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The study objective was to determine the feasibility and selection criteria for discharge within 24 h posttotal laparoscopic hysterectomy with or without bilateral salpingo-oophorectomy (TLH with or without BSO) in Hospital Putrajaya.

A total of thirty patients among all gynecology inpatients who were planned for TLH with or without BSO with controlled medical diseases, normal preoperative investigations, and uncomplicated surgery were recruited from January 2014 to December 2016. Data were collected from electronic medical records. selleck chemicals llc Postoperatively, patients who fulfilled the selection criteria were discharged within 24 h and were followed up at 6 weeks and 3 months postsurgery. The results were presented as frequency with percentage and mean standard deviation.

All patients who had uncomplicated surgery and blood loss <1 l with no early postoperative complications were discharged within 24 h. They had a pain score of < 3 and were able to ambulate and tolerated orally well. None of these patients who were discharged 24 h postsurgery required readmissions. During follow-up, there were no reported complications such as persistent pain, wound infection, or herniation.

Twenty-four hours' discharge post-TLH with or without BSO is feasible and safe if the selection process is adhered to.

Twenty-four hours' discharge post-TLH with or without BSO is feasible and safe if the selection process is adhered to.

Vaginal-assisted laparoscopic sacrohysteropexy (VALH) is a new modified form of uterine-sparing prolapse surgery using a combined vaginal and laparoscopic approach. We aimed to compare 1 year efficacy and safety of VALH and vaginal hysterectomy with vaginal vault suspension (VH + VVS) in the surgical treatment of apical pelvic organ prolapse (POP).

Women who requested surgical treatment for stage 2-4 symptomatic uterine prolapse were recommended to participate in one year-long randomized study between July 2017 and January 2019. POP Quantification (POP-Q) examination and validated questionnaires such as International Consultation on Incontinence Questionnaire Vaginal Symptoms (IVIQ-VS) survey, Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire Short Form (IIQ-7), and Patient Global Impression of Improvement (PGI-I) were recorded at baseline and 12 months after surgery. The main primary outcome measure was apical prolapse recurrence. Secondary results were duration of surgery, pain score, blood loss, postoperative hospital stay, and quality of life scores related to prolapse.

There were 15 women in VALH and 19 women in the VH + VVS group. ICIQ-VS score, ICIQ-QOL, UDI-6, and IIQ-7 scores were improved for both groups. According to the PGI-I scores, 80% of subjects in the VALH group, and 100% in the VH + VVS group, were "very much better" or "much better" with their prolapse symptoms at their 1-year follow-up. There was no reoperation or operation-related complication in both groups.

VALH and VH + VVS have similar 1-year cure rates and patient satisfaction.

VALH and VH + VVS have similar 1-year cure rates and patient satisfaction.

Ureteral injuries may occur subsequent to abdominal or laparoscopic hysterectomy. In total laparoscopic hysterectomy (TLH), we usually check for ureteral damage by confirming urinary outflow from the bilateral ureteral orifices by cystoscopy after vaginal stump suture. In this work, we investigated the causes of urine outflow disruption after TLH.

We conducted a retrospective review of all TLHs performed for benign diseases at our hospital from February 2012 to March 2016. There were 11 cases with no or poor urine outflow from the ureteral orifice after vaginal stump suture. For these cases, we assessed the treatment to recover urine outflow and examined the cases with intraoperative manipulation. EZR version 1.25 was used for statistical analysis. Correlation coefficients were calculated with Spearman's rank correlation coefficient test.

The abnormality was on the right and left sides in seven and four cases, respectively. In all cases, apart from one, urine outflow was recovered by removing the sutures at the affected side, where the initial suture had included a small amount of the connective tissue near the urinary bladder. It was inferred that ureteral deviation due to vaginal stump sutures that picked up the connective tissue near the ureter caused ureteral peristaltic disorder and abnormal ureteral orifice outflow.

TLH without ureter isolation requires sufficient separation of the bladder from the anterior vaginal wall and careful vaginal stump suture without involving the bladder-side tissue to avoid ureteral injury.

TLH without ureter isolation requires sufficient separation of the bladder from the anterior vaginal wall and careful vaginal stump suture without involving the bladder-side tissue to avoid ureteral injury.

Many surgeons use uterine manipulator (UM) during laparoscopic hysterectomy (LH). In this study, we aimed to compare the outcomes of LH operations performed by using partially reusable UM with the articulated system (artUM) and disposable (dUM) UM without articulation.

A total of 99 patients underwent the LH operation. This study was carried out with 35 of those 99 Caucasian patients who met the inclusion criteria. Group 1 consisted for 7 LH operations using the articulated RUMI

II/KOH-Efficient™ (Cooper Surgical, Trumbull, CT, USA) system (artUM), while Group II consisted of 28 patients using old-type V Care

(ConMed Endosurgery, Utica, New York, USA) dUM as UM.

