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Vaginal prolapse

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https://www.readbyqxmd.com/read/29219861/sacrocolpopexy-with-concomitant-total-vs-supracervical-hysterectomy-functional-support-comparisons-in-cadavers
#1
Pedro Antonio Maldonado, Kyle P Norris, Maria E Florian-Rodriguez, Nemi M Shah, Clifford Y Wai
OBJECTIVE: This study aimed to compare the ability of abdominal sacrocolpopexy (ASC) with concomitant total vs supracervical hysterectomy to resist downward traction as a measure of functional anatomic support in human cadavers. METHODS: Supracervical hysterectomy was performed on unembalmed cadaver specimens, followed by ASC attaching polypropylene mesh to the posterior cervix/vagina only and then the anterior and posterior cervix/vagina. Using a metal bolt placed through the cervix tied to a filament passing through a fixed pulley system, successive weights of 0...
December 7, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29207889/primary-carcinosarcoma-of-the-vagina-associated-with-differentiated-squamous-intraepithelial-neoplasia-in-a-patient-with-complete-uterine-prolapse-case-report-and-review-of-the-literature
#2
Emina Babarović, Karla Sladoljev, Ena Perin, Marko Klarić, Ružica Karnjuš-Begonja, Tamara Sinožić, Morana Dinter, Lana Glavan Gačanin, Senija Eminović
Vaginal carcinosarcomas (VCSs) are rare and clinically aggressive neoplasms. Primary vaginal malignancies are among the rarest malignant tumors, so clear management guidelines and optimal therapy, especially in the presence of significant pelvic organ prolapse, has not been determined. Here, we present a case of primary VCS closely associated with differentiated squamous intraepithelial neoplasia (DSIN), from which it appeared to have arisen in a postmenopausal patient with complete uterine prolapse. The unusual presentation of our case with DSIN in the adjacent vaginal epithelium with possible diagnostic pitfalls emphasizes the need for systemic presentation of these cases to help pathologists and clinicians know that such lesions can initially present in a patient with complete uterine prolapse...
December 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29207786/recurrent-vaginal-cuff-dehiscence-in-a-treated-case-of-carcinoma-cervix
#3
Sunesh Kumar, Seema Singhal, Yamini Kansal, Dayanand Sharma
Vaginal Cuff Dehiscence (VCD) is partial or total separation of anterior and posterior vaginal cuff layers. We report a case of recurrent vault cuff dehiscence in a patient of cervical carcinoma. A 60-year-old treated case of carcinoma cervix post surgery and radiotherapy was found to have vault dehiscence and intestinal prolapse second time during a routine speculum examination. She underwent an emergency laparotomy and closure of vault. Vaginal Cuff Dehiscence with Evisceration (VCDE) is a rare but potentially fatal complication following hysterectomy...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29201518/transobturator-four-arms-mesh-in-the-surgical-management-of-stress-urinary-incontinence-with-cystocele
#4
Hammouda Sherif, Tarek Soliman Othman, Amr Eldkhakhany, Hussein Elkady, Adel Elfallah
Objective: This study aims to evaluate safety and efficacy of four arms polypropylene mesh in the long- term follow-up in the management of stress urinary incontinence (SUI) associated with cystocele. Material and methods: This prospective study was conducted on 50 female patients with SUI associated with cystocele. Patients underwent placement of transobturator four-arms mesh implants. Stress incontinence was evaluated using cough stress test with and without prolapse reduction, Stamey's grading of SUI, the validated Arabic version of the International Consultation on Incontinence Questionnaire-Short Form and King Health Questionnaire forms...
December 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29184855/dealing-with-complex-overactive-bladder-syndrome-patient-profiles-with-focus-on-fesoterodine-in-or-out-of-the-eau-guidelines
#5
REVIEW
John Heesakkers, Montserrat Espuña Pons, Philip Toozs Hobson, Emmanuel Chartier-Kastler
Overactive bladder (OAB) syndrome is a common, complex, and challenging condition. To assist the management of these patients, the European Association of Urology (EAU) updates its guidelines annually. This review reports the presentations from the symposium titled "Dealing with complex OAB patient profiles: in or out of the EAU guidelines?" held at the 32nd EAU Annual Congress in March 2017 in London. The symposium focused on three groups of OAB patients: women who may also suffer pelvic organ prolapse, stress urinary incontinence, the genitourinary syndrome of menopause (GSM); patients at risk of cognitive impairment; and elderly patients...
2017: Research and Reports in Urology
https://www.readbyqxmd.com/read/29183884/nice-to-ban-mesh-for-vaginal-wall-prolapse
#6
Jacqui Wise
No abstract text is available yet for this article.
