J. P. W. R. Roovers

The effect of urinary incontinence and overactive bladder symptoms on quality of life in young women.

Objective  To assess the consequences that the symptoms of urinary incontinence and an overactive bladder have on the quality of life in young, community‐dwelling women.

The contribution of hysterectomy to the occurrence of urge and stress urinary incontinence symptoms

Objective To study the contribution of hysterectomy to the occurrence of urge‐or stress urinary incontinence symptoms

Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta‐analysis of randomised trials

The combination of prolapse surgery with an incontinence procedure can reduce the incidence of stress urinary incontinence (SUI) after surgery, but may increase adverse events. We compared the effectiveness and safety of prolapse surgery versus combined prolapse and incontinence surgery in women with pelvic organ prolapse.

Long-term cervical cancer survivors suffer from pelvic floor symptoms: A cross-sectional matched cohort study

OBJECTIVE The aim of this study was to determine prevalence of and experienced distress from pelvic floor symptoms in cervical cancer survivors (CCS). METHODS For this cross-sectional matched cohort study, we matched CCS, treated in the Academic Medical Center, Amsterdam between 1997 and 2007, to a random female population sample aged 20 to 70 years (reference group). We assessed prevalence of and distress from bladder and bowel symptoms with validated pelvic-floor-related questionnaires. Severe distress was defined as values above the 90th percentile of reference groups symptom domain scores. RESULTS One-hundred and forty-six CCS underwent radical hysterectomy and pelvic lymph node dissection (RH and LND), 49 underwent surgery and adjuvant radiotherapy (SART), and 47 underwent primary radiotherapy (PRT). Urinary incontinence and obstructive voiding were reported by each treatment group more frequently than by the reference group and caused more distress. Patients treated with RH and LND reported more distress from most uro-genital symptoms, except from overactive bladder symptoms. Patients treated with PRT reported more distress from each uro-genital symptom than matched controls. The RH and LND group reported more distress from constipation and obstructive defecation than the reference group. Patients who underwent primary or adjuvant radiotherapy reported more distress from anal incontinence than their matched controls. CONCLUSIONS Treatment of cervical cancer impairs pelvic floor function. Patients treated with PRT report the most adverse effects on pelvic floor function. The results of our study enable physicians to counsel accurately about specific symptoms. Furthermore, to facilitate referral to pelvic floor specialists when bothersome symptoms occur, we recommend evaluating pelvic floor symptoms as a standard during follow-up.

Risk factors for postpartum urinary retention: a systematic review and meta-analysis.

Please cite this paper as: Mulder F, Schoffelmeer M, Hakvoort R, Limpens J, Mol B, van der Post J, Roovers J. Risk factors for postpartum urinary retention: a systematic review and meta‐analysis. BJOG 2012;119:1440–1446.

Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for vaginal hysterectomy: a randomised controlled trial: Vessel sealing vs clamping for vaginal hysterectomy

Please cite this paper as: Lakeman M, The S, Schellart R, Dietz V, ter Haar J, Thurkow A, Scholten P, Dijkgraaf M, Roovers J. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for vaginal hysterectomy: a randomised controlled trial. BJOG 2012;119:1473–1482.

Patient preferences for clean intermittent catheterisation and transurethral indwelling catheterisation for treatment of abnormal post-void residual bladder volume after vaginal prolapse surgery

Please cite this paper as: Hakvoort R, Nieuwkerk P, Burger M, Emanuel M, Roovers J. Patient preferences for clean intermittent catheterisation and transurethral indwelling catheterisation for treatment of abnormal post‐void residual bladder volume after vaginal prolapse surgery. BJOG 2011;118:1324–1328.

Hysterectomy and Lower Urinary Tract Symptoms: A Nonrandomized Comparison of Vaginal and Abdominal Hysterectomy

Background/Aims: It has been reported that lower urinary tract symptoms (LUTS) are more prevalent in patients who have undergone hysterectomy. However, the effects of surgical approach of hysterectomy on micturition have not been well documented. The aim of this study is to compare LUTS between patients who underwent vaginal and abdominal hysterectomy. Methods: Prospective observational study among 430 patients undergoing vaginal or abdominal hysterectomy for benign disease other than genital prolapse. Participating patients completed a validated disease-specific questionnaire before surgery, 6 months and 3 years after surgery. Results: 112 women underwent vaginal hysterectomy and 318 abdominal hysterectomy. After correction for differences in uterine size, descent of the uterus and other differences, LUTS were more common at 3 years after surgery following vaginal than following abdominal hysterectomy (OR 2.2, 95% CI 1.3–4.0). After adjustment for descent of the uterus, uteral size, parity and indication for hysterectomy, this difference was still statistical significant (adjusted OR 3.0, 95% CI 1.4–6.2). Conclusion: As compared to abdominal hysterectomy, LUTS appear to be more common following vaginal hysterectomy.

Reasons for not seeking medical help for severe pelvic floor symptoms: a qualitative study in survivors of gynaecological cancer

Objective  (1) To explore the reasons for not seeking help for severe pelvic floor symptoms after gynaecological cancer treatment. (2) To determine the willingness to undergo treatment for these symptoms. (3) To invite suggestions to improve outpatient care.

Postpartum urinary retention: a systematic review of adverse effects and management

Introduction and hypothesisPostpartum urinary retention (PUR) is a well-known condition after childbirth. Often clinicians assume that this condition is transient, either through belief or by not being aware that its occurrence as measurement of post-void residual volume (PVRV) is often not routine. However, long lasting urinary retention is a serious condition that needs management in order to prevent urogenital tract morbidity. By performing a systematic review of the adverse effects of PUR and management of this condition, we aimed to identify the necessity of diagnosing this condition in the puerperium and to evaluate whether treatment is required.MethodsWe searched for all studies on PUR in OVID MEDLINE, OVID EMBASE, and ongoing Trial registers. Two reviewers independently screened and extracted the data.ResultsTwenty-four papers were included in this review. Limited data on adverse effects demonstrate potential morbidities, like micturition symptoms and sporadically spontaneous bladder ruptures, related to PUR.ConclusionsBased on current literature, evidence stating that PUR is harmless is lacking. Future research should focus on management strategies for overt PUR and the long-term consequences of covert PUR. Until these results are available, clinicians should be aware of the potential consequences and therefore keep trying to identify patients at risk of PUR and patients with the actual condition.