Pub Date : 2024-04-10DOI: 10.1097/SPV.0000000000001494
João Pedro Paulino Ruas, Thiago Vasconcellos Andrade, Edgard Costa Scopacasa, Felipe Garcia Prado, Miguel Horwacz, Luiz Felipe Costa Mello, Rafael Fernandes Abrahão, João Ernesto Aldred Pinto Filho
{"title":"Urethral Mucinosous Adenocarcinoma in a Female Patient-A Case Report.","authors":"João Pedro Paulino Ruas, Thiago Vasconcellos Andrade, Edgard Costa Scopacasa, Felipe Garcia Prado, Miguel Horwacz, Luiz Felipe Costa Mello, Rafael Fernandes Abrahão, João Ernesto Aldred Pinto Filho","doi":"10.1097/SPV.0000000000001494","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001494","url":null,"abstract":"","PeriodicalId":517282,"journal":{"name":"Urogynecology","volume":"579 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140719540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/SPV.0000000000001508
Brittany Roberts, Rebecca G. Rogers, Katherine Husk, Jessmehar Walia, Bradley Jacobs, Gillian Wolff, Erin C. Deverdis
IMPORTANCE Urogynecology patients often present with sexual dysfunction; limited information on vibrator utilization to improve sexual function in this population exists. OBJECTIVE The aim of this study was to assess patient knowledge of and receptivity to vibrator use. STUDY DESIGN We conducted a cross-sectional, survey-based cohort study. The survey included patient characteristics, Pelvic Floor Distress Inventory-20 (PFDI-20), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form 12, and vibrator use questions. Our primary outcome was vibrator utilization rates comparing younger (<65) and older (≥65 years) urogynecology patients. RESULTS Of 213 distributed, 165 (78%) surveys were analyzed. Of these, 104 participants (63%) were aged <65 years and 61 (37%) were ≥65 years. Baseline characteristics were similar between groups (all P's > 0.05). Older patients reported less vibrator utilization than younger patients (30% vs 64%, P ≤ 0.001) and were less likely to be sexually active with a partner (36% vs 62%, P = 0.002) or masturbate (23% vs 51%, P ≤ 0.001). Most patients (76%) thought physicians should discuss vibrators with patients who would like to improve their sexual function with no differences between age groups (71% vs 80%, P = 0.17). Among women receptive to vibrator use, in a multivariable analysis, patients who reported masturbation (odds ratio [OR], 13.8; 95% confidence interval [CI], 2.80-67.71), vibrator use in the past (OR, 24.4; 95% CI, 6.65-89.53), or who believed physicians should discuss vibrators in a clinical setting (OR, 11.66; 95% CI, 2.9-46.81) were more receptive to vibrator use to improve sexual function. Age did not influence receptivity. CONCLUSIONS Vibrator utilization is greater among younger than older patients. Most urogynecologic patients think health care providers should discuss vibrator use with patients who wish to improve sexual function.
{"title":"Prevalence of Sexual Function and Vibrator Use Among Urogynecology Patients.","authors":"Brittany Roberts, Rebecca G. Rogers, Katherine Husk, Jessmehar Walia, Bradley Jacobs, Gillian Wolff, Erin C. Deverdis","doi":"10.1097/SPV.0000000000001508","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001508","url":null,"abstract":"IMPORTANCE\u0000Urogynecology patients often present with sexual dysfunction; limited information on vibrator utilization to improve sexual function in this population exists.\u0000\u0000\u0000OBJECTIVE\u0000The aim of this study was to assess patient knowledge of and receptivity to vibrator use.\u0000\u0000\u0000STUDY DESIGN\u0000We conducted a cross-sectional, survey-based cohort study. The survey included patient characteristics, Pelvic Floor Distress Inventory-20 (PFDI-20), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form 12, and vibrator use questions. Our primary outcome was vibrator utilization rates comparing younger (<65) and older (≥65 years) urogynecology patients.\u0000\u0000\u0000RESULTS\u0000Of 213 distributed, 165 (78%) surveys were analyzed. Of these, 104 participants (63%) were aged <65 years and 61 (37%) were ≥65 years. Baseline characteristics were similar between groups (all P's > 0.05). Older patients reported less vibrator utilization than younger patients (30% vs 64%, P ≤ 0.001) and were less likely to be sexually active with a partner (36% vs 62%, P = 0.002) or masturbate (23% vs 51%, P ≤ 0.001). Most patients (76%) thought physicians should discuss vibrators with patients who would like to improve their sexual function with no differences between age groups (71% vs 80%, P = 0.17). Among women receptive to vibrator use, in a multivariable analysis, patients who reported masturbation (odds ratio [OR], 13.8; 95% confidence interval [CI], 2.80-67.71), vibrator use in the past (OR, 24.4; 95% CI, 6.65-89.53), or who believed physicians should discuss vibrators in a clinical setting (OR, 11.66; 95% CI, 2.9-46.81) were more receptive to vibrator use to improve sexual function. Age did not influence receptivity.\u0000\u0000\u0000CONCLUSIONS\u0000Vibrator utilization is greater among younger than older patients. Most urogynecologic patients think health care providers should discuss vibrator use with patients who wish to improve sexual function.","PeriodicalId":517282,"journal":{"name":"Urogynecology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140717567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/SPV.0000000000001510
