Objective: The purpose of this study was to compare gene expression of skeletal muscle heavy-chain polypeptide 3(MYH3) and myosin binding protein H (MyBP- H) in the pubococcygeus muscle of patients with pelvic organ p...Objective: The purpose of this study was to compare gene expression of skeletal muscle heavy-chain polypeptide 3(MYH3) and myosin binding protein H (MyBP- H) in the pubococcygeus muscle of patients with pelvic organ prolapse and controls. Study design: Genes previously identified by microarray genechip analysis of pubococcygeus muscle biopsies were examined using real-time quantitative reverse transcriptase polymerase chain reaction (RT- PCR) analysis. Specimens were obtained from 17 patients with stage III or IV pelvic organ prolapse and 23 controls with minimal to no prolapse. Glyceraldehyde 3- phosphate dehydrogenase (GAPDH) was used as the housekeeping gene. Samples and controls were run in triplicatein separate wells, and the levels of gene expression were analyzed quantitatively using the comparative critical threshold(Ct) method. Differences in gene expression were analyzed using Wilcoxon rank-sum testing. Results: Significant differences in gene expression were observed between patients with prolapse and controls for both genes. Skeletal muscle myosin heavy-chain polypeptide 3 was 6.5 times underexpressed in patients with pelvic organ prolapse compared to controls (P = .028). Similarly, myosin binding protein H was 3.2 times underexpressed in patients with prolapse (P = .042). Overall,patients had a mean age of 62.4 ± 6.5 years compared with controls with a mean age of 45.3 ± 7.4 years (P < .001),so analysis was also performed on an age-matched subset of 8 patients and controls (mean ages of 58.1 ± 5.4 years and 53.3 ± 5.0 years, respectively, P = .02) with similar results.Prolapse patients in this subset were similar in parity and race to controls but had lower body mass index (23.2 vs 29.9, P = .04). MYH3 was 10.9 times underexpressed in patients with pelvic organ prolapse compared to controls (P = .027). My BPH was 10.4 times underexpressed in patients with prolapse (P = .036). Conclusion: These findings suggest that the differences between patients with advanced pelvic organ prolapse and controls may be related to differential gene expression of structural proteins related to myosin. Specifically, advanced pelvic organ prolapse may be related to down-regulation of skeletal muscle heavy-chain polypeptide 3 and myosin binding protein H.展开更多
Objective: The purpose of this study was to examine risk factors for mesh erosion, including concomitant hysterectomy,in abdominal sacral colpopexies. Study design: Weconducted a retrospective cohort study of 313 wome...Objective: The purpose of this study was to examine risk factors for mesh erosion, including concomitant hysterectomy,in abdominal sacral colpopexies. Study design: Weconducted a retrospective cohort study of 313 women who underwent an abdominal sacral colpopexy. Data regarding patient demographics, operative techniques, length of follow-up,postoperative complications, and mesh erosion were collected.Results: Of 313 subjects, 101 (32.3% ) had concomitant hysterectomies and 212 (67.7% ) had had previous hysterectomies.The overall rate of mesh erosion was 5.4% . In bivariate analysis,concomitant hysterectomy was not associated with erosion(6.9% vs 4.7% previous hysterectomy, P = .42); however, estrogen therapy was an effect modifier. In women on estrogen,hysterectomy (OR 4.9, CI 1.2- 19.7) and anterior imbrication(OR 5.6, CI 1.1- 28.6) were associated with mesh erosion. No risk factors were identified in women not on estrogen. Conclusion:In women on estrogen therapy, hysterectomy was associated with mesh erosion in abdominal sacral colpopexy.展开更多
Objective: The purpose of this study was to assess microscopic hematuria as a predictive factor for detecting bladder cancer at cystoscopy in women with irritative voiding symptoms. Study design: We conducted a retros...Objective: The purpose of this study was to assess microscopic hematuria as a predictive factor for detecting bladder cancer at cystoscopy in women with irritative voiding symptoms. Study design: We conducted a retrospective cohort analysis of women with irritative voiding symptoms who presented for urodynamic testing and cystoscopy. Irritative voiding symptoms were defined as urgency, urge incontinence, frequency, dysuria, and/or nocturia. Patient demographics, risk factors for bladder cancer,presence of microscopic hematuria, urodynamic findings,and cystoscopy and biopsy results were recorded. Results: Of 735 patients with irritative voiding symptoms, 264 (35.9% )- had microscopic hematuria and 471 (64.1% ) had no hematuria.Bladder cancer was detected in 3 women, for an overall detectionrate of 0.4% . Microscopic hematuria, urgency, frequency,dysuria, nocturia, age, and tobacco use were not significantly associated with bladder cancer. Conclusion: In this cohort of women with irritative voiding symptoms, microscopic hematuria was not predictive for bladder cancer.展开更多
