Research

9 pages, 265 KiB

Open AccessArticle

Functional Polymorphism in the ADRB3 Gene, Encoding the Beta-3 Adrenergic Receptor, and Response to Intra-Detrusor Injection of Botulinum Toxin-A in Women with Overactive Bladder

by Sylwester Michał Ciećwież, Klaudyna Lewandowska, Agnieszka Boroń, Jacek Brodowski, Jacek Kociszewski, Jeremy Simon Clark and Andrzej Ciechanowicz

J. Clin. Med. 2022, 11(24), 7491; https://doi.org/10.3390/jcm11247491 - 17 Dec 2022

Viewed by 1065

Abstract

Background: There are reports suggesting an association between the rs4994 polymorphism in the ADRB3 gene encoding the beta-3 adrenergic receptor and OAB risk in females. The injection of botulinum toxin-A into the bladder wall is recommended as a possible treatment for OAB patients [...] Read more.

Background: There are reports suggesting an association between the rs4994 polymorphism in the ADRB3 gene encoding the beta-3 adrenergic receptor and OAB risk in females. The injection of botulinum toxin-A into the bladder wall is recommended as a possible treatment for OAB patients in whom first-line therapies have failed. The aim of our study was to analyze the possible association between the ADRB3:rs4994 polymorphism and the patient-perceived response to a single intra-detrusor injection of botulinum toxin-A in Polish women with overactive bladder. Methods: The study group consisted of 115 consecutive female patients with OAB. The response to botulinum toxin-A was evaluated at three months after injection, as absolute or relative reductions in OAB symptoms or in scores from questionnaires ICIQ-OAB (parts A and B) and ICIQ-LUTS-QoL (parts A and B). ADRB3:rs4994 variants were identified by the sequencing of genomic DNA extracted from buccal swabs. Results: There were no statistically significant differences between ADRB3:rs4994 [T];[T] homozygotes and [T];[C]+[C];[C] subjects for absolute or relative reductions in symptoms or in scores from all four questionnaire parts at three months after the injection of botulinum toxin-A. Conclusions: Our results do not support the hypothesis that ADRB3:rs4994 polymorphism is associated with the response to the intra-detrusor injection of botulinum toxin-A in Polish females with overactive bladder. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

11 pages, 2844 KiB

Open AccessArticle

Validity and Reliability of an Offline Ultrasound Measurement of Bladder Base Displacement in Women

by Sandra Martínez-Bustelo, Asunción Ferri-Morales, Fernando J. Castillo-García, Antonio Madrid and M. Amalia Jácome

J. Clin. Med. 2022, 11(9), 2319; https://doi.org/10.3390/jcm11092319 - 21 Apr 2022

Cited by 1 | Viewed by 1790

Abstract

The effect of different exercises on the position of pelvic organs in women has not been sufficiently assessed. The objective was to analyze the validity and reliability of a new two-dimensional ultrasound algorithm to measure offline the displacement of the bladder base during [...] Read more.

The effect of different exercises on the position of pelvic organs in women has not been sufficiently assessed. The objective was to analyze the validity and reliability of a new two-dimensional ultrasound algorithm to measure offline the displacement of the bladder base during abdominal exercises. This algorithm could be a useful method to future studies in determine the most appropriate exercises in sports and in rehabilitative program for the pelvic floor in women. All subjects were tested by transverse transabdominal ultrasound. The measurements were conducted offline using a customized code written in MATLAB (Ecolab) for image-processing, and manually on the ultrasound monitor using electronic calipers. The agreement was assessed with a paired t-test, Pearson’s linear correlation coefficient (r), the Lin’s concordance correlation coefficient (CCC), the intraclass correlation coefficient ICC (A,2) and a Bland–Altman plot. The reliability was confirmed by the interdays intra-rater ICC coefficient. The results were that Ecolab and ultrasound transducer measures did not differ statistically (p = 0.246). Furthermore, both methods showed a very strong relationship, and the Ecolab demonstrated to be a valid and reliable method. We concluded that Ecolab seemed to be a valid and reliable tool to assess the effect of abdominal contractions in the female pelvic floor. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

