Browsing by Author "Jeffery, Stephen"
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- ItemOpen AccessAcupuncture for women with refractive Overactive Bladder Syndrome(2010) Cloete, Marinus; Jeffery, StephenTo evaluate the efficacy of acupuncture in refractive OAB. The primary aim was to evaluate the effect on frequency, nocturia and urge urinary incontinence. The secondary aim was to evaluate the effect of the response on self-perceived quality-of-life.
- ItemOpen AccessComparison of short-term outcomes between two sacrospinous suture capture devices : a randomised controlled trial(2016) Ras, Lamees; Brouard, Kendall; Jeffery, StephenBACKGROUND Sacrospinous Fixation is a procedure for mid-compartment apical suspension in pelvic organ prolapse surgery with high success rates. The approach by traditional wide dissection has been well-documented. The literature is lacking however with regard to newer devices on the market that use less extensive dissection to perform this procedure. METHODS A randomised controlled trial was carried out comparing the Boston Scientific's Capio Slim® (control) and Bard's Fixt® (intervention) for bilateral sacrospinous fixation in women with mid-compartment prolapse requiring surgery and who met the study criteria. The primary outcome was time (in seconds) to successful bilateral suspension suture placements. Secondary outcomes examined were used to assess short-term safety and efficacy of the devices at the time of the procedure and at the six week follow-up.
- ItemOpen AccessDo urologists and gynaecologists manage posterior compartment prolapse differently?(2011) Adam, Ameera; Jeffery, Stephen; Adam, Ahmed; de Jong, Peter; Arieff, YusufIntroduction and hypothesis. A comparative study assessing the management of posterior compartment prolapse (PCP) by gynaecologists and urologists in South Africa. Methods. Questionnaires relating to the above procedures were posted to a nationwide random selection of urologists and gynaecologists. Results. Of 500 questionnaires 106 (21%) were returned, 26 from urologists and 80 from gynaecologists. Urologists performed fewer PCP procedures, with 73% (N=19) doing less than one case per month; 58% of the urologists who indicated their procedure of choice would use a mesh kit. Of the gynaecologists, 60% (N=48) performed at least 5 procedures per month. Vaginal hysterectomy was not used in the management of prolapse by any of the responding urologists, compared with 82% (N=66) of the gynaecologists. In defining a successful outcome, only 12% (N=3) of the urologists and 14 % (N=11) of the gynaecologists mentioned sexual function, while 46% (N=12) of the urologists and 37% (N=30) of the gynaecologists mentioned bowel function. Conclusion. Urologists use significantly more mesh kits and gynaecologists perform more traditional repairs.
- ItemOpen AccessHealing and functional outcomes after obstetric anal sphincter injury in HIV positive vs HIV negative patients(2009) Van den Berg, Julie; Jeffery, StephenAim: To determine whether HIV-positive patients have a longer time to healing, more complications and poorer functional outcomes after Obstetric Anal Sphincter Injury (OASI) than an HIV-negative control group.
- ItemOpen AccessPelvic floor dysfunction in female triathletes(2018) Mkhombe, Welile; Jeffery, Stephen; Petro, GregoryBackground: In the past few decades, an increasing number of women have been participating in high-impact sports which involves jumping, landing and/ or running activities. Recent data have shown, however, that this kind of activity might be associated with adverse effects, including pelvic floor disorders. Nevertheless, there is very little in the literature about pelvic floor effects associated with endurance sports where high-impact exercise is performed at submaximal intensity for prolonged periods of time. Objective: The primary objective of the present paper is to describe the prevalence of pelvic floor dysfunction (PFD) in a female triathlete population. Methods: An anonymous on-line survey was administered from September 2015 to March 2016 to women who self-identified as triathletes. We used two validated questionnaires: the Pelvic Floor Distress Inventory Questionnaire short form (PFDI) and the Pelvic Floor Impact Questionnaire short form (PFIQ). In addition, respondents were asked for demographics (age, height, weight, occupation), general health status (medical history, pelvic/abdominal surgical history, pregnancy and birth history) as well as sport practice characteristics (duration of training, level of competition, number of hours spent per week swimming, cycling, and running), so as to characterise these female triathletes. The survey remained active online for seven months, during which time the majority of responses were obtained from having our survey on the IRONMAN December 2015 newsletter. The balance of responses came from various triathlon clubs which we had approached within Western Cape Province. Results: Sixty-seven female triathletes responded to the online survey which we designed on SurveyMonkey. The respondents were between the ages of 22 and 56 years, the mean being 37 years. They had a mean BMI of 22.6 kg/m2. None of them had any medical conditions known to increase the risk of PFD. Of the known surgical history risk factors, 74.6% had had no previous pelvic or abdominal surgery. In the cohort, 69.2% were nulliparous and 30.8% parous. Most of the respondents competed in the recreational age group (70.4%), compared