Aversion to Mesh Use in Pelvic Floor Surgery in a Latina Population at the U.S.-Mexico Border.

Importance: Limited studies have examined patient aversion to mesh use in pelvic surgery, especially in Latinas.

Objective: This study aimed to assess aversion to pelvic surgery with mesh for urinary incontinence and pelvic organ prolapse in a sample of Latinas on the U.S.

Perceptions of Mesh Use for Pelvic Floor Surgery in Latinas: Face Validity of a Spanish Questionnaire.

Objective: The aim of the study was to validate a Spanish-translated survey assessing patients' perceptions of mesh use in pelvic floor surgery.

Methods: An English-language survey evaluating perceptions of mesh use underwent a process of Spanish translation and validation, using a forward-backward translation validation protocol. Self-identified bilingual Latinas with symptoms of pelvic floor disorders were recruited to participate in cognitive interviews after completing the survey in English and Spanish.

A Structured, Hybrid Cystoscopy Simulation Curriculum for Obstetrics/Gynecology Residents.

Objectives: This study aimed to assess the subjective and objective cystoscopy skills of gynecology residents before and after implementation of a comprehensive simulation curriculum.

Methods: Residents in an obstetrics/gynecology program at a single academic institution participated in a 6-week cystoscopy simulation course. Residents attended an initial orientation and didactic presentation, and then weekly 20- to 30-minute training sessions using a water balloon model and a virtual reality simulator.

Staged repair of concomitant rectovaginal fistula and pelvic organ prolapse after removal of a neglected pessary.

Rectovaginal fistulas are a rare complication of neglected pessaries and can pose challenges in managing pelvic organ prolapse. We describe a 66-year-old woman with uterine procidentia who presented with a neglected Gellhorn pessary in place for 5 years. She complained of constipation and persistent vaginal bulge.

Qualitative Analysis of Knowledge, Attitudes, and Beliefs About Pessary Use Among Spanish-Speaking Women on the US-Mexico Border.

Objectives: To explore the knowledge, attitudes, and beliefs related to pessary use in Spanish-speaking women along the US-Mexico border.

Methods: Spanish-speaking women with symptoms of vaginal bulge were recruited from the urogynecology/gynecology clinics at Texas Tech University Health Sciences Center El Paso to participate in moderated focus groups. Discussion topics included knowledge of prolapse/pessaries, pros/cons of pessaries, alternatives, and prolapse surgery.

Return to Baseline Functional Status in Older Women Undergoing Surgery for Pelvic Organ Prolapse.

Objective: The aim of the study was to determine the rate of return to baseline functional status 3 months after surgery for pelvic organ prolapse (POP) in women 65 years or older.

Methods: This is a multicenter prospective cohort study of women older than 65 years undergoing POP surgery. Functional status was determined by the Activities Assessment Scale at the preoperative visit and 3 months after surgery.

Posterior Vaginal Compartment Anatomy: Implications for Surgical Repair.

Objectives: To examine the gross and histologic anatomy of the proximal, mid, and distal posterior vaginal compartment and discuss implications for surgical repair.

Study Design: In this cadaver study, pelvic organs were resected en bloc, immersed in formalin solution, and transected in the mid sagittal plane. Measured distances included: posterior vaginal wall length, cervicovaginal junction or vaginal cuff to posterior peritoneal reflection, peritoneal reflection to proximal edge (apex) of perineal body, and perineal body apex to hymenal remnant (height).

Comparisons of Functional Apical Support After Sacral Hysteropexy Versus Sacral Colpopexy: A Cadaveric Study.

Objectives: Prolapse procedures with uterine preservation offer an alternative to colpopexy with hysterectomy. Few studies have examined the differences in anatomic or subjective outcomes following sacral hysteropexy versus sacral colpopexy with hysterectomy. This study sought to compare the ability of sacral hysteropexy and sacral colpopexy with hysterectomy to resist downward traction as an estimate of apical support in human cadavers.

Long-Term Outcomes After Overlapping Sphincteroplasty for Cloacal-Like Deformities.

Objective: The aim of this study was to report subjective, long-term outcomes and describe patient demographics, presenting symptoms, perioperative management, and complications after overlapping sphincteroplasty repair for chronic fourth-degree lacerations (cloacal-like deformities).

Methods: In this retrospective study, hospital records were reviewed for women who underwent overlapping anal sphincteroplasty for a cloacal-like deformity of the perineum at a single institution from 1996 to 2013. Details including patient demographics, presenting symptoms, perioperative management, and complications were abstracted from the medical record.

