Knowledge of pelvic floor muscle (PFM) location, function, and antepartum exercises may prevent urinary incontinence (UI) symptoms. The objectives of this study were to evaluate the awareness of PFMs and PFM exercises, including knowledge, training, and experience, among pregnant women and to investigate the relationship between PFM awareness and UI. This cross-sectional study involved 522 pregnant women aged 18 years and older recruited from 8 centers. A questionnaire was used to assess PFM awareness; knowledge of PFM exercises; training and experience with these exercises; and the presence of UI, pelvic organ prolapse (POP), and fecal incontinence (FI). PFM knowledge and awareness were compared between pregnant women with and without UI. Of the 522 participants, 134 (25.7%) reported UI, 10 (1.9%) had POP, and 5 (1%) had FI. Among those with UI, 94 (70.1%) reported that their symptoms began during pregnancy. A significant proportion of women demonstrated limited PFM knowledge: 379 (72.6%) were unaware of PFM location, 385(73.8%) did not know PFM function, and 380 (72.8%) had not heard of PFM exercises. Pregnant women without UI were more likely to report performing PFM exercises than those with UI (66.7% vs 37.5%, respectively, P=0.002). Furthermore, women without UI were more likely to have performed PFM exercises for 8 weeks or more compared with those with UI (71.6% vs 40.0%, respectively, P=0.019). This study highlights a concerning lack of knowledge and awareness regarding PFMs and PFM exercises among pregnant women. Educational programs are needed to improve understanding of PFM function and to provide instruction on correct PFM exercise techniques.

Total, somatic, and cognitive-affective depressive symptoms trajectories and urinary incontinence: Evidence from two national longitudinal cohorts.

Postpartum urinary incontinence is an important but underreported maternal health issue, with limited available evidence from Ethiopia, particularly in Northwest Ethiopia. This study aimed to determine the magnitude and its associated factors among women attending the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. An institution‑based cross‑sectional study was conducted among 423 postpartum women selected via systematic random sampling from January 1 to April 30, 2025. Data were collected by interviewer‑administered questionnaires and analyzed using STATA 17. Variables with p ≤ 0.25 in bivariable analysis were entered into multivariable logistic regression. Statistical significance was declared at p < 0.05, and adjusted odds ratios with 95% confidence intervals were reported. A total of 421 women participated (99.50% response rate). The magnitude of postpartum urinary incontinence was 28.00% (95% CI: 24.15%, 32.77%). Thus, parity two or more (AOR = 11.23; 95% CI: 7.32, 15.23), body mass index ≥ 25kg/m² (AOR = 2.87; 95% CI: 1.06, 7.44), history of abortion (AOR = 7.61; 95% CI: = 4.43, 12.21), episiotomy (AOR = 4.27; 95% CI: 1.15, 10.85), and constipation (AOR = 2.09; 95% CI: 1.14, 9.45) were significantly associated with urinary incontinence. Urinary incontinence was common among postpartum women in the study area. Findings may contribute to the need for weight management counseling, prevention and management of constipation, and focused counseling for women with identified obstetric risk factors such as multiparty, episiotomy, and history of abortion for women with obstetric risk factors such as multiparty, episiotomy, and prior abortion during postpartum care. Not applicable.

Societal guidelines for the management of extraperitoneal bladder injuries (EBIs) are based on limited evidence. Current recommendations support nonoperative management of simple EBIs despite a high persistent urinary leak rate. Conversely, operative management is often associated with a lower leak rate. This study evaluated clinical outcomes associated with operative versus nonoperative management of EBIs. We hypothesized that cystorrhaphy would be associated with fewer persistent urinary leaks, reduced catheter duration, fewer infectious complications, and decreased interval imaging use and timing. An 8-year retrospective review (2017-2024) of EBIs was conducted within a university-based Level I/II trauma system. Those who died during hospitalization, underwent suprapubic catheterization, or sustained ureteral, urethral, or intraperitoneal bladder injuries were excluded. Demographic, injury, and management variables were abstracted. Patients were stratified by initial management strategy (operative vs. nonoperative). Outcomes included persistent urinary leak, catheter duration, infectious complications, and interval imaging use and timing. Seventy patients met the inclusion criteria, of whom 39 (55.7%) underwent operative repair. Demographics and injury characteristics were similar across cohorts, although operative patients had larger (2.3 vs. 1.3cm, p <0.01) and higher-grade injuries (American Association for the Surgery of Trauma grade ≥3: 71.8% vs. 25.8%, p <0.01). Operative repair was associated with fewer urinary leaks on interval imaging (2.6% vs. 25.8%, p =0.01) and shorter urinary catheter duration (17.6 ± 13.2 vs. 31.1 ± 24.9d, p =0.01). No significant differences were observed between cohorts with respect to catheter-associated urinary tract infections (38.5% vs. 45.2%, p =0.57), pelvic hardware infections (15.4% vs. 12.9%, p =0.73), frequency (84.6% vs. 96.8%, p =0.12) or timing (15.9 vs. 19.7d, p =0.39) of interval imaging. Operative repair of EBIs is associated with reduced urinary leak rates and catheter duration despite greater bladder injury severity. Other outcomes were similar between strategies. Concomitant cystorrhaphy during non-urologic abdominal or pelvic operations may expedite recovery in selected patients. ( J Trauma Acute Care Surg . 2026;101: 65-70. Copyright © 2026 The Author(s). Published byWolters Kluwer Health, Inc. on behalf of the American Association for the Surgery of Trauma.). Therapeutic/Care Management; Level III.

