Neutrophil Gelatinase-Associated Lipocalin Biomarker and Urinary Tract Infections: A Diagnostic Case-Control Study (NUTI Study).

Objectives: Acute uncomplicated urinary tract infection (UTI) in women is often treated based on symptoms alone. Urinary tract infection symptoms are highly sensitive but lack specificity and result in overuse of antibiotics. We sought to determine if urine neutrophil gelatinase-associated lipocalin (uNGAL) levels in urine can accurately discriminate between UTI and healthy women.

Latency to vaginal mesh exposure with mesh placed abdominally versus vaginally in pelvic floor surgery: A retrospective comparative study.

The primary aim was to compare the difference in time to mesh exposure between mesh placed abdominally versus vaginally. This is a retrospective comparative study of patients presented with vaginal mesh exposure between January 2001 and July 2012. This study compares patients who had undergone vaginally placed mesh procedures to those who had had abdominally placed mesh.

Tension-Free Vaginal Tape Failure After Robotic Sacrocolpopexy and Tension-Free Vaginal Tape for Concomitant Prolapse and Stress Incontinence.

Objective: Evidence of surgical cure with tension free vaginal tape (TVT) is robust for isolated stress urinary incontinence, but rigorous studies investigating combined prolapse and incontinence are lacking. Our study measured cure of stress incontinence in concomitant robotic sacrocolpopexy and retropubic sling (TVT). We hypothesized a higher rate of objective failure as measured by the cough stress test (CST) compared to failures reported in recent randomized trials of TVT in patients without prolapse (aggregate 8% failure).

Pelvic Floor and Urinary Distress in Women with Fibromyalgia.

Fibromyalgia (FM) patients were recently found to have more symptom burden from bothersome pelvic pain syndromes that women seeking care for pelvic floor disease at a urogynecology clinic. We sought to further characterize pelvic floor symptoms in a larger sample of FM patients using of validated questionnaires. Female listserv members of the Fibromyalgia Information Foundation completed an online survey of three validated questionnaires: the Pelvic Floor Distress Inventory 20 (PFDI-20), the Pelvic Pain, Urgency and Frequency Questionnaire (PUF), and the Revised Fibromyalgia Impact Questionnaire (FIQR).

Vaginal birth after cesarean: an effective method to reduce cesarean.

Cesarean deliveries represent almost one third of US births. Given that repeat cesarean is the most common single indication for cesarean, trial of labor after cesarean (TOLAC) with subsequent vaginal birth after cesarean (VBAC) is an important mechanism to reduce the overall cesarean rate. The 2010 National Institutes of Health Conference found that one of the biggest barriers to VBAC is the lack of patient access to TOLAC.

Delayed diagnosis of vascular injury with a retropubic midurethral sling.

Background: Retropubic midurethral slings are the mainstay of treatment for female stress urinary incontinence. Complications of this approach may have long-term implications.

Case: A 55-year-old woman underwent tension-free vaginal tape (TVT) placement.

Trial of labor and vaginal delivery rates in women with a prior cesarean.

Objective: To evaluate evidence on trial of labor (TOL) and vaginal delivery rates in women with a prior cesarean and to understand the characteristics of women offered a trial of labor.

Data Sources: MEDLINE, DARE, and Cochrane databases were searched for articles evaluating mode of delivery for women with a prior cesarean delivery published between 1980 and September 2009.

Study Selection: Studies were included if they involved human participants, were in English, conducted in the United States or in developed countries, and if they were rated fair or good base on U.

Mesh erosion in robotic sacrocolpopexy.

Objective: This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH).

Methods: This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery.

Bladder pain syndrome: a review.

: Bladder pain syndrome (BPS), including the specific variant interstitial cystitis, is a chronic condition characterized by bladder, urethral, and pelvic pain; urinary urgency; and urinary frequency. Bladder pain syndrome poses many clinical challenges: (1) The diagnosis is one of exclusion and is often inappropriately assigned; (2) a wide-range spectrum of symptoms can be noted in the population from minimally affected to debilitated; and (3) the etiology for the disease is unknown, which has made the development of directed therapies problematic. The objective of this article was to review the current theories of etiology of BPS and the diagnosis of BPS and understand treatment options including surgical, complementary, and pharmaceutical.

New insights on vaginal birth after cesarean: can it be predicted?

Objective: To evaluate existing vaginal birth after cesarean (VBAC) screening tools and to identify additional factors that may predict VBAC or failed trial of labor.

Data Sources: Relevant studies were identified through MEDLINE, Database of Abstracts of Reviews of Effectiveness, and the Cochrane databases (1980-September 2009), and from recent systematic reviews, reference lists, reviews, editorials, web sites, and experts.

Methods Of Study Selection: Inclusion criteria limited studies to those of humans, written in English, studies conducted in the United States and developed countries, and those rated good or fair quality by the U.

Vaginal birth after cesarean: new insights.

Objectives: To synthesize the published literature on vaginal birth after cesarean (VBAC). Specifically, to review the trends and incidence of VBAC, maternal benefits and harms, infant benefits and harms, relevant factors influencing each, and the directions for future research.

Data Sources: Relevant studies were identified from multiple searches of MEDLINE; DARE; the Cochrane databases (1966 to September 2009); and from recent systematic reviews, reference lists, reviews, editorials, Web sites, and experts.

Vaginal birth after cesarean: new insights on maternal and neonatal outcomes.

Objective: To systematically review the evidence about maternal and neonatal outcomes relating to vaginal birth after cesarean (VBAC).

Data Sources: Relevant studies were identified from multiple searches of MEDLINE, DARE, and the Cochrane databases (1980 to September 2009) and from recent systematic reviews, reference lists, reviews, editorials, Web sites, and experts.

Methods Of Study Selection: Inclusion criteria limited studies to the English-language and human studies conducted in the United States and developed countries specifically evaluating birth after previous cesarean delivery.

The presacral space and its impact on sacral neuromodulator implantation.

Purpose: We describe the presacral space and its potential impact on sacral neuromodulator implantation and bowel injury.

Materials And Methods: Parasagittal images containing bilateral sacral foramina (S2-S4) were examined on 45 pelvic magnetic resonance images. Images were excluded from analysis if they were poor quality or had any history causing distortion of normal anatomy.

Reoperation 10 years after surgically managed pelvic organ prolapse and urinary incontinence.

Objective: This study measured the 10-year risk of reoperation for surgically treated pelvic organ prolapse and urinary incontinence (POPUI) in a community population.

Study Design: We conducted a prospective cohort analysis of 374 women who were > 20 years old and who underwent surgery for POPUI in 1995.

Results: The 10-year reoperation rate was 17% by Kaplan Meier analysis.

Validating a clinical measure of levator hiatus size.

Objective: We evaluate the interrater reliability of levator hiatus (LH) size and correlate size to other measures of muscle function.

Study Design: Participants were examined independently by 2 examiners. During maximal contraction of the levator ani, the muscle was assessed by using Brink's scale.