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Janpaul W R Roovers - One of the best experts on this subject based on the ideXlab platform.
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the effects of prolapse surgery on vaginal wall sensibility vaginal Vasocongestion and sexual function a prospective single centre study
Neurourology and Urodynamics, 2014Co-Authors: Marielle M E Lakeman, Ellen Laan, Janpaul W R RooversAbstract:Aims Prolapse surgery has been shown to positively alter body image and decrease pelvic floor symptoms, hereby possibly improving sexual function. However, the surgical trauma itself may adversely affect sexual function, by damaging vaginal innervation and vascularization. The aim of this study is to evaluate the effects of vaginal prolapse surgery on vaginal Vasocongestion, vaginal wall sensibility, and sexual function. Methods A prospective study was performed, including patients scheduled for vaginal prolapse surgery. Participants underwent measurements before and 6 months after surgery, during non-erotic and erotic visual stimuli. Measurements were performed using a vaginal combi-probe which includes vaginal photoplethysmography to assess vaginal pulse amplitude (VPA) (representing vaginal Vasocongestion), and four pulse-generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (FSFI, FSDS-R, SSAQ). Results Twenty-nine women were included, 24 (83%) completed the 6 months follow-up. VPA analysis showed a significant reduction in vaginal Vasocongestion during sexual stimulation post-operatively (pre-op 2.4 mV (SD 2.5) vs. post-op 1.7 mV (SD 2.4), P = 0.05). Vaginal wall sensibility in the cranial posterior vaginal wall was significantly reduced after surgery (pre-op 13.3 mA vs. post-op 17.5 mA, P < 0.05). Vaginal wall sensibility in the other three locations was not affected by surgery. Sexual function as assessed with questionnaires, was not significantly affected. Conclusion Prolapse surgery negatively impacted levels of vaginal Vasocongestion during erotic stimuli as well as vaginal wall sensibility in the cranial posterior wall. Future studies are needed to tease out if these changes in physiological factors are relevant for subjective sexual function. Neurourol. Urodynam. 33:1217–1224, 2014. © 2013 Wiley Periodicals, Inc.
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the effects of vaginal prolapse surgery using synthetic mesh on vaginal wall sensibility vaginal Vasocongestion and sexual function a prospective single center study
The Journal of Sexual Medicine, 2014Co-Authors: Maaike A Weber, Ellen Laan, Marielle M E Lakeman, Janpaul W R RooversAbstract:Abstract Introduction Vaginal mesh surgery in patients with pelvic organ prolapse (POP) has been associated with sexual dysfunction. Implantation of synthetic mesh might damage vaginal innervation and vascularization, which could cause sexual dysfunction. Aim We aim to evaluate the effects of vaginal mesh surgery on vaginal Vasocongestion and vaginal wall sensibility in patients with recurrent POP. Methods A prospective study was performed among patients with previous native tissue repair, scheduled for vaginal mesh surgery. Measurements were performed before and 6 months after surgery, during nonerotic and erotic visual stimuli, using a validated vaginal combi‐probe. Main Outcome Measures The combi‐probe involves vaginal photoplethysmography to assess Vaginal Pulse Amplitude (VPA) (representing vaginal Vasocongestion) and four pulse‐generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (Female Sexual Function Index, Female Sexual Distress Scale‐Revised, and Subjective sexual arousal and affect questionnaire). Results Sixteen women were included, 14 completed the 6‐month follow‐up visit. Vaginal Vasocongestion under erotic conditions did not significantly alter after mesh implantation. Vaginal wall sensibility of the distal posterior wall was significantly increased after mesh surgery (preoperative threshold 6.3 mA vs. postoperative 3.4 mA, P = 0.03). Sexual function as assessed with questionnaires was not significantly affected. Conclusions In women with a history of vaginal prolapse surgery, vaginal mesh surgery did not decrease vaginal Vasocongestion or vaginal wall sensibility. Vaginal Vasocongestion prior to mesh surgery appeared to be lower than that of women never operated on. Apparently, native tissue repair decreased preoperative vaginal Vasocongestion levels to such extent that subsequent mesh surgery had no additional detrimental effect. Our findings should be interpreted cautiously. Replication of the findings in future studies is essential. Weber MA, Lakeman MME, Laan E, and Roovers JPWR. The effects of vaginal prolapse surgery using synthetic mesh on vaginal wall sensibility, vaginal Vasocongestion, and sexual function: A prospective single‐center study. J Sex Med 2014;11:1848–1855.