14 pages, 3740 KiB

Open AccessArticle

Perioperative and Long-Term Anatomical and Subjective Outcomes of Laparoscopic Pectopexy and Sacrospinous Ligament Suspension for POP-Q Stages II–IV Apical Prolapse

by Paulina Szymczak, Magdalena Emilia Grzybowska, Sambor Sawicki, Konrad Futyma and Dariusz Grzegorz Wydra

J. Clin. Med. 2022, 11(8), 2215; https://doi.org/10.3390/jcm11082215 - 15 Apr 2022

Cited by 6 | Viewed by 1632

Abstract

The aim of this paper was to analyze perioperative and long-term outcomes in 114 women undergoing surgery for POP-Q ≥ 2 apical prolapse: sacrospinous ligament colpo/hysteropexy (SSLF/SSHP)—61; laparoscopic pectopexy (LP)—53. Validated questionnaires (PGI-I, ISI, #35 EPIQ, PFIQ-7, PFDI-20) were completed at baseline and [...] Read more.

The aim of this paper was to analyze perioperative and long-term outcomes in 114 women undergoing surgery for POP-Q ≥ 2 apical prolapse: sacrospinous ligament colpo/hysteropexy (SSLF/SSHP)—61; laparoscopic pectopexy (LP)—53. Validated questionnaires (PGI-I, ISI, #35 EPIQ, PFIQ-7, PFDI-20) were completed at baseline and follow-up. POP-Q stages II, III and IV were diagnosed in 1 (0.9%), 84 (73.7%) and 29 (25.4%) patients, respectively. Mean operative time and hospital stay were 151.8 ± 36.2 min/2.6 ± 1.1 days for LP and 69 ± 20.4 min (p < 0.001)/2.7 ± 1.0 days for SSLF. Severe intraoperative complications occurred in two (1.8%) patients. Mean follow-up was 26.9 ± 12 and 37.3 ± 17.5 months for LP and SSLF, respectively. At follow-up, significant improvement for all POP-Q points was observed in both groups (p < 0.001). Shortening of total vaginal length was found in both groups, but predominantly in SSLF patients (p = 0.01). The sensation of vaginal bulge (EPIQ) was reduced, and total PFDI-20 and PFIQ-7 scores improved (p < 0.04) in both groups. Subjective success was reported by 40 (75.5%) LP and 44 (72.1%) SSLF patients. ISI detected no deterioration in urinary incontinence. PGI-I, PFDI-20, #35 EPIQ, PFIQ-7 and ISI did not differ between the groups. In conclusion both, SSLF and LP for apical prolapse generate good anatomical and subjective outcomes, with protective effect on the anterior compartment observed for LP. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

9 pages, 1639 KiB

Open AccessArticle

Construction of a Prognostic Score for Ultrasound Evaluation of the Transobturator Sling for Stress Urinary Incontinence

by Espada-Gonzalez Cristina, Sabonet-Morente Lorena, Perez-Gonzalez Rita, Gonzalez-Mesa Ernesto Santiago and Jimenez-Lopez Jesus Salvador

J. Clin. Med. 2022, 11(5), 1296; https://doi.org/10.3390/jcm11051296 - 27 Feb 2022

Cited by 1 | Viewed by 1635

Abstract

Currently, pelvic floor ultrasound allows us to correctly visualize the synthetic material used in stress urinary incontinence surgery. The objective of this study is the construction of a score and its correlation with the SUU clinic. During the study period, 81 patients with [...] Read more.

