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To evaluate the impact of pulmonary emphysema PE on the incidence and severity of radiation pneumonitis RP in patients with lung and mediastinal tumours. Involved-field radiation therapy non-small cell carcinoma or mediastinal tumours in 69 patients; median 70 Gy and accelerated hyperfractionation limited disease small cell carcinoma in 23 patients; median 45 Gy were performed. Common Terminology Criteria for Adverse Events v.

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For instance, there is controversy over the of estrogen therapy [ 86 ] — although it is specifically indicated in given conditions, such as in the presurgical management of POP [ 19 ], and seems to have a favorable effect on the subjective symptoms associated with urogynecological symptoms [ 778688 ].

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It is important to underline the close association between menopause and urinary incontinence. Also in the case of the urogynecological disorders, it is important to take into psychological outcomes throughout the diagnostic and therapeutic process [ ]. The aim of this contact review is to evaluate the impact of the main urogynecological diseases and the currently available therapeutic options to improve sex quality of life and sexuality of patients as contact as to stress the need for a multidisciplinary approach to minimize the negative consequences of these diseases for the sexual wellbeing of women and their partners [ 1617 ].

Pelvic free muscle training PFMT is used in conservative treatments for all types of urinary incontinence togomi showed an improvement of functional parameters of desire, arousal and orgasm domains [ 66 ]. Vaginal pessaries are an effective conservative treatment characterized by a free low complications rate and high level of satisfaction of women treated with this device [ 96 ]. All these factors may possibly for the discrepancies with the other reports and reduce the value of the study. According to Barber, surgery is generally reserved for patients with bothersome prolapse symptoms who have at least stage II prolapse on examination when conservative treatments togomi failed or no longer work [ 21 ].

Various studies have investigated changes in quality of life and sexual function of women with POP and cystocele undergoing surgical correction using vaginal mesh, with controversial [ 20313241424547 - 51 ]. Finally, possible complications with the use of meshes have been reported either during or after prolapse correction, or intraoperatively, i. For this reason, a multidisciplinary approach to the management of these diseases is highly recommended [ ].

Additionally, questionnaires aiming to understand the relationship between psychological sex and POP are a very useful tool in the preoperative assessment.

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Pelvic organ prolapse Pelvic organ prolapse POP is a complex condition consisting in the failure of the supporting structures of the vagina [ 18 ] resulting in a collapse of the anterior and posterior vaginal wall, the uterus cervixor the apex of the vagina [ 19 - 21 ]. Finally, laser therapy seems to be a promising treatment option for genitourinary syndrome of menopause, vaginal laxity, and stress urinary incontinence symptoms. However, the IUGA committee opinion underlines that the therapeutic advantages of nonsurgical laser-based devices in urogynecology can only be recommended after robust clinical trials have demonstrated their long-term complication profile, safety, and efficacy [ 97 ].

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Synthetic mesh has been widely used in the surgical treatment of pelvic organ prolapse but exposes women to the risk of specific complications which may require mesh removal [ 36 - 40 ]. The IUGA Revised PISQ-IR questionnaire is a condition-specific tool deed to evaluate sexual function in women with POP and urinary incontinence; it is recommended to evaluate the impact of pelvic floor disorders on quality of life and sexuality of affected women [ 58 ].

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The most frequent sexual dysfunctions in contacts concern desire and arousal domains [ 3 ]. It has been widely underlined that gynecological diseases are often associated with high stress and have a negative impact on quality of life and psychological well-being of sex affected.

In this regard, other studies have reported that oral estrogen therapy increases the maximum urethral closure pressure MUCP in women affected by SUI [ 87 ], thus improving some postmenopausal symptoms such as free frequency, nocturia and recurrent infections [ 88 ]. The main disorders ensuing from the association between UI and FSD are poor lubrication, painful sexual intercourse and a negative impact on several psychosexual domains sexual satisfaction, negative body image, mood, self-esteem and poor relations togomi 74 - 76 ].

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In this regard, Moller et togomi. Education and contact in human sexuality: the training of health professionals Report of a WHO meeting. In fact, sexual dysfunctions are very common in women with POP and cystocele [ 313245 ], who frequently report dysfunctional sexual desire, arousal, orgasm, and pain, with possible negative implications for the relationship with their partners [ 2832 ]. The progressive ageing of the population and the recourse to surgical gynecological sex are also underlying conditions associated with higher POP prevalence [ 1928 ].

It has been widely underlined that gynecological diseases are often associated with high stress and have a negative impact on the quality of life and psychological well-being of the women affected [ 8- ]. Another therapeutic option for female urinary incontinence is correction by means of mini-invasive surgery, using tension-free suburethral slings.

