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Vaginal sling

Mahmut Kuntay Kokanalı, Sabri Cavkaytar, Demet Kokanalı, Orhan Aksakal, Melike Doganay
There is little data comparing the surgical outcomes of tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures in obese women. Therefore, we aimed to compare the surgical outcomes of TOT and TVT procedures among obese women with a diagnosis of stress urinary incontinence (SUI). One hundred and eighty-nine women who underwent TVT or TOT procedures due to pure SUI were included. Women in whom the body mass index (BMI) was ≥30 kg/m(2) were considered as obese, while <30 kg/m(2) were non-obese...
October 19, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Dorothy Kammerer-Doak, Kamil Svabik, Tony Bazi
INTRODUCTION AND HYPOTHESIS: Members of the International Urogynecological Association (IUGA) come from different geographic locations and practice settings. A member survey regarding practice patterns provides valuable information for practitioners and researchers alike, and allows the IUGA to discover areas to focus on education and information dissemination. METHODS: A questionnaire was developed by the IUGA Research and Development committee and distributed electronically to IUGA surgeons...
October 17, 2016: International Urogynecology Journal
Yuko M Komesu, Holly E Richter, Darrell L Dinwiddie, Nazema Y Siddiqui, Vivian W Sung, Emily S Lukacz, Beri Ridgeway, Lily A Arya, Halina M Zyczynski, Rebecca G Rogers, Marie Gantz
INTRODUCTION AND HYPOTHESIS: We describe the rationale and methods of a study designed to compare vaginal and urinary microbiomes in women with mixed urinary incontinence (MUI) and similarly aged, asymptomatic controls. METHODS: This paper delineates the methodology of a supplementary microbiome study nested in an ongoing randomized controlled trial comparing a standardized perioperative behavioral/pelvic floor exercise intervention plus midurethral sling versus midurethral sling alone for MUI...
October 13, 2016: International Urogynecology Journal
Eugene Adel, Robert Shapiro, Stanley Zaslau
INTRODUCTION AND HYPOTHESIS: Polypropylene (PP) mesh has come under increased scrutiny owing to previous FDA safety communications regarding the risks of mesh in trans-vaginal surgery and ensuing class action litigation for post-operative complications. Additional concerns have been raised regarding a possible link between implanted PP mesh and the long-term development of malignancy. Until recently, no research was specifically committed to the exploration of such a link. Our objective was to provide an overview of the recent literature focusing on any association between the use of PP mesh for midurethral sling procedures and the development of malignancy...
October 13, 2016: International Urogynecology Journal
Chailee F Moss, Lynn A Damitz, Richard H Gracely, Alice C Mintz, Denniz A Zolnoun, A Lee Dellon
INTRODUCTION: Transobturator slings can be successfully used to treat stress urinary incontinence and improve quality of life through a minimally invasive vaginal approach. Persistent postoperative pain can occur and pose diagnostic and therapeutic dilemmas. Following a sling procedure, a patient complained of pinching clitoral and perineal pain. Her symptoms of localized clitoral pinching and pain became generalized over the ensuing years, eventually encompassing the entire left vulvovaginal region...
2016: Journal of Pain Research
Mohamed E Gaber, Tamer Borg, Hazem Samour, Mai Nawara, Ahmed Reda
AIM: The aim of this study was to compare the outcome of two single-incision mini-slings (the Contasure-Needleless [C-NDL] and the endopelvic free anchorage) with the standard midurethral transobturator tension-free vaginal tape (TVT-O) procedure. METHODS: A double blind randomized controlled study was conducted at Ain Shams University Maternity Hospital from August 2014 until July 2015. A total of 209 patients were randomized into three groups. The first group underwent the TVT-O procedure, the second group underwent the endopelvic free anchorage procedure and the third group underwent the C-NDL procedure...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
Erin A Brennand, Selphee Tang, Colin Birch, Magnus Murphy, Sue Ross, Magali Robert
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the impact of preoperative body mass index ≥30 on objective and subjective cure rates 5 years after midurethral sling surgery. METHODS: Secondary analysis of the 5-year results of a randomized clinical trial evaluating tension-free vaginal tape vs transobturator tape surgery. Women (n = 176) were classified as obese or non-obese based on preoperative height and weight. Women self-reported symptoms and quality of life, and underwent standardized physical examinations and pad-testing...
