Database : MEDLINE
Search on : pelvic and floor and disorders [Words]
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[PMID]: 29306355
[Au] Autor:Bianchi F; Squintani GM; Osio M; Morini A; Bana C; Ardolino G; Barbieri S; Bertolasi L; Caramelli R; Cogiamanian F; Currà A; de Scisciolo G; Foresti C; Frasca V; Frasson E; Inghilleri M; Maderna L; Motti L; Onesti E; Romano MC; Del Carro U
[Ti] Title:Neurophysiology of the pelvic floor in clinical practice: a systematic literature review.
[So] Source:Funct Neurol;22(4):173-193, 2017 Oct/Dec.
[Is] ISSN:1971-3274
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:Neurophysiological testing of the pelvic floor is recognized as an essential tool to identify pathophysiological mechanisms of pelvic floor disorders, support clinical diagnosis, and aid in therapeutic decisions. Nevertheless, the diagnostic value of these tests in specific neurological diseases of the pelvic floor is not completely clarified. Seeking to fill this gap, the members of the Neurophysiology of the Pelvic Floor Study Group of the Italian Clinical Neurophysiology Society performed a systematic review of the literature to gather available evidence for and against the utility of neurophysiological tests. Our findings confirm the utility of some tests in specific clinical conditions [e.g. concentric needle electromyography, evaluation of sacral reflexes and of pudendal somatosensory evoked potentials (pSEPs) in cauda equina and conus medullaris lesions, and evaluation of pSEPs and perineal sympathetic skin response in spinal cord lesions], and support their use in clinical practice. Other tests, particularly those not currently supported by high-level evidence, when employed in individual patients, should be evaluated in the overall clinical context, or otherwise used for research purposes.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process

  2 / 2527 MEDLINE  
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[PMID]: 29513796
[Au] Autor:Vesentini G; Marini G; Piculo F; Damasceno DC; Matheus SMM; Felisbino SL; Calderon IMP; Hijaz A; Barbosa AMP; Rudge MVC
[Ad] Address:Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, SP, Brasil.
[Ti] Title:Morphological changes in rat rectus abdominis muscle induced by diabetes and pregnancy.
[So] Source:Braz J Med Biol Res;51(4):e7035, 2018 Mar 01.
[Is] ISSN:1414-431X
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:The urethral muscle of diabetic pregnant rats is affected by long-term mild diabetes and short-term severe diabetes, which plays a crucial role in the pathogenesis of pelvic floor disorders. We hypothesized that muscles outside the pelvis are subject to similar changes. The current study aimed at analyzing the effects of long-term mild and short-term severe diabetes on the structure and ultrastructure of fiber muscles and collagen in rats' rectus abdominis (RA) muscle. Therefore, the RA muscle of virgin, pregnant, long-term mild diabetic, short-term severe diabetic, long-term mild diabetic pregnant and short-term severe diabetic pregnant 3-month-old Wistar rats were collected. The structure was analyzed by picrosirius red staining, immunohistochemistry for fast and slow muscle fibers and transmission electron microscopy. We investigated two levels of STZ- induced diabetes: long-term mild diabetes (blood glucose level: 120-200 mg/dL) and short-term severe diabetes (blood glucose level >300 mg/dL). Long-term mild diabetic pregnant and short-term severe diabetic pregnant rats had decreased fast fibers and increased slow fibers, disrupted areas of sarcomere, intermyofibrillar mitochondria and myelin figures in the RA muscle. Both groups enabled us to analyze the specific influence of pregnancy, separately from diabetes. The current study demonstrated that diabetes and pregnancy induced intramuscular transformation and reorganization of RA muscle with a switch of fiber type adjusting their architecture according to intensity and duration of hyperglycemic insult within pregnancy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process

