Validity and Reliability of the Modified Manchester Health Questionnaire in Assessing Patients With Fecal Incontinence

To date, no measures of fecal incontinence severity or its impact on quality of life have been validated for telephone interview. This study was designed to 1) compare responses of a self-administered and a telephone-administered Fecal Incontinence Severity Index; 2) compare a self-administered Fecal Incontinence Quality of Life Scale to the Manchester Health Questionnaire after modifying the latter for telephone administration and American English (Modified Manchester Health Questionnaire); 3) assess test-retest reliability of the telephone-administered Modified Manchester Health Questionnaire; and 4) assess the internal consistency of the Modified Manchester Health Questionnaire subscales.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41395/1/10350_2004_Article_899.pd

Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse

To estimate the risk of repeat surgery for recurrent prolapse or mesh removal after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse

Does urethral competence affect urodynamic voiding parameters in women with prolapse?

Aims To (1) compare voiding parameters and (2) correlate symptoms and urodynamic findings in women with pelvic organ prolapse (POP) and varying degrees of urethral competence. Methods We compared three groups of women with stages II–IV POP. Groups 1 and 2 were symptomatically stress continent women participating in the Colpopexy and Urinary Reduction Efforts (CARE) trial; during prolapse reduction before sacrocolpopexy, Group 1 (n = 67) did not have and Group 2 (n = 84) had urodynamic stress incontinence (USI) during prolapse reduction. Group 3 participants (n = 74), recruited specifically for this study, had stress urinary incontinence (SUI) symptoms and planned sacrocolpopexy. Participants completed standardized uroflowmetry, pressure voiding studies, and validated symptom questionnaires. Results Subjects' median age was 61 years, median parity 3 and 87% had stage III or IV POP. Fourteen percent of women in Group 3 demonstrated USI without, and 70% with, prolapse reduction. Women in Groups 2 and 3 had more detrusor overactivity (DO) than Group 1 (17 and 24% vs. 6%, P  = 0.02) and detrusor overactivity incontinence (DOI) (15 and 8% vs. 0%, P  = 0.004). Based on the Blaivis–Groutz nomogram, 60% of all women were obstructed. Post-void residual volume (PVR), peak flow rate, detrusor pressure at peak flow, voiding mechanisms, voiding patterns, obstruction and urinary retention did not differ among groups. Women in Group 3 had higher irritative and obstructive symptom scores than Group 1 or 2; neither score differed by presence of DO nor obstruction, respectively. Conclusion Women with POP have significant rates of urodynamic obstruction and retention, independent of their continence status. Symptoms of obstruction and retention correlate poorly with urodynamic findings. Neurourol. Urodynam. 26:1030–1035, 2007. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/57365/1/20436_ftp.pd

Trends in use of surgical mesh for pelvic organ prolapse

Limited data exist on the rates of pelvic organ prolapse procedures utilizing mesh. The objective of this study was to examine trends in vaginal mesh prolapse procedures (VM), abdominal sacrocolpopexy (ASC) and minimally-invasive sacrocolpopexy (MISC) from 2005–2010

Risk Factors for Fecal and Urinary Incontinence After Childbirth: The Childbirth and Pelvic Symptoms Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73402/1/j.1572-0241.2007.01364.x.pd

Risk factors for mesh/suture erosion following sacral colpopexy

To identify risks for mesh/suture erosions following sacrocolpopexy (ASC)

Gastrointestinal complications following abdominal sacrocolpopexy for advanced pelvic organ prolapse

The aims of this secondary analysis of the “Colpopexy And Urinary Reduction Efforts” (CARE) study were to estimate the incidence of post-operative gastrointestinal complications and identify risk factors

Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: Design and methods

The goals of this trial are to determine the efficacy and safety of two treatments for women experiencing fecal incontinence. First, we aim to compare the use of loperamide to placebo and second, to compare the use of anal sphincter exercises with biofeedback to usual care. The primary outcome is the change from baseline in the St. Mark's (Vaizey) Score 24 weeks after treatment initiation. As a Pelvic Floor Disorders Network (PFDN) trial, subjects are enrolling from eight PFDN clinical centers across the United States. A centralized data coordinating center supervises data collection and analysis. These two first-line treatments for fecal incontinence are being investigated simultaneously using a two-by-two randomized factorial design: a medication intervention (loperamide versus placebo) and a pelvic floor strength and sensory training intervention (anal sphincter exercises with manometry-assisted biofeedback versus usual care using an educational pamphlet). Interventionists providing the anal sphincter exercise training with biofeedback have received standardized training and assessment. Symptom severity, diary, standardized anorectal manometry and health-related quality of life outcomes are assessed using validated instruments administered by researchers masked to randomized interventions. Cost effectiveness analyses will be performed using prospectively collected data on care costs and resource utilization. This article describes the rationale and design of this randomized trial, focusing on specific research concepts of interest to researchers in the field of female pelvic floor disorders and all other providers who care for patients with fecal incontinence

A multicentered comparison of measurements obtained with microtip and external water pressure transducers

This study compared simultaneous intravesical pressure readings obtained with catheter-mounted microtip transducers and external water pressure transducer catheters during filling cystometry. Women undergoing multichannel urodynamic testing were randomly assigned to one of three groups: two microtip catheters, two external water pressure transducer catheters, or one of each type. Intravesical pressure was measured simultaneously for each transducer combination in each subject for minimal and maximal Valsalva effort and minimal, moderate, and maximal cough effort at two sequential bladder volumes (150 and 300 ml). Paired t tests were used to compare the means of the intravesical pressure obtained by the two types of catheters. The largest mean differences were observed when comparing microtip and water pressure transducers. Correlations of maximum pressure were consistently high between two microtip transducers and two water pressure transducers but lower for the microtip–water combination. Excellent reproducibility was demonstrated with transducers of similar types for intravesical pressures recorded during Valsalva and cough in women without prolapse. However, considerable variability was seen in pressures recorded by different transducers, particularly dependent on the water catheter manufacturer, indicating that intravesical pressure recordings from microtip and water-based systems are not interchangeable.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45850/1/192_2005_Article_27.pd