METHODS: This was a retrospective study of women with pelvic organ prolapse who underwent LSC from January 2013 to January 2016 in a tertiary center. Urinary function was clinically evaluated using the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), the Overactive Bladder Symptom Score (OABSS) and the Pelvic Floor Distress Inventory Questionnaire- - Short Form 20 (PFDI-20). Urodynamic assessment was performed before and 6 months after surgery. The Wilcoxon signed-ranks test and the McNemar test were applied with p lower P det Q max, increased voided volume and reduced postvoid residual urine volume). Clinically, there was a significant increase after LSC in stress urinary incontinence and a significant reduction in urgency urinary incontinence, overactive bladder and voiding dysfunction.
CONCLUSIONS: Apart from increased stress urinary incontinence, there was an improvement in overall urinary function in terms of patient-reported symptoms and urodynamics, despite deep vesicovaginal space dissection. Hence, LSC is a viable surgical option for pelvic organ prolapse, restoring both level 1 and level 2 support without detrimental effects on urinary function.
MATERIALS AND METHODS: We conducted a cross-sectional study of men aged above 40 years with no history of prostate cancer, prostate surgery, or 5α-reductase inhibitor treatment. Serum prostate-specific antigen (PSA) and total PV were measured in each subject. Potential sociodemographic and clinical variables including age, weight, comorbidities, and International Prostate Symptom Score (IPSS) were collected. Of 1034 subjects, 837 were used in building the PV calculator using regression analysis. The remaining 1/5 (n = 197) was used for model validation.
RESULTS: There were 1034 multiethnic Asian men (Chinese 52.9%, Malay 35.4%, and Indian 11.7%) with mean age of 60 ± 7.6 years. Average PV was 29.4 ± 13.0 mL while the overall mean of PSA was 1.7 ± 1.7 ng/mL. We identified age, IPSS, weight, and PSA (all P
METHODS: Retrospective cohort study in a tertiary center from May 2021-December 2022 included 150 patients with symptomatic anterior or apical POP stage III and IV, who underwent pelvic reconstructive surgery with Surelift-A mesh combined with SSF. All completed a 72-h voiding diary, urodynamic study (UDS), and multiple validated QoL questionnaires at baseline, 6 and 12 months postoperatively. Primary outcomes were the development of post operative de novo stress urinary incontinence (SUI), objectively via cough stress test and UDS, and subjectively by evaluation of UDI-6, question 3 score >1 and IIQ-7, QoL and surgical complications. Secondary outcomes were the objective cure of POP, defined as anterior and apical prolapse Pelvic Organ Prolapse Quantification System ≤ stage I, and subjective cure based on negative answers to Pelvic Organ Prolapse Distress Inventory 6, quality of life, sexual function, major and minor complications.
RESULT: At one-year follow-up, the objective cure rate was 96.7 %, whereas the subjective cure rate was 93.3 %, with favorable anatomical outcomes. Significant QoL improvements were observed. Among those without mid-urethral sling (MUS), a (60.0 %) improvement in SUI occurred. De novo SUI emerged in 10.5 % objectively and 12 % subjectively. Mesh exposure rate was 1.3 %.
CONCLUSION: The Combined Surelift-A and SSF approach shows effective cure rates with minimal complications, and a slight risk of de novo SUI.
MATERIALS/METHODS: Multivariable models developed to predict atomised and generalised urinary symptoms, both acute and late, were considered for validation using a dataset representing 754 participants from the TROG 03.04-RADAR trial. Endpoints and features were harmonised to match the predictive models. The overall performance, calibration and discrimination were assessed.
RESULTS: 14 models from four publications were validated. The discrimination of the predictive models in an independent external validation cohort, measured using the area under the receiver operating characteristic (ROC) curve, ranged from 0.473 to 0.695, generally lower than in internal validation. 4 models had ROC >0.6. Shrinkage was required for all predictive models' coefficients ranging from -0.309 (prediction probability was inverse to observed proportion) to 0.823. Predictive models which include baseline symptoms as a feature produced the highest discrimination. Two models produced a predicted probability of 0 and 1 for all patients.
CONCLUSIONS: Predictive models vary in performance and transferability illustrating the need for improvements in model development and reporting. Several models showed reasonable potential but efforts should be increased to improve performance. Baseline symptoms should always be considered as potential features for predictive models.