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Vaginal prolapse

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https://www.readbyqxmd.com/read/28431204/factors-that-affect-outcomes-of-prolapse-repair-using-single-incision-vaginal-mesh-procedures
#1
Hsiao-Yun Hsieh, Ching-Pei Tsai, Chih-Ku Liu, Pao-Sheng Shen, Yao-Ching Hung, Man-Jung Hung
AIMS: Single-incision vaginal mesh (SIVM) procedures for pelvic organ prolapse (POP) differed in mesh fabrication and implantation that may affect treatment outcomes. We aim to evaluate and compare the safety and effectiveness of two SIVM procedures, and explore factors that may have associations with surgical effectiveness. METHODS: Our data of using two SIVM procedures for a total (anterior and posterior) vaginal mesh repair were studied. Patients who had ≧stage 2 POP and underwent either Elevate (n = 85) using anchored, lightweight meshes or Prosima procedures (n = 95) using non-anchored, original meshes were assessed...
April 21, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28430726/vaginal-mesh-removal-outcomes-eight-years-of-experience-at-an-academic-hospital
#2
Olivia O Cardenas-Trowers, Pouran Malekzadeh, David E Nix, Kenneth D Hatch
OBJECTIVES: The purpose of this study is to describe the clinical history leading up to and the outcomes after vaginal mesh removal surgery at an academic hospital. METHODS: A retrospective case series of patients who underwent vaginal mesh removal from 2008 to 2015 was conducted. Demographics, clinical history, physical examination, pre- and postoperative symptoms, and number and type of reoperations were abstracted. RESULTS: Between February 2008 and November 2015, 83 patients underwent vaginal mesh removal surgery at our hospital...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28420505/risk-factors-and-management-of-vaginal-mesh-erosion-after-pelvic-organ-prolapse-surgery
#3
Yung-Wen Cheng, Tsung-Hsien Su, Hsuan Wang, Wen-Chu Huang, Hui-Hsuan Lau
OBJECTIVE: Mesh erosion is a serious and not uncommon complication in women undergoing vaginal mesh repair. We hypothesized that mesh erosion is associated with the patient's comorbidities, surgical procedures, and mesh material. The aims of this study were to identify the risk factors and optimal management for mesh erosion. MATERIALS AND METHODS: All women who underwent vaginal mesh repair from 2004 to 2014 were retrospectively reviewed. Data on patients' characteristics, presenting symptoms, treatment and outcomes were collected from their medical records...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28419911/safety-and-long-term-efficacy-of-fractional-co2-laser-treatment-in-women-suffering-from-genitourinary-syndrome-of-menopause
#4
Fariba Behnia-Willison, Sara Sarraf, Joseph Miller, Behrang Mohamadi, Alison S Care, Alan Lam, Nadia Willison, Leila Behnia, Stefano Salvatore
OBJECTIVES: To evaluate the safety and long-term efficacy of fractional CO2 laser treatment in reducing the severity of symptoms of genitourinary syndrome of menopause (GSM) in menopausal women. STUDY DESIGN: 102 women presenting with symptomatic GSM were treated with the fractional CO2 laser (MonaLisa Touch, DEKA) system across a series of treatments delivered at intervals of six or more weeks. The Australian Pelvic Floor Questionnaire was used to gather data on sexual function and side-effects at three time-points across the study period (prospective panel design study)...
April 2, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28413041/defining-cervical-elongation-a-prospective-observational-study
#5
Patrick A Nosti, Robert E Gutman, Cheryl B Iglesia, Amy J Park, Eshetu Tefera, Andrew I Sokol
OBJECTIVES: Our primary aim was to define cervical elongation (CE) using the following methods: (1) measurement of pathology specimen, (2) physician perception, (3) intraoperative estimate of anterior cervical length, and (4) office Pelvic Organ Prolapse Quantification (POP-Q) points C and D. Our secondary aim was to determine whether these definitions correlate with perioperative outcomes. METHODS: Women undergoing vaginal hysterectomy and prolapse repair were enrolled...
April 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28409269/short-term-outcomes-of-laparoscopic-ventral-rectopexy-for-obstructed-defecation-in-patients-with-overt-pelvic-structural-abnormalities-a-chinese-pilot-study
#6
G Y Ye, Z Wang, K E Matzel, Z Cui
AIM: As laparoscopic ventral rectopexy (LVR) gained increasing popularity in the past decade, studies from non-western area remain rare. The aim of this pilot study is to evaluate the efficacy and safety of LVR for obstructed defecation (OD) in Chinese patients with overt pelvic structural abnormalities. METHODS: A series of 19 consecutive patients is presented undergoing LVR for OD. All patients showed various forms of pelvic structural abnormalities which were verified by dynamic defecography exam...
