Moonless night sky increases Isistius species (cookiecutter shark) and live human contact.

The nocturnal feeding behavior and zoogeographical habitat of cookiecutter sharks Isistius brasiliensis and Isistius plutodus (Isistius spp.) greatly reduces interaction of this species with live humans. Attacks on live humans are exceedingly rare with 7 cases reported worldwide, 6 of them in Hawai'i, and 5 of these occuring among channel swimmers.

Vaginal trachelectomy following laparoscopic supracervical hysterectomy and sacrocervicopexy.

Background: Current evidence supports cervical preservation at the time of abdominal prolapse repair using synthetic mesh to minimize vaginal mesh extrusion. This report aims to describe management of benign cervical disease following laparoscopic sacrocervicopexy including successful trachelectomy performed vaginally.

Case: A 70-year-old sexually active woman presented with symptomatic pelvic organ prolapse and stress urinary incontinence.

Rectal mesh erosion after robotic sacrocolpopexy.

We report an unusual case of rectal mesh erosion presenting 16 months after robotic sacrocolpopexy. The patient initially underwent a robotic sacrocolpopexy, lysis of adhesions, midurethral sling, and posterior colporrhaphy for symptomatic grade 2 pelvic organ prolapse and urodynamic stress incontinence. Her postoperative recovery was uneventful.

Urethral mesh erosion after single-incision mid-urethral sling.

Background: This report aims to describe urethral mesh erosion after a single-incision synthetic midurethral sling placement and to discuss possible causes for this complication.

Case: A 41-year-old woman presented with recurrent stress urinary incontinence after an anchored single-incision midurethral sling placement. Cystourethroscopy and translabial pelvic ultrasonography demonstrated the size and location of the injury.

Perineal body length among different racial groups in the first stage of labor.

Objective: Anatomic differences among racial groups may contribute to observed differences in the occurrence of severe perineal lacerations at the time of vaginal delivery. The purpose of this study was to identify differences in perineal body length between racial groups.

Methods: Perineal body length was measured in primigravid women aged 18 to 45 years who were admitted in labor.

Assessment of internet-based information regarding pelvic organ prolapse and urinary incontinence.

Objective: This study aimed to establish descriptive data on the content, accuracy, and relevance of Internet-based information regarding pelvic organ prolapse and urinary incontinence.

Methods: Using the search terms, urinary incontinence, uterine prolapse, dropped uterus, cystocele, and dropped bladder, the first 20 Web sites that appeared in each of 3 highly used search engines were identified. Two experienced reviewers independently evaluated each site for specific content, relevance, and accuracy.

Pelvic organ prolapse quantification use in the literature.

Objective: This study aimed to determine whether the Pelvic Organ Prolapse Quantification (POPQ) system should be simplified based on its use in the peer-reviewed literature.

Methods: The American Journal of Obstetrics and Gynecology, Obstetrics and Gynecology, and International Urogynecology Journal were used for this study. All articles relating to pelvic organ prolapse published in these journals from January 2005 to December 2010 were reviewed for their use of the POPQ system.

Vaginal repair of neobladder-vaginal fistula: a case report and review of the literature.

Neobladder substitution after radical cystectomy for invasive cancer has become commonplace as it preserves normal volitional voiding through the native urethra and avoids urinary diversion. Neobladder-vaginal fistula (NVF) is a rare postoperative complication of this procedure that results in decreased quality of life. We describe a case of vaginal repair of a NVF and present a review of the literature.

Defining an at-risk population for obstetric anal sphincter laceration.

Objective: The purpose of this study was to calculate the number of cesarean deliveries needed to prevent 1 case of obstetric anal sphincter laceration associated with operative vaginal delivery in an at-risk cohort.

Study Design: An institutional, computerized database was used to analyze women with obstructed labor who could have been managed by either operative vaginal or cesarean delivery from September 2006 to March 2008. Women with 1 or more of the following diagnoses comprised the cohort: cephalopelvic disproportion (CPD), arrest of descent, maternal exhaustion, and fetal distress.

Actinomyces infection associated with the transobturator sling.

We present a case of Actinomyces infection associated with the transobturator sling. The patient had a transobturator sling complicated only by a left vaginal sulcal perforation. She subsequently developed mesh erosion that led to two partial mesh resections performed in the operating room at 6 weeks and again at 6 months after the initial surgery.

Effectiveness of transobturator tape in women with decreased urethral mobility.

Objective: To determine whether preoperative urethral mobility is associated with success of the transobturator insertion of suburethral polypropylene slings.