文摘Objective: The purpose of this study was to compare gene expression of skeletal muscle heavy-chain polypeptide 3(MYH3) and myosin binding protein H (MyBP- H) in the pubococcygeus muscle of patients with pelvic organ prolapse and controls. Study design: Genes previously identified by microarray genechip analysis of pubococcygeus muscle biopsies were examined using real-time quantitative reverse transcriptase polymerase chain reaction (RT- PCR) analysis. Specimens were obtained from 17 patients with stage III or IV pelvic organ prolapse and 23 controls with minimal to no prolapse. Glyceraldehyde 3- phosphate dehydrogenase (GAPDH) was used as the housekeeping gene. Samples and controls were run in triplicatein separate wells, and the levels of gene expression were analyzed quantitatively using the comparative critical threshold(Ct) method. Differences in gene expression were analyzed using Wilcoxon rank-sum testing. Results: Significant differences in gene expression were observed between patients with prolapse and controls for both genes. Skeletal muscle myosin heavy-chain polypeptide 3 was 6.5 times underexpressed in patients with pelvic organ prolapse compared to controls (P = .028). Similarly, myosin binding protein H was 3.2 times underexpressed in patients with prolapse (P = .042). Overall,patients had a mean age of 62.4 ± 6.5 years compared with controls with a mean age of 45.3 ± 7.4 years (P < .001),so analysis was also performed on an age-matched subset of 8 patients and controls (mean ages of 58.1 ± 5.4 years and 53.3 ± 5.0 years, respectively, P = .02) with similar results.Prolapse patients in this subset were similar in parity and race to controls but had lower body mass index (23.2 vs 29.9, P = .04). MYH3 was 10.9 times underexpressed in patients with pelvic organ prolapse compared to controls (P = .027). My BPH was 10.4 times underexpressed in patients with prolapse (P = .036). Conclusion: These findings suggest that the differences between patients with advanced pelvic organ prolapse and controls may be related to differential gene expression of structural proteins related to myosin. Specifically, advanced pelvic organ prolapse may be related to down-regulation of skeletal muscle heavy-chain polypeptide 3 and myosin binding protein H.
文摘Objective: The purpose of this study was to examine risk factors for mesh erosion, including concomitant hysterectomy,in abdominal sacral colpopexies. Study design: Weconducted a retrospective cohort study of 313 women who underwent an abdominal sacral colpopexy. Data regarding patient demographics, operative techniques, length of follow-up,postoperative complications, and mesh erosion were collected.Results: Of 313 subjects, 101 (32.3% ) had concomitant hysterectomies and 212 (67.7% ) had had previous hysterectomies.The overall rate of mesh erosion was 5.4% . In bivariate analysis,concomitant hysterectomy was not associated with erosion(6.9% vs 4.7% previous hysterectomy, P = .42); however, estrogen therapy was an effect modifier. In women on estrogen,hysterectomy (OR 4.9, CI 1.2- 19.7) and anterior imbrication(OR 5.6, CI 1.1- 28.6) were associated with mesh erosion. No risk factors were identified in women not on estrogen. Conclusion:In women on estrogen therapy, hysterectomy was associated with mesh erosion in abdominal sacral colpopexy.
文摘Objective: The purpose of this study was to assess microscopic hematuria as a predictive factor for detecting bladder cancer at cystoscopy in women with irritative voiding symptoms. Study design: We conducted a retrospective cohort analysis of women with irritative voiding symptoms who presented for urodynamic testing and cystoscopy. Irritative voiding symptoms were defined as urgency, urge incontinence, frequency, dysuria, and/or nocturia. Patient demographics, risk factors for bladder cancer,presence of microscopic hematuria, urodynamic findings,and cystoscopy and biopsy results were recorded. Results: Of 735 patients with irritative voiding symptoms, 264 (35.9% )- had microscopic hematuria and 471 (64.1% ) had no hematuria.Bladder cancer was detected in 3 women, for an overall detectionrate of 0.4% . Microscopic hematuria, urgency, frequency,dysuria, nocturia, age, and tobacco use were not significantly associated with bladder cancer. Conclusion: In this cohort of women with irritative voiding symptoms, microscopic hematuria was not predictive for bladder cancer.
