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Apical Prolapse

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https://www.readbyqxmd.com/read/28199078/anterior-six-arms-prolene-mesh-for-high-stage-vaginal-prolapse-five-years-follow-up
#1
Luis Gustavo M de Toledo, André Costa-Matos, Susane Mey Hwang, Raquel Dória Ramos Richetti, Silvia S Carramão, Antônio P F Auge
INTRODUCTION: In high stage vaginal prolapse, recurrence risk patients, anterior and apical defects need to be addressed in the same procedure. The pre-molded commercial mesh kits are expensive and not always available. Alternative effective and safe treatment ways, with lower costs are desirable. OBJECTIVE: To present long term follow-up of patients treated with a homemade mesh shape to correct high stage prolapses. MATERIALS AND METHODS: We describe prospectively 18 patients with anterior and apical vaginal prolapses, stages III and IV, repaired using this specific design of mesh...
February 15, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28191790/safety-and-short-term-outcomes-of-a-new-truly-minimallyinvasive-mesh-less-and-dissection-less-anchoring-system-for-pelvic-organ-prolapse-apical-repair
#2
Adi Y Weintraub, Masha Ben Zvi, David Yohay, Joerg Neymeyer, Yonatan Reuven, Menahem Neuman, Alex Tsivian
OBJECTIVE: To evaluate the safety and short term outcomes of a new, truly minimallyinvasive, mesh-less and dissection-less anchoring system for pelvic floor apical repair. METHODS: A prospective study was conducted using the NeuGuide™ device system for pelvic floor apical repair. The primary effectiveness outcome was centro-apical pelvic floor prolapse by POP-Q after six months. The primary safety outcome was intra-operative, immediate (first 48 h) post-operative complications and adverse effects after six months...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28188468/transvaginal-uterosacral-ligament-suspension-for-posthysterectomy-vaginal-vault-prolapse-repair
#3
Rodolfo Milani, Matteo Frigerio, Federico Spelzini, Stefano Manodoro
INTRODUCTION AND HYPOTHESIS: Posthysterectomy vaginal vault prolapse repair represents a challenge for urogynecologists. Surgical management can be successfully achieved with native tissue using a vaginal approach with uterosacral ligament (USL) suspension. However, severe complications have been described, mainly related to ureteral injury. METHODS: A 57-year-old woman with symptomatic stage 2 vaginal vault prolapse underwent transvaginal USL suspension according to the described technique...
February 10, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28168410/entry-into-the-peritoneal-cavity-in-posthysterectomy-prolapse-an-educational-video
#4
C Emi Bretschneider, Karl Jallad, Patrick M Lang, Mickey M Karram, Mark D Walters
INTRODUCTION AND HYPOTHESIS: Entry into the peritoneal cavity can be challenging in patients with posthysterectomy prolapse; however, it is important for vaginal surgeons to be able to enter the peritoneal cavity using various techniques to perform an intraperitoneal vaginal vault suspension. METHODS: We present surgical footage of various methods of accessing the peritoneal cavity in posthysterectomy prolapse using posterior, anterior and apical approaches. RESULTS: This video highlights surgical techniques that can be used to enter the peritoneal cavity in posthysterectomy prolapse in a safe and reliable manner...
February 6, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28155202/native-tissue-repairs-for-pelvic-organ-prolapse
#5
REVIEW
Justin Houman, James M Weinberger, Karyn S Eilber
Pelvic organ prolapse (POP) is a generalized term that refers to prolapse of any of the three vaginal compartments: anterior (cystocele), posterior (rectocele), and apical (uterine and vault prolapse). POP may affect up to 50% of parous women, and as a result, one in nine women will undergo at least one surgery for POP in her lifetime. Native tissue repair is the cornerstone of prolapse surgery, especially in light of the scrutiny placed on the use of mesh for prolapse. Refinements in the procedures over time have been based on both basic anatomy and fundamentals of surgery, as well as the ongoing acquisition of new knowledge through clinical studies...
January 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28145915/the-relationship-of-anterior-vaginal-and-apical-position-to-postvoid-residual-urine
#6
Keri S Wong, Jenny Y Mei, Cecilia K Wieslander, Christopher M Tarnay
OBJECTIVE: The aim of the study was to investigate the association between severity of anterior vaginal or apical prolapse and postvoid residual volume (PVR). METHODS: The charts of all women who presented to Urogynecology Clinic at Olive View-UCLA Medical Center for a 2-year period were reviewed. Demographic data, the degree of prolapse pelvic organ prolapse quantification points Aa, Ba, and C, and PVR were recorded. Patients with incomplete pelvic organ prolapse quantification assessment or improperly measured PVR were excluded...
