Objective: To provide a description of laparoscopic approach to correct pelvic organ prolapses and evaluate the risk factors associated with the prolapse recurrence. Study design: We retrospectively analyzed 418 patients with symptomatic pelvic organ prolapse who underwent a laparoscopic reparation at our university center from 2010 to 2020. Prolapses were assessed by Baden-Walker system (stage I-IV). The association between the potential prognostic factors and the recurrence was analyzed using Cox regression. Results: We included 418 patients. Most patients (97.6%) had at least one vaginal delivery and 92 (22%) had a previous prolapse surgery. In 29.74% of cases levator ani muscle avulsion was observed. We performed a cervicosacropexy in 336 (80.38%) cases, a sacrohysteropexy in 13 (3.11%), and a sacrocolpopexy in 69 (16.5%). Also, concomitantly, 66 (15.79%) patients with stress and occult urinary incontinence underwent TOT surgery. Surgical complications were low (9.51%) and the majority were minor. Median follow-up was 37 months (IQR 10.5, 61.4 months), and the global recurrence rate was 9.57%. Only 4.06% of cases required reintervention. In Cox regression analysis only levator ani muscle avulsion remained as a recurrence-associated factor. Conclusion: Our series is one of the largest and with the longest follow-up. Recurrence rate was low, and comparable to other large series. The only independent factor related to recurrence was the levator ani muscle avulsion.

Introduction and hypothesis Pelvic floor dysfunction (PFD) is common in women but few seek medical attention. Poor recognition of the condition as pathological and unawareness of treatments may account for low consultation rates. Methods This cross-sectional study was based on an online survey that was responded to in February and March 2020 by 768 female university students. Knowledge of PFD was assessed using the Prolapse and Incontinence Knowledge Questionnaire (PIKQ). Descriptive and inferential analyses were performed using IBM-SPSS (V26.0). Results Respondents had poor knowledge of PFD and especially of pelvic organ prolapse. Health science students ( n = 531; 69.1%) obtained significantly higher scores ( p < 0.001) than other students ( n = 237; 30.9%). Those who had received information on how to perform pelvic floor muscle training were more likely to score higher than those who had not received previous information. Conclusions While health science students have better knowledge of PFD than other students, university students in general are little aware of PFD. Most students considered the issue of PFD to be important and wanted more information. Our findings may be useful in planning strategies to raise women’s awareness of PFD and its prevention and treatment.

Objective: To provide a description of laparoscopic myomectomy and the two hemostatic techniques per -formed over the last 11 years in a single reference center for gynecology and obstetrics and to evaluate the factors associated with favorable surgical outcomes. Study Design: We retrospectively analyzed 625 who underwent laparoscopic myomectomy from January 2009 to December 2019. Results: Of 625 patients, 437 (69.8%) were symptomatic. The most common symptoms were heavy uter-ine bleeding (33.2%). 188 patients (30.1%) were asymptomatic but were operated in 77 cases (12.3%) for rapid fibroid growth, 32 (5.1%) for uterine cavity distortion and, in 45 cases (8.6%), the myomectomy was indicated during a surgery for other medical reason due to its accessibility. In 173 cases (27.9%) intramy-ometrial adrenaline was injected and in 246 cases (39.7%) a temporary blockage of the uterus blood sup-ply was performed. Only 35 (5.6%) patients presented complications, of which, 14 (40%) were hemorrhagic. These hemor-rhagic complications were more frequent when intramyometrial adrenaline was used (5,8%) than after the temporary clipping of the uterine arteries and infundibulopelvic ligaments (0,8%; p < 0,001). In the multivariate logistic regression model, the only factor statistically associated with favorable sur-gical outcome was the use of temporary clipping of the uterine arteries at their origin and infundibu-lopelvic ligaments as hemostatic technique during the surgery. Conclusion: Laparoscopic myomectomy was generally safe with a high level of favorable outcomes. The temporary clipping of uterine arteries and infundibulopelvic ligaments presented fewer intraoperative bleedings compared with injecting intramyometrial adrenaline. (c) 2021 Published by Elsevier B.V.

Juan Ambrosioni1*†, Sandra Coll2†, Christian Manzardo1, David Nicolás1, Fernando Agüero1, José Luis Blanco1, Montse Tuset3, Mercé Brunet4, José M. Gatell1 and José M. Miró1 Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain; School of Medicine, University of Barcelona, Barcelona, Spain; Pharmacy Service, Hospital ClinicIDIBAPS, University of Barcelona, Barcelona, Spain; Toxicology and Pharmacology Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain