Impact of Obesity on Midurethral Sling Failure in a Highly Hispanic Population.

Importance: Mixed data exist in the literature regarding the impact of obesity on midurethral sling (MUS) failure rates.

Objective: The aim of this study was to evaluate the impact of obesity and Hispanic ethnicity on MUS failure.

Study Design: This was a retrospective cohort study of females who underwent MUS surgery, alone or with concomitant prolapse repair, with at least 1 year of follow-up.

Repair of Vesicovaginal Fistulae: A Systematic Review.

Objective: To assess and compile the current level of evidence regarding successful surgical treatment of vesicovaginal fistulae and how these perioperative interventions affect anatomic, patient-centered, and adverse outcomes.

Data Sources: PubMed and EMBASE were searched from inception through September 9, 2022.

Methods Of Study Selection: This review included comparative studies (of any sample size) and single-group studies (1,000 or more participants) of primary or recurrent vesicovaginal fistula (ie, vesicovaginal fistula, urethrovaginal fistula, and bladder neck-vaginal fistula).

Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas: A Systematic Review.

Objective: To conduct a systematic review to evaluate the effect of procedural interventions for leiomyomas on pelvic floor symptoms.

Data Sources: PubMed, EMBASE, and ClinicalTrials.gov were searched from inception to January 12, 2023, searching for leiomyoma procedures and pelvic floor disorders and symptoms, restricted to primary study designs in humans.

International Urogynecology Consultation Chapter 1 Committee 5: relationship of pelvic organ prolapse to associated pelvic floor dysfunction symptoms: lower urinary tract, bowel, sexual dysfunction and abdominopelvic pain.

Introduction And Hypothesis: This article from Chapter 1 of the International Urogynecology Consultation (IUC) on Pelvic Organ Prolapse (POP) establishes the prevalence of lower urinary tract disorders, bowel symptoms, vulvo-vaginal/lower abdominal/back pain and sexual dysfunction in women with POP.

Methods: An international group of nine urogynecologists/urologists and one medical student performed a search of the literature using pre-specified search terms in Ovid, MEDLINE, Embase and CINAHL from January 2000 to March 2019. Publications were eliminated if not relevant or they did not include clear definitions of POP or the symptoms associated with POP.

Comparison of Methods to Identify Stress Urinary Incontinence in Women With Pelvic Organ Prolapse.

Objective: The aim of the study was to compare which test is most sensitive in identifying stress urinary incontinence (SUI) in women with pelvic organ prolapse using urodynamics (UDS) as the criterion standard: cough stress test (CST) or pyridium pad test.

Methods: This was a prospective study of women with pelvic organ prolapse stage II or greater who desired surgical management for prolapse. Each patient underwent preoperative urinary testing: UDS, CST, and a 24-hour pyridium pad test.

Changes in Sexual Activity and Function After Pelvic Organ Prolapse Surgery: A Systematic Review.

Objective: We aimed to systematically review the literature to describe sexual activity and function before and after prolapse surgery.

Data Sources: We searched MEDLINE, EMBASE, and ClinicalTrials.gov databases from inception to April 2018.

Anesthetics' role in postoperative urinary retention after pelvic organ prolapse surgery with concomitant midurethral slings: a randomized clinical trial.

Introduction And Hypothesis: Spinal anesthesia can be a potential risk factor for postoperative urinary retention (POUR). Our objective was to compare POUR rates for outpatient vaginal pelvic floor surgeries when using spinal versus general anesthesia. Our hypothesis was that spinal anesthesia would have higher POUR rates compared with general anesthesia.

Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review.

Introduction And Hypothesis: Spinal anesthesia has been reported to be a risk factor for postoperative urinary retention (POUR) in various surgical specialties. We hypothesized that spinal anesthesia was a risk factor for POUR after outpatient vaginal surgery for pelvic organ prolapse (POP).

Methods: This was a retrospective review of an urogynecology database for all outpatient POP vaginal surgeries performed in 2014 to evaluate the risk of POUR after general versus spinal anesthesia.

