Please select the eligibility criteria that correspond to the clinical trial below.
Title: Is There a Difference in Pain and Quality of Life Following Vaginal Hysterectomy With Vaginal Reconstruction Compared to Robotic Colpopexy? A Prospective Cohort Study
Brief Summary: The purpose of this study is to to determine if there is a difference in patient related outcomes of pain and quality of life following vaginal hysterectomy with vaginal prolapse repair compared to robotic-assisted repair.

We hypothesize that pain and quality of life following robotic-assisted repair will be similar to that following vaginal reconstruction, when performed in conjunction with vaginal hysterectomy.


Options:
A: Inclusion Criteria:

* Undergoing Hysterectomy
* Able to consent to the procedure

Exclusion Criteria:

1. Medical conditions not allowing for pneumoperitoneum
2. Medical conditions not allowing proper ventilation during anesthesia
3. Pelvic organ prolapse amendable to a vaginal approach
4. Pregnant women
5. Patients undergoing planned combined procedures including bowel resection (other than coincidental appendectomy) or major urologic procedures.
B: Inclusion Criteria:

* Women who are 21 years of age or greater
* Status post hysterectomy with apical vaginal prolapse POPQ stages II-IV (prolapse from 1cm proximal to the hymen to all points distal) that desire laparoscopic surgical management.

Exclusion Criteria:

* Patients that are not candidates for general anesthesia
* Inability to consent
* History of prior sacralcolpopexy
* Suspicious adnexal masses or other factors that may indicate pelvic malignancy
* History of pelvic inflammatory disease
* Morbid obesity (body mass index greater than or equal to 40)
* History of prior or need for concomitant rectopexy with sigmoid resection.
C: Inclusion Criteria:

* Over 18 years of age
* Scheduled to total hysterectomy and/or bilateral salpingo-oophorectomy (BSOE).
* Both malignant or benign indications
* The operation should be technically possible to perform with laparoscopy or by abdominal incision, including approval from an anesthesiologist
* Acceptance to participate in the study and signed written informed consent document
* Proficiency in Swedish language

Exclusion Criteria:

* The operation is anticipated to comprise more than the hysterectomy + BSOE
* Diabetes mellitus
* Severe chronic pain or massive pain medication
* Severe inflammatory disease like active severe endometriosis or inflammatory bowel disease
* Known severe adhesions in the abdomen
* Contraindications on non steroidal analgesia
* Medication with drugs or disease affecting insulin resistance for example cortisone
* Mentally disabled women who cannot fill in the questionnaires or understand the consequences of participating in a trial
* Severe psychiatric disease or on medication for psychiatric disease so that the physician consider participation in the trial inappropriate
D: Inclusion Criteria:

* patients of Cincinnati Urogynecology Associates
* aged 18-90
* planning to undergo a vaginal hysterectomy with robotic or vaginal reconstructive surgery for pelvic organ prolapse as well as a posterior/rectocele repair, with or without a suburethral sling or ovarian removal.
* undergoing general anesthesia
* able to speak and read English
* able to understand the informed consent statement

Exclusion Criteria:

* scheduled for repairs not involving a hysterectomy
* use of mesh in the vaginal prolapse repair
* obliterative procedures to the vagina
* concurrent removal of a suburethral sling
* anterior, posterior or apical vaginal mesh kit at the time of their surgery
* performance of vaginal 'relaxing incisions' at the time of vaginal surgery
* concurrent anal incontinence repair such as a sphincteroplasty
* presence of uterine, cervical or ovarian malignancy
* use of regional anesthesia for their surgery.

Answer: D