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Objective To determine whether pelvic organ prolapse (POP) and sexual dysfunction are more severe in women with benign joint hypermobility syndrome (BJHS) than in the normal population.Design Case-control study.Setting King's College Hospital NHS Foundation Trust, London, UK and University College Hospital, London, UK.Population Women diagnosed with BJHS (n = 60) at University College Hospital. Control participants (n = 60) recruited from King's College Hospital NHS Foundation Trust.Methods Objective assessment of POP was undertaken using the Pelvic Organ Prolapse Quantification System (POP-Q). Both groups were asked to complete the Prolapse quality of life (P-QOL) and pelvic organ prolapse/urinary incontinence sexual (PISQ-12) questionnaires.Main outcome measures Comparison of vaginal anatomy using POP-Q between the two groups. Comparison of P-QOL and PISQ-12 quality of life scores between the two groups.Results In all, 120 women (60 in Study group, 60 in Control group) were recruited. All women in the study group were matched with healthy control women according to age, parity and ethnicity. There was a statistically significant difference between points Aa, Ba, Ap, Bp and C in study and control groups showing that prolapse is objectively more severe in those with BJHS. Significantly more women with BJHS felt that POP interfered with sex and defecation compared with the control group. The impact of prolapse symptoms on quality of life was statistically different in almost all nine P-QOL domains.Conclusions A large number of women with BJHS have prolapse symptoms, which significantly affect their quality of life. POP is more severe in women with BJHS.

What's known on the subject? and What does the study add? Overactive bladder syndrome (OAB) is a highly prevalent medical condition, which is linked to the urodynamic observation of detrusor overactivity (DO). Urodynamics detect DO in about half of female patients with OAB. Our study detects significant differences between female patients with OAB with and without DO. DO could be considered as a more severe form in the wide OAB spectrum and the two terms should not be used interchangeably. The detected differences should be taken into account in the design of studies for the assessment of new selective or combination treatments of OAB and in the provision of treatment in everyday clinical practice. Objective To determine if there are differences between female patients complaining of symptoms of overactive bladder (OAB) with and without detrusor overactivity (DO). Patients and Methods The present study was a cross‐sectional study of consecutive women attending a one‐stop urodynamic assessment clinic with OAB symptoms. The King's Health Questionnaire (KHQ) and a 3‐day bladder diary incorporating the Patient's Perception of Intensity of Urgency Scale (PPIUS) were used to assess symptoms and health‐related quality of life (HRQoL). The participants underwent multichannel urodynamics (UDS) according to the International Continence Society (ICS) recommendations. Patients whose symptom of urgency was not reproduced during the laboratory test underwent a 4‐h ambulatory UDS test. Results Of the 556 patients who were included in the study, 43% were diagnosed with DO by either laboratory (227/556) or ambulatory UDS (11/39). There was no difference between the groups in age, body mass index (BMI), menopausal status or the presence of prolapse. Patients with DO had a smaller functional bladder capacity (P < 0.001), higher urgency episode frequency (P < 0.001) and larger maximum and mean urge ratings (P < 0.001). No significant differences were found in daytime or nocturnal micturitions between the groups. The presence of DO had a more negative impact on the quality of life, with a statistically significant difference between the groups in six of the domains of the KHQ. Conclusions The present study detects objective and subjective differences between female patients with OAB with and without DO. Women with DO experience more significant impairment to their quality of life and have a greater degree of bladder dysfunction.

Introduction and hypothesis Benign joint hypermobility syndrome (BJHS) is a connective tissue disorder associated with joint hypermobility. BJHS is under-recognised by medical professionals and is poorly managed. The aim of our study was to determine whether lower urinary tract symptoms (LUTS), including urinary incontinence (UI) and anterior compartment prolapse, are more common in women with BJHS than in the normal population.Methods This was a prospective case-control study. Women diagnosed with BJHS according to the Brighton criteria were recruited from a tertiary referral clinic. Controls were recruited from hospital personnel. Both groups completed the King's Health Questionnaire (KHQ) and the Prolapse Quality of Life Questionnaire (P-QoL). Objective assessment of pelvic organ prolapse (POP) was undertaken using the Pelvic Organ Prolapse Quantification (POP-Q) system. Analyses were performed using SPSS version 17.0. The statistical difference was analysed using McNemar's test. Comparison of QoL scores was performed with the Wilcoxon signed-rank test. Results Sixty individuals were recruited and matched with 60 healthy women. The prevalence of UI in those with BJHS was significantly higher than in controls(73.3 % vs. 48.3 %). The impact of UI on QoL was statistically significant in all domains of the KHQ. There was a significant difference between groups in most urinary-specific symptoms of the KHQ. A significant number of women with BJHS suffer from voiding difficulties. Prolapse of the anterior vaginal wall was objectively more severe in those with BJHS. Conclusions Women with BJHS have LUTS and anterior compartment prolapse, which significantly impair their QoL. It is important to identify women who are symptomatic. The addition of a systematic active case-finding approach may be more effective in identifying these cases.

This study reveals that women are exposed to relatively small amounts of radiation during VUDS. The use of fluoroscopy only without additional static radiographic images minimises exposure to a level consistent with the "as low as reasonably achievable" radiological principle.

Open colposuspension is an effective option for treating persistent or recurrent stress urinary incontinence after failed midurethral tape, with a high success rate.

Self-motivation is essential in order to determine improved success rates with PFMT.