Scholars@Duke
Alison Catherine Weidner

Alison Catherine Weidner

Professor of Obstetrics and Gynecology
Obstetrics and Gynecology, Urogynecology
5324 McFarland Drive Suite 310, Box 3192, Durham, NC 27707
5324 McFarland Drive Suite 310, Box 3192, Durham, NC 27707

Selected Publications

Postoperative Sexual Function After Vaginal Surgery and Clitoral Size, Position, and Shape.

Journal Article JAMA Surg · April 1, 2025 IMPORTANCE: Transvaginal surgery is commonly performed to treat pelvic organ prolapse. Little research focuses on how sexual function relates to clitoral anatomy after vaginal surgery despite the clitoris' role in the sexual response. OBJECTIVE: To determi ... Full text Link to item Cite

The Role of Sleep Apnea in Postoperative Neurocognitive Disorders Among Older Noncardiac Surgery Patients: A Prospective Cohort Study.

Journal Article Anesth Analg · January 1, 2025 BACKGROUND: Obstructive sleep apnea is associated with increased dementia risk, yet its role in postoperative neurocognitive disorders is unclear. Here, we studied whether the severity of untreated obstructive sleep apnea is associated with the severity of ... Full text Link to item Cite

Patient perspectives in adverse event reporting after vaginal apical prolapse surgery.

Journal Article Am J Obstet Gynecol · August 2024 BACKGROUND: Many clinical trials use systematic methodology to monitor adverse events and determine grade (severity), expectedness, and relatedness to treatments as determined by clinicians. However, patient perspectives are often not included in this proc ... Full text Link to item Cite

Apical Suspension Repair for Vaginal Vault Prolapse: A Randomized Clinical Trial.

Journal Article JAMA Surg · August 1, 2024 IMPORTANCE: The optimal surgical repair of vaginal vault prolapse after hysterectomy remains undetermined. OBJECTIVE: To compare the efficacy and safety of 3 surgical approaches for vaginal vault prolapse after hysterectomy. DESIGN, SETTING, AND PARTICIPAN ... Full text Link to item Cite

Noncongenital Vaginal Obliteration: Surgical Restoration of Vaginal Patency for GVHD.

Journal Article J Minim Invasive Gynecol · July 2024 STUDY OBJECTIVE: To provide a brief overview of noncongenital causes of vaginal obliteration and stenosis, discuss a unique case of vaginal agglutination in a patient who developed genital graft-versus-host disease (GVHD) after receiving a bone marrow tran ... Full text Link to item Cite

Vaginal morphology and position associated with prolapse recurrence after vaginal surgery: A secondary analysis of the DEMAND study.

Journal Article BJOG · February 2024 OBJECTIVE: To identify vaginal morphology and position factors associated with prolapse recurrence following vaginal surgery. DESIGN: Secondary analysis of magnetic resonance images (MRI) of the Defining Mechanisms of Anterior Vaginal Wall Descent cross-se ... Full text Link to item Cite

Adherence to Perioperative Behavioral Therapy With Pelvic Floor Muscle Training in Women Receiving Vaginal Reconstructive Surgery for Pelvic Organ Prolapse.

Journal Article Phys Ther · September 1, 2023 OBJECTIVE: The objective of this study was to describe adherence to behavioral and pelvic floor muscle training in women undergoing vaginal reconstructive surgery for organ prolapse and to examine whether adherence was associated with 24-month outcomes. ME ... Full text Link to item Cite

Urinary basement membrane graft-augmented sacrospinous ligament suspension: a description of technique and short-term outcomes.

Journal Article Int Urogynecol J · May 2022 INTRODUCTION AND HYPOTHESIS: Since the discontinuation of manufacture and distribution of surgical mesh for transvaginal prolapse repair, the use of biologic grafts for transvaginal apical suspension has gained renewed attention. However, there is no FDA-a ... Full text Link to item Cite

Defining mechanisms of recurrence following apical prolapse repair based on imaging criteria.

Journal Article Am J Obstet Gynecol · November 2021 BACKGROUND: Prolapse recurrence after transvaginal surgical repair is common; however, its mechanisms are ill-defined. A thorough understanding of how and why prolapse repairs fail is needed to address their high rate of anatomic recurrence and to develop ... Full text Link to item Cite

Characteristics Associated With Treatment Failure 1 Year After Midurethral Sling in Women With Mixed Urinary Incontinence.

Journal Article Obstet Gynecol · August 1, 2021 OBJECTIVE: To evaluate characteristics associated with treatment failure 1 year after midurethral sling in women with mixed urinary incontinence. METHODS: Four-hundred three women who participated in a randomized trial that compared midurethral sling and b ... Full text Link to item Cite

Methods for the defining mechanisms of anterior vaginal wall descent (DEMAND) study.

Journal Article Int Urogynecol J · April 2021 INTRODUCTION AND HYPOTHESIS: The protocol and analysis methods for the Defining Mechanisms of Anterior Vaginal Wall Descent (DEMAND) study are presented. DEMAND was designed to identify mechanisms and contributors of prolapse recurrence after two transvagi ... Full text Link to item Cite

Evaluation of Host Immune Cellular and Extracellular Matrix Responses to Prolapse Mesh With and Without Tension in a Rat Model.

Journal Article Female Pelvic Med Reconstr Surg · February 1, 2021 OBJECTIVES: We sought to determine whether vaginal host immune cellular and extracellular matrix responses are altered in a rat sacrocolpopexy model when lightweight polypropylene mesh is attached on tension versus without tension. METHODS: We performed hy ... Full text Link to item Cite

Polycarbonate Urethane Mesh: A New Material for Pelvic Reconstruction.

Journal Article Female Pelvic Med Reconstr Surg · February 1, 2021 OBJECTIVE: Polycarbonate urethane (PCU) is a new biomaterial, and its mechanical properties can be tailored to match that of vaginal tissue. We aimed to determine whether vaginal host immune and extracellular matrix responses differ after PCU versus lightw ... Full text Link to item Cite

Design of a Study to Measure Patient-Perspectives in Adverse Event Reporting (the PPAR Study): Supplementary Study to the ASPIRe Trial.

Journal Article Female Pelvic Med Reconstr Surg · January 1, 2021 OBJECTIVES: The primary objective of this study is to compare patient versus physician rankings of adverse event (AE) and adverse symptom (AS) severity after pelvic reconstructive surgery. Secondary objectives include to estimate the association between pa ... Full text Link to item Cite

Do Women Who Self-report More Exercise Have Increased Rates of Symptomatic Stress Urinary Incontinence After Midurethral Slings?

Journal Article Female Pelvic Med Reconstr Surg · January 1, 2021 OBJECTIVES: There is a paucity of data on postoperative exercise and how it relates to surgical failure, specifically after midurethral sling (MUS) surgery. We aimed to assess if women with higher self-reported activity levels as measured by strenuous exer ... Full text Link to item Cite

Streamlining Postoperative Void Trials: A Study Comparing Standard Backfill Versus Backfill in the Operating Room.

Journal Article Female Pelvic Med Reconstr Surg · January 1, 2021 OBJECTIVE: The standard backfill void trial (VT) performed after urogynecologic surgery is time-consuming. We adopted a new VT protocol in which the bladder is backfilled in the operating room (OR). We hypothesized that this protocol would result in (1) sh ... Full text Link to item Cite

Outcomes of native tissue transvaginal apical approaches in women with advanced pelvic organ prolapse and stress urinary incontinence.

Journal Article Int Urogynecol J · October 2020 INTRODUCTION AND HYPOTHESIS: Limited data exist comparing different surgical approaches in women with advanced vaginal prolapse. This study compared 2-year surgical outcomes of uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF) ... Full text Link to item Cite

Does Mesh Weight Affect Time to Failure After Robotic-Assisted Laparoscopic Sacrocolpopexy?

Journal Article Female Pelvic Med Reconstr Surg · September 2020 OBJECTIVE: The objective of this study was to compare time to anatomic failure after robotic sacrocolpopexy with use of ultralightweight versus heavier weight mesh types. METHODS: We performed a retrospective cohort study of women who underwent robotic sac ... Full text Link to item Cite

Characteristics Associated With Treatment Failure 1 Year After Midurethral Sling in Women With Mixed Urinary Incontinence.

Journal Article Obstet Gynecol · September 2020 OBJECTIVE: To evaluate characteristics associated with treatment failure 1 year after midurethral sling in women with mixed urinary incontinence. METHODS: Four hundred three women who participated in a randomized trial that compared midurethral sling and b ... Full text Link to item Cite

Design of a 3-Arm Randomized Trial for Posthysterectomy Vault Prolapse Involving Sacral Colpopexy, Transvaginal Mesh, and Native Tissue Apical Repair: The Apical Suspension Repair for Vault Prolapse in a Three-Arm Randomized Trial.

Journal Article Female Pelvic Med Reconstr Surg · July 2020 OBJECTIVE: The objective of this study was to present the design of the Apical Suspension Repair for Vault Prolapse in a Three-Arm Randomized Trial (ASPIRe), which compares the efficacy and safety of 3 apical repairs: native tissue (NT) transvaginal repair ... Full text Link to item Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Recruitment and retention: A randomized controlled trial of video-enhanced versus standard consent processes within the E-OPTIMAL study.

Journal Article Clin Trials · October 2019 BACKGROUND/AIMS: In this study, we compared two research consent techniques: a standardized video plus usual consent and usual consent alone. METHODS: Individuals who completed 24-month outcomes (completers) in the Operations and Pelvic Muscle Training in ... Full text Link to item Cite

Effect of Behavioral and Pelvic Floor Muscle Therapy Combined With Surgery vs Surgery Alone on Incontinence Symptoms Among Women With Mixed Urinary Incontinence: The ESTEEM Randomized Clinical Trial.

Journal Article JAMA · September 17, 2019 IMPORTANCE: Mixed urinary incontinence, including both stress and urgency incontinence, has adverse effects on a woman's quality of life. Studies evaluating treatments to simultaneously improve both components are lacking. OBJECTIVE: To determine whether c ... Full text Link to item Cite

Controlling faecal incontinence in women by performing anal exercises with biofeedback or loperamide: a randomised clinical trial.

Journal Article Lancet Gastroenterol Hepatol · September 2019 BACKGROUND: Well designed, large comparative effectiveness trials assessing the efficacy of primary interventions for faecal incontinence are few in number. The objectives of this study were to compare different combinations of anorectal manometry-assisted ... Full text Open Access Link to item Cite

Open sacrocolpopexy and vaginal apical repair: retrospective comparison of success and serious complications.

