Objective To investigate the prevalence of vaginal flatus (VF) in women with pelvic floor disorders and its impact on quality of life. Design A cross-sectional study. Setting A tertiary medical center. Population Women visited a urogynecologic clinic in 2019. Methods Patients were asked about their experience of VF. Other evaluations included urodynamics, genital prolapse stage, and valid questionnaires, including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7). Clinical characteristics, urodynamic parameters, stage of prolapse, and quality of life scores were compared between women with and without VF. Main Outcome Measures: The impact of VF on quality of life. Results: Among 341 women, 118 (35%) reported VF, which was more common in those who were younger (49.3±9.2 vs. 59.9±13.4 yr, p<0.001) and more sexually active (98% vs. 55%, p<0.001) women. Women with VF had significantly worse sexual function (PISQ-12, 16.3±15.9 vs. 30.9±8.0, p<0.001), and incontinence-related quality of life (UDI-6, 23.4±10.5 vs. 17.8±8.9, p=0.039; IIQ-7, 25.5±14.5 vs. 17.2±12.5, p=0.012). For frequency and bother, 46% (48/116) of the women reported often or always having symptoms during sexual activity, 15% (5/34) when performing daily activities, and 12% (4/31) when exercising; and 60% (70/116) felt least moderate bothersome during sexual activity compared to 5% (2/34) when performing daily activities and 18% (6/31) when exercising. Conclusions: VF is prevalent in younger and sexually active urogynecologic patients. It has a significantly negative impact on sexual function. Routine counseling should be considered for these patients.

Introduction: Adhesion is associated to delayed delivery of the neonate and higher incidence of intraoperative and postoperative complications. Currently, there is no definite consensus regarding the use of adhesion barriers at cesarean section. Objective: To analyze the postoperative outcomes among two adhesion barrier groups and control group at the primary and the secondary cesarean section. Methods: This retrospective study includes 199 Asian women undergoing primary and secondary cesarean section between January1, 2011, and September 31, 2019. We used regression to analyze risk factors of postcesarean fever at primary cesarean section. Further we used interaction analysis to examine the effect of surgical site infection risk factors and use of adhesion barrier on postcesarean fever rates at the primary cesarean section. Results: We found that use of adhesion barrier at the primary cesarean section is associated with a significantly higher incidence of postcesarean fever (p=0.045). The risk factor for postcesarean fever is the use of anti-adhesion filmduring emergency cesarean section (p=0.041). In the subgroup of labor before operation and emergency cesarean section, adhesion barrier user had significant higher risk of postcesarean fever than nonuser (p<0.05). Conclusion: The patients used of anti-adhesion films during emergency cases and when a woman has labor before operation is associated with a significantly higher risk of postcesarean fever which potentially means increased risk of surgical site infection.