Wolfgang Umek

• ao.Univ.Prof.Dr.med.univ.
• Senior Scientist at Medical University of Vienna

Background: The anterior vaginal wall is frequently affected by prolapse, which is frequently treated with anterior colporrhaphy. However, this repair has a high recurrence rate, and no standardized approach exists. Our study aimed to compare two suture techniques concerning postoperative outcomes. Methods: This randomized, single-center trial invo...

Here is the permanent link to our preprint on Authorea: https://doi.org/10.22541/au.173130506.65606430/v1

Introduction and Hypothesis Sacrospinous hysteropexy is one of the preeminent uterus-preserving surgical techniques for treating pelvic organ prolapse supported by level one evidence. As training on models greatly improves surgical skills and outcomes, we developed a simple and inexpensive model to simulate sacrospinous hysteropexy. Methods A step...

(Abstracted from Urogynecology 2024;30:714–720) The most common surgical technique for apical pelvic organ prolapse involves a hysterectomy, but uterine-preserving surgeries have become more common and studies have shown many women prefer them. Though uterine-preserving procedures are rising in popularity, long-term outcomes are still under-studied...

(1) Background: Pelvic organ prolapse (POP) affects millions of women globally, impacting their quality of life and potentially influencing family planning decisions. This study aimed to assess the impact of uterus-preserving prolapse surgery on the sexual function, desire for children, and pregnancy outcomes in premenopausal women with symptomatic...

Importance There are still doubts about long-term satisfaction rates of native tissue uterine preserving surgical techniques for pelvic organ prolapse. Objective The objective of this study was to compare long-term subjective success rates and satisfaction rates between vaginal sacrospinous hysteropexy (SSHP) and vaginal hysterectomy with uterosac...

Purpose of the research: Vaginal pessary use is an established, non-surgical treatment option for pelvic organ prolapse. While satisfaction rates are initially high, they seem to decline over time. We aimed to determine the median duration of pessary use among our patients and to evaluate reasons for discontinuation. Methods: All patients who we...

Introduction and hypothesis: Botulinum toxin (BoNT) is a widely used treatment for overactive bladder (OAB). Despite its common use, no standardized treatment regimen exists so far. The aim of this survey was to evaluate the variation in perioperative treatment strategies among members of the German-speaking urogynecologic societies. Materials an...

Purpose This guideline provides recommendations for the diagnosis, treatment and follow-up care of 3rd and 4th degree perineal tears which occur during vaginal birth. The aim is to improve the management of 3rd and 4th degree perineal tears and reduce the immediate and long-term damage. The guideline is intended for midwives, obstetricians and phys...

Introduction and hypothesis In women, the risk of pelvic floor prolapse is known to be associated with age and parity. Different studies suggested that it is also related to pelvic dimensions, e.g. biomechanical modelling showed that a larger pelvic canal results in higher values of displacement, stress and strain in the pelvic floor muscles, which...

Purpose At least half of surgical complications can be avoided by using surgical checklists. However, universal implementation and compliance have been reported as being variable. Patients undergoing urgent surgical intervention are at increased risk for complications. The aim of this study was to evaluate the checklist compliance together with the...

Background Local estrogen therapy (LET) has beneficial effects on genitourinary atrophy; however it is currently unclear if LET improves sexual function in postmenopausal women with pelvic organ prolapse (POP). Aim To evaluate if LET vs placebo results in an improved sexual function in postmenopausal women with symptomatic POP. Methods We perform...

Study Objective To assess if deep endometriosis surgery affects the bladder function. Design Prospective multicenter observational study (Canadian Task Force classification II-2). Setting Academic researches centers. Patients Thirty-two patients with diagnosis of deep endometriosis requiring surgery. Interventions Women were evaluated with urod...

Background: Correct tack placement at the sacral promontory for mesh fixation in ventral mesh rectopexy is crucial to avoid bleeding, nerve dysfunction and spondylodiscitis. Objective: The present cadaver study was designed to assess the true location of tacks after mesh fixation during laparoscopic ventral mesh rectopexy in relation to vascular...

