A randomised controlled trial evaluating the use of polyglactin mesh, polydioxanone and polyglactin sutures for pelvic organ prolapse surgery

To compare the effectiveness of polyglactin mesh, and polydioxanone or polyglactin sutures in women having pelvic organ prolapse surgery. Randomised controlled trial with a factorial 2(2 design of polyglactin mesh or not, and polydioxanone or polyglactin suture. Outcomes were assessed using questionnaires at baseline and on the third day and at 6 months after surgery. Women were also examined clinically 3 months after surgery. The primary outcome was the subjective improvement in prolapse symptoms and quality of life scores from baseline to 6 months. There was a subjective improvement in the prolapse symptom score from baseline to 6 months after surgery (mean difference of 9.2 (95% CI for difference 7.2-11.2, p < 0.001) and an improvement in the mean quality of life score over the same period with a reduction of 3.4 (95% CI for difference 2.4-4.3, p < 0.001). However, there were no significant differences in the mean difference in prolapse symptoms and quality of life (QoL) scores according to the randomised groups. The majority (86%) of women were satisfied with their surgery. Our study demonstrated that at short-term follow-up, there was no significant difference in the mean differences in prolapse symptoms and QoL scores after surgery using polyglactin mesh or not, polyglactin or polyglactin sutures, but the numbers were too small for a definitive conclusion. Longer-term follow-up and/or a larger trial are required

A randomised controlled trial evaluating the use of polyglactin (Vicryl) mesh, polydioxanone (PDS) or polyglactin (Vicryl) sutures for pelvic organ prolapse surgery : outcomes at 2 years

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Case study : a patient-clinician collaboration that identified and prioritized evidence gaps and stimulated research development

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Electrical stimulation with non-implanted devices for stress urinary incontinence in women

The authors would like to thank Luke Vale, Imran Omar, Sheila Wallace and Suzanne MacDonald at the Cochrane Incontinence Group for their support. We would also like to thank Mette Frahm Olsen, Gavin Stewart, Miriam Brazelli, Anna Sierawska, and Beatriz Gualeo for help with translations.Peer reviewedPublisher PD

Determining the Activity of Three HDAC Variants in the Presence of Compounds Containing 1,2,3-and 1,2,4-Triazoles as Zinc Binding Groups

Histone Deacetylase (HDAC) plays a vital role in cellular processes, for example gene expression, cell growth, and apoptosis. Finding drug candidates to inhibit the over activity of HDACs in cancer is a growing area of interest. Inhibitors, thus far, have three important motifs to be studied: the zinc binding group, a hydrophobic linker, and a cap group. By altering these groups on the inhibitor, not only can activity be increased but also selectivity within the classes of HDACs. We present the design of two novel sets of molecules that contain either a 1,2,3-triazole or 1,2,4-triazole. The 1,2,3-triazoles were synthesized using “click chemistry” with a novel pyridyl triazine catalyst. The 1,2,4-triazoles were synthesized utilizing substitution chemistry. This set of molecules was designed after suberoylanilide hydroxamic acid (SAHA) but replaced the hydroxamate with the triazole as the zinc binding group. The activity of these inhibitors against HDAC 1, HDAC 6, and SIRT 1 were tested using the Biomol Fluor de Lys in vitro kits. Though none of the synthesized compounds were strong activators or inhibitors of any of the classes of HDACs, trends were observed that could lead to the design of more potent inhibitors

A randomised controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse

Abstract Forty-seven women participated in a pilot study for a multi-centre randomized controlled trial of the effectiveness of pelvic floor muscle training (PFMT) for women with prolapse. Women with symptomatic stage I or II prolapse [measured by Pelvic Organ Prolapse Quantification (POP-Q)] were randomized to a 16-week physiotherapy intervention (PFMT and lifestyle advice; n=23) or a control group receiving a lifestyle advice sheet (n=24). Symptom severity and quality of life were measured via postal questionnaires. Blinded POP-Q was performed at baseline and follow-up. Intervention women had significantly greater improvement than controls in prolapse symptoms (mean score decrease 3.5 versus 0.1, p=0.021), were significantly more likely to have an improved prolapse stage (45% versus 0%, p=0.038) and were significantly more likely to say their prolapse was better (63% versus 24%, p=0.012). The data support the feasibility of a substantive trial of PFMT for prolapse. A multi-centre trial is underway.This study was funded by the Chief Scientist Office, Scottish Government (CZH/4/95)

