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Female Pelvic Medicine & Reconstructive Surgery

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https://www.readbyqxmd.com/read/28430729/impact-of-distance-to-treatment-center-on-care-seeking-for-pelvic-floor-disorders
#1
Emily English, Lisa Rogo-Gupta
OBJECTIVE: The aim of this study was to evaluate the impact of distance from residence to treatment center on access to care for female pelvic floor disorders at an academic institution. METHODS: A retrospective cross-sectional study was conducted of women seen for pelvic floor disorders at an academic institution from 2008 to 2014. Patient characteristics were extracted from charts. Geographical and US census data was obtained from public records and used to calculate distance from patient residence to physician office...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430728/the-impact-of-a-dedicated-robotic-team-on-robotic-assisted-sacrocolpopexy-outcomes
#2
Charelle M Carter-Brooks, Angela L Du, Michael J Bonidie, Jonathan P Shepherd
BACKGROUND: Robotic-assisted sacrocolpopexy has been criticized for high cost. A strategy to increase operating room efficiency and decrease cost is implementation of a dedicated robotic team. Our objective was to determine if a dedicated robotic team decreases operative time. STUDY DESIGN: This institutional review board-approved retrospective cohort study included all robotic-assisted sacrocolpopexy performed from June 2010 to August 2015 by a single surgeon at 2 institutions in 1 health system...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430727/changing-referral-patterns-to-urogynecology
#3
Julia Geynisman-Tan, Oluwateniola Brown, Margaret Mueller, Alix Leader-Cramer, Bhumy Dave, Katarzyna Bochenska, Sarah Collins, Christina Lewicky-Gaupp, Kimberly Kenton
OBJECTIVE: The study aims to identify sources of and changes in referral patterns for pelvic floor disorders. METHODS: All new patient visits to urogynecology at our institution between January 2010 and December 2015 were identified. Patient demographics, referral source, insurance type, and visit diagnoses using ICD-9 codes were abstracted. ICD-9 codes were grouped into 18 urogynecologic diagnoses. Data were analyzed using SPSS (Version 20; Chicago, IL). RESULTS: Five thousand seven hundred ninety-nine new patient visits were included in the analysis...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430726/vaginal-mesh-removal-outcomes-eight-years-of-experience-at-an-academic-hospital
#4
Olivia O Cardenas-Trowers, Pouran Malekzadeh, David E Nix, Kenneth D Hatch
OBJECTIVES: The purpose of this study is to describe the clinical history leading up to and the outcomes after vaginal mesh removal surgery at an academic hospital. METHODS: A retrospective case series of patients who underwent vaginal mesh removal from 2008 to 2015 was conducted. Demographics, clinical history, physical examination, pre- and postoperative symptoms, and number and type of reoperations were abstracted. RESULTS: Between February 2008 and November 2015, 83 patients underwent vaginal mesh removal surgery at our hospital...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430725/awareness-regarding-perineal-protection-obstetric-anal-sphincter-injury-and-episiotomy-among-obstetrics-and-gynecology-residents-effects-of-an-educational-workshop
#5
Anna M Stecher, Jennifer Yeung, Catrina C Crisp, Rachel N Pauls
OBJECTIVES: Appropriate perineal protection may reduce rates of obstetric anal sphincter injuries (OASIS). We sought to investigate the knowledge and attitudes of obstetrics and gynecology residents concerning perineal protection, OASIS, and episiotomy before and after an educational workshop. METHODS: This was an institutional review board-approved cross-sectional survey study of obstetrics and gynecology residents. Two experts in perineal protection, whose methods have been shown to reduce OASIS by 50%, provided 1 week of education...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430724/the-effect-of-lithotomy-position-on-nerve-stretch-a-cadaveric-study
#6
Nicolette E Deveneau, Courtney Forbis, Lioudmilla Lipetskaia, Casey L Kinman, Anubhav Agrawal, Nicole R Herring, Sean L Francis
OBJECTIVE: The objective of our study was to design a method to measure nerve stretch in cadaveric subjects and then use the method to assess femoral nerve stretch in the lithotomy position with varying degrees of flexion and extension. METHODS: A university-based, cadaveric observational study of femoral nerve stretch was conducted. In 6 cadaveric subjects, femoral nerve near the inguinal ligament was dissected in each cadaveric subject. The nerve was marked, and digital images of the nerve were obtained in the supine position and lithotomy position in both flexion and extension...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430723/colpocleisis-a-survey-of-current-practice-patterns
#7
Keisha Jones, Gary Wang, Robert Romano, Peter St Marie, Oz Harmanli
