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Article ; Online: Pelvic organ prolapse: prevention by training?

Dekker, Janny H

2017 Volume 389, Issue 10067, Page(s) 336–337

Language	English
Publishing date	2017-01-28
Publishing country	England
Document type	Journal Article
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(16)32108-0
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Article ; Online: High rates of anorectal chlamydia in women: a cross-sectional study in general practice.

Ab, Elisabeth / Luijt, Dirk / Ott, Alewijn / Dekker, Janny H

BJGP open

2022 Volume 6, Issue 3

Abstract: Background: Genital and anorectal : Aim: To investigate the prevalence of co-occurrent genital and anorectal chlamydia infection, and to study whether sexual behaviour is associated with anorectal infection.: Design & setting: A cross-sectional ... ...

Abstract	Background: Genital and anorectal Aim: To investigate the prevalence of co-occurrent genital and anorectal chlamydia infection, and to study whether sexual behaviour is associated with anorectal infection. Design & setting: A cross-sectional study in general practices in the north of the Netherlands. Method: Women attending general practice with an indication for genital chlamydia testing were included and asked to complete a structured questionnaire on sexual behaviour. Anorectal infection prevalence was compared according to testing indications: standard versus experimental (based on questionnaire answers). Variables associated with anorectal chlamydia were analysed by univariate and multivariate logistic regression analyses. Results: Data could be analysed for 497 of 515 women included. Overall, 17.8% ( Conclusion: The prevalence of anorectal disease is high among women who visit their GP with an indication for genital CT testing. Many anorectal infections are missed despite taking comprehensive sexual histories, meaning that standard treatment of genital infection with azithromycin may result in rectal persistence. Performing anorectal testing in all women with an indication for genital CT testing is, therefore, recommended.
Language	English
Publishing date	2022-09-28
Publishing country	England
Document type	Journal Article
ISSN	2398-3795
ISSN (online)	2398-3795
DOI	10.3399/BJGPO.2021.0223
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Article ; Online: Authors' reply to the comment by Hanis et al. on "Predictors of unsuccessful pessary fitting in women with prolapse: a cross-sectional study in general practice," by Panman et al.

Dekker, Janny H / Burger, Huibert

International urogynecology journal

2017

Language	English
Publishing date	2017-07-26
Publishing country	England
Document type	Letter
ZDB-ID	1050631-7
ISSN	1433-3023 ; 0937-3462
ISSN (online)	1433-3023
ISSN	0937-3462
DOI	10.1007/s00192-017-3421-5
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Article ; Online: Is dit een soa?

Boeke, A J P / Dekker, Janny H / van Bokhoven-Rombouts, Colette A J / van Dam, Alje P / Oldhoff, J M

Nederlands tijdschrift voor geneeskunde

2022 Volume 166

Abstract: STD-associated questions and symptoms are submitted frequently to general practitioners and STD outpatient-clinics. In this teaching article we address 10 important clinical questions regarding epidemiology, risk assessment, testing policy, diagnostics ... ...

Title translation	Is it a sexually transmitted disease?
Abstract	STD-associated questions and symptoms are submitted frequently to general practitioners and STD outpatient-clinics. In this teaching article we address 10 important clinical questions regarding epidemiology, risk assessment, testing policy, diagnostics and prevention. STD's form a separate category of infectious diseases because of the role of sexuality. Good communication about sexual behavior is indispensable for an adequate diagnosis. We discuss the recognition of extragenital manifestations of STD, which requires alertness. Estimating the STD-risk based on sexual behavior is essential for testing policy. Persons at high risk are tested for the big five. In other cases testing is based on symptoms and complaints. HIV and syphilis are serious std's. Early detection followed by treatment is important in preventing health damage and preventing further spread. Hiv-indicator-conditions are useful alarm-signs for this purpose. PrEP can help not to acquire hiv and increases sexual health. It can be prescribed by gp's and public health clinicians. But condom-use remains crucial in prevention.
MeSH term(s)	Humans ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/epidemiology ; Sexually Transmitted Diseases/prevention & control ; Sexual Behavior ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Ambulatory Care Facilities
Language	Dutch
Publishing date	2022-08-30
Publishing country	Netherlands
Document type	English Abstract ; Journal Article
ZDB-ID	82073-8
ISSN	1876-8784 ; 0028-2162
ISSN (online)	1876-8784
ISSN	0028-2162
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Article ; Online: Comparing male and female pelvic floor muscle function by the number and type of pelvic floor symptoms.

