99

Oral Presentations FRIDAY, NOVEMBER 11, 2005 (11:10 AM–11:20 AM) Plenary 10 —Hysteroscopy 99 Hysteroscopic Sterilization with Essure in an Office Setting Under Local Anesthesia: Patient Assessment of Procedural Pain and Satisfaction Chudnoff S, Levie MD, Levy B, Snyder D. Bronx, New York; Federal Way, Washington; Greenfield, Indiana; Montefiore Hospital, Teaneck, New Jersey Study Objective: To assess the pain associated with hysteroscopic sterilization under local anesthesia, as well as patient satisfaction. Design: Prospective analysis of patients undergoing hysteroscopic sterilization. Setting: Offices of three gynecologists: 1) An urban academic practice in Bronx, New York. 2) A private practice in Greenfield Indiana 3) A private practice in Federal Way Washington. Patients: To date 72 patients undergoing in office hysteroscopic sterilization have been enrolled in this ongoing study. Intervention: All patients were surveyed immediately after completion of the procedure. Pain was assessed on a scale of 1–10. Patients were asked to assess the pain they experience during their menstrual cycle using the same scale. This gave perspective to the pain encountered during the procedure. Patients were also contacted after their 12-week hysterosalpingogram (HSG) to evaluate satisfaction with the procedure. Measurements and Main Results: 72 patients were surveyed immediately post-procedure. Patients said that the average pain of their menstrual cycle was 3.65. The average pain encountered during the procedure was 2.81, and the most pain encountered was 3.61. Fifty-two patients had reached the 12-week HSG and were surveyed. 96% of patients would recommend the procedure to a friend, and on a scale of 1–5 the average satisfaction rating was 4.28. Conclusion: Office hysteroscopic sterilization using the Essure system is well tolerated under local anesthesia. Patients felt that the pain during the procedure was less than or equal to a menstrual cycle. Patients were extremely satisfied with their choice and would recommend it to a friend. FRIDAY, NOVEMBER 11, 2005 (10:30 AM–10:40 AM) Plenary 11—Urogynecology 100 Should Cystoscopy be Done Routinely During the TVT-O Inside-Out Suburethral Sling Procedure for Stress Urinary Incontinence? Khandwala SS, Tumaneng D, Lingam D. Oakwood Hospital and Medical Center, Dearborn, Michigan Study Objective: To determine whether cystoscopy should be performed routinely during a TVT-O transobturator sub-

S41 urethral sling procedure performed for stress urinary incontinence Design: Retrospective analysis of 120 consecutive TVT-O sling procedures performed for stress urinary incontinence. Setting: Oakwood Hospital and Medical Center. Patients: One hundred twenty consecutive patients undergoing the TVT-O suburethral sling procedure for urinary incontinence. Intervention: TVT-O inside-out suburethral sling procedure was done for stress urinary incontinence. Most cases were done under local anesthesia. Cystoscopy was routinely performed in all patients at the end of the procedure. Measurements and Main Results: There were no cases of bladder, ureteral or urethral injuries. Conclusion: The inside-out nature of needle passage draws it away from the bladder and towards the obturator membrane. Despite there being no urinary injuries in this series, the authors would like to highlight that these surgeries were done by a urogynecologist skilled in incontinence surgeries with an extensive experience with different types of suburethral sling procedures. Moreover, we would like to stress that any surgeon attempting a TVT-O procedure should be capable of performing cystoscopy in case there is a problem. Certain marketing strategies have targeted physicians who do not have cystoscopy privileges or skills to perform the transobturator procedures based upon the low incidence of bladder perforation. However, it should be superfluous to say that any physician involved in doing anti-incontinence surgeries should be well-versed in cystoscopy. FRIDAY, NOVEMBER 11, 2005 (10:40 AM–10:50 AM) Plenary 11—Urogynecology 101 Neovagina Technique and Vaginal Wall Suspension Using Polypropylene Mesh in Women with Pelvic Organ Prolapse McKinney TB, Hashemi EA, Greenleaf B, Boyer S. Athena Women’s Medical Center, Turnersville, New Jersey; Athena Women’s Medical Center, Turnersville, New Jersey; Athena Women’s Medical Center, Turnersville, New Jersey; Turnersville, New Jersey Study Objective: To assess the efficacy and safety of neovagina graft interposition in patients with pelvic organ prolapse. Design: A retrospective analysis of 183 women with stage II or more pelvic organ prolapse who underwent neovagina surgery with graft from September 2002 until March 2005. All patients had undergone complete history, physical exam, cystoscopy, urodynamics, and POPQ tests. Setting: Urogynecology and advanced pelvic surgery teaching hospital. Patients: One hundred eighty-three women with pelvic organ prolapse. Intervention: This technique replaces the pubocervical