbers, long follow-up periods) and challenges in interpreting clinical relevance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Most systematic reviews and all high-quality systematic reviews support the symptomatic efficacy of intra-articular hyaluronic acid in knee osteoarthritis. Negative interpretations arise when restrictive inclusion criteria challenge the clinical relevance of results. However, given the methodological limitations, variability in review quality, and inconsistent interpretations, the overall certainty of evid","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"203 ","pages":"Article 108779"},"PeriodicalIF":3.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the association between dietary metals and prostate health: Identifying benign prostatic hyperplasia using a SHAP-based interpretable machine learning model in US adults","authors":"Yan Wang ,&nbsp;Jiaming Chen ,&nbsp;Wangqiang Chen ,&nbsp;Xuejuan Jiang ,&nbsp;Caifei Ding ,&nbsp;Jingyu Zhu","doi":"10.1016/j.maturitas.2025.108776","DOIUrl":"10.1016/j.maturitas.2025.108776","url":null,"abstract":"<div><h3>Background</h3><div>Benign prostatic hyperplasia affects roughly 50 % of men aged 51–60 and 70 % of those aged 61–70. While heavy metals have been linked to prostate cancer and inflammation, little is known about how the dietary intake of trace metals influences BPH risk. This study aimed to establish an interpretable, machine-learning–based framework using U.S. NHANES data to identify key dietary metals associated with BPH risk.</div></div><div><h3>Methods</h3><div>We analyzed adult male participants from NHANES cycles 2005–2008, extracting daily intake estimates for six trace metals. This study compared six algorithms to elucidate the relationship between dietary metal intake and BPH risk, assessing their performance in associating BPH risk across seven evaluation metrics to identify the optimal model and enhance interpretability through analysis with SHapley Additive exPlanations (SHAP). Subgroup analyses explored nonlinear intake–risk relationships.</div></div><div><h3>Results</h3><div>LightGBM demonstrated superior performance (AUC = 0.668). SHAP ranking identified zinc, iron, and selenium as the top protective nutrients. The most pronounced protective effect against BPH was observed within the moderate zinc and selenium intake strata. Iron demonstrated a consistent protective association, with risk reduction observed across its intake range. Copper intake demonstrated a shift from risk reduction for BPH at low to moderate levels to an increased risk at high intake levels.</div></div><div><h3>Conclusions</h3><div>These findings suggest that calibrated intake of these key micronutrients may attenuate BPH susceptibility, providing a data-driven foundation for targeted nutritional interventions and public-health strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"203 ","pages":"Article 108776"},"PeriodicalIF":3.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term subjective assessment of tension-free vaginal tape for recurrent stress urinary incontinence: A comparison with primary trans-obturator tape","authors":"Michael Babin ,&nbsp;Ehud Grinstein ,&nbsp;Masha Ben-Zvi ,&nbsp;Irit Segman ,&nbsp;Jonathan Harmatz ,&nbsp;Ohad Gluck ,&nbsp;Ron Sagiv ,&nbsp;Shimon Ginath","doi":"10.1016/j.maturitas.2025.108778","DOIUrl":"10.1016/j.maturitas.2025.108778","url":null,"abstract":"<div><h3>Objectives</h3><div>Stress urinary incontinence (SUI) affects 10–20 % of the female population. The primary surgical treatment for women with SUI is mid-urethral sling surgery (MUS). No clear guidelines exist for second-line management in patients with recurrences. This study compared quality of life and the occurrence of urinary symptoms after a secondary retropubic tension-free vaginal tape (TVT) intervention in patients with failure of primary transobturator tape (TOT) surgery with those who had experienced successful primary TOT surgery.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional study to compare efficacy and quality of life in patients who underwent the primary TOT procedure versus those who had a secondary TVT intervention after a failed TOT surgery. The Urinary Distress Inventory 6 (UDI-6) (questions 15–20 in the PFDI-20) was used to assess urinary symptoms.</div></div><div><h3>Results</h3><div>Sixty-seven patients were enrolled in the study. Forty-five patients underwent successful primary TOT surgery (defined as no bothersome SUI symptoms post-surgery), while twenty-two underwent secondary TVT surgery for recurrent symptoms. Basic demographic characteristics were comparable in both groups. The median follow-up was 32 months for the successful primary TOT group and 25.5 months for the secondary TVT group (<em>p</em> = 0.33). There were no significant differences in UDI-6 scores (24.3 ± 25.3 for the successful primary TOT group versus 29.5 ± 27.2 for the secondary TVT group, <em>p</em> = 0.44). Rates of stress urinary incontinence, urgency urinary incontinence, and voiding dysfunction were also comparable between the groups. There were no surgical complications in the secondary TVT group.</div></div><div><h3>Conclusion</h3><div>Quality of life, as assessed by the UDI-6 inventory, and rates of urinary symptoms were similar in the secondary TVT and successful primary TOT groups. The secondary TVT procedure may present a favorable surgical option for treating recurrent SUI after failed primary TOT.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"203 ","pages":"Article 108778"},"PeriodicalIF":3.6,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed-methods investigation of women's health-friendly organisations as perceived by menopausal working women","authors":"Claire Hardy ,&nbsp;Amanda Griffiths ,&nbsp;Eleanor Thorne ,&nbsp;Myra S. Hunter","doi":"10.1016/j.maturitas.2025.108775","DOIUrl":"10.1016/j.maturitas.2025.108775","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine women's perspectives on what constitutes a women's health-friendly work culture, and to assess whether perceiving one's organisation as women's health-friendly is associated with menopausal symptom experience and work-related outcomes.</div></div><div><h3>Methods</h3><div>A cross-sectional mixed-methods online survey collected self-reported quantitative and qualitative data from working menopausal women. Primary outcome measures included presence of menopausal symptoms (past four weeks), vasomotor symptom problem rating, job stress, and whether participants perceived their organisation as supportive of women's health (dependent variable). Two open-ended questions explored participants' views on what makes a work culture friendly or unfriendly to women's health.</div></div><div><h3>Results</h3><div>From the responses of 300 participants, over two-thirds (65.7%) perceived their organisation as supportive of women's health. These participants reported significantly lower job stress and less problematic vasomotor symptoms than those who did not. No significant association was found between menopausal symptom presence. Thematic analysis of qualitative responses revealed two overarching themes capturing shared perceptions of women's health-friendly and unfriendly work cultures. Theme 1 focused on the <em>people at work</em>: <em>awareness and understanding</em> of women's health, <em>attitudes towards women and work</em>, and their <em>talking about women's health at work</em>. Theme 2 addressed more structural factors of <em>organisational arrangements and provisions</em>: <em>flexibility in work arrangements</em>, <em>resources and support</em>, and the <em>physical work environment</em>.</div></div><div><h3>Conclusions</h3><div>This study provides novel insights into how women perceive a health-friendly work culture and the potential relevance to menopausal experiences and work. The findings have clear implications for policy and practice, warranting further attention and investigation.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"205 ","pages":"Article 108775"},"PeriodicalIF":3.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}