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https://www.readbyqxmd.com/read/28616118/stress-urinary-incontinence-in-women-current-and-emerging-therapeutic-options
#1
REVIEW
Samer Shamout, Lysanne Campeau
Surgical management of stress urinary incontinence (SUI) is most commonly achieved by midurethral synthetic sling (MUS) insertion as a first-line surgical option. A great deal of research continues to evolve new management strategies to reach an optimal balance of high efficacy and minimal adverse events. This expert opinion review provides a brief and comprehensive discussion of recent advances and ongoing research in the management of SUI, with an emphasis on single-incision mini-slings, vaginal laser treatment, and cell-based therapy...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28616116/the-pubovaginal-sling-reintroducing-an-old-friend
#2
REVIEW
Gregory G Bailly, Kevin V Carlson
The surgical management of female stress urinary incontinence (SUI) has evolved over the past century, using various techniques of retropubic colposuspensions and sling procedures. In the past two decades, the sling has become the mainstay of surgical treatment of SUI, with the synthetic midurethral sling (MUS) leading the way. With the recent concerns raised by the U.S. Food and Drug Administration (FDA) and Health Canada about the safety of vaginal surgery using mesh implants, including the MUS, urologists and gynecologists should be familiar with suitable alternatives, including the pubovaginal sling (PVS), which often incorporates autologous fascia...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28578172/major-postoperative-complications-following-surgical-procedures-for-pelvic-organ-prolapse-a-secondary-database-analysis-of-the-acs-nsqip
#3
Elisabeth Erekson, Regan L Murchison, Kristen A Gerjevic, Vivienne T Meljen, Kris Strohbehn
BACKGROUND: Surgical approaches to the correction of pelvic organ prolapse include abdominal, vaginal and obliterative approaches. These approaches require vastly different anatomical dissections, surgical techniques and operative times and are often selected by the patient and surgeon to match preoperative multi-morbidity and ability of the patient to tolerate the stress of surgery. OBJECTIVE: To describe the occurrence of postoperative complications occurring after three different surgical approaches to treat pelvic organ prolapse: vaginal, abdominal and obliterative...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28479203/updated-systematic-review-and-meta-analysis-of-the-comparative-data-on-colposuspensions-pubovaginal-slings-and-midurethral-tapes-in-the-surgical-treatment-of-female-stress-urinary-incontinence
#4
REVIEW
Ferdinando Fusco, Mohamed Abdel-Fattah, Christopher R Chapple, Massimiliano Creta, Sabrina La Falce, David Waltregny, Giacomo Novara
CONTEXT: Retropubic (RP-TVT) and transobturator miurethral (TO-TVT) midurethral sling (MUS) are popular surgical treatments for female stress urinary incontinence. The long-term efficacy and safety of the procedures is still a topic of intense clinical research and several randomised controlled trials (RCTs) have been published in the last years OBJECTIVE: To evaluate the efficacy and safety of MUS compared with other surgical treatments for female stress urinary incontinence. EVIDENCE ACQUISITION: A systematic review and meta-analysis of the literature was performed using the Medline, Scopus, and Web of Science databases to update our previously published analyses...
May 4, 2017: European Urology
https://www.readbyqxmd.com/read/28476681/the-risk-of-recurrent-urinary-incontinence-requiring-surgery-after-suburethral-sling-removal-for-mesh-complications
#5
P Ramart, A L Ackerman, S Cohen, J H Kim, S Raz
OBJECTIVES: We sought to examine the risk of recurrent stress urinary incontinence (SUI) after suburethral sling mesh removal or excision. METHODS: We conducted a retrospective cohort study of patients who were continent before removal or excision of synthetic mid-urethral slings; this cohort of 278 subjects was much larger than seen in previous such studies. Patients with preoperative incontinence, additional vaginal mesh placements, prior mesh revision/excision, existing SUI, and prior pelvic radiation or fistula were excluded...
May 2, 2017: Urology
https://www.readbyqxmd.com/read/28470366/technique-of-the-transobturator-puborectal-sling-in-fecal-incontinence
#6
C Brochard, M Queralto, P Cabarrot, L Siproudhis, G Portier
BACKGROUND: The puborectoplasty in fecal incontinence (FI) has been described through retropubic approach. Here, we describe a puborectal sling placement through transobturator approach with a device used for vaginal vault prolapse and report long-term outcome at 5 years. METHODS: Six women with FI for whom usual treatments (including sacral nerve stimulation) have failed were enrolled in a pilot study. Cleveland Clinic Incontinence Score (CCIS) and FI quality of life (FIQL) were used to evaluate results...
