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pelvic floor reconstructive surgery

Tsia-Shu Lo, Yi-Hao Lin, Hsiao-Chien Chu, Eileen Feliz M Cortes, Leng Boi Pue, Yiap Loong Tan, Ma Clarissa Uy-Patrimonio
AIM: By investigating the association of urodynamics and urogenital nerve growth factor (NGF) levels in vaginal mesh surgery, we may be able to associate the likelihood of postoperative lower urinary tract symptoms developing as a result of synthetic mesh implanted for pelvic floor reconstructive surgery. METHODS: Thirty-eight female Sprague-Dawley rats were divided into three groups: mesh, sham (no mesh), and control. Urodynamic study and NGF analysis of the urogenital tissues were done and results were compared among all groups...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Wei Ge, Song-Song Jiang, Wang Qi, Hao Chen, Li-Ming Zheng, Gang Chen
GOAL: To share our experience of extra-levator abdominoperineal excision (ELAPE) for low rectal cancer, focusing on perineal repair with biological mesh. METHODS: We retrospectively analyzed medical records of all patients with low rectal cancer who underwent the ELAPE procedure using biological mesh for perineal repair at the Gastrointestinal Surgery of Nanjing Drum Power Hospital between January 2013 and September 2015. All patients were closely followed up to now...
October 6, 2016: Oncotarget
Mahshid Vashaghian, Behrouz Zandieh, Jan Paul Roovers, Theodoor Henri Smit
Electrospun matrices are proposed as an alternative for polypropylene meshes in reconstructive pelvic surgery. Here, we investigated the effect of fiber diameter on i) the mechanical properties of electrospun poly (glycolide-co-lactide acid)-blended-poly(caprolactone) (PLGA/PCL) matrices; ii) cellular infiltration; and iii) the newly-formed extracellular matrix (ECM) in vitro. We compared electrospun matrices with 1- and 8μm fiber diameter and used non-porous PLGA/PCL films as controls. The 8-μm matrices were almost twice as stiff as the 1-μm matrices with 1...
September 27, 2016: Tissue Engineering. Part A
Seth A Cohen, Howard B Goldman
Perforation of a viscus with a mesh product either during or subsequent to pelvic floor reconstruction can be associated with devastating outcomes. If surgeons are going to place mesh, they also need to be familiar with symptoms concerning for perforation. The index of suspicion should always be present, as these patients can present years after initial mesh placement. The best opportunity for intervention in these serious complications is the first intervention. As bits of mesh are chipped away during attempted interventions, residual mesh fragments become disjointed, frayed, and scarred further, making their removal even more challenging, in addition to traumatizing likely already weakened tissues...
September 2016: Current Urology Reports
Taylor Brueseke, Tyler Muffly, William Rayburn, AnnaMarie Connolly, Maria Nieto, Jacquia De La Cruz, Jennifer Wu
OBJECTIVES: The aim of this study was to assess how the projected increase in prevalence of pelvic floor disorders (PFDs) will impact the number of patients per female pelvic medicine and reconstructive surgery (FPMRS) subspecialist between 2015 and 2045. METHODS: We performed a workforce analysis of FPMRS subspecialists in the United States by developing a model to predict the number of FPMRS subspecialists in 5-year increments from 2015 to 2045. Our model allowed for selection of the number of current FPMRS subspecialists, the number and sex of new FPMRS subspecialists added per year, and retirement age of FPMRS subspecialists...
September 2016: Female Pelvic Medicine & Reconstructive Surgery
Joke Hellinga, Patrick C K H Khoe, Boudewijn van Etten, Patrick H J Hemmer, Klaas Havenga, Martin W Stenekes, Yassir Eltahir
BACKGROUND: The extralevator abdominoperineal excision (ELAPE) procedure creates an extensive soft tissue defect of the pelvic floor. It has been suggested that primary reconstruction reduces the risk of wound infection and delayed wound healing in this high-risk area. Use of myocutaneous flaps or omentoplasty are associated with functional limitations and complications. We performed the perineal variant of the lotus petal flap, which was originally described for vulvar reconstruction...
