Biologic correlates of sexual function in women with stress urinary incontinence.

INTRODUCTION: Stress urinary incontinence (SUI) has a great impact on the quality of life and sexual function. We hypothesized that specific risk factors for SUI may be correlated with reduced sexual function in women with SUI. AIMS: To explore significant associations between the risk factors for SUI and female sexual function. METHODS: Women with SUI (N=223) were surveyed about their sexual function. Demographic data and clinical findings on pelvic examination and the 1-hour pad test were recorded. Sexually active respondents completed the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). MAIN OUTCOME MEASURE: PISQ-12 and the correlation of the risk factors for SUI with PISQ-12 scores. RESULTS: Of the 223 subjects, 68 (30%) reported no sexual activity for 6 months or more prior to the interview and did not respond to the PISQ-12. In comparison with the 155 (70%) of women who were sexually active, sexually inactive respondents were older and more likely to be postmenopausal and had a higher parity and more severe prolapse (all P<0.01). Among those completing the PISQ-12 questionnaire, the same factors (age, parity, severity of prolapse, menopausal status) were significantly associated with lower PISQ-12 scores. The scores were not correlated with body mass index, delivery mode, genital hiatus length, and total vaginal length by the short form of the Pelvic Organ Prolapse Quantification (POP-Q) system, or estrogen therapy. Lower points Ba and C of the POP-Q system were associated with lower PISQ-12 scores (r= -0.200, P=0.026; r= -0.191, P=0.035, respectively). Multivariate analysis identified parity as the only factor independently predictive of sexual dysfunction (r= -0.225, P=0.013). CONCLUSIONS: Anatomic and biologic pathology does not satisfactorily predict the level of sexual functioning in women with SUI.

Optical imaging of ovarian cancer using a matrix metalloproteinase-3-sensitive near-infrared fluorescent probe.

Epithelial ovarian cancer (EOC) is the seventh most common cancer among women worldwide. The 5-year survival rate for women with EOC is only 30%-50%, which is largely due to the typically late diagnosis of this condition. EOC is difficult to detect in its early stage because of its asymptomatic nature. Recently, near-infrared fluorescent (NIRF) imaging has been developed as a potential tool for detecting EOC at the molecular level. In this study, a NIRF-sensitive probe was designed to detect matrix metalloproteinase (MMP) activity in ovarian cancer cells. A cyanine fluorochrome was conjugated to the amino terminus of a peptide substrate with enzymatic specificity for MMP-3. To analyze the novel MMP-3 probe, an in vivo EOC model was established by subcutaneously implanting SKOV3 cells, a serous-type EOC cell line, in mice. This novel MMP-3-sensitive probe specifically reacted with only the active MMP-3 enzyme, resulting in a significantly enhanced NIRF emission intensity. Histological analysis demonstrated that MMP-3 expression and activity were enhanced in the stromal cells surrounding the ovarian cancer cells. These studies establish a molecular imaging reporter for diagnosing early-stage EOC. Additional studies are required to confirm the early-stage activity of MMP-3 in EOC and its diagnostic and prognostic significance.

Correction: Effects of collagen matrix and bioreactor cultivation on cartilage regeneration of a full-thickness critical-size knee joint cartilage defects with subchondral bone damage in a rabbit model.

[This corrects the article DOI: 10.1371/journal.pone.0196779.].

Effects of collagen matrix and bioreactor cultivation on cartilage regeneration of a full-thickness critical-size knee joint cartilage defects with subchondral bone damage in a rabbit model.

Cartilage has limited self-repair ability. The purpose of this study was to investigate the effects of different species of collagen-engineered neocartilage for the treatment of critical-size defects in the articular joint in a rabbit model. Type II and I collagen obtained from rabbits and rats was mixed to form a scaffold. The type II/I collagen scaffold was then mixed with rabbit chondrocytes to biofabricate neocartilage constructs using a rotating cell culture system [three-dimensional (3D)-bioreactor]. The rabbit chondrocytes were mixed with rabbit collagen scaffold and rat collagen scaffold to form neoRBT (neo-rabbit cartilage) and neoRAT (neo-rat cartilage) constructs, respectively. The neocartilage matrix constructs were implanted into surgically created defects in rabbit knee chondyles, and histological examinations were performed after 2 and 3 months. Cartilage-like lacunae formation surrounding the chondrocytes was noted in the cell cultures. After 3 months, both the neoRBT and neoRAT groups showed cartilage-like repair tissue covering the 5-mm circular, 4-mm-deep defects that were created in the rabbit condyle and filled with neocartilage plugs. Reparative chondrocytes were aligned as apparent clusters in both the neoRAT and neoRBT groups. Both neoRBT and neoRAT cartilage repair demonstrated integration with healthy adjacent tissue; however, more integration was obtained using the neoRAT cartilage. Our data indicate that different species of type II/I collagen matrix and 3D bioreactor cultivation can facilitate cartilage engineering in vitro for the repair of critical-size defect.

Correction: Optical imaging of ovarian cancer using a matrix metalloproteinase-3-sensitive near-infrared fluorescent probe.

[This corrects the article DOI: 10.1371/journal.pone.0192047.].

Histological and Immunohistochemical Analyses of Repair of the Disc in the Rabbit Temporomandibular Joint Using a Collagen Template.

A previous study demonstrated that the reconstituted type I collagen matrix extracted from rabbit tendons enabled the TMJ disc to regenerate in the rabbit. The aim of this study was to investigate changes in the extracellular matrix (ECM) and mechanisms of regeneration in the TMJ disc. In 36 New Zealand rabbits that underwent a partial discectomy, discs were replaced with reconstituted collagen templates for 3 months. A histological analysis showed that moderate to severe degeneration appeared in partially discectomized joints without implantation. In contrast, discs experienced regeneration of reconstituted collagen template implantation and the joint returned to normal function. Cells in the regenerative tissue expressed ECM, and fibers became regular and compact due to tissue remodeling over time. Reparative cells differentiated into chondroblasts, and showed highly dense pericellular fibers. The morphology and collagen composition of the disc and condyle in the 3-month experimental group were similar to those of normal tissues. In conclusion, the reconstituted collagen template facilitated the regeneration of surgically discectomized discs. Type I and type II collagens play a crucial role in the regeneration of articular discs.

Transobturator vaginal tape inside out procedure for stress urinary incontinence: results of 102 patients.

Multiple behavioral and surgical treatments exist for the treatment of stress urinary incontinence (SUI). We report herein on the safety and efficacy of the transobturator vaginal tape inside out (TVT-O) procedure for patients with SUI. A retrospective study of 102 consecutive patients with SUI who underwent the TVT-O procedure was conducted. Pre and postoperative evaluations included urodynamic studies and a 60-min pad test. Based on the 4th and 8th week postoperative evaluations, 97 of 102 (95%) patients had a complete cure. Of 88 patients who were followed for 12 months, 84 (95%) achieved a complete cure. Two instances of intraoperative lateral vaginal sulcus perforation occurred. Pain over the inner thigh was noted in 17 (17%) patients. Mesh erosion was noted in one case. TVT-O procedure is a safe, effective, and minimally invasive procedure for SUI with a low rate of complications.

Postpartum urinary incontinence: a comparison of vaginal delivery, elective, and emergent cesarean section.

The aim of this study was to assess the impact of delivery on the pelvic floor and whether cesarean section (C/S) can prevent pelvic floor injury. Five hundred thirty nine women were divided into three groups according to the delivery method adopted: elective C/S, emergent C/S, and vaginal delivery. A urinary incontinence questionnaire survey was conducted around 1 year postpartum. Emergent C/S may be a major risk factor for postpartum urinary incontinence and interfere with the benefit of elective C/S for preventing pelvic floor injury. Hence, not all C/S deliveries can reduce the likelihood of postpartum urinary incontinence. The key lies in whether the C/S is performed before labor.