International Urogynecology Journal (INT UROGYNECOL J)

Publications in this journal

• Article: Selective managemet of female genito-urinary fistulae: an analysis of 45 cases.

  J T Nel
  International Urogynecology Journal 02/2013; 5:326..
• Article: A passing of the gavel: looking back and looking forward

  Peter Dwyer, Paul Riss
  International Urogynecology Journal 05/2012; 22(2):125-125.
• Article: The IUGA/ICS classification of complications of prosthesis and graft insertion

  C. Skala, K. Renezeder, S. Albrich, A. Puhl, R. M. Laterza, G. Naumann, H. Koelbl
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  ABSTRACT: Introduction and hypothesisThis is a presentation of case series after the use of alloplasic material in urogynaecology. MethodsFrom 2004 to 2010, a total 179 patients with complications have been referred directly after the use of alloplastic material in incontinence and prolapse surgery. Of this total, 125 patients had a previous vaginal sling plasty because of urinary stress incontinence, while 54 patients underwent a prolapse surgery with mesh use. Symptoms and findings are expressed by the recently introduced International Urogynecological Association/International Continence Society (IUGA/ICS) terminology. ResultsThe most frequent findings after vaginal sling plasty were bladder outlet obstruction, pain and tape exposure. The most frequent findings after prolapse surgery were pain and mesh erosion. The IUGA/ICS classification does not give the possibility to express functional disorders. Most revisions were done more than 2months after surgery. After incontinence surgery, mostly the vaginal area of suture line was affected; after prolapse surgery, the vagina and the trocar passage were affected. ConclusionsMesh complication and affected site after prolapse surgery do differ from those after incontinence surgery. The IUGA/ICS classification of mesh complication facilitates the comparison of mesh complication. KeywordsProlapse surgery–Vaginal slings plasty–Pelvic floor reconstruction–Incontinence surgery alloplastic material–IUGA/ICS Classification of Mesh Complications
  International Urogynecology Journal 05/2012; 22(11):1429-1435.
• Article: A prospective comparison of two commercial mesh kits in the management of anterior vaginal prolapse

  Benjamin Feiner, Peter O’Rourke, Christopher Maher
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  ABSTRACT: Introduction and hypothesisVaginal mesh kits are increasingly used in the management of pelvic organ prolapse. This study aimed to determine similarity of outcomes of the Anterior Prolift® with Perigee® systems for anterior compartment prolapse. MethodsConsecutive women undergoing Perigee® or Anterior Prolift® for symptomatic stage 2 or greater anterior vaginal prolapse were prospectively evaluated. Main outcome measures included objective and subjective success rates, perioperative outcomes, patient satisfaction, and complications. ResultsOne hundred and six women (Prolift, 52; Perigee, 54) completed questionnaires, and 91 (Prolift, 46; Perigee, 45) were examined postoperatively. At follow-up (Prolift: median, 11.0; range, 5–23months; Perigee: median, 11.5; range, 6–23months), objective success rates (Prolift, 89%; Perigee, 80%; p = 0.23), subjective success rates (Prolift, 94%; Perigee, 96%; p = 0.62), mean ± SD patient satisfaction (Prolift, 8.2 ± 2.0; Perigee, 8.2 ± 1.8; p = 0.91), and complication rates did not differ significantly between the two groups. ConclusionsThe Anterior Prolift® was found to not differ significantly from Perigee® at 11months. KeywordsPerigee–Prolapse–Prolift–Vaginal mesh
  International Urogynecology Journal 04/2012; 23(3):279-283.
• Article: Prospective study of anterior transobturator mesh kit (Prolift™) for the management of recurrent anterior vaginal wall prolapse