  3 / 2527 MEDLINE  
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[PMID]: 29229409
[Au] Autor:Swenson CW; DePorre JA; Haefner JK; Berger MB; Fenner DE
[Ad] Address:Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI. Electronic address: scarolyn@med.umich.edu.
[Ti] Title:Postpartum depression screening and pelvic floor symptoms among women referred to a specialty postpartum perineal clinic.
[So] Source:Am J Obstet Gynecol;218(3):335.e1-335.e6, 2018 Mar.
[Is] ISSN:1097-6868
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Postpartum depression and pelvic floor disorders are both common conditions that affect women; however, the association between the 2 has yet to be determined. OBJECTIVE: The aims of our study are to: (1) determine the prevalence of a positive postpartum depression screen in a specialty postpartum perineal clinic, and (2) identify risk factors for postpartum depression in this population. STUDY DESIGN: A retrospective chart review was performed of 294 women referred to a specialty postpartum perineal clinic at the University of Michigan from March 30, 2012, through May 3, 2016. Women who completed a new patient intake form, including the Edinburgh Postnatal Depression Scale, were included. The prevalence of a positive Edinburgh Postnatal Depression Scale screen (≥10) was determined. Bivariate analyses were used to compare demographics, delivery characteristics, referral indications, and postpartum pelvic floor symptoms between women with and without a positive Edinburgh Postnatal Depression Scale screen. Significant variables identified in the analyses were then used to perform logistic regression to identify factors independently associated with a positive Edinburgh Postnatal Depression Scale screen. RESULTS: In all, 15.6% (46/294) of women had a positive postpartum depression screen. Average age was 30.6 ± 4.8 years, average body mass index was 28.9 ± 5.06 kg/m , 68.0% (200/294) were Caucasian, 79.6% (234/294) were primiparous, and 86.0% (245/285) were breast-feeding. Using multivariable logistic regression, women with a positive postpartum depression screen had higher odds of being non-Caucasian (adjusted odds ratio, 2.72; 95% confidence interval, 1.27-5.832; P = .01), having a history of depression and/or anxiety (adjusted odds ratio, 2.77; 95% confidence interval, 1.23-6.24; P = .01), having been referred for pain (adjusted odds ratio, 2.61; 95% confidence interval, 1.24-5.49; P = .01), and reporting urinary incontinence during and after pregnancy (adjusted odds ratio, 3.81; 95% confidence interval, 1.57-9.25; P = .003). CONCLUSION: Urinary incontinence during and after pregnancy and referral for pain were pelvic floor symptoms independently associated with a positive postpartum depression screen in women referred to a specialty perineal clinic. Therefore, consideration should be given to depression screening in women presenting with perinatal urinary incontinence and persistent postpartum pain, as these women may be at increased risk of developing postpartum depression.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review

  4 / 2527 MEDLINE  
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[PMID]: 29508047
[Au] Autor:Araujo CC; Coelho SSA; Martinho N; Tanaka M; Jales RM; Juliato CRT
[Ad] Address:School of Medicine, University of Campinas (UNICAMP), R. Tessália Vieira de Camargo, 126, Campinas, São Paulo, 13083-887, Brazil. araujoc.sm@gmail.com.
[Ti] Title:Clinical and ultrasonographic evaluation of the pelvic floor in primiparous women: a cross-sectional study.
[So] Source:Int Urogynecol J;, 2018 Mar 06.
[Is] ISSN:1433-3023
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION AND HYPOTHESIS: We used clinical examination and transperineal 3D/4D ultrasound (US) to evaluate pelvic floor muscles (PFM) after different delivery modes. METHODS: Women were surveyed using validated questionnaires. PFM were evaluated and classified according to the Modified Oxford Scale following 3D/4D transperineal US. For statistical analysis, Kruskal-Wallis, Mann-Whitney, chi-square, and Fisher exact tests were used. RESULTS: Fifty-three women were evaluated: 32 with previous vaginal delivery (VD) and 21 with cesarean section (CS) (8 nonelective and 13 elective). No significant difference among groups was observed regarding urinary incontinence (UI) after delivery (p = 0.39), loss of muscle strength referred by the patient (p = 0.48), or evaluated through digital examination (p = 0.87). No patient with elective CS had avulsion, with difference between VD and elective CS (p = 0.008). US evaluation identified no differences in bladder-neck elevation (p = 0.69) or descent (p = 0.65) , and no difference in genital hiatus size (p = 0.35), levator ani thickness (p = 0.35 -0.44), or presence of major or minor levator ani avulsion (p = 0.10). CONCLUSIONS: We evaluated primiparous women within 12 to 24 months of delivery and found that VD was associated with PFM avulsion. There was no difference among VD and nonelective or elective CS in symptomatology or other anatomic alterations evaluated through 3D/4D transperineal US.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1007/s00192-018-3581-y

