BACKGROUND: Abdominal and laparoscopic sacro-colpopexy (LSC) is considered the standard surgical option for the management of a symptomatic apical pelvic organ prolapse (POP). Women who have their uterus, and for whom an LSC is indicated, can have a laparoscopic sacro-hysteropexy (LSH), a laparoscopic supra-cervical hysterectomy and laparoscopic sacro-cervicopexy (LSCH + LSC) or a total laparoscopic hysterectomy and laparoscopic sacro-colpopexy (TLH + LSC). The main aim of this study was to compare clinical and patient reported outcomes of uterine sparing versus concomitant hysterectomy LSC procedures. METHODS: A retrospective analysis of clinical, imaging and patient reported outcomes at baseline, 3 and 12 months after LSH versus either LSCH + LSC or TLH + LSC between January 2015 and January 2019 in a tertiary referral urogynecology center in Pilsen, the Czech Republic. RESULTS: In total, 294 women were included in this analysis (LSH n = 43, LSCH + LSC n = 208 and TLH + LSC n = 43). There were no differences in the incidence of perioperative injuries and complications. There were no statistically significant differences between the concomitant hysterectomy and the uterine sparing groups in any of the operative, clinical or patient reported outcomes except for a significantly lower anterior compartment failure rate (p = 0.017) and higher optimal mesh placement rate at 12 months in women who had concomitant hysterectomy procedures (p = 0.006). CONCLUSION: LSH seems to be associated with higher incidence of anterior compartment failures and suboptimal mesh placement based on postoperative imaging techniques compared to LSC with concomitant hysterectomy.

• Klíčová slova
• Cervicopexy, Compartment, Hysteropexy, LSC, LSCH + LSC, LSH, Laparoscopic, Mesh, PFDI, PGI-I, POP-Q, Sacrocolpopexy, TLH + LSC,
• MeSH
• gynekologické chirurgické výkony MeSH
• hysterektomie MeSH
• kohortové studie MeSH
• laparoskopie * MeSH
• lidé MeSH
• prolaps pánevních orgánů * chirurgie   MeSH
• retrospektivní studie MeSH
• uterus MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• chirurgické síťky škodlivé účinky   MeSH
• dospělí MeSH
• gynekologie normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• odstranění implantátu normy   MeSH
• prolaps pánevních orgánů chirurgie   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• stresová inkontinence moči chirurgie   MeSH
• suburetrální pásky škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• úvodníky MeSH

INTRODUCTION AND HYPOTHESIS: Members of the International Urogynecological Association (IUGA) come from different geographic locations and practice settings. A member survey regarding practice patterns provides valuable information for practitioners and researchers alike, and allows the IUGA to discover areas to focus on education and information dissemination. METHODS: A questionnaire was developed by the IUGA Research and Development committee and distributed electronically to IUGA surgeons. Answers were analyzed in reference to demographics, geographic distribution, and academic affiliation. RESULTS: Five hundred sixty-four members answered the questionnaire, representing a 28 % response rate, and closely reflecting the geographic distribution of IUGA membership. Preferred surgical treatment for uncomplicated SUI was the mid-urethral trans-obturator sling (49.7 %). Vaginal mesh was mainly used for repair of recurrent POP (20.4 %). Pessary use was offered "always" or "frequently" by 61.5 %, with no difference in academic affiliation, but significant differences based on region of practice. Compared to practitioners in non-academic centers, those with academic affiliation utilized Urodynamic studies (UDS) and Magnetic Resonance Imaging (MRI) more frequently in the evaluation of POP. Regions of practice significantly influenced the majority of practice patterns, with the highest impact found in the use of robotic assistance. CONCLUSIONS: Many practice patterns in the evaluation and treatment of POP and SUI depend on academic affiliation and geographic location. Practice patterns are not always based on most recent evidence-based data.

• Klíčová slova
• Academic practice, Pelvic floor disorders, Physician survey, Practice patterns, Stress urinary incontinence, Urodynamic studies,
• MeSH
• chirurgické síťky statistika a číselné údaje   MeSH
• dospělí MeSH
• gynekologie statistika a číselné údaje   MeSH
• internacionalita MeSH
• lékařská praxe - způsoby provádění statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie statistika a číselné údaje   MeSH
• mladý dospělý MeSH
• pesary statistika a číselné údaje   MeSH
• prolaps pánevních orgánů chirurgie   MeSH
• průzkumy a dotazníky MeSH
• stresová inkontinence moči chirurgie   MeSH
• suburetrální pásky statistika a číselné údaje   MeSH
• ultrasonografie statistika a číselné údaje   MeSH
• urologie statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION AND HYPOTHESIS: This committee opinion paper summarizes available evidence about recurrent pelvic organ prolapse (POP) to provide guidance on management. METHOD: A working subcommittee from the International Urogynecological Association (IUGA) Research and Development Committee was formed. The literature regarding recurrent POP was reviewed and summarized by individual members of the subcommittee. Recommendations were graded according to the 2009 Oxford Levels of Evidence. The summary was reviewed by the Committee. RESULTS: There is no agreed definition for recurrent POP and evidence in relation to its evaluation and management is limited. CONCLUSION: The assessment of recurrent POP should entail looking for possible reason(s) for failure, including persistent and/or new risk factors, detection of all pelvic floor defects and checking for complications of previous surgery. The management requires individual evaluation of the risks and benefits of different options and appropriate patient counseling. There is an urgent need for an agreed definition and further research into all aspects of recurrent POP.

• Klíčová slova
• Cost, Definition, Diagnosis, Etiology, Incidence, Pelvic organ prolapse, Prevalence, Recurrent, Treatment,
• MeSH
• konsensus MeSH
• konzervativní terapie MeSH
• lidé MeSH
• prolaps pánevních orgánů diagnóza   ekonomika   terapie   MeSH
• randomizované kontrolované studie jako téma MeSH
• recidiva MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH