Comparing Ketorolac With Ibuprofen for Postoperative Pain: A Randomized Clinical Trial.

Objectives: The objective of this study was to identify differences in pain perception and satisfaction with pain control in women receiving nonsteroidal anti-inflammatory drugs postoperatively.

Methods: This was a prospective, randomized controlled trial including urogynecology surgical patients. After surgery, all patients were randomized to receive either intravenous (IV) ketorolac or ibuprofen.

Characteristics of Providers Performing Urogynecologic Procedures on Medicare Patients 2012-2014.

Objective: To analyze the characteristics of providers performing stress urinary incontinence (SUI) and pelvic organ prolapse (POP) procedures in the United States.

Methods: The Centers for Medicare Services public database, released for years 2012 through 2014, was queried for SUI-related and POP-related Healthcare Common Procedure Coding System. Providers were categorized as Female Pelvic Medicine and Reconstructive Surgery (FPMRS) providers and non-FPMRS providers, using a list of FPMRS board-certified providers compiled through the American Board of Medical Subspecialties website.

Increasing Age Is a Risk Factor for Decreased Postpartum Pelvic Floor Strength.

Objectives: This study aimed to determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery (VD) in a cohort of low-risk women.

Methods: This is a secondary analysis of a prospective study examining the risk of pelvic floor injury in a cohort of primiparous women. All recruited participants underwent an examination, three-dimensional ultrasound and measurement of PFS in the third trimester and repeated at 4 weeks to 6 months postpartum using a perineometer.

Barriers to Global Health Training in Obstetrics and Gynecology.

Background: The Lancet Commission on Global Surgery includes obstetrics and gynecology as an area needing international strengthening in low- and middle-income countries. Despite interest, a majority of participants in US residency programs graduate with little exposure to global health or preparation to work abroad.

Objective: The aim of this study was to determine the level of interest of obstetrics and gynecology (Ob/Gyn) residents in gaining global health training and to identify perceived barriers to receiving training.

The significant morbidity of removing pelvic mesh from multiple vaginal compartments.

Objective: To investigate perioperative complications of mesh removal performed in the operating room from a single-site, tertiary care center with a large volume of referrals for mesh removal and to compare the morbidity associated with single-compartment mesh removal compared with removal from multiple vaginal compartments.

Methods: A retrospective review was performed on all patients who underwent mesh removal from January 2008 to April 2014. Patients were identified based on Current Procedural Terminology codes for removal of vaginal mesh or sling.

Teaching robotic surgery skills: comparing the methods of generalists and subspecialists.

Background: To compare opinions of general and subspecialty obstetricians and gynecologists regarding teaching robotic surgery (RS) to residents.

Methods: After obtaining IRB approval, 2189 gynecologic surgeons trained on the DaVinci Surgical System® (Intuitive Surgical, Sunnydale, CA) were asked to complete an online survey. Anonymous responses were obtained and compared using the chi-squared test, including opinions on training residents in RS.

Avoiding major vessel injury during laparoscopic instrument insertion.

Major vessel injuries during laparoscopy most commonly occur during insertion of Veress needle and port trocars through the abdominal wall. This article reviews methods for avoiding major vessel injury while gaining laparoscopic access, including anatomic relationships of abdominal wall landmarks to the major retroperitoneal vessels. Methods for periumbilical placement of the Veress needle and primary trocar are reviewed in terms of direction and angle of insertion, and alternative methods and locations are discussed.