Objective: To evaluate if locally applied vaginal estrogen affects prolapse-associated complaints compared to placebo treatment in postmenopausal women prior to surgical prolapse repair. Design: Randomised, double-masked, placebo-controlled, multicenter study. Setting: Urogynaecology unit at the Medical University of Vienna and University Hosp...

The aim of this prospective randomized, double-masked, placebo-controlled, multicenter study was to analyze the surgeon’s individual assessment of tissue quality during pelvic floor surgery in postmenopausal women pre-treated with local estrogen therapy (LET) or placebo cream. Secondary outcomes included intraoperative and early postoperative cours...

Despite an estimated prevalence of 13% in women, the exact etiology of non-neurogenic overactive bladder syndrome is unclear. The aim of our study was to gain a better understanding of the pathophysiology of female overactive bladder syndrome by mapping the urinary proteomic profile. We collected urine samples of 20 patients with overactive bladder...

To date there is no standardized regimen or evidence-based practical guideline concerning post-void residual (PVR) measurement after urogynecologic surgeries. This survey aimed to evaluate current practice patterns and the approach taken among urogynecologists surrounding PVR measurement. An online survey was sent to members of several urogynecolog...

Objective To define potential risk factors for recurrence of prolapse. Methods This short report included all women who presented with recurrence of prolapse as well as without any recurrence signs after a vaginal approach of native tissue prolapse repair at an urogynecological center in Austria. Results A total of 124 recurrence cases and 64 wom...

The COVID-19 pandemic led to dramatical changes in elective medical care. We analysed its impact on patients with female pelvic floor dysfunction during the 6 weeks of lockdown in Austria. A cross-sectional study was conducted: All 99 women who presented at the urogynaecologic outpatient clinic of the Medical University of Vienna with pelvic organ...

Objectives The relationship between pelvic organ prolapse (POP) treatment and subjective pelvic-floor related quality of life (QoL) was examined. Study design 130 postmenopausal women with symptomatic POP were included: 45% (59/130) were treated conservatively with pessary and 55% (71/130) underwent pelvic floor surgery. All participants answered...

Background: The aim of this study was to identify clinical risk factors for increased post-void residual (PVR) volumes in patients undergoing vaginal prolapse surgery and to find out whether uterus preservation or prolapse hysterectomy influences the incidence of postoperative urinary retention. Methods: This retrospective study included women w...

In 2019, the American Association of Physical Anthropologists issued a statement on biological aspects of race, concluding that “pure races, in the sense of genetically homogenous populations, do not exist in the human species today, nor is there any evidence that they have ever existed in the past.” The statement continues: “… The only living spec...

Introduction and hypothesis Hysterectomy is one of the most commonly performed gynecological surgical procedures. One of the long-term risks associated with hysterectomy is the occurrence of pelvic organ prolapse (POP). To prevent post-hysterectomy POP, several suspension procedures are routinely performed at the time of hysterectomy. We performed...

Study Objective Sacrocolpopexy (SCP) has become the standard procedure to correct uterovaginal prolapse in women, but techniques and approaches are not standardized. We report the results of the Austrian Sacrocolpopexy Registry, which aimed to collect data on surgical techniques and perioperative outcomes. Design The Austrian Urogynecology Working...

Introduction and hypothesisTriage has become a valid tool to reduce workload during the first consultation in a specialized clinic. A nurse-led telephone intervention prior to the first urogynecologic visit reduces visit duration and increases patients’ and physicians’ satisfaction.Methods All patients scheduled for their very first visit were recr...

Objective Aim of the study was to investigate the expression of transforming growth factor-β1 (TGF-β1), a key regulator of the extracellular matrix composition, in the uterosacral ligaments (USLs) of women with pelvic organ prolapse (POP) compared with controls. We hypothesized that the expression pattern of TGF-β1 differs between postmenopausal wo...

Purpose: Overactive bladder (OAB) syndrome has severe effects on quality of life. Certain drugs are known risk factors for OAB but have not been investigated in a population-wide cohort. The objective of this study was to investigate the role of prescription drugs in the etiology of the OAB. Methods: Retrospective cohort study using a population...