Journal Article Int Urogynecol J · August 2018 INTRODUCTION AND HYPOTHESIS: We compared treatment success and adverse events between women undergoing open abdominal sacrocolpopexy (ASC) vs vaginal repair (VAR) using data from women enrolled in one of three multicenter trials. We hypothesized that ASC w ... Full text Link to item Cite

Surgical Alteration of Genital Hiatus Size and Anatomic Failure After Vaginal Vault Suspension.

Journal Article Obstet Gynecol · June 2018 OBJECTIVE: To compare anatomic outcomes after native tissue vaginal vault suspension among women categorized by their preoperative and 6-week postoperative genital hiatus size. METHODS: We performed a retrospective cohort study in women who underwent nativ ... Full text Link to item Cite

Surgical outcomes after apical repair for vault compared with uterovaginal prolapse

Journal Article Obstetrical and Gynecological Survey · June 1, 2018 The incidence of posthysterectomy prolapse ranges from 6% to 8%. Many surgeons treat posthysterectomy or vault prolapse differently than uterovaginal prolapse in women planning to undergo surgery for apical pelvic organ prolapse (POP), because they believe ... Full text Cite

Effect of Uterosacral Ligament Suspension vs Sacrospinous Ligament Fixation With or Without Perioperative Behavioral Therapy for Pelvic Organ Vaginal Prolapse on Surgical Outcomes and Prolapse Symptoms at 5 Years in the OPTIMAL Randomized Clinical Trial.

Journal Article JAMA · April 17, 2018 IMPORTANCE: Uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF) are commonly performed pelvic organ prolapse procedures despite a lack of long-term efficacy data. OBJECTIVE: To compare outcomes in women randomized to (1) ULS or ... Full text Open Access Link to item Cite

Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse.

Journal Article Obstet Gynecol · March 2018 OBJECTIVE: To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II-IV prolapse. METHODS: Women in one of three Pelvic Floor ... Full text Link to item Cite

Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort of Absorbable and Permanent Suture Groups.

Journal Article Female Pelvic Med Reconstr Surg · 2018 OBJECTIVE: The aim of this study was to compare anatomic results after vaginal uterosacral ligament suspension with absorbable versus permanent suture. METHODS: We performed a retrospective cohort study of women who underwent vaginal uterosacral ligament s ... Full text Link to item Cite

Refractory urgency urinary incontinence treatment in women: impact of age on outcomes and complications.

Journal Article Am J Obstet Gynecol · January 2018 BACKGROUND: Women with refractory urgency urinary incontinence (ie, unresponsive to behavioral and pharmacological interventions) are treated with onabotulinumtoxinA or sacral neuromodulation. OBJECTIVE: The objective of the study was to compare treatment ... Full text Link to item Cite

Perioperative Behavioral Therapy and Pelvic Muscle Strengthening Do Not Enhance Quality of Life After Pelvic Surgery: Secondary Report of a Randomized Controlled Trial.

Journal Article Phys Ther · November 1, 2017 BACKGROUND: There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. ... Full text Link to item Cite

Do Mixed-Flora Preoperative Urine Cultures Matter?

Journal Article South Med J · June 2017 OBJECTIVES: To determine whether mixed-flora preoperative urine cultures, as compared with no-growth preoperative urine cultures, are associated with a higher prevalence of postoperative urinary tract infections (UTIs). METHODS: This was a retrospective co ... Full text Link to item Cite

Methods for a multicenter randomized trial for mixed urinary incontinence: rationale and patient-centeredness of the ESTEEM trial.

Journal Article Int Urogynecol J · October 2016 INTRODUCTION AND HYPOTHESIS: Mixed urinary incontinence (MUI) can be a challenging condition to manage. We describe the protocol design and rationale for the Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM) trial ... Full text Open Access Link to item Cite

Quality of Life and Sexual Function 2 Years After Vaginal Surgery for Prolapse.

Journal Article Obstet Gynecol · June 2016 OBJECTIVE: To longitudinally assess the effect of native tissue vaginal apical prolapse repair with anti-incontinence surgery on quality of life, sexual function, and body image between uterosacral and sacrospinous suspensions. METHODS: A planned secondary ... Full text Link to item Cite

Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: Design and methods.

Journal Article Contemp Clin Trials · September 2015 The goals of this trial are to determine the efficacy and safety of two treatments for women experiencing fecal incontinence. First, we aim to compare the use of loperamide to placebo and second, to compare the use of anal sphincter exercises with biofeedb ... Full text Open Access Link to item Cite

LONG-TERM QUALITY OF LIFE AND SEXUAL FUNCTION AFTER VAGINAL SURGERY FOR APICAL PROLAPSE

Journal Article INTERNATIONAL UROGYNECOLOGY JOURNAL · June 1, 2015 Link to item Cite

Vaginal native tissue repair versus transvaginal mesh repair for apical prolapse: how utilizing different methods of analysis affects the estimated trade-off between reoperation for mesh exposure/erosion and reoperation for recurrent prolapse.

Journal Article Int Urogynecol J · May 2015 INTRODUCTION AND HYPOTHESIS: Informed decision-making about optimal surgical repair of apical prolapse with vaginal native tissue (NT) versus transvaginal mesh (TVM) requires understanding the balance between the potential "harm" of mesh-related complicati ... Full text Link to item Cite

Symptom improvement in women after fecal incontinence treatments: a multicenter cohort study of the pelvic floor disorders network.

