Findings suggest need for patient reassurance about the prevalence and benign course of POP and UI upon initial assessment, with continued reinforcement of basic concepts after diagnosis, and need for increased awareness and information resources for healthcare providers and Spanish-speaking Latina women regarding these common pelvic floor disorders.

During transvaginal USLS, performance of a concomitant anterior colporrhaphy increased the risk of ureteral occlusion, while the use of a suture-capturing device for suspension suture placement was associated with decreased risk.

Objectives To explore the knowledge, attitudes, and beliefs related to pessary use in Spanish-speaking women along the US-Mexico border. Methods Spanish-speaking women with symptoms of vaginal bulge were recruited from the urogynecology/gynecology clinics at Texas Tech University Health Sciences Center El Paso to participate in moderated focus groups. Discussion topics included knowledge of prolapse/pessaries, pros/cons of pessaries, alternatives, and prolapse surgery. Audio-recorded group discussions were transcribed verbatim, and qualitative analysis completed by independent review using grounded theory methodology. Common themes were identified and then aggregated to form consensus concepts, agreed upon by the reviewers. Results Twenty-nine Spanish-speaking women participated in 6 focus group discussions. Approximately half of women reported little or no prior knowledge about pessaries. Three main themes were identified from analysis: knowledge/perceptions, misinformation/misconceptions, and surgery-related concerns. Concepts identified from common themes included limited knowledge of pessaries, confusing “pessary” with “mesh,” willingness to try pessaries in order to avoid surgery, desire to try pessary if it was recommended by physician, limited efficacy or complications of surgery, and mesh-related concerns. Interestingly, some women reported that pessaries appear to be a treatment more often offered in the United States rather than in Mexico. Conclusions Most participants showed a willingness to try a pessary for symptoms of pelvic organ prolapse in an effort to avoid surgery, despite expressing limited knowledge about this treatment. Physician recommendations and risks of pessary use influence their likelihood of trying a pessary. These concepts serve as focus points for effective pessary counseling to help improve education and informed decision making in this patient population.

Objective The objective of this study was to evaluate the effect of patients’ immediate prevoiding pain level after vaginal pelvic reconstructive surgery on their ability to void. Methods We conducted a retrospective cohort study of women with and without urinary retention after urogynecologic procedures. Postoperative pain, measured by a visual analog scale, was recorded for each patient before a voiding trial. Demographic, surgical characteristics, prevoiding trial pain, and rate of postoperative urinary retention were compared. Multiple-logistic regression analysis was used with all analyses controlled for univariate variables with a P value of ≤0.1 to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Two-tailed tests were used, with P < 0.05. Results A total of 458 patients were identified, of which 21% (97/458) failed their voiding trial. In our study, 62% (284/458) of women had a voiding trial on postoperative day 1, and 38% (174/458) underwent a same-day voiding trial. No differences were noted between groups comparing race, ethnicity, hysterectomy, urinary sling, estimated surgical blood loss, utilization of intraoperative or postoperative narcotics, or the proportion of same-day voiding trials. Women with postoperative urinary retention had higher mean prevoiding pain when compared with women without urinary retention (pain visual analog scale, 25 mm vs 12 mm [P < 0.001], respectively). After multiple-logistic regression analysis, a significant association between postoperative urinary retention persisted for prevoiding trial pain score (aOR, 1.02; 95% CI, 1.01–1.03), age (aOR, 1.05; 95% CI, 1.02–1.02), and anterior colporrhaphy (aOR, 2.13; 95% CI, 1.18–3.8). Conclusions Prevoiding pain after pelvic surgery is significantly associated with increased rates of postoperative urinary retention.

Objective This study aimed to present the evaluation, diagnoses, and surgical management of symptomatic periurethral masses of women at an academic institution. Methods This study is an institutional review board–approved retrospective case series of women who presented with a symptomatic periurethral mass and scheduled for surgery within the Department of Urology and Female Pelvic Medicine and Reconstructive Surgery over a 10-year period (October 2003–July 2014). Results Fifty-nine women (mean age, 46 years; range, 22–73 years) were evaluated during the study period. Final pathology revealed 38 (64%) urethral diverticula and 21 (36%) from other benign etiologies. Of the 38 urethral diverticula, 2 (5%) were associated with adenocarcinoma and 4 (11%) with previous bulking agents. Of the 21 nondiverticula, there were 7 (12%) Skene duct cysts/abscesses, 3 (5%) Gartner duct cysts, 2 (3%) vaginal wall inclusion cysts, 2 (3%) bulking agents, 2 (3%) urethral polyps, and one (2%) of each of the following: leiomyoma, angiomyofibroblastoma, redundant vaginal mucosa epithelium, suture abscess, and encapsulated mesh remnant. Fifty-seven women underwent surgical excision (97%), and 2 elected observation. Most (78%) reported resolution of symptoms after excision. Of the patients surgically managed, 7% had postoperative stress urinary incontinence and 12% had persistent lower urinary tract symptoms. Of the 38 women with urethral diverticula, 17% had recurrence and were more likely to have multiple diverticula (44% vs 8%, P = 0.03). Conclusion Although urethral diverticulum was the most common cause of a periurethral mass, final pathology revealed a variety of benign diagnoses in more than one-third of cases, demonstrating the importance of a thorough investigation for accurate diagnosis.