Health Care-Seeking Characteristics of Women With Pelvic Floor Disorders After Obstetric Anal Sphincter Injury.

Objectives: Obstetric anal sphincter injury (OASIS) is a potentially serious complication of vaginal delivery and can lead to both short-term and long-term sequelae. This study sought to identify health care seeking patterns of women who developed pelvic floor symptoms including pelvic pain after OASIS. It also identified demographic and clinical factors associated with seeking subspecialty care from a pelvic floor specialist and demographic and clinical factors associated with seeking care for pelvic pain after OASIS.

Indications and Complications Associated with the Removal of 506 Pieces of Vaginal Mesh Used in Pelvic Floor Reconstruction: A Multicenter Study.

Study Objective: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal.

Design: This was a retrospective study.

The Indication and Surgical Treatment of 286 Midurethral Synthetic Sling Complications: A Multicenter Study.

Introduction And Hypothesis: 1) Evaluate the most common indication for sling removal in patients with synthetic mesh slings; 2) identify the location of pain for each of the three types of synthetic sling procedures including retropubic (RP) sling, transobturator (TOT) sling, and single incision slings (SIS), and 3) describe the surgical approach to each of the above and its associated complications.

Materials And Methods: A retrospective chart review of all patients who underwent surgical removal of a sling due to a mesh-related complications from 2011 to 2013 at three referral centers.

Results: There were 337 sling complications followed by the IUGA/ICS mesh complication classification.

Obstetric Anal Sphincter Injury as a Quality Metric: 16-Year Experience at a Single Institution.

Objective: To evaluate trends in annual rates of vaginal birth, cesarean delivery, and obstetric anal sphincter injury at a single institution before and after the designation of obstetric anal sphincter injury as a measure of obstetric quality and safety.

Methods: This was a retrospective cohort study of women undergoing a singleton vaginal delivery and diagnosed with obstetric anal sphincter injury over a 16-year period. International Classification of Diseases, 9th Revision codes for perineal lacerations were used as identifiers.

The IUGA/ICS classification of synthetic mesh complications in female pelvic floor reconstructive surgery: a multicenter study.

Introduction And Hypothesis: The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications.

Methods: This was a retrospective chart review of all patients who underwent surgical removal of sling, transvaginal mesh, and sacrocolpopexy for mesh-related complications from 2011 to 2013 at three tertiary referral centers. The International Urogynecological Association (IUGA)/International Continence Society (ICS) classification system was utilized.

Apical Suspension at the Time of Hysterectomy for Uterovaginal Prolapse: A Comparative Analysis of 2001 and 2011.

Objectives: The primary aim of this study was to compare the proportion of concomitant apical procedures in women undergoing hysterectomy for uterovaginal prolapse in 2001 and 2011. The secondary aim was to identify factors associated with receiving concomitant apical procedures in 2001 and 2011.

Methods: The Nationwide Inpatient Sample database was queried for women with a primary diagnosis of uterovaginal prolapse who underwent hysterectomy in 2001 and 2011.

Bowel and bladder dysfunction following surgery within the presacral space: an overview of neuroanatomy, function, and dysfunction.

Introduction And Hypothesis: The presacral space contains a dense and complex network of nerves that have significant effects on the innervation of the pelvic viscera and support structures. The proximity of this space to the bony promontory of the sacrum has lead to its involvement in an array of corrective surgical procedures for pelvic floor disorders including sacrocolpopexy and rectopexy. Other procedures involving the same space include presacral neurectomy which involves intentional transection of the contained neural plexus to relieve refractory pelvic pain and resection of retrorectal or presacral tumors.

Outcomes of robotic sacrocolpopexy: a systematic review and meta-analysis.

Objectives: Robotic sacrocolpopexy has been rapidly incorporated into surgical practice without comprehensive and systematically published outcome data. The aim of this study was to systematically review the currently published peer-reviewed literature on robotic-assisted laparoscopic sacrocolpopexy with more than 6 months of anatomic outcome data.

Methods: Studies were selected after applying predetermined inclusion and exclusion criteria to a MEDLINE search.

Iatrogenic lower urinary tract injury at the time of pelvic reconstructive surgery: does previous pelvic surgery increase the risk?

Introduction And Hypothesis: The objective of this study was to evaluate whether a history of previous pelvic surgery is associated with lower urinary tract (LUT) injury at the time of pelvic reconstructive surgery (PRS).

Methods: A retrospective analysis of patients undergoing pelvic reconstructive surgery from 2006 to 2011 was performed. Patients were divided into two groups: those with previous pelvic surgery and those without previous pelvic surgery.

Complete transvaginal surgical management of multiple bladder calculi and obstructed uterine procidentia.

Background: Bladder calculi are rare in women and are associated with irreducible pelvic organ prolapse. We report a case of irreducible uterine procidentia and bladder calculi that was surgically managed with a complete transvaginal approach.

