1.The Presence of Preoperative Urinary Incontinence Significantly Correlates With Postoperative Urinary Incontinence Following Laparoscopic Sacrocolpopexy
Kenji KURODA ; Koetsu HAMAMOTO ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2025;29(1):27-33
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.
2.The Presence of Preoperative Urinary Incontinence Significantly Correlates With Postoperative Urinary Incontinence Following Laparoscopic Sacrocolpopexy
Kenji KURODA ; Koetsu HAMAMOTO ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2025;29(1):27-33
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.
3.The Presence of Preoperative Urinary Incontinence Significantly Correlates With Postoperative Urinary Incontinence Following Laparoscopic Sacrocolpopexy
Kenji KURODA ; Koetsu HAMAMOTO ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2025;29(1):27-33
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.
4.Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT)
Yusuke KOBAYASHI ; Muneaki SHIMADA ; Masato TAMATE ; Hyun Woong CHO ; Jun ZHU ; Hung-Hsueh CHOU ; Hiroaki KAJIYAMA ; Aikou OKAMOTO ; Daisuke AOKI ; Sokbom KANG ; Jeong-Won LEE ; Jae-Weon KIM ; Jae-Hoon KIM ; Zhongqiu LIN ; Jihong LIN ; Xiaohua WU ; Hung-Cheng LAI ; Ting-Chang CHANG ; Chyong-Huey LAI ; Yong Man KIM ; Takayuki ENOMOTO
Journal of Gynecologic Oncology 2024;35(3):e87-
Ovarian cancer, notable for its severe prognosis among gynecologic cancers, has seen substantial progress in treatment approaches recently. Enhanced protocols in chemotherapy and the introduction of poly (ADP-ribose) polymerase (PARP) inhibitors for maintenance therapy have markedly improved outcomes for patients with specific genetic profiles, such as those positive for BRCA mutations or exhibiting homologous recombination deficiency (HRD). Additionally, the method of intraperitoneal chemotherapy administration has emerged as a valuable alternative to traditional transvenous routes, showing promise for wider clinical adoption. The field of surgery has also evolved, with increasing exploration into the benefits and feasibility of laparoscopic methods over more invasive traditional surgeries, aiming for complete tumor removal but with reduced patient impact. The hereditary nature of ovarian cancer underscores the importance of genetic testing, which has become integral in tailoring treatment strategies, particularly in determining suitability for PARP inhibitors.The formation of the East Asian Gynecologic Oncology Trial Group (EAGOT) aims to optimize treatment across Japan, Korea, China, and Taiwan. The ovarian cancer committee of EAGOT shared the current policies, focusing on 5 topics: 1) strategies for maintenance therapy after initial surgery and chemotherapy, 2) drug regimens for platinum-sensitive and platinum-resistant recurrence, 3) intraperitoneal chemotherapy, 4) laparoscopic surgery as an alternative to laparotomy, and 5) current status of genetic testing (BRCA, HRD, and panel tests) for ovarian cancer and its prospects. EAGOT’s multi-national trials aim to harmonize these evolving treatment strategies, ensuring that the latest and most effective protocols are accessible across the region, thereby significantly impacting patient outcomes in East Asia.