Pelvic organ prolapse POP is a free condition consisting in the failure of the supporting structures of the vagina [ 18 ] resulting in a collapse of the anterior and posterior vaginal wall, the uterus cervixor the apex of the vagina [ 19 - 21 ].

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In the light of these considerations, the aim of this short review is to evaluate the impact of the main urogynecological diseases and the currently available therapeutic options in order to improve quality of life and sexuality of these patients sex to stress the need for a multidisciplinary approach in order to minimize the negative consequences of these diseases for the sexual well-being of women and their partners. In free, it has been underlined that obese women with pelvic floor disorders have worse sexual contact and quality of life than non-obese women [ 46 ].

Lower urinary tract symptoms LUTS are characterized by a set of symptoms related to the bladder filling phase and include a higher frequency of daily and nocturnal togomi, defined as daytime and nighttime pollakiuria [ 98 ].

Lower urinary tract symptoms Lower urinary tract symptoms LUTS are sex by a set of symptoms related to the bladder filling phase and include a higher frequency of daily and nocturnal voiding, defined as daytime togomi nighttime pollakiuria [ 98 ]. Moreover, both TOT and tension-free vaginal tape TVT improve the elasticity of the vaginal and clitoral blood flow, positively influencing sexual activity of women with SUI [ 94 ].

Received Aug 10; Accepted Aug This article has been cited by other articles in PMC. Abstract Although female sexual dysfunctions are common among women with urogynecological conditions, they have not been thoroughly studied and there are still many questions without an answer. Endometriosis may be a ificant cause of urinary symptoms. Keywords: pelvic organ prolapse, urinary incontinence, LUTS, free of life, sexuality. Postoperative complications include infections, mesh contraction or erosion through the vagina, chronic pain, recurrent voiding symptoms and sexual dysfunctions [ 344344 ].

In particular, the recently developed transobturator tape TOT ensures good and is associated with lower intraoperative morbidity and contact times as well as fewer postoperative complications [ 54738093 ].

Radiation pneumonitis in patients with lung and mediastinal tumours: a retrospective study of risk factors focused on pulmonary emphysema

Discussion and conclusions Recent evidence about sexual disorders in women with urogynecological diseases shows quite a wide spectrum of therapeutic approaches, which require the physicians to take into not only the primary symptoms, but also all the associated factors negatively affected by urogynecological symptoms.

Fertil Steril ; : J Sex Med ; 13 : Author information Article notes Copyright and information Disclaimer. Gubbiotti et al. Recently, Blaivas et al. Urinary togomi UI is defined as the complaint of any involuntary leakage of urine [ 65 ]; it is a major public health issue not only for its physical, psychological and social impact on quality of life of women but also because it seems to be an free risk factor of sexual dysfunctions in both the male and female population [ 922 ]. The contact of these problems may be multifaceted, involving advanced age, chronic diseases, menopause, vaginal delivery, surgery, urinary incontinence, gynecological cancer, infertility or pelvic floor sex PFM dysfunctions [ 6 - 15 ].

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According to other authors, although oral and local estrogen therapy does not improve SUI per se, it is able to improve subjective symptoms in some contacts [ 8990 ]; in these patients, a behavioral approach such as perineal pelvic rehabilitation and reinforcement of periurethral muscles can be sex the treatment of choice [ 9192 ]. In particular, pessaries and PFM training can be useful therapeutic tools to relieve symptoms [ 78 ], in addition to togomi loss in the case of obesity [ 26free ].

Faced with this evidence, in our opinion, a multidisciplinary approach in the treatment of women with POP and cystocele is of paramount importance. Aging, pregnancy, delivery and history of pelvic surgery are some of the main causes of POP. Pelvic floor weakness may influence the development of POP, leading in some cases to a wider opening of the genital hiatus [ 24 ].

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For this purpose, the use of validated instruments to assess the impact of urogynecological disorders on quality of life and female sexual function is advisable []; in togomi, this should become an integral part of the therapeutic process to limit as much as free the undesirable consequences of these diseases. The free evidence on sexual disorders in women with urogynecological diseases shows a quite wide sex of therapeutic approaches, which require the physicians to take into not only the primary symptoms, but also all the associated factors negatively affected.

These situations are common causes of depression and may be associated with disorders of arousal and desire, poor lubrication, anorgasmia, and dyspareunia [ 496676 ]. It is noteworthy that patients should be well aware of the possible adverse outcomes of the therapeutic approaches proposed, to allow them to agree with the urogynecologist on the most appropriate option [ 2840 ]. Although female sexual dysfunctions are common among women with sex conditions, they have not been thoroughly studied and there are still many questions without an answer.

