首页 > 最新文献

Urogynecology (Hagerstown, Md.)最新文献

英文 中文
Genitourinary Fistulas After Cerclage: A Case Series and Scoping Review. 结扎术后泌尿生殖系统瘘管:一个病例系列和范围回顾。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001680
Hunter L Terry, Deborah J Shim, Michelle M Doering, Shannon E Beermann, Roxane M Rampersad, Sara C Wood, Chiara Ghetti, Siobhan Sutcliffe, Jerry L Lowder

Importance: Genitourinary fistula is a rare complication of obstetric cerclage with limited evidence to guide prevention and management.

Objective: The aim of the study was to describe 5 new cases of vesicovaginal fistula (VVF) after cerclage and evaluate existing cases, including shared features, to generate hypothesis for future etiologic research.

Study design: Case series and scoping review.

Results: Five patients presented with VVF symptoms after cerclage placement; 4 were diagnosed during pregnancy, 1 postpartum. Two patients had prior cervical procedures and were noted to have difficult cerclage placements. Three cerclages remained until delivery, 1 was removed antepartum, and another was replaced. All VVFs were diagnosed by cystoscopy and were repaired postpartum transvaginally. In the scoping review, 14 studies met inclusion criteria, and 19 cases were identified. Compiled cases had a history of cervical procedure(s), shortened cervix, McDonald technique, anterior knot placement, and Mersilene tape use. Fistulas were identified by cystoscopy when performed. Most reports described VVFs near the bladder trigone and midline of the vagina. All VVFs required surgical repair.

Conclusions: Genitourinary fistula after cerclage is rare but may be more common after prior cervical surgery, shortened cervix, and McDonald cerclage. Methods to mitigate morbidity associated with fistula after cerclage placement include cystoscopy if bladder injury is suspected at the time of cerclage placement and consideration of abdominal cerclage when intravaginal access to the cervix is limited. Patients with urinary leakage after cerclage should be evaluated for genitourinary fistula, not just incontinence. Postpartum surgical repair remains the primary treatment for VVF, ideally by a vaginal approach.

重要性:泌尿生殖系统瘘管是产科环扎术中一种罕见的并发症,指导预防和管理的证据有限。目的:对5例膀胱阴道瘘(VVF)环切术后的新病例进行描述,并对现有病例进行评价,包括共同特征,为今后的病因学研究提供假设。研究设计:病例系列和范围回顾。结果:5例患者在结扎后出现VVF症状;孕期确诊4例,产后确诊1例。2例患者既往宫颈手术,并注意到有困难环置入。三个环扣一直到分娩,一个在产前被移除,另一个被替换。所有VVFs均通过膀胱镜检查诊断,并在产后经阴道修复。在范围审查中,14项研究符合纳入标准,并确定了19例病例。所汇编的病例均有宫颈手术史、缩短宫颈、麦克唐纳技术、前结放置史和Mersilene胶带使用史。手术时通过膀胱镜检查确定瘘管。大多数报告描述了膀胱三角区和阴道中线附近的VVFs。所有的vvf都需要手术修复。结论:环切术后泌尿生殖系统瘘管罕见,但在既往宫颈手术、缩短宫颈和麦克唐纳环切术后可能更为常见。减轻环扎术后瘘管相关发病率的方法包括:如果在环扎术时怀疑膀胱损伤,应进行膀胱镜检查;当阴道内进入宫颈受限时,应考虑进行腹部环扎术。环扎术后出现尿漏的患者应评估泌尿生殖系统瘘,而不仅仅是尿失禁。产后手术修复仍然是VVF的主要治疗方法,理想情况下通过阴道途径。
{"title":"Genitourinary Fistulas After Cerclage: A Case Series and Scoping Review.","authors":"Hunter L Terry, Deborah J Shim, Michelle M Doering, Shannon E Beermann, Roxane M Rampersad, Sara C Wood, Chiara Ghetti, Siobhan Sutcliffe, Jerry L Lowder","doi":"10.1097/SPV.0000000000001680","DOIUrl":"10.1097/SPV.0000000000001680","url":null,"abstract":"<p><strong>Importance: </strong>Genitourinary fistula is a rare complication of obstetric cerclage with limited evidence to guide prevention and management.</p><p><strong>Objective: </strong>The aim of the study was to describe 5 new cases of vesicovaginal fistula (VVF) after cerclage and evaluate existing cases, including shared features, to generate hypothesis for future etiologic research.</p><p><strong>Study design: </strong>Case series and scoping review.</p><p><strong>Results: </strong>Five patients presented with VVF symptoms after cerclage placement; 4 were diagnosed during pregnancy, 1 postpartum. Two patients had prior cervical procedures and were noted to have difficult cerclage placements. Three cerclages remained until delivery, 1 was removed antepartum, and another was replaced. All VVFs were diagnosed by cystoscopy and were repaired postpartum transvaginally. In the scoping review, 14 studies met inclusion criteria, and 19 cases were identified. Compiled cases had a history of cervical procedure(s), shortened cervix, McDonald technique, anterior knot placement, and Mersilene tape use. Fistulas were identified by cystoscopy when performed. Most reports described VVFs near the bladder trigone and midline of the vagina. All VVFs required surgical repair.</p><p><strong>Conclusions: </strong>Genitourinary fistula after cerclage is rare but may be more common after prior cervical surgery, shortened cervix, and McDonald cerclage. Methods to mitigate morbidity associated with fistula after cerclage placement include cystoscopy if bladder injury is suspected at the time of cerclage placement and consideration of abdominal cerclage when intravaginal access to the cervix is limited. Patients with urinary leakage after cerclage should be evaluated for genitourinary fistula, not just incontinence. Postpartum surgical repair remains the primary treatment for VVF, ideally by a vaginal approach.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"737-746"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782139","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}
引用次数: 0
Urinary Incontinence Care-Seeking Barriers Among Latina Patients: What Are We Missing? 拉丁裔患者寻求尿失禁护理的障碍:我们遗漏了什么?
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001555
Anna Pancheshnikov, Bryna J Harrington, Victoria L Handa, Liz I Yanes, Margot Le Neveu, Kristin M Voegtline, Sarah B Olson, Joan L Blomquist, Stephanie Jacobs, Danielle Patterson, Chi Chiung Grace Chen

