Removal Of Wall Research Articles

OUTCOME OF INITIAL 100 CASES OF ENDOSCOPIC DACRYOCYSTORHINOSTOMY IN KIRKUK

This study aimed at determining the effect and safety of endoscopic dacryocystorhinostomy (ENDO-DCR) in initial 100 cases of nasolacrimal duct obstruction. This study was done in Kirkuk general hospital from 2010 to 2017 with a total of 100 cases. A standardized method was applied to all cases through employing an endonasal technique to the lachrymal sac. Then, an operative resection was applied to the mucosa of nose, lacrimal bone and a part of the anterior maxilla. Next, a complete removal of the medial wall of the lacrimal sac was done. A tube of canalicular silicone intubation was placed for 6 months after operation. The key results of such measures were epiphora resolution, lack of discharge and clearness of the ostium. The success of ENDO-DCR method with adjunctive tube of canalicular silicon intubation was demonstrated in 80 cases (80%) and 10 cases represented acceptable improvements. However, there were minor complications faced during or after operation period. Finaly Endoscopic dacryocystorhinostomy is a safe and effective method for treating nasolacrimal duct obstruction in adults and children with nasolacrimal duct obstruction and epiphora.

Transurethral resection of a bladder trigone leiomyoma: a rare case report

BackgroundBladder leiomyomas are rare and benign tumors of the bladder. They account for 0.43% of all bladder tumors, and only 250 cases have been reported in English literature. Based on the size and localization of the lesion, their symptoms vary considerably. Women seem to be more affected, and obstructive symptoms predominate. Surgical treatment is almost always highly effective, leaving a low recurrence rate.Case presentationWe present a clinical case of a 52-year old man with macroscopic hematuria and obstructive lower urinary tract symptoms due to a large bladder trigone leiomyoma. CT and MRI showed a well-defined large bladder leiomyoma and cystoscopy established the initial findings. The patient underwent successful transurethral resection of the lesion, and pathology findings confirmed the diagnosis.ConclusionsThis case report demonstrates that transurethral resection of a large bladder trigone leiomyoma is a feasible and successful procedure. Long term follow-up proves that there is neither scarring distortion of the bladder trigone area nor damage in the ureteral orifices, even though there was a thorough removal of the trigone wall.

In Reply: Colloid Cysts: Evolution of Surgical Approach Preference and Management of Recurrent Cysts.

BACKGROUND Optimal management of third ventricular colloid cysts remains debated. While microsurgery offers greater resection rates and lower recurrences, endoscopy offers a perceived less invasive option. OBJECTIVE To describe the evolution of our practice to favor microsurgery and determine the optimal management of recurrent colloid cysts. METHODS Any patient having undergone surgery for a colloid cyst by the senior author was identified and included in the study cohort. Clinical, radiographic, and operative records were reviewed, with attention paid to those patients requiring recurrent surgery. RESULTS Thirty-three patients were treated for intracranial colloid cysts between 1995 and 2017. Two patients had initial surgical treatment at an outside institution prior to presentation at our institution. Microsurgery was used in 15/31 initial cases, endoscopy in 13 cases, and ventriculoperitoneal shunting in 3 cases. Between 1995 and 2005, 89% of colloid cysts (8/9 cases) were resected endoscopically, whereas 74% of colloid cysts (14/19 cases) were resected by microsurgery after 2005. Of the 13 patients treated endoscopically, 6 (46%) required surgery for recurrent cysts. Incomplete cyst wall resection at the initial operation increased the recurrence rate to 55%. There were no recurrences in the microsurgery cohort. CONCLUSION Surgical resection of recurrent colloid cysts should focus on complete removal of the cyst wall to minimize the chance of recurrence. Microsurgery has been shown to provide the highest success rates for cyst wall resection and lowest rates of recurrence and is therefore recommended for patients undergoing surgery for primary and recurrent colloid cysts.

