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Fertil Steril 2021 Apr 8. Epub 2021 Apr 8.

Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan.

Objective: To describe the anatomic and technical highlights of a novel nerve-sparing surgery in deep endometriosis (DE) using near-infrared (NIR) fluorescence technology and indocyanine green (ICG).

Design: Stepwise demonstration of this method with narrated video footage.

Setting: An urban general hospital. Read More

J Endourol 2021 Mar 31. Epub 2021 Mar 31.

Lewis Katz School of Medicine at Temple University, 12314, Urology, Philadelphia, Pennsylvania, United States;

Objectives: To describe our multi-institutional experience with robotic repair of iatrogenic urogynecologic fistulae (UGF), including vesicovaginal fistulae (VVF) and ureterovaginal fistulae (UVF).

Methods: We performed a retrospective review identifying patients who underwent robotic repair of vesicovaginal and ureterovaginal fistulae between January 2010 and May 2019. All patients failed conservative management with foley catheter or upper tract drainage (ureteral stent and/or nephrostomy tube), respectively. Read More

Int Urogynecol J 2021 Jan 6. Epub 2021 Jan 6.

Department of Urology, Wake Forest Baptist Health, One Medical Center Boulevard, Winston-Salem, NC, 27101, USA.

Introduction And Hypothesis: Ureteral injury during gynecological surgery can be managed in a variety of ways, from endoscopic stent placement to ureteroneocystotomy with accompanying psoas hitch and/or Boari flap. The majority of these occur during hysterectomy; therefore, gynecologic surgeons may not be as familiar with repair in women with intact uteri. Herein we present our technique for delayed robotic-assisted ureteral reimplant and psoas hitch in a woman with a ureteral injury sustained during cesarean section, which initially presented as a uretero-cervical fistula. Read More

J Minim Invasive Gynecol 2021 Apr 27;28(4):779-787. Epub 2020 Nov 27.

Instituto do Câncer, Dr. Arnaldo Vieira de Carvalho (Drs. da Cunha and Tobias-Machado); Urology Division, ABC Medical School, Santo André (Drs. Bautzer and Tobias-Machado); Hospital São Luiz Morumbi, Rede D´Or (Dr. Tobias-Machado), São Paulo.

Objective: To review the literature for the preoperative clinical characteristics, surgical findings, and outcomes of patients who underwent laparoscopic surgical treatment of ureteral endometriosis (UE).

Data Sources: A systematic search was performed in the PubMed and Scopus databases.

Methods Of Study Selection: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies in English language that assessed UE treated surgically by laparoscopy published between 2008 and 2020 were selected. Read More

Am J Obstet Gynecol 2021 May 3;224(5):502.e1-502.e10. Epub 2020 Nov 3.

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL.

Background: Complex lower urinary tract injury resulting from hysterectomy is a rare but highly morbid complication. Although intraoperative recognition reduces the risk of serious sequelae, observational studies have shown that most complex lower urinary tract injuries are recognized in the postoperative period. To date, limited research exists describing the timing of diagnosis of complex lower urinary tract injury or risk factors associated with complex lower urinary tract injury diagnosed in the postoperative period. Read More

Ann Surg Oncol 2020 Oct 23. Epub 2020 Oct 23.

Gynecologic Unit, Donostia University Hospital-Biodonostia Health Research Institute, Basque Country University, San Sebastián, Spain.

Background: This study aimed to review the current knowledge on the utility of intraoperative fluorescence imaging in gynecologic surgery and to give evidence-based recommendations to improve the quality of care for women who undergo gynecologic surgery.

Methods: A computer-based systematic review of the MEDLINE, CENTRAL, Pubmed, EMBASE, and SciSearch databases as well as institutional guidelines was performed. The time limit was set at 2000-2019. Read More

BMC Surg 2020 Oct 12;20(1):234. Epub 2020 Oct 12.

Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai, 200090, China.

Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the vNOTES hysterectomy for uterus ≥1 kilogram (kg).

Methods: From January 2019 to March 2020, patients with benign indications in cases of uterus weighing ≥1 kg, underwent vNOTES hysterectomy were studied retrospectively. Read More

J Minim Invasive Gynecol 2020 Sep 20. Epub 2020 Sep 20.