  Abdalla M. Fayyad, Carolyn North, Fiona M. Reid, Anthony R.B. Smith
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  ABSTRACT: Introduction and hypothesisAssessment of the 2-year outcome of anterior Prolift™ for women with recurrent anterior vaginal wall prolapse. This is a prospective study which was conducted in a tertiary unit in the North West of England and comprised 36 consecutive women with recurrent anterior vaginal wall prolapse. MethodsWomen were assessed preoperatively and postoperatively at 6months and 2years. Women completed the Prolapse Quality of Life Questionnaire (P-QOL), Prolapse and Incontinence Sexual Function Questionnaire-Short Form (PISQ-12), and postoperatively, the Global Impression of Improvement Questionnaire. Women were examined using the Pelvic Organ Prolapse Quantification System (POP-Q). Anatomical success was defined as stage ≤1 prolapse in the anterior compartment. Main outcome measures Postoperative POP-Q stage, quality of life domains and mesh exposure rate. ResultsPreoperatively all but two women had stage 2 or greater anterior vaginal wall prolapse. At a mean follow-up of 24.6months, 19 women (53%) had stage ≤1 anterior wall prolapse. Fifteen women had stage 2 anterior wall prolapse and two women had stage 3 prolapse. Twenty-nine women felt improvement in their prolapse symptoms. 16 women were sexually active preoperatively, of whom seven reported worsening dyspareunia. There was poor correlation between anatomical and functional outcomes. Seven women had mesh exposure. Five needed revision in theatre. ConclusionsAnterior Prolift™ for recurrent anterior vaginal wall prolapse has 53% anatomical success rate in the medium term, with mesh exposure rate of 19%. Majority of patients felt overall improvement in their symptoms, but this did not correlate with the anatomical outcome. KeywordsProlapse–Anterior wall–Mesh–Prolift™–Recurrent–Erosion
  International Urogynecology Journal 04/2012; 22(2):157-163.
• Article: J Stoker, S.A. Taylor and J.O.L. DeLancey (eds) Imaging pelvic floor disorders, 2nd edition

  Sharif I. M. F. Ismail
  International Urogynecology Journal 04/2012; 20(7):885-885.
• Article: J. Thomas Benson (ed.): Atlas of Female Pelvic Medicine and Reconstructive Surgery, 2nd edn.

  Sharif I. M. F. Ismail
  International Urogynecology Journal 04/2012; 20(12):1527-1528.
• Article: Inflammatory response to bovine pericardium: reply to letter by Davila

  George Lazarou, Kenneth Powers, Carlos Pena, Lance Bruck, Magdy S. Mikhail
  International Urogynecology Journal 04/2012; 17(5):551-551.
• Article: Ethical aspects of urinary diversion for women with irreparable obstetric fistulas in developing countries: response to comments by Morgan and Husain

  L. Lewis Wall, Steven D. Arrowsmith, Brian Hancock
  International Urogynecology Journal 04/2012; 20(5):613-614.
• Article: Sphincter tears in primiparous women: is age a factor?

  C. Bryce Bowling, Thomas L. Wheeler II, Kimberly A. Gerten, Victoria R. Chapman, Kathryn L. Burgio, Holly E. Richter
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  ABSTRACT: Anal sphincter tears during vaginal delivery may result in serious sequelae. We examined whether younger primiparous patients were at increased risk for sphincter tears during vaginal delivery. Data from an obstetric automated record were analyzed. Primiparous women delivering term infants (n = 5,937) were included to test for an association between age and sphincter tear rates. Three age groups were considered: young adolescents (≤16years), older adolescents (17–20years), and adults (≥21years). No significant difference was found in tear rates among age cohorts (9.2%, 8.0%, and 9.6% respectively; p = 0.12). Logistic regression modeling revealed that young adolescents were not more likely to have sphincter tears compared to older cohorts. Younger adolescents may not be at increased risk of anal sphincter tears. Decisions regarding interventions to decrease sphincter tears during vaginal delivery should not be made on the basis of maternal age alone.
  International Urogynecology Journal 04/2012; 20(5):565-569.
• Article: Predicting the development of stress urinary incontinence 3 years after hysterectomy

