Soft-tissue dystocia due to paradoxical contraction of the levator ani as a cause of prolonged second stage: concept, diagnosis, and potential treatment.

Smaller pelvic floor dimensions seem to have been an evolutionary need to provide adequate support for the pelvic organs and the fetal head. Pelvic floor dimension and shape contributed to the complexity of human birth. Maternal pushing associated with pelvic floor muscle relaxation is key to vaginal birth.

Coexisting overactive-underactive bladder and detrusor overactivity-underactivity in pelvic organ prolapse.

Objective: The coexisting overactive-underactive bladder (COUB) syndrome could be related to the increased urethral resistance caused by severe pelvic organ prolapse (POP). We aimed to evaluate the clinical and urodynamic findings of patients with COUB and/or detrusor overactivity-underactivity (DOU) in a cohort of patients scheduled for POP surgery and the possible risk factors of COUB after surgery.

Methods: This retrospective study analyzed all patients who underwent POP repair between 2008 and 2013, excluding women with a history of pelvic floor surgery.

Native-tissue prolapse repair: Efficacy and adverse effects of uterosacral ligaments suspension at 10-year follow up.

Objective: To evaluate the 10-year outcomes of high uterosacral ligaments suspension as a primary repair for apical prolapse and to evaluate the long-term impact of prognostic factors.

Methods: A retrospective study analyzed 10-year follow up after repair of primary apical prolapse through high uterosacral ligament suspension. Bulging symptoms and postoperative prolapse stage II or above were considered subjective and objective recurrences, respectively.

Mode of birth in women with low-lying placenta: protocol for a prospective multicentre 1:3 matched case-control study in Italy (the MODEL-PLACENTA study).

Introduction: The term placenta praevia defines a placenta that lies over the internal os, whereas the term low-lying placenta identifies a placenta that is partially implanted in the lower uterine segment with the inferior placental edge located at 1-20 mm from the internal cervical os (internal-os-distance). The most appropriate mode of birth in women with low-lying placenta is still controversial, with the majority of them undergoing caesarean section. The current project aims to evaluate the rate of vaginal birth and caesarean section in labour due to bleeding by offering a trial of labour to all women with an internal-os-distance >5 mm as assessed by transvaginal sonography in the late third trimester.

Screening for Early Signs of Paternal Perinatal Affective Disorder in Expectant Fathers: A Cluster Analysis Approach.

Previous studies documented gender-related differences in the expression of Perinatal Affective Disorders. However, little attention has been paid to screening the male population during the perinatal period. This study was based on three aims: (1) to investigate the mental health of expectant fathers based on their levels of depression, anxiety, addiction, anger attacks/hostility, and somatization, identifying psychological profiles; (2) to analyze the association between these profiles and the individual variable of perceived stress; (3) and to examine the association between these profiles and the couple's variable of marital adjustment.

Single-incision slings for the treatment of stress urinary incontinence: efficacy and adverse effects at 10-year follow-up.

Introduction And Hypothesis: Single-incision slings are not considered a first-choice surgical treatment owing to a lack of data about long-term outcomes. We aimed to assess the long-term results of urinary incontinence treatment after single-incision sling implantation at 10 years' follow-up and to investigate possible deterioration over time.

Methods: This retrospective study analyzed women with subjective and urodynamically proven stress urinary incontinence who underwent single-incision sling procedure.

The PLART study: incidence of preterm labor and adverse pregnancy outcomes after assisted reproductive techniques-a retrospective cohort study.

Key Message: Even though assisted reproductive techniques represent one of the greatest achievements in modern medicine, the risk of preterm birth related to these pregnancies is about twice as high. This must be highlighted and further investigated to optimize the management of both mothers and newborns.

Purpose: The purpose of this study was to compare adverse pregnancy outcomes after assisted reproductive techniques (ART) and spontaneous conceptions, focusing on the incidence of preterm births (PTB) and distinguishing between iatrogenic and spontaneous events.

Long-term outcomes and five-year recurrence-free survival curves after native-tissue prolapse repair.

Objective: To evaluate the long-term objective and subjective outcomes to build recurrence-free survival curves after mesh-free uterosacral ligament suspension and to evaluate the long-term impact of prognostic factors on outcome measures.

Methods: A retrospective study analyzed 5-year follow-up after repair of primary prolapse through high uterosacral ligament suspension. Bulging symptoms and post-operative prolapse stage II or above were considered subjective and objective recurrences, respectively.

Risk factors for persistent, de novo and overall overactive bladder syndrome after surgical prolapse repair.

Objective: Overactive bladder (OAB) symptoms are frequently associated with pelvic organ prolapse (POP) and both postoperative improvement and de novo onset of OAB symptoms have been described. The aim of the study is to identify risk factors for persistent, de novo and overall postoperative OAB after POP repair.

Study Design: This was a retrospective study including patients who underwent primary POP surgery.

Long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse: a systematic review.

Purpose: To focus attention on the long-term effects of episiotomy on urinary incontinence and pelvic organ prolapse.

