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Apical Prolapse

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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
#1
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
#2
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...
November 28, 2016: 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
#3
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
#4
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...
November 14, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27886523/two-years-follow-up-of-270-patients-treated-by-transvaginal-mesh-for-anterior-and-or-apical-prolapse
#5
Florence Hugele, Laure Panel, Camille Farache, Amgad Kashef, Arnaud Cornille, Christophe Courtieu
OBJECTIVE: The aim of this study was to assess the 1 and 2 years outcomes of transvaginal single incision mesh surgery (SIMS) for anterior pelvic organ prolapse (POP). MATERIAL AND METHODS: This was a prospective study including all patients from November 2008 to December 2012 who underwent SIMS for symptomatic anterior prolapse stage≥2, according to the POP Quantification (POP-Q). Symptoms and quality of life were assessed using validated questionnaires: Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact questionnaire (PFIQ-7), and Prolapse/Incontinence Sexual Questionnaire (PISQ-12)...
November 11, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27824746/readmission-and-prolapse-recurrence-after-abdominal-and-vaginal-apical-suspensions-in-older-women
#6
Tatiana V D Sanses, Jan M Hanley, Peter Zhang, Holly E Richter, Steven R Gambert, Chris S Saigal
OBJECTIVE: Our objective was to evaluate 30-day readmission, 12-month prolapse recurrence, and complications after apical surgeries in older women. METHODS: A retrospective cohort study was conducted using 2002-2011 Medicare data in women 65 years or older who underwent abdominal sacrocolpopexy with synthetic mesh, vaginal uterosacral, or sacrospinous colpopexy with 12 months follow-up. Vaginal mesh procedures were excluded. The primary outcome was 30-day inpatient readmission...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27796653/sacrocolpopexy-surgical-technique-outcomes-and-complications
#7
REVIEW
Elizabeth B Takacs, Karl J Kreder
PURPOSE OF REVIEW: Pelvic organ prolapse is a non-life-threatening condition that has a wide variety of symptoms. Sacrocolpopexy has been the "gold standard" for management of apical pelvic organ prolapse with reported high success rates for anatomic correction. Herein, we review the surgical procedure, anatomic, and functional outcomes, as well as the intraoperative and postoperative complications. RECENT FINDINGS: Findings suggest that the ASC has an acceptably low overall complication rate comparable between open and minimally invasive approach...
December 2016: Current Urology Reports
https://www.readbyqxmd.com/read/27782977/iatrogenic-bladder-diverticulum-11-years-after-sacrospinous-ligament-fixation-for-apical-prolapse
#8
Laura Faye Gephart, Anthony Lewis, Emily Wu, Erin Bird, Kristofer Wagner, Thomas J Kuehl, Wilma Larsen
INTRODUCTION: In this case, we describe a bladder diverticulum due to apical vaginal suspension to the sacrospinous ligament presenting 11 years after surgery. This case report explores her signs and symptoms, diagnostic work-up, surgical intervention, and postoperative course. CASE DESCRIPTION: A 71-year-old G2P2 presented with symptoms of urinary urgency. Work-up including cystoscopy and retrograde fistulogram revealed a bladder diverticulum extending to the level of the sacrospinous ligament...
October 25, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27757813/reasons-for-and-against-use-of-non-absorbable-synthetic-mesh-during-pelvic-organ-prolapse-repair-according-to-the-prolapsed-compartment
#9
Stavros Kontogiannis, Evangelia Goulimi, Konstantinos Giannitsas
Awareness and reporting of mesh-related complications of pelvic organ prolapse repairs have increased in recent years. As a result, deciding whether to use a mesh or not has become a difficult task for urogynecologists. Our aim was to summarize reasons for and against the use of mesh in prolapse repair based on a review of relevant literature. Scopus and PubMed databases were searched for papers reporting on the efficacy and safety of native tissue versus non-absorbable, synthetic mesh prolapse repairs. Randomized controlled trials, systematic reviews, and meta-analyses were included...