Charlotte M Ter Haar, Q. Class, William H Kobak, Lopa K Pandya
IMPORTANCE Telehealth offers advantages to patients with pelvic floor disorders because they face unique barriers to care; however, attendance of telehealth appointments is unknown. OBJECTIVE The objective of this study was to examine the attendance of telehealth appointments in urogynecology patients receiving pelvic floor physical therapy as compared with in-person visits before and during the COVID-19 pandemic. STUDY DESIGN We retrospectively collected electronic medical record data from patients engaging in pelvic floor physical therapy from 2019, and pre- and post-COVID-19 in 2020. Information included appointment type, attendance, age, primary diagnoses, insurance status, and zip code. Cohort differences were examined using the χ2 test and analyses of variance. RESULTS Our sample included 359 individuals scheduled for in-person visits in 2019, 57 for telehealth visits in 2020, and 283 for in-person visits in 2020. Patients scheduled for telehealth appointments were younger (39 ± 13 years) than patients in 2019 (45 ± 14 years) or 2020 (42 ± 14 years) in-person cohorts (χ2 (2, 696) = 6.8, P < 0.001). Patients attended telehealth appointments at higher rates (73.7%) than in-person visits in 2019 (56.8%) and 2020 (45.6%; χ2 (2, 699) = 26.2, P < 0.001). Attendance did not differ across primary diagnoses. Proximity based on zip code was not associated with attendance. CONCLUSIONS Pelvic floor physical therapy attendance rates were highest for patients with telehealth visits as compared with in-person visits. Our findings encourage health care providers to continue or begin to offer telehealth visits for pelvic floor physical therapy for the urogynecology patient population.
{"title":"Telehealth in a Pelvic Floor Physical Therapy Clinic: A Retrospective Cohort Study.","authors":"Charlotte M Ter Haar, Q. Class, William H Kobak, Lopa K Pandya","doi":"10.1097/SPV.0000000000001510","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001510","url":null,"abstract":"IMPORTANCE\u0000Telehealth offers advantages to patients with pelvic floor disorders because they face unique barriers to care; however, attendance of telehealth appointments is unknown.\u0000\u0000\u0000OBJECTIVE\u0000The objective of this study was to examine the attendance of telehealth appointments in urogynecology patients receiving pelvic floor physical therapy as compared with in-person visits before and during the COVID-19 pandemic.\u0000\u0000\u0000STUDY DESIGN\u0000We retrospectively collected electronic medical record data from patients engaging in pelvic floor physical therapy from 2019, and pre- and post-COVID-19 in 2020. Information included appointment type, attendance, age, primary diagnoses, insurance status, and zip code. Cohort differences were examined using the χ2 test and analyses of variance.\u0000\u0000\u0000RESULTS\u0000Our sample included 359 individuals scheduled for in-person visits in 2019, 57 for telehealth visits in 2020, and 283 for in-person visits in 2020. Patients scheduled for telehealth appointments were younger (39 ± 13 years) than patients in 2019 (45 ± 14 years) or 2020 (42 ± 14 years) in-person cohorts (χ2 (2, 696) = 6.8, P < 0.001). Patients attended telehealth appointments at higher rates (73.7%) than in-person visits in 2019 (56.8%) and 2020 (45.6%; χ2 (2, 699) = 26.2, P < 0.001). Attendance did not differ across primary diagnoses. Proximity based on zip code was not associated with attendance.\u0000\u0000\u0000CONCLUSIONS\u0000Pelvic floor physical therapy attendance rates were highest for patients with telehealth visits as compared with in-person visits. Our findings encourage health care providers to continue or begin to offer telehealth visits for pelvic floor physical therapy for the urogynecology patient population.","PeriodicalId":517282,"journal":{"name":"Urogynecology","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140718170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/SPV.0000000000001503
