Redefining the Spectrum of Pentosan Polysulfate Retinopathy: Multimodal Imaging Findings from a Cross-Sectional Screening Study.

Purpose: There is growing evidence of a direct association between pentosan polysulfate (PPS) therapy and the development of macular changes. Using standardized visual acuity (VA) testing and multimodal imaging, we investigated the impact of PPS therapy on vision and described an expanded spectrum of imaging findings among PPS users.

Design: Cross-sectional screening study.

Urethral Masses.

Urethral and periurethral masses in women include both benign and malignant entities that can be difficult to clinically differentiate. Primary urethral carcinoma is rare and the optimal treatment modality may vary depending on the stage at presentation. Because cancer-free survival is poor, clinicians shouldhave a high index of suspicion when evaluating a urethral mass.

Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy.

Introduction And Hypothesis: To determine whether consultation with pelvic floor physical therapy (PFPT) at the time of initial urogynecologic evaluation increases adherence to PFPT and to identify factors associated with PFPT attendance and completion.

Methods: We performed a retrospective chart review of all patients evaluated for new urogynecology consultation at our institution in a 1-year period, abstracting data about demographics, diagnoses, and PFPT referral, attendance, and completion. Descriptive analyses compared patients who were referred to, attended, and completed PFPT, stratified by whether they saw PFPT the same day as their initial urogynecologic consultation.

Consumption of sweetened, dried cranberries may reduce urinary tract infection incidence in susceptible women--a modified observational study.

Background: Urinary tract infections (UTIs) are one of the most common bacterial infections, and over 50% of women will have a UTI during their lifetimes. Antibiotics are used for prophylaxis of recurrent UTIs but can lead to emergence of drug-resistant bacteria. Therefore, it is reasonable to investigate nutritional strategies for prevention of UTIs.

The iatrogenic ureterovaginal fistula.

A 46-year-old woman underwent a robotic-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy for the treatment of endometriosis. Two weeks postoperatively, she presented with pelvic pain and vaginal drainage. A right ureterovaginal fistula was diagnosed with the assistance of computed tomography (CT) urography and nephrostogram.

Retropubic versus transobturator midurethral synthetic slings: does one sling fit all?

The purpose of this article is to evaluate the recent evidence base for the choice between transobturator and retropubic approaches to midurethral slings used to treat stress urinary incontinence. While the retropubic and transobturator approaches to midurethral sling surgery for stress urinary incontinence demonstrate equivalent efficacy across a number of randomized controlled trials, they do not appear to be equivalent when particular patient populations are considered separately. The retropubic approach appears to be a better option in patients with intrinsic sphincter deficiency and limited urethral mobility.

Contemporary length of stay and resource utilization when using a fast-track regimen for mid-urethral sling surgery.

Objectives: To evaluate the length of stay and need for postoperative laboratory monitoring in a fast-track regimen, as despite the excellent safety profile of the tensionless synthetic midurethral sling, many advocate routine in-house postoperative monitoring of both vital signs and laboratory values.

Methods: A retrospective chart review was performed of all patients presenting for isolated, midurethral sling surgery by a single surgeon from February 2005 to July 2007. Patients followed a perioperative care pathway.

Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits.

Objective: The purpose of this study was to determine the complications, treatments, and outcomes in patients choosing to undergo removal of mesh previously placed with a mesh procedural kit.

Study Design: This was a retrospective review of all patients who underwent surgical removal of transvaginal mesh for mesh-related complications during a 3-year period at Cleveland Clinic. At last follow-up, patients reported degree of pain, level of improvement, sexual activity, and continued symptoms.

Sacral neuromodulation in the older woman.

In the last 10 years, sacral neuromodulation has evolved from an experimental therapy to a safe and proven treatment option for patients with a variety of complex lower urinary tract disorders. It is currently Food and Drug Administration approved for the following indications: intractable urge incontinence, urgency-frequency, and nonobstructive urinary retention. Herein, we will discuss some of the factors complicating incontinence treatment in the elderly population paying particular attention to sacral neuromodulation, its history, indications, and applications within the elderly female population.

Bilateral extravesical ureteral reimplantation in toilet trained children: Is 1-day hospitalization without urinary retention possible?

Purpose: Bilateral extravesical ureteral reimplantation has been associated with urinary retention. We developed a critical pathway and modification of surgical technique to determine whether the bilateral extravesical procedure could be performed in toilet trained children with patients discharged home after a 1-day hospitalization and without urinary retention.

Materials And Methods: A total of 50 consecutive toilet trained children were evaluated after undergoing bilateral extravesical ureteral reimplantation using a modified technique that limits ureteral dissection, ureteral mobilization and detrusor dissection to as distally as possible so that a 5:1 ratio of tunnel length to ureteral diameter can be accomplished.