Our results indicated that isoflavones and curcumin could modulate serum PSA levels. Curcumin presumably synergizes with isoflavones to suppress PSA production in prostate cells through the anti-androgen effects.
Apart from increased stress urinary incontinence, there was an improvement in overall urinary function in terms of patient-reported symptoms and urodynamics, despite deep vesicovaginal space dissection. Hence, LSC is a viable surgical option for pelvic organ prolapse, restoring both level 1 and level 2 support without detrimental effects on urinary function.
Objectives
To evaluate subjective and objective outcomes, complication, recurrence, and reoperation rates after transvaginal mesh surgery for the management of pelvic organ prolapse.
Methods
This was a retrospective analysis of transvaginal mesh surgery carried out using self‐cut mesh measuring subjective outcomes using validated questionnaires, and objective outcomes using Pelvic Organ Prolapse Quantification. Patients diagnosed with stage ≥2 pelvic organ prolapse were counseled about all possible surgical options. After thorough explanation about the benefits and risks during transvaginal mesh surgery, patients who gave signed consent were scheduled for surgery and evaluated at 1 and 3 years postoperatively.
Results
We included 101 patients who completed a minimum of 3‐year follow up. One year and 3‐year follow up showed significant improvement both on subjective and objective outcomes. Recurrences were observed in three patients (3%), with one (1%) patient undergoing reoperation. One case (1%) of intraoperative complication (bladder injury) and four cases (4%) of postoperative complications (two mesh exposure, one hematoma and one significant increase in post‐voiding residual) were recorded. Overall patients’ satisfaction was positive.
Conclusions
Transvaginal mesh surgery using self‐cut mesh is associated with significant improvement in both subjective and objective outcomes, offering low recurrence and complication rates, and high patient satisfaction rates. It can be a safe, effective and cost‐efficient option not only for recurrence cases, but also as primary management of pelvic organ prolapse using a standardized technique and proper patient selection.
This study demonstrated a significant relationship between the change in renal function and the change in renal volume in Japanese ADPKD patients without renal insufficiency. It is possible that the volume measurements can be used as useful markers for disease progression in Japanese ADPKD patients.
Objectives
To evaluate the mid‐range subjective and objective success rate of laparoscopic sacrocolpopexy.
Methods
Of the 317 women with pelvic organ prolapse who underwent laparoscopic sacrocolpopexy surgery at the same center between January 2013 and March 2015, we assessed 233 patients who were followed up for >3 years. We carried out urogynecological examinations and used questionnaires for the postoperative assessment of the patients. Scoring 0 points on question 3 of the Pelvic Floor Distress Inventory‐20 was considered to show subjective success. Objective success was defined as stage 0 or 1 on the Pelvic Organ Prolapse Quantification.
Results
The subjective and objective success rates in the third year after surgery were 89.7% (209/233) and 90.6% (211/233), respectively, and those in the first year were 90.6% (211/233) and 91.0% (212/233), respectively. Perioperative complications included bladder injury (0.4%) in one case and vaginal wall injury (0.4%) in one case. Postoperative complications included the incidence of chronic pain (mesh retraction) in one case, which was the only case requiring re‐operation due to complications (0.4%); vaginal suture exposure (0.4%) in one case; port‐site hernia (0.4%) in one case; and subileus (0.4%) in one case. The complications associated with voiding function included de novo stress urinary incontinence (20.6%) in 48 cases, out of which there were 12 cases of de novo overactive bladder (5.2%) and eight cases required midurethral sling procedures.
Conclusions
Laparoscopic sacrocolpopexy provides a good outcome with a low rate of subjective and objective recurrence and surgical complications.
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