More With Less: Single-Incision Sling Insertion Techniques.

Study Objective: To demonstrate reproducible procedures for efficient single-incision sling insertion and troubleshooting.

Design: Narrated video footage with stepwise demonstration of single-incision sling insertion technique with anchor system.

Setting: The mesh midurethral sling is a highly effective and safe procedure that is considered the gold standard for surgical treatment of stress urinary incontinence.

Risk factors of lower urinary tract injury with laparoscopic sacrocolpopexy.

Background: Lower urinary tract injuries can occur during pelvic reconstructive surgery, including sacrocolpopexy. The reported injury rates range from 0.4% to 10.

Sacrocolpopexy Techniques for the Savvy Surgeon.

Laparoscopic sacrocolpopexy (LSCP) can be challenging even for the experienced surgeon. Knowledge and adequate visualization of the sacral and pelvic anatomy is paramount to prevent potentially catastrophic intra-operative hemorrhage, nerve or ureteral injury, and to facilitate presacral dissection. We highlight several techniques to maximize surgical efficiency, optimize visualization of the sacral anatomy during presacral dissection, as well as a method to facilitate peritoneal closure over the mesh during LSCP.

Effects of Preoperative Gabapentin on Clinical Outcomes After Outpatient Midurethral Sling Placement.

Objectives: This study aimed to evaluate transient urinary retention in women undergoing outpatient midurethral sling placement who received preoperative gabapentin (treated) versus those who did not (untreated). Secondary outcomes included unexpected admission rates, analgesic usage, time to discharge, and pain.

Methods: This was a retrospective cohort study including women who underwent outpatient midurethral sling placement from 2015 to 2019.

Suprapubic Versus Transurethral Catheterization: Perioperative Outcomes After Colpocleisis.

Objectives: Transient postoperative urinary retention occurs in approximately half of women after colpocleisis; however, the optimal strategy for postoperative catheter management is unclear. This study compared length of catheterization and postoperative complications after colpocleisis between planned suprapubic catheter placement and transurethral catheterization.

Methods: This is a retrospective cohort study including all women undergoing colpocleisis from January 2015 to December 2019 in a large female pelvic medicine and reconstructive surgery practice.

Risk Factors for Urinary Retention After Colpocleisis.

Objectives: Transient urinary retention occurs frequently after pelvic organ prolapse surgery. While the prevalence of postoperative urinary retention has been reported for reconstructive procedures, a paucity of data exists for colpocleisis. The objectives of this retrospective cohort study were to identify risk factors for transient urinary retention after colpocleisis and to determine the rate of its occurrence.

Outside-In: Intraperitoneal Anterior and Posterior Plication During Prolapse Surgery.

Objective: To demonstrate a novel technique of intraperitoneal vaginal wall plication combining the benefits of anterior and posterior colporrhaphy with laparoscopic sacrocolpopexy.

Design: Video demonstration of laparoscopic anterior and posterior colporrhaphy techniques, highlighting the various clinical scenarios in which they would be beneficial.

Setting: Sacrocolpopexy is recommended for the treatment of advanced-stage prolapse [1-3].

Urinary symptoms in women receiving carboplatin/paclitaxel for treatment of gynecologic cancers.

Objectives: Urinary incontinence is estimated to affect up to 34% of women with gynecologic cancers. Chemotherapeutic effects on urinary symptoms have been scarcely studied. The aim of our study was to examine the impact of carboplatin/paclitaxel chemotherapy on urinary symptoms.

Ureteral Compromise in Laparoscopic Versus Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort.

Objectives: The aim of this study was to evaluate if ureteral compromise is significantly different between laparoscopic and vaginal uterosacral ligament suspension (USLS).

Methods: This is a retrospective cohort study comparing all women who underwent laparoscopic and vaginal USLSs at 2 institutions (part of a single training program with procedures performed by 11 fellowship-trained Female Pelvic Medicine and Reconstructive Surgery gynecologic surgeons) between January 2008 and June 2013.

Results: A total of 208 patients in the study underwent a USLS, 148 in the laparoscopic group and 60 in the vaginal group.

Safety of combined abdominal sacral colpopexy and sigmoid resection with suture rectopexy: a retrospective cohort study.

Objectives: This study aimed to determine if abdominal sacral colpopexy (ASC) using mesh can be safely combined with sigmoid resection and anastomosis.

Methods: This is a single institution, retrospective chart review of patients who underwent combined ASC and suture rectopexy with sigmoid resection between January 1, 2007, and December 31, 2011. Charts were screened for outcome data and complications related to the placement of synthetic mesh at the time of bowel resection to include readmission and reoperation rates, infection, bowel obstruction, fistula, and mesh erosion.

Commonalities of cerclage-related genitourinary fistulas.

Objectives: The purpose of this review was to identify common features of cerclage-related genitourinary fistulas.

Methods: A retrospective case series of cerclage-related fistulas was performed. The results were then pooled with available published case reports to identify common factors in these cases.

Intraoperative and postoperative gastrointestinal complications associated with laparoscopic sacrocolpopexy.

Objective: This study aimed to quantify the risks of intraoperative and postoperative gastrointestinal (GI) complications associated with laparoscopic sacrocolpopexy and identify possible risk factors.

Methods: A total of 390 medical records were retrospectively reviewed for GI complications. Complications were classified as functional complications [ileus, small bowel obstruction (SBO), and prolonged nausea/emesis] or bowel injury.

A pilot study on vaginally assisted laparoscopic sacrocolpopexy for patients with uterovaginal prolapse.

Objectives: : The primary objective of this pilot study was to compare the short-term anatomic outcomes and complication rates of vaginally assisted laparoscopic sacrocolpopexy (VALS) with those of conventional laparoscopic sacrocolpopexy (LS) in patients undergoing concurrent hysterectomy. The secondary objective was to compare operative times of the 2 different techniques.

Methods: : This is a retrospective pilot study comparing VALS-a method using transvaginal mesh attachment to the vaginal apex-to conventional LS in patients undergoing concurrent hysterectomy.

Effect of operative technique on mesh exposure in laparoscopic sacrocolpopexy.

Objectives: To determine if opening the vaginal cuff during laparoscopic sacrocolpopexy influences the rate of mesh exposure.

Methods: A total of 390 medical records were retrospectively reviewed for demographic information, operative technique, and relevant outcomes.

Results: Eleven mesh exposures (2.

De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair.

Objective: We sought to determine the rate of de novo stress incontinence, pelvic muscle symptoms, mesh exposure, visceral injury rate, and recurrent prolapse after transvaginal mesh repair.

Study Design: We conducted a retrospective review of 335 consecutive women with stage II or worse vaginal prolapse who underwent Prolift (Ethicon, Somerville, NJ) between July 7, 2005 and Jan. 31, 2008.

Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse.

Objectives: Our purpose was (1). to report long-term objective and subjective outcome data after total colpocleisis with high levator plication and (2). to compare operative morbidity of total colpocleisis in patients with prior versus concurrent hysterectomy.

Urethral adenocarcinoma associated with urethral diverticulum in a patient with progressive voiding dysfunction.

Urethral adenocarcinoma associated with urethral diverticulum is a rare condition that requires a high index of suspicion to ensure early diagnosis and appropriate therapy. The development of urethral stenosis in a patient with a urethral diverticulum warrants early biopsy to rule out a malignant lesion.