Short and long-term urodynamic and quality of life assessment after nerve sparing radical hysterectomy: a prospective pilot study.

OBJECTIVE: The aim of this study was to compare pre- and postoperative bladder function and quality of life (QoL) in women diagnosed with gynecologic malignancy and treated with nerve sparing radical hysterectomy (NSRH). STUDY DESIGN: Before and after NSRH for uterine malignancy, bladder function was prospectively assessed in a small cohort of 12 women (39-72 years) suffering from uterine malignancy using urodynamic studies and a validated self-administered condition specific QoL questionnaire. Urodynamic studies were performed one day before (U0) as well as one week (U1) and 22 months (U2) after surgery. The questionnaire was applied at U0 and U2. RESULTS: Cystometry showed detrusor contractions leading to overactive bladder incontinence in six out of nine women at short-term, which persisted in three women at long-term follow-up leading to a significant impaired QoL. Voiding function and bladder sensation remained uncompromised after surgery. CONCLUSIONS: NSRH preserves voiding function and bladder sensation. However, short and long-term urodynamic detrusor overactivity and urge incontinence was observed in a significant number of women although symptoms improved over time. These data are important for counselling women and for the design of larger studies to assess the benefits of NSRH versus conventional radical hysterectomy (RH).

[Evaluation of the theatre play Have Courage! A powerful play about feelings, boundaries and trust in the frame of the national campaign for the prevention of child sexual abuse]. / Evaluation des Theaterstücks "Trau dich! Ein starkes Stück über Gefühle, Grenzen und Vertrauen" im Rahmen der bundesweiten Initiative zur Prävention des sexuellen Kindesmissbrauchs.

This article reports on the evaluation of the effectiveness of a school-based preventive theatre play. The play is part of a national campaign for the prevention of child sexual abuse called Trau dich! (Have courage!). A total of 639 students in third to sixth grade from Schleswig-Holstein and Saxony participated in the study. Scenarios in the play imparted prevention messages and self-protective skills regarding situations of sexual assault or abuse, targeting children aged 8 to 12. Acquisition of knowledge about access to help systems and children's rights were measured pre- and post viewing as well as at a follow-up point two to six months later. Children estimated their competences regarding sensibility, sensing/setting boundaries, social support/to entrust oneself to somebody and knowledge. Based on cognitive empathy, children suggested self-protective skills for situations of conflict. The theatre play contributed to the acquisition of knowledge and an increase of children's self-assessed knowledge and competences. They estimated their competences of distinguishing between good and bad secrets, safe and unsafe touching, and disclosing oneself to somebody; their suggestions for self-protective skills improved compared to baseline data. The effects were still present at follow-up. Girls estimated their competences and self-protective skills to have improved more than boys. Measured negative effects were only temporary. The results indicate that the interactive educative theatre play contributed effectively to the prevention of child sexual abuse through imparting knowledge, self-protective skills, and sensitization.