  5 / 2527 MEDLINE  
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[PMID]: 29508046
[Au] Autor:Furtado-Albanezi D; Jürgensen SP; Avila MA; Correia GN; Driusso P
[Ad] Address:Physical Therapy Graduate Program, Federal University of São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, 13565-905, Brazil.
[Ti] Title:Effects of two nonpharmacological treatments on the sleep quality of women with nocturia: a randomized controlled clinical trial.
[So] Source:Int Urogynecol J;, 2018 Mar 06.
[Is] ISSN:1433-3023
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION AND HYPOTHESIS: The objective was to check the effects of two nonpharmacological treatments on the sleep quality of women with nocturia. METHODS: A randomized controlled clinical trial in which 40 women with nocturia were randomized into two groups; one was subjected to tibial nerve stimulation (GTNS) and the other received pelvic floor muscle training associated with behavioral therapy (GPFMT). Both groups were followed for 12 weeks, with one session/week; evaluated by the Pittsburgh Sleep Quality Index (PSQI), King's Heath Questionnaire (KHQ), and Epworth Sleepiness Scale (ESS). The Wilcoxon test was used to compare intra-group data and the Mann-Whitney test for intergroup results. Effect size and confidence interval were calculated, and the level of significance was set at 5%. RESULTS: Both groups showed improvements in quality of sleep, observed by the PSQI total score (GTNS from 9 ± 0.88 to 7 ± 0.94, p = 0.002; GPFMT from 8 ± 0.80 to 5 ± 0.94, p < 0.001) and the sleep/energy domain of the KHQ (GTNS from 66.66 ± 9.03 to 16.66 ± 7.20, p = 0.002; GPFMT from 66.66 ± 9.30 to 0.00 ± 7.26, p = 0.001). CONCLUSIONS: Both nonpharmacological treatments proposed (TNS or PFMT) were equally able to improve quality of sleep of women with nocturia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1007/s00192-018-3584-8

  6 / 2527 MEDLINE  
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[PMID]: 29502982
[Au] Autor:Thibault-Gagnon S; Goldfinger C; Pukall C; Chamberlain S; McLean L
[Ad] Address:Queen's University, School of Rehabilitation Therapy, Kingston, ON, Canada.
[Ti] Title:Relationships Between 3-Dimensional Transperineal Ultrasound Imaging and Digital Intravaginal Palpation Assessments of the Pelvic Floor Muscles in Women With and Without Provoked Vestibulodynia.
[So] Source:J Sex Med;15(3):346-360, 2018 Mar.
[Is] ISSN:1743-6109
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Digital intravaginal palpation remains the favored method for clinical assessment of pelvic floor muscle (PFM) function in women; however, there is growing interest in using transperineal ultrasound imaging (TPUSI). TPUSI does not involve vaginal penetration, making it particularly relevant for PFM assessment in women with genito-pelvic pain and penetration disorders. AIMS: To study the relations between measures of PFM morphology and function assessed using 3-dimensional (3D) TPUSI and PFM assessment through intravaginal palpation. METHODS: 77 nulliparous premenopausal women with (n = 38) and without (n = 39) PVD participated. 3D TPUSI was used to measure levator hiatal dimensions at rest, at maximal voluntary contraction (MVC) of the PFMs, and at maximal Valsalva maneuver (MVM). Intravaginal palpation was used to assess PFM strength, PFM tone, PFM relaxation after contraction, and vaginal flexibility; each was scored using an ordinal grading scale. Ultrasound and palpation outcomes were compared using Spearman correlation coefficients and Kruskal-Wallis 1-way analyses of variance by rank. OUTCOMES: Outcomes included ultrasound measures of the levator hiatal area, anteroposterior diameter, and left-right transverse diameter at rest, at MVC, and at MVM; raw and relative changes in hiatal dimensions between rest and MVC and between rest and MVM; and palpation measures of PFM strength, tone, and relaxation after contraction, and vaginal flexibility. RESULTS: Weak to fair correlations were found between ultrasound and palpation measures. A smaller levator hiatus at rest was associated with greater PFM tone, less PFM relaxation, and less vaginal flexibility. Greater levator hiatal constriction and shortening of the hiatal anteroposterior diameter at MVC were associated with greater palpated PFM strength. Greater hiatal distention at MVM was associated with lower PFM tone and greater relaxation. CLINICAL TRANSLATION: 3D TPUSI and intravaginal palpation provide related but distinct information about PFM function in young women with and without PVD with high functioning PFMs. STRENGTHS AND LIMITATIONS: This was the first study to compare PFM assessment using 3D TPUSI and intravaginal palpation in nulliparous premenopausal women. A main strength of the study was the inclusion of women with PVD and asymptomatic controls, which provided a wide range in outcomes because differences in PFM morphology and function exist between women with and without PVD. The lack of inclusion of older women and women with weaker and/or hypotonic PFMs limits the generalizability of the findings. CONCLUSION: Although TPUSI has several advantages, including painless application, it is not recommended as a replacement for digital palpation in the clinical assessment of PFM function. Thibault-Gagnon S, Goldfinger C, Pukall C, et al. Relationships Between 3-Dimensional Transperineal Ultrasound Imaging and Digital Intravaginal Palpation Assessments of the Pelvic Floor Muscles in Women With and Without Provoked Vestibulodynia. J Sex Med 2018;15:346-360.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review

