实时三维盆底超声对产后压力性尿失禁患者疗效评估作用及与尿动力学的相关性分析

摘要 目的：探讨实时三维盆底超声对产后压力性尿失禁（SUI）患者疗效评估作用及与尿动力学的相关性。方法：选择2020年4月至2022年12月石家庄市人民医院收治的139例产后SUI患者,均接受盆底生物反馈电刺激联合盆底肌锻炼治疗。治疗前后分别进行实时三维盆底超声检查和尿动力学检查。比较治疗前后实时三维盆底超声参数、尿动力学指标差异。Pearson法分析实时三维盆底超声参数与尿动力学指标的相关性。结果：实时三维盆底超声图像特征显示：治疗前盆膈裂孔内的结构疏松,回声变弱,盆腔器官结缔组织疏松,间隙增宽,盆膈裂孔面积、尿道旋转角、膀胱尿道后角以及膀胱颈移动度较大;治疗后盆膈裂孔两侧耻骨直肠肌对称,耻骨内脏肌呈带状高回声,盆膈裂孔面积、尿道旋转角、膀胱尿道后角以及膀胱颈移动度较治疗前降低。产后SUI患者治疗后静息状态和Valsalva状态下盆膈裂孔面积、尿道旋转角、膀胱尿道后角、膀胱颈移动度均较治疗前降低（P＜0.05）,腹压漏尿点压、最大逼尿肌压力均较治疗前增加（P＜0.05）。产后SUI患者静息状态和Valsalva状态下盆膈裂孔面积、尿道旋转角、膀胱尿道后角、膀胱颈移动度与最大逼尿肌压力、腹压漏尿点压呈负相关（P＜0.05）,与最大膀胱容量和残余尿量无关（P＞0.05）。结论：产后SUI患者经盆底生物反馈电刺激联合盆底肌锻炼治疗后实时三维盆底超声参数较治疗前降低,与尿动力学改善有关。临床可通过实时三维盆底超声检查,对产后SUI患者进行临床疗效评价,以指导临床治疗。     

经利用网片的前盆底重建术治疗重度盆腔器官脱垂的临床疗效

目的:探讨经利用网片的前盆底重建术治疗重度盆腔器官脱垂的临床效果。方法:选取2013年1月-2015年3月我院妇科收治的以前中盆腔联合缺陷为主的盆底障碍性疾病患者39例(POP-Q分度III-IV度)。实施经阴道Avaulta前盆腔重建术,24例切除子宫,9例保留子宫,其中6例因中盆腔重度脱垂联合行阴道残端骶棘韧带固定术,2例合并尿失禁同时行经尿道无张力悬吊术。术后随访12-25月,根据盆腔脏器脱垂评分(POP-Q)测量及PFIQ-7评分进行客观评价及主观感受评价进行中短期的临床效果分析。结果:39例患者手术过程顺利,术后无严重并发症,POP-Q评分均较术前显著降低,客观疗效理想。术后阴道前壁及子宫、阴道穹窿脱垂等症状显著改善;到目前为止无一例复发。结论:经阴道前盆腔重建术治疗前盆腔重度盆腔脱垂为主以及合并尿失禁等复杂情况的并发症少,治愈率高,复发率低,临床效果好。     

三维超声技术对于评估压力性尿失禁女性患者盆底肌肉收缩及膀胱颈活动度的价值研究

摘要 目的：探讨三维超声技术对于评估压力性尿失禁（SUI）女性患者盆底肌肉收缩及膀胱颈活动度的价值。方法：选取2020年1月至2021年8月本院的收治的因产后SUI的女性患者60例作为观察组,另选择同期产后正常的女性受试者60例作为对照组,所有受试者均行经会阴三维超声检查。比较两组之间盆底肌肉收缩及膀胱颈活动度等相关指标的差异。结果：在静息状态和最大Valsalva状态下,观察组中盆膈裂孔前后径、左右径、肛提肌裂孔面积以及膀胱颈后角均显著大于对照组（P<0.05）,观察组尿道长度显著低于对照组（P<0.05）;而仅在最大Valsalva状态下,观察组的膀胱颈位置显著低于对照组（P<0.05）;此外观察组膀胱漏斗化所占比例显著高于对照组（P<0.05）。结论：三维超声技术可以清晰直观地显示女性盆底组织结构和功能,对于评估SUI女性患者盆底肌肉收缩及膀胱颈活动度具有一定的诊断价值,并为临床提供真实客观的影像学证据。     

