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Apical Prolapse

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https://www.readbyqxmd.com/read/28547270/comparison-of-single-versus-multicenter-outcomes-for-pelvic-organ-prolapse-repair-using-a-mesh-capturing-device
#1
Edward Morcos, Daniel Altman, Daniel Hunde, Christian Falconer
INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the results of pelvic organ prolapse repair using a capturing device-guided transvaginal mesh in a single- vs multicenter setting. METHODS: One hundred and twelve women operated by two surgeons at one center (2-year follow-up) were compared with 207 women operated on by 26 surgeons at 24 centers (1-year follow-up). Patients were screened at baseline for apical (uterine or vaginal vault) prolapse stage II with or without concomitant anterior vaginal wall prolapse ≥ stage 2 according to the pelvic organ prolapse quantification (POP-Q) system...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28530619/-current-status-of-laparoscopic-sacrocolpopexy-in-the-treatment-of-pelvic-organ-prolapse
#2
Carmen González-Enguita, Natalia Gennaro-DellaRossa, Esther López-López, Juliana Escobar-Castaño, Percy Miguel Rodríguez-Castro, Raquel González-López
OBJECTIVES: Surgical restoration of pelvic floor anatomy in pelvic organ prolapse (POP) should avoid extensive areas that may injure healthy tissues and lead to scar fibrosis producing dysfunctional rigidity. Laparoscopic sacrocolpopexy corrects POP by lifting pelvic elements with a minimally invasive procedure.Various current strategies and approaches make it a diverse procedure. METHODS: We performed a bibliographic review on the published experience about abdominal sacrocolpopexy over the last 20 years...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28506944/effect-of-sacrocolpopexy-and-retropubic-sling-on-overactive-bladder-symptoms
#3
Muhammad Faisal Aslam, William T Gregory, Blake Osmundsen
OBJECTIVE: In this study, we aimed to evaluate the effect of sacrocolpopexy and retropubic midurethral sling, or transvaginal tape (TVT) procedure, on overactive bladder (OAB) symptoms. Our null hypothesis was that concomitant sacrocolpopexy and TVT exacerbate OAB symptoms. MATERIAL AND METHODS: This is a prospective cohort study. All subjects had apical/anterior prolapse and underwent robotic-assisted sacrocolpopexy and TVT, with or without concomitant hysterectomy...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28487243/towards-rebuilding-vaginal-support-utilizing-an-extracellular-matrix-bioscaffold
#4
Rui Liang, Katrina Knight, Deanna Easley, Stacy Palcsey, Steven Abramowitch, Pamela A Moalli
As an alternative to polypropylene mesh, we explored an extracellular matrix (ECM) bioscaffold derived from urinary bladder matrix (MatriStem™) in the repair of vaginal prolapse. We aimed to restore disrupted vaginal support simulating application via transvaginal and transabdominal approaches in a macaque model focusing on the impact on vaginal structure, function, and the host immune response. In 16 macaques, after laparotomy, the uterosacral ligaments and paravaginal attachments to pelvic side wall were completely transected (IACUC# 13081928)...
May 6, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28481045/pre-and-postoperative-magnetic-resonance-imaging-mri-findings-in-patients-treated-with-laparoscopic-sacrocolpopexy-is-it-a-safe-procedure-for-all-patients
#5
Dimitrios Zacharakis, Themos Grigoriadis, Charis Bourgioti, Eleni Pitsouni, Athanasios Protopapas, Lia A Moulopoulos, Stavros Athanasiou
INTRODUCTION: Laparoscopic sacrocolpopexy (LSCP) is a reference operation for apical compartment prolapse repair. Aim of this study is to describe the early and midterm postoperative MRI findings of the lumbosacral region (LSR) in patients undergoing LSCP and to detect any imaging changes that the presence of the mesh may cause on patients with preexisting degenerative disease of the LSR. METHODS: Patients with POP-Q grade III and IV uterovaginal or vaginal vault prolapse who were considered eligible for LSCP were invited to participate...
