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Rachel Pope, Prakash Ganesh, Jeffrey Wilkinson
Urethral incontinence is an issue for approximately 10-15% of women with an obstetric fistula. Various surgical interventions to prevent this exist, including the pubococcygeal sling and refixation of the pubocervical fascia. Neither has been evaluated in comparison to one another. Therefore, this retrospective evaluation for superiority was performed. The primary outcome was urinary stress incontinence, and secondary outcomes were operative factors. There were 185 PC slings, but 12 were excluded because of urethral plications...
2018: Obstetrics and Gynecology International
Tsia-Shu Lo, Sandy Chua, Yiap Loong Tan, Ma Clarissa Patrimonio, Leng Boi Pue
OBJECTIVE: To compare the ultrasonographic positional changes of mid-urethral sling(MUS) tape in relation to symphysis pubis, and the different clinical outcomes among women who underwent MUS insertion with MiniArcTM or MonarcTM for the treatment of stress urinary incontinence 3 years after. MATERIALS AND METHODS: A retrospective follow-up study on patients with clinically confirmed stress urodynamic incontinence and urodynamic stress incontinence who had undergone MiniArc or Monarc surgery...
2018: PloS One
Alex Gomelsky, Stavros Athanasiou, Myung-Soo Choo, Michel Cosson, Roger R Dmochowski, Cristiano M Gomes, Ash Monga, Charles W Nager, Roy Ng, Eric S Rovner, Peter Sand, Hikaru Tomoe
Urinary incontinence is a prevalent condition worldwide and causes a tremendous impact on a woman's quality of life. While conservative and non-surgical therapies are options for treatment, surgery for stress urinary incontinence (SUI) is common. Options include colposuspension, slings (pubovaginal and midurethral), and periurethral bulking. While evidence supports each of these options in the treatment of SUI, each is associated with various rates of success and unique adverse event profiles. Urgency urinary incontinence (UUI) is initially treated with behavioral modification and pharmacologic means, with surgery reserved for those with refractory symptoms or significant complications from medication use...
December 4, 2018: Neurourology and Urodynamics
Ishu Bishnoi, Daljit Singh, Sheikhoo Bishnoi, Tushit Mewada, Deepashu Sachdeva, Amit Mittal, Shrinivas H Odugora
Introduction: Various nerve compression syndromes, such as trigeminal neuralgia (TN), glossopharyngeal neuralgia (GN), and hemifacial spasm (HFS), are caused by compression of the concerned nerve by the adjacent vessel. Patients who do not respond to medical management are usually treated by "microvascular decompression (MVD) of the nerve." Teflon patch graft is the most commonly used material for MVD. This graft has been used in various shapes like a patch, in the shredded form, or as a sling...
November 2018: Neurology India
Peter L Dwyer, Debjyoti Karmakar
Mid-urethral sling procedures (MUS) have been the surgical option of choice for most gynaecologists and urologists treating stress urinary incontinence (SUI) in women around the world for almost 20 years, since their introduction in the late 1990s. The evidence suggests that the long-term effectiveness of the MUS is good and similar to the Burch Colposuspension and the fascial pubovaginal slings. The bulking agents are now being put forward as another minimally invasive option for the surgical treatment of SUI...
October 30, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Long Wang, Li Cai, Hai Qian, Jae-Sang Oh, Rokuya Tanikawa, Xiang'en Shi
OBJECTIVE: The repositioning of a dolichoectatic vertebrobasilar artery for arterial decompression has been extensively utilized in the clinical setting. This study aims to describe and summarize the technical characteristics and clinical results of the sling technique. METHODS: The terms "dolichoectatic aneurysm", "dolichoectasia", "ectasia" and "megadolichoectasia" were used to search for pertinent articles related to the VBA territory...
November 29, 2018: World Neurosurgery
Diana C Patterson, Debbie Chi, Bradford O Parsons, Paul J Cagle
BACKGROUND: Reverse total shoulder arthroplasty (RSA) accounts for nearly one-third of shoulder arthroplasty utilization nationally. The complication rate has increased concurrently. Consensus is lacking regarding the incidence, etiology, and treatment of acromial or scapular spine fractures after RSA. The purpose of our study was to perform a systematic review of the literature to analyze the occurrence and outcomes of this complication. METHODS: The MEDLINE, Embase, Google Scholar, and Cochrane databases were queried in late 2017 for combinations of the words "acromial," "fracture," "reverse," "shoulder," and "arthroplasty...