Case: A 76-year-old woman presented with irreducible complete uterine procidentia.

Predictive factors for voiding dysfunction after transobturator slings.

Purpose: To identify the predictive factors for voiding dysfunction after transobturator slings.

Methods: We retrospectively reviewed the records of all patients who underwent a transobturator sling between March 2003 and December 2008. A total of 514 women had available data with at least a six-week follow-up.

The outcome of transobturator anterior vaginal wall prolapse repair using porcine dermis graft: intermediate term follow-up.

Introduction And Hypothesis: We evaluated the anatomical success and complications of Perigee® with porcine dermis Graft in the repair of anterior vaginal wall prolapse (AVWP) MATERIALS AND METHODS: After Institutional Review Board (IRB) approval, the charts of all patients who underwent AVWP repair using the Perigee/InteXen® kit from July 2005 to July 2009 were reviewed. Patients who had less than 6-month follow-up were excluded. Preoperative data including patient age, previous AVWP repairs, hysterectomy status, preoperative dyspareunia and pertinent physical findings were collected and recorded.

Repeat versus primary slings in patients with intrinsic sphincter deficiency.

Introduction And Hypothesis: Our goal was to compare outcomes of repeat vs. primary synthetic slings in patients with stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD).

Materials And Methods: We reviewed patients who underwent a sling for SUI with ISD from 2003 to 2010.

Spanish translation and validation of four short pelvic floor disorders questionnaires.

Introduction And Hypothesis: Globally, Spanish is the primary language for 329 million people; however, most urogynecologic questionnaires are available in English. We set out to develop valid Spanish translations of the Questionnaire for Urinary Incontinence Diagnosis (QUID), the Three Incontinence Questions (3IQ), and the short Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7).

Methods: The TRAPD method (translation, review, adjudication, pretesting, and documentation) was used for translation.

A randomized clinical trial of the impact of local estrogen on postoperative tissue quality after vaginal reconstructive surgery.

Objective: To evaluate the use and effect of early administration of vaginal estrogen via a continuous low-dose estradiol vaginal ring placed immediately after pelvic reconstructive surgery.

Methods: This was a randomized controlled trial of 65 postmenopausal women undergoing vaginal reconstructive surgery. The subjects were randomly assigned to receive an estradiol-releasing vaginal ring, placebo vaginal ring, or control without vaginal ring for 12 weeks immediately after vaginal reconstructive surgery.

Predictors of successful salpingo-oophorectomy at the time of vaginal hysterectomy.

Study Objective: To determine prognostic factors related to successful salpingo-oophorectomy in menopausal women at the time of vaginal hysterectomy.

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

Setting: Tertiary care center.

Rectovaginal fistula as a complication to a Bartholin gland excision.

Background: Rectovaginal fistula is a rare complication of inflammatory bowel disease, obstetric trauma, pelvic surgery, radiation, and trauma. We present a rectovaginal fistula occurring after an excision of a Bartholin gland.

Case: A healthy 43-year-old woman presented with flatus per vagina immediately after a Bartholin gland excision.

LeFort colpocleisis and stress incontinence: weighing the risk of voiding dysfunction with sling placement.

Introduction And Hypothesis: This study aims to evaluate clinical outcomes of concomitant suburethral sling with LeFort colpocleisis including its effect on postoperative voiding.

Methods: We performed a retrospective review of all LeFort colpocleisis procedures from our institution. We reviewed demographics, symptoms of stress urinary incontinence, incontinent events/day, pads usage/day, urodynamic parameters, and presence of voiding dysfunction.

Symptomatic vaginal enterocele associated with malfunctioning ventriculoperitoneal shunt and cerebrospinal ascites.

Abdominal pseudocyst formation is a rare adult complication associated with ventriculoperitoneal (VP) shunts. Presenting symptoms are primarily abdominal and include distention, pain and anorexia, and secondarily neurological with signs and symptoms of shunt malfunction. We describe a case of VP shunt-related pseudocyst formation presenting as symptomatic pelvic organ prolapse with stage 4 enterocele 4 years after VP shunt placement.

Biologic grafts for cystocele repair: does concomitant midline fascial plication improve surgical outcomes?

Introduction And Hypothesis: This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication.

Methods: Women with symptomatic anterior prolapse who underwent transvaginal repair, using biologic graft via transobturator approach, were retrospectively studied. An initial cohort had the graft placed without fascial plication.

Validation of a global pelvic floor symptom bother questionnaire.

Introduction And Hypothesis: This study aimed to validate a symptom questionnaire to assess presence and patient bother as related to common pelvic floor disorders.

Methods: The validation of the Pelvic Floor Bother Questionnaire (PFBQ) included evaluation of internal reliability, test-retest reliability, and validity of the items.

Results: A total of 141 patients with mean age of 61.