For mixed urinary incontinence, concomitant midurethral sling (MUS) and onabotulinumtoxinA (Botox® (BTX-A)) can be considered, but data regarding safety are sparse. Adverse event rates following combined MUS + BTX-A are hypothesized to be similar to those following MUS alone. This was a retrospective matched cohort study comparing adverse events in patients with mixed incontinence undergoing MUS (n = 200) versus combined MUS + BTX-A (n = 100) between January 1, 2011, and March 31, 2024. The primary outcome was culture proven urinary tract infection (UTI) at 3 and 6 months. Secondary outcomes included any UTI (culture proven or empirically treated), urinary retention, and postoperative overactive bladder (OAB) treatment. Logistic regression was used to assess the impact of baseline variables on outcomes. Patients undergoing concurrent MUS + BTX-A were more likely to have prior stress incontinence surgery, OAB treatment, and postoperative prophylactic antibiotic use. Culture-proven UTI occurred more frequently in the MUS + BTX-A group at 3 months (23.0
The choice between obliterative and reconstructive surgery for older women with advanced pelvic organ prolapse is preference sensitive. This review synthesized comparative evidence across perioperative safety, durability, urinary, bowel/anorectal, and patient-reported outcomes. PubMed, Web of Science, and the Cochrane Library were searched through 1 May 2026. English-language comparative studies in older advanced-prolapse populations were included. Two reviewers independently screened records, extracted data, assessed risk of bias using Risk Of Bias In Nonrandomized Studies of Interventions, and rated certainty using Grading of Recommendations Assessment, Development and Evaluation. Findings were narratively synthesized because of heterogeneity. Of 664 records, 29 reports representing 27 study families were included. Safety outcomes were reported in 23 reports, durability/recurrence in 16, urinary outcomes in 12, bowel/anorectal outcomes in 9, and broad patient-reported outcomes/quality of life in 10. Twelve of the 14 non-overlapping comparisons reported shorter operative time after obliterative surgery; blood loss favored obliteration in 8 of the 12 comparisons and hospital stay in 5 out of 11. Overall complications were not consistently lower. Anatomical/composite durability numerically favored obliteration in 7 out of 10 comparisons, and recurrence-related reoperation was lower in 7 out of 8. Urinary, bowel, and patient-reported outcomes were inconsistent or similar. Certainty was low for operative time and very low for other key outcomes. Current evidence supports a more definitive conclusion about lower procedural burden, particularly shorter operative time, than about global complications, anatomical superiority, or functional outcomes. Findings should inform counseling that integrates frailty, comorbidity, sexual goals, functional symptoms, durability expectations, treatment burden, and patient preference.
Urinary incontinence (UI) often changes over time. Although UI has been associated with falls, disability, and psychological outcomes, it remains unclear whether newly developed, remitting, or persistent UI is associated with different subsequent risks across aging populations. We conducted a harmonized longitudinal analysis of 85,788 cohort-specific analytical records from five international aging cohorts. Both men and women were included. UI status between baseline and follow-up was classified as persistent non-UI (no UI at either assessment), incident UI (no UI at baseline and UI at follow-up), remitting UI (UI at baseline and no UI at follow-up), or persistent UI (UI at both assessments). The three prespecified primary outcomes, assessed subsequently, were incident falls, worsening of basic activities of daily living (ADLs), and incident depressive symptoms. Cohort-specific logistic regression estimates were pooled using random-effects meta-analysis, and absolute risk differences were summarized for clinical interpretation. Baseline UI prevalence ranged from 5.7
Antenatal perineal massage (APM) is recommended by international organizations as a strategy to reduce the risk of perineal trauma during childbirth. The increasing prevalence of misinformation on digital platforms highlights the need to assess content quality, including those related to APM. This cross-sectional study evaluated the quality and reliability of educational content about APM on TikTok videos in Spanish, Portuguese, and English. A purposive sampling strategy was applied using a newly created TikTok account and relevant hashtags. Two researchers independently selected eligible videos and assessed content quality using the DISCERN scale, with near-perfect inter-rater agreement (κ > 0.90). Data extracted from the videos included interaction metrics, characteristics of the content creators, and specific instructions related to APM. Of the 1306 videos identified, 250 were included in the final analysis and 214 (85.6
Pelvic girdle pain (PGP) is a common musculoskeletal disorder that can substantially affect quality of life during pregnancy and the postpartum period. We aimed to estimate the pooled prevalence of PGP, identify associated factors and summarise commonly used clinical assessment methods. We searched MEDLINE/PubMed, Embase, CINAHL, Emcare, Scopus, and PEDro from inception to 24 July 2026. Methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Random-effects meta-analysis with subgroup and sensitivity analyses were conducted. Heterogeneity was assessed using the I2 statistic. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Thirty-two studies (N = 145,091) were included. The pooled prevalence of PGP was 59