Division of Obstetrics and Gynecology, Department of Experimental and Clinical Medicine, University of Pisa, Pisa, Italy (all authors).

Study Objective: To show feasibility of using indocyanine green (ICG) in endometriosis surgery, especially bowel endometriosis shaving, and to discuss its potential benefits.

Design: Stepwise demonstration of this technique with narrated video footage.

Setting: Endometriosis is a common benign chronic disorder, characterized by the presence of endometrial tissue outside the uterus. Read More

Zhonghua Fu Chan Ke Za Zhi 2020 Sep;55(9):600-608

Department of Gynecologic Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.

To investigate the efficacy and safety of laparoscopic radical hysterectomy for early cervical adenocarcinoma. A retrospective observational study was performed by reviewing medical records of patients with staging Ⅰb1-Ⅱa2 International Federation of Gynecology and Obstetrics (FIGO, 2009) cervical adenocarcinoma who underwent laparoscopic or abdominal radical hysterectomy from 2007 to 2017 in the Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences. The difference among clinicopathologic characteristics, surgery-related parameters and complications, and prognosis were analyzed between the laparoscopic group and abdominal group. Read More

Arch Gynecol Obstet 2021 01 19;303(1):169-179. Epub 2020 Sep 19.

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Purpose: To assess the feasibility and safety of total laparoscopic hysterectomy (TLH) for uteri ≥ 1.5 kg.

Methods: We prospectively evaluated all elective TLHs (with or without adnexectomy) performed for fibromatous uteri between August 2009 and August 2019 in the Department of Obstetrics and Gynecology, Sirai Hospital, Carbonia, and the Department of Gynecologic Oncology, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari. Read More

J Minim Invasive Gynecol 2020 Aug 31. Epub 2020 Aug 31.

Division of Minimally Invasive Gynecologic Surgery and Robotics (Drs. Wang, Mesbah, Wells, and Nezhat). Electronic address:

Study Objective: To demonstrate intra- and postoperative steps in a successful management of a complicated vesico-[utero]/cervicovaginal fistula.

Design: Stepwise demonstration of the technique with narrated video footage.

Setting: A urogenital fistula in developed countries mostly occurs after gynecologic surgeries but rarely from obstetric complications. Read More

J Endourol Case Rep 2019 2;5(4):142-144. Epub 2019 Dec 2.

Division of Urology, University of Utah School of Medicine, Salt Lake City, Utah.

Iatrogenic ureteral injury represents an uncommon, but significant, complication of gynecologic surgery. Endoscopy has typically played little to no role in the treatment of these injuries, which are traditionally managed with re-exploration or delayed repair. Delayed repair with temporary urinary diversion exposes the patient to significant morbidity. Read More

J Minim Invasive Gynecol 2021 Mar 27;28(3):684-691.e2. Epub 2020 Jul 27.

Department of Urogynecology and Pelvic Floor Disorders, Ob/Gyn & Women's Health Institute (Drs. Propst and Ridgeway).

Objective: To systematically review tools for the prevention of urinary tract injury in adult women undergoing minimally invasive gynecologic surgery.

Data Sources: A medical librarian (M.P. Read More

Int J Gynecol Cancer 2020 08 15;30(8):1210-1214. Epub 2020 Jul 15.

Department of Special Operative and Oncologic Gynecology, Asklepios Klinik Altona, Hamburg, Hamburg, Germany.

Objective: Radical vaginal trachelectomy is the fertility-preserving surgery for patients with early stage cervical cancer. However, it has not gained widespread approval by gynecologic oncologists because of difficulties in the dissection of the bladder pillars and identification of the ureter during the vaginal portion of the surgery.

Method: We describe a modification of radical vaginal trachelectomy for easier dissection of the bladder pillar. Read More

Arch Gynecol Obstet 2020 10 14;302(4):879-886. Epub 2020 Jul 14.

Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Purpose: To examine whether the presence of peritoneal adhesions at the second cesarean delivery (CD), attributable to the first CD, are associated with maternal intra-operative organ injury and adverse neonatal outcomes.