Journal Article Female Pelvic Med Reconstr Surg · 2015 OBJECTIVES: The study aims were to characterize women with fecal incontinence (FI) and measure changes in FI severity and quality of life 3 and 12 months after treatment. METHODS: This study is a secondary analysis of a multicenter study measuring adaptive ... Full text Link to item Cite

Incidence and Predictors of Anal Incontinence After Obstetric Anal Sphincter Injury in Primiparous Women.

Journal Article Female Pelvic Med Reconstr Surg · 2015 OBJECTIVE: This study aimed to describe the incidence of fecal incontinence (FI) at 6, 12, and 24 weeks postpartum; anal incontinence (AI) and fecal urgency at 24 weeks; and identify predictors of AI in women with obstetric anal sphincter injury (OASI). ME ... Full text Link to item Cite

Effectiveness of blinding: sham suprapubic incisions in a randomized trial of retropubic midurethral sling in women undergoing vaginal prolapse surgery.

Journal Article Am J Obstet Gynecol · November 2014 OBJECTIVE: This planned secondary analysis of the Outcomes Following Vaginal Prolapse Repairs and Midurethral Sling trial assessed whether treatment knowledge differed between randomized groups at 12 months and whether treatment success was affected by tre ... Full text Link to item Cite

Does concomitant anterior/apical repair during midurethral sling improve the overactive bladder component of mixed incontinence?

Journal Article Int Urogynecol J · September 2014 INTRODUCTION AND HYPOTHESIS: Midurethral sling (MUS) can improve overactive bladder (OAB) symptoms. It is unclear if anterior/apical prolapse (AA) repair provides additional benefit. We hypothesized that women with mixed urinary incontinence (MUI) experien ... Full text Link to item Cite

Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial.

Journal Article JAMA · March 12, 2014 IMPORTANCE: More than 300,000 surgeries are performed annually in the United States for pelvic organ prolapse. Sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are commonly performed transvaginal surgeries to correct apical p ... Full text Link to item Cite

Botulinum toxin type a (BOTOX) for refractory myofascial pelvic pain

Journal Article Obstetrical and Gynecological Survey · January 1, 2014 Full text Cite

Perioperative anticholinergic medications and risk of catheterization after urogynecologic surgery.

Journal Article Female Pelvic Med Reconstr Surg · 2014 OBJECTIVE: This study aimed to examine how anticholinergic medication exposure affects the risk of failed postoperative void trial (VT) in women undergoing urogynecologic surgery. METHODS: We conducted a retrospective cohort study of women undergoing outpa ... Full text Link to item Cite

How does site of pelvic organ prolapse repair affect overactive bladder symptoms?

Journal Article Female Pelvic Med Reconstr Surg · 2014 OBJECTIVES: To assess how site of pelvic organ prolapse repair affects overactive bladder (OAB) symptoms, we compared change in OAB symptoms in women undergoing isolated anterior/apical (AA) repair versus isolated posterior (P) repair. METHODS: This is a r ... Full text Link to item Cite

Long-Term Outcomes of Vaginal Mesh vs. Native Tissue Repair for Anterior Vaginal Wall Prolapse

Journal Article PHARMACOEPIDEMIOLOGY AND DRUG SAFETY · October 1, 2013 Link to item Cite

Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.

Journal Article Int Urogynecol J · August 2013 INTRODUCTION AND HYPOTHESIS: To estimate the risk of repeat surgery for recurrent prolapse or mesh removal after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. METHODS: We utilized longitudinal, adjudicated, healthcare claims ... Full text Link to item Cite

Adherence to behavioral interventions for stress incontinence: rates, barriers, and predictors.

Journal Article Phys Ther · June 2013 BACKGROUND: First-line conservative treatment for stress urinary incontinence (SUI) in women is behavioral intervention, including pelvic-floor muscle (PFM) exercise and bladder control strategies. OBJECTIVE: The purposes of this study were: (1) to describ ... Full text Link to item Cite

Computer modeling informs study design: vaginal estrogen to prevent mesh erosion after different routes of prolapse surgery.

Journal Article Int Urogynecol J · March 2013 Featured Publication INTRODUCTION AND HYPOTHESIS: Many clinicians use perioperative vaginal estrogen therapy (estradiol, E(2)) to diminish the risk of mesh erosion after prolapse surgery, though supporting evidence is limited. We assessed the feasibility of a factorial randomi ... Full text Link to item Cite

Vaginal prolapse recurrence after uterosacral ligament suspension in normal-weight compared with overweight and obese women.

Journal Article Obstet Gynecol · March 2013 Featured Publication OBJECTIVE: To compare recurrent prolapse after vaginal uterosacral ligament suspension in normal-weight compared with overweight or obese women. METHODS: We performed a retrospective cohort study of the risk of recurrent prolapse after uterosacral ligament ... Full text Link to item Cite

Trends in use of surgical mesh for pelvic organ prolapse.

Journal Article Am J Obstet Gynecol · January 2013 Featured Publication OBJECTIVE: Limited data exist on the rates of pelvic organ prolapse procedures utilizing mesh. The objective of this study was to examine trends in vaginal mesh prolapse procedures (VMs), abdominal sacrocolpopexy (ASC), and minimally invasive sacrocolpopex ... Full text Link to item Cite

The effect of urodynamic testing on clinical diagnosis, treatment plan and outcomes in women undergoing stress urinary incontinence surgery.