BACKGROUND: Currently, there are no standard treatment guidelines for colpocleisis. Clinical practice varies widely for this safe and effective procedure. OBJECTIVE: The aim of this study was to evaluate the current practice patterns in the United States among surgeons who perform colpocleisis. METHODS: A 27-item anonymous Web-based survey was sent to all practicing physicians affiliated with the American Urogynecologic Society. It consisted of questions regarding the demographic background of the physicians and their current practice as it relates to colpocleisis...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28441277/symptomatic-epidermoid-cyst-presenting-as-a-paravaginal-mass
#8
Abigail P Davenport, Carl W Zimmerman, Bryan J Hill, Jeffrey Davis
BACKGROUND: Ischioanal fossa epidermoid cysts are uncommon masses of epithelial origin and are believed to be either congenital or the result of trauma. Surgical excision is preferred as opposed to incision and drainage because these masses may enlarge, recur, become infected, or undergo malignant transformation. CASE: This report describes a case of a 62-year-old woman who presented for evaluation of vaginal and perineal discomfort and fullness. Physical examination and computed tomography scan revealed a 7...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28441276/augs-consensus-statement-association-of-anticholinergic-medication-use-and-cognition-in-women-with-overactive-bladder
#9
(no author information available yet)
Overactive bladder affects a significant portion of the overall population and has substantial impact on daily activities and quality-of-life. When considering treatment, behavioral therapies should be instituted first, followed by medical therapies. Anticholinergic medications and beta-3 agonists are often used as initial pharmacologic therapy, but caution should be taken in prescribing anticholinergic medications in frail or cognitively impaired patients. Recently, concerns have developed regarding anticholinergic medications and the associated risk of cognitive impairment, dementia, and Alzheimer disease in the general population...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28441275/peer-reviewers-are-our-strength
#10
Matthew D Barber
No abstract text is available yet for this article.
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28398930/management-of-mesh-and-graft-complications-in-gynecologic-surgery
#11
(no author information available yet)
This document focuses on the management of complications related to mesh used to correct stress urinary incontinence or pelvic organ prolapse. Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections after mesh placement should prompt an examination and possible further evaluation for exposure or erosion. A careful history and physical examination is essential in the diagnosis of mesh and graft complications. A clear understanding of the location and extent of mesh placement, as well as the patient's symptoms and therapy goals, are necessary to plan treatment approaches...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28277472/transvaginal-repair-of-complex-rectovaginal-fistulas-using-the-porcine-urinary-bladder-matrix-as-an-augmenting-graft
#12
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: After the US Food and Drug Administration issued a safety warning concerning vaginal mesh implants in 2008, their use in correction of pelvic floor defects have decreased in the United States (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm479732.htm). However, we are still treating patients who have had complications associated with their use, rectovaginal fistulas (RVFs) being one of them. Rectovaginal fistulas are considered complex if greater than 2.5 cm, recurrent, associated with inflammatory bowel disease, or if they are proximal in location...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28145916/hydronephrosis-presenting-6-months-after-sacral-colpopexy-case-report-and-literature-review
#13
Emily Weber LeBrun, Estefania Santamaria, Louis Moy
OBJECTIVES: The aim of this study was to describe a case of uterovaginal prolapse managed with robotic-assisted sacral colpopexy complicated by severe right-sided hydronephrosis despite normal intraoperative cystoscopy. METHODS: A 68-year-old woman presented with a worsening vaginal bulge over the past 2 years. Tricompartment stage 2 uterovaginal prolapse, with dominant cystocele and skin erosion at the posterior fourchette from prolapse friction, was identified on physical examination, and the patient underwent pelvic reconstructive surgery, including sacral colpopexy...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28134703/pneumothorax-after-laparoscopic-robotic-assisted-supracervical-hysterectomy-and-sacrocolpopexy
#14
Ashley Kim, Julia Geynisman-Tan, Christina Lewicky-Gaupp
We present a case of a patient in whom subcutaneous emphysema, pneumoperitoneum, and pneumothorax occurred on postoperative day 1 after robotic-assisted supracervical hysterectomy, bilateral salpingectomy, sacrocolpopexy, and retropubic midurethral sling placement for pelvic organ prolapse and stress urinary incontinence. This case demonstrates a rare complication of gynecologic laparoscopic procedures.
