Confidence in performing normal vaginal delivery in the obstetrics clerkship: a randomized trial of two simulators.

Objective: To compare clerkship medical students' confidence in performing a simulated normal vaginal delivery (NVD) after participating in a simulation training session using two different models.

Methods: Medical students were randomized to participate in a simulated NVD session using either an obstetrics mannequin or a birthing pelvis model. Questionnaires were used to assess confidence and evaluate the simulation before and immediately after the session and on the last day of the obstetrics clerkship rotation.

A retrospective review of tension-free vaginal tape/transobturator tape procedures done concomitantly with prolapse repair.

Objective: Midurethral slings have become the standard of care for women with stress urinary incontinence; prolapse repair is often also required. The primary objective of our study was to compare voiding dysfunction rates and the need for reoperation between patients having midurethral sling procedures alone versus those having midurethral sling procedures with concomitant prolapse repair.

Methods: We performed a retrospective chart review over a two-year period in a tertiary urogynaecology clinic.

A rare complication of suprapubic catheterisation following pelvic reconstructive surgery for urinary incontinence.

Suprapubic (SP) catheterisation is commonly used for drainage of the bladder following pelvic surgery. Although it is a widely employed procedure, it is not without complications, such as infection and blockage. The authors report a rare complication of SP catheterisation involving a persistent SP catheter site fistulous tract and an infected haematoma significantly complicating a patient's postoperative course.

Renal calyceal rupture and perirenal urinary extravasation from complete procidentia.

Genital prolapse is common among ageing women. Urinary obstruction and hydronephrosis have been reported as one of the most severe and fortunately uncommon complications. An 82-year-old multiparous woman with symptomatic pelvic organ prolapse quantification stage 4 genital procidentia fails multiple trials of pessary and abandons the trials due to significant side effects.

A 56-year-old woman with early acute pulmonary emboli following pelvic reconstructive surgery.

Venous thromboembolism (VTE) remains a significant cause of postoperative morbidity and mortality. There are few reports on acute symptomatic pulmonary embolism (PE) following urogynaecological surgery. The authors report a case of an adult woman who developed a massive acute PE early on postoperative day 1 following a complex reconstructive surgery.

The prevalence of anal incontinence in post-partum women following obstetrical anal sphincter injury.

Introduction And Hypothesis: The primary objective of this study was to determine the prevalence of anal incontinence (AI) in post-partum women following obstetrical anal sphincter injury (OASI). We also assessed quality of life and prevalence of other pelvic floor symptoms.

Methods: Women who had third or fourth degree OASI were asked to complete the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7).

A retrospective review of patients seen in a multidisciplinary pelvic floor clinic.

Background: Multidisciplinary team care is becoming more popular for complex health issues, including pelvic floor dysfunction.

Methods: We conducted a retrospective review of the records of 207 patients attending a multidisciplinary pelvic floor dysfunction clinic. A telephone survey was also conducted.

Videoconferencing for resident teaching of subspecialty topics: the pediatric and adolescent gynecology experience at the Hospital for Sick Children.

Study Objective: Videoconferencing enables distance learning and subspecialty teaching. The objective of this study is to describe and evaluate a 3-hour teaching session on Pediatric and Adolescent Gynecology held by videoconferencing from the Hospital for Sick Children and broadcast to 8 other Canadian universities.

Design: Evaluation forms were completed by attendees on the clinical applicability, content quality, delivery quality, meeting of objectives and overall assessment of each session.

Case report of tension-free vaginal tape-associated bowel obstruction and relationship to body habitus.

Tension-free vaginal tape (TVT) is increasingly being used as the gold standard to treat stress urinary incontinence. Previously reported complications include peritoneal perforation with acute bowel injury. A thin, petite 51-year-old woman with stress urinary incontinence underwent uneventful TVT placement.

Success of pubovaginal sling in patients with stress urinary incontinence and efficacy of vaginal sling release in patients with post-sling voiding dysfunction.

Objective: To assess the overall success of sling procedures and surgical sling release in achieving urinary continence and voiding function in women with stress urinary incontinence.

Methods: We reviewed the charts of 107 patients with stress urinary incontinence who had a two-team abdominal-vaginal fascial sling procedure performed between January 2000 and December 2003. Data reviewed included the patients' medical history, demographic data, findings on physical examination, urodynamic studies, operative report, and findings at visits 6 weeks, 6 months, and 12 months after surgery.

Reflection on academic protected time: an opportunity to integrate educational programs.

Objectives: We sought to identify the structure of academic protected time curriculum and to determine interest in a knowledge-sharing, web-based initiative.

Methods: We undertook a survey of the 16 obstetrics and gynaecology program directors in Canada.

Results: The response rate was 88%.

The evaluation of stress incontinence prior to primary surgery.

Objective: To provide clinical guidelines for the evaluation of women with stress urinary incontinence prior to primary anti-incontinence surgery.

Options: The modalities of evaluation range from basic pelvic examination through to the use of adjuncts including ultrasound and urodynamic testing.

Outcomes: These guidelines provide a comprehensive approach to the preoperative evaluation of urinary incontinence to ensure that excessive evaluation is avoided without sacrificing diagnostic accuracy.