May 8, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28479877/laparoscopic-uterovaginal-prolapse-surgery-in-the-elderly-feasibility-and-outcomes
#6
Samuel W King, Helen Jefferis, Simon Jackson, Alexander G Marfin, Natalia Price
BACKGROUND: Uterovaginal prolapse in very elderly women is a growing problem due to increased life expectancy. Surgeons and anaesthetists may be wary of performing quality of life surgery on this higher risk group. Where surgery is undertaken, it is commonly performed vaginally; there is a perception that this is better tolerated than abdominal surgery. Little data is published about laparoscopic prolapse surgery tolerability in this population, and laparoscopic surgery is perceived within the urogynaecological community as complex and lengthy and hence inherently unsuitable for the very elderly...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28479480/complete-excision-of-sacrocolpopexy-mesh-with-autologous-fascia-sacrocolpopexy
#7
Janine L Oliver, Zaid Q Chaudhry, Andrew R Medendorp, Lauren N Wood, Z Chad Baxter, Ja-Hong Kim, Shlomo Raz
OBJECTIVES: To evaluate the safety and short-term efficacy of complete sacrocolpopexy mesh excision with concomitant autologous fascia sacrocolpopexy. METHODS: A retrospective cohort study of patients undergoing complete sacrocolpopexy mesh excision and concomitant autologous fascia sacrocolpopexy from March 2013 to September 2016 was conducted. The primary objective was assessment of perioperative outcomes including complications within 60 days of surgery. The secondary outcome measure was surgical success defined as no need for retreatment by either surgery for apical prolapse or pessary...
May 4, 2017: Urology
https://www.readbyqxmd.com/read/28461989/is-overactive-bladder-in-the-female-surgically-curable-by-ligament-repair
#8
Bernhard Liedl, Hiromi Inoue, Yuki Sekiguchi, Max Haverfield, Peter Richardson, Alexander Yassourides, Florian Wagenlehner
INTRODUCTION: Overactive bladder (OAB) symptoms (urge, frequency, nocturia) are not generally considered surgically curable by learning institutions. The Integral Theory hypothesizes that OAB is a prematurely activated, but normal micturition reflex caused by loose suspensory ligaments and potentially curable surgically by repairing such ligaments. To test this hypothesis by surgical repair of loose cardinal and uterosacral ligaments in patients with 2(nd) degree or greater uterine/apical prolapse...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28453958/the-novel-technique-of-post-hysterectomy-vaginal-vault-prolapse-repair-apical-sling-and-neocervix-formation
#9
Dmitry Shkarupa, Nikita Kubin, Ekaterina Shapovalova, Anastasiya Zaytseva, Alexey Pisarev, Olga Staroseltseva
OBJECTIVE: We primarily aimed to evaluate the effectiveness of the novel technique: bilateral sacrospinous fixation by monofilament polypropylene apical sling combined with "neocervix" formation in surgical treatment of post - hysterectomy vaginal vault prolapse. The secondary objective was to estimate the impact of the surgery on voiding function and quality of life. STUDY DESIGN: This prospective study involved 61 women suffering from post-hysterectomy prolapse...
April 23, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28451705/demonstration-of-a-box-stitch-technique-for-laparoscopic-uterosacral-ligament-suspension
#10
Allison M Wyman, Lindsey Hahn, Emad Mikhail, Stuart Hart
AIM: We demonstrate a novel box stitch technique of laparoscopic post-hysterectomy uterosacral ligament suspension for apical prolapse in restorative pelvic reconstructive surgery. MATERIAL AND METHODS: We present a case of a 58yo female with symptomatic stage III pelvic organ prolapse with a history of a total abdominal hysterectomy 30 years prior. She strongly desired the usage of no synthetic or biologic mesh for her restorative surgical repair. This video provides a step-by-step guide on how to perform a laparoscopic box stitch as a technique for uterosacral ligament suspension as an apical native tissue option for patients with the need for post hysterectomy apical prolapse...