经会阴实时三维盆底超声评估不同分娩方式对产后女性前腔室结构和盆膈裂孔的影响

摘要 目的：探讨经会阴实时三维盆底超声评估不同分娩方式对产后女性前腔室结构和盆膈裂孔的影响。方法：回顾性分析2015年1月至2019年10月在我院接受检查的100例产妇的诊治资料。根据分娩方式的不同,将患者分为经阴道分娩组（n=55）和剖宫产分娩组（n=45）。比较两组产妇在静息状态和Valsalva状态下的前腔室和盆膈裂孔超声参数。结果：在静息状态下,两组的膀胱颈位置、逼尿肌厚度、膀胱后角和尿道倾斜角相比无差异（P>0.05）。经阴道分娩组在Valsalva状态下的膀胱颈移动度和尿道旋转角均大于剖宫产分娩组,尿道内口漏斗形成率和膀胱膨出率均高于剖宫产分娩组（P<0.05）。在Valsalva状态下,经阴道分娩组的盆膈裂孔前后径、左右径、面积和周长均大于剖宫产分娩组（P<0.05）;在静息状态下,两组的上述指标相比,差异均无统计学意义（P>0.05）。结论：应用经会阴实时三维盆底超声技术观察产妇前腔室结构和盆膈裂孔的参数变化,可评估产妇盆底功能受损的程度,经阴道分娩对其影响较大。     

探讨女性盆底功能障碍性疾病的相关因素及盆底超声测定压力性尿失禁SUI的临床意义

目的:探讨女性盆底功能障碍性疾病的相关因素及盆底超声测定压力性尿失禁SUI的临床意义。方法:选取我院2019年-2020年共收治的63例盆底功能障碍性疾病患者作为研究对象,将其分为研究组,另取同期来我院进行体检的63例健康女性作为对照组,对所有女性应用盆底超声检测,对比两组女性静息状态下和Valsalva状态下的盆底超声检查指标,对通过问卷调查方式,调查两组女性的一般临床治疗,对于女性盆底功能障碍性疾病的相关因素进行单因素分析与多因素分析,最终得出盆底肌功能障碍性疾病的相关因素。结果:在静息状态下通过盆底超声发现,研究组与对照组膀胱尿道后角、肛提肌裂孔面积、尿道倾斜度对比差异显著(P<0.05),两组女性膀胱颈位置、膀胱位置对比无明显差异(P>0.05);在Valsalva状态下通过盆底超声发现,研究组与对照组膀胱尿道后角、肛提肌裂孔面积、尿道倾斜度、膀胱颈位置、膀胱位置对比差异显著(P<0.05);两组女性年龄、BMI、孕次、产次、绝经情况以及白带清洁度是否≥Ⅲ度情况对比差异显著(P<0.05),两组女性子宫肌瘤史情况对比无显著差异(P>0.05);logistic回归分析结果显示,年龄、绝经情况、子宫肌瘤史和白带清洁度≥Ⅲ度不是盆底功能障碍性疾病的独立危险因素(P>0.05),BMI、孕次、产次为盆底功能障碍性疾病的独立危险因素(P<0.05)。结论:盆底肌超声在对盆底功能障碍性疾病患者压力性尿失禁的诊断中具有重要价值,在静息状态下和Valsalva状态下发现患者的膀胱经移动情况与尿道倾斜情况。年龄、BMI、孕次、产次、绝经情况以及白带清洁度是否≥Ⅲ度可能与盆底功能障碍性疾病具有一定关系,BMI、孕次、产次为盆底功能障碍性疾病的独立危险因素。     