Advanced uterovaginal prolapse: is vaginal hysterectomy with McCall culdoplasty as effective as in lesser degrees of prolapse?

Introduction And Hypothesis: There is a paucity of data on the success of vaginal surgery for severe prolapse. The authors hypothesized that the success rates of total vaginal hysterectomy (TVH) with McCall culdoplasty in women with advanced pelvic organ prolapse (POP) and in women with less severe POP are similar.

Methods: This was a retrospective review of women undergoing TVH with McCall culdoplasty from 2005 to 2014.

Transvaginal Repair of Complex Rectovaginal Fistulas Using the Porcine Urinary Bladder Matrix as an Augmenting Graft.

Background: After the US Food and Drug Administration issued a safety warning concerning vaginal mesh implants in 2008, their use in correction of pelvic floor defects have decreased in the United States (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm479732.

Resolution of Rectal Prolapse by Vaginal Reconstruction.

Background: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy.

Intraoperative Cystoscopic Evaluation of Ureteral Patency: A Randomized Controlled Trial.

Objective: To compare different modalities to aid in the evaluation of intraoperative ureteral patency on cystoscopy in the postindigo carmine era.

Methods: In a randomized controlled trial, participants undergoing pelvic surgery were randomized into one of four groups: saline distention (control), 10% dextrose distention, oral phenazopyridine, or intravenous sodium fluorescein. Our primary outcome was visibility of the ureteral jets.

Health Care Disparities Among English-Speaking and Spanish-Speaking Women With Pelvic Organ Prolapse at Public and Private Hospitals: What Are the Barriers?

Objectives: The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP).

Methods: Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and reconstructive surgery. Standardized questions were asked regarding patients' emotions to when they initially noticed the POP, if they sought family support, and their response to the diagnosis and treatment.

Are suburethral slings less successful in the elderly?

Introduction And Hypothesis: We aimed to evaluate the success of suburethral slings in women ≥70 years of age.

Methods: This was a retrospective cohort study of women who underwent suburethral sling placement. Subjects were separated into three groups: ≤50 years of age (group 1), 51 to 69 years of age (group 2), and ≥70 years of age (group 3).

The Quality of Care Provided to Women with Urinary Incontinence in 2 Clinical Settings.

Purpose: Our aim was to test the feasibility of a set of quality of care indicators for urinary incontinence and at the same time measure the care provided to women with urinary incontinence in 2 clinical settings.

Materials And Methods: This was a pilot test of a set of quality of care indicators. A total of 20 quality of care indicators were previously developed using the RAND Appropriateness Method.

Apical sling: an approach to posthysterectomy vault prolapse.

Introduction And Hypothesis: This video demonstrates a transvaginal technique for vaginal vault suspension using an apical sling suspended from the sacrospinous ligaments.

Methods: This was a retrospective review of apical sling procedures performed from July 2013 to November 2014. The technique is started by marking the vaginal apex.

Management of apical pelvic organ prolapse.

Unlabelled: Pelvic organ prolapse is a prevalent condition, with up to 12 % of women requiring surgery in their lifetime. This manuscript reviews the treatment options for apical prolapse, specifically. Both conservative and surgical management options are acceptable and should be based on patient preferences.

Misconceptions and miscommunication among Spanish-speaking and English-speaking women with pelvic organ prolapse.

Introduction And Hypothesis: Limited data exist on women's experience with pelvic organ prolapse (POP) symptoms. We aimed to describe factors that prevent disease understanding among Spanish-speaking and English-speaking women.

Methods: Women with POP were recruited from female urology and urogynecology clinics in Los Angeles, California, and Albuquerque, New Mexico.

Measuring the quality of care provided to women with pelvic organ prolapse.

Objective: Health care providers are increasingly being evaluated by the quality of care they provide. Our aim was to assess the feasibility of recently developed quality indicators (QIs) for pelvic organ prolapse (POP) and identify possible deficits in care.

Study Design: A panel ranked 14 QIs based on the RAND appropriateness method assessing screening and diagnosis, pessary management, and surgery for POP.