Ovarian vein thrombosis (OVT) is a rare but potentially serious condition. We conducted a scoping review of published data to provide a better understanding of OVT management. MEDLINE and Cochrane databases were searched. Eligibility criterion was original articles including women with OVT until May 2024. Quantitative data were pooled via CMA software. Quality of the primary studies was assessed via the Newcastle‒Ottawa Scale. Out of 1,007 identified records, 19 primary studies including 1,128 patients were selected. Mean age at OVT diagnosis was 37 years old. Frequency of OVT depended on the clinical situation: cancer (37%) and postpartum (0.06%), including cesarean (0.19%), or persistent fever despite antibiotics (23%). Magnetic resonance imaging was associated with the best diagnostic performance, followed by computed tomography. Pulmonary embolism and extension to the iliac vein, inferior vena cava or left renal vein occurred in 6.5%, 5.9%, 10.3% and 9.6% of patients, respectively. Among anticoagulants, low-molecular-height heparin with/without oral anticoagulant was preferred for three to six months. Among the women tested, thrombophilia was present in 18% of the patients. Recanalization, recurrent thrombosis or major bleeding occurred in 70%, 8% and 2% of patients, respectively. Majority of studies had poor evidence. This scoping review provides a comprehensive evaluation of available data. Frequency of OVT depends on the clinical setting. Physicians should be aware of OVT in postpartum women with persistent fever despite the use of antibiotics. Ovarian vein thrombosis belongs to the spectrum of venous thromboembolism and should be considered both in puerperal settings and in cancer patients.

Periprosthetic acetabular fractures (PPAF) are fractures of the acetabulum with a hip endoprosthesis in place. They are a rare complication, although they are occurring more frequently due to the increase in patients being fitted with total hip arthroplasty (THA) and the long service life of the implants. At present, only a small amount of scientific literature exists, particularly regarding the surgical treatment of these fracture types.The aim of this paper is to provide an overview of the topic of PPAF with a critical review of the current literature and to present the necessary surgical treatment.An evaluation of the current literature on the topic of PPAF with a focus on the surgical treatment of fractures is carried out.Surgical treatment is technically demanding due to the pelvic ring instability with removal of the bone tension for secure acetabular cup fixation and should lead to the recovery of the biomechanical stability of the pelvis and thus the secure anchoring of the acetabular cup. An interdisciplinary approach requiring both trauma surgery and orthopaedic expertise is certainly recommended, as older and comorbid patients with poor bone quality are particularly frequently affected.The treatment of periprosthetic acetabular fractures, especially in older patients, requires not only the individual expertise of surgeon involved in the operation but also a goal-oriented and consistent interdisciplinary approach by the surgeons involved from the fields of orthopaedics and trauma surgery in view of the patients\' frequent comorbidities. By working together, the optimal and individualized operation can be performed for the patient.
UNASSIGNED: Periprothetische Azetabulumfrakturen (PPAF) sind Hüftpfannenfrakturen bei einliegender Hüftendoprothese. Sie stellen eine seltene Komplikation dar, die allerdings durch die Zunahme der Versorgung von Patient*innen mit einer Hüfttotalendoprothese (HTEP) und die lange Lebensdauer der Implantate häufiger vorkommen. Derzeit existiert nur eine geringe Anzahl an wissenschaftlicher Literatur, vor allem in Bezug auf die chirurgische Versorgung dieser Frakturtypen.Ziel der Arbeit ist einerseits, einen Überblick zum Thema der PPAF mit einer kritischen Betrachtung der aktuellen Literatur zu vermitteln und andererseits die notwendige operative Versorgung darzustellen.Es erfolgt eine Auswertung der aktuellen Literatur zu dem Thema der PPAF mit dem Schwerpunkt der operativen Versorgung der Frakturen.Die chirurgische Behandlung ist aufgrund der Beckenringinstabilität mit Aufhebung der Knochenspannung zur sicheren Hüftpfannenfixation technisch anspruchsvoll und soll zur Rückgewinnung der biomechanischen Stabilität des Beckens und damit der sicheren Verankerungsmöglichkeit der Hüftprothesenpfanne führen. Ein interdisziplinärer Ansatz mit bei dem sowohl unfallchirurgisches und orthopädisches Wissen notwendig ist, ist dabei sicher zu empfehlen, da besonders häufig ältere und komorbide Patient*innen betroffen sind, die eine entsprechend schlechte Knochenqualität aufweisen.Die Behandlung der periprothetischen Azetabulumfraktur insbesondere des älteren Patient*innen erfordert angesichts der häufig bestehenden Komorbiditäten der Patient*innen neben der singulären Expertise jedes einzelnen an der Operation beteiligten Mitarbeitenden eine zielorientierte und konsequente Interdisziplinarität der beteiligten Chirurg*innen aus dem Fachgebiet der Orthopädie und Unfallchirurgie. Durch die Zusammenarbeit kann so für die Patient*innen eine optimale und individualisierte Operation erfolgen.

