OBJECTIVES To describe pelvic organ prolapse surgical success rates using a variety of definitions with differing requirements for anatomic, symptomatic, or re-treatment outcomes. METHODS Eighteen different surgical success definitions were evaluated in participants who underwent abdominal sacrocolpopexy within the Colpopexy and Urinary Reduction Efforts trial. The participants’ assessments of overall improvement and rating of treatment success were compared between surgical success and failure for each of the definitions studied. The Wilcoxon rank sum test was used to identify significant differences in outcomes between success and failure. RESULTS Treatment success varied widely depending on definition used (19.2–97.2%). Approximately 71% of the participants considered their surgery “very successful,” and 85.2% considered themselves “much better” than before surgery. Definitions of success requiring all anatomic support to be proximal to the hymen had the lowest treatment success (19.2–57.6%). Approximately 94% achieved surgical success when it was defined as the absence of prolapse beyond the hymen. Subjective cure (absence of bulge symptoms) occurred in 92.1% while absence of re-treatment occurred in 97.2% of participants. Subjective cure was associated with significant improvements in the patient’s assessment of both treatment success and overall improvement, more so than any other definition considered (P<.001 and <.001, respectively). Similarly, the greatest difference in symptom burden and health-related quality of life as measured by the Pelvic Organ Prolapse Distress Inventory and Pelvic Organ Prolapse Impact Questionnaire scores between treatment successes and failures was noted when success was defined as subjective cure (P<.001). CONCLUSION The definition of success substantially affects treatment success rates after pelvic organ pro-lapse surgery. The absence of vaginal bulge symptoms postoperatively has a significant relationship with a patient’s assessment of overall improvement, while anatomic success alone does not.

No abstract

Rat electroretinograms were measured as a function of dietary supplements of purified ethyl esters of linolenic acid, linoleic acid, and oleic acid. Polyunsaturated fatty acids derived from precursors of linolenic and linoleic acids appear to be important functional components of photoreceptor cell membranes, although in equal dietary concentrations, linolenic acid precursors affect electroretinogram amplitudes to a greater extent than linoleic acid precursors. The electrical response of photoreceptor cell membranes appears to be a function of the position of the double bonds as well as a function of the total number of double bonds in fatty acid supplements.

The fatty acid composition of rat photoreceptor membranes was altered by dietary manipulation. A functional alteration was also observed in the component of the electroretinogram which is generated by the photoreceptors. A membrane fatty acid, docosahexaenoic acid, appears to be involved in the transduction process of visual excitation.

Objective-Estimate the minimum important difference (MID) for the Urinary Distress Inventory (UDI), UDI-stress subscale of the Pelvic Floor Distress Inventory (PFDI), and Urinary Impact Questionnaire (UIQ) of the Pelvic Floor Impact Questionnaire (PFIQ).Methods-We calculated MID using anchor-and distribution-based approaches from a randomized trial for non-surgical stress incontinence treatment. Anchors included a global impression of change, incontinence episodes from a urinary diary, and the Incontinence Severity Index. Effect size and standard error of measurement were the distribution methods employed.Results-Anchor-based MIDs ranged from −22.4 to −6.4 points for the UDI, −16.5 to −4.6 points for the UDI-stress, and −17.0 to −6.5 points for the UIQ. These data were supported by two distribution-based estimates.Conclusion-Reasonable estimates of MID are 11, 8, and 16 points for the UDI, UDI-stress subscale and UIQ, respectively. Statistically significant improvements that meet these thresholds should be considered clinically important. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptAm J Obstet Gynecol. Author manuscript; available in PMC 2010 May 1.