{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:03:19Z","timestamp":1791892999795,"version":"4.3.4"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To compare three conservative treatment options, standard care, pelvic floor muscle training (PFMT), and vaginal pessaries, for postpartum urinary incontinence (UI) that are accessible to most patients and practitioners in a generalizable cohort.<\/jats:p>\n                  <jats:p>A multicenter, open-label, parallel group, pragmatic randomized controlled clinical trial comparing standard care, PFMT, and vaginal cube pessary for postpartum urinary incontinence was conducted in six outpatient clinics. Sample size was based on large treatment effects (Cramers\u2019 V\u00a0&gt;\u00a00.35) with a power of 80% and an alpha of 0.05 for a 3\u00a0\u00d7\u00a03 contingency table, 44 patients needed to be included in the trial. Outcomes were analyzed according to the intention-to-treat principle. Group comparisons were made using analysis of variance (ANOVA), Kruskal-Wallis, and chi-square test as appropriate. P\u00a0&lt;\u00a00.05 was considered statistically significant.<\/jats:p>\n                  <jats:p>Of the 516 women screened, 111 presented with postpartum UI. Of these, 52 were randomized to one of three treatment groups: standard care (n\u00a0=\u00a017), pelvic floor muscle training (n\u00a0=\u00a017), or vaginal cube pessary (n\u00a0=\u00a018). After 12 weeks of treatment, treatment success, as measured by patient satisfaction, was significantly higher in the vaginal pessary group (77.8%, n\u00a0=\u00a014\/18), compared to the standard care group (41.2%, n\u00a0=\u00a07\/17), and the PFMT (23.5%, n\u00a0=\u00a04\/17; \u03c72\n            2,n\u00a0=\u00a052\u00a0=\u00a014.55; p\u00a0=\u00a00.006, Cramer-V\u00a0=\u00a00.374). No adverse events were reported. SUI and MUI accounted for 88.4% of postpartum UI.<\/jats:p>\n                  <jats:p>Vaginal pessaries were superior to standard care or PFMT to satisfyingly reduce postpartum UI symptoms. No complications were found.<\/jats:p>","DOI":"10.1055\/a-2243-3784","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T19:29:23Z","timestamp":1709753363000},"page":"246-255","source":"Crossref","is-referenced-by-count":11,"title":["Comparison of Vaginal Pessaries to Standard Care or Pelvic Floor Muscle Training for Treating Postpartum Urinary Incontinence: a Pragmatic Randomized Controlled Trial"],"prefix":"10.1055","volume":"84","clinical-trial-number":[{"clinical-trial-number":"nct06031870","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9066-7380","authenticated-orcid":false,"given":"S\u00f6ren","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria"},{"name":"Department of Gynecology, University Hospital Zurich, Zurich, Switzerland"},{"name":"University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Lange","sequence":"additional","affiliation":[{"name":"DieGyn-Praxis, Alzey\/Lampertheim\/Mainz\/Bad Kreuznach, Germany"},{"name":"Pelvic floor center Rheinhessen, Klinikum Worms gGmbH, Worms, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Tabibi","sequence":"additional","affiliation":[{"name":"DieGyn-Praxis, Alzey\/Lampertheim\/Mainz\/Bad Kreuznach, Germany"},{"name":"Department of Obstetrics and Gynecology, Medical Faculty, Heinrich-Heine-University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hitschold","sequence":"additional","affiliation":[{"name":"Pelvic floor center Rheinhessen, Klinikum Worms gGmbH, Worms, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika I.","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"Institute of Neuroscience and Medicine (INM-7), Research Centre J\u00fclich, J\u00fclich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"Naumann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Helios-Klinikum, Erfurt, Germany"},{"name":"Department of Obstetrics and Gynecology, Medical Faculty, Heinrich-Heine-University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s00192-009-1011-x","article-title":"Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors","volume":"21","author":"SJ Brown","year":"2010","journal-title":"Int Urogynecology J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.3109\/00016349.2010.526188","article-title":"Prevalence of postpartum urinary incontinence: a systematic review","volume":"89","author":"DH Thom","year":"2010","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1007\/s00192-013-2061-7","article-title":"Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment","volume":"24","author":"B Sangsawang","year":"2013","journal-title":"Int Urogynecology J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1111\/1471-0528.13395","article-title":"Urinary incontinence persisting after childbirth: extent, delivery history, and effects in a 12-year longitudinal cohort study","volume":"123","author":"C MacArthur","year":"2016","journal-title":"BJOG"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2428","DOI":"10.1056\/NEJMcp1914037","article-title":"Stress Incontinence in Women","volume":"384","author":"JM Wu","year":"2021","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1111\/j.1532-5415.1990.tb03525.x","article-title":"Knowledge and beliefs about urinary incontinence in adulthood and old age","volume":"38","author":"LS Mitteness","year":"1990","journal-title":"J Am Geriatr Soc"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e001632","DOI":"10.1136\/bmjopen-2012-001632","article-title":"What is a disease? 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National survey of family physicians\u2019 knowledge, attitudes, and practices","volume":"48","author":"JG Swanson","year":"2002","journal-title":"Can Fam Physician Med Fam Can"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s12905-020-01124-0","article-title":"Do future healthcare professionals have adequate knowledge about risk factors for stress urinary incontinence in women?","volume":"20","author":"J Witko\u015b","year":"2020","journal-title":"BMC Womens Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1111\/1471-0528.12963","article-title":"Consultation about urinary and faecal incontinence in the year after childbirth: a cohort study","volume":"122","author":"S Brown","year":"2015","journal-title":"BJOG"},{"issue":"05","key":"ref11","doi-asserted-by":"publisher","first-page":"CD007471","DOI":"10.1002\/14651858.CD007471.pub4","article-title":"Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women","author":"SJ Woodley","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1097\/AOG.0b013e3181d055d4","article-title":"Continence Pessary Compared With Behavioral Therapy or Combined Therapy for Stress Incontinence: A Randomized Controlled Trial","volume":"115","author":"HE Richter","year":"2010","journal-title":"Obstet Gynecol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"592.e1","DOI":"10.1016\/j.ajog.2008.02.004","article-title":"Effects of the incontinence dish pessary on urethral support and urodynamic parameters","volume":"198","author":"KL Noblett","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"195","DOI":"10.2147\/IJWH.S152616","article-title":"Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life","volume":"10","author":"G Al-Shaikh","year":"2018","journal-title":"Int J Womens Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1055\/a-1967-1726","article-title":"Diagnosis and Therapy of Female Urinary Incontinence. 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Subjective 1-year outcomes","volume":"24","author":"Z Nemeth","year":"2013","journal-title":"Int Urogynecology J"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2243-3784.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T05:56:14Z","timestamp":1730786174000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2243-3784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":31,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2024,3,6]]},"published-print":{"date-parts":[[2024,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2243-3784","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}