Currently, pelvic floor ultrasound allows us to correctly visualize the synthetic material used in stress urinary incontinence surgery. The objective of this study is the construction of a score and its correlation with the SUU clinic. During the study period, 81 patients with transobturator slings were studied using ultrasound. Through multivariate analysis, the statistically significant variables were the distance from the sling to the urethral wall (p = 0.004), the shape of the sling at rest (p = 0.003), and the symmetry of the mesh (p = 0.016). Through these variables, the construction of a score was carried out. Once the model was constructed, its internal validation was carried out to determine the discrimination capacity of patients who present clinical stress and those who do not, with an area under the curve of 0.848 (95% CI (0.72–0.97), p < 0.001). This simple score using three ultrasound variables serves to adequately and objectively discriminate patients who have successful surgery and absence of clinical effort. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

7 pages, 507 KiB

Open AccessArticle

Urine Nerve Growth Factor May Not Be Useful as a Biomarker of Overactive Bladder in Patients with Pelvic Organ Prolapse

by Katarzyna Jankiewicz, Michał Bogusiewicz, Łukasz Nowakowski, Tomasz Rechberger, Artur Rogowski and Pawel Miotla

J. Clin. Med. 2022, 11(4), 971; https://doi.org/10.3390/jcm11040971 - 13 Feb 2022

Cited by 1 | Viewed by 1617

Abstract

(1) Background: Overactive bladder (OAB) symptoms are frequently present in women with pelvic organ prolapse (POP). Although urinary nerve growth factor (NGF) is a promising biomarker of OAB, little is known about its role in patients with OAB secondary to POP. The aim [...] Read more.

(1) Background: Overactive bladder (OAB) symptoms are frequently present in women with pelvic organ prolapse (POP). Although urinary nerve growth factor (NGF) is a promising biomarker of OAB, little is known about its role in patients with OAB secondary to POP. The aim of the study was to evaluate urinary NGF levels in patients with POP involving the anterior vaginal wall and check if it may serve as a predicting factor for postoperative resolution of OAB symptoms. (2) Methods: Eighty-three Caucasian women included in the study were divided into three groups: pure OAB, one associated with POP (POP&OAB) and a control group composed of healthy volunteers. The urine NGF and creatinine were assessed with ELISA tests to calculate the NGF/creatinine ratio. (3) Results: The NGF/creatinine ratio was significantly higher in patients with pure OAB in comparison with other groups; however, it did not differ between the control group and the POP&OAB group. There was no correlation between NGF/creatinine ratio and age, menopausal status, BMI, parity or urodynamic findings. The NGF/creatinine ratio was not a prognostic factor for OAB symptoms’ resolution after surgical treatment of POP. (4) Conclusions: Urinary NGF excretion is not increased in women with OAB secondary to POP; thus, it may not serve as an OAB biomarker in these patients. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

8 pages, 848 KiB

Open AccessArticle

A Comprehensive Approach to Clinical Staging of Bladder Cancer

by Przemysław Adamczyk, Paweł Pobłocki, Mateusz Kadlubowski, Adam Ostrowski, Andrzej Wróbel, Witold Mikołajczak, Jan Adamowicz, Tomasz Drewa and Kajetan Juszczak

J. Clin. Med. 2022, 11(3), 761; https://doi.org/10.3390/jcm11030761 - 30 Jan 2022

Cited by 7 | Viewed by 2155

Abstract

Background: A significant number of patients with advanced urothelial cell carcinoma are under- or over-staged. Implementation of clinical variables could be useful for improving the accuracy of clinical staging. Aim: To explore the differences between clinical and pathological diagnosis in patients with UCC, [...] Read more.

Background: A significant number of patients with advanced urothelial cell carcinoma are under- or over-staged. Implementation of clinical variables could be useful for improving the accuracy of clinical staging. Aim: To explore the differences between clinical and pathological diagnosis in patients with UCC, and to identify clinical variables that might play a role in under- or overstating. Materials: A total of 553 patients after radical cystectomy were included in the analysis. Clinical stage of the disease was diagnosed according to CT or MRI in relation to clinical data. Results: Higher clinical stage correlated with a higher pathological stage (p < 0.00005), but in 306 patients did not correspond (142 patients were under-staged and 164 over-staged). Over half (54.2%) of the patients staged as cT1–cT2 were misdiagnosed: 137 patients were under-staged and 133 over-staged. Hydronephrosis was associated with a higher pathological stage (p < 0.000005), mostly pT3–4 (45.13% had pT4 disease) and higher risk of nodal metastasis (p = 0.0028). The highest percentage of PSM was found in patients with pT4 (33.12%). Conclusions: Clinical staging of bladder cancer is poorly executed, with one third of patients under-staged and one third over-staged. To improve accuracy, we recommend a multimodal approach, combining histopathological evaluation with results of imaging studies. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