Importance: The Latina population is the largest growing ethnic group in the United States with high levels of health disparities in urinary incontinence (UI) treatment and complications rates, which may be due to disproportionately high barriers to UI care-seeking among Latinas.

Objectives: The objectives of this study were to compare barriers to UI care-seeking among Latina, non-Latina Black, and non-Latina White patients by utilizing the Barriers to Incontinence Care Seeking Questionnaire (BICS-Q) total scores, and to compare specific barriers utilizing BICS-Q subscales.

Study design: In this cross-sectional study, patients accessing primary care were recruited to complete the BICS-Q, International Consultation on Incontinence Questionnaire-Short Form, and Prolapse and Incontinence Knowledge Questionnaire-Urinary Incontinence. The BICS-Q total and subscale scores were compared among ethnic/racial groups.

Results: A total of 298 patients were included in the study with 83 Black, 144 Latina, and 71 White participants per self-identified ethnicity/race. The total BICS-Q score was highest for Latina participants, followed by White and Black participants (11.2 vs 8.2 vs 4.9, respectively, P  < 0.0001). Latina participants had significantly higher BICS-Q subscale scores compared with Black participants with no significant differences between Latina and White participants. After controlling for potential confounders, Latina ethnicity/race was still associated with a higher BICS-Q score when compared to Black ethnicity/race ( P  = 0.0077), and lower Prolapse and Incontinence Knowledge Questionnaire-Urinary Incontinence scores remained independently associated with higher BICS-Q scores ( P  = 0.0078).

Conclusions: In our study population, Latina patients and patients with lower UI knowledge experience higher barriers to UI care-seeking compared with Black patients and patients with higher UI knowledge. Addressing these barriers may increase care-seeking and improve health equity in the field.