Transsphenoidal Optic Canal Decompression for Traumatic Optic Neuropathy Assisted by a Computed Tomography Image Postprocessing Technique.

The endoscopic transethmoidal approach is favored for the lack of external scars, a wide field of view, and rapid recovery time. But the effect of iatrogenic trauma should not be ignored due to the removal of the uncinate process and anterior and posterior ethmoidal sinus. Anatomically, the optic nerve is close to the sphenoid sinus and Onodi cell. In order to preserve the uncinate process and ethmoidal sinus, we perform endoscopic transsphenoidal optic canal decompression (ETOCD), which is less invasive. However, the anatomy of sphenoid sinus is quite variable, and the anatomical landmarks are rare. Therefore, identifying the position of optic canal is particularly important during surgery. To solve this, we use a postprocessing technique to identify the position of the optic nerve and internal carotid artery on the sphenoid sinus wall. Our results find that VA in 13 patients improved, with a total improve rate of 59.1%. No serious complications were found. We also found that the length of optic canal is different and the medial wall of the optic canal was the longest (p < 0.05). The middle section of the optic canal is the narrowest, which was significantly different from cranial mouth and orbital mouth (p < 0.05). We assumed that decompression may not require removal of all medial wall. If we remove the length of the shortest wall on the medial wall of the optic canal, the compression may be relieved. Thus, ETOCD was a feasible, safe, effective, and less-invasive approach for patients with TON. The CT postprocessing imaging facilitated recognition of the optic canal during surgery. The decompression length of the medial wall may not need to be completely removed, especially near the cranial mouth.

Chest wall resection and reconstruction: a case series of 20 patients in Hospital Kuala Lumpur, Malaysia

Chest wall resection is defined as partial or full-thickness removal of the chest wall. Significant morbidity has been recorded, with documented respiratory failure as high as 27%. Medical records of all patients who had undergone chest wall resection and reconstruction were reviewed. Patients' demographics, length of surgery, reconstruction method, size of tumor and chest wall defect, histopathological result, complications, duration of post-operative antibiotics, and hospital stay were assessed. From 1 April 2017 to 30 April 2019, a total of 20 patients underwent chest wall reconstructive surgery. The median age was 57years, with 12 females and 8 males. Fourteen patients (70%) had malignant disease and 6 patients (30%) had benign disease. Nine patients underwent rigid reconstruction (titanium mesh for sternum and titanium plates for ribs), 6 patients had non-rigid reconstruction (with polypropylene or composite mesh), and 5 patients had primary closure. Nine patients (45%) required closure with myocutaneous flap. Complications were noted in 70% of patients. Patients who underwent primary closure had minor complications. In total, 66.7% of patients who had closure with either fasciocutaneous or myocutaneous flaps had threatened flap necrosis. Two patients developed pneumonia and 3 patients (15%) had respiratory failure requiring tracheostomy and prolonged ventilation. There was 1 mortality (5%) in this series. In conclusion, chest wall resections involving large defects require prudent clinical judgment and multidisciplinary assessments in determining the choice of chest wall reconstruction to improve outcomes.

The Lateral Orbitotomy Approach for Intraorbital Lesions.

The lateral orbitotomy approach (LOA) was first described by Kronlein in 1888 and has since been subject to many modifications and variations. When considering orbital approaches, the location of the pathology is often more important in decision making than the type of pathology. The LOA is best suited for access to intraconal and extraconal lesions lateral to the optic nerve. Pathologies treated via the LOA include primary orbital tumors, extraorbital tumors with local extension into the orbit, and distantly metastatic lesions to the orbit. These all often initially manifest with vision loss, oculomotor deficits, or proptosis. The expertise of a multidisciplinary team is needed to execute safe and effective treatment. Collaboration between many specialties may be required, including ophthalmology, neurosurgery, otolaryngology, plastic surgery, oncology, and anesthesiology. The modern technique involves either a lateral canthotomy or eyelid crease incision with removal of the lateral orbital wall. It affords many advantages over a pterional craniotomy, primarily a lower approach morbidity and superior cosmetic outcomes. Reconstruction is fairly simple and the rate of complications-vision loss and extraocular muscle palsy-are low and infrequently permanent. Deep orbital apex location and intracranial extension have traditionally been considered limitations of this approach. However, with increased surgeon comfort, modern technique, and the adoption of endoscopy, these limits have expanded to even include primarily intracranial pathologies. This review details the LOA, including the general technique, its indications and limitations, reconstruction considerations, complications, and recent data from case series. The focus is on microscopic access to intraorbital lesions.