Notenboom-Nas, Françoise J M / Knol-de Vries, Grietje E / Slieker-Ten Hove, Marijke C P / Dekker, Janny H / Keuken, Debby G / van Koeveringe, Gommert A / Blanker, Marco H

Neurourology and urodynamics

2023 Volume 42, Issue 4, Page(s) 875–885

Abstract: Aims: Pelvic floor symptoms (PFS), including lower urinary tract symptoms, defecation problems, sexual dysfunction, and pelvic pain, are common in males and females. Comparing pelvic floor musculature (PFM) function between sexes may reveal important ... ...

Abstract	Aims: Pelvic floor symptoms (PFS), including lower urinary tract symptoms, defecation problems, sexual dysfunction, and pelvic pain, are common in males and females. Comparing pelvic floor musculature (PFM) function between sexes may reveal important differences relevant to clinical care. This study aimed to compare male and female PFM function and to assess the function of both sexes with the number and type of PFS. Methods: We purposively enrolled males and females aged ≥ 21 years with 0-4 PFS based on questionnaire responses in an observational cohort study. Participants then underwent PFM assessment, and muscle function in the external anal sphincter (EAS) and puborectal muscle (PRM) were compared between sexes. The relationships between muscle function and the number and type of PFS were explored. Results: Of the invited 400 males and 608 females, 199 and 187 underwent PFM assessment, respectively. Compared with females, males more often showed increased EAS and PRM tone during assessments. Compared with males, females more often showed weaker maximum voluntary contraction (MVC) of the EAS and dysfunctional endurance of both muscles; additionally, those with zero or one PFS, sexual dysfunction, and pelvic pain more often showed a weak MVC of the PRM. Conclusions: Despite a few similarities between males and, females we found differences in muscle tone, MVC, and endurance between male and female PFM function. These findings provide useful insights into the differences in PFM function between males and females.
MeSH term(s)	Female ; Male ; Humans ; Pelvic Floor ; Muscle Contraction/physiology ; Pelvic Floor Disorders ; Anal Canal ; Sexual Dysfunction, Physiological ; Pelvic Pain
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604904-7
ISSN	1520-6777 ; 0733-2467
ISSN (online)	1520-6777
ISSN	0733-2467
DOI	10.1002/nau.25149
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Article ; Online: Quality of life in children with functional constipation: Are child self-reports and parent proxy-reports interchangeable?

Van Summeren, Jojanneke J G T / Holtman, Gea A / Dekker, Janny H / Berger, Marjolein Y

The Journal of pediatrics

2019 Volume 217, Page(s) 216

MeSH term(s)	Child ; Constipation ; Humans ; Proxy ; Psychometrics ; Quality of Life ; Self Report
Language	English
Publishing date	2019-11-20
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2019.10.066
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Article ; Online: Effectiveness and costs of a new framework for selecting absorbent urinary incontinence products compared with current practice: a cohort study.

Schreuder, Miranda C / van der Worp, Henk / Balkestein, Beate / Malmberg, Alec Gga / van den Bos, Tine / Dekker, Janny H / de Boer, Michiel R / Vermeulen, Karin M / Blanker, Marco H

BMJ open

2022 Volume 12, Issue 9, Page(s) e059654

Abstract: Objectives: To improve continence care in the Netherlands, a new framework has been developed in which a shift has been made from incontinence severity as the sole criterion for selecting incontinence products to a focus on patient need for daily life ... ...

Abstract	Objectives: To improve continence care in the Netherlands, a new framework has been developed in which a shift has been made from incontinence severity as the sole criterion for selecting incontinence products to a focus on patient need for daily life activities. The impact of the framework on daily care has not been assessed. We aimed to compare treatment effectiveness and costs between participants who did and did not undergo re-evaluation according to the new framework. Design: Cohort study SETTING: Twelve pharmacies in the Netherlands PARTICIPANTS: Existing users of absorbent incontinence materials for urinary incontinence. Interventions: Participants were offered the option to have their incontinence products re-evaluated within the new framework at their pharmacy. Primary and secondary outcome measures: Effectiveness and cost outcomes were assessed at 3 and 6 months through questionnaires. These questionnaires included the International Consultation on Incontinence Questionnaire (ICIQ) Lower Urinary Tract Symptoms Quality of Life Module, ICIQ Urinary Incontinence Short Form, ICIQ Absorbent Pads, questions about satisfaction and the iPCQ and iMCQ. Results: 303 users consented and 279 completed the baseline questionnaire. Of these participants, 72 agreed to a re-evaluation of their incontinence materials. There was a small improvement at 3 months in the re-evaluation group compared with the other group on most outcomes. However, these improvements were not clinically relevant. Moreover, these differences did not change much from 3 to 6 months. Small differences were also observed in the changes in costs, but with very wide CIs on both sides of zero (€99.38; 95% CI -633.48 to 832.23). Conclusions: The current study showed no clinically relevant effect of a newly implemented framework for selecting incontinence materials in pharmacies when compared with an existing method. Given that the study also showed no differences in effectiveness and costs, introducing the new framework in pharmacies may not lead to better incontinence care.
MeSH term(s)	Humans ; Quality of Life ; Cohort Studies ; Urinary Incontinence/therapy ; Surveys and Questionnaires ; Treatment Outcome
Language	English
Publishing date	2022-09-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-059654
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Article ; Online: Exploring pelvic floor muscle function in men with and without pelvic floor symptoms: A population-based study.

