ABSTRACT
OBJECTIVE: To produce a Czech version of a validated tool for sexual quality of life assessment among women with pelvic floor disorders; PISQ-IR (Pelvic organ prolapse/Incontinence Sexual Questionnaire - Internationally Revised). DESIGN: Original study. SETTING: Department of Obstetrics and Gynecology, University Hospital and Faculty of Medicine, Charles University in Pilsen. METHODS: The whole process of translation and linguistic validation of the questionnaire followed the protocol of the International Urogynecology Association developed for this purpose. The original translation was repeatedly discussed with patients with incontinence or prolapse in order to preserve the meaning and comprehensibility of the items. The resulting questionnaire was reversely translated into English by an independent translator and sent to IUGA translation working group for validation. The translation was finalized based on recommendations from the group. RESULTS: PISQ-IR is a self-administered questionnaire improved from the previous and short versions. It contains 20 questions, the first question determines whether section 1 for sexually inactive or section 2 for sexually active women is to be completed. The first section for sexually inactive women contains five questions with 12 items. The second section comprises of 14 questions with 22 items for sexually active women with a partner or 12 questions with 19 items for those without a partner. The questionnaire is evaluated separately for individual sub-scales. Compared to former PISQ-12, the PISQ-IR was improved to enable separate assessment of individual domains and its subscales, and to be useful also in non-sexually active women and women with anal incontinence. At the same time it can be also utilized in case of incompletely filled-in questionnaire. A certain disadvantage for clinical practice is its more complex evaluation. CONCLUSION: Linguistic validation of a PISQ-IR questionnaire was performed and the questionnaire is presented. We present a Czech translation of a validated tool for assessment of quality of sexual life in women with prolapse or urinary/anal incontinence. Psychometric evaluation remains yet to be performed.
Subject(s)
Language , Pelvic Organ Prolapse/complications , Sexual Behavior/psychology , Sexual Dysfunction, Physiological/psychology , Sexuality/physiology , Surveys and Questionnaires/standards , Urinary Incontinence/complications , Adult , Aged , Aged, 80 and over , Czech Republic , Female , Humans , Linguistics , Pelvic Organ Prolapse/psychology , Psychometrics , Quality of Life , Sexual Dysfunction, Physiological/diagnosis , Sexual Dysfunctions, Psychological/etiology , Translating , Translations , Urinary Incontinence/psychologyABSTRACT
OBJECTIVE: The aim of this study is to compare quality of life in 3-month follow-up after the use of transobturator tape TVT-O and single incision tape AJUST in the treatment of urodynamic stress urinary incontinence (USI). DESIGN: Randomized trial. SETTING: Gynekologicko-porodnická klinika LF UK a FN Plzen, Gynekologicko-porodnická klinika 1. LF UK a VFN Praha. MATERIALS AND METHODS: Between May 2010 and May 2012 100 women with proven urodynamic stress urinary incontinence were included in this randomized trial. These patients were randomly chosen and devided into two group: 50 patients for TVT-O procedure and 50 patients for AJUST procedure. All of the patients underwent a complete urogynecological examination prior to the actual procedure (clinical examination, urodynamic examination, ultrasound examination) and filled in ICIQ-SF and iQol questionnaires. After the surgery, the patients satisfaction was evaluated by visual analoque scale (VAS) and Likert scale and by ICIQ-SF and iQol questionnaires. The intensity and length of postoperative pain was monitored using the visual analogue scale. The patients underwent an examination after 3 months. RESULTS: In both groups of participants no significant differences regarding age, BMI, parity, history of surgery for gynecological disorders, were found. Preoperative urodynamic, ICIQ-SF and iQol parameters were also not significantly different. In the 3-month follow-up 48 participants from TVT-O group and 50 participants from the AJUST group were monitored. No statistically significant differences in subjective and objective parameters were found. Subjectively stress incontinence was not present in 97.9% in the TVT-O and 96.0% in the group AJUST. Objectively stress test was negative in 93.8% in the TVT-O and 94% in group AJUST. By evaluating the ICIQ and iQol were found no statistical differences in the quality of life in both operating groups. CONCLUSION: At 3-months follow up we did not find any statistical difference between subjective and objective outcome for single incision tape AJUST and TVT-O. In the AJUST group lower intensity and shorter duration of postoperative pain were observed.