Nitrate removal and greenhouse gas production of woodchip denitrification walls under a humid subtropical climate

Denitrification walls are a low-cost technology with the capability to reduce nitrogen (N) loading in shallow groundwater beneath agricultural systems. The aims of this study were to quantify the effect of different carbon (C) substrates on nitrate removal rate (NRR) and greenhouse gas (GHG) production in two soil-capped denitrification walls (volume ≈ 27 m3) under subtropical climate conditions. The relative performance of softwood and hardwood woodchips to promote denitrification was tested over a 2-year program of weekly monitoring, during which water samples were collected for nitrate (NO3−) and dissolved GHG analysis. Both the softwood and the hardwood wall had similar average NRR (2.0 and 1.6 g N m−3 d−1, respectively) but were NO3− limited, and acted as a sink for nitrous oxide (N2O) produced in the walls and dissolved in the aquifer. Both walls produced carbon dioxide (CO2) and methane (CH4), with the hardwood producing respectively 3-fold and 2.5-fold higher fluxes compared to the softwood. Calculation of the Global Warming Potential (GWP) permitted a comparison of the GHG emissions within the walls in terms of CO2 equivalents (CO2-eq). Both the walls emitted CO2-eq lower than natural environments, with the softwood producing null emissions and the hardwood emitting 65-fold higher than softwood. The results of the present study suggest that woodchip bioreactors may be used to reduce nutrient loading from agricultural areas into surrounding aquatic environments as well as to decrease GHG emissions under subtropical climates, with softwood being a preferable substrate.

Latex-casting of vessels relevant during vaginectomy in bitches

Vaginectomy is an infrequently performed invasive surgery to control vaginal disorders in bitches. Indications for vaginectomy include vaginal tumors (leiomyoma, fibroleiomyoma and leiomyosarcoma), polyps and vaginal prolapse. The surgical technique is a two-step procedure and consists of an extended laparotomy approach with caudal ovariohysterectomy followed by an episiotomy approach with removal and reconstruction of the vaginal wall. Although the surgery itself is invasive, the combined approach results in a favorable outcome with an apparently low risk of intra- and postoperative complications. During vaginectomy, traction is placed on the vagina and its supplying blood vessels via the episiotomy site. By means of a post-mortem study of five dogs, it was investigated if this traction resulted in damage or rupture of the supplying vessels. In this study, it was demonstrated that the uterine branch of the vaginal artery and the caudal vesical artery rupture during the traction phase of a vaginectomy via the episiotomy site. Rupture of these vessels might result in insufficient perfusion of the bladder and extensive intraabdominal and -pelvic bleeding.

Endonasal endoscopic transpterygoid approach to the upper parapharyngeal space.

Lesions of the upper parapharyngeal space (UPPS) present a surgical challenge. The objective of this study was to ascertain the feasibility of a novel technique of modified transpterygoid approach to the UPPS. Six fresh cadaveric specimens (12 sides) were dissected, developing a technique that includes en bloc mobilization of the lateral pterygoid plate and muscle to access the UPPS. Following an endoscopic Denker's approach and the removal of posterolateral wall of the antrum, the lateral pterygoid plate was detached from the pterygoid process. Subsequently, the lateral pterygoid plate and muscle were displaced laterally as a unit, allowing the identification of the posterior trunk of V3 and the fat in prestyloid compartment. Dissecting off the styloid aponeurosis affords entering the poststyloid UPPS exposing the internal carotid artery, internal jugular vein, and cranial nerves IX to XII. This novel modification of the endonasal transpterygoid approach offers a viable alternative for access to the UPPS.