Notenboom-Nas, Françoise J M / Knol-de Vries, Grietje E / Beijer, Lotte / Tolsma, Yme / Slieker-Ten Hove, Marijke C Ph / Dekker, Janny H / van Koeveringe, Gommert A / Blanker, Marco H

Neurourology and urodynamics

2022 Volume 41, Issue 8, Page(s) 1739–1748

Abstract: Background: Pelvic floor symptoms (PFS), such as lower urinary tract symptoms, defecation disorders, sexual problems, and genital-pelvic pain, are prevalent in men. Thorough physical assessments of the external anal sphincter (EAS) and the puborectal ... ...

Abstract	Background: Pelvic floor symptoms (PFS), such as lower urinary tract symptoms, defecation disorders, sexual problems, and genital-pelvic pain, are prevalent in men. Thorough physical assessments of the external anal sphincter (EAS) and the puborectal muscle (PRM) are the keys to unraveling the role of muscle dysfunction. Objectives: To explore associations within and between the EAS and PRM and between muscle (dys-) function and the number of male PFS. Methods: This cross-sectional study purposively enrolled men aged ≥21 years with 0-4 symptoms from a larger study. After extensive external and internal digital pelvic floor assessment, we explored (1) agreement between muscle function of the EAS versus PRM (using cross tabulation), (2) associations within and between the EAS and PRM (using heatmaps), and (3) associations between muscle function and number of PFS (using a visual presentation [heatmaps] and χ<sup>2</sup> tests). Results: Overall, 42 out of 199 men (21%) had completely normal muscle function. Sixty-six (33.2%) had no symptoms, of which 53 (80%) had some degree of muscle dysfunction. No clear dose-response relationship existed between muscle (dys-) function and the number of symptoms. The PRM showed both more dysfunction and severer dysfunction than the EAS. Conclusions: No clear association exists between muscle dysfunction and the number of symptoms, and the absence of PFS does not indicate normal muscle function for all men. Dysfunction levels are highest for the PRM. Further pelvic floor muscle research is warranted in men with PFS.
MeSH term(s)	Humans ; Male ; Pelvic Floor ; Cross-Sectional Studies ; Anal Canal ; Lower Urinary Tract Symptoms ; Physical Examination ; Pain
Language	English
Publishing date	2022-07-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604904-7
ISSN	1520-6777 ; 0733-2467
ISSN (online)	1520-6777
ISSN	0733-2467
DOI	10.1002/nau.24996
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Article ; Online: Cost-effectiveness of physiotherapy in childhood functional constipation: a randomized controlled trial in primary care.

van Summeren, Jojanneke J G T / Holtman, Gea A / Lisman-van Leeuwen, Yvonne / van Ulsen-Rust, Alice H C / Vermeulen, Karin M / Tabbers, Merit M / Kollen, Boudewijn J / Dekker, Janny H / Berger, Marjolein Y

Family practice

2022 Volume 39, Issue 4, Page(s) 662–668

Abstract: Objective: Health care expenditures for children with functional constipation (FC) are high, while conservative management is successful in only 50% of the children. The aim is to evaluate whether adding physiotherapy to conventional treatment (CT) is a ...

