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Introduction: Ureteral obstruction following vaginal mesh placement is a rare complication.Hypothesis: We propose a mechanism of traction of the bladder neck as a cause for ureteral kinking and obstruction.Methods: In this report we describe two surgical cases using vaginal mesh implant which presented with ureteral obstruction two days following the procedure.Results: The patients were treated using temporary ureteral stents without removal of the implant.Conclusion: Controlled tension of the implant during the procedure and routine diagnostic cystoscopy can prevent the complication.Brief summary: Ureteral obstruction following vaginal implant treated with ureteral stents. A mechanism of traction of the bladder neck as a cause for ureteral obstruction is proposed.

Aim: In the process of opening a new Pelvic Floor Medicine Unit, we aimed to map the pelvic floor dysfunction and sexual issues using validated quality of life (QOL) questionnaires. Material and Methods: All the patients who attended the Pelvic Floor Medicine Unit clinic in Assuta University Medical Center in Ashdod, Israel, were given a validated Pelvic Floor Distress Inventory 20 (PFDI-20) and Prolapse Urinary Incontinence Sexual Questionnaire 12 (PISQ-12) questionnaires prior to meeting the physician. The patient’s age, parity, and route of delivery were collected from the medical record. All data has been statistically analyzed using Kruskal Wallis Test and Mann-Whitney U Test. Results: 647 patients were included in the study, of them 462 filled out the PFDI-20 questionnaires and 221 completed the PISQ-12 questionnaire filling. In the PFDI-20 results, POPDI-6 higher scores were found to be associated with higher parity (p=0.043) and with higher age (p=0.03). CARD-8 scores were found to be significantly associated with cesarean delivery only in patients’ history (p=0.023) and with higher age (p=0.05). UDI-6 scores were found significantly associated with older age (p Conclusions: Using validates questionnaires, we could demonstrate a correlation between parity and age, an association between aging and higher rates of bowel and sexual dysfunction, an association between higher parity and pelvic organ prolapse complaints, and an association between previous cesarean deliveries only and higher rates of bowel disfunction. The use of validated QoL questionnaires for describing the population suffering from PFDs presents an important tool in understanding the epidemiology of PFD in different communities.

Introduction: We suspected that paraovarian cysts of neoplastic origin may be underreported. This study was designed to evaluate our data on the pathologic characteristics of cystic lesions located in the paraovarian area and compare them with previous studies that claimed the vast majority of these lesions were simple paraovarian cysts and only few (1.69% to 5%) were neoplastic ones. Methods: This is a retrospective analysis of the clinical, surgical, ultrasonographic, and pathologic features of 59 women operated on for cystic paraovarian lesions at our institution from January 2002 to April 2006. Results: Forty-four women (74.6%) had simple paraovarian cysts, and 15 (25.4%) had benign neoplastic paraovarian cysts (7 cystadenomas and 8 cystadenofibromas). There were no cases of malignant tumor. There was no difference in the clinical presentation of the women with either type of cyst. Preoperative ultrasound examinations (n=50) demonstrated more complex cysts with internal papillary projections in the group with neoplastic paraovarian cysts (41.7% compared with 7.9%, P=0.01). The macroscopic pathologic examinations revealed a significantly increased percentage of gross papillary excrescences in the group of neoplastic paraovarian cysts (10/ 15, 66.7%) compared with the group with simple paraovarian cysts (3/44, 6.8%, P