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Apical Prolapse

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https://www.readbyqxmd.com/read/28321474/transvaginal-iliococcygeus-fixation-for-posthysterectomy-vaginal-vault-prolapse-repair
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28258345/effect-of-pessary-use-on-hydronephrosis-in-women-with-advanced-pelvic-organ-prolapse-a-self-selected-interventional-trial
#4
Christina E Dancz, Daphne Walker, Diane Thomas, Nuzhath Hussain, Begüm Özel
INTRODUCTION AND HYPOTHESIS: The purpose of this study was to determine the proportion of women who demonstrate improvement in hydronephrosis after pessary placement for advanced pelvic organ prolapse (POP). METHODS: This was a planned subset analysis of a prospective study on the prevalence of hydronephrosis in women with advanced POP. Women with anterior or apical POP ≥1 cm past the hymenal remnant were enrolled and screened for hydronephrosis. All were offered expectant management, pessary placement or surgery...
March 3, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28254232/comparing-the-midterm-outcome-of-single-incision-vaginal-mesh-and-transobturator-vaginal-mesh-in-treating-severe-pelvic-organ-prolapse
#5
Tsai-Hwa Yang, Ling-Ying Wu, Fei-Chi Chuang, Fu-Tsai Kung, Kuan-Hui Huang
OBJECTIVE: The aim of this study is to compare perioperative parameters and midterm clinical outcomes using two different mesh kits: transobturator vaginal mesh (TVM) (both Perigee and Apogee), versus single incision vaginal mesh (SIM) (combined Elevate anterior/apical system and Elevate posterior/apical system) in treating severe pelvic organ prolapse (POP). MATERIALS AND METHODS: This is a retrospective cohort study. During 2008 and 2013, those women with severe POP [POP quantification system (POP-Q), Stage III and Stage IV], who received either TVM or SIM operation, were enrolled for cohort comparison...
February 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28238313/-laparoscopic-lateral-suspension-another-way-to-treat-genital-prolapse
#6
J B Dubuisson, N Veit-Rubin, J M Wenger, J Dubuisson
The laparoscopic sacrocolpopexy is the treatment of choice of pelvic organ prolapses since more than twenty years. The laparoscopic lateral suspension with mesh is an alternative technique. Its originality is the subperitoneal passing of the lateral arm of the mesh in the lateral abdominal wall, leaving the skin above the iliac crest, in a place without risks of vascular, nerve, bowel injuries. We report in this article the results of the three main publications on the subject. The indications are cystocele and apical descent...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28230565/outcomes-of-transvaginal-high-uterosacral-ligaments-suspension-over-500-patient-single-center-study
#7
Rodolfo Milani, Matteo Frigerio, Alice Cola, Carlo Beretta, Federico Spelzini, Stefano Manodoro
BACKGROUND: Uterosacral ligament (USL) suspension is a safe and effective procedure in terms of anatomical, functional, and subjective outcomes for primary surgical treatment of prolapse. OBJECTIVES: There has been a renewed interest toward native tissue prolapse repair by vaginal route because of low cost and lack of mesh-related complications. Uterosacral ligaments are considered safe, effective, and durable as suspending structures for primary surgical repair of the apical compartment...
February 23, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28213799/the-hybrid-technique-of-pelvic-organ-prolapse-treatment-apical-sling-and-subfascial-colporrhaphy
#8
Dmitry Shkarupa, Nikita Kubin, Alexey Pisarev, Anastasiya Zaytseva, Ekaterina Shapovalova
INTRODUCTION AND HYPOTHESIS: The majority of patients with cystocele undergoing reconstructive surgery have combined defects of pubocervical fascia and uterosacral/cardinal ligament complex. In this regard, the simultaneous correction of both defects is rational. Furthermore, decreasing the use of synthetic materials in pelvic floor surgery is an important goal. The aim was to evaluate the objective and subjective cure rate of a hybrid technique: bilateral sacrospinous fixation using modern monofilament synthetic tape (apical sling) combined with the original technique of subfascial colporrhaphy...
February 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28199078/anterior-six-arms-prolene-mesh-for-high-stage-vaginal-prolapse-five-years-follow-up
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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%C3%A2-for-middle-compartment-prolapse
#19
Yisong Chen, Keqin Hua
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
#20
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
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