Outcomes of Pessary Use at 1 Year in Women Treated for Pelvic Organ Prolapse in a Large Multicenter Registry: Developed by the Pelvic Floor Disorders Registry.

Importance: There is a lack of high-quality long-term follow-up regarding pessary treatment. Most studies are case series or retrospective with a small sample size and short-term follow-up.

Objectives: This study aimed to evaluate differences in women who continue versus discontinue pessary use and the effectiveness, quality of life, and safety associated with pessary management at 1 year.

Generic Health-Related Quality of Life in Patients Seeking Care for Pelvic Organ Prolapse.

Objective: Using the American Urogynecologic Society multicenter Pelvic Floor Disorder Registry for Research, we (1) compared generic quality of life (QOL) in women planning pelvic organ prolapse (POP) treatment (surgery vs pessary), (2) correlated generic and condition-specific QOL scores, and (3) identified associations between generic QOL and other factors.

Methods: This cross-sectional analysis assessed generic physical and mental QOL using the Patient-Reported Outcomes Measurement Information System Global Health Scale at baseline. Global Physical and Mental T-scores center on a representative US population sample (mean [SD], 50 [10]; higher scores, better health).

Non-indicated use of prophylactic antibiotics in gynaecological surgery at an academic tertiary medical centre.

Surgical site infections (SSI) are the most common surgical complication. Perioperative antibiotics can reduce SSI when used properly. Despite guidelines from The American College of Obstetrics and Gynecology, non-indicated antibiotic use is widespread which exposes women to unnecessary risks.

Intravaginal Diazepam for the Treatment of Pelvic Floor Hypertonic Disorder: A Double-Blind, Randomized, Placebo-Controlled Trial.

Objectives: Pelvic floor hypertonic disorder is characterized by an involuntary spasm of the levator ani muscles and is associated with several clinical syndromes. Several treatment options have been described; however, treatment efficacy data are limited. The objective of this study was to determine the efficacy of intravaginal diazepam for the treatment of pelvic pain secondary to levator ani muscle spasm in comparison to placebo.

The Feasibility of Clean Intermittent Self-Catheterization Teaching in an Outpatient Setting.

Objectives: The aim of this study was to evaluate the feasibility of teaching clean intermittent self-catheterization (CISC) in an outpatient setting to women planning surgery for pelvic organ prolapse (POP) and/or urinary incontinence (UI).

Methods: This was a prospective observational study of 55 women who planned surgical correction of POP and/or UI. All women were taught CISC as part of their preoperative education.

Antibiotic prophylaxis for urinary tract infection after midurethral sling: a randomized controlled trial.

Objective: Because of the reported high percentage of bladder infections after placement of a midurethral sling (8.9%-34%), this study was undertaken to determine if a 3-day postoperative course of a urinary antibiotic would significantly lower the incidence of urinary tract infection (UTI) among treated women.

Methods: Women who were planning outpatient vaginal surgery for stress incontinence were enrolled, after informed consent, and randomized to receive placebo or nitrofurantoin (100 mg 2 times a day) for 3 days after surgery.

Uncomplicated urinary tract infections in women.

Uncomplicated urinary tract infections (UTIs) present a significant problem for women and a challenge for the doctors who care for them. The diagnosis of uncomplicated UTI, which usually is not challenging, can be achieved best by a thorough assessment of patient symptoms with or without the addition of a urine dipstick test. Treatment should be based on the most recent Infectious Disease Society of America guidelines, taking into account resistance patterns in the local community.

A randomized, controlled trial evaluating 2 techniques of postoperative bladder testing after transvaginal surgery.

Objective: The purpose of this pilot study was to compare the efficacy of 2 techniques for evaluating bladder function after transvaginal surgery.

Study Design: Subjects scheduled for transvaginal, outpatient surgery were consecutively enrolled and randomized to backfill-assisted voiding trial or a trial of spontaneous voiding after surgery.

Results: Sixty subjects were enrolled.

Surgical excision of eroded mesh after prior abdominal sacrocolpopexy.

