共查询到20条相似文献,搜索用时 0 毫秒
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Introduction and hypothesis
The aim was to determine the impact of pelvic organ prolapse surgery on bladder function.Methods
Every 4 years, and as part of the Fifth International Collaboration on Incontinence we reviewed the English-langauage scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] or systematic reviews), level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies and level 4 case reports. The highest level of evidence was utilised by the committee to make evidence-based recommendations based upon the Oxford grading system. Grade A recommendation usually depends on consistent level 1 evidence. Grade B recommendation usually depends on consistent level 2 and/or 3 studies, or “majority evidence” from RCTs. Grade C recommendation usually depends on level 4 studies or “majority evidence” from level 2/3 studies or Delphi processed expert opinion. Grade D “no recommendation possible” would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without a formal analytical process, such as by Delphi.Results
Continent women undergoing anterior compartment prolapse surgery have a lower rate of de novo stress urinary incontinence (SUI) after anterior repair than armed mesh procedures (grade A). Data are conflicting on whether colposuspension should be performed prophylactically in continent women undergoing sacral colpopexy (grade C). No clear conclusion can be made regarding the management of continent women undergoing prolapse surgery without occult SUI. In continent women undergoing POP surgery with occult SUI the addition of continence surgery reduces the rate of postoperative SUI (grade A). In women with prolapse and SUI symptoms prolapse procedures alone (transobturator mesh and anterior repair) are associated with low success rates for SUI. Concomitant continence procedures reduce the risk of postoperative SUI (grade B). Preoperative bladder overactivity may resolve in 40 % undergoing POP surgery and de novo bladder overactivity occurs in 12 %. No valid conclusions regarding voiding dysfunction following POP surgery can be drawn from the available data.Conclusion
SUI and occult stress urinary incontinence should be treated at the time of prolapse surgery. 相似文献3.
The aim of this study was to evaluate symptoms and bother in patients with pelvic organ prolapse (POP) and to compare symptoms with POP-Q grading and measurements. One hundred and ten women with POP filled in a symptom-bother questionnaire concerning frequency of mechanical, bladder, bowel and sexual problems, and a 4-point bother score. The POP was grouped grade 0-1 versus grade >or=2 in each compartment. Symptoms more than once per week were associated with a higher bother score. Mechanical symptoms, reported in 70%, were the most troublesome. Various bladder, bowel and sexual symptoms were reported in 5%-52%, 5%-39%, and 35%-57%, respectively. We concluded that symptoms from all domains were frequent and reported generally and with little relation to prolapse in a specific compartment or POP-Q value. 相似文献
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Tiny A. de Boer Kirsten B. Kluivers Mariella I. J. Withagen Alfredo L. Milani Mark E. Vierhout 《International urogynecology journal》2010,21(9):1143-1149
Introduction and hypothesis
This study focussed on the factors which predict the presence of symptoms of overactive bladder (OAB) after surgery for pelvic organ prolapse (POP). 相似文献5.
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PURPOSE: We compared sexual function in women with pelvic organ prolapse to that in women without prolapse. MATERIALS AND METHODS: We collected sexual function data using a standardized, validated, condition specific questionnaire. The study group consisted of 30 women with pelvic organ prolapse and it was compared with 30 unmatched controls without evidence of prolapse. RESULTS: The 2 groups were similar in age, race, parity and postmenopausal hormone use. Subjects in the study group were more likely to have undergone previous pelvic surgery. Mean total Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire scores +/- SD were lower in the study group compared with controls (81.4 +/- 7.3 vs 106.4 +/- 15.5, p <0.001). In the study group total questionnaire scores in women with prior pelvic surgery were similar to those in women without prior pelvic surgery (79.3 +/- 14.9 vs 82.9 +/- 10.2, p = 0.61). CONCLUSIONS: Pelvic organ prolapse appears to have a significant negative impact on sexual function. 相似文献
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Introduction and hypothesis
The aim was to review the impact of pelvic organ prolapse surgery on sexual function.Methods
Every 4 years and as part of the Fifth International Collaboration on Incontinence we reviewed the English-language scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] systematic reviews), level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies) and level 4 (case reports). The highest level of evidence was utilised by the committee to make evidence based recommendations based upon the Oxford grading system. Grade A recommendation usually depends on consistent level 1 evidence. Grade B recommendation usually depends on consistent level 2 and/or 3 studies, or “majority evidence” from RCTs. Grade C recommendation usually depends on level 4 studies or “majority evidence” from level 2/3 studies or Delphi process expert opinion. Grade D “no recommendation possible” would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without formal analytical process, such as by Delphi.Results
With regard to the anterior compartment, the use of mesh is associated with neither a worsening in sexual function nor an increase in de novo dyspareunia compared with traditional anterior colporrhaphy (grade B). There is insufficient information to provide evidence-based recommendations on sexual function after vaginal mesh in the posterior compartment or after new lightweight or absorbable meshes (grade D).Conclusion
There is a paucity of data on the impact of prolapse surgery on sexual function. Sexual function and dyspareunia rates are similar after anterior polypropylene mesh and anterior colporrhaphy (grade B). We recommend using validated questionnaires measuring sexual function in women before and after prolapse surgery and reporting sexual activity and dyspareunia rates pre- and post-intervention in all patients. 相似文献9.
