The International Female Coital Incontinence Questionnaire: Translation, Validation, and Reliability Study of the Persian Version.

INTRODUCTION AND HYPOTHESIS: This study was aimed at validating the Persian version of the International Female Coital Incontinence Questionnaire (IFCI-Q). METHODS: In the current study, 150 sexually active women with complaints of any kind of sexual dysfunction from January 2022 to July 2023, who were referred to urogynecology outpatient clinics, completed the IFCI-Q. Age ≥ 18 years and sexually active women were the inclusion criteria for the study. Quantitative calculations were made to determine the content validity ratio and content validity index. A test-retest procedure was utilized to determine the scale reliability. RESULTS: The mean (SD) age of participants was 35.66 (7.03) years. Among a total of 150 women, 21 (14.0%) had coital incontinence (CI), and this disorder happened during penetration in 11 cases (7.3%), orgasm in 9 (6.1%), or both conditions in one woman (0.7%). The intraclass correlation coefficient (95% confidence interval) was 0.79 (0.74, 0.84), and the Cronbach's α coefficient was 0.89. A positive association between the Female Sexual Function Index and the IFCI-Q was also demonstrated by the criteria validity (r = 0. 87 and p = 0.001). CONCLUSION: Regarding validity and reliability, the Persian version of the IFCI-Q can properly evaluate CI in women with sexual dysfunction or complaining of CI.

Efficacy and safety of desmopressin in nocturia and nocturnal polyuria control of neurological patients: A systematic review and meta-analysis.

PURPOSE: Evidence on the efficacy of desmopressin in nocturia in patients with neurological diseases is still very limited except for multiple sclerosis (MS). Our aim was to evaluate the efficacy and safety of desmopressin treatment on nocturia in patients with underlying neurological diseases. METHODS: Studies were identified by electronic search of PubMed, Embase, Cochrane, CINAHL, and Google Scholar databases. Studies were considered if they provided information on the effectiveness and safety of desmopressin (1-desamino-8-d-arginine vasopressin, or DDAVP) in the treatment of nocturia and their participants had acquired neurological pathology. Two researchers independently extracted the articles using specified datasets, such as quality-of-study indicators. Statistical meta-analysis was carried out using Review Manager (RevMan) 5.4 statistical software (Cochrane Collaboration). RESULTS: Of a total of 1042 articles in the initial search, 14 studies were included. Most of the published papers were related to MS (n = 7), two were on spinal cord injury, and other conditions were neural tube defect, myelodysplasia, Parkinson's disease, stroke, and multiple system atrophy. Overall, a total of 200 patients (mostly females) were enrolled. Thirteen studies evaluated the intranasal formulation of desmopressin and one study evaluated oral desmopressin. A significant decrease in nocturia episodes was reported in seven studies evaluating this topic. An increase in the maximum hours of uninterrupted sleep was reported in the three studies in which this outcome was assessed. A significant reduction in the volume of nocturnal incontinence was found in one study. Three studies were eligible to include in the meta-analysis. The results showed that desmopressin compared to placebo, significantly reduced nighttime urination (mean difference: -0.75, 95% CI: -1.10 to -0.41; p < 0.00001). The rate of adverse events ranged from 0% to 68.42%. The critical appraisal results for all trials showed that most of the studies had low or moderate quality. CONCLUSIONS: Our results emphasized desmopressin's safety and efficacy in reducing nocturia episodes, with transient adverse effects on neurological patients. However, the data were achieved from low or medium-quality trials, and further well-designed randomized controlled trials are needed.

Management of urolithiasis in pregnancy: A systematic review and meta-analysis.

