I-Chieh Sung

Background/Objectives: De novo stress urinary incontinence (SUI) can develop postoperatively in patients without prior symptoms, and can persist beyond 6 months, posing clinical challenges. This study aimed to identify predictors of persistent de novo SUI after transvaginal mesh (TVM) surgery and to evaluate management strategies. Methods: A retrospective review of 817 women with anterior and apical pelvic organ prolapse (POP) (stage II–IV) who underwent TVM surgery from 2013 to 2021 was conducted. Fifty patients developed de novo SUI postoperatively. Assessments included urodynamic studies, validated symptom questionnaires, and POP quantification (POP-Q) staging. Logistic regression analysis was used to identify predictors of persistent symptoms. Results: Spontaneous resolution occurred in 30% (15/50) of participants within six months, while 70% (35/50) had persistent SUI. Concomitant posterior mesh repair was more frequent in the persistent group compared to the self-limiting group (29% vs. 7%), and was significantly associated with symptom persistence (OR 5.6, 95% CI, 0.65–48.4; p = 0.03, chi-square test). During conservative management with observation alone, 30% (15/50) experienced spontaneous resolution within 6 months, while 70% (35/50) had persistent symptoms. Among those with persistent symptoms, 56% required no further treatment, 10% improved with vaginal laser therapy, and 4% underwent sling surgery. Conclusions: Conservative management remains critical in the early postoperative period, given the high rate of spontaneous symptom resolution. For persistent cases, minimally invasive options such as vaginal laser therapy may be beneficial. Notably, only 4% required anti-incontinence surgery.

Background/Objectives: Pelvic organ prolapse (POP) and urinary incontinence are prevalent conditions among women, significantly affecting their quality of life. Vaginal mesh surgeries, including the use of the Calistar mesh, have become an essential intervention aimed at alleviating symptoms associated with POP and urinary dysfunction. This study evaluates the clinical outcomes of Calistar vaginal mesh surgeries, focusing on pre- and post-operative changes in urinary parameters and prolapse severity. Methods: Data from 180 patients undergoing Calistar procedures were analyzed, revealing significant improvements in anatomical markers (Aa, Ba, C, Ap, and Bp) and urinary distress metrics (UDI-6 and IIQ-7) postoperatively. Results: The results demonstrate that Calistar mesh procedures are effective in reducing urinary frequency, incontinence, and incomplete bladder emptying. Conclusions: Calistar mesh procedures offer a safe and effective surgical option for managing POP and associated urinary dysfunction. The observed anatomical and functional improvements suggest that Calistar mesh significantly enhances patient outcomes and quality of life.

Objectives: Stress urinary incontinence (SUI) negatively affects the quality of life and sexual function in women. This study aimed to evaluate the efficacy of radiofrequency (RF) therapy in reducing SUI symptoms and its impact on sexual function. Methods: Thirty-four women with SUI were enrolled and underwent a single RF treatment session using the Viveve^® System (Viveve Medical Inc., USA) with parameters of 90 J/cm² and 220 pulses per hour. Assessments at baseline and 6 months post treatment included perineal ultrasound and personal interviews to evaluate lower urinary tract symptoms and sexual function. Urodynamic studies, voiding diaries, and questionnaires such as the Female Sexual Function Index (FSFI), Overactive Bladder Symptom Score (OABSS), Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) measured outcomes. Results: RF therapy significantly improved sexual function, with higher FSFI scores in all domains except pain at 6 months. SUI symptoms were significantly reduced, as indicated by improved scores on OABSS, UDI-6, IIQ-7, and ICIQ-SF, alongside better voiding diary results. Anatomical changes included reduced bladder neck mobility, decreased vaginal width, and a reduced rotation angle of the proximal urethra. Conclusions: RF therapy is effective and safe for treating mild to moderate SUI and enhances sexual function, potentially due to changes in vaginal topography. These results suggest RF therapy as a viable non-surgical option for managing SUI and improving sexual health.

Objectives: Stress urinary incontinence (SUI) negatively affects the quality of life and sexual function in women. This study aimed to evaluate the efficacy of radiofrequency (RF) therapy in reducing SUI symptoms and its impact on sexual function. Methods: Thirty-four women with SUI were enrolled and underwent a single RF treatment session using the Viveve® System (Viveve Medical Inc., USA) with parameters of 90 J/cm² and 220 pulses per hour. Assessments at baseline and 6 months post-treatment included perineal ultrasound and personal interviews to evaluate lower urinary tract symptoms and sexual function. Urodynamic studies, voiding diaries, and questionnaires such as the Female Sexual Function Index (FSFI), Overactive Bladder Symp-tom Score (OABSS), Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Question-naire-7 (IIQ-7), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) measured outcomes. Results: RF therapy significantly improved sexual function, with higher FSFI scores in all domains except pain at 6 months. SUI symptoms were significantly re-duced, as indicated by improved scores on OABSS, UDI-6, IIQ-7, and ICIQ-SF, alongside better voiding diary results. Anatomical changes included reduced bladder neck mobility, decreased vaginal width, and a reduced rotation angle of the proximal urethra. Conclusions: RF therapy is effective and safe for treating mild to moderate SUI and enhances sexual function, potentially due to changes in vaginal topography. These results suggest RF therapy as a viable non-surgical op-tion for managing SUI and improving sexual health.