L. López-Fando

The 3‐day bladder diary is a feasible, reliable and valid tool to evaluate the lower urinary tract symptoms in women

To evaluate the feasibility (% of completion), reliability (test–retest and inter‐observer) and validity (convergent vs. questionnaires and vs. urodynamic study‐UDS) of the 3‐day bladder diary (3dBD) in women with lower urinary tract symptoms (LUTS).

Prospective long-term results, complications and risk factors in pelvic organ prolapse treatment with vaginal mesh

OBJECTIVE To assess the long-term results and complications of pelvic organ prolapse treatment with transvaginal mesh. STUDY DESIGN Prospective observational study of 75 women who underwent surgery between 2005 and 2008 by the same surgeon. 44 patients (58,7%) underwent concomitant treatment of stress urinary incontinence. Anatomical criterion for failure was prolapse grade >I in any compartment. Analysis of functional features consisted of an assessment of urinary, sexual, and defecation symptoms, and pelvic pain. Subjective global evaluation of the treatment was carried out through the Visual Analogue Scale (VAS). Analysis of the early and late complications and their medical or surgical management was performed. Evaluation of risk factors for failure of treatment and extrusion was carried out through logistic regression. RESULTS The median follow-up was 5,3 years. The anatomical results showed correction in 91,3% of the patients. Median subjective VAS evaluation: 9/10. Urinary symptoms improved after the surgery. Constipation and dyspareunia rates worsened. Pelvic pain improved. There were two early complications: one rectal perforation, repaired intraoperatively and one pulmonary embolism, managed medically. Late complications: 9 extrusions (3 managed with topical oestrogen, 3 with expectant management, and 3 reoperated, one twice), one cervix elongation and one forgotten gauze (both reoperated), 4 de novo pain managed successfully conservatively. 58,8% of the complications occurred after one year. Risk factors analyzed showed no statistical significance. CONCLUSIONS Vaginal mesh provides favorable anatomical, functional and subjective outcomes in long-term follow-up. The number of complications is relatively low, but many complications occurred a long-time after surgery.

Cómo debemos abordar el diagnóstico de la vejiga hiperactiva en mujeres

OBJECTIVE Determine the degree of completion, agreement and diagnostic performance of various instruments for assessing the presence and intensity of urgency and other symptoms of idiopathic overactive bladder (OAB) and determine which is the best diagnostic combination. MATERIAL AND METHODS Observational, noninterventional, cross-sectional multicentre study on 247 women aged 18 years or older, with a clinical diagnosis of OAB, evaluated in 55 functional urology and urodynamic units. The women completed the Patient Perception of Intensity of Urgency Scale questionnaire, an independent bladder control self-assessment questionnaire (B-SAQ), the Overactive Bladder Questionnaire Short-Form and a 3-day voiding diary (VD3d), and they underwent a urodynamic study (UDS). The degree of completion and agreement among the instruments was assessed using the Kappa index (95% CI) and Cramérs V. The diagnostic performance of each tool and their combination was studied using absolute frequencies of positive cases for each OAB symptom. RESULTS The patients mean age was 57.66 years (SD, 13.43). There was a high degree of completion (>85%). The agreement among the instruments was poor or moderate, and there was no agreement with the UDS. The best combination of tools for the diagnosis of OAB in women was the B-SAQ and VD3d. CONCLUSIONS The degree of completion of all instruments was high, the agreement between them was poor-moderate and not significant for the UDS. The instruments that had the best diagnostic performance for assessing urgency and other OAB symptoms, providing data on their severity and discomfort, were the B-SAQ and the VD3d.

Development and feasibility assessment of a 3 day electronic bladder diary as an app for smart-phone

To develop a 3 day bladder diary (BD) as an easy‐to‐use application for smart‐phone (eDM3d). To test its feasibility and acceptance in a reduced number of patients.