Psychometric properties of the Pelvic Organ Prolapse Symptom Score

Objective To assess the internal consistency, construct validity and sensitivity to change of a pelvic organ prolapse symptom score (POP-SS). Design Analysis of data from three prolapse studies, including symptomatic and asymptomatic women who completed the POP-SS. Setting (1) A community setting in New Zealand, (2) two gynaecology outpatient departments in Scotland and (3) a gynaecological surgery department in Scotland. Population or sample (1) Participants from a survey of postnatal women at 12-year follow up, invited to complete a prolapse questionnaire and have prolapse assessment, (2) new gynaecology outpatients presenting with prolapse symptoms, randomised to pelvic floor muscle training (PFMT) or control and (3) women having anterior and/or posterior prolapse surgery, randomised to mesh insert or no mesh. Method Data were analysed to assess internal consistency, construct validity and sensitivity to change of the POP-SS. Main outcome measures Cronbach's alpha, significance of differences in POP-SS scores between studies and significance of difference in POP-SS scores pre- to post-intervention. Results For internal consistency, Cronbach's alpha ranged from 0.723 to 0.828. Women having surgery had higher POP-SS scores than those having conservative management (mean difference 5.0, 95% CI 3.1–6.9), who in turn had higher scores than the asymptomatic women (mean difference 5.9, 95% CI 4.4–7.4). Significant differences in POP-SS score were detected after surgery and PFMT. The improvement due to surgery was significantly greater than that associated with PFMT (z =−3.006, P = 0.003). Conclusion The POP-SS has good internal consistency and construct validity and is sensitive to change.1 ProLong: University of Otago Postgraduate Scholarship in Obstetrics and Gynaecology. 2 POPPY: Health Services Research Committee grant, Chief Scientist Office, Scottish Government. 3 IMPRESS: None

Space Station Operations Capabilities in a Shoebox: Marshall Space Flight Center’s Telescience Resource Kit

The International Space Station (ISS) has provided the world an unprecedented capability, establishing a continuous human foothold in outer space for more than 22 years now. But maintaining that capability and supporting the ambitious portfolio of scientific research it hosts has required another unprecedented capability – providing ground-based operations support for the crew and a diverse manifest of research payloads, all simultaneously. To help meet this challenge, NASA’s Marshall Space Flight Center (MSFC) developed TReK, the Telescience Resource Kit, providing a robust solution for data, command, metadata, and file transfer capabilities. In response to an increasingly wide and diverse need for operations support resources, the TReK team has worked to find ways to make the software more flexible in order to support a wide range of missions. Today it has supported not only hundreds of ISS payloads, but also free-flying spacecraft and even aircraft-based research. This presentation will discuss how the team has modified capabilities needed to enable 24/7/365 research aboard ISS to provide the flexibility needed to support Small Sat missions, going back to one of MSFC’s first “minisatellite” missions in 2010 and beyond

Changes in urethral resistance in the presence of detrusor activity

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Validation of the Polish version of P-QoL questionnaire

Objective: Pelvic organ prolapse (POP) is a common morbidity that affects many women and significantly decreases quality of life. The severity and the impact of the prolapse on the quality of life are important parameters in the management and follow-up of affected patients. The aim of this validation study was to validate the Polish version of the Prolapse Quality of Life questionnaire (P-QoL). Material and methods: The P-QOL questionnaire was translated into Polish and administered to women recruited from two gynecological outpatient clinics (n = 231). Both symptomatic and asymptomatic women were included in the study and examined in supine position using the Pelvic Organ Prolapse Quantification System (POP-Q). The validity was assessed by comparing symptom scores and quality-of-life scores between symptomatic and asymptomatic women. Results: A total number of 154 symptomatic and 77 asymptomatic women were included. There was a strong correlation between severity of the disease based on physical findings (POP-Q scale) and the P-QoL scores in main prolapse quality-of-life domains. The overall scores for each life domain were significantly different between symptomatic and asymptomatic women (p < 0.001). All the questions regarding symptoms showed significant differences (p < 0.001) between both groups. Conclusions: The Polish version of P-QoL is a valid, reliable, and easily comprehensible instrument to assess quality of life and symptoms in Polish-speaking women suffering from urogenital prolapse