Awareness of crime prevention effects associated with a wall removal project in Seoul

ABSTRACTThis study investigated Groups' awareness of how wall removal affects crime prevention. Group 1 comprised of burglars, Group 2 of non-residents who have not removed walls, and Group 3 of residents who have removed walls and are living in wall removal project areas. First, we examine differences in awareness between Groups 1 and 2 regarding ease of crime in relation to the presence or absence of a wall. Second, we examined the awareness levels of Groups 1 and 2 in relation to important factors considered by intruders when committing a burglary. Finally, we examined how wall removal reduces the fear of crime in Groups 2 and 3. Group 1 believed a house with a wall was an easier target for crime, but Group 2, comprised of residents who did not perform wall removal, had contrary opinions. Group 2 believed that wall removal did not reduce the fear of crime, unlike Group 3. These results indicate that Group 2 has negative perceptions of wall removal in the context of crime prevention, which stems from the common belief that a wall will protect a house from outside threats. Therefore, changes in mindset are needed to create safe environments in detached housing areas.

Wall Structure Affects Insulation of Nests Built by Thrushes

Incubation and rearing of nestlings are energetically demanding activities that can be affected by insulation conferred by the nest wall. Although thermal properties of nests are widely studied, no reports to date have dealt with the relative effects of the various structural parts of the nest wall. This experimental study investigated the effects of air movement, and for the first time, the effects of wall structure, on nest insulation for the Common Blackbird Turdus merula and Song Thrush Turdus philomelos of the Turdidae. Insulatory values, i.e. difference in cooling rate measured simultaneously inside and outside a nest, and internal cooling rates within the nest cup, were determined using temperature loggers under still-air and moving-air conditions. Moving-air increased insulatory values and internal cooling rates in both species. Insulatory values were positively correlated with the nest base thickness, but not nest side wall thickness. Removal of the outer nest wall and cup lining to reveal the internal mud cup of thrush nests reduced the insulatory value compared to the whole nest, the effect of which was exacerbated under moving-air conditions. These results may reflect that the nest wall confers huge insulatory advantages and especially so during periods of air movement. However, it is unclear whether this is related to the presence of particular nest materials that confer insulation, or to the amount of air trapped in the nest wall. Alternatively, the thermal conductivity of the materials lining the cup wall may be important.

Colloid Cysts: Evolution of Surgical Approach Preference and Management of Recurrent Cysts.

Optimal management of third ventricular colloid cysts remains debated. While microsurgery offers greater resection rates and lower recurrences, endoscopy offers a perceived less invasive option. To describe the evolution of our practice to favor microsurgery and determine the optimal management of recurrent colloid cysts. Any patient having undergone surgery for a colloid cyst by the senior author was identified and included in the study cohort. Clinical, radiographic, and operative records were reviewed, with attention paid to those patients requiring recurrent surgery. Thirty-three patients were treated for intracranial colloid cysts between 1995 and 2017. Two patients had initial surgical treatment at an outside institution prior to presentation at our institution. Microsurgery was used in 15/31 initial cases, endoscopy in 13 cases, and ventriculoperitoneal shunting in 3 cases. Between 1995 and 2005, 89% of colloid cysts (8/9 cases) were resected endoscopically, whereas 74% of colloid cysts (14/19 cases) were resected by microsurgery after 2005. Of the 13 patients treated endoscopically, 6 (46%) required surgery for recurrent cysts. Incomplete cyst wall resection at the initial operation increased the recurrence rate to 55%. There were no recurrences in the microsurgery cohort. Surgical resection of recurrent colloid cysts should focus on complete removal of the cyst wall to minimize the chance of recurrence. Microsurgery has been shown to provide the highest success rates for cyst wall resection and lowest rates of recurrence and is therefore recommended for patients undergoing surgery for primary and recurrent colloid cysts.

