Search PubMed⌕ Search

Biomedical subjects

Mary P FitzGerald

Publications and source records attributed to Mary P FitzGerald.

10 recordsLinked to original sources
PubMed2007

Prevalence and impact of nocturia in a urogynecologic population.

To determine the prevalence of nocturia and associated bother among patients presenting to a tertiary urogynecology clinic and to describe patient characteristics related to nocturic frequency and associated bother. Chart review of sequential new patients presenting to our clinic between June 2004 and May 2005. We recorded patients' response to a question about their frequency of nocturia, the level of associated bother, demographic data, history of chronic medical illness and clinical urogynecologic diagnosis. Seven hundred sixty patients were of mean age 56 (19-95) years. Eighty-seven percent of patients voided at least once nightly, and 60% usually voided at least twice nightly. Forty one percent of patients reported bother >or=5/10 from nocturia. High bother rating was associated with increasing number of nocturic episodes (p < 0.0005) and mixed incontinence (p = 0.012). Nocturia is common and bothersome to women presenting for urogynecologic care. Concomitant mixed incontinence significantly increases bother arising from nocturia.

Adult↗
PubMed2007

Anatomic and functional changes of the lower urinary tract during pregnancy.

Pregnant women usually acknowledge and more or less accept symptoms of urinary frequency, nocturia, and leakage as annoying aspects of pregnancy that are expected to resolve when the pregnancy is over. Studies have shown that urinary symptoms may be more than just "annoying" - the symptoms can markedly reduce quality of life. This article provides an overview of the lower urinary tract during pregnancy, including considerations of symptoms of urinary frequency; nocturia and incontinence; changes in bladder support; and the occurrence of urinary retention, a urologic emergency.

Female↗
PubMed2006

Nocturnal polyuria and nocturia relief in patients treated with solifenacin for overactive bladder symptoms.

The objectives of this study are to determine whether patients with overactive bladder (OAB) and nocturia achieved relief of their nighttime voiding symptoms when treated with solifenacin and whether having nocturnal polyuria (NP) affected that response. The patients pooled from four phase III clinical trials were evaluated for reductions in nocturia episodes after treatment with solifenacin (5 or 10 mg) or placebo. A second analysis was performed in patients with and without NP. The patients treated with solifenacin experienced statistically significant reductions in nocturia episodes; median reductions were -35.5% for 5 mg of solifenacin and -36.4% for 10 mg of solifenacin compared with -25.0% for placebo, and significantly more patients treated with solifenacin vs placebo achieved a mean nocturic frequency of <or=1 episode/night. Solifenacin significantly reduced nocturia episodes only in patients without NP (mean change was -0.61 episodes/night for both doses compared with -0.43 episodes for placebo). Solifenacin significantly improved nocturia symptoms only in OAB patients without NP.

Female↗
PubMed2005

Colpocleisis: a review.

OBJECTIVE: To summarize published data about colpocleisis and to highlight areas about which data are lacking. DATA SOURCES: We conducted a literature search on Medline using Ovid and PubMed, from 1966 to January 2004, using search terms "colpocleisis", "colpectomy", "vaginectomy", "pelvic organ prolapse (POP) and surgery", and "vaginal vault prolapse and surgery" and included articles with English-language abstracts. We examined reference lists of published articles to identify other articles not found on the electronic search. METHODS OF STUDY SELECTION: We examined all studies identified in our search that provided any outcome data on colpocleisis. Because of the heterogeneity of outcome measures and follow-up intervals in case series, we did not apply meta-analytic techniques to the data. RESULTS: Colpocleisis for POP is apparently successful in nearly 100% of patients in recent series. The rate of reoperation for stress incontinence or POP after colpocleisis is unknown. Concomitant elective hysterectomy is associated with increased blood loss and length of hospital stay, without known improvement in outcomes. Few studies systematically assess pelvic symptoms. The role of preoperative urodynamic testing to direct optimal management of urinary incontinence and retention remains to be established in this setting. CONCLUSIONS: Colpocleisis is an effective procedure for treatment of advanced POP in patients who no longer desire preservation of coital function. Complications are relatively common in this group of elderly patients. Prospective trials are needed to understand the impact of colpocleisis on functional outcomes and patient satisfaction.

Age Factors↗
PubMed2005

Localization of the urge to void in patients with painful bladder syndrome.

AIMS: Our aim was to describe the location of urinary urgency or bladder discomfort in patients with painful bladder syndrome (PBS) and controls. METHODS: Patients with symptomatic diagnoses of PBS, overactive bladder (OAB) syndrome, stress urinary incontinence (SUI), and asymptomatic controls were asked to indicate the location of their urinary urge/urgency/discomfort on a body map. RESULTS: We present results for 30 PBS patients, 25 OAB patients, 15 SUI patients, and 15 asymptomatic controls. In asymptomatic subjects and those with SUI, the urge to void was localized to the suprapubic region only. More than half (53%) of patients with PBS and a minority (20%) of those with OAB localized their urinary urgency/discomfort to both suprapubic and vulvar/urethral locations. Some patients with PBS also localized their urinary discomfort to other body sites including low back, upper and lateral buttocks, lower abdomen, and upper thighs. CONCLUSIONS: In most patients with PBS and some with OAB, complaints of bladder discomfort or urgency may refer to sensations that are localized at sites other than suprapubic. The etiology of widespread sensation may include an expansion of dermatomes of referral of bladder sensation, and/or the presence of associated somatic abnormalities.

Adult↗
PubMed2003

Patient-selected goals: a new perspective on surgical outcome.

OBJECTIVE: This study was undertaken to study the relationship between achievement of patient goals, overall satisfaction, and objective outcome measures. STUDY DESIGN: After Institutional Review Board approval, we prospectively evaluated 78 women undergoing pelvic reconstructive surgery at Loyola University Medical Center. After informed consent for surgery, patients were asked to state their goals for surgery. In a follow-up telephone conversation, these goals were reviewed and negotiated to modify expectations. The same physician investigator contacted women 3 months after surgery to assess goal achievement, overall satisfaction, and their surgical experience. Date were analyzed with Spearman correlation and Mann-Whitney tests. RESULTS: Of 78 women, 75% indicated that they met most of their goals, and 72% were more than 80% satisfied. Patient satisfaction was moderately correlated to goal achievement (rho=0.57, P<.001). Objective cure, defined as no urodynamic stress incontinence and stage 0 or I prolapse, was not related to satisfaction (P=.14). Dissatisfaction was highly associated with feeling "unprepared for surgery" (P<.001). CONCLUSION: Objective and subjective outcomes are necessary to predict patient satisfaction.

Academic Medical Centers↗
PubMed2003

Colpocleisis and urinary incontinence.

OBJECTIVE: The study was undertaken to review results of colpocleisis performed for advanced pelvic organ prolapse (POP) in elderly women, with attention to perioperative stress incontinence. STUDY DESIGN: We performed a retrospective chart review of all colpocleisis procedures performed July 2000 through March 2002. RESULTS: Sixty-four women with median age 78 years (68-90 years) with symptoms and signs of advanced POP underwent partial vaginectomy and colpocleisis. Concomitantly, 21 (33%) women underwent suburethral sling and 12 (19%) underwent suburethral plication procedures for treatment of stress urinary incontinence (SUI). Three patients with dementia were unable to offer subjective symptoms. One patient died in hospital from multisystem organ failure unrelated to colpocleisis. When last seen, 2 (3%) of the remaining 60 patients had some persistence of symptoms of POP. Of 30 women without preoperative symptoms of SUI, 8 had new-onset SUI symptoms after surgery. CONCLUSION: Colpocleisis is an effective method for treatment of advanced POP. Lower urinary tract evaluation and treatment remain challenging in this setting.

Aged↗
PubMed2003

Chronic pelvic pain.

The topic of chronic pelvic pain (CPP) has long been a frustrating one for physicians and patients alike, with difficulties in diagnosis and management leading to delays in recovery. Recent insights into the neurobiology of chronic pain disorders and into mechanisms of visceral pain suggest that significant advances in treatment of CPP are likely to occur during coming years. These insights suggest that we consider directing our treatment efforts away from the visceral organ presumed to be primarily responsible for the CPP and toward treatment of the neurologic mechanisms that sustain chronic pain.

Animals↗
PubMed2002

Urinary incontinence symptom scores and urodynamic diagnoses.

The aim of this study was to determine whether scores on two validated urinary incontinence symptom scales predicted eventual urodynamic diagnoses. Two hundred ninety-three patients undergoing multi-channel urodynamic testing rated their symptoms of urinary incontinence and/or pelvic organ prolapse (POP), using the Incontinence Impact Questionnaire, the Urogenital Distress Inventory, and an obstructive symptom subscale from the long form of the Incontinence Impact Questionnaire. Among the 202 (69%) patients without advance-stage POP, increasing scores on scale items related to stress and urge incontinence predicted increasing frequency of the diagnoses of genuine stress incontinence (GSI) and detrusor instability, respectively. Among the 91 (31%) patients with advance-stage POP, there was no association. Among all patients with GSI, the presence of intrinsic sphincter deficiency could not be predicted by responses to the symptom scales. Scores on the symptom scales were inadequate predictors of eventual urodynamic diagnoses, especially among women with advance-stage POP.

Adolescent↗