Pelvic Floor Disorders Registry: Study Design and Outcome Measures.

Pelvic floor disorders affect up to 24% of adult women in the United States, and many patients with pelvic organ prolapse (POP) choose to undergo surgical repair to improve their quality of life. While a variety of surgical repair approaches and techniques are utilized, including mesh augmentation, there is limited comparative effectiveness and safety outcome data guiding best practice. In conjunction with device manufacturers, federal regulatory organizations, and professional societies, the American Urogynecologic Society developed the Pelvic Floor Disorders Registry (PFDR) designed to improve the quality of POP surgery by facilitating quality improvement and research on POP treatments.

Vaginal hysterectomy: past, present, and future.

Vaginal hysterectomy is the oldest and least invasive of the hysterectomy techniques and fulfills the evidence-based requirements as the preferred route of hysterectomy for benign gynecologic disease. Currently, vaginal hysterectomy is commonly utilized for treating uterine prolapse, but despite proven safety and effectiveness, the use of vaginal hysterectomy for treating non-prolapse conditions has been and remains underutilized in surgical practice. Improving the use of vaginal hysterectomy in the future will likely depend on addressing the key issues of training and maintaining skills in the technique and increasing awareness of the scientific evidence supporting its use.

Abdominal sacrocolpopexy and urinary incontinence: surgical planning based on urodynamics.

Objective: The objective of the study was to evaluate the use of urodynamics to determine the need for incontinence surgery at the time of abdominal sacrocolpopexy (ASC).

Study Design: The records of 441 women undergoing ASC during 2005-2007 were reviewed. Group 1 consisted of 204 women (46.

Pelvic floor muscle function in women presenting with pelvic floor disorders.

Introduction And Hypothesis: This observational study was undertaken to determine knowledge, prior instruction, frequency of performance, and ability to perform pelvic floor muscle exercises in a group of women presenting for evaluation of pelvic floor disorders.

Methods: Three hundred twenty-five women presenting for evaluation of pelvic floor disorders were questioned concerning knowledge and performance of pelvic floor muscle exercises (PMEs) and then examined to determine pelvic floor muscle contraction strength.

Results: The majority of women (73%) had heard of PMEs, but only 42% had been instructed to perform them and 62.

Natural orifice hysterectomy.

Minimally invasive surgery (MIS) such as natural orifice surgery is perceived as a relatively recent development partly because many MIS techniques utilize new technology and devices. However, a natural orifice/MIS approach for hysterectomy (vaginal hysterectomy, VH) has existed for over a century. VH is typically thought of in the realm of the urogynecologist as a component of reconstructive pelvic surgery for pelvic organ prolapse.

A randomized trial comparing methods of vaginal cuff closure at vaginal hysterectomy and the effect on vaginal length.

Objective: The objective of the study was to compare the effect of horizontal versus vertical closure of the vaginal cuff during vaginal hysterectomy on vaginal length.

Study Design: Forty-three women were randomized to undergo horizontal (n = 23) or vertical (n = 20) vaginal cuff closure during vaginal hysterectomy at a community hospital. The primary outcome of vaginal length before and after surgery was compared by the Student t test and the paired t test.

Vaginal evisceration managed by transvaginal bowel resection and vaginal repair.

When evisceration occurs through a large enterocele surgical repair can be performed vaginally, including bowel resection and reanastomosis, thereby avoiding the morbidity associated with laparotomy.

Povidone-iodine spray technique versus traditional scrub-paint technique for preoperative abdominal wall preparation.

Objective: The study was conducted to compare povidone-iodine spray and traditional scrub-paint techniques in reducing abdominal wall bacteria during preoperative preparation.

Study Design: Sixty patients scheduled to undergo vaginal surgery were recruited for study. Cultures of the abdominal skin were performed before and after preparation with two techniques: A traditional 5-minute iodophor soap scrub-paint on one half and povidone-iodine aqueous spray on the other.