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Vaginal prolapse

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https://www.readbyqxmd.com/read/28333822/committee-opinion-no-694-management-of-mesh-and-graft-complications-in-gynecologic-surgery
#1
(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 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333818/practice-bulletin-no-176-pelvic-organ-prolapse
#2
(no author information available yet)
Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP (). Although POP can occur in younger women, the peak incidence of POP symptoms is in women aged 70-79 years (). Given the aging population in the United States, it is anticipated that by 2050 the number of women experiencing POP will increase by approximately 50% ()...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333814/committee-opinion-no-694-summary-management-of-mesh-and-graft-complications-in-gynecologic-surgery
#3
(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 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333810/practice-bulletin-no-176-summary-pelvic-organ-prolapse
#4
(no author information available yet)
Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP (1). Although POP can occur in younger women, the peak incidence of POP symptoms is in women aged 70-79 years (2). Given the aging population in the United States, it is anticipated that by 2050 the number of women experiencing POP will increase by approximately 50% (3)...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28323222/laparoscopic-nerve-preserving-sacropexy
#5
Alfredo Ercoli, Stefano Cosma, Francesca Riboni, Giuseppe Campagna, Paolo Petruzzelli, Daniela Surico, Saverio Danese, Giovanni Scambia, Chiara Benedetto
STUDY OBJECTIVE: to demonstrate our developed nerve preserving technique during laparoscopic sacropexy (LSP) for multicompartment pelvic organ prolapse. DESIGN: exemplificative case of our surgical procedure based on a multicentric experience consisting of more than 800 cases in 10 years without major intraoperative complications. Informed consent was taken from the subject, and the institutional review board approved this research. SETTING: public practice at Maggiore della Carità University Hospital, Novara; at Sant'Anna Hospital, City of Health and Science, University of Torino; at A...
March 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28323221/laparoscopic-promontohysteropexy-during-pregnancy
#6
L Pirtea, O Balint, C Secosan, R Ilina, D Grigoras
STUDY OBJECTIVE: to present a case of uterine prolapse in a 10 weeks pregnant patient that was successfully treated by laparoscopic promontohysteropexy. To our knowledge, this is the first case of laparoscopic promontopexy during pregnancy to ever be reported in literature. DESIGN: step by step explanation of the surgery using video SETTING: Uterine prolapse is a rare condition in young patients and extremely are in pregnant women. The incidence of uterine prolapse during pregnancy reported in literature is 1 per 10...
March 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28321474/transvaginal-iliococcygeus-fixation-for-posthysterectomy-vaginal-vault-prolapse-repair
#7
Rodolfo Milani, Matteo Frigerio, Federico Spelzini, Stefano Manodoro
INTRODUCTION AND HYPOTHESIS: Posthysterectomy vaginal vault prolapse repair is a surgical challenge. Successful surgical management using native tissue can be achieved via the vaginal approach by iliococcygeus fascia fixation. However, although iliococcygeus fascia fixation is technically simple and has a low morbidity, it is not commonly performed. The aim of the video is to provide anatomic views and the surgical steps necessary to achieve successful transvaginal iliococcygeus fascia fixation for vaginal vault prolapse repair...
March 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28321472/feasibility-and-benefits-of-the-ewe-as-a-model-for-vaginal-surgery-training
#8
Yohan Kerbage, Géraldine Giraudet, Chrystèle Rubod, Charles Garabedian, Géraldine Rivaux, Michel Cosson
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the ewe as an animal model for teaching and training in vaginal surgery. METHODS: Twenty-nine postgraduate surgeons attended a training course on vaginal prolapse surgery. After a review of human and sheep anatomy, the participants performed transvaginal meshes, vaginal hysterectomy, SSLF (Richter), and OAS repair in ewes and human cadavers. Participants completed questionnaires on the whole course. RESULTS: Questionnaires showed the significant superiority of ewes over human cadavers for all items evaluated regarding surgical dissections...
March 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28316850/a-report-of-two-cases-of-age-related-changes-in-cervical-morphology-in-postmenopausal-women-with-vaginal-adenosis
#9
Marguerite B Vigliani
This paper presents two cases of women who had extensive vaginal adenosis from prenatal DES exposure, extending almost halfway down the vaginal canal. Both women were followed for decades with annual exams and Pap smears until after menopause. Clinical examination in both cases initially showed an absent pars vaginalis of the cervix, vaginal adenosis, and shallowness of the fornices. Several decades of annual exams showed these stigmata of DES exposure gradually disappear as the upper vagina progressively contracted...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28306603/current-treatment-of-pelvic-organ-prolapse-correlated-with-chronic-pelvic-pain-bladder-and-bowel-dysfunction
#10
Bernhard Liedl, Klaus Goeschen, Leopold Durner
PURPOSE OF REVIEW: The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. RECENT FINDINGS: In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years...
March 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#11
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/28299405/validation-of-the-international-consultation-on-incontinence-questionnaire-vaginal-symptoms-iciq-vs-in-two-south-asian-languages
#12
Chanil D Ekanayake, Arunasalam Pathmeswaran, Rasika P Herath, H Suharshi S Perera, Malitha Patabendige, Prasantha S Wijesinghe
INTRODUCTION: The multifaceted nature of pelvic floor disorders means that a systematic evaluation is required for optimal treatment outcome. It is also generally acknowledged that a valid tool is necessary to objectively assess symptoms reported by affected women. METHODS: The International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) questionnaire was translated to Sinhala and Tamil and a validation study carried out among women attending gynecology clinics at North Colombo Teaching Hospital, Ragama, and the district general hospitals Mannar and Vavuniya...
