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The Sensitivity And Specificity Of A Simple Test To Distinguish Between Urge And Stress Urinary Incontinence., Jeanette Brown, Catherine Bradley, Leslee Subak, Holly Richter, Stephen Kraus, Linda Brubaker, Feng Lin, Eric Vittinghoff, Deborah Grady Apr 2013

The Sensitivity And Specificity Of A Simple Test To Distinguish Between Urge And Stress Urinary Incontinence., Jeanette Brown, Catherine Bradley, Leslee Subak, Holly Richter, Stephen Kraus, Linda Brubaker, Feng Lin, Eric Vittinghoff, Deborah Grady

Catherine S. Bradley

BACKGROUND: Urinary incontinence is common in women. Because treatments differ, urge incontinence should be distinguished from stress incontinence. To make this distinction, current guidelines recommend an extensive evaluation that is too time-consuming for primary care practice. OBJECTIVE: To test the accuracy of a simple questionnaire to categorize type of urinary incontinence in women. DESIGN: Multicenter, prospective study of the accuracy of the 3 Incontinence Questions (3IQ) compared with an extended evaluation to distinguish between urge incontinence and stress incontinence. SETTING: 5 academic medical centers in the United States. PARTICIPANTS: 301 women enrolled from April to December 2004 who were older …


Endometrial Adenocarcinoma With Trophoblastic Differentiation., Catherine Bradley, I. Benjamin, J. Wheeler, S. Rubin Apr 2013

Endometrial Adenocarcinoma With Trophoblastic Differentiation., Catherine Bradley, I. Benjamin, J. Wheeler, S. Rubin

Catherine S. Bradley

OBJECTIVE: To report a case of stage IIIc poorly differentiated endometrial adenocarcinoma with trophoblastic differentiation and to review previously reported cases. METHODS: The clinical course and histopathology of the case were reviewed, and a literature search for other reported cases was performed. RESULTS: The tumor contained syncytiotrophoblast-like giant cells that stained positively for the beta subunit of human chorionic gonadotropin (beta-hCG), and the patient's serum beta-hCG level was elevated (95 mIU/ml), but became undetectable after treatment. Beta-hCG was used as a tumor marker during further therapy. At 16 months' survival, she remains without evidence of disease and with a beta-hCG …


Pelvic Support, Pelvic Symptoms, And Patient Satisfaction After Colpocleisis., M. Fitzgerald, H. Richter, Catherine Bradley, W. Ye, A. Visco, G. Cundiff, H. Zyczynski, P. Fine, A. Weber Apr 2013

Pelvic Support, Pelvic Symptoms, And Patient Satisfaction After Colpocleisis., M. Fitzgerald, H. Richter, Catherine Bradley, W. Ye, A. Visco, G. Cundiff, H. Zyczynski, P. Fine, A. Weber

Catherine S. Bradley

The objective was to study the effect of colpocleisis on pelvic support, symptoms, and quality of life and report-associated morbidity and postoperative satisfaction. Women undergoing colpocleisis for treatment of pelvic organ prolapse (POP) were recruited at six centers. Baseline measures included physical examination, responses to the Pelvic Floor Distress Inventory, and Pelvic Floor Impact Questionnaire. Three and 12 months after surgery we repeated baseline measures. Of 152 patients with mean age 79 (+/-6) years, 132 (87%) completed 1 year follow-up. Three and 12 months after surgery, 90/110 (82%) and 75/103 (73%) patients following up had POP stage < or = 1. …


Pelvic Organ Prolapse In Older Women: Prevalence And Risk Factors., Ingrid Nygaard, Catherine Bradley, Debra Brandt Apr 2013

Pelvic Organ Prolapse In Older Women: Prevalence And Risk Factors., Ingrid Nygaard, Catherine Bradley, Debra Brandt

Catherine S. Bradley

OBJECTIVE: We sought to estimate the prevalence of pelvic organ prolapse in older women using the Pelvic Organ Prolapse Quantification examination and to identify factors associated with prolapse. METHODS: Women with a uterus enrolled at one site of the Women's Health Initiative Hormone Replacement Therapy randomized clinical trial were eligible for this ancillary cross-sectional study. Subjects underwent a Pelvic Organ Prolapse Quantification examination during a maximal Valsalva maneuver and in addition completed a questionnaire. Logistic regression was used to identify independent risk factors for each of 2 definitions of prolapse: 1) Pelvic Organ Prolapse Quantification stage II or greater and …


