Bupivacaine-Induced Regeneration in Rabbit Extraocular Muscles: Implications for the Treatment of Strabismus

Ophthalmology Science · 2026-05-01

Passive Mechanical Testing of Female Human Levator Ani and Superficial Perineal Muscles

Annals of Biomedical Engineering · 2026-04-18

Cesarean Delivery on Maternal Request

JAMA · 2026-02-09

This JAMA Insights discusses cesarean delivery on maternal request, including the need for counseling regarding maternal and infant risks, composite outcomes, and patient autonomy.

Shaping the future of urogynecology through regenerative medicine

Current Opinion in Obstetrics & Gynecology · 2025-09-29

PURPOSE OF REVIEW: The etiology of urogynecologic conditions is multifactorial and complex. However, the inability of the host pelvic tissues to repair and regain their original function in response to various insults, including maternal birth injury or age-related changes in the endogenous regenerative potential, underlies the pathophysiology of the morbid pelvic floor disorders (PFDs). Regenerative medicine approaches are poised to not only treat but potentially prevent the development of these deleterious conditions, the prevalence of which continues to increase. We aim to highlight the existent work at the crossroads of urogynecology and regenerative medicine and to underscore areas in need for continued and novel investigations. RECENT FINDINGS: Regenerative medicine techniques, including stem cell therapies, extracellular vesicles, secretomes, platelet-rich plasma, laser-based interventions, and bioinductive acellular scaffolds, are being studied in the context of urogynecology, with many showing promise in revolutionizing prevention and treatment of PFDs by enhancing constructive tissue repair. SUMMARY: Regenerative medicine techniques hold the key to changing the clinical paradigm in Urogynecology from reactive to preventive.

Providing Clarification on the Use of Interstitial Cystitis/Bladder Pain Syndrome

Urogynecology · 2025-10-31

Chapter 4.5: New Proposed Treatments for Pelvic Organ Prolapse

International Urogynecology Journal · 2025-12-01 · 1 citations

Pelvic organ prolapse (POP) is a morbid and costly condition that affects millions of women worldwide. Given the shortcommings of the current treatments, novel preventative and therapeutic approaches are needed. This manuscript is part of the International Urogynaecologogy Consultation (IUC) on pelvic organ prolapse (POP) chapter four on new and novel treatments for pelvic organ prolapse. The current expert narrative review (1) highlights the rationale for novel treatments for POP; (2) summarizes the exisitng mechanistic insights into physiologic alterations needed to inform the development of novel preventative and therapeutic strategies for POP; (3) reviews relevant modern tools that can help establish causal relationships between epidemiologic risk factors and POP pathogenesis; (4) describes prevention-focused interventions and advancements in treatment-focused interventions to date; and (4) emphasizes requirements for responsible translation of discoveries into novel treatments and safe incorporation of new treatments into clinical practice. Importantly, the review underscores the need for multidisciplinary adequately funded research and training programs as an absolute prerequisite for enabling a long overdue shift in clinical paradigm-instead of relying on delayed compensatory "one-size-fits-all" treatments that do not address the underlying pathophysiology, the focus should be on preventing or mitigating POP through personalized medicine approaches supported by team science.

Effect of lactation on postpartum pelvic floor muscle regeneration in preclinical model

npj Women s Health · 2025-06-12 · 1 citations

Pelvic floor muscle (PFM) recovery following childbirth is essential for preserving pelvic floor function. Despite this, the impact of parturition and lactation on pelvic muscle stem cells (MuSCs), indispensable for skeletal muscle maintenance and regeneration, remains unknown. We determined that vaginal delivery does not cause mechanical injury of the rat PFMs, enabling us to uncouple the effects of lactation on muscle homeostasis from PFM regeneration following simulated birth injury (SBI). Tibialis anterior (TA) served as non-pelvic control. This novel study demonstrates that in the absence of birth injury, lactation blocks MuSC proliferation in PFM and TA, suggesting that postpartum systemic milieu affects MuSCs in pelvic and non-pelvic muscles. In contrast, SBI negated the inhibitory effect of lactation on MuSCs in PFM but not in TA, indicating that local signals released by the injured muscle overcome systemic inhibitory effects of lactation, which persist in muscles remote from the site of injury.

