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Female Pelvic Medicine & Reconstructive Surgery

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https://www.readbyqxmd.com/read/29894327/persistent-vaginal-leakage-in-the-setting-of-an-apical-vaginal-sinus-tract-a-case-report
#1
Dina Bastawros, Hamza Beano, Michael J Kennelly, Kevin J E Stepp
Fistulas are defined as abnormal connections between 2 organ, vessels, or structures. They can often present in the genitourinary tract as a result of iatrogenic injury during pelvic surgery. A 46-year-old female presents many years after a hysterectomy for persistent vaginal leakage with concern for a vesicovaginal fistula. Computed tomography urogram, intravenous retrograde pyelogram, and cystoscopy were negative for vesicovaginal fistula; however, a vaginal sinus tract was noted and further explored. This case report will describe the use of both laparoscopy and concomitant vaginoscopy to diagnose and, ultimately, surgically excise a salpingovaginal fistula...
June 12, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29894326/stress-urinary-incontinence-surgery-in-washington-state-before-and-after-introduction-of-the-mesh-midurethral-sling
#2
Lauren E Stewart, Michelle A Eston, Rebecca G Symons, Michael F Fialkow, Anna C Kirby
OBJECTIVES: Mesh midurethral slings (MUSs) are safe, effective treatments for female stress urinary incontinence (SUI), but many companies have ceased production because of controversies surrounding transvaginal mesh. To determine if introduction of MUS has increased the complication rate associated with SUI surgery, we compared women undergoing SUI surgery in the MUS era to those who had surgery prior its introduction. METHODS: This was a retrospective cohort study of a statewide hospital discharge database...
June 12, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29794544/shear-wave-elastography-to-assess-perineal-body-stiffness-during-labor
#3
Ghazaleh Rostaminia, Charbel Awad, Cecilia Chang, Siddhartha Sikdar, Qi Wei, S Abbas Shobeiri
OBJECTIVES: The objective of this study was to evaluate perineal body stiffness intrapartum using shear wave elastography ultrasound and to study its association with maternal and labor characteristics. METHODS: This was a prospective observational study. Pregnant women with term pregnancy who had been admitted for labor management were recruited into the study. Transperineal shear wave elastography of perineal body was performed. Maternal and labor data were retrieved from electronic medical charts...
May 22, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29787461/cost-effectiveness-of-routine-postoperative-retrograde-voiding-trials-following-pelvic-surgeries
#4
Rui Wang, Djøra I Soeteman, Michele R Hacker, Roger Lefevre
OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of retrograde voiding trials in the management of postoperative voiding dysfunction. METHODS: We developed a disease simulation model to assess under which conditions routine retrograde voiding trial is the optimal strategy in terms of cost per quality-adjusted life-year and cost per case of chronic voiding dysfunction avoided. We varied the incidence of voiding dysfunction between 2% and 60%...
May 22, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29787462/current-role-of-urethrolysis-and-partial-excision-in-patients-seeking-revision-of-anti-incontinence-sling
#5
Alice Drain, Ekene Enemchukwu, Nihar Shah, Raveen Syan, Nirit Rosenblum, Victor W Nitti, Benjamin M Brucker
OBJECTIVES: Stress urinary incontinence is highly prevalent and sling surgery has increased since 2000. Urethrolysis traditionally had been standard management of complications after anti-incontinence surgery; however, partial excision is a less aggressive option. This study describes the different populations in a contemporary cohort that undergo sling excision and urethrolysis and their surgical outcomes. METHODS: Chart analysis was performed on patients assigned Current Procedural Terminology codes for removal or revision of sling for stress incontinence, urethrolysis, or revision of graft at our institution from 2010 to 2015...
May 21, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29746393/female-veterans-with-diagnoses-of-both-chronic-pelvic-pain-and-overactive-bladder-how-do-they-compare-to-women-diagnosed-with-interstitial-cystitis
#6
Katherine A Volpe, Sara B Cichowski, Yuko K Komesu, Rebecca G Rogers, Allison Murata, Glen Murata
OBJECTIVE: The objective of this study was to compare women with a known diagnosis of interstitial cystitis (IC) to a population that might be at risk for the diagnosis of IC, women with diagnoses of both chronic pelvic pain (CPP) and overactive bladder (OAB). METHODS: We conducted a retrospective study of data from the Veterans Affairs Corporate Data Warehouse. The cohort included all female veterans who had established care with a primary care provider from 1997 to present...
May 10, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29734200/effect-of-morbid-obesity-on-midurethral-sling-efficacy-for-the-management-of-stress-urinary-incontinence
#7
Solafa Elshatanoufy, Alexandra Matthews, Mairy Yousif, Marcus Jamil, Sravanthi Gutta, Harmanjit Gill, Shelley L Galvin, Ali M Luck
OBJECTIVES: The aim of our study was to assess midurethral sling (MUS) failure rate in the morbidly obese (body mass index [BMI] ≥40 kg/m) population as compared with normal-weight individuals. Our secondary objective was to assess the difference in complication rates. METHODS: This is a retrospective cohort study. We included all patients who underwent a synthetic MUS procedure from January 1, 2008, to December 31, 2015, in our health system. Failure was defined as reported stress urinary incontinence symptoms or treatment for stress urinary incontinence...