November 28, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29170793/clinical-predictors-and-risk-factors-for-vaginal-mesh-extrusion
#7
Usah Khrucharoen, Patkawat Ramart, Judy Choi, Diana Kang, Ja-Hong Kim, Shlomo Raz
PURPOSES: Our study aims to enhance the accuracy of the clinical diagnosis in patients with vaginal mesh extrusion following transvaginal mesh placement for pelvic organ prolapse using significant clinical parameters and risk factors. METHODS: All patients who underwent vaginal mesh removal were retrospectively reviewed from January 2000 to May 2014. Eligible patients were divided into two groups according to the presence of vaginal mesh extrusion. RESULTS: A total of 862 patients, 798 were included...
November 24, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29170509/measuring-tissue-displacement-of-the-anterior-vaginal-wall-using-the-novel-aspiration-technique-in-vivo
#8
Barbara Röhrnbauer, Cornelia Betschart, Daniele Perucchini, Michael Bajka, Daniel Fink, Caroline Maake, Edoardo Mazza, David Amos Scheiner
Little is known about the mechanical properties of pelvic floor structures and their role in the course and treatment of pelvic organ prolapse (POP). We hypothesize that in vivo mechanical properties of the vaginal wall are related to the appearance of POP and pre-and post-operative states. We used a suction device for intravaginal application, the aspiration device, to evaluate two in vivo mechanical parameters of the anterior vaginal wall, the load dependent tissue displacement and the initial displacement, by image analysis in pre- and post-menopausal women with (POP) and without (control) cystocele (POP: pre-menopausal: N = 6, post-menopausal: N = 19, control: pre-menopausal: N = 17, post-menopausal: N = 6)...
November 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29169578/post-hysterectomy-vaginal-vault-prolapse
#9
REVIEW
Dudley Robinson, Gans Thiagamoorthy, Linda Cardozo
Post-hysterectomy vaginal vault prolapse (PHVP) is a recognised although rare complication following both abdominal and vaginal hysterectomy and the risk is increased in women following vaginal surgery for urogenital prolapse. The management of PHVP remains challenging and whilst many women will initially benefit from conservative measures, the majority will ultimately require surgery. The purpose of this paper is to review the prevalence and risk factors associated with PHVP as well to give an overview of the clinical management of this often complicated problem...
January 2018: Maturitas
https://www.readbyqxmd.com/read/29167974/long-term-outcome-of-vaginal-mesh-or-native-tissue-in-recurrent-prolapse-a-randomized-controlled-trial
#10
Alfredo L Milani, Anne Damoiseaux, Joanna IntHout, Kirsten B Kluivers, Mariella I J Withagen
INTRODUCTION AND HYPOTHESIS: Our aim was to evaluate clinically relevant long-term outcomes of transvaginal mesh or native tissue repair in women with recurrent pelvic organ prolapse (POP). METHODS: We performed a 7-year follow-up of a randomized controlled trial on trocar-guided mesh placement or native tissue repair in women with recurrent POP. Primary outcome was composite success, defined as absence of POP beyond the hymen, absence of bulge symptoms, and absence of retreatment for POP...
November 22, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/29162957/geriatric-pelvic-organ-prolapse-surgery-going-the-extra-mile
#11
Seethalakshmi Krishnan
Background: To assess the quality of life in geriatric patients after reconstructive and obliterative vaginal surgery for advanced pelvic organ prolapse (POP). Methods: Prospective observational study was conducted between January 2009 and December 2014 at the department of Urogynaecology, Government Kasturbha Gandhi Hospital. A total of 424 women (between the age group of 60 and 94 years) with advanced pelvic organ prolapse underwent vaginal hysterectomy along with vaginal apical suspension procedures which were McCalls culdoplasty (35...
December 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29159667/uterus-sparing-vaginolaparoscopic-sacrocolpopexy-for-apical-pelvic-organ-prolapse
#12
Atef Darwish, Mostafa Bahlol, AbdelGhafar Ahmad, Mohamed Fekry
INTRODUCTION AND HYPOTHESIS: Our aim was to evaluate the safety, feasibility, and effectiveness of a vaginolaparoscopic sacrocolpopexy (VLS) technique for treating apical pelvic organ prolapse (POP). MATERIALS AND METHODS: This was a prospective interventional case series (design classification: Canadian Task Force II3) performed in the endoscopic unit of a tertiary care referral facility and university hospital. We assessed 15 symptomatic parous women with stage ≥2 apical POP according to the POP Quantification (POP-Q) classification...
