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Apical Prolapse

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https://www.readbyqxmd.com/read/28453958/the-novel-technique-of-post-hysterectomy-vaginal-vault-prolapse-repair-apical-sling-and-neocervix-formation
#1
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/28431952/evaluation-of-patient-preparedness-for-surgery-a-randomized-controlled-trial
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28230565/outcomes-of-transvaginal-high-uterosacral-ligaments-suspension-over-500-patient-single-center-study
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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