Dexamethasone administration to improve patient recovery in ambulatory vaginal reconstructive surgery: a randomized prospective trial.

Introduction And Hypothesis: Dexamethasone is a potent glucocorticoid that may improve quality of recovery (QoR). We hypothesized that standard administration of dexamethasone at induction may improve QoR compared to placebo in subjects undergoing ambulatory vaginal reconstructive surgeries.

Methods: This was a randomized prospective clinical trial on subjects scheduled for ambulatory vaginal reconstructive surgery for prolapse and/or urinary incontinence.

Comparison of Methods to Identify Stress Urinary Incontinence in Women With Pelvic Organ Prolapse.

Objective: The aim of the study was to compare which test is most sensitive in identifying stress urinary incontinence (SUI) in women with pelvic organ prolapse using urodynamics (UDS) as the criterion standard: cough stress test (CST) or pyridium pad test.

Methods: This was a prospective study of women with pelvic organ prolapse stage II or greater who desired surgical management for prolapse. Each patient underwent preoperative urinary testing: UDS, CST, and a 24-hour pyridium pad test.

Anesthetics' role in postoperative urinary retention after pelvic organ prolapse surgery with concomitant midurethral slings: a randomized clinical trial.

Introduction And Hypothesis: Spinal anesthesia can be a potential risk factor for postoperative urinary retention (POUR). Our objective was to compare POUR rates for outpatient vaginal pelvic floor surgeries when using spinal versus general anesthesia. Our hypothesis was that spinal anesthesia would have higher POUR rates compared with general anesthesia.

Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review.

Introduction And Hypothesis: Spinal anesthesia has been reported to be a risk factor for postoperative urinary retention (POUR) in various surgical specialties. We hypothesized that spinal anesthesia was a risk factor for POUR after outpatient vaginal surgery for pelvic organ prolapse (POP).

Methods: This was a retrospective review of an urogynecology database for all outpatient POP vaginal surgeries performed in 2014 to evaluate the risk of POUR after general versus spinal anesthesia.

Pelvic floor muscle weakness: a risk factor for anterior vaginal wall prolapse recurrence.

Introduction And Hypothesis: Native tissue vaginal repairs are associated with relatively high levels of recurrence. Systematic reviews have noted that preoperative pelvic floor muscle strength was associated with increased risk of recurrence in the short term.

Methods: This is a retrospective review of patients who underwent a primary reconstructive surgery for anterior compartment vaginal prolapse between 2001 and 2015.

Advanced uterovaginal prolapse: is vaginal hysterectomy with McCall culdoplasty as effective as in lesser degrees of prolapse?

Introduction And Hypothesis: There is a paucity of data on the success of vaginal surgery for severe prolapse. The authors hypothesized that the success rates of total vaginal hysterectomy (TVH) with McCall culdoplasty in women with advanced pelvic organ prolapse (POP) and in women with less severe POP are similar.

Methods: This was a retrospective review of women undergoing TVH with McCall culdoplasty from 2005 to 2014.

Transvaginal Repair of Complex Rectovaginal Fistulas Using the Porcine Urinary Bladder Matrix as an Augmenting Graft.

Background: After the US Food and Drug Administration issued a safety warning concerning vaginal mesh implants in 2008, their use in correction of pelvic floor defects have decreased in the United States (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm479732.

Resolution of Rectal Prolapse by Vaginal Reconstruction.

Background: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy.

Apical sling: an approach to posthysterectomy vault prolapse.

Introduction And Hypothesis: This video demonstrates a transvaginal technique for vaginal vault suspension using an apical sling suspended from the sacrospinous ligaments.

Methods: This was a retrospective review of apical sling procedures performed from July 2013 to November 2014. The technique is started by marking the vaginal apex.

Vaginal hysterectomy at the time of transvaginal mesh placement.

Introduction: : Previous investigations have shown an increased risk of mesh erosion when concomitant vaginal hysterectomy is performed at the time of transvaginal reconstruction with mesh. We hypothesize that vaginal hysterectomy can be performed without a high risk of erosion.

Methods: : This is a retrospective, repeated-measures study of women with uterovaginal prolapse who underwent vaginal hysterectomy and pelvic reconstruction with a transvaginal mesh technique using the Prolift system.