June 23, 2016: Annals of Surgical Oncology
Donna Mazloomdoost, Gregory Kanter, Robert C Chan, Nicolette Deveaneau, Allison M Wyman, Emily C Von Bargen, Zaid Chaudhry, Solafa Elshatanoufy, Jeannine M Miranne, Christine M Chu, Rachel N Pauls, Lily A Arya, Danielle D Antosh
BACKGROUND: Internet resources are becoming increasingly important for patients seeking medical knowledge. It is imperative to understand patient use and preferences for using the Internet and social networking websites to optimize patient education. OBJECTIVES: The purpose of this study was to evaluate social networking and Internet use among women with pelvic floor complaints to seek information for their conditions, as well as describe the likelihood, preferences, and predictors of website usage...
June 16, 2016: American Journal of Obstetrics and Gynecology
Margaret G Mueller, Dana Elborno, Bhumy A Davé, Alix Leader-Cramer, Christina Lewicky-Gaupp, Kimberly Kenton
INTRODUCTION AND HYPOTHESIS: Although postoperative complications in women undergoing reconstructive pelvic surgery (RPS) have been characterized, little is known regarding the timeline of these occurrences. We aimed to determine the timeframe after RPS during which the majority of complications occur, to assist with planning intervals between postoperative visits. METHODS: Women undergoing RPS were identified through billing information. Demographic, surgical, and complications data were extracted from electronic medical records...
June 16, 2016: International Urogynecology Journal
Tomasz Rechberger, Łukasz Nowakowski, Ewa Rechberger, Alicja Ziętek, Izabela Winkler, Paweł Miotła
OBJECTIVES: Due to prolonged life expectancy, regardless of the fact that elderly women are more likely to suffer from comorbidities, urogynaecologists worldwide should expect a growing demand for counseling and effective treatment for patients with pelvic floor defects. The aim of the study was to investigate the incidence of popular comorbidities among urogynaecological patients. MATERIAL AND METHODS: The retrospective analysis included clinical data of 4,065 consecutive female patients who under-went surgical treatment in the 2nd Department of Gynaecology at the Medical University of Lublin due to urogynaecological disorders between January 2005 and December 2014...
2016: Ginekologia Polska
Sumerova Natalia, Neuman Menahem, Krissi Haim, Pushkar Dmitri
OBJECTIVES: To evaluate the feasibility, safety and surgical results of skeletonized mesh implants to form a pelvic harness for pelvic floor reconstruction surgery. STUDY DESIGN: Patients with advanced pelvic floor prolapse were enrolled to this study. Study model was a kit mesh, reduced to 75% of the original surface area by cutting out mesh material from the central mesh body. Patients were evaluated at the end of the 1st and 6th post-operative months and interviewed at the study conclusion...
May 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Jorge Uriel Méndez-Ibarra, Juan Manuel Mora-Sevilla, Gerardo Evaristo-Méndez
BACKGROUND: Primary posterior perineal hernias in men are rare. We report a case of this type of hernia associated with dolichocolon, a condition which, to our knowledge, has not been reported previously. CLINICAL CASE: A 71-year old male presenting with a perineal tumour of 40 years evolution. He had no history of perineal surgery or trauma. On physical examination, a lump of 4×3cm was observed in the right para-anal region, which increased in volume during the Valsalva manoeuvre...
March 30, 2016: Cirugia y Cirujanos
Sabine Hannes, Johanna M Nijboer, Alexander Reinisch, Wolf O Bechstein, Nils Habbe
Vulva cancer is the fourth leading gynaecological malignancy, accounting for approximately 4 % of all gynaecological cancers. Surgery represents the treatment of choice, and cases of advanced or recurrent vulvar cancers are to date a major challenge to multidisciplinary teams. Abdominoperineal excision (APE) in combination with vulvectomy and inguinal lymphadenectomy is the only curative treatment option. Patients' files of all women with squamous cell carcinoma of the vulva who underwent abdominoperineal resection were retrospectively reviewed with special regards to technical challenges the general surgeon will face...
December 2015: Indian Journal of Surgery
Q Y Lai, X Yang, Y Zhu, C Tan, M Ling
OBJECTIVE: To evaluate the short-term efficacy of Perigee system in the treatment of anterior pelvic organ prolapse. METHODS: From October 2012 to September 2014, 59 patients with pelvic organ prolapse, pelvic organ prolapse quantitation system (POP-Q) were diagnosed as anterior pelvic organ prolapse Ⅲ degree and above were performed Perigee anterior pelvic floor reconstruction, while some patients combined with sacrospinous ligament suspension, posterior wall repair or posterior pelvic reconstruction surgery for pelvic prolapses...