Lammers K Lince SL Spath MA van Kempen LC Hendriks JC Vierhout ME Kluivers KB 《International urogynecology journal》2012,23(3):313-319
Introduction and hypothesis
Pelvic organ prolapse (POP) and other disorders, such as varicose veins and joint hypermobility, have been associated with changes in collagen strength and metabolism. We hypothesized that these various disorders were more prevalent in both POP patients and their family members. 相似文献10.
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Markus Huebner Rebecca U. Margulies John O. L. DeLancey 《International urogynecology journal》2008,19(6):863-867
The aim of this study was to determine whether there is an association between architectural distortion seen on magnetic resonance
(MR) scans (lateral “spill” of the vagina and posterior extension of the space of Retzius) and pelvic organ prolapse. Secondary
analysis of MR imaging scans from a case-control study of women with prolapse (maximum point ≥+1cm; N = 144) and normal controls (maximum point ≤−1cm; N = 126) was done. Two independent investigators, blinded to prolapse status and previously established levator-defect scores,
determined the presence of architectural distortion on axial MR scans. Women were categorized into three groups based on levator
defects and architectural distortion. Among the three groups, women with levator defects and architectural distortion have
the highest proportion of prolapse (78%; p < 0.001). Among women with levator defects, those with prolapse had an odds ratio of 2.2 for the presence of architectural
distortion (95% CI = 1.1–4.6). Pelvic organ prolapse is associated with the presence of visible architectural distortion on
MR scans.
This work has been presented in abstract form at the Annual Scientific Meeting of the Society of Gynecologic Surgeons, April
11th–14th 2007, Orlando, FL, USA. 相似文献
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Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse
Marijke Slieker-ten Hove Annelies Pool-Goudzwaard Marinus Eijkemans Regine Steegers-Theunissen Curt Burger Mark Vierhout 《International urogynecology journal》2010,21(3):311-319
Introduction and hypothesis
This study aims to examine the relationship between pelvic floor muscle function (PFMF) and pelvic organ prolapse (POP) in a general female population. 相似文献13.
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Jeannine M. Miranne Vrishali Lopes Cassandra L. Carberry Vivian W. Sung 《International urogynecology journal》2013,24(8):1303-1308
Introduction and hypothesis
This study evaluates the effect of baseline pelvic organ prolapse (POP) severity on improvement in overactive bladder (OAB) symptoms after pelvic reconstructive surgery.Methods
We performed a retrospective cohort study of women with POP and OAB who underwent surgical correction of symptomatic apical and/or anterior POP. OAB was defined as an affirmative response to item #15 (urinary frequency) and/or item #16 (urge incontinence) of the Pelvic Floor Distress Inventory (PFDI). POP severity was dichotomized as Pelvic Organ Prolapse Quantification (POP-Q) stage 1–2 versus stage 3–4. Our primary outcome was complete resolution or improvement of urinary frequency or urge incontinence on the PFDI 12 months postoperatively.Results
At 12 months postoperative, 41 (89%) women with stage 1–2 POP versus 47 (85 %) with stage 3–4 POP reported improvement in urinary frequency (p?=?0.58). Thirty five (90 %) with stage 1–2 and 34 (85 %) with stage 3–4 POP reported improvement in urge incontinence (p?=?0.74). On multiple logistic regression, women with stage 3–4 POP had a decreased odds of improvement in frequency or urge incontinence compared with women with stage 1–2 POP (adjusted odds ration [AOR]?=?0.06 [95 % CI 0.01–0.67]), after adjusting for confounders.Conclusions
Women with coexisting POP and OAB who undergo surgical correction of POP experience improvement in OAB symptoms after surgery, although women with more severe POP may be at a higher risk of persistent frequency or urge incontinence. 相似文献19.
Iane Glauce Ribeiro Melotti Cássia Raquel Teatin Juliato Mariana Tanaka Cassio Luiz Zanettini Riccetto 《Neurourology and urodynamics》2018,37(1):223-228