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Female Pelvic Medicine & Reconstructive Surgery

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https://www.readbyqxmd.com/read/28106657/impact-of-case-order-on-laparoscopic-sacrocolpopexy-do-surgeons-need-a-warm-up
#1
Erin Seifert Lavelle, Lindsay C Turner, Jonathan P Shepherd
OBJECTIVES: Warm-up is defined as a preparatory activity or procedure. Using case order as a surrogate for surgeon warm-up, first cases were compared with second or later cases for intraoperative complications, operative time, and length of stay (LOS) among women undergoing laparoscopic sacrocolpopexy. METHODS: This is a retrospective study of laparoscopic sacrocolpopexies performed from 2009 through 2014 at a large academic center. Any surgery preceding laparoscopic sacrocolpopexy was considered a surrogate for surgeon warm-up...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106656/pessary-education-for-residents
#2
Aisling A Clancy, Dante Pascali, Hisham Khalil
No abstract text is available yet for this article.
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106655/transurethral-polyacrylamide-hydrogel-injection-therapy-in-women-not-eligible-for-midurethral-sling-surgery
#3
Daniel Altman, Francesca Ghilotti, Rino Bellocco, Jan Zetterström, Helena Kopp Kallner
OBJECTIVES: This study aims to determine the effects of transurethral polyacrylamide hydrogel injection in patients considered ineligible for midurethral sling surgery. METHODS: In this prospective observational study, 81 patients received treatment with transurethral polyacrylamide hydrogel injection. Patients were considered ineligible for placement of a midurethral sling based on significant comorbidity (48%), 1 or more previously failed invasive treatments (16%), mixed urinary incontinence (27%), continuous incontinence (5%), or previous pelvic radiation therapy (4%)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106654/ultrasonographic-features-of-female-urethral-diverticula-a-retrospective-study-of-25-patients
#4
Xia Wang, Chaoran Dou, Yulin Yan, Yun Bai, Bing Hu, Tao Ying
OBJECTIVES: This article summarizes the ultrasonographic features of female urethral diverticula on biplane transrectal ultrasound (B-TRUS). METHODS: A retrospective study was performed with 25 consecutive women who were diagnosed and treated as having urethral diverticulum (UD) between January 2012 and March 2016. All the patients were preoperatively evaluated using B-TRUS. The number, location, configuration, size, and type of the UD on B-TRUS were assessed. RESULTS: Twenty-eight diverticula were found on B-TRUS...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106653/outcomes-of-rectovaginal-fistula-repair
#5
Jenifer N Byrnes, Jennifer J Schmitt, Benjamin M Faustich, Kristin C Mara, Amy L Weaver, Heidi K Chua, John A Occhino
OBJECTIVES: Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach. METHODS: This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106652/prospective-outcomes-of-a-pelvic-floor-rehabilitation-program-including-vaginal-electrogalvanic-stimulation-for-urinary-defecatory-and-pelvic-pain-symptoms
#6
Jennifer J Schmitt, Ruchira Singh, Amy L Weaver, Kristin C Mara, Randina R Harvey-Springer, Felecia R Fick, John A Occhino
OBJECTIVES: This study evaluated our experience after implementing a pelvic floor rehabilitation program including behavioral modification, biofeedback, and vaginal electrogalvanic stimulation (EGS). METHODS: This prospective cohort study evaluated outcomes of patients with pelvic floor dysfunction (urinary or defecatory dysfunction, pelvic pain/dyspareunia) who underwent pelvic floor rehabilitation. Patients received 4 to 7 sessions (1 every 2 weeks) including biofeedback and concluded with 30 minutes of vaginal EGS...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106651/evaluating-the-impact-of-intraoperative-surgical-team-handoffs-on-patient-outcomes
#7
Lauren E Giugale, Sarah Sears, Erin S Lavelle, Charelle M Carter-Brooks, Michael Bonidie, Jonathan P Shepherd
OBJECTIVE: The aim of the study was to assess the impact of intraoperative personnel handoffs on clinical outcomes in patients undergoing minimally invasive sacrocolpopexy (SCP). METHODS: We retrospectively reviewed SCPs performed at an academic center between 2009 and 2014. We analyzed the number of staff handoffs, defined as any instance a scrub technician (tech) or circulating nurse handed off responsibility for a break or shift change. Outcomes included operative (OR) time and composite variables for major complications (conversion to an open procedure, bladder injury, bowel injury, blood transfusion, infection, ileus, bowel obstruction, readmission, or mesh complication) and prolapse recurrence (prolapse at or beyond the hymen or retreatment)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106650/trends-in-ambulatory-management-of-urinary-incontinence-in-women-in-the-united-states
