Enhanced recovery program for minimally invasive and vaginal urogynecologic surgery.

Introduction And Hypothesis: Enhanced recovery protocols (ERPs) are evidenced-based interventions designed to standardize perioperative care and expedite recovery to baseline functional status after surgery. There remains a paucity of data addressing the effect of ERPs on pelvic reconstructive surgery patients.

Methods: An ERP was implemented at our institution including: patient counseling, carbohydrate loading, avoidance of opioids, goal-directed fluid resuscitation, immediate postoperative feeding and early ambulation.

Practicalities and pitfalls of pessaries in older women.

Pelvic floor disorders are known to increase with age. With the number of elderly women more than doubling in the coming decades, gynecologists will need to be skilled in the assessment and treatment of these conditions. Conservative forms of therapy such as pessaries can often be successfully employed.

Effects of aging on lower urinary tract and pelvic floor function in nulliparous women.

Objective: To evaluate the effects of aging, independent of parity, on pelvic organ and urethral support, urethral function, and levator function in a sample of nulliparous women.

Methods: A cohort of 82 nulliparous women, aged 21-70 years, were recruited from the community through advertisements. Subjects underwent pelvic examination using pelvic organ prolapse quantification, urethral angles by cotton-tipped swab, and multichannel urodynamics and uroflow.