The Role of Biomarkers in the Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome: What Does Current Evidence Reveal?

Neurourology and Urodynamics · 2025-09-11 · 2 citations

AIMS: This narrative expert review aims to elucidate the role of biomarkers in the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), highlighting their potential to enhance patient care by enabling more precise and individualized therapeutic strategies. METHODS AND RESULTS: We performed a comprehensive review of literature focused on biomarkers relevant to IC/BPS, including bladder capacity, symptom intensity, bladder wall thickness, as well as serum and urinary inflammatory cytokines and other biomarkers of inflammation, oxidative stress, and urothelial and extracellular matrix remodeling. Evidence indicates that biomarkers such as TNF-α, IL-8, and bladder capacity can differentiate between Hunner lesion and non-Hunner lesion IC subtypes, predict treatment responses, and guide effective interventions. Furthermore, advanced statistical methods and machine learning applications show promise in improving diagnostic accuracy and treatment outcome predictions through clustering of the biomarker data. CONCLUSIONS: Reliable biomarkers are vital for improving diagnostic precision and tailoring therapies for IC/BPS patients. Ongoing research and validation of these biomarkers are essential for advancing understanding, guiding treatment decisions, and enhancing the quality of life for individuals affected by this complex syndrome. The need for integrated biomarker profiles and multipronged research approaches is crucial for the future of IC/BPS management.

Addressing the crisis in women’s health research: an American Gynecological and Obstetrical Society statement

American Journal of Obstetrics and Gynecology · 2025-05-30 · 3 citations

Novel Application of T1ρ Magnetic Resonance Imaging for Noninvasive Assessment of Bladder Hyperpermeability Biomarkers: A Focus on Glycosaminoglycan Content

Neurourology and Urodynamics · 2025-05-04

PURPOSE: Bladder wall hyperpermeability due to glycosaminoglycan depletion is implicated in interstitial cystitis/bladder pain syndrome pathogenesis. This study sought to validate T1ρ MRI as a noninvasive imaging sequence for assessing bladder wall hyperpermeability biomarkers, with a focus on bladder glycosaminoglycan content, in protamine sulfate-induced models of interstitial cystitis/bladder pain syndrome. MATERIALS AND METHODS: Rat bladders (n = 8) treated with saline (control), protamine sulfate, pentosan polysulfate, or protamine sulfate + pentosan polysulfate (rescue) were imaged in situ using T1ρ and standard MRI sequences. Predominant bladder glycosaminoglycans, chondroitin and heparan sulfate, were measured in subsequently harvested rat bladders via aniline tagging coupled with mass spectrometry. Human bladder biopsies (n = 12) were similarly imaged before and after protamine sulfate treatment, and post-imaging glycosaminoglycan analysis was performed. Data were compared between groups using one-way ANOVA or paired Student t-test. T1ρ relaxivity was correlated with chemically measured glycosaminoglycan content using linear regression. RESULTS: Protamine sulfate-treated rat bladders had decreased glycosaminoglycans and higher T1ρ relaxivity relative to controls. Pentosan polysulfate also decreased glycosaminoglycans versus controls and did not mitigate protamine-mediated glycosaminoglycan depletion. Importantly, T1ρ relaxivity correlated with chemical glycosaminoglycan quantification (chondroitin sulfate: r = 0.86, p < 0.01; heparan sulfate r = 0.80, p = 0.02). In human biopsies, T1ρ relaxivity increased after protamine sulfate treatment versus baseline (154.2 ± 5.9 vs. 131.0 ± 4.4 ms, p < 0.001), consistent with decreased glycosaminoglycans, while chemical analyses failed to capture statistically significant changes in bladder glycosaminoglycans. CONCLUSIONS: T1ρ MRI accurately measured glycosaminoglycans in rat bladders and differentiated protamine sulfate-treated bladder biopsies from unperturbed specimens in humans. T1ρ MRI warrants further investigation as a novel biomarker of bladder glycosaminoglycan content in interstitial cystitis/bladder pain syndrome.