#8
James C Forde, Bilal Chughtai, Meagan Cea, Benjamin V Stone, Alexis Te, Tara F Bishop
OBJECTIVES: Urinary incontinence (UI) is a common condition, but despite the availability of guidelines, variations exist in the care of patients. We sought to assess the changes in assessment and management of women with UI over time in the United States. METHODS: The National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey are annual surveys from a nationally representative sample of visits to physicians. From 1999 through 2010, we identified visits by women to physicians where the chief complaint was UI using reason-for-visit and International Classification of Diseases, Ninth Revision codes...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106649/neutrophil-gelatinase-associated-lipocalin-biomarker-and-urinary-tract-infections-a-diagnostic-case-control-study-nuti-study
#9
Jameca Renee Price, Larissa Guran, Jeong Youn Lim, Christina J Megli, Amanda L Clark, Sharon Renee Edwards, Mary Anna Denman, W Thomas Gregory
OBJECTIVES: Acute uncomplicated urinary tract infection (UTI) in women is often treated based on symptoms alone. Urinary tract infection symptoms are highly sensitive but lack specificity and result in overuse of antibiotics. We sought to determine if urine neutrophil gelatinase-associated lipocalin (uNGAL) levels in urine can accurately discriminate between UTI and healthy women. METHODS: We recruited adult women aged 18 to 85 years presenting in the ambulatory setting from November 2014 to January 2016...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106648/effect-of-concurrent-prolapse-surgery-on-stress-urinary-incontinence-outcomes-after-tvto
#10
David E Rapp, Mary Ellen Dolat, Joshua Wiley, Bruce Rowe
OBJECTIVES: A variety of pelvic organ prolapse (POP) surgeries are performed concomitant to midurethral sling (MUS) placement. It is unknown whether differing POP surgeries may affect stress urinary incontinence outcomes after MUS placement. METHODS: We performed a retrospective cohort analysis of patients undergoing TVT obturator system in conjunction with a variety of POP repair (cystocele with mesh graft, cystocele with cadaveric fascia, colpocleisis, and sacrocolpopexy)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106647/estimation-of-uterine-size-how-accurate-are-we
#11
Tanya P Hoke, Babak Vakili
OBJECTIVE: To evaluate the accuracy of gynecologic surgeons at estimating uterine dimensions and weight. METHODS: Six model uteri of various sizes were created to simulate the size and consistency of a uterus and displayed at 3 stations. The visual station (VS) comprised 2 specimens placed on an unmarked table. The laparoscopic station (LS) consisted of 2 model uteri, each placed in a separate simulated abdomen with a 0 degree laparoscope and 2 operative trocars with standard instruments...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28079569/standing-vs-supine-does-it-matter-in-cough-stress-testing
#12
Radhika Patnam, Autumn L Edenfield, Steven E Swift
OBJECTIVES: The aim of this study was to compare the sensitivity of cough stress test in the standing versus supine position in the evaluation of incontinent females. METHODS: We performed a prospective observational study of women with the chief complaint of urinary incontinence (UI) undergoing a provocative cough stress test (CST). Subjects underwent both a standing and a supine CST. Testing order was randomized via block randomization. Cough stress test was performed in a standard method via backfill of 200 mL or until the subject described strong urge...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28079568/two-dimensional-and-three-dimensional-transperineal-ultrasound-findings-in-women-with-high-pressure-voiding-after-midurethral-sling-placement
#13
Kindra Larson, Lauren Scott, Tina D Cunningham, Yili Zhao, Alfred Abuhamad, Peter Takacs
OBJECTIVES: The aim of this study was to evaluate dynamic two-dimensional (2D) and 3D transperineal pelvic ultrasound findings with urodynamic studies in women with lower urinary tract symptoms after midurethral sling placement. METHODS: On 2D images, the sling position, and on 3D imaging the sling angle, urethral diameter, urethral height, and urethral cross sectional area were recorded with and without Valsalva. Patients were categorized into 3 groups based on 2D imaging: group 1-at rest, the sling lies parallel to the urethral lumen, and during Valsalva, the sling becomes C shaped; group 2-both at rest and during Valsalva, the sling runs parallel to the urethral lumen; group 3-at rest, the sling is C shaped, and during Valsalva, this curved shape is maintained...
