International urogynecology journal
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Randomized Controlled Trial Comparative Study
Combined spinal and general anesthesia vs general anesthesia for robotic sacrocervicopexy: a randomized controlled trial.
Gynecologic laparoscopic surgery is frequently accompanied by early postoperative pain. This study assessed the effect of combined general and spinal anesthesia on postoperative pain score, analgesic use, and patient satisfaction following robotic surgeries. ⋯ Reported levels of pain and analgesic use during the first 24 h following robotic gynecologic surgery were significantly lower following general and spinal anesthesia compared to general anesthesia alone.
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Randomized Controlled Trial
Warm-up on a simulator improves residents' performance in laparoscopic surgery: a randomized trial.
Our aim was to assess the impact of immediate preoperative laparoscopic warm-up using a simulator on intraoperative laparoscopic performance by gynecologic residents. ⋯ Performing a brief warm-up exercise before a major or minor laparoscopic procedure significantly improved the intraoperative performance of residents irrespective of the difficulty of the case.
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Mesh complications, both erosions and extrusions, are becoming more common in the practice of urology. We present the case of a 58-year-old woman who presented with lower urinary tract symptoms (LUTS) and recurrent urinary tract symptoms following treatment for stress urinary incontinence and who was found to have two slings eroded into her urethral lumen. The slings were debulked in the urethra using the holmium laser, thereby avoiding a more complex urethral reconstruction.
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This study evaluates the effect of baseline pelvic organ prolapse (POP) severity on improvement in overactive bladder (OAB) symptoms after pelvic reconstructive surgery. ⋯ Women with coexisting POP and OAB who undergo surgical correction of POP experience improvement in OAB symptoms after surgery, although women with more severe POP may be at a higher risk of persistent frequency or urge incontinence.
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Our aim was to determine the impact of pregnancy on sacral neuromodulation (SNM) and vice versa in patients with Fowler's syndrome (FS), which is typified by chronic urinary retention (CUR). ⋯ Turing off the SNM during pregnancy results in recurrence of CUR, with an increased risk of recurrent UTI associated with preterm delivery. This did not impact foetal well-being. The option of keeping the SNM on during pregnancy should therefore be considered, and as caesarean section affects the SNM device, we advise that caesarean section should only be performed for obstetric reasons.