November 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/29155140/pregnancy-and-parturition-negatively-impact-vaginal-angle-and-alters-expression-of-vaginal-mmp-9
#13
Sallie Oliphant, Timothy Canavan, Stacy Palcsey, Leslie Meyn, Pamela Moalli
BACKGROUND: Parity is the greatest risk factor for the development of pelvic organ prolapse. The normally supported vagina is pulled up and back over the levator ani. Loss of vaginal angulation has been associated with prolapse and may represent injury to the vaginal supportive tissues. OBJECTIVE: We propose that 1) pregnancy and delivery impact support to the vagina leading to loss of vaginal angle; 2) vaginal angulation is restored postpartum; and 3) uncomplicated vaginal delivery (VD) is associated with accelerated remodeling of the vaginal fibrillar matrix...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29150302/skin-advanced-glycation-content-reflects-vaginal-tissue-glycation-level-in-relation-to-pregnancy
#14
Homayemem Weli, Jason Cooper, Ying Yang
A few studies have revealed that the advanced glycation content of the vaginal wall in pelvic organ prolapse tissues is elevated. This elevation makes advanced glycation a significant association with the disease. Early detection of vaginal wall glycation could therefore be relevant in the prevention and management of pelvic organ prolapse. A vaginal wall biopsy to detect this would be ideal, but is invasive. Therefore the use of a more accessible organ to access, such as skin, would be beneficial. Our previous independent study suggests that conditions such as pregnancy, can induce a change in the vaginal tissues' glycation content...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29144955/re-clinical-effectiveness-and-cost-effectiveness-of-surgical-options-for-the-management-of-anterior-and-or-posterior-vaginal-wall-prolapse-two-randomised-controlled-trials-within-a-comprehensive-cohort-study-results-from-the-prospect-study
#15
https://www.readbyqxmd.com/read/29134243/-implants-for-genital-prolapse-pro-mesh-surgery
#16
REVIEW
J Neymeyer, D-E Moldovan, K Kornienko, K Miller, A Weichert
There has been an overall increase in pelvic organ prolapse due to demographic changes (increased life expectancy). Increasing sociocultural demands of women require treatments that are more effective with methods that are more successful. In the treatment of pelvic floor insufficiency and uterovaginal prolapse, pelvic floor reconstructions with mesh implants have proven to be superior to conventional methods such as the classic colporrhaphy, reconstructions with biomaterial, and native tissue repair in appropriately selected patients and when applying exact operation techniques, especially because of good long-term results and low recurrence rates...
November 13, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29128440/mccall-culdoplasty-during-total-laparoscopic-hysterectomy-a-pilot-randomized-controlled-trial
#17
Sara R Till, Kumari A Hobbs, Janelle K Moulder, John F Steege, Matthew T Siedhoff
STUDY OBJECTIVE: To assess the feasibility and safety of a McCall culdoplasty at time of total laparoscopic hysterectomy and to evaluate differences in total vaginal length, vaginal apex during valsalva, and sexual function 12 months after McCall culdoplasty compared to standard cuff closure. DESIGN: Pilot randomized controlled, single masked trial (Canadian Task Force classification I) SETTING: Academic tertiary care hospital PATIENTS: Women undergoing total laparoscopic hysterectomy for benign indications from June 2013 to December 2013...
November 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29107118/transvaginal-single-port-laparoscopy-sacrocolpopexy
#18
Yisong Chen, Junwei Li, Ying Zhang, Keqin Hua
STUDY OBJECTIVE: To describe our technique of transvaginal sacrocolpopexy using single-port laparoscopy for middle compartment Pelvic Organ Prolapse (POP). DESIGN: Step-by-step explanation of the procedure using video. SETTING: More and more patients are pursuing minimally invasive surgery, which is becoming the trends for gynecological surgery nowadays. POP is not an exception. With application of natural orifice transluminal endoscopic surgery (NOTEs), minimally invasive transvaginal sacrocolpopexy surgery assisted by single-port laparoendoscopy for POP becomes feasible...
October 26, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29103241/unexpected-significant-uterine-pathological-findings-at-vaginal-hysterectomy-despite-unremarkable-preoperative-workup
#19
Yossi Mizrachi, Samer Tannus, Jacob Bar, Ron Sagiv, Tally Levy, Alexander Condrea, Shimon Ginath
BACKGROUND: Several studies have addressed the issue of undetected uterine pathology in women undergoing hysterectomy for pelvic organ prolapse (POP). However, these studies differ largely with respect to the incidence of malignancy found, study population, and preoperative evaluation. OBJECTIVES: To assess the risk of unexpected pre-malignant and malignant uterine pathological findings after vaginal hysterectomy for POP repair, in a single medical center in Israel...
October 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29103165/the-urethral-closure-mechanism-is-deteriorated-after-anterior-colporrhaphy
#20
Yasmine Khayyami, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Urethral pressure reflectometry (UPR) has proven highly reproducible in women with pelvic organ prolapse. We hypothesized that urethral parameters would decrease after anterior colporrhaphy. METHODS: A prospective, observational study where women with anterior vaginal wall prolapse ≥stage II were assessed before and after anterior colporrhaphy. Assessments consisted of prolapse staging according to the Pelvic Organ Prolapse Quantification system, UPR measurements at rest, during squeezing and straining (at a standardized abdominal pressure of 50 cmH2O, PO-Abd 50), standardized stress tests with 300 ml saline, and answering the International Consultation on Incontinence - Urinary incontinence short form...
November 4, 2017: International Urogynecology Journal
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