17 pages, 577 KiB

Open AccessArticle

Effectiveness of Magnetic Stimulation in the Treatment of Urinary Incontinence: A Systematic Review and Results of Our Study

by David Lukanović, Tina Kunič, Marija Batkoska, Miha Matjašič and Matija Barbič

J. Clin. Med. 2021, 10(21), 5210; https://doi.org/10.3390/jcm10215210 - 08 Nov 2021

Cited by 13 | Viewed by 5973

Abstract

Urinary incontinence (UI) is becoming an increasingly common health problem. UI treatment can be conservative or surgical. This paper focuses on the effectiveness of magnetic stimulation (MS) in the treatment of UI. We performed a systematic review in order to combine and compare [...] Read more.

Urinary incontinence (UI) is becoming an increasingly common health problem. UI treatment can be conservative or surgical. This paper focuses on the effectiveness of magnetic stimulation (MS) in the treatment of UI. We performed a systematic review in order to combine and compare results with results from our clinical study. A clinical prospective non-randomized study was carried out at the Ljubljana University Medical Center’s Gynecology Division. It included 82 randomly selected female patients, irrespective of their UI type. The success rate of using MS in treating UI was based on standardized ICIQ-UI SF questionnaires. Patients completed 10 therapy sessions on MS, and follow-up was performed 3 months after the last therapy session. UI improved after treatment with MS. The ICIQ-UI SF score improved in patients regardless of the type of UI. However, the greatest decrease in post-treatment assessment ICIQ-UI SF scores was seen in patients with stress urinary incontinence (SUI). Based on the findings described above, it can be concluded that MS is a successful non-invasive conservative method for treating UI. Future studies are necessary, all of which should include a large sample size, a control group, an optimal research protocol, pre-treatment analyses, standardization, and longer follow-ups. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

10 pages, 459 KiB

Open AccessArticle

Prevalence of Perineal Tear Peripartum after Two Antepartum Perineal Massage Techniques: A Non-Randomised Controlled Trial

by María Álvarez-González, Raquel Leirós-Rodríguez, Lorena Álvarez-Barrio and Ana F. López-Rodríguez

J. Clin. Med. 2021, 10(21), 4934; https://doi.org/10.3390/jcm10214934 - 25 Oct 2021

Cited by 7 | Viewed by 4708

Abstract

Perineal massage increases elasticity of myofascial perineal tissue and decreases the burning and perineal pain during labour, thus optimising child birth, although an application protocol has not been standardised yet. The objective of this study is to determine the efficiency of massage in [...] Read more.

Perineal massage increases elasticity of myofascial perineal tissue and decreases the burning and perineal pain during labour, thus optimising child birth, although an application protocol has not been standardised yet. The objective of this study is to determine the efficiency of massage in perineal tear prevention and identification of possible differences in massage application. Total of 90 pregnant participants were divided into three groups: perineal massage and EPI-NO^® device group, applied by an expert physiotherapist, self-massage group, where women were instructed to apply perineal massage in domestic household, and a control group, which received ordinary obstetric attention. Results: The results showed significant differences among the control group and the two perineal massage groups in perineal postpartum pain. Correlations in perineal postpartum pain, labour duration and the baby’s weight were not statistically significant. Lithotomy posture was significantly less prevalent in the massage group than in the other two; this variable is known to have a direct effect on episiotomy incidence and could act as a causal covariate of the different incidence of episiotomy in the groups. Perineal massage reduces postpartum perineal pain, prevalence and severity of perineal tear during delivery. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

12 pages, 1199 KiB

Open AccessFeature PaperArticle

Quality of Sexual Life after Native Tissue versus Polypropylene Mesh Augmented Pelvic Floor Reconstructive Surgery

by Aleksandra Kamińska, Katarzyna Skorupska, Agnieszka Kubik-Komar, Konrad Futyma, Joanna Filipczak and Tomasz Rechberger

J. Clin. Med. 2021, 10(21), 4807; https://doi.org/10.3390/jcm10214807 - 20 Oct 2021

Viewed by 1542

Abstract

There are still controversies around reconstructive surgeries used in POP treatment. The aim of this study was to compare the QoSL after VNTR vs. TVM surgery due to POP via the use of PISQ-12 and FSFI questionnaires. The study included a group of [...] Read more.