A New Questionnaire For Urinary Incontinence Diagnosis In Women: Development And Testing, Catherine Bradley, E. Rovner, M. Morgan, M. Berlin, J. Novi, J. Shea, L. Arya Apr 2013

A New Questionnaire For Urinary Incontinence Diagnosis In Women: Development And Testing, Catherine Bradley, E. Rovner, M. Morgan, M. Berlin, J. Novi, J. Shea, L. Arya

Catherine S. Bradley

OBJECTIVE: The purpose of this study was to develop a questionnaire for urinary incontinence diagnosis in women and to test its reliability and validity, with incontinence specialists' clinical evaluations as the gold standard. STUDY DESIGN: One hundred seventeen urogynecology outpatients with urinary incontinence symptoms completed the Questionnaire for Urinary Incontinence Diagnosis at enrollment and 1 week and 9 months later. Baseline clinical diagnoses were compared with Questionnaire for Urinary Incontinence Diagnosis diagnoses (criterion validity). Nine-month Questionnaire for Urinary Incontinence Diagnosis change scores were compared across treatment groups (responsiveness). RESULTS: Clinical diagnoses included stress (n = 15), urge (n = 26), …


The Sensitivity And Specificity Of A Simple Test To Distinguish Between Urge And Stress Urinary Incontinence, J. S. Brown, Catherine Bradley, L. L. Subak, H. E. Richter, S. R. Kraus, L. Brubaker, F. Lin, E. Vittinghoff, D. Grady Apr 2013

The Sensitivity And Specificity Of A Simple Test To Distinguish Between Urge And Stress Urinary Incontinence, J. S. Brown, Catherine Bradley, L. L. Subak, H. E. Richter, S. R. Kraus, L. Brubaker, F. Lin, E. Vittinghoff, D. Grady

Catherine S. Bradley

BACKGROUND: Urinary incontinence is common in women. Because treatments differ, urge incontinence should be distinguished from stress incontinence. To make this distinction, current guidelines recommend an extensive evaluation that is too time-consuming for primary care practice. OBJECTIVE: To test the accuracy of a simple questionnaire to categorize type of urinary incontinence in women. DESIGN: Multicenter, prospective study of the accuracy of the 3 Incontinence Questions (3IQ) compared with an extended evaluation to distinguish between urge incontinence and stress incontinence. SETTING: 5 academic medical centers in the United States. PARTICIPANTS: 301 women enrolled from April to December 2004 who were older …


Magnetic Resonance Assessment Of Pelvic Anatomy And Pelvic Floor Disorders After Childbirth, V. Handa, M. Lockhart, K. Kenton, Catherine Bradley, J. Fielding, G. Cundiff, C. Salomon, C. Hakim, W. Ye, H. Richter Apr 2013

Magnetic Resonance Assessment Of Pelvic Anatomy And Pelvic Floor Disorders After Childbirth, V. Handa, M. Lockhart, K. Kenton, Catherine Bradley, J. Fielding, G. Cundiff, C. Salomon, C. Hakim, W. Ye, H. Richter

Catherine S. Bradley

To compare pelvic anatomy, using magnetic resonance imaging, between postpartum women with or without pelvic floor disorders. We measured postpartum bony and soft tissue pelvic dimensions in 246 primiparas, 6-12-months postpartum. Anatomy was compared between women with and without urinary or fecal incontinence, or pelvic organ prolapse; P < 0.01 was considered statistically significant. A deeper sacral hollow was significantly associated with fecal incontinence (P = 0.005). Urinary incontinence was marginally associated with a wider intertuberous diameter (P = 0.017) and pelvic arch (P = 0.017). There were no significant differences in pelvimetry measures between women with and without prolapse (e.g., vaginal or cervical descent to or beyond the hymen). We did not detect meaningful differences in soft tissue dimensions for women with and without these pelvic floor disorders. Dimensions of the bony pelvis do not differ substantially between primiparous women with and without postpartum urinary incontinence, fecal incontinence and prolapse.