PURPOSE: Management of nephrolithiasis is unique in pregnancy and requires multidisciplinary care. To identify the effectiveness or safety of temporary drainage or definitive treatment methods to manage urolithiasis in pregnancy. METHODS: The search strategy aimed to find both published and unpublished studies was conducted in August 2021. Studies published in any language on any date were considered for inclusion. RESULTS: Of a total of 3349 publications, 36 studies were included in our qualitative evaluation and 32 studies in the quantitative synthesis. The commonly reported method was stent insertion (n = 29 studies), pneumatic (n = 12), laser (n = 9) lithotripsy, and stone removal using any devices (basket, grasper, or forceps) (n = 11). In seven studies, the authors reported the outcomes of conservative management, and the results showed that the stone-free rate is 54%, and symptom relief occurred in 62% of women. Seven eligible studies reported that 79.9% of urolithiasis were expulsed through stent insertion, while this rate was 94.6% among percutaneous nephrostomy use in two included studies, 88.5% for pneumatic lithotripsy (n = 7 studies), and 76.4% for laser lithotripsy (n = 4 studies), or 95.4% for stone removal method. In addition, adverse events were reported in less than 10% of pregnant women. CONCLUSIONS: The results showed that stent, pneumatic or laser lithotripsy, and ureteroscopic stone removal were the commonest used methods in the included studies. They can be effective and safe treatment approaches without major maternal or neonatal complications, and could be introduced as an effective and safe therapeutic method for urolithiasis during pregnancy. However, most of the included studies had moderate quality according to critical appraisal checklists. Further prospective studies are needed to reach a conclusion.

Acellular dermal matrix in reconstructive surgery: Applications, benefits, and cost.

Modern tissue engineering has made substantial advancements that have revolutionized plastic surgery. Acellular dermal matrix (ADM) is an example that has gained considerable attention recently. ADM can be made from humans, bovines, or porcine tissues. ADM acts as a scaffold that incorporates into the recipient tissue. It is gradually infiltrated by fibroblasts and vascularized. Fortunately, many techniques have been used to remove cellular and antigenic components from ADM to minimize immune system rejection. ADM is made of collagen, fibronectin, elastin, laminin, glycosaminoglycans, and hyaluronic acid. It is used in critical wounds (e.g., diabetic wounds) to protect soft tissue and accelerate wound healing. It is also used in implant-based breast reconstruction surgery to improve aesthetic outcomes and reduce capsule contracture risk. ADM has also gained attention in abdominal and chest wall defects. Some studies have shown that ADM is associated with less erosion and infection in abdominal hernias than synthetic meshes. However, its higher cost prevents it from being commonly used in hernia repair. Also, using ADM in tendon repair (e.g., Achilles tendon) has been associated with increased stability and reduced rejection rate. Despite its advantages, ADM might result in complications such as hematoma, seroma, necrosis, and infection. Moreover, ADM is expensive, making it an unsuitable option for many patients. Finally, the literature on ADM is insufficient, and more research on the results of ADM usage in surgeries is needed. This article aims to review the literature regarding the application, Benefits, and costs of ADM in reconstructive surgery.

Quality of the Systematic Reviews in Cochrane Gynecological Cancer Group and Their Understudied RCTs.

Purpose: Gynecological cancers are common neoplasms in clinical settings with a high impact on the economy of communities. The medical literature is an essential resource to guide clinical decision-making, and misconduct in researches undermines the credibility and integrity of research in general. We aimed to evaluate the quality of Cochrane gynecological cancers reviews and their understudies RCTS among the different biases dimensions. Methods: This cross-sectional analytical study was performed on 118 systematic reviews published by the Cochrane gynecological cancers Group up to June 2021. The risk of bias was assessed in each Cochrane survey using the Joanna Bridges Institute (JBI) critical assessment tool consisting of 11 questions. The JBI checklist for systematic reviews and research syntheses is available at https://jbi.global/critical-appraisal-tools. After a systematic critical evaluation of the reviews and meta-analysis, we extracted a different bias from all of their understudied RCTs examined in these systematic reviews, which were evaluated by systematic review authors using a standard bias risk tool developed by the Cochrane Group. Results: Cochrane gynecological cancers reviews had high quality based on appraise results using the JBI appraisal checklist. In addition, all of the included studies used PRISMA standards for reporting their results. However, in their understudied RCTs, the most prevalent risk of bias was unclear selection bias (allocation concealment) and performance bias (blinding of participants and personnel). Also, the highest risk of bias was blinding participants and personnel (performance bias) and incomplete outcome data (attrition bias). Our results showed that the lowest risk of bias was incomplete outcome data (attrition bias) and random sequence generation (selection bias). Conclusion: Although most Cochrane gynecological cancers reviews had high quality, unclear performance bias was the highest in their understudied RCTs, indicating structural deficiencies. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-022-01655-6.