October 18, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27734794/robotic-versus-laparoscopic-sacrocolpopexy-for-apical-prolapse-a-case-control-study
#10
G Cucinella, G Calagna, G Romano, G Di Buono, G Gugliotta, S Saitta, G Adile, M Manzone, G Accardi, A Perino, A Agrusa
The apical prolapse has always been considered the most complex of the defects of the pelvic floor, for both the difficulty of the surgical corrective technique and for the high post-surgical recurrence rate. Today, the laparoscopic sacrocolpopexy can be considered the standard treatment for apical prolapse. In the last years, several author performed robotic sacrocolpopexy, obtaining positive results. So, we developed a casecontrol study in order to compare the surgical outcome of robotic group with a control group of laparoscopic approach in patients with symptomatic apical pro-lapsed between January 2015 and December 2015 at University Hospital Policlinico "P...
May 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27729364/basal-left-ventricular-dilatation-and-reduced-contraction-in-patients-with-mitral-valve-prolapse-can-be-secondary-to-annular-dilatation-preoperative-and-postoperative-speckle-tracking-echocardiographic-study-on-left-ventricle-and-mitral-valve-annulus-interaction
#11
Shota Fukuda, Jae-Kwan Song, Keitaro Mahara, Hiroshi Kuwaki, Jeong Yoon Jang, Masaaki Takeuchi, Byung Joo Sun, Yun Jeong Kim, Tetsu Miyamoto, Yasushi Oginosawa, Shinjo Sonoda, Masataka Eto, Yosuke Nishimura, Shuichiro Takanashi, Robert A Levine, Yutaka Otsuji
BACKGROUND: Prominent mitral valve (MV) annular dilatation with only modest left ventricular (LV) dilatation in patients with MV prolapse (MVP) suggests predominant dilatation in adjacent basal LV, which may augment regional wall tension and attenuate contraction by Laplace's law. We hypothesized that MV annular dilatation in patients with MVP is associated with the basal predominance of LV dilatation and attenuated contraction, which can be altered by surgical MV plasty with annulus reduction...
October 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27696355/surgery-for-women-with-apical-vaginal-prolapse
#12
REVIEW
Christopher Maher, Benjamin Feiner, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Julie Brown
BACKGROUND: Apical vaginal prolapse is a descent of the uterus or vaginal vault (post-hysterectomy). Various surgical treatments are available and there are no guidelines to recommend which is the best. OBJECTIVES: To evaluate the safety and efficacy of any surgical intervention compared to another intervention for the management of apical vaginal prolapse. SEARCH METHODS: We searched the Cochrane Incontinence Group's Specialised Register of controlled trials, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials...
October 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27682746/perioperative-complications-and-cost-of-vaginal-open-abdominal-and-robotic-surgery-for-apical-vaginal-vault-prolapse
#13
Mallika Anand, Amy L Weaver, Kristin M Fruth, Bijan J Borah, Christopher J Klingele, John B Gebhart
OBJECTIVES: To determine the rate of perioperative complications and cost associated with Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), and robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. METHODS: We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery (MMC, ASC, or RSC) between January 1, 2000, and June 30, 2012, at our institution. For all patients identified, perioperative complications, length of hospital stay, and inpatient costs to patients were abstracted from the medical records and compared by procedure...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27678145/de-novo-stress-urinary-incontinence-after-pelvic-organ-prolapse-surgery-in-women-without-occult-incontinence
#14
Alexandriah N Alas, Orawee Chinthakanan, Luis Espaillat, Leon Plowright, G Willy Davila, Vivian C Aguilar
INTRODUCTION AND HYPOTHESIS: There is a paucity of data evaluating the risk of de novo stress urinary incontinence (SUI) after surgery for pelvic organ prolapse (POP) in women with no preoperative occult SUI. We hypothesized that apical suspension procedures would have higher rates of de novo SUI. METHODS: This was a retrospective database review of women who had surgery for POP from 2003 to 2013 and developed de novo SUI at ≥6 months postoperatively. Preoperatively, all patients had a negative stress test and no evidence of occult SUI on prolapse reduction urodynamics...
September 27, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27640944/definitions-of-apical-vaginal-support-loss-a%C3%A2-systematic-review
#15
REVIEW
Melanie R L Meister, Siobhan Sutcliffe, Jerry L Lowder
OBJECTIVE: We sought to identify and summarize definitions of apical support loss utilized for inclusion, success, and failure in surgical trials for treatment of apical vaginal prolapse. BACKGROUND: Pelvic organ prolapse is a common condition affecting more than 3 million women in the US, and the prevalence is increasing. Prolapse may occur in the anterior compartment, posterior compartment or at the apex. Apical support is considered paramount to overall female pelvic organ support, yet apical support loss is often under recognized and there are no guidelines for when an apical support procedure should be performed and/or incorporated into a procedure designed to address prolapse...