Methods: A retrospective cohort study was conducted, comparing severe maternal intra-operative organ injury and adverse neonatal outcomes, between women with and without peritoneal adhesions. All women with two CDs during the follow-up period were included. Read More

Fertil Steril 2020 07;114(1):185-186

Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China. Electronic address:

Objective: To introduce an effective approach using laparoscopy in the treatment of upper vaginal leiomyoma.

Design: Step-by-step video explanation of the surgical procedure with still pictures and surgical video clips to demonstrate the detailed technique, approved by the Shengjing Hospital of China Medical University.

Setting: Hospital. Read More

Gynecol Oncol 2020 08 2;158(2):294-302. Epub 2020 Jun 2.

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address:

Objective: The primary objective was to describe the incidence and risk factors of urologic complications during radical hysterectomy for cervical cancer. The secondary objective was to investigate the impact of urologic complications on long-term survival.

Methods: Patients who underwent radical hysterectomy for cervical cancer from 2004 to 2016 were identified in the MSCCCC (Major Surgical Complications of Cervical Cancer in China) database. Read More

J Minim Invasive Gynecol 2021 02 29;28(2):282-287. Epub 2020 May 29.

Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Drs. Misal, Wright, Greene, and Siedhoff).

Study Objective: Compare odds of postoperative urinary symptoms in women who had cystoscopy after benign laparoscopic hysterectomy with 50% dextrose and with normal saline solution with intravenous indigo carmine.

Design: Retrospective cohort study.

Setting: Two tertiary care centers. Read More

Int Urogynecol J 2020 09 11;31(9):1969-1971. Epub 2020 Apr 11.

Department of Urology, University of Louisville, Louisville, KY, USA.

Introduction And Hypothesis: Iatrogenic ureteral injuries can occur during any surgery but are more likely to occur during urologic and gynecologic procedures. The middle and distal ureter are especially at risk of injury during these surgeries.

Methods: The objective of this surgical educational video was to demonstrate how to repair middle to distal ureteral injuries with the following techniques: direct ureteroureterostomy, ureteroneocystotomy, vesico-psoas hitch, and Boari-Ockerblad bladder flap. Read More

J Minim Invasive Gynecol 2020 Nov - Dec;27(7):1603-1609. Epub 2020 Mar 8.

Department of Medical and Surgical Gynecology (Drs. Delara, Yi, and Wasson).

Study Objective: To compare the incidence of perioperative complications of total vaginal hysterectomy (TVH) in women with and without a prior cesarean section (CS).

Design: Retrospective cohort.

Setting: Tertiary care academic institution. Read More

Case Rep Obstet Gynecol 2020 28;2020:9214613. Epub 2020 Jan 28.

Department of Urology, Lewis Katz School of Medicine at Temple University, Temple University Hospital, 3401 N. Broad St, Philadelphia, PA 19140, USA.

Iatrogenic injury to the urinary system is a known complication of gynecologic surgery; therefore, intraoperative cystoscopy is frequently performed to assess for such injuries. However, if an abnormality is seen, the differential diagnosis extends beyond iatrogenic causes. A 42-year-old patient underwent a total abdominal hysterectomy and had absent efflux from the right ureteral orifice on cystoscopy. Read More

BMC Pregnancy Childbirth 2020 Jan 31;20(1):65. Epub 2020 Jan 31.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, 10833 Le Conte Avenue, Room 27-139 CHS, Los Angeles, CA, 90095-1740, USA.

Background: To investigate differences in perioperative outcomes by type of skin incision, transverse versus vertical, for planned cesarean hysterectomy for placenta accreta spectrum (PAS).

Methods: A retrospective cohort study of all women who underwent a planned cesarean hysterectomy for abnormal placentation at a single academic medical center over 5 years. The Student's t-test was used for continuous variables and Fisher's exact test compared categorical variables. Read More

J Small Anim Pract 2020 Mar 20;61(3):170-176. Epub 2020 Jan 20.

Queen Mother Hospital for Animals, Royal Veterinary College, University of London, Hatfield, Hertfordshire, AL9 7TA, UK.

Objectives: To describe the presentation, treatment and outcome of unilateral and bilateral ureter injuries resulting from ovariohysterectomy complications in cats and dogs.

