Does pelvic floor muscle training abolish symptoms of urinary incontinence? A randomized controlled trial.

OBJECTIVE: To determine whether symptoms of urinary incontinence is reduced by pelvic floor muscle training, to determine whether urinary incontinence can be totally eliminated by strengthening the pelvic floor muscle to grade 5 on the Oxford scale. DESIGN: Prospective randomized controlled clinical trial. SETTING: Outpatient urogynecology department. SUBJECTS: One hundred thirty cases with stress and mixed urinary incontinence. INTERVENTION: All participants were randomly allocated to the pelvic floor muscle training group or control group. A 12-week home based exercise program, prescribed individually, was performed by the pelvic floor muscle training group. MAIN MEASURES: Urinary incontinence symptoms (Incontinence Impact Questionnaire-7, Urogenital Distress Inventory-6, bladder diary, stop test and pad test) were assessed, and the pelvic floor muscle strength was measured for (PERFECT testing, perineometric and ultrasound) all participants before and after 12 weeks of treatment. RESULTS: The pelvic floor muscle training group had significant improvement in their symptoms of urinary incontinence (P=0.001) and an increase in pelvic floor muscle strength (P=0.001, by the dependent t test) compared with the control group. All the symptoms of urinary incontinence were significantly decreased in the patients that had reached pelvic floor muscle strength of grade 5 and continued the pelvic floor muscle training (P<0.05). CONCLUSION: The study demonstrated that pelvic floor muscle training is effective in reducing the symptoms of stress and mixed urinary incontinence and in increasing pelvic floor muscle strength.

Comparison of the success of histopathological diagnosis with dilatation-curettage and Pipelle endometrial sampling.

The aim of this study is to compare collection of sufficient material and diagnostic accuracy of Pipelle biopsy with curettage and hysterectomy. A total of 82 cases with indications for endometrial biopsy for any reason and in which endometrial biopsy was performed with dilatation and curettage (D&C) and Pipelle aspiration biopsy, and 66 cases in which an indication for hysterectomy was established for any reason were included in the study. Histopathological findings were examined in the following six groups: normal; endometrial polyps; hyperplasia without atypia; hyperplasia with atypia; atrophy; and insufficient material. Descriptive statistical methods and McNemar's test were used. When the histopathological compatibility between Pipelle and D&C was considered (n=82), a diagnosis that was different from that obtained by D&C was obtained in 22 of the 63 cases (34%), in whom normal endometrial histology was found with a Pipelle biopsy specimen. It was observed that only 1 of 13 cases of endometrial polyps was diagnosed with Pipelle biopsy. Insufficient material was obtained in six cases (7%) with Pipelle biopsies and three cases (4%) with D&C. While Pipelle biopsies and D&C have a nearly equal level of success in widespread endometrial lesions, Pipelle biopsies provide limited diagnostic accuracy in cases with focal pathologies.

Does high maternal first trimester iron status have an effect on the 50 g oral glucose test?

We aimed to test the hypothesis that 1st trimester high body iron status is associated with a high positive 50 g oral glucose tolerance test. In this study, 29 pregnant women with positive 50 g oral glucose tolerance test were compared with 94 negative 50 g OGTT patients as the control group in terms of 1st trimester iron status. Both groups had similar age, weight, height, body mass index and also median gravidity and parity values. Our results showed that there were no differences between groups in mean haemoglobin, haematocrit, serum iron, serum ferritin, total iron binding capacity and transferrin. Since it seems that free radicals have much influence on oxidative stress and glucose metabolism, prospective, randomised clinical trials should be designed to demonstrate the possible relation between maternal iron status and glucose intolerance.