Obstetrics and Gynecology International New Advances in Urogynecology Guest Editors: Lior Lowenstein, Peter L. Rosenblatt, Hans Peter Dietz, Johannes Bitzer, and Kimberly Kenton New Advances in Urogynecology Obstetrics and Gynecology New Advances in Urogynecology Guest Editors: Lior Lowenstein, Peter L. Rosenblatt, Hans Peter Dietz, Johannes Bitzer, and Kimberly Kenton Copyright © 2012 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in volume 2012 of “Obstetrics and Gynecology.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Sean Blackwell, USA Howard D. Homesley, USA Julian T. Parer, USA Diane C. Bodurka, USA Shi-Wen Jiang, USA Faustino R. Perez-L´ opez,´ Spain Curt W. Burger, The Netherlands Marc J. N. C. Keirse, Australia Tonse N.K. Raju, USA Linda D. Cardozo, UK Russell K. Laros Jr., USA Neal S. Rote, USA Nancy Chescheir, USA Jonathan Ledermann, UK Giovanni Scambia, Italy Robert Coleman, USA Kimberly K. Leslie, USA Peter E. Schwartz, USA W. T. Creasman, USA Lawrence D. Longo, USA John J. Sciarra, USA Mary E. D’Alton, USA G. A. Macones, USA J. L. Simpson, USA Gian Carlo Di Renzo, Italy Everett Magann, USA Anil Sood, USA Keith A. Eddleman, USA James A. McGregor, USA Wiebren A. A. Tjalma, Belgium Edmund F. Funai, USA Liselotte Mettler, Germany J. R. Van Nagell, USA Thomas Murphy Goodwin, USA Daniel R. Mishell, USA John M. G. van Vugt, The Netherlands WilliamA.Grobman,USA Bradley J. Monk, USA M. A. Williams, USA Enrique Hernandez, USA John J. Moore, USA Deborah A. Wing, USA Thomas Herzog, USA J. C. Morrison, USA Judith K. Wolf, USA Wolfgang Holzgreve, Switzerland Errol R. Norwitz, USA Edward V. Younglai, Canada Contents New Advances in Urogynecology, Lior Lowenstein, Peter L. Rosenblatt, Hans Peter Dietz, Johannes Bitzer, and Kimberly Kenton Volume 2012, Article ID 453059, 2 pages Contribution of Primary Pelvic Organ Prolapse to Micturition and Defecation Symptoms, Annette G. Groenendijk, Erwin Birnie, Jan-Paul W. Roovers, and Gouke J. Bonsel Volume 2012, Article ID 798035, 9 pages Ambulatory Pessary Trial Unmasks Occult Stress Urinary Incontinence, Bilal Chughtai, Sara Spettel, Jonathan Kurman, and Elise De Volume 2012, Article ID 392027, 5 pages Measuring Urinary Sensation with Current Perception Threshold: A Comparison between Method of Limits and Method of Levels, Carley Davis, Lior Lowenstein, Elizabeth Mueller, Linda Brubaker, and Kimberly Kenton Volume 2012, Article ID 868915, 4 pages Transurethral Radiofrequency Collagen Denaturation for Treatment of Female Stress Urinary Incontinence: A Review of the Literature and Clinical Recommendations,JamesChivianLukban Volume 2012, Article ID 384234, 6 pages Pelvic Organ Distribution of Mesenchymal Stem Cells Injected Intravenously after Simulated Childbirth Injury in Female Rats, Michelle Cruz, Charuspong Dissaranan, Anne Cotleur, Matthew Kiedrowski, Marc Penn, and Margot Damaser Volume 2012, Article ID 612946, 7 pages Is Mesh Becoming More Popular? Dilemmas in Urogynecology: A National Survey, Alexander Condrea, Itamar Netzer, Shimon Ginath, Joseph Eldor-Itskovitz, Abraham Golan, and Lior Lowenstein Volume 2012, Article ID 672356, 4 pages Uterine Prolapse: From Antiquity to Today, Keith T. Downing Volume 2012, Article ID 649459, 9 pages Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey, A. Cornet, O. Porta, L. Pin eiro, E. Ferriols, I. Gich, and J. Calaf Volume 2012, Article ID 316983, 7 pages Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2012, Article ID 453059, 2 pages doi:10.1155/2012/453059 Editorial New Advances in Urogynecology Lior Lowenstein,1, 2 Peter L. Rosenblatt,3 Hans Peter Dietz,4 Johannes Bitzer,5 and Kimberly Kenton6 1 Department of Obstetrics and Gyenceology, Rambam Health Care Campus, Haifa, Israel 2 Ruth and Baruch Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel 3 Division of Urogynecology and Reconstructive Surgery, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA 4 Department of Pelvic Reconstructive Surgery and Urogynaecology, Sydney Medical School Nepean, Penrith, NSW, Australia 5 Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland 6 Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Obstetrics & Gynecology and Urology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA Correspondence should be addressed to Lior Lowenstein, [email protected] Received 9 November 2011; Accepted 9 November 2011 Copyright © 2012 Lior Lowenstein et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pelvic floor disorders, including