Purpose To investigate the prevalence of pelvic floor disorders (PFDs) in a cohort of Austrian women either during their early or late pregnancy and to search for clinical risk factors which correlate with pelvic floor symptoms during pregnancy. Methods A prospective study was conducted and 200 pregnant women answered the validated German pelvic f...

Introduction and hypothesis The aim of this study was to compare preferences of patients with pelvic organ prolapse (POP) regarding their uterus between German- and Russian-speaking areas. Methods Six urogynecologic tertiary referral centers participated in this prospective study: three centers from German-speaking countries and three from differe...

Objective To investigate which specific clinical factors influence patients’ choice of prolapse treatment. Methods This study includes a total of 510 cases with symptomatic pelvic organ prolapse (POP) of stage II or higher requiring prolapse treatment. Patients were divided into surgery and pessary groups according to their own choice and treatmen...

Entgegen der landläufigen Annahme einer „sterilen Blase“ weist die gesunde weibliche Harnblase ein vielfältiges Mikrobiom auf. Die Erforschung der Zusammensetzung und Bedeutung der darin enthaltenen Bakterienstämme steht aber erst am Anfang. Es gibt erste schlüssige Hinweise für signifikante Unterschiede zwischen den Mikrobiomen von gesunden Frauen...

Introduction and hypothesis Previous studies have indicated a hereditary component of stress urinary incontinence; however, evidence on candidate genes or single-nucleotide polymorphisms (SNPs) is scarce. We hypothesize a genetic association of female stress urinary incontinence based on significant differences of the urinary and serum proteomic pa...

Introduction and hypothesis Abnormalities of connective tissue structure or its repair mechanism may predispose women to pelvic organ prolapse (POP). We hypothesized that the expression of tenascin-X in the uterosacral ligament of postmenopausal women with symptomatic POP is increased compared with postmenopausal women without POP. Furthermore, we...

Aims Our aim was to evaluate, in a second data analysis of the prospective randomized controlled trial conducted by Austrian Urogynaecology Working Group, the effect of age, BMI and parity at the time of surgery on short- and long-term outcomes of women primarily treated for SUI (stress urinary incontinence) with midurethral slings. Methods In the...

Data used for the statistical analysis. Data used for the statistical analysis of the study, collected in excel files. (ZIP)

Objective: To assess associations between anterior and/or fundal uterine leiomyoma and overactive bladder syndrome. Methods: The present cohort study recruited women diagnosed with fundal/anterior uterine leiomyoma by standardized transvaginal ultrasonography at the Medical University of Vienna, Austria, between January 1, 2010, and December 31,...

Objective To examine the relationship between endogenous sex steroids and various condition-specific quality of life domains in postmenopausal women with pelvic floor disorders. We hypothesized that woman with lowest androgen and estradiol concentrations would report worse scores of quality of life domains. Methods Forty-six women with pelvic organ...

The pathophysiology of Stress Urinary Incontinence (SUI) is poorly understood. The aim of this study was to identify the serum proteomic profile in patients with SUI and to replicate findings from a preceding study in which a significant difference in the urinary proteome was identified. Serum samples were collected from 38 patients (19 SUI; 19 mat...

Introduction: Anterior colporrhaphy (AC) is considered a standard procedure and is performed all over the world. However, not a single step of the procedure has ever been truly standardized and the rates of failure show a wide range in the literature from 0% up to 92%. The aim of this systematic review was to evaluate the differences in technique...

PurposeThe aim of this study was to systematically review the literature on antibiotic prophylaxis in gynaecologic surgeries to prevent inflammatory complications after gynaecological operations. The study was carried out as a systematic review. Methods Only randomised controlled trials of women undergoing gynaecological surgery were included. The...

Objective: We compared sex steroid levels of postmenopausal patients with symptomatic pelvic organ prolapse (POP) with postmenopausal matched patients without any sign of POP. Furthermore, we evaluated a possible relationship between sex steroid levels and various urogynecologic parameters in cases with POP. Main outcome of interest were differenc...

