Validation of the Simulated Vaginal Hysterectomy Trainer.

Study Objective: To establish construct validity of the simulated vaginal hysterectomy trainer (SimVaHT).

Design: A cross-sectional validation study (Canadian Task Force classification II-2).

Setting: A single academic medical center in the United States.

Patient Satisfaction With Nurse-Led Telephone Follow-up in an Ambulatory Setting.

Objectives: We studied our practice of using nurse telephone follow-up under physician direction to assess symptom improvement and patient satisfaction.

Methods: Women were recruited when their clinical care merited nurse telephone follow-up in the opinion of the attending physician. Women specified a preferred telephone number and completed a symptom questionnaire at the time of enrollment.

Intraoperative cervix location and apical support stiffness in women with and without pelvic organ prolapse.

Background: It is unknown how initial cervix location and cervical support resistance to traction, which we term "apical support stiffness," compare in women with different patterns of pelvic organ support. Defining a normal range of apical support stiffness is important to better understand the pathophysiology of apical support loss.

Objective: The aims of our study were to determine whether: (1) women with normal apical support on clinic Pelvic Organ Prolapse Quantification, but with vaginal wall prolapse (cystocele and/or rectocele), have the same intraoperative cervix location and apical support stiffness as women with normal pelvic support; and (2) all women with apical prolapse have abnormal intraoperative cervix location and apical support stiffness.

In vivo properties of uterine suspensory tissue in pelvic organ prolapse.

The uterine suspensory tissue (UST), which includes the cardinal (CL) and uterosacral ligaments (USL), plays an important role in resisting pelvic organ prolapse (POP). We describe a technique for quantifying the in vivo time-dependent force-displacement behavior of the UST, demonstrate its feasibility, compare data from POP patients to normal subjects previously reported, and use the results to identify the properties of the CL and USL via biomechanical modeling. Fourteen women with prolapse, without prior surgeries, who were scheduled for surgery, were selected from an ongoing study on POP.

Pathologic evaluation of explanted vaginal mesh: interdisciplinary experience from a referral center.

Objectives: In light of vaginal mesh safety concerns, we reviewed our institutional experience with analytic processes and pathologic findings of explanted vaginal mesh to identify problems and opportunities to facilitate improved documentation and research.

Methods: We reviewed gross and microscopic pathology reports and archival slides of explanted mesh specimens from January 2010 through February 2012. Specimen requisition clinical history, number of mesh specimens per case, and type of examination (gross or histologic) were abstracted from pathology records using the initial search word "mesh".

A novel technique to measure in vivo uterine suspensory ligament stiffness.

Objective: The purpose of this study was to describe a new computer-controlled research apparatus for measuring in vivo uterine ligament force-displacement behavior and stiffness and to present pilot data for women with and without prolapse.

Study Design: Seventeen women with varying uterine support underwent testing in the operating room (OR) after anesthetic induction. A tripod-mounted computer-controlled linear servoactuator was used to quantify force-displacement behavior of the cervix and supporting ligaments.

Post-reduction stress urinary incontinence rates in posterior versus anterior pelvic organ prolapse: a secondary analysis.

Introduction/hypothesis: Stress incontinence with vaginal prolapse reduction is less common in women with posterior-predominant prolapse (rectocele) compared with those with anterior-predominant prolapse (cystocele).

Methods: This was a secondary analysis of a cohort of prospectively enrolled women with symptomatic pelvic organ prolapse at or beyond the hymen and prolapse-reduced stress urinary incontinence (SUI) testing. Subjects were included if they had anterior- or posterior-predominant prolapse with at least a 1 cm difference in pelvic organ prolapse quantification (POP-Q) points Ba and Bp (N = 214).

The multicenter urogynecology study on education: associations between educational outcomes and clerkship center characteristics.

Objective: : The objective of the study was to examine the effect of center characteristics on educational experiences and female pelvic medicine knowledge changes in third-year students at 6 medical schools.

Methods: : In this secondary analysis of data acquired during a prospective, multicenter study conducted from May 2008 through June 2009, preclerkship and postclerkship third-year medical students scored their knowledge of 12 female pelvic medicine topics and 4 office procedures (knowledge scores [KSs]). Postclerkship, students also reported the number and type of learning experiences they had encountered.

Comparison of the puborectal muscle on MRI in women with POP and levator ani defects with those with normal support and no defect.

Introduction And Hypothesis: The objective of this study was to compare puborectal muscle integrity and bulk in women with both major levator ani (LA) defects on MRI and pelvic organ prolapse (POP) to women with normal LA muscle and normal support.

Methods: This is a case-control study comparing 24 cases with known major LA defects and POP to 24 controls with normal LA and normal support. Axial T-2 weighted MRI scans of the pelvis were evaluated for integrity of the puborectal muscle and degree of muscle bulk.