Trends in urinary incontinence among women in the United States from 2001 to 2023.

Early oncologic and functional outcomes of partial gland high-intensity focused ultrasound (HIFU) for prostate cancer: First 110 cases at a large U.S. tertiary referral center.

If medical treatment and/or interventional methods have failed, and high intravesical pressure and urinary incontinence or recurring urinary tract infections persist combined with present vesicoureteral reflux and impaired renal function, surgical treatment in terms of bladder augmentation is indicated. The main objective of this study was to evaluate whether we have to do ureteral reimplantation in patients with spastic neurogenic bladder during augmentation. A total of 72 patients with spastic neurogenic bladder with VUR were included in the study. The median age at surgery was 12 years, ranging from 3 to 27 years. All of them underwent augmentation cystoplasty for the period between 2016 and 2023. The changes in VUR grade and urodynamic findings were retrospectively evaluated. The median follow-up after AC surgery was 1.5 years, ranging from 0.3 to 2.3 years. The changes in vesicoureteral reflux (VUR) grade before and after surgery: VUR was detected in 72 patients, involving 89 ureters. Among the 89 ureters, the reflux grade was V in 31, IV in 34, III in 23, I in 11. Postoperative VCUG revealed that the reflux resolved in 74 ureters (83%) and was downgraded in 15 ureters (17%). During urodynamics, it was observed that the bladder capacity at which VUR occurred significantly increased from 50 to 450 mL (p < 0.05). However, there was no significant change in detrusor pressure at the onset of VUR. In patients with spastic neurogenic bladder undergoes augmentation cystoplasty: Routine ureteral reimplantation may not be necessary.

Post-pubertal outcomes in patients with cloacal malformations: Colorectal, urological, and gynaecological function with patient-reported sexual outcomes.

To measure the morphology of the pelvic floor muscle and levator ani hiatus (LAH) using 3D MRI segmentation in females with (SUI) and to assess correlations with age, body mass index (BMI), and parity. This study includes 80 patients with SUI who underwent 3.0 T pelvic MRI. Patients were grouped based on age, BMI, and parity. Manual segmentation and 3D modeling of the pelvic floor muscle and LAH were performed to get volumetric and dimensional measurements. Statistical analysis included Kruskal-Wallis, Mann-Witney, and post hoc testing to evaluate group variations. The cohort included patients from 20 to 90 years old (mean 53.9 ± 11.7), with a mean BMI of 25.3 ± 3.4 and a mean parity of 1.85 ± 1.03. Significant variations in LAM surface (H(2) = 6.650, p = 0.036), flatness (H(2) = 6.471, p = 0.039), median intensity (H(2) = 8.218, p = 0.016), and curvature mean (H(2) = 7.382, p = 0.025) among age groups. The greatest LAM surface rankings were found in the 50-65 age range, whereas the highest LAM flatness ranks were found in those over 65 years old. BMI demonstrated a limited association, with overweight/obese participants exhibiting 11.3% larger LAM surface area compared to normal/underweight individuals (p = 0.044, r = 0.225). No significant associations were found between parity and any pelvic floor morphometric parameters (all p > 0.05). This study identifies age-dependent morphological changes in levator ani muscle architecture as the primary determinant of pelvic floor structural adaptation in women with stress urinary incontinence. These quantitative shape-based parameters offer novel diagnostic and therapeutic insights, advancing precision medicine approaches in urogynecological assessment and management.

