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Fotocópia
[PMID]:29376591
[Au] Autor:Kasyan GR; Vishnevskii DA; Akulenko LV; Kozlova YO; Sharova EI; Tupikina NV; Pushkar' DY
[Ad] Endereço:Department of Urology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.
[Ti] Título:[Association of polymorphism of 1800255 COL3A1 gene with pelvic organ prolapse and urinary incontinence in women: preliminary data].
[So] Source:Urologiia;(6):30-33, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:RELEVANCE: Collagen type I and III have a significant role in the development of pelvic organ prolapse (POP) and urinary incontinence in women. The role of the COL3A1 gene polymorphism remains debatable. Some studies and meta-analyzes have found a direct correlation between genetic defects and POP, while other researchers have not confirmed this association. This study aimed to investigate the association of the 1800255 COL3A1 gene polymorphism with the development of POP and urinary incontinence in women. MATERIALS AND METHODS: The study group comprised 52 patients (mean age 64.4 years) with verified POP and stress urinary incontinence. The control group included 21 patients without pelvic floor dysfunction. Patients were comparable in age and had at least one or more risk factors for developing pelvic floor dysfunction. Exclusion criteria for both groups were Marfan and Ehlers-Danlos syndromes and a history of surgery for POP or incontinence (for the control group). In all women, saliva samples were collected to detect polymorphism at the rs1800255 locus of the COL3A1 gene. Genotyping was conducted by Sanger sequencing. RESULTS: In patients with isolated genital prolapse, homozygous polymorphism (AA) had a low sensitivity (0.06) but an extremely high specificity (0.95). Heterozygote (GA) had the sensitivity of 0.35, the specificity of 0.53, and the AUC of 0.44. For urinary incontinence by homozygote (AA), sensitivity was 0.08, specificity 0.96, and by heterozygote (GA) 0.45 and 0.63, respectively. For the combination of pelvic prolapse and urinary incontinence by homozygote (AA), sensitivity was 0.07, specificity 1.0, and heterozygote (GA) 0.41 and 0.62, respectively. CONCLUSION: Given the high specificity of the polymorphism at the rs1800255 locus of the COL3A1 gene, determined by the Sanger sequencing, it can be concluded that there is an association between this polymorphism and urinary incontinence and POP in women.
[Mh] Termos MeSH primário: Colágeno Tipo III/genética
Prolapso de Órgão Pélvico/genética
Polimorfismo Genético
Incontinência Urinária/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Meia-Idade
Prolapso de Órgão Pélvico/patologia
Prolapso de Órgão Pélvico/fisiopatologia
Incontinência Urinária/patologia
Incontinência Urinária/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (COL3A1 protein, human); 0 (Collagen Type III)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