Ellen Laan - One of the best experts on this subject based on the ideXlab platform.
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the effects of prolapse surgery on vaginal wall sensibility vaginal Vasocongestion and sexual function a prospective single centre study
Neurourology and Urodynamics, 2014Co-Authors: Marielle M E Lakeman, Ellen Laan, Janpaul W R RooversAbstract:Aims Prolapse surgery has been shown to positively alter body image and decrease pelvic floor symptoms, hereby possibly improving sexual function. However, the surgical trauma itself may adversely affect sexual function, by damaging vaginal innervation and vascularization. The aim of this study is to evaluate the effects of vaginal prolapse surgery on vaginal Vasocongestion, vaginal wall sensibility, and sexual function. Methods A prospective study was performed, including patients scheduled for vaginal prolapse surgery. Participants underwent measurements before and 6 months after surgery, during non-erotic and erotic visual stimuli. Measurements were performed using a vaginal combi-probe which includes vaginal photoplethysmography to assess vaginal pulse amplitude (VPA) (representing vaginal Vasocongestion), and four pulse-generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (FSFI, FSDS-R, SSAQ). Results Twenty-nine women were included, 24 (83%) completed the 6 months follow-up. VPA analysis showed a significant reduction in vaginal Vasocongestion during sexual stimulation post-operatively (pre-op 2.4 mV (SD 2.5) vs. post-op 1.7 mV (SD 2.4), P = 0.05). Vaginal wall sensibility in the cranial posterior vaginal wall was significantly reduced after surgery (pre-op 13.3 mA vs. post-op 17.5 mA, P < 0.05). Vaginal wall sensibility in the other three locations was not affected by surgery. Sexual function as assessed with questionnaires, was not significantly affected. Conclusion Prolapse surgery negatively impacted levels of vaginal Vasocongestion during erotic stimuli as well as vaginal wall sensibility in the cranial posterior wall. Future studies are needed to tease out if these changes in physiological factors are relevant for subjective sexual function. Neurourol. Urodynam. 33:1217–1224, 2014. © 2013 Wiley Periodicals, Inc.
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the effects of vaginal prolapse surgery using synthetic mesh on vaginal wall sensibility vaginal Vasocongestion and sexual function a prospective single center study
The Journal of Sexual Medicine, 2014Co-Authors: Maaike A Weber, Ellen Laan, Marielle M E Lakeman, Janpaul W R RooversAbstract:Abstract Introduction Vaginal mesh surgery in patients with pelvic organ prolapse (POP) has been associated with sexual dysfunction. Implantation of synthetic mesh might damage vaginal innervation and vascularization, which could cause sexual dysfunction. Aim We aim to evaluate the effects of vaginal mesh surgery on vaginal Vasocongestion and vaginal wall sensibility in patients with recurrent POP. Methods A prospective study was performed among patients with previous native tissue repair, scheduled for vaginal mesh surgery. Measurements were performed before and 6 months after surgery, during nonerotic and erotic visual stimuli, using a validated vaginal combi‐probe. Main Outcome Measures The combi‐probe involves vaginal photoplethysmography to assess Vaginal Pulse Amplitude (VPA) (representing vaginal Vasocongestion) and four pulse‐generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (Female Sexual Function Index, Female Sexual Distress Scale‐Revised, and Subjective sexual arousal and affect questionnaire). Results Sixteen women were included, 14 completed the 6‐month follow‐up visit. Vaginal Vasocongestion under erotic conditions did not significantly alter after mesh implantation. Vaginal wall sensibility of the distal posterior wall was significantly increased after mesh surgery (preoperative threshold 6.3 mA vs. postoperative 3.4 mA, P = 0.03). Sexual function as assessed with questionnaires was not significantly affected. Conclusions In women with a history of vaginal prolapse surgery, vaginal mesh surgery did not decrease vaginal Vasocongestion or vaginal wall sensibility. Vaginal Vasocongestion prior to mesh surgery appeared to be lower than that of women never operated on. Apparently, native tissue repair decreased preoperative vaginal Vasocongestion levels to such extent that subsequent mesh surgery had no additional detrimental effect. Our findings should be interpreted cautiously. Replication of the findings in future studies is essential. Weber MA, Lakeman MME, Laan E, and Roovers JPWR. The effects of vaginal prolapse surgery using synthetic mesh on vaginal wall sensibility, vaginal Vasocongestion, and sexual function: A prospective single‐center study. J Sex Med 2014;11:1848–1855.
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definitions of women s sexual dysfunction reconsidered advocating expansion and revision
Journal of Psychosomatic Obstetrics & Gynecology, 2003Co-Authors: Rosemary Basson, Julia R. Heiman, Lori A. Brotto, Ellen Laan, Sandra R Leiblum, Leonard R Derogatis, Jean L Fourcroy, Kerstin S Fuglmeyer, A Graziottin, Cindy M. MestonAbstract:In light of various shortcomings of the traditional nosology of women's sexual disorders for both clinical practice and research, an international multi-disciplinary group has reviewed the evidence for traditional assumptions about women's sexual response. It is apparent that fullfillment of sexual desire is an uncommon reason/incentive for sexual activity for many women and, in fact, sexual desire is frequently experienced only after sexual stimuli have elicited subjective sexual arousal. The latter is often poorly correlated with genital Vasocongestion. Complaints of lack of subjective arousal despite apparently normal genital Vasocongestion are common. Based on the review of existing evidence-based research, many modifications to the definitions of women's sexual dysfunctions are recommended. There is a new definition of sexual interest/desire disorder, sexual arousal disorders are separated into genital and subjective subtypes and the recently recognized condition of persistent sexual arousal is included. The definition of dyspareunia reflects the possibility of the pain precluding intercourse. The anticipation and fear of pain characteristic of vaginismus is noted while the assumed muscular spasm is omitted given the lack of evidence. Finally, a recommendation is made that all diagnoses be accompanied by descriptors relating to associated contextual factors and to the degree of distress.
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the enhancement of vaginal Vasocongestion by sildenafil in healthy premenopausal women
Journal of women's health and gender-based medicine, 2002Co-Authors: Ellen Laan, Rik H W Van Lunsen, Walter Everaerd, Alan Riley, Elizabeth Scott, Mitradev BoolellAbstract:Objective: This study examined the effect of a single oral dose of sildenafil citrate (Viagra®, Pfizer, Inc., New York, NY) on vaginal Vasocongestion and subjective sexual arousal in healthy premenopausal women. Methods: Twelve women without sexual dysfunction were randomly assigned to receive either a single oral 50 mg dose of sildenafil or matching placebo in a first session and the alternate medication in a second session. Subjective measures of sexual arousal were assessed after participants had been exposed to erotic stimulus conditions. Vaginal Vasocongestion was recorded continuously during baseline, neutral, and erotic stimulus conditions. At the end of each session, subjects were also asked to specify which treatment they suspected they had received. Results: Significant increases in vaginal Vasocongestion were found with sildenafil treatment compared with placebo. There were no differences between treatments on subjective sexual arousal experience. Analyses by suspected treatment received found ...