重要性:拉丁裔人口是美国增长最快的族群,在尿失禁(UI)治疗和并发症发生率方面存在很大的健康差异,这可能是由于拉丁裔寻求尿失禁护理的障碍过高所致:本研究的目的是通过尿失禁就医障碍问卷(BICS-Q)的总分来比较拉丁裔、非拉丁裔黑人和非拉丁裔白人患者的尿失禁就医障碍,并通过 BICS-Q 的分量表来比较具体障碍:在这项横断面研究中,研究人员招募了接受初级保健服务的患者,让他们填写 BICS-Q、尿失禁国际咨询问卷-简表和尿失禁知识问卷-尿失禁。对不同民族/种族群体的 BICS-Q 总分和分量表得分进行了比较:共有 298 名患者参与了研究,其中黑人 83 人,拉丁裔 144 人,白人 71 人。拉丁裔参与者的 BICS-Q 总分最高,其次是白人和黑人参与者(分别为 11.2 vs 8.2 vs 4.9,P < 0.0001)。拉丁裔参与者的 BICS-Q 分量表得分明显高于黑人参与者,拉丁裔和白人参与者之间没有明显差异。在控制了潜在的混杂因素后,拉丁裔/种族与黑人/种族相比仍与较高的 BICS-Q 评分相关(P = 0.0077),较低的脱垂和尿失禁知识问卷-尿失禁评分仍与较高的 BICS-Q 评分独立相关(P = 0.0078):在我们的研究人群中,拉丁裔患者和尿失禁知识水平较低的患者与黑人患者和尿失禁知识水平较高的患者相比,在寻求尿失禁护理时会遇到更多障碍。解决这些障碍可提高就医率并改善该领域的健康公平性。
{"title":"Urinary Incontinence Care-Seeking Barriers Among Latina Patients: What Are We Missing?","authors":"Anna Pancheshnikov, Bryna J Harrington, Victoria L Handa, Liz I Yanes, Margot Le Neveu, Kristin M Voegtline, Sarah B Olson, Joan L Blomquist, Stephanie Jacobs, Danielle Patterson, Chi Chiung Grace Chen","doi":"10.1097/SPV.0000000000001555","DOIUrl":"10.1097/SPV.0000000000001555","url":null,"abstract":"<p><strong>Importance: </strong>The Latina population is the largest growing ethnic group in the United States with high levels of health disparities in urinary incontinence (UI) treatment and complications rates, which may be due to disproportionately high barriers to UI care-seeking among Latinas.</p><p><strong>Objectives: </strong>The objectives of this study were to compare barriers to UI care-seeking among Latina, non-Latina Black, and non-Latina White patients by utilizing the Barriers to Incontinence Care Seeking Questionnaire (BICS-Q) total scores, and to compare specific barriers utilizing BICS-Q subscales.</p><p><strong>Study design: </strong>In this cross-sectional study, patients accessing primary care were recruited to complete the BICS-Q, International Consultation on Incontinence Questionnaire-Short Form, and Prolapse and Incontinence Knowledge Questionnaire-Urinary Incontinence. The BICS-Q total and subscale scores were compared among ethnic/racial groups.</p><p><strong>Results: </strong>A total of 298 patients were included in the study with 83 Black, 144 Latina, and 71 White participants per self-identified ethnicity/race. The total BICS-Q score was highest for Latina participants, followed by White and Black participants (11.2 vs 8.2 vs 4.9, respectively, P  < 0.0001). Latina participants had significantly higher BICS-Q subscale scores compared with Black participants with no significant differences between Latina and White participants. After controlling for potential confounders, Latina ethnicity/race was still associated with a higher BICS-Q score when compared to Black ethnicity/race ( P  = 0.0077), and lower Prolapse and Incontinence Knowledge Questionnaire-Urinary Incontinence scores remained independently associated with higher BICS-Q scores ( P  = 0.0078).</p><p><strong>Conclusions: </strong>In our study population, Latina patients and patients with lower UI knowledge experience higher barriers to UI care-seeking compared with Black patients and patients with higher UI knowledge. Addressing these barriers may increase care-seeking and improve health equity in the field.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"757-766"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794251","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}
引用次数: 0
The Reliability of 3-Dimensional Endoanal Ultrasonography Early and Late Postpartum. 产后早期和晚期三维肛门内超声波检查的可靠性。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001559
Søren Gräs, Marianne Starck, Hanna Jangö, Gunnar Lose, Niels Klarskov

Importance: There is no consensus on how to define obstetric anal sphincter defects detected by 3-dimensional endoanal ultrasonography (3D-EAUS), and the reported rates vary significantly in the postpartum period.

Objective: The objective of this study was to establish a diagnostic strategy with a high and clinically relevant interrater reliability both early and late postpartum.

