Bowel preparation prior to minimally invasive sacrocolpopexy: a randomized controlled trial.

Introduction And Hypothesis: The objective was to determine if a bowel preparation prior to minimally invasive sacrocolpopexy (MIS) influences post-operative constipation symptoms. We hypothesized that women who underwent a bowel preparation would have an improvement in post-operative defecatory function.

Methods: In this randomized controlled trial, women undergoing MIS received a pre-operative bowel preparation or no bowel preparation.

The Impact of Individual Surgeon Volume on Hysterectomy Costs.

Background And Objective: Hysterectomy is one of the most common surgical procedures women will undergo in their lifetime. Several factors affect surgical outcomes. It has been suggested that high-volume surgeons favorably affect outcomes and hospital cost.

The use of mechanical bowel preparation in laparoscopic gynecologic surgery: a decision analysis.

Objective: The use of mechanical bowel preparation prior to laparoscopy is common in gynecology, but its use may affect the rates of perioperative events and complications. Our objective was to compare different mechanical bowel preparations using decision analysis techniques to determine the optimal preparation prior to laparoscopic gynecological surgery.

Study Design: A decision analysis was constructed modeling perioperative outcomes with the following mechanical bowel preparations: magnesium citrate, sodium phosphate, polyethylene glycol, enema, and no bowel preparation.

Cost analysis when open surgeons perform minimally invasive hysterectomy.

Background And Objective: The costs to perform a hysterectomy are widely variable. Our objective was to determine hysterectomy costs by route and whether traditionally open surgeons lower costs when performing laparoscopy versus robotics.

Methods: Hysterectomy costs including subcategories were collected from 2011 to 2013.

Adoption of robotic sacrocolpopexy at an academic institution.

Objectives: To describe the introduction of robotic sacrocolpopexy (RSC) in a urogynecology fellowship program, including operative times and patient outcomes.

Methods: Data were retrospectively extracted from all women who underwent RSC between May 1, 2009 and December 31, 2011 by a single urogynecologist with fellow and resident assistance. Patient demographics, operative times, intraoperative complications, length of hospital stay, and postoperative course were analyzed.

Predictors of postoperative acute urinary retention in women undergoing minimally invasive sacral colpopexy.

Objectives: Our aim was to determine predictors of acute urinary retention in women undergoing laparoscopic and robotic sacral colpopexy.

Methods: Records from all minimally invasive sacral colpopexies performed from 2009 to 2012 were reviewed. All women had a retrograde fill voiding trial (RGVT) on postoperative day 1, except in cases of intraoperative bladder injury or chronic urinary retention.

Apical support at the time of hysterectomy for uterovaginal prolapse.

Introduction And Hypothesis: The aim was to determine factors associated with performing concurrent apical support procedures in hysterectomies carried out for uterovaginal prolapse.

Methods: Hysterectomies performed for uterovaginal prolapse from 2000 to 2010 were identified by ICD-9 codes. Uterovaginal prolapse was a proxy for apical descent.

Cost-effectiveness of test phase implantation strategies for InterStim® sacral neuromodulation.

Objective: Sacral neuromodulation with InterStim can be performed with staged implants or peripheral nerve evaluation followed by a combined stage I/II procedure. In both, unilateral or bilateral leads can be placed for the testing phase. Our objective was to determine the cost-effectiveness of these strategies in patients with refractory overactive bladder.

Introduction of laparoscopic sacral colpopexy to a fellowship training program.

Introduction And Hypothesis: Minimally invasive sacral colpopexy has increased over the past decade, with many senior physicians adopting this new skill set. However, skill acquisition at an academic institution in the presence of postgraduate learners is not well described. This manuscript outlines the introduction of laparoscopic sacral colpopexy to an academic urogynecology service that was not performing minimally invasive sacral colpopexies, and it also defines a surgical learning curve.

Menstrual suppression in the adolescent.

Menstrual suppression, the use of contraceptive methods to eliminate or decrease the frequency of menses, is often prescribed for adolescents to treat menstrual disorders or to accommodate patient preference. For young women using hormonal contraceptives, there is no medical indication for menstruation to occur monthly, and various hormonal contraceptives can be used to decrease the frequency of menstruation with different side effect profiles and rates of amenorrhea. This article reviews the different modalities for menstrual suppression, common conditions in adolescents which may improve with menstrual suppression, and strategies for managing common side effects.

Sacral neuromodulation and intravesical botulinum toxin for refractory overactive bladder.

Purpose Of Review: To provide an overview of sacral neuromodulation (SNM) and intravesical botulinum toxin (BTX) injections in the treatment of refractory overactive bladder (OAB) and urge urinary incontinence.

Recent Findings: SNM has been a successful treatment option for OAB for over a decade with efficacy rates reported between 50 and 90%. Recently, intravesical BTX has been studied as a less invasive but more transient option with similar efficacy rates.