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SUMMARYWe have demonstrated 30-Hz three-photon imaging using a single 24-MHz mode-locked Cr:forsterite oscillator with a center wavelength at 1260 nm. By managing the dispersion distribution in the resonator using double-chirped mirrors, we have produced 32-fs pulses with 22-nJ pulse energy. Using the oscillator as a driving source, we have realized multi-color three-photon images using a GFP-labeledDrosophilabrain and an AF647-labeled mouse brain. To demonstrate the capability of deep-tissue imaging, we have obtained a 10-times higher SBR from the three-photon images than the two-photon results at different depths in a GFP-labeledDrosophilabrain dissection. Furthermore, we have shown the impact of excitation pulse width on three-photon deep-tissue imaging. Our results indicate the superiority of using shorter pulses for deeper-tissue imaging, especially in theDrosophilabrain. In addition, we have recorded the three-photon calcium imagingin vivofrom theDrosophilamushroom body in response to external electric shocks. We believe our demonstration provides a robust approach for high-speed three-photon microscopy applications, especially for intravital investigations in theDrosophilabrain.

This study examined the associated factors (i.e., obstetric and maternal-newborn factors) related to cumulative incidence of urinary incontinence and changes in urinary incontinence during pregnancy and the first year postpartum. This prospective, longitudinal, within-subject study included 501 women who completed the Incontinence Questionnaire-Urinary Incontinence Short Form during pre-pregnancy, early pregnancy, mid-pregnancy, and late pregnancy and at five time points during the first year postpartum. Data were analyzed by multivariate logistic regression, McNemar’s and analysis of variance (ANOVA) tests. According to the multivariate analysis, the gestational week and number of previous vaginal deliveries increased the risk of cumulative incidence of urinary incontinence (CIUI) during pregnancy (both p

We examined obstetric and maternal-newborn factors and UI history for stress urinary incontinence (UI) and urge UI during pregnancy and the first year postpartum. This prospective cohort study included 1447 pregnant women who underwent prenatal examinations and completed an Incontinence Questionnaire-Urinary Incontinence Short Form before pregnancy, during early, mid- and late pregnancy, and at five visits during the first year postpartum. Data were analyzed using univariate/multivariate generalized estimating equation (GEE) logistic regression analyses. The prevalence rates of stress UI during late pregnancy (42.5%) and urge UI at 3–5 days postpartum (10.4%) were the highest throughout pregnancy and the first year postpartum. After adjusting for covariates, gestational age increased the risks of stress UI (p

An equivalent electric circuit is exploited for interpreting the dynamic behavior of a photovoltaic (PV) panel based on the commonly used one-diode model with an additional parasitic capacitance. By drawing rippled currents from the PV panel with a boost converter, the circuit parameters of the model can be obtained simply from a few test points without the need of the intrinsic parameters of the PV panel given by datasheets. Experimental tests are carried out on a laboratory system to demonstrate the capability of simulating the dynamic responses of a PV panel with the derived circuit parameters.

Purpose To identify factors predicting the presence of overactive bladder syndrome (OAB)-wet, compared with OAB-dry. Methods Between September 2007 and September 2013, the medical records of 623 women with OAB who completed a 3-day bladder diary and underwent urodynamic studies in a medical center were retrospectively reviewed. OAB-wet was diagnosed in patients who complained of at least one episode of urgency incontinence in the previous month; otherwise, OAB-dry was diagnosed. Multivariable logistic regression analysis was used to predict the presence of OAB-wet. Results Age (odds ratio [OR], 1.05; P

Objectives The impact of mirabegron on clinical outcome and urodynamic parameters may be important for clinical practice. Thus, the aim of this study was to compare the clinical outcomes and urodynamic effects of mirabegron (Betmiga 50 mg) versus tolterodine (Detrusitol ER 4 mg) treatment for women with overactive bladder syndrome (OAB). Methods Women with OAB were randomized to receive 12 weeks of mirabegron 50 mg, tolterodine extended-release 4 mg or placebo treatment. The clinical outcomes and urodynamic effects were compared between the subgroups. Results Thirty-three women completed 12 weeks of mirabegron (n = 12), tolterodine (n = 12) or placebo (n = 9) treatment. A significant increase in the volumes at strong desire to void and a decrease in the daytime frequency episodes were identified in the mirabegron and tolterodine groups (all P < 0.05). Nonetheless, a decrease in the total voided volume was identified following mirabegron treatment but not tolterodine (P = 0.02). Conclusions Mirabegron and tolterodine exhibit similar changes in the urodynamics and bladder diary parameters. However, mirabegron may decrease the total voided volume. These findings may serve as an initial guide or assist in consultations regarding the treatment of OAB patients with mirabegron.