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[PMID]:29424981
[Au] Autor:Arango-Buitrago V; Restrepo-Moreno M; Echavarría-Restrepo LG; Gómez-Londoño M
[Ti] Título:[Pelvic organ prolapse during pregnancy: treatment with vaginal pessary. A report of two cases].
[Ti] Título:Prolapso de órganos pélvicos durante el embarazo tratado con pesario. Reporte de dos casos..
[So] Source:Ginecol Obstet Mex;84(9):601-6, 2016 Sep.
[Is] ISSN:0300-9041
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Background: Pelvic organ prolapse during pregnancy is a rare condition that may be associated with maternal and fetal complications. Objetive: To describe the experience of two cases of pelvic organ prolapse during pregnancy managed with vaginal pessary. Case report: The cases of two patients with grade 4 vaginal prolapse during pregnancy managed with vaginal pessary until the time of delivery are presented. The patients had improvement of their symptoms without complications related to prolapse or pessary use. Conclusion: Early recognition, monitoring and management of this condition are essential. The vaginal pessary is a good option for transient treatment and is associated with few complications.
[Mh] Termos MeSH primário: Prolapso de Órgão Pélvico/terapia
Pessários
Complicações na Gravidez/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
Resultado da Gravidez
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:29424509
[Au] Autor:Calderón-Lara SA; Morgan-Ortíz F; Trapero-Morales M; Trapero-Corona IM; Peraza-Garay FJ
[Ti] Título:[Operative morbidity of the hidrodisección with epinefrina during the surgery for prolapse of pelvic organs].
[Ti] Título:Morbilidad operatoria de la hidrodisección con epinefrina en la cirugía del prolapso de órganos pélvicos..
[So] Source:Ginecol Obstet Mex;84(8):484-90, 2016 08.
[Is] ISSN:0300-9041
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Objetive: To assess the effect of the hydrodissection on operative morbidity and operative time in patients undergoing vaginal surgery for pelvic organ prolapse. Material and methods: Experimental, prospective, longitudinal, comparative, randomized study: randomized controlled clinical. Randomly, 44 patients were assigned to receive management hydrodissection with epinephrine (Group 1= 22) or not hydrodissection (Group 2= 22) prior to the start of the surgical procedure. The variables analyzed were operative morbidity (defined as infection, hematoma and surgical postoperative bleeding requiring transfusion) and surgical time required to complete the procedure. Results: The average age was 58.1 years (± 9.3) in the group of hydrodissection and 63.0 years (± 10.6) in the group without hydrodissection (p = .111). The frequency of postoperative complications was similar enters both groups (p> .05) presenting only one case of postoperative hematoma in Group 1 and none in Group 2. The operative bleeding was significantly lower in the hydrodissection group (240.9 ± 111.9 mL) compared with the group of non hydrodissection (324.1 ± 104.9 mL). No significant difference in operative time was found (p = 0.67) compared with 135.5 (± 22.6) minutes in Group 1 and 139.3 (± 32.5) minutes. Conclusion: Hydrodissection with epinephrine compared with non Hydrodissection significantly reduces operative bleeding but no differences in operative morbidity and operative time in patients undergoing vaginal surgery in the management of pelvic organ prolapse.
[Mh] Termos MeSH primário: Dissecação/métodos
Epinefrina/administração & dosagem
Prolapso de Órgão Pélvico/cirurgia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Estudos Longitudinais
Meia-Idade
Duração da Cirurgia
Hemorragia Pós-Operatória/epidemiologia
Estudos Prospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
YKH834O4BH (Epinephrine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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Texto completo
[PMID]:29217786
[Au] Autor:Heneghan C; Aronson JK; Goldacre B; Mahtani KR; Plüddemann A; Onakpoya I
[Ad] Endereço:Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK carl.heneghan@phc.ox.ac.uk.
[Ti] Título:Transvaginal mesh failure: lessons for regulation of implantable devices.
[So] Source:BMJ;359:j5515, 2017 12 07.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Aprovação de Equipamentos/normas
Prolapso de Órgão Pélvico/cirurgia
Telas Cirúrgicas/normas
Incontinência Urinária/cirurgia
[Mh] Termos MeSH secundário: Feminino
Procedimentos Cirúrgicos em Ginecologia/instrumentação
Procedimentos Cirúrgicos em Ginecologia/legislação & jurisprudência
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5515


  5 / 2363 MEDLINE  
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Registro de Ensaios Clínicos
Texto completo
[PMID]:29215511
[Au] Autor:Yeung J; Crisp CC; Mazloomdoost D; Kleeman SD; Pauls RN
[Ad] Endereço:Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, TriHealth Good Samaritan Hospital, Cincinnati, Ohio.
[Ti] Título:Liposomal Bupivacaine During Robotic Colpopexy and Posterior Repair: A Randomized Controlled Trial.
[So] Source:Obstet Gynecol;131(1):39-46, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effect of liposomal bupivacaine on postoperative pain among patients undergoing robotic sacrocolpopexy with posterior repair. METHODS: This was a randomized, patient-blinded, placebo-controlled trial of women undergoing robotic sacrocolpopexy with posterior repair. Liposomal bupivacaine or normal saline placebo was injected into laparoscopic and vaginal incisions at completion of surgery. Perioperative care was standardized. Visual analog scales were collected at 4, 18, and 24 hours postoperatively in hospital. Starting on postoperative day 1, participants completed twice-daily pain scales and a pain medication diary up until the evening of postoperative day 3. The primary outcome was a 20-mm change in the visual analog scale 18 hours postoperatively. Secondary measures included additional pain scores, satisfaction, and narcotic use. Sample size calculation revealed that 32 patients per arm were required to detect the 20-mm difference with 90% power and an α of 0.05. To allocate for dropout, a goal of 70 was set. RESULTS: Between March 2015 and April 2016, 100 women were screened and 70 women were enrolled: 35 women were randomized to liposomal bupivacaine and 35 to placebo, of whom 64 (91%) were included in the final analysis: 33 liposomal bupivacaine and 31 placebo. No difference in demographics, surgical data, or satisfaction between groups was noted. Median VAS at 18 hours after surgery was not statistically different in those who received liposomal bupivacaine compared with normal saline (15 mm compared with 20 mm; P=.52). Other pain scales and total morphine equivalents were also similar (P=.90). CONCLUSION: In this study of robotic sacrocolpopexy with posterior repair, there were no differences in pain scores or narcotic use between liposomal bupivacaine and placebo injected into laparoscopic and vaginal incisions. Given its lack of clinical benefit, routine use of liposomal bupivacaine is not supported for this surgical intervention. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02449915.
[Mh] Termos MeSH primário: Bupivacaína/administração & dosagem
Colposcopia/métodos
Dor Pós-Operatória/tratamento farmacológico
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestésicos Locais
Colposcopia/efeitos adversos
Feminino
Seguimentos
Seres Humanos
Lipossomos/administração & dosagem
Meia-Idade
Medição da Dor
Dor Pós-Operatória/fisiopatologia
Prolapso de Órgão Pélvico/cirurgia
Medição de Risco
Procedimentos Cirúrgicos Robóticos/efeitos adversos
Método Simples-Cego
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Liposomes); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002375