Journal Article J Urol · January 2013 PURPOSE: We evaluated the influence of preoperative urodynamic studies on diagnoses, global treatment plans and outcomes in women treated with surgery for uncomplicated stress predominant urinary incontinence. MATERIALS AND METHODS: We performed a secondar ... Full text Link to item Cite

Obesity as a risk for the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy.

Journal Article J Reprod Med · 2013 OBJECTIVE: To determine whether obese body mass index is associated with the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy. STUDY DESIGN: We conducted a retrospective cohort study of the risk of recurrent anterior prolapse 6 mont ... Link to item Cite

The efficacy of posterior tibial nerve stimulation for the treatment of overactive bladder in women: a systematic review.

Journal Article Int Urogynecol J · November 2012 INTRODUCTION AND HYPOTHESIS: Posterior tibial nerve stimulation (PTNS) is a percutaneous method of peripheral, sacral neuromodulation. Its current use is limited; however, published data suggest PTNS may be an effective treatment for overactive bladder (OA ... Full text Link to item Cite

Matrix metalloproteinase-9 genetic polymorphisms and the risk for advanced pelvic organ prolapse.

Journal Article Obstet Gynecol · September 2012 OBJECTIVE: Matrix metalloproteinase-9 (MMP9) is a protease associated with degradation of collagen and elastin. Because increased MMP9 activity in vaginal tissue has been associated with pelvic organ prolapse (POP), we sought to comprehensively estimate MM ... Full text Link to item Cite

Do urodynamic parameters predict persistent postoperative stress incontinence after midurethral sling? A systematic review.

Journal Article Int Urogynecol J · July 2012 INTRODUCTION AND HYPOTHESIS: It is unclear whether preoperative urodynamic study (UDS) values are predictive of outcomes after midurethral sling. MATERIALS AND METHODS: We systematically reviewed multiple databases from January 1989 to October 2011 for Eng ... Full text Link to item Cite

Single-incision mini-sling compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial.

Journal Article Obstet Gynecol · February 2012 Featured Publication OBJECTIVE: To compare the efficacy of a single-incision mini-sling, placed in the "U" position, with tension-free vaginal tape (TVT) in the treatment of stress urinary incontinence. METHODS: Women with urodynamic stress incontinence with or without genital ... Full text Link to item Cite

Trends in inpatient urinary incontinence surgery in the USA, 1998-2007.

Journal Article Int Urogynecol J · November 2011 Featured Publication INTRODUCTION AND HYPOTHESIS: This study was conducted to assess national rates in stress urinary incontinence (SUI) surgery in the USA from 1998 to 2007. METHODS: We utilized the 1998-2007 Nationwide Inpatient Sample and assessed women aged 20 years and ol ... Full text Link to item Cite

Shifts in national rates of inpatient prolapse surgery emphasize current coding inadequacies.

Journal Article Female Pelvic Med Reconstr Surg · July 2011 OBJECTIVE: : This study aimed to assess national rates, types, and routes of inpatient surgery for pelvic organ prolapse in the United States in 1998 compared to those in 2007. METHODS: : We used the 1998 and 2007 Nationwide Inpatient Sample, which represe ... Full text Link to item Cite

Further validation of the short form versions of the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ).

Journal Article Neurourol Urodyn · April 2011 AIMS: To evaluate validity and responsiveness of PFDI and PFIQ short forms across four multi-center studies and develop conversion formulas between short and long versions. METHODS: 1,006 participants in four prospective studies of pelvic floor disorders c ... Full text Link to item Cite

Sexual function before and after non-surgical treatment for stress urinary incontinence.

Journal Article Female Pelvic Med Reconstr Surg · 2011 Featured Publication OBJECTIVES: (1) to describe sexual function in women seeking treatment of stress urinary incontinence (SUI); (2) to compare the impact on sexual function of three SUI treatments; and (3) to investigate whether non-surgical treatment of SUI is associated wi ... Full text Link to item Cite

Neural entrapment during uterosacral ligament suspension: an anatomic study of female cadavers.

Journal Article Obstet Gynecol · September 2010 Featured Publication OBJECTIVE: To describe retroperitoneal neural structures at risk during uterosacral ligament suspension and to estimate risk of neural injury based on uterosacral ligament suspension suture placement technique. METHODS: Uterosacral ligament suspension was ... Full text Link to item Cite

Correlation between levator ani muscle injuries on magnetic resonance imaging and fecal incontinence, pelvic organ prolapse, and urinary incontinence in primiparous women.

Journal Article Am J Obstet Gynecol · May 2010 Featured Publication OBJECTIVE: The objective of the study was to correlate the presence of major levator ani muscle (LAM) injuries on magnetic resonance imaging (MRI) with fecal incontinence (FI), pelvic organ prolapse (POP), and urinary incontinence (UI) in primiparous women ... Full text Link to item Cite

Continence pessary compared with behavioral therapy or combined therapy for stress incontinence: a randomized controlled trial.

Journal Article Obstet Gynecol · March 2010 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 ... Full text Link to item Cite

Change in urethral sphincter neuromuscular function during pregnancy persists after delivery.

Journal Article Am J Obstet Gynecol · November 2009 Featured Publication OBJECTIVE: The purpose of this study was to assess the effect of pregnancy and first vaginal delivery on urethral striated sphincter neuromuscular function. STUDY DESIGN: Quantitative electromyographic (EMG) interference pattern analysis of the urethral sp ... Full text Link to item Cite

Fecal incontinence in US adults: epidemiology and risk factors.