OBJECTIVE: Surgical repair is the mainstay of genital prolapse management. Among native-tissue apical procedures, high uterosacral ligaments suspension is considered a valid and effective option for central compartment repair. In this study, we aimed to evaluate the effectiveness, complications rate, and functional results of high USL suspension as a primary prolapse repair technique in a large cohort of patients.
METHODS: Patients who underwent vaginal hysterectomy followed by high uterosacral ligaments suspension for POP between January 2008 and December 2020 were retrospectively analyzed. Questionnaires and clinical interviews were preoperatively performed to assess symptoms and severity of urinary, bowel, and sexual dysfunctions. After surgical procedure, diagnostic cystoscopy was performed to evaluate ureteral patency. Postoperative data, objective, and subjective cure rate were then noted at the follow-up evaluation.
RESULTS: A total of 1099 patients underwent high uterosacral ligaments suspension. The total complication rate was 3.4 % and recurrence in any of the vaginal compartments was 12.4 %. Reoperation for symptomatic prolapse recurrence or pessary treatment was required in 9 women (0.9 %). In the evaluation of postoperative questionnaires, functional outcomes analysis revealed a significant improvement (p < 0.05) in terms of stress urinary incontinence, urge urinary incontinence, voiding symptoms, constipation, and dyspareunia after prolapse repair.
CONCLUSIONS: Uterosacral ligament suspension is a safe and effective procedure for primary surgical treatment of pelvic organ prolapse. Anatomical, functional, and subjective outcomes were very satisfactory, and the reoperation rate for recurrence was below 1%.

Endometrioid ovarian adenocarcinoma is a common subtype of epithelial ovarian cancer that can arise on a background of endometriosis. Maximal cytoreductive effort with an aim to remove all macroscopic disease (achieve R0) is the single independent prognostic factor for survival. Complex multidisciplinary surgeries may be required in order to achieve this.

OBJECTIVE: This study is to investigate the safety and efficacy of ureteroscope-assisted laparoscopic ureteroplasty in treating ureteral stricture after pelvic surgery.
METHODS: A retrospective analysis of the clinical data of 95 patients treated for ureteral stricture at Ganzhou People\'s Hospital from June 2017 to March 2023 after pelvic surgery. In this group, 49 patients underwent ureteroscope and laparoscopic ureteroplasty under lithotomy position. The control group consisted of 46 patients who underwent simple laparoscopic ureteroplasty in a supine position. Postoperative data from both groups were collected and compared, including operation time, amount of blood loss during surgery, postoperative hospital stay, incidence of complications, success rate of ureteroplasty, and effectiveness of the operation.
RESULTS: The success rate of end-to-end ureteral anastomosis in the observation group was 93.88%, and the operation effectiveness rate was 100%. The success rate in the control group was 78.26% and the operation effectiveness rate was 89.1%.The average operation time and intraoperative blood loss in the observation group were (121.3 ± 44.6) min and (137.5 ± 34.2) ml, respectively, while in the control group they were (151.2 ± 52.3) min and (165.6 ± 45.8) ml, the difference were statistically significant (P < 0.05). The incidence of perioperative complications in the observation group was 2%, significantly lower than that in the control group (19.6%) (P < 0.05).
CONCLUSIONS: Ureteroscope-assisted laparoscopic ureteroplasty for ureteral stricture after pelvic surgery has the advantages of shortened operation time, increased success rate, and reduced incidence of complications, making it an optional surgical scheme in clinical practice.