盆底超声参数预测剖宫产术后压力性尿失禁的效能及其与盆底组织E-cadherin和Vimentin表达的关系研究

摘要 目的：研究盆底超声参数预测剖宫产术后压力性尿失禁（SUI）的效能及其与盆底组织钙粘附蛋白E（E-cadherin）和波形蛋白（Vimentin）表达的关系。方法：选取2020年1月～2021年1月湖南省妇幼保健院收治的124例剖宫产患者。将其按照是否发生SUI分为SUI组18例以及无SUI组106例。对所有患者均进行盆底超声检查,比较两组静息期（R）、张力期Valsalva动作（V）的膀胱尿道后角（PUA）以及膀胱颈到耻骨联合下缘水平垂直距离（BNS）,膀胱颈移动度（BND）、尿道旋转角度（UR）。通过受试者工作特征（ROC）曲线分析盆底超声参数预测剖宫产术后SUI的效能。另外,对比两组盆底组织E-cadherin和Vimentin mRNA水平,采用Pearson相关性分析各项盆底超声参数和盆底组织E-cadherin、Vimentin mRNA表达的相关性。结果：SUI组R-PUA、V-PUA、BND以及UR均高于无SUI组,而R-BNS以及V-BNS均低于无SUI组（均P＜0.05）。ROC曲线分析结果：各项盆底超声参数联合预测剖宫产术后SUI的效能均优于各项参数单独预测。SUI组盆底组织E-cadherin mRNA水平低于无SUI组,而Vimentin mRNA水平高于无SUI组（均P＜0.05）。经Pearson相关性分析发现,R-PUA、V-PUA、BND、UR均和盆底组织E-cadherin mRNA水平呈负相关关系,与Vimentin mRNA水平呈正相关关系;而R-BNS、V-BNS均和盆底组织E-cadherin mRNA水平呈正相关关系,与Vimentin mRNA水平呈负相关关系（均P＜0.05）。结论：盆底超声参数预测剖宫产术后SUI的效能较高,且和盆底组织E-cadherin、Vimentin表达有关。     

补中益气汤联合生物反馈电刺激在产后盆底功能障碍患者的应用研究

目的:研究探讨补中益气汤联合生物反馈电刺激对产后盆底功能障碍患者的临床治疗效果及对其盆底肌肉张力的影响。方法:选择我院就诊的90例产后盆底功能障碍气虚证患者(2017年11月～2018年10月),按照随机数字表法划分为30例/组的A组、B组、C组,A组实施常规盆底肌锻炼,B组采用盆底治疗仪实施生物反馈电刺激治疗,C组实施生物反馈电刺激联合中药补中益气汤治疗,比较三组的疗效、盆底肌力评分、阴道最大收缩压、盆腔器官脱垂、尿失禁、性生活质量评分。结果:(1)组间临床疗效、证候疗效比较,C组的临床总有效率、证候改善总有效率均高于A组、B组(P0.05),而A组与B组之间比较均无统计学差异(P0.05)。(2)治疗后,C组的盆底肌力评分、阴道最大收缩压、性生活质量评分均高于A组、B组(P0.05),A组与B组之间比较均无统计学差异(P0.05)。(3)C组的盆腔器官脱垂、尿失禁等发生率均低于A组、B组(P0.05),而A组与B组比较均无统计学差异(P0.05)。结论:生物反馈电刺激联合补中益气汤治疗可有效改善产后盆底功能障碍患者的盆底肌力和阴道压力,达到良好的临床疗效,有利于预防盆腔器官脱垂、尿失禁的发生,改善其性生活质量。     