Sacrocolpopexy With Concomitant Total vs Supracervical Hysterectomy: Functional Support Comparisons in Cadavers.

Objective: This study aimed to compare the ability of abdominal sacrocolpopexy (ASC) with concomitant total vs supracervical hysterectomy to resist downward traction as a measure of functional anatomic support in human cadavers.

Methods: Supracervical hysterectomy was performed on unembalmed cadaver specimens, followed by ASC attaching polypropylene mesh to the posterior cervix/vagina only and then the anterior and posterior cervix/vagina. Using a metal bolt placed through the cervix tied to a filament passing through a fixed pulley system, successive weights of 0.

Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall.

Objective: Reconstructive surgery for pelvic organ prolapse is plagued with high failure rates possibly due to impaired healing or regeneration of the vaginal wall. Here, we tested the hypothesis that postoperative administration of local estrogen, direct injection of mesenchymal stem cells (MSCs), or both lead to improved wound healing of the injured vagina in a menopausal rat model.

Methods: Ovariectomized rats underwent surgical injury to the posterior vaginal wall and were randomized to treatment with placebo (n = 41), estrogen cream (n = 47), direct injection of MSCs (n = 39), or both (n = 43).

Proximity of uterosacral ligament suspension sutures and S3 sacral nerve to pelvic landmarks.

Introduction And Hypothesis: To describe the relationships between pelvic bony landmarks to points along the third sacral nerve and to uterosacral ligament suspension sutures.

Methods: Three transvaginal uterosacral ligament suspension sutures were placed bilaterally in unembalmed female human cadavers. The third sacral nerve was marked at the foramen (S3a) and at two additional points at 1-cm intervals along its course caudally (S3b, S3c).

Pelvic Organ Prolapse: New Concepts in Pelvic Floor Anatomy.

As the field of reconstructive pelvic surgery continues to evolve, with descriptions of new procedures to repair pelvic organ prolapse, it remains imperative to maintain a functional understanding of pelvic floor anatomy and support. The goal of this review was to provide a focused, conceptual approach to differentiating anatomic defects contributing to prolapse in the various compartments of the vagina. Rather than provide exhaustive descriptions of pelvic floor anatomy, basic pelvic floor anatomy is reviewed, new and historical concepts of pelvic floor support are discussed, and relevance to the surgical management of specific anatomic defects is addressed.

Safety of Manual Morcellation After Vaginal or Laparoscopic-assisted Vaginal Hysterectomy.

Unlabelled: STUDY

Objective: To determine the safety of manual vaginal morcellation by evaluating the rates of incidental uterine malignancy and manual vaginal morcellation after vaginal or laparoscopic-assisted vaginal hysterectomy.

Design: Retrospective analysis (Canadian Task Force classification II-2).

Setting: University of Texas Southwestern Medical Center, Dallas, TX.

Anatomic variations of pudendal nerve within pelvis and pudendal canal: clinical applications.

Objective: The objective of the study was to examine the anatomic variation of the pudendal nerve in the pelvis, on the dorsal surface of the sacrospinous ligament, and in the pudendal canal.

Study Design: Detailed dissections of the pudendal nerve were performed in unembalmed female cadavers. Pelvic measurements included the distance from the origin of the pudendal nerve to the tip of ischial spine and the nerve width at its origin.

Patient satisfaction following midurethral sling surgeries.

Purpose Of Review: Patient-reported outcomes and satisfaction are recognized as being equally important as traditional objective measures of success following midurethral sling (MUS) procedures. The objective of this article is to review the success after MUSs in the context of patient satisfaction.

Recent Findings: Patient satisfaction for both transobturator and retropubic MUSs at 2 years is high with rates up to 88%.

Anatomic relationships of psoas muscle: clinical applications to psoas hitch ureteral reimplantation.

Objective: The objective of the study was to examine the anatomic relationship of the genitofemoral and femoral nerves to the psoas major muscle.

Study Design: Dissections were performed in 17 unembalmed female cadavers. Point A was used as the approximate location for placement of psoas hitch sutures and as the reference point from which all measurements were taken.

Children's exposure to pesticides used in homes and farms.

Commercial and residential use of pesticides is common in El Paso, Texas, especially in agricultural areas. Recently, concerns have arisen about the type of pesticides used by residents because of the ease with which methyl parathion can be obtained from the neighboring border city of Juarez in Chihuahua, Mexico. Survey data were collected regarding residents' perceptions about pesticide safety and use of pesticides, and their preferred source of health information.