University of Calgary

Research Spotlight

Research Highlights

• Dr. Erin Brennand is one of the co-PIs on the GROWW (Guiding interdisciplinary Research on Women's and girls health and Wellbeing) project which is a $2.4M team grant funded by the CIHR. This is a University of Calgary led national health research training program focusing on girls and women's health from a life-course perspective. Co-PIs also include Dr. Amy Metcalfe (U of Calgary), Dr. Jennifer Gorden (U of Regina) and Dr. Ryan van Leishout (McMaster), as well as 57 investigators from 23 academic institutions, representing 8 provinces and 1 territory, as well as multiple partners from government, industry and the not-for-profit sector. This program will develop capacity for women's health research in Canada by training the next generation of graduate students and clinical trainees. (The Section of FPMRS at U of Calgary was a valued stakeholder in the proposal's development and is a formal stakeholder).
• The O’Brien Institute for Public Health at the University of Calgary is also in the midst of developing a Sex, Gender and Women's Health Research Unit which will be headed by Dr. Erin Brennand. Stay tuned for more interesting research from this group.

Featured Publications
Kim-Fine S, Antosh DD, Balk EM, Meriwether KV, Kanter G, Dieter AA, Mamik MM, Good M, Singh R, Alas A, Foda M, Rahn DD, Rogers RG. Relationship of postoperative vaginal anatomy and sexual function: a systematic review with meta-analysis. Int Urogynecol J. 2021 Aug;32(8):2125-2134. doi: 10.1007/s00192-021-04829-4. Epub 2021 May 14. PMID: 33988785

• Dr. Kim-Fine (FPMRS, University of Calgary) led this esteemed group of international FPMRS specialists in a planned secondary analysis of a systematic review by the Society of Gynecologic Surgeons Systematic Review Group (2020). This secondary review sought to describe the relationships between vaginal anatomic measures and sexual function outcomes before and following POP surgery. The primary aim of this systematic review was to determine whether pre- and post-operative TVL and GH were related to sexual function scores and dyspareunia after POP repair.
• For the primary systematic review, randomized controlled trials and prospective nonrandomized comparative studies that compared different POP surgeries and evaluated sexual function as measured with either validated questionnaires or dyspareunia outcomes in women undergoing POP surgery were included.
• In the original search in 2018, 3124 studies were screened and 74 papers representing 67 original studies were accepted. PISQ-12 was the most commonly reported validated questionnaire (in 26 studies). Nine studies reported TVL and dyspareunia outcomes, eight studies reported GH and PISQ-12 outcomes, and seven studies reported GH and dyspareunia outcomes.
• Associations of PISQ-12 and total vaginal length: Across studies change in PISQ-12 after POP surgery was significantly associated with pre-operative TVL (adjusted β = −2.4, 95% CI –4.6 to −0.2, p = 0.033). In studies with shorter mean TVL preoperatively, patients had larger increases in PISQ-12, and better sexual function after surgery. However, change in PISQ-12 was not associated with postoperative TVL or change in TVL.
• Associations of dyspareunia and total vaginal length: Neither pre- nor post-operative TVL was associated with total or de novo dyspareunia.
• Associations of PISQ-12 and genital hiatus: Neither pre- nor post-operative GH was associated with PISQ-12.
• Associations of dyspareunia and genital hiatus: The mean pre-operative GH was not associated with pre- or post-operative dyspareunia or de novo dyspareunia. There were insufficient observations to meta-analyze for associations between post-operative dyspareunia/de novo dyspareunia and post-operative GH or change in GH.
• CONCLUSION: Evidence does not support an association between vaginal anatomic measurements and sexual function scores and dyspareunia following POP surgery. Future studies should aim to report pre- and post-operative outcome measures according to the most recent IUGA/ICS joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction.

Cummings S, RamageK, Scime NV, Ahmed SB, Brennand EA. Gender expression is associated with selection of uterine preservation or hysterectomy for pelvic organ prolapse surgery: Novel methodology for sex- and gender-based analysis in gynecologic research. Int J Gynaecol Obstet. 2022 Mar 8. doi: 10.1002/ijgo.14169. Epub ahead of print. PMID: 35262193.

• This is a study out of the Calgary Women's Pelvic Health Research Group, led by Dr. Brennand, and was supported through a CIHR Women's Health Clinical Mentorship Grant and M.S.I. Foundation Grant. 
• This study specifically aimed to determine if gender expression is associated with patients' choice of whether to have the uterus preserved or removed during POP surgery. This is the first known study to investigate gender expression in a clinical gynecologic study.
• Data was collected from a prospective cohort of patients undergoing their first POP surgery. Patients were able to self-select their study group, either the uterine-preserving or hysterectomy-based groups for POP procedure.
• Gender expression was measured through self-report before surgery. Using a framework set by Magliozzi et al (a short gender expression tool), participants ranked how they saw themselves on a scale of 0 (not at all) and 6 (very) for both femininity and masculinity. 
• Baseline scores were collected in 177 patients, all of whom were cisgender, and 165 patients underwent surgery with 58 patients in the uterine-preserving group and 107 in the hysterectomy group. 
• In the multivariable model adjusting for sociodemographic characteristics and patient reported outcomes based on POP symptoms, women with non-polar gender scores had higher odds of selecting uterine-preserving surgery (OR of 2.53 (95% CI 1.06–6.09)). 
• Key findings of this study included: (1) variation in gender scores and the concept of gender expression exist even within a group of cisgender, nearly all heterosexual, women, (2) gender score was not strongly associated with sociodemographic variables, and (3) gender expression is associated with a women's decision making to have their uterus preserved or removed at the time of POP surgery. 
• CONCLUSION: Women with masculine traits (non-polarity) in gender expression were more likely to choose uterine-preservation over hysterectomy to treat POP. This is an important finding and suggests that uterine-preserving surgeries should be widely offered to those seeking POP surgery. This study also demonstrated the feasibility of using a short gender expression tool and advocates for further gender expression research in gynecologic health.
  
