Transcultural translation and validation of the FIGO Assessment Scoring System (FASS) to Portuguese language.

INTRODUCTION AND HYPOTHESIS: Our aim was to validate the Brazilian Portuguese version of the International Federation of Gynecology and Obstetrics (FIGO) Assessment Scoring System (FASS) to identify and quantify signs and symptoms related to pelvic floor dysfunction. METHODS: One hundred and seventy-nine women aged 18-82 (47.68 ± 14.42) years participated in this validation study. Collected data included a sociodemographic and clinical questionnaire, application of the FASS, and physical examination using the Pelvic Prgan Prolapse Quantification (POP-Q) system. The translation and cross-cultural adaptation were performed following the international methodology. The psychometric properties tested were criterion validity, construct validity, stability, and reliability. For this purpose, the comparison with POP-Q findings and between symptomatic and asymptomatic patients, test-retest and internal consistency (Cronbach's alpha) were used, respectively. The intraclass correlation coefficient (ICC) was calculated to assess the level of agreement between evaluations (inter- and intraobservers). P < 0.05 was considered statistically significant. RESULTS: The calculated Cronbach's alpha coefficient was 0.76, indicating strong reliability for the validation sample. Symptomatic women had different scores on all FASS items as well as total score when compared with asymptomatic women (p < 0.001). Intraobserver coefficient ranged from 0.91 (urinary symptoms) to 0.98 (FASS total score), indicating excellent concordance level in all items. Interobserver coefficient ranged from 0.47 (intestinal symptoms) to 0.90 (FASS total score), indicating moderate to excellent correlation. CONCLUSIONS: The psychometric properties tested in the FASS Portuguese version proved to be a valid and reliable for evaluating signs and symptoms related to pelvic floor function in Brazilian women.

Native vaginal tissue repair for genital prolapse surgical treatment: a minimum of 30 months of results.

OBJECTIVE: The aim of this study was to assess the impact of using native vaginal tissue repair as a surgical treatment for pelvic organ prolapse (POP) on quality of life using validated questionnaires. STUDY DESIGN: Fifty-one women underwent surgical POP repair. All of the women were evaluated by physical examination using the POP-Q, ICIQ-VS and P-QoL questionnaires prior to surgery as well as six and at least 30 months after surgery. RESULTS: Fifty-one patients returned for assessment at least 30 months after surgery (median 36 months, range 30-50 months). There was significant improvement in most points - Aa, Ba, C, Bp, Ap, and hg - and at the stage of prolapse. There were statistically significant improvements in bulge symptoms after surgery (p<0.001), and significant differences were also seen regarding questions related to urinary and bowel symptoms. Indeed, most quality of life questionnaire domains showed significant differences before and after surgery. CONCLUSION: Native vaginal tissue repair improved POP-related symptoms and quality of life after 30-50 months of assessment.

Fascial surgical repair for vaginal prolapse: effect on quality of life and related symptoms.

OBJECTIVE: The aim of this study was to evaluate the impact of surgical treatment for pelvic organ prolapse (POP) on quality of life and on bladder, vaginal and bowel symptoms using validated questionnaires such as the prolapse quality of life questionnaire (P-QoL). STUDY DESIGN: Sixty-five women underwent surgical POP repair. All were evaluated by physical examination and by the use of ICIQ-VS and P-QoL questionnaires before surgery as well as three and six months after surgery. RESULTS: The preoperative scores of all domains on the ICIQ-VS and P-QoL questionnaires and the scores obtained from quantification of the urinary, sexual and bowel symptoms were higher than those at three and six months after surgery (p<0.0001). There was no significant difference in the domain scores for the ICIQ-VS and P-QoL questionnaires at three and at six months after surgery (p>0.05). The preoperative staging was higher than that at three and six months after surgery (p<0.001), and there was no difference in staging between the two postoperative time points (p>0.05). CONCLUSIONS: Surgery with fascial repair for the treatment of pelvic organ prolapse improved health-related quality of life, as assessed by the P-QoL and ICIQ-VS, as well as urinary, vaginal and intestinal symptoms.

Texture analysis of magnetic resonance images of patients with juvenile myoclonic epilepsy.

BACKGROUND/PURPOSE: Juvenile myoclonic epilepsy (JME) is the most frequent subsyndrome of the idiopathic generalized epilepsies, and experimental investigations support that the thalamus is a key structure in the mechanisms of JME. Texture analysis (TA) is an image processing technique which can be used to characterize images such as MRI. OBJECTIVE: The goal of this work was to investigate the thalamus of patients with JME using TA, a quantitative neuroimaging technique. METHODS: Patients and controls were submitted to MRI investigation. Images were acquired in a 2-Tesla scanner. The T1 volumetric sequence was used for thalamic segmentation and extraction of texture parameters. Twenty-four patients with a diagnosis of JME and 20 healthy volunteers were investigated. RESULTS: Texture analysis revealed differences between the right thalamus of patients and controls. CONCLUSIONS: The present investigation supports the participation of the thalamus in the disease mechanisms of JME. Texture analysis may be a useful tool in the quantitative neuroimaging investigation of the epilepsies and can be important to understand JME.

Validation of the Prolapse Quality-of-Life Questionnaire (P-QoL) in Portuguese version in Brazilian women.

INTRODUCTION AND HYPOTHESIS: The aim of this study is to validate the Portuguese translated version of the Prolapse Quality-of-Life Questionnaire (P-QoL). METHODS: Ninety-eight women completed the P-QoL questionnaire translated into Portuguese at baseline and on the second visit, 2 weeks later. Clinical data and Pelvic Organ Prolapse Quantification Index (POP-Q) according to the International Continence Society were obtained. Psychometric properties of the questionnaire were assessed. RESULTS: Sixty-eight symptomatic and 30 asymptomatic women for POP symptoms were studied. Most patients presented POP-Q > 2. The P-QoL demonstrated good psychometric properties. The test-retest reliability confirmed a highly significant stability between the total scores for each domain (P < 0.0001). The construct validation distinguished differences in P-QoL questionnaire scores between symptomatic and asymptomatic women. CONCLUSION: The Portuguese version of the P-QoL questionnaire is a valid and reliable instrument to assess quality of life in Brazilian women with pelvic organ prolapse.