Recurrent Incontinence After Transvaginal Partial Sling Excision in Patients with Prior Mid-Urethral Sling.

Introduction: Patients may develop recurrent urinary tract infections, pain syndromes, dyspareunia, and voiding difficulty after mid-urethral sling placement that can be treated by partial sling excision.

Objective: The primary objective of this study was to evaluate the incidence of de novo incontinence and voiding difficulty after partial sling excision. A secondary objective was to assess risk factors associated with future incontinence surgery in this subset of patients.

Perioperative management of pregnant women undergoing nonobstetric surgery.

Nonobstetric surgery during pregnancy should be avoided if possible, but when surgery is required, an obstetrician should be part of the perioperative team. In general, preoperative assessment is similar regardless of whether a woman is pregnant, but cardiovascular, pulmonary, hematologic, and renal changes of pregnancy can increase surgical risk and must be taken into account. Special management considerations include pregnancy-associated laboratory changes, timing of surgery, anesthesia choice, intubation precautions, patient positioning, preoperative blood typing, intraoperative fetal monitoring, and venous thromboembolism prophylaxis.

Urethral Diverticulum following Polypropylene Mesh Midurethral Slings: A Literature Review.

Aims: It is currently unknown whether an association exists between polypropylene mesh and urethral diverticulum formation following placement of polypropylene midurethral slings (MUS) for the treatment of stress urinary incontinence (SUI). We aimed to examine the literature associating MUS with the occurrence of urethral diverticula.

Methods: Multiple online research databases, including PubMed, Google Scholar, EBSCOhost, and the Cochrane Library, were searched, from January 2019 to February 2019, for evidence related to the occurrence of urethral diverticula following polypropylene MUS procedures.

Safety and Efficacy of a Disposable Vaginal Device for Stress Urinary Incontinence.

Objective: The aim of this study was to evaluate the efficacy and safety of an over-the-counter device for the treatment of stress urinary incontinence (SUI) in females.

Methods: A multicenter, interventional, single-arm study involving 5 different sites was conducted including women diagnosed with symptomatic SUI using a self-inserted pessary device. A 1-week baseline period was followed by a 2-week period of wearing the device.

Recurrent Anterior Vaginal Wall Hernia after a Radical Cystectomy.

True pelvic floor areas are uncommon conditions, but they can occur after extensive pelvic surgery including radical cystectomies or pelvic exenteration. We present the case of a patient with a persistent hernia that failed a native tissue repair and required a prosthetic mesh implant as definitive surgical treatment.

The Effect of Toileting Position in Uroflow Curves in Young Healthy Nulliparous Women.

The objective of our study was to determine the effect of voiding positions on uroflow parameters in young, healthy nulliparous women with no pelvic floor disorders. . From December 2017 to February 2018, we performed a single-institution cross-sectional study with 30 healthy volunteers comparing uroflow curves in sitting and hovering positions.

Accuracy of Bladder Scanner for the Assessment of Postvoid Residual Volumes in Women With Pelvic Organ Prolapse.

Objectives: The aim of the study was to evaluate the accuracy of the bladder scanner in assessing postvoid residual (PVR) volumes in patients with pelvic organ prolapse (POP).

Methods: We performed a prospective parallel cohort study evaluating the accuracy of the BVI 3000 bladder scanner in patients with POP. Patients with POP to the hymen were offered inclusion.

The Effect of Oral Phenazopyridine on Perioperative Voiding After Midurethral Slings (EPIPhANy Study).

Objective: To determine the effect of preoperative oral phenazopyridine on postoperative voiding dysfunction in women undergoing a retropubic midurethral sling.

Methods: A single-institution randomized clinical trial was performed from September 2015 to March 2017, comparing 200 mg of oral phenazopyridine versus no phenazopyridine in patients undergoing a retropubic midurethral sling under general anesthesia with no concomitant procedures. A power calculation indicated that we required at least 40 subjects per arm.

The Effect of Preoperative Phenazopyridine on Urinary Retention Following Midurethral Sling.

Objective: The aim of this study was to determine the effect of preoperative oral phenazopyridine on short-term voiding dysfunction in patients undergoing a retropubic midurethral sling.

Methods: We conducted a retrospective cohort study in subjects undergoing a retropubic midurethral sling comparing those who received preoperative oral phenazopyridine with those who did not. We included all women who underwent a retropubic midurethral sling without concomitant procedures under general anesthesia at our institution.

Voiding Function After Midurethral Slings With and Without Local Anesthetic: Randomized Controlled Trial.

