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Pelvic sling

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https://www.readbyqxmd.com/read/28616115/management-of-patients-with-stress-urinary-incontinence-after-failed-midurethral-sling
#1
REVIEW
Alex Kavanagh, May Sanaee, Kevin V Carlson, Gregory G Bailly
Surgical failure rates after midurethral sling (MUS) procedures are variable and range from approximately 8-57% at five years of followup. The disparity in long-term failure rates is explained by a lack of long-term followup and lack of a clear definition of what constitutes failure. A recent Cochrane review illustrates that no high-quality data exists to recommend or refute any of the different management strategies for recurrent or persistent stress urinary incontinence (SUI) after failed MUS surgery. Clinical evaluation requires a complete history, physical examination, and establishment of patient goals...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28616104/medicolegal-basics-and-update-on-transvaginal-mesh-in-canada
#2
REVIEW
Brock Hengel, Blayne Welk, Richard J Baverstock
In recent years, midurethral slings (MUS) and transvaginal mesh procedures have experienced blazing growth and popularity. However, the US Food and Drug Administration (FDA) and Health Canada regulatory advisories threw water on that fire and created a confusing environment surrounding their continued usage. MUS usage has continued in Canada and transvaginal mesh kits for pelvic organ prolapse have become a rarity. Several large organizations (the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction [SUFU], the American Urogynecologic Society [AUGS], and the Canadian Urological Association [CUA]) have developed "mesh statements" to clarify the issues surrounding mesh for patients and medical professionals; however, often the legal system sees things differently in either individual cases or class action lawsuits...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28616103/canadian-urological-association-position-statement-on-the-use-of-transvaginal-mesh
#3
REVIEW
Blayne Welk, Kevin V Carlson, Richard J Baverstock, Stephen S Steele, Gregory G Bailly, Duane R Hickling
Stress incontinence (SUI) and pelvic organ prolapse (POP) are common conditions. There is high-level evidence that midurethral mesh slings for stress incontinence are effective and safe; however, the rare but serious potential risks of this surgery must be discussed with the patient. The use of transvaginal mesh for prolapse repair does not appear to be supported by the current evidence, and its use should be restricted to specialized pelvic floor surgeons and specific clinical situations.
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28589063/teaching-the-retropubic-midurethral-sling-using-a-novel-cadaver-and-model-based-approach
#4
Sallie Oliphant, Eliza Beth Littleton, Gabriella Gosman, Gary Sutkin
OBJECTIVE: To measure the impact of a model-based teaching program on resident comfort and skill with retropubic midurethral sling (MUS). STUDY DESIGN: Residents were assessed before and after a retropubic MUS teaching session, which included a brief lecture and three interactive teaching stations (cadaver pelvis, retropubic MUS pelvic model, cystoscopy model). Self-assessment measures included MUS-related visual analog scale (VAS), Likert, and open-ended questions...
May 2, 2017: Curēus
https://www.readbyqxmd.com/read/28578172/major-postoperative-complications-following-surgical-procedures-for-pelvic-organ-prolapse-a-secondary-database-analysis-of-the-acs-nsqip
#5
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/28575903/do-mixed-flora-preoperative-urine-cultures-matter
#6
Michael R Polin, Amie Kawasaki, Cindy L Amundsen, Alison C Weidner, Nazema Y Siddiqui
OBJECTIVES: To determine whether mixed-flora preoperative urine cultures, as compared with no-growth preoperative urine cultures, are associated with a higher prevalence of postoperative urinary tract infections (UTIs). METHODS: This was a retrospective cohort study. Women who underwent urogynecologic surgery were included if their preoperative clean-catch urine culture result was mixed flora or no growth. Women were excluded if they received postoperative antibiotics for reasons other than treatment of a UTI...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28547273/case-distribution-and-complications-of-mid-urethral-sling-surgery-in-a-canadian-city-before-and-after-the-health-canada-advisory-on-pelvic-floor-mesh
#7
Kevin Carlson, Richard Baverstock, Andrea Civitarese, R Trafford Crump
INTRODUCTION AND HYPOTHESIS: Increased incidences of complications related to the use of mid-urethral slings (MUS) for the treatment of stress urinary incontinence resulted in both the Food and Drug Administration (FDA) and Health Canada issuing advisories in 2008 and 2010 respectively. The purpose of this study was to assess the effect these advisories had on the number of surgeons performing MUS surgery and post-surgical complications in Calgary, Canada. METHODS: In this study, we conducted a retrospective analysis of administrative data between 2006 and 2011...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28503532/changes-in-gait-kinematics-and-muscle-activity-in-stroke-patients-wearing-various-arm-slings
#8
Young-In Hwang, Jangwhon Yoon
Stroke patients often use various arm slings, but the effects of different slings on the joint kinematics and muscle activity of the arm in the gait have not been investigated. The effects of joint kinematics and muscle activity in the gait were investigated to provide suggestions for gait training for stroke patients. In all, 10 chronic stroke patients were voluntarily recruited. An eight-camera three-dimensional motion analysis system was used to measure joint kinematics while walking; simultaneously, electromyography data were collected for the anterior and posterior deltoids and latissimus dorsi...