  Mariëlle M. E. Lakeman, C. Huub Van Der Vaart, Jan Willem Van Der Steeg, Jan-Paul W. R. Roovers, On behalf of the HysVA study group
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  ABSTRACT: Introduction and hypothesisWe aimed to develop a prediction rule to predict the individual risk to develop stress urinary incontinence (SUI) after hysterectomy. MethodsProspective observational study with 3-year follow-up among women who underwent abdominal or vaginal hysterectomy for benign conditions, excluding vaginal prolapse, and who did not report SUI before surgery (n = 183). The presence of SUI was assessed using a validated questionnaire. ResultsSignificant prognostic factors for de novo SUI were BMI (OR 1.1 per kg/m2, 95% CI 1.0–1.2), younger age at time of hysterectomy (OR 0.9 per year, 95% CI 0.8–1.0) and vaginal hysterectomy (OR 2.3, 95% CI 1.0–5.2). Using these variables, we developed the following rule to predict the risk of developing SUI: 32 + BMI − age + (7.5 × route of surgery). ConclusionsWe defined a prediction rule that can be used to counsel patients about their individual risk on developing SUI following hysterectomy. KeywordsHysterectomy–Prognosis–Stress urinary incontinence
  International Urogynecology Journal 04/2012; 22(9):1179-1184.
• Article: Constipation symptoms before and after vaginal and abdominal pelvic reconstructive surgery

  Minita Patel, David M. O’Sullivan, Christine A. LaSala
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  ABSTRACT: Introduction and hypothesisThis article aims to evaluate how constipation symptoms change after pelvic reconstructive surgery using the Patient Assessment of Constipation Symptom Questionnaire (PAC-SYM). Our primary hypothesis was that constipation would improve after surgery. MethodsNinety-four subjects completed the PAC-SYM before and 7weeks after pelvic reconstructive surgery from 2007 through 2009 inclusive. PAC-SYM scores were compared for the cohort before and 7weeks post-surgery and based on route of surgery: vaginal or abdominal. ResultsBaseline PAC-SYM scores between those undergoing abdominal or vaginal reconstructive surgery were not significantly different (0.76 versus 0.83, respectively; p = 0.586). Subjects in the vaginal surgery group had a significant reduction in PAC-SYM scores, 0.83 to 0.62 (p = 0.049). After abdominal surgery, subjects had an increase in abdominal subscale scores, 0.69 to 1.03 (p = 0.012). ConclusionsWomen undergoing vaginal prolapse surgery may have a short-term improvement in constipation symptoms, while those undergoing abdominal surgery have worsening of abdominal constipation symptoms. KeywordsConstipation–Pelvic organ prolapse–Pelvic reconstructive surgery
  International Urogynecology Journal 04/2012; 22(11):1413-1419.
• Article: Sonohysterography in evaluation of Youssef’s syndrome

  Ibrahim Veysel Fenkci, Murat Demirbas, Ozer Oztekin
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  ABSTRACT: A 31-year-old woman with Youssef syndrome was reported. Vesicouterine fistula is responsible for the symptoms of Youssef syndrome. An easy and feasible diagnostic method of vesicouterine fistula is sonohysterography. KeywordsYoussef syndrome-Sonohysterography-Vesicouterine fistula
  International Urogynecology Journal 04/2012; 21(5):607-608.
• Article: Use of a beef tongue model and instructional video for teaching residents fourth-degree laceration repair

  Minita Patel, Christine LaSala, Paul Tulikangas, David M. O’Sullivan, Adam C. Steinberg
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  ABSTRACT: Introduction and hypothesisThis study seeks to compare the utility of the beef tongue model versus an instructional video in teaching obstetric and gynecology residents how to repair a fourth-degree laceration. MethodsTwenty-seven residents were randomized to participate in a workshop with a beef tongue model or assigned to watch an instructional video on repair of fourth-degree lacerations and read a chapter on the repair. All subjects were tested with a pre- and postintervention written test. These scores were compared with paired t test at 0.05 significance level. ResultsResidents with no prior experience in fourth-degree laceration repairs showed an improvement in knowledge (49.5% versus 64.1%, p < 0.001) on written exams about the repairs. ConclusionsAn instructional video or beef tongue model and textbook chapter on fourth-degree laceration repair can improve skills in repair of a fourth-degree laceration among residents with no experience in these repairs.
  International Urogynecology Journal 04/2012; 21(3):353-358.
• Article: Surgical management of Skene’s gland abscess/infection: a contemporary series