Abstract	Objective: Health care expenditures for children with functional constipation (FC) are high, while conservative management is successful in only 50% of the children. The aim is to evaluate whether adding physiotherapy to conventional treatment (CT) is a cost-effective strategy in the management of children with FC aged 4-18 years in primary care. Methods: A cost-effectiveness analysis was performed alongside a randomized controlled trial (RCT) with 8-month follow-up. Costs were assessed from a societal perspective, effectiveness included both the primary outcome (treatment success defined as the absence of FC and no laxative use) and the secondary outcome (absence of FC irrespective of laxative use). Uncertainty was assessed by bootstrapping and cost-effectiveness acceptability curves (CEACs) were displayed. Results: One hundred and thirty-four children were randomized. The incremental cost-effectiveness ratio (ICER) for one additional successfully treated child in the physiotherapy group compared with the CT group was €24,060 (95% confidence interval [CI] €-16,275 to €31,390) and for the secondary outcome €1,221 (95% CI €-12,905 to €10,956). Subgroup analyses showed that for children with chronic laxative use the ICER was €2,134 (95% CI -24,975 to 17,192) and €571 (95% CI 11 to 3,566), respectively. At a value of €1,000, the CEAC showed a probability of 0.53 of cost-effectiveness for the primary outcome, and 0.90 for the secondary outcome. Conclusions: Physiotherapy added to CT as first-line treatment for all children with FC is not cost-effective compared with CT alone. Future studies should consider the cost-effectiveness of physiotherapy added to CT in children with chronic laxative use. Trial registration: The RCT is registered in the Netherlands Trial Register (NTR4797), on the 8th of September 2014. The first child was enrolled on the 2nd of December 2014. https://www.trialregister.nl/trial/4654.
MeSH term(s)	Child ; Constipation/therapy ; Cost-Benefit Analysis ; Humans ; Physical Therapy Modalities ; Primary Health Care ; Treatment Outcome
Language	English
Publishing date	2022-02-08
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	605939-9
ISSN	1460-2229 ; 0263-2136
ISSN (online)	1460-2229
ISSN	0263-2136
DOI	10.1093/fampra/cmab147
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Article ; Online: Cost-effectiveness of an app-based treatment for urinary incontinence in comparison with care-as-usual in Dutch general practice: a pragmatic randomised controlled trial over 12 months.

Loohuis, Anne M M / Van Der Worp, Henk / Wessels, Nienke J / Dekker, Janny H / Slieker-Ten Hove, Marijke C Ph / Berger, Marjolein Y / Vermeulen, Karin M / Blanker, Marco H

BJOG : an international journal of obstetrics and gynaecology

2022 Volume 129, Issue 9, Page(s) 1538–1545

Abstract: Objective: To assess the cost-effectiveness of app-based treatment for female stress, urgency or mixed urinary incontinence (UI) compared with care-as-usual in Dutch primary care.: Design: A pragmatic, randomised controlled, superiority trial.: ... ...

Abstract	Objective: To assess the cost-effectiveness of app-based treatment for female stress, urgency or mixed urinary incontinence (UI) compared with care-as-usual in Dutch primary care. Design: A pragmatic, randomised controlled, superiority trial. Setting: Primary care in the Netherlands from 2015 to 2018, follow-up at 12 months. Population: Women with ≥2 UI-episodes per week, access to mobile apps, wanting treatment. Methods: The standalone app included conservative management for UI with motivation aids (e.g. reminders). Care-as-usual delivered according to the Dutch GP guideline for UI. Main outcome measures: Costs and cost-effectiveness and -utility were assessed from a societal perspective, based on incontinence impact adjusted life years (IIALYs), quality adjusted life years (QALYs) and medical, non-medical and productivity costs. Information on costs was obtained with the iMCQ and iPCQ questionnaires (medical consumption and productivity cost questionnaires). Results: In all, 262 women were andomised equally to app or care-as-usual; 89 (68%) and 83 (63%) attended follow-up, respectively. Costs were lower for app-based treatment with € -161 (95% confidence interval [CI -180 to -151) per year. Cost-effectiveness showed small mean differences in effect for IIALY (0.04) and QALY (-0.03) and thus larger incremental cost-effectiveness ratios (ICER: -€3696) and incremental cost-utility ratios (ICUR: €6379). Conclusion: App-based treatment is a cost-effective alternative to care-as-usual for women with UI in Dutch primary care. Tweetable abstract: App-treatment for female urinary incontinence cost-effective compared to care-as-usual in general practice after 12 months.
MeSH term(s)	Cost-Benefit Analysis ; Female ; General Practice ; Humans ; Mobile Applications ; Quality of Life ; Quality-Adjusted Life Years ; Urinary Incontinence/therapy
Language	English
Publishing date	2022-05-31
Publishing country	England
Document type	Journal Article ; Pragmatic Clinical Trial ; Randomized Controlled Trial
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17191
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