The Effect of Intravenous Acetaminophen on Postoperative Pain and Narcotic Consumption After Vaginal Reconstructive Surgery: A Double-Blind Randomized Placebo-Controlled Trial.

Objective: This study aimed to determine the effect of intravenous acetaminophen versus placebo on postoperative pain, satisfaction with pain control, and narcotic use after vaginal reconstructive surgery.

Methods: This was an institutional review board-approved, double-blind placebo-controlled randomized trial. Women scheduled for reconstructive surgery including vaginal hysterectomy and vaginal vault suspension were enrolled.

Histologic Anatomy of the Anterior Vagina and Urethra.

Background: Vaginal and urethral histology is important to understanding the pathophysiology of the pelvic floor.

Methods: En bloc removal of 4 female cadaveric pelvises was performed, with 18 to 25 serial sections obtained from each. The vaginal and urethral lengths were divided into distal and proximal sections; urethra was divided into anterior and posterior segments as well.

Comparative Perioperative Pain and Recovery in Women Undergoing Vaginal Reconstruction Versus Robotic Sacrocolpopexy.

Background: In this study of patients undergoing vaginal hysterectomy with either robotic or vaginal prolapse repair, there was no difference in quality of life in the weeks following surgery; however, less narcotics were used, less pain was documented by nurses and Surgical Pain Scale (SPS), and better performance on voiding trials was noted in those undergoing robotic sacrocolpopexy.

Objectives: Minimally invasive surgery for pelvic organ prolapse is the preferred surgical route for optimal recovery. However, information regarding patient-centered outcomes among various techniques is lacking.

Primary care providers' attitudes, knowledge, and practice patterns regarding pelvic floor disorders.

Introduction And Hypothesis: Understanding barriers to seeking care for pelvic floor disorders is necessary. We sought to assess familiarity with pelvic floor disorders, as well as identify screening and referral patterns among primary care providers.

Methods: This Institutional Review Board approved study was distributed through a secure online server (SurveyMonkey®).

Impact of Pelvic Floor Physical Therapy on Quality of Life and Function After Obstetric Anal Sphincter Injury: A Randomized Controlled Trial.

Objectives: There is no standard of care for women sustaining an obstetric anal sphincter injury (OASIS). We sought to determine whether pelvic floor physical therapy (PFPT) would improve the quality of life and function in women 12 weeks after OASIS.

Methods: This institutional review board-approved randomized trial enrolled primiparous women 2 weeks after delivery complicated by OASIS.

To Pack or Not to Pack? A Randomized Trial of Vaginal Packing After Vaginal Reconstructive Surgery.

Objective: Placement of vaginal packing after pelvic reconstructive surgery is common; however, little evidence exists to support the practice. Furthermore, patients have reported discomfort from the packs. We describe pain and satisfaction in women treated with and without vaginal packing.

Attitudes Regarding Labial Hypertrophy and Labiaplasty: A Survey of Members of the Society of Gynecologic Surgeons and the North American Society for Pediatric and Adolescent Gynecology.

Objective: The aim of this study was to describe gynecologists' attitudes toward labial hypertrophy and explore possible differences among providers for pediatric/adolescent patients.

Methods: This was an institutional review board-approved, cross-sectional survey of physician attendees at 2 national meetings in 2014: the Society of Gynecologic Surgeons (SGS) and the North American Society for Pediatric and Adolescent Gynecology (NASPAG). The survey was designed to query demographics and impressions regarding labial hypertrophy and labiaplasty.

Critical Anatomy Relative to the Sacral Suture: A Postoperative Imaging Study After Robotic Sacrocolpopexy.

Objective: This study aimed to characterize pertinent anatomy relative to the sacral suture placed at time of robotic sacrocolpopexy using postoperative computed tomography and magnetic resonance imaging.

Methods: A vascular clip was placed at the base of the sacral suture at the time of robotic sacrocolpopexy. Six weeks postoperatively, subjects returned for a computed tomography scan and magnetic resonance imaging.

The Impact of Robotic-Assisted Surgery on Training Gynecology Residents.

Introduction: To investigate the changes in surgical route of hysterectomy after implementation of robotics and to assess the impact on the surgical training of gynecology residents.

Methods: This was an institutional review board-approved retrospective analysis at 2 large academic community hospitals. Subjects undergoing hysterectomy during 2005 and 2011 were identified.

Survey of male perceptions regarding the vulva.

Objective: The purpose of this study was to characterize male preferences of vulvar appearance, their awareness of labiaplasty, and their knowledge of genital anatomy.

Study Design: Men 18-80 years old were recruited via emails sent by an Internet provider to participate in a 27-question web-based survey. The questionnaire included images and queried demographics, men's familiarity with vulvar anatomy, preferences regarding labial appearance, and awareness of labiaplasty.

Effects of dexamethasone on quality of recovery following vaginal surgery: a randomized trial.

Objective: Dexamethasone is a corticosteroid with minimal side effects that may improve quality of recovery. We sought to evaluate standard use of this medication prior to vaginal reconstructive surgery.

Study Design: This was a double-blind, randomized, placebo-controlled trial of women undergoing vaginal reconstructive surgery for pelvic organ prolapse.

Impact of robotic technology on hysterectomy route and associated implications for resident education.

Objective: We sought to compare the proportion of benign hysterectomies performed vaginally and the mean number of hysterectomies with resident involvement by route before and after robot implementation.

Study Design: This multicenter, retrospective cohort study using nonsynchronous controls was conducted through the Society of Gynecologic Surgeons Fellows' Pelvic Research Network. The route of hysterectomy for benign disease was compared for 1-year periods before (prerobot) and after (postrobot) robotic introduction at 4 academic institutions.

Age as a predictor of osteoporotic fracture compared with current risk-prediction models.

Objective: To compare several fracture risk-prediction models and their predictive values.

Methods: Women older than age 49 years were sent for dual-energy X-ray absorptiometry screening between January 2007 and March 2009. Data collection included multiple osteoporosis risk factors.

Delayed presentation of an enterocutaneous fistula after tension-free vaginal tape sling.

Background: : Bowel injury is a rare but serious complication associated with tension-free vaginal tape (TVT) sling procedures.

Case: : A 50-year-old woman with a previous history of pelvic surgery underwent TVT for stress urinary incontinence. Surgery and the immediate postoperative period were unremarkable; however, she returned 5 months later with bloody, purulent discharge from a suprapubic exit site.