Population Twenty adult parous Texel ewes.Methods Sheep were implanted with Gynemesh M, a 28-g/m² polypropylene mesh reinforced with polyglecaprone fibres, under general anaesthesia. Dissection into the rectovaginal septum was performed to accommodate a flat 50 9 50 mm (n = 10) or 35 9 35 mm (n = 10) mesh, which was sutured to the underlying tissues. A 50 9 50 mm mesh was laid over a primarily sutured, fullthickness, 40-mm longitudinal abdominal wall incision. Sacrifice was at 60 days (n = 10) or 90 days (n = 5).Main outcome measures The occurrence of exposure, the degree of contraction and examination of the biomechanical properties of explants with a minimum radius of 32 mm via biaxial tensiometry.Results Insertion of a 50 9 50 mm mesh led to exposures in 30% (3/10) of cases, and the average contraction rate was 52 ± 14%. In the 35 9 35 mm implants, there were no exposures, and the contraction rate was 25 ± 26.3%. Vaginal explants with no GRCs and of sufficient size had biomechanical properties that were comparable with those of abdominal explants. ConclusionVaginal mesh insertion is associated with GRCs, such as exposure and contraction. Although other factors probably play a role, this study illustrates that mesh size may also induce these complications. In a vaginal surgery model, clinically occurring GRCs can be reproduced. In addition, biomechanics of uncomplicated vaginal explants are comparable with those measured on abdominal explants.

Our study showed a 40.9% prevalence of DU in POP patients. DU was associated with the presence of voiding symptoms and positive PVR. Moreover, cystocele showed to be more severe in DU group. After surgical repair of POP, voiding symptoms of DU patients became equal to non-DU ones, suggesting that obstruction removal might recover DU in these patients.

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AbstractSince SARS-COV-2 appeared in Wuhan City, China and rapidly spread throughout Europe, a real revolution occurred in the daily routine and in the organization of the entire health system. While non-urgent clinical services have been reduced as far as possible, all kind of specialists turned into COVID-19 specialists. Obstetric assistance cannot be suspended and, at the same time, safety must be guaranteed. In addition, as COVID-19 positive pregnant patients require additional care, some of the clinical habits need to be changed to face emerging needs for a vulnerable but unstoppable kind of patients. We report the management set up in an Obstetrics and Gynecology Unit during the COVID-19 era in a University Hospital in Milan, Italy.