There are still controversies around reconstructive surgeries used in POP treatment. The aim of this study was to compare the QoSL after VNTR vs. TVM surgery due to POP via the use of PISQ-12 and FSFI questionnaires. The study included a group of 121 sexually active patients qualified for reconstructive surgery due to symptomatic POP, and 50 control. The average results of PISQ-12 before and after surgery were compared using the t-test. The significance of the mean differences in demographic groups was measured using the t-test for independent samples and one-way ANOVA. The results in the demographic groups were compared using the Mann–Whitney U test and the Kruskal–Wallis test. Fifty-eight women had VNTR, while 63 had TVM. Results of PISQ-12 revealed significant improvement in the sexual life after reconstructive surgery (27.24 vs. 32.43; p < 0.001, t = 8.48) both after VNTR and TVM. There were no significant differences in the assessment of the QoSL according to PISQ-12 and FSFI results between both analyzed groups of patients (PISQ-12: VNTR vs. TVM; t-test p = 0.19 and FSFI: VNTR vs. TVM; Mann–Whitney U test p = 0.54). VNTR is the treatment of choice in the case of uncomplicated primary POP. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

► Show Figures

Figure 1

11 pages, 253 KiB

Open AccessArticle

Reliability of the Polish Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Assessment of Sexual Function before and after Pelvic Organ Prolapse Reconstructive Surgery—A Prospective Study

by Aleksandra Kamińska, Katarzyna Skorupska, Agnieszka Kubik-Komar, Konrad Futyma, Joanna Filipczak and Tomasz Rechberger

J. Clin. Med. 2021, 10(18), 4167; https://doi.org/10.3390/jcm10184167 - 15 Sep 2021

Cited by 2 | Viewed by 1387

Abstract

It is estimated that 31–44% of all patients with symptomatic POP and/or UI suffer from sexual dysfunction. We aimed to validate the PISQ-12 in pre-and postmenopausal women and to assess the sexual function before and after POP reconstructive surgery. One hundred and forty [...] Read more.

It is estimated that 31–44% of all patients with symptomatic POP and/or UI suffer from sexual dysfunction. We aimed to validate the PISQ-12 in pre-and postmenopausal women and to assess the sexual function before and after POP reconstructive surgery. One hundred and forty sexually active patients were hospitalized due to symptomatic POP and 50 healthy controls were enrolled into the study. The patients were asked to complete PISQ-12, the FSFI and Beck’s depression scale questionnaires twice. The Cronbach’s alpha (α) was used to estimate the internal consistency. The scores were compared using the Intraclass Correlation Coefficient (ICC). Improvement in the QoSL (quality of sexual life) was observed in each age group of women. Pre-menopausal patients’ QoSL was much better, both before and after surgery (29.62 and 34.64 points, respectively). The correlation between questionnaires before surgery was 0.63, and after was −0.76. The α value for the PISQ-12 was 0.83 before the procedure and 0.80 afterwards. In all the groups, the test–retest reliability was good—ICC = 0.72. Vaginal reconstructive surgeries improve the QoSL. The only demographic factor influencing the QoSL was the menopausal status. The Polish version of the PISQ-12 is a reliable and responsive instrument for assessing the sexual function in patients with diagnosed POP and/or UI. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

12 pages, 301 KiB

Open AccessArticle

Psychiatric History and Overactive Bladder Symptom Severity in Ambulatory Urogynecological Patients

by Artur Rogowski, Maria Krowicka-Wasyl, Ewa Chotkowska, Tomasz Kluz, Andrzej Wróbel, Dominika Berent, Paweł Mierzejewski, Halina Sienkiewicz-Jarosz, Adam Wichniak, Marcin Wojnar, Jerzy Samochowiec, Katarzyna Kilis-Pstrusinska and Przemyslaw Bienkowski