April 27, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28431952/evaluation-of-patient-preparedness-for-surgery-a-randomized-controlled-trial
#11
Kristie A Greene, Allison M Wyman, Lauren A Scott, Stuart Hart, Lennox Hoyte, Renee Bassaly
BACKGROUND: Patient preparedness for pelvic reconstructive surgery has important implications for patient satisfaction and perception of improvement after surgery. The ideal method in which to optimally prepare patients for surgery has not been determined. OBJECTIVE: To evaluate the impact of a preoperative patient education video on patient preparedness prior to sacrocolpopexy as measured by a preoperative preparedness questionnaire (PPQ). STUDY DESIGN: We performed a single-blind, randomized stratified clinical trial at a single academic center evaluating the use of a preoperative patient education video as an adjunct to preoperative counseling on patient preparedness...
April 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28429054/variables-affecting-maximum-urethral-closure-pressure-mucp-and-abdominal-leak-point-pressure-alpp-measurements
#12
Bryan J Hill, Sarah Fletcher, Jeffrey Blume, Rony Adam, Renée Ward
INTRODUCTION AND HYPOTHESIS: The relationship between pelvic floor muscles and measurements of urethral function is not well studied. It is not known whether adjusting for clinical, demographic and urodynamic parameters would improve the association between MUCP and ALPP. Our hypothesis was that pelvic floor muscle strength (PFMS) influences the relationship between MUCP and ALPP. METHODS: This was a retrospective study of women who underwent a complex urodynamic study with evaluation of MUCP and ALPP using ICD-9 codes with documentation of PFMS...
April 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28417156/patient-satisfaction-after-laparoscopic-lateral-suspension-with-mesh-for-pelvic-organ-prolapse-outcome-report-of-a-continuous-series-of-417-patients
#13
Nikolaus Veit-Rubin, Jean-Bernard Dubuisson, Angèle Gayet-Ageron, Sören Lange, Isabelle Eperon, Jean Dubuisson
INTRODUCTION AND HYPOTHESIS: Sacropexy is considered the gold standard for the treatment of pelvic organ prolapse (POP) although dissection of the promontory may be challenging, particularly in obese women. Laparoscopic lateral suspension with mesh (LLS) could be an alternative. METHODS: LLS provides lateral attachment by fibrosis of a vesicovaginal mesh. Clinical evaluation was performed at 1 year using the simplified POP quantification system (POP-Q). Primary outcomes were objective and subjective cure at 1 year...
April 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28396951/robot-assisted-laparoscopic-pectouteropexy-an-alternative-uterus-sparing-technique-for-pelvic-organ-prolapse-surgery
#14
Taner Usta, Tolga Karacan, Ahmet Kale, Sevgin Mutlu, Talha Tıryakı
The aim of this video is to demonstrate the alternative technique of robot-assisted laparoscopic pectouteropexy for uterus preservation in obese patients with pelvic organ prolapse. We present the case report of a 44-year-old patient with apical pelvic organ prolapse. A pelvic examination was performed during a Valsalva maneuver in the dorsal lithotomy position and in the standing position, and the patient was diagnosed with stage III apical prolapse in accordance with the Pelvic Organ Prolapse Quantification system of the International Continence Society (POP-Q: Аа -1, Ва 0, Вр 0, С +2)...
April 10, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28364874/is-the-hymen-a-suitable-cut-off-point-for-clinically-relevant-pelvic-organ-prolapse
#15
Marian Wiegersma, Chantal M C R Panman, Boudewijn J Kollen, Marjolein Y Berger, Yvonne Lisman-van Leeuwen, Janny H Dekker
OBJECTIVES: The primary objective was to evaluate the ability of different anatomic cut-off points, as established in specialist urogynecology populations, to identify clinically relevant prolapse in a population of postmenopausal women with pelvic floor symptoms recruited from primary care. STUDY DESIGN: Cross-sectional study among 890 women (≥55 years) screened for pelvic floor symptoms. MAIN OUTCOME MEASURES: The Pelvic Floor Distress Inventory 20 was used to measure symptoms, and the Pelvic Organ Prolapse Quantification (POP-Q) system was used to assess prolapse...