Background: The consumption of certain drugs can cause urinary incontinence. The aim of this study is to determine the frequency of consumption of drugs that can favour incontinence, the incidence of polypharmacy and the incidence of potentially dangerous drug-drug interactions in female patients suffering from overactive bladder (OAB) who presente...

Introduction and hypothesis: Previous studies aiming to identify specific pre-defined urine protein biomarkers for stress urinary incontinence (SUI) have not identified clinically important differences. The hypothesis of our study was that the global distribution of urinary proteins, the proteome, differs between women with and those without SUI....

Introduction and hypothesis: We hypothesized that knowledge of pelvic organ prolapse (POP) and patient information-seeking preferences are the same in the two capital cities. Methods: First-visit patients were recruited at tertiary referral urogynaecological units in Vienna (137) and in Moscow (112). A 16-item scale was used to assess the patien...

Introduction and hypothesis Recent studies applying molecular techniques have demonstrated the presence of a urinary microbiota not detected by standard microbiological techniques. These have been found in the urine of healthy individuals and in those suffering from clinical symptoms. The present article reviews the findings of these studies to dat...

This is a clinical trial update without results. The aim of the trial is to identify a urinary proteomic pattern, including gender aspects, for patients with overactive bladder syndrome in comparison to healthy controls.

Introduction: Nowadays, cycling is not only an increasingly popular recreational sport, but is also playing a significant role in means of transportation. Thus, it is important to know which negative impact cycling can have on the human body. This review summarizes the current evidence on the epidemiology, treatment and prevention of genital and pe...

The aim of this study was to compare urinary and anal dysfunction after laparoscopic (LRH) and abdominal (ARH) radical hysterectomy for cervical cancer. Consecutive patients who underwent radical hysterectomy for treatment of cervical cancer were enrolled in this study and divided into two groups, according to the surgical approach. Urinary and ana...

Cycling has become a popular athletic activity worldwide and can lead to genital and pelvic floor dysfunction. This review summarizes the current body of evidence about the epidemiology of genital and pelvic floor symptoms in female cyclists, the therapy, and preventive interventions. Two electronic meta-databases, OvidSP™ and Deutsches Institut fü...

We performed a randomised controlled trial of percutaneous tibial nerve stimulation (PTNS) versus tolterodine for treating treatment naïve women with overactive bladder (OAB). 36 patients with symptoms of OAB were randomised to 3 months of treatment with weekly PTNS or tolterodine (2mg bid p.o.). The primary outcome measure was the difference of mi...

To investigate authors' adherence to the CONSORT reporting guideline for randomized controlled trials (RCTs) in the sub-specialty Female Pelvic Medicine and to detect any changes in adherence between the years 2008 and 2013. Bibliometric study. We included Female Pelvic Medicine RCTs published in 2008 and 2012-2013 in 10 journals. Full-text version...

The ethical behavior of authors, editors, and journals is increasingly placed in the spotlight, by both the public and the research community. Disclosures and conflict of interest (COI) statements of publishing authors represent one important aspect. We aimed to unravel the current management of disclosures, COI, and funding statements in the subsp...

AimsPoor reporting of research may limit critical appraisal and reproducibility, whereas adherence to reporting guidelines (RG) can guarantee completeness and transparency. We aimed to determine the explicit citing of RGs (CONSORT, PRISMA, STROBE) in urogynecology articles in 2013, the requirements of relevant journals and a potential difference be...

Fragestellung: Spannungsfreie Suburethralbänder gelten als Gold-Standard in der operativen Therapie der Stressharninkontinenz. Die Arbeitsgemeinschaft für Urogynäkologie und rekonstruktive Beckenbodenchirurgie Österreich (AUB) initiierte eine Studie zum Vergleich von TVT und TVT-O als gängige Varianten dieser Suburethralbänder. Die 5-Jahres Ergebni...

Several mesh repair systems for pelvic organ prolapse (POP) were introduced into clinical practice with limited data on safety, complications or success rates, and impact on sexual function. The Austrian Urogynecology Working Group initiated a registry to assess the use of transvaginal mesh devices for POP repair. We looked at perioperative data, a...