Surgeons traditionally place the synthetic midurethral sling (MUS) after completing the apical suspension procedure during surgical procedures for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). We hypothesize it may be more efficient to perform the MUS procedure at the beginning of the case without compromising MUS treatment success. The objective of this study was to determine whether MUS timing affects SUI treatment outcomes 3 months after surgery. A retrospective cohort study was performed of patients who had minimally invasive sacrocolpopexy (SCP) at a single tertiary care center between June 2023 and June 2024. As routine practice, 4 surgeons place MUS before and 4 place MUS after completion of the SCP. Surgical cases were categorized into "MUS pre-SCP" and "MUS post-SCP". SUI treatment failure was defined as (1) patient report of persistent or de novo SUI, (2) positive cough stress test result, and/or (3) retreatment for SUI (including pelvic floor physical therapy, pessary, or surgery). Sixty-six participants had MUS placed before the SCP (MUS pre-SCP), and 111 had MUS placed after completing the SCP (MUS post-SCP). The MUS pre-SCP group was more likely to have advanced stage 3/4 POP ( P < 0.001). The MUS pre-SCP group was more likely to have had a concomitant hysterectomy ( P = 0.01), total hysterectomy ( P < 0.001), single-port robotic procedure ( P <0.001), and shorter operative times ( P < 0.001). Overall, SUI treatment failure was similar between MUS pre-SCP and post-SCP cohorts ( P = 0.54). Placing an MUS before minimally invasive SCP did not affect SUI treatment outcomes at 3 months and was associated with shorter operative time.

Postprostatectomy urinary incontinence (PPUI) is a prevalent complication following radical prostatectomy, with long‑term incontinence affecting up to one‑third of patients. Conventional treatments are limited by inconsistent efficacy, side effects or invasiveness, indicating demand for alternative therapies. This narrative review assessed clinical evidence of regenerative therapies, especially autologous stem cell approaches, for PPUI. We searched multiple databases for studies published between 2010 and 2024; eligible articles were clinical trials using stem cell therapies for PPUI, while non‑PPUI incontinence or non‑clinical outcome studies were excluded. Eight studies enrolling 311 patients were included: six used adipose‑derived stem cells (ADSCs) and two used muscle‑derived cells, administered via periurethral, transurethral or surgical implantation. Overall, 43.7% of patients achieved continence improvement, with efficacy ranging from 0% to 100% across studies; adverse events were mostly mild and self‑limiting. However, heterogeneity in study design, small sample sizes, inconsistent outcomes and short follow‑up restricted generalizability. Regenerative cell therapies, particularly ADSCs, are promising and well‑tolerated for PPUI. ADSCs are superior in easy harvest, scalability and multilineage differentiation. Although early data are encouraging, large‑scale, long‑term studies are required to confirm efficacy, optimize delivery and evaluate long‑term safety and durability.

Despite its common use, there is limited contemporary evidence regarding the place of simple cystometry (SC) in the evaluation of urinary function. Our objective was to assess the accuracy of SC with respect to complex urodynamic study (UDS), evaluate the correlation between them, and determine whether performing both tests on the same patient offers any additional benefit. In this retrospective cohort study, 609 consecutive women aged >18 years who underwent both UDS and SC within the same 6-month period between January 1, 2017, and December 31, 2022, were evaluated at a tertiary academic center. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SC were evaluated for detecting stress urinary incontinence (SUI) and detrusor overactivity (DO), using UDS as the gold standard. Pearson correlation for filling parameters was calculated. Each patient served as their own control for each test. There was a weak correlation between SC and UDS for first sensation ( r =0.30), first urge ( r =0.38), and maximum cystometric capacity (MCC) ( r =0.43). SC detected DO with a sensitivity of 38% (28-48%) and a specificity of 86% (82-89%). SC detected SUI with a sensitivity of 79% (75-83%) and a specificity of 53% (46-60%). When UDS was performed in conjunction with SC, an additional 14% of patients (n=87) were found to have SUI. The correlation between SC and UDS with respect to filling phase parameters is low. SC testing demonstrated a high sensitivity for SUI and a high specificity for DO. The combination of SC and UDS may enhance SUI detection rates.

