Despite a relatively low initial success rate (60%), most rectovaginal fistulas can be successfully repaired with subsequent operations. Crohn's disease and smoking are associated with adverse outcomes.

The PFBQ is a useful tool that can be easily used for identification and severity or bother assessment of various pelvic floor symptoms.

I.

Objective To describe the technique for and urodynamic changes during therapeutic instillations of intravesical capsaicin in patients with detrusor hyper‐reflexia. Patients and methods Ninety intravesicalinstillationsof capsaicin were performed as a therapeutic procedure in 30 patients; 21 patients had various causes of non‐traumatic spinal cord disease, five patients were very severely neurologically impaired and were bed‐bound with an indwelling catheter, and four were neurologically normal. Simultaneous cystometry was performed in 25 patients during the instillation of capsaicin; 100 mL of 1 or 2 mmol/L capsaicin in 30% ethanol/saline was instilled into the bladder for 30 min and two patients received 30% ethanol/saline only. The last 56 capsaicin treatments were preceded by the instillation of 40 mL of 2% lignocaine for 20 min. Detrusor hyper‐reflexia was decreased and urinary continence improved for 3–6 months after a single instillation; the instillation was then repeated. Two patients who received only ethanol/saline showed no clinical or urodynamic improvement. Results The treatment was not abandoned in any patient due to discomfort and there were no short‐ or medium‐term complications. All patients with spinal cord disease and phasic detrusor hyper‐reflexia had similar, frequent and repetitive detrusor contractions during the instillation of capsaicin. These acute reactive contractions did not occur in the neurologically normal patients. Similarly, the instillation of intravesical lignocaine only caused no phasic detrusor contractions. Intravesical lignocaine instillation before capsaicin markedly reduced and sometimes abolished the detrusor overactivity and lessened the discomfort for the patients. The instillation of lignocaine before capsaicin did not alter the benefit from each instillation of intravesical capsaicin. Conclusion A method has been developed for administering capsaicin intravesically which diminishes discomfort for the patient and in the short‐and medium‐term is free of complications. The study also provides functional evidence of the role of capsaicin‐sensitive afferents in phasic detrusor hyper‐reflexia due to spinal cord disease.

There was no specific correlation between distribution of pelvic floor disorders and mode of delivery in this study. Patients of age greater than 50 years had a higher incidence of significant rectocele.

The aim of this paper was to discuss the embryological aspects of Müllerian duct anomalies and to analyze the current diagnostic methods and therapy.Müllerian anomalies are congenital defects of the female reproductive tract resulting from failure in the development of the Müllerian ducts and their associated structures. Their cause has yet to be fully clarified, and it is currently believed to be multifactorial. Symptoms appear principally during adolescence or early adulthood, and affect the reproductive capacity of these women. When clinically suspected, investigations leading to diagnosis include imaging methods such as hysterosalpingography, ultrasonography and magnetic resonance. The classification of these malformations relates to their embryogenesis, and defines the therapy and prognosis. Müllerian anomalies consist of a wide range of defects that may vary from patient to patient.Therefore, their management must also be individual, taking anatomical and clinical characteristics into consideration, as well as the patient's wishes. RESUMOO objetivo deste trabalho foi discutir as malformações müllerianas desde seus aspectos embriológicos, analisando os atuais métodos diagnóstico e terapêuticos. As malformações müllerianas são anomalias congênitas do trato reprodutivo feminino decorrentes de falha do desenvolvimento dos ductos de Müller e estruturas associadas. Sua causa não foi completamente elucidada, acreditando-se, atualmente, que seja multifatorial. Os sintomas se manifestam, principalmente, durante a adolescência e início da vida adulta, e afetam a capacidade reprodutiva dessas mulheres. A partir da suspeita clínica, a investigação diagnóstica inclui métodos de imagem, como a histerosalpingografia, ultrassonografia e ressonância magnética. A classificação das malformações está relacionada à sua embriogênese e direciona a terapêutica e prognóstico. As malformações müllerianas são um grupo amplo de anomalias que variam de paciente para paciente. Portanto, sua abordagem também é individual, devendo-se considerar os aspectos anatômicos, clínicos e o desejo da paciente.

The Brazilian Portuguese version of the PFBQ is a reliable, valid, and user-friendly instrument that can be used for assessing the presence and severity of pelvic floor symptoms in clinical and research settings in Brazil.

Recurrent cystocele repair has a higher anatomic failure rate than primary repair at 2-year follow-up. Alternative surgical techniques that provide better long-term durability may be beneficial in repair of recurrent anterior wall prolapse.