Continent women with advanced pelvic organ prolapse (POP) > 66 years, with DM or low MUCP and FUL values during preoperative urodynamic evaluation have higher risk of developing de novo SUI; therefore, we suggest counselling such women for concomitant PRS and anti-incontinent surgery.

Elevate(™) a offered lower incidence of mesh erosion and comparable results on anatomical POP correction; however, incidence of de novo SUI was high. There is an apparent lengthening of implanted Elevate® mesh sonographically.

Age, education level and ability to pay insurance significantly affect 12-month outcome of RVF. Surgery is the preferred option, while medical treatment should be used only for small rectovaginal fistulas or for patients not suitable for surgery and anesthesia. More support and assistance should be offered to those patients with unfavorable factors, such as old age, low education level and inability to afford insurance. All RVF secondary to obstetrical injury had a 100% favorable outcome compared with those secondary to surgery or malignancy. Women with suspected RVF should receive prompt and extensive evaluation to ensure immediate effective management and prevention of further serious complications.

Overt USI with advanced POP together with low MUCP and FUL values have a higher risk of developing P-USI. Therefore, counseling these women is worthwhile while considering the type of mesh used.

1: Gynecologic oncologists as benign gynecologic surgeons

Management of nulliparous advanced POP poses significant challenges with regard to uterine preservation, future pregnancy and childbirth. Conservative management with pessary insertion should be offered followed by surgical correction. Reconstructive surgery with mesh may improve prolapse symptoms objectively and subjectively.

a b s t r a c tShock focusing in water is a phenomenon that can occur during the impact of a shock wave generated by an underwater explosion onto any type of convergent marine structures. To predict the dynamic material response of the marine structure, it is important to understand the shock wave dynamics during the focusing event. In this paper, both experimental investigations and numerical studies of twodimensional shock focusing in water are presented. Here, a convergent geometry given by a logarithmic spiral curve is used to focus the shock waves. In the experiments, the interaction between three types of materials and the shock wave in water is explored by using high-speed photography. Distinct features of such flows are unveiled. Three scenarios have been considered in simulations: a rigid structure where only the water-filled region is taken into account, a fluid-structure interaction problem in which the surrounding material responses are included, and an axisymmetric simulation to determine the threedimensional effects.

Management of recurrent pelvic organ prolapse using transvaginal mesh would be an option for patients treated previously by sacrocolpopexy.