The Survey of Barriers for Vaginal Access Surgery Study.

Study Objective: The primary objective of this study was to describe vaginal hysterectomy practice patterns as well as facilitators and inhibitors to performing vaginal hysterectomy among gynecologic surgeons. Secondary objectives were to describe facilitators and inhibitors to the teaching and training of vaginal hysterectomy.

Design: A quantitative analysis of an online survey and qualitative analyses of the one-on-one interviews with gynecologic surgeons were conducted.

Temporal Changes in Depressive Symptoms Among Goodville Farm Game Players: A 6-Week Observational Study.

The primary objective was to evaluate the potential impact of the Goodville farm game on depressive symptoms. The Goodville game, characterized by its unique farming features, incorporates elements of emotional well-being and various mental health assessment tools, enabling players to monitor and improve their emotional state. Using self-reported Patient Health Questionnaire-8 (PHQ-8) data from 1717 US and UK players, changes were monitored weekly over a 6-week period.

A randomized trial of retropubic vs single-incision sling among patients undergoing vaginal prolapse repair.

Background: The choice of midurethral sling type may impact efficacy and complications in women undergoing transvaginal native tissue repair of pelvic organ prolapse.

Objective: The primary aim was to determine if the single-incision sling is noninferior to retropubic sling for the management of stress urinary incontinence among patients undergoing reconstructive or obliterative native tissue vaginal repair. The secondary aims were to compare adverse events and surgeon ease of use with sling assignment.

A prospective pilot study to assess for histologic changes on vulvar biopsies in postmenopausal women with lichen sclerosus treated with fractionated CO laser therapy.

Objectives: To investigate the histologic characteristics of vulvar tissues before and after completion of fractionated carbon dioxide (CO ) laser therapy (FxCO2) for vulvar lichen sclerosus (LS). The secondary objective was to assess subjective improvement in symptoms via the Skindex-16 questionnaire.

Methods: This prospective single-arm study was conducted from April 2021 to August 2022 at one academic medical center.

Assessing the Impact of Vaginal Hysterectomy with Vaginal Mesh Attachment on Outcomes and Complications during Minimally Invasive Sacrocolpopexy.

Study Objective: To compare mesh complications and failure rates after 1 year in laparoscopic minimally invasive sacrocolpopexy (MISC) with ultralightweight mesh attached vaginally during total vaginal hysterectomy (TVH), laparoscopically if posthysterectomy (PH), or laparoscopically during supracervical hysterectomy.

Design: Single-center retrospective cohort study.

Setting: Tertiary referral center.

Mesh Exposure Following Vaginal Versus Laparoscopic Hysterectomy at the Time of Sacrocolpopexy.

Introduction And Hypothesis: To compare vaginal mesh exposure rates, adverse events and composite failure within 1 year postoperatively in patients who undergo vaginal hysterectomy with vaginal mesh attachment (TVH) versus laparoscopic hysterectomy with abdominal mesh attachment (TLH) for minimally invasive sacrocolpopexy.

Methods: This multicenter retrospective cohort study is a secondary analysis of data collected retrospectively at one institution and the multicenter randomized control PACT trial. Women were excluded for no follow-up between 9 months and 2 years postoperatively or undergoing concurrent non-urogynecologic procedures.

Minimally Invasive Surgery Survey: A Survey of Surgical Team Members' Perceptions for Successful Minimally Invasive Surgery.

Study Objective: To develop a valid and reliable survey to measure surgical team members' perceptions regarding their institution's requirements for successful minimally invasive surgery (MIS).

Design: Questionnaire development and validation study (Canadian Task Force classification II-2).

Setting: Three hospital types: rural, urban/academic, and community/academic.

Defining Cervical Elongation: A Prospective Observational Study.

Objectives: Our primary aim was to define cervical elongation (CE) using the following methods: (1) measurement of pathology specimen, (2) physician perception, (3) intraoperative estimate of anterior cervical length, and (4) office Pelvic Organ Prolapse Quantification (POP-Q) points C and D. Our secondary aim was to determine whether these definitions correlate with perioperative outcomes.