Effects Of Colpocleisis On Bowel Symptoms Among Women With Severe Pelvic Organ Prolapse, R. Gutman, Catherine Bradley, W. Ye, A. Markland, W. Whitehead, M. Fitzgerald Apr 2013

Effects Of Colpocleisis On Bowel Symptoms Among Women With Severe Pelvic Organ Prolapse, R. Gutman, Catherine Bradley, W. Ye, A. Markland, W. Whitehead, M. Fitzgerald

Catherine S. Bradley

INTRODUCTION AND HYPOTHESIS: Our objective was to evaluate bowel symptoms after colpocleisis. METHODS: This was a planned ancillary analysis of a prospective, colpocleisis cohort study of 152 women. Those with baseline and 1-year questionnaires (Colorectal-Anal Distress Inventory (CRADI) and the Colorectal-Anal Impact Questionnaire (CRAIQ)) were included. "Bothersome" CRADI symptoms (score>2("moderately", "quite a bit")) were identified. CRADI and CRAIQ scores were compared, and postoperative symptom resolution and new symptom development were measured. RESULTS: Of 121 (80%) subjects with complete data, mean age was 79.2 +/- 5.4 years and all had stage 3-4 prolapse. Procedures performed: partial colpocleisis (61%), total colpocleisis …


Non-Surgical Management Of Stress Urinary Incontinence: Ambulatory Treatments For Leakage Associated With Stress (Atlas) Trial, H. Richter, K. Burgio, P. Goode, D. Borello-France, Catherine Bradley, L. Brubaker, V. Handa, P. Fine, A. Visco, H. Zyczynski, J. Wei, A. Weber Apr 2013

Non-Surgical Management Of Stress Urinary Incontinence: Ambulatory Treatments For Leakage Associated With Stress (Atlas) Trial, H. Richter, K. Burgio, P. Goode, D. Borello-France, Catherine Bradley, L. Brubaker, V. Handa, P. Fine, A. Visco, H. Zyczynski, J. Wei, A. Weber

Catherine S. Bradley

BACKGROUND: Non-surgical treatment for stress urinary incontinence (SUI) is recommended as first-line therapy, yet few prospective studies and no randomized trials compare the most common non-surgical treatments for SUI. PURPOSE: To present the design and methodology of the ambulatory treatments for leakage associated with stress (ATLAS) trial, a randomized clinical trial comparing three interventions for predominant SUI in women: intravaginal continence pessary; behavioral therapy (including pelvic floor muscle training and exercise and bladder control strategies); and a combination of the two treatments. METHODS: Treatment outcome measures, collected at 12 weeks and six and 12 months post randomization, include the Patient …


Vaginal Wall Descensus And Pelvic Floor Symptoms In Older Women, Catherine Bradley, I. Nygaard Apr 2013

Vaginal Wall Descensus And Pelvic Floor Symptoms In Older Women, Catherine Bradley, I. Nygaard

Catherine S. Bradley

OBJECTIVE: To understand the clinical significance of early pelvic organ prolapse in older women, we studied associations between vaginal descensus and pelvic floor symptoms. METHODS: In this cross-sectional study, 270 women enrolled at one site of the Women's Health Initiative clinical trial completed a questionnaire modified from the Pelvic Floor Distress Inventory on pelvic floor symptoms and underwent a Pelvic Organ Prolapse Quantification (POP-Q) examination. We tested associations between symptoms (individual and grouped) with anterior, posterior, uterine, and maximum vaginal descensus. RESULTS: Mean age was 68 years. Ninety-six percent had POP-Q stages I or II. Only obstructive urinary symptoms and …


The Questionnaire For Urinary Incontinence Diagnosis (Quid): Validity And Responsiveness To Change In Women Undergoing Non-Surgical Therapies For Treatment Of Stress Predominant Urinary Incontinence, Catherine Bradley, D. Rahn, I. Nygaard, M. Barber, C. Nager, K. Kenton, N. Siddiqui, R. Abel, C. Spino, H. Richter Apr 2013

The Questionnaire For Urinary Incontinence Diagnosis (Quid): Validity And Responsiveness To Change In Women Undergoing Non-Surgical Therapies For Treatment Of Stress Predominant Urinary Incontinence, Catherine Bradley, D. Rahn, I. Nygaard, M. Barber, C. Nager, K. Kenton, N. Siddiqui, R. Abel, C. Spino, H. Richter