Objective: We previously described an endoscopic-assisted transvaginal mesh excision technique. This study compares surgical outcomes after transvaginal mesh excision vs endoscopic-assisted transvaginal mesh excision. In addition, we reviewed our postoperative outcomes with excision via laparotomy.

A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse.

Objective: The objective of this study was to evaluate the impact of transvaginal prolapse surgery on overactive bladder symptoms in elderly women.

Study Design: Women (> or = 65 years old) with stage III or IV prolapse who enrolled in a prospective study that compared vaginal reconstructive surgery (n = 39) to obliterative surgery (n = 26) and who underwent preoperative urodynamics are the subjects of this study. The women completed the Pelvic Floor Distress Inventory at baseline and again 6 months and 12 months after surgery.

Predicting implantation with a neuromodulator using two different test stimulation techniques: A prospective randomized study in urge incontinent women.

Aims: The purpose of this study was to determine whether a percutaneous needle electrode (PNE) technique or a surgical first stage lead placement (FSLP) better predicted whether a patient would progress to implantation of a pulse generator (IPG) in older urge incontinent women.

Methods: Thirty subjects > or =55 years with refractory urge incontinence who had been selected to undergo a test stimulation procedure were randomized to either PNE or FSLP. Thirteen underwent PNE placement and seventeen underwent FSLP placement.

In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24-hr pad weight after the initial test stimulation best predicts long-term patient satisfaction.

Aims: To evaluate long-term patient satisfaction of sacral neuromodulation and to correlate satisfaction with incontinence parameters.

Methods: Patients at least 1-year remote from sacral neuromodulation were mailed a questionnaire to evaluate satisfaction and assess incontinence symptoms.

Results: Fifty-two patients were consecutively enrolled in the study.

The utility of magnetic resonance imaging for diagnosis and surgical planning before transvaginal periurethral diverticulectomy in women.

The objective of this paper is to report the value of magnetic resonance imaging (MRI) in the evaluation of urethral diverticulum in women. Medical records were identified by a query of urethral diverticulectomy billing data from January 1, 2000 through December 31, 2004. Patient demographics, preoperative evaluation data, and surgical outcomes were collected.

Distribution and immunohistochemical characterization of primary afferent neurons innervating the levator ani muscle of the female squirrel monkey.

Objective: This study was undertaken to examine the neurofilament and neurochemical composition of subpopulations of primary afferent neurons innervating the levator ani muscle by combining retrograde tracing and triple labeling immunofluorescence in the female squirrel monkey.

Study Design: Cholera toxin B subunit (CTB) was injected unilaterally into the levator ani muscle of 3 monkeys to identify primary sensory neurons in the dorsal root ganglia (DRG) and their central projections in the spinal cord. L7-S2 DRG were processed for dual or triple labeling immunofluorescence 3 days after injection to examine labeling of the 200 kD neurofilament marker RT97 (a marker of myelinated neurons), calcitonin gene-related peptide (CGRP; a marker of peptidergic neurons), isolectin B4 (IB4; a marker of small, unmyelinated neurons), and nerve growth factor receptor (TrkA) in CTB-positive neurons.

Racial differences in pelvic morphology among asymptomatic nulliparous women as seen on three-dimensional magnetic resonance images.

Objective: Compare pelvic morphology between asymptomatic African-American and white nulliparous women.

Study Design: Resting supine T2-weighted magnetic resonance (MR) images were obtained in 12 African-American (AA) and 10 white American (WA) women without pelvic floor dysfunction. Three-dimensional models were reconstructed from the MR images by a masked investigator, and predefined bony and soft tissue pelvic floor parameters were measured and compared.

Differential transmission of parvovirus B19 in a twin gestation: a case report.

Maternal infection with parvovirus B19 during pregnancy can cause aplastic anemia in the fetus. Severe anemia may lead to nonimmune hydrops or fetal demise. In the case reported, the demise of one twin was diagnosed by ultrasonography in an asymptomatic 21-year-old para 1-0-2-1 African American at the gestational age of 25 weeks.