Evaluation of Choline and Acetylcholine Levels in Responders and Nonresponders to Anticholinergic Therapy for Overactive Bladder Syndrome
Conclusion In women with overactive bladder, urinary Ach and Ch levels are higher in responders to anticholinergic therapy compared with nonresponders. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Needs Assessment for Lower Urinary Tract Injury Curriculum for FPMRS Fellowships
Conclusions FPMRS PDs and fellows agree that the evaluation and management of LUTI are important; however, most programs use only didactics and hands-on learning in the operating room with extremely low case volumes, leading to decreased proficiency. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Patient Satisfaction and Refill Rates After Decreasing Opioids Prescribed for Urogynecologic Surgery
The objective of this study was to investigate the effect of implementing a multimodal, opioid-sparing analgesia regimen on opioid use, patient satisfaction, and refill rates. Materials and Methods This was a retrospective observational study of female patients undergoing urogynecologic surgery at an academic center from 2017 to 2019, before and after introduction of an opioid-sparing multimodal regimen protocol advocating for standing ibuprofen and acetaminophen. Demographic information, opioid prescription details (oral morphine equivalent [OME]), and refill rate data were collected from the chart. Postoperative o...
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Urinary Catheter Management Approaches Among Women Undergoing Benign Gynecologic Surgery: A Randomized Trial
The objective of this study was to identify differences in voiding trial success rates between delayed (postoperative day 1) and day of surgery catheter removal (“fast track”) among women undergoing benign gynecologic surgery. Rates of urinary tract infection, patient satisfaction, and lower urinary tract symptoms were compared between catheter management schemes. Methods Women undergoing benign gynecologic surgery were randomized to either “conventional” delayed urinary catheter care removal on postoperative day 1 or day of surgery catheter removal (fast track) 4 hours after surgery. Subject...
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Opioid Prescriptions for Female Pelvic Reconstructive Surgery Patients Before and After Implementation of Tennessee State Legislation
Conclusions State legislation was associated with a significant decrease in prescribed OMEs at the time of discharge in patients undergoing female pelvic reconstructive surgery. These results support ongoing legislative efforts to address the current opioid crisis. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Barriers to Optimizing Perioperative Pain Control After Ambulatory Urogynecologic Surgery
No abstract available (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Letter to the Editor Source Type: research

A Clinical Risk Calculator to Predict Obstetric Anal Sphincter Injuries in Laboring Patients
No abstract available (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Letter to the Editor Source Type: research

Practice Patterns Regarding Apical Support Procedures at Time of Hysterectomy for Pelvic Organ Prolapse
Objectives We sought to understand practice patterns of non–female pelvic medicine and reconstructive surgery (FPMRS) clinicians regarding concurrent apical support procedures during hysterectomies when primarily performed for the treatment of pelvic organ prolapse. We also sought to describe differences between those receiving and not receiving apical support. Methods This retrospective study analyzed medical records of individuals undergoing hysterectomy for the primary indication of pelvic organ prolapse between 2012 and 2017 at all locations within the TriHealth system. Surgeries performed by board-cer...
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Increasing Age Predicts Increasing Residual Urine Volume
Conclusions The majority of patients presenting for urogynecologic evaluation had a low PVR with a median of 20 mL. Postvoid residual was higher for older age groups but nearly all volumes were less than 100 mL. The utility of a PVR measurement is highest for patients with pelvic organ prolapse, urinary frequency, narcotic use, or history of stroke. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Pelvic Organ Prolapse Recurrence and Patient-Centered Outcomes Following Minimally Invasive Abdominal Uterosacral Ligament and Mesh-Augmented Sacrohysteropexy
Conclusions One in 5 patients experienced POP recurrence with fewer than 10% undergoing repeat surgery for recurrence. There does not seem to be a significant difference in the incidence of recurrence between MSH and USLH. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

