Background/Objectives: Pelvic organ prolapse (POP) surgery can lead to postoperative stress urinary incontinence (SUI) in previously continent women, termed de novo SUI. This study assessed the incidence and risk factors of de novo SUI after apical POP repair, hypothesizing that reduced bladder neck elasticity—particularly within the zone of critical elasticity (ZCE) described by the Integral Theory—contributes to its development. Methods: A retrospective single-center analysis was performed in 206 postmenopausal women (≥60 years) who underwent apical POP surgery without concomitant anti-incontinence procedures. Patients were classified by surgical approach as laparoscopic sacrocolpopexy (SCP) or vaginal native tissue repair. Results: The overall incidence of de novo SUI was 8.7%. Laparoscopic SCP for vaginal vault prolapse was significantly associated with a higher risk of postoperative SUI (OR 10.37, 95% CI 2.70–39.79, p = 0.001), whereas other procedures showed no significant association. Neither prior hysterectomy nor cystocele stage was an independent predictor of de novo SUI. Conclusions: These results suggest that surgical alteration of the ZCE—particularly excessive tension or reduced elasticity near the bladder neck—may impair urethral closure. Therefore, preserving ZCE integrity and carefully adjusting mesh tension during apical POP repair may reduce the risk of de novo SUI.

When there is a time-dependency between the biomarker and the event of interest (death, disease, relapse etc.), classical receiver operating characteristic (ROC) analysis may not be able to estimate the true performance of the biomarker. For such cases, time-dependent ROC, an extended version of the standard ROC, is developed. In this study, the aim is to demonstrate applications of this modified ROC method on medical datasets and find out if it should be preferred over classical ROC for time-dependent situations. Comparison between classical ROC and Kaplan-Meier (KM) estimator, which is one of the two time-dependent ROC estimators, has been made using datasets in this study. Nearest Neighbor Estimator (NNE), the alternative of KM estimator, is also applied on all datasets. Then the findings of these two approaches are compared. It is concluded that time-dependent ROC method is superior to the standard ROC analysis. In general, the closer to the event time, the higher performance is observed. Especially, biomarkers measured at last 12 or 6 months before the event are determined to be better at classification than the earlier measurements. Though in all applications KM and NNE yielded very similar results, the latter is considered to be more appropriate to evaluate the performance of a biomarker when a time dependent data is also censored. Results of this study show that time-dependent ROC analysis performs more accurately when there is a time dependency between the biomarker and the event of interest; therefore, it is recommended.

Amaç: Dünya genelinde, bisiklet kazaları önlenebilir çocuk yaralanmalarında önemli bir yer tutmaktadır. Çocuklarda yaralanmalara neden olan risk faktörlerinin bilinmesi etkin önlemlerin alınması için gereklidir. Gereç ve Yöntemler: Ocak-Aralık 2018 tarihleri arasında bisiklet kazası nedeni ile Çukurova Üniversitesi Tıp Fakültesi Hastanesi, çocuk acil servisine getirilen 2-18 yaş arasındaki bisiklet sürücüleri geriye dönük olarak değerlendirildi. Tıbbi kayıtlar incelenerek demografik veriler, yaralanma durumları, aldıkları tanılar ve uygulanan tedaviler araştırıldı. Motorlu taşıt karışan ve karışmayan olgular karşılaştırıldı. Bulgular: Bisiklet kazası nedeniyle getirilen 158 hastanın yer alan hastaların yaş ortancası 9 (Aralık 2-17) yıl idi. Hastaların %68,4’si erkek ve %31,6’sı kadındı. Başvuru nedenlerinin en sık olanları sırası ile üst ekstremite ağrısı/yaralanması (%32,3), alt ekstremitede ağrı/yaralanma (%29,1) ve yüz bölgesinde ağrı/ yaralanma (%27,8) idi. Bisiklet kazalarından 17 (%10,8) tanesine motorlu bir taşıt karışmıştı. Motorlu taşıtın karışmış olduğu bisiklet kazaları ayrı bir grup olarak değerlendirildi ve bu kazalarda hem maksillofasiyal kırık hem de baş-boyun yaralanması tanısı alan hastaların daha yüksek sıklıkta olduğu görüldü. Bu olgulardaki cerrahi bölümlerden konsültasyon istenme oranları ve cerrahi müdahale gereksinimleri motorlu taşıtın karışmadığı bisiklet kazalarına göre anlamlı olarak yüksek bulundu (p < 0,05). Hastaların hiçbirinde kask kullanımı mevcut değildi. Ölen hasta yoktu. Çocuk yoğun bakım ihtiyacı olan 3 hastanın kafa travması mevcuttu. Sonuç: Bisiklet kazalarında hayatı tehdit eden en büyük sorun kafa travmalarıdır. Çalışmamızın sonuçları önceki çalışmalar ile uyumludur. Kask, uyarı işaretleri ve diğer güvenlik araçlarının bilinçli kullanımı ile bisiklet kazalarının vereceği zarar azaltılabilir. Acillerdeki sağlık personeli bu önemli hasta grubunda karşılaşılacak sorunlar ile ilgili bilgi sahibi olmalıdır.