Study design: The study was prospective and observational, and 3D-EAUS was performed 10-14 days and 9-12 months postpartum in an unselected cohort of primiparous women with vacuum-assisted deliveries. Two experienced examiners evaluated the ultrasonographic results, which were divided into the categories intact, inconclusive, small, moderate, and large defects based on Starck scores. Three different diagnostic strategies were validated, and the prevalence- and bias-adjusted kappa (PABAK) values calculated.

Results: Of 334 eligible women, 184 (55.1%) completed both examinations. Disagreements involving small defects were predominant and observed in 34 and 39 cases, respectively, at the 2 time points. The highest overall agreement rates (91.3% and 92.4%, respectively) and PABAK values (0.83 and 0.85, respectively) were reached when the disagreements were minimized by dichotomizing the results into Starck scores >4 (designated a significant defect) versus Starck scores 0-4 (all others).

Conclusions: The interrater reliability of detecting small anal sphincter defects by 3D-EAUS was low at both time points for the 2 experienced raters. In contrast, the interrater reliability of detecting a significant defect was classified as almost perfect agreement at both time points.

重要性:对于如何定义三维肛门内超声(3D-EAUS)检测到的产科肛门括约肌缺损,目前尚未达成共识,产后报告的比例也有很大差异:研究设计:研究设计:该研究为前瞻性观察性研究,在未经选择的真空助产初产妇群中,分别于产后 10-14 天和 9-12 个月进行 3D-EAUS 检查。两名经验丰富的检查员对超声波检查结果进行评估,并根据斯塔克评分将结果分为完好、不确定、小、中、大缺损等类别。对三种不同的诊断策略进行了验证,并计算了患病率和偏倚调整卡帕(PABAK)值:在 334 名符合条件的妇女中,184 人(55.1%)完成了两次检查。在两个时间点观察到的分歧主要涉及小缺陷,分别为 34 例和 39 例。通过将结果分为Starck评分>4分(指定为重大缺陷)和Starck评分0-4分(所有其他缺陷),将分歧最小化,从而达到最高的总体一致率(分别为91.3%和92.4%)和PABAK值(分别为0.83和0.85):结论:在两个时间点上,两名经验丰富的评分员通过 3D-EAUS 检测肛门括约肌小缺损的评分间可靠性都很低。相比之下,在两个时间点上,检测重大缺陷的评分者间可靠性几乎完全一致。
{"title":"The Reliability of 3-Dimensional Endoanal Ultrasonography Early and Late Postpartum.","authors":"Søren Gräs, Marianne Starck, Hanna Jangö, Gunnar Lose, Niels Klarskov","doi":"10.1097/SPV.0000000000001559","DOIUrl":"10.1097/SPV.0000000000001559","url":null,"abstract":"<p><strong>Importance: </strong>There is no consensus on how to define obstetric anal sphincter defects detected by 3-dimensional endoanal ultrasonography (3D-EAUS), and the reported rates vary significantly in the postpartum period.</p><p><strong>Objective: </strong>The objective of this study was to establish a diagnostic strategy with a high and clinically relevant interrater reliability both early and late postpartum.</p><p><strong>Study design: </strong>The study was prospective and observational, and 3D-EAUS was performed 10-14 days and 9-12 months postpartum in an unselected cohort of primiparous women with vacuum-assisted deliveries. Two experienced examiners evaluated the ultrasonographic results, which were divided into the categories intact, inconclusive, small, moderate, and large defects based on Starck scores. Three different diagnostic strategies were validated, and the prevalence- and bias-adjusted kappa (PABAK) values calculated.</p><p><strong>Results: </strong>Of 334 eligible women, 184 (55.1%) completed both examinations. Disagreements involving small defects were predominant and observed in 34 and 39 cases, respectively, at the 2 time points. The highest overall agreement rates (91.3% and 92.4%, respectively) and PABAK values (0.83 and 0.85, respectively) were reached when the disagreements were minimized by dichotomizing the results into Starck scores >4 (designated a significant defect) versus Starck scores 0-4 (all others).</p><p><strong>Conclusions: </strong>The interrater reliability of detecting small anal sphincter defects by 3D-EAUS was low at both time points for the 2 experienced raters. In contrast, the interrater reliability of detecting a significant defect was classified as almost perfect agreement at both time points.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"790-798"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006073","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}
引用次数: 0
Global Surgical Packages: Developed by the AUGS Coding Committee. 全球手术包:由AUGS编码委员会制定。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001716
Nemi M Shah, Marc Toglia
{"title":"Global Surgical Packages: Developed by the AUGS Coding Committee.","authors":"Nemi M Shah, Marc Toglia","doi":"10.1097/SPV.0000000000001716","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001716","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 8","pages":"735-736"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088546","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}
引用次数: 0
In Just 3 Minutes, You Can Bring Urogynecology Closer to Getting Its Own Specialty Code: Developed by the AUGS Coding Committee. 在短短3分钟内,你可以让泌尿妇科更接近获得自己的专业代码:由AUGS编码委员会开发。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001711
Evelyn F Hall, Sarah A Collins
{"title":"In Just 3 Minutes, You Can Bring Urogynecology Closer to Getting Its Own Specialty Code: Developed by the AUGS Coding Committee.","authors":"Evelyn F Hall, Sarah A Collins","doi":"10.1097/SPV.0000000000001711","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001711","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 8","pages":"733-734"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088518","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}
引用次数: 0
Individuals With Impact: How You Can Shape the Future of Funding in Pelvic Floor Disorders: Erratum. 有影响的个人:如何塑造盆底疾病资金的未来:勘误。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001718
Julia K Shinnick, David Sheyn, Nazema Y Siddiqui
{"title":"Individuals With Impact: How You Can Shape the Future of Funding in Pelvic Floor Disorders: Erratum.","authors":"Julia K Shinnick, David Sheyn, Nazema Y Siddiqui","doi":"10.1097/SPV.0000000000001718","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001718","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 8","pages":"822"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088483","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}
引用次数: 0
Small Bowel Complications After Sacrocolpopexy: A Case Series. 骶尾部结肠切除术后的小肠并发症:病例系列。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001682
Hoang-Hoa T Nguyen, Jennifer W H Wong, Olga Ramm, Julia Geynisman-Tan, Christina Lewicky-Gaupp, Kimberly Kenton, Margaret Mueller