April 13, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28407297/short-term-complications-associated-with-the-use-of-transvaginal-mesh-in-pelvic-floor-reconstructive-surgery-results-from-a-multi-institutional-prospectively-maintained-dataset
#7
Maxx Caveney, Devin Haddad, Catherine Matthews, Gopal Badlani, Majid Mirzazadeh
AIMS: Vaginal reconstructive surgery can be performed with or without mesh. We sought to determine comparative rates of perioperative complications of native tissue versus vaginal mesh repairs for pelvic organ prolapse. METHODS: Using the National Surgical Quality Improvement Program (NSQIP) database, we concatenated surgical data from vaginal procedures for prolapse repair, including anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and vaginal colpopexy using Current Procedural Terminology (CPT) coding...
April 13, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28405713/vaginal-vault-prolapse-in-a-patient-with-mayer-rokitansky-k%C3%A3-ster-hauser-syndrome-a-video-case-presentation
#8
Carolyn Botros, Shilpa Iyer, Alexis M Tran, Roger P Goldberg
INTRODUCTION AND HYPOTHESIS: Several reports have described vaginal prolapse in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients after creation of a neovagina. To our knowledge, no reports of primary vaginal prolapse of a blind pouch without previous intervention, or surgery for this condition, have been described. METHODS: In this case report, we describe a 19-year-old woman with MRKH and complete prolapse of her shortened vaginal pouch. Surgical correction utilizing permanent suture-based sacrospinous ligament fixation was performed...
April 12, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28399595/can-the-pessary-use-modify-the-vaginal-microbiological-flora-a-cross-sectional-study
#9
Suelene Costa de Albuquerque Coelho, Paulo César Giraldo, Juliana Oquendo Florentino, Edilson Benedito de Castro, Luiz Gustavo Oliveira Brito, Cássia Raquel Teatin Juliato
Introduction Vaginal pessary is used as a conservative treatment for pelvic organ prolapse (POP). Some studies have shown that common complaints of its use may include vaginal discomfort and increased vaginal discharge. Scant information is available about the microflora status after using this device. Objective To determine if the usage of vaginal pessary can interfere with the vaginal environment. Methods A cross-sectional study was performed from March of 2014 to July of 2015 including 90 women with POP...
April 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28398930/management-of-mesh-and-graft-complications-in-gynecologic-surgery
#10
(no author information available yet)
This document focuses on the management of complications related to mesh used to correct stress urinary incontinence or pelvic organ prolapse. Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections after mesh placement should prompt an examination and possible further evaluation for exposure or erosion. A careful history and physical examination is essential in the diagnosis of mesh and graft complications. A clear understanding of the location and extent of mesh placement, as well as the patient's symptoms and therapy goals, are necessary to plan treatment approaches...
April 10, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28398023/clinical-profile-of-women-with-vva-who-are-not-candidates-for-local-vaginal-oestrogen-therapy
#11
Rossella E Nappi, Filippo Murina, Giuseppina Perrone, Paola Villa, Nicoletta Biglia
Vulvar and vaginal atrophy (VVA) is a chronic medical condition in postmenopausal women, which is predominantly due to a permanent cessation of ovarian oestrogen production. Current available treatment options for VVA are over-the-counter (OTC) symptomatic relief products or local oestrogen therapy (LET) aiming to treat this underlying atrophic condition. Recent surveys indicated that these products decrease sexual spontaneity, are messy and indiscrete. Ospemifene is an oral daily drug, which has proven to treat vaginal dryness and dyspareunia effectively...
April 10, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28396018/urinary-incontinence-and-other-pelvic-floor-disorders-after-radiation-therapy-in-endometrial-cancer-survivors
#12
Saya Segal, Gabriella John, Mary Sammel, Uduak Umoh Andy, Christina Chu, Lily A Arya, Justin Brown, Kathryn Schmitz
OBJECTIVE: To investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors. STUDY DESIGN: We performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation...
March 18, 2017: Maturitas
https://www.readbyqxmd.com/read/28394497/prediction-of-mid-urethral-sling-failure-with-clinical-findings-and-urodynamics
#13
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/28374826/ovine-multiparity-is-associated-with-diminished-vaginal-muscularis-increased-elastic-fibres-and-vaginal-wall-weakness-implication-for-pelvic-organ-prolapse
#14
Stuart Emmerson, Natharnia Young, Anna Rosamilia, Luke Parkinson, Sharon L Edwards, Aditya V Vashi, Miranda Davies-Tuck, Jacinta White, Kirstin Elgass, Camden Lo, John Arkwright, Jerome A Werkmeister, Caroline E Gargett
Pelvic Organ Prolapse (POP) is a major clinical burden affecting 25% of women, with vaginal delivery a major contributing factor. We hypothesised that increasing parity weakens the vagina by altering the extracellular matrix proteins and smooth muscle thereby leading to POP vulnerability. We used a modified POP-quantification (POP-Q) system and a novel pressure sensor to measure vaginal wall weakness in nulliparous, primiparous and multiparous ewes. These measurements were correlated with histological, biochemical and biomechanical properties of the ovine vagina...