  

2021-2022 Publication List

Edwards A, Carter Ramirez A, Scime NV, Kim-Fine S, Brennand EA. Authors' Reply (RE. Does Size Matter? Opioid Use after Laparoscopy for Apical Pelvic Organ Prolapse Using an 8 mm versus 10-12 mm Accessory Port. J Minim Invasive Gynecol. 2021 Dec 17:S1553-4650(21)01325-X. doi: 10.1016/j.jmig.2021.12.007. ) J Minim Invasive Gynecol. 2022 Jan 31:S1553-4650(22)00041-3. doi:10.1016/j.jmig.2022.01.013. Epub ahead of print. PMID: 35101630.

Chaikof M, McDermott CD, Brennand E, Sanaee M. Patients Seeking "Vaginoplasty" Deserve Assessment and Treatment by Experts in Female Pelvic Medicine and Reconstructive Surgery. Aesthet Surg J. 2021 Mar 12;41(4):NP148-NP149. doi: 10.1093/asj/sjaa286. PMID: 33165577; PMCID: PMC7954535.

Walter JE, Brennand EA, Lemos N, Cundiff GW; Canadian Society of Pelvic Medicine Mesh Complications Writing Group. Letter: Canadian Society of Pelvic Medicine Response to the Collège des Médecins du Québec Rapport d'Enquête. J Obstet Gynaecol Can. 2021 Mar;43(3):298-299. doi: 10.1016/j.jogc.2020.10.004. Erratum in: J Obstet Gynaecol Can. 2021 May;43(5):650. PMID: 33640099.

Scime NV, Brown HK, Metcalfe A, Brennand EA. Prevalence of Hysterectomy by Self-Reported Disability Among Canadian Women: Findings from a National Cross- Sectional Survey. Womens Health Rep (New Rochelle). 2021 Nov 29;2(1):557-565. doi: 10.1089/whr.2021.0069. PMID: 34909762; PMCID: PMC8665278.

Walter JE, Brennand EA, Lemos N, Cundiff GW; Canadian Society of Pelvic Medicine Mesh Complications Writing Group. Corrigendum to 'Canadian Society of Pelvic Medicine Response to the Collège des Médecins du Québec Rapport d'Enquête' [Journal of Obstetrics and Gynaecology Canada 43/3 (2021) 298-299]. J Obstet Gynaecol Can. 2021 May;43(5):650. doi: 10.1016/j.jogc.2021.03.008. Erratum for: J Obstet Gynaecol Can. 2021 Mar;43(3):298-299. PMID: 33992128.

Scime NV, Ramage K, Brennand EA; Calgary Women’s Pelvic Health Research Group. Protocol for a prospective multisite cohort study investigating hysterectomy versus uterine preservation for pelvic organ prolapse surgery: the HUPPS study. BMJ Open. 2021 Oct 4;11(10):e053679. doi: 10.1136/bmjopen-2021-053679. PMID: 34607873; PMCID: PMC8491422.

Edwards A, Carter Ramirez A, Scime NV, Kim-Fine S, Brennand EA. Does Size Matter? Opioid Use after Laparoscopy for Apical Pelvic Organ Prolapse Using an 8 mm versus 10-12 mm Accessory Port. J Minim Invasive Gynecol. 2021 Dec 17:S1553-4650(21)01325-X. doi: 10.1016/j.jmig.2021.12.007. Epub ahead of print. PMID: 34929399.

Shah FI, Ramage K, Scime NV, Brennand EA, Walker LM. Pelvic Organ Prolapse Takes Up Space in the Bedroom: A Mixed Method Exploration of the Circular Sexual Response Cycle in Women With Pelvic Organ Prolapse. Female Pelvic Med Reconstr Surg. 2021 Nov 10. doi: 10.1097/SPV.0000000000001123. Epub ahead of print. PMID: 34768257.

Anglim BC, Ramage K, Sandwith E, Brennand EA; Calgary Women’s Pelvic Health Research Group. Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol. BMC Womens Health. 2021 May 11;21(1):195. doi: 10.1186/s12905-021-01330-4. PMID: 33975584; PMCID: PMC8111911.

Cummings S, Ramage K, Scime NV, Ahmed SB, Brennand EA. Gender expression is associated with selection of uterine preservation or hysterectomy for pelvic organ prolapse surgery: Novel methodology for sex- and gender-based analysis in gynecologic research. Int J Gynaecol Obstet. 2022 Mar 8. doi: 10.1002/ijgo.14169. Epub ahead of print. PMID: 35262193.

Kim-Fine S, Greenfield J, Chaput KH, Robert M, Metz LM. Cannabinoids and bladder symptoms in multiple sclerosis. Mult Scler Relat Disord. 2021 Sep;54:103105. doi: 10.1016/j.msard.2021.103105. Epub 2021 Jun 23.

