Urinary incontinence associates with poor work ability in middle-aged women: A Northern Finland Birth cohort 1966 study.

INTRODUCTION: Urinary incontinence is a common ailment in women and is likely to affect their work ability. We investigated the associations between the different subtypes of urinary incontinence and several dimensions of perceived work ability in middle-aged general population. MATERIAL AND METHODS: Cross-sectional survey at age 46 among participants of the Northern Finland Birth Cohort 1966 study (n = 3706, response rate 72%). Urinary incontinence symptoms and several items of Work Ability Index were collected by postal questionnaire. Work ability was dichotomized as good or poor work ability in general, in relation to physical job demands, to diseases and own 2-year prospect of work ability. The associations between urinary incontinence and work ability measures were assessed using logistic regression models, with further adjustments for biological, behavioral and work-related factors as well as general health. RESULTS: The odds ratio (OR), from lowest to highest, for poor work ability were 1.4-fold among women with stress urinary incontinence (OR 1.37, 95% confidence interval [CI] 1.09-1.72), 2.5-fold with mixed urinary incontinence (OR 2.51, 95% CI 1.68-3.74) and 3.3-fold with urgency urinary incontinence (OR 3.34, 95% CI 1.95-5.70). We note that our results reflect work ability in a Nordic society. CONCLUSIONS: Especially urgency and mixed types of urinary incontinence are associated with poor work ability among middle-aged women.

Long-term results of a prospective randomized trial comparing tension-free vaginal tape versus transobturator tape in stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: This study was aimed at investigating the long-term effectiveness of minimally invasive mid-urethral sling (MUS) surgery and at comparing the outcomes between retropubic (tension-free vaginal tape, TVT) and transobturator tape (TOT) methods in the treatment of stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) with a predominant stress component in a long-term follow-up of a randomized controlled trial. METHODS: This work is a long-term follow-up study of a previous prospective randomized trial conducted in the Department of Obstetrics and Gynecology at Oulu University Hospital between January 2004 and November 2006. The original 100 patients were randomized into the TVT (n=50) or TOT (n=50) group. The median follow-up time was 16 years, and the subjective outcomes were evaluated using internationally standardized and validated questionnaires. RESULTS: Long-term follow-up data were obtained from 34 TVT patients and 38 TOT patients. At 16 years after MUS surgery, the UISS significantly decreased from a preoperative score in the TVT (11.88 vs 5.00, p<0.001) and TOT (11.05 vs 4.95, p<0.001) groups, showing a good long-term success of the MUS surgery in both groups. In comparing the TVT and TOT procedures, the subjective cure rates did not differ significantly between the study groups in long-term follow-up according to validated questionnaires. CONCLUSION: Midurethral sling surgery had good long-term outcomes in the treatment of SUI and MUI with a predominant stress component. The subjective outcomes of the TVT and TOT procedures were similar after a 16-year follow-up.

Hormone profiling, including anti-Müllerian hormone (AMH), for the diagnosis of polycystic ovary syndrome (PCOS) and characterization of PCOS phenotypes.

Objective was to evaluate serum anti-Müllerian hormone (AMH) levels in polycystic ovary syndrome (PCOS) and in its different phenotypes in relation to clinical, endocrine and metabolic parameters using a new automated VIDAS® method and to compare it with the Gen II method. Study design was multi-center study including 319 PCOS women and 109 healthy controls. Serum AMH levels measured using VIDAS® were significantly higher in PCOS women than controls (p < .001), and they correlated with those measured using the AMH Gen II method. An AMH cutoff value of 42.1 pmol/L distinguished PCOS women from controls with 67% sensitivity and 83% specificity. The PCOS women with three Rotterdam criteria or hyperandrogenism displayed significantly higher AMH levels compared with those with two Rotterdam criteria or normoandrogenism. In PCOS, AMH levels correlated positively with luteinizing hormone (LH), androgen and sex hormone-binding globulin (SHBG) levels and negatively with BMI, abdominal obesity, follicle-stimulating hormone (FSH), fasting glucose and insulin, and insulin resistance. In conclusion, AMH evaluated using the VIDAS® method distinguished PCOS patients from healthy controls relatively well, especially in those with more severe phenotypes. Further studies are needed to establish whether AMH measurements can distinguish PCOS patients with different metabolic risk factors.