Stress urinary incontinence (SUI) adversely impacts millions worldwide due to weakened pelvic floor muscles and urethral sphincter dysfunction. To date, there is a lack of effective non-surgical treatment for SUI, and no clear consensus has been reached on the optimal stem cell source under regenerative therapy. Existing studies have shown no precise molecular mechanisms underlying stem cell-mediated external urethral sphincter (EUS) regeneration. Therefore, we investigated the regenerative and reparative potential of our clinical-grade human amniotic fluid stem cells (hAFSCs) for treating SUI. We determined the immunophenotype, multi-differentiation potential, and secretome of AFSCs. Treated animals were grouped into sham, UI, phosphate buffer saline, and hAFSC groups. Pudendal nerve injury was created to induce SUI in female rats and treated with hAFSCs by administering them into the external urethral sphincter. Isolated AFSCs showed trilineage potential and expressed neuronal-specific markers such as Nestin, Tuj-1, MAP2, and GFAP. hAFSCs-treated group showed significantly (p < 0.01) improved leak point pressure, intercontractile interval, and total muscle cell proliferation numbers. hAFSCs showed elevated levels of VEGF, IL-8, TIMP-1, and TIMP-2. Histological assessment of bladder tissues reveals that hFASCS ameliorated lower ulceration and edema. Immunofluorescence staining and myogenic differentiation markers, i.e., Myf5, Myogenin, and MyoD, indicate the bladder tissue regenerating potential of hAFSCs. No hAFSC trafficking was observed in other tissues and organs. These findings highlight hAFSCs' potential as a novel therapy for SUI, warranting more extensive clinical trials to optimize dosing and long-term efficacy while addressing scalability and safety challenges in translating this regenerative approach to clinical practice.

Comparison of transobturator tape and functional electrical stimulation methods in pure stress urinary incontinence.

This study evaluates changes in bladder storage capacity and function following mid-urethral sling (MUS) surgery in women with urodynamic stress incontinence (USI). In this retrospective cohort study, 685 women with USI underwent MUS using single-incision sling devices (Ophira, Solyx, or I-Stop Mini) between 2015 and 2024 at a tertiary urogynecology center. Preoperative and postoperative assessments included validated quality-of-life (QoL) questionnaires, 1-h pad test, and multichannel urodynamic studies. Subgroup analysis was performed in women with greater baseline leakage burden (pad test ≥5 g). The primary outcome was change in cystometric capacity (CC); secondary outcomes included urodynamic parameters, QoL, and continence outcomes. Objective cure was defined as a 1-h pad test <2 g with no leakage on urodynamics and subjective cure as Urogenital Distress Inventory-6 Question 3 ≤1. At 1 year, objective and subjective cure rates were 89.5% and 87.0%, respectively. Although overall CC increased modestly (369.6 ± 118.8 to 377.1 ± 121.3 mL; P = 0.097), a significant improvement was observed in women with greater baseline leakage (374.1 ± 118.2 to 391.8 ± 122.5 mL; P = 0.005). Mean 1-h pad test weight decreased markedly (25.1-2.7 g; P < 0.001). QoL scores improved significantly across both success and failure groups. De novo detrusor overactivity occurred in 3.9% of patients. Mid-urethral sling surgery achieved high continence rates and significant QoL improvement in women with USI. Although overall postoperative changes in cystometric capacity were modest and did not reach statistical significance, patients with greater baseline leakage (pad test ≥5 g) demonstrated significant improvements in bladder storage parameters. These findings suggest a possible association between successful continence restoration and improved bladder storage function in selected patients. Further prospective studies are warranted to confirm these observations and clarify underlying mechanisms.

Pelvic muscle training and electrostimulation to treat weak pelvic floor: a multicentre-randomised parallel group trial.

Consumer-directed female technology ("femtech") is rapidly expanding into pelvic floor and sexual health, yet clinicians have limited guidance on the safety, efficacy, and appropriate use of these products. The objective of this review is to summarize currently marketed female technology products relevant to pelvic floor disorders, sexual function, and vaginal health, and to highlight key evidence, limitations, and implications for clinical practice. This is a narrative review of commercially available technologies for urinary incontinence, sexual dysfunction, and vaginal health. Product categories include external and intravaginal pelvic floor muscle training devices, vibrators, and dilators for sexual function and pain, regenerative medicine interventions such as platelet-rich plasma injections, sexual wellness applications, and direct-to-consumer vaginal microbiome testing platforms. Pelvic floor devices and in-office energy therapies offer nonsurgical options for urinary incontinence, but high-quality, independent long-term data are scarce, and costs are often substantial. Sexual wellness devices, including vibrators and dilators, are increasingly recognized as therapeutic tools but are variably supported by clinical research. Early studies of platelet-rich plasma suggest potential benefit for sexual function, yet protocols and outcomes remain heterogeneous. Digital applications and microbiome tests expand access and patient engagement but frequently lack rigorous validation and may raise concerns regarding privacy, equity, and interpretation of results. Female technology offers novel opportunities to address pelvic floor and sexual health outside traditional care pathways. Urogynecologists should be familiar with these products, provide balanced counseling on benefits, risks, and cost, and advocate for independent trials to define their role within evidence-based care.

