Prevalence of pelvic floor dysfunction: a Saudi national survey.

BACKGROUND: Pelvic Floor Dysfunction (PFD) is a global health problem affecting millions of women worldwide and comprises a broad range of clinical dysfunctions such as urinary incontinence (UI), fecal incontinence (FI), pelvic organ prolapse (POP) vaginal laxity (VL), vaginal wind (VW), and overactive bladder (OAB). This study aims to estimate the prevalence of PFD among Saudi women attending primary health care centers (PHCCs) across 13 regions of Saudi Arabia and their characteristics along with associated factors. METHODS: A cross-sectional study was conducted on 2,289 non-pregnant women. The probability population proportional sampling technique was employed followed by a convenient sampling technique to recruit eligible women. Types of PFD were assessed using a self-administered electronic questionnaire. Pelvic Floor Distress Index (PFDI-20) was used to assess the primary study outcomes (FI, VL, POP, VW, and OAB). A multivariate logistic regression model was used to identify independent associated factors for PFD. RESULTS: The findings showed that 830 women (36.3%) had any type of UI. Stress UI affected726 (31.7%) women, whilst 525 women (22.9%) had urge UI. VL occurred in 505 women (22.1%), whilst POP occurred in 536 women (23.4%). VW occurred in 733 participants and (32%) 1238 women (54.1%) had OAB. The multivariate analysis suggested that region, location, parity, and assisted birth were significantly associated with UI, VL, FI and PFD (P < 0.001). CONCLUSION: PFD is a common condition among Saudi women. UI, VL, VW, OAB, POP and FI increased consistently among urban women with increased age, greater parity, assisted birth, and post-menopausal status.

Spontaneous Retroperitoneal Hematomas Following Uncomplicated Vaginal Deliveries: A Case Report and Literature Review.

INTRODUCTION: Retroperitoneal hematomas are rare in obstetrics. CASE PRESENTATION: A 36-year-old female presented two days following uncomplicated non-traumatic spontaneous vaginal delivery with an acute onset of severe left lower quadrant abdominal pain. The patient was hypotensive, tachycardic, and febrile. The hemoglobin dropped post delivery to 75 g/L. A non-contrast CT scan revealed a retroperitoneal hematoma. MANAGEMENT AND OUTCOME: Conservative management approaches resulted in spontaneous remission of the retroperitoneal hematoma.

Surgical Option in the Management of a Giant Vesical Calculus Post Augmentation Cystoplasty.

We describe a rare instance of enormous, calcified stone development in an enlarged urinary bladder. The patient was a 24-year-old female suffering from the development of vesical calculus as a result of complicated bladder augmentation. She had a small bladder capacity and had undergone augmentation ileocystoplasty in childhood. The abdomen was examined using X-ray and computerized tomography, which revealed a significantly huge urinary bladder stone. An open cystolithotomy was performed and a giant vesicle calculus was extracted along with another small stone. Although stone development is a typical side effect following augmented bladder, it may be avoided with frequent bladder irrigation and attentive aftercare.

Pregnancy, delivery, and neonatal outcomes among women with incarcerated uteri: A population-based study of a large US database.

OBJECTIVE: Incarcerated uterus occurs at a rate of 1:3000 pregnancies. Previous studies focused on risk factors and management options, providing limited information about pregnancy outcomes. This study evaluates the effect of incarcerated uterus on pregnancy, delivery, and neonatal outcomes. METHODS: Retrospective study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 2004 to 2014. Incarcerated uterus was identified using ICD-9 code 654.3X. Multivariate logistic regression analysis was used to compare maternal and neonatal outcomes among women with and without incarcerated uterus while adjusting for confounders. RESULTS: Incarcerated uteri were identified in 370 pregnancies, and 9,096,418 pregnancies were control cases. Compared to controls, women with incarcerated uterus were more likely to be Caucasian, have smoked during pregnancy, have had a previous caesarean section, have thyroid disease, endometriosis, leiomyomas, pelvic inflammatory disease and adhesions, and ovarian cyst (P-value < 0.05 all). Women with incarcerated uterus were more likely to have placenta previa (aOR 3.1, 95% CI 1.3-7.4), deliver by caesarean section (aOR 2.4, 95% CI 1.8-3.1), have postpartum hemorrhage (aOR 2.8, 95% CI 1.8-4.4), and require blood transfusion (aOR 5.2, 95% CI 3.1-8.8). Hydronephrosis occurred more often in women with incarcerated uterus (0.8% versus 0.1%). Moreover, they were more likely to have infants with congenital anomalies (aOR 4.0, 95% CI 1.5-10.6). Rates of preeclampsia, preterm birth, and small for gestational age were similar between the two groups (P-value > 0.05, all). CONCLUSION: Women with incarcerated uterus were more likely to encounter adverse delivery and neonatal outcomes compared to the general population. These findings may help guide prenatal counseling and prenatal surveillance.