OBJECTIVE: This study is aiming to compare the results of early and late removal of urinary catheters after rectal cancer surgery.
METHODS: Patients who undergone rectal cancer surgery in a single center were included in this prospective randomized study. The timing of the urinary catheter removal was randomized by a computer-assisted program and divided into 2 groups, which are early (first 48 h) and late (after 48 h). The primary outcome of this study was to compare the urinary retention and re-catheterization rates between patients with early and those with late catheter removal.
RESULTS: Sixty-six patients were included in this study. The median age was 60 (31-88 years), and the patient group was predominantly male (n: 40, 60.9%). Urinary retention after catheter removal developed in 8 (12%) of 66 patients. There was no difference between the two groups in terms of the need for re-catheterization (14% vs. 10%, p: 0.63). All the patients who required re-catheterization (n: 8) and were discharged with a urinary catheter (n: 4) were male. When the male and female patients were evaluated separately, there was no difference in urinary retention in the early or late groups.
CONCLUSIONS: Early or late removal of the catheter does not play a role in the development of urinary retention in patients undergoing rectal cancer surgery.
OBJECTIVE: Comparar los resultados de la retirada precoz y tardía de la sonda urinaria tras la cirugía de cáncer rectal.
UNASSIGNED: Estudio prospectivo aleatorizado que incluyó pacientes sometidos a cirugía de cáncer rectal en un único centro. El momento de la retirada de la sonda urinaria se aleatorizó y se dividió en dos grupos: primeras 48 horas y después de 48 horas. Se compararon las tasas de retención urinaria y de nueva cateterización entre los pacientes con retirada precoz y tardía de la sonda.
RESULTS: Se incluyeron 66 pacientes, con una mediana de edad de 60 años (31-88 años) y predominio del sexo masculino (n = 40, 60.9%). Se produjo retención urinaria tras la retirada de la sonda en 8 (12%). No hubo diferencias entre los dos grupos en cuanto a necesidad de nueva cateterización (14% frente a 10%, p = 0.63). Todos los pacientes que precisaron un nuevo cateterismo (n = 8) y fueron dados de alta con una sonda urinaria (n = 4) eran varones.
CONCLUSIONS: La retirada precoz o tardía de la sonda no influye en la aparición de retención urinaria en pacientes intervenidos de cáncer de recto.

Introduction: Inconsistencies exist in the nomenclature pertaining to the terms dorsal and ventral female urethra. This survey study was devised to demonstrate this inconsistency, and to identify any surgeon characteristics that contribute to this confusion in urologic and gynecologic reconstructive surgeons.Methods: Genitourinary surgeons were anonymously surveyed using email and social media platforms and asked how they would anatomically label 2 distinctly indicated regions of the female urethra using \"dorsal\" and \"ventral\" nomenclature. χ2 statistical analyses were used to compare categorical responses.Results: We received a total of 155 responses: 128 urologists, 26 gynecologists, and 1 medical student. The medical student was excluded from the analysis. Responses to the red/dorsal marker were 48% dorsal, 27% ventral, and 25% free response. Responses to the green/ventral marker were 52% ventral, 26% dorsal, and 22% free response. Urologists were more likely than gynecologists to use the correct \"dorsal\" label (χ2 [1, N = 122] = 33.6, P < .00001) and \"ventral\" label (χ2 [1, N = 124] = 32.3, P < .00001). There was no statistically significant difference between attendings vs trainees responding either \"dorsal\" or \"ventral\" to describe the red marker (χ2 [1, N = 124] = 0.24, P < .63) or the green marker (χ2 [1, N = 122] = 0.21, P < .65).Conclusions: The terms dorsal and ventral female urethra are not consistent between urologist and gynecologist reconstructive surgeons, and efforts to standardize terminology should be made at the residency training level.

