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pelvic floor reconstructive surgery

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https://www.readbyqxmd.com/read/29333592/3d-models-of-female-pelvis-structures-reconstructed-and-represented-in-combination-with-anatomical-and-radiological-sections
#1
L Asensio Romero, M Asensio Gómez, A Prats-Galino, J A Juanes Méndez
We present a computer program designed to visualize and interact with three-dimensional models of the main anatomical structures of the female pelvis. They are reconstructed from serial sections of corpse, from the Visible Human project of the Medical Library of the United States and from serial sections of high-resolution magnetic resonance. It is possible to represent these three-dimensional structures in any spatial orientation, together with sectional images of corpse and magnetic resonance imaging, in the three planes of space (axial, coronal and sagittal) that facilitates the anatomical understanding and the identification of the set of visceral structures of this body region...
January 15, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29289624/laparoscopic-approach-for-shull-repair-of-pelvic-floor-defects
#2
Stefano Restaino, Carlo Ronsini, Angelo Finelli, Alessandro Santarelli, Giovanni Scambia, Francesco Fanfani
Study Objective To prove the feasibility of Shull technique by a laparoscopy approach in patient affected by pelvic organ prolapse (POP) with apical loss of support. Design A step-by-step demonstration of the technique in a surgical video, including the fundamental steps for a laparoscopic uterosacral ligament suspension (USLS) (Canadian Task Force Classification III). Setting According to the National Health and Nutrition Examination Survey, approximately 3% of women in the United States report symptoms linked to POP...
December 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29237218/-cylindric-abdominoperineal-rectum-exstirpation-with-partial-vulvar-and-vaginal-resection-as-well-as-perineal-and-vaginal-defect-reconstruction-by-a-vertical-rectus-abdominis-myocutaneous-vram-flap
#3
Christian Krautz, Klaus Weber, Roland Croner, Axel Denz, Matthias Maak, Raymund E Horch, Robert Grützmann
Introduction Patients with low rectal cancer or anal cancer undergoing abdominoperineal excision (APE) benefit from extended surgery and the subsequent avoidance of surgical "waisting" at the level of the puborectalis muscle. The method of cylindrical APE was introduced by T. Holm and led to a reduction of intraoperative perforations and involvement of circumferential resection margins, and subsequently reduced the risk of local recurrence. The use of myocutaneous flaps reduces perineal wound complications, which occur in up to 60% of patients with primary closure of perineal defects, especially following neoadjuvant radiochemotherapy...
December 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29219859/in-search-of-mobile-applications-for-patients-with-pelvic-floor-disorders
#4
Neha T Sudol, Emily Adams-Piper, Rachel Perry, Felicia Lane, Katherine T Chen
OBJECTIVES: The aims of the study were to identify patient-centered applications (apps) in female pelvic medicine and reconstructive surgery and to evaluate them using a modified APPLICATIONS scoring system. METHODS: A comprehensive list of female pelvic medicine and reconstructive surgery search terms was used to identify apps in the iTunes store. Apps that were eligible for scoring were in English, pertinent to the search term, patient centered, and accurate. All five authors independently evaluated eligible apps using a modified APPLICATIONS scoring system and subsequently reconciled differences by discussion...
December 7, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29166313/the-perineal-turnover-perforator-flap-a-new-and-simple-technique-for-perineal-reconstruction-after-extralevator-abdominoperineal-excision
#5
Maria Chasapi, Mohamed Maher, Peter Mitchell, Milind Dalal
BACKGROUND: Extralevator abdominoperineal excision (ELAPE) is increasingly used to treat locally advanced low rectal cancer as it has been related to superior oncological outcomes than traditional abdominoperineal excision.However, ELAPE also has been associated with high perineal wound morbidity rates as it creates a larger perineal cavity than standard abdominoperineal excision. This greater defect, along with the effects of preoperative chemoradiation on wound healing, makes uneventful perineal reconstruction post-ELAPE a real challenge for the plastic surgeon...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29162957/geriatric-pelvic-organ-prolapse-surgery-going-the-extra-mile
#6
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/29134243/-implants-for-genital-prolapse-pro-mesh-surgery
#7
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...