urinary incontinence, pelvic of these disorders and look into the future by discussing organ prolapse (POP), and bowel dysfunction, affect millions possible novel interventions for the treatment of pelvic floor of women worldwide resulting in considerable cost and qual- dysfunction. ity of life impact. One-third of all women will suffer from The first paper of this issue, published by a group of clini- these disorders at some point in their lives [1–5]. Significant cians from The Netherlands, explores the association of research efforts are underway to improve our understanding POP severity and subjective pelvic floor symptoms. As one of the pathophysiology, optimal evaluation, and effective might expect, presence of POP on exam was associated with treatment for women with pelvic floor disorders. More than patient-reported symptoms of prolapse and voiding dys- ever before, research is providing meaningful developments function, but not with urinary incontinence or defecatory into etiologies and novel treatment modalities. Additionally, symptoms. The second paper evaluates the role of pessary researchers advance our understanding of improved meth- trial in predicting postoperative outcomes of occult stress ods for evaluating treatment outcomes, including patient- urinary incontinence. The authors suggest that pessary trial reported outcomes. These advances are largely due to the is an effective method to evaluate POP patients for occult efforts of an increasing number of clinician-scientists who stress incontinence, as 20% of patients with occult stress in- design and conduct high-quality clinical trials and transla- continence were identified by pessary trial alone. The third tional studies. In addition to learning more about basic pa- paper presents a comparative study between two common thophysiology, recent technical advances offer excellent treat- methods to evaluate afferent neural function in the lower ment efficacy with reduced morbidity. This work is facilitated urinary tract. The current perception test is becoming in- by the efforts of multidisciplinary teams composed of a wid- creasingly important in diagnosing abnormalities of afferent ening group of pelvic floor specialists, including radiologists, neural pathways. Since these neurologic problems may con- physiotherapists, urologists, and urogynecologists. The clin- tribute to certain pelvic floor disorders, it is important to es- ical advances in urogynecology are advancing rapidly and tablish the best methods for these neural changes. The au- will improve the well-being of millions of women who suffer thors conclude that the method of levels is superior to the from pelvic floor disorders. method of limits when evaluating current perception thresh- The main focus of this special issue is on new and existing olds in the lower urinary tract. The fourth manuscript re- diagnostic and treatment methods for pelvic floor disorders. views a new treatment for stress urinary incontinence, tran- The articles summarize current approaches to the treatment surethral radio frequency treatment of the bladder neck and 2 Obstetrics and Gynecology International proximal urethra. Radio frequency is thought to reduce fun- [2] A. H. MacLennan, A. W. Taylor, D. H. Wilson, and D. Wilson, neling of the bladder neck through the denaturation of sub- “The prevalence of pelvic floor disorders and their relationship mucosal collagen, with a resultant reduction in tissue com- to gender, age, parity and mode of delivery,” British Journal of pliance and increased Valsalva leak point pressure. The Obstetrics and Gynaecology, vol. 107, no. 12, pp. 1460–1470, authors conclude that radio frequency is an effective conser- 2000. vative treatment for stress incontinence with few side effects. [3] K. Holst and P. D. Wilson, “The prevalence of female urinary incontinence and reasons for not seeking treatment,” New In the fifth paper, from the Cleveland Clinic, an animal Zealand Medical Journal, vol. 101, no. 857, pp. 756–758, 1988. model was used to evaluate whether intravenously injected [4] J. V. Jolleys, “Reported prevalence of urinary incontinence in mesenchymal stem cells home to pelvic organs after simu- women in a general practice,” British Medical Journal, vol. 296, lated childbirth injury. The findings of this interesting paper no. 6632, pp. 1300–1302, 1988. provide evidence that intravenous administration of mesen- [5] S. L. Jackson and T. L. Hull, “Fecal incontinence in women,” chymal