ObjectiveThe objective of this study is to identify the incidence of and risk factors for urinary tract infection (UTI) after office cystoscopy and urodynamic studies (UDS) in a female population.MethodsThis was a retrospective cohort study investigating incidence of and risk factors for UTI after office testing. Inclusion criteria included women presenting for either cystoscopy or UDS from September 2019 to February 2020. Modified Poisson regression with robust error variance was used to identify risk factors for UTI after cystoscopy and UDS in a female population.ResultsA total of 274 patients met inclusion criteria. One hundred eighty-five patients underwent office cystoscopy. Nine (4.8%) had a postcystoscopy UTI. Significant risk factors for postcystoscopy UTI included recurrent UTI (relative risk, 7.51; 95% confidence interval, 1.66–34.05) and a history of interstitial cystitis (relative risk, 4.56; 95% confidence interval, 1.52–13.73). Of those with recurrent UTI, 13.7% had a postcystoscopy UTI. Among patients with interstitial cystitis, 25% had a postcystoscopy UTI. One hundred ninety-two patients underwent UDS. Ten (5.2%) developed a post-UDS UTI. No risk factors were identified.ConclusionsPatients with recurrent UTI were 7.51 times more likely to develop a UTI after cystoscopy, whereas those with interstitial cystitis were 4.56 times more likely to develop a UTI after cystoscopy. The incidence of UTI after UDS was low overall. Understanding who is at higher risk of postprocedural UTIs may help identify subpopulations that may benefit from prophylactic strategies.

discusses techniques that are utilized to decrease the risk of bleeding or bladder injury in a patient with a scarred bladder flap and/or lower uterine segment mass. These techniques include isolating the uterine artery at its origin, backfilling the bladder, and the low lateral technique. Additionally, this video reviews the basic facts of an isthmocele and an epithelioid trophoblastic tumor. CONCLUSION: This is a unique case in which the lower uterine segment mass was thought to be a benign sequela of 3 prior cesarean sections, but the mass in question was actually a rare malignancy.

OBJECTIVES: To demonstrate a minimally invasive robot-assisted technique to resect a cesarean scar ectopic pregnancy also involving the cervix and subsequent metroplasty. DESCRIPTION: Cesarean scar ectopic pregnancy occurs in approximately 1 in 2000 pregnancies and has the potential to cause significant maternal morbidity and mortality due to risk of hemorrhage. It is unclear the most effective treatment of cesarean scar pregnancy due to limited available data. The case presented is a 30-year old female gravida two para one at 15 weeks gestation with cesarean scar ectopic pregnancy who underwent a robot-assisted resection after failed methotrexate treatment. After placement of the robotic port sites, the bladder flap was developed distal to the cervix. A large window was visualized in the lower uterine segment and cervical region. The cesarean scar ectopic was visualized involving also the cervical region just above the internal os; this was resected until normal myometrium was encountered. The myometrium was subsequently re-approximated in layers of 2-0-Monocryl suture. Hysteroscopy was then performed, where the sutures were visualized and the endocervical canal verified to be patent. Post-operative imaging revealed resolution of previously visualized ectopic pregnancy as well as a reinforced anterior lower uterine segment myometrium. CONCLUSION: Robot-assisted resection of cesarean scar ectopic pregnancy and metroplasty is a safe and feasible method for treatment of a cesarean scar ectopic pregnancy also involving the cervix.

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