High Patient Satisfaction With Local Anesthesia and Light Sedation in a Novel Fast-Track Setup for Sacrospinous Fixation
Conclusions The SSF can be performed using local anesthesia and light sedation with high degree of patient satisfaction. These preliminary data indicate that the concept of ambulatory surgery might be implemented more widely if the use of local anesthesia is also applied to more advanced surgical procedures. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Posterior Vaginal Compartment Anatomy: Implications for Surgical Repair
Conclusions These findings support evidence showing absence of a rectovaginal fascia. The anal sphincter lacks a fibrous capsule, which is important during closure of third-/fourth-degree obstetric lacerations. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Effect of Visual Aids During Surgical Consents on Patient Understanding and Satisfaction
Conclusions We found that using visual aids during the consent process for patients undergoing robotic sacrocolpopexy or suburethral sling surgeries did not improve knowledge. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Overactive Bladder Symptoms After Pelvic Organ Prolapse Repair
Conclusions Approximately 61% of patients undergoing POP surgery had resolution of OAB symptoms postoperatively whether or not an incontinence procedure was performed. Older age was significantly related to persistent OAB symptoms in both univariate (P = 0.038) and multivariate (P = 0.049) models. The rate of de novo OAB symptoms was 6%. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Gel-Infused Translabial Ultrasound in the Evaluation of Female Urethral Stricture
Conclusions Gel-infused translabial ultrasound is a novel and accurate technique that in this small series appeared to identify and further characterize female urethral stricture in cases where it was utilized. Further research is needed to determine its role in preoperative planning and in providing a definitive diagnosis of stricture when other studies are equivocal. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Survey of Postoperative Activity Guidelines After Minimally Invasive Gynecologic and Pelvic Reconstructive Surgery
Conclusions After minimally invasive gynecologic or pelvic reconstructive surgery, providers recommend a wide range of postoperative restrictions and prescribe significantly different quantities of opioids during the postoperative period. This study highlights some of the recommendations with the greatest variability. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Predictors of Urinary Retention After Vesicovaginal Fistula Surgery: A Retrospective Case-Control Study
Conclusions Vertical closure of the bladder and patients without a history of prior fistula repairs are predictors for developing urinary retention after fistula repair surgery. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Improved Understanding of Female Pelvic Medicine and Reconstructive Surgery Concepts Through Targeted Case-Based Educational Intervention: A Pilot Study
Objectives Given the complex anatomy and pathophysiology of urogynecologic disorders, obstetrics and gynecology residents can have difficulty learning the subject's principles. There are no standardized resources for educators in this subspecialty. We hypothesized that our case-based educational intervention was associated with enhanced knowledge and greater resident satisfaction versus traditional urogynecology lectures. Methods This is a prospective study involving 19 obstetrics and gynecology residents at a single institution. Residents participated in three 1-hour case-based lectures, which included prelectu...
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Original Articles Source Type: research

Our Professional Responsibility and Social Media: A Call to Action in Female Pelvic Medicine and Reconstructive Surgery
No abstract available (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Editorials Source Type: research

We Should Abandon “Race” as a Biological Category in Biomedical Research
No abstract available (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - November 24, 2020 Category: Surgery Tags: Editorials Source Type: research

A Case of Mistaken Identity: Macroplastique Injections Mimicking Recurrent Peritoneal Cancer on Multiple Imaging Tests Resulting in Radical Hysterectomy
No abstract available (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Case Report Source Type: research

Female Veterans With Diagnoses of Both Chronic Pelvic Pain and Overactive Bladder; How Do They Compare to Women Diagnosed With Interstitial Cystitis?
The objective of this study was to compare women with a known diagnosis of interstitial cystitis (IC) to a population that might be at risk for the diagnosis of IC, women with diagnoses of both chronic pelvic pain (CPP) and overactive bladder (OAB). Methods We conducted a retrospective study of data from the Veterans Affairs Corporate Data Warehouse. The cohort included all female veterans who had established care with a primary care provider from 1997 to present. International Classification of Diseases, Ninth Revision codes were used to identify women with a diagnosis of IC, CPP, and OAB. Demographic data and comorbid...
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

A Hypothesis Generating the Mechanical Systems Underlying Posterior Vaginal Prolapse Based on Observed Displacements by Dynamic Magnetic Resonance Imaging
Conclusions Quantified displacements of the PVW and its supporting structure were shown on dynamic MRI, and the mechanical mechanisms were hypothesized regarding the interaction between pressure and the support force contributing to the deformation of the PVW and the supporting structures. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Postoperative Opioid Prescribing Following Gynecologic Surgery for Pelvic Organ Prolapse
Conclusions Pain scores, opioid prescription amounts, and refills varied by patient age and surgical approach but were unaffected by concomitant procedures. Further work in correlating pain scores to opioid utilization is needed to ensure appropriate prescribing patterns and reduce risks of opioid dependence and diversion. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