Eliza F Burr, E. Myer, Jacqueline Y Kikuchi, Chi Chiung Grace Chen
IMPORTANCE Nocturnal lower urinary tract symptoms are part of obstructive sleep apnea (OSA), and urogynecology clinics may serve as OSA screening sites. OBJECTIVE This study's aim was to determine the accuracy of nocturia and nocturnal enuresis (NE) as screening tools for OSA in new patients at a urogynecology clinic. STUDY DESIGN Using a retrospective study design, we gathered information regarding diagnostic OSA testing, continuous positive airflow pressure use, and lower urinary tract symptoms improvement from women in a urogynecology clinic who were previously screened for OSA using validated questionnaires. Nocturia and NE were tested for sensitivity and specificity using positive OSA diagnosis by polysomnography as the gold standard. RESULTS Nocturia with a cutoff of ≥2 episodes per night had the best test characteristics-86.4% sensitivity (95% confidence interval [CI], 65.1-97.1) and 58.5% specificity (95% CI, 44.1-71.9) for an overall accuracy of 78.4% (95% CI, 67.0-89.8). Nocturnal enuresis with a cutoff of ≥1 episode per week had the best NE characteristics with 31.8% sensitivity (95% CI, 13.9-54.9) and 79.3% specificity (95% CI, 65.9-89.2) for an overall accuracy of 56.1% (95% CI, 41.2-71). CONCLUSIONS Lower urinary tract symptoms such as nocturia and NE are routinely assessed in urogynecology clinics, making them useful for OSA screening and referral. The present study found nocturia symptoms with ≥2 episodes per night to retain acceptable test characteristics in screening for OSA, whereas NE was found to have less acceptable test characteristics for OSA screening. Urogynecology clinics may utilize nocturia symptoms in clinical decision making for OSA referral.
重要意义夜间下尿路症状是阻塞性睡眠呼吸暂停（OSA）的一部分，泌尿妇科诊所可作为 OSA 筛查场所。本研究旨在确定夜尿和夜间遗尿（NE）作为泌尿妇科诊所新患者 OSA 筛查工具的准确性。研究设计通过回顾性研究设计，我们收集了泌尿妇科诊所中先前使用有效问卷筛查过 OSA 的女性患者有关诊断性 OSA 测试、持续气流正压使用和下尿路症状改善的信息。结果以每晚≥2次为临界值的夜尿症具有最佳的测试特征--86.4%的灵敏度（95% 置信区间 [CI]，65.1-97.1）和 58.5%的特异性（95% CI，44.1-71.9），总体准确率为 78.4%（95% CI，67.0-89.8）。结论夜尿和NE等下尿路症状是泌尿妇科门诊的常规评估项目，因此有助于OSA筛查和转诊。本研究发现，在筛查 OSA 时，每晚发作次数≥2 次的夜尿症状具有可接受的测试特征，而 NE 在筛查 OSA 时的测试特征可接受度较低。泌尿妇科诊所可利用夜尿症状做出转诊 OSA 的临床决策。
{"title":"Nocturnal Urinary Symptoms as Screening Tools for Obstructive Sleep Apnea.","authors":"Eliza F Burr, E. Myer, Jacqueline Y Kikuchi, Chi Chiung Grace Chen","doi":"10.1097/SPV.0000000000001503","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001503","url":null,"abstract":"IMPORTANCE\u0000Nocturnal lower urinary tract symptoms are part of obstructive sleep apnea (OSA), and urogynecology clinics may serve as OSA screening sites.\u0000\u0000\u0000OBJECTIVE\u0000This study's aim was to determine the accuracy of nocturia and nocturnal enuresis (NE) as screening tools for OSA in new patients at a urogynecology clinic.\u0000\u0000\u0000STUDY DESIGN\u0000Using a retrospective study design, we gathered information regarding diagnostic OSA testing, continuous positive airflow pressure use, and lower urinary tract symptoms improvement from women in a urogynecology clinic who were previously screened for OSA using validated questionnaires. Nocturia and NE were tested for sensitivity and specificity using positive OSA diagnosis by polysomnography as the gold standard.\u0000\u0000\u0000RESULTS\u0000Nocturia with a cutoff of ≥2 episodes per night had the best test characteristics-86.4% sensitivity (95% confidence interval [CI], 65.1-97.1) and 58.5% specificity (95% CI, 44.1-71.9) for an overall accuracy of 78.4% (95% CI, 67.0-89.8). Nocturnal enuresis with a cutoff of ≥1 episode per week had the best NE characteristics with 31.8% sensitivity (95% CI, 13.9-54.9) and 79.3% specificity (95% CI, 65.9-89.2) for an overall accuracy of 56.1% (95% CI, 41.2-71).\u0000\u0000\u0000CONCLUSIONS\u0000Lower urinary tract symptoms such as nocturia and NE are routinely assessed in urogynecology clinics, making them useful for OSA screening and referral. The present study found nocturia symptoms with ≥2 episodes per night to retain acceptable test characteristics in screening for OSA, whereas NE was found to have less acceptable test characteristics for OSA screening. Urogynecology clinics may utilize nocturia symptoms in clinical decision making for OSA referral.","PeriodicalId":517282,"journal":{"name":"Urogynecology","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140717306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1097/SPV.0000000000001486
E. Slopnick
{"title":"Response to Letter to the Editor re: \"Pudendal Nerve Block Analgesia at the Time of Vaginal Surgery: A Randomized, Double-Blinded, Sham-Controlled Trial\".","authors":"E. Slopnick","doi":"10.1097/SPV.0000000000001486","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001486","url":null,"abstract":"","PeriodicalId":517282,"journal":{"name":"Urogynecology","volume":"67 11","pages":"401-402"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.1097/spv.0000000000001441
