Urogynecology: Insights in the Management, Treatment Approaches and Novel Therapies

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: 20 May 2024 | Viewed by 3265

Special Issue Editors


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Chief Guest Editor
Urogynecology Unit, 1st Department of Obstetrics & Gynecology, “Alexandra Hospital”, National and Kapodistrian University of Athens, Lourou 2, 11528 Athens, Greece
Interests: urogynecology; reconstructive pelvic floor surgery; minimal invasive surgery; quality of life; female incontinence

E-Mail Website
Guest Editor
Urogynecology Unit, 1st Department of Obstetrics & Gynecology, “Alexandra Hospital”, National and Kapodistrian University of Athens, Lourou 2, 11528 Athens, Greece
Interests: urogynecology; reconstructive pelvic floor surgery

E-Mail Website
Guest Editor
Urogynecology Unit, 1st Department of Obstetrics & Gynecology, “Alexandra Hospital”, National and Kapodistrian University of Athens, Lourou 2, 11528 Athens, Greece
Interests: urogynecology; pelvic floor disorders; minimally invasive gynecology; benign gynecologic diseases
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Special Issue Information

Dear Colleagues,

Urogynecology is a subspecialty of Gynecology and Urology focusing on women with dysfunction of the pelvic floor and the lower urinary tract. Pelvic floor disorders (PFD) include pelvic organ prolapse (POP), urinary incontinence (UI), defecatory disorders, chronic pelvic pain and sexual dysfunction. The estimated prevalence of PFDs is 20%–25% among adult women, while the lifetime risk of suffering from a urogynecological disorder increases with age. As the population ages, the number of women with PFDs is expected to rise, which further enhances the respective burden and costs for health care systems and societies. Recent therapeutic advances of both conservative and surgical treatments aim to improve women’s quality of life by restoring pelvic floor normal function.

There is a rapidly expanding knowledge of the pathophysiologic mechanisms, the management and the diagnostic evaluation of PFDs. However, some of the functional and anatomical aspects of the pelvic floor remain elusive and complex. The identification of novel and innovative diagnostic modalities and therapeutic approaches of PFDs is of critical importance.

The aim of our Special Issue is to shed light on the progress made in the past years in the field of surgical treatment of PFD and on future challenges. Our article collection will review outcomes from traditionally used surgical interventions, as well as the cutting edge, emerging techniques in modern clinical practice.

Dr. Themos Grigoriadis
Dr. Dimitrios Zacharakis
Dr. Anastasia Prodromidou
Guest Editors

Manuscript Submission Information

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Keywords

  • gynecological disease

  • pelvic floor disorders (PFD)
  • pelvic organ prolapse surgery
  • pelvic organ prolapse (POP)
  • urinary incontinence (UI)
  • lower urinary tract dysfunction
  • chronic pelvic pain
  • sexual dysfunction
  • personalized medicine
  • urogynecology
  • Incontinence surgery

Published Papers (2 papers)

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Review

15 pages, 2415 KiB  
Review
CO2 Laser versus Sham Control for the Management of Genitourinary Syndrome of Menopause: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Anastasia Prodromidou, Dimitrios Zacharakis, Stavros Athanasiou, Nikolaos Kathopoulis, Antonia Varthaliti, Athanasios Douligeris, Lina Michala, Veatriki Athanasiou, Stefano Salvatore and Themos Grigoriadis
J. Pers. Med. 2023, 13(12), 1694; https://doi.org/10.3390/jpm13121694 - 8 Dec 2023
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Abstract
In the context of the menopausal transition, genitourinary syndrome of menopause (GSM) refers to a range of genitourinary symptoms, from vaginal dryness to dysuria and urinary urgency. While hormonal treatments are standard, their associated side effects have driven the exploration of alternatives like [...] Read more.
In the context of the menopausal transition, genitourinary syndrome of menopause (GSM) refers to a range of genitourinary symptoms, from vaginal dryness to dysuria and urinary urgency. While hormonal treatments are standard, their associated side effects have driven the exploration of alternatives like vaginal CO2 laser. We aimed to evaluate the randomized controlled trials (RCTs) comparing vaginal CO2 laser treatment for GSM to sham controls. This systematic review sourced four electronic databases until June 2023. The analysis incorporated seven RCTs with 407 women. The CO2 laser and sham control were comparable for most parameters, including the female sexual function index (FSFI) and visual analogue scale (VAS) for dyspareunia, vaginal health index, pH, and patient satisfaction. However, the CO2 laser group showed significant improvement in the vaginal assessment scale for GSM symptoms. Sensitivity analyses revealed that parameters like FSFI showed significant differences in favor of CO2 laser group upon the exclusion of specific studies. In conclusion, vaginal CO2 laser therapy emerges as a promising alternative for GSM management, especially for most bothersome GSM symptoms; however, the need for further well-designed RCTs remains to validate its broad safety and efficacy. Full article
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12 pages, 2416 KiB  
Review
The Effect of Intravenous Tranexamic Acid on Myomectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Nikolaos Kathopoulis, Anastasia Prodromidou, Dimitrios Zacharakis, Ioannis Chatzipapas, Michail Diakosavvas, Konstantinos Kypriotis, Themos Grigoriadis and Athanasios Protopapas
J. Pers. Med. 2022, 12(9), 1492; https://doi.org/10.3390/jpm12091492 - 13 Sep 2022
Cited by 1 | Viewed by 1599
Abstract
Myomectomy is the preferred surgical treatment for symptomatic women with uterine myomas who wish to preserve their fertility. The procedure may be associated with significant intraoperative blood loss, which predisposes to increased transfusion rates and morbidity. The objective of our systematic review and [...] Read more.
Myomectomy is the preferred surgical treatment for symptomatic women with uterine myomas who wish to preserve their fertility. The procedure may be associated with significant intraoperative blood loss, which predisposes to increased transfusion rates and morbidity. The objective of our systematic review and meta-analysis is to investigate whether intravenous (IV) use of tranexamic acid (TXA) may reduce blood loss during myomectomy. Three electronic databases were screened until June 2022. The eligible studies were assessed for risk of bias. Four randomized controlled trials that reported outcomes from a total of 310 women were finally included in the meta-analysis—155 patients received intravenous TXA while the remaining 155 received placebo injection with normal saline or water for injection. Total estimated blood loss was significantly lower in patients who received TXA before myomectomy compared to control (230 patients MD −227.09 mL 95% CI −426.26, −27.91, p = 0.03). This difference in favor of TXA group remained when intraoperative and postoperative blood loss was separately analyzed. Postoperative hematocrit values and hemoglobin levels did not differ among the two groups (180 patients MD 0.67% 95% CI −0.26, 1.59, p = 0.16 and 250 patients MD 0.17 mg/dL 95% CI 0.07, 0.41, p = 0.17, respectively). The number of patients that received blood transfusion was also not different (310 patients OR 0.46 95% CI −0.14, 1.49, p = 0.19). Total operative time was significantly prolonged in control group compared to TXA (310 patients MD −16.39 min 95% CI −31.44, −1.34 p = 0.03). Our data show that the IV use of TXA may significantly reduce intraoperative blood loss in patients undergoing myomectomy and contribute to reduced operative time. Full article
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