Background/purpose Factors affecting the anti-incontinence efficacy of a tailored anterior transvaginal mesh (ATVM) surgery are undetermined. Thus, our aim was to investigate predictors for anti-incontinence efficacy of this ATVM surgery. Methods Medical records of women with pelvic organ prolapse and concomitant evident or occult urodynamic stress incontinence, who underwent the ATVM surgery but without concomitant anti-incontinence surgery, were reviewed. Results A total of 134 women were reviewed, including those who underwent ATVM only (n = 45), ATVM and posterior transvaginal mesh surgery (n = 88), and ATVM with total vaginal hysterectomy (n = 1). Multivariable analysis revealed that stage of cystocele (coefficient = 56.4), functional profile length (cm, coefficient = 61.1) and the score of general health perceptions in the King's Health Questionnaire (coefficient = −3.3) were independent predictors of the percentage change in pad weight from baseline. Seven (5.2%) women were found to have recurrent or persistent stress urinary incontinence, and 6 of the above 7 women underwent transobturator mid-urethral sling procedure. Free of further anti-incontinence surgery probabilities were 94.7% and 89.2% at 3 and 6 years after surgery, respectively. Functional profile length (hazard ratio = 2.61) was also identified as a predictor for further anti-incontinence surgery. Conclusion Lesser degree of cystocele, shorter functional profile length and poorer general health perceptions were predictors of greater anti-incontinence effect after the tailored ATVM surgery. Besides, longer functional profile length was also a predictor for further anti-incontinence surgery after the ATVM surgery.

Endometrial stromal tumors are rare uterine tumors (

Closely associated with visceral obesity, hepatic steatosis resulting from non-alcoholic fatty liver disease (NAFLD) exacerbates insulin resistance. Developing effective drugs to treat NAFLD is imperative. Here, we investigated the pharmacological mechanism of ugonin J (UJ) in controlling metabolic disorder and ameliorating NAFLD pathophysiology in diet-induced obese mice. The effects of UJ were assessed in 5-week-old C57BL/6 J mice fed a high-fat diet (HFD) for 12 weeks. UJ treatment averted HFD-induced body weight gain by reducing fat deposition in adipose tissues and reduced HFD-induced hyperlipidemia and hepatic inflammation. UJ also improved HFD-induced glucose tolerance and insulin resistance. Moreover, the mode of action of UJ was analyzed in palmitate (PA)-induced steatotic human HuS-E/2 hepatocytes and in hyperglycemia-simulating rat BRIN-BD11 pancreatic β cells. In PA-induced steatotic human hepatocytes, UJ treatment promoted lipid clearance via pAMPK, pACC and CPT-1 upregulation and SREBP-1c downregulation. Interestingly, UJ upregulated Akt activity in hepatocytes and increased insulin secretion from β cells in acute insulin secretion tests. Taken together, UJ improved adipocyte hypertrophy, hyperinsulinemia, hyperglycemia, hyperlipidemia and fat deposition in livers. UJ also reduced fatty acid accumulation by modulating key metabolic regulators. Our findings demonstrated the therapeutic potential of UJ for the treatment of NAFLD and diet-induced metabolic disorders.

Objectives The aim of this study is to compare the re-treatment probabilities after a 3-month versus a 6-month course of antimuscarinic treatment for women with overactive bladder syndrome (OAB). Study design A prospective randomized controlled study. Main outcome measures Between-group differences in the probability of re-treatment for OAB between the 3-month and 6-month groups. Methods Women with OAB were randomly allocated to receive solifenacin (5 mg per day) for a treatment interval of either 3 or 6 months. Results Ninety-one patients were treated in each group. The probability of re-treatment did not differ between the 3-month and 6-month groups (P = 0.11). Parity (hazard ratio = 1.81, P = 0.001), number of incontinence episodes (hazard ratio = 1.09, P = 0.008) and suboptimal response (hazard ratio = 3.56, P = 0.006) were independent predictors of re-treatment of OAB. Physical limitation, as indicated on the King’s Health Questionnaire, was the only independent factor predicting completion of the scheduled treatment period (odds ratio = 1.01, P = 0.008). Conclusions Prolonged antimuscarinic treatment does not decrease the need for re-treatment of OAB. Nonetheless, female patients with increased parity, more severe incontinence and a suboptimal response to antimuscarinic treatment are more likely to seek re-treatment of OAB due to recurrence of symptoms. In addition, patients with more serious physical limitation related to OAB are more likely to complete the scheduled treatment period. These findings could serve as a guide in clinical consultations regarding antimuscarinic treatment and if taken into consideration in future studies could lower the dropout rate.