April 2017: Journal of Exercise Rehabilitation
https://www.readbyqxmd.com/read/28479238/challenging-the-myth-transvaginal-mesh-is-not-associated-with-carcinogenesis
#9
Bilal Chughtai, Art Sedrakyan, Jialin Mao, Dominique Thomas, Karyn S Eilber, J Quentin Clemens, Jennifer T Anger
PURPOSE: We sought to determine if there was a potential link between synthetic polypropylene mesh implantation for transvaginal pelvic organ prolapse (POP) and stress urinary incontinence (SUI) and carcinogenesis using statewide administrative data. MATERIALS AND METHODS: Adult women undergoing transvaginal surgery for POP or SUI) with mesh between January 2008 and December 2009 in New York State were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes and Current Procedural Terminology Coding System, Fourth Edition (CPT-4) codes...
May 4, 2017: Journal of Urology
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
#10
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
#11
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/28464426/structured-behavioral-treatment-research-protocol-for-women-with-mixed-urinary-incontinence-and-overactive-bladder-symptoms
#12
REVIEW
Diane K Newman, Diane Borello-France, Vivian W Sung
AIMS: The primary aim is to provide detailed rationale and methodology for the development and implementation of a perioperative behavioral/pelvic floor exercise research protocol for women who self-chose surgical intervention and who may or may not have been offered behavioral treatments initially. This protocol is part of the ESTEEM trial (Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence Trial) which was designed to determine the effect of a combined surgical and perioperative behavioral/pelvic floor exercise intervention versus surgery alone on improving mixed urinary incontinence (MUI) and overactive bladder (OAB) symptoms...
May 2, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28462429/on-the-stiffness-of-the-mesh-and-urethral-mobility-a-finite-element-analysis
#13
Sofia Brandão, Marco Parente, Thuane Huyer Da Roza, Elisabete Silva, Isabel Maria Ramos, Teresa Mascarenhas, Renato Manuel Natal Jorge
Midurethral slings are used to correct urethral hypermobility in female stress urinary incontinence, defined as the complaint of involuntary urine leakage when the intra-abdominal pressure is increased. Structural and thermal features influence their mechanical properties, which may explain postoperative complications, e.g., erosion, urethral obstruction. We studied the effect of the mesh stiffness on urethral mobility at Valsalva maneuver, under impairment of the supporting structures (levator ani and/or ligaments), by using a numerical model...
May 2, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28461989/is-overactive-bladder-in-the-female-surgically-curable-by-ligament-repair
#14
Bernhard Liedl, Hiromi Inoue, Yuki Sekiguchi, Max Haverfield, Peter Richardson, Alexander Yassourides, Florian Wagenlehner
INTRODUCTION: Overactive bladder (OAB) symptoms (urge, frequency, nocturia) are not generally considered surgically curable by learning institutions. The Integral Theory hypothesizes that OAB is a prematurely activated, but normal micturition reflex caused by loose suspensory ligaments and potentially curable surgically by repairing such ligaments. To test this hypothesis by surgical repair of loose cardinal and uterosacral ligaments in patients with 2(nd) degree or greater uterine/apical prolapse...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28413126/consensus-statement-of-the-european-urology-association-and-the-european-urogynaecological-association-on-the-use-of-implanted-materials-for-treating-pelvic-organ-prolapse-and-stress-urinary-incontinence
#15
REVIEW
Christopher R Chapple, Francisco Cruz, Xavier Deffieux, Alfredo L Milani, Salvador Arlandis, Walter Artibani, Ricarda M Bauer, Fiona Burkhard, Linda Cardozo, David Castro-Diaz, Jean Nicolas Cornu, Jan Deprest, Alfons Gunnemann, Maria Gyhagen, John Heesakkers, Heinz Koelbl, Sheila MacNeil, Gert Naumann, Jan-Paul W R Roovers, Stefano Salvatore, Karl-Dietrich Sievert, Tufan Tarcan, Frank Van der Aa, Francesco Montorsi, Manfred Wirth, Mohamed Abdel-Fattah
CONTEXT: Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae. Implantable materials have been adopted for the treatment of female and male stress urinary incontinence (SUI) and female pelvic organ prolapse (POP). OBJECTIVE: A consensus review of existing data based on published meta-analyses and reviews. EVIDENCE ACQUISITION: This document summarises the deliberations of a consensus group meeting convened by the European Association of Urology (EAU) and the European Urogynecological Association, to explore the current evidence relating to the use of polypropylene (PP) materials used for the treatment of SUI and POP, with reference to the 2016 EAU guidelines (European Association of Urology 2016), the European Commission's SCENIHR report on the use of surgical meshes (SCENIHR 2015), other available high-quality evidence, guidelines, and national recommendations...
April 13, 2017: European Urology
https://www.readbyqxmd.com/read/28394497/prediction-of-mid-urethral-sling-failure-with-clinical-findings-and-urodynamics
#16
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
#17
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/28356625/instantaneous-changes-in-respiratory-function-induced-by-passive-pelvic-suspension-in-the-supine-position-in-relation-to-increased-diaphragm-excursion
#18
Tatsuya Ishizuka, Naoya Nishida, Yuuki Homma, Tetsuro Hirayama, Yukisato Ishida, Fujiyasu Kakizaki, Masato Konishi
[Purpose] This study aimed to introduce an approach of pelvic suspension (PS) using sling cords and to obtain evidence for changes in respiratory function of healthy subjects. [Subjects and Methods] Subjects were 25 healthy men. In the supine position, with hip and knee joints flexed at 90°, the subjects' pelvises were suspended with sling belts. Diaphragm excursion, respiratory function, and respiratory comfort in these postures were measured using ultrasonography, respirometry, and visual analog scale (VAS), respectively...
March 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#19
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
#20
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
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