A randomized, double-blind, placebo-controlled trial of onabotulinumtoxin A trigger point injections for myofascial pelvic pain.

Background: Pelvic pain is estimated to effect 15% of women, and onabotulinumtoxin A is used to treat a variety of pain disorders. However, the data on the use of onabotulinumtoxin A for the treatment of women with myofascial pelvic pain are limited.

Objective: The objective of the study was to compare the effect of onabotulinumtoxin A vs placebo injections to the pelvic floor muscles in women with myofascial pelvic pain.

Obliterative Versus Reconstructive Prolapse Repair for Women Older than 70: Is There an Optimal Approach?

Objectives: This study aimed to evaluate outcomes among women 70 years and older who underwent obliterative compared with reconstructive procedures for pelvic organ prolapse.

Methods: This was a retrospective cohort study of patients 70 years and older who underwent surgical prolapse repair at our institution from January 2004 through June 2010. Only patients with at least 4 weeks of follow-up were included.

Effect of vaginal estrogen on pessary use.

Introduction And Hypothesis: Many providers recommend concurrent estrogen therapy with pessary use to limit complications; however, limited data exist to support this practice. We hypothesized that vaginal estrogen supplementation decreases incidence of pessary-related complications and discontinuation.

Methods: We performed a retrospective cohort study of women who underwent a pessary fitting from 1 January 2007 through 1 September 2013 at one institution; participants were identified by billing code and were eligible if they were postmenopausal and had at least 3 months of pessary use and 6 months of follow-up.

Effect of Scopolamine Patch Use on Postoperative Voiding Function After Transobturator Slings.

Objectives: The aim of this study was to determine whether the use of a preoperative transdermal scopolamine (TDS) patch for postoperative nausea and vomiting prophylaxis affects the success of a voiding trial after a transobturator tape sling procedure.

Methods: This study is a retrospective cohort study of adult women who underwent a transobturator tape sling procedure without concomitant procedures from February 1, 2009 through August 1, 2010. The exposed group included all eligible women who received a preoperative TDS patch.

Bladder Symptoms and Attitudes in an Ethnically Diverse Population.

Objective: The aim of the study was to assess pelvic floor symptoms and attitudes in an ethnically diverse population.

Methods: We conducted a cross-sectional survey of women presenting to 2 community-based, ethnically diverse gynecology clinics. Before being seen by a provider, participants were asked to complete a questionnaire.

Pelvic Floor Physical Therapy as Primary Treatment of Pelvic Floor Disorders With Urinary Urgency and Frequency-Predominant Symptoms.

Objective: To assess the efficacy of pelvic floor physical therapy (PFPT) as primary treatment of urinary urgency and frequency symptoms

Methods: We conducted a prospective cohort study of women with urinary urgency and frequency symptoms. Participants underwent PFPT once or twice per week for 10 weeks. Symptom improvement was assessed by validated questionnaires (Pelvic Floor Distress Inventory-Short Form 20 and Patient Global Impression of Improvement), voiding diaries, and subjective measures.

Do Obstetrical Providers, Counsel Women About Postpartum Pelvic Floor Dysfunction?

Objective: To assess prenatal counseling practices of obstetrics providers related to postpartum pelvic floor dysfunction at centers with integrated urogynecology services.

Study Design: A cross-sectional survey was distributed to obstetrical providers through urogynecology colleagues. The survey included questions about level of training as well as counseling practices related to common postpartum pelvic floor symptoms.

Laparoscopic supracervical hysterectomy with transcervical morcellation and sacrocervicopexy for the treatment of uterine prolapse.

Introduction And Hypothesis: The objective is to describe our surgical approach for management of uterine prolapse using 5-mm skin incisions and transcervical morcellation.

Methods: This video presents a novel approach for laparoscopic supracervical hysterectomy, bilateral salpingectomy, and sacrocervicopexy using only 5-mm skin incisions and transcervical morcellation. The procedure begins with a laparoscopic supracervical hysterectomy with bilateral salpingectomy.

Use of a vessel loop to ensure tunnel patency during LeFort colpocleisis.

Introduction: The objective was to describe a novel method for maintaining bilateral channel patency for potential uterine drainage during LeFort colpocleisis.

Methods: This video presents a novel approach for ensuring bilateral channel patency during colpocleisis. An 88-year-old gravida 2 para 2 with stage 4 uterovaginal prolapse presented for definitive surgical management.

Attitudes toward transvaginal mesh among patients in a urogynecology practice.

Introduction And Hypothesis: There has been increasing media attention regarding transvaginal mesh (TVM). We hypothesized that new urogynecology patients have limited knowledge and negative opinions of TVM.

Methods: An anonymous survey was distributed to all new patients presenting to the Mt Auburn Hospital urogynecology practice from 1 November 2012 to 31 January 2013.