January 10, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067749/association-between-obesity-and-perioperative-morbidity-in-open-versus-laparoscopic-sacrocolpopexy
#14
Gabriela E Halder, Jason L Salemi, Stuart Hart, Emad Mikhail
OBJECTIVES: The aim of this study was to compare differences in 30-day perioperative morbidity and mortality for women undergoing open sacrocolpopexy (OSCP) versus laparoscopic sacrocolpopexy (LSCP) across all body mass index (BMI) groups and between patients of ideal versus elevated BMI (includes overweight, obese, and morbidly obese). MATERIALS AND METHODS: Data for this retrospective review were obtained from the American College of Surgeons-National Surgical Quality Improvement Project database using current procedural terminology...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067748/levator-ani-muscle-defects-in-patients-with-surgical-failure
#15
Allison M Wyman, Kristie A Greene, Renee Bassaly, Lindsey Hahn, Simon Patton, Branko Miladinovic, Lennox Hoyte
INTRODUCTION: The objective of the study was to use a well-described system of measuring levator ani (LA) muscle defects from magnetic resonance images to evaluate whether major defects are correlated to an increased risk of surgical failure. METHODS: A retrospective cohort study performed on patients who underwent laparoscopic uterosacral ligament suspension from 2010 to 2012. Surgical failure was defined as a composite score of anatomic bulge beyond the hymen with sensation of bulge or repeat treatment of prolapse via pessary or surgery by 1-year follow-up...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067747/readmission-and-reoperation-after-surgery-for-pelvic-organ-prolapse
#16
Erik D Hokenstad, Amy E Glasgow, Elizabeth B Habermann, John A Occhino
OBJECTIVES: We aimed to determine the rates of readmission and reoperation for patients undergoing surgery for pelvic organ prolapse (POP). METHODS: The American College of Surgeons National Surgical Quality Improvement Program Participant User File was used to select all surgeries performed for POP from 2012 through 2014. The cohort was then reviewed for unplanned readmissions and unplanned reoperations within 30 days of POP surgery. Patient and procedural factors associated with readmission or reoperation were compared using χ analyses and Student t test...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067746/increasing-age-is-a-risk-factor-for-decreased-postpartum-pelvic-floor-strength
#17
Lieschen H Quiroz, Stephanie D Pickett, Jennifer D Peck, Ghazaleh Rostaminia, Daniel E Stone, S Abbas Shobeiri
OBJECTIVES: This study aimed to determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery (VD) in a cohort of low-risk women. METHODS: This is a secondary analysis of a prospective study examining the risk of pelvic floor injury in a cohort of primiparous women. All recruited participants underwent an examination, three-dimensional ultrasound and measurement of PFS in the third trimester and repeated at 4 weeks to 6 months postpartum using a perineometer...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067745/effect-of-trospium-chloride-on-cognitive-function-in-women-aged-50-and-older-a-randomized-trial
#18
Elizabeth J Geller, Julie B Dumond, J Michael Bowling, Christine M Khandelwal, Jennifer M Wu, Jan Busby-Whitehead, Daniel I Kaufer
OBJECTIVES: This study aimed to investigate the effect of trospium chloride on cognitive function in postmenopausal women treated for overactive bladder (OAB). METHODS: Randomized double-blind placebo-controlled trial conducted from April 2013 to April 2015. Women aged 50 years or older seeking treatment for OAB were randomized to either trospium chloride XR 60 mg daily or placebo. Baseline cognitive function was assessed via Hopkins Verbal Learning Test-Revised (HVLT-R), Mini Mental Status Exam, Mini Mental Status X, Digit Span, Trails A, Trails B, and Epworth Sleepiness Scale...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067744/resident-education-in-female-pelvic-medicine-and-reconstructive-surgery
#19
Katie Propst, Adam C Steinberg, David M O'Sullivan, Megan O Schimpf, Christine LaSala
OBJECTIVE: The aim of this study was to evaluate whether obstetrics and gynecology trainees feel satisfied with the female pelvic medicine and reconstructive surgery (FPMRS) education received in residency. METHODS: This is a survey study of obstetrics and gynecology residents in the United States and Puerto Rico during the 2015-2016 academic year. The anonymous 29-question survey was approved by the Hartford HealthCare institutional review board. Responses were included only if the trainee had ever rotated on the FPMRS service...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067743/comparative-perioperative-pain-and-recovery-in-women-undergoing-vaginal-reconstruction-versus-robotic-sacrocolpopexy
#20
Lauren B Westermann, Catrina C Crisp, Donna Mazloomdoost, Steven D Kleeman, Rachel N Pauls
BACKGROUND: In this study of patients undergoing vaginal hysterectomy with either robotic or vaginal prolapse repair, there was no difference in quality of life in the weeks following surgery; however, less narcotics were used, less pain was documented by nurses and Surgical Pain Scale (SPS), and better performance on voiding trials was noted in those undergoing robotic sacrocolpopexy. OBJECTIVES: Minimally invasive surgery for pelvic organ prolapse is the preferred surgical route for optimal recovery...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
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