PMID: 34216995

Antosh DD, Dieter AA, Balk EM, Kanter G, Kim-Fine S, Meriwether KV, Mamik MM, Good MM, Singh R, Alas A, Foda MA, Rahn DD, Rogers RG. Sexual function after pelvic organ prolapse surgery: a systematic review comparing different approaches to pelvic floor repair. Am J Obstet Gynecol. 2021 Nov;225(5):475.e1-475.e19. doi: 10.1016/j.ajog.2021.05.042. Epub 2021 Jun 2. PMID: 34087227

Kim-Fine S, Antosh DD, Balk EM, Meriwether KV, Kanter G, Dieter AA, Mamik MM, Good M, Singh R, Alas A, Foda M, Rahn DD, Rogers RG. Relationship of postoperative vaginal anatomy and sexual function: a systematic review with meta-analysis. Int Urogynecol J. 2021 Aug;32(8):2125-2134. doi: 10.1007/s00192-021-04829-4. Epub 2021 May 14. PMID: 33988785  

Sandwith E, Robert M. Rug-pee study: the prevalence of urinary incontinence among female university rugby players. Int Urogynecol J. 2021 Feb; 32(2):281-285. doi: 10.1007/s00192-020-04510-2. Epub 2020 Aug 28. PMID: 32857177.

Flynn MJ, Campbell TS, Robert M, Nasr-Esfahani M, Rash JA. Intranasal oxytocin as a treatment for chronic pelvic pain: A randomized controlled feasibility study. Int J Gynaecol Obstet. 2021 Mar;152(3):425-432. doi:

10.1002/ijgo.13441. Epub 2020 Dec 8. PMID: 33112417.

McLean L, Charette M, Varette K, Brooks K, Harvey MA, Robert M, Baker K, Day A, Della Zazzera V, Sauerbrei E, Brison R. Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial. Int Urogynecol J. 2021 Mar 3. doi: 10.1007/s00192-020-04668-9. Epub ahead of print. PMID: 33660001.

Brooks KCL, Varette K, Harvey MA, Robert M, Brison RJ, Day A, Baker K, Della Zazzera V, Sauerbrei E, McLean L. A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence. Int Urogynecol J. 2021 Mar;32(3):719-728. doi: 10.1007/s00192-020-04583-z. Epub 2020 Nov 25. PMID: 33237355; PMCID: PMC7902568

Rash JA, Campbell TS, Cooper L, Flusk D, MacInnes A, Nasr-Esfahani M, Mekhael AA, Poulin PA, Robert M, Yi Y. Evaluating the efficacy of intranasal oxytocin on pain and function among individuals who experience chronic pain: a protocol for a multisite, placebo-controlled, blinded, sequential, within-subjects crossover trial. BMJ Open. 2021 Sep 23;11(9):e055039. doi: 10.1136/bmjopen-2021-055039. PMID: 34556520; PMCID: PMC8461687.

University of Alberta, Edmonton

Research Spotlight

Featured Publications

Lina Roa, Sarah Kent , Maryna Yaskina , Jane Schulz , Annick Poirier. Knowledge of pelvic floor disorders amongst immigrant women in Canada. International Urogynecology Journal. 2021 Nov;32(11):3077-3084 

Lina Roa and team assessed the knowledge of Pelvic Floor Disorders (PFDs) amongst women in Edmonton, hypothesizing that immigrant women are less knowledgeable about PFDs than Canadian-born women. Studies have shown that women with less knowledge of PFDs are less likely to seek care for these conditions. Researchers conducted a cross-sectional study of 106 immigrant and 102 Canadian-born women using the Prolapse and Incontinence Knowledge Questionnaire (PIKQ). The team found a significant difference between immigrant women and Canadian-born counterparts in Edmonton (12.7 versus 14.4, p = 0.04). Immigrant women have lower proficiency levels in their knowledge of symptoms, risk factors, and treatments for UI and POP. Importantly, this lack of knowledge has been associated with their passive health-seeking behavior. Congratulations to Dr. Roa and the team for highlighting the importance and need for designing interventions to educate immigrant women with PFDs to seek care for treatable conditions that will significantly enhance their quality of life and for publishing their work in International Urogynecology Journal.

View Publication

Research Highlights

• An Assessment of Women’s Experiences of Virtual Care Delivery during the COVID-19 Pandemic: Perspectives from the Urogynecology Wellness Program. This project has been funded by the Women and Children’s Health Research Institute. The resident working on the project was awarded with a Resident grant; the medical student working in the project has received summer scholarships in 2021, and 2022.
• Prophylactic Antibiotics During Treatment of Idiopathic Overactive Bladder with Intradetrusor Onabotulinumtoxin A for the Reduction of Postoperative UTI: A Randomized Blinded Placebo-controlled Trial. This clinical trial has been funded by the Women and Children’s Health Research Institute. Study participants are currently being recruited. Although recruitment was delayed due to COVID-19, the investigators are back on track to complete the recruitment.
• Sarah Conrad is a second-year master’s student in the Rehabilitation Medicine (Physical Therapy) program whose research focuses on measurement tools based on patient experience in non-surgical environment to diagnose pelvic organ prolapse. She is a 3MT 2022 finalist. - VIEW PRESENTATION
  
  

2021-2022 Publication List

Wang R, Kaarid KP, Sanaee M. Barriers to Surgical Innovation Research: A Canadian Study on Public Funding Trends. Surg Innov. 2022 Apr 15. DOI: 10.1177/15533506221085469

Johnson GE, Kan L, Nguyen J, Campbell K, Ralph L, Koenig N, Sanaee M, Maher C, Cundiff GW. Development of patient-centered outcomes for labour and birth: a qualitative study. Clin Exp Obstet Gynecol. 2022; 49(1): 021.

Harvey MA, Lemieux M, Robert M, Schulz JA. Guideline No. 114: Vaginal Pessary Use. Journal of Obstetrics and Gynaecology Canado. 2021;43(2):255-266.