J. Clin. Med. 2021, 10(17), 3988; https://doi.org/10.3390/jcm10173988 - 03 Sep 2021

Cited by 1 | Viewed by 3944

Abstract

Introduction and hypothesis: A link between psychiatric comorbidities and overactive bladder symptomatology has been suggested by preclinical and clinical studies. Given this, we hypothesized that a psychiatric history and current treatment with psychotropic medications could be related to the severity of overactive bladder [...] Read more.

Introduction and hypothesis: A link between psychiatric comorbidities and overactive bladder symptomatology has been suggested by preclinical and clinical studies. Given this, we hypothesized that a psychiatric history and current treatment with psychotropic medications could be related to the severity of overactive bladder and incontinence symptoms in patients referred to a tertiary care urogynecological center. Methods: One hundred and twenty-seven female patients diagnosed with an overactive bladder were screened for a lifetime history of psychiatric disorders and the type and number of psychotropic medications currently taken. The overall severity of overactive bladder symptoms was assessed using the Indevus Urgency Severity Scale. The severity and impact of urinary incontinence on the quality of life were quantified with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Urinary incontinence was further quantified with the aid of the Urinary Distress Inventory-6. The patients were screened for stress urinary incontinence using the Stamey Incontinence Score. Results: A psychiatric history, as well as current use of at least two psychotropic medications, was associated with increased severity of overactive bladder symptoms. A history of depression and current treatment with any selective serotonin reuptake inhibitor was associated with increased severity of stress urinary incontinence symptoms. Current treatment with other psychotropic medications, including sedative-hypnotics and drugs with anticholinergic properties was not related to the severity of overactive bladder and incontinence symptoms. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

8 pages, 249 KiB

Open AccessArticle

Impact of Hysterectomy on Quality of Life, Urinary Incontinence, Sexual Functions and Urethral Length

by Katarzyna Skorupska, Sara Wawrysiuk, Michal Bogusiewicz, Pawel Miotła, Izabela Winkler, Agnieszka Kwiatkowska and Tomasz Rechberger

J. Clin. Med. 2021, 10(16), 3608; https://doi.org/10.3390/jcm10163608 - 16 Aug 2021

Cited by 5 | Viewed by 4104

Abstract

The aim of the study was to evaluate the influence of different types of hysterectomy on UI symptoms, quality of life and sexual functions using dedicated questionnaires. We investigated a correlation between the urethral length (UL), UI symptoms and the length of the [...] Read more.

The aim of the study was to evaluate the influence of different types of hysterectomy on UI symptoms, quality of life and sexual functions using dedicated questionnaires. We investigated a correlation between the urethral length (UL), UI symptoms and the length of the cervix (left after LSH and SH) with sexual functions. The study enrolled 500 consecutive women referred for hysterectomy: 121 underwent VH, 171 underwent LSH, 96 underwent SH, 68 underwent TAH, and 44 underwent TLH. The patients filled in the UI-specific questionnaires and FSFI before and 12 months after hysterectomy. The UL was measured by introital ultrasound before and 12 months after hysterectomy. Before surgery, 137 out of 399 (34.3%) patients had UI symptoms; afterwards, 139 (34.8%) indicated the same (p > 0.05). There was no statistically significant difference in the UL in the patients before and after the procedure, and the cervix length did not differ between patients after LSH and SH. When the entire investigated population was analyzed, a significant improvement of the QoL was found on the IIQ-7. Hysterectomy performed due to benign diseases has effects on UI regardless of the surgical technique used. The UI symptoms improved only in the patients after LSH. The UL measured 12 months after hysterectomy did not change. Full article

(This article belongs to the Special Issue Current Trends in Urogynecology)

Journal Menu

Journal Browser

Current Trends in Urogynecology

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Published Papers (12 papers)

Research

Further Information

Guidelines

MDPI Initiatives

Follow MDPI