5.Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT)
Yusuke KOBAYASHI ; Muneaki SHIMADA ; Masato TAMATE ; Hyun Woong CHO ; Jun ZHU ; Hung-Hsueh CHOU ; Hiroaki KAJIYAMA ; Aikou OKAMOTO ; Daisuke AOKI ; Sokbom KANG ; Jeong-Won LEE ; Jae-Weon KIM ; Jae-Hoon KIM ; Zhongqiu LIN ; Jihong LIN ; Xiaohua WU ; Hung-Cheng LAI ; Ting-Chang CHANG ; Chyong-Huey LAI ; Yong Man KIM ; Takayuki ENOMOTO
Journal of Gynecologic Oncology 2024;35(3):e87-
Ovarian cancer, notable for its severe prognosis among gynecologic cancers, has seen substantial progress in treatment approaches recently. Enhanced protocols in chemotherapy and the introduction of poly (ADP-ribose) polymerase (PARP) inhibitors for maintenance therapy have markedly improved outcomes for patients with specific genetic profiles, such as those positive for BRCA mutations or exhibiting homologous recombination deficiency (HRD). Additionally, the method of intraperitoneal chemotherapy administration has emerged as a valuable alternative to traditional transvenous routes, showing promise for wider clinical adoption. The field of surgery has also evolved, with increasing exploration into the benefits and feasibility of laparoscopic methods over more invasive traditional surgeries, aiming for complete tumor removal but with reduced patient impact. The hereditary nature of ovarian cancer underscores the importance of genetic testing, which has become integral in tailoring treatment strategies, particularly in determining suitability for PARP inhibitors.The formation of the East Asian Gynecologic Oncology Trial Group (EAGOT) aims to optimize treatment across Japan, Korea, China, and Taiwan. The ovarian cancer committee of EAGOT shared the current policies, focusing on 5 topics: 1) strategies for maintenance therapy after initial surgery and chemotherapy, 2) drug regimens for platinum-sensitive and platinum-resistant recurrence, 3) intraperitoneal chemotherapy, 4) laparoscopic surgery as an alternative to laparotomy, and 5) current status of genetic testing (BRCA, HRD, and panel tests) for ovarian cancer and its prospects. EAGOT’s multi-national trials aim to harmonize these evolving treatment strategies, ensuring that the latest and most effective protocols are accessible across the region, thereby significantly impacting patient outcomes in East Asia.
6.Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT)
Yusuke KOBAYASHI ; Muneaki SHIMADA ; Masato TAMATE ; Hyun Woong CHO ; Jun ZHU ; Hung-Hsueh CHOU ; Hiroaki KAJIYAMA ; Aikou OKAMOTO ; Daisuke AOKI ; Sokbom KANG ; Jeong-Won LEE ; Jae-Weon KIM ; Jae-Hoon KIM ; Zhongqiu LIN ; Jihong LIN ; Xiaohua WU ; Hung-Cheng LAI ; Ting-Chang CHANG ; Chyong-Huey LAI ; Yong Man KIM ; Takayuki ENOMOTO
Journal of Gynecologic Oncology 2024;35(3):e87-
Ovarian cancer, notable for its severe prognosis among gynecologic cancers, has seen substantial progress in treatment approaches recently. Enhanced protocols in chemotherapy and the introduction of poly (ADP-ribose) polymerase (PARP) inhibitors for maintenance therapy have markedly improved outcomes for patients with specific genetic profiles, such as those positive for BRCA mutations or exhibiting homologous recombination deficiency (HRD). Additionally, the method of intraperitoneal chemotherapy administration has emerged as a valuable alternative to traditional transvenous routes, showing promise for wider clinical adoption. The field of surgery has also evolved, with increasing exploration into the benefits and feasibility of laparoscopic methods over more invasive traditional surgeries, aiming for complete tumor removal but with reduced patient impact. The hereditary nature of ovarian cancer underscores the importance of genetic testing, which has become integral in tailoring treatment strategies, particularly in determining suitability for PARP inhibitors.The formation of the East Asian Gynecologic Oncology Trial Group (EAGOT) aims to optimize treatment across Japan, Korea, China, and Taiwan. The ovarian cancer committee of EAGOT shared the current policies, focusing on 5 topics: 1) strategies for maintenance therapy after initial surgery and chemotherapy, 2) drug regimens for platinum-sensitive and platinum-resistant recurrence, 3) intraperitoneal chemotherapy, 4) laparoscopic surgery as an alternative to laparotomy, and 5) current status of genetic testing (BRCA, HRD, and panel tests) for ovarian cancer and its prospects. EAGOT’s multi-national trials aim to harmonize these evolving treatment strategies, ensuring that the latest and most effective protocols are accessible across the region, thereby significantly impacting patient outcomes in East Asia.