Journal Article Gastroenterology · August 2009 BACKGROUND & AIMS: The study aims were to estimate the prevalence of different types and frequencies of fecal incontinence (FI), describe demographic factors, and identify risk factors. METHODS: The National Health and Nutrition Examination Survey (NHANES) ... Full text Link to item Cite

Levator ani denervation and reinnervation 6 months after childbirth.

Journal Article Am J Obstet Gynecol · May 2009 Featured Publication OBJECTIVE: The objective of the study was to assess the prevalence of levator ani denervation and reinnervation 6 months after the first delivery. STUDY DESIGN: Ninety-six primigravida women underwent quantitative electromyography of the levator ani during ... Full text Link to item Cite

Early vs late midline sling lysis results in greater improvement in lower urinary tract symptoms.

Journal Article Am J Obstet Gynecol · May 2009 OBJECTIVE: Lower urinary tract symptoms (LUTS) occur in 5-20% of women after antiincontinence procedures. Symptoms include complete urinary retention or storage, voiding, and postmicturition symptoms. The goal of this study was to determine the effect of t ... Full text Link to item Cite

Operations and pelvic muscle training in the management of apical support loss (OPTIMAL) trial: design and methods.

Journal Article Contemp Clin Trials · March 2009 The primary aims of this trial are: 1) to compare surgical outcomes following sacrospinous ligament fixation to uterosacral vaginal vault suspension in women undergoing vaginal surgery for apical or uterine pelvic organ prolapse and stress urinary incontin ... Full text Link to item Cite

Are single nucleotide polymorphisms associated with pelvic organ prolapse?

Journal Article Journal of Pelvic Medicine and Surgery · January 1, 2008 OBJECTIVE: Evaluate possible association of genetic variability detected via single nucleotide polymorphisms (SNPs) and pelvic organ prolapse (POP). METHODS: Thirty six women with stage III-IV POP and 36 controls matched for race, age, parity, and body mas ... Full text Cite

Racial differences in pelvic floor muscle thickness in asymptomatic nulliparas as seen on magnetic resonance imaging-based three-dimensional color thickness mapping.

Journal Article Am J Obstet Gynecol · December 2007 OBJECTIVE: The objective of the study was to compare levator and obturator thickness between asymptomatic black and white nulliparas using three-dimensional (3D) magnetic resonance imaging (MRI) color mapping. STUDY DESIGN: 3D color-mapped MRI of pelvic mu ... Full text Link to item Cite

Surgical excision of eroded mesh after prior abdominal sacrocolpopexy.

Journal Article Am J Obstet Gynecol · December 2007 Featured Publication OBJECTIVE: We previously described an endoscopic-assisted transvaginal mesh excision technique. This study compares surgical outcomes after transvaginal mesh excision vs endoscopic-assisted transvaginal mesh excision. In addition, we reviewed our postopera ... Full text Link to item Cite

A randomized, controlled trial evaluating 2 techniques of postoperative bladder testing after transvaginal surgery.

Journal Article Am J Obstet Gynecol · December 2007 OBJECTIVE: The purpose of this pilot study was to compare the efficacy of 2 techniques for evaluating bladder function after transvaginal surgery. STUDY DESIGN: Subjects scheduled for transvaginal, outpatient surgery were consecutively enrolled and randomi ... Full text Link to item Cite

Outcomes after combined perineoplasty with overlapping anal sphincteroplasty for fecal incontinence

Journal Article Journal of Pelvic Medicine and Surgery · November 1, 2007 OBJECTIVES: To assess long-term fecal incontinence symptoms after combined perineoplasty with overlapping anal sphincteroplasty using the Fecal Incontinence Severity Index (FISI) questionnaire. METHODS: A retrospective review identified all 22 subjects who ... Full text Cite

Lack of psychological resilience: an important correlate for urinary incontinence.

Journal Article Int Urogynecol J Pelvic Floor Dysfunct · October 2007 Featured Publication Our study evaluated medical conditions, level of physical functioning, and psychological health as correlates of urinary continence (UI) for four different age groups of women. Survey questions from the 1996 MIDUS survey were used in three domains of healt ... Full text Link to item Cite

Is Burch colposuspension ever cost-effective compared with tension-free vaginal tape for stress incontinence?

Journal Article Am J Obstet Gynecol · July 2007 OBJECTIVE: This study was undertaken to evaluate the cost-effectiveness of Burch colposuspension compared with tension-free vaginal tape. STUDY DESIGN: A Markov decision model was developed to compare costs (2005 US dollars) and effectiveness (quality-adju ... Full text Link to item Cite

Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery.

Journal Article Int Urogynecol J Pelvic Floor Dysfunct · July 2007 The objective of this study was to determine if obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse improve quality of life in elderly women. Women age 65 years or older with stage 3 or 4 pelvic organ prolapse who desired sur ... Full text Link to item Cite

A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse.

Journal Article Am J Obstet Gynecol · July 2007 OBJECTIVE: The objective of this study was to evaluate the impact of transvaginal prolapse surgery on overactive bladder symptoms in elderly women. STUDY DESIGN: Women (> or = 65 years old) with stage III or IV prolapse who enrolled in a prospective study ... Full text Link to item Cite

Levator ani abnormality 6 weeks after delivery persists at 6 months.

