Same-day discharge after RA-SCP is safe and does not result in increased health care utilization (provider visits or postoperative phone calls).

Introduction and Hypothesis Weight-loss has been demonstrated to result in an improvement in fecal incontinence (FI) severity; however, there is a paucity of data addressing differential impact of FI on quality of life (QOL) and results of diagnostic testing across BMI categories. We wished to evaluate symptom distress, QOL, and diagnostic testing parameters among normal, overweight, and obese women with fecal incontinence. Methods Women undergoing evaluation for FI between 2003 and 2012 were identified. Participants completed validated, symptom specific distress, impact, and general QOL measures including the Modified Manchester Questionnaire (MMHQ) which includes the Fecal Incontinence Severity Index (FISI), and the mental and physical component summary scores, MCS and PCS, respectively of the Short Form-12. Anorectal manometry measures were also included. Multivariable regression analyses were performed. Results Participants included 407 women with a mean age ± SD of 56 ± 13. Multivariable analyses revealed no differences in symptom specific distress and impact as measured by MMHQ, MCS and PCS across BMI groups, however, obese women had increased resting and squeeze pressures compared to normal and overweight BMI women (p<0.0001and p<0.0001; p = 0.007 and p = 0.004, respectively). Conclusions Obese women with FI did not have more general impact and symptom-specific distress and impact on quality of life as compared to normal and overweight women. Obese women with FI had higher baseline anal resting and squeeze pressures suggesting a lower threshold to leakage with pressure increases.

Crowdsourced assessments of recorded dry lab surgical drills using a validated assessment tool are a rapid and suitable alternative to expert surgeon evaluation.

In women with mixed-flora compared with no-growth preoperative urine cultures, there were no differences in the prevalence of postoperative UTI. The clinical practice of interpreting mixed-flora cultures as negative is appropriate.

Aim: To identify risk factors for positive preoperative urine cultures in asymptomatic women undergoing urogynecologic surgery. We also sought to identify risk factors for mixed flora clean catch urine cultures.Methods: This is a cross-sectional study. Demographic data and screening preoperative urine cultures were extracted on all women who underwent urogynecologic surgery between 9/2011 and 9/2013. Urine culture results were defined as: negative (no growth), positive (≥100K organisms), and contaminated (mixed flora). Women with <100K colony-forming units of a single organism were excluded. Logistic regression models were constructed to evaluate for differences between groups.Results: 490 women were included. When comparing positive to negative cultures, the positive culture group was more likely to have a history of recurrent urinary tract infections (UTIs) (20% vs. 5%, p=0.001). In a logistic regression model,a history of recurrent UTIs remained a risk factor for a positive preoperative urine culture (OR 6.9, 95% CI 2.3-20.8), whereas vaginal estrogen usage decreased the risk of a positive preoperative culture (OR 0.3, 95% CI 0.1-0.9). When comparing contaminated to negative cultures, the contaminated culture group was more likely to be obese (45% vs. 28%, p=0.001). In a logistic regression model, obesity remained a risk factor for contaminated preoperative urine cultures (OR 2.0, 95% CI 1.3-3.2). Conclusion:A history of recurrent UTIs was a risk factor for a positive preoperative urine culture in asymptomatic women undergoing urogynecologic surgery. Vaginal estrogen therapy was associated with fewer positive preoperative urine cultures. Obesity was an independent risk factor for contaminated (mixed flora) clean catch urine culture results.