February 2016: Zhonghua Fu Chan Ke za Zhi
Pakeeza Alam, Cheryl B Iglesia
Informed consent is the process in which a patient makes a decision about a surgical procedure or medical intervention after adequate information is relayed by the physician and understood by the patient. This process is critical for reconstructive pelvic surgeries, particularly with the advent of vaginal mesh procedures. In this article, we review the principles of informed consent, the pros and cons of different approaches in reconstructive pelvic surgery, the current legal issues surrounding mesh use for vaginal surgery, and tips on how to incorporate this information when consenting patients for pelvic floor surgery...
March 2016: Obstetrics and Gynecology Clinics of North America
Pedro A Maldonado, Clifford Y Wai
As the field of reconstructive pelvic surgery continues to evolve, with descriptions of new procedures to repair pelvic organ prolapse, it remains imperative to maintain a functional understanding of pelvic floor anatomy and support. The goal of this review was to provide a focused, conceptual approach to differentiating anatomic defects contributing to prolapse in the various compartments of the vagina. Rather than provide exhaustive descriptions of pelvic floor anatomy, basic pelvic floor anatomy is reviewed, new and historical concepts of pelvic floor support are discussed, and relevance to the surgical management of specific anatomic defects is addressed...
March 2016: Obstetrics and Gynecology Clinics of North America
John R Miklos, Orawee Chinthakanan, Robert D Moore, Gretchen K Mitchell, Sheena Favors, Deborah R Karp, Gina M Northington, Gladys M Nogueiras, G Willy Davila
INTRODUCTION AND HYPOTHESIS: The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications. METHODS: This was a retrospective chart review of all patients who underwent surgical removal of sling, transvaginal mesh, and sacrocolpopexy for mesh-related complications from 2011 to 2013 at three tertiary referral centers. The International Urogynecological Association (IUGA)/International Continence Society (ICS) classification system was utilized...
June 2016: International Urogynecology Journal
Sabine Hannes, Alexander Reinisch, Wolf O Bechstein, Nils Habbe
BACKGROUND: Squamous cell cancer of the anus (SCCA) is a rare disease of the gastrointestinal tract. Even though chemoradiation therapy is the treatment of choice, a substantial number of patients develop recurrent cancers or present with persisting SCCA. Therefore, abdominoperineal excisions as a salvage therapy are the only chance of cure. PATIENTS AND METHODS: Hospital files of all patients with recurrent squamous cell carcinoma of the anus who underwent abdominoperineal excision performed at the Department of General and Visceral Surgery of the University Hospital Frankfurt between January 2003 and December 2013 were retrospectively reviewed...
March 2016: International Journal of Colorectal Disease
Sharifah Syed Abdul Jalil, Rodrigo Guzmán Rojas, Hans Peter Dietz
INTRODUCTION: Levator avulsion is found in 15-30% of parturients and associated with pelvic organ prolapse (POP) recurrence following surgery, although most published evidence relates to postoperative diagnosis. We performed a study to determine whether diagnosis of avulsion after pelvic floor surgery can be used as a proxy for preoperative diagnosis. METHODS: This is a retrospective study on 207 patients seen before and after prolapse surgery. All assessments included 3D/4D transperineal tomographic ultrasound, with volume data saved and analysed at a later date, blinded against all clinical data...
December 11, 2015: Ultrasound in Obstetrics & Gynecology
Yingjie Bao, Mengcai Hu, Guixiang Gao, Jie Huang, Zhihong Zhang
OBJECTIVE: To investigate the risky factors for pelvic floor functional disorder.
 METHODS: A total of 346 patients, who undergone surgery for pelvic floor reconstruction from January 2007 to December 2013 in the Third Affiliated Hospital of Zhengzhou University, were enrolled for this study and served as an experimental group. Meanwhile, 349 female healthy subjects were selected as a control group. The data including the times of gestation and parity, history of menopause, hysterectomy surgery, uterine fibroid and leucorrhea were recorded...
November 2015: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Axel Heidenreich, Daniel Porres, David Pfister
Androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone (LHRH) analogues or antagonists represents the treatment of choice in men with metastatic prostate cancer (PCA). Depending on the serum concentration of the prostate-specific antigen (PSA) nadir, the survival might vary between 11 and 78 months. In castration-resistant PCA (CRPC), all new medical treatment options can induce complete and partial remissions in metastatic foci, but they have no profound effect on the prostate itself, as has been shown recently...
2015: Oncology Research and Treatment
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