Jinchai Zhao, Yibin Liu, Lili Cui, Xianghang Sun, Li Meng, Yi Zhao, Xiaoyuan Zhou, Xianghua Huang
As an increasing number of mesh-related complications have been reported, the availability of nonmesh alternatives becomes crucial for situations where mesh is not desired or unavailable. A new modified procedure of nonmesh laparoscopic sacral colpopexy (LSC) was performed in our department, which used a nonabsorbable polyester suture (Ethibond) combined with uterosacral ligament suspension. The aim of this study was to evaluate the clinical efficacy of the modified procedure in comparison with traditional LSC in patients with pelvic organ prolapse. This retrospective study assessed the treatment outcomes of 60 patients who were underwent LSC with or without mesh from January 2017 to April 2019. Patients were divided into 2 groups based on the presence or absence of mesh during the operation: mesh group (n = 34) and nonmesh group (n = 26). General data, perioperative indexes, postoperative complications, and recurrence rates were comparatively analyzed between 2 groups. In perioperative indexes, the nonmesh group exhibited shorter operation time (P < 0.001) and less intraoperative blood loss compared with the mesh group (P = 0.004). There was no significant difference in postoperative indwelling urinary catheter duration (P = 0.425) and hospitalization time (P = 0.827) between the 2 groups. In postoperative complications, the incidence of postoperative complications showed no significant difference between the 2 groups (P > 0.05). No occurrences of mesh exposure and erosion were observed in the mesh group during at least a 2-year follow-up period. In postoperative recurrence, none of the patients in either group experienced prolapse recurrence. In comparison with the traditional LSC with mesh, the modified laparoscopic nonmesh sacral colpopexy presents advantages of reduced surgical trauma, less pain, and lower cost. However, a long-term and large sample study is required for evaluating the surgery’s long-term efficacy.
{"title":"Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse","authors":"Jinchai Zhao, Yibin Liu, Lili Cui, Xianghang Sun, Li Meng, Yi Zhao, Xiaoyuan Zhou, Xianghua Huang","doi":"10.1097/spv.0000000000001441","DOIUrl":"https://doi.org/10.1097/spv.0000000000001441","url":null,"abstract":"\u0000 \u0000 As an increasing number of mesh-related complications have been reported, the availability of nonmesh alternatives becomes crucial for situations where mesh is not desired or unavailable. A new modified procedure of nonmesh laparoscopic sacral colpopexy (LSC) was performed in our department, which used a nonabsorbable polyester suture (Ethibond) combined with uterosacral ligament suspension.\u0000 \u0000 \u0000 \u0000 The aim of this study was to evaluate the clinical efficacy of the modified procedure in comparison with traditional LSC in patients with pelvic organ prolapse.\u0000 \u0000 \u0000 \u0000 This retrospective study assessed the treatment outcomes of 60 patients who were underwent LSC with or without mesh from January 2017 to April 2019. Patients were divided into 2 groups based on the presence or absence of mesh during the operation: mesh group (n = 34) and nonmesh group (n = 26). General data, perioperative indexes, postoperative complications, and recurrence rates were comparatively analyzed between 2 groups.\u0000 \u0000 \u0000 \u0000 In perioperative indexes, the nonmesh group exhibited shorter operation time (P < 0.001) and less intraoperative blood loss compared with the mesh group (P = 0.004). There was no significant difference in postoperative indwelling urinary catheter duration (P = 0.425) and hospitalization time (P = 0.827) between the 2 groups. In postoperative complications, the incidence of postoperative complications showed no significant difference between the 2 groups (P > 0.05). No occurrences of mesh exposure and erosion were observed in the mesh group during at least a 2-year follow-up period. In postoperative recurrence, none of the patients in either group experienced prolapse recurrence.\u0000 \u0000 \u0000 \u0000 In comparison with the traditional LSC with mesh, the modified laparoscopic nonmesh sacral colpopexy presents advantages of reduced surgical trauma, less pain, and lower cost. However, a long-term and large sample study is required for evaluating the surgery’s long-term efficacy.\u0000","PeriodicalId":517282,"journal":{"name":"Urogynecology","volume":"24 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139896727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.1097/spv.0000000000001441
