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Full-Text Articles in Medicine and Health Sciences

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 …


Urodynamic Evaluation Of The Bladder And Pelvic Floor, Catherine Bradley, K. Smith, K. Kreder Apr 2013

Urodynamic Evaluation Of The Bladder And Pelvic Floor, Catherine Bradley, K. Smith, K. Kreder

Catherine S. Bradley

Pelvic floor disorders including lower urinary tract dysfunction are common, and may be evaluated by urodynamic tests, such as cystometry, uroflowmetry, pressure flow studies, electromyography, and video-urodynamics. These urodynamic tests provide objective information regarding the normal and abnormal function of the urinary tract and pelvic floor, and provide a better understanding of the pathophysiologic processes that cause lower urinary tract symptoms. This article describes typical urodynamic studies and their roles in the evaluation of common pelvic floor disorders, including stress urinary incontinence, overactive bladder, and pelvic organ prolapse.


Spanish Translation And Validation Of Four Short Pelvic Floor Disorders Questionnaires, A. Treszezamsky, D. Karp, M. Dick-Biascoechea, N. Ehsani, C. Dancz, T. Montoya, C. Olivera, A. Smith, R. Cardenas, T. Fashokun, Catherine Bradley Apr 2013

Spanish Translation And Validation Of Four Short Pelvic Floor Disorders Questionnaires, A. Treszezamsky, D. Karp, M. Dick-Biascoechea, N. Ehsani, C. Dancz, T. Montoya, C. Olivera, A. Smith, R. Cardenas, T. Fashokun, Catherine Bradley

Catherine S. Bradley

INTRODUCTION AND HYPOTHESIS: Globally, Spanish is the primary language for 329 million people; however, most urogynecologic questionnaires are available in English. We set out to develop valid Spanish translations of the Questionnaire for Urinary Incontinence Diagnosis (QUID), the Three Incontinence Questions (3IQ), and the short Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). METHODS: The TRAPD method (translation, review, adjudication, pretesting, and documentation) was used for translation. Eight native Spanish-speaking translators developed Spanish versions collaboratively. These were pretested with cognitive interviews and revised until optimal. For validation, bilingual patients at seven clinics completed Spanish and English questionnaire …


Predictors Of Success And Satisfaction Of Nonsurgical Therapy For Stress Urinary Incontinence, J. Schaffer, C. Nager, F. Xiang, D. Borello-France, Catherine Bradley, J. Wu, E. Mueller, P. Norton, M. Paraiso, H. Zyczynski, H. Richter Apr 2013

Predictors Of Success And Satisfaction Of Nonsurgical Therapy For Stress Urinary Incontinence, J. Schaffer, C. Nager, F. Xiang, D. Borello-France, Catherine Bradley, J. Wu, E. Mueller, P. Norton, M. Paraiso, H. Zyczynski, H. Richter

Catherine S. Bradley

OBJECTIVE: To identify factors that may predict success and satisfaction in women undergoing nonsurgical therapy for stress urinary incontinence. METHODS: Baseline demographic and clinical characteristics of women participating in a multicenter randomized trial of pessary, behavioral, or combined therapy for stress urinary incontinence were evaluated for potential predictors of success and satisfaction. Success and satisfaction outcomes were assessed at 3 months and included the Patient Global Impression of Improvement, stress incontinence subscale of the Pelvic Floor Distress Inventory, and Patient Satisfaction Questionnaire. Logistic regression was performed to identify predictors, adjusting for treatment and other important clinical covariates. Adjusted odds ratios …


Risk Factors For Painful Bladder Syndrome In Women Seeking Gynecologic Care, Colleen Kennedy, Catherine Bradley, R. Galask, I. Nygaard Apr 2013

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 …


Continence Pessary Compared With Behavioral Therapy Or Combined Therapy For Stress Incontinence: A Randomized Controlled Trial, H. Richter, K. Burgio, L. Brubaker, I. Nygaard, W. Ye, A. Weidner, Catherine Bradley, V. Handa, D. Borello-France, P. Goode, H. Zyczynski, E. Lukacz, J. Schaffer, M. Barber, S. Meikle, C. Spino Apr 2013

Continence Pessary Compared With Behavioral Therapy Or Combined Therapy For Stress Incontinence: A Randomized Controlled Trial, H. Richter, K. Burgio, L. Brubaker, I. Nygaard, W. Ye, A. Weidner, Catherine Bradley, V. Handa, D. Borello-France, P. Goode, H. Zyczynski, E. Lukacz, J. Schaffer, M. Barber, S. Meikle, C. Spino

Catherine S. Bradley

OBJECTIVE: To compare the effectiveness of a continence pessary to evidence-based behavioral therapy for stress incontinence and to assess whether combined pessary and behavioral therapy is superior to single-modality therapy. METHODS: This was a multisite, randomized clinical trial (Ambulatory Treatments for Leakage Associated with Stress Incontinence [ATLAS]) that randomly assigned 446 women with stress incontinence to pessary, behavioral therapy, or combined treatment. Primary outcome measures, at 3 months, were Patient Global Impression of Improvement and the stress incontinence subscale of the Pelvic Floor Distress Inventory. A priori, to be considered clinically superior, combination therapy had to be better than both …


Natural History Of Pelvic Organ Prolapse In Postmenopausal Women, Catherine Bradley, M. Zimmerman, Y. Qi, I. Nygaard Apr 2013

Natural History Of Pelvic Organ Prolapse In Postmenopausal Women, Catherine Bradley, M. Zimmerman, Y. Qi, I. Nygaard

Catherine S. Bradley

OBJECTIVE: To describe the natural history of pelvic organ prolapse and risk factors for changes in vaginal descent in older women. METHODS: This 4-year prospective observational study included 259 postmenopausal women with a uterus enrolled at one Women's Health Initiative clinical site who completed at least two annual pelvic organ prolapse quantification (POP-Q) examinations. We calculated 1-year and 3-year incidence and resolution risks for prolapse (defined as maximal vaginal descent to or beyond the hymen) and estimated progression and regression rates (1 cm or greater and 2 cm or greater changes in maximal vaginal descent) and risk factors. RESULTS: Mean …


The "Costs" Of Urinary Incontinence For Women, L. Subak, J. Brown, S. Kraus, L. Brubaker, F. Lin, H. Richter, Catherine Bradley, D. Grady Apr 2013

The "Costs" Of Urinary Incontinence For Women, L. Subak, J. Brown, S. Kraus, L. Brubaker, F. Lin, H. Richter, Catherine Bradley, D. Grady

Catherine S. Bradley

OBJECTIVE: To estimate costs of routine care for female urinary incontinence, health-related quality of life, and willingness to pay for incontinence improvement. METHODS: In a cross-sectional study at 5 U.S. sites, 293 incontinent women quantified supplies, laundry, and dry cleaning specifically for incontinence. Costs were calculated by multiplying resources used by national resource costs and presented in 2005 United States dollars (2005). Health-related quality of life was estimated with the Health Utilities Index. Participants estimated willingness to pay for 25-100% improvement in incontinence. Potential predictors of these outcomes were examined using multivariable linear regression. RESULTS: Mean age was 56 +/- …


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 Apr 2013

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 Apr 2013

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 …