Purpose of review This article will review current guidelines regarding surgical protocols for elective and nonelective surgeries during the severe acute respiratory syndrome coronavirus 2 pandemic. Recent findings Perioperative management for surgical patients should be modified to promote the safety and wellbeing of patients and caregivers amidst the COVID-19 pandemic. COVID-19 testing should be performed preoperatively with subsequent preprocedure quarantine. Nonemergent or nonlife-threatening surgery should be postponed for COVID-19 positive patients. The consensus of surgical societies is to use a laparoscopic surgical approach for COVID-19 positive patients when appropriate and to avoid port venting at the end of procedures. For COVID-19 positive patients requiring an emergent procedure, the use of personal protective equipment is strongly recommended. Summary After over a year of the COVID-19 pandemic, effective protocols and precautions have been established to decrease the morbidity and mortality of patients undergoing surgery and to promote the safety of healthcare personnel. Continued investigations are necessary as cases of new, possibly more virulent, strains of the virus arise.

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Introduction: Uterine leiomyomas are benign smooth muscle tumors that affect approximately 70–80% of women worldwide. Erosion of leiomyomas into surrounding tissues is a rare complication. We present a case of a postmenopausal female with uterine leiomyoma eroding into the urinary bladder. Case Report: A 55-year-old, postmenopausal female with history of uterine fibroids previously treated with uterine artery embolization presented with recurrent bladder stones, hematuria, and pelvic pain. Pelvic magnetic resonance imaging described a 4.3 cm heterogenous mass involving the ventral uterine fundus and bladder dome concerning for malignancy. She underwent robotic-assisted total laparoscopic hysterectomy, right salpingo-oophorectomy, left salpingectomy, and partial bladder cystectomy. Pathology was significant for benign calcified leiomyoma and benign calcifications within the bladder mucosa. Conclusion: Erosion of leiomyoma through the bladder mucosa is rare complication but should be considered in the differential diagnosis for patients presenting with hypercalciuria and recurrent bladder stones in the setting of uterine fibroids previously treated with uterine artery embolization.

One thousand new patients had mean age 58.4 AE 15.8 with BMI 28.8 AE 6.5. Subjects were mostly white (91.9%) and married (62.4%). Half (49.7%) were sexually active, 34.8% had dyspareunia, and few reported history of abnormal pap smears (26.0%) or sexually transmitted infections (2.1%). DV prevalence was 11.9%. Pelvic Pain was the least common CC (8.6%), but most commonly reported DV (24.4%). Prolapse was the most common CC (36.2%), but had the lowest prevalence of DV (6.1%). DV was reported by 15.2% with Overactive Bladder, 14.4% with Stress Incontinence, and 11.6% with CC of "other." Patients with Pelvic Pain CC were more than twice as likely to report DV compared to all other CCs (OR ¼ 2.690, 95% CI ¼ 1.576-4.592). Those with pelvic pain were more likely to report DV when compared individually to prolapse (OR ¼ 4.993, 95% CI ¼ 2.596-9.604) and "other" (OR ¼ 2.472, 95% CI ¼ 1.282-4.766). There was no statistical difference compared to overactive bladder (OR ¼ 1.798, 95% CI ¼ 0.988-3.271) or stress urinary incontinence (OR ¼ 1.915, 95% CI ¼ 0.905-4.055). Multivariable regression is shown in Table 1 with 5 predictors of DV on both univariable and multivariable logistic regression. After adjustment, CC of pelvic pain was still 1.862 times as likely to report DV. Nocturia was an additional urogynecologic variable predictive of DV (OR ¼ 1.162 per nightly episode, 95% CI ¼ 1.033-1.308). Smoking conferred the highest likelihood of DV (OR ¼ 3.676, 95% CI ¼ 2.252-5.988). CONCLUSION: Domestic violence was experienced by 11.9% of outpatient urogynecology patients. This is lower than reported in the general population, potentially due to reporting bias or the older age of our patients. While those with CC of prolapse were less likely to report DV, we recommend routine screening in all women. Special efforts should be made to screen those at higher risk with CC of pelvic pain who were younger, smokers, with higher BMI, and with increased nocturia.