May 4, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29727372/the-effect-of-commonly-performed-exercises-on-the-levator-hiatus-area-and-the-length-and-strength-of-pelvic-floor-muscles-in-postpartum-women
#8
Lauren N Siff, Audra J Hill, Samantha J Walters, Ginny Walters, Mark D Walters
OBJECTIVE: The aim oft his study was to compare the effects of 10 common exercises to traditional pelvic floor muscle (PFM) contractions (Kegel) on levator hiatus (LH) area and PFM length and strength. METHODS: This is a cross-sectional study of 15 healthy postpartum women. Ten exercises were studied. These were common variations of leg, core, and back exercises used in yoga, Pilates, strength training, and physical therapy. Each participant performed all 10 exercises at a single visit in 2 examination settings: transperineal ultrasound and perineometry...
May 2, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29683885/sentiment-analysis-of-web-sites-related-to-vaginal-mesh-use-in-pelvic-reconstructive-surgery
#9
Deslyn T G Hobson, Kate V Meriwether, Sean L Francis, Casey L Kinman, J Ryan Stewart
OBJECTIVES: The purpose of this study was to utilize sentiment analysis to describe online opinions toward vaginal mesh. We hypothesized that sentiment in legal Web sites would be more negative than that in medical and reference Web sites. METHODS: We generated a list of relevant key words related to vaginal mesh and searched Web sites using the Google search engine. Each unique uniform resource locator (URL) was sorted into 1 of 6 categories: "medical", "legal", "news/media", "patient generated", "reference", or "unrelated"...
May 2, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29727374/differences-in-pelvic-floor-symptoms-during-pregnancy-between-hispanic-and-non-hispanic-white-women
#10
Hanna M Saltzman, Marlene J Egger, Tyler Bardsley, Qian Ding, Janet M Shaw, Ingrid E Nygaard
OBJECTIVES: This study aimed to describe and compare pelvic floor symptoms and symptom burden between nulliparous Hispanic and non-Hispanic white women in the third trimester of pregnancy and to determine, in women with stress urinary incontinence (SUI), whether bother differs between groups, adjusted for UI severity. METHODS: In this cross-sectional analysis, participants completed the Epidemiology of Prolapse and Incontinence and Incontinence Severity Index questionnaires...
April 28, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29727373/summary-2017-international-consultation-on-incontinence-evidence-based-surgical-pathway-for-pelvic-organ-prolapse
#11
Christopher F Maher, Kaven K Baessler, Matthew D Barber, Cecilia Cheon, Esther C J Consten, Kevin G Cooper, Xavier Deffieux, Viviane Dietz, Robert E Gutman, Jan J van Iersel, Charles W Nager, Vivian W Sung, Renaud de Tayrac
OBJECTIVE: The aim of this article is to summarize the relevant findings that inform the 2017 International Consultation on Incontinence pathway for surgical treatment of pelvic organ prolapse (POP). METHODS: We conducted an evidence-based review of the English-language peer-reviewed literature relating to POP surgery published prior to December 2016. Level 1 evidence (randomized controlled trials [RCTs] or systematic reviews of RCTs) was preferred; however, level 2 (poor-quality RCT, prospective cohort studies) or 3 evidence (case series or retrospective studies) has been included if level 1 data were lacking...
April 28, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29698366/female-caudal-duplication-syndrome-a-surgical-case-report-with-10-year-follow-up-and-review-of-the-literature
#12
Jenny Y Mei, My-Linh T Nguyen, Shlomo Raz
Caudal duplication syndrome is an exceedingly rare condition that manifests as duplicative anomalies of the gastrointestinal and genitourinary systems. We present a case of an adult patient born with multiple congenital anomalies including duplicated reproductive and urinary systems. She presented to our center for initial evaluation 11 years ago largely experiencing right-sided pelvic organ prolapse and bilateral urinary tract voiding dysfunction. She underwent successful surgical management and presented several years later for recurrent symptoms...
April 25, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29698365/a-case-of-mesh-erosion-to-the-sigmoid-after-laparoscopic-sacrocolpopexy-and-a-literature-review-of-mesh-related-complications
#13
Xiaoting Lin, Pei Du, Liquan Chen, Yaping Gan, Xiaowei Zhang
Sacrocolpopexy has long been the preferred surgical procedure for the management of apical vaginal prolapse. The published literature regarding rectal mesh erosion after sacrocolpopexy includes only 6 cases in MEDLINE. We report a case of sigmoid vaginal fistula identified 4 years after laparoscopic sacrocolpopexy, along with an analysis of the follow-up of 140 patients over 12 months or more.