Catherine S. Bradley

AIMS: The Questionnaire for Urinary Incontinence Diagnosis (QUID), a 6-item urinary incontinence (UI) symptom questionnaire, was developed and validated to distinguish stress and urge UI. This study's objective was to evaluate QUID validity and responsiveness when used as a clinical trial outcome measure. METHODS: Participants enrolled in a multi-center trial of non-surgical therapy (continence pessary, pelvic floor muscle training or combined) for stress-predominant UI and completed baseline and 3-month diaries, the Urinary Distress Inventory (UDI) and QUID. Data from all treatment groups were pooled. QUID internal consistency (Cronbach's alpha) and convergent/discriminant validity (Pearson correlations) were evaluated. Responsiveness to change was …


Urinary Incontinence Self-Report Questions: Reproducibility And Agreement With Bladder Diary, Catherine Bradley, J. Brown, S. Van Den Eeden, M. Schembri, A. Ragins, D. Thom Apr 2013

Urinary Incontinence Self-Report Questions: Reproducibility And Agreement With Bladder Diary, Catherine Bradley, J. Brown, S. Van Den Eeden, M. Schembri, A. Ragins, D. Thom

Catherine S. Bradley

INTRODUCTION AND HYPOTHESIS: This study aims to measure self-report urinary incontinence questions' reproducibility and agreement with bladder diary. METHODS: Data were analyzed from the Reproductive Risk of Incontinence Study at Kaiser. Participating women reporting at least weekly incontinence completed self-report incontinence questions and a 7-day bladder diary. Self-report question reproducibility was assessed and agreement between self-reported and diary-recorded voiding and incontinence frequency was measured. Test characteristics and area under the curve were calculated for self-reported incontinence types using diary as the gold standard. RESULTS: Five hundred ninety-one women were included and 425 completed a diary. The self-report questions had moderate …


Vaginal Erosion After Pubovaginal Sling Procedures Using Dermal Allografts, Catherine Bradley, M. Morgan, L. Arya, E. Rovner Apr 2013

Vaginal Erosion After Pubovaginal Sling Procedures Using Dermal Allografts, Catherine Bradley, M. Morgan, L. Arya, E. Rovner

Catherine S. Bradley

No abstract provided.


Urodynamically Defined Stress Urinary Incontinence And Bladder Outlet Obstruction Coexist In Women, Catherine Bradley, E. Rovner Apr 2013

Urodynamically Defined Stress Urinary Incontinence And Bladder Outlet Obstruction Coexist In Women, Catherine Bradley, E. Rovner

Catherine S. Bradley

PURPOSE: The definition and significance of female bladder outlet obstruction (BOO) are poorly understood. We identified patients with urodynamic evidence of BOO in a cohort of women with stress urinary incontinence (SUI). MATERIALS AND METHODS: Women with SUI were identified from a videourodynamic data base and pressure flow studies were reexamined. Subjects were excluded if detrusor pressures could not be measured. BOO was diagnosed if the maximum flow rate was less than 12 ml per second and detrusor pressure at maximum flow was greater than 20 cm water or maximum detrusor pressure was greater than 20 cm water in those …


Pharmacologic Treatment For Urgency-Predominant Urinary Incontinence In Women Diagnosed Using A Simplified Algorithm: A Randomized Trial, A. Huang, R. Hess, L. Arya, H. Richter, L. Subak, Catherine Bradley, R. Rogers, D. Myers, K. Johnson, W. Gregory, S. Kraus, M. Schembri, J. Brown Apr 2013

Pharmacologic Treatment For Urgency-Predominant Urinary Incontinence In Women Diagnosed Using A Simplified Algorithm: A Randomized Trial, A. Huang, R. Hess, L. Arya, H. Richter, L. Subak, Catherine Bradley, R. Rogers, D. Myers, K. Johnson, W. Gregory, S. Kraus, M. Schembri, J. Brown

Catherine S. Bradley

OBJECTIVE: The purpose of this study was to evaluate clinical outcomes associated with the initiation of treatment for urgency-predominant incontinence in women diagnosed by a simple 3-item questionnaire. STUDY DESIGN: We conducted a multicenter, double-blinded, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence in ambulatory women diagnosed by the simple 3-item questionnaire. Participants (N = 645) were assigned randomly to fesoterodine therapy (4-8 mg daily) or placebo. Urinary incontinence was assessed with the use of voiding diaries; postvoid residual volume was measured after treatment. RESULTS: After 12 weeks, women who had been assigned randomly to fesoterodine therapy reported 0.9 …