Mean operation time was found to be 157.1 ± 42.0 min. The operation time was found statistically longer in Group 1, consisted of artUM used patients (

= 0.006 and

< 0.05). No statistically significant difference was found between two groups in terms of surgical results such as, delta hemoglobin value (

= 0.483 and

< 0.05), length of hospital stay (

= 0.138 and

< 0.05), and postoperative maximum body temperature (

= 0.724 and

< 0.05).

The UM type did not alter the surgical outcomes except the operating time in our study. According to our results, the surgical technique is a more significant variable than instruments used in LH for normal size uterus. Further prospective, large-scale studies comparing various UM systems are mandatory.

The UM type did not alter the surgical outcomes except the operating time in our study. According to our results, the surgical technique is a more significant variable than instruments used in LH for normal size uterus. Further prospective, large-scale studies comparing various UM systems are mandatory.

The objective of this study is to assess the perioperative outcomes when prophylactic bilateral salpingo-oophorectomy (BSO) is performed concomitantly with surgery to repair pelvic organ prolapse (POP) or stress urinary incontinence (SUI).

This is a retrospective case-control study of patients who underwent abdominal surgery for the correction of POP and/or SUI with or without concomitant BSO at a tertiary care center. The primary outcome measures were postsurgery length of hospitalization, estimated blood loss, and 30-day readmission rate. The secondary outcome measure was detection of ovarian cancer precursor lesions.

We identified 734 patients who had surgery for POP and/or SUI. The control group contained 385 patients, and the BSO group contained 349 patients. There was no difference between the control and BSO groups in the postsurgery length of stay (LOS) (35.2 h vs. 34.1 h;

= 0.49), and all-cause 30-day readmission rate (14.2% vs. 11.6%;

= 0.3085). However, there was decreased blood loss (40.8 ml vs. link2 67.2 ml,

< 0.0001) in the BSO group compared to the control group. Sub-analysis of primary outcomes in postmenopausal women (age > 55) showed decreased postsurgery LOS (33.4 h vs. 37.4 h;

= 0.0208) and decreased blood loss (35.9 ml vs. 82.7 ml;

< 0.0001) in the BSO group compared to control.

Secondary to the lack of additional complications, we recommend surgeons give more consideration to finding appropriate candidates for a risk reducing BSO at time of abdominal surgery to repair POP or SUI.

Secondary to the lack of additional complications, we recommend surgeons give more consideration to finding appropriate candidates for a risk reducing BSO at time of abdominal surgery to repair POP or SUI.With the advance of minimally invasive surgery (MIS), the surgical trends of hysterectomy changed significantly during past 2 decades. Total number (age-standardized) of all types of hysterectomy decreased, which may be due to the availability of some other alternatives, e.g. hysteroscopy, laparoscopic myomectomy. However, laparoscopic hysterectomy (LH) still remains the mainstream of surgical treatment. LH significantly increases for benign gynecologic conditions in Taiwan and worldwide. The increase of LH was accompanied with decrease of TAH; VH kept stationary, and SAH increased slightly. The increase in popularity of LH and SAH; provides evidence of surgical trends and a paradigm shift for hysterectomy. This time-frame shift suggests LH has reached a u during the later years. Older patients tend to receive AH, while middle-aged women tend to receive LH. Oder surgeons tend to perform AH, while younger surgeons tend to perform LH. However, all type hysterectomy and LH were more commonly performed by older surgeons aged over 50 years. It means both patients and surgeons became older during the time-frames. The above phenomena may also happen due to less young surgeons entered in the gynecologic practice. Most of the LHs were performed by high-volume surgeons, however, there is a shift from high-volume, to medium- and low-volume surgeons. link3 The above scenario may be due to the wide spread of LH techniques. Surgical volume has important impacts on both complications and costs. The high-volume surgeons have lower complications, which result in lower costs. In the future, how to increase the use of LH, to improve the training and monitoring system deserves more attentions.There are overwhelming increases of studies and over 200,000 publications related to all the aspects of COVID-19. Among them, 262 papers were published by authors from 67 countries regarding COVID-19 with water science and technology. Although the transmission routes of SARS-CoV-2 in water cycle have not been proved, the water and wastewater play an important role in the control of COVID-19 pandemic. Accordingly, it is scholarly relevant and interesting to look into publications of COVID-19 in water science and technology to track the investigations for moving forward in the years to come. It is believed that, through the literature survey, the question on what we know and what we do not know about COVID-19 so far can be clear, thus providing useful information for helping curbing the epidemic from water sector. This forms the basis of the current study. As such, a bibliometric analysis was conducted. It reveals that wastewater-based epidemiology (WBE) has recently gained global attention with the source and survival characteristics of coronavirus in the aquatic environment; the methodology of virus detection; the water hygiene; and the impact of the COVID-19 pandemic on the water ecosystem being the main topics in 2020. Various studies have shown that drinking water is safety whereas wastewater may be a potential risk during this pandemic. From the perspective of the water cycle, the scopes for further research needs are discussed and proposed, which could enhance the important role and value of water science in warning, monitoring, and predicting COVID-19 during epidemic outbreaks.