April 25, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29688899/depression-anxiety-and-pelvic-floor-symptoms-before-and-after-surgery-for-pelvic-floor-dysfunction
#14
Maryse Larouche, Lori A Brotto, Nicole A Koenig, Terry Lee, Geoffrey W Cundiff, Roxana Geoffrion
OBJECTIVES: We aimed to explore the correlation between perioperative symptoms of depression and anxiety with pelvic floor symptoms after urogynecologic surgery. Postoperative pain, goal attainment, quality of life, and satisfaction were assessed. METHODS: A prospective cohort study of women undergoing inpatient urogynecologic surgery was conducted. Preoperative questionnaires included Beck Depression and Beck Anxiety Inventories, Pain Catastrophizing Scale, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and a detailed goals and perioperative supports questionnaire...
April 23, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29688898/vaginal-myomectomy-to-resolve-bladder-outlet-obstruction-50-years-after-hysterectomy
#15
Shorty Johansson, Rustin Walters, Kaitlyn Mayer, Stuart Shippey
BACKGROUND: Leiomyomas can develop after hysterectomy and, when located in the bladder, can result in voiding dysfunction and incontinence. CASE: Fifty years after a hysterectomy, a 77-year-old woman presented with a 1-year history of urinary retention requiring self-catheterization and bothersome urinary incontinence. Multiple imaging modalities demonstrated a well-circumscribed 2-cm mass abutting the bladder beneath the trigone. After ureteral stent placement, we excised the nonpalpable mass using ultrasound guidance...
April 23, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29683889/alterations-of-vascular-endothelial-growth-factor-a-expression-and-microvessel-density-associated-with-polypropylene-vaginal-mesh
#16
Joseph T Kowalski, Michael J Goodheart, Rene Genadry, Ava Bhattarai, Catherine S Bradley
OBJECTIVE: Vaginal mesh exposure is the most common complication from mesh use in prolapse and incontinence surgery. Angiogenesis is an essential component of tissue healing, and defective angiogenesis plays a role in chronic wounds. We hypothesized that patients with exposures will have impaired angiogenesis as evidenced by altered tissue vascular endothelial growth factor A (VEGFA) expression and microvessel density. The study objective was to compare angiogenesis in women with vaginal mesh exposures, those with vaginal mesh without exposures, and in women who were mesh-naive...
April 20, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29683888/transfusion-rates-and-the-utility-of-type-and-screen-for-pelvic-organ-prolapse-surgery
#17
Taylor J Brueseke, Maggie F Wilkins, Marcella G Willis-Gray, Katherine E Husk, Alexis R Peedin, Elizabeth J Geller, Jennifer M Wu
OBJECTIVES: Limited data exist directly comparing the likelihood of blood transfusion by route of apical pelvic organ prolapse (POP) surgery. In addition, limited evidence is available regarding the risk of not ordering preoperative type and screen (T&S) in apical POP surgery. The objectives of the study are to (1) provide baseline data regarding the current need for preoperative T&S by comparing perioperative blood transfusion rates between 3 routes of apical POP surgery and (2) determine the rate of a positive preoperative antibody screen in women who underwent apical POP surgery...
April 20, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29683887/association-of-anticholinergic-risk-score-with-functional-status-in-patients-preparing-for-pelvic-reconstructive-surgery
#18
Taylor J Brueseke, Maria de la Luz Nieto, Samantha Pulliam, Jennifer M Wu
OBJECTIVES: Anticholinergic medication use has been associated with cognitive impairment and other functional limitations, particularly in older patients. The anticholinergic risk score (ARS) can be used to measure a patient's cumulative exposure to medications with anticholinergic properties. Our primary objective was to evaluate the correlation between ARS and functional status, as measured by instrumental activities of daily living (IADL), in patients preparing to undergo urogynecologic surgery...
April 20, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29683886/a-modern-comparison-of-urodynamic-findings-in-diabetic-versus-nondiabetic-women
#19
Rena D Malik, Joshua A Cohn, Jessica Volsky, Sarah Garvey, Charles Chang, Gregory T Bales, Doreen E Chung
OBJECTIVES: Few contemporary studies exist regarding urodynamic (UDS) findings in patients with diabetes mellitus (DM), and data are conflicting. Our aim was to compare UDS findings in women with and without DM. METHODS: Data from female patients in a prospectively maintained UDS database (2010-2014) were reviewed. Studies were performed according to International Continence Society standards. Clinical data, presenting symptoms, and UDS findings were compared in women with and without DM, controlling for demographic and pertinent variables...
April 20, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29649079/in-search-of-mobile-applications-for-urogynecology-providers
#20
Shannon L Wallace, Shailja Mehta, Sara Farag, Robert S Kelley, Katherine T Chen
INTRODUCTION: Thousands of medical applications (apps) are available for mobile devices. Finding accurate, health care provider-centered apps may be time consuming and frustrating for urogynecologists. The objective of this study was to identify and evaluate urogynecology (urogyn) apps using a modified APPLICATIONS scoring system. MATERIALS AND METHODS: Urogyn apps were identified from the Apple iTunes and Google Play Stores using the following 10 MeSH terms: urogynecology, incontinence, prolapse, urinary tract infection, pelvic surgery, fecal incontinence, defecation disorder, voiding disorder, urethral diverticulum, and fistula...
April 11, 2018: Female Pelvic Medicine & Reconstructive Surgery
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