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Objective: The aim of the study was to determine whether an easy-to-read patient education card given at the preoperative visit can increase patient recall of the planned surgery., Methods: This was a randomized controlled trial. Patients scheduled to undergo pelvic reconstructive surgery were recruited during their preoperative visits. All participants received standard surgical counseling, whereas the intervention group also received a 4 × 6 inch card highlighting the anticipated procedure. The primary outcome was correct recall of the planned surgery as measured by a preoperative questionnaire. Secondary outcomes were correct recall of the surgery postoperatively and patient satisfaction with the information provided., Results: One hundred twenty-eight patients were enrolled with 64 participants in each arm. One hundred twenty-seven participants were analyzed because 1 patient was lost to follow-up. No difference was found between patient demographics, including types of surgical procedures performed. There was a statistically significant improvement in preoperative recall: 30 of 63 participants (47.6%) in the intervention group answered all questions correctly versus 18 of 64 patients (28.6%) patients in the standard counseling group (P = 0.021). There was no difference in the postoperative scores between the 2 groups: 48.3% (28 of 58) and 52.5% (32 of 61) of the participants answered all questions correctly in the intervention and standard counseling only groups, respectively (P = 0.648). There was no difference in satisfaction scores, with a median score of 20 out of 20 for either group (interquartile range = 19-20)., Conclusions: A concise and easy-to-use education card enhanced patient preoperative recall of the proposed surgery. This difference was not sustained postoperatively. High satisfaction with the information provided was reported regardless of counseling method., Competing Interests: The authors have declared they have no conflicts of interest., (Copyright © 2021 American Urogynecologic Society. All rights reserved.)

Objectives: To provide information on the effect of the coronavirus disease of 2019 (COVID-19) pandemic on people with epilepsy and provide consensus recommendations on how to provide the best possible care for people with epilepsy while avoiding visits to urgent care facilities and hospitalizations during the novel coronavirus pandemic., Methods: The authors developed consensus statements in 2 sections. The first was "How should we/clinicians modify our clinical care pathway for people with epilepsy during the COVID-19 pandemic?" The second was "What general advice should we give to people with epilepsy during this crisis? The authors individually scored statements on a scale of -10 (strongly disagree) to +10 (strongly agree). Five of 11 recommendations for physicians and 3/5 recommendations for individuals/families were rated by all the authors as 7 or above (strongly agree) on the first round of rating. Subsequently, a teleconference was held where statements for which there was a lack of strong consensus were revised., Results: After revision, all consensus recommendations received a score of 7 or above. The recommendations focus on administration of as much care as possible at home to keep people with epilepsy out of health care facilities, where they are likely to encounter COVID-19 (including strategies for rescue therapy), as well as minimization of risk of seizure exacerbation through adherence, and through ensuring a regular supply of medication. We also provide helpful links to additional helpful information for people with epilepsy and health providers., Conclusion: These recommendations may help health care professionals provide optimal care to people with epilepsy during the coronavirus pandemic., (© 2020 American Academy of Neurology.)

Background: Vaginal agenesis is a congenital disorder affecting 1 in 4000 to 1 in 10,000 females. Lack of normal vaginal support structures may lead these patients to develop prolapse of the distal rudimentary vagina. Presently, there is no consensus regarding the best surgical option. However, the goal of surgery is to restore normal anatomy and establish normal sexual function., Case: We report the case of a 28-year-old woman with müllerian agenesis, diagnosed at age 19 years, who presented with complaints of dyspareunia and vaginal eversion. One year before presentation to our practice, the patient underwent an anterior and posterior repair with mesh and a transobturator sling. After careful evaluation, the patient underwent excision of mesh and a second procedure to elongate and suspend her vagina. Her vaginal length was extended from 4 to 8 cm., Conclusions: Prolapse of the neovagina in müllerian agenesis is a rare event; it can occur after nonsurgical or surgical treatments. Although there have been reported cases of abdominal or laparoscopic sacrocolpopexy to correct vaginal vault prolapse in these patients, there is a scarcity of information addressing the vault suspension in cases lacking healthy vaginal tissue. Our case shows how successful anatomical functional correction can be achieved with a simpler technique using an allograft to achieve a normal vaginal length in combination with a sacrocolpopexy.

Objective: To characterize the clinical and EEG features of the syndrome of benign childhood partial seizures with ictal vomiting and EEG occipital spikes (Panayiotopoulos syndrome [PS])., Methods: Prospective study of children with normal general and neurologic examinations who had seizures with ictal vomiting and EEG with occipital spikes., Results: From February 1990 to 1997, the authors found 66 patients with PS and 145 children with benign childhood epilepsy with centrotemporal spikes. Peak age at onset of PS was 5 years. Ictal deviation of the eyes and progression to generalized seizures were common. One-third had partial status epilepticus. During sleep, all had seizures. While awake, one-third also had seizures. Five children with PS had concurrent symptoms of rolandic epilepsy and another five developed rolandic seizures after remission of PS. Prognosis was excellent: one-third had a single seizure, one-half had two to five seizures, and only 4.5% had frequent seizures., Conclusions: Panayiotopoulos-type benign childhood occipital epilepsy is less common than benign childhood epilepsy with centrotemporal spikes but is well defined and recognizable by clinical and EEG features.