Introduction Describe differences in sexual activity and function in women with and without pelvic floor disorders (PFDs). Methods Heterosexual women > 40 years of age who presented to either Urogynecology or general gynecology clinics at 11 clinical sites were recruited. Women were asked if they were sexually active with a male partner. Validated questionnaires and Pelvic Organ Prolapse Quantification (POPQ) examinations assessed urinary incontinence (UI), fecal incontinence (FI) and/or pelvic organ prolapse (POP). Sexual activity and function was measured by the Female Sexual Function Index (FSFI). Student’s t-tests were used to assess continuous variables; categorical variables were assessed with Fisher’s exact test and logistic regression. Univariate and multivariate analyses were used to assess the impact of PFDs on FSFI total and domain scores. Results 505 women met eligibility requirements and consent for participation. Women with and without PFDs did not differ in race, BMI, co-morbid medical conditions, or hormone use. Women with PFDs were slightly older than women without PFDs (55.6 + 10.8 vs. 51.6 + 8.3 years, P <0.001); all analyses were controlled for age. Women with PFDs were as likely to be sexually active as women without PFDs (61.6 vs. 75.5%, P=0.09). There was no difference in total FSFI scores between cohorts (23.2 + 8.5 vs. 24.4 + 9.2, P= 0.23) or FSFI domain scores (all p = NS). Conclusion Rates of sexual activity and function are not different between women with and without PFDs.

Introduction and hypothesis-This study seeks to determine if total vaginal length (TVL) or genital hiatus (GH) impact sexual activity and function.

Early administration of vaginal estrogen after vaginal surgery via an estradiol-releasing ring is feasible and results in improved markers of tissue quality postoperatively compared to placebo and controls.

CPT is an objective measure of pelvic floor strength and provides consistent, reproducible results.

Importance: Since the US Food and Drug Administration's 2016 ban of transvaginal mesh use in vaginal prolapse surgery, there has been growing public scrutiny over the use of synthetic mesh slings (SSs) for the surgical management of female stress urinary incontinence (SUI). Although long considered the mainstay of current practice, interest in biological alternatives has grown.Objectives: This article reviews the last 20 years of data comparing the success of autologous fascial slings (AFSs) and SSs in the treatment of female SUI.Evidence Acquisition: We reviewed the literature for randomized controlled trials comparing autologous pubovaginal sling and SS for the primary surgical treatment of female SUI using several search engines and databases between January 1, 2000, and March 31, 2020.Study Appraisal and Synthesis Methods: Data were retrieved and compared across studies. Trials were evaluated for study setting, type, population characteristics, sample size, success definition and rate, recurrence rate, operative time, length of hospital stay, complications, and quality of life.Results: Of the 1382 articles reviewed, 8 met eligibility criteria, representing 6 distinct cohorts and 726 subjects. Synthetic slings available for review were either tension-free vaginal tape (TVT) or minisling. The vast majority of studies demonstrated similar short-and long-term success rates of AFS and SS procedures utilizing a range of outcome measures. Both AFS and TVT sling had low recurrence rates in short-and long-term followup. However, AFS had significantly longer operative time, and longer hospital stay. Bladder perforation, on the other hand, occurred more commonly in TVT sling. Health-related quality-of-life scores, including sexual function, were similar between groups.Conclusions: Autologous fascial sling and SS are both highly effective surgical procedures for the treatment of female SUI. Although success rates are comparable, AFS is associated with less favorable operative measures.Relevance: This review supports the effectiveness of AFS in treating female SUI as concerns over the use of synthetic materials in vaginal surgery rise. However, clinicians must weigh the risks conferred by this nonsynthetic alternative.Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After participating in this activity, the learner should be better able to compare the benefits and drawbacks of available sling types for the surgical management of female stress urinary incontinence; discuss complication rates related to each sling type; and explain their impact on quality of life. This study has not been presented in any meeting prior to this submission.All authors, faculty, and staff have no relevant financial relationships with any ineligible organizations regarding this educational activity.

This was a cross-sectional study evaluating the prevalence of UI in pregnant young females and adolescents.

Among examiners who routinely perform POP-Q examinations, there is no significant difference between "eyeball"/estimated and measured POP-Q values and stage.

The purpose of this review is to provide an in-depth overview of the role of pelvic floor muscle (PFM) training in the management of stress urinary incontinence (SUI). The definition, epidemiology, and pathogenesis of SUI are described. We review the anatomy of the PFM and the importance of PFM strength in maintaining urinary continence and establishing normal voiding function. A brief description of the surgical options currently available for SUI and the existing data regarding the role of perioperative PFM training for SUI are included. Critical research questions to better evaluate and assess PFM training during the perioperative period are proposed. Promising novel approaches in the treatment of SUI are also presented. This review is useful for physiatrists, urogynecologists, female urologists, and nurse practitioners who specialize in the management and treatment of women with SUI. LEVEL OF EVIDENCE: IV.