Fibroid surgery and improvement in bladder symptoms: The FAB study

Houlihan, Sara; Koenig, Nicole; Friedman, Boris; Lee, Terry; Geoffrion, Roxana

doi:10.1002/nau.23541

Cited by 9 publications

(10 citation statements)

References 21 publications

(34 reference statements)

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“…The postoperative Urinary Distress Inventory-6 total score was similar to those in other studies. 13,22,23 The reoperation rate was 2.37%, which was similar to other studies in the literature. [24][25][26][27] In all 5 cases, the pelvis was clear of adhesions with the added advantage of not having to remove an old mesh.…”

Section: Karon and Chatterjeesupporting

confidence: 87%

“…The PFDI-20 and PFIQ-7 scores ( Table 2) were comparable to the post-sacrocolpopexy and post-pelvic-surgery scores found in the literature. [13][14][15][16][17][18][19][20][21][22] Patients reported a feeling of overall improvement. The OAB symptom complaints comprised the most-common call-back reason for up to 3 months postoperatively and then steadily declined up to 1 year (Fig.…”

Section: Karon and Chatterjeementioning

confidence: 99%

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Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

Karon

Chatterjee

2019

Journal of Gynecologic Surgery

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Objective: This study was conducted to evaluate the use of non-crosslinked acellular dermal matrix (ADM) in laparoscopic sacrocolpopexy by analyzing clinical outcomes and patient-satisfaction surveys. Materials and Methods: Two hundred and eleven patients underwent laparoscopic sacrocolpopexy for pelvic organ prolapse (POP) between January 6, 2012, and December 31, 2017. Each patient had her pelvic-floor measurements diagrammed with the POP-Q [Quantification] system using the interactive tool provided by the American Urogynecologic Society. The Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7), used to make comprehensive assessments of women with urogynecologic problems, were mailed to all patients. If responses were not received, the patients were contacted by telephone. Patients who were not reached by either mail or telephone had their charts individually reviewed to extract the information. Trained surveyors scored the PFDI-20 and the PFIQ-7 questionnaires. The de-identified data were analyzed for patient satisfaction and outcomes. This information was obtained by a review of patient charts at 4-week postoperative and annual examinations; any phone calls with complaints and/or problem office visits were noted. Biopsies from the sacrocolpopexy area were taken if a patient had another incidental gynecologic procedure unrelated to the prolapse or at the time of repeat sacrocolpopexy for POP and the paraffin cell block was sent to McGowan Institute for Tissue Regeneration. Results: One hundred and five patients responded to the survey. Charts were completed for 106. The majority of interviewed patients stated that they were doing a ''little better'' or ''much better'' (77/88; 87.5%). The thirdquartile PFDI-20 score was 93 with a median of 60 and the PFIQ-7 score was 43 with a median of 29. Five patients underwent reoperations (4.76%). The most-common postoperative complaint was overactive bladder symptoms, followed by vaginal discharge. Histology showed either a lack of regenerative healing tissue at the failure site or good results showing neovascularization and a presence of connective and ligamentous tissue around the matrix. No intense fibrosis or neoplastic formation was reported. Conclusions: A non-crosslinked ADM patch can be a good alternative to synthetic polypropylene mesh in patients undergoing sacrocolpopexy for POP. ( J GYNECOL SURG 35:337)

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Section: Karon and Chatterjeesupporting

confidence: 87%

Section: Karon and Chatterjeementioning

confidence: 99%

Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

Karon

Chatterjee

2019

Journal of Gynecologic Surgery

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“…23,31,32 A significant improvement was also noted 4–6 years after surgical debulking (myomectomy or hysterectomy) (n=30), with a median score change of −28.4 (interquartile range −58.8 to −0.9). 33,34…”

Section: Resultsmentioning

confidence: 99%

“…Ten articles (nine studies) reported on UI 25,26,29,33,34,41,48,49,52,53 ; five of these reported on UUI, 26,29,33,34,52 six on SUI, 25,26,29,33,34,41 and five on incontinence not otherwise specified. 29,41,48,49,53 Overall, the quality of evidence was moderate (Appendix 3, http://links.lww.com/AOG/D227).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies in five articles (one RCT 23,31,32 and one single-group study 33,34 ) reported on the full form of the UDI (Appendix 2, http://links.lww.com/AOG/ D227). There was a similar, significant improvement in UDI scores after both uterine artery embolization (n581) and hysterectomy (n575) for leiomyomas, and this improvement was maintained up to 60 months after intervention (mean change: uterine artery embolization 210.7; hysterectomy 28.4) but not at 120 months (mean change: uterine artery embolization 20.4; hysterectomy 3.2).…”

Section: Resultsmentioning

confidence: 99%

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Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas

Gupta

Balk

Lenger

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To conduct a systematic review to evaluate the effect of procedural interventions for leiomyomas on pelvic floor symptoms. DATA SOURCES: PubMed, EMBASE, and ClinicalTrials.gov were searched from inception to January 12, 2023, searching for leiomyoma procedures and pelvic floor disorders and symptoms, restricted to primary study designs in humans. METHODS OF STUDY SELECTION: Double independent screening for studies of any study design in all languages that reported pelvic floor symptoms before and after surgical (hysterectomy, myomectomy, radiofrequency volumetric thermal ablation) or radiologic (uterine artery embolization, magnetic resonance-guided focused ultrasonography, high-intensity focused ultrasonography) procedures for management of uterine leiomyomas. Data were extracted, with risk-of-bias assessment and review by a second researcher. Random effects model meta-analyses were conducted, as feasible. TABULATION, INTEGRATION, AND RESULTS: Six randomized controlled trials, one nonrandomized comparative study, and 25 single-group studies met criteria. The overall quality of the studies was moderate. Only six studies, reporting various outcomes, directly compared two procedures for leiomyomas. Across studies, leiomyoma procedures were associated with decreased symptom distress per the UDI-6 (Urinary Distress Inventory, Short Form) (summary mean change −18.7, 95% CI −25.9 to −11.5; six studies) and improved quality of life per the IIQ-7 (Incontinence Impact Questionnaire, Short Form) (summary mean change −10.7, 95% CI −15.8 to −5.6; six studies). There was a wide range of resolution of urinary symptoms after procedural interventions (7.6–100%), and this varied over time. Urinary symptoms improved in 19.0–87.5% of patients, and the definitions for improvement varied between studies. Bowel symptoms were inconsistently reported in the literature. CONCLUSION: Urinary symptoms improved after procedural interventions for uterine leiomyomas, although there is high heterogeneity among studies and few data on long-term outcomes or comparing different procedures. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42021272678.

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Female pelvic medicine & reconstructive surgery (FPMRS) challenges on behalf of the collaborative research in pelvic surgery consortium (CoRPS): managing complicated cases series 7: can fibroids worsen incontinence?

Weingarten

Digesu

Huebner³

et al. 2020

Int Urogynecol J

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Fibroid surgery and improvement in bladder symptoms: The FAB study

Abstract: Urinary symptoms are common in women undergoing surgery for uterine fibroids. Fibroid debulking may be offered as treatment for bladder symptoms in symptomatic women.

Cited by 9 publications

References 21 publications

Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas

Female pelvic medicine & reconstructive surgery (FPMRS) challenges on behalf of the collaborative research in pelvic surgery consortium (CoRPS): managing complicated cases series 7: can fibroids worsen incontinence?

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