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physiological measures of vaginal Vasocongestion
International Journal of Impotence Research, 1998Co-Authors: Ellen Laan, Walter EveraerdAbstract:This paper reviews reliability, specificity, and practical applicability of the two most promising and widely used methods for measuring blood flow within the vagina: the oxygenation-temperature method and vaginal photoplethysmography. It was concluded that the oxygenation-temperature method and vaginal pulse amplitude as measured by the photoplethysmograph are both specific indicators of physiological sexual arousal. Although vaginal pulse amplitude seems to be the method of choice for measuring vaginal Vasocongestion up to orgasm, and the oxygenation-temperature method for measuring orgasm, these measures should not be used in isolation. It is argued that women's sexual function should be evaluated using vaginal Vasocongestion measures in conjunction with subjective indices. Finally, the field is in need of studies comparing physiological and subjective sexual responses in clinical and non-clinical groups.
Webb G Mcknight - One of the best experts on this subject based on the ideXlab platform.
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a monoclonal antibody against the cd18 leukocyte adhesion molecule prevents indomethacin induced gastric damage in the rabbit
Gastroenterology, 1991Co-Authors: John L Wallace, K E Arfors, Webb G McknightAbstract:The role of leukocyte adherence in the mechanism of gastropathy induced by nonsteroidal antiinflammatory drugs was investigated using a rabbit model. Gastric damage was induced by intragastric instillation of indomethacin (5 mg/mL) for a period of 30 minutes. Histologically, this treatment resulted in extensive vascular congestion and leukocyte margination within the mucosa. Pretreatment with a monoclonal antibody (IB-4) directed against the common beta subunit of the CD11/CD18 adhesion glycoprotein complex significantly (P < 0.05) reduced both the Vasocongestion and the prevalence of leukocyte margination. Macroscopically, indomethacin treatment resulted in the formation of numerous hemorrhagic lesions in the corpus region of the stomach. Pretreatment with IB-4 reduced the extent of gastric hemorrhagic damage by ~ 85% (P < 0.001). Damage in the group pretreated with IB-4 did not differ significantly from that in rabbits that did not receive indomethacin. In separate experiments, the dose of IB-4 used was shown to completely suppress the recruitment of granulocytes in response to two different agonists. These results support the hypothesis that leukocyte adherence to the vascular endothelium is an important event in the pathogenesis of ulceration induced by nonsteroidal antiinflammatory drugs. Leukocytes might contribute to ulceration by occluding microvessels, thereby reducing mucosal blood flow, and by releasing various mediators, proteases, and free radicals that can produce tissue necrosis.
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a monoclonal antibody against the cd18 leukocyte adhesion molecule prevents indomethacin induced gastric damage in the rabbit
Gastroenterology, 1991Co-Authors: John L Wallace, K E Arfors, Webb G McknightAbstract:The role of leukocyte adherence in the mechanism of gastropathy induced by nonsteroidal antiinflammatory drugs was investigated using a rabbit model. Gastric damage was induced by intragastric instillation of indomethacin [5 mg/mL] for a period of 30 minutes. Histologically, this treatment resulted in extensive vascular congestion and leukocyte margination within the mucosa. Pretreatment with a monoclonal antibody [IB-4] directed against the common beta subunit of the CD11/CD18 adhesion glycoprotein complex significantly (P less than 0.05) reduced both the Vasocongestion and the prevalence of leukocyte margination. Macroscopically, indomethacin treatment resulted in the formation of numerous hemorrhagic lesions in the corpus region of the stomach. Pretreatment with IB-4 reduced the extent of gastric hemorrhagic damage by approximately 85% (P less than 0.001). Damage in the group pretreated with IB-4 did not differ significantly from that in rabbits that did not receive indomethacin. In separate experiments, the dose of IB-4 used was shown to completely suppress the recruitment of granulocytes in response to two different agonists. These results support the hypothesis that leukocyte adherence to the vascular endothelium is an important event in the pathogenesis of ulceration induced by nonsteroidal antiinflammatory drugs. Leukocytes might contribute to ulceration by occluding microvessels, thereby reducing mucosal blood flow, and by releasing various mediators, proteases, and free radicals that can produce tissue necrosis.