Importance: Ileus and small bowel obstructions are known but rare complications associated with minimally invasive sacrocolpopexy that can result in variable management.

Objectives: The objectives of this study were to describe the clinical presentation, management and outcomes of ileus or small bowel obstructions after minimally invasive sacrocolpopexy.

Study design: This was a multicenter retrospective case series of postoperative ileus or small bowel obstruction after minimally invasive sacrocolpopexy. Demographics, clinical, surgical, and complication characteristics were manually abstracted. Descriptive statistics were performed via SPSS along with associative and comparative analyses.

Results: Ileus or small bowel obstruction was diagnosed in 2.5%, 95% CI = 1.8,3.3%, of all minimally invasive sacrocolpopexy cases across institutions. Presentation for small bowel complication ranged from 1 to 2,432 days after surgery with 70% presenting within 14 days of the index surgery. Remoteness from the surgery was associated with whether the index team was involved in the management of the bowel complication. Patients who were conservatively managed were admitted for a significantly shorter amount of time with a mean length of stay of 4.52 (±3) days compared to 10.3 (±6, P  < 0.001) days for those who were surgically managed.

Conclusions: Small bowel complication is a known rare risk following minimally invasive sacrocolpopexy. Conservative management resolves the majority of cases and should be considered to reduce the risk of surgical morbidity or disruption of the mesh. Given that multiple clinical teams may encounter and manage these complications, our study highlights the importance of keeping a high index of suspicion and thoughtful communication about these events.