Sexual Function In Women After Rectocele Repair With Acellular Porcine Dermis Graft Vs Site-Specific Rectovaginal Fascia Repair, J. Novi, Catherine Bradley, N. Mahmoud, M. Morgan, L. Arya Apr 2013

Sexual Function In Women After Rectocele Repair With Acellular Porcine Dermis Graft Vs Site-Specific Rectovaginal Fascia Repair, J. Novi, Catherine Bradley, N. Mahmoud, M. Morgan, L. Arya

Catherine S. Bradley

The objective of the study was to compare preoperative and postoperative sexual function between women undergoing rectocele repair with porcine dermis graft and women undergoing site-specific repair of rectovaginal fascia. A standardized, validated questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire [PISQ]) was used to collect preoperative sexual function data from 100 patients with rectocele pelvic organ prolapse quantification stage 2 or greater. Fifty women underwent rectocele repair utilizing porcine dermis graft (group 1) and 50 women underwent a site-specific repair of the rectovaginal fascia (group 2). The same questionnaire was administered to all subjects 6 months after surgery. The …


Bowel Symptoms In Women Planning Surgery For Pelvic Organ Prolapse, Catherine Bradley, M. Brown, G. Cundiff, P. Goode, K. Kenton, I. Nygaard, W. Whitehead, P. Wren, A. Weber Apr 2013

Bowel Symptoms In Women Planning Surgery For Pelvic Organ Prolapse, Catherine Bradley, M. Brown, G. Cundiff, P. Goode, K. Kenton, I. Nygaard, W. Whitehead, P. Wren, A. Weber

Catherine S. Bradley

OBJECTIVE: The objective of the study was to measure associations between bowel symptoms and prolapse. STUDY DESIGN: Baseline data were analyzed from 322 women in the Colpopexy And Urinary Reduction Efforts trial of sacrocolpopexy with or without Burch colposuspension. Women completed the Colorectal-Anal Distress Inventory and Colorectal-Anal Impact Questionnaire and underwent Pelvic Organ Prolapse Quantification. Associations between symptoms and questionnaire scores and Pelvic Organ Prolapse Quantification measures were assessed. RESULTS: Mean age was 61 +/- 10 years. Pelvic Organ Prolapse Quantification stages were II (14%), III (67%), and IV (19%). Colorectal-Anal Distress Inventory symptoms did not increase with prolapse stage. …


Gastrointestinal Complications Following Abdominal Sacrocolpopexy For Advanced Pelvic Organ Prolapse, W. Whitehead, Catherine Bradley, M. Brown, L. Brubaker, R. Gutman, R. Varner, A. Visco, A. Weber, H. Zyczynski Apr 2013

Gastrointestinal Complications Following Abdominal Sacrocolpopexy For Advanced Pelvic Organ Prolapse, W. Whitehead, Catherine Bradley, M. Brown, L. Brubaker, R. Gutman, R. Varner, A. Visco, A. Weber, H. Zyczynski

Catherine S. Bradley

OBJECTIVE: The aims of this secondary analysis of the "Colpopexy And Urinary Reduction Efforts" (CARE) study were to estimate the incidence of postoperative gastrointestinal complications and identify risk factors. STUDY DESIGN: We prospectively identified gastrointestinal complications and serious adverse events (SAE) for 12 months after sacrocolpopexy. Two surgeons independently reviewed reports of ileus or small bowel obstruction (SBO). RESULTS: Eighteen percent of 322 women (average age 61.3 years) reported "nausea, emesis, bloating, or ileus" during hospitalization and 9.8% at 6 weeks. Nineteen women (5.9%; CI 3.8%, 9.1%) had a possible ileus or SBO that generated SAE reports: 4 (1.2%, CI …


Constipation In Pregnancy: Prevalence, Symptoms, And Risk Factors, Catherine Bradley, Colleen Kennedy, A. Turcea, S. Rao, I. Nygaard Apr 2013

Constipation In Pregnancy: Prevalence, Symptoms, And Risk Factors, Catherine Bradley, Colleen Kennedy, A. Turcea, S. Rao, I. Nygaard

