Treatment of Vaginal Shortening and Narrowing With Autologous Buccal Mucosa Graft Augmentation Without Vaginal Mold.

Vaginal foreshortening can occur after hysterectomy leading to inability to engage successfully in vaginal intercourse resulting in decreased quality of life. Vaginal elongation using autologous buccal mucosal graft with mold and postoperative bed rest has been reported extensively for vaginal stenosis and foreshortening, but graft without mold has never been described. A 61-year-old woman 5 years after robotic-assisted hysterectomy with foreshortened vagina and vaginal stricture sought care secondary to the inability to have sexual intercourse.

A novel approach to recurrent vaginal vault prolapse in a patient with müllerian agenesis.

Background: Vaginal agenesis is a congenital disorder affecting 1 in 4000 to 1 in 10,000 females. Lack of normal vaginal support structures may lead these patients to develop prolapse of the distal rudimentary vagina. Presently, there is no consensus regarding the best surgical option.

Surgical treatment of persistent vaginal granulation tissue using CO(2) laser vaporization under colposcopic and laparoscopic guidance.

Introduction: There have been many reports in the literature on vaginal mesh erosion as a complication of pelvic floor reconstructive surgery. Several reports describe successful surgical excision of the exposed mesh as a resolution. However, in rare cases of mesh erosion, poor surgical outcomes and multiple resection failures have been reported.

Postoperative urinary retention following vaginal mesh procedures for the treatment of pelvic organ prolapse.

Introduction And Hypothesis: The objective of the study was to assess vaginal mesh procedures and patient characteristics that are associated with postoperative urinary retention (PUR) following pelvic reconstructive surgery.

Methods: The charts of 142 patients who underwent transvaginal reconstructive surgery with mesh were included in the analysis. Primary outcome was the incidence of PUR following surgery with mesh.

Characteristics of physicians who choose fellowship training in obstetrics and gynecology.

Introduction: : To determine the attributes and motivation of physicians who pursue fellowship training in the subspecialties of Obstetrics and Gynecology (Ob/Gyn).

Methods: : We surveyed current fellows and recent graduates from the ABOG recognized subspecialties in Ob/Gyn. Demographics and reasons for pursuing fellowship training were obtained.

Risk factors for mesh erosion 3 months following vaginal reconstructive surgery using commercial kits vs. fashioned mesh-augmented vaginal repairs.

Introduction And Hypothesis: Our objective was to establish the overall graft erosion rate in a synthetic graft-augmented repair 3 months postoperatively.

Methods: A retrospective chart review was performed on a cohort of subjects who underwent mesh-augmented vaginal reconstructive surgery during an 18-month period. We defined graft erosion as exposure of any mesh upon visual inspection of the entire vagina at the 3-month postoperative visit.

Anatomic relationships of the "top-down" mid-urethral sling.

Objective: To determine the anatomic relationships between the "top-down" mid-urethral sling (MUS) and pelvic structures.

Study Design: Placement of the sling needle delivery device was performed in 10 cadaveric hemi-pelves. The distances between major structures in the pelvis and the needle delivery device were recorded.

Urinary tract injury during hysterectomy based on universal cystoscopy.

Objective: To estimate the incidence and location of injury to the urinary tract during hysterectomy for benign gynecologic disease.

Methods: This was a prospective clinical study in an academic environment performed at three sites. Diagnostic cystourethroscopy was performed on all patients after hysterectomy for benign disease.

The incidence of urinary tract injury during hysterectomy: a prospective analysis based on universal cystoscopy.

Objective: To evaluate the incidence of urinary tract injury due to hysterectomy for benign disease.

Study Design: Patients were enrolled prospectively from 3 sites. All patients undergoing abdominal, vaginal, or laparoscopic hysterectomy for benign disease underwent diagnostic cystourethroscopy.

Levator contraction strength and genital hiatus as risk factors for recurrent pelvic organ prolapse.

Objective: To correlate levator ani contraction strength and genital hiatus measurements with surgical failure in prolapse.

Study Design: This retrospective study involved chart review for documentation of levator contraction strength, genital hiatus measurement, and recurrent pelvic floor disorders in women who underwent surgery for prolapse.

Results: The recurrent prolapse rate was 34.

Sinus formation after insertion of a silicone-coated suburethral sling.

We report the case of a 65-year-old woman who developed a sinus tract after a suburethral synthetic silicone mesh sling placement. After removal of the sling material with debridement and reconstruction of the suburethral tissue, fascia lata harvest with a sling to abdominal rectus fascia was performed. Silicone mesh may erode to form a sinus tract if used as suburethral sling material.

The anatomy of midurethral slings and dynamics of neurovascular injury.

The aim of this study was to investigate the course of midurethral slings using tension-free vaginal tape. The TVT procedure was performed on six fresh pelves, measurements were obtained, and the structures were cross-referenced in 16 embalmed pelves. The midurethral sling enters the suburethral tissue 2.

Medium-term follow-up of transvaginal suburethral slings: variance in outcome success using two different evaluation methods.

Objectives: To compare Groutz-Blaivas' Simplified Urinary Incontinence Outcome Score (SUIOS) with retrospective chart review for medium-term evaluation of transvaginal suburethral slings.

Methods: A total of 127 consecutive women underwent transvaginal suburethral sling surgery using In-fast bone screw technology, with a fascia lata graft, from April 1997 to September 1998 (30-month follow-up), performed by a single method. Retrospective evaluation of the patients' office charts was compared with the outcome data determined by the previously validated SUIOS.