Jinchai Zhao, Yibin Liu, Lili Cui, Xianghang Sun, Li Meng, Yi Zhao, Xiaoyuan Zhou, Xianghua Huang
As an increasing number of mesh-related complications have been reported, the availability of nonmesh alternatives becomes crucial for situations where mesh is not desired or unavailable. A new modified procedure of nonmesh laparoscopic sacral colpopexy (LSC) was performed in our department, which used a nonabsorbable polyester suture (Ethibond) combined with uterosacral ligament suspension. The aim of this study was to evaluate the clinical efficacy of the modified procedure in comparison with traditional LSC in patients with pelvic organ prolapse. This retrospective study assessed the treatment outcomes of 60 patients who were underwent LSC with or without mesh from January 2017 to April 2019. Patients were divided into 2 groups based on the presence or absence of mesh during the operation: mesh group (n = 34) and nonmesh group (n = 26). General data, perioperative indexes, postoperative complications, and recurrence rates were comparatively analyzed between 2 groups. In perioperative indexes, the nonmesh group exhibited shorter operation time (P < 0.001) and less intraoperative blood loss compared with the mesh group (P = 0.004). There was no significant difference in postoperative indwelling urinary catheter duration (P = 0.425) and hospitalization time (P = 0.827) between the 2 groups. In postoperative complications, the incidence of postoperative complications showed no significant difference between the 2 groups (P > 0.05). No occurrences of mesh exposure and erosion were observed in the mesh group during at least a 2-year follow-up period. In postoperative recurrence, none of the patients in either group experienced prolapse recurrence. In comparison with the traditional LSC with mesh, the modified laparoscopic nonmesh sacral colpopexy presents advantages of reduced surgical trauma, less pain, and lower cost. However, a long-term and large sample study is required for evaluating the surgery’s long-term efficacy.
{"title":"Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse","authors":"Jinchai Zhao, Yibin Liu, Lili Cui, Xianghang Sun, Li Meng, Yi Zhao, Xiaoyuan Zhou, Xianghua Huang","doi":"10.1097/spv.0000000000001441","DOIUrl":"https://doi.org/10.1097/spv.0000000000001441","url":null,"abstract":"\u0000 \u0000 As an increasing number of mesh-related complications have been reported, the availability of nonmesh alternatives becomes crucial for situations where mesh is not desired or unavailable. A new modified procedure of nonmesh laparoscopic sacral colpopexy (LSC) was performed in our department, which used a nonabsorbable polyester suture (Ethibond) combined with uterosacral ligament suspension.\u0000 \u0000 \u0000 \u0000 The aim of this study was to evaluate the clinical efficacy of the modified procedure in comparison with traditional LSC in patients with pelvic organ prolapse.\u0000 \u0000 \u0000 \u0000 This retrospective study assessed the treatment outcomes of 60 patients who were underwent LSC with or without mesh from January 2017 to April 2019. Patients were divided into 2 groups based on the presence or absence of mesh during the operation: mesh group (n = 34) and nonmesh group (n = 26). General data, perioperative indexes, postoperative complications, and recurrence rates were comparatively analyzed between 2 groups.\u0000 \u0000 \u0000 \u0000 In perioperative indexes, the nonmesh group exhibited shorter operation time (P < 0.001) and less intraoperative blood loss compared with the mesh group (P = 0.004). There was no significant difference in postoperative indwelling urinary catheter duration (P = 0.425) and hospitalization time (P = 0.827) between the 2 groups. In postoperative complications, the incidence of postoperative complications showed no significant difference between the 2 groups (P > 0.05). No occurrences of mesh exposure and erosion were observed in the mesh group during at least a 2-year follow-up period. In postoperative recurrence, none of the patients in either group experienced prolapse recurrence.\u0000 \u0000 \u0000 \u0000 In comparison with the traditional LSC with mesh, the modified laparoscopic nonmesh sacral colpopexy presents advantages of reduced surgical trauma, less pain, and lower cost. However, a long-term and large sample study is required for evaluating the surgery’s long-term efficacy.\u0000","PeriodicalId":517282,"journal":{"name":"Urogynecology","volume":"26 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139893315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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