Catherine S. Bradley

OBJECTIVE: To prospectively estimate constipation prevalence and risk factors in pregnancy. METHODS: We enrolled healthy pregnant women in this longitudinal study during the first trimester. At each trimester and 3 months postpartum, participants completed a self-administered bowel symptom questionnaire, physical activity and dietary fiber intake measures, and a prospective 7-day stool diary. Constipation was defined using the Rome II criteria (presence of at least two of the following symptoms for at least one quarter of defecations: straining, lumpy or hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, manual maneuvers to facilitate defecation, and fewer than three defecations per …


Obesity And Outcomes After Sacrocolpopexy, Catherine Bradley, K. Kenton, H. Richter, X. Gao, H. Zyczynski, A. Weber, I. Nygaard Apr 2013

Obesity And Outcomes After Sacrocolpopexy, Catherine Bradley, K. Kenton, H. Richter, X. Gao, H. Zyczynski, A. Weber, I. Nygaard

Catherine S. Bradley

OBJECTIVE: The purpose of this study was to compare outcomes after sacrocolpopexy (SC) between obese and healthy-weight women. STUDY DESIGN: Baseline and postoperative data were analyzed from the Colpopexy And Urinary Reduction Efforts (CARE) randomized trial of SC with or without Burch colposuspension in stress continent women with stages II-IV prolapse. Outcomes and complications were compared between obese and healthy-weight women. RESULTS: CARE participants included 74 obese (body mass index >/=30 kg/m(2)), 122 overweight (25-29.9 kg/m(2)), and 125 healthy-weight (18.5-24.9 kg/m(2)) women, and 1 underweight (< 18.5 kg/m(2)) woman. Compared to healthy-weight women, obese women were younger (59.0 +/- 9.9 vs 62.1 +/- 10.3 yrs; P = .04), more likely to have stage II prolapse (25.7% vs 11.2%; P = .01), and had longer operative times (189 +/- 52 vs 169 +/- 58 min; P = .02). Two years after surgery, stress incontinence, prolapse, symptom resolution, and satisfaction did not differ between the obese and healthy-weight groups. CONCLUSION: Most outcomes and complication rates after SC are similar in obese and healthy-weight women.


Anal Sphincter Laceration At Vaginal Delivery: Is This Event Coded Accurately?, L. Brubaker, Catherine Bradley, V. Handa, H. Richter, A. Visco, M. Brown, A. Weber Apr 2013

Anal Sphincter Laceration At Vaginal Delivery: Is This Event Coded Accurately?, L. Brubaker, Catherine Bradley, V. Handa, H. Richter, A. Visco, M. Brown, A. Weber

Catherine S. Bradley

OBJECTIVE: To determine the error rate for discharge coding of anal sphincter laceration at vaginal delivery in a cohort of primiparous women. METHODS: As part of the Childbirth and Pelvic Symptoms study performed by the National Institutes of Health Pelvic Floor Disorders Network, we assessed the relationship between perineal lacerations and corresponding discharge codes in three groups of primiparous women: 393 women with anal sphincter laceration after vaginal delivery, 383 without anal sphincter laceration after vaginal delivery, and 107 after cesarean delivery before labor. Discharge codes for perineal lacerations were compared with data abstracted directly from the medical record shortly …


Racial Differences In Pelvic Anatomy By Magnetic Resonance Imaging, V. Handa, M. Lockhart, J. Fielding, Catherine Bradley, L. Brubaker, G. Cundiff, W. Ye, H. Richter Apr 2013

Racial Differences In Pelvic Anatomy By Magnetic Resonance Imaging, V. Handa, M. Lockhart, J. Fielding, Catherine Bradley, L. Brubaker, G. Cundiff, W. Ye, H. Richter

Catherine S. Bradley

OBJECTIVES: To use static and dynamic magnetic resonance imaging (MRI) to compare dimensions of the bony pelvis and soft tissue structures in a sample of African-American and white women. METHODS: This study used data from 234 participants in the Childbirth and Pelvic Symptoms Imaging Study, a cohort study of 104 primiparous women with an obstetric anal sphincter tear, 94 who delivered vaginally without a recognized anal sphincter tear and 36 who underwent by cesarean delivery without labor. Race was self-reported. At 6-12 months postpartum, rapid acquisition T2-weighted pelvic MRIs were obtained. Bony and soft tissue dimensions were measured and compared …