Materials And Methods: Retrospective case series of cats and dogs with ureteric injuries resulting from an ovariohysterectomy complication. Patient signalment, history, presenting clinical signs, clinical pathology, imaging, diagnosis, treatment and outcome were obtained from the medical records and telephone contact with the owners. Read More

BMC Urol 2019 Dec 9;19(1):128. Epub 2019 Dec 9.

Department of Translational Research and New Technologies in Medicine and Surgery, Sections of Urology, University of Pisa, via Paradisa 2, 56126, Pisa, Italy.

Background: The angiogenesis inhibitor monoclonal antibody Bevacizumab is presently the standard treatment for numerous neoplasms but particular toxicities are emerging, such as hypertension, haemorrhage, thromboembolism, gastrointestinal perforation, fistulae, and delayed wound healing. The addition of Bevacizumab to radio and chemotherapy has improved the overall survival rate in patients with metastatic, persistent or recurrent cervical carcinoma. However an increased risk of enteric or urinary fistula formation has been documented, related to hypoxia which is induced by the inhibition of angiogenesis. Read More

Gynecol Oncol 2020 01 2;156(1):115-123. Epub 2019 Dec 2.

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. Electronic address:

Objectives: To report the trends in surgical approaches and compare the major surgical complication rates of laparoscopic and abdominal radical hysterectomy for cervical cancer.

Methods: From the major surgical complications of cervical cancer in China (MSCCCC) database, we obtained the demographic, clinical, treatment hospital and complication data of patients with cervical cancer who underwent radical hysterectomy from 2004 to 2015 at 37 hospitals. The patients were assigned to the laparoscopic and abdominal surgery groups. Read More

Medicine (Baltimore) 2019 Dec;98(49):e18250

Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea.

Rationale: Various types of internal hernias have been reported including paraduodenal, intersigmoidal, pericecal, foramen of Winslow, as well as transmesenteric and retroanastomotic hernias. However, small bowel obstruction secondary to an internal hernia caused by the ureter is rare, and only a few cases have been reported worldwide. We report a case of small bowel herniation caused by the ureter in a woman who underwent radical hysterectomy for cervical cancer. Read More

Int J Gynaecol Obstet 2020 Feb 10;148(2):168-173. Epub 2019 Dec 10.

Minimally Invasive Gynecology Surgery Center, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan, R.O.C.

Objective: To assess the safety and efficacy of contained manual morcellation (CMM) with a tissue pouch during minimally invasive robotic or laparoscopic surgeries.

Methods: A retrospective cohort study included women who underwent robotic or laparoendoscopic single-site surgery at a tertiary referral center between February 2014 and April 2017. The specimen was postoperatively contained, sliced into one or more long strips, and then pulled out. Read More

J Minim Invasive Gynecol 2020 Sep - Oct;27(6):1354-1362. Epub 2019 Nov 16.

Department of Obstetrics and Gynecology, Divisions of Gynecologic Oncology (Drs. Chang, Mandelbaum, Matsuzaki, Roman, and Matsuo, Mr. Nusbaum, and Ms. Violette); Norris Comprehensive Cancer Center (Drs. Roman and Matsuo), University of Southern California, Los Angeles, California. Electronic address:

Study Objective: The findings of previous studies have been inconsistent as to whether benign hysterectomy via minimally invasive laparoscopic surgery increases the risk of vesicoureteral injury when compared with laparotomy. The objectives of our study were to (1) examine the rate of vesicoureteral injury on benign hysterectomy by the surgical approach and (2) compare the risk of vesicoureteral injury specifically between minimally invasive laparoscopic and abdominal hysterectomy on a populational level.

Design: Retrospective population-based observational study. Read More

Yeungnam Univ J Med 2018 12 31;35(2):179-186. Epub 2018 Dec 31.

Department of Urology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Background: To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries.

Methods: A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Read More

Am J Obstet Gynecol 2019 10 22;221(4):357.e1-357.e5. Epub 2019 Jul 22.

Minnesota Perinatal Physicians, Allina Health, Minnesota, MN.

Background: Placenta accreta spectrum affects approximately 3 in 1000 pregnancies. There is a paucity of data evaluating the effect of placental location on diagnosis, risk factors, and resultant outcomes in cases of placenta accreta spectrum.

Objective: We analyzed placenta accreta spectrum cases to assess whether risk factors or maternal outcomes varied based on placental location. Read More