Attributes of successful and unsuccessful female pelvic medicine and reconstructive surgery fellowship applicants.

OBJECTIVE: : To evaluate qualifications of successful applicants to Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowship programs. METHODS: : A 55-point web-based survey was sent to 49 applicants participating in the 2008 FPMRS Match. RESULTS: : The survey achieved a 59% response rate, with a total of 29 respondents. Regarding prematch educational preparations pursued by applicants, 11 of the 24 matched respondents (46%) trained at residencies that offered FPMRS fellowship training. About 19 matched applicants (19/21, 90%) and 2 unmatched applicants (2/5, 40%) received a letter of recommendation from a "nationally-known" female pelvic medicine surgeon. About 40% of matched and unmatched applicants authored at least one manuscript. CONCLUSIONS: : If these respondents are representative of all fellowship candidates in FPMRS match, then it would be expected that combined application costs for all candidates would be almost $350,000.

Factors used by female pelvic medicine and reconstructive surgery fellowship directors to select their fellows.

INTRODUCTION AND HYPOTHESIS: We report the attributes of Female Pelvic Medicine and Reconstructive Surgery (FPM&RS) fellowship applicants that are most valued by fellowship program directors during the ranking process. METHODS: Anonymous questionnaires were filled out by FPM&RS fellowship program directors following the 2008 match. The survey was designed to assess the relative importance of various factors in the ranking of fellowship applicants. RESULTS: Surveys were sent to 67 program directors, and 21 completed the survey (31%). Items ranked as the most important in the selection process were a high quality obstetrics and gynecology residency education (8.2+/-1.2), followed by clinical research experience (7.4+/-1.4). Ability to work well with staff and work ethic were considered to be the most important subjective criteria. CONCLUSIONS: Our results support anecdotal evidence that placed emphasis on research experience and interpersonal skills in the selection of FPM&RS fellows.

An evaluation of knot integrity when tied robotically and conventionally.

OBJECTIVE: The purpose of this study was to evaluate the knot integrity of 3 commonly used sutures in sacrocolpopexy that were tied conventionally (by hand) and robotically. STUDY DESIGN: Knots were tied with polyglactin 910, polypropylene, and polyester, with 5-6 knots tied, depending on the suture used. We compared the knots that were subjected to tensile force until the suture broke or untied. RESULTS: The mean force that was required for the suture to untie was 47.7 +/- 18.8 (SD) Newtons and was seen only among the robotically tied polyglactin 910 knots. Robotically tied polyglactin 910 knots were significantly weaker than all other robotic and conventional knots that were tested (P < .05). The tying modality and material interaction was significant (P < .001), which suggests that the effect of suture material varied, depending on the tying modality. CONCLUSION: Knot failure rates for conventional or robotically tied suture varied based on the suture material that was used.

Patient characteristics that are associated with urodynamically diagnosed detrusor instability and genuine stress incontinence.

OBJECTIVE: We sought to compare characteristics of patients with urodynamically diagnosed detrusor instability or genuine stress incontinence. STUDY DESIGN: A retrospective audit of 293 consecutive women who were referred to a urogynecologist for evaluation of urinary incontinence between June 1996 and April 2000. RESULTS: Of the 293 patients, 289 women had a physical examination and urodynamic testing, which revealed genuine stress incontinence (35%), detrusor instability (32%), mixed incontinence (29%), or normal urodynamic function (4%). Compared with patients with detrusor instability, those women with genuine stress incontinence were more likely to be white than African American (P <.0001) and to have a cystocele(P =.027), rectocele (P <.0001), or paravaginal defect (P =.004). No differences in age, gravidity, parity, estrogen treatment, or previous anti-incontinence procedure were identified between women with detrusor instability and women with genuine stress incontinence. CONCLUSION: In a tertiary referral center, the distribution of urinary incontinence is evenly divided among genuine stress incontinence, detrusor instability, and mixed incontinence. Patients with genuine stress incontinence are more likely to be white and to have pelvic floor prolapse and symptoms of pure stress incontinence.