经会阴盆底超声联合血清雌二醇对女性压力性尿失禁的诊断价值研究

摘要 目的：研究经会阴盆底超声联合血清雌二醇对女性压力性尿失禁（SUI）的诊断价值。方法：选取川北医学院附属医院2018年1月～2022年12月收治的女性SUI患者81例,记作观察组。另选取同期体检正常女性80例作为对照组。比较两组盆底超声参数以及血清雌二醇水平。采用受试者工作特征（ROC）曲线分析上述各项指标单独和联合检测的诊断效能。结果：观察组静息状态下近段尿道和人体纵轴间夹角（UIA）、最大Valsalva动作下近段尿道和膀胱后壁的夹角（PUVA）以及尿道旋转角（URA）相较于对照组较高（均P＜0.05）。观察组血清雌二醇水平相较于对照组明显更低（P＜0.05）。经ROC曲线分析发现：各项盆底超声参数联合血清雌二醇诊断女性SUI的效能优于各项指标单独诊断。结论：经会阴盆底超声可诊断女性SUI,在联合血清雌二醇时诊断女性SUI的价值更高。     

电针阴部神经刺激疗法联合Kegel盆底康复训练对产后压力性尿失禁患者盆底肌力、尿流动力学和生活质量的影响

摘要 目的：探讨电针阴部神经刺激疗法联合Kegel盆底康复训练对产后压力性尿失禁（SUI）患者盆底肌力、尿流动力学和生活质量的影响。方法：选取2019年6月~2021年11月期间于我院就诊的产后SUI患者109例,按照入院就诊奇偶顺序分为两组,其中对照组54例,接受Kegel盆底康复训练,研究组55例,接受电针阴部神经刺激疗法联合Kegel盆底康复训练。对比两组疗效、漏尿量、尿失禁程度、盆底肌力、尿流动力学和生活质量。结果：研究组的临床总有效率高于对照组（P<0.05）。两组治疗后盆底肌肌力各指标（手测肌力和Ⅰ类肌纤维最大值、Ⅱ类肌纤维平均值）均升高,且研究组高于对照组（P<0.05）。两组治疗后漏尿量、尿失禁程度评分均下降,且研究组低于对照组（P<0.05）。两组治疗后尿流动力学相关指标[腹压漏尿点压（AL-PP）、最大尿流率（Qmax）和最大尿道闭合压力（MUCP）]均升高,且研究组高于对照组（P<0.05）。两组治疗后尿失禁生活质量量表（I-QOL）各维度（限制性行为、心理影响、社交活动受限）评分及总分均升高,且研究组高于对照组（P<0.05）。结论：电针阴部神经刺激疗法联合Kegel盆底康复训练可有效改善产后SUI患者的盆底肌肌力和尿失禁情况,减少漏尿量,同时可促进尿流动力学恢复,进而提高患者的生活质量。     

子宫托对阴道微生态的影响以及应用雌激素的作用

通常将阴道前后壁、膀胱或直肠等盆腔脏器突入阴道内,称为盆腔脏器脱垂,常发生于老年女性。盆腔脏器脱垂及其引起的排尿相关症状严重影响患者的生活质量。目前临床上治疗盆腔脏器脱垂最常用的方法为佩戴子宫托。子宫托治疗盆腔脏器脱垂已有久远的历史。使用子宫托可明显改善盆腔脏器脱垂患者的临床症状,提高患者的生活质量。然而研究显示,对于机体而言,阴道内放置子宫托可在一定程度上影响阴道微生态环境平衡,从而使佩戴子宫托患者的细菌性阴道病患病率增加4.37倍。同时使用雌激素可明显减少由使用子宫托引起的阴道微环境改变、出血、溃疡等症状的发生。现就子宫托对阴道微生态的影响以及应用雌激素的作用做一简要综述。     

Prediction of nonlinear elastic behaviour of vaginal tissue: experimental results and model formulation