  7 / 2527 MEDLINE  
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[PMID]: 29476354
[Au] Autor:Hartigan SM; Smith AL
[Ad] Address:Division of Urology, Department of Surgery, University of Pennsylvania, Perelman Center for Advanced Medicine, 3rd Floor West Pavilion, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. Siobhan.hartigan@uphs.upenn.edu.
[Ti] Title:Disparities in Female Pelvic Floor Disorders.
[So] Source:Curr Urol Rep;19(2):16, 2018 Feb 23.
[Is] ISSN:1534-6285
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE OF REVIEW: Pelvic floor disorders include urinary incontinence, pelvic organ prolapse, fecal incontinence, and other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts which are widely prevalent among women and largely undertreated. Many disparities exist among women with pelvic floor disorders which may affect prevalence estimates and treatment options offered. RECENT FINDINGS: Findings suggest that there are many disparities among women with pelvic floor disorders including age, race, inadequate knowledge, access to care, and socioeconomic status. Better understanding disparities among women with pelvic floor disorders can help to guide further programs for education, outreach, and treatment of women with pelvic floor disorders.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process
[do] DOI:10.1007/s11934-018-0766-3

  8 / 2527 MEDLINE  
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[PMID]: 29500515
[Au] Autor:Johannessen HH; Stafne SN; Falk RS; Stordahl A; Wibe A; Mørkved S
[Ad] Address:Department of Physical Medicine and Rehabilitation, Department of Research, Østfold Hospital Trust, P.O. Box 300, 1714, Grålum, Norway. hege.holmo.johannessen@so-hf.no.
[Ti] Title:Prevalence and predictors of double incontinence 1 year after first delivery.
[So] Source:Int Urogynecol J;, 2018 Mar 02.
[Is] ISSN:1433-3023
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION AND HYPOTHESIS: Urinary (UI) and anal incontinence (AI) are common pelvic floor disorders (PFD), and postpartum women experiencing double incontinence (DI), the combination of UI and AI, tend to have more severe symptoms and a greater impact on quality of life. Our objective was to investigate the prevalence and predictors of postpartum DI and UI alone 1 year after first delivery. METHODS: In this prospective cohort study, 976 women reported the prevalence of DI and UI alone 1 year after their first delivery in one of two hospitals in Norway using the St Marks score and the ICI-Q UI SF. RESULTS: DI was significantly reduced from 13% in late pregnancy to 8% 1 year later, whereas 30% reported UI at both time points. Incontinence in late pregnancy predicted incontinence 1 year after delivery. Higher age was associated with UI alone. Compared with caesarean delivery, normal vaginal or instrumental delivery increased the risk of UI alone more than three and four times respectively. Obstetric anal sphincter injuries showed a four-fold increase in the risk of DI. CONCLUSIONS: Nearly 50% reported incontinence symptoms 1 year after first delivery. Continence status during pregnancy was one of the main predictors of postpartum continence status. Mode of delivery increased the risk of postpartum UI, whereas obstetric anal sphincter injuries increased the risk of postpartum DI.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher
[do] DOI:10.1007/s00192-018-3577-7