Methods: A systematic review was conducted including only studies with mean follow-up ≥ 5 years. We searched using combinations of the following keywords and text words: "episiotomy", "perineal laceration", "perineal tear", "perineal damage" and "long term", "long term outcomes", "prolapse", "pelvic organ prolapse", "pelvic floor", "pelvic floor dysfunction", "urinary incontinence", "hysterocele", "cystocele" and "rectocele".

Efficacy of needle retractor device in single-incision slings for treatment of stress urinary incontinence.

Background: Single-incision slings demonstrated overall similar effectiveness and less pain and recovery time compared to standard tapes. Efficacy rates vary widely among different commercial kits and may be affected by device characteristics. The aim was to evaluate the impact needle removal device of single-incision sling on objective, subjective and functional outcomes.

Outcomes of Transvaginal High Uterosacral Ligaments Suspension: Over 500-Patient Single-Center Study.

Background: Uterosacral ligament (USL) suspension is a safe and effective procedure in terms of anatomical, functional, and subjective outcomes for primary surgical treatment of prolapse.

Objectives: There has been a renewed interest toward native tissue prolapse repair by vaginal route because of low cost and lack of mesh-related complications. Uterosacral ligaments are considered safe, effective, and durable as suspending structures for primary surgical repair of the apical compartment.

Transvaginal native-tissue repair of vaginal vault prolapse.

Background: Posthysterectomy vaginal vault prolapse repair is a challenge for pelvic floor surgeons. Native-tissue repair procedures imply lower costs and reduced morbidity. Our study aims to evaluate operative data, complications, objective, subjective and functional outcomes of transvaginal native-tissue repair for posthysterectomy vaginal vault prolapse.

Risk factors for stress urinary incontinence recurrence after single-incision sling.

Aims: The aim of the study was to identify in a pure stress urinary incontinence (SUI) population risk factors for recurrence after single-incision slings (SIS).

Methods: This retrospective study analyzed women with complaints of SUI symptoms and urodynamically proven SUI. Exclusion criteria were recurrent SUI, overactive bladder syndrome/detrusor overactivity, preoperative postvoid residual >100 mL, reduced urethral mobility (<10° at the Q-tip test), concomitant anterior prolapse >I stage and previous history of radical pelvic surgery.

Risk factors for stress urinary incontinence after native-tissue vaginal repair of pelvic organ prolapse.

Objective: To identify risk factors for postoperative stress urinary incontinence (POSUI) after native-tissue prolapse repair without a concomitant anti-incontinence procedure.

Methods: The present single-center retrospective study included women with genital prolapse who underwent high uterosacral ligament suspension without a concomitant anti-incontinence procedure during 2008-2013. Univariate and multivariate analyses were performed to identify risk factors for POSUI (identified through clinical interview and International Consultation on Incontinence Modular Questionnaire-Short Form [ICIQ-SF] self-administration) at 6 months.

Detrusor underactivity in pelvic organ prolapse.

Introduction And Hypothesis: The association between pelvic organ prolapse (POP) and detrusor underactivity (DU) is not well defined. The primary outcome of this study was to evaluate the prevalence of DU in a cohort of patients with POP and its association with symptoms, anatomy. and urodynamic findings.

Tips and tricks for uterosacral ligament suspension: how to avoid ureteral injury.

Introduction And Hypothesis: Uterosacral ligament (USL) suspension is an effective and versatile surgical technique for repairing pelvic organ prolapse. However, ureteral injury is a feared complication that may act as a significant deterrent to the use of USL suspension. The aim of the video is to provide key steps to minimize the risk of ureteral injury while achieving successful transvaginal USL suspension.

Learning curve for the single-incision suburethral sling procedure for female stress urinary incontinence.

Objective: To evaluate the learning curve for the single-incision sling (SIS) procedure in a single-surgeon case series.

Methods: Data were retrospectively analyzed from women with non-recurrent symptomatic stress urinary incontinence confirmed by urodynamics and treated at San Gerardo Hospital, Monza, Italy, between October 2008 and November 2015. All women underwent the SIS procedure using a MiniArc sling fitted by the same urogynecologic surgeon.

Risk factors for recurrence after hysterectomy plus native-tissue repair as primary treatment for genital prolapse.

Introduction And Hypothesis: Identification of risk factors for pelvic organ prolapse (POP) recurrence is crucial to provide adequate preoperative counselling and tailor surgical treatment. The aim of this retrospective study was to identify risk factors for recurrence in a large series of patients with POP treated with primary transvaginal native-tissue repair involving high uterosacral ligament suspension.

Methods: Postoperative descent of POP-Q stage 2 or higher in any compartment was considered as recurrence.

Mini-sling efficacy in obese versus non-obese patients for treatment of stress urinary incontinence.

Background: The impact of obesity on single-incision has been object of concerns. The aim of the study was to compare the outcomes of MiniArc single-incision sling in normal weight, overweight and obese patients.

Methods: This retrospective study analyzed women with proven stress urinary incontinence (SUI).

Transvaginal iliococcygeus fixation for posthysterectomy vaginal vault prolapse repair.

Introduction And Hypothesis: Posthysterectomy vaginal vault prolapse repair is a surgical challenge. Successful surgical management using native tissue can be achieved via the vaginal approach by iliococcygeus fascia fixation. However, although iliococcygeus fascia fixation is technically simple and has a low morbidity, it is not commonly performed.