Quality of life and sexual function analysis in a group of Italian postmenopausal women after COVID-19 vaccination.

AIM: The aim of the study was to evaluate the impact of SARS-CoV-2 vaccination on quality of life, psychological aspect and sexual life in a group of Italian postmenopausal women during the COVID-19 pandemic. METHODS: The study was a prospective, observational analysis of postmenopausal women before and after the COVID-19 vaccination. The population previously answered different questionnaires, such as the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), the 36-Item Short Form Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Twelve weeks after the end of the vaccine cycle, these women were invited to complete the same questionnaires by e-mail to evaluate if vaccination coverage could positively impact the quality of life of postmenopausal women. The Patient Impression of Global Improvement (PGI-I) after three months of treatment was also calculated. RESULTS: A total of 114 patients were reported. The median age was 60.96 (52-66) years. Mean sexual intercourses/month increased from 1.28 ± 1.23 to 4.21 ± 1.80 (p = 0.001). The FSFI increased (19.22 ± 3.31 vs 29.24 ± 4.21, p < 0.0001) and the FSDS decreased significantly (20.12 ± 5.23 vs 9.32 ± 5.55, p < 0.0001) 12 weeks after vaccination coverage. The SF-36 increased from 64.23 ± 11.76 to 82.21 ± 10.24 (p < .0001) and the HADS questionnaire improved significantly from 9.3 ± 2.73 to 5.1 ± 1.34 after the COVID-19 vaccine execution (p<.0001). CONCLUSIONS: The spread of COVID-19 vaccine coverage positively influenced sexual function, quality of life and psychological aspect in postmenopausal women.

Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women.

BACKGROUND: The beginning of 2020 was characterized by the COVID-19 pandemic. The world governments have adopted restrictive measures to reduce the spread of infection. These measures could affect the sexual function and quality of life of women living with their partner. AIM: The aim is to assess the impact of the social distancing measures caused by the COVID-19 pandemic on sexual function and quality of life of noninfected reproductive-age women, living with their sexual partner. METHODS: Observational analysis on sexually active women, living with their partner, and without COVID-19 infection was performed. The population previously answered FSFI, FSDS, and SF-36 questionnaires. 4 weeks after the introduction of the restrictive measures, these women were invited to complete the same questionnaires by e-mail for an evaluation during the COVID-19 outbreak. MAIN OUTCOME MEASURES: The primary endpoint was the assessment of the women's sex function change during the social restriction period, by analyzing the FSFI and FSDS questionnaires. The secondary endpoint was the evaluation of the impact on the quality of life calculated by the SF-36 questionnaire. RESULTS: 89 patients were considered. The median age was 39 (28-50) years. Mean sexual intercourses/month decreased from 6.3 ± 1.9 to 2.3 ± 1.8, mean difference: -3.9 ± 1.2. FSFI decreased significantly (29.2 ± 4.2 vs 19.2 ± 3.3, mean difference: -9.7 ± 2.6) and FSDS increased significantly (9.3 ± 5.5 vs 20.1 ± 5.2, mean difference: 10.8 ± 3.4). The SF-36 showed a significant change from 82.2 ± 10.2 to 64.2 ± 11.8 4 weeks after the introduction of the restrictive measures; mean difference: -17.8 ± 6.7. The univariable analysis identified working outside the home, university educational level, and parity ≥1 as predictive factors of lower FSFI. In multivariable analysis, working outside the home and combination of working outside the home + university educational level + parity ≥1 were the independent factors of a lower FSFI. CLINICAL IMPLICATION: The negative impact of the COVID-19 epidemic period on sexual function and quality of life in women shows how acute stress might affect the psychological state. Thus, psychological or sexual support could be useful. STRENGTHS AND LIMITATIONS: To our knowledge, this study is the first that analyzes the change in sexual activity in women during the COVID-19 outbreak period. The limitations were the low number of the analyzed participants, psychological tests were not included, and no data were collected on masturbation, self-heroism, solitary, and nonpenetrative sex. CONCLUSION: The COVID-19 epidemic and the restrictive social distancing measures have negatively influenced the sexual function and quality of life in not-infected reproductive-age women who live with their sexual partners. Schiavi MC, Spina V, Zullo MA, et al. Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women. J Sex Med 2020;17:1407-1413.

Minimally Invasive Treatment of Stress Urinary Incontinence in Women: A Prospective Comparative Analysis between Bulking Agent and Single-Incision Sling.

