The objective of this study was to identify factors associated with anatomical anterior compartment recurrence after laparoscopic mesh sacropexy. This single-center ambispective cohort study included 143 women who underwent laparoscopic mesh sacropexy for symptomatic pelvic organ prolapse. Women operated on before initiation of the study were identified retrospectively from institutional surgical records and subsequently recalled for postoperative anatomical assessment, whereas patients treated during the later study period were followed longitudinally. Only women with an anatomical postoperative assessment performed ≥12 months after surgery were included. Anatomical anterior compartment recurrence was evaluated using Pelvic Organ Prolapse Quantification (POP-Q) measurements. Associations with recurrence were examined using univariable and multivariable logistic regression. Recurrence occurred in 18 women (12.6%). Patients with recurrence were older and had greater preoperative descent of the upper anterior vaginal wall (POP-Q point Ba). In the primary multivariable model, age [odds ratio (OR) 1.09/year, 95% confidence interval (CI) 1.02-1.17; p=0.007], Ba (OR 1.29/cm, 95% CI 1.00-1.66; p=0.048), and anterior dissection length (OR 0.81/cm, 95% CI 0.67-0.98; p=0.034) were associated with recurrence. Body mass index was not independently associated. Adjustment for the year of surgery attenuated the dissection association (p=0.127). Greater preoperative Ba and increasing age were associated with anterior recurrence. Greater anterior dissection was associated with lower recurrence odds in the primary model, but this finding was sensitive to adjustments for the surgical year.
Genitourinary syndrome of menopause (GSM) is a symptom affecting both the urinary tract and vagina due to decreased sex hormones, especially estrogen, during menopause. This study aims to compare the efficacy of vaginal erbium-doped yttrium aluminum garnet (Er-YAG) laser therapy and topical estrogen treatment in managing GSM. A systematic literature search was conducted following PRISMA guidelines, utilizing electronic databases. The databases searched included PubMed, Scopus, Google Scholar, and the Cochrane Library. Clinical trials are included that evaluate GSM patients treated with vaginal Er-Yag laser therapy. All studies were assessed for risk of bias using the Newcastle-Ottawa scale. Among 695 studies in the initial search, only three cohorts are eligible in this review, representing the analysis of 546 patients across the globe. Our analysis shows vaginal dryness and dyspareunia significantly decreased (60% asymptomatic for dyspareunia, 30% for dryness at 12 months; VAS for dryness/dyspareunia decreased from 8.3/8.5 to 5.6/5.3 at 12 months). Vaginal health indicators also improved: the vaginal health index score increased (10.6 to 16.5), maturation value significantly increased (20.8 to 52.2; median 5 to 80), vaginal pH decreased, and sexual satisfaction (e.g., orgasm frequency p=0.007) in the laser group compared to the estrogen group. Compelling evidence shows the efficacy of Er-YAG laser therapy in improving sexual function outcomes and alleviating symptoms associated with GSM more than topical estrogen therapy.
This erratum corrects Table 1 published in Urogynaecologia 2026; 38:368 (doi: 10.4081/uij.2026.368).
Vesicovaginal fistula (VVF) remains a challenging condition requiring precise surgical repair to achieve durable closure, and robotic-assisted techniques provide enhanced visualization and dexterity, particularly in complex or recurrent cases. This retrospective study evaluated the outcomes of a double-layer interposition technique using urachal and omental flaps in 5 patients who underwent robotic transabdominal VVF repair between January 2023 and June 2025, all of whom had supratrigonal fistulae confirmed by cystoscopy and computed tomography urography + cystography. The surgical approach involved layered closure of the fistula tract followed by placement of vascularized urachal and omental flaps, with perioperative parameters, postoperative complications, and fistula closure rates recorded. The mean patient age was 46.2 years; hysterectomy was the predominant etiology in 80% of cases; 3 patients had previously failed transvaginal repair, and the mean fistula size was 1.8 cm. The mean operative time was 178 minutes with a mean blood loss of 90 mL, and no intraoperative complications were observed; 1 patient developed a Clavien-Dindo grade II urinary tract infection postoperatively. Complete fistula closure was demonstrated in all patients on postoperative cystography, with catheter removal between 16 and 21 days, and at a mean follow-up of 8.6 months, all patients remained continent without recurrence, suggesting that robotic-assisted VVF repair with combined urachal and omental flap interposition is safe, feasible, and associated with excellent short-term outcomes, with dual-layer reinforcement providing improved vascular support and suture-line separation that may reduce recurrence in complex or previously failed cases, although larger prospective studies are required for further validation.
Intermittent catheterization is the gold standard method for bladder emptying in neurogenic and non-neurogenic lower urinary tract dysfunction patients. Despite their usage, eyelet catheters are associated with frequent flow stops, incomplete bladder emptying, and mucosal trauma that leads to patients’ discomfort and contributes to chronic urinary tract infections. This systematic review and meta-analysis aim to assess the safety and impact of the micro-hole zone catheter in this population. Several databases were widely searched for studies through 2025. The primary outcome was bladder emptying, and secondary outcomes were flow stops and microtrauma. The Cochrane risk of bias tool 2.0 was used to assess the risk of bias. We identified four publications with a total of 253 patients. There was a significant difference in the residual urine volume between the two groups [mean difference: -21.40 mL; 95% confidence interval (CI): -40.03 to -2.80, p=0.0005]. The mean difference in flow stop rate was 0.20 (95% CI: 0.12 to 0.34, p=0.3173), and the mean difference in microtrauma was 0.15 (95% CI: 0.09 to 0.26, p=0.628). All favor the micro-hole zone catheter. The micro-hole zone catheter demonstrated a safety option compared to the eyelet catheter with regard to microtrauma, residual urine volume, and fewer flow stops that lead to better emptying of the bladder.
