COMET (Composite Outcomes of Mesh vs suture Techniques for prolapse repair)- Protocol for a single blind randomized controlled multicenter trial testing surgical innovation in female pelvic surgery.

Background: Pelvic organ prolapse (POP) increases in incidence and severity with aging. At least 1 in 4 women seek pelvic floor care and many more suffer with concurrent symptoms of bowel, bladder and sexual dysfunction, which can have a large impact on quality of life. It is estimated that 1 in 5 women will undergo surgery for POP.

Procedure-specific simulation for vaginal surgery training: A randomized controlled trial.

Introduction: Vaginal surgery has a superior outcome profile compared with other surgical routes, yet skills are declining because of low case volumes. Graduating residents' confidence and preparedness for vaginal surgery has plummeted in the past decade. The objective of the present study was to investigate whether procedure-specific simulation skills, vs usual training, result in improved operative competence.

Validity Evidence for Procedure-specific Competence Assessment Tools in General Surgery: A Scoping Review.

Objective: This study aims to provide a focused and detailed assessment of the validity evidence supporting procedure-specific operative assessment tools in general surgery.

Summary Of Background Data: Competency-based assessment tools should be supported by robust validity evidence to be used reliably for evaluation of operative skills. The contemporary framework of validity relies on five sources of evidence: content, response process, internal structure, relation to other variables, and consequences.

Calling for Openness to the Study of Cannabis Use in Chronic Pelvic Pain.

Chronic pelvic pain affects women across all demographics. Its management is complex and requires a multimodal approach. Cannabis has been legal for medical purposes for many years; however, its pharmacokinetics are just beginning to be understood, as are its analgesic effects and other benefits, such as improved sleep quality and reduced nausea and vomiting.

What Are the Clinical Factors That Are Predictive of Persistent Pessary Use at 12 Months?

Objective: Urinary incontinence and pelvic organ prolapse are highly prevalent in women and have a significant impact on quality of life. Pessaries are devices that are used as a conservative management option. Many women use pessaries, which avoid surgical intervention with its associated morbidity and cost.

Pregnancy-Associated Pelvic Floor Health Knowledge and Reduction of Symptoms: The PREPARED Randomized Controlled Trial.

Objectives: Pregnancy and childbirth can lead to pelvic floor disorders, yet this topic is not routine in antenatal education. We aimed to determine the impact of a pregnancy workshop on women's postpartum pelvic floor health knowledge, performance of pelvic floor muscle exercises (PFME), symptoms, condition-specific quality of life, mode of delivery, and satisfaction.

Methods: This was a RCT.

Rare Enterorectal Pelvic Floor Hernia-A Cadaveric Study.

We present a cadaveric case study of an 88-year-old woman with an unusual posterior perineal hernia containing small bowel, rectum, and mesentery. Dissection revealed several loops of the small bowel occupying the presacral space and displacement of the rectum into a large perineal evagination. The intestinal mucosa appeared to have been healthy at the time of death, and we did not find any indication of rectal prolapse.

Is Pelvic Floor Dysfunction an Independent Threat to Sexual Function? A Cross-Sectional Study in Women With Pelvic Floor Dysfunction.

Introduction: Prior studies have reported an association of sexual dysfunction with pelvic floor dysfunction (PFD), but without defining causation.

Aim: To investigate predictors of sexual function in women with PFD, including pelvic organ prolapse, stress urinary incontinence, overactive bladder, obstructed defecation, and fecal incontinence.

Methods: This retrospective cross-sectional study included 755 women (mean age = 56 years, 68% postmenopausal) referred for PFD (2008-2013).

Pelvic Floor Health Education: Can a Workshop Enhance Patient Counseling During Pregnancy?

Objectives: Pelvic floor disorders commonly affect women's quality of life. Their etiology is multifactorial, yet pregnancy and vaginal delivery (VD) are major inciting risk factors. Our objectives were to assess pelvic floor health information given by maternity providers to their pregnant patients, to create a pelvic floor health information workshop, and to determine its impact on women's preferences for mode of delivery.

Study of Prolapse-Induced Cervical Elongation.

Objective: The cervix often appears to be elongated in women with pelvic organ prolapse (POP). This can pose surgical challenges. MRI evidence has suggested that prolapsed cervices are significantly longer than those in normal controls.

Bilateral sacrospinous vault fixation with tailored synthetic mesh arms: clinical outcomes at one year.

Objectives: Bilateral sacrospinous fixation with tailored mesh arms (bSSVF) uses polypropylene mesh to suspend the vault to the sacrospinous ligaments bilaterally with minimal tension, recreating nulliparous midline anatomy. It can be used with uterine conservation. Our primary objective was to determine objective cure rate at one year following bSSVF compared with a control group undergoing abdominal sacrocolpopexy (ASC).

Timing cervicovesical fistula repair with repeat cesarean section.

We present a case in which there was optimal management of recurrent cervicovesical fistula. The patient sustained a fistula shortly after a cesarean for cephalopelvic disproportion in the second stage. She underwent an unsuccessful attempt at vaginal repair 3 months postpartum and continued experiencing intermittent urinary leakage through the vagina.

Cervical elongation following sacrospinous hysteropexy: a case series.

In recent years, pelvic floor surgeons have increasingly repaired pelvic organ prolapse around an intact uterus. Uterine conservation and hysteropexy have been driven by patient preference, less risk of mesh erosion, shorter operative time, and decreased blood loss and postoperative pain. We present a case series of patients with cervical elongation after vaginal sacrospinous hysteropexy using polypropylene mesh arms, a novel technique developed by the senior author.