A Cost Analysis of Icon Reusable Underwear Versus Disposable Pads for Mild to Moderate Urinary Incontinence
Conclusions Reusable incontinence underwear can be an economically feasible alternative to disposable pads for light to moderate urinary incontinence after 2 years of use assuming underwear has a 2-year longevity and the consumer is using 2 PPD with regular underwear. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Comparison of Patient Impact and Clinical Characteristics Between Urgency and Passive Fecal Incontinence Phenotypes
This study is a prospective cross-sectional study of women with at least monthly FI. All women completed the St Mark’s Vaizey and the Fecal Incontinence Quality of Life questionnaires and underwent anorectal manometry and endoanal ultrasound. We compared women with urgency FI to women with passive FI. Results Forty-six women were enrolled, 21 (46%) with urgency FI and 25 (54%) with passive FI. Clinical severity by Vaizey score did not differ between groups (urgency 11.7 ± 1.6 vs passive 11.0 ± 1.0, P = 0.51). Women with urgency FI had worse median (range) lifestyle and coping scores than passive FI (...
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

The Safety and Feasibility of Gynecologic Cancer Surgery Combined With Surgery for Pelvic Floor Dysfunction
Objectives Women with gynecologic cancer may also present with pelvic floor dysfunction that can have a significant effect on quality of life. Combined surgical intervention for both malignancy and pelvic floor dysfunction may improve quality of life with minimal additional risk. We sought to determine the safety, feasibility, and frequency of combined gynecologic cancer surgery and surgery for pelvic floor dysfunction. Methods This is a retrospective cohort study that utilized the National Surgical Quality Improvement Program database provided through the American College of Surgeons. The National Surgical Quality Im...
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Long-term Pelvic Floor Symptoms, Recurrence, Satisfaction, and Regret Following Colpocleisis
Conclusions Colpocleisis remains an excellent surgical option for elderly patients. However, regret and dissatisfaction may increase over time as bowel and bladder symptoms may be perceived to be the result of surgery. Our findings highlight the continued need for detailed consent and expectation setting for women considering colpocleisis. There are insufficient studies on long-term outcomes following colpocleisis, which limits physicians' ability to effectively counsel patients. The purpose of this study was to assess pelvic floor symptoms, recurrence, satisfaction, and regret among patients who underwent colpocleisis ...
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Female Urology and Urogynecology: The Outcome of Patients Participating in Live Surgical Broadcasts
Conclusions With careful planning, LSB can offer a safe way of sharing current operative techniques and decision making with similar 30- and 90-day complication rates to standard practices and comparable functional outcomes to standard practice. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Clinical Utility of Routine Preoperative Laboratory Assessment in a Urogynecologic Population
Conclusions Routine preoperative laboratory testing does not identify clinically meaningful abnormalities or alter surgical management in women undergoing urogynecologic surgery. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Lidocaine Use in Vaginal Surgery and Risk of Toxicity
Objectives The primary objective of this study was to compare the amount of lidocaine administered for vaginal reconstruction with versus without hysterectomy. The secondary objective was to assess the risk of lidocaine toxicity. Methods This retrospective cohort study compares lidocaine dose in 2 cohorts: women who underwent vaginal hysterectomy with additional vaginal reconstruction (VH + VR) versus those who underwent vaginal reconstruction without hysterectomy (VR only). Total intraoperative lidocaine dose included the intravenous dose from anesthesia and the vaginally injected dose from the surgeon. The risk of t...
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Uterosacral Ligament Suspension: A Radiographic Study of Suture Location in Live Subjects
Conclusions In live subjects, our study confirms that the vasculature, ureter, and rectum of the pelvic side wall are near suture placement for USLS. This information highlights the importance of careful dissection and awareness of anatomic landmarks. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Does Mesh Weight Affect Time to Failure After Robotic-Assisted Laparoscopic Sacrocolpopexy?
Conclusions Women receiving ultralightweight mesh are more likely to experience earlier anatomic failure in the anterior compartment. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Medial Thigh Anatomy in Female Cadavers: Clinical Applications to the Transobturator Midurethral Sling
Conclusions Familiarity with the medial thigh is essential for surgeons utilizing transobturator midurethral slings. Risks of mesh excision should be weighed against benefits before extensive thigh dissection for pain-related indications. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - September 1, 2020 Category: Surgery Tags: Original Articles Source Type: research