March 16, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28293789/development-of-an-ovine-model-for-training-in-vaginal-surgery-for-pelvic-organ-prolapse
#13
A Mansoor, S Curinier, S Campagne-Loiseau, L Platteeuw, B Jacquetin, B Rabischong
INTRODUCTION AND HYPOTHESIS: This aim of this study was to evaluate the feasibility and usefulness of an ovine model for training in vaginal surgery. METHODS: Four senior urogynaecological surgeons and five residents attended five sessions of vaginal surgery for pelvic organ prolapse (POP) in five old multiparous female sheep. Urogynaecological examinations were performed and measurements similar to the POP-Q classification in humans were obtained. Standard POP surgical procedures with and without mesh were performed...
March 14, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28280801/a-large-uterine-leiomyoma-leading-to-non-puerperal-uterine-inversion-a-case-report
#14
Batool Teimoori, Arezoo Esmailzadeh
BACKGROUND: Although leiomyomas are the most common gynecologic disorders, non-puerperal uterine inversion due to leiomyoma is considered as a rare clinical problem. This condition can occur as a complication of a large sub-mucous leiomyoma that leads to dilate cervix and protrude into vagina. The patient may have several symptoms such as heavy vaginal bleeding, pelvic pain and intermittent acute urinary retention. CASE: We presented a 32-year-old nulliparous woman with 17 years of unexplained infertility and diagnosis of a large vaginal prolapsed non-pedunculated leiomyoma...
January 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/28277472/transvaginal-repair-of-complex-rectovaginal-fistulas-using-the-porcine-urinary-bladder-matrix-as-an-augmenting-graft
#15
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...
March 9, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28277359/vaginal-delivery-after-d%C3%A3-hrssen-incisions-in-a-patient-with-bladder-exstrophy-and-uterine-prolapse
#16
Ruben Lachica, Yen Chan, Kristen R Uquillas, Richard H Lee
BACKGROUND: Bladder exstrophy is a rare congenital anomaly affecting the lower abdominal wall, pelvis, and genitourinary structures. Pregnant women with bladder exstrophy present a unique challenge to the obstetrician. CASE: The patient is a 35-year old pregnant woman with bladder exstrophy, an extensive surgical history, and uterine prolapse with an abnormal, rubbery consistency to her cervix. Prenatally, she was counseled on the potential use of Dührssen incisions to facilitate vaginal delivery...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28277355/activity-restriction-recommendations-and-outcomes-after-reconstructive-pelvic-surgery-a-randomized-controlled-trial
#17
Margaret G Mueller, Christina Lewicky-Gaupp, Sarah A Collins, Melinda G Abernethy, Alex Alverdy, Kimberly Kenton
OBJECTIVE: To assess the relationship between prescribed postoperative activity recommendations (liberal compared with restricted) after reconstructive prolapse surgery and patient satisfaction and pelvic floor symptoms. METHODS: In our multicenter, randomized, double-blind clinical trial, women undergoing reconstructive prolapse surgery were randomized to liberal compared with restricted postoperative activity recommendations. Liberal recommendations instructed women to resume postoperative activity at the woman's own pace with no restrictions on lifting or high-impact activities...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28276574/taking-the-tube-uptake-of-salpingectomy-at-the-time-of-hysterectomy-for-benign-indications
#18
Yee S Lin, Alana M Cole, Susannah Lyes, Erika K Hunter
BACKGROUND: International guidelines recommend the fallopian tubes be removed at the time of hysterectomy, to lower the incidence of ovarian cancer in women. AIMS: To determine the rate of salpingectomy at the time of hysterectomy at our institution and to discuss a standard rate. MATERIALS AND METHODS: Hysterectomies (n = 200) performed for benign indications from 13 January 13, 2015 until 26 April 26, 2016 were reviewed. RESULTS: The overall rate of salpingectomy was 76...
March 9, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28267057/female-pelvic-floor-biomechanics-bridging-the-gap
#19
Deanna C Easley, Steven D Abramowitch, Pamela A Moalli
PURPOSE OF REVIEW: The pelvic floor is a complex assembly of connective tissues and striated muscles that simultaneously counteracts gravitational forces, inertial forces, and intra-abdominal pressures while maintaining the position of the pelvic organs. In 30% of women, injury or failure of the pelvic floor results in pelvic organ prolapse. Surgical treatments have high recurrence rates, due, in part, to a limited understanding of physiologic loading conditions. It is critical to apply biomechanics to help elucidate how altered loading conditions of the pelvis contribute to the development of pelvic organ prolapse and to define surgeries to restore normal support...
March 4, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28266815/efficacy-and-safety-of-elevate%C3%A2-system-on-apical-and-anterior-compartment-prolapse-repair-with-personal-technique-modification
#20
Daniele Castellani, Vikiela Galica, Pietro Saldutto, Giuseppe Paradiso Galatioto, Carlo Vicentini
AIM: To evaluate the effectiveness and safety of Anterior Elevate® mesh kit system (AES) in woman with symptomatic stage 3 or 4 anterior and/or apical pelvic organ prolapse (POP). MATERIALS AND METHODS: This retrospective, monocentric, single surgeon study enrolled between May 2010 and January 2013 fifty-six woman experiencing symptomatic anterior vaginal prolapse with or without apical descent (POP-Q stage 3 or 4). All women received a AES and 7 (12.5%) received a concomitant transvaginal hysterectomy...
March 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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