November 26, 2018: Journal of Shoulder and Elbow Surgery
B D O’Leary, A M Hanly, G J Agnew
Introduction Pelvic floor dysfunction is a global term used to describe conditions such as pelvic organ prolapse, and faecal or urinary incontinence. The Pelvic Floor Centre is a multi-disciplinary clinic for pelvic floor dysfunction. The aim of this study was to assess patient satisfaction following joint colorectal-urogynaecology surgery in the Pelvic Floor Centre. Methods All patients who underwent a joint procedure in the Pelvic Floor Centre from 1st October 2015 to 31st October 2016 were contacted via telephone...
May 10, 2018: Irish Medical Journal
Tsia-Shu Lo, Sandy Chua, Ling-Hong Tseng, Cheng-Yu Long, Chuan-Chi Kao, Wu-Chiao Hsieh
INTRODUCTION AND HYPOTHESIS: To determine the clinical outcomes of adding a tension-releasing suture (TRS) appendage for manipulation of over-tensioned single-incision slings (SIS) as a means to relieve postoperative voiding dysfunction. METHODS: A retrospective observational study conducted from January 2010 to July 2017. The records of patients with urodynamic stress incontinence (USI) without needing concurrent procedures who underwent anti-incontinence surgery using MiniArc, Solyx, and Ajust with voiding dysfunction were collated and analyzed...
November 28, 2018: International Urogynecology Journal
Hueih Ling Ong, Hann-Chorng Kuo
OBJECTIVE: This study investigated the long-term success rate of retropubic suburethral sling in the treatment of women with stress urinary incontinence (SUI) and different bladder function. METHODS: Surgical outcomes of women with SUI undergoing a retropubic suburethral sling procedure between October 1989 and November 2014 were analyzed retrospectively. Bladder function was evaluated in every patient preoperatively using videourodynamic studies. Patients were classified as having stable bladder, detrusor overactivity (DO), or detrusor underactivity (DU)...
November 28, 2018: Lower Urinary Tract Symptoms
M Ritsch
OBJECTIVE: Reconstruction of the chronic pectoralis major rupture with reconstruction of the anatomy and the original initial length of the muscle-tendon unit as well as the full strength. INDICATIONS: Basically all chronic tears of the pectoralis major, causing discomfort. CONTRAINDICATIONS: Infections and tumors in the operation area. SURGICAL TECHNIQUE: Skin incision medial to the anterior axillary line about 6 cm long in the split lines of the skin...
December 2018: Operative Orthopädie und Traumatologie
Julie R Whittington, Aaron T Poole
Objective  Aim of this study was to introduce posterior axilla sling traction (PAST) in delivering providers and nursing staff as an adjunct to the management of shoulder dystocia and evaluate comfort in performing the maneuver. Methods  A presimulation questionnaire had given to all participants. A brief training on how to perform PAST was also given. A simulated shoulder dystocia was run where usual maneuvers failed. Participants used PAST for delivery of posterior shoulder, delivery of posterior arm, and to assist with rotation...
October 2018: American Journal of Perinatology Reports
Christopher Iwanoff, Charbel Salamon
STUDY OBJECTIVE: The primary objective was to study the effects of liposomal bupivacaine (LB) compared to bupivacaine HCL with lidocaine on postoperative day 1 pain scores. DESIGN: A randomized control trial (Canadian Task Force classification level 1). SETTING: An academic medical center within the department of female pelvic medicine and reconstructive surgery. PATIENTS: Fifty-seven patients undergoing a midurethral sling by a fellowship-trained Urogynecologic surgeon and a fellow in female pelvic medicine and reconstructive surgery...