Transvaginal Trigger Point Injections Improve Pain Scores in Women with Pelvic Floor Hypertonicity and Pelvic Pain Conditions
We describe our method of transvaginal trigger point injections (TPIs) and report outcomes using change in pain scores. Methods This was a retrospective review of women treated with in-office pelvic floor muscle injections from January 2012 to August 2015. Lidocaine 1% and 2%, bupivacaine 0.5%, or ropivacaine 0.5% with or without the addition of triamcinolone 40 mg was used for the injections. Pain was reported on a 0- to 10-point numerical rating scale before and after injection. Differences in pretreatment and posttreatment pain scores were analyzed after the first injection and after subsequent injections. Repeated-m...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

The Accuracy of Portable Ultrasound Bladder Scanner Measurements of Postvoid Residual Volume in Women With Pelvic Organ Prolapse
Conclusions The portable bladder scanner accurately measures PVR in patients with pelvic organ prolapse and could be considered as an alternative to catheterized assessment. However, stage III/IV prolapse is associated with increased bladder scanner error, which should be considered when determining appropriate candidates for bladder scanner PVR assessment. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Health Care–Seeking Characteristics of Women With Pelvic Floor Disorders After Obstetric Anal Sphincter Injury
Conclusions The study showed that multiple visits were needed to both diagnose and treat pelvic floor disorders (PFD) after OASIS. Pelvic pain was the most common primary PFD after OASIS. There should be a high level of suspicion for pelvic floor disorders, especially pain disorders, in women who have sustained a third- or fourth-degree laceration. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

A Telephone Call to Decrease Patient Anxiety Before Urodynamic Testing: A Randomized Controlled Trial
Conclusions Our study showed that a telephone call before undergoing UDS did not decrease anxiety compared with standard care; however, the telephone call was associated with higher satisfaction with pre-UDS counseling. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Information Priorities for Deciding on Treatment of Pelvic Organ Prolapse
Conclusions Women with POP identified the most important FAQs related to treatment success and complications, quality of life, and understanding how the treatment works. This information will be used to develop a comprehensive decision aid for women considering treatment options for POP. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Duration of Catheterization After Retropubic Midurethral Sling
The objective of this study was to describe the expected duration of self-catheterization in women discharged home performing intermittent self-catheterization (ISC) after retropubic midurethral sling (RMUS). Methods We conducted a retrospective cohort analysis of women who underwent an isolated RMUS by 3 providers between 2009 and 2014 at a single institution. A 300 mL retrograde-fill voiding trial (VT) was performed before discharge. Those who failed their VT (postvoid residual [PVR]>1/3 total bladder volume [TBV]) and could perform ISC are included in this analysis. Subjects were categorized into mild retention (P...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Sexual Satisfaction Changes Reported by Men After Their Partners' Robotic-Assisted Laparoscopic Sacrocolpopexies
This study aimed to compare the preoperative and postoperative sexual satisfaction reported by male sexual partners of women undergoing surgical correction of pelvic organ prolapse. Methods This was a single-center prospective cohort study. Heterosexual, sexually active English-speaking couples in which the women were planning to undergo robotic-assisted laparoscopic sacrocolpopexy for correction of pelvic organ prolapse were eligible for enrollment in the study. Validated sexual function questionnaires—the Sexual Experience Questionnaire (SEX-Q; Mulhall et al. J Sex Med. 2008) and Pelvic Organ Prolapse/Urinary In...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Concomitant Repair of Pelvic Floor Disorders in Women Undergoing Surgery for Gynecologic Malignancies
Conclusions Using a large national surgical database, only 2.4% of women undergoing gynecologic cancer surgery had a concomitant POPUI procedure. Our data suggest that postoperative complications may not increase when concomitant surgery for POPUI is done at the time of gynecologic cancer surgery. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Stress Urinary Incontinence Surgery in Washington State Before and After Introduction of the Mesh Midurethral Sling
Objectives Mesh midurethral slings (MUSs) are safe, effective treatments for female stress urinary incontinence (SUI), but many companies have ceased production because of controversies surrounding transvaginal mesh. To determine if introduction of MUS has increased the complication rate associated with SUI surgery, we compared women undergoing SUI surgery in the MUS era to those who had surgery prior its introduction. Methods This was a retrospective cohort study of a statewide hospital discharge database. Stress urinary incontinence surgeries from 1987 to 1996 and 2007 to 2013 were identified using International Cla...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Impact of Trainee Involvement on Complication Rates Following Pelvic Reconstructive Surgery
Objective Trainee involvement in surgical procedures has been associated with longer surgical times and increased rates of certain complications. There has been limited study of the impact trainee involvement has on outcomes in urogynecologic surgery. We sought to determine the impact of resident and fellow involvement in pelvic reconstructive surgeries on 30-day complication rates. Methods Using the American College of Surgeons National Surgical Quality Improvement Program database, patients who underwent pelvic floor surgery were identified between 2010 and 2015. Patients were stratified into 3 groups: no trainee, r...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Predictors of Opioid Administration in the Acute Postoperative Period
Objectives Our primary objective was to evaluate age as a predictor of postanesthesia care unit (PACU) opioid administration in women undergoing reconstructive pelvic surgery. Our secondary objective was to identify additional predictors of PACU opioid administration. Methods We conducted a retrospective cohort study of women undergoing outpatient urogynecologic surgery for pelvic organ prolapse and/or stress urinary incontinence between September 2015 to October 2016 at 1 academic medical center. We compared 2 cohorts (1) women older than 65 years and (2) women older than 65 years. Our primary outcome was any opioid ...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

