The racial distribution of female pelvic floor disorders in an equal access health care system.

PURPOSE: We examined ethnic differences in female pelvic disorders in an equal access health care system. MATERIALS AND METHODS: An electronic medical record review was performed for patients with pelvic floor disorders at a military female pelvic medicine and reconstructive surgery division for a 1-year period. Primary diagnosis codes and patient reported race were reviewed. RESULTS: Mean +/- SD cohort age was 55 +/- 16.3 years. A total of 720 patients were identified, of whom 68.8% were white and 18.6% were black. Pelvic organ prolapse was the primary diagnosis in 34.2% of the women, while 19.7% had stress urinary incontinence and 10.8% had urge urinary incontinence. There was no difference in the prevalence of prolapse between black and white women. However, of patients with incontinence there was a statistically significant difference with urge incontinence in more black women (51.2%) and stress incontinence in more white women (66.2%) (chi-square p <0.05). CONCLUSIONS: There is a similar ethnic distribution of pelvic organ prolapse in an equal access health care system. Of women with incontinence there was a higher prevalence of urge urinary incontinence in black women and a higher prevalence of stress urinary incontinence in white women.

Use of end-to-end anastomotic sizer with occlusion balloon to prevent loss of pneumoperitoneum in robotic vesicovaginal fistula repair.

Maintaining the pneumoperitoneum in robotic-assisted surgery can be difficult when vaginal integrity is compromised, such as in vesicovaginal fistula. We report an approach using an anastomotic sizer modified with an occlusion balloon for manipulation of the vaginal apex and maintenance of the pneumoperitoneum for robotic-assisted vesicovaginal fistula repair.