Purpose: Urinary incontinence (UI) is a significant complication following surgery for pelvic organ prolapse (POP), including laparoscopic sacrocolpopexy (LSC). Although the incidence of postoperative UI is lower after LSC than after transvaginal mesh surgery, a subset of patients still experience UI. This study aimed to determine which factors, including mesh-related factors, contribute to UI impairing daily life following LSC. Methods: The study enrolled 96 patients who underwent LSC at our institution between June 2016 and September 2023. The Pearson chi-square test, multiple logistic regression analysis, and Cox proportional hazards model were used to determine the independent factors contributing to UI after LSC. Results: The Pearson chi-square test showed that body mass index, POP quantification (POP-Q) stage 4 and the presence of preoperative UI significantly correlated with the postoperative UI among preoperative and intraoperative factors (all P<0.05). POP-Q stage 4 and the presence of preoperative UI were also significant factors in both univariate and multivariate analyses of multiple logistic regression analysis (all P<0.05). However, only preoperative UI remained an independent predictor for shorter time to UI onset in the multivariate Cox proportional hazards model (hazard ratio, 3.56; 95% confidence interval, 1.29–11.58; P=0.0158). Conclusions Patients with preoperative UI and stage 4 POP should receive close monitoring for postoperative UI.

Purpose: Urinary incontinence (UI) is a significant complication following surgery for pelvic organ prolapse (POP), including laparoscopic sacrocolpopexy (LSC). Although the incidence of postoperative UI is lower after LSC than after transvaginal mesh surgery, a subset of patients still experience UI. This study aimed to determine which factors, including mesh-related factors, contribute to UI impairing daily life following LSC. Methods: The study enrolled 96 patients who underwent LSC at our institution between June 2016 and September 2023. The Pearson chi-square test, multiple logistic regression analysis, and Cox proportional hazards model were used to determine the independent factors contributing to UI after LSC. Results: The Pearson chi-square test showed that body mass index, POP quantification (POP-Q) stage 4 and the presence of preoperative UI significantly correlated with the postoperative UI among preoperative and intraoperative factors (all P<0.05). POP-Q stage 4 and the presence of preoperative UI were also significant factors in both univariate and multivariate analyses of multiple logistic regression analysis (all P<0.05). However, only preoperative UI remained an independent predictor for shorter time to UI onset in the multivariate Cox proportional hazards model (hazard ratio, 3.56; 95% confidence interval, 1.29–11.58; P=0.0158). Conclusions Patients with preoperative UI and stage 4 POP should receive close monitoring for postoperative UI.

Purpose: Urinary incontinence (UI) is a significant complication following surgery for pelvic organ prolapse (POP), including laparoscopic sacrocolpopexy (LSC). Although the incidence of postoperative UI is lower after LSC than after transvaginal mesh surgery, a subset of patients still experience UI. This study aimed to determine which factors, including mesh-related factors, contribute to UI impairing daily life following LSC. Methods: The study enrolled 96 patients who underwent LSC at our institution between June 2016 and September 2023. The Pearson chi-square test, multiple logistic regression analysis, and Cox proportional hazards model were used to determine the independent factors contributing to UI after LSC. Results: The Pearson chi-square test showed that body mass index, POP quantification (POP-Q) stage 4 and the presence of preoperative UI significantly correlated with the postoperative UI among preoperative and intraoperative factors (all P<0.05). POP-Q stage 4 and the presence of preoperative UI were also significant factors in both univariate and multivariate analyses of multiple logistic regression analysis (all P<0.05). However, only preoperative UI remained an independent predictor for shorter time to UI onset in the multivariate Cox proportional hazards model (hazard ratio, 3.56; 95% confidence interval, 1.29–11.58; P=0.0158). Conclusions Patients with preoperative UI and stage 4 POP should receive close monitoring for postoperative UI.

Purpose: Stress urinary incontinence is a postoperative complication occurring in patients with pelvic organ prolapse (POP). Although the 1-hour pad test measures the degree of urinary incontinence qualitatively and quantitatively, some elderly women undergoing POP surgery do not have the daily activities of living to perform the pad test. Therefore, we examined whether the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) could be used as an alternative tool for pad tests. Methods: We retrospectively evaluated 132 patients with POP. In our hospital, 57 patients were treated by laparoscopic sacrocolpopexy (LSC), whereas 75 were treated by transvaginal mesh surgery (TVM). We measured the changes in symptoms preand postoperatively using the ICIQ-SF and 1-hour pad weight testing, and investigated the correlation between the total plus component question scores of the ICIQ-SF and 1-hour pad weight. Results: The preoperative ICIQ total scores in all patients decreased significantly as the amount of leakage on the 1-hour pad weight decreased. The component question scores also decreased significantly with decreasing levels of 1-hour pad weight. The LSC and TVM groups had decreased ICIQ-SF total and component question scores as pad weight decreased. At 12 months postoperatively, the ICIQ total scores in all patients significantly declined as the amount of leakage on the 1-hour pad weight decreased. In the LSC group, the ICIQ-SF total and component question scores also decreased with decreased pad weight, but the differences were not always significant between ICIQ scores and pad weight. In the TVM group, the ICIQ-SF total and component question scores also significantly decreased as the pad weight decreased. Conclusions The ICIQ-SF could be an appropriate substitute for the 1-hour pad weight testing in predicting the severity of urinary incontinence. In the future, we hope to predict the level of urine leakage based on the ICIQ-SF score.

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.

We experienced a patient, who complained severe fatigue in spite of adequate hormonal supplement after pituitary tumor removal, was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. bukuryoshigyakuto is still unknown, but this formulation has been used for pre-shock conditions in the terminal stage of infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and maintain core temperature of the human body. The authors propose that Kampo medicine is a hopeful alternative way in the management of such patients.

Drug dispensing is a statutory and designated duty of a pharmacist. We aimed to examine the changes in the nature of drug dispensing using a text mining method. Our corpus consisted of text documents from “Chozai Shishin”, the most standard manual for dispensing drugs in Japan, Editions 1 to 13 (Japan Pharmaceutical Association), and we used the KH Coder software for text mining. We constructed networks showing the association between frequent word co-occurrence and edition number, and co-occurrence relations for frequent words in each edition. We found that “patient” superseded “dispensing” as a frequent term over time. “Dispensing” was another frequent term with a highly centralized node in each edition. Accordingly, we targeted the term “dispensing” for network analysis to depict its co-occurrence relations. We found that the range of related words for “dispensing” broadened from “preparation” and “compounding” to include “patient adherence instructions”, “assessment”, “medical treatment”, and “information provision”. Accordingly, we concluded that the content of “dispensing”, which is a pharmacist’s duty, has expanded from the duties of “dispensing drugs” to include “responding to patients” within the definition of “dispensing”, and we were able to present this finding as objective data by using the mechanical method known as text mining.

A Kampo formulation boibukuryoto is originally described in the classic textbook “Kinkiyouryaku,” which indication is involuntary muscle movement (IMM) of extremities, similar to the movement of leaves of an elm tree. We experienced two cases of IMM successfully treated with boibukuryoto. This report presented the details of these two cases of IMM and the results of surface electromyogram (EMG). There has never been a report of boibukuryoto for the treatment of IMM. The results of EMG indicate that IMM may be associated with myokymia.