Fractional CO laser for treatment of stress urinary incontinence.

Objectives: To evaluate the impact of trans-vaginal fractional CO laser treatment on symptoms of stress urinary incontinence (SUI) in women.

Study Design: Women clinically diagnosed with SUI preferring non-surgical treatment were recruited to the study. Fractional CO laser system (MonaLisa T, DEKA) treatments were administered trans-vaginally every 4-6 weeks for a total of three treatments.

Combined site-specific sacral neuromodulation and pudendal nerve release surgery in a patient with interstitial cystitis and persistent arousal.

A variety of neuromodulation approaches have been described for the management of pelvic neuropathies, including interstitial cystitis, pudendal neuralgia and persistent genital arousal disorder. The benefits of a combined sacral and pudendal nerve neuromodulator has yet to be explored for these patients. In this report, we describe the case of a 35-year-old woman with a complex pelvic neuropathy resulting in urinary, sexual and gastro-intestinal dysfunction.

Mechanism of action of the Adiana(®) device: a histologic perspective.

Background: The study was conducted to confirm the mechanism of action of the Adiana permanent contraception device by means of histologic analysis of long-term specimens.

Study Design: Fifteen specimens were obtained from eight subjects undergoing hysterectomy 2 to 4 years after the Adiana procedure. Serial sections were stained with hematoxylin and eosin, as well as epithelial membrane antigen immunostain.

The Adiana System for permanent contraception: safety and efficacy at 3 years.

Study Objective: To evaluate the efficacy of the Adiana System for preventing pregnancy in women desiring permanent sterilization.

Design: This study is a prospective, single-arm, multicenter, international trial. The primary endpoint was pregnancy prevention rate at 12 months.

The management of intrauterine synechiae.

Purpose Of Review: Intrauterine adhesions are a rare but significant cause of menstrual disturbance and infertility. Most cases are caused by uterine instrumentation. It is important for clinicians to understand the cause, diagnostic tools and rationale behind treatment.

A comparative, single-blind, randomized trial of pain associated with suction or non-suction drains after gynecologic laparoscopy.

Study Objective: To estimate the difference in pain associated with the wearing or removal of suction or non-suction drains after gynecologic laparoscopic surgery.

Design: A randomized controlled trial from August 2006 through October 2007 (Canadian Task Force Classification I).

Setting: Royal Hospital for Women, Department of Endo-Gynaecology and School of Women's and Children's Health University of New South Wales.

A 12-month prospective evaluation of transcervical sterilization using implantable polymer matrices.

Objective: To evaluate placement efficacy and reliability of a an intratubal occlusion device for permanent contraception and to assess tolerability and overall satisfaction.

Methods: Seven hundred seventy women with known parity were recruited to participate in a prospective, multicenter study. Bipolar, low-level radiofrequency energy delivery and porous silicon inserts were used.

Fluoroscopically guided synechiolysis for patients with Asherman's syndrome: menstrual and fertility outcomes.

Objective: To describe a 5-year experience of fluoroscopically guided hysteroscopic synechiolysis for Asherman's syndrome.

Design: Retrospective, uncontrolled cohort study.

Setting: Department of Endo-Gynaecology, University of New South Wales, Royal Hospital for Women, Randwick, Sydney, New South Wales, Australia.

Clinical and quality-of-life outcomes after fertility-sparing laparoscopic surgery with bowel resection for severe endometriosis.

Study Objective: To describe the effect of fertility-sparing laparoscopic excision of endometriosis and bowel resection on clinical and quality-of-life outcomes.

Design: Prospective observational cohort study (Canadian Task Force classification II-2).

Setting: Australian tertiary referral center for the surgical treatment of endometriosis.

Peri-operative physiotherapy improves outcomes for women undergoing incontinence and or prolapse surgery: results of a randomised controlled trial.

Background: Urinary incontinence and pelvic organ prolapse are common complaints in women. Physiotherapy and surgery to correct these conditions are often seen as mutually exclusive. No study has yet investigated their synergistic potential.

Assessment of a method to expel intraperitoneal gas after gynecologic laparoscopy.

Study Objective: To assess a method using instillation of saline to expel all residual intraperitoneal CO2 after laparoscopy. If successful, this would enable clinicians to use radiography as a simple diagnostic test to detect bowel perforation following laparoscopic surgery.

Design: Cohort study (Canadian Task Force classification II-2).

Pilot study of botulinum toxin type A in the treatment of chronic pelvic pain associated with spasm of the levator ani muscles.

Objective: To investigate whether botulinum toxin type A (BOTOX) injected into the levator ani muscles of women with objective pelvic floor muscle spasm decreases pain symptoms and improves quality of life.

Design: A prospective cohort study.

Setting: Outpatient clinic in a tertiary referral centre, Sydney, Australia.

MycroMesh is not a suitable soft tissue prosthesis for repair of the defective vaginal wall.

Thirty-one women had recurrent vaginal wall prolapse repaired with insertion of a soft tissue prosthesis-MycroMesh in 22 (group B) and other materials in 9 (group A). Rejection rates were 18% and zero percent, respectively. Given these data, MycroMesh is not recommended to repair a defective vaginal wall.