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Apical Prolapse

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https://www.readbyqxmd.com/read/28101639/laparoscopic-hysteropexy-10%C3%A2-years-experience
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27886523/two-years-follow-up-of-270-patients-treated-by-transvaginal-mesh-for-anterior-and-or-apical-prolapse
#12
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)...
January 2017: 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
#13
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
#14
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
#15
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...
January 2017: 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
#16
REVIEW
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...
January 2017: Advances in Therapy
https://www.readbyqxmd.com/read/27734794/robotic-versus-laparoscopic-sacrocolpopexy-for-apical-prolapse-a-case-control-study
#17
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
#18
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
#19
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
#20
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...
January 2017: Female Pelvic Medicine & Reconstructive Surgery
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