INTRODUCTION: The study aims to compare the efficacy and safety of bulking agents and single-incision slings in the treatment of urinary incontinence in 159 patients during a 29-month follow-up period. MATERIAL AND METHODS: Of the 159 patients suffering from stress urinary incontinence, 64 were treated with bulking agents (PAHG Bulkamid®) and 75 with a single-incision sling (Altis®). The ICIQ-UI-SF (Incontinence Questionnaire-Urine Incontinence-Short Form), PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaires short form), FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Scale), and PGI-I (Patient Global Improvement Index) were used to assess efficiency and quality of life. RESULTS: The bulking agents showed high efficacy and safety during the 29-month follow-up. Post-operative complications were recorded in both groups, with only two significant differences. The Bulkamid group experienced no pain, while 10.8% of the ALTIS group experienced groin pain and 5% experienced de novo urgency. Furthermore, patients treated with bulking agents experienced reduced nicturia (0.78 vs. 0.92 in patients treated with single-incision slings.). In both groups, we noticed a significant improvement in QoL (quality of life), with a halved ICIQ-UI-SF (International Consultation on Incontinence Questionnaire-Urine Incontinence-Short Form) score which was completed to assess the impact of urine symptoms. After 24 months of therapy, the Bulkamid group saw a decrease from 14.58 ± 5.11 at baseline to 5.67 ± 1.90 (p < 0.0001), whereas the ALTIS group experience a decrease from 13.75 ± 5.89 to 5.83 ± 1.78. Similarly, we observed an improvement in sexual function, with the number of sexually active patients increasing from 29 to 44 (56.4%) in the Bulkamid group (p = 0.041) and from 31 to 51 (61.7%) in the ALTIS group (p = 0.034). According to the most recent statistics, the PISQ-12, FSFI, and FSDS scores all demonstrated an improvement in women's sexual function. CONCLUSIONS: In terms of efficacy and safety, bulking agents had notable results over the 29-month follow-up period. Furthermore, the patients treated with bulking agents reported a lower incidence of postoperative complications and a no discernible difference in terms of quality of life and sexual activity compared to the ones treated with single-incision slings. Bulking agents can be considered a very reliable therapeutic option based on accurate patient selection.

Evaluation of the efficacy and safety of single incision sling vs TVT-O in obese patients with stress urinary incontinence: Quality of life and sexual function analysis.

OBJECTIVES: The aim of the study is to demonstrate the best stress urinary incontinence (SUI) surgical technique for women with a Body mass index higher than 30. The results of Transvaginal Tension Free Vaginal Tape-Obturator and Mini-sling surgery were analyzed and compared through both clinical examination and standardized questionnaires at 36 months of follow-up. MATERIALS AND METHODS: This is a retrospective multicenter study over 159 women with SUI who underwent surgery. Seventy-eight women underwent TVT-O and 81 Mini-sling technique. Intra and post-operative complications were recorded. Patients were monitored for 36 months by analyzing symptoms, voiding diary, quality of life and sexual activity through standardized questionnaires. RESULTS: Complications had a low incidence in both groups and inter-group differences were superimposable. Only groin pain was statistically higher after TVT-O than after Mini-sling (12.8% vs1.2%, p = 0.03). At 36 months of follow-up, a statistically significant decrease in Positive stress test (%) and Q-Tip test (grade) was observed in both groups with no differences between them (p = 0.54 and p = 0.32 respectively). The mean number of daily voids was higher after TVT-O (p = 0.04) than after Altis (p = 0.22) with a significant difference in favor of the Altis group (p = 0.03). After 36 months, there were no significant differences between groups in terms of quality of life and sexual activity. PGI-I did not show any difference between groups (p = 0.21). CONCLUSION: TVT-O and Minisling had the same efficacy and results in the surgical treatment of SUI in obese women. Both techniques relieved their symptoms and improved their quality of life without any significant difference except for a lower incidence of post- Mini-sling complications.

Iodized Salt May Not Be Sufficient to Guarantee an Adequate Iodine Intake in Pregnant Women.

