Objective: To describe the microbiome of the vagina and fallopian tubes, and its relation with hydrosalpinx. Design: Prospective case-control study. Population and Settings: Women who underwent salpingectomy for hydrosalpinx or other indications at our medical center . Main Outcome Measures: Samples obtained during surgery and were subjected to 16S rRNA amplicon sequencing, and analyses of alpha diversity and beta diversity meseaures were compared between sites and groups. Differential abundances of bacteria associated with vaginal dysbiosis was compared between cases and controls. Results: Nine women with hydrosalipnx, and 23 women without hydrosalpinx were included in the study. The mean age of studied women was 41 (range: 29-54), and most (89%) were premenopausal. After in silico decontamination, only 30% of control fallopian tubes samples, and 10% of case fallopian tubes samples, had evidence of bacterial presence. The vaginal microbiota of control patients showed greater abundance of lactobacilli whereas the vaginal microbiome of case patients contained relatively more bacterial vaginosis associated bacteria such as Prevotella, Gardenrella and Atopobium. A significant difference was found in alpha and beta diversity between the vaginal and FT microbiomes in control patients, as fallopian tubes samples were more diverse. We found that women with hydrosalpinx had a more “dysbiotic” vaginal microbiome, and in women without hydrosalpinx, microbial composition within the vagina and FT differed, possibly representing two distinct ecological environments. Conclusion: women undergoing salpingectomy for various reasons harbored bacteria within their FT, women with hydrosalpinx generally did not. This suggests that even though infection may be an underlying cause of hydrosalpinx, bacteria may not be present by the time patients require surgery.

Objective To date, apart from groin and thigh pain, there is a paucity of data regarding the association between transobturator tape (TOT) surgery and lower extremity function. We have aimed to evaluate the association between TOT and various indices of hip joint pain and function. Design Prospective cohort study Settings and Population 37 patients who underwent TOT surgery for the treatments of stress urinary incontinence (SUI). Methods Various tests and questionnaires aimed to assess hip function and surgery outcomes were completed before and after the TOT surgery, at the post-operative clinic. Paired data were compared using the paired sample t-test, after testing for normal distribution. Main Outcome Measures Hip range of motion (ROM), joint function and muscle strength, walking functions, leg length, subjective effect of surgery on patients’ quality of life and the impact of urinary incontinence on daily activities, mental and physical quality of life. Results Decrease in ROM was observed in most cardinal movements of the hip. An increase in leg length following TOT was observed (mean difference in centimeters for both legs 0.87-0.88; p<0.001). An overall trend of decreased strength was noticed, significant for hip adduction. The IIQ-7 and UDI-6 questionnaires demonstrated a significant improvement in urinary function (31.95- and 25.27-point reduction respectively; p<0.05 for both). No significant change was noted in gait function following surgery. Results of the FJS assessment revealed no difference in patient’s awareness of their hip joint. Conclusion Our findings provide support for a yet underestimated association between TOT surgery and hip dysfunction.

Objective: To investigate whether an association exists between deceleration and acceleration areas on continuous fetal cardiotocography (CTG) and neonatal encephalopathy (NE). Design: A retrospective case-control study. Setting: A single tertiary medical center with over 15,000 births a year. Population: All deliveries complicated by neonatal encephalopathy in our center during the study period, with two controls for every case, matched by gestational age and cord blood pH. Methods: We compared CTG characteristics of low-risk pregnancies (35 weeks gestation or more), complicated by moderate to severe NE with matched controls. We analyzed the intrapartum CTG recordings by calculation of the deceleration and acceleration areas. Main outcome measure: Deceleration and acceleration areas and the ratio between the two. Results: During the period between 2013 and 2019, we identified 95 cases of low-risk pregnancies that were complicated by moderate to severe NE in our center. Thirty-three (34.7%) deliveries were excluded, mostly due to an insufficient duration of the CTG recordings. The remaining 62 cases were matched with 123 controls. We found that NE was significantly associated with an increased total deceleration area, a decreased total acceleration area and a lower acceleration-to-deceleration ratio. Conclusions: In our population, NE was significantly associated with increased total deceleration area, decreased total acceleration area and a lower acceleration-to-deceleration ratio, irrespective of cord blood pH. Development of a computerized real-time analysis of fetal heart rate tracings may contribute to making these measurements a more valid clinical tool.

Objective: Stress urinary incontinence is a common health problem, with grave social and economic consequences, that is associated with a reduced quality of life. Stem cell therapy has developed as a novel modality for regeneration of injured tissues and could be a promising strategy for treatment of stress urinary incontinence. The objective of this systematic review is to summarize the clinical trials available to date, on stem cells therapy for treatment of stress urinary incontinence in woman. Study design: PubMed, Cochrane Library, Scopus and Embase were searched for studies published until January 2020 on Stem cell therapy for Stress urinary incontinence in woman. Quality of the included studies was assessed formally and independently by two authors using the JBI Critical Appraisal Checklists according to the PRISMA guidelines. Results: 19 studies were included and their quality was assessed with the JBI Critical Appraisal Checklists. These studies imply that stem cells therapy for treatment of stress urinary incontinence is a safe and effective treatment. Conclusions: While it is difficult to draw specific conclusions, initial results of stem cell therapy for the treatment of stress urinary incontinence seem encouraging. The great variability in cell types, injection protocols, follow up duration and evaluation tests, outcome measures and adverse effects indicates the need for standardization and validation of this treatment modality before it could be recommended for routine use.