To identify factors predicting cervical elongation in women with uterine prolapse.The medical records of women with uterine prolapse who underwent vaginal hysterectomy were reviewed. Multivariable logistic regression analysis was performed to identify predictors of cervical elongation.Of 295 women with uterine prolapse, 136 (46.1%) patients had cervical elongation, according to Berger et al. Classification (i.e., cervical length3.38 cm and/or cervix-to-corpus lengths ratio0.79). Multivariable analysis revealed that lower parity (odds ratio = 0.85, 95% confidence interval [CI] = 0.73 to 0.99, P = 0.04) and advanced stage of uterine prolapse (odds ratio = 1.97, 95% CI = 1.35-2.88, P 0.001) were predictors for cervical elongation. Based on a receiver operating characteristic curve (ROC) analysis, the following optimum cut-off values were determined for cervical elongation: (1) parity ≤3, ROC area = 0.60 (95% CI = 0.53 to 0.66); (2) stage of uterine prolapse ≥3, ROC area = 0.63 (95% CI = 0.56 to 0.69). Thus, the predicted logit(p) for a given parity (a) and stage of uterine prolapse (b) can be denoted by logit(p) = -1.26 - 0.16 x a + 0.68 x b. The optimum cut-off values of logit(p) ≥-0.18 to predict cervical elongation were determined using ROC analysis (area = 0.66, 95% CI = 0.59 to 0.73). For women with parity ≤6, we can use either (1) stage 2 uterine prolapse and parity ≤1, or (2) ≥ stage 3 uterine prolapse as criteria to predict cervical elongation.Lower parity and advanced stage of uterine prolapse are predictors of cervical elongation in women with uterine prolapse. Thus, stage of uterine prolapse ≥3 or logit(p) ≥-0.18 may be useful for predicting cervical elongation.

Aim: The aim of this study was to identify the factors associated with fecal incontinence in female patients with lower urinary tract symptoms. Material and Methods: Data regarding clinical and urodynamic parameters and history of fecal incontinence of 1334 women with lower urinary tract symptoms who had previously undergone urodynamic evaluation were collected and subjected to univariate, multivariate, and receiver–operator characteristic curve analysis to identify significant associations between these parameters and fecal incontinence. Results: Multivariate analysis identified age (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01–1.05, P = 0.005), presence of diabetes (OR = 2.10, 95%CI = 1.22–3.61, P = 0.007), presence of urodynamic stress incontinence (OR = 1.90, 95%CI = 1.24–2.91, P = 0.003), pad weight (OR = 1.01, 95%CI = 1.00–1.01, P = 0.04), and detrusor pressure at maximum flow (OR = 1.02, 95%CI = 1.01–1.03, P = 0.003) as independent risk factors for fecal incontinence. Receiver–operator characteristic curve analysis identified age ≥ 55 years, detrusor pressure at maximum flow ≥ 35 cmH2O, and pad weight ≥ 15 g as having positive predictive values of 11.4%, 11.5%, and 12.4%, respectively, thus indicating that they are the most predictive values in concomitant fecal incontinence. Conclusions: Detrusor pressure at maximum flow and pad weight may be associated with fecal incontinence in female patients with lower urinary tract symptoms, but require confirmation as indicators by further study before their use as screening tools.

Objective The aim of the study was to investigate predictive factors of the need for persistent antimuscarinic therapy or re-treatment (PR) after discontinuation of antimuscarinic therapy for women with overactive bladder syndrome (OAB). Methods All consecutive OAB women were enrolled in a prospective cohort study, and treated with solifenacin for 12 weeks in a University Hospital. Factors affecting PR were analyzed by Cox regression analysis. Results A total of 122 women were enrolled, and 107 women underwent 12-week solifenacin treatment. The dropout rate was 12.3%. The median follow-up period was 20.4 weeks (25-75 interquartile range: 16-102.3 wk). Twenty-seven (25%) women had PR. The median PR-free interval was 125.4 weeks (95% CI = 58.4 to - wk). Nocturia episodes (hazard ratio = 1.54), a suboptimal response (hazard ratio = 2.53), and the strong-desire volume (hazard ratio = 0.992) were independent predictors of PR by Cox backward stepwise regression analysis. The areas under the receiver-operating characteristic curves for nocturia episodes, a suboptimal response, and the strong-desire volume to predict PR were only 0.65, 0.63, and 0.59, respectively. In addition, normalized urinary nerve growth factor level was not significant (hazard ratio = 1.005, P = 0.68) for predicting PR. Furthermore, normalized urodynamic findings did not correlate with PR, a suboptimal response, or changes of Overactive Bladder Symptom Score and urinary nerve growth factor level. Conclusions Frequent nocturia episodes, a suboptimal response, and small bladder capacity may predict PR after solifenacin treatment. These findings may serve as an initial guide in consultation regarding the treatment of OAB.