The mechanical properties of the vaginal tissue need to be characterised to perform accurate simulations of prolapse and other pelvic disorders that commonly affect women. This is also a fundamental step towards the improvement of therapeutic techniques such as surgery. Issues like the efficiency of using autologous tissue in pelvic reconstruction may be addressed. The goal of this study was to characterise the elastic behaviour of vaginal tissue. For this purpose, prolapsed vaginal tissue from eight different post-menopausal patients, excised during prolapse corrective surgery, was mechanically tested. The mechanical testing of vaginal tissue, consisting of uniaxial tension tests performed along the longitudinal axis of the vagina, revealed the nonlinear mechanical behaviour of the tissue. The material model parameters were fit to the experimental data using the Levenberg–Marquardt optimisation algorithm. All the curve fittings showed a good agreement between experimental and theoretical results, evidenced by R ² values close to 1 and by very low ? values.     

大鼠产后压力性尿失禁模型的建立与探讨

目的 应用在大鼠阴道内放置水囊模拟产伤破坏大鼠盆底组织的方法建立产后压力性尿失禁( postpartum urinary incontinence,PPUI)的动物模型,并对此模型进行初步研究.方法 对40只SD雌性大鼠进行持续8h水囊扩张阴道,随机选取PPUI模型建立成功的大鼠25只并与对照同龄大鼠5只分别于模型建立后1d、1周、2周、4周、8周进行喷嚏实验以及尿动力学测定,张力换能器测定盆底肌肉肌力强度,采用JSCC标准化对应法测定血清生化指标(LDH,CK),应用逆转录-聚合酶链反应检测caspase-3基因表达,胆碱酯酶染色法计数盆底肌肉乙酰胆碱受体数量.结果 建模后喷嚏实验阳性率明显升高,阳性率为72.5％(29/40),尿动力学检测最大膀胱容量及漏尿点压力均降低,盆底肌肉收缩力下降,血清LDH、CK水平上升,盆底耻尾肌乙酰胆碱受体数量减少,与对照组比较均差异有显著性(P＜0.05).耻尾肌组织中caspase-3基因表达在建立模型当日达到最高,与对照组差异有显著性(P＜0.05),之后逐渐下降.结论 大鼠阴道内放置8h水囊的方法可以成功模拟产后压力性尿失禁,引起尿动力以及盆底肌肉的相关损伤指标发生改变.     

生物反馈电刺激联合Kegel训练对产后盆底功能障碍性疾病患者盆底功能电生理指标和生活质量的影响

目的:观察生物反馈电刺激联合Kegel训练对产后盆底功能障碍性疾病(PFD)患者盆底功能电生理指标和生活质量的影响。方法:研究对象为2018年3月~2020年12月我院收治的80例产后PFD患者。采用双色球随机分组法将患者分为对照组(n=40)和研究组(n=40)。对照组给予Kegel训练,研究组给予生物反馈电刺激联合Kegel训练,两组均治疗8周。对比两组治疗8周后的疗效和尿失禁、盆底器官脱垂程度的改善情况。对比两组治疗前、治疗8周后的盆底功能电生理指标、日常生活质量和性生活质量。结果:治疗8周后,研究组的临床总有效率较对照组高(P<0.05)。治疗8周后,研究组I类肌纤维疲劳度、Ⅱ类肌纤维疲劳度、快肌最大肌电值及阴道动态压力均优于对照组(P<0.05)。研究组治疗8周后尿失禁、盆底器官脱垂程度的改善情况优于对照组(P<0.05)。治疗8周后,研究组盆底功能影响问卷简表(PIFQ-7)评分、盆腔器官脱垂-尿失禁性功能问卷(PISQ-12)评分均低于对照组(P<0.05)。结论:产后PFD患者采用生物反馈电刺激联合Kegel训练治疗疗效明确,可促进尿失禁、盆底器官脱垂程度情况及盆底功能改善,提高患者日常生活质量和性生活质量。     

The controversies regarding the role of estrogens in urogynecology

Estrogens are crucial for the proper functioning of genitourinary tract. Hypoestrogenism related to menopause could be linked to numerous disturbances of lower urinary tract. However, the results of most well designed clinical studies do not support use of estrogen or hormone replacement therapy for the treatment of genitourinary symptoms. According to evidence base medicine stress urinary incontinence, overactive bladder syndrome or pelvic organ prolapse are best treated by the surgery or non-hormonal drug therapy.     