Congenital Mucocele of the Tongue: A case report with review of the literature

Mucocele are benign lesions of the oral cavity that develop as a result of retention or extravasation of mucous material from minor salivary glands. Congenital mucocele are very rare. Mucocele involving the ventral surface of the tongue are very rare with sporadic cases reported in the world literature accounting to 2-8 of oral Mucocele.This report describes a new born baby with large swelling involving the ventral surface of the tongue presented with difficulty in breast feeding. An en block excision of the cystic swelling with removal of entire cyst wall was done.

Preparing Chromatin and RNA from Rare Cell Types with Fluorescence-Activated Nuclear Sorting (FANS).

The application of fluorescent tags to generate cell type-specific translational and transcriptional reporter lines is routine in plants, but separation of different cell types for downstream analyses is hampered by the presence of cell walls and tight connections between cells. Enzymatic removal of cell walls induces a wound response, dedifferentiation, or reprogramming of the resulting protoplasts. Their osmotic and mechanical instability and their large size range are challenging for FACS, a flow -sorting procedure based on differential expression of fluorescent tags. In contrast, plant nuclei are relatively robust and easy to isolate. Here, we describe a protocol for fluorescence-activated nuclear sorting (FANS) that allows efficient purification of very few fluorescence-tagged nuclei from a large background of non-labeled tissue. Purified nuclei are suitable for genome, epigenome, transcriptome, or proteome analyses. We describe in detail how to analyze nuclear RNA and DNA methylation from sorted nuclei representing the limited number of stem cells in the shoot apical meristem of Arabidopsis.

Gene transfer to German chamomile (L chamomilla M) using cationic carbon nanotubes

The use of nanoparticles to transfer genes to plant cells can solve some problems encountered in other gene transfer methods, including limited host range in the use of Agrobacterium, cell wall removal in the use of polyethylene glycol and electroporation, and high cell damage while using a gene gun. In this research, cationic carbon nanotubes (CNTs) were used to transfer ssDNA-FITC to German chamomile cells. The ability of nanoparticles to interact with and protect of DNA against enzymes and ultrasound damages was investigated using 0.8 % agarose gel. To investigate the morphology of CNTs loaded with DNA (Nanotube- Polyethyleneimine/DNA nanoparticles), scanning electron microscopy (SEM) was used. The biocompatibility effect of CNTs (Nanotube- Polyethyleneimine) on German chamomile cells was also determined by trypan blue staining. Agarose gel images showed that CNTs have a high ability to interact with DNA and can effectively protect it from damage by ultrasound and digestive enzymes. In addition, the SEM images of CNTs/DNA nanoparticles showed that these nanoparticles were rod-shaped with lengths around 100–200 nm. The fluorescence microscope results from German chamomile cells treated with CTNs/ssDNA-FITC nanoparticles showed the ability of these nanoparticles to transfer ssDNA-FITC to German chamomile cells. The results also revealed that the simultaneous use of ultrasound and CNTs significantly increased the transfer efficiency of ssDNA-FITC.

Experimental Study of Disproportionate Collapse Prevention Mechanisms for Mass-Timber Floor Systems

This paper presents and discusses experiments examining the responses of mass-timber floor systems under idealized removal of an interior load-bearing wall. Testing was performed on continuous double-span (2×L) and discontinuous single-span (L) floor assemblies with both conventional (lap-joint and self-tapping screws) and novel (additional internal steel tubes) floor-to-floor panel connection detailing. The continuous floor systems depended solely on the panels’ bending resistance, and brittle failure occurred at a deflection of 6% of L. Improved performance associated with ductile behavior was obtained with the introduction of floor-to-floor connections with maximum deflections of 8% and 12% of L for conventional and novel detailing, respectively. For the floors with conventional connection detailing, failure was observed after compressive arching due to the low axial strength and ductility. The addition of steel tubes enabled catenary action, in which the floor systems maintained high load-carrying capacity while undergoing large deflections. This study demonstrated that adequate connection detailing can ensure structural robustness of mass-timber floors for disproportionate collapse prevention.