December 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29077924/perioperative-behavioral-therapy-and-pelvic-muscle-strengthening-do-not-enhance-quality-of-life-after-pelvic-surgery-secondary-report-of-a-randomized-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Alison C Weidner, Matthew D Barber, Alayne Markland, David D Rahn, Yvonne Hsu, Elizabeth R Mueller, Sharon Jakus-Waldman, Keisha Y Dyer, Lauren Klein Warren, Marie G Gantz, Susie Meikle
Background: There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective: The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI)...
November 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28988907/validity-of-utility-measures-for-women-with-pelvic-organ%C3%A2-prolapse
#9
Heidi S Harvie, Daniel D Lee, Uduak U Andy, Judy A Shea, Lily A Arya
BACKGROUND: Pelvic organ prolapse is a common condition that frequently coexists with urinary and fecal incontinence. The impact of prolapse on quality of life is typically measured through condition-specific quality-of-life instruments. Utility preference scores are a standardized generic health-related quality-of-life measure that summarizes morbidity on a scale from 0 (death) to 1 (optimum health). Utility preference scores quantify disease severity and burden and are widely used in cost-effectiveness research...
October 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28954448/-evaluation-of-transperineal-sonography-for-lower-urinary-tract-symptoms-after-pelvic-floor-reconstruction
#10
X L Zhong, J Song, Y L Xu, X L Lyu, X H Zhong, A P Wang, Y F Song
Objective: To evaluate transperineal sonography for lower urinary tract symptoms after pelvic floor reconstruction. Methods: Eighty-three patients with severe pelvic organ prolapse received surgeries in Fuzhou General Hospital from September 2014 to September 2015, dividing into two groups: 27 patients were selected to receive transvaginal mesh (TVM) pelvic floor reconstruction surgery with tension-free vaginal tape-Abbrevo (TVT-Abbrevo) incontinence surgery, named TVM+TVT-Abbrevo group; 56 patients were selected to receive TVM pelvic floor reconstruction surgery only, named TVM group...
September 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28953080/health-literacy-in-women-presenting-to-a-urogynecology-practice
#11
Abhishek A Sripad, Betty M Rupp, Jessica L Gage, Katherine M Feliciano, Marcella Willis-Gray, Jennifer M Wu
OBJECTIVE: Health literacy (HL) is the degree to which an individual can obtain, process, and communicate basic health information to make appropriate health decisions. Understanding HL of patients can improve outcomes. Thus, we evaluated HL in women with pelvic floor disorders and investigated its relationship to patient demographics, reading level, and cognition. METHODS: We conducted a cross-sectional study with a convenience sample of English-speaking women 18 years or older, recruited from female pelvic medicine and reconstructive surgery clinics from July 2016 to January 1, 2017...
September 25, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28884342/pre-operative-guided-imagery-in-female-pelvic-medicine-and-reconstructive-surgery-a-randomized-trial
#12
Elizabeth J Billquist, Aaron Michelfelder, Cynthia Brincat, Linda Brubaker, Colleen M Fitzgerald, Elizabeth R Mueller
INTRODUCTION AND HYPOTHESIS: The purpose was to determine if pre-operative guided imagery (GIM) would help women to feel more prepared, less anxious, and have higher satisfaction scores 6 weeks after surgery compared with routine care. METHODS: Eligible women planning to undergo pelvic floor surgery were enrolled and randomized. The GIM group received an institution-specific CD that uses GIM to detail day of surgery (DOS) events and expectations. Participants were asked to listen to the CD once daily during the week before surgery...
September 7, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28816554/vaginal-axis-on-mri-after-unilateral-and-bilateral-sacral-hysteropexy-a-controlled-study
#13
Mehmet B Senturk, Cetin Kilicci, Sibel Aydin, Mesut Polat, Cigdem Abide Yayla, Ates Karateke
The objective of this study was to evaluate the vaginal position on magnetic resonance imaging (MRI) after bilateral abdominal sacral hysteropexy (BASH) and classical abdominal sacral hysteropexy (ASH) and to investigate which method keeps the vagina the most proximate to its original anatomical position. Ten patients, with 10 having BASH, 10 ASH and 10 being nulliparous, were compared. The angle between the vagina and the pubococcygeal plate, the angle between the upper and lower vaginal segments, the distance between the posterior fornix and the 2nd vertebra and the distances between the lateral fornices and spina ischiadica were measured on MRI...