The impact of mirabegron on clinical outcome and urodynamic parameters may be important for clinical practice. Thus, the aim of this study was to compare the clinical outcomes and urodynamic effects of mirabegron (Betmiga 50 mg) versus tolterodine (Detrusitol ER 4 mg) treatment for women with overactive bladder syndrome (OAB).Women with OAB were randomized to receive 12 weeks of mirabegron 50 mg, tolterodine extended-release 4 mg or placebo treatment. The clinical outcomes and urodynamic effects were compared between the subgroups.Thirty-three women completed 12 weeks of mirabegron (n = 12), tolterodine (n = 12) or placebo (n = 9) treatment. A significant increase in the volumes at strong desire to void and a decrease in the daytime frequency episodes were identified in the mirabegron and tolterodine groups (all P0.05). Nonetheless, a decrease in the total voided volume was identified following mirabegron treatment but not tolterodine (P = 0.02).Mirabegron and tolterodine exhibit similar changes in the urodynamics and bladder diary parameters. However, mirabegron may decrease the total voided volume. These findings may serve as an initial guide or assist in consultations regarding the treatment of OAB patients with mirabegron.

Uterine sarcomas account for 3–7% of all uterine cancers. Because of their rarity, unknown etiology, and highly divergent genetic aberration, there is a lack of consensus on risk factors for occurrence and predictive poor outcomes as well as optimal therapeutic choices. Tumor types according to the World Health Organization classification include leiomyosarcoma, endometrial stroma sarcoma, and undifferentiated sarcoma. Staging is done using the 2014 Federation International Gynecology and Obstetrics and 2010 American Joint Committee on Cancer tumor, lymph node, and metastases systems. Tumor grade can be classified based on the French Federation of Cancer Centers Sarcoma Group system or the Broder’s system that incorporates tumor differentiation, mitotic count, and tumor necrosis. This review is a series of articles discussing uterine sarcoma, and this is Part I, which focuses on one of the subtypes of uterine sarcomas—uterine leiomyosarcoma. The clinical characteristics, diagnosis, outcome, and recent advances are summarized in this article.

May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, was first reported in 1957 by May and Thurner on the basis of dissecting 430 cadavers. MTS is a clinical entity of left iliac vein compression by the anteriorly positioned right common iliac artery (RCIA) causing isolated left lower extremity swelling and pain. In this retrospective review of previously treated MTS patients, we present those case particulars and discuss the changes of surgical corrections over the years. From February 2006 to December 2010, 278 patients with chronic swelling of lower extremity were reviewed. Patients with history of gynecological surgery and/or pelvic radiotherapy were excluded; 15 patients without any known etiology were classified as primary lymphedema. Image study with iliac venography, and multi-detector computed tomography confirmed the diagnosis of MTS. Fifteen patients with MTS underwent surgical treatment with different modalities. Prior to the era of endovascular therapy in our institute, three patients were treated with decompression surgery by division of RCIA with reconstruction through retroperitoneal approach; two patients received pelvic angiolysis with relocation of RCIA without arterial division; two patients underwent angiolysis and relocation of RCIA with percutaneous angioplastic balloon dilation; two patients underwent pelvic angiolysis, angioplastic balloon dilation with iliac vein stenting. Six patients underwent percutaneous angioplastic dilatation with iliac vein stenting without open angiolysis. The postoperative results were satisfactory in terms of subsidence of clinical symptoms. No operative mortality encountered and morbidities were acceptable. MTS should not be neglected because of its progressiveness and the long-term disabling complications. The principle of treatment is to relieve the extrinsic compression and to expand the narrowed portion of iliac vein. We consider that endovascular balloon dilatation with stenting is the treatment of choice. Open pelvic angiolysis with iliac vein stenting is reserved for the balloon-dilatation resistant patient. Long-term follow up is necessary to verify the benefit of this endovenous stenting procedure.

