Pelvic Organ Prolapse Repair with and without Concomitant Burch Colposuspension in Incontinent Women: A Randomised Controlled Trial with at Least 5-Year Followup

The aim of this study was to reevaluate and update the followup of a previously published randomized controlled trial (RCT) on the impact of Burch Colposuspension (BC), as an anti-incontinence procedure, in patients with UI and POP, who underwent POP repair. Forty-seven women were randomly assigned to abdominal POP repair and concomitant BC (24 patients; group A) or POP repair alone without any anti-incontinence procedure (23 patients; group B). Median followup was 82 months (range 60–107); from over 47 patients, 30 reached 6-year followup. Two patients were lost at followup. In group A, 2 patients showed a stage I rectocele. In group B, 2 patients had a stage I rectocele and 1 a stage II rectocele. In group A, 13/23 (56.5%) were still incontinent after surgery compared with 9/22 patients (40.9%) in group B (P = 0.298). No significant changes were observed between the first and the current followup. The update of long-term followup confirmed that BC did not improve outcome significantly in incontinent women when they undergo POP repair

Role of phytotherapy associated with antibiotic prophylaxis in female patients with recurrent urinary tract infections

Objective: Aim of this study is to evaluate the efficacy of a phytotherapic which includes Solidago, Orthosiphon and Birch extract (Cistimev®) in association with antibiotic prophylaxis in female patients affected by recurrent urinary tract infections (UTIr). Materials and methods: Patients affected by UTIr older than 18 years started a 3-months antibiotic prophylaxis (Prulifloxacin 600 mg, 1 cps/week or Phosphomicyn 1 cachet/week) according to antibiogram after urine culture. The patients were divided in 2 groups: Group A: antibiotic prophylaxis plus phytotherapy (1 cps/die for 3 months) and Group B: antibiotic prophylaxis alone. Results: 164 consecutive patients were studied: 107 were included in group A (mean age 59 ± 17.3 years) and 57 (mean age 61 ± 15.7) in group B. During the treatment period the relapse frequencies between the two groups were not significantly different (p = 0.854): 12/107 (11.21%) patients interrupted the treatment for UTIr in group A and 6/57 (10.52%) in group B. In the long term follow-up the relapse UTI risk was significant different in the two groups with a relapse risk 2.5 greater in group B than in group A (p < 0.0001). Conclusion: Our study demonstrated that in female patients affected by recurrent UTI, the association between antibiotic prophylaxis and of a phytotherapic which includes Solidago, Orthosiphon and Birch extract reduced the number of UTI in the 12 months following the end of prophylaxis and obtained a longer relapsing time, greatly improving the quality of life of the patients

Management of healing abnormalities after abdominal pelvic organ prolapse repair

abstract N°32 Comunicazion

Prevalence of sexual activity in waiting list women for pelvic organ prolapse and/or urinary incontinence surgery: a cross sectional survey

Objective. To assess the sexual activity in women who are in waiting list for surgical treatment of pelvic organ prolapse and/or urinary incontinence. Material and methods. Between January 2005 and December 2007, 671 patients referred for surgical repair of pelvic organ prolapse and/or urinary incontinence, were assessed for sexual activity by a cross sectional survey. Eligibility criteria for surgery were set as pelvic organ prolapse > 2 (pelvic organ prolapse was assessed according to B&W and pelvic organ prolapse-Q systems), urinary incontinence, according to the ICS definition, and age ≥ 18. All patients were assessed by history, clinical examination, Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 questionnaires, bladder diary, urine culture and pelvic ultrasound. All the women were asked if in the past three months had sexual activity with a partner. Sexual activity was defined as caressing, foreplay, masturbation and vaginal intercourse. Those who had not been sexual active were asked if they had a partner at that time. Results. Over 671 patients, 225 (33.5%) did not report any sexual activity while 446 (66.5%) had have in the three months before their referral some sort of sexual activity. The mean age of patients with sexual activity was statistically significant lower, that the group without (p 0.0001). No statistical significant difference was recorded about body mass index (p 0.089), Incontinence Impact Questionnaire (p 0.74) and Urogenital Distress Inventory (p 0.53). The women with sexual activity in the last three months showed a lower incidence of rectocele (p 0.011), hysterocele (p 0.003), number of vaginal delivery (p 0.006) and a positive PC test (p 0.001). Non significant difference were recorded regarding the presence/absence of comorbidities (hypertension, anxiety, thyroid diseases, ischemic cardiopaty, diabetes). 95.6% of patients without sexual activity were in menopause and 71.1% of women without sexual activity presented urinary incontinence Conclusions. The distress due to know undergoing surgery for pelvic organ prolapse or urinary incontinence, seems to not increase the prevalence of sexual dysfunction in waiting list women