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

     
    • A comparison of outcomes between simple and complex patients post autologous pubovaginal sling found overall improvement rates of 96% in simple and 93% in complex patients. The complex patients were most likely to need additional continence procedures. Mesh excision at the time of pubovaginal sling increased postoperative retention and reoperation rates more than pubovaginal slings alone.
    • Reproduction of symptoms on urodynamics or symptom score do not correlate with risk of urinary retention in patients with Valsalva voiding or in patients with normal bladder contractility.
    • Urodynamics and physical exam are equivalent in demonstrating occult stress incontinence; therefore, urodynamics with or without prolapse reduction is not mandatory.
    • A review of video urodynamics as related to patient positioning found that nearly 17% of stress-incontinent patients required video urodynamics to be done in the standing position to demonstrate leakage. The authors recommended video urodynamics be performed in both the lying and standing position.
    • In patients undergoing pudendal versus sacral neuromodulation, both groups experienced modest but similar improvements in pelvic pain. Pudendal neuromodulation was effective in those who failed sacral neuromodulation and was used preferentially in patients with a primary pain diagnosis.
    • In New York state, InterStim is placed by urologists (60.5%), gynecologists (14.8%), and colorectal surgeons (19.2%). Researchers found no statistical difference in revision or removal rates based on FPMRS fellowship training or those without a surgical specialty.
    • Researchers evaluated electrical stimulation of afferent nerves in the foot with transcutaneous adhesive pad electrodes (Footstim) in women with refractory overactive bladder. Durations of 30 minutes daily for 1 week and 3 hours daily for 1 week were compared. Both durations decreased urge urinary incontinence frequencies, but the 3-hour group had better improvement of all OAB symptoms.

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