A randomized trial comparing methods of vaginal cuff closure at vaginal hysterectomy and the effect on vaginal length.

Objective: The objective of the study was to compare the effect of horizontal versus vertical closure of the vaginal cuff during vaginal hysterectomy on vaginal length.

Study Design: Forty-three women were randomized to undergo horizontal (n = 23) or vertical (n = 20) vaginal cuff closure during vaginal hysterectomy at a community hospital. The primary outcome of vaginal length before and after surgery was compared by the Student t test and the paired t test.

Uterosacral ligament vault suspension: five-year outcomes.

Objective: To evaluate the five-year anatomic and functional outcomes of the high uterosacral vaginal vault suspension.

Methods: One hundred ten patients with advanced symptomatic uterovaginal or posthysterectomy prolapse treated between January 1997 and January 2000 were identified and 72 (65%) consented to participate in this study. Anatomic outcomes were obtained by Pelvic Organ Prolapse Quantification.

Sexual function in patients presenting to a urogynecology practice.

The purpose of this study was to evaluate sexual function in women referred to a urogynecology practice. All new patients were mailed an optional female sexual function index (FSFI) in conjunction with their history forms; other sexual function information was obtained during the physician interview. Over 6 months, four hundred fifty new patients were enrolled.

The efficacy of the tension-free vaginal tape in the treatment of five subtypes of stress urinary incontinence.

Purpose: To determine the efficacy of tension-free vaginal tape (TVT) for the treatment of five sub-types of stress urinary incontinence (SUI).

Materials And Methods: A retrospective review was performed from November 1998 to November 2001 on all patients with SUI who underwent a TVT procedure either alone or with other reconstructive pelvic procedures. The patients were subdivided into five categories.

Practice patterns of physician members of the American Urogynecologic Society regarding female sexual dysfunction: results of a national survey.

The purpose of the study was to evaluate practice patterns of members of the American Urogynecologic Society (AUGS) with respect to female sexual dysfunction (FSD). A brief self-administered survey of 20 questions was mailed to 966 physician members of the AUGS in the United States of America and Canada; 471 surveys were returned (49% response rate). The majority of responders see urogynecology (19%) or urogynecology and general gynecology patients (43%).

Prevalence of persistent and de novo overactive bladder symptoms after the tension-free vaginal tape.

Objective: The purpose of this study was to assess 1) the proportion of de novo urge incontinence and overactive bladder symptoms after a tension-free vaginal tape (TVT), and 2) the natural history of preoperative urge incontinence and overactive bladder symptoms after a TVT.

Methods: A chart review was performed on all patients who underwent a TVT without concomitant procedures from November 1998 to November 2002. Preoperative and postoperative stress and mixed urinary incontinence symptoms as well as overactive bladder symptoms were assessed subjectively, as was the use of anticholinergics to treat overactive bladder symptoms.

Paravaginal defects: prevalence and accuracy of preoperative detection.

The objective of this study was to determine the prevalence of paravaginal defects and to report the correlation between diagnosing a paravaginal defect preoperatively and observing the presence of one intraoperatively. This was a prospective study in which 77 patients with at least stage 2 prolapse of the anterior vaginal wall who desired surgical correction of their prolapse were assessed pre- and intraoperatively for the detection of a paravaginal defect. In order to differentiate a midline or central defect from a paravaginal defect, an index finger or ring forceps was placed vaginally toward each ischial spine separately.

Tension-free vaginal tape: a quality-of-life assessment.

Objective: To assess whether tension-free vaginal tape (TVT) results in significant improvements in urinary incontinence and its effect on patients' quality of life (QOL) utilizing two validated questionnaires.

Methods: One hundred sixty-two tension-free vaginal tape procedures were performed at two sites between October 1998 and January 2001. All patients were requested to complete the Incontinence Impact Questionnaire (IIQ-7) and Urinary Distress Inventory (UDI-6) as part of their preoperative assessment.

Evaluation and management of rectoceles.

Purpose Of Review: As life expectancy increases, the prevalence of pelvic organ prolapse in general, and rectoceles, in particular, will continue to grow. The objectives of this article are to review the basic anatomy and contributing factors associated with the development of rectoceles and to discuss the appropriate work-up and treatment options.

Recent Findings: The main themes in the current literature stress the importance of not only anatomic restoration, but also quality of life issues regarding visceral and sexual function when performing a rectocele repair.