Background: Stress urinary incontinence (SUI) is one of the most common pelvic floor disorders in women and is frequently treated surgically using midurethral sling procedures. Despite the high success rates of these procedures, postoperative voiding dysfunction remains a clinically relevant complication that may negatively affect patient satisfaction and quality of life. The underlying mechanisms are multifactorial and not completely understood. In particular, the interaction among sling position, urethral mobility, and pelvic floor dynamics during increases in intra-abdominal pressure may influence postoperative urinary function. Dynamic transperineal ultrasound has emerged as a valuable imaging modality for evaluating sling position and urethral mobility; however, the relationship between dynamic sonographic sling parameters and postoperative urinary symptoms has not yet been sufficiently clarified. Objective: This study aims to investigate the association between dynamic sonographic sling parameters and postoperative changes in patient-reported lower urinary tract symptoms following retropubic tension-free vaginal tape surgery. Methods: This prospective, noninterventional observational pilot study will be conducted at the Department of Obstetrics and Gynecology, University Medical Center Mainz, Germany. Female patients scheduled for retropubic tension-free vaginal tape surgery for SUI will be recruited consecutively. Preoperative assessment will include clinical examination, completion of the International Prostate Symptom Score (IPSS) questionnaire, and standardized transperineal ultrasound imaging at rest and during the Valsalva maneuver. Postoperative follow-up will be performed 3 months after surgery and will include repeat ultrasound examination and IPSS assessment. Sonographic parameters will include urethral mobility, sling-pubis gap, tape-urethra distance, and sling morphology. The primary outcome will be the correlation between changes in the sling-pubis gap during the Valsalva maneuver and changes in IPSS scores. Secondary outcomes will include associations among clinical variables, sonographic findings, and postoperative voiding symptoms. Results: Ethics approval for this study has been obtained from the Ethics Committee of the State Medical Association of Rhineland-Palatinate (reference number 2025-18448). At the time of manuscript submission, participant recruitment had not yet begun and was scheduled to begin in August 2026. The target sample size for this pilot study is 55 participants. Data collection is expected to take approximately 24 months, and the final study results are anticipated to be available in 2028. Conclusions: This study will investigate dynamic sonographic parameters associated with postoperative urinary symptoms following midurethral sling surgery. A better understanding of sling-urethra interactions during increases in intra-abdominal pressure may improve the prediction of postoperative voiding dysfunction and contribute to more individualized surgical planning and patient counseling in women undergoing treatment for SUI.

Purpose: One of the sources of information about biostatistics in recent years is the Internet. Many videos about biostatistics are available on YouTube. However, there are uncertainties as to whether the videos on YouTube contain safe and accurate information. In this study, we aimed to evaluate the use of videos as a source of information by determining the reliability and quality levels of videos related to biostatistics on YouTube.Material and Methods: In the study, a total of 540 videos under different subheadings on biostatistics on YouTube (http://www.youtube.com) were evaluated. The reliability of the videos was evaluated with the DISCERN tool. The quality of the videos, on the other hand, was evaluated by GQS.Results: The quality levels of the videos were different from each other in terms of the video sources (p = 0.013). The difference between the reliability scores of the videos according to the quality levels of the videos was found to be significant (p = 0.017). 51.57% of the videos were of high quality.Conclusion: Videos created by statisticians/biostatisticians and non-profit organizations provide more reliable and quality information. It is recommended that researchers and students should determine the video they will watch as a source of information according to its source.