重要性:肠梗阻和小肠梗阻是已知的,但与微创骶colpop固定术相关的罕见并发症可能导致不同的处理。目的:本研究的目的是描述微创骶结肠固定术后肠梗阻或小肠阻塞的临床表现、处理和结果。研究设计:这是一个多中心回顾性病例系列,微创骶colpop固定术后肠梗阻或小肠梗阻。人工提取人口统计学、临床、手术和并发症特征。通过SPSS进行描述性统计以及关联分析和比较分析。结果:在所有微创骶colpop固定术病例中,肠梗阻或小肠梗阻的诊断率为2.5%,95% CI = 1.8,3.3%。小肠并发症的出现时间从手术后1天到2432天不等,70%在手术后14天内出现。手术距离远与指数组是否参与肠并发症的处理有关。保守治疗的患者入院时间明显较短,平均住院时间为4.52(±3)天,而手术治疗的患者住院时间为10.3(±6,P < 0.001)天。结论:微创骶髋固定术后小肠并发症是一种罕见的风险。保守治疗解决了大多数病例,应考虑降低手术并发症或补片破坏的风险。鉴于多个临床团队可能会遇到并处理这些并发症,我们的研究强调了保持高度怀疑和对这些事件进行深思熟虑沟通的重要性。
{"title":"Small Bowel Complications After Sacrocolpopexy: A Case Series.","authors":"Hoang-Hoa T Nguyen, Jennifer W H Wong, Olga Ramm, Julia Geynisman-Tan, Christina Lewicky-Gaupp, Kimberly Kenton, Margaret Mueller","doi":"10.1097/SPV.0000000000001682","DOIUrl":"10.1097/SPV.0000000000001682","url":null,"abstract":"<p><strong>Importance: </strong>Ileus and small bowel obstructions are known but rare complications associated with minimally invasive sacrocolpopexy that can result in variable management.</p><p><strong>Objectives: </strong>The objectives of this study were to describe the clinical presentation, management and outcomes of ileus or small bowel obstructions after minimally invasive sacrocolpopexy.</p><p><strong>Study design: </strong>This was a multicenter retrospective case series of postoperative ileus or small bowel obstruction after minimally invasive sacrocolpopexy. Demographics, clinical, surgical, and complication characteristics were manually abstracted. Descriptive statistics were performed via SPSS along with associative and comparative analyses.</p><p><strong>Results: </strong>Ileus or small bowel obstruction was diagnosed in 2.5%, 95% CI = 1.8,3.3%, of all minimally invasive sacrocolpopexy cases across institutions. Presentation for small bowel complication ranged from 1 to 2,432 days after surgery with 70% presenting within 14 days of the index surgery. Remoteness from the surgery was associated with whether the index team was involved in the management of the bowel complication. Patients who were conservatively managed were admitted for a significantly shorter amount of time with a mean length of stay of 4.52 (±3) days compared to 10.3 (±6, P  < 0.001) days for those who were surgically managed.</p><p><strong>Conclusions: </strong>Small bowel complication is a known rare risk following minimally invasive sacrocolpopexy. Conservative management resolves the majority of cases and should be considered to reduce the risk of surgical morbidity or disruption of the mesh. Given that multiple clinical teams may encounter and manage these complications, our study highlights the importance of keeping a high index of suspicion and thoughtful communication about these events.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"816-821"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782140","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}
引用次数: 0
Incidence of Dementia Among Medicare Beneficiaries With and Without Urinary Incontinence. 有尿失禁和无尿失禁的医疗保险受益人中痴呆症的发病率。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001552
Rachel A High, Cassie B Ford, Victoria L Handa, Jennifer Anger

Importance: Dementia and urinary incontinence (UI) have been associated in cross-sectional studies. The temporal relationship between these 2 conditions is not well understood.

Objective: The aim of the study was to investigate the risk of incident dementia in female adults with and without UI using the Medicare 5% Limited Data Set.

Study design: This retrospective cohort study matched females with UI to continent controls by index year, age, and dual Medicare/Medicaid eligibility. A 2-year look back period was used to exclude prevalent dementia and neurologic disorders. The 5-year cumulative incidence of dementia was estimated for women with UI and controls. Cox proportional hazard models assessed the association of variables with dementia, adjusting for age, dual Medicare/Medicaid eligibility, race, and comorbidities.

Results: A total of 8,651 female beneficiaries with UI (n = 8,651) were more likely than matched controls (n = 8,651) to report White race and several medical comorbidities. The 5-year cumulative incidence of dementia diagnosis was lower in the UI versus controls (8.8% vs 10.6%, P  < 0.001). In multivariable analysis with adjustment for covariates, UI diagnosis was associated with a lower hazard of dementia diagnosis (hazard ratio 0.82 [0.74, 0.91], P  < 0.001).

Conclusions: Among female Medicare beneficiaries without baseline neurologic disorders, having any UI diagnosis was associated with a lower risk of dementia diagnosis. Further studies assessing UI symptoms and dementia diagnosis with rigorous and valid assessment tools are needed to confirm this finding.