Study Design: A cohort of women who underwent a transobturator insertion of a suburethral polypropylene sling for urodynamic stress incontinence between October 2003 and January 2005 was prospectively assessed.

Results: Of the 134 women in the study cohort, 107 (80%) provided postoperative data at a median followup interval of 10 months.

Incisional endometriomas after Cesarean section: a case series.

Objective: To review a series of women with endometriomas developing in the scar of the skin incision performed for cesarean section.

Study Design: A total of 37 patients diagnosed with incisional endometrioma at the time of surgical excision from 1975 to 2005 were identified from the comprehensive surgical database, which includes all operative procedures performed at this institution. The medical records of 33 of the 37 patients were available for review.

Decreased rate of obstetrical anal sphincter laceration is associated with change in obstetric practice.

A study was conducted to describe the rate of obstetrical anal sphincter laceration in a large cohort of women and to identify the characteristics associated with this complication. Data from all vaginal deliveries occurring between January 1996 and December 2004 at one institution were used to compare women with and without anal sphincter lacerations. Among 16,667 vaginal deliveries, 1,703 (10.

Polypoid cystitis resulting from ovarian abscess.

We present the case of a 41-year-old woman who presented with gross hematuria, urinary urgency and frequency, and intermittent abdominal pain after vaginal hysterectomy 2 years prior. The presence of an adnexal mass was suspected by pelvic examination and confirmed by transvaginal pelvic ultrasonography. Cystoscopy with biopsy was consistent with an inflammatory bladder polyp, which was initially discovered by pelvic ultrasonography and noted to be contiguous with the adnexal mass.

Increased prevalence of interstitial cystitis in women with detrusor overactivity refractory to anticholinergic therapy.

Objectives: To estimate the prevalence of interstitial cystitis in women with detrusor overactivity refractory to anticholinergic medication using the potassium sensitivity test (PST).

Methods: Women with complaints of urinary frequency, urgency, and/or urge incontinence of 3 months' duration or longer were referred to the urogynecology clinic. Between October 2003 and June 2004, 47 consecutive women were diagnosed with phasic, idiopathic detrusor overactivity after evaluation by history, physical examination, urinalysis, urine culture, urodynamic testing, and cystoscopy.

The impact of pelvic organ prolapse on sexual function in women with urinary incontinence.

The aim of the study is to evaluate the impact of pelvic organ prolapse (POP) on sexual function in women with urinary incontinence (UI). In this retrospective, case-cohort study, we reviewed the medical records of all women evaluated for UI between March and November 2003. All patients completed the short forms of the Urogenital Distress Inventory, Incontinence Impact Questionnaire, and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire.

Validation of Spanish version of Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale.

Objectives: To translate the previously described Pelvic Pain and Urgency/Frequency (PUF) questionnaire into Spanish using a back-translation technique and to validate the Spanish version in a group of bilingual women with symptoms consistent with interstitial cystitis or painful bladder syndrome.

Methods: Bilingual women with complaints of urinary urgency/frequency and/or pelvic pain were randomized to complete initially either the Spanish version or the original English version of the PUF questionnaire followed by the questionnaire in the other language. To evaluate retest reliability, subjects completed the Spanish version a second time 1 week later.

Effect of transobturator tape procedure on proximal urethral mobility.

Objectives: To assess prospectively the degree of urethral mobility in the preoperative and postoperative periods after the transobturator tape procedure and correlate the findings with surgical outcome.

Methods: Thirty-six consecutive patients with stress urinary incontinence underwent the transobturator tape procedure. A cotton-swab test was performed before the procedure and at the 6-week postoperative follow-up visit to evaluate proximal urethral mobility.

Treatment of voiding dysfunction after transobturator tape procedure.

Voiding dysfunction after mid-urethral sling procedures is uncommon but not completely avoidable. We report on a method to adjust the transobturator mid-urethral sling under local anesthesia in the early postoperative period for postoperative voiding difficulty. At postoperative day 17 and 18, 2 women, who had undergone the transobturator tape procedure for stress incontinence, underwent successful loosening of the mesh through the previous vaginal incision, without the need to transect or remove the tape.

Bladder injury during transobturator sling.

The new minimally invasive transobturator sling for surgical treatment of female genuine stress urinary incontinence is designed to reproduce the natural suspension of the urethral fascia while eliminating the need for retropubic needle passage. We report 3 cases of bladder perforation during the transobturator sling procedure. All injuries were identified intraoperatively by cystoscopy, and successful reinsertion of the mesh was accomplished.