In 2021, the German Society of Otorhinolaryngology, Head Neck Surgery celebrates the 100th anniversary of its foundation. The aim of this research is to present the main advances and innovations developed in Germany since 1921-as selected and studied from outside Germany, first in other languages and then in German, hence an international «Made in Germany»-that either directly or indirectly expanded or impacted the development of Otorhinolaryngology (ORL). This gives an unusual but extremely interesting perspective on the history of ORL in Germany. However, events that are too recent to have already entered into the history of ORL are not discussed, not least due to the often huge difficulties in actually identifying the main protagonists. In all, 11 landmarks regarded to be «Made in Germany» and which have had a major impact on the development of ORL since 1921 are presented. Some of these are well known, some not, but their importance must not be underestimated. They are presented here in chronological and specific sections 1. Indisputable glasses to observe nystagmus; 2. Most monumental ORL encyclopedia ever published; 3. Histology of the inner ear is efficient; 4. Introduction of antibiotics to treat ORL infections; 5. Color atlas of ORL pathologies as support for teaching; 6. AF-353 in vitro Tympanoplasty concept revolutionizes surgery of the ear; 7. Zeiss operating ear microscope broadens the surgical field; 8. Microlaryngoscopy suspension technique defines a new era in laryngeal surgery; 9. Septum resection becomes septum correction; 10. Karl Storz nasal endoscope opens up new surgical techniques; 11. The history of ORL must belong to ORL. This research demonstrates that Germany played a major role in and has had a profound impact on advances in ORL since 1921, a real otorhinolaryngological «Made in Germany.»

Pudendal nerve block analgesia (PNB) is used as pain relief in the final stage of childbirth. We hypothesized that PNB is associated with higher rates of postpartum urinary retention.

We performed a cohort study among primiparous women with a singleton, cephalic vaginal birth at Oslo University Hospital, Norway. Women receiving PNB were included in the exposed group, while the subsequent woman giving birth without PNB was included in the unexposed group. We compared the likelihood of postpartum urinary retention, defined as catheterization within 3h after birth. Logistic regression analysis stratified by mode of delivery was performed adjusting for epidural analgesia, episiotomy and birth unit.

Of the 1007 included women, 499 were exposed to PNB and 508 were unexposed. In adjusted analyses, women exposed to PNB did not differ in likelihood of postpartum urinary retention compared to women unexposed to PNB in either spontaneous (odds ratio[OR] 0.82, 95% confidence interval [CI] 0.55-1.22) or instrumental (OR 1.45, 95% CI 0.89-2.39) births. Furthermore, no differences between the groups were observed with excessive residual urine volume or catheterization after > 3h.

PNB was associated with neither risk of postpartum urinary retention nor excessive residual urine volume and is therefore unlikely to hamper future bladder function.

PNB was associated with neither risk of postpartum urinary retention nor excessive residual urine volume and is therefore unlikely to hamper future bladder function.

We compared the impact of a mesh manufactured from the soft elastomer polydimethylsiloxane (PDMS) to that of a widely used lightweight polypropylene (PP) mesh. To achieve a similar overall device stiffness between meshes, the PDMS mesh was made with more material and therefore was heavier and less porous. We hypothesized that the soft polymer PDMS mesh, despite having more material, would have a similar impact on the vagina as the PP mesh.

PDMS and PP meshes were implanted onto the vaginas of 20 rabbits via colpopexy. Ten rabbits served as sham. At 12weeks, mesh-vagina complexes were explanted and assessed for contractile function, histomorphology, total collagen, and glycosaminoglycan content. Outcome measures were compared using one-way ANOVA and Kruskal-Wallis testing with appropriate post-hoc testing.

Relative to sham, vaginal contractility was reduced following the implantation of PP (p = 0.035) but not the softer PDMS (p = 0.495). PP had an overall greater negative impact on total collagen and glycosaminoglycan content, decreasing by 53% (p < 0.001) and 54% (p < 0.001) compared to reductions of 35% (p = 0.004 and p < 0.001) with PDMS. However, there were no significant differences in the contractility, collagen fiber thickness, total collagen, and glycosaminoglycan content between the two meshes.

Despite having a substantially higher weight, PDMS had a similar impact on the vagina compared to a low-weight PP mesh, implicating soft polymers as potential alternatives to PP. The notion that heavyweight meshes are associated with a worse host response is not applicable when comparing across materials.

Despite having a substantially higher weight, PDMS had a similar impact on the vagina compared to a low-weight PP mesh, implicating soft polymers as potential alternatives to PP. The notion that heavyweight meshes are associated with a worse host response is not applicable when comparing across materials.

Post-hysterectomy vaginal vault prolapse is quite frequent and at the same time a challenging surgery for pelvic organ prolapse.

One of the most popular methods of treatment is sacrospinous fixation, including its mesh modification.

Despite the high efficiency in the apical compartment, the incidence of the anterior compartment prolapse is quite high. Erosion remains an unsolved problem. A 44-year-old patient with grade IV post-hysterectomy prolapse underwent a sacrospinous fixation procedure with mesh according to the described technique. Surgery was performed successfully without complications. The duration of the operation was 40min. A year after the operation, the recurrence of POP was not recorded in any compartments of the pelvic floor. It was possible to maintain the length of the vagina. Dyspareunia and vaginal erosion were not detected. The patient also noted a significant improvement in her quality of life.

The demonstrated approach allows performing minimally invasive reconstruction of all three compartments of the pelvic floor.