with 29.6% who described themselves as being in the competitive age group. Over 94.4% of the participants had been involved in triathlon training for a period of more than 6 months. At the peak of their training, athletes described their weekly training regime as comprising a mean of 5.4 hours running, 3.9 hours swimming and 9.1 hours cycling. Of those who performed any form of 'core exercises', 29.6% performed pelvic floor exercises, 16.7% yoga, and 25.9% Pilates as part of their routine training. Eighty-two per cent of the triathletes had competed in the half IRONMAN and 37.8% in at least one full IRONMAN competition. The PFDI revealed a number of commonly occurring pelvic floor symptoms. The most reported urinary symptoms were urinary frequency, stress urinary incontinence (SUI) and urge urinary incontinence (UUI) (45.8%, 33.3% and 37.5%, respectively). The most reported colorectal symptoms were incomplete bowel emptying (41.7%), faecal urgency (43.8%), and flatal incontinence (41.7%). Pelvic organ prolapse symptoms were least reported, but those who had symptoms mostly experienced heaviness or dullness in the pelvic area (33.3%), pressure in the lower abdomen (31.3%) and a need for vaginal/rectal digitation in order to have or complete a bowel movement (25%). It was noteworthy to find that the nulliparous triathletes had more pelvic floor symptoms than the parous group. A higher prevalence of colorectal/rectal symptoms were reported by those who had had forceps deliveries. Colorectal symptoms were found to be slightly more prevalent in those who performed any pelvic floor exercises (PFE), yoga or Pilates than amongst those who did not. Even with the myriad symptoms reported, these women were not significantly bothered by their symptoms. Conclusion: It is apparent that PFDs are prevalent in the population reviewed, although the majority of individuals did not seem to be bothered by the symptoms that also did not appear to interrupt training or quality of life. For those who are concerned or troubled by the symptoms, it would be beneficial for them to be identified early so that management options can be offered to relieve the symptoms.
- ItemOpen AccessProcedures in obstetrics and gynaecology(2010) Jeffery, StephenBook providing practical approach to broad range of procedures in obstetrics and gynaecology. Textbook relevant to fourth through six year medical students.
- ItemOpen AccessTextbook of urogynaecology(2010) Jeffery, Stephen; De Jong, PeterMulti-authored textbook by multi-disciplinary team of experts summarising the most up-to-date concepts and management strategies in urogynaecology. Used to teach physiotherapists and nurses working in the field of Urogynaecology.
- ItemOpen AccessThe accuracy of 2D transvaginal ultrasound in the diagnosis of benign endometrial pathology: a comparison between ultrasonography and hysteroscopy(2018) Jagot, Khatija H; Jeffery, StephenSTUDY OBJECTIVE: To evaluate the diagnostic accuracy of transvaginal sonography compared to hysteroscopy in diagnosing benign endometrial pathology. DESIGN: Retrospective cross-sectional study. Canadian Task force classification II – 2 SETTING: Department of Gynaecology, Groote Schuur Hospital, Cape Town, South Africa. PATIENTS: Patients having an office hysteroscopy procedure between January 2014 and December 2016, with a record of a recent transvaginal ultrasound and endometrial histology were included in this study. All malignant cases were excluded. INTERVENTIONS: Transvaginal ultrasound, endometrial biopsy and office hysteroscopy. MEASUREMENTS AND MAIN RESULTS: A total of one hundred and forty two patients, pre- and postmenopausal, were included in this study. The most common indications for hysteroscopy were abnormal uterine bleeding and postmenopausal bleeding. Sensitivity, specificity, positive and negative predictive values were calculated for ultrasonography and hysteroscopy in diagnosing benign endometrial pathology by comparing them to histological diagnosis as gold standard. The most common pathologies identified at histology were polyps and fibroids. For those patients who had a normal endometrium at ultrasound (n=59), hysteroscopy revealed 33.9% polyps, 5.1% submucosal fibroids and 49.2% normal/atrophic endometrium. The remainder of these patients demonstrated proliferative or hyperplastic endometrium, suspicious endometrium and adhesions. For those patients who had a normal hysteroscopy (n=26), ultrasound demonstrated 7.7% polyps, 7.7% submucosal fibroids, 11.5% cystic areas, 3.9% no comment on endometrium and 69.2% normal endometrium. In diagnosing polyps, hysteroscopy had a higher sensitivity (78%) than ultrasound (37.3%). However, ultrasound had a higher specificity (85.5%), compared to that of hysteroscopy which was 71.1%. The negative predictive value of hysteroscopy for polyps was 81.9% and ultrasound, 65.7%. In the diagnosis of submucosal fibroids, ultrasound had a higher sensitivity than hysteroscopy but they both had similar specificity. Ultrasound and hysteroscopy had high negative predictive values and low positive predictive values. The combination of ultrasound and hysteroscopy did not improve sensitivity, PPV or NPV with a small decline in specificity. CONCLUSION: This study demonstrated that hysteroscopy was more accurate in the diagnosis of endometrial polyps than ultrasound with a higher sensitivity and negative predictive value. However hysteroscopy had a lower sensitivity when diagnosing submucosal fibroids.