September 15, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27636221/outcomes-of-robotic-sacrocolpopexy-using-only-absorbable-suture-for-mesh-fixation
#16
Brian J Linder, Mallika Anand, Christopher J Klingele, Emanuel C Trabuco, John B Gebhart, John A Occhino
OBJECTIVE: The optimal suture selection for mesh attachment during robotic sacrocolpopexy (RSC) is currently unknown. Here, we sought to evaluate the outcomes of RSC using absorbable sutures for vaginal and sacral mesh attachment. METHODS: We retrospectively reviewed 132 RSC surgeries that were performed for vaginal vault prolapse in the Division of Gynecologic Surgery at our institution from February 2007 to December 2013. All cases were performed with absorbable suture (polyglactin) for vaginal and sacral mesh fixation...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27636218/identifying-gaps-and-inconsistencies-in-urogynecologic-surgical-training-of-obstetrics-and-gynecology-residents
#17
Emily E Weber LeBrun, Hazel Asumu, Anne M Richardson, LouAnn A Cooper, John D Davis
OBJECTIVE: This study aims to determine the expectations of Obstetrics and Gynecology (ObGyn) residency and Female Pelvic Medicine & Reconstructive Surgery (FPMRS) fellowship program directors (FPDs) for the independent performance of urogynecologic procedures during residency and to compare these expectations with the Council on Resident Education in Obstetrics and Gynecology (CREOG) educational objectives. MATERIALS AND METHODS: Two parallel, anonymous surveys were distributed simultaneously to all directors of accredited ObGyn residency and FPMRS fellowship programs in the United States...
November 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27631421/robotic-and-laparoendoscopic-single-site-utero-sacral-ligament-suspension-for-apical-vaginal-prolapse-evaluation-of-our-technique-and-perioperative-outcomes
#18
Hugo H Davila, Taryn Gallo, Lindsey Bruce, Christopher Landrey
The objective of this study was to evaluate our technique and steps of robotic and laparoendoscopic single-site utero-sacral ligament suspension in the treatment of patients with symptomatic apical vaginal prolapse. A retrospective analysis was done using the data in 2 community hospital. Eighteen women presented with vaginal apex prolapse and desired minimally invasive surgery (video): (a) Laparoendoscopic single-site utero-sacral ligament suspension (LESS-UTSLS) (n = 13) or (b) robotic-assisted single-site utero-sacral ligament suspension (RASS-UTSLS) (n = 5) were eligible to participate...
September 8, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27619780/anatomical-and-functional-outcomes-of-prolift-transvaginal-mesh-for-treatment-of-pelvic-organ-prolapse
#19
Wan Song, Tae Heon Kim, Jin Woo Chung, Won Jin Cho, Ha Na Lee, Young Suk Lee, Kyu-Sung Lee
OBJECTIVES: To evaluate anatomical and functional outcomes of the Prolift Transvaginal Mesh for treatment of pelvic organ prolapse (POP) with regard to safety and satisfaction. METHODS: We reviewed the medical records of 163 patients who underwent POP repair with Prolift Transvaginal Mesh between December 2005 and March 2012. An "optimal" anatomic outcome was defined as Pelvic Organ Prolapse Quantification System (POP-Q) stage 0, and a "satisfactory" anatomic outcome was defined as POP-Q stage 1...
September 2016: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/27615439/intraoperative-cervix-location-and-apical-support-stiffness-in-women-with-and-without-pelvic-organ-prolapse
#20
Carolyn W Swenson, Tovia M Smith, Jiajia Luo, Giselle E Kolenic, James A Ashton-Miller, John O DeLancey
BACKGROUND: It is unknown how initial cervix location and cervical support resistance to traction, which we term "apical support stiffness," compare in women with different patterns of pelvic organ support. Defining a normal range of apical support stiffness is important to better understand the pathophysiology of apical support loss. OBJECTIVE: The aims of our study were to determine whether: (1) women with normal apical support on clinic Pelvic Organ Prolapse Quantification, but with vaginal wall prolapse (cystocele and/or rectocele), have the same intraoperative cervix location and apical support stiffness as women with normal pelvic support; and (2) all women with apical prolapse have abnormal intraoperative cervix location and apical support stiffness...
September 8, 2016: American Journal of Obstetrics and Gynecology
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