Short-term mesh exposure after robotic sacrocolpopexy with and without concomitant hysterectomy.

Objectives: The primary objective of this study was to compare the short-term rate of mesh exposure after a robotic sacrocolpopexy (RSCP) compared with those after RSCP with a concomitant hysterectomy. Secondary objectives included a comparison of mesh exposure from total hysterectomies (TH) versus supracervical hysterectomies (SCH) and determination of risk factors for mesh exposure.

Methods: This was a retrospective cohort study of women who underwent RSCP between January 2009 and December 2011 at one academic center.

Randomized trial of a web-based tool for prolapse: impact on patient understanding and provider counseling.

Introduction And Hypothesis: Effective patient/provider communication is important to ensure patient understanding, safety, and satisfaction. Our hypothesis was that interactive patient/provider counseling using a web-based tool (iPad application) would have a greater impact on patient satisfaction with understanding prolapse symptoms compared with standard counseling (SC).

Methods: Women with complaints of seeing/sensing a vaginal bulge were enrolled in this randomized controlled trial.

Robotic versus vaginal urogynecologic surgery: a retrospective cohort study of perioperative complications in elderly women.

Objectives: The primary objective was to compare perioperative complications after robotic surgery (RS) versus vaginal surgery (VS) for apical prolapse repair in elderly women. The secondary objectives were to (1) assess whether tools designed to predict surgical morbidity, the American Society of Anesthesiologists (ASA) class and the Charlson Comorbidity Index (CCI), are useful in the elderly urogynecologic population and (2) to classify complications during urogynecologic apical procedures using the Dindo classification system.

Methods: We reviewed medical records of women 65 years or older who underwent RS or VS between March 2006 and April 2011.

Relationship between race and abdominal anatomy: effect on robotic port placement.

Objectives: We sought to characterize differences between African American women and white women in abdominal wall dimensions that could affect robotic port placement. By better understanding these differences, surgeons could assess and adjust port placement to accommodate varying abdominal wall anatomy.

Methods: A radiologist blinded to race-reviewed abdominal/pelvic computed tomographic scans of women aged 30 to 70 prescreened for demographic inclusion criteria.

Obstetric sphincter injury interacts with diarrhea and urgency to increase the risk of fecal incontinence in women with irritable bowel syndrome.

Objectives: This study aimed to confirm that fecal urgency and diarrhea are independent risk factors for fecal incontinence (FI), to identify obstetrical risk factors associated with FI in women with irritable bowel syndrome, and to determine whether obstetric anal sphincter injuries interact with diarrhea or urgency to explain the occurrence of FI.

Methods: The study is a supplement to a diary study of bowel symptoms in 164 female patients with irritable bowel syndrome. Subjects completed daily bowel symptom diaries for 90 consecutive days and rated each bowel movement for stool consistency and presence of urgency, pain, and FI.

Effect of anticholinergic use for the treatment of overactive bladder on cognitive function in postmenopausal women.

Background: Overactive bladder (OAB) is a common condition affecting the elderly. The mainstay of treatment for OAB is medical therapy with anticholinergics. However, adverse events have been reported with this class of drugs, including cognitive changes.

Diagnostic accuracy of visual urethral mobility exam versus Q-Tip test: a randomized crossover trial.

Objective: The objective of the study was to compare the diagnostic accuracy of a visual urethral mobility examination (VUME) with a Q-Tip test in the assessment of urethral hypermobility.

Study Design: Subjects were randomized to a VUME or Q-Tip test first, followed by the alternate assessment. Outcomes included hypermobile, not hypermobile, or indeterminate.

Diagnostic accuracy of retrograde and spontaneous voiding trials for postoperative voiding dysfunction: a randomized controlled trial.

Objective: To compare the diagnostic accuracy of two voiding trial methods to predict postoperative voiding dysfunction.

Methods: Women undergoing operations for urinary incontinence, prolapse, or both urinary incontinence and prolapse from November 2009 and March 2010 were randomized into one of two groups: retrograde or spontaneous. All patients underwent both techniques of voiding trials with randomization determining order.

Vaginal cuff dehiscence after robotic total laparoscopic hysterectomy.

Background: Vaginal cuff dehiscence with small bowel evisceration after hysterectomy is a rare event that may be occurring more frequently with the advent of robotic laparoscopic hysterectomies.

Cases: Two women underwent robotic total laparoscopic hysterectomy for menorrhagia and stage I endocervical adenocarcinoma, respectively. Each presented 7-8 weeks postoperatively with abdominal pain and vaginal pressure after intercourse.

Transthoracic repair of an unsuspected left foramen of Morgagni hernia.

Left-sided foramen of Morgagni herniae are rare and may present both diagnostic and therapeutic challenges. This case report describes chronically herniated greater omentum mimicking an enlarging fatty tumor requiring transthoracic repair.

Robotic division of an unusual variant of a right aortic arch.

Anomalies of the right aortic arch are rare. Right aortic arch with remnants of various components of the left aortic arch and ductus can create a vascular ring resulting in obstruction of the aerodigestive tracts. This case report describes the rare form of retroesophageal left innominate artery with ligamentum between the base of the subclavian artery to the pulmonary artery, and the first time management by the novel robotic approach.