Three-dimensional saline infusion vaginography for sonographic assessment of the anterior vaginal wall and pelvic floor descent.

Ultrasound has been recognized as an important tool for pelvic floor evaluation. A main limitation of the two-dimensional transvaginal examination is in delineation of the posterior vaginal compartment and its relation to the cervix. We describe the use of three-dimensional saline infusion vaginography as a complementary technique for the assessment of the vaginal wall and pelvic floor descent.

Gross and microscopic hematuria: guidelines for obstetricians and gynecologists.

Although gross hematuria is a relatively uncommon condition in general obstetrics and gynecology practice, microscopic hematuria is a common incidental finding during routine antepartum or gynecologic office visits. The proper evaluation and treatment options are understudied in females. In fact, work-up of females is controversial, and no consensus guidelines exist at this time.

Neglected pessary causing a rectovaginal fistula: a case report.

Background: Pessaries, properly maintained, have been shown to be safe for long-term care of symptomatic vaginal prolapse. Complications from neglected pessaries include impaction, erosion and fistula formation. Vesicovaginal fistulas have been described, but literature reports of rectovaginal fistulas are scarce.

Innervation of the levator ani muscles: description of the nerve branches to the pubococcygeus, iliococcygeus, and puborectalis muscles.

We described the innervation of the levator ani muscles (LAM) in human female cadavers. Detailed pelvic dissections of the pubococcygeus (PCM), iliococcygeus (ICM), and puborectalis muscles (PRM) were performed on 17 formaldehyde-fixed cadavers. The pudendal nerve and the sacral nerves entering the pelvis were traced thoroughly, and nerve branches innervating the LAM were documented.

Rupture of a tuboovarian abscess into the anterior abdominal wall: a case report.

Background: Rupture of a tuboovarian abscess is a life-threatening emergency. The current standard of care is surgery to manage the onset of peritonitis and sepsis.

Case: A 34-year-old woman presented with gradually worsening abdominal pain over several weeks.

Delayed urethral erosion after tension-free vaginal tape.

Urethral erosions have been reported with various sling materials placed by means of various techniques. The patient often presents in the immediate postoperative period, although late presentations have been described. The diagnosis is made on cystoscopy, and mesh excision with urethral reconstruction is advocated.

Pessary use in advanced pelvic organ prolapse.

The objective of this study was to review our experience with pessary use for advanced pelvic organ prolapse. Charts of patients treated for Stage III and IV prolapse were reviewed. Comparisons were made between patients who tried or refused pessary use.