Marielle M E Lakeman - One of the best experts on this subject based on the ideXlab platform.
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the effects of prolapse surgery on vaginal wall sensibility vaginal Vasocongestion and sexual function a prospective single centre study
Neurourology and Urodynamics, 2014Co-Authors: Marielle M E Lakeman, Ellen Laan, Janpaul W R RooversAbstract:Aims Prolapse surgery has been shown to positively alter body image and decrease pelvic floor symptoms, hereby possibly improving sexual function. However, the surgical trauma itself may adversely affect sexual function, by damaging vaginal innervation and vascularization. The aim of this study is to evaluate the effects of vaginal prolapse surgery on vaginal Vasocongestion, vaginal wall sensibility, and sexual function. Methods A prospective study was performed, including patients scheduled for vaginal prolapse surgery. Participants underwent measurements before and 6 months after surgery, during non-erotic and erotic visual stimuli. Measurements were performed using a vaginal combi-probe which includes vaginal photoplethysmography to assess vaginal pulse amplitude (VPA) (representing vaginal Vasocongestion), and four pulse-generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (FSFI, FSDS-R, SSAQ). Results Twenty-nine women were included, 24 (83%) completed the 6 months follow-up. VPA analysis showed a significant reduction in vaginal Vasocongestion during sexual stimulation post-operatively (pre-op 2.4 mV (SD 2.5) vs. post-op 1.7 mV (SD 2.4), P = 0.05). Vaginal wall sensibility in the cranial posterior vaginal wall was significantly reduced after surgery (pre-op 13.3 mA vs. post-op 17.5 mA, P < 0.05). Vaginal wall sensibility in the other three locations was not affected by surgery. Sexual function as assessed with questionnaires, was not significantly affected. Conclusion Prolapse surgery negatively impacted levels of vaginal Vasocongestion during erotic stimuli as well as vaginal wall sensibility in the cranial posterior wall. Future studies are needed to tease out if these changes in physiological factors are relevant for subjective sexual function. Neurourol. Urodynam. 33:1217–1224, 2014. © 2013 Wiley Periodicals, Inc.
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the effects of vaginal prolapse surgery using synthetic mesh on vaginal wall sensibility vaginal Vasocongestion and sexual function a prospective single center study
The Journal of Sexual Medicine, 2014Co-Authors: Maaike A Weber, Ellen Laan, Marielle M E Lakeman, Janpaul W R RooversAbstract:Abstract Introduction Vaginal mesh surgery in patients with pelvic organ prolapse (POP) has been associated with sexual dysfunction. Implantation of synthetic mesh might damage vaginal innervation and vascularization, which could cause sexual dysfunction. Aim We aim to evaluate the effects of vaginal mesh surgery on vaginal Vasocongestion and vaginal wall sensibility in patients with recurrent POP. Methods A prospective study was performed among patients with previous native tissue repair, scheduled for vaginal mesh surgery. Measurements were performed before and 6 months after surgery, during nonerotic and erotic visual stimuli, using a validated vaginal combi‐probe. Main Outcome Measures The combi‐probe involves vaginal photoplethysmography to assess Vaginal Pulse Amplitude (VPA) (representing vaginal Vasocongestion) and four pulse‐generating electrodes to measure vaginal wall sensibility (representing vaginal innervation). Sexual function was assessed using validated questionnaires (Female Sexual Function Index, Female Sexual Distress Scale‐Revised, and Subjective sexual arousal and affect questionnaire). Results Sixteen women were included, 14 completed the 6‐month follow‐up visit. Vaginal Vasocongestion under erotic conditions did not significantly alter after mesh implantation. Vaginal wall sensibility of the distal posterior wall was significantly increased after mesh surgery (preoperative threshold 6.3 mA vs. postoperative 3.4 mA, P = 0.03). Sexual function as assessed with questionnaires was not significantly affected. Conclusions In women with a history of vaginal prolapse surgery, vaginal mesh surgery did not decrease vaginal Vasocongestion or vaginal wall sensibility. Vaginal Vasocongestion prior to mesh surgery appeared to be lower than that of women never operated on. Apparently, native tissue repair decreased preoperative vaginal Vasocongestion levels to such extent that subsequent mesh surgery had no additional detrimental effect. Our findings should be interpreted cautiously. Replication of the findings in future studies is essential. Weber MA, Lakeman MME, Laan E, and Roovers JPWR. The effects of vaginal prolapse surgery using synthetic mesh on vaginal wall sensibility, vaginal Vasocongestion, and sexual function: A prospective single‐center study. J Sex Med 2014;11:1848–1855.
