The authors performed a web-based questionnaire survey of 667 members of the ICS and AUGS to determine the current use of the pelvic organ prolapse quantification (POPQ) system by members of the professional societies which have advocated its use. Three hundred and eighty (57%) gynecologists responded. This international survey shows that only 40.2% of ICS and AUGS members who responded routinely use the POPQ system in their clinical practice and provides information on the most common reasons for not using it. The results highlight some of the concerns regarding the complex nature of the system and its acceptance and use by specialists worldwide. It also suggests the need for a simplified version of the classification system that is user-friendly and can be adopted by all practitioners.
This study assessed the effect of moderate weight loss in obese women with urodynamically proven urinary incontinence using the International Consultation on Incontinence recommended outcome measures. Sixty-four incontinent women were offered a weight reduction programme with a target loss of 5-10%. This included a low-calorie diet and exercise. An anti-obesity drug (Orlistat) was offered to those who failed to achieve their target. Forty-two (65%) achieved the target weight loss and had significant reduction in body mass index and girth. Weight loss was associated with significant reduction in pad test loss (median difference, 19 g; 95% confidence interval, 13-28 g; p < 0.001). There was also a clinical and statistically significant improvement in quality of life measures. These results suggest that weight reduction of 5% of initial body weight can improve urinary incontinence severity and its effects on quality of life in obese women.
The objectives of this prospective study were to determine the prevalence of pelvic organ prolapse (POP) after colposuspension and to investigate possible preoperative and operative risk factors. Seventy-seven women who underwent colposuspension between 1996 and 1997 were investigated. POP was assessed before colposuspension using the pelvic organ prolapse quantification system (POPQ). Women were reassessed at one and seven to eight years (or when referred with symptomatic POP). By seven to eight years, of the 77 women, 29 (38%) had developed symptomatic prolapse, 29 (38%) had asymptomatic prolapse, 7 (9%) had no symptoms and no prolapse, and 12 (15%) could not be assessed. POP at one year was significantly associated with the presence of posterior vaginal descent before colposuspension (odds ratio 3.07, 95% CI 1.10-8.60, p = 0.03). No variable reached statistical significance by eight years postcolposuspension. In conclusion, this is the first study to assess POP prospectively using a validated method before and after colposuspension. The results add support to the view that there is an association between colposuspension and the development of symptomatic POP (requiring surgery).
Our results reveal an apparent global lack of adequate education in female sexuality and expose the breadth of the problem among Arab Gyns. Therefore, there is a need to improve training at the undergraduate and postgraduate levels to enable Gyns in Arab countries to provide better sexual healthcare.
OBJECTIVES: To assess various disorders of breast regarding their frequency, presentation, pathology and management at a University Hospital. DESIGN: A descriptive study. SETTING:. PATIENTS AND METHODS: One hundred and fifty patients with different breast disorders were studied. All cases were assessed clinically by getting history on a predesigned proforma and diagnosis was confirmed with help of relevant investigations. Patients with various breast diseases were included in the study except those who were having either no definite lump or no breast pathology. The treatment given was according to type of lesion in the form of surgery or conservative. Patients with benign breast diseases were assured and followed up after surgical treatment or kept on hormone therapy where as cases with malignant disease were referred to oncologist for cancer registry purpose and chemo-radiotherapy. RESULTS: Among 150 cases, majority was females with female to male ratio of 24:1. All patients presented with breast lump (100%), followed by pain in the lump (53.33%) as main symptoms. Left breast was involved in 53.33% and right breast in 44.66% of cases. Majority of cases (84.67%) underwent surgery. Histopathology revealed fibro-adenoma in 30.66%, fibrocystic disease in 15.33% and carcinoma in 35.33% cases as main disorders. All six male patients had gy-naecomastia. CONCLUSION: In our set up, frequency of carcinoma of breast is increasing as compared to benign lesions. However, overall benign problems are more frequent than breast cancer. KEY WORDS: Breast diseases. Pathology. Malignancy. Surgery.
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