OBJECTIVE: This video illustrates a rare surgical case involving a urethral diverticulum, urethrovaginal fistula, and mesh erosion.
METHODS: We present a 58-year-old patient attending a tertiary care center with a suspected urethrovaginal fistula. Her concerns included stress urinary incontinence (SUI), recurrent urinary tract infection, and vaginal pain. The surgical history was notable for the placement of two different mesh slings during the same procedure to treat SUI. Preoperative evaluation and findings are illustrated in detail. The video uses a high-definition surgical camera to emphasize the initial intraoperative evaluation with localization of the fistula and diverticulum. We then demonstrate the approach to the dissection with the goal of ensuring complete resection of the diverticulum, fistula, and mesh, while preserving healthy tissue for subsequent closure. The utilization of unique and specialized tools for each portion of the procedure is also illustrated. A layered vaginal closure, including a Martius flap, is created to prevent recurrence.
RESULTS: The surgery was accomplished without complications.
CONCLUSIONS: To our knowledge, concomitant findings of a urethral diverticulum, urethrovaginal fistula, and mesh erosion are unique in the literature. We postulate that this triad could have resulted from the mesh burden in this particular patient.

OBJECTIVE: The objective was to develop a prediction model for urinary tract infection (UTI) after pelvic surgery.
METHODS: We utilized data from three tertiary care centers of women undergoing pelvic surgery. The primary outcome was a UTI within 8 weeks of surgery. Additional variables collected included procedural data, severity of prolapse, use of mesh, anti-incontinence surgery, EBL, diabetes, steroid use, estrogen use, postoperative catheter use, PVR, history of recurrent UTI, operative time, comorbidities, and postoperative morbidity including venous thromboembolism, surgical site infection. Two datasets were used for internal validation, whereas a third dataset was used for external validation. Algorithms that tested included the following: multivariable logistic regression, decision trees (DTs), naive Bayes (NB), random forest (RF), gradient boosting (GB), and multilayer perceptron (MP).
RESULTS: For the training dataset, containing both University of British Columbia and Mayo Clinic Rochester data, there were 1,657 patients, with 172 (10.4%) UTIs; whereas for the University of Calgary external validation data, there were a total of 392 patients with a UTI rate of 16.1% (n = 63). All models performed well; however, the GB, DT, and RF models all had an area under the curve (AUC) > 0.97. With external validation the model retained high discriminatory ability, DT: AUC = 0.88, RF: AUC = 0.88, and GB: AUC = 0.90.
CONCLUSIONS: A model with high discriminatory ability can predict UTI within 8 weeks of pelvic surgery. Future studies should focus on prospective validation and application of randomized trial models to test the utility of this model in the prevention of postoperative UTI.

(1) Introduction: The laparoscopic approach to low pelvic tumors is challenging and hindered by suboptimal tumor visualization and dissection, with possible oncological failure. Stereotactic navigation provides real-time image guidance that may optimize safety, accuracy, and precision when dissecting challenging low pelvic tumors. (2) Methods: Preoperative CT images were acquired with eight skin-fixed fiducials and loaded into a navigation system. A patient tracker was mounted on the bed side. Patient-to-image paired point registration was performed, and an instrument tracker was mounted on a laparoscopic instrument and calibrated for instrument tracking. Surgical operations were performed with real-time stereotactic navigation assistance. (3) Results: Three patients underwent stereotactic navigation surgery. Fiducial registration errors were good to optimal (±1.9, ±3.4, and ±3.4 mm). Lesions were easily identified and targeted with real-time navigation. Surgeries were uneventful. Histopathology examinations identified one retro-rectal schwannoma, one lateral pelvic recurrence from rectal adenocarcinoma, and one advanced anal canal carcinoma. No navigation-related complications, readmissions, or postoperative mortalities were observed. (4) Conclusions: The application of laparoscopic stereotactic navigation surgery to complex low pelvic tumors is feasible and could impact oncological surgical quality by enabling tumor targeting and ensuring resection margins. Further wider series are needed to confirm stereotactic navigation\'s impact on challenging low pelvic tumors.