We conducted a prospective randomized controlled noninferiority trial to compare objective and subjective outcomes of retropubic tension-free vaginal tape (TVT) with those of transobturator tape (TVT-O) as primary treatment for stress urinary incontinence (SUI) in women. The study was conducted at 25 gynecology units in Austria and Germany; regiona...

Introduction and hypothesis: The aim of this study was to evaluate pelvic floor dysfunction and anatomical signs of pelvic organ prolapse (POP) in patients with levator ani muscle (LAM) trauma compared with patients with an intact LAM 1 year postpartum. Methods: In a prospective case-control study, primiparous women after vaginal delivery, with...

Introduction and Hypothesis: Aim of this study was to evaluate pelvic floor dysfunction and anatomical signs of pelvic organ prolapse (POP) in patients with levator ani muscle (LAM) trauma in comparison with patients with intact LAM one year postpartum. Methods: This is a prospective case-control study. Primiparous women after vaginal delivery with...

Die Urogynäkologie war von Beginn ihrer Etablierung als Subspezialisierung innerhalb der Frauenheilkunde eng mit der Bildgebung verbunden. Der dreidimensionale Ultraschall (3-D-US) ist in dieser Hinsicht die neueste Entwicklung und hat neben den allgemeinen Vorteilen des medizinisch-diagnostischen Ultraschalles (wenig Belastung für die Patientin, W...

Introduction: The purpose of these guidelines is to provide help in decision-making concerning the diagnosis, treatment and follow-up of patients with higher grade perineal tears (perineal tears grades 3 and 4) and thus minimise the risk for persisting complaints. Methods: In 2007 the Austrian Urogynecology Working Group (Arbeitsgemeinschaft für Ur...

The purpose of this guideline is to provide a decision aid for diagnosis, treatment, and follow-up of patients with major perineal tears and thus minimize the risk of persistent symptoms. In 2007, the "Guideline for the management of third and fourth degree perineal tears after vaginal birth" was established by members of the Austrian Urogynecologi...

This study evaluates the expression of estrogen receptor isoforms alpha (ERα) and beta (ERβ), progesterone receptor (PR), and relaxin receptor isoforms 1 and 2 (LGR7, LGR8) in uterosacral ligament (USL) tissue of women with pelvic organ prolapse and controls. Tissue samples of USL from women with and without pelvic organ prolapse (POP) were subject...

While urinary incontinence is often labeled as a taboo in the literature, we found no scientific data addressing this issue exclusively. The aim of our study was to measure the perception of urinary incontinence as a taboo and how this compares to other medical conditions that may be embarrassing. 150 test persons completed a self-administered 13-i...

To quantify the distribution of morphologic appearances of urethral anatomy and measure variables of urethral sphincter anatomy in continent, nulliparous, pregnant women by high resolution magnetic resonance imaging (MRI). We studied fifteen women during their first pregnancy. We defined and quantified bladder neck and urethral morphology on axial...

Using magnetic resonance images we analyzed the relationship between urethral sphincter anatomy, urethral function and pelvic floor function. A total of 103 women with stress incontinence and 108 asymptomatic continent controls underwent urethral profilometry, urethral axis measurement with a cotton swab, vaginal closure force measurement with an i...

IUGA 2009

The main objective was to assess the prevalence of physical, sexual, or psychological violence in a cohort of patients with gynaecological symptoms who presented at a psychosomatic outpatient clinic. We assessed differences in prevalence rates of gynaecological symptoms and mental health problems in women with and without a history of experiencing...

A systematic review was undertaken using the Cochrane and PubMed databases to answer the question of how wound closure affects wound healing after gynecologic surgery. Leaving the vaginal vault open after vaginal and abdominal hysterectomy is as safe as closing it. When closing the vaginal vault, there is no difference between sutures and staples....

To evaluate the interobserver repeatability of measurement of the pubovisceral muscle and levator hiatus, and the position of related organs, during rest, muscle contraction and Valsalva maneuver using three- and four-dimensional (3D and 4D) transperineal ultrasound. Seventeen women were included in the study. The position and dimensions of the pub...