Long-term compliance of vaginal pessaries: Does stress urinary incontinence matter?

Vaginal pessary treatment for pelvic organ prolapse (POP) is relatively safe and cost-effective. Since long-term use is an important key to keep the benefit of pessary treatment, we would like to investigate the factors which might affect the compliance of vaginal pessaries. In this retrospective study, 65 women were included, and we found poor compliance in women with severe stress urinary incontinence (SUI) after reduction (1-hour pad test >10 gm vs ≦10 gm, 57.1% vs. 84.3%, P = .027). Besides, women younger than 60 years-old also had poor compliance (age ≦60-year-old vs >60-year-old, 58.3% vs 83.0%, P = .04). Other factors such as POP stage, history of hysterectomy, and types of pessaries, did not show significant influence on the long-term compliance in this study. Therefore, to evaluate the severity of SUI after reduction before providing pessary treatment is important to predict long-term compliance. Meanwhile, long-term pessary treatment seems to be more acceptable to elderly patients.

The short-term outcome of laser in the management of female pelvic floor disorders: Focus on stress urine incontinence and sexual dysfunction.

OBJECTIVE: Female pelvic floor disorders, including female stress urinary incontinence (SUI) or sexual dysfunction are notorious for affecting the quality of women's life. It is reported that laser therapy might result in collagen remodeling and improvement in tissue firmness. The study was conducted to evaluate the short-term outcome of female pelvic floor disorders treated by laser therapy. MATERIALS AND METHODS: Women with self-reported symptoms of female pelvic floor disorders (limited to SUI and sexual dysfunction) were included in the study. The participants were treated with the Er:YAG laser or the fractional microablative carbon dioxide (CO2) laser system. The therapeutic effect was focused on SUI symptoms and sexual dysfunction. RESULTS: There were 31 women underwent laser treatment, including 21 patients treated with Erbium:YAG laser and 10 treated with CO2 laser. In the Erbium:YAG laser group, International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ- SF) scores were dropped from 8.25 ± 5.66 to 5.00 ± 3.99 (P = 0.007); and in the CO2 laser group, scores were dropped from 11.11 ± 6.85 to 6.44 ± 4.25 (P = 0.035), contributing to the drop of ICI-Q-SF scores from 9.14 ± 6.08 to 5.45 ± 4.05 for all enrolled patients (P = 0.001). However, objective measure using pad test did not show a statistically significant difference between before and after treatment (from 3.20 ± 5.84 g to 1.54 ± 3.18 g, P = 0.224). Sexual dysfunction was improved in 13 patients (44.83%), but Female Sexual Function Index (FSFI) scores were not different before and after laser treatment (44.22 ± 23.36 vs. 44.09 ± 24.51, P = 0.389). CONCLUSION: Laser therapy either by Erbium:YAG laser or CO2 laser seemed to be useful for female pelvic floor disorders, especially on improvement of SUI symptoms; however, the effectiveness needs further confirmation.

Single-step protein purification by back flush in ion exchange chromatography.

Ion exchange chromatography, one of the major procedures for protein purification, seldom provides single-step purification due to a lack of specific affinity. In this work, a novel and simple method called "back flush" (i.e., reversing the flow direction of elution relative to that of sample loading) was developed to achieve single-step purification on an ion exchanger. Tips for the conditions and operation by back flush are presented. Our study demonstrates, for the first time, the feasibility and dramatic improvement for protein purification by the back-flush method.