Gyhagen M, Engh ME, Husslein H, Koelbl H, Nilsson IEK, Schulz J, Wagg A, Milsom I. Temporal trends in obstetric anal sphincter injury from the first vaginal delivery in Austria, Canada, Norway, and Sweden. Acta Obstetrica et Gynecologica Scandinavica. 2021;100(11):1969-1976.

Roa L, Kent S, Yaskina M, Schulz J, Poirier A. Knowledge of pelvic floor disorders amongst immigrant women in Canada. International Urogynecology Journal. 2021;32:3077-3084.

Manz J, Hyakutake M, Kelly E. Calling for Openness to the Study of Cannabis Use in Chronic Pelvic Pain. Journal of Obstetrics and Gynaecology Canada. 2021 May;43(5):611-613.

Chaikof M, McDermott CD, Brennand E, Sanaee M. Patients Seeking “Vaginoplasty” Deserve Assessment and Treatment by Experts in Female Pelvic Medicine and Reconstructive Surgery. Aesthetic Surgery Journal. 2021;41(4):NP148-NP149.

University of Ottawa

Research Spotlight

Featured Publications (2)

 

1) Antônio FI, Yamamoto G, Varette K, McLean L. One in four women with stress urinary incontinence who are taught "the knack" maneuver adopt this motor pattern while coughing: A prospective interventional cohort study. Neurourol Urodyn 2023 Aug;42(6):1290-1298.  doi: 10.1002/nau.25196.

This study aimed to evaluate whether women with stress urinary incontinence who receive instruction to perform the knack maneuver perform it during voluntary coughing without specific instruction to do so. Furthermore, it aimed to determine whether subjective and objective stress urinary incontinence outcomes are better among those who perform a knack maneuver during voluntary coughing. This study was a secondary analysis of data acquired from a prospective interventional cohort. Participants received 12 weeks of pelvic floor muscle training including instruction to perform the knack exercise. Performance of the knack before a voluntary cough was confirmed through ultrasound imaging and stress urinary incontinence severity was determined subjectively (International Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms [ICIQ-FLUTS] overall score, ICIQ-FLUTS UI subscale score, 3-day bladder diary) and objectively (30-min pad test). At baseline, none of the 69 participants performed the knack when asked to cough. At follow-up, more participants performed the knack during a voluntary cough [18/69 (26%), 95% confidence interval [CI] 15%–35%] than at baseline. The extent of improvement in SUI symptoms was not different between participants who did and did not demonstrate the knack during a voluntary cough [FLUTS-UI subscale score (d = 0.31, 95% CI –0.78 to 2.77, n = 69), FLUTS overall score (d = 0.26, 95% CI −1.52–4.23, n = 69), 30-min pad test (d = 0.03, 95% CI −9.35 to 10.32, n = 69), 3-day bladder diary (d = 0.03, 95% CI −4.07 to 3.60, n = 51)]. Approximately one in four women appeared to adopt the knack as a motor response to a cough command, however, adopting the knack was not independently associated with greater improvements in SUI.

Importance: This study highlights the need for providers to explain the benefit of contracting the pelvic floor muscles to prevent urinary leakage, and to ensure patients do these exercises consistently. Furthermore, studies evaluating the long-term benefit of pelvic floor contraction exercises on the pelvic floor may be valuable.

Publications 2024

McLean L, Pulsifer J, Keshwani N, Dumoulin C, Azer N, Lazareck-Devlin A, Dufour S, Sabourin J, Faghani N, Groves V, Cordova L, Sanaee M. CSPM Position Statement: The Landscape of Pelvic Health Physiotherapy in Canada. J Obstet Gynaecol Can 2024 Jul;46(7):102565. doi: 10.1016/j.jogc.2024.102565. Epub 2024 May 29.

Charette M, McLean L. Geographic Accessibility to Pelvic Health Physiotherapy Services Across Ontario: A Geographic Information System Analysis. Physiotherapy Canada 2024 https://doi.org/10.3138/ptc-2023-0114

Horwood G, Flaxman T, McInnes M, McLean L, Singh SS. Ultrasound Elastography in Benign Gynecology: A Scoping Review. Reprod Sci. 2024 Aug;31(8):2508-2522. doi: 10.1007/s43032-024-01535-6.

Camila de Lima Alves da Silva T, da Silva Dantas H, Eduarda Macedo L, Duarte Martins T, Silva-Filho E, Pegado R, McLean L, Thereza Albuquerque Barbosa Cabral Micussi M. Investigating the efficacy of transcranial direct current stimulation on chronic pain management in endometriosis patients: A randomized controlled trial protocol. PLoS One 2024 Aug 1;19(8):e0306405. doi: 10.1371/journal.pone.0306405.

Petter Rodrigues M, Bérubé MÈ, Charette M, McLean L. Conservative interventions for female exercise-induced urinary incontinence: a systematic review.  BJU Int 2024 Jul 23.  doi: 10.1111/bju.16474. 

Clancy A, Stairs J. The effect of subsequent pregnancy and childbirth on stress urinary incontinence recurrence after midurethral sling procedure: a comment. Am J Obstet Gynecol. 2024 Aug;231(2):e76. doi: 10.1016/j.ajog.2024.03.022.

Klahsen O, Thibault-Gagnon S, McLean L. A theoretical model for brisk walking- and running-induced lower urinary tract symptoms (BRUTS) and the development of the BRUTS-questionnaire (BRUTS-Q): A focus group and Delphi study. Neurourol Urodyn 2024 Jul 20. doi: 10.1002/nau.25523.

Coleman CEM, Bonasia K, Pascali D, Clancy A. Complications of obliterative versus reconstructive vaginal surgery for pelvic organ prolapse in octogenarians: A retrospective cohort study. Neurourol Urodynamics 2024 Jun;43(5):1171-1178. doi: 10.1002/nau.25444.