Optimiser l’efficacité de la rééducation périnéale dans le traitement de l’incontinence urinaire d’effort chez la femme : que nous disent les évidences scientifiques?

La rééducation des muscles du plancher pelvien est le traitement de première ligne de l’incontinence urinaire d’effort chez la femme. Toutefois, les composantes de cette rééducation varient considérablement d’un essai clinique randomisé à l’autre. Par conséquent, plusieurs questions persistent quant au contenu optimal d’une rééducation périnéale. Les séances d’entraînement supervisées sont-elles nécessaires après l’enseignement des exercices? Combien de contractions musculaires du plancher pelvien devrait-on faire par jour pour un effet maximal? Quelle est la meilleure combinaison de techniques de rééducation : les exercices du plancher pelvien seul, avec le biofeedback, la stimulation ou les cônes vaginaux? Les questions sont infinies. Comme point de départ de notre réflexion visant à identifier le contenu optimal d’une rééducation périnéale, la présente propose d'examiner les éléments de preuve qui concernent l'efficacité des diverses techniques de rééducation périnéale, de discuter de nos connaissances actuelles des dysfonctions musculaires du plancher pelvien, de rappeler les principes d’entraînement musculaire les plus à jour et de discuter des facteurs influençant l'adhésion des femmes à la rééducation périnéale

Sexual function, delivery mode history, pelvic floor muscle exercises and incontinence : a cross-sectional study six years postpartum

Background: There is controversy over the effect of mode of delivery, pelvic floor muscle exercises (PFME), incontinence and sexual function. Aim: To investigate the relationship of sexual function with delivery mode history, PFMEs and incontinence. Methods: This was a cross-sectional postal survey of women, six years post-partum, who had given birth in maternity units in Aberdeen, Birmingham and Dunedin and had answered a previous questionnaire. Each sexual function question was analysed separately by ANOVA. Results: At six years post-index delivery, 4214 women responded, of whom 2765 (65%) answered the optional ten sexual function questions. Although there was little association between delivery mode history and most sexual function questions, women who had delivered exclusively by caesarean section scored significantly better on the questions relating to their perception of vaginal tone for their own (P-value < 0.0001) and partner's (P-value 0.002) sexual satisfaction, especially when compared with women who had had vaginal and instrumental deliveries. Women who reported that they were currently performing PFME scored significantly better on seven questions. Women with urinary or faecal incontinence scored significantly poorer on all sexual function questions. Conclusions: Mode of delivery history appeared to have minimal effect on sexual function. Current PFME performance was positively associated with most aspects of sexual function, however, all aspects were negatively associated with urinary and faecal incontinence.The original study was supported by Wellbeing and the Health Research Council of New Zealand and the follow-up study by the Health Services Research Unit, which is core funded by a grant from the Chief Scientist Office of the Scottish Executive Health Department

Translation and validation of the German version of the Mother-Generated Index and its application during the postnatal period.

the Mother-Generated Index (MGI) is a validated tool to assess postnatal quality of life. It is usually administered several weeks or months after birth and correlates with indices of post partum mood states and physical complaints. The instrument had not been translated into German before or validated for use among German-speaking women, nor have the results of the tool been assessed specifically for the administration directly after birth. This paper aims to describe the systematic translation process of the MGI into German and to assess the convergent validity of the German version of the instrument directly after birth and seven weeks post partum

Reflecting on the methodological challenges of recruiting to a United Kingdom-wide, multi-centre, randomised controlled trial in gynaecology outpatient settings

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