7.Response to the Letter to the Editor: Evaluation of the Association between Neck Pain and the Trapezius Muscles in Patients with Cervical Myelopathy Using Motor Evoked Potential: A Retrospective Study
Sadayuki ITO ; Yoshihito SAKAI ; Atsushi HARADA ; Kei ANDO ; Kazuyoshi KOBAYASHI ; Hiroaki NAKASHIMA ; Masaaki MACHINO ; Shunsuke KAMBARA ; Taro INOUE ; Tetsuro HIDA ; Kenyu ITO ; Naoki ISHIGURO ; Shiro IMAGAMA
Asian Spine Journal 2024;18(1):160-161
8.The International Consultation on Incontinence Questionnaire Short Form as a Substitute for 1-Hour Pad Weight Testing in the Evaluation of Urinary Incontinence in Patients With Pelvic Organ Prolapse Undergoing Surgery
Kenji KURODA ; Koetsu HAMAMOTO ; Kazuki KAWAMURA ; Ayako MASUNAGA ; Hiroaki KOBAYASHI ; Akio HORIGUCHI ; Keiichi ITO
International Neurourology Journal 2024;28(3):215-224
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.
9.Asian Young Doctors Session at the 64th Annual Meeting of the Japanese Society for Gynecologic Oncology (JSGO): Educational Initiatives in the Next Generation for a New Era after the COVID-19 Pandemic
Yusuke KOBAYASHI ; Hiroaki KOMATSU ; Masanori ISOBE ; Jyoti MEENA ; Chia-Sui WENG ; Se Ik KIM ; Jeslyn JL WONG ; Shuk Tak KWOK ; Jie YANG ; Panida MATHAVEECHOTIKUL ; Kanddy Loo Chin YEE ; Jae-Weon KIM ; Kimio USHIJIMA
Journal of Gynecologic Oncology 2023;34(1):e22-
10.Trend and characteristics of minimally invasive surgery for patients with endometrial cancer in Japan
Hiroshi YOSHIDA ; Hiroko MACHIDA ; Koji MATSUO ; Yoshito TERAI ; Takuma FUJII ; Masaki MANDAI ; Kei KAWANA ; Hiroaki KOBAYASHI ; Mikio MIKAMI ; Satoru NAGASE
Journal of Gynecologic Oncology 2023;34(3):e56-
Objective:
Owing to the potential benefits of minimally invasive hysterectomy for endometrial cancer, the practice pattern has recently shifted in Japan. This study examined the trends in minimally invasive surgery (MIS) in patients with endometrial cancer in Japan.
Methods:
This retrospective observational study examined the Japan Society of Obstetrics and Gynecology Tumor Registry database between 2015–2019. This study examined the time-specific proportion change and predictors of MIS use in initial endometrial cancer treatment in Japan, and compared it with the use of abdominal surgery. Additionally, the association between hospital surgical treatment volume and MIS use was examined.
Results:
A total of 14,059 patients (26.5%) underwent minimally invasive hysterectomy, and 39,070 patients (73.5%) underwent abdominal hysterectomy in the study period. Patients who underwent MIS were more likely to be treated at high-volume centers, younger, central, or western Japan residents, registered in recent years, and had a tumor with stage I disease, type 1 histology, and less myometrial invasion (all adjusted p<0.05). The proportion of MIS treatments increased from 19.1% in 2015 to 34.3% in 2019 (p<0.001). On multivariable analysis, treatment at high-volume centers was a contributing factor for MIS (adjusted odds ratio=3.85; 95% confidence interval=3.44–4.30). MIS at high-volume centers increased significantly from 24.8% to 41.0% (p<0.001) during the study period, whereas MIS at low-volume centers remained at median 8.8%.
Conclusion
MIS has increased significantly in recent years, accounting for nearly 34% of surgical management of endometrial cancer in Japan. High-volume treatment centers take the lead in performing MIS.

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