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Pelvic prolapse

Sybil G Dessie, Alex Shapiro, Miriam J Haviland, Michele R Hacker, Eman A Elkadry
OBJECTIVES: This study aimed to evaluate outcomes among women 70 years and older who underwent obliterative compared with reconstructive procedures for pelvic organ prolapse. METHODS: This was a retrospective cohort study of patients 70 years and older who underwent surgical prolapse repair at our institution from January 2004 through June 2010. Only patients with at least 4 weeks of follow-up were included. Patient characteristics and relevant pre, intra, and postoperative information were abstracted from medical records...
October 25, 2016: Female Pelvic Medicine & Reconstructive Surgery
Victoria L Handa, Alvaro Muňoz, Joan L Blomquist
BACKGROUND: Posterior vaginal prolapse is thought to cause difficult defecation and splinting for bowel movements. However, the temporal relationship between difficult defecation and prolapse is unknown. Does posterior vaginal prolapse lead to the development of defecation symptoms? Conversely, does difficult defecation lead to posterior prolapse? This prospective longitudinal study offered an opportunity to study these unanswered questions. OBJECTIVE: We sought to investigate: (1) Are symptoms of difficult defecation more likely to develop (and less likely to resolve) among women with posterior vaginal prolapse? (2) Is posterior vaginal prolapse more likely to develop among women who complain of difficult defecation? STUDY DESIGN: In this longitudinal study, parous women were assessed annually for defecatory symptoms (Epidemiology of Prolapse and Incontinence Questionnaire) and pelvic organ support (POP-Q examination)...
October 22, 2016: American Journal of Obstetrics and Gynecology
John R Miklos, Orawee Chinthakanan, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
STUDY OBJECTIVE: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. DESIGN: This was a retrospective study...
October 26, 2016: Surgical Technology International
Ting-Ting Cao, Xiu-Li Sun, Shi-Yan Wang, Xin Yang, Jian-Liu Wang
BACKGROUND: Pelvic organ prolapse (POP) is a major health concern that affects women. Surgeons have increasingly used prosthetic meshes to correct POP. However, the most common used is synthetic mesh, and absorbable mesh is less reported. This research aimed to evaluate the clinical effectiveness of porcine small intestinal submucosa (SIS). METHODS: Consecutive forty POP patients who met the inclusion criteria underwent pelvic reconstruction surgery with SIS between March 2012 and December 2013...
2016: Chinese Medical Journal
Mohamed Youssef, Sameh Hany Emile, Waleed Thabet, Hossam Ayman Elfeki, Alaa Magdy, Waleed Omar, Wael Khafagy, Mohamed Farid
BACKGROUND AND AIM: Two types of rectocele exist; type I is characterized by relatively high resting anal pressures, whereas type II has lower resting anal pressures with associated pelvic organ prolapse. We compared trans-perineal repair (TPR) of rectocele with or without limited internal sphincterotomy (LIS) in the treatment of type I anterior rectocele. PATIENTS AND INTERVENTIONS: Consecutive patients with anterior rectocele were evaluated for inclusion. Sixty-two female patients with type I anterior rectocele were randomized and equally allocated to receive TPR alone (group I) or TPR with LIS (group II)...
October 24, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
L Le Normand, M Cosson, F Cour, X Deffieux, L Donon, P Ferry, B Fatton, J-F Hermieu, H Marret, G Meurette, A Cortesse, L Wagner, X Fritel
OBJECTIVE: Develop guidelines for surgery for primary pelvic organ prolapse (POP). METHODS: Literature review, establishment of levels of evidence, external review, and grading of recommendations by 5 French academic societies: Association Française d'Urologie, Collège National des Gynécologues et Obstétriciens Français, Société Interdisciplinaire d'Urodynamique et de Pelvi-Périnéologie, Société Nationale Française de Colo-proctologie, and Société de Chirurgie Gynécologique et Pelvienne...
October 21, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Elizabeth J Geller, Emma Babb, Andrea G Nackley, Denniz Zolnoun
STUDY OBJECTIVE: Our aim was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation. DESIGN: This is a retrospective study of women with no baseline pelvic pain who underwent surgery with mesh implant for the treatment of prolapse and/or incontinence at least one year prior to study period. DESIGN: Classification: Canadian Task Force Level II-2 SETTING: Single university hospital PATIENTS: Women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor disorders including prolapse and incontinence INTERVENTIONS: Telephone interviews to assess pain, sexual function and general health...
October 20, 2016: Journal of Minimally Invasive Gynecology
Debjyoti Karmakar, Peter L Dwyer
INTRODUCTION AND BACKGROUND: Vaginal surgery for the treatment of urinary stress incontinence (USI) and pelvic organ prolapse (POP) using a synthetic polypropylene mesh is going through a time of unprecedented turmoil and debate. This review focuses on vaginal surgery for vaginal prolapse and looks at the current scientific literature on issues surrounding surgery including consent and expectations. SAFETY AND EFFECTIVENESS OF SURGICAL OPTIONS: Synthetic mesh has been used both abdominally and vaginally to improve the effectiveness of POP surgery...
December 2016: Current Urology Reports
Kelsey L Shnaekel, Michael P Wendel, Nader Z Rabie, Everett F Magann
Objective: The aim of this review was to describe the risk factors, clinical and radiographic criteria, and management of this rare complication of pregnancy. Methods: A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched. Results: There were 60 articles identified, with 53 articles being the basis of this review. Multiple risk factors have been suggested in the literature including retroverted uterus in the first trimester, deep sacral concavity with an overlying sacral promontory, endometriosis, previous abdominal or pelvic surgery, pelvic or uterine adhesions, ovarian cysts, leiomyomas, multifetal gestation, uterine anomalies, uterine prolapse, and uterine incarceration in a prior pregnancy...