August 17, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28799675/biomimetic-implants-for-pelvic-floor-repair
#14
REVIEW
Mahshid Vashaghian, Sebastianus J Zaat, Theodoor H Smit, Jan-Paul Roovers
BACKGROUND: Polypropylene implants are used for the reconstructive surgery of urogynaecological disorders like pelvic organ prolapse, but severe complications associated with their use have been reported. There is evidence that surface properties and a difference in mechanical stiffness between the implant and the host tissue contribute to these adverse events. Electrospinning is an innovative engineering alternative that provides a biomimetic microstructure for implants, resulting in a different mechano-biological performance...
August 11, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28762694/pelvic-organ-prolapse
#15
REVIEW
Cheryl B Iglesia, Katelyn R Smithling
Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is primarily associated with pregnancy and vaginal delivery, which lead to direct pelvic floor muscle and connective tissue injury. Hysterectomy, pelvic surgery, and conditions associated with sustained episodes of increased intra-abdominal pressure, including obesity, chronic cough, constipation, and repeated heavy lifting, also contribute to prolapse...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28719393/restrictions-and-limitations-after-pelvic-floor-surgery-what-s-the-evidence
#16
Miles Murphy
PURPOSE OF REVIEW: A common concern regarding pelvic floor surgery is the relatively high risk of recurrence. In an effort to minimize this risk, many surgeons instruct their patients to avoid certain activities during the healing process so as not to damage the repair before proper healing has occurred. However, many of these restrictions have been historically based on little to no hard evidence. The purpose of this review is to present the latest evidence-based recommendations regarding restrictions and limitations after pelvic floor surgery...
July 17, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28709582/the-incidence-of-transfusion-and-associated-risk-factors-in%C3%A2-pelvic-reconstructive-surgery
#17
Lopa K Pandya, Courtney D Lynch, Andrew F Hundley, Silpa Nekkanti, Catherine O Hudson
BACKGROUND: Almost 400,000 female pelvic reconstructive operations were performed in 2010 for urinary incontinence and pelvic organ prolapse in the United States, and it is likely that this will continue to increase each year. There is a lack of population-based data evaluating the risk of blood transfusion after urogynecologic procedures. OBJECTIVE: We sought to assess the incidence of blood transfusion related to pelvic reconstructive surgery in a large national surgical quality database and to identify transfusion-associated risk factors...
July 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28681229/late-reconstruction-of-severe-open-book-deformities-of-the-pelvis-tips-and-tricks
#18
Christian Fang, Hatem Alabdulrahman, Roman Pfeifer, Ivan S Tarkin, Hans-Christoph Pape
BACKGROUND: The primary goal of treatment for open book pelvic injuries after high-energy trauma is to control haemorrhage and to close the pelvic ring anatomically. Less commonly, patients may present late with malunion or non-union. METHODS: We reviewed five operatively treated patients with delayed severe open book deformities who had a diastasis of more than 6 cm. We describe the pre-operative workup, surgical strategy and challenges experienced. They specifically include: extensive scar and contracture formation, malunion, urogenital prolapse and difficult reduction of vertical shear element...
September 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28673602/platelet-rich-plasma-as-a-minimally-invasive-approach-to-uterine-prolapse
#19
E L Chrysanthopoulou, V Pergialiotis, D Perrea, S Κourkoulis, C Verikokos, S K Doumouchtsis
Pelvic organ prolapse (POP) is a major health problem that affects many women with potentially severe physical and psychological impact as well as impact on their daily activities, and quality of life. Several surgical techniques have been proposed for the treatment of POP. The FDA has published documents that refer to concerns about the use of synthetic meshes for the treatment of prolapse, in view of the severe complications that may occur. These led to hesitancy in use of these meshes and partial increase in use of other biological grafts such as allografts and xenografts...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28670059/management-of-pelvic-floor-disorder-in-a-diethylstilbestrol-daughter
#20
Christopher P Chung, Suzanne Cao, Grace Wakabayashi, Ernest S Han
Between 1947 and 1971, the synthetic estrogen diethylstilbestrol (DES) was prescribed to pregnant women to prevent spontaneous abortions. Many studies have demonstrated adverse consequences of prenatal DES exposure. This report describes a DES daughter treated for uterine cancer who presented with a foreshortened vagina of 4 cm and stage III pelvic organ prolapse. She underwent successful vaginal native tissue reconstructive surgery with uterosacral colpopexy and anterior and posterior repair to lengthen her vagina and treat her prolapse...
July 2017: Proceedings of the Baylor University Medical Center
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