Mission Operations, Cubed: NASA Marshall Operations Support for SmallSats

SmallSats have come a long way since the Huntsville Operations Support Center (HOSC) at NASA’s Marshall Space Flight Center supported its first “minisatellite” mission in 2010. And just as SmallSats themselves have evolved in those 12 years, so too has the HOSC’s mission support for SmallSats. Marshall Space Flight Center has a long history with payload and mission operations, including support for the Apollo missions to the moon, the Space Shuttle program, and 21 years of continuous around-the-clock science operations support for research aboard the International Space Station. Today, the HOSC is a multi-tenant facility, supporting not only ISS, but also NASA’s Commercial Crew program, the Space Launch System, the Hubble and Chandra observatories and others – including multiple SmallSat missions. Two SmallSat solar sail missions will be among those taking advantage of the HOSC’s resources for planning, training for and executing mission operations – the Near Earth Asteroid (NEA) Scout and Solar Cruiser missions. One of 10 6U CubeSats manifest on the Artemis I launch of NASA’s Space Launch System rocket this year, NEA Scout’s three-year mission will be supported through a more traditional operations concept, with a dedicated Flight Controller staff operating within the HOSC. Scheduled to launch as part of the Interstellar Mapping and Acceleration Probe (IMAP) in February 2025, Solar Cruiser’s 11-month mission will take a next[1]generation approach to operations by utilizing a multi-mission flight controller concept, as well as Marshall’s Telescience Resource Kit (TreK). TreK provides a suite of software applications and libraries that allow the Mission Operations Center to serve as an in-house ground system which incorporates remote and automation capability options for engineers and scientists. This presentation will compare the approaches the HOSC will use to support these two missions as a way of demonstrating the array of options NASA MSFC offers for operations support for CubeSat and SmallSat missions

Validation of the Polish version of P-QoL questionnaire

Objective: Pelvic organ prolapse (POP) is a common morbidity that affects many women and significantly decreases quality of life. The severity and the impact of the prolapse on the quality of life are important parameters in the management and follow-up of affected patients. The aim of this validation study was to validate the Polish version of the Prolapse Quality of Life questionnaire (P-QoL). Material and methods: The P-QOL questionnaire was translated into Polish and administered to women recruited from two gynecological outpatient clinics (n = 231). Both symptomatic and asymptomatic women were included in the study and examined in supine position using the Pelvic Organ Prolapse Quantification System (POP-Q). The validity was assessed by comparing symptom scores and quality-of-life scores between symptomatic and asymptomatic women. Results: A total number of 154 symptomatic and 77 asymptomatic women were included. There was a strong correlation between severity of the disease based on physical findings (POP-Q scale) and the P-QoL scores in main prolapse quality-of-life domains. The overall scores for each life domain were significantly different between symptomatic and asymptomatic women (p &lt; 0.001). All the questions regarding symptoms showed significant differences (p &lt; 0.001) between both groups. Conclusions: The Polish version of P-QoL is a valid, reliable, and easily comprehensible instrument to assess quality of life and symptoms in Polish-speaking women suffering from urogenital prolapse

Sacral nerve modulation for patients with fecal incontinence: long-term outcome and effects on sexual function

Double incontinence; Sacral nerve modulation; Urinary incontinenceDoble incontinencia; Modulación del nervio sacro; Incontinencia urinariaDoble incontinència; Modulació del nervi sacre; Incontinència urinàriaSacral nerve modulation has become an established treatment for fecal and urinary incontinence, and sexual disorders. The objective of this study was to evaluate the long-term outcome of sacral neuromodulation in patients with fecal or combined fecal and urinary incontinence (double incontinence), assessing its safety, efficacy, and impact on quality of life and sexual function. This was a multicentric, retrospective, cohort study including patients with fecal or double incontinence who received sacral neuromodulation at seven European centers between 2007 and 2017 and completed a 5-year follow-up. The main outcome measures included improvements of incontinence symptoms and quality of life compared with baseline, evaluated using validated tools and questionnaires at 1-, 6-, 12-, 36- and 60-month follow-up. 108 (102 women, mean age 62.4 ± 13.4 years) patients were recruited, of whom 88 (81.4%) underwent definitive implantation of the pacemaker. Patients’ baseline median Cleveland Clinic Incontinence Score was 15 (10–18); it decreased to 2 (1–4) and 1 (1–2) at the 12- and 36-month follow-up (p < 0.0001), remaining stable at the 5-year follow-up. Fecal incontinence quality of life score improved significantly. All patients with sexual dysfunction (n = 48) at baseline reported symptom resolution at the 5-year follow-up. The study was limited by the retrospective design and the relatively small patient sample. Sacral nerve modulation is an effective treatment for fecal and double incontinence, achieving satisfactory long-term success rates, with resolution of concomitant sexual dysfunction.Open access funding provided by Università degli Studi della Campania Luigi Vanvitelli within the CRUI-CARE Agreement. This research was not funded by any agency in the public, commercial, or not-for-profit sectors

