Functional Anatomy of Urogenital Hiatus Closure: the Perineal Complex Triad Hypothesis

DeLancey, John O.; Pipitone, Fernanda; Masteling, Mariana; Xie, Bing; Ashton-Miller, James A.; Chen, Luyun

doi:10.1007/s00192-023-05708-w

Int Urogynecol J

2024

DOI: 10.1007/s00192-023-05708-w

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Functional Anatomy of Urogenital Hiatus Closure: the Perineal Complex Triad Hypothesis

John O. DeLancey,

Fernanda Pipitone,

Mariana Masteling

et al.

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Cited by 2 publications

References 28 publications

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Neuromodulation Improves Stress Urinary Incontinence-Like Deficits in Female Rabbits

Rahman,

Yousuf,

Castelán

et al. 2025

IEEE Open J. Eng. Med. Biol.

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Objective: Stress urinary incontinence (SUI) affects a third of the female population and is characterized by involuntary urine leakage during abdominal efforts such as sneezing, laughing, or coughing. Acute neuromodulation of the bulbospongiosus nerve (BsN) was shown to increase bladder efficiency in aged and multiparous rabbits. This study investigates the efficacy of sub-chronic BsN neuromodulation in alleviating SUI-like deficits in mature multiparous rabbits, characterized by increased urine leakage and reduced leak point pressure . Results: Using the voiding spot assay, we observed a 40% reduction in urine leakage events after 30 days of BsN stimulation, which correlated with a 60% increase in daily micturition volume, a 10-fold increase in voided volume, and improvements in voiding efficiency and leak point pressure compared to negative control animals. Conclusion: In multiparous rabbits, BsN neuromodulation improves important SUI-like metrics including bladder capacity and urethral closure, supporting the use of this bioelectronic modality as treatment for SUI.

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Neuromodulation Improves Stress Urinary Incontinence-Like Deficits in Female Rabbits

Rahman,

Yousuf,

Castelán

et al. 2025

IEEE Open J. Eng. Med. Biol.

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Opinions of Gynecologists About Indication and Technique of Perineoplasty

Swieten,

Stralen,

Vollebregt

et al. 2024

JCM

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Background. Perineoplasty is a frequently performed procedure as part of prolapse surgery. Despite its frequent use, there is a lack of evidence on the optimal indication, surgical technique and adverse outcomes. We intended to gain insight into the current opinions on indications and techniques of perineoplasty among (uro)gynecologists worldwide. Methods. We conducted a survey among members of the International UroGynecological Association (IUGA) to objectify indications for perineoplasty and aspects of surgical technique. Results. A total of 114 urogynecologists responded, with 98% performing perineoplasty. A total of 85% of respondents aimed to approximate the bulbocavernosus muscle, whereas 27% aimed to include the puborectal muscle as well. A total of 86% of respondents used 1–4 resorbable sutures, especially vicryl 2/0 (39%) or vicryl 0 (52%). According to the respondents, a “wide genital hiatus at physical examination” (87%) and “subjective complaints of a wide genital hiatus” (84%) were considered good/excellent indications for perineoplasty, whereas “fecal incontinence”, “apical prolapse” and “perineal pain” were absolutely/mostly not a good indication. Reasons to not perform perineoplasty were pelvic pain (59%) and dyspareunia (64%). Most responders underlined the need for more research on this topic (8.5 out of 10). Conclusions. Perineoplasty is a frequently performed procedure. There is a wide variation in the indications for and surgical techniques of perineoplasty. Therefore, research is needed to identify which patients will benefit from perineoplasty and how to optimally perform this surgery.

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Functional Anatomy of Urogenital Hiatus Closure: the Perineal Complex Triad Hypothesis

Cited by 2 publications

References 28 publications

Neuromodulation Improves Stress Urinary Incontinence-Like Deficits in Female Rabbits

Neuromodulation Improves Stress Urinary Incontinence-Like Deficits in Female Rabbits

Opinions of Gynecologists About Indication and Technique of Perineoplasty

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