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28134702/single-port-robotic-assisted-sacrocolpopexy-our-experience-with-the-first-25-cases
#15
Emad Matanes, Roy Lauterbach, Susana Mustafa-Mikhail, Amnon Amit, Zeev Wiener, Lior Lowenstein
OBJECTIVES: In single-port surgery, the surgeon operates almost exclusively through a single entry point, typically the patient's navel, leaving only a single small scar. The aims of this study were to share some tips and tricks of single-port robotic-assisted sacrocolpopexy and to evaluate the learning curve of mastering the skills to operate this procedure. METHODS: This is a retrospective study of the first 25 single-port; robotic-assisted sacrocolpopexy surgeries performed during July to December 2015 at Rambam Health Care Campus by a single surgeon...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106647/estimation-of-uterine-size-how-accurate-are-we
#16
Tanya P Hoke, Babak Vakili
OBJECTIVE: To evaluate the accuracy of gynecologic surgeons at estimating uterine dimensions and weight. METHODS: Six model uteri of various sizes were created to simulate the size and consistency of a uterus and displayed at 3 stations. The visual station (VS) comprised 2 specimens placed on an unmarked table. The laparoscopic station (LS) consisted of 2 model uteri, each placed in a separate simulated abdomen with a 0 degree laparoscope and 2 operative trocars with standard instruments...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27918341/two-cases-of-suspected-rejection-of-polydimethylsiloxane-urethral-bulking-agent
#17
Alaina Town Bennett, Emily Spencer Lukacz
We report the cases of 2 women who had urethral bulking injections with polydimethylsiloxane for stress urinary incontinence with intrinsic sphincter deficiency and reported initial improvement of symptoms followed by rapid return of stress urinary incontinence several weeks later associated with extrusion of the bulking material. We hypothesize this unique adverse outcome could represent immune rejection of this urethral bulking agent.
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27918339/irritable-bowel-syndrome-and-quality-of-life-in-women-with-fecal-incontinence
#18
Alayne D Markland, J Eric Jelovsek, David D Rahn, Lu Wang, Leah Merrin, Ashok Tuteja, Holly E Richter, Susan Meikle
OBJECTIVES: The objectives of this work were to determine the prevalence of irritable bowel syndrome (IBS) and IBS subtypes in women presenting for fecal incontinence (FI) treatment and to assess the impact of IBS on FI symptoms and quality of life (QOL). METHODS: In this multicenter prospective cohort study, women reported at least monthly solid, liquid, or mucus FI. Rome III clinical criteria defined IBS. Women also self-reported having an IBS diagnosis. Baseline questionnaires included the following: Modified Manchester Health Questionnaire, Fecal Incontinence Severity Index, Bristol Stool Scale, Pelvic Floor Distress Inventory, and the Pelvic Floor Impact Questionnaire...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27918338/female-pelvic-medicine-and-reconstructive-surgery-in-canada-a-survey-of-obstetrician-gynecologists-and-urologists
#19
Marie K Christakis, Eliane M Shore, Ariel Pulver, Colleen D McDermott
OBJECTIVE: The aim of this study was to assess the current status of female pelvic medicine and reconstructive surgery (FPMRS) in Canada, including level of training, practice patterns, barriers to practice and opinions among obstetrician-gynecologists (OB/GYNs) and urologists. METHODS: Electronic surveys were distributed to 737 OB/GYNs through the Society of Obstetricians and Gynaecologists of Canada and to 489 urologists through the Canadian Urological Association...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27782979/operationalizing-the-measurement-of-socioeconomic-position-in-our-urogynecology-study-populations-an-illustrative-review
#20
Michael Heit, Nayera Guirguis, Nadine Kassis, Michelle Takase-Sanchez, Janet Carpenter
OBJECTIVES: The purpose of this illustrative review is to provide guidance for the measurement of socioeconomic position when conducting health disparities research in urogynecology study populations. METHODS: Deidentified data were extracted from existing investigational review board-approved research databases for illustrative purposes. Attributes collected included the study participant's marital status, level of educational attainment (in number of years of school completed) and occupation as well as the study participant's last/only spouses' level of education and occupation...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
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