Objectives: This study aimed to compare the effect of periurethral infiltration of bupivacaine versus normal saline on postoperative voiding function and pain in patients undergoing retropubic midurethral sling METHODS: A randomized double-blind placebo-controlled study was performed at the University of Massachusetts from March 2012 to June 2015. Ninety patients were randomized to receive 0.5% bupivacaine with epinephrine or normal saline with epinephrine solution for periurethral hydrodissection.

Pharmacological Agents to Decrease New Episodes of Recurrent Lower Urinary Tract Infections in Postmenopausal Women. A Systematic Review.

Objectives: The purpose of this systematic review was to evaluate and summarize pharmacological interventions evaluated in randomized clinical trials designed to prevent recurrent episodes of urinary tract infections (UTIs) in postmenopausal women.

Methods: Excerpta Medica dataBASE, Pubmed, Medline, and Cochrane Library were accessed to search for nonexperimental drugs evaluated in randomized clinical trials published in peer reviewed journals from January 1, 1970, to August 1, 2015, to reduce the number of recurrent UTIs in postmenopausal women.

Results: A systematic search yielded 9 articles that met eligibility criteria.

Patient-focused websites related to stress urinary incontinence and pelvic organ prolapse: a DISCERN quality analysis.

Introduction And Hypothesis: The quality of information related to pelvic floor disorders is varied and understudied. Using a validated instrument we evaluated the quality of selected websites addressing treatment options for pelvic organ prolapse (POP) and stress urinary incontinence (SUI).

Methods: English-language, patient-focused professional, governmental, and consumer websites related to POP and SUI were identified using the International Urogynecology Association (IUGA) list of continence societies worldwide, search terms, and provider nomination.

A randomized, clinical trial of ketorolac tromethamine vs ketorolac trometamine plus complex B vitamins for cesarean delivery analgesia.

Background: Ketorolac is widely used for postoperative analgesia in patients who undergo cesarean delivery. In countries where the use of opioids is considerably restricted, alternatives to narcotics are required.

Aim: We hypothesize that the addition of complex B synergize the analgesic effect of ketorolac in postoperative cesarean patients, thus requiring a smaller dose of the anti-inflammatory agent, and therefore decreasing the potential side effects of ketorolac.

[Disputes and history of fetal heart monitoring].

The concept of fetal heart monitoring to determine the fetal wellbeing state has been employed for almost 300 years, but in the last 50 years it has observed drastic changes due to the incorporation of the electronic devices that has started controversy since the moment of its description and point of start. The purpose of this article is to mention the key points and controversial moments in the history of the cardiotocography

Bilateral ovarian krukenberg tumor in a full-term pregnancy.

Objective. Krukenberg tumors in pregnancy are very rare and their management can present a dilemma for the obstetrician gynecologist. Case Report.

Utility of the pulsatility index of the uterine arteries and human chorionic gonadotropin in a series of cases of placenta accreta.

The conservative management of retained placenta accreta has been proposed as an alternative option in selected cases. Three patients under conservative management of placenta accreta were followed using the pulsatility index of the uterine arteries and the β fraction of human chorionic gonadotropin to determine the degree of vascularity between the uterus and the placenta. In this series of cases of conservative management of placenta accreta, the pulsatility index of the uterine arteries showed a better correlation with the uteroplacental circulation than serum β fraction of human chorionic gonadotropin.

[Telemedicine and robotic surgery in gynecology].

This paper reviews most relevant issues in robotic surgery and its applications in gynecology. Surgery is one of medicine's branches that have achieved most progress in last years. Robotic surgery is a new technology with several applications in teaching, medical service, minimal invasion surgery, and microsurgery fields.

Bladder rupture caused by postpartum urinary retention.

Background: Postpartum bladder rupture is an uncommon surgical emergency and a diagnostic challenge.

Case: A primigravida delivered a healthy newborn without complications at 39.4 weeks of gestation.

Topical hemostatic agents in gynecologic surgery.

Biosurgical compounds and pharmacologic agents can serve as surgical adjuncts to prevent or curtail intraoperative bleeding. Medline, PubMed, and Cochrane electronic data bases were used to search the English literature from 1966 to March 2007 using the terms topical, hemostatic agents, and gynecologic surgery. Several effective topical hemostatic agents are available to reduce intraoperative blood loss.

Giant intravesical calculus during pregnancy.

Urolithiasis is commonly found during pregnancy; but the presence of a giant vesical calculus during pregnancy is a very rare entity, associated with several potential obstetric complications. A 25-year-old primigravida at 25 weeks of gestational age was referred to our tertiary care unit because she presented a giant hyperechoic intravesical mass and inability to pass urine with suprapubic pain since 2 days. An open cystolithotomy revealed a huge intravesical calculus.