Endoanal Ultrasound Findings And Fecal Incontinence Symptoms In Women With And Without Recognized Anal Sphincter Tears, H. Richter, J. Fielding, Catherine Bradley, V. Handa, P. Fine, M. Fitzgerald, A. Visco, A. Wald, C. Hakim, J. Wei, A. Weber Apr 2013

Endoanal Ultrasound Findings And Fecal Incontinence Symptoms In Women With And Without Recognized Anal Sphincter Tears, H. Richter, J. Fielding, Catherine Bradley, V. Handa, P. Fine, M. Fitzgerald, A. Visco, A. Wald, C. Hakim, J. Wei, A. Weber

Catherine S. Bradley

OBJECTIVE: To estimate whether endoanal ultrasound findings are more prevalent in primiparous women with a history of anal sphincter tear than in women without this history and whether the findings are associated with fecal incontinence symptoms. METHODS: A total of 251 primiparous women at seven clinical sites underwent standardized ultrasound assessment of the internal and external anal sphincter 6-12 months after delivery. Participants were women in the three cohorts of the Childbirth and Pelvic Symptoms Study: 1) women with clinically evident third- or fourth-degree tear at vaginal delivery (n=106); 2) no tear at vaginal delivery (n=106); and 3) cesarean delivery …


Urinary Incontinence, Depression And Posttraumatic Stress Disorder In Women Veterans, Catherine Bradley, I. Nygaard, M. Mengeling, J. Torner, Colleen Stockdale, B. Booth, A. Sadler Apr 2013

Urinary Incontinence, Depression And Posttraumatic Stress Disorder In Women Veterans, Catherine Bradley, I. Nygaard, M. Mengeling, J. Torner, Colleen Stockdale, B. Booth, A. Sadler

Catherine S. Bradley

OBJECTIVE: To study associations between urinary incontinence (UI) symptoms, depression, and posttraumatic stress disorder in women veterans. STUDY DESIGN: This cross-sectional study enrolled women 20 to 52 years of age registered at 2 midwestern US Veterans Affairs Medical Centers or outlying clinics within 5 years preceding study interview. Participants completed a computer-assisted telephone interview assessing urogynecologic, medical, and mental health. Multivariable analyses studied independent associations between stress and urgency UI and depression and posttraumatic stress disorder. RESULTS: Nine hundred sixty-eight women mean aged 38.7 +/- 8.7 years were included. Of these, 191 (19.7%) reported urgency/mixed UI and 183 (18.9%) stress …


Bowel Symptoms In Women 1 Year After Sacrocolpopexy, Catherine Bradley, I. Nygaard, M. Brown, R. Gutman, K. Kenton, W. Whitehead, P. Goode, P. Wren, C. Ghetti, A. Weber Apr 2013

Bowel Symptoms In Women 1 Year After Sacrocolpopexy, Catherine Bradley, I. Nygaard, M. Brown, R. Gutman, K. Kenton, W. Whitehead, P. Goode, P. Wren, C. Ghetti, A. Weber

Catherine S. Bradley

OBJECTIVE: The objective of the study was to evaluate changes in bowel symptoms after sacrocolpopexy. STUDY DESIGN: This was a prospectively planned, ancillary analysis of the Colpopexy and Urinary Reduction Efforts study, a randomized trial of sacrocolpopexy with or without Burch colposuspension in stress continent women with stages II-IV prolapse. In addition to sacrocolpopexy (+/- Burch), subjects underwent posterior vaginal or perineal procedures (PR) at each surgeon's discretion. The preoperative and 1 year postoperative Colorectal-anal Distress Inventory (CRADI) scores were compared within and between groups using Wilcoxon signed-rank and rank-sum tests, respectively. RESULTS: The sacrocolpopexy + PR group (n = …


Bladder And Bowel Symptoms Among Women With Vulvar Disease: Are They Universal?, Colleen Kennedy, I. Nygaard, Catherine Bradley, R. Galask Apr 2013

Bladder And Bowel Symptoms Among Women With Vulvar Disease: Are They Universal?, Colleen Kennedy, I. Nygaard, Catherine Bradley, R. Galask