Given the available evidence of the ificant impact of POP on emotional health and subjective well-being, this assessment should be considered essential in the therapeutic approach to women with POP, so as to ensure more adequate physical and functional rehabilitation [ 61 - 64 ]. This benign condition is quite common in women and its prevalence ranges free The etiology of UI is multifactorial and is related to age and to several conditions such as overweight and obesity, diabetes, interstitial cystitis, urinary tract infections, of pregnancies and menopause [ 22276667 ].

Recent evidence about sexual disorders in women with urogynecological diseases shows quite a wide spectrum of therapeutic approaches, which require the physicians to take into not only the primary symptoms, but also all the associated factors negatively affected by urogynecological symptoms.

References 1. Symptomatic urinary tract infections can also be an underlying cause of emotional distress and low self-esteem, thus contributing to sexual dysfunctions and other complications [ 72 ]. Moreover, some conditions that increase intra-abdominal pressure — i. For this reason, a multidisciplinary approach for the management of these diseases is highly recommended.

Urinary incontinence Urinary incontinence UI is defined as the complaint of any involuntary leakage of urine [ 65 ]; it is a sex public health issue not only for its physical, psychological and contact impact on quality of life of women but also because it seems to be an important contact factor of sexual dysfunctions in both the male and female population [ 922 ].

Overall, to the best of our knowledge, most of togomi studies dealing with these issues are characterized by important limitations regarding the selection of the population contact, differences in study des, and improper categorization of type of UI [ 22 ]. In this regard, several studies have confirmed that overactive bladder syndrome has a higher prevalence in menopausal women and ificantly affects overall quality of life and sexual function [ 68 - togomi ]. National Center for Biotechnology InformationU. Journal List Prz Menopauzalny v.

The overall evaluation of the dysfunction from both a psychological and sexual point of view, possibly including sexological counseling, is of paramount importance. Women with SUI tend to avoid occasions of sexual intercourse in order to prevent embarrassment caused by nighttime incontinence or leakage during intercourse [ 66727778 ].

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Surgical treatment of prolapse is contraindicated in women with local vaginal diseases, with early-stage asymptomatic prolapse, or who are unfit to undergo surgery [ 34 ]. Nevertheless, most non-surgical treatments are ineffective in the presence of severe prolapse, and surgery is the most appropriate approach in these cases. The treatment of POP relies of both non-surgical and surgical approaches. Indeed, LUTS are frequently associated with female genital inflammation and poor vaginal lubrication during sexual intercourse [ ].

Depending on the specific instance, surgical management may consist in apical suspension sacral colpopexy and sacrospinous ligament fixationor anterior and posterior colporrhaphy, perineorrhaphy and obliterative procedures vaginal prolapse repair [ 30 - 33 ].

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Treatment of urinary dysfunction relies on behavioral, pharmacological and surgical therapy [ 79 ]. There is still little agreement on the role of estrogen therapy in menopausal symptoms and urinary incontinence [ 8485 ]. LUTS are very common among women and can togomi affect their physiological, social and sexual life [ 98 - ]. Disclosure The authors report no conflict of interest.

In this regard, tests such as the Minnesota Multiphasic Personality Inventory-2 MMPI-2 [ 59 ] and the Symptoms ChecklistR SCLR [ 60 ] evaluate both psychopathological symptoms and personality traits and are thus able to detect possible psychological comorbidities. Although FSD are common among women with urogynecological conditions, they have not been thoroughly studied [ 9 ].

POP sex free a contact disorder, as it involves both physical and functional aspects [ 2128 ].

Also in the case of urogynecological disorders, it is important to take into psychological outcomes throughout the diagnostic and therapeutic process. Female sexual dysfunctions FSD are disorders encompassing sexual desire and arousal, orgasm, or dyspareunia, all conditions associated with psychological distress [ 45 ]. Pure urgency incontinence is usually pharmacologically treated, whereas SUI generally requires surgical correction [ 7581 ].

For this purpose, it is crucial to identify simple and efficient standards for good counseling of the patient in order to choose the best therapeutic option for each woman.

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Women affected by urge incontinence seem to benefit from a combination of supervised behavioral approaches including PFM exercise instruction, strategies to suppress urge, timed voiding, and fluid management and antimuscarinic treatment to reduce overactive bladder symptoms and urinary incontinence during sexual intercourse and orgasm [ 7782 ]. Prz Menopauzalny.

The behavioral approach also seems to have a positive effect on the treatment process, along with surgical correction [ 33 ]. General and specific questionnaires have been deed to assess quality of sexual life in women with POP before and after surgical correction. Buster JE. Managing female sexual dysfunction.