Prevalence of Musculoskeletal Disorders Among Surgeons Performing Minimally Invasive Surgery: A Systematic Review.

Objective: The aim of this study was to review musculoskeletal disorder (MSD) prevalence among surgeons performing minimally invasive surgery.

Background: Advancements in laparoscopic surgery have primarily focused on enhancing patient benefits. However, compared with open surgery, laparoscopic surgery imposes greater ergonomic constraints on surgeons.

The Impact of Midurethral Sling Surgery on Sexual Activity and Function in Women With Stress Urinary Incontinence.

Introduction: Stress urinary incontinence has a negative impact on sexual function.

Aim: To assess the effect of midurethral sling surgery on sexual activity and function in women with stress urinary incontinence.

Methods: This is a secondary analysis of the Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS-II) study, which assessed the value of urodynamics in women with (predominantly) stress urinary incontinence.

Sacrospinous hysteropexy versus vaginal hysterectomy with suspension of the uterosacral ligaments in women with uterine prolapse stage 2 or higher: multicentre randomised non-inferiority trial.

Objective: To investigate whether uterus preserving vaginal sacrospinous hysteropexy is non-inferior to vaginal hysterectomy with suspension of the uterosacral ligaments in the surgical treatment of uterine prolapse.

Design: Multicentre randomised controlled non-blinded non-inferiority trial.

Setting: 4 non-university teaching hospitals, the Netherlands.

Results of primary versus recurrent surgery to treat stress urinary incontinence in women.

Introduction And Hypothesis: We compared cure rates and complication rates in patients who had undergone primary or recurrent (secondary) surgery for stress urinary incontinence (SUI).

Methods: A retrospective cohort study that included patients who underwent surgery to treat SUI in a tertiary referral center was carried out. All patients had, predominantly, SUI.

Collagen type III alpha 1 polymorphism (rs1800255, COL3A1 2209 G>A) assessed with high-resolution melting analysis is not associated with pelvic organ prolapse in the Dutch population.

Introduction And Hypothesis: The rs1800255, COL3A1 2209 G>A polymorphism in the alpha 1 chain of collagen type III has been associated with an increased risk of pelvic organ prolapse (POP). In one of our previous studies however, polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) misdiagnosed rs1800255, COL3A1 2209 G>A in 6 % of cases. The high-resolution melting (HRM) analysis on the contrary obtained a 100 % accordance for this specific polymorphism and was used in the present study to validate this risk factor for POP.

Bladder function after radical hysterectomy for cervical cancer.

Aim: To report the effects of radical hysterectomy and nerve-sparing techniques on lower urinary tract function in women.

Methods: A literature search was performed in Pubmed and Medline using the keywords bladder after radical hysterectomy, nerve sparing radical hysterectomy, and urinary dysfunction following radical hysterectomy. Significant results and citations were reviewed manually by the authors.

Dynamic magnetic resonance imaging before and 6 months after laparoscopic sacrocolpopexy.

Introduction And Hypothesis: The objective of this study was to correlate dynamic magnetic resonance imaging (MRI) with Pelvic Organ Prolapse Quantification (POP-Q) measurements and pelvic floor symptoms in order to determine the value of dynamic MRI for evaluating vaginal vault prolapse both before and 6 months after laparoscopic sacrocolpopexy.

Methods: This was a prospective, single-center cohort study in 43 patients who underwent a modified laparoscopic sacrocolpopexy/hysteropexy operation using bone-anchor fixation and synthetic mesh. The study included dynamic MRI, POP-Q staging, and validated questionnaires before and 6 months after laparoscopic sacrocolpopexy.

A pictorial overview of pubovisceral muscle avulsions on pelvic floor magnetic resonance imaging.

Objectives: Despite extensive research aimed at clarifying (failing) pelvic organ support, the complete aetiology of pelvic organ prolapse (POP) is still not fully understood. During vaginal delivery, the pelvic floor can be irreversibly traumatised, resulting in pubovisceral muscle avulsions. The aetiology of these avulsions is discussed in this pictorial overview.

Value of urodynamics before stress urinary incontinence surgery: a randomized controlled trial.

Objective: To estimate whether a strategy of immediate surgery was noninferior to a strategy based on discordant urodynamic findings followed by individually tailored therapy in women with stress urinary incontinence (SUI).

Methods: A multicenter diagnostic cohort study with an embedded noninferiority randomized controlled trial was conducted in six academic and 24 nonacademic Dutch hospitals. Women with predominant SUI eligible for surgical treatment based on clinical assessment were included between January 2009 and November 2010.

Correlating signs and symptoms with pubovisceral muscle avulsions on magnetic resonance imaging.

Objective: We sought to correlate signs and symptoms of pelvic organ prolapse (POP) with pubovisceral muscle avulsions on magnetic resonance imaging (MRI).

Study Design: In this retrospective cohort study of 189 women with recurrent POP or unexplained symptoms of pelvic floor dysfunction, we reviewed T2-weighted pelvic floor MRI and categorized defects as minor or major avulsion, or as no defect present. Outcomes were correlated to quality-of-life questionnaire scores and data on obstetric and surgical history, together with POP-Quantification (POP-Q) measurements.

Extreme cervical elongation after sacrohysteropexy.

We present a case of extreme cervical elongation with a cervix of 12 cm after an unusual operation in which the uterine corpus was directly fixed to the promontory, and which became symptomatic after 8 years. The possible pathophysiology of cervical elongation is discussed. Diagnosing a case of severe cervical elongation can be important in the pre-operative evaluation.

Urinary incontinence after surgery for pelvic organ prolapse.

Aims: This study focused on the changes in urinary incontinence (UI) rates pre- and postoperatively and identified risk factors which predict the presence of symptoms of urgency urinary incontinence (UUI) or stress urinary incontinence (SUI) after surgery for pelvic organ prolapse (POP) without concomitant or previous anti-incontinence surgery.

Methods: All consecutive women who underwent POP surgery without concomitant or previous anti-incontinence surgery in the years 2004-2010 were included. Assessments were performed preoperatively and at 1-year follow-up, including pelvic organ prolapse quantification score and a standardized urogynecological questionnaire (Urogenital Distress Inventory, UDI).

Does training of the nondominant upper extremity reduce the surgeon's muscular strain during laparoscopy?: Results from a randomized controlled trial.

Introduction: In laparoscopy, suboptimal ergonomics frequently lead to morbidity for surgeons. Physical complaints are more commonly reported on the dominant upper extremity. This may be the consequence of challenging laparoscopic tasks being easier to perform with the dominant side.

Diagnosing pubovisceral avulsions: a systematic review of the clinical relevance of a prevalent anatomical defect.

The aims of this systematic literature review were to assess whether the detection of pubovisceral avulsions using magnetic resonance (MR) imaging or perineal ultrasonography was clinically relevant in women with pelvic floor dysfunction and to evaluate the relation with anatomy, symptoms, and recurrence after surgery. We performed a systematic literature review using three bibliographical databases (PubMed, Embase, and CINAHL) as data sources. Clinical studies were included in which pubovisceral avulsions were studied in relation to pelvic organ prolapse (POP) stage, pelvic floor symptoms, and/or recurrence of POP after surgery.

A systematic review of clinical studies on hereditary factors in pelvic organ prolapse.

Introduction And Hypothesis: There is growing evidence that pelvic organ prolapse (POP) is at least partly caused by underlying hereditary risk factors. The aim of our study was to provide a systematic literature review and meta-analysis of clinical studies on family history of POP as a risk factor for POP in individual women.

Methods: The databases PubMed and Embase were searched.

Outcomes and predictors of failure of trocar-guided vaginal mesh surgery for pelvic organ prolapse.

Objective: The objective of the study was to compare the 1 year conventional and composite outcomes of trocar-guided vaginal mesh surgery and the identification of the predictors of failure.

Study Design: This was a prospective observational cohort study. Failure outcome definitions were as follows: I, prolapse stage II or greater in mesh treated compartments; II, overall prolapse stage II or greater; III, composite outcome of overall prolapse greater than the hymen and the presence of bulge symptoms or repeat surgery.

Quality of life after laparoscopic and abdominal hysterectomy: a randomized controlled trial.

Objective: To report the 4-year follow-up quality-of-life data of a randomized controlled trial between abdominal and laparoscopic hysterectomy and to investigate whether any difference in quality of life would remain long-term.

Methods: Patients scheduled for hysterectomy for benign indications were randomized and received the Dutch version of the Short Form 36 questionnaire. The Short Form 36 consists of eight domains in which 100 points can be obtained.

Identification of six loci associated with pelvic organ prolapse using genome-wide association analysis.

Objective: There is evidence that both environmental and genetic factors contribute to pelvic organ prolapse. We conducted a genome-wide association study to investigate whether common genetic variants modify the risk of pelvic organ prolapse.

Methods: We recruited women who had been evaluated and treated for pelvic organ prolapse at the University of Utah from 1996 to 2008 and their affected female relatives.

Laparoscopic sacrocolpopexy with bone anchor fixation: short-term anatomic and functional results.

Introduction And Hypothesis: The aim of this study was to evaluate short-term anatomic and functional outcomes and safety of laparoscopic sacrocolpopexy with bone anchor fixation.

Methods: A prospective cohort study of women undergoing laparoscopic sacrocolpopexy between 2004 and 2009. Anatomic outcome was assessed using the pelvic organ prolapse quantification score (POP-Q).

[Uterus preserving surgery versus vaginal hysterectomy in treatment of uterine descent: a systematic review].

Objective: To compare the outcomes of uterus preserving procedures and vaginal hysterectomy in treatment of uterine prolapse.

Design: Systematic review.

Method: We searched in Pubmed, Embase, the Cochrane Library and the reference lists of relevant publications for articles comparing uterus preserving procedures with vaginal hysterectomy.

A randomized trial of training the non-dominant upper extremity to enhance laparoscopic performance.

Introduction: In laparoscopy, the surgeon's dominant arm will execute difficult tasks with less effort compared to the non-dominant arm. This leads to a relative overuse of muscles on this side. We hypothesized that training the non-dominant arm would improve laparoscopic skills.

The value of preoperative urodynamics according to gynecologists and urologists with special interest in stress urinary incontinence.

Introduction And Hypothesis: The aim of this study is to assess variations in practice in the use of preoperative urodynamics in women with stress urinary incontinence (SUI).

Methods: We performed an E-survey among all Dutch gynecologists and urologists who have SUI as focus in daily practice. The questions concerned the common policy and preferred policy.

Risk factors for exposure, pain, and dyspareunia after tension-free vaginal mesh procedure.

Objective: To identify possible risk factors for exposure, dyspareunia, and pain after insertion of tension-free vaginal mesh in pelvic organ prolapse surgery.

Methods: This was a prospective observational cohort study. Consecutive women who underwent surgery with a trocar-guided tension-free vaginal mesh kit were included and evaluated at 6 weeks and at 6 and 12 months after surgery with respect to anatomy and complications.

Predictors for overactive bladder symptoms after pelvic organ prolapse surgery.

Purpose Of Review: To review the predictors for overactive bladder (OAB) symptoms after pelvic organ prolapse (POP) surgery.

Recent Findings: In general, an improvement on OAB can be expected after POP surgery. There are few studies which study the predictors of OAB after POP surgery and most studies had a different perspective.