Maturitas最新文献

Objectives: To evaluate the long-term efficacy and safety of a single injection session of cross-linked hyaluronic acid for postmenopausal vulvovaginal atrophy.

Study design: 12-week, randomised, placebo-controlled, single-blind phase followed by 40-week open-label phase. At study start, patients received hyaluronic acid or placebo injection. At 12 weeks, patients who initially received placebo received hyaluronic acid.

Main outcome measures: Mean change from baseline in the severity score of the most bothersome symptom, scores for vulvovaginal atrophy individual symptoms, score on the Female Sexual Function Index and vaginal pH after hyaluronic acid injection. Patients receiving hyaluronic acid were followed to 36 weeks or 52 weeks if treated at study start.

Results: 115 patients receiving hyaluronic acid were analysed. The mean score for most bothersome symptom and all individual symptom scores were significantly reduced from baseline at all time points (p < 0.001). The initial decrease in most bothersome symptom was observed at 4 weeks, with a mean (SD) decrease of -1.05 (1.05) to 1.69 (1.11), and maintained up to 52 weeks. Mean full-scale score on the Female Sexual Function Index was significantly increased from baseline at all time points (p < 0.001). The initial increase was observed at 4 weeks, with a mean increase of 4.50 (6.51) to 20.54 (8.60), and maintained up to 52 weeks. Improvement was observed across all domains of the Female Sexual Function Index. There was a general trend for improvement in vaginal pH.

Conclusions: A single injection session of hyaluronic acid is effective in reducing vulvovaginal symptomatology and in improving sexual function for up to 52 weeks, making it a suitable management option for moderate to severe vulvovaginal atrophy symptoms.

Clinical trials: gov identifier NCT04219722.

Introduction: Several studies indicate that regular physical activity can reduce systolic and diastolic blood pressure, improve endothelial function, and enhance overall cardiovascular fitness in postmenopausal women. To gain a deeper understanding, we conducted a narrative review of systematic reviews to assess the impact of exercise on cardiovascular parameters in postmenopausal women.

Method: The literature search was conducted using the Excerpta Medica, Medical Literature Analysis and Retrieval System Online, Scopus, and Web of Science databases. We included systematic reviews investigating the effects of exercise on cardiovascular parameters in postmenopausal women, with publications considered up until December 2024.

Results: Following the exclusion of 187 publications, three systematic reviews were selected. These reported significant exercise-induced improvements in vasomotor symptoms, systolic blood pressure, diastolic blood pressure and heart rate.

Conclusion: This narrative review revealed that exercise benefits cardiovascular health in postmenopausal women. Still, methodological limitations emphasize the need for better systematic reviews. Clinicians ought to interpret findings carefully when recommending physical exercise.

An increasing number of women of menopausal age, many of whom experience menopausal symptoms, are participating in the workforce. Understanding the factors that influence work productivity in this life stage can inform the development of targeted interventions. This systematic review explores which health-related, lifestyle, work-related, and socio-demographic factors are associated with work productivity among menopausal women. A systematic search was conducted for observational studies in PubMed, PsycINFO, and Embase up to July 2024. The risk of bias was assessed using an adapted Newcastle-Ottawa scale. The GRADE framework for prognostic research was applied to evaluate the quality of evidence. A total of 29 studies were included. Menopausal symptoms in general, as well as psychological and vasomotor symptoms, and lower sleep quality were associated with lower at-work productivity, with moderate to high quality of evidence. Additionally, there was moderate quality of evidence that better (perceived) health was associated with higher at-work productivity. Regarding absenteeism, moderate evidence was found for an association with vasomotor symptoms. Inconclusive evidence was found for socio-demographic, work-related factors and remaining health-related and lifestyle factors in relation to both at-work productivity and absenteeism. This review highlights the association of menopausal symptoms and poor sleep quality with decreased work productivity in menopausal women. The evidence for other associations was limited due to the low quality of available evidence or a lack of studies. Further research on modifiable lifestyle and work-related factors is needed to improve the work functioning of women during menopause.

Objectives: To describe the translabial ultrasound findings in patients with stress urinary incontinence (SUI) who underwent single-incision sling (SIS) insertion and to determine the correlation between these findings and results after surgery.

Study design: Retrospective and analytical study of patients with SUI who underwent SIS. Translabial ultrasound was performed 12 months after surgery. Success was assessed using the cough test. Satisfaction was assessed using the Treatment Benefit Scale (TBS). The presence of de novo urgency and de novo voiding dysfunction were assessed by anamnesis and questionnaires.

Main outcome measures: Objective resolution of incontinence, patient satisfaction, de novo urgency and voiding dysfunction.

Results: 111 patients were analyzed. Among the patients with resolution of SUI (92 patients, 82,9 %), 93,5 % (86 patients) had the mesh in the middle third of the urethra, reducing to 78,9 % (15 patients) in patients with SUI unresolved (p = 0,04). In the group of SUI cured, 78,3 % of these patients showed a mean reduction of 17,4 ± 20 % of mesh-pubis distance in Valsalva compared with rest and in the group of SUI unresolved this distance showed an increase of 1,6 ± 16 % (p = 0,02). Mesh-urethral lumen distance was significantly shorter in patients who experienced de novo voiding dysfunction compared with patients without voiding dysfunction (4(3-4,9)mm vs 5(4-7)mm, p = 0,03). The prevalence of voiding dysfunction was 19 % (13 patients) when the mesh-urethral lumen distance was <5 mm, reducing to 2 % (1 patient) in patients with a larger distance (p = 0,01). Urgency was not correlated with any of the variables evaluated.

Conclusions: Translabial ultrasound findings after SIS are correlated to objective resolution of SUI and de novo voiding dysfunction.