Objective To evaluate the efficacy and safety of vaginal cystocele repair using a pursestring suture technique reinforced with custom-tailored 2-armed mesh. Methods The records of patients who underwent isolated cystocele repair by a single surgeon were retrospectively reviewed. All women were assessed by clinical examination and lower urinary tract symptoms preoperatively and at 3 and 6 months and every year postoperatively. The principal outcome measure was anatomic cure (stage 1 or lower) assessed by the Pelvic Organ Prolapse Quantification system. Results From May 2005 to June 2009, 50 consecutive patients with minimum stage 2 (Aa or Ba 0) cystocele were treated using the procedure. The mean follow-up was 24 months (range 12-54), and the success rate was 96% (48 of 50). No intraoperative complications occurred. Two developed vaginal erosion (4%) and underwent excision of the extruded mesh smoothly. The final 21 consecutive patients underwent urodynamic assessment pre- and postoperatively. Compared with the baseline urodynamic findings, surgery resulted in decreased maximal urethral pressure and maximal urethral closure pressures. However, neither increased de novo incontinence nor reduced cystometric bladder capacity developed. Conclusion The use of the pursestring suture technique reinforced with custom-tailored 2-armed mesh for vaginal cystocele repair is safe, effective, and economic.

Aim: To evaluate the urodynamic effects, therapeutic efficacy and safety of solifenacin versus tolterodine treatment for women with overactive bladder syndrome. Methods: Patients were randomized to receive either solifenacin 5 mg or tolterodine ER 4 mg once a day for 12 weeks at each four-week visit in a post-marketing study. Only women (solifenacin [n = 26] vs. tolterodine [n = 22]) were included in this subgroup analysis. Adverse events and changes of urodynamic values and clinical data were compared between the solifenacin and tolterodine groups. Results: The volume voided per micturition increased in the solifenacin group (n = 21) (P = 0.04). The strong desire to void and pad-test result improved in the tolterodine group (n = 21; P = 0.02 and 0.03, respectively). There were no between-group differences in changes of any urodynamic data, voiding diary values or adverse events after treatment; however, changes of heart rate differed between the two groups (P = 0.0004), especially at visit 2 (solifenacin vs. tolterodine, −4.3 vs. 3.8, P = 0.02) and visit 3 (−3.2 vs. 4.8, P = 0.03). Conclusions: Both solifenacin and tolterodine had similar urodynamic effects, therapeutic efficacy and adverse events in treating women with overactive bladder syndrome; however, tolterodine had a greater effect in increasing heart rate than solifenacin.

Aim. To translate the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) from English to Taiwanese and to evaluate its reliability and validity for pregnant Taiwanese women. Background. Urinary incontinence in pregnant women has been little investigated in Taiwan. A validated assessment instrument for urinary incontinence is needed for pregnant Taiwanese women. Design. A non-experimental design was used to test the psychometric properties of the Taiwanese version of the ICIQ-UI SF. Method. The internal consistency reliability and construct validity of the Taiwanese version of the ICIQ-UI SF for pregnant women were evaluated in a random sample of 121 pregnant women at a medical center in Taiwan. Test–retest reliability was assessed for a sample of 55 pregnant women who completed this version at two time points in four weeks. Construct validity was verified with three questions and seven urinary-leakage situations by factor analysis. Results. The Taiwanese version of the ICIQ-UI SF showed adequate test–retest reliability in pregnant Taiwanese women. The Pearson’s correlation coefficient of the total score was 0·75, kappa statistics showed excellent or good reproducibility for most items and McNemar’s test confirmed that there was no significant difference in the test–retest pair for each item of the scale. The internal consistency reliability of the scale was good, with Cronbach’s α = 0·80. Three factors were extracted and identified with an eigenvalue ≥1·04, explaining 65·64% the total variance. The first, second and third factors were ‘symptom and quality of life’, ‘stress incontinence or other types’ and ‘urge or overflow incontinence’. Conclusions. The results provide evidence of the validity and reliability of the psychometric properties of the Taiwanese version of the ICIQ-UI SF for pregnant women. Relevance to clinical practice. This questionnaire is a suitable instrument for evaluating urinary incontinence in pregnant Taiwanese women.

Aim: To investigate changes in urodynamic parameters after tolterodine treatment for female overactive bladder syndrome, especially in patients with voiding dysfunction. Methods: Between January and December 2006, 44 patients were enrolled for six months of treatment with tolterodine. Pre-treatment and post-treatment urodynamic studies were scheduled for the enrolled patients. Results: Among the remaining 33 patients (11 dropped out), bladder capacity (P