Localisation and measurement of VIP in the genitourinary system of man and animals

VIP is present in the genitourinary system of man and animals. In man the highest concentrations are found in the penis, the uterus and vagina and in the urinary bladder. VIP nerves heavily innervate the erectile tissue of the male external genitalia, the uterine smooth muscle and blood vessels, the seromucous glands of the cervix, and the lamina propria and vaginal epithelium. In the urinary bladder, VIP nerves are located beneath the transitional epithelium, in the lamina propria and in the smooth muscle. Other areas well innervated by VIP nerves include the prostate, seminal vesicles and vasa deferentia. Chemical (phenol- and 6-OHDA) or surgical (hypogastric or pelvic nerve section) extrinsic denervation fail to deplete the genitourinary system of its VIP content, supporting the view that VIP-containing nerves originate from local ganglion cells. Indeed, neuronal cell bodies containing VIP are seen in the paracervical ganglia of the female genitalia, the para- or intramural bladder ganglia and scattered through the base of the cavernosum body, the neck of the bladder and the prostate. The finding of elevated levels of VIP in the local circulation after induced penile erection in man and mammals and the ability of VIP to relax the detrusor muscle of the bladder suggests that the peptide may be involved in penile erection and bladder relaxation, as does the marked VIP depletion in the penis or bladder in patients suffering from diabetic impotence or bladder instability.     

Experiments and finite element modelling for the study of prolapse in the pelvic floor system

Pelvic prolapse affects one woman in three of all ages combined and is quite common for more than 60% of patients over 60 years of age. The treatment of this pathological problem is one of the biggest challenges to the gynaecologist today. The rate of surgical intervention failure is quite significant. The recurrence of prolapse could be related to inadequate surgical technique or the pathology or/and biomechanical deficiency of the soft tissues. The modelling and simulation of the behaviour of the pelvic cavity could be a major tool for specific evaluation of pelvic status. A first stage of this model is being developed and reported. The computer-aided design model of the organs of the pelvic floor is created using magnetic resonance image data and the ligament boundary conditions are defined. A multi-organ geometric model is thus created and studied.     

女性压力性尿失禁患者盆底三维超声显像初步研究

目的:通过三维超声对正常未孕妇女及产后压力性尿失禁(SUI)患者的盆底结构显像,研究SUI患者的膀胱颈尿道活动度及肛提肌变化,评估三维超声显像对女性盆底病变的诊断价值.方法:分别对研究组和对照组行盆底结构三维超声检查,测量膀胱尿道连接部的直接移动度(UVJ-M)、张力期膀胱尿道后角、静息期及张力期耻骨直肠肌厚度、耻骨直肠肌夹角,观察肛提肌形态.结果:SUI研究组UVJ-M 15.93± 2.07mm,较对照组7.64± 1.37mm增大(P＜0.01),研究组张力期膀胱尿道后角145.90±22.03°,较对照组106.49±14.32°增大(P＜0.01),研究组静息期耻骨直肠肌厚度6.39±0.48小于对照组6.71±0.69(P＜0.05),研究组张力期耻骨直肠肌厚度6.13±0.49小于对照组6.64± 0.61(P＜0.05),静息期研究组耻骨直肠肌夹角70.08±3.15大于对照组69.45±2.19°,但无统计学意义(P＞0.05),张力期75.49±3.92大于对照组70.35±1.51° (P＜0.01).结论:三雏超声显像能直观有效地观察女性尿道、肛提肌等盆底结构,对诊断压力性尿失禁是一个有意义的辅助手段.     

