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Full-Text Articles in Medicine and Health Sciences
Pelvic Organ Prolapse In Older Women: Prevalence And Risk Factors., Ingrid Nygaard, Catherine Bradley, Debra Brandt
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 …
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
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.
Vaginal Wall Descensus And Pelvic Floor Symptoms In Older Women, Catherine Bradley, I. Nygaard
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 …
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
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
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 …
Pelvic Organ Prolapse, Constipation, And Dietary Fiber Intake In Women: A Case-Control Study, L. Arya, J. Novi, A. Shaunik, M. Morgan, Catherine Bradley
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 …
Risk Factors For Painful Bladder Syndrome In Women Seeking Gynecologic Care, Colleen Kennedy, Catherine Bradley, R. Galask, I. Nygaard
Risk Factors For Painful Bladder Syndrome In Women Seeking Gynecologic Care, Colleen Kennedy, Catherine Bradley, R. Galask, I. Nygaard
Catherine S. Bradley
The aim of this cross-sectional study was to report risk factors for painful bladder syndrome in women. We surveyed 645 women presenting for care to general gynecology clinics and a vulvar specialty clinic using a standardized questionnaire and validated outcome measures. We used two definitions for painful bladder syndrome, based on the O'Leary-Sant interstitial cystitis symptom and problem indices. Of those women surveyed, 29.5% met broader criteria and 8.5% met more restrictive criteria for painful bladder syndrome. After adjusting for confounders, bladder pain was significantly associated with current smoking, irritable bowel syndrome, and a generalized pain disorder. Tobacco use, the …
Risk Factors For Sonographic Internal Anal Sphincter Gaps 6-12 Months After Delivery Complicated By Anal Sphincter Tear, Catherine Bradley, H. Richter, R. Gutman, M. Brown, W. Whitehead, P. Fine, C. Hakim, F. Harford, A. Weber
Risk Factors For Sonographic Internal Anal Sphincter Gaps 6-12 Months After Delivery Complicated By Anal Sphincter Tear, Catherine Bradley, H. Richter, R. Gutman, M. Brown, W. Whitehead, P. Fine, C. Hakim, F. Harford, A. Weber
Catherine S. Bradley
OBJECTIVE: The objective of the study was to identify risk factors for internal anal sphincter (IAS) gaps on postpartum endoanal ultrasound in women with obstetric anal sphincter tear. STUDY DESIGN: This prospective study included 106 women from the Childbirth and Pelvic Symptoms Imaging Supplementary Study who had third- or fourth-degree perineal laceration at delivery and endoanal ultrasound 6-12 months postpartum. Data were analyzed using Fisher's exact and t tests and logistic regression. RESULTS: Mean (+/- SD) age was 27.7 (+/- 6.2) years. Seventy-nine women (76%) were white and 22 (21%) black. Thirty-seven (35%) had sonographic IAS gaps. Risk factors for …
Vaginal Descent And Pelvic Floor Symptoms In Postmenopausal Women: A Longitudinal Study, Catherine Bradley, M. Zimmerman, Q. Wang, I. Nygaard
Vaginal Descent And Pelvic Floor Symptoms In Postmenopausal Women: A Longitudinal Study, Catherine Bradley, M. Zimmerman, Q. Wang, I. Nygaard
Catherine S. Bradley
OBJECTIVE: To determine whether vaginal descent changes are associated with pelvic floor symptoms in postmenopausal women. METHODS: This 4-year prospective study included 260 postmenopausal women with an intact uterus enrolled at one Women's Health Initiative (WHI) clinical trial site. All completed at least two annual pelvic organ prolapse quantification (POP-Q) examinations and symptom questionnaires (30 bladder, bowel, and prolapse symptom items, modified from the Pelvic Floor Distress Inventory). Symptoms were grouped, and group scores categorized into two or three evenly distributed levels. Year 4 data collection was incomplete because the overall WHI study halted. Generalized logistic linear models and generalized …