Introduction Childbirth impacts sexual function in women, but few reports have addressed sexual function shortly after childbirth. Aim Using the Taiwan version of the Female Sexual Function Index (FSFIT), this study aimed to describe women's sexual function and to examine differences between groups in sexual function shortly after delivery. Methods A prospective longitudinal investigation was performed in women who completed the FSFIT, a numeric analog scale, the Taiwan version of the Center for Epidemiologic Studies Depression Scale (CES-D), and a demographic questionnaire in a Taiwanese medical center at 3 days and 6 weeks postpartum. Main Outcome Measures Using a general linear model, differences were tested between groups, including those defined by delivery mode, type of feeding, depression score, pain score, and birth history. Results After adjusting for covariates, (i) significant differences in sexual function and desire were found between the vaginal delivery and Cesarean section groups at day 3 and week 6 postpartum ( P = 0.0419 and desire and satisfaction between the tubal ligation and not groups were significant at both time points ( P = 0.0346 and 0.0338); (iii) differences in sexual function and sexual activity or intercourse between low and high CES-D scores were significant at 6 weeks postpartum ( P = 0.0040 and 0.0043, respectively); and (iv) differences between pain level groups in sexual activity or intercourse and desire were significant at 6 weeks ( P = 0.0493 and 0.0004). At 3 days postpartum, significant differences between educational level and ethnic groups were observed ( P = 0.0002 and 0.0414). Conclusions The results showed significant differences in sexual function shortly after delivery between groups based on delivery method, tubal ligation, depression, pain, ethnicity, and educational level. This information may help health professionals to be more aware of women's perception of sexuality and may foster sensitivity in assessing their sexual function after childbirth. Chang S-R, Chang T-C, Chen K-H, and Lin H-H. Sexual function in women 3 days and 6 weeks after childbirth: A prospective longitudinal study using the Taiwan version of the Female Sexual Function Index.

Introduction Health professionals should pay more attention to the sexual concerns of pregnant women. An assessment instrument for female sexual function is needed for pregnant women in the Taiwanese population. Aim To translate the Female Sexual Function Index (FSFI) from English to traditional Chinese, and to evaluate the reliability and validity of this new version for pregnant women. Methods Test–retest reliability of the newly developed Taiwan version of the FSFI for pregnant women was assessed in 55 pregnant women who completed this version of the questionnaire at two time points within 4 weeks. The internal consistency reliability and construct validity of the Taiwan version of the FSFI in a medical center in Taiwan were evaluated using a random sample of 121 pregnant women. Main Outcome Measures Reliability was tested using Cronbach's alpha coefficient, Kappa statistics, McNemar's test, and Pearson's correlation coefficient. Construct validity was verified by factor analysis using the principal component option. Results The Taiwan version of the FSFI showed adequate test–retest reliability for pregnant women. The Pearson correlation coefficient of the total score was 0.69, Kappa statistics showed good reproducibility for most items, and McNemar's test confirmed that there were no significant differences in the test–retest pair for the 19 items of the scale. The internal consistency reliability of the scale was excellent (Cronbach's [alpha] = 0.96). Three factors were identified with eigenvalues ≥1.03, explaining 87.10% of the total variance. The first, second, and third factors were “coitus,”“satisfaction,” and “desire”, accounting for 72.32%, 9.37%, and 5.42% of the variance, respectively. Conclusion The results provided evidence of the validity and reliability of the Taiwan version of the FSFI for pregnant women. The questionnaire is a suitable instrument for measuring the sexual function of pregnant women and will be useful in research, teaching, and clinical practice. Chang SR, Chang TC, Chen KH, and Lin HH. Developing and validating a Taiwan version of the Female Sexual Function Index for pregnant women. J Sex Med 2009;6:1609–1616.

Objectives To identify the risk factors affecting cure after the tension-free vaginal tape procedure (TVT) or transobturator tape procedure (TOT). Methods A total of 121 women with urodynamically proved stress incontinence underwent TVT (n = 61) or TOT (n = 60). We analyzed all data with univariate and multivariate logistic regression analyses. Results Univariate analysis revealed that a larger postvoid residual urine volume, greater pad weight test, and lower maximal flow rate were associated with a greater risk of failure to be cured after TVT. A lower maximal urethral closure pressure (MUCP) was associated with a greater risk of failure after the TOT procedure. With additional analysis, we found that a MUCP of ≤40 cm H 2 O (odds ratio [OR] 9.21, P = .004) was associated with a significantly greater risk of failure to be cured after the TOT procedure but not a MUCP of ≤50 cm H 2 O (OR 2.24, P = .21). Multivariate analysis revealed that preoperative detrusor overactivity was an independent risk factor affecting cure after TVT (OR 113.1, 95% confidence interval 1.84-6592.77, P = .02) or TOT (OR 23.7, 95% confidence interval 1.63-344.53, P = .02), and MUCP ≤40 cm H 2 O (OR 8.34, 95% confidence interval 1.52-45.65, P = .01) was another risk factor for TOT. Conclusions The risk factors affecting cure after mid-urethral tape procedures were preoperative detrusor overactivity for TVT and TOT and MUCP ≤40 cm H 2 O for TOT.

Endometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities.

Aim Our goal was to examine Taiwanese women's perspectives on the way menopause affected their sexual behaviour to gain an in-depth understanding of their experiences during this transition. Background Physical symptoms associated with menopause may affect women's sexual experiences. Little is known about how menopause-related changes in sexual behaviour may affect role identity of women living in a modernizing urban culture that is still strongly rooted in traditional beliefs and attitudes. Design This was a qualitative study involving face-to-face interviews using open-ended questions. Methods During 2011–2012, eighteen peri or postmenopausal women visiting a medical clinic for gynaecological examinations or treatment were interviewed about their sexual experiences. Responses were analysed for common themes. Findings Four themes were identified about the effects of menopause on women's sex life: (1) changes in physical responses during sex; (2) the acceptance/non-acceptance of the current situation; (3) sexual pressure related to their marital role; (4) efforts to improve sexual interest or activity. Menopause-related physical changes often (but not always) made sexual interactions difficult. But women's responses to the changes varied. Some used sexual discomfort as a reason to avoid sexual intercourse. Others sought to improve their sexual encounters through behavioural modifications or hormone therapy. Conclusions Given the variety of reactions to the impact of menopause on sexual behaviour/relationships seen here, it is clear that health professionals need to assess of each woman's specific situation and be prepared to recommend a variety of behavioural or hormonal treatment options.

To investigate the efficacy and urodynamic effects of baclofen in women with functional bladder outlet obstruction.Between January 2011 and December 2012, women who underwent baclofen treatment for functional bladder outlet obstruction, defined as15 mL/s maximum flow rate and20 cmH2 O detrusor pressure at maximum flow rate, but without significant anatomic causes, were retrospectively reviewed. Urodynamic variables at baseline and after 12 weeks of treatment were compared.Twenty women with functional bladder outlet obstruction underwent 12 weeks of baclofen treatment (oral baclofen 5 mg, three times daily). All patients reported improvement in voiding dysfunction symptoms after treatment, and no significant adverse effects were found on review of medical records. All patients underwent urodynamic studies after 12 weeks' treatment. Voided volume, voiding efficiency and maximum flow rate at voiding cystometry were significantly improved (mean, 273 vs. 368 mL, P = 0.002; 62.8% vs. 73.6%, P 0.001, and 10.3 vs. 11.6 mL/s, P = 0.046; respectively). Moreover, baclofen did not affect continence function, as indicated by non-significant changes in the parameters of urethral pressure profiles.Oral baclofen can improve symptoms of voiding dysfunction, voided volume, voiding efficiency and maximum flow rate in women with functional bladder outlet obstruction. None of the patients experienced intolerable side-effects. Thus, oral baclofen may be used as an initial treatment for women with symptoms of voiding dysfunction.

Background. To compare the effect of hormone replacement therapy (HRT) using estrogen plus dydrogesterone or estrogen plus medroxyprogesterone acetate (MPA) on the risk factors for coronary heart disease (CHD) in postmenopausal women. Methods. A randomized, prospective 1-year clinical trial was designed. All of the postmenopausal women (n = 279) received sequential conjugated equine estrogen (CEE) at a dose of 0.625 mg/day for 25 days (days 1-25) of each month. These women were also randomly assigned to receive either dydrogesterone 10 mg/day (E + D group, n = 140) or MPA 5 mg/day (E + P group, n = 139) for 14 days (days 12-25) of each month. Serum biochemical markers, lipoproteins, plasma prothrombin time (PT), partial prothrombin time (PPT) and antithrombin III-antigen (ATIII-Ag) were analyzed at baseline, and after 6 and 12 months of treatment. Results. Liver function, renal function, PT and PPT did not change significantly during the 12-month trial. The E + D group had a more pronounced increase in hi...