September 29, 2016: International Urogynecology Journal
Laura Didomizio, Hisham Khalil, Dante Pascali
BACKGROUND: Midurethral slings are the most widely used surgical treatment for stress urinary incontinence. Complications include bladder injury, voiding dysfunction, mesh exposure/erosion, dyspareunia, and failure to correct the incontinence. Complete mesh infection is rare. CASE: A 48-year-old woman underwent a repeat retropubic tension-free vaginal tape (TVT) procedure for stress urinary incontinence. She presented eight weeks postoperatively with a tender suprapubic mass and urinary retention...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Tsia-Shu Lo, Nagashu Shailaja, Wu-Chiao Hsieh, Ma Clarissa Uy-Patrimonio, Faridah Mohd Yusoff, Rami Ibrahim
INTRODUCTION AND HYPOTHESIS: The objective of this study was to identify the predictors of postoperative voiding dysfunction in women following extensive vaginal pelvic reconstructive surgery. METHODS: We enrolled 1,425 women who had pelvic organ prolapse of POP-Q stage III or IV and had undergone vaginal pelvic reconstructive surgery with or without transvaginal mesh insertion from January 2006 to December 2014. All subjects were required to complete a 72-h voiding diary, and the IIQ-7, UDI-6, POPDI-6 and PISQ-12 questionnaires...
September 19, 2016: International Urogynecology Journal
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...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
Dani Zoorob, Mickey Karram, Anna Stecher, Rose Maxwell, James Whiteside
OBJECTIVES: To identify litigation predictors among women with complications of transvaginal mesh. METHODS: Chart review and patient survey were conducted among women who had undergone a complication-related explant of a transvaginal prolapse or incontinence sling mesh. Trained study personnel administered a 57-question survey addressing subjective complaints related to bowel, bladder, sexual dysfunction, and development of pain or recurrent prolapse. These data were analyzed with respect to the subject's reported pursuit of litigation related to the mesh complication...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
Louise-Helene Gagnon, Selphee Tang, Erin Brennand
INTRODUCTION AND HYPOTHESIS: The primary objective of this study was to determine significant predictors of length of stay (LOS) beyond the first postoperative day after urogynecological surgery. METHODS: A single-center retrospective cohort study was conducted in 2015. Our study population included women who underwent inpatient pelvic reconstructive surgery. The primary outcome was LOS beyond the first postoperative day. A logistic regression analysis explored the relationship between 11 selected predictor variables [age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, distance from home to hospital, length of surgery, anesthesia during surgery, route of surgical approach, trial of void recordings, choice of bladder protocol, presence of concomitant sling, surgeon], and LOS...