October 2016: Obstetrical & Gynecological Survey
Robert Moore, Christopher Moriarty, Orawee Chinthakanan, John Miklos
INTRODUCTION AND HYPOTHESIS: There has been a trend toward robotic sacrocolpopexy in the United States despite longer operating times and higher costs compared with traditional laparoscopy. The current study objective was to evaluate incision to closure times of laparoscopic sacrocolpopexy in a urogynecologic practice with extensive experience in the laparoscopic approach for pelvic reconstruction. METHODS: We conducted a single-center retrospective evaluation of consecutive patients undergoing laparoscopic sacrocolpopexy for vaginal vault prolapse using a permanent polypropylene Y-mesh over a 1-year period...
October 20, 2016: International Urogynecology Journal
Casey L Kinman, Courtney A Lemieux, Anubhav Agrawal, Jeremy T Gaskins, Kate V Meriwether, Sean L Francis
INTRODUCTION AND HYPOTHESIS: A variety of factors affect the amount of bother experienced by different women with equivalent pelvic organ prolapse (POP). The goal of this study was to describe the relationship between age and bother experienced from objectively equivalent stages of POP. METHODS: Records of all patients presenting to a pelvic floor subspecialty clinic between January 2014 and March 2015 were reviewed. Women with POP stage ≥ 2 were included...
October 20, 2016: International Urogynecology Journal
R M Islam, R J Bell, B Billah, M B Hossain, S R Davis
OBJECTIVE: To investigate the prevalence of, and risk factors for, pelvic floor disorders (PFDs) in women in Bangladesh. METHODS: A nationally representative sample of 1590 Bangladeshi women, aged 30-59 years, was recruited using a multistage cluster sampling technique, between September 2013 and March 2014. Urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) were assessed using validated questionnaires. The weighted prevalence and the factors associated with each PFD were investigated using multivariable weighted logistic regression...
October 20, 2016: Climacteric: the Journal of the International Menopause Society
Xianghua Liang, Lili Zhang, Yanwei Lv
AIM: A complete and non-splice porcine small-intestine submucosa (SIS) patch was used for total pelvic anatomical repair of organ prolapse. METHODS: This study included a total of 17 patients with severe total pelvic organ prolapse, including five patients with combined stress urinary incontinence (SUI). Panhysterectomy was performed, and then a porcine SIS patch was placed on the anterior (posterior) vaginal wall. The top of the vaginal wall was moved to the corresponding side of the vaginal wall, and the patch was sutured to bilateral uterosacral ligaments, the sacrospinous ligament, and arcus tendineus fasciae pelvis...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
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...
October 18, 2016: Advances in Therapy
Shi Lu, Hong-Ling Zhang, Ya-Jun Zhang, Qing-Chun Shao
This study investigated the prevalence and risk factors of urinary incontinence (UI) among perimenopausal women in Wuhan. A cross-sectional survey was performed on 1067 women aged 40-65 years sampled in Wuhan urban area from April to October 2014. Information about demographic characteristics, menstruation, parity and UI symptoms was collected using a questionnaire. The data were evaluated by Chi-square test and multiple Logistic regression analysis. The prevalence rate of UI was 37.2%, with stress UI (32.2%) being more prevalent than urgency UI (21...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
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
Rune Lykke, Jan Blaakær, Bent Ottesen, Helga Gimbel
INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the incidence of subsequent pelvic organ prolapse (POP) repair in women following radical hysterectomy versus total abdominal hysterectomy. METHODS: From the Danish National Patient Registry, we collected data on all radical hysterectomies, all total abdominal hysterectomies, and all POP operations performed in Denmark from 1 January 1977 to 31 December 2009. We excluded patients with prior POP repair, POP diagnosis, or concomitant POP repair at hysterectomy...
October 17, 2016: International Urogynecology Journal
Marian Wiegersma, Chantal M C R Panman, Marjolein Y Berger, Henrica C W De Vet, Boudewijn J Kollen, Janny H Dekker
BACKGROUND: The Pelvic Floor Distress Inventory-20 is used to evaluate symptoms and treatment effects in women with pelvic floor disorders. To interpret changes in the scores of this inventory, information is needed on what patients and clinicians perceive as the minimal important (meaningful) change. Although this change in the inventory score has previously been investigated in women undergoing pelvic floor surgery, the results could not be generalized to women with milder symptoms (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
S Vigoureux, A Perreaud, G Legendre, D Salet-Lizée, R Villet
OBJECTIVES: For the treatment of prolapse, the vaginal route is less standardized than laparoscopy and seems abandoned by younger doctors. Our objectives were to evaluate the surgical experience of resident and youth gynecology and obstetrics assistants in pelviperineology and the level of confidence and mastery of the different surgical treatment of pelvic. METHODS: An anonymous questionnaire sent via an Internet platform interviewing residents and young assistants of gynecology and obstetrics (promotion 2005 to 2010) in France on their surgical training in pelviperineology...
October 14, 2016: Gynécologie, Obstétrique & Fertilité
Fei-Chi Chuang, Li-Ching Chu, Fu-Tsai Kung, Kuan-Hui Huang
OBJECTIVE: To validate the traditional Chinese translated version of the prolapse quality of life questionnaire (P-QOL). MATERIALS AND METHODS: The P-QOL questionnaire was translated into traditional Chinese characters and administered to women recruited from gynecologic outpatient clinics of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. After the test-retest reliability and internal consistency were established in a pilot study, all participants completed the P-QOL questionnaire and were examined in the lithotomy position using the Pelvic Organ Prolapse Quantification System (POP-Q)...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
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