Metformin decreases serum 8-hydroxy-2'-deoxyguanosine levels in polycystic ovary syndrome.

OBJECTIVE: To learn whether metformin treatment affects oxidative stress as measured by serum concentrations of 8-hydroxy-2'-deoxyguanosine (8-OHdG). DESIGN: Double-blind, randomized, placebo-controlled trial. SETTING: University outpatient clinic. PATIENT(S): The study cohort consisted of 50 obese women (body mass index [BMI] ≥ 27 kg/m(2)) and 60 nonobese patients (BMI <27 kg/m(2)), mean age was 27.7 ± 4.0 SD years. INTERVENTION(S): Randomization to receive metformin or placebo for 3 months. MAIN OUTCOME MEASURE(S): Serum levels of 8-OHdG before and after medical treatment. RESULT(S): The levels of 8-OHdG were equal at baseline in the placebo and metformin groups. Obese women had higher baseline serum concentrations of 8-OHdG. Levels of 8-OHdG were statistically significantly reduced with metformin treatment, especially in obese patients with polycystic ovary syndrome. This study was a secondary subanalysis of a previously conducted prospective multicenter, randomized, placebo-controlled study on the effects of metformin on miscarriage, pregnancy, and miscarriage rates. CONCLUSION(S): Metformin treatment, compared with placebo, statistically significantly decreased 8-OHdG levels in women with polycystic ovary syndrome. CLINICAL TRIAL REGISTRATION NUMBER: NCT00994812.

Down-regulation of 8-hydroxydeoxyguanosine and peroxiredoxin II in the pathogenesis of endometriosis-associated ovarian cancer.

AIM: To evaluate the roles of oxidative stress marker 8-hydroxydeoxyguanosine (8-OHdG) and peroxiredoxin (PRX) antioxidants in the development of endometriosis and endometriosis-associated ovarian cancer (EAC). MATERIALS AND METHODS: Tissue expressions of 8-OHdG, PRX II and PRX IV were determined immunohistochemically in tissue from 22 women with benign endometriosis (BE) and 33 women with EAC, among whom endometriosis and cancer tissues were analyzed separately. RESULTS: When all three groups were compared simultaneously, EAC tumor cells had significantly weaker nuclear 8-OHdG and PRX II expression (p<0.05 and p<0.01, respectively) and significantly weaker cytoplasmic 8-OHdG expression (p<0.01) than EAC endometriosis and BE epithelial cells. This same trend was also observed when groups were compared pair-wise. CONCLUSION: Nuclear PRX II and 8-OHdG were down-regulated in EAC tumorous tissue compared with BE and EAC endometriotic tissue, suggesting a role of oxidative stress in the pathogenesis of EAC.

Distinctively low levels of serum 8-hydroxydeoxyguanosine in women with polycystic ovary syndrome.

OBJECTIVE: To investigate oxidative stress and angiogenetic factors in polycystic ovary syndrome (PCOS). DESIGN: Prospective cohort study. SETTING: University outpatient clinic. SUBJECTS: Fifty women with PCOS were divided into two groups: body mass index (BMI) >27 kg/m(2) (n = 25) and BMI <27 kg/m(2) (n = 25). The control group consisted of 20 age- and BMI-matched healthy women. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Enzyme-linked immunosorbent assays were used to measure serum levels of 8-hydroxydeoxyguanosine (8-OHdG), angiopoietin-2, and vascular endothelial growth factor (VEGF). RESULT(S): Women with PCOS had significantly lower serum 8-OHdG levels (mean 137.8 pg/mL, range 53.4-282.9 pg/mL) compared with the control subjects (mean 219.78 pg/mL, 124.6-372.4 pg/mL). This difference was obvious in both lean (BMI <27 kg/m(2)) and obese (BMI >27 kg/m(2)) subjects. Concentrations of VEGF were higher among obese subjects with PCOS. CONCLUSION(S): Serum 8-OHdG levels are significantly lower in women with PCOS than in healthy controls. The clinical significance of this finding is discussed.