重要性:在横断面研究中,痴呆症与尿失禁(UI)有关联。这两种情况之间的时间关系尚不十分清楚:该研究的目的是利用医疗保险 5% 有限数据集调查有尿失禁和无尿失禁的成年女性患痴呆症的风险:这项回顾性队列研究按指数年、年龄和医疗保险/医疗补助双重资格将患有尿崩症的女性与大陆对照组进行配对。研究采用 2 年回溯期,以排除流行性痴呆和神经系统疾病。对患有尿失禁的女性和对照组的痴呆症 5 年累积发病率进行了估算。Cox 比例危险模型评估了各变量与痴呆症的关系,并对年龄、双重医疗保险/医疗补助资格、种族和合并症进行了调整:共有 8,651 名患有 UI 的女性受益人(n = 8,651)比匹配的对照组(n = 8,651)更有可能报告白种人和几种合并症。与对照组相比,UI 患者痴呆诊断的 5 年累积发病率较低(8.8% vs 10.6%,P < 0.001)。在对协变量进行调整的多变量分析中,UI 诊断与较低的痴呆诊断风险相关(风险比为 0.82 [0.74, 0.91],P < 0.001):结论:在没有神经系统疾病基线的女性医疗保险受益人中,任何尿频症状诊断都与较低的痴呆症诊断风险相关。要证实这一发现,还需要使用严格有效的评估工具对尿路感染症状和痴呆诊断进行进一步的研究。
{"title":"Incidence of Dementia Among Medicare Beneficiaries With and Without Urinary Incontinence.","authors":"Rachel A High, Cassie B Ford, Victoria L Handa, Jennifer Anger","doi":"10.1097/SPV.0000000000001552","DOIUrl":"10.1097/SPV.0000000000001552","url":null,"abstract":"<p><strong>Importance: </strong>Dementia and urinary incontinence (UI) have been associated in cross-sectional studies. The temporal relationship between these 2 conditions is not well understood.</p><p><strong>Objective: </strong>The aim of the study was to investigate the risk of incident dementia in female adults with and without UI using the Medicare 5% Limited Data Set.</p><p><strong>Study design: </strong>This retrospective cohort study matched females with UI to continent controls by index year, age, and dual Medicare/Medicaid eligibility. A 2-year look back period was used to exclude prevalent dementia and neurologic disorders. The 5-year cumulative incidence of dementia was estimated for women with UI and controls. Cox proportional hazard models assessed the association of variables with dementia, adjusting for age, dual Medicare/Medicaid eligibility, race, and comorbidities.</p><p><strong>Results: </strong>A total of 8,651 female beneficiaries with UI (n = 8,651) were more likely than matched controls (n = 8,651) to report White race and several medical comorbidities. The 5-year cumulative incidence of dementia diagnosis was lower in the UI versus controls (8.8% vs 10.6%, P  < 0.001). In multivariable analysis with adjustment for covariates, UI diagnosis was associated with a lower hazard of dementia diagnosis (hazard ratio 0.82 [0.74, 0.91], P  < 0.001).</p><p><strong>Conclusions: </strong>Among female Medicare beneficiaries without baseline neurologic disorders, having any UI diagnosis was associated with a lower risk of dementia diagnosis. Further studies assessing UI symptoms and dementia diagnosis with rigorous and valid assessment tools are needed to confirm this finding.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"750-756"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
American Urogynecologic Society Best Practice Statement: Evaluation and Counseling of Patients With Pelvic Organ Prolapse: Erratum. 美国泌尿妇科学会最佳实践声明:盆腔器官脱垂患者的评估和咨询:勘误。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001721
Cassandra L Carberry, Paul K Tulikangas, Beri M Ridgeway, Sarah A Collins, Rony A Adam
{"title":"American Urogynecologic Society Best Practice Statement: Evaluation and Counseling of Patients With Pelvic Organ Prolapse: Erratum.","authors":"Cassandra L Carberry, Paul K Tulikangas, Beri M Ridgeway, Sarah A Collins, Rony A Adam","doi":"10.1097/SPV.0000000000001721","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001721","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 8","pages":"823"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088510","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}
引用次数: 0
To Stent or Not to Stent. 支架还是不支架。
IF 1.2 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-01 DOI: 10.1097/SPV.0000000000001697
Jessica Hammett, Gina Northington
{"title":"To Stent or Not to Stent.","authors":"Jessica Hammett, Gina Northington","doi":"10.1097/SPV.0000000000001697","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001697","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":"31 8","pages":"747-749"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088561","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}
引用次数: 0
期刊
Urogynecology (Hagerstown, Md.)
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1