Charette M, Pacheco-Brousseau L, Poitras S, Ashton R, McLean L. Management of urinary incontinence in females by primary care providers: a systematic review. BJU Int 2024 May;133(5):498-512.  doi: 10.1111/bju.16234.

Bérubé MÈ, McLean L. The acute effects of running on pelvic floor morphology and function in runners with and without running-induced stress urinary incontinence.
Int Urogynecol J 2024 Jan;35(1):127-138

Publications 2023

Stairs J, Gujral P, Ehlebracht A, van Diepen A, Clancy AA. Women's attitudes towards pessary self-care: a qualitative study. International Urogynecology Journal 2023 Aug;34(8):1899-1906. doi: 10.1007/s00192-023-05472-x

Hamelin A, Pascali D, Leppard J. Just the facts: precipitous deliveries in the emergency department. CJEM. 2023 Oct;25(10):799-801. doi: 10.1007/s43678-023-00552-9.

Bonasia K, Clancy A, Stairs J. Prevalence and risk factors for urinary incontinence up to 2 years postpartum: a cross-sectional population-based study.  International Urogynecology Journal. Oct;34(10):2467-2472. doi: 10.1007/s00192-023-05571-9.

Kupfer N, Clancy A, Maguire F, Stairs J. Prevalence and risk factors for urinary incontinence in nulliparous women: a contemporary, population-based cohort study. Urogynecology 2023 May 1;29(5):520-527. doi: 10.1097/SPV.0000000000001296. 

Gujral P, Clancy AA. Vesicovaginal Fistula Caused by Complete Procidentia.  J Obstet Gynaecol Can 2023 Dec;45(12):101998. doi: 10.1016/j.jogc.2022.07.007

Berube ME, McLean L. Differences in pelvic floor muscle morphology and function between female runners with and without running-induced stress urinary incontinence. Neurourol Urodyn 2023 Nov;42(8):1733-1744.  doi: 10.1002/nau.25274

Clancy AA, Ramirez FD. Gender Disparities in Medical Industry Payments. JAMA Surg. 2023 Oct 1;158(10):1112. doi: 10.1001/jamasurg.2023.1667.

Puranda JL, da Silva DF, Edwards CM, Nagpal TS, Souza SCS, Semeniuk K, McLean L, Adamo KB. Characteristics Associated with Pelvic Floor Disorders among Female Canadian Armed Forces Members. J Obstet Gynaecol Can 2023 Sep;45(9):646-654. doi: 10.1016/j.jogc.2023.05.027.

Kanji S, Clancy AA. Stress urinary incontinence and synthetic mesh midurethral slings in women. CMAJ. 2023 Aug 21;195(32):E1082. doi: 10.1503/cmaj.221592.

Antônio FI, Yamamoto G, Varette K, McLean L. One in four women with stress urinary incontinence who are taught "the knack" maneuver adopt this motor pattern while coughing: A prospective interventional cohort study. Neurourol Urodyn 2023 Aug;42(6):1290-1298.  doi: 10.1002/nau.25196.

Bouchard ME, Stairs J, Hickling D, Clancy A, Khalil H. The use of tissue adhesive in management of genitourinary fistulas: a systematic review and case report.  Int Urogynecol J 2023 Feb;34(2):445-451. doi: 10.1007/s00192-022-05297-0.

Dufour S, Clancy A, Wu M. Technical Update No. 433: eHealth Solutions for Urinary Incontinence Among Women. J Obstet Gynaecol Can 2023 Feb;45(2):150-159.e1. doi: 10.1016/j.jogc.2022.10.005. Epub 2022 Oct 21.

Publications 2022 (additional)

Wuebbolt D, Bouchard ME, Hussein S, Pascali D, Clancy AA. Complications Following Posterior Colporrhaphy With and Without Anal Sphincteroplasty: An Analysis of Cases in the National Surgical Quality Improvement Program Database. J Obstet Gynaecol Can 2022 Dec;44(12):1257-1261.  doi: 10.1016/j.jogc.2022.10.011.

Bouchard ME, Baker K, Schachter J, Khalil H, Pascali D, Hickling D, Clancy A. Preoperative anemia and complications after surgery for pelvic organ prolapse: an analysis of the national surgical quality improvement program database. Int Urogynecol J. 2022 Jul;33(7):1827-1831. doi: 10.1007/s00192-021-04800-3. 

McLean L, Charette M, Varette K, Brooks K, Harvey MA, Robert M, Baker K, Day A, Della Zazzera V, Sauerbrei E, Brison R. Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial. Int Urogynecol J. 2022 Apr;33(4):809-819. doi: 10.1007/s00192-020-04668-9. Epub 2021 Mar 3. PMID: 33660001.

Stairs J, Clancy AA. Letter to the Editor: Hysterectomy Versus Uterine Preservation at the Time of Pelvic Reconstructive Surgery. J Obstet Gynaecol Can 2022 Sep;44(9):951. doi: 10.1016/j.jogc.2022.06.001.

McLean L, Reeves J. RE: The article entitled "Effect of footwear on intramuscular EMG activity of plantar flexor muscles in walking" by Péter, A., Arndt, A., Hegyi, A., Finni, T., Andersson, E., Alkjaer, T., Tarassova, O., Ronquist, G., Cronin, N J Electromyogr Kinesiol 2022 Jun:64:102661. doi: 10.1016/j.jelekin.2022.102661. Epub 2022 Apr 16.

McLean L, Hickling D. Reply to "Androgen deficiency and stress urinary incontinence" Int Urogynecol J 2022 May;33(5):1355-1356.  doi: 10.1007/s00192-022-05161-1.