  6 / 2363 MEDLINE  
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[PMID]:29240331
[Au] Autor:Bretschneider CE; Nieto ML; Geller EJ; Palmer MH; Wu JM
[Ti] Título:The Association of the Braden Scale Score and Postoperative Morbidity Following Urogynecologic Surgery.
[So] Source:Urol Nurs;36(4):191-7, 2016 Jul-Aug.
[Is] ISSN:1053-816X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Braden scale is a widely used tool to assess pressure ulcer risk. Preoperative Braden scores were significantly associated with postoperative morbidity among women undergoing urogynecologic surgery for stress incontinence and pelvic organ prolapse.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos em Ginecologia
Prolapso de Órgão Pélvico/cirurgia
Complicações Pós-Operatórias/epidemiologia
Incontinência Urinária por Estresse/cirurgia
Procedimentos Cirúrgicos Urológicos
[Mh] Termos MeSH secundário: Fatores Etários
Índice de Massa Corporal
Comorbidade
Feminino
Fragilidade/epidemiologia
Seres Humanos
Modelos Logísticos
Duração da Cirurgia
Lesão por Pressão/epidemiologia
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Fumar/epidemiologia
Fumar Tabaco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  7 / 2363 MEDLINE  
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[PMID]:28747206
[Au] Autor:Coolen AWM; van IJsselmuiden MN; van Oudheusden AMJ; Veen J; van Eijndhoven HWF; Mol BWJ; Roovers JP; Bongers MY
[Ad] Endereço:Department of Obstetrics and Gynaecology, Máxima Medical Centre Veldhoven, De Run, 4600 5500, MB, Veldhoven, The Netherlands. anne_lotte_coolen@hotmail.com.
[Ti] Título:Laparoscopic sacrocolpopexy versus vaginal sacrospinous fixation for vaginal vault prolapse, a randomized controlled trial: SALTO-2 trial, study protocol.
[So] Source:BMC Womens Health;17(1):52, 2017 07 26.
[Is] ISSN:1472-6874
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hysterectomy is one of the most performed surgical procedures during lifetime. Almost 10 % of women who have had a hysterectomy because of prolapse symptoms, will visit a gynaecologist for a surgical correction of a vaginal vault prolapse thereafter. Vaginal vault prolapse can be corrected by many different surgical procedures. A Cochrane review comparing abdominal sacrocolpopexy to vaginal sacrospinous fixation considered the open abdominal procedure as the treatment of first choice for prolapse of the vaginal vault, although operation time and hospital stay is longer. Literature also shows that hospital stay and blood loss are less after a laparoscopic sacrocolpopexy compared to the abdominal technique. To date, it is unclear which of these techniques leads to the best operative result and the highest patient satisfaction. Prospective trials comparing vaginal sacrospinous fixation and laparoscopic sacrocolpopexy are lacking. The aim of this randomized trial is to compare the disease specific quality of life of the vaginal sacrospinous fixation and laparoscopic sacrocolpopexy as the treatment of vaginal vault prolapse. METHODS: We will perform a multicentre prospective randomized controlled trial. Women with a post-hysterectomy symptomatic, POP-Q stage ≥2, vaginal vault prolapse will be included. Participants will be randomized to the vaginal sacrospinous fixation group or the laparoscopic sacrocolpopexy group. Primary outcome is disease specific quality of life at 12 months follow-up. Secondary outcome will be the effect of the surgical treatment on prolapse related symptoms, sexual functioning, procedure related morbidity, hospital stay, post-operative recovery, anatomical results using the POP-Q classification after one and 5 years follow-up, type and number of re-interventions, costs and cost-effectiveness. Analysis will be performed according to the intention to treat principle and not as a per protocol analysis. With a power of 90% and a level of 0.05, the calculated sample size necessary is 96 patients. Taking into account 10% attrition, a number of 106 patients (53 in each arm) will be included. DISCUSSION: The SALTO-2 trial is a randomized controlled multicentre trial to evaluate whether the laparoscopic sacrocolpopexy or vaginal sacrospinous fixation is the first-choice surgical treatment in patients with a stage ≥2 vault prolapse. TRIAL REGISTRATION: Netherlands Trial Register (NTR): NTR3977 ; Registered 28 April 2013.
[Mh] Termos MeSH primário: Colposcopia/métodos
Procedimentos Cirúrgicos em Ginecologia/métodos
Histerectomia/efeitos adversos
Laparoscopia/métodos
Prolapso de Órgão Pélvico/cirurgia
Complicações Pós-Operatórias/cirurgia
[Mh] Termos MeSH secundário: Adulto
Protocolos Clínicos
Feminino
Seres Humanos
Tempo de Internação
Meia-Idade
Países Baixos
Músculos Paraespinais/cirurgia
Prolapso de Órgão Pélvico/etiologia
Complicações Pós-Operatórias/etiologia
Estudos Prospectivos
Região Sacrococcígea/cirurgia
Resultado do Tratamento
Vagina/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1186/s12905-017-0402-2