Catherine S. Bradley

OBJECTIVE: To compare the prevalence of painful bladder syndrome, recurrent urinary tract infections, urinary leakage and irritable bowel syndrome between women with specific vulvar disorders and controls. STUDY DESIGN: Women with a primary diagnosis of vulvar intraepithelial neoplasia (dysplasia), vulvar vestibulitis (vestibulitis), contact vulvitis, atrophic vulvovaginitis, lichen simplex, lichen sclerosus and lichen planus, were compared to women presenting for annual examinations. RESULTS: As compared to controls, painful bladder syndrome was more prevalent among subjects with dysplasia, vestibulitis and contact vulvitis; a history of recurrent urinary tract infection was more prevalent among subjects with contact vulvitis; and urinary incontinence was less …


Sexual Function 6 Months After First Delivery, L. Brubaker, V. Handa, Catherine Bradley, A. Connolly, P. Moalli, M. Brown, A. Weber Apr 2013

Sexual Function 6 Months After First Delivery, L. Brubaker, V. Handa, Catherine Bradley, A. Connolly, P. Moalli, M. Brown, A. Weber

Catherine S. Bradley

OBJECTIVE: To explore the association of anal sphincter laceration and sexual function 6 months postpartum in the Childbirth and Pelvic Symptoms (CAPS) cohort. METHODS: The primary CAPS study, a prospective cohort study, was designed to estimate the postpartum prevalence and incidence of urinary and fecal incontinence. Three cohorts of new mothers (vaginal delivery with a third- or fourth-degree anal sphincter tear, vaginal delivery without a third- or fourth-degree anal sphincter tear, and cesarean delivery without labor) were compared at 6 months postpartum. Sexual function was assessed with the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12). Urinary and fecal …


Prevalence Of Vulvar And Vaginal Symptoms During Pregnancy And The Puerperium, Colleen Kennedy, A. Turcea, Catherine Bradley Apr 2013

Prevalence Of Vulvar And Vaginal Symptoms During Pregnancy And The Puerperium, Colleen Kennedy, A. Turcea, Catherine Bradley

Catherine S. Bradley

OBJECTIVE: To identify the prevalence of vulvar and vaginal symptoms during pregnancy and at 3 months post partum. METHODS: A prospective, longitudinal, descriptive study of 103 pregnant women was undertaken in which a self-administered questionnaire was completed at each trimester and 3 months post partum. Retrospective data was collected from 122 women, queried using similar tools, who comprised a nonpregnant control group. Descriptive and comparative statistics were employed. RESULTS: The prevalence of vulvar burning, itching, pain, and vaginal discharge generally increased during pregnancy, and improved postpartum. Dyspareunia increased during pregnancy, but remained elevated post partum. Compared with the historical nonpregnant …


Incontinence Surgery In The Older Woman, V. Sharp, Catherine Bradley, K. Kreder Apr 2013

Incontinence Surgery In The Older Woman, V. Sharp, Catherine Bradley, K. Kreder

Catherine S. Bradley

PURPOSE OF REVIEW: To review recently published studies on stress urinary incontinence surgery outcomes in older women. RECENT FINDINGS: Five prospective and two retrospective studies were identified that reported tension-free vaginal tape (n = 6), colposuspension (n = 1) and cadaveric fascia transvaginal sling (n = 1) procedure results. In each study, 21-175 older women were included, with mean ages ranging from 71 to 83 years; most studies included younger comparison groups. Mean follow-ups ranged from 3 to 30 months. Subjective stress urinary incontinence 'cure/improvement' rates after surgery were significantly lower in older women when compared with younger women in …


Pelvic Organ Prolapse, Constipation, And Dietary Fiber Intake In Women: A Case-Control Study, L. Arya, J. Novi, A. Shaunik, M. Morgan, Catherine Bradley Apr 2013

Pelvic Organ Prolapse, Constipation, And Dietary Fiber Intake In Women: A Case-Control Study, L. Arya, J. Novi, A. Shaunik, M. Morgan, Catherine Bradley

Catherine S. Bradley

OBJECTIVE: This study was undertaken to determine whether there is an association among pelvic organ prolapse, constipation, and dietary fiber intake. STUDY DESIGN: Sixty consecutive women with prolapse were compared with 30 control women without prolapse. All women completed 2 validated questionnaires to assess constipation and dietary fiber intake. Multivariate analysis was performed. RESULTS: The risk for constipation was greater in women with prolapse than controls (odds ratio 4.03, 95% CI 1.5-11.4). Median insoluble fiber intake was significantly lower in women with prolapse (2.4 g) than controls (5.8 g, P < .01). The increased risk for constipation was reduced but remained …