 

---

2) McLean L, Charette M, Varette K, Brooks K, Harvey MA, Robert M, Baker K, Day A, Della Zazzera V, Sauerbrei E, Brison R. Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial. Int Urogynecol J. 2022 Apr;33(4):809-819. doi: 10.1007/s00192-020-04668-9. Epub 2021 Mar 3. PMID: 33660001.

This was a single-blind randomised controlled trial comparing peri-operative physiotherapist-supervised pelvic floor muscle training versus receiving a pelvic floor muscle therapy handout. Efficacy on stress urinary incontinence (SUI) symptoms improvement and other urinary symptoms was assessed. Women with SUI planning mid-urethral sling insertion (N=103) were randomized to one of the 2 arms and followed for 3 months after the surgery; they were recontacted at up to 2 years. Women in the physiotherapy group (N=52) participated in 6 physiotherapist-led sessions over 12 weeks preoperatively, as well as 3 postoperative sessions, while the control group (N=51) received standard recommendations by handout. At 3 months postoperatively, all participants in both groups show improvement compared to baseline. The physiotherapy group reported better improvement in SUI symptoms and higher cure at 3 months postoperatively than the control group. However, no difference between groups was found on pad test, filling or voiding symptoms. Fifty-two women attended 1-year follow-up and 36 completed 2-year follow-up, with overall results similar to 3 months. It was concluded that a postoperative physiotherapist-led program of pelvic floor muscle training was more effective than providing handouts for SUI cure at 3 months postoperatively. Larger longer-term studies are needed.

2021-2022 Publication List

Stairs J, Rolnik D, Pascali D, Clancy A. Association between obstetrical anal sphincter injury and postpartum urinary retention: a contemportary nationwide cohort study. International Urogynecology Journal 2022. (epub ahead of print, doi: 10.1007/s00192-022-05346-8).

Xia W, Ameri G, Fakim D, Akhuanzada H, Raza MZ, Abbas Shobeiri S, McLean L, Chen ECS. Automatic plane of minimal hiatal dimensions extraction from 3D female pelvic floor ultrasound. IEEE Trans Med Imaging. 2022 Aug 19;PP. doi: 10.1109/TMI.2022.3199968. Epub ahead of print. PMID: 35984794.

Arranz-Martín B, Navarro-Brazález B, Sánchez-Sánchez B, McLean L, Carazo-Díaz C, Torres-Lacomba M. The Impact of Hypopressive Abdominal Exercise on Linea Alba Morphology in Women Who Are Postpartum: A Short-Term Cross-Sectional Study. Phys Ther. 2022 Aug 4;102(8):pzac086. doi: 10.1093/ptj/pzac086. PMID: 35908286.

Niederauer S, Bérubé MÈ, Brennan A, McLean L, Hitchcock R. Pelvic floor tissue damping during running using an intra-vaginal accelerometry approach. Clin Biomech (Bristol, Avon). 2022 Feb;92:105554. doi: 10.1016/j.clinbiomech.2021.105554. Epub 2021 Dec 29. PMID: 34974336; PMCID: PMC8863648.

Bernard S, McLean L, Boucher S, Hébert LJ, Plante M, Grégoire J, Sebastianelli A, Renaud MC, Froment MA, Moffet H. An in-home rehabilitation program for the treatment of urinary incontinence symptoms in endometrial cancer survivors: a single-case experimental design study. Int Urogynecol J. 2021 Nov;32(11):2947-2957. doi: 10.1007/s00192-021-04981-x. Epub 2021 Sep 25. PMID: 34562132; PMCID: PMC8536558.

Antônio FI, Rodrigues MP, Brooks K, Varette K, McLean L. What improvements in levator ani motor function lead to improvement in stress urinary incontinence signs and symptoms in females? Int Urogynecol J. 2022 Oct;33(10):2735-2747. doi: 10.1007/s00192-021-04931-7. Epub 2021 Sep 3. PMID: 34477898.

Bouchard ME, Stairs J, Hickling D, Clancy A, Khalil H. The use of tissue adhesive in management of genitourinary fistulas: a systematic review and case report. International Urogynecology Journal 2022. (epub ahead of print, doi: 10.1007/s00192-022-05297-0).

Gujral P, Clancy AA. Vesicovaginal fistula caused by complete procidentia. Journal of Obstetrics and Gynecology of Canada 2022; S1701-2163(22)00471-6. (epub ahead of print, doi: 10.1016/j.jogc.2022.07.007).

Brooks KCL, Varette K, Harvey MA, Robert M, Brison RJ, Day A, Baker K, Della Zazzera V, Sauerbrei E, McLean L. A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence. Int Urogynecol J. 2021 Mar;32(3):719-728.

Kanji S, Pascali D, Clancy AA. Short term complications in mesh augmented vaginal repair of pelvic organ prolapse are not higher when compared with native tissue repair. Int Urogynecol J. 2022, 33(7):1941-1947. (epub ahead of print, doi: 10.1007/s00192-021-04915-7).

Bouchard ME, Baker K, Schachter J, Khalil H, Pascali D, Hickling D, Clancy A. Preoperative anemia and complications after surgery for pelvic organ prolapse: an analysis of the national surgical quality improvement program database. Int Urogynecol J. 2021; (epub ahead of print, doi: 10.1007/s00192-021-04800-3).

Stairs J, Minassian V, Clancy A. Complications after vaginal vault suspension versus minimally invasive sacrocolpopexy in women with elevated body mass index: A retrospective cohort study using data from the national surgical quality improvement program database. Female Pelvic Med Reconstr Surg 2022, 28(6):391-396.