The energy based devices for vaginal "rejuvenation," urinary incontinence, vaginal cosmetic procedures, and other vulvo-vaginal disorders: An international multidisciplinary expert panel opinion

Aims: Energy-based devices using radiofrequency and laser technologies have gained popularity as therapies for vaginal atrophy, urinary incontinence, and vaginal prolapse. They have been promoted by cosmetic and aesthetic industries for vaginal "laxity" and vaginal "rejuvenation," both of which are undefined conditions and terms. This article aims to review the current available literature and its quality on this emerging technology. Methods: An international panel of gynaecologists, urogynaecologists, and urologists undertook a review of the available published literature, identifying articles, guidance, and society statements on the use vaginal energy-based devices. Results: There is currently no formal guidance for the use of vaginal energy based therapies. No randomized controlled trials have been published. No comparative studies to existing treatment has been carried out. Studies suggest that vaginal laser can be used in the treatment of vaginal prolapse or "vaginal laxity" and stress urinary incontinence with no quality evidence supporting the use of the therapy for vaginal atrophy or lichen sclerosis. Conclusions: This international group propose that whilst there remains a paucity of good quality data describing the safety, benefits, and appropriate use of vaginal radiofrequency or laser treatments in gynaecology and urogynaecology, a consensus best practice document by an established scientific community needs to be developed.info:eu-repo/semantics/publishedVersio

The use of laser in urogynaecology

Introduction The use of lasers in urogynaecology has increased in recent years. Their use has been described in pelvic organ prolapse, urinary incontinence and genito-urinary symptoms of menopause. The aim of this study was to review the published literature on CO2 and erbium:YAG laser use in urogynaecological conditions. Methods An extensive search of literature databases (PubMed, EMBASE) was performed for publications (full text and abstracts) written in English up to July 2018. Relevant trials were selected and analysed by an independent reviewer. Twenty-five studies were identified in total. Results All studies were either prospective cohort or case-control studies. The results of individual studies indicate that both CO2 and erbium lasers are effective in treating urogynaecological conditions. Most studies use a vaginal approach with only two investigations of intraurethral application. Conclusion The use of lasers to treat these conditions may seem appealing; however, the lack of good-quality evidence in the form of multi-centre randomised placebo-controlled trials is concerning. The safety and effectiveness of these laser devices have not been established. Use of lasers may lead to serious adverse events such as vaginal burns, scarring, dyspareunia and chronic pain. Randomised placebo-controlled trials in addition to formal evaluation of the laser devices are required before this treatment modality can be recommended

Quality of life among women with symptoms of gynecological morbidities: results of a cross‐sectional study in Karachi, Pakistan

AIMS: A population-based cross-sectional study design was used to study the effects of symptoms of various gynecological morbidities (GM) on health-related quality of life (HRQoL) of women, residents of squatter settlements of Karachi, Pakistan. MATERIAL AND METHODS: This cross-sectional study was conducted in squatter settlements of Karachi from September 2012 to August 2013, with 1002 married, non-pregnant women. After obtaining written informed consent from every participant, a structured questionnaire was used to collect information about symptoms of GM and their effect on four domains of HRQoL (physical, social, functional and financial domains). RESULTS: Of 1002 women who participated in the study, 578 reported suffering from one or more symptoms of GM. The most commonly reported symptoms were foul-smelling vaginal discharge, dysmenorrhea and uterovaginal prolapse while the least reported symptom was post-coital bleeding. Symptoms of GM were found to have a negative impact on HRQoL. Approximately one-third of women with the symptoms of GM reported having negative influences on the physical, financial and functional domains of HRQoL with social domain being comparatively less affected. Compared to other symptoms, dysmenorrhea and uterovaginal prolapse were reported to be mostly associated with poor HRQoL of women. CONCLUSION: The concept of HRQoL has been kept marginal and inconspicuous by clinicians. In order to achieve the psychosocial satisfaction of the patient, the focus needs to be diverted to all domains of HRQoL