To elucidate the impact of aging of hepatitis B carrier women on their viral replicative markers in a hepatitis B endemic area, all the parturients admitted to the Hospital were studied from 1985 to 2000. Serum hepatitis B surface (HBsAg) and hepatitis B e antigen (HBeAg) were tested by radioimmunoassay. Mann-Whitney U and Student's t-tests were used for statistical analysis. The results showed the yearly prevalence rate of HBsAg in pregnant women seemed stable with a mean of 12.0 +/- 1.1% during the period. The yearly positive rate of HBeAg among HBsAg-positive pregnant women varied between 30.4% and 42.6% from 1985 to 1992 and declined from 29.6% in 1993 to 18.1% in 2000. The mean ratio of HBeAg/HBsAg in carrier parturients was 24.7% [intraquantile range (IQR) 20.5-28.4] from 1993 to 2000, which was significantly lower than that of 32.4% (IQR 31.0-39.0) from 1985 to 1992 (P < 0.0001). The mean age of HBeAg-positive primiparas from 1993 to 2000 was 29.1 +/- 3.9 years and significantly higher than that of 28.0 +/- 3.7 years from 1985 to 1993 (P < 0.001), as well as in secundiparas 31.2 +/- 3.8 years vs. 30.1 +/- 3.4 years (P < 0.001) and in total parturients 30.3 +/- 4.2 years vs. 29.3 +/- 3.8 years (P < 0.001). Thus, no significant decrease of HBsAg carriage was observed in the past 16 years, whereas a decreased ratio of HBeAg/HBsAg was noted in carrier parturients in the past 8 years and the elderly HBeAg-positive parturients from 1993 to 2000 may be the cause.

Objectives To investigate the characteristics of autonomic function and arterial stiffness of OAB women, their relations with urodynamic parameters, and the impact of antimuscarinics on the above parameters. Study design A total of 85 OAB women and another 65 women without OAB were selected. Forty-two OAB women who enrolled before March 2009 were treated with tolterodine for 12 weeks, and another 43 OAB women who enrolled thereafter were treated with solifenacin. Main outcome measures The differences of the heart rate variability, cardio-ankle vascular index (CAVI) and ankle-brachial pressure index (ABI) between OAB and asymptomatic women, and their changes after 12 weeks’ antimuscarinics for OAB women. Results OAB women had higher low frequency/high frequency ratios (LF/HF) (OAB: 1.5 ± 1.1 vs. the control: 1.1 ± 0.7, P = 0.04). Nonetheless, CAVI and ABI did not differ between OAB and the control group. The square root of the mean squared differences of successive NN intervals (RMSSD) is associated with nocturia (Spearman's ρ = 0.23, P = 0.049), LF is associated with urgency episodes (Spearman's ρ = 0.28, P = 0.01), and maximum urethral closure pressure is negatively associated with CAVI (Spearman's ρ = −0.26, P = 0.02). After 12 weeks’ treatment, a decrease of RMSSD, HF, CAVI and an increase of LF/HF were found in the tolterodine group but not in the solifenacin group. Conclusions OAB women have higher severity of autonomic dysfunction with sympathetic predominance. Tolterodine may improve arterial stiffness but may deteriorate autonomic dysfunction to more sympathetic predominance. Thus, tolteridine should be used for OAB with caution in women with preexisting symptoms of autonomic dysfunction.

a b s t r a c t Objectives: To investigate the characteristics of psychological distress (PD), personality traits, and family support in women with overactive bladder syndrome (OAB), and the effects of antimuscarinic treatment. Study design: Women with and without OAB (age- and body mass index (BMI)-matched control group) were prospectively enrolled; they recorded bladder diaries, underwent urodynamic studies, and com- pleted PD, personality traits, and filled family support questionnaires before and after antimuscarinic treatment. OAB women underwent treatment with tolterodine or solifenacin for 12 weeks. The control group completed questionnaires. Main outcome measures: The differences in PD, personality traits, and family support scores between both groups, and the changes after antimuscarinic treatment in OAB women. Results: Eighty-five women with OAB (tolterodine, n = 42; solifenacin, n = 43) and 65 without OAB completed the studies. Linear regression analysis with age and BMI adjustment revealed: coefficients of OAB were significant (all P < 0.05) for somatic complaints (mean: 0.87 vs. 0.63, coefficient = 0.21), obsessive-compulsive symptoms (0.69 vs. 0.44, coefficient = 0.25), anxiety symptoms (0.42 vs. 0.27, coef- ficient = 0.14), General Symptom Index (GSI, 0.48 vs. 0.33, coefficient = 0.14), neuroticism (9.23 vs. 5.17, coefficient = 3.73), and extroversion-introversion (13.64 vs. 15.25, coefficient = −1.73). Anxiety symp- toms (0.42 vs. 0.36) and GSI (0.48 vs. 0.39) improved after antimuscarinics (all P < 0.05). High Overactive Bladder Symptom Score questionnaire score (coefficient = −0.39), low hostility score (coefficient = 2.11), and high additional symptoms score (coefficient = −1.46) were associated with good therapeutic effect (all P < 0.05). Conclusions: OAB women experience more PD, neuroticism, and introversion than asymptomatic women, and antimuscarinics could improve PD.