  8 / 2363 MEDLINE  
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[PMID]:28748254
[Au] Autor:Hanis SM; Khazaei S; Ayubi E; Mansori K
[Ad] Endereço:Dezful University of Medical Sciences, Dezful, Iran.
[Ti] Título:Comment on: Predictors of unsuccessful pessary fitting in women with prolapse: a cross-sectional study in general practice.
[So] Source:Int Urogynecol J;28(9):1439, 2017 09.
[Is] ISSN:1433-3023
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Prolapso de Órgão Pélvico
Pessários
[Mh] Termos MeSH secundário: Estudos Transversais
Feminino
Medicina Geral
Seres Humanos
Prolapso Uterino
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171205
[Lr] Data última revisão:
171205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1007/s00192-017-3359-7


  9 / 2363 MEDLINE  
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[PMID]:28748253
[Au] Autor:Dekker JH; Burger H
[Ad] Endereço:Department of General Practice, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands. j.h.dekker@umcg.nl.
[Ti] Título:Authors' reply to the comment by Hanis et al. on "Predictors of unsuccessful pessary fitting in women with prolapse: a cross-sectional study in general practice," by Panman et al.
[So] Source:Int Urogynecol J;28(9):1441, 2017 09.
[Is] ISSN:1433-3023
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Prolapso de Órgão Pélvico
Pessários
[Mh] Termos MeSH secundário: Estudos Transversais
Feminino
Medicina Geral
Seres Humanos
Prolapso Uterino
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171205
[Lr] Data última revisão:
171205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1007/s00192-017-3421-5


  10 / 2363 MEDLINE  
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[PMID]:29077924
[Au] Autor:Weidner AC; Barber MD; Markland A; Rahn DD; Hsu Y; Mueller ER; Jakus-Waldman S; Dyer KY; Warren LK; Gantz MG; Meikle S
[Ad] Endereço:Department of Obstetrics and Gynecology, Duke University Medical Center, 5324 McFarland Dr, Suite 310, Durham, NC 27707 (USA).
[Ti] Título:Perioperative Behavioral Therapy and Pelvic Muscle Strengthening Do Not Enhance Quality of Life After Pelvic Surgery: Secondary Report of a Randomized Controlled Trial.
[So] Source:Phys Ther;97(11):1075-1083, 2017 Nov 01.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective: The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Design: This study is a secondary report of a 2 × 2 factorial randomized controlled trial. Setting: This study was a multicenter trial. Participants: Participants were adult women with stage 2-4 POP and SUI. Intervention: Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided. Measurements: Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse-Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores. Results: The 374 participants were randomized to BPMT (n = 186) and usual care (n = 188). Outcomes were available for 137 (74%) of BPMT participants and 146 (78%) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures. Limitations: The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures. Conclusions: Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.
[Mh] Termos MeSH primário: Terapia Comportamental
Prolapso de Órgão Pélvico/reabilitação
Prolapso de Órgão Pélvico/cirurgia
Assistência Perioperatória
Qualidade de Vida
Treinamento de Resistência
[Mh] Termos MeSH secundário: Imagem Corporal
Feminino
Seres Humanos
Meia-Idade
Prolapso de Órgão Pélvico/psicologia
Comportamento Sexual
Slings Suburetrais
Inquéritos e Questionários
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171028
[St] Status:MEDLINE
[do] DOI:10.1093/ptj/pzx077



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