January 31, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28118173/symptom-relief-and-retreatment-after-vaginal-open-or-robotic-surgery-for-apical-vaginal-prolapse
#7
Mallika Anand, Amy L Weaver, Kristin M Fruth, Emanuel C Trabuco, John B Gebhart
OBJECTIVES: The aim of this work was to determine the degree of symptom relief and survival free of retreatment after Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), and robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. METHODS: We retrospectively studied patients who had undergone surgery for posthysterectomy apical vaginal prolapse from January 1, 2000, through June 30, 2012, at our institution. Baseline characteristics and perioperative outcomes were abstracted from electronic health records...
January 24, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28118169/the-k-technique-a-novel-technique-for-laparoscopic-apical-suspension-using-barbed-sutures
#8
Tarek Khalife, Rabbie K Hanna
OBJECTIVES: Hysterectomy is among the most common gynecologic procedures performed for women, second only to cesarean sections, and the proportion of it performed laparoscopically continues to increase. Addressing apical support at the time of the hysterectomy is crucial to minimizing the risk of posthysterectomy prolapse. Barriers to addressing apical support include the lack of experience in laparoscopic suturing and knot tying that require advanced skills and dexterity. The K-technique is a novel modification of the uterosacral ligament suspension procedure using the knot-less barbed suture technology, rendering suturing easier and quicker to perform...
January 24, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28116884/robotic-sacrocolpopexy-for-posthysterectomy-vaginal-vault-prolapse-a-case-series-of-31-patients-by-a-single-surgeon-with-a-long-term-follow-up
#9
Antonio Pellegrino, Gianluca R Damiani, Mario Villa, Ciro Sportelli, Maria G Pezzotta
BACKGROUND: The aim of this paper was to evaluate the feasibility, short-term complications of robotic surgery and clinical outcomes in terms of long-term complications, pain relief and recurrence rate, for the treatment of vaginal vault prolapse (VVP). METHODS: Prospective analysis of robotic-assisted laparoscopic sacrocolpopexy (RALS) performed between October 2011 and February 2015, in patients with advanced post-hysterectomy VVP and significant apical defects as defined by Baden- Walker Score ≥3...
February 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28101639/laparoscopic-hysteropexy-10%C3%A2-years-experience
#10
Helen Jefferis, Natalia Price, Simon Jackson
INTRODUCTION AND HYPOTHESIS: Uterine prolapse is common and has traditionally been treated by vaginal hysterectomy. Increasingly, women are seeking uterine-preserving alternatives. Laparoscopic hysteropexy offers resuspension of the uterus using polypropylene mesh. We report on 10 years' experience with this technique. METHODS: All hysteropexy procedures in our unit since 2006 were reviewed. Primary outcome was safety of hysteropexy, as assessed by intraoperative and major postoperative complications...
January 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28099748/medium-term-outcomes-of-laparoscopic-sacrocolpopexy-or-sacrohysteropexy-versus-vaginal-sacrospinous-ligament-fixation-for-middle-compartment-prolapse
#11
Chen Yisong, Hua Keqin
OBJECTIVE: To compare laparoscopic sacrocolpopexy (LSC) or sacrohysteropexy (LSH) with vaginal sacrospinous ligament fixation (VSSLF) for middle compartment pelvic organ prolapse (POP). METHODS: Data were retrospectively reviewed from patients with POP (stage 3 or worse) who underwent LSC, LSH, or VSSLF at a center in Shanghai between January 2009 and March 2014. POP quantification (POP-Q) and Pelvic Floor Distress Inventory scores were compared at the 2-year follow-up...
January 6, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28070600/transvaginal-sacrospinous-ligament-fixation-for-posthysterectomy-vaginal-vault-prolapse-repair
#12
Rodolfo Milani, Matteo Frigerio, Stefano Manodoro
INTRODUCTION AND HYPOTHESIS: Posthysterectomy vaginal vault prolapse repair is a challenge for urogynecologists. Surgical management can be successful with native tissue by the vaginal approach with sacrospinous ligament fixation. However, severe complications have been described, including nerve injury and life-threatening hemorrhage. METHODS: A 68-year-old woman with symptomatic stage III vaginal vault prolapse was admitted for transvaginal sacrospinous ligament fixation according to the described technique...
January 9, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28056432/cadaver-study-of-anchorless-implant-for-the-treatment-of-anterior-and-apical-vaginal-wall-prolapse
#13
Mauro Cervigni, Alfredo Ercoli, Gil Levy
OBJECTIVE: This cadaver study was performed in order to evaluate the feasibility and the anatomical landmarks of a Self-Retaining device, a new unanchored mesh, for the treatment of anterior and apical vaginal prolapse. STUDY DESIGN: The Self-retaining device was implanted transvaginally in two cadavers. One cadaver underwent a detailed trans-abdominal dissection of the pelvis and the other cadaver, frozen after the implant placement, underwent a cross section dissection of the pelvis...