Journal Article Am J Obstet Gynecol · July 2007 Featured Publication OBJECTIVE: Assess postpartum changes in the levator ani muscle using magnetic resonance imaging and relate these changes to obstetric events and risk factors associated with pelvic floor dysfunction. STUDY DESIGN: A board-certified radiologist specializing ... Full text Link to item Cite

Neuropathic injury to the levator ani occurs in 1 in 4 primiparous women.

Journal Article Am J Obstet Gynecol · December 2006 OBJECTIVE: We measured levator ani neuromuscular function before and after first delivery to identify the location, timing, and mechanism of injury. STUDY DESIGN: Fifty-eight primiparous women underwent electromyographic examination of the levator ani ante ... Full text Link to item Cite

Sensory nerve injury after uterosacral ligament suspension.

Journal Article Am J Obstet Gynecol · December 2006 OBJECTIVE: Uterosacral ligament suspension is a technique that is performed commonly to suspend the prolapsed vaginal apex. This case series describes our experience with the clinical evaluation and management of lower extremity sensory nerve symptoms afte ... Full text Link to item Cite

Racial differences in pelvic morphology among asymptomatic nulliparous women as seen on three-dimensional magnetic resonance images.

Journal Article Am J Obstet Gynecol · December 2005 Featured Publication OBJECTIVE: Compare pelvic morphology between asymptomatic African-American and white nulliparous women. STUDY DESIGN: Resting supine T2-weighted magnetic resonance (MR) images were obtained in 12 African-American (AA) and 10 white American (WA) women witho ... Full text Link to item Cite

Vascular anatomy of the presacral space: a fresh tissue cadaver dissection.

Journal Article Am J Obstet Gynecol · May 2005 OBJECTIVE: To assess variability in the vascular structures of the presacral space and to estimate the risk of injury because of blind suture placement during sacral colpopexy. STUDY DESIGN: Ten fresh frozen female cadavers were evaluated. Three 0-polyeste ... Full text Link to item Cite

Nocturnal polyuria in women with overactive bladder symptoms and nocturia.

Journal Article Am J Obstet Gynecol · May 2005 Featured Publication OBJECTIVE: This study was undertaken to determine the prevalence of nocturnal polyuria in women complaining of nocturia and overactive bladder (OAB) symptoms and to identify clinical and health characteristics associated with nocturnal polyuria. STUDY DESI ... Full text Link to item Cite

Patient characteristics and management of dermal allograft extrusions.

Journal Article Int Urogynecol J Pelvic Floor Dysfunct · 2005 Featured Publication The objective of this study was to describe our rate of extrusion of dermal allograft material when used in anterior or posterior colporrhaphy and to review our success in treating extrusions with conservative management. A retrospective review of all subj ... Full text Link to item Cite

Transvaginal endoscopic removal of eroded mesh after abdominal sacral colpopexy.

Journal Article Obstet Gynecol · May 2004 Featured Publication BACKGROUND: Abdominal sacral colpopexy with permanent mesh has become the preferred abdominal technique for correcting posthysterectomy vaginal vault prolapse. Although rare, mesh erosion after sacral colpopexy is often challenging to manage. We report on ... Full text Link to item Cite

Basic science and translational research in female pelvic floor disorders: proceedings of an NIH-sponsored meeting.

Journal Article Neurourol Urodyn · 2004 Featured Publication AIMS: To report the findings of a multidisciplinary group of scientists focusing on issues in basic science and translational research related to female pelvic floor disorders, and to produce recommendations for a research agenda for investigators studying ... Full text Link to item Cite

Cost-effectiveness of universal cystoscopy to identify ureteral injury at hysterectomy.

Journal Article Obstet Gynecol · May 2001 OBJECTIVE: To evaluate the cost-effectiveness of routine cystoscopy at the time of abdominal, vaginal, and laparoscopically assisted vaginal hysterectomy in terms of cost per ureteral injury identified and treated. METHODS: Using a hospital-based perspecti ... Full text Link to item Cite

Effectiveness of laparoscopic cadaveric dissection in enhancing resident comprehension of pelvic anatomy.

Journal Article J Am Coll Surg · April 2001 Featured Publication BACKGROUND: Anatomic instruction during preclinical years of medical school has been in decline recently. There is evidence that residents already lose a considerable portion of basic anatomic knowledge in the transition from student to clinician, and this ... Full text Link to item Cite

Vaginal mesh erosion after abdominal sacral colpopexy.

Journal Article Am J Obstet Gynecol · February 2001 Featured Publication OBJECTIVE: Our goal was to compare the prevalence of vaginal mesh erosion between abdominal sacral colpopexy and various sacral colpoperineopexy procedures. STUDY DESIGN: We undertook a retrospective analysis of all sacral colpopexies and colpoperineopexie ... Full text Link to item Cite

The standardization of terminology for researchers in female pelvic floor disorders.

Journal Article Int Urogynecol J Pelvic Floor Dysfunct · 2001 Featured Publication The lack of standardized terminology in pelvic floor disorders (pelvic organ prolapse, urinary incontinence, and fecal incontinence) is a major obstacle to performing and interpreting research. The National Institutes of Health convened the Terminology Wor ... Full text Link to item Cite

Which women with stress incontinence require urodynamic evaluation?

