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    Female Urology: How dynamic MRI compares with physical exam for evaluating POP

     
    • Two groups presented on pelvic mesh excision and outcomes. The first looked at 47 patients post partial or complete mesh excision with 14 months’ follow-up. Preoperatively, 80% of these patients had pain and 83% had exposure, and postoperatively, 68% were improved. The second group looked at 84 patients post vaginal mesh removal. Of these patients, 83% were deemed better postoperatively, and 35% required at least one reoperation.
    • Findings from two randomized placebo-controlled, phase III trials on SER120, a low-dose desmopressin nasal spray for the treatment of nocturia, showed that treatment with SER120 led to significant and durable improvement over 2 years with no evidence of hyponatremia.
    • Researchers performed overnight ambulatory urodynamic studies on patients with nocturia and nocturnal enuresis, and found that 80% of patients with nocturia and 88% of patients with nocturnal enuresis demonstrated detrusor overactivity.
    • Pioglitazone improved bladder function (capacity and frequency) in cyclophosphamide-induced cystitis.
    • A novel research model engaging multiple stakeholders for biomarker development discovered three proteins with highly significant differences between interstitial cystitis with ulcers versus interstitial cystitis without ulcers and controls.
    • Three different groups used the National Health and Nutritional Examination Survey to evaluate stress incontinence risk factors. In the first, researchers found that incontinence correlated to vaginal delivery and not age at time of childbirth. The second group reported a significant inverse correlation between serum testosterone and incontinence. Women in the lowest quartile of serum testosterone concentration were more likely to have stress incontinence and mixed urinary incontinence. A third group used bone mineral density data to identify an independent association between osteoporosis and stress incontinence due to connective tissue weakness.
    • In a rat model, tramadol enhanced urethral baseline pressure by 79% and was effective for enhancing the active urethral continence reflex during sneezing at the spinal level.
    • Bariatric surgery was associated with a significant improvement in pelvic floor disorders and sexual performance. Separately, increased age and abdominal circumference were found to raise the risk of female stress urinary incontinence. Age >52 years and menopause correlated with stress incontinence persistence after weight loss.
    • Women who had undergone incontinence surgery but still had stress incontinence receiving autologous muscle-derived cell bulking injections had a >50% reduction in leak frequency at 1 and 2 years. The modality was deemed safe and durable for this population.
    • An evaluation of patients in retention after Macroplastique injection found one-third of patients had post-op urinary retention, defined as 24-48 hours of catheterization after bulking. At 2 years, they were dry or significantly improved and declined further stress incontinence therapy more so than patients who had never been in retention.

    Next: A comparison of outcomes between simple and complex patients post autologous pubovaginal sling

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