International urogynecology journal
-
The prevalence of sexual dysfunction in postmenopausal women is high. Theoretically pelvic floor muscle (PFM) strength could influence sexual function, but to date there is scant evidence on this topic. The aim of this study was to evaluate the relationship between PFM strength and sexual function in postmenopausal women. The relationship between reported urinary incontinence (UI) and sexual dysfunction was also investigated. ⋯ Postmenopausal women with sexual dysfunction showed lower PFM strength than women without sexual dysfunction. There was a weak correlation between urinary incontinence severity and sexual function.
-
Polypropylene (PP) mesh has come under increased scrutiny owing to previous FDA safety communications regarding the risks of mesh in trans-vaginal surgery and ensuing class action litigation for post-operative complications. Additional concerns have been raised regarding a possible link between implanted PP mesh and the long-term development of malignancy. Until recently, no research was specifically committed to the exploration of such a link. Our objective was to provide an overview of the recent literature focusing on any association between the use of PP mesh for midurethral sling procedures and the development of malignancy. ⋯ Given the scarcity of evidence suggesting otherwise, the likelihood of PP mesh causing malignancy is exceptionally low. However, with few studies and an unknown latency period between exposure and diagnosis, more observational data would prove useful to exclude causality.
-
High vesicovaginal fistulas (VVF) in the setting of good apical support are best repaired via a transabdominal approach. Laparoscopic VVF repair was first reported in 1998. Several series of robot-assisted VVF repairs have since been published. The robot-assisted approach allows repair of high apical vaginal fistulas while avoiding the morbidity of laparotomy, shortening convalescence, and facilitating the use of omental interposition flaps. This video presents the technique for robot-assisted extravesical VVF repair utilizing a laparoscopically mobilized omental flap. ⋯ Robot-assisted extravesical VVF repair avoids the morbidity of a laparotomy, provides excellent exposure, and avoids a large cystotomy. It maintains vaginal length and allows for significantly better visualization compared with the transvaginal approach. This repair offers improved outcomes for certain patients depending on their history, anatomy, and the surgeon's experience.
-
Understanding barriers to seeking care for pelvic floor disorders is necessary. We sought to assess familiarity with pelvic floor disorders, as well as identify screening and referral patterns among primary care providers. ⋯ Primary care providers within a large healthcare system were more familiar with UI and OAB than POP, often underestimating the prevalence of POP. Nearly one-fifth were unaware of urogynecologists within their system. Educational outreach regarding pelvic floor disorders and the urogynecology specialty would likely improve patient access to care.