A National Contemporary Analysis of Perioperative Outcomes for Vaginal Vault Prolapse: Minimally Invasive Sacrocolpopexy Versus Nonmesh Vaginal Surgery
Objective The aim of this study was to compare the perioperative morbidity of minimally invasive sacrocolpopexy (MISC) and nonmesh apical vaginal surgeries for repair of vaginal vault prolapse using data from a contemporary nationwide cohort. Methods The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify women who underwent apical prolapse surgery via vaginal approach or MISC from 2010 to 2016. Those undergoing concomitant hysterectomy or transvaginal mesh placement were excluded. Associations of surgical approach with 30-day complications, prolonged hospitalizati...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Same-Day Discharge After Robotic-Assisted Sacrocolpopexy
Objective The aim of the study was to compare unplanned postoperative encounters in women discharged same day versus later after robotic-assisted sacrocolpopexy (RA-SCP). Methods This is a retrospective cohort study of women who underwent RA-SCP at a tertiary care center January 2013 to September 2015. Women were divided into 2 cohorts based on their day of discharge: (1) same day or (2) postoperative day 1 (POD ≥ 1) or later. Our primary outcome was unplanned provider visits (clinic, urgent care, emergency department, or hospital readmission) during the 6 weeks after surgery. Secondary outcomes included unplanned ...
Source: Journal of Pelvic Medicine and Surgery - August 27, 2019 Category: Surgery Tags: Original Articles Source Type: research

Peripartum Perineal Hernia: A Case Report and a Review of the Literature
Conclusions Obstetric trauma is a previously unreported cause of perineal hernias. Perineal hernias are rare conditions that must be considered in any patient who presents with a bulging perineal mass. Puerperal pubic symphysis rupture can lead to a large bladder hernia. Our combined abdominal-perineal approach of repair resulted in minimal perioperative morbidity and short-term resolution of the hernia. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - August 28, 2018 Category: Surgery Tags: Review Article Source Type: research

Rare Enterorectal Pelvic Floor Hernia—A Cadaveric Study
We present a cadaveric case study of an 88-year-old woman with an unusual posterior perineal hernia containing small bowel, rectum, and mesentery. Dissection revealed several loops of the small bowel occupying the presacral space and displacement of the rectum into a large perineal evagination. The intestinal mucosa appeared to have been healthy at the time of death, and we did not find any indication of rectal prolapse. There was also no evidence of past surgery, suggestive of a primary hernia. We conclude this patient had a posterior enterorectal perineal hernia. Suggestions for surgical repair are described. (Source: Jo...
Source: Journal of Pelvic Medicine and Surgery - August 28, 2018 Category: Surgery Tags: Case Reports Source Type: research

Mayer-Rokitansky-Küster-Hauser Syndrome With Bilateral Ovarian Sertoli Cell Tumors: Review of the Literature and Report of a Rare Case
Conclusions The case presented is unique in that 2 rare pathologies, bilateral Sertoli cell tumors of the ovary and MRKH syndrome, developed concomitantly in the same patient. (Source: Journal of Pelvic Medicine and Surgery)
Source: Journal of Pelvic Medicine and Surgery - August 28, 2018 Category: Surgery Tags: Case Reports Source Type: research