September 8, 2016: International Urogynecology Journal
Tolgay Tuyan Ilhan, Akin Sivaslioglu, Türkan Ilhan, Mustafa Gazi Uçar, İsmail Dolen
INTRODUCTION: Vaginal vault prolapsus is a challenging problem for the patients and physicians. There may be differences between young and elderly patients in terms of efficiency and safety of surgical procedures. AIM: The aim of our study was to compare the efficiency of the Posterior Intravaginal Sling (PIVS) procedure in older versus younger patient groups. MATERIALS AND METHODS: A total of 40 patients who underwent the PIVS procedure were chosen...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Ajit Sawant, Gaurav Vinod Kasat, Vikash Kumar, Prakash Pawar, Ashwin Tamhankar, Sumit Bansal, Lomesh Kapadnis, Abhishek Savalia
INTRODUCTION: Female urethral injury is a rare disease. Causes of urethral injuries are prolonged obstructed labour, gynaecological surgeries like vaginoplasty and post traumatic urethral injuries. The present study was conducted to evaluate outcome of female urethral reconstruction using tubularized anterior vaginal wall flap covered with fibroadipose martius flap and autologous fascia sling in patients with urethral loss. AIM: Aim of study was to evaluate outcome of reconstruction of female urethra with tubularized anterior vaginal flap...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Audra Jolyn Hill, Karl Jallad, Mark D Walters
STUDY OBJECTIVE: To describe a technique for performing laparoscopic Burch colposuspension using a 3-trocar system. DESIGN: This educational video provides step-by-step instructions for performing a laparoscopic Burch colposuspension. SETTING: Midurethral slings are an effective surgical treatment for women with stress urinary incontinence, but not all patients are candidates for, or desire, vaginal mesh. For stress incontinence, non-mesh surgical procedures include pubovaginal fascial slings and retropubic Burch colposuspenion...
August 20, 2016: Journal of Minimally Invasive Gynecology
Sonè van der Walt, Frans J van Wijk, Zeelha Abdool, Anna C Oettlé
INTRODUCTION AND HYPOTHESIS: To avoid injury to the perineal branches of the pudendal nerve during urinary incontinence sling procedures, a thorough knowledge of the course of these nerve branches is essential. The dorsal nerve of the clitoris (DNC) may be at risk when performing the retropubic (tension-free vaginal tape) procedure as well as the inside-out and outside-in transobturator tape procedures. The purpose of this study was to identify the anatomical relationships of the DNC to the tapes placed during the procedures mentioned and to determine the influence of body variations...
August 22, 2016: International Urogynecology Journal
Marisa M Clifton, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Complications of synthetic midurethral sling surgery include bladder outlet obstruction, mesh extrusion, and vaginal pain. A treatment of these complications is transvaginal mesh removal. The objectives of this video are to present cases of complications after sling placement and describe techniques to help with successful sling removal. METHODS: Three patients are presented in this video. One experienced urinary hesitancy and was found to have bladder outlet obstruction on urodynamic study...
August 16, 2016: International Urogynecology Journal
Marisa M Clifton, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: In the developed world, urethrovaginal fistulas are most the likely the result of iatrogenic injury. These fistulas are quite rare. Proper surgical repair requires careful dissection and tension-free closure. The objective of this video is to demonstrate the identification and surgical correction of an urethrovaginal fistula. METHODS: The case presented is of a 59-year-old woman with a history of pelvic organ prolapse and symptomatic stress urinary incontinence who underwent vaginal hysterectomy, anterior colporrhaphy, posterior colporrhaphy, and synthetic sling placement...
August 15, 2016: International Urogynecology Journal
Javier Pizarro-Berdichevsky, Michelle P Goldman, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Urethral perforations after synthetic midurethral sling (MUS) placement are uncommon. Transvaginal removal is an option. The objective of this English and Spanish video is to demonstrate removal of an MUS that had perforated the urethra and the concomitant urethral reconstruction. METHODS: A 66-year-old woman with a history of an anterior and posterior colporrhaphy and a retropubic MUS 12 years earlier presented with difficulty voiding, recurrent urinary tract infections, and mild stress incontinence (SUI)...
August 15, 2016: International Urogynecology Journal
Lisa H Jambusaria, Jessica Heft, W Stuart Reynolds, Roger Dmochowski, Daniel H Biller
BACKGROUND: Midurethral slings have become the preferred surgical treatment for stress urinary incontinence. Midline transection of midurethral sling for dysfunctional voiding is an effective treatment and also has a low rate of recurrent stress incontinence. Recurrent stress incontinence after sling revision for pain and mesh exposure has not been well defined. It is therefore difficult to counsel patients on risk of recurrent stress incontinence when sling revision is performed for pain or mesh exposure...
July 20, 2016: American Journal of Obstetrics and Gynecology
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