Decreasing post hysterectomy surgical site infections with the implementation of a hysterectomy-specific bundle.

Background: Surgical site infections (SSI) are a common complication of hysterectomy. Surgical bundles have been shown to reduce SSIs. Here we describe a bundle that was used to combat an abnormal rise in SSI events that resulted in a greater than 75% reduction at our institution.

Contained specimen morcellation during robotics-assisted laparoscopic supracervical hysterectomy for pelvic organ prolapse.

Introduction And Hypothesis: Robotics-assisted laparoscopic supracervical hysterectomy (RALSH) with concomitant apical robotics-assisted POP repair provides advantages of minimally invasive procedures; however specimen removal without intraperitoneal spillage of potential pathology remains challenging. The primary aim of our study is to determine the factors affecting contained manual morcellation (CMM) of specimens during RALSH for POP surgery. The secondary aim of the study is to report complications associated with CMM and on specimen pathology.

Multidisciplinary Management of Cutaneous Gluteus Vaginal Fistula After Sacrospinous Ligament Fixation.

Introduction: Cutaneous gluteal vaginal fistula is a rare but significant postoperative complication which may present years after sacrospinous ligament fixation (SSLF) surgery There is limited data on the management of cutaneous vaginal fistula following SSLF.

Case Description: This case report describes a 77-year-old who presents twenty years after SSLF with cutaneous gluteal vaginal abscess and fistula. She underwent successful management with CT-guided percutaneous drainage of gluteal abscess and placement of guiding cutaneous vaginal catheter, laparoscopic pelvic wall dissection and evaluation, and transvaginal localization and removal of the infected permanent suture.

Pessaries and rectovaginal fistulae: consequences of delayed clinical follow-up in the Covid-19 pandemic.

Introduction And Hypothesis: While 2017 guidelines from The American College of Obstetricians & Gynecologists called for pessary replacement every 3 to 4 months, a recent study in Obstetrics and Gynecology suggested that uninterrupted pessary use up to 6 months is not an independent risk factor for development of pessary-related complications.

Methods: Our recent experience throughout the Covid-19 pandemic highlights the potential ramifications of delayed clinical follow-up.

Results: During the Covid-19 pandemic, 3 of our patients developed rectovaginal fistulae secondary to Gellhorn pessary erosion in the context of delayed clinical follow-up.

Improved Understanding of Female Pelvic Medicine and Reconstructive Surgery Concepts Through Targeted Case-Based Educational Intervention: A Pilot Study.

Objectives: Given the complex anatomy and pathophysiology of urogynecologic disorders, obstetrics and gynecology residents can have difficulty learning the subject's principles. There are no standardized resources for educators in this subspecialty. We hypothesized that our case-based educational intervention was associated with enhanced knowledge and greater resident satisfaction versus traditional urogynecology lectures.

Outcomes of stress urinary incontinence in women undergoing TOT versus Burch colposuspension with abdominal sacrocolpopexy.

Introduction And Hypothesis: To compare postoperative rates of stress urinary incontinence (SUI) in patients with pelvic organ prolapse and SUI undergoing abdominal sacrocolpopexy (ASC) with Burch colposuspension or a transobturator tape (TOT) sling.

Methods: In this retrospective cohort study, medical records of 117 patients who underwent ASC with Burch (n = 60) or TOT (n = 57) between 2008 and 2010 at NYU Winthrop Hospital were assessed. Preoperative evaluation included history, physical examination, cough stress test (CST), and multichannel urodynamic studies (MUDS).

Impact of Obesity on Robotic-Assisted Sacrocolpopexy.

Study Objective: To compare operative time in women stratified by body mass index (BMI) undergoing robotic-assisted sacrocolpopexy (RASC). Secondary objectives included characterizing perioperative characteristics and reoperation rates.

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

Update on Urinary Tract Markers in Interstitial Cystitis/Bladder Pain Syndrome.

Interstitial cystitis (IC)/painful bladder syndrome/bladder pain syndrome (BPS) is a chronic hypersensory condition of unknown etiology. Moreover, the optimal modality for diagnosing IC remains disputed. Several urinary markers have been investigated that may have potential utility in the diagnosis or confirmation of IC/BPS.

Obstetric fistulae in West Africa: patient perspectives.

Objective: The objective of this study is to gain insight into the nature of obstetric fistulae in Africa through patient perspectives.

Study Design: At l'Hôpital Saint Jean de Dieu in Tanguieta, Benin, 37 fistula patients underwent structured interviews about fistula cause, obstacles to medical care, prevention, and reintegration by 2 physicians via interpreters.

Results: The majority of participants (43%) thought their fistulae were a result of trauma from the operative delivery.

Neglected pessary causing a rectovaginal fistula: a case report.

Background: Pessaries, properly maintained, have been shown to be safe for long-term care of symptomatic vaginal prolapse. Complications from neglected pessaries include impaction, erosion and fistula formation. Vesicovaginal fistulas have been described, but literature reports of rectovaginal fistulas are scarce.

Anatomic variations of the pelvic floor nerves adjacent to the sacrospinous ligament: a female cadaver study.

Our objective was to document variations in the topography of pelvic floor nerves (PFN) and describe a nerve-free zone adjacent to the sacrospinous ligament (SSL). Pelvic floor dissections were performed on 15 female cadavers. The course of the PFN was described in relation to the ischial spine (IS) and the SSL.

Innervation of the levator ani muscles: description of the nerve branches to the pubococcygeus, iliococcygeus, and puborectalis muscles.

We described the innervation of the levator ani muscles (LAM) in human female cadavers. Detailed pelvic dissections of the pubococcygeus (PCM), iliococcygeus (ICM), and puborectalis muscles (PRM) were performed on 17 formaldehyde-fixed cadavers. The pudendal nerve and the sacral nerves entering the pelvis were traced thoroughly, and nerve branches innervating the LAM were documented.

[Cost analysis in patients admitted with COPD in 2002].

Unlabelled: The aim of the study was to assess the costs of hospital admission for COPD patients in a high level unit ("Marius Nasta" Institute of Pulmonology) in order to appreciate the financial burden of the disease. We analyzed retrospectively the medical charts of patients admitted between January and September 2002. 181 charts were included.