Methods: Women undergoing vaginal hysterectomy and prolapse repair were enrolled.

Vaginal and laparoscopic mesh hysteropexy for uterovaginal prolapse: a parallel cohort study.

Background: There is growing interest in uterine conservation at the time of surgery for uterovaginal prolapse, but limited data compare different types of hysteropexy.

Objective: We sought to compare 1-year efficacy and safety of laparoscopic sacral hysteropexy and vaginal mesh hysteropexy.

Study Design: This multicenter, prospective parallel cohort study compared laparoscopic sacral hysteropexy to vaginal mesh hysteropexy at 8 institutions.

Effect of a New Risk Calculator on Patient Satisfaction With the Decision for Concomitant Midurethral Sling During Prolapse Surgery: A Randomized Controlled Trial.

Objective: To determine whether use of a new personalized risk calculator increases patient satisfaction with the decision whether or not to have a prophylactic midurethral sling (MUS) during pelvic organ prolapse (POP) surgery.

Methods: We performed a randomized controlled trial involving English-speaking women without symptoms of stress urinary incontinence (SUI) with ≥ stage 2 POP who planned to undergo POP surgery with 1 of 4 fellowship-trained urogynecologists at a single academic center. Women with a history of prior POP or incontinence surgery, or who were pregnant, or unable to complete study forms were excluded.

Transvaginal Versus Transabdominal Placement of Synthetic Mesh at Time of Sacrocolpopexy.

Objectives: Our primary aim was to compare mesh-related complications at the time of total vaginal hysterectomy with laparoscopic sacrocolpopexy (TVH-LSC) versus laparoscopic placement of sacrocolpopexy mesh at time of laparoscopic supracervical hysterectomy (LSH-LSC). Our secondary aim was to compare operative time, intraoperative and postoperative complications, as well as subjective and objective success between these groups.

Methods: We performed a retrospective cohort study with prospective follow-up for patients with uterovaginal prolapse who underwent TVH-LSC or LSH-LSC from June 2008 to July 2012.

Significance of cystoscopic bladder trabeculations in women undergoing midurethral sling.

Introduction: To determine the significance of bladder trabeculations seen on preoperative cystoscopy prior to midurethral sling surgery with respect to lower urinary tract symptoms and sling outcomes.

Materials And Methods: This retrospective study included women with preoperative cystoscopy who underwent midurethral slings for urinary incontinence from 2006-2009. Cystoscopic findings of bladder trabeculations, as well as pre and postoperative urinary symptoms were recorded.

Foley catheter guide use during midurethral slings: does it make a difference?

Introduction: Our objective was to evaluate whether foley catheter guide use decreased the risk of cystotomy and urethrotomy during retropubic midurethral sling placement.

Materials And Methods: This retrospective cohort study included all women undergoing retropubic synthetic midurethral sling placement at a single academic institution between January 2011 and September 2012. Patients were divided into groups based on whether or not the foley catheter guide was used during surgery.

Effects of bilateral salpingo-oophorectomy at the time of hysterectomy on pelvic organ prolapse: results from the Women's Health Initiative trial.

Objective: This study aims to estimate the effects of bilateral salpingo-oophorectomy (BSO) at the time of hysterectomy and estrogen therapy on vaginal prolapse.

Methods: A retrospective analysis of the Women's Health Initiative estrogen-alone trial was performed. Women who retained their ovaries were compared with women who had BSO at the time of hysterectomy for the presence of cystocele or rectocele at entry into the study.

Hysterectomy and urinary incontinence in postmenopausal women.

Introduction And Hypothesis: To evaluate an association between hysterectomy and urinary incontinence (UI) in postmenopausal women.

Methods: Women (aged 50-79) with uteri (N = 53,569) and without uteri (N = 38,524) who enrolled in the Women's Health Initiative (WHI) Observational Study between 1993 and 1996 were included in this secondary analysis. Baseline (BL) and 3-year demographic, health/physical forms and personal habit questionnaires were used.