Subject(s)
Patient Satisfaction , Quality of Life , Urinary Incontinence, Stress/surgery , Adult , Aged , Female , Humans , Middle Aged , Suburethral Slings/adverse effects , Surveys and Questionnaires , Treatment Outcome , Urinary Incontinence, Stress/psychology , UrodynamicsABSTRACT
OBJECTIVE: To describe a case of a severe postoperative bleeding after Total Prolift procedure for vaginal vault prolapse. DESIGN: Case study. SETTINGS: Department of Obstetrics and Gynecology, Medical Faculty in Pilsen, Charles University in Prague. CASE: A 55-year-old woman underwent a surgery with a Prolift procedure for vaginal prolapse after hysterectomy. The surgery was carried out without any complications. In the first 24 hours after Prolift surgery we diagnosed massive bleeding and hypovolemic shock. The condition required repeated re-exploration and ligation of hypogastric artery and pelvic packing to stop the bleeding. CONCLUSION: Bleeding is a major complication in gynecological surgery. Severe hemorrhage is a rare condition after surgical treatment of vaginal prolapse after hysterectomy using a Prolift procedure.
Subject(s)
Gynecologic Surgical Procedures/adverse effects , Pelvic Organ Prolapse/surgery , Postoperative Hemorrhage/etiology , Female , Hemostasis, Surgical/methods , Humans , Middle Aged , Postoperative Hemorrhage/diagnosis , Postoperative Hemorrhage/surgeryABSTRACT
OBJECTIVE: To develop guidelines for the ultrasound examination of cervical cancer, including a unified ultrasound terminology. SUBJECT: Original paper. SETTING: Gynecological Oncology Center, Department of Obstetrics and Gynecology, Masaryk University and General Faculty Hospital Brno, and Gynecological Oncology Center, Department of Obstetrics and Gynecology, Charles University in Prague - First Faculty of Medicine and General Faculty Hospital Prague. SUBJECT AND METHOD: The standard diagnostic algo-rithm for examination of cervical cancer in oncogynecology centers in the Czech Republic is based on published studies, own experience (Oncogynecological Center, Department of Gynecology and Obstetrics,1st Medical Faculty, Charles University) and the experiences of a group of ultrasonographers involved in the grant project IGA MZ CR NT13070 focused on the implementation of an oncogynecological ultrasound into clinical practice. Standard ultrasound examination includes two-dimensional real-time ultrasound examination (sagittal and transverse views). Transrectal or transvaginal ultrasound examination is combined with transabdominal ultrasound. Prerequisites are quality ultrasound equipment, a high frequency microconvex linear probe and abdominal convex and linear probe. The examination is performed by an experienced sonographer (level 2 or 3 according to the recommendations of the Ultrasound division of the Czech Society of Obstetrics and Gynecology and the Czech Society of Ultrasound in Obstetrics and Gynecology). Intravenous administration of contrast material or three-dimensional ultrasound examination do not influence accuracy of the examination and is not a prerequisite. CONCLUSION: Based on the consensus of experienced sonographers and a review of the literature, guidelines were created for ultrasound staging of cervical cancer.
Subject(s)
Uterine Cervical Neoplasms/diagnostic imaging , Algorithms , Female , Humans , Neoplasm Staging , Practice Guidelines as Topic , Ultrasonography/standards , Uterine Cervical Neoplasms/pathologyABSTRACT
The extent of the staging surgery in cases of histologically proven endometrial cancer depends on whether the tumor is of high risk or low risk for extrauterine spread and recurrence. There are several significant prognostic factors - histological subtype and grade of dediferentiation from preoperative biopsy and local stage of uterine involvement based on imaging methods. The depth of myometrial invasion and presence of cervical stromal infiltration (local staging) can be assessed by ultrasound with the overall accuracy comparable to that of magnetic resonance. Transvaginal ultrasound enables to vizualize detailed pelvic anatomy and that is why it is considered to be a suitable tool for assessment of local stage of endometrial cancer. It is advisable to use the standardized terminology defined by International Endometrial Tumor Analysis group (IETA) to describe ultrasound findings. The standardized methodology of ultrasound preoperative staging examination based on prearranged protocols is recommended.
