Robotic-Assisted Laparoscopic Removal of Mid-Urethral Mesh Slings Eroded into the Bladder.

Introduction And Objectives: Depending on the indication, there are multiple surgical approaches for the removal of mid-urethral mesh slings (MUS): transvaginal, endoscopic, open abdominal, and robotic. We demonstrate the robotic approach to treat MUS that have eroded into the bladder. The robotic approach offers excellent exposure, visualization, and accessibility.

Levels and drivers of burnout during the COVID-19 pandemic among a diverse group of resident physicians.

Objectives: Evidence has shown significant impacts of the COVID-19 pandemic on physicians. We hypothesized that these effects would impact surgical and non-surgical resident education differently, with non-surgical specialties being more heavily impacted by frontline work and surgical specialties losing elective cases.

Methods: We examined well-being and burnout among resident physicians in surgical and non-surgical specialties during the peak of the COVID-19 pandemic using the Mayo Physician Well-Being Index (WBI).

Spouses Speak Up: The Impact of Mesh Sling Complications on the Patient's Spouse-A Qualitative Analysis Study.

Objective: To examine the perspectives, attitudes, and beliefs of the spouses of women with complications of mesh midurethral sling (MUS) surgery with the goal of increasing our understanding of the multidimensional nature of MUS surgery complications.

Methods: After IRB approval, the spouses of patients who underwent surgery for MUS complications at a single tertiary care institution participated in qualitative interviews. Using an interview guide with standardized prompts, semistructured interviews were conducted.

Female pelvic medicine and reconstructive surgery fellows' case logs remained stable during the COVID-19 pandemic.

Introduction: During the COVID-19 pandemic and subsequent staffing shortages there was concern about the case volume, and thus competency, of graduating trainees due to reduced surgical volumes. Elective procedures were particularly affected, which includes Female Pelvic Medicine and Reconstructive Surgery (FPMRS) cases. To understand whether FPMRS fellows were affected, we assessed their case logs for changes during the pandemic.

"Vagina" Is Not a Bad Word: Historical and Contemporary Censorship of the Word "Vagina".

Objective: To characterize instances of censorship of the word "vagina" to better understand perceptions and behaviors surrounding the word.

Methods: Internet and relevant database (PubMed, Academic OneFile, Proquest, Health Business Elite, etc) searches were conducted for the words "vagina," "censor," and related wildcard terms. Search results were filtered by three independent reviewers for relevance.

Outcomes of prostatic urethral lift in a medically complex population at a veterans affairs hospital.

Objective: The objective of this study is to report "real-world" outcomes of prostatic urethral lift (PUL) in a medically complex US military veteran population while employing liberalized procedural indications.

Methods: A retrospective review was conducted of patients who underwent PUL at our institution. There were no prostatic size requirements, patients were accepted on anti-platelet/anticoagulant therapy, no benign prostatic hyperplasia (BPH) medication washout was required, and there was no maximum post-void residual PVR.

Innovative Approaches to Battling Resident Burnout in a Urology Residency Program.

Introduction: Data suggest many U.S. physicians experience burnout, affecting up to 65% of U.

Para-aortic haemangioma mimics paraganglioma on MRI.

Here, we report a case of a 70-year-old man referred for an incidentally discovered left renal lesion with peri-aortic lymphadenopathy following a CT scan for back pain. A follow-up MRI scan demonstrated a Bosniak IIF left renal cyst and a T2-hyperintense para-aortic lesion concerning for extra-adrenal paraganglioma (EAP). [I] Metaiodobenzylguanidine scintigraphy of the para-aortic lesion and urine catecholamines were equivocal.

A 26-Year-old Woman With Dysuria and Hematuria.

In this case, we present imaging findings characteristic of chronic genitourinary schistosomiasis. Schistosoma haematobium, a blood fluke endemic to Africa and the Middle East, is a prominent cause of hematuria and bladder cancer in regions lacking adequate water sanitation. Luminal calcifications of the genitourinary tract, that is, of the bladder and/or ureters, from deposition of fluke eggs are a classic sign of chronic S.

Education Time Out and Debrief: Structured Implementation of Perioperative Resident Technical Education Discussion.

Background: We designed a model for pre- and postoperative discussions between faculty and trainees to maximize educational yield of cases and accelerate residents' technical development. We sought to study its effect on surgical education via participant perceptions and longitudinal validated performance evaluations.

Study Design: Our model included preoperative collaborative technical goal-setting, specific to the resident, or "Time Out," and immediate postoperative granular feedback guided by validated evaluation tools, or "Debrief.

Outcomes of Prophylactic Mid-Urethral Sling at the Time of Robotic Sacrocolpopexy.

Objective: To compare outcomes of patients who underwent robotic sacrocolpopexy (RSC) with and without concomitant mid-urethral sling (MUS) placement for prophylaxis or treatment of preoperative stress urinary incontinence (SUI) METHODS: We performed a retrospective review of all patients without prior incontinence procedures who underwent RSC with or without MUS placement by 3 surgeons (JA, LA, KE) at a single institution from 2012 to 2017 for treatment of pelvic organ prolapse. Patients had a MUS placed for either documented SUI or prophylaxis of SUI. We compared patient characteristics, operative details, postoperative outcomes, and complications between the groups.

The Prevalence and Treatment of Erectile Dysfunction in Male Solid Organ Transplant Recipients.

Introduction: Erectile dysfunction (ED) is a prevalent and under-recognized complaint among male solid organ transplant recipients. Most research on this topic has focused on kidney transplant recipients alone. In this review, we integrate current research on ED across all types of solid organ transplant recipients and assess the success of current methods of ED treatment in transplant populations.

Is pain relief after vaginal mesh and/or sling removal durable long term?

Introduction And Hypothesis: This study was to review our experience of pain relief durability in women who experienced initial pain resolution after vaginal mesh and/or sling removal (VMSR).

Methods: A retrospective chart review of consecutive, nonneurogenic women who underwent VMSR for pain and reported persistent pain relief at the 6-month postoperative follow-up visit were assessed. Pre- and postoperative data collected were self-reported chief complaints, physical examination, other medical conditions associated with chronic pain, use of pain medications, Urogenital Distress Inventory-6 (in which question 6 specifically addresses pain), and the Numerical Pain Rating Scale (NPRS).

Long-term management of luminal urethral stricture in women.

Introduction And Hypothesis: The objective was to report our long-term experience of luminal urethral stricture (LUS) in women treated with dilation under general anesthesia.

Methods: Following institutional review board approval, charts of women who underwent urethral dilation (UD) under general anesthesia for LUS and had over 6 months' follow-up were reviewed. LUS was confirmed by urethroscopy.

Long-term outcomes after the excision of horseshoe urethral diverticulum.

Introduction And Hypothesis: The objective was to report our long-term experience with horseshoe urethral diverticulum (HUD) excised using the urethral preservation technique.

Methods: Following IRB approval, charts of women who underwent HUD excision and had at least 6 months' follow-up were reviewed. HUD was defined as a bilateral posterior diverticulum that extended laterally and anteriorly past 3 and 9 o'clock on the left and right sides respectively.

While You Were Sleepwalking: Science and Neurobiology of Sleep Disorders & the Enigma of Legal Responsibility of Violence During Parasomnia.

In terms of medical science and legal responsibility, the sleep disorder category of parasomnias, chiefly REM sleep behavior disorder and somnambulism, pose an enigmatic dilemma. During an episode of parasomnia, individuals are neither awake nor aware, but their actions appear conscious. As these actions move beyond the innocuous, such as eating and blurting out embarrassing information, and enter the realm of rape and homicide, their degree of importance and relevance increases exponentially.