Journal Article Am J Obstet Gynecol · January 2001 OBJECTIVE: This study was undertaken to determine the predictive value of the symptom of stress urinary incontinence and to evaluate the ability of other factors suggested by a published Agency for Health Care Policy and Research guideline for the discrimi ... Full text Link to item Cite

Pelvic muscle electromyography of levator ani and external anal sphincter in nulliparous women and women with pelvic floor dysfunction.

Journal Article Am J Obstet Gynecol · December 2000 OBJECTIVE: The purpose of this study was to compare results of electromyographic assessment of muscular recruitment between nulliparous control subjects without pelvic floor dysfunction and parous subjects with genuine stress urinary incontinence and with ... Full text Link to item Cite

Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse.

Journal Article Am J Obstet Gynecol · December 2000 OBJECTIVE: The anatomic and functional success of suspension of the vaginal cuff to the proximal uterosacral ligaments is described. STUDY DESIGN: Forty-six women underwent vaginal site-specific repair of endopelvic fascia defects with suspension of the va ... Full text Link to item Cite

Quantitative electromyographic analysis of levator ani and external anal sphincter muscles of nulliparous women.

Journal Article Am J Obstet Gynecol · November 2000 Featured Publication OBJECTIVES: Our aims were to introduce a method of digital quantitative electromyography of the levator ani and external anal sphincter muscles and to establish reference values. STUDY DESIGN: Fifteen nulliparous, symptom-free women underwent concentric ne ... Full text Link to item Cite

A survey of pessary use by members of the American urogynecologic society.

Journal Article Obstet Gynecol · June 2000 OBJECTIVE: To describe trends in pessary use for pelvic organ prolapse. METHODS: An anonymous survey administered to the membership of the American Urogynecologic Society covered indications, management, and choice of pessary for specific support defects. ... Full text Link to item Cite

A survey of pessary use by members of the american urogynecologic society

Journal Article Obstetrics and Gynecology · January 1, 2000 To describe trends in pessary use for pelvic organ prolapse. © 2000 Lippincott Williams & Wilkins, Inc. ... Full text Cite

An anatomic and functional assessment of the discrete defect rectocele repair

Journal Article International Urogynecology Journal · January 1, 2000 Cite

Observed patient compliance with a structured outpatient bladder retraining program.

Journal Article Am J Obstet Gynecol · December 1999 Featured Publication OBJECTIVE: Our purpose was to determine patient compliance with a telephone-based retraining program. STUDY DESIGN: This was a retrospective study of 123 women with urinary urgency or urge incontinence who were offered bladder retraining with facsimile mac ... Full text Link to item Cite

Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse.

Journal Article Am J Obstet Gynecol · July 1999 Featured Publication OBJECTIVE: The objective of this study was to determine the accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse. STUDY DESIGN: A retrospective chart review of all women undergoing surgery for anterior vaginal ... Full text Link to item Cite

Imaging studies of the pelvic floor.

Journal Article Obstet Gynecol Clin North Am · December 1998 Featured Publication A variety of imaging modalities complement the history and physical examination in the investigation of pelvic floor dysfunction in women. Current fluoroscopic techniques, including defocography, can reveal underlying pelvic floor defects by reproducing no ... Full text Link to item Cite

An anatomic and functional assessment of the discrete defect rectocele repair.

Journal Article Am J Obstet Gynecol · December 1998 Featured Publication OBJECTIVE: The aim of this study was to describe the anatomic and functional results of the discrete fascial defect rectocele repair. STUDY DESIGN: Sixty-nine women underwent rectocele repair at Duke University Medical Center during a 3-year period beginni ... Full text Link to item Cite

A comprehensive resident training program in operative endoscopy.

Journal Article Obstet Gynecol · November 1998 Featured Publication Full text Link to item Cite

Sacral osteomyelitis: an unusual complication of abdominal sacral colpopexy.

Journal Article Obstet Gynecol · October 1997 Featured Publication BACKGROUND: Abdominal sacral colpopexy using permanent mesh is an established technique for repair of vaginal vault prolapse. Infection is not a frequent complication. We report two cases of lumbosacral osteomyelitis treated with intravenous antibiotics wi ... Full text Link to item Cite

Terminology of pelvic organ prolapse.

Journal Article Curr Opin Obstet Gynecol · October 1997 Featured Publication Pelvic organ prolapse is a common gynecologic condition, yet until recently no standard classification system to describe prolapse existed. A validated and standardized terminology system is now in use that allows accurate description of physical findings ... Link to item Cite

Diagnosing intrinsic sphincteric deficiency: comparing urethral closure pressure, urethral axis, and Valsalva leak point pressures.

Journal Article Am J Obstet Gynecol · August 1997 Featured Publication OBJECTIVES: Our purpose was to compare three measures proposed to diagnose intrinsic sphincteric deficiency: maximum urethral closure pressure, Valsalva leak point pressure, and straining urethral axis. STUDY DESIGN: A total of 159 women with pure genuine ... Full text Link to item Cite

Abnormalities of circulating T-cell subpopulations in patients with cutaneous T-cell lymphoma: cutaneous lymphocyte-associated antigen expression on T cells correlates with extent of disease.

Journal Article Leukemia · June 1993 The recent characterization of the cutaneous lymphocyte-associated antigen (CLA) as a skin-selective homing receptor for skin-associated memory T cells has suggested a possible mechanism for the tropism demonstrated by the neoplastic T cells in cutaneous T ... Link to item Cite