November 22, 2018: Journal of Minimally Invasive Gynecology
Farzaneh Sharifiaghdas, Nastaran Mahmoudnejad, Mehdi Honarkar Ramezani, Hamid Reza Shemshaki, Fatemeh Ameri
OBJECTIVE: To evaluate long term outcomes of autologous pubovaginal fascial sling (AFPVS) as a salvage procedure following different types of failed anti-incontinence surgeries. MATERIALS AND METHODS: We retrospectively reviewed medical records of patients who had undergone salvage AFPVS after any kind of anti-incontinence surgery from 2005-2015 at our medical center. Patients were contacted by telephone. Revised Urinary Incontinence Scale (RUIS) was used to determine the success rate...
November 21, 2018: Urology Journal
Ericka M Sohlberg, Christopher S Elliott
The Burch colposuspension has a 50-plus year history demonstrating strong long-term outcomes with minimal complications. Iterations of the procedure, including laparoscopic, robotic, and mini-incisional approaches, appear to have equal efficacy to the open procedure. Although the current use of the Burch colposuspension has waned with the growing shift toward sling surgery, it continues to have a role in the treatment of stress urinary incontinence. Specifically, a Burch procedure should be considered when vaginal access is limited, concurrent intra-abdominal surgery is planned, or mesh is contraindicated...
February 2019: Urologic Clinics of North America
Jerry G Blaivas, Vannita Simma-Chiang, Zeynep Gul, Linda Dayan, Senad Kalkan, Melissa Daniel
This article describes the operative technique of autologous fascial pubovaginal sling (AFPVS) surgery, examines the senior author's outcomes with AFPVS, compares these outcomes with those of other large studies and meta-analyses, and compares the safety and efficacy of AFPVS with those of the synthetic midurethral sling (SMUS). Recently, the SMUS has become the treatment of choice for most surgeons. The efficacy of the SMUS remains unchallenged and comparable with that of AFPVS, but SMUS are associated with more severe complications...
February 2019: Urologic Clinics of North America
Laura L Giusto, Patricia M Zahner, Howard B Goldman
The synthetic midurethral sling has become the gold standard for treatment of stress urinary incontinence since its introduction more than 20 years ago. With its utilization, the incidence of mesh-related complications has also increased. Mesh exposure and perforation are 2 common mesh complication scenarios that pelvic floor surgeons should be prepared to treat. This article highlights preoperative, perioperative, and postoperative factors to minimize the chance of vaginal wall mesh exposure or perforation of mesh into the lower urinary tract...
February 2019: Urologic Clinics of North America
Brian J Linder, Daniel S Elliott
Synthetic midurethral sling placement is the most studied anti-incontinence procedure available. Multiple randomized trials demonstrate its safety and efficacy, with results out to 5 years. With long-term follow-up, it seems there may be some benefit in efficacy to retropubic sling placement compared with the transobturator approach. Single-incision slings are a newer modification to multi-incision sling placement, and the data regarding safety and efficacy are not as mature as other forms of sling placement...
February 2019: Urologic Clinics of North America
Youn-Shen Bee, Pei-Jhen Tsai, Muh-Chiou Lin, Ming-Ying Chu
BACKGROUND: Amblyopia is a main concern in children undergoing frontalis sling surgery for repairing congenital ptosis. This study aimed to evaluate factors related to amblyopia in children undergoing frontalis sling surgery. METHODS: IRB-approved retrospective review of children under the age of 12 who received frontalis sling surgery. Preoperative demographic data, strabismus, margin reflex distance 1 (MRD1), lid fissure height, sling type, refraction errors, surgical outcome and amblyopia were evaluated...
November 21, 2018: BMC Ophthalmology
Peng-Hu Lian, Zhi-Gang Ji, Han-Zhong Li, He Xiao, Wei-Gang Yan, Zhong-Ming Huang
BACKGROUND: Incidence of intraoperative vaginal perforation is generally considered to be low but varies among different procedures. Vaginal perforation could not only prolong the surgeries and aggravate surgical trauma but also result in postoperative discomfort or even a second surgery. METHOD: Vaginal perforation, vaginal epithelial perforation, vaginal wall perforation, vaginal penetration, urinary incontinence were searched in PubMed, Cochrane, Embase database to identify the qualified clinical trial and relevant literature sources were also searched...
November 21, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
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