Three-year outcomes of vaginal mesh for prolapse: a randomized controlled trial.

Objective: To present the 3-year outcomes of a double-blind, multicenter, randomized trial comparing vaginal prolapse repair with and without mesh.

Methods: This was a planned final analysis of women with Pelvic Organ Prolapse Quantification (POP-Q) stage 2-4 prolapse randomized to traditional vaginal prolapse surgery without mesh and vaginal colpopexy repair with mesh. We evaluated anatomic, symptomatic, and combined cure rates for those with at least 3-year validated quality-of-life questionnaires and 2- or 3-year postoperative blinded POP-Q examination.

Surgical repair of rectovaginal fistulas in patients with Crohn's disease.

Objectives: To report surgical outcomes of patients who underwent rectovaginal fistula (RVF) repair with a history of Crohn's disease utilizing several reconstructive techniques.

Study Design: Retrospective case series of women (n=6) with Crohn's disease surgically treated with either vaginal or rectal advancement flaps. Demographic information and data specific to Crohn's disease at the time of surgery were collected.

Vaginal dilators for prevention of dyspareunia after prolapse surgery: a randomized controlled trial.

Objective: To compare rates of de novo dyspareunia in women with and without vaginal dilator use after posterior colporrhaphy.

Methods: This randomized controlled trial included sexually active patients with prolapse and no bothersome baseline dyspareunia undergoing posterior colporrhaphy. Patients were randomized to daily vaginal dilator use from postoperative weeks 4 through 8 or to no dilator use.

Blinded assessment of operative performance after fundamentals of laparoscopic surgery in gynecology training.

Study Objective: To determine the pass rate for the Fundamentals of Laparoscopic Surgery (FLS) examination among senior gynecology residents and fellows and to find whether there is an association between FLS scores and previous laparoscopic experience as well as laparoscopic intraoperative (OR) skills assessment.

Design: Prospective cohort study (Canadian Task Force classification II-2).

Setting: Three gynecology residency training programs.

Incidence of corneal abrasions during pelvic reconstructive surgery.

Objectives: To compare the incidence of corneal abrasions after robotic/laparoscopic sacral colpopexies versus vaginal apical suspensions, and to determine risk factors associated with the development of corneal abrasions.

Study Design: This retrospective cohort study included all women undergoing robotic/laparoscopic sacral colpopexy or vaginal apical suspensions over a 5-year period. The incidence of corneal abrasions was compared between groups and statistical analysis was performed.

Interest in cosmetic vulvar surgery and perception of vulvar appearance.

Objective: The objective of the study was to determine whether reproductive-age women are more likely to perceive their vulva as abnormal compared with older-aged women.

Study Design: Women aged 18-44 years (group 1) and 45-72 years (group 2) completed a survey on demographics, grooming patterns, vulvar perceptions, and source of information about the vulva.

Results: There was no difference between group 1 and group 2 in how often women looked at their vulva or their perception of having a normal vulva (91% vs 93%, P = .

Unusual findings on cystoscopy in a patient with detrusor overactivity.

Background: Chronic lithium ingestion has been shown to cause polyuria and polydipsia in 20% to 40% of patients, secondary to diabetes insipidus. However, it has not been reported to cause lithium deposition in the bladder.

Case: A 77-year-old woman presented to our clinic with complaints of urinary incontinence, urinary urgency, and nocturnal enuresis for the past 3 to 4 years.

Short-term outcomes of robotic versus conventional laparoscopic sacral colpopexy.

Objective: This study aimed to compare operative times and short-term outcomes between robotic and laparoscopic sacral colpopexy.

Methods: A retrospective cohort study using a convenience sample was performed comparing patients who underwent robotic and laparoscopic sacral colpopexy during a 4-year period. Operative time, blood loss, perioperative complications, and objective cure of prolapse at 3 months were compared.