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Objective: To evaluate the impact of laparoscopic sacrocolpopexy on symptoms, health-related quality of life (HRQL) and sexuality among women with symptomatic urogenital prolapse (UGP)., Patients and Methods: A prospective analysis was carried out including 148 women with symptomatic UGP. Baseline characteristics, medical and obstetric history were recorded. The Pelvic Organ Prolapse Quantification (POP-Q) classification was used to stage the UGP. Validated tools were used to evaluate symptoms (Pelvic Floor Distress Inventory, PFDI-20) and HRQL (Pelvic Floor Impact Questionnaire, PFIQ-7). Sexual function was evaluated using the Pelvic organ prolapse urinary Incontinence Sexual Questionnaire (PISQ-12). Measurements were recorded at the preoperative examination, then at 3 and 12 months after surgery. We compared the follow-up results with preoperative data., Results: The anatomical results at 3 months showed a significant correction (P < 0.05) relative to the preoperative values, on the three pelvic floor parameters measured, with a clinical relapse rate of 6.3%. This improvement remained significant after 12 months (P < 0.05). There was no difference between the results obtained at 3 months and those at 12 months. At 3 months compared with the preoperative data, there was a significant improvement in PFDI-20 total mean score (32.24 vs 94.31, P < 0.05). At 12 months, the improvement remained significant (38.06 vs 94.31, P < 0.05) for all scores compared with the preoperative scores. Again, there was no difference between results at 3 months, and those at 12 months. The results showed a significant improvement in the PFIQ-7 score at 3 (16.61 vs 64.04, P < 0.05) and 12 months (18.21 vs 64.04, P < 0.05). There was no significant difference between the scores at 3 months and those at 12months. The total PISQ-12 score was linked significantly to urinary symptoms (P < 0.05), pelvic symptoms (P < 0.05) but not with ano-rectal ones. At 3 months, the total mean PISQ-12 score had improved significantly compared with the preoperative score (35.42 vs 32.07, P < 0.05). At this time, only two items of the PISQ-12 questionnaire were significantly increased: 'existence of negative emotions during sexual activity' (P < 0.05) and 'the avoidance of sexual activity because of prolapse' (P < 0.05). The total mean score remained significantly improved at 12 months (36.56 vs 32.07, P < 0.05) and there was no statistical difference compared with the results at 3 months., Conclusions: Laparoscopic sacrocolpopexy resulted in the early improvement (primarily during the first 3 months) of all symptoms, HRQL and sexual function. This improvement was persistent in the medium term. Symptoms linked with UGP had different effects on sexuality fields. Anatomical improvement was not related to an improvement in all sexual fields., (© 2013 The Authors. BJU International © 2013 BJU International.)

Purpose: The aim of this prospective study was to investigate the effect of extracorporeal shock wave lithotripsy (SWL) on kidneys of patients with pyelic stone disease. The effects of SWL were assessed by high-resolution proton nuclear magnetic resonance (HNMR) spectroscopy of urine samples., Methods: Twenty-three patients, aged 31-80years (mean: 55years), with pyelic stone disease were investigated before and after SWL. Multiparameter analysis was performed by HNMR spectroscopy of urine samples collected before and 5h after SWL (second miction post-SWL)., Results: The most relevant resonances determined by HNMR spectroscopy were acetate, lactate, trimethylamine N-oxide and amino acids. Excretion of these markers increased significantly in comparison with pre-SWL urinary samples., Conclusion: These results show that early ischemic damage occurs after SWL. Post-SWL. HNMR spectroscopy is an effective tool for noninvasive follow-up of renal damage., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Purpose: In this study in a menopausal rat model we describe the effect of androgen withdrawal on motoneurons innervating 2 muscles involved in female urinary continence, namely the intrinsic urethral sphincter and the pubococcygeus muscle., Materials and Methods: The 5 groups studied were 2 ovariectomized groups and their sham operated controls plus 1 ovariectomized group with dihydrotestosterone supplementation. Blood testosterone assays were performed. Androgen receptor immunohistochemistry was performed on spinal cord sections, in which specific motoneuron subpopulations were identified. Maximal somal cross-sectional area was compared among the groups., Results: Differences in somal cross-sectional area of motoneurons innervating the pubococcygeus muscle were observed after ovariectomy. Androgen receptor immunopositive nuclei staining disappeared, in line with undetectable blood testosterone levels., Discussion: The modifications of androgen receptor expression and somal morphological appearance in the pudendal motoneurons controlling the external urethral sphincter of ovariectomized female rats suggests that testosterone probably influences neurotransmission and coordination of urinary continence at the spinal level.