May 3, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28453958/the-novel-technique-of-post-hysterectomy-vaginal-vault-prolapse-repair-apical-sling-and-neocervix-formation
#7
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/28394497/prediction-of-mid-urethral-sling-failure-with-clinical-findings-and-urodynamics
#8
Serdar Aydin, Çağrı Arioğlu Aydin, Fırat Ersan
OBJECTIVE: Mid-urethral slings (MUS) become a standard, minimally invasive surgery to treat urinary stress incontinence. Our aim is to investigate the contribution of preoperative urodynamics to mid-urethral slings success and determine predictors for choosing mid-urethral sling route. METHODS: Women with stress urinary incontinence and who desired surgical correction of their incontinence were included in the study. The selection of the procedure was according to an algorithm used in an institution...
May 2017: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/28370305/teaching-mid-urethral-sling-surgery-to-residents-impact-on-operative-time-and-postoperative-outcomes
#9
Ali-Reza Sharif-Afshar, Lauren N Wood, Catherine Bresee, Colby P Souders, Bruno S Gross, Eugene Shkolyar, Jennifer T Anger, Karyn S Eilber
AIMS: The purpose of this study was to determine the impact of resident teaching on outcomes of mid-urethral sling surgery. METHODS: A retrospective review of female patients who underwent an outpatient transobturator (TOT) synthetic mid-urethral sling procedure with and without concomitant prolapse repair by two surgeons (JA, KE) in a tertiary female pelvic medicine practice was performed. Total procedure time (TPT = time from incision to closure including sling placement and any prolapse procedure), estimated blood loss (EBL), and postoperative complications including urinary retention, mesh exposure, reoperation, vaginal bleeding, and leg pain were compared between cases with and without the presence of a resident...
March 31, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28363810/a-meta-analysis-detailing-overall-sexual-function-and-orgasmic-function-in-women-undergoing-midurethral-sling-surgery-for-stress-incontinence
#10
REVIEW
Nicole Szell, Barry Komisaruk, Sue W Goldstein, Xianggui Harvey Qu, Michael Shaw, Irwin Goldstein
INTRODUCTION: More than 200,000 midurethral slings are placed yearly for stress urinary incontinence. Approximately 14% to 20% of women experience worsening sexual function overall after these procedures. We postulated that sling placement injures neural pathways regulating "female prostate" tissue within the anterior vaginal wall. AIM: To perform a meta-analysis for overall sexual function and orgasm using validated questionnaires for transvaginal tape, transobturator tape, and their variants...
June 2017: Sexual Medicine
https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#11
REVIEW
Gunhilde M Buchsbaum, Toy Gee Lee
Importance: Pelvic organ prolapse is a common condition, the prevalence of which is likely to increase with the aging of our population. Also changing are parameters by which outcomes are assessed, shifting toward patient-centered care. Objective: To review vaginal obliterative procedures for surgical treatment of advanced pelvic organ prolapse historically and to discuss evidence on indications for colpocleisis, outcomes, and complications, as well as review pros and cons for concomitant vaginal hysterectomy and anti-incontinence procedures...
March 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28299781/architectural-differences-in-the-anterior-and-middle-compartments-of-the-pelvic-floor-of-young-adult-and-postmenopausal-females
#12
Yi Wu, Noshir F Dabhoiwala, Jaco Hagoort, Li-Wen Tan, Shao-Xiang Zhang, Wouter H Lamers
The pelvic floor guards the passage of the pelvic organs to the exterior. The near-epidemic prevalence of incontinence in women continues to generate interest in the functional anatomy of the pelvic floor. However, due to its complex architecture and poor accessibility, the classical 'dissectional' approach has been unable to come up with a satisfactory description, so that many aspects of its anatomy continue to raise debate. For this reason, we opted for a 'sectional' approach, using the Chinese Visible Human project (four females, 21-35 years) and the Visible Human Project (USA; one female, 59 years) datasets to investigate age-related changes in the architecture of the anterior and middle compartments of the pelvic floor...