  Sagar R. Shah, Grace Y. Biggs, Nirit Rosenblum, Victor W. Nitti
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  ABSTRACT: Introduction and hypothesisWe report our experience with surgical excision for treatment of Skene’s gland abscess/infection after conservative measures have failed. MethodsA retrospective review of patients that underwent surgical excision of Skene’s gland abscess/infection by a single surgeon from 06/1995 to 09/2008 was performed. Patients were separated into groups based on indication for procedure. Recurrence rate and success rate were calculated. ResultsThe final study group included 34 patients. After initial excision, 88.2% (30/34) of patients had resolution of symptoms. Recurrence of signs and symptoms that prompted further treatment occurred in 30% (9/30). In those that recurred, 88.8% (8/9) of patients had resolution of symptoms after further therapy. Overall success rate in complete resolution of symptoms after all treatment was 85.3%. Only patients to fail were in the urethral pain and recurrent UTI groups. ConclusionSurgical excision is a safe and effective therapy for the treatment of Skene’s gland abscess/infection after conservative measures have failed. KeywordsSkene’s gland–Infection–Surgical management
  International Urogynecology Journal 04/2012; 23(2):159-164.
• Article: In vitro and in vivo assessment of silver-coated polypropylene mesh to prevent infection in a rat model

  Wassim Badiou, Jean-Philippe Lavigne, Philippe-Jean Bousquet, David O’Callaghan, Pierre Marès, Renaud de Tayrac
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  ABSTRACT: Introduction and hypothesisThe purpose of this study is to determine the effect of silver coating of polypropylene implants on infection in hernia surgery. MethodsSilver-coated and non-silver-coated large pore monofilament polypropylene mesh implants were compared with and without infection (four groups). The implants were inserted in the abdominal wall of female Wistar rats. An Escherichia coli strain was inoculated intraoperatively in the two infected groups. The implants were removed, and clinical, bacteriological, and histological analyses were performed at 2, 15, and 30days postoperatively. ResultsEighty-four rats were studied. All inoculated rats (n = 21) in the non-silver-coated polypropylene group presented periprosthetic E. coli infection, compared with only five inoculated rats in the silver-coated polypropylene group (p < 0.0001). Erosion was significantly higher in the infected than in the non-infected silver-coated polypropylene groups (p < 0.01). There was no histological difference between the four groups. ConclusionsSilver-coated implants appear effective against bacterial infection in our rat model, with good histological tolerance but delayed healing. KeywordsGenitourinary prolapse–Polypropylene–Prosthetic infection–Rat model–Silver-coated implant
  International Urogynecology Journal 04/2012; 22(3):265-272.
• Article: IUGA guidelines for training in female pelvic medicine and reconstructive pelvic surgery (FPM-RPS)

  H. P. Drutz, IUGA Education Committee
  International Urogynecology Journal 04/2012; 21(12):1445-1453.
• Article: Kari Bø, Bary Berghmans, Siv Mørkved, Marijke Van Kampen (eds): Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice

  Sharif I. M. F. Ismail
  International Urogynecology Journal 04/2012; 20(11):1399-1400.
• Article: Pelvic floor muscle function in women presenting with pelvic floor disorders

  Michael D. Moen, Michael B. Noone, Brett J. Vassallo, Denise M. Elser, for the Urogynecology Network
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  ABSTRACT: Introduction and hypothesisThis observational study was undertaken to determine knowledge, prior instruction, frequency of performance, and ability to perform pelvic floor muscle exercises in a group of women presenting for evaluation of pelvic floor disorders. MethodsThree hundred twenty-five women presenting for evaluation of pelvic floor disorders were questioned concerning knowledge and performance of pelvic floor muscle exercises (PMEs) and then examined to determine pelvic floor muscle contraction strength. ResultsThe majority of women (73%) had heard of PMEs, but only 42% had been instructed to perform them and 62.5% stated they received verbal instruction only. Only 23.4% of patients could perform pelvic muscle contractions with Oxford Scale 3, 4, or 5 strengths. Increased age, parity, and stage of prolapse were associated with lower Oxford scores. ConclusionsAlthough most women with pelvic floor disorders are familiar with PMEs, less than one fourth could perform adequate contractions at the time of initial evaluation.
  International Urogynecology Journal 04/2012; 20(7):843-846.