Computed Tomography-Based Prediction of Exophthalmos Reduction After Deep Lateral Orbital Wall Decompression for Graves' Orbitopathy.

To examine the predictability of exophthalmos reduction using preoperative computed tomography (CT) in deep lateral orbital wall decompression for Graves' orbitopathy. This was a retrospective, observational, case-control study conducted at a single institution. Forty-three patients (43 orbits) who were treated with deep lateral decompression with (27 patients) and without (16 patients) fat removal. Multivariate linear regression analyses were used to identify factors influencing exophthalmos reduction 3 months postoperatively. Variables investigated included age; smoking history; history of corticosteroid therapy and/or radiotherapy; preoperative diplopia; width, depth, and height of the greater wing of the sphenoid bone (trigone); and volume of fat removed. The influence of these parameters on the area of the orbital opening was also analyzed. Trigone width and amount of fat removed were positively correlated with exophthalmos reduction (both, P < .050); none of the other variables exhibited significant correlations. The predictive equation for postoperative reduction in Hertel exophthalmometric values was 0.57 + 0.15 × trigone width (mm) + 1.1 × fat removed (cm3). Depth and height were positively correlated (both, P < .050) and width was negatively correlated (P = .0045) with orbital opening area. Trigone width and amount of fat removed were positive predictors of exophthalmos reduction after deep lateral decompression. Trigone width was inversely associated with orbital width, and results showed that larger exophthalmos reductions could be achieved in narrower orbits. This CT-based prediction method will assist preoperative decision-making regarding additional fat removal and/or removal of another orbital wall.

Clinical features and efficacy of microsurgery for treatment of cerebral cysticercosis of the fourth ventricle: a report of 24 patients

To analyze the clinical characteristics of 24 patients with cysticercosis of the fourth ventricle, and to evaluate the therapeutic efficacy of microsurgery. The clinical data of 24 patients with cysticercosis of the fourth ventricle referred the Department of Neurosurgery of the Affiliated Hospital of Qinghai University from January 2000 to December 2018 were collected, and the clinical features, imaging characteristics, surgical methods, therapeutic efficacy and postoperative complications were analyzed. The 24 patients included 15 men and 9 women, and had a mean age of 43.5 years (range, 16 to 68 years). Preoperative imaging examinations showed obvious dilatation of bilateral lateral ventricles, the third ventricle and middle cerebral aqueduct, and spherical or cystic dilatation of the fourth ventricle. There were 18 cases positive for antibodies against cysticercus, and 3 of the 21 cases were egg positives. All 24 cases received microsurgery, including 8 cases via the median aperture approach, 7 cases via the median aperture-cerebellar vermis approach, and 9 cases via the transcerebellomedullary fissure approach. There were 17 cases with complete delivery of vesicles, 5 cases with vesicle rupture and 2 cases with extraction of cystic fluid followed by separation and removal of cystic wall. All cases had obvious retraction of the ventricular system and disappearance of intracranial hypertension following surgery. There were 19 cases (79.17%) with well recovery, and 5 cases (20.83%) with aggravation or development of cerebellar ataxia, which recovered following treatment for 1 to 2 weeks. The transcerebellomedullary fissure approach is a safe and lowly invasive approach for the treatment of cysticercosis of the fourth ventricle.