March 16, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28277472/transvaginal-repair-of-complex-rectovaginal-fistulas-using-the-porcine-urinary-bladder-matrix-as-an-augmenting-graft
#13
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: After the US Food and Drug Administration issued a safety warning concerning vaginal mesh implants in 2008, their use in correction of pelvic floor defects have decreased in the United States (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm479732.htm). However, we are still treating patients who have had complications associated with their use, rectovaginal fistulas (RVFs) being one of them. Rectovaginal fistulas are considered complex if greater than 2.5 cm, recurrent, associated with inflammatory bowel disease, or if they are proximal in location...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28266818/update-on-complications-of-synthetic-suburethral-slings
#14
Cristiano Mendes Gomes, Fabrício Leite Carvalho, Carlos Henrique Suzuki Bellucci, Thiago Souto Hemerly, Fábio Baracat, Jose de Bessa, Miguel Srougi, Homero Bruschini
Synthetic suburethral slings have become the most widely used technique for the surgical treatment of stress urinary incontinence. Despite its high success rates, significant complications have been reported including bleeding, urethral or bladder injury, urethral or bladder mesh erosion, intestinal perforation, vaginal extrusion of mesh, urinary tract infection, pain, urinary urgency and bladder outlet obstruction. Recent warnings from important regulatory agencies worldwide concerning safety issues of the use of mesh for urogynecological reconstruction have had a strong impact on patients as well as surgeons and manufacturers...
March 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28247724/-surgical-treatment-of-stress-urinary-incontinence
#15
N A Kravtsova, T G Melkoniants, M Yu Gvozdev, V A Krutova
OBJECTIVE: Urinary stress incontinence considerably decreases the life quality of women, which makes search for effective methods of treatment essential. The research presents results of surgical treatment of 230 patients with stress urinary incontinence between 2011 and 2014. MATERIALS AND METHODS: Efficiency of treatment of urinary incontinence in women, using Tension-free Vaginal Tape (TVT-O) and mini-sling Ophira was presented. The evaluation was made out of complaints and physical examination in target groups, including patients with concurrent genital prolapse and mixed urinary incontinence...
August 2016: Urologii︠a︡
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/28213795/thigh-exploration-for-excision-of-a-transobturator-sling
#17
Alana M Murphy, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Groin pain is a known complication of transobturator mesh placement. The objective of this instructional video is to present the surgical technique used to excise the thigh portion of a sling in a patient with persistent thigh pain after placement of a transobturator sling. METHODS: The featured patient is a 49-year-old woman with a history of bilateral groin pain since undergoing placement of a type one polypropylene transobturator sling...
February 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28192735/risk-factors-for-postoperative-urinary-tract-infection-following-midurethral-sling-procedures
#18
Melike Doganay, Sabri Cavkaytar, Mahmut Kuntay Kokanali, Irfan Ozer, Orhan Seyfi Aksakal, Salim Erkaya
OBJECTIVE: To identify the potential risk factors for urinary tract infections following midurethral sling procedures. STUDY DESIGN: 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4-8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection...
April 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28039517/solvent-dehydrated-dermal-allograft-axis%C3%A2-augmented-cystocele-repair-longitudinal-results
#19
Saad Juma, Omer A Raheem
INTRODUCTION AND HYPOTHESIS: Surgical repair options for pelvic organ prolapse (POP) include native tissue, allograft, xenograft, and synthetic grafts. Solvent-dehydrated dermal allograft (SDDG) has an improved safety profile. We evaluated the long-term safety and efficacy of SDDG use for cystocele repair. METHODS: A total of 184 patients completed a minimum follow-up of 12 months. Incontinence Impact Questionnaire (IIQ), Urogenital Distress Inventory (UDI), and Visual Analogue Scale (VAS) were used pre and post operatively...
December 30, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/28034649/is-vaginal-mesh-a-stimulus-of-autoimmune-disease
#20
Bilal Chughtai, Art Sedrakyan, Jialin Mao, Karyn S Eilber, Jennifer T Anger, J Quentin Clemens
BACKGROUND: Polypropylene mesh has been used as a means of reinforcing weak tissues in women with pelvic organ prolapse and stress urinary incontinence. OBJECTIVE: We sought to investigate a potential link between the development of systemic/autoimmune disorders and synthetic polypropylene mesh repairs. STUDY DESIGN: New York State Department of Health Statewide Planning and Research Cooperative System data were utilized to conduct this retrospective cohort study...
May 2017: American Journal of Obstetrics and Gynecology
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