December 23, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28042167/diagnosis-and-therapy-of-female-pelvic-organ-prolapse-guideline-of-the-dggg-sggg-and-oeggg-s2e-level-awmf-registry-number-015-006-april-2016
#14
K Baeßler, T Aigmüller, S Albrich, C Anthuber, D Finas, T Fink, C Fünfgeld, B Gabriel, U Henscher, F H Hetzer, M Hübner, B Junginger, K Jundt, S Kropshofer, A Kuhn, L Logé, G Nauman, U Peschers, T Pfiffer, O Schwandner, A Strauss, R Tunn, V Viereck
Aims: The aim was to establish an official interdisciplinary guideline, published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). The guideline was developed for use in German-speaking countries. In addition to the Germany Society of Gynecology and Obstetrics, the guideline has also been approved by the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). This is a guideline published and coordinated by the DGGG. The aim is to provide evidence-based recommendations obtained by evaluating the relevant literature for the diagnostic, conservative and surgical treatment of women with female pelvic organ prolapse with or without stress incontinence...
December 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27987068/single-site-robotic-assisted-apical-lateral-suspension-ss-r-als-for-advanced-pelvic-organ-prolapse-first-case-reported
#15
Andrea Giannini, Eleonora Russo, Paolo Mannella, Tommaso Simoncini
While single-port laparoscopy for gynecological surgery is technically challenging, the Da Vinci Single-Site(®) robotic surgery platform may help to overcome some of the difficulties of this rapidly evolving technique. The authors of this article present the first case of single-incision, robotic apical lateral suspension (R-ALS) using this device in pelvic organ prolapse (POP) surgery. A 71-year-old female with advanced symptomatic anterior and apical prolapse (POP-Q stage III/III) was operated with a single-site approach using the Da Vinci Single-Site(®) robotic surgery device...
December 17, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27942792/transvaginal-uterosacral-ligament-hysteropexy-a-video-tutorial
#16
Rodolfo Milani, Matteo Frigerio, Federico Spelzini, Stefano Manodoro
INTRODUCTION AND HYPOTHESIS: Uterine-sparing procedures could be attractive in patients concerned about fertility preservation and corporeal image changes. Transvaginal uterosacral ligaments (USLs) hysteropexy can provide a mesh-free technique for uterine suspension. This video is intended to serve as a tutorial for surgical steps. METHODS: A 38-year-old woman with symptomatic stage III POP desired preserving fertility. After proper counseling, the patient was admitted for vaginal hysteropexy through bilateral high USL suspension according to the featured technique...
December 10, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27930942/trocar-guided-trans-vaginal-mesh-surgery-for-pelvic-organ-prolapse-effects-on-urinary-continence-and-anatomical-and-functional-outcomes-a-prospective-observational-study
#17
F Natale, E Costantini, C La Penna, E Illiano, R Balsamo, A Carbone, M Cervigni
OBJECTIVE: Primary objective of this study was to assess the effects of trocar-guided transvaginal mesh surgery (TVM) on cure and prevention rates for incontinence, without concomitant surgery for Stress Urinary Incontinence (SUI). Our secondary objectives were anatomical outcomes, relief of symptoms and effect on quality of life (QoL). STUDY DESIGN: This prospective observational study evaluated women who underwent TVM for symptomatic stage >2 Pelvic Organ Prolapse (POP)...
November 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27898453/resolution-of-rectal-prolapse-by-vaginal-reconstruction
#18
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone...
January 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27896472/safety-and-perioperative-morbidity-of-laparoscopic-sacropexy-a-systematic-analysis-and-a-comparison-with-laparoscopic-hysterectomy
#19
R Joukhadar, S Baum, J Radosa, C Gerlinger, A Hamza, I Juhasz-Böss, E-F Solomayer
PURPOSE: The high prevalence of Pelvic Organ Prolapse (POP) along with the demographic trend of the ageing population raises the value of sacropexy in the treatment of POP. Thus, efforts to decrease risks associated with this procedure have the potential for public health impact. We examined the perioperative morbidity of laparoscopic sacropexy regarding the surgical access and compared it with the morbidity of one of the most common gynecological procedure, the laparoscopic hysterectomy...
November 28, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27894034/quality-of-life-after-uphold%C3%A2-vaginal-support-system-surgery-for-apical-pelvic-organ-prolapse-a-prospective-multicenter-study
#20
Päivi Rahkola-Soisalo, Daniel Altman, Christian Falconer, Edward Morcos, Martin Rudnicki, Tomi S Mikkola
OBJECTIVE: To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold™ System. STUDY DESIGN: In this prospective cohort study, women (n=207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold™ Vaginal Support System. Follow-up for quality of life was performed at 12 months after surgery, and assessed by the PFDI-20, and PFIQ-7, and sexual function by the PISQ-12...
January 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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