When cesarean delivery is indicated in ELBW infants and intubation after birth is anticipated, DCC after establishing a secured airway may help maintain neonatal cardiovascular stability and allow physicians to resolve the technical difficulties of intubation.

To determine the objective and subjective outcomes of pelvic organ prolapse (POP) surgery using a modified Surelift system (Neomedic International, Barcelona, Spain) and to evaluate surgical complications and postoperative impact on quality of life (QOL) and lower urinary tract symptoms. Design: Retrospective cohort study. Setting: Tertiary-care university hospital. Patients: Patients with symptomatic anterior or apical POP stage III and above. Interventions: All patients underwent pelvic reconstructive surgery with a modified Surelift transvaginal mesh kit. Measurements and Main Results: Eighty-three women who underwent pelvic reconstructive surgery with a modified Surelift for symptomatic anterior or apical prolapse stage III and above from April 2018 to January 2019 were reviewed retrospectively. All completed a 72-hour voiding diary, urodynamic study, and multiple validated QOL questionnaires at baseline and at between 6 and 12 months postoperatively. Descriptive statistics were used for demographics and perioperative data. Paired-samples t test and the McNemar test were applied for comparison of pre-and postoperative continuous and categoric data, respectively. The primary outcomes were the objective cure of POP, defined as anterior and apical prolapse Pelvic Organ Prolapse Quantification System ≤ stage I, and subjective cure on the basis of negative answers to Pelvic Organ Prolapse Distress Inventory 6. The objective and subjective cure rates at 1 year were 97.6% and 92.8%, respectively. There were significant improvements in QOL scores postoperatively. Although bladder outlet obstruction improved, de novo urodynamic stress incontinence and stress urinary incontinence were increased at 18.9% and 21.6%, respectively, at 1-year follow-up. The mesh extrusion rate was 4.8%. Conclusion:A modified Surelift has good objective and subjective cure rates at 1 year postoperatively with 4.8% mesh extrusion rate. There was significant improvement in lower urinary tract symptoms and QOL. De novo urodynamic stress incontinence at 6 months to 12 months was increased, but it was not sufficiently bothersome to warrant surgery. (2021) 28, 107−116.

patients with pelvic organ prolapse (pop) often have accompanying lower urinary tract symptoms. Symptoms such as stress urinary incontinence(SUi-UD) and detrusor overactivty(Do) would co-exist in a number of patients. Management entails relieving the obstructive element. to determine the clinical outcome of patients with urodynamics mixed type urinary incontinence(MUi-U) after vaginal pelvic reconstructive surgery(PRS), a retrospective study was conducted. MUI-U was defined as having urodynamic findings of both of DO/DOI (derusor overactivity incontinence) and SUI-UD. Main outcome measures: Objective cure-absence of involuntary detrusor contraction on filling cystometry and no demonstrable leakage of urine during increased abdominal pressure; Subjective cure-assessment index score of <1 on UDI-6 question #2 and #3. Of the 82 patients evaluated, 14 underwent vaginal PRS with concomitant mid-urethral sling(MUS) insertion while 68 had vaginal PRS alone. Pre-operatively, 49(60%) patients had stage III and 33(40%) had stage IV prolapse. Post-operatively, 1-year data shows an objective cure of 56% (46/82) and subjective cure of 54% (44/82). MUI-U was significantly improved. improvement of SUi UD and results of the 1-hour pad test were more pronounced in patients with concomitant MUS insertion. ergo, vaginal pRS cures symptoms of MUi-U in >50% of patients and concomitant MUS can be offered to SUI predominant MUI. Mixed urinary incontinence (MUI) alone has been the leading cause of urinary incontinence in women above 65 years old. The ten-year cumulative incidence of urinary incontinence rates MUI as the first reported symptom in 37.2% of elderly patients 1. The International Urogynecological Association (IUGA) and International Continence Society (ICS) define MUI as the complaint of involuntary leakage of urine associated with exertion, sneezing, or coughing, as well as leakage associated with urgency 2. The cause of which is due to striated muscle atrophy, estrogen deficiency, abnormalities in histomorphology, and microstructural changes 3. Diagnosis of MUI through urodynamic studies pose a great challenge, since results fail to correlate with patient's symptoms, which lead to under diagnosis. Management of these group patients has generally been based on the predominant symptom that the patients report as the most bothersome 4. On the other hand, patients with pelvic organ prolapse (POP) often have lower urinary tract symptoms (LUTS). The use of urodynamic study for pre-operative evaluation of patients with POP becomes mandatory per recommendation by International Consultation on Incontinence 5. Urodynamic studies unmask occult stress urinary incontinence (SUI-UD) and identify women with concomitant detrusor overactivity (DO) and overt SUI-UD. Women with DO and SUI-UD are considered to have mixed type urinary incontinence (MUI-U). The incidence of MUI in patients with POP is 34.3% 6. Relieving the obstructive element becomes the main focus of management

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