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Objective The aims of this study were to determine the percentage of patients who opt to undergo pessary self-care versus those who return to the office for care and to identify any differences in the characteristics between the 2 groups. Methods This study is a retrospective chart review conducted at a tertiary care center. Demographic data; details regarding pessary use; body weight; pelvic organ prolapse stage; and medical, surgical, and obstetrical histories were evaluated. Variables were compared between groups of patients using the t test, Wilcoxon rank sum test, χ2 test, and Fisher exact test. Results The rate of patients choosing to perform pessary self-care was 31%. The patients in the self-care group were significantly younger (65.0 vs 75.0 years, P < 0.001). Those who were performing self-care were more likely to be premenopausal (6.9% vs 1.5%, P = 0.003), have a lower stage of pelvic organ prolapse (61.3% vs 42.1%, P < 0.001), and more likely to be sexually active (40.5% vs 9.6%, P < 0.001). Those not performing self-care had higher rates of vaginal bleeding (26.0% vs 16.4%, P = 0.012) and erosion (23.5% vs 9.9%, P < 0.001). Self-care patients predominantly used the ring with support pessary, whereas those in the non–self-care group were mostly using the Gellhorn. Conclusions Only one third of patients who use a pessary chose to perform self-care. Patients who use self-care are younger, premenopausal, sexually active, and have lower degrees of prolapse. These data can help educate patients on the characteristics more often seen in those choosing self-care. This study highlights the importance of further exploring pessary care preferences and using this information for counseling.

A 26‐year‐old female, G4 P2012 presented for an anatomy scan at 18 weeks. Multiple macrocysts were seen in the left fetal lung, which lead to a diagnosis of congenital pulmonary airway malformation (CPAM) type II. A fetal MRI examination performed at 24 weeks of gestation confirmed the diagnosis of CPAM type II. A genetic amniocentesis was done to rule out a fetal chromosomal abnormality and the fetus was found to have mosaic Klinefelter syndrome. Fetal CPAM is not usually associated with chromosomal abnormalities unless there are other fetal malformations present. This is the first known case where a fetus with CPAM and no other malformation was found to have mosaic Klinefelter syndrome. Therefore, we believe it is prudent to offer prenatal diagnostic testing whenever a fetus with CPAM is identified with ultrasound.

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INTRODUCTION: The aim of this study is to assess the safety and feasibility of Indocyanine Green (ICG) dye in patients with adnexal torsion. Our hypothesis is that the use of ICG dye will aid in the surgical determination of tissue viability, ultimately preventing the resection of salvageable ovaries. METHODS: An IRB approved pilot study is currently enrolling patients 18-45 years old with suspected adnexal torsion in a multicentered tertiary care hospital setting. During laparoscopy, the involved adnexa is untwisted and ICG dye is injected intravenously. The untwisted ovary is then observed. Adnexal tissue demonstrating perfusion is preserved and patients are followed postoperatively with anti-Mullerian hormone level and ultrasound. Non-perfused tissue is resected and histologically evaluated for necrosis. RESULTS: Eleven patients with suspected adnexal torsion were enrolled, of which eight had surgically confirmed torsion. Six women demonstrated perfusion with the use of ICG dye even though three of these patients had minimal or no flow on preoperative ultrasound. The remaining 2/8 patients with confirmed torsion failed to demonstrate perfusion with the ICG dye and oophorectomies were performed. One of these patients had confirmed histologic necrosis. There have been no adverse events. CONCLUSION: The use of intravenous ICG dye appears to be a safe and valuable adjunct in the surgical management of adnexal torsion. This may be particularly helpful in patients with diminished adnexal perfusion on preoperative ultrasound. Further research is recommended to determine the generalized role of ICG dye in patients with adnexal torsion.