Nayak AL, Breau R, Hickling D, Pascali D, Clancy A, Mallick R, Chen I. Risk Factors for Urologic Injury in Women Undergoing Hysterectomy for Benign Indication. J Obstet Gynaecol Can. 2022, 44(3):247-254.

Reeves J, McLean L. The influence of contraction type, prior performance of a maximal voluntary contraction and measurement duration on fine-wire EMG amplitude. J Electromyogr Kinesiol. 2021 Aug;59:102566. doi: 10.1016/j.jelekin.2021.102566. Epub 2021 Jun 8. PMID: 34139549.

Bernard S, Frenette AG, McLean L, Noël P, Froment MA, Hébert LJ, Moffet H. Reliability of ultrasound imaging of pelvic floor morphology and function among females who have undergone pelvic radiotherapy. Neurourol Urodyn. 2021 Apr;40(4):1001-1010. doi: 10.1002/nau.24656. Epub 2021 Mar 19. PMID: 33739537.

McLean L, Charette M, Varette K, Brooks K, Harvey MA, Robert M, Baker K, Day A, Della Zazzera V, Sauerbrei E, Brison R. Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial. Int Urogynecol J. 2022 Apr;33(4):809-819. doi: 10.1007/s00192-020-04668-9. Epub 2021 Mar 3. PMID: 33660001.

Falah-Hassani K, Reeves J, Shiri R, Hickling D, McLean L. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2021 Mar;32(3):501-552. doi: 10.1007/s00192-020-04622-9. Epub 2021 Jan 8. Erratum in: Int Urogynecol J. 2021 Jun;32(6):1607. PMID: 33416968; PMCID: PMC8053188.

Czyrnyj CS, Bérubé MÈ, Lanteigne E, Brennan A, Bader Y, Lomovtsev D, Vandermolen M, Boucher S, Mitri L, McLean L. Design and validation of an automated dual-arm instrumented intravaginal dynamometer. Neurourol Urodyn. 2021 Feb;40(2):604-615. doi: 10.1002/nau.24600. Epub 2021 Jan 7. PMID: 33410542.

Padoa A, McLean L, Morin M, Vandyken C. The Overactive Pelvic Floor (OPF) and Sexual Dysfunction. Part 2: Evaluation and Treatment of Sexual Dysfunction in OPF Patients. Sex Med Rev. 2021 Jan;9(1):76-92. doi: 10.1016/j.sxmr.2020.04.002. Epub 2020 Jul 4. PMID: 32631813.

Clancy AA, Ilin J, Shehata F, Pascali D, Hickling D. Outcomes of an overnight-stay unit for urogynecologic surgery: feasibility and risk factors for failure of next-day discharge. Female Pelvic Med Reconstr Surg 2021,1;27(2):98-104.

Clancy AA, Chen I, Pascali D, Minassian V. Surgical approach and unplanned readmission following pelvic organ prolapse surgery: a retrospective cohort study using data from the National Surgical Quality Improvement Program (NSQIP). Int Urogynecol J.  2021, 32(4): 945-953.

Shehata F, Hickling D, Pascali D. Urethral erosion of an obturator midurethral sling. J Obstet Gynaecol Can. 2021, 43(4):423.

University of British Columbia

Research Spotlight

Publication Highlights

Geoffrion, Roxana MD*; Koenig, Nicole A. BA*; Zheng, Meimuzi MSc*; Sinclair, Nicholas BSc*; Brotto, Lori A. PhD*; Lee, Terry PhD†; Larouche, Maryse MD MPH‡ Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes, Annals of Surgery: March 2021 - Volume 2 - Issue 1 - p e049 doi: 10.1097/AS9.0000000000000049

Roxana Geoffrion, Obstetrics and Gynecology Associate Professor at the University of British Columbia and team aimed to quantify the association of pre-operative depression and anxiety symptoms on postoperative complications and to explore sex differences and sex-specific coping mechanisms in patients undergoing major surgery. They conducted a prospective cohort study of depression and anxiety symptoms using several validated questionnaires in patients undergoing major surgery and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Postoperative data collection included a visual analogue scale for pain, narcotic use, post-op complications, length of stay, and readmissions. Pre-operative depression, anxiety and coping mechanisms were associated with adverse surgical outcomes and postoperative pain, with females significantly more impacted than males. Their work also highlighted the use of validated, brief questionnaires that can be easily used in the clinical setting and the importance of holistic pre-operative medical care and patient education. In addition, sleep and exercise emerged as novel therapeutic targets to optimize outcomes for patients undergoing major surgery. Congratulations to Dr Geoffrion and team on publishing one of the largest prospective cohort investigations of mental health in both sexes with recruitment from various surgical specialties in the Annals of Surgery.

2020-2021 Publication List

Moreira Vasconcelos CT, Silva Gomes ML, Geoffrion R, Saboia DM, de Castro Bezerra K, Vasconcelos Neto JA. Pessary evaluation for genital prolapse treatment: from acceptance to successful fitting. Neurourology and Urodynamics. 2020 Nov;39(8):2344-2352.

Harvey MA, Chih HJ, Geoffrion R, Amir B, Bhide A, Miotla P, Rosier PFWM, Offiah I, Pal M, Alas AN. International Urogynecology Consultation Chapter 1 Committee 5: relationship of pelvic organ prolapse to associated pelvic floor dysfunction symptoms: lower urinary tract, bowel, sexual dysfunction and abdominopelvic pain.Int Urogynecol J. 2021 Oct;32(10):2575-2594. doi: 10.1007/s00192-021-04941-5. Epub 2021 Aug 2.PMID: 34338825.