May 2017: Maturitas
https://www.readbyqxmd.com/read/28364131/comparative-analysis-of-overall-cost-and-rate-of-healthcare-utilization-among-apical-prolapse-procedures
#16
Lannah L Lua, Erika D Vicente, Prathamesh Pathak, Daniel Lybbert, Vani Dandolu
INTRODUCTION AND HYPOTHESIS: The annual cost of prolapse surgeries is expected to grow at twice the rate of population growth. Understanding the economic impact of apical prolapse procedures, including sacrospinous fixation (SSF), abdominal sacrocolpopexy (ASC), and laparoscopic sacrocolpopexy (LSC), is crucial. We aimed to compare overall cost of SSF versus ASC and LSC, as well as health resource utilization, up to 90-day follow-up. METHODS: Truven Marketscan Commercial Claims and Encounter databases 2008-2012 were used to calculate index and 90-day follow-up costs for SSF, ASC, and LSC with/without hysterectomy...
March 31, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28361513/surgical-outcomes-and-safety-of-robotic-sacrocolpopexy-in-women-with-apical-pelvic-organ-prolapse
#17
Hyun Hwan Sung, Kwang Jin Ko, Yoon Seok Suh, Gyu Ha Ryu, Kyu-Sung Lee
PURPOSE: This study aimed to investigate the surgical outcomes and safety of robotic sacrocolpopexy (RSC) in patients with uterine/vaginal vault prolapse. METHODS: Between January 2009 and June 2015, 16 women with apical prolapse underwent RSC. Pelvic organ prolapse quantification (POP-Q) examination was performed, and treatment success was defined as the presence of grade 0 or I apical prolapse upon POP-Q examination at the final follow-up. Pelvic floor distress inventory-short form 20 (PFDI-SF 20) was administered at every follow-up...
March 24, 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28321474/transvaginal-iliococcygeus-fixation-for-posthysterectomy-vaginal-vault-prolapse-repair
#18
Rodolfo Milani, Matteo Frigerio, Federico Spelzini, Stefano Manodoro
INTRODUCTION AND HYPOTHESIS: Posthysterectomy vaginal vault prolapse repair is a surgical challenge. Successful surgical management using native tissue can be achieved via the vaginal approach by iliococcygeus fascia fixation. However, although iliococcygeus fascia fixation is technically simple and has a low morbidity, it is not commonly performed. The aim of the video is to provide anatomic views and the surgical steps necessary to achieve successful transvaginal iliococcygeus fascia fixation for vaginal vault prolapse repair...
March 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28266815/efficacy-and-safety-of-elevate%C3%A2-system-on-apical-and-anterior-compartment-prolapse-repair-with-personal-technique-modification
#19
Daniele Castellani, Vikiela Galica, Pietro Saldutto, Giuseppe Paradiso Galatioto, Carlo Vicentini
AIM: To evaluate the effectiveness and safety of Anterior Elevate® mesh kit system (AES) in woman with symptomatic stage 3 or 4 anterior and/or apical pelvic organ prolapse (POP). MATERIALS AND METHODS: This retrospective, monocentric, single surgeon study enrolled between May 2010 and January 2013 fifty-six woman experiencing symptomatic anterior vaginal prolapse with or without apical descent (POP-Q stage 3 or 4). All women received a AES and 7 (12.5%) received a concomitant transvaginal hysterectomy...
March 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28258346/sacrospinous-hysteropexy-review-and-meta-analysis-of-outcomes
#20
REVIEW
Shveta Kapoor, Kanapathippillai Sivanesan, Jessica Amy Robertson, Mayooran Veerasingham, Vishal Kapoor
INTRODUCTION: Sacrospinous hysteropexy is a uterine-preserving procedure for treatment of apical prolapse. We present a literature review evaluating the sacrospinous hysteropexy procedure and its current place in the surgical management of pelvic organ prolapse. Additionally, to assess the efficacy of the procedure, we performed a meta-analysis of studies comparing sacrospinous hysteropexy to vaginal hysterectomy and repair in terms of anatomical outcomes, complications, and repeat surgery...
March 3, 2017: International Urogynecology Journal
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