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Vaginal prolapse

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
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
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
G Cucinella, G Calagna, G Romano, G Di Buono, G Gugliotta, S Saitta, G Adile, M Manzone, G Accardi, A Perino, A Agrusa
The apical prolapse has always been considered the most complex of the defects of the pelvic floor, for both the difficulty of the surgical corrective technique and for the high post-surgical recurrence rate. Today, the laparoscopic sacrocolpopexy can be considered the standard treatment for apical prolapse. In the last years, several author performed robotic sacrocolpopexy, obtaining positive results. So, we developed a casecontrol study in order to compare the surgical outcome of robotic group with a control group of laparoscopic approach in patients with symptomatic apical pro-lapsed between January 2015 and December 2015 at University Hospital Policlinico "P...
May 2016: Il Giornale di Chirurgia
Ido Feferkorn, Meirav Schmidt, Yakir Segev, Ariel Zilberlicht, Ron Auslender, Yoram Abramov
OBJECTIVES: Infected pelvic hematoma is a relatively common complication of vaginal hysterectomy, manifesting with postoperative pain and fever which often necessitate surgical drainage. We aimed to assess the effect of the surgical technique for vaginal cuff closure on the incidence of this complication. STUDY DESIGN: Until March 31, 2010, our surgical protocol for vaginal hysterectomy included complete vaginal cuff closure. After this date, all surgeries were performed using another technique, by which a patent tract was left at the vaginal cuff for drainage of blood, secretions and debris...
September 20, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jyothi Subramanya, Natasha Curtiss, Aswini Balachandran, Jonathan Duckett
OBJECTIVE: Vaginal packs are commonly inserted after pelvic organ prolapse (POP) surgery to absorb excess blood loss and to reduce haematoma formation. Randomised trials have shown little benefit in terms of reduced haematoma formation. However, the amount of blood loss absorbed on the pack has not been studied. The use of packs has financial costs and is associated with catheterisation and may delay hospital discharge. If packs are not effective in reducing blood loss and haematoma formation there could be an argument that packs should not be used at all...
September 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Johanna Quist-Nelson, Kathryn Landers, Rebekah McCurdy, Vincenzo Berghella
BACKGROUND: External cephalic version (ECV) increases the likelihood of a vaginal delivery in patients with breech presentation. Our objective was to determine the rate of cephalic vaginal delivery in women undergoing ECV after PROM. METHODS: We performed a systematic review of all case reports, case series, and clinical trials of patients undergoing an ECV after PROM ≥ 24 weeks. Maternal demographics and outcome data were obtained. The primary outcome was rate of cephalic vaginal delivery...
October 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
Maurizio Serati, Diaa Rizk, Stefano Savatore
Based on the available urogynecological literature, the role of hysterectomy in the surgical strategy of pelvic organ prolapse (POP) repair remains controversial. Currently, there are no data to favor either the removal or preservation of the uterus in women with POP. The findings that hysterectomy may contribute to a higher success rate and to the development of urinary incontinence and/or female sexual dysfunction are not supported by evidence. It is not clear why both hysteropexy was sometimes performed in the presence of overt uterine prolapse and/or concomitant vaginal hysterectomy was often included in vaginal prolapse repair in the absence of uterine prolapse...
October 4, 2016: International Urogynecology Journal
Amanda Marie Hill, K Meryl David, Lindsay Clark-Donat, Lee Marvin Hammons, Masoud Azodi, Dan-Arin Silasi
OBJECTIVE: To determine whether vertical versus horizontal closure of the vaginal cuff during laparoscopic hysterectomy has an effect on postoperative vaginal length and pelvic organ prolapse. DESIGN: Prospective randomized controlled trial. Subjects were randomly assigned to vertical or horizontal vaginal cuff closure at the time of total laparoscopic hysterectomy. POP-Q tests were performed before surgery, two to four weeks after surgery, and three to four months after surgery...
October 1, 2016: Journal of Minimally Invasive Gynecology
Christopher Maher, Benjamin Feiner, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Julie Brown
BACKGROUND: Apical vaginal prolapse is a descent of the uterus or vaginal vault (post-hysterectomy). Various surgical treatments are available and there are no guidelines to recommend which is the best. OBJECTIVES: To evaluate the safety and efficacy of any surgical intervention compared to another intervention for the management of apical vaginal prolapse. SEARCH METHODS: We searched the Cochrane Incontinence Group's Specialised Register of controlled trials, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials...
October 1, 2016: Cochrane Database of Systematic Reviews
Iman Khalil, Saad E Itani, Zeina Naja, Ahmad Salah Naja, Fouad M Ziade, Jean-Marc Ayoubi, Mariam A El-Rajab, Zoher M Naja
STUDY OBJECTIVE: Compare the effectiveness of nerve stimulator-guided pudendal nerve block (PNB) vs general anesthesia (GA) for anterior and posterior (AP) colporrhaphy in terms of pain relief and analgesic consumption within 24 and 48 hours postoperatively. DESIGN: Prospective randomized trial. PATIENTS: Fifty-seven patients whose ages ranged between 20 and 53 years scheduled to undergo AP colporrhaphy due to the presence of cystorectocele...
November 2016: Journal of Clinical Anesthesia
Mallika Anand, Amy L Weaver, Kristin M Fruth, Bijan J Borah, Christopher J Klingele, John B Gebhart
OBJECTIVES: To determine the rate of perioperative complications and cost associated with Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), and robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. METHODS: We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery (MMC, ASC, or RSC) between January 1, 2000, and June 30, 2012, at our institution. For all patients identified, perioperative complications, length of hospital stay, and inpatient costs to patients were abstracted from the medical records and compared by procedure...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
Joseph T Kowalski, Gerardo Heredia Melero, Amandeep Mahal, Rene Genadry, Catherine S Bradley
INTRODUCTION AND HYPOTHESIS: Seeing or feeling a vaginal bulge is the most specific symptom for identifying prolapse. Bulge symptoms are becoming increasingly important as a surgical outcome measure. Our objectives were to identify patient characteristics associated with the symptom of a vaginal bulge and to determine whether those characteristics impact the relationship between symptoms and anatomic prolapse. METHODS: A cross-sectional analysis of new urogynecology patients was performed...
September 28, 2016: International Urogynecology Journal
A T Yoldemir, C Cimsit, M Guclu, I N Akpinar
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
T-H Young, F-T Kung, F-C Chuang, K-H Huang
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Rhiannon Bray, Alex Derpapas, Ruwan Fernando, Vik Khullar, Demetri C Panayi
INTRODUCTION AND HYPOTHESIS: The pathophysiology of prolapse is not well understood. However, two main theories predominate: either the fibromuscular layer of the vagina develops a defect/tears away from its supports, or its tissues are stretched and attenuated. The aim of this study was to assess how vaginal wall thickness (VWT) is related to vaginal prolapse. METHODS: The study group comprised 243 women with symptomatic prolapse recruited from the Outpatient Department of a tertiary referral centre for urogynaecology...
September 27, 2016: International Urogynecology Journal
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