Computed Tomography-Guided Placement of Sacral Electrodes.

Background: The current approach to performing sacral neuromodulation consists of a two-stage procedure, the first of which includes insertion of the sacral electrode under fluoroscopic visualization of the S3 foramen. Alternatively, in certain situations computed tomography (CT)-guided insertion can be used.

Objectives: To evaluate the use of CT in cases of reinsertion of the electrode due to infection, dislocation, or rupture.

The effect of preemptive local anesthesia on postoperative pain following vaginal hysterectomy: A randomized controlled trial.

Objective: We aimed to study the effect of preemptive local anesthetic without adrenaline on postoperative pain following vaginal hysterectomy and concomitant trans obturator tape (TOT).

Study Design: This was a double-blinded, randomized, controlled trial. Women who undergone elective vaginal hysterectomy were included.

Expression of Heparanase in uterosacral ligaments of women with or without uterine prolapse.

Objective: Pelvic organ prolapse (POP) is a global health problem for which the pathophysiological mechanism remains unclear. The loss of extracellular matrix proteins is considered an important molecular basis for this pathology. Heparanase is a heparin sulfate degrading endoglycosidase that has an important role in various biological processes and is a key component of extracellular matrix.

Risk of Mesh Erosion after Pelvic Organ Prolapse Repair with or without Concomitant Vaginal Hysterectomy.

Background: Hysterectomy is common in the management of symptomatic uterine prolapse. Vaginal wall repair is often necessary, for which vaginal mesh remains a popular option.

Objectives: To evaluate the risk of mesh erosion following mesh-augmented vaginal prolapse repair, with or without concomitant vaginal hysterectomy.

Are women with cervical incompetence at a higher risk of experiencing urinary and pelvic organ prolapse symptoms?

Introduction And Hypothesis: Pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTs), in addition to cervical incompetence, have a multifactorial etiology. Connective tissue disorders are common risk factors in both entities. The objective of this study was to compare long-term urinary and pelvic organ prolapse-related symptoms in patients who experienced cervical incompetence and those who did not.

Protracted postpartum urinary retention-a long-term problem or a transient condition?

Introduction And Hypothesis: Protracted postpartum urinary retention (P-PUR) is a rare puerperal complication of overt urinary retention that proceeds beyond the 3rd postpartum day. Long-term consequences of P-PUR are poorly reported. The objective of the study was to compare the long-term outcome of patients with P-PUR with a matched control group, using a validated pelvic floor distress questionnaire.

Is There a Difference in the Outcome of Mid-Urethral Sling Operations Performed by Urogynecologists Compared with Supervised Residents?

Study Objective: To compare the operative results of midurethral sling (MUS) surgeries for stress urinary incontinence (SUI) performed by residents under the guidance of an attending specialist in urogynecology and those performed by attendings.

Design: Retrospective chart review (Canadian Task Force classification II-2).

Setting: University hospital.

Unexpected Significant Uterine Pathological Findings at Vaginal Hysterectomy Despite Unremarkable Preoperative Workup.

Background: Several studies have addressed the issue of undetected uterine pathology in women undergoing hysterectomy for pelvic organ prolapse (POP). However, these studies differ largely with respect to the incidence of malignancy found, study population, and preoperative evaluation.

Objectives: To assess the risk of unexpected pre-malignant and malignant uterine pathological findings after vaginal hysterectomy for POP repair, in a single medical center in Israel.

The optimal angle of the mediolateral episiotomy at crowning of the head during labor.

Introduction And Hypothesis: The aim of the mediolateral episiotomy incision is to increase the diameter of the soft tissue of the vaginal outlet to facilitate birth and to prevent vaginal tears. Episiotomy angles that are too narrow and close to the midline increase the risk of obstetric anal sphincter injuries. In order to determine the optimal angle of the episiotomy, we assessed the changes in the angles of episiotomy lines marked during the first stage of labor and measured at the time of crowning of the head.

Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors.

Obstetric anal sphincter injuries (OASIs) following vaginal deliveries are the main reason for subsequent development of anal incontinence in women. The diagnosis of such tears is crucial for treating and preventing such a grave sequela. The reported rate of OASIs in Israel was between 0.

Effects of Sacral Neuromodulation on Urinary and Fecal Incontinence.

Background: Fecal incontinence is defined as involuntary passage of stool through the anus. It may vary from soiling to complete evacuation. This involuntary loss of feces, flatus or urge incontinence adversely affects quality of life.

Contour Transtar in true rectal prolapse.

Background: A new device, the CCS-30 Contour Transtar, was recently launched for the treatment of obstructed defecation syndrome (ODS).

Objectives: To evaluate the efficacy of the Contour Transtar in resection of true rectal prolapse in relation to age and concomitant urogynecologic procedures.

Methods: During a 50 (median) month period 15 women with rectal prolapse of ≥ 5 cm and complaints of obstructed defecation underwent perineal resection of rectal prolapse with the Contour Transtar.

Differences between adnexal torsion in pregnant and nonpregnant women.

Study Objective: To compare the clinical manifestation, management, and outcome of adnexal torsion in pregnant and nonpregnant women.

Design: Retrospective case-control study (Canadian Task Force classification II-3).

Setting: Tertiary care university hospital.

Mesh erosion following abdominal sacral colpopexy in the absence and presence of the cervical stump.

Introduction And Hypothesis: We compared the role of abdominal sacral colpopexy (ASCP) with concomitant supracervical hysterectomy to ASCP alone in patients with prior hysterectomy in the prevention of mesh erosion.

Materials And Methods: We performed a retrospective chart review of 277 consecutive patients who underwent ASCP with one surgeon. Patients were separated into two groups based on the presence of a uterus at the time of surgery.

Magnetic resonance imaging of abdominal versus vaginal prolapse surgery with mesh.

Introduction And Hypothesis: We compared two surgical approaches in patients with symptomatic prolapse of the vaginal apex with normal controls by analyzing pelvic landmark relationships measured using magnetic resonance imaging (MRI) before and after surgery.

Methods: In this prospective multicenter pilot study involving 16 participants, nulliparous controls (n = 6) were compared with ten parous (3.0 ± 1.

Is mesh becoming more popular? Dilemmas in urogynecology: a national survey.

The use of vaginal mesh in pelvic organ prolapse (POP) repair surgery has become more common in recent years. The purpose of the current study was to evaluate the common practice of Israeli urogynecologists, and to determine whether surgical practice has changed over the last two years. Methods.

MRI pelvic landmark angles in the assessment of apical pelvic organ prolapse.

Purpose: The aim of the study was to evaluate the utility of magnetic resonance imaging (MRI) pelvic landmark angles and lines in the assessment of apical vault prolapse.

Methods: Seventeen women were evaluated as part of a prospective surgical trial. Baseline data are presented as a pilot study of the utility of MRI in addition to this evaluation of 6 nulliparous volunteers without prolapse and 11 parous women with symptomatic ≥ stage II uterine prolapse.

Endometrial polyps: symptomatology, menopausal status and malignancy.

Aims: To assess the frequency of premalignant and malignant endometrial polyps in symptomatic and asymptomatic women.

Methods: Retrospective registration of 1,124 patients who underwent hysteroscopic resection of endometrial polyps. Patient characteristics included age, menopausal status, presence or absence of symptoms, and use of hormonal medication.

Endometrial carcinoma after endometrial resection for dysfunctional uterine bleeding.

Background: Endometrial destruction is an accepted conservative surgical approach for women with dysfunctional uterine bleeding. However, this procedure cannot guarantee complete removal of the entire endometrium. The possibility exists that endometrial carcinoma may develop even years after such procedure.