Defining Cervical Elongation: A Prospective Observational Study.

Objectives: Our primary aim was to define cervical elongation (CE) using the following methods: (1) measurement of pathology specimen, (2) physician perception, (3) intraoperative estimate of anterior cervical length, and (4) office Pelvic Organ Prolapse Quantification (POP-Q) points C and D. Our secondary aim was to determine whether these definitions correlate with perioperative outcomes.

Methods: Women undergoing vaginal hysterectomy and prolapse repair were enrolled.

Transvaginal Versus Transabdominal Placement of Synthetic Mesh at Time of Sacrocolpopexy.

Objectives: Our primary aim was to compare mesh-related complications at the time of total vaginal hysterectomy with laparoscopic sacrocolpopexy (TVH-LSC) versus laparoscopic placement of sacrocolpopexy mesh at time of laparoscopic supracervical hysterectomy (LSH-LSC). Our secondary aim was to compare operative time, intraoperative and postoperative complications, as well as subjective and objective success between these groups.

Methods: We performed a retrospective cohort study with prospective follow-up for patients with uterovaginal prolapse who underwent TVH-LSC or LSH-LSC from June 2008 to July 2012.

Outcomes of abdominal and minimally invasive sacrocolpopexy: a retrospective cohort study.

Objective: To compare perioperative and postoperative surgical outcomes between and among open and minimally invasive sacrocolpopexies (MISCs).

Methods: We performed a multicenter retrospective cohort study comparing abdominal sacrocolpopexy (ASC) and MISC from January 1999 to December 2010.

Results: A total of 1124 subjects underwent sacrocolpopexy, with 589 ASCs and 535 MISCs.

Three-year outcomes of vaginal mesh for prolapse: a randomized controlled trial.

Objective: To present the 3-year outcomes of a double-blind, multicenter, randomized trial comparing vaginal prolapse repair with and without mesh.

Methods: This was a planned final analysis of women with Pelvic Organ Prolapse Quantification (POP-Q) stage 2-4 prolapse randomized to traditional vaginal prolapse surgery without mesh and vaginal colpopexy repair with mesh. We evaluated anatomic, symptomatic, and combined cure rates for those with at least 3-year validated quality-of-life questionnaires and 2- or 3-year postoperative blinded POP-Q examination.

Surgical repair of rectovaginal fistulas in patients with Crohn's disease.

Objectives: To report surgical outcomes of patients who underwent rectovaginal fistula (RVF) repair with a history of Crohn's disease utilizing several reconstructive techniques.

Study Design: Retrospective case series of women (n=6) with Crohn's disease surgically treated with either vaginal or rectal advancement flaps. Demographic information and data specific to Crohn's disease at the time of surgery were collected.

Incidence of unanticipated uterine pathology at the time of minimally invasive abdominal sacrocolpopexy.

Study Objective: To determine the incidence of unanticipated uterine pathologic findings in women undergoing hysterectomy concomitant with minimally invasive sacrocolpopexy.

Design: Retrospective case series (Canadian Task Force classification III).

Setting: Four institutions in the United States.

Medicolegal issues surrounding devices and mesh for surgical treatment of prolapse and incontinence.

Legal issues related to vaginal mesh devices for prolapse and incontinence include abnormal injury and inadequate informed consent. Although vaginal mesh devices are currently cleared through the 510(k) process, new developments at the US Food and Drug Administration requiring additional postmarket studies (522 studies) for transvaginal mesh for prolapse and mini-suburethral synthetic slings have been issued to ensure product safety and effectiveness. New initiatives including unique device identification numbers and the Pelvic Floor Disorders Registry have been developed to improve surveillance throughout the total product/device life cycle.

Unusual findings on cystoscopy in a patient with detrusor overactivity.

Background: Chronic lithium ingestion has been shown to cause polyuria and polydipsia in 20% to 40% of patients, secondary to diabetes insipidus. However, it has not been reported to cause lithium deposition in the bladder.

Case: A 77-year-old woman presented to our clinic with complaints of urinary incontinence, urinary urgency, and nocturnal enuresis for the past 3 to 4 years.

Current cystoscopy practice of recent graduates of obstetrics and gynecology residency: a survey study.

Objective: To provide data regarding the training, credentialing and use of cystoscopy among recent obstetrics and gynecology (Ob/Gyn) residents.

Study Design: A total of 98 surveys were sent to recent graduates of Ob/Gyn residency programs in the District of Columbia (DC). Questions concerning cystoscopy in residency training, current cystoscopy privileges and utilization of this technique were asked.

Risk of mesh erosion after abdominal sacral colpoperineopexy with concomitant hysterectomy.

Objective: The purpose of this study was to evaluate the effect of concomitant hysterectomy at the time of abdominal sacral colpoperineopexy on the risk of mesh erosion with the use of type 1 polypropylene mesh.

Study Design: This was a retrospective case control study. All cases of vaginal mesh erosion (n = 31) were compared with matched control cases (n = 93) in a 3:1 ratio.

Tobacco use is a risk factor for mesh erosion after abdominal sacral colpoperineopexy.

Objective: The purpose of this study was to evaluate the association between smoking and vaginal mesh erosion after abdominal sacral colpoperineopexy with the use of type 1 polypropylene mesh.

Study Design: All cases of mesh erosion (n = 27) that were diagnosed between October 2003 and June 2006 were identified and compared with matched control cases (n = 81). Control cases were matched for age, diabetes mellitus status, hypoestrogenic state (menopausal status, chronic steroid use, use of hormone therapy), abdominal-vaginal rectocele repair, culdoplasty, and concomitant hysterectomy.