John L Wallace - One of the best experts on this subject based on the ideXlab platform.
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a monoclonal antibody against the cd18 leukocyte adhesion molecule prevents indomethacin induced gastric damage in the rabbit
Gastroenterology, 1991Co-Authors: John L Wallace, K E Arfors, Webb G McknightAbstract:The role of leukocyte adherence in the mechanism of gastropathy induced by nonsteroidal antiinflammatory drugs was investigated using a rabbit model. Gastric damage was induced by intragastric instillation of indomethacin (5 mg/mL) for a period of 30 minutes. Histologically, this treatment resulted in extensive vascular congestion and leukocyte margination within the mucosa. Pretreatment with a monoclonal antibody (IB-4) directed against the common beta subunit of the CD11/CD18 adhesion glycoprotein complex significantly (P < 0.05) reduced both the Vasocongestion and the prevalence of leukocyte margination. Macroscopically, indomethacin treatment resulted in the formation of numerous hemorrhagic lesions in the corpus region of the stomach. Pretreatment with IB-4 reduced the extent of gastric hemorrhagic damage by ~ 85% (P < 0.001). Damage in the group pretreated with IB-4 did not differ significantly from that in rabbits that did not receive indomethacin. In separate experiments, the dose of IB-4 used was shown to completely suppress the recruitment of granulocytes in response to two different agonists. These results support the hypothesis that leukocyte adherence to the vascular endothelium is an important event in the pathogenesis of ulceration induced by nonsteroidal antiinflammatory drugs. Leukocytes might contribute to ulceration by occluding microvessels, thereby reducing mucosal blood flow, and by releasing various mediators, proteases, and free radicals that can produce tissue necrosis.
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a monoclonal antibody against the cd18 leukocyte adhesion molecule prevents indomethacin induced gastric damage in the rabbit
Gastroenterology, 1991Co-Authors: John L Wallace, K E Arfors, Webb G McknightAbstract:The role of leukocyte adherence in the mechanism of gastropathy induced by nonsteroidal antiinflammatory drugs was investigated using a rabbit model. Gastric damage was induced by intragastric instillation of indomethacin [5 mg/mL] for a period of 30 minutes. Histologically, this treatment resulted in extensive vascular congestion and leukocyte margination within the mucosa. Pretreatment with a monoclonal antibody [IB-4] directed against the common beta subunit of the CD11/CD18 adhesion glycoprotein complex significantly (P less than 0.05) reduced both the Vasocongestion and the prevalence of leukocyte margination. Macroscopically, indomethacin treatment resulted in the formation of numerous hemorrhagic lesions in the corpus region of the stomach. Pretreatment with IB-4 reduced the extent of gastric hemorrhagic damage by approximately 85% (P less than 0.001). Damage in the group pretreated with IB-4 did not differ significantly from that in rabbits that did not receive indomethacin. In separate experiments, the dose of IB-4 used was shown to completely suppress the recruitment of granulocytes in response to two different agonists. These results support the hypothesis that leukocyte adherence to the vascular endothelium is an important event in the pathogenesis of ulceration induced by nonsteroidal antiinflammatory drugs. Leukocytes might contribute to ulceration by occluding microvessels, thereby reducing mucosal blood flow, and by releasing various mediators, proteases, and free radicals that can produce tissue necrosis.