April 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28370456/predictors-for-detrusor-overactivity-following-extensive-vaginal-pelvic-reconstructive-surgery
#15
Tsia-Shu Lo, Shailaja Nagashu, Wu-Chiao Hsieh, Ma Clarissa Uy-Patrimonio, Lin Yi-Hao
AIM: This study aims to identify the predictors for detrusor overactivity (DO) in women following extensive vaginal pelvic reconstructive surgery (PRS) for advanced pelvic organ prolapse (POP). METHODS: We enrolled 1503 women who had prolapse POP-Q stage ≥ 3 and underwent vaginal PRS with or without MUS from January 2006 to December 2015. All subjects completed a 72-h voiding diary, IIQ-7, UDI-6, POPDI-6, and PISQ-12. Urodynamics (UDS) was performed pre- and post-operatively...
March 31, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28370305/teaching-mid-urethral-sling-surgery-to-residents-impact-on-operative-time-and-postoperative-outcomes
#16
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/28364874/is-the-hymen-a-suitable-cut-off-point-for-clinically-relevant-pelvic-organ-prolapse
#17
Marian Wiegersma, Chantal M C R Panman, Boudewijn J Kollen, Marjolein Y Berger, Yvonne Lisman-van Leeuwen, Janny H Dekker
OBJECTIVES: The primary objective was to evaluate the ability of different anatomic cut-off points, as established in specialist urogynecology populations, to identify clinically relevant prolapse in a population of postmenopausal women with pelvic floor symptoms recruited from primary care. STUDY DESIGN: Cross-sectional study among 890 women (≥55 years) screened for pelvic floor symptoms. MAIN OUTCOME MEASURES: The Pelvic Floor Distress Inventory 20 was used to measure symptoms, and the Pelvic Organ Prolapse Quantification (POP-Q) system was used to assess prolapse...
May 2017: Maturitas
https://www.readbyqxmd.com/read/28364861/laser-therapy-for-the-restoration-of-vaginal-function
#18
REVIEW
Marco Gambacciani, Santiago Palacios
Laser therapy has a therapeutic role in various medical conditions and most recently has gained interest as a non-hormonal treatment for genitourinary syndrome of menopause (GSM) and as a non-invasive option for stress urinary incontinence (SUI). Several therapies are available to alleviate GSM symptoms, including hormonal and non-hormonal products. Both microablative fractional CO2 laser and the non-ablative vaginal Er:YAG laser (VEL) induce morphological changes in the vaginal tissues, and data from non-randomized clinical trials suggest that laser therapy can alleviate vaginal dryness and dyspareunia...
May 2017: Maturitas
https://www.readbyqxmd.com/read/28364131/comparative-analysis-of-overall-cost-and-rate-of-healthcare-utilization-among-apical-prolapse-procedures
#19
Lannah L Lua, Erika D Vicente, Prathamesh Pathak, Daniel Lybbert, Vani Dandolu
INTRODUCTION AND HYPOTHESIS: The annual cost of prolapse surgeries is expected to grow at twice the rate of population growth. Understanding the economic impact of apical prolapse procedures, including sacrospinous fixation (SSF), abdominal sacrocolpopexy (ASC), and laparoscopic sacrocolpopexy (LSC), is crucial. We aimed to compare overall cost of SSF versus ASC and LSC, as well as health resource utilization, up to 90-day follow-up. METHODS: Truven Marketscan Commercial Claims and Encounter databases 2008-2012 were used to calculate index and 90-day follow-up costs for SSF, ASC, and LSC with/without hysterectomy...
March 31, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28361513/surgical-outcomes-and-safety-of-robotic-sacrocolpopexy-in-women-with-apical-pelvic-organ-prolapse
#20
Hyun Hwan Sung, Kwang Jin Ko, Yoon Seok Suh, Gyu Ha Ryu, Kyu-Sung Lee
PURPOSE: This study aimed to investigate the surgical outcomes and safety of robotic sacrocolpopexy (RSC) in patients with uterine/vaginal vault prolapse. METHODS: Between January 2009 and June 2015, 16 women with apical prolapse underwent RSC. Pelvic organ prolapse quantification (POP-Q) examination was performed, and treatment success was defined as the presence of grade 0 or I apical prolapse upon POP-Q examination at the final follow-up. Pelvic floor distress inventory-short form 20 (PFDI-SF 20) was administered at every follow-up...
March 24, 2017: International Neurourology Journal
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