In addition to biomechanical changes, metabolic alterations, such as gestational diabetes mellitus (GDM), may contribute to the development of pelvic floor dysfunction, such as urinary incontinence (UI). Despite the high prevalence of UI during pregnancy, important gaps in the literature still exist. Thus, the objective of this study was to evaluate the association between clinical, obstetric, and metabolic factors and the presence of UI in pregnant women. A cross-sectional study was conducted with a sample of 417 high-risk pregnant women. The volunteers were divided into a group of women with GDM (G-GDM: n = 217) and pregnant women without GDM (G-ND: n = 200). The presence and severity of UI were evaluated using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Clinical, obstetric, and metabolic variables were analyzed by multiple logistic regression, statistical significance was set at 5% (p < 0.05). No significant differences were observed between the groups regarding the frequency and severity of UI (p = 0.36). Multiparity was the only independently associated predictor of UI, indicating that each additional pregnancy increases the probability of occurrence by approximately 20% (OR 1.20; 95% CI 1.03-1.41; p = 0.02). GDM was not significantly associated with UI (OR 1.46; 95% CI 0.96-2.25; p = 0.08). The findings suggest that the biomechanical changes resulting from successive pregnancies appear to be more strongly associated with UI than the influence of GDM. Screening, prevention, and treatment strategies for UI should prioritize multiparous women, aiming to preserve pelvic floor function.

Urinary incontinence (UI) is a highly prevalent condition worldwide, with stress urinary incontinence (SUI) and overactive bladder (OAB) representing major clinical subtypes. Pelvic floor muscle training (PFMT) has been studied extensively as a conservative intervention for UI, yet the global research landscape of PFMT-related UI studies, particularly in terms of collaboration patterns and evolving research themes, has not been mapped in a targeted manner. This study was aimed at providing a bibliometric overview of publication trends, knowledge structure, and emerging hotspots in UI/PFMT research. Literature published between 2000 and 2025 was retrieved from the Web of Science Core Collection. Scientometric analyses were conducted to examine co-authorship networks (countries, institutions, and authors), co-citation structures, and keyword co-occurrence patterns. China, the USA, the UK, and Brazil were among the major contributors to UI/PFMT research, with China showing rapid growth in publication output in recent years. Thematic mapping suggested increasing research attention to implementation- and technology-assisted rehabilitation topics, including biofeedback, electrical stimulation, and digital or artificial-intelligence-supported training approaches. This bibliometric analysis offers an updated descriptive map of the UI/PFMT research field over the past 25years, highlighting major contributors, collaboration structures, and shifting thematic emphases. The findings may support future research planning by identifying active areas of investigation and emerging directions within the PFMT-related UI literature.

To examine the role of health-related quality of life (HRQoL) assessments and patient-reported outcome measures (PROMs) in the economic evaluation of urological interventions, highlighting methodological challenges, and identifying areas for future development. This narrative review synthesises key frameworks for economic evaluation in urology, describes methods for utility derivation, and critically appraises the application of both generic and disease-specific PROMs. Evidence is drawn from major urological trials and model-based evaluations, with attention to their impact on health technology assessment decisions. Patient-reported outcome measures underpin cost-utility analyses across the full spectrum of urological conditions, including benign prostatic hyperplasia (BPH), urinary incontinence, overactive bladder, bladder cancer, renal cancer, and prostate cancer. Generic instruments such as the EuroQoL five Dimensions (EQ-5D) and 36-item Short-Form Health Survey (SF-36) facilitate cross-disease comparison but may lack sensitivity to urological symptoms. Disease-specific tools (e.g., International Prostate Symptom Score, Overactive Bladder Questionnaire, 26-item Expanded Prostate cancer Index Composite) provide granularity but often require mapping to utility values, introducing uncertainty. Trial-based evaluations (e.g., Trans European Research into the use of Management Policies for LUTS suggestive of BPH in Primary Healthcare [TRIUMPH], Single-Incision Mini-Slings [SIMS], Refractory Overactive Bladder: Sacral NEuromodulation vs BoTulinum Toxin Assessment [ROSETTA]) demonstrate that PROM-derived quality-adjusted life year differences can decisively influence cost-effectiveness. Surgery-related PROMs including the Consultation and Relational Empathy measure can capture important short-term recovery outcomes not measured by generic tools. Health-related quality of life and PROMs are foundational to value-based urological care. Accurate and context-sensitive measurement ensures that cost-utility analyses reflect patient experience as well as clinical outcomes. Future priorities include development of preference-based urology-specific PROMs, improved digital/electronic PROM capture, validation of mapping algorithms, and integration of surgery-related PROMs into economic evaluations.