  9 / 2527 MEDLINE  
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[PMID]: 29307482
[Au] Autor:Rejano-Campo M; Desvergée A; Pizzoferrato AC
[Ad] Address:Service de médecine physique et de réadaptation, CHU de Caen, CHU de Caen Normandie, 14000 Caen, France. Electronic address: montserejano@hotmail.com.
[Ti] Title:Caractéristiques et symptômes pelvi-périnéaux dans les douleurs de la ceinture pelvienne : une revue de la littérature. [Relationship between perineal characteristics and symptoms and pelvic girdle pain: A literature review].
[So] Source:Prog Urol;28(4):193-208, 2018 Mar.
[Is] ISSN:1166-7087
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:INTRODUCTION: Pelvic girdle pain (PGP) is characterized by the presence of pain in the posterior pelvic area, distally and laterally to the fifth lumbar vertebra, and/or at the pubic symphysis. PGP is a very common pain condition in women, especially during pregnancy and postpartum. After delivery, pain prevalence decreases to 7 % in the first three months. The current literature describes an association between pelvic girdle pain and different perineal characteristics and symptoms. OBJECTIVES: A better understanding of perineal structures influence on PGP could assist towards the management of this condition. The aim of this review is to describe the peer-reviewed literature about perineal function in patients with PGP. METHODS: A bibliographic search on PubMed was conducted. The key words used were: pelvic girdle pain, pregnacy-related low back pain, lumbopelvic pain, posterior pelvic pain, peripartum pelvic pain, pelvic girdle relaxation, pelvic joint instability, peripartum pelvic pain, sacroiliac joint pain, sacroiliac joint dysfunction, sacroiliac-joint related pelvic pain and pelvic floor. Two hundred and twenty-one (221) articles were identified. Out of them, a total of nine articles were selected. The level of evidence was determined using Oxford's scale. RESULTS: Patients with PGP showed increased activity of the pelvic floor muscles (P=0.05) (LE3), decreased urogenital hiatus area (PGP 12.4 cm ±2.7, control 13.7 cm ±2.8, P=0.015) (LE3), shorter endurance time (PGP 17.8 s; control 54.0 s, P=0.00) (LE3), significantly later onset time during affected side leg elevation (PGP 25ms, control -129ms, P=0.01) (LE3), levator ani and obturator internus tenderness (PGP 25/26; control 5/25, P<0.001) (LE3) and a higher prevalence of vesico-sphincteric disorders compared to asymptomatic subjects (LE3). CONCLUSION: This review confirms that subjects suffering PGP present particular perineal characteristics regarding morphology and biomechanics. It would be interesting to develop clinical research concerning pelvic floor release effect in PGP.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Process

  10 / 2527 MEDLINE  
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[PMID]: 29487993
[Au] Autor:Mothes AR; Runnebaum M; Runnebaum IB
[Ad] Address:Department of Gynaecology and Reproductive Medicine and Center for Gynecologic Oncology, University Women's Hospital Jena, Jena University Hospital, Friedrich-Schiller-University Jena, Am Klinikum 1, 07747, Jena, Germany.
[Ti] Title:Ablative dual-phase Erbium:YAG laser treatment of atrophy-related vaginal symptoms in post-menopausal breast cancer survivors omitting hormonal treatment.
[So] Source:J Cancer Res Clin Oncol;, 2018 Feb 27.
[Is] ISSN:1432-1335
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: First evaluation of dual-phase vaginal Er:YAG laser to omit hormonal treatment for atrophy-related symptoms in post-menopausal breast cancer survivors following prolapse surgery. METHODS: Patients with a history of breast cancer at the time of surgery for pelvic organ prolapse were offered non-hormonal vaginal Er:YAG laser treatment when complaining of atrophy-related genitourinary syndrome of menopause. A single 10-min course of dual-phase protocol of pulsed Er:YAG laser (2940 nm, fractional ablative and thermal mode, fluence according to tissue thickness). Follow-up included subjective satisfaction, vaginal pH, vaginal health index (VHI), and complications after 6 weeks. RESULTS: A total of 16 breast cancer survivors (age 71 years, SD 7) had been seeking treatment for pelvic floor symptoms related to vaginal atrophy at follow-up visits after prolapse surgery. All ablative vaginal Er:YAG laser outpatient procedures were successfully completed, all patients returned to daily activities without a need for analgetic medication. Evaluation was performed after 8.3 (SD 2.5) weeks. Pre-laser VHI scored 16 (SD 4.6) and post-laser VHI 20 (SD 3) with p = 0.01. Patients were satisfied in 94% (n = 15) regarding symptom relief. CONCLUSIONS: Breast cancer survivors with atrophy-related complaints after pelvic floor surgery may benefit from vaginal application of this innovative dual protocol of Er:YAG laser technology as a non-hormonal treatment approach.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:Publisher
[do] DOI:10.1007/s00432-018-2614-8


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