3D finite element modeling of pelvic organ prolapse

Objectives: The purpose of this study is to develop a validated 3D finite element model of the pelvic floor system which can offer insights into the mechanics of anterior vaginal wall prolapse and have the ability to assess biomedical device treatment methods. The finite element results should accurately mimic the clinical findings of prolapse due to intra-abdominal pressure (IAP) and soft tissues impairment conditions. Methods: A 3D model of pelvic system was created in Creo Parametric 2.0 based on MRI Images, which included uterus, cervix, vagina, cardinal ligaments, uterosacral ligaments, and a simplified levator plate and rectum. The geometrical model was imported into ANSYS Workbench 14.5. Mechanical properties of soft tissues were based on experimental data of tensile test results from current literature. Studies were conducted for IAP loadings on the vaginal wall and uterus, increasing from lowest to extreme values. Results: Anterior vaginal wall collapse occurred at an IAP value corresponding to maximal valsalva and showed similar collapsed shape as clinical findings. Prolapse conditions exhibited high sensitivity to vaginal wall stiffness, whereas healthy tissues was found to support the vagina against prolapse. Ligament impairment was found to have only a secondary effect on prolapse.     

A Retrospective Analysis of the Effectiveness of a Modified Abdominal High Uterosacral Colpopexy in the Treatment of Uterine Prolapse

To evaluate the clinical value of a novel method for high uterosacral colpopexy in the treatment of uterine prolapse. Thirty-one cases with severe pelvic organ prolapse diagnosed by pelvic organ prolapse quantification (POP-Q) system received a novel high sacral colpopexy method. Clinical parameters associated perioperative period and 12?months after surgery and complications were analyzed. A questionnaire survey on pelvic floor distress inventory and pelvic organ prolapse/urinary incontinence and sexual function was implemented. Between January 2007 and June 2008, 31 patients successfully received a Modified Abdominal High Uterosacral Colpopexy. The mean operation time was 50?±?15?min, and the average blood loss was 100?±?20?mls. 28 Patients returned for a 1-year follow-up, and the average follow-up period was 14?±?6?months. According to POP-Q system evaluation, the rate of operational success reached 100?%. There were no significant intraoperative and postoperative complications. A total of 31 responses on pelvic floor distress inventory short form questionnaire and 24 responses on pelvic organ prolapse/urinary incontinence sexual questionnaire showed that there was statistical significant difference before and after the procedure. This novel, high uterosacral colpopexy method is a safe and effective method for the treatment of uterine prolapse.     

Tissue Selective Androgen Receptor Modulators (SARMs) Increase Pelvic Floor Muscle Mass in Ovariectomized Mice

Stress urinary incontinence (SUI), a prevalent condition, is represented by an involuntary leakage of urine that results, at least in part, from weakened or damaged pelvic floor muscles and is triggered by physical stress. Current treatment options are limited with no oral therapies available. The pelvic floor is rich in androgen receptor and molecules with anabolic activity including selective androgen receptor modulators (SARMs) may serve as therapeutic options for individuals with SUI. In this study, two SARMs (GTx‐024 and GTx‐027) were evaluated in a post‐menopausal animal model in order to determine their effect on pelvic floor muscles. Female C57BL/6 mice were ovariectomized and their pelvic muscles allowed to regress. The animals were then treated with vehicle or doses of GTx‐024 or GTx‐027. Animal total body weight, lean body mass, and pelvic floor muscle weights were measured along with the expression of genes associated with muscle catabolism. Treatment with the SARMs resulted in a restoration of the pelvic muscles to the sham‐operated weight. Coordinately, the induction of genes associated with muscle catabolism was inhibited. Although a trend was observed towards an increase in total lean body mass in the SARM‐treated groups, no significant differences were detected. Treatment of an ovariectomized mouse model with SARMs resulted in an increase in pelvic floor muscles, which may translate to an improvement of symptoms associated with SUI and serves as the basis for evaluating their clinical use. J. Cell. Biochem. 118: 640–646, 2017. © 2016 The Authors. Journal of Cellular Biochemistry published by Wiley Periodicals, Inc.