Adequate iodine intake is of crucial importance in pregnancy to meet the thyroid hormone needs of both mother and fetus. In the present study, undertaken as a part of the surveillance actions following the introduction in Italy of a national salt iodination program in 2005, the iodine intake was investigated in 123 pregnant women and 49 control women living in the same area of central Italy. All the participants were screened for urinary iodine concentration (UIC), serum level of thyrotropin, free-thyroxine, free-triiodothyronine, and thyroid volume. Moreover, they were provided with a questionnaire on the use of iodine-containing salt or supplements. Control women had a median UIC of 102 µg/L, consistent with an iodine sufficiency, while in pregnant women the median UIC value was 108 µg/L, lower than the endorsed UIC of 150 µg/L. In addition, pregnant women showed a significantly increased median thyroid volume compared to controls. Interestingly, the median UIC did not differ between pregnant women not using iodine-containing salt or supplements and those regularly consuming iodized salt alone, while pregnant women with a daily intake of iodine-containing supplements had an adequate median UIC (168 µg/L). In conclusion, the data reported here showed that pregnant women and their fetuses are still exposed to the detrimental effects of iodine deficiency and that the consumption of iodine-containing supplements should be recommended in pregnancy.

Laparoscopic stripping versus endometrioma ethanol sclerotherapy in women with endometrioma awaiting IVF: a long-term analysis of ovarian reserve and pregnancy outcome.

BACKGROUND: The aim of this study was to compare ovarian reserve, oocytes quality and pregnancy outcome of endometrioma treatment by laparoscopic stripping (LS) versus endometrioma ethanol sclerotherapy (EST) in infertile women awaiting in-vitro fertilization (IVF). METHODS: Retrospective analysis was performed. Twenty-three women underwent EST and 26 women LS. Intra- and postoperative complications were recorded. The women were followed-up for 36 months for cyst recurrence, oocytes quality and pregnancy outcome. Serum anti-Müllerian hormone (AMH) levels after treatment were measured to observe the impact on the ovarian reserve. Women's satisfaction was investigated with PGI-I. RESULTS: During follow-up, there were 3 endometriomas recurrences after LS and none after EST. Six months after treatment AMH was 3.17±2.15 in EST vs. 2.22±1.97 in LS, P=0.045. Symptoms' improvement was comparable. No intraoperative complications occurred. In the LS group the postoperative complications were significantly higher. After IVF cycles, the quality of the retrieved oocytes was the same. In EST group, clinical pregnancy (48.1% vs. 19.6%) and live birth rates (36.5% vs. 14.3%) were significantly increased compared to LS. Women's satisfaction was comparable at PGI-I. Both EST and the presence of an endometrioma sized 6 cm or less proved to be independent factors of a better live birth rate in multivariate analysis. CONCLUSIONS: EST efficacy was greater than LS for endometrioma. Ovarian function was well preserved. Hospital stay was shorter, fewer complications occurred. Pregnancy outcome was better after EST.

Urogynecological survey in a group of Italian women treated for overactive bladder: Symptoms and quality of life analysis during the Covid-19 period.

OBJECTIVES: The aim of this study is to assess the impact of life change and social distancing measures, during the Covid-19 outbreak, on the OAB symptoms and quality of life in women underwent different types of treatment. MATERIALS AND METHODS: Observational survey analysis in OAB treated patients was performed. The women showed a greater than 50% improvement during specific therapy for OAB. Population had previously completed bladder diary, OAB-Q symptom, OAB HRQL scale, SF-36 and PGI-I questionnaires. Four weeks after the introduction of the restrictive measures, these women were invited to complete the same questionnaires by e-mail for new evaluation during Covid-19 outbreak. Primary endpoint was changes in number of voids/24h, urgent micturitions/24h, urinary incontinence events/24h, nocturia events. Secondary endpoints were the assessment of the change in the OAB-SF, SF-36 questionnaires and PGI-I satisfaction. RESULTS: Six hundred seventy-three patients were considered. The mean age was 63.21 ± 10.24 years. Four weeks after the start of the social distancing measures, the increase in mean number of voids/24h (7.13 ± 1.08 vs 9.76 ± 2.12, p < 0.0001), urgent micturition episodes/24h (2.65 ± 1.11 vs 4.57 ± 1.28, p < 0.0001), nocturia episodes (1.19 ± 1.21 vs 2.83 ± 0.94, p < 0.0001) was observed. The OAB symptom scores (32.67 ± 12.88 vs 51.23 ± 12.11, p < 0.0001), OAB-HRQL (75.45 ± 12.76 vs 48.23 ± 10.34, p < 0.0001), and SF-36 (82.15 ± 11.78 vs 69.39 ± 10.85, p < 0.0001) changed significantly. The satisfaction decreased significantly at the PGI-I during the Covid-19 period 79.8% vs 45% (p < 0.0001). CONCLUSIONS: The Covid-19 outbreak and the restrictive social distancing measures have negatively influenced the OAB symptoms and quality of life in women underwent different types of treatment.