1367 A Rare Feat: Successful ERCP Treatment of Mirrizi's Syndrome After Failed Surgery

INTRODUCTION: Mirizzi's syndrome (MS) is a rare complication, occurring in around 1% of all cholecystectomies and affecting around 0.1% of all patients with gallstones (GS). MS occurs when an impacted GS in the neck of the gallbladder (GB) or cystic duct (CD) causes compression of the common bile duct (CBD) or common hepatic duct (CHD), resulting in obstruction and potential progression to a cholecystocholedochal fistula. MS is usually managed by surgery. We report a rare case of a critically ill patient who was successfully cleared of obstructing stones via ERCP after failed surgery, allowing the patient to undergo subsequent successful heart transplantation. CASE DESCRIPTION/METHODS: A 42-year-old male with a history of coronary artery disease and ischemic cardiomyopathy presented with cholangitis due to CBD obstruction. Despite successful ERCP duct clearance, he was deemed not to be a surgical candidate due to severe cardiac morbidities. Months later he represented with cholangitis and was found on ERCP to have a CBD/CHD obstruction due to a large stone, originating from the CD, which was filled with many large stones. He underwent an attempt of GB resection. However, safe GB resection was precluded due to profound adhesions, complete tissue plane loss, and extensive fibrosis. GB wall debridement and removal of multiple large gallstones was surgically attempted to alleviate the CBD/CHD obstruction. A follow-up ERCP for stent removal showed persistent MS, thereby precluding the patient from heart transplant listing due to persistent cholangitis risk. Three subsequent ERCPs with aggressive SpyScope exploration of the CBD/CHD and CD, electrohydraulic shockwave as well as mechanical basket lithotripsy within the CD, and basket and balloon stone fragment removal resulted in complete clearance of all CD and CBD/CHD stones. Shortly afterwards, the patient presented with decompensated heart failure and underwent successful heart transplantation. DISCUSSION: MS presents a significant challenge to clinicians. The treatment is surgical, although inflammation, adhesions, and associated tissue plane distortion pose a challenge to even the best surgeon with an increased risk of bile duct injury. ERCP allows for diagnostic confirmation and biliary drainage via stent placement to alleviate the obstruction and cholangitis. We describe the successful implementation of ERCP as definitive therapy by utilizing a multitude of tools to clear the CD, CBD/CHD stones after failed surgery.

Vaginal Dehiscence and Evisceration After Robotic-assisted Radical Cystectomy: A Case Series and Review of the Literature

To describe a rare complication in 5 women who had vaginal prolapse, dehiscence, and/or evisceration after having undergone robotic-assisted radical cystectomy with creation of ileal conduit urinary diversion. Radical cystectomy is the standard of care in the extirpative treatment for muscle invasive urothelial carcinoma. Anterior exenteration in the female patient requires removal of the anterior vaginal wall, urethra, uterus, and adnexa which results in significant changes to the pelvic floor. Retrospective identification of all women having undergone robotic-assisted radical cystectomy for urothelial carcinoma who ultimately represented with vaginal prolapse, dehiscence, and/or evisceration between January 2012 and April 2019. We identified patient characteristics detailing their presentation. A review of the available literature highlighted the lack of available information in this uncommon cohort. Five women with vaginal dehiscence and/or evisceration who had previously undergone robotic-assisted radical cystectomy, anterior vaginectomy with urethrectomy, pelvic lymph node dissection, and creation of ileal conduit by 4 surgeons were identified. Mean interval time to initial presentation of prolapse or dehiscence was 44.4 weeks (range 11-120). In the 2 patients that eviscerated prior to repair, this occurred at 5 and 25 weeks after initial outpatient consultation. All reconstructive efforts were approached transvaginally. Two patients underwent 2 or more repairs. Management options included expectant management, pessary, and immediate vs delayed transvaginal surgical repair. Our case series describes the unique and potentially devastating complication of vaginal dehiscence and bowel evisceration in women with history of robotic-assisted radical cystectomy.