Larouche M, Belzile E, Geoffrion R. Surgical Management of Symptomatic Apical Pelvic Organ Prolapse: A Systematic Review and Meta-analysis. Obstet Gynecol. 2021 Jun 1;137(6):1061-1073. doi: 10.1097/AOG.0000000000004393.PMID: 33957652.

Zhang BY, Wong JMH, A Koenig N, Lee T, Geoffrion R. Risk factors for urinary retention after urogynecologic surgery: A retrospective cohort study and prediction model. Neurourol Urodyn. 2021 Jun;40(5):1182-1191. doi: 10.1002/nau.24676. Epub 2021 Apr 23.PMID: 33891339.

Gong M, Mann GK, Koenig N, Geoffrion R. Documenting Perineal and Obstetrical Anal Sphincter Injury Care at Childbirth: A Cross-Sectional Study. J Obstet Gynaecol Can. 2021 Oct;43(10):1164-1169. doi: 10.1016/j.jogc.2021.02.120. Epub 2021 Mar 6.PMID: 33684531.

Geoffrion R, Larouche M. Guideline No. 413: Surgical Management of Apical Pelvic Organ Prolapse in Women. J Obstet Gynaecol Can. 2021 Apr;43(4):511-523.e1. doi: 10.1016/j.jogc.2021.02.001. Epub 2021 Feb 3.PMID: 33548503.

Geoffrion R, Larouche M. Directive clinique no 413 : Traitement chirurgical du prolapsus génital apical chez les femmes. J Obstet Gynaecol Can. 2021 Apr;43(4):524-538.e1. doi: 10.1016/j.jogc.2021.02.002. Epub 2021 Feb 3.PMID: 33548502.

Geoffrion R, Yang EC, Koenig NA, Brotto LA, Barr AM, Lee T, Allaire C, Bedaiwy MA, Yong P. Recreational Cannabis Use Before and After Legalization in Women With Pelvic Pain. J.Obstet Gynecol. 2021 Jan 1;137(1):91-99. doi: 10.1097/AOG.0000000000004207.PMID: 33278297.

Stothers L, Locke JA, Abdulaziz M, Lazare D, Kavanagh A, Macnab A. Standing open magnetic resonance imaging improves detection and staging of pelvic organ prolapse. Can Urol Assoc J. 2021 Aug 26. doi: 10.5489/cuaj.7244. Online ahead of print.PMID: 34464248.

Brennand EA, Wu G, Houlihan S, Globerman D, Gagnon LH, Birch C, Hyakutake M, Carlson KV, Al-Shankiti H, Robert M, Lazare D, Kim-Fine S; Calgary Women's Pelvic Health Research Group. Two Intraoperative Techniques for Midurethral Sling Tensioning: A Randomized Controlled Trial. Obstet Gynecol. 2020 Sep;136(3):471-481. doi: 10.1097/AOG.0000000000004027.PMID: 32769657 Free PMC article. Clinical Trial.

Walter JE, Brennand EA, Lemos N, Cundiff GW; Canadian Society of Pelvic Medicine Mesh Complications Writing Group. Corrigendum to 'Canadian Society of Pelvic Medicine Response to the Collège des Médecins du Québec Rapport d'Enquête' [Journal of Obstetrics and Gynaecology Canada 43/3 (2021) 298-299]. J Obstet Gynaecol Can. 2021 May;43(5):650. doi: 10.1016/j.jogc.2021.03.008.PMID: 33992128 No abstract available.

Walter JE, Brennand EA, Lemos N, Cundiff GW; Canadian Society of Pelvic Medicine Mesh Complications Writing Group. Letter: Canadian Society of Pelvic Medicine Response to the Collège des Médecins du Québec Rapport d'Enquête. J Obstet Gynaecol Can. 2021 Mar;43(3):298-299. doi: 10.1016/j.jogc.2020.10.004.PMID: 33640099 No abstract available.

Cundiff GW. Le Collège des médecins du Québec devrait-il déterminer l'utilisation adéquate des bandelettes sous-urétrales au Canada? Une analyse du rapport d'enquête. J Obstet Gynaecol Can. 2021 Mar;43(3):285-287. doi: 10.1016/j.jogc.2021.01.007.PMID: 33640096 No abstract available.

Cundiff GW. Should the Collège des Médecins du Québec Determine How Mid-Urethral Slings Are Used in Canada? A Review of the Rapport d'Enquête. J Obstet Gynaecol Can. 2021 Mar;43(3):283-284. doi: 10.1016/j.jogc.2020.09.014.PMID: 33640095 No abstract available.

Chen I, Mallick R, Allaire C, Bajzak KI, Belland LM, Bougie O, Cassell KA, Choudhry AJ, Cundiff GW, Kroft J, Leyland NA, Maheux-Lacroix S, Rajakumar C, Randle E, Robertson D, Thiel JA, Tulandi T, Yong PJ, Laberge PY; Canadian Women's Investigators for Surgical Excellence in Research (CanWISER) Collaboration.J Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies. Minim Invasive Gynecol. 2021 May;28(5):1041-1050. doi: 10.1016/j.jmig.2021.01.010. Epub 2021 Jan 18.PMID: 33476750. 10.1002/ijgo.13441. Epub 2020 Dec 8. PMID: 33112417.

Larouche M, Albert AYK, Lipsky N, Walmsley S, Loutfy M, Smaill F, Trottier S, Bitnun A, Yudin MH, Cundiff GW, Money DM. Urinary symptoms and quality of life in women living with HIV: a cross-sectional study. Int Urogynecol J. 2021 Feb;32(2):353-358. doi: 10.1007/s00192-020-04343-z. Epub 2020 May 22.PMID: 32440885.