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pelvic floor reconstructive surgery

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https://www.readbyqxmd.com/read/28719393/restrictions-and-limitations-after-pelvic-floor-surgery-what-s-the-evidence
#1
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-pelvic-reconstructive-surgery
#2
Lopa K Pandya, Courtney 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. OBJECTIVES: 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
#3
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...
July 5, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28673602/platelet-rich-plasma-as-a-minimally-invasive-approach-to-uterine-prolapse
#4
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
#5
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
https://www.readbyqxmd.com/read/28647959/-re-treatments-of-recurrence-after-pelvic-floor-repair-surgery
#6
S X Fan, F M Wang, L S Lin, Y F Song
Objective: To analyze re-treatments of recurrence after the pelvic floor repair surgery. Methods: The protocol and the effect of re-treatments were investigated by reviewing and analyzing the clinical data of 81 recurrent patients (grade Ⅱ and above), who had received the pelvic floor repair surgery from January 2011 to January 2016. Pelvic organ prolapse quantitation system (POP-Q) and two questionnaires about quality of life [pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7)] were used to evaluate objective and subjective efficacy, respectively...
June 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28647957/-long-term-effectiveness-of-transvaginal-high-uterosacral-ligament-suspension
#7
L Duan, Y X Lu, W J Shen, X Liu, J X Liu, Y H Zhang, J Ge, Y Zhao, K Niu, W Y Wang
Objective: To assess the long-term effectiveness of the transvaginal high uterosacral ligament suspension (HUS) in women suffering from advanced pelvic organ prolapse (POP). Methods: A retrospective review of records identified 118 women who underwent transvaginal HUS with or without additional concomitant anterior and (or) posterior repairs from June 2003 to August 2009 in the First Affiliated Hospital, General Hospital of People's Liberation Army. Of 118 women, 104 women completed the follow-up during study period; these 104 women were analysed...
June 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28616108/advances-in-basic-science-methodologies-for-clinical-diagnosis-in-female-stress-urinary-incontinence
#8
REVIEW
Marwa Abdulaziz, Emily G Deegan, Alex Kavanagh, Lynn Stothers, Denise Pugash, Andrew Macnab
We provide an overview of advanced imaging techniques currently being explored to gain greater understanding of the complexity of stress urinary incontinence (SUI) through better definition of structural anatomic data. Two methods of imaging and analysis are detailed for SUI with or without prolapse: 1) open magnetic resonance imaging (MRI) with or without the use of reference lines; and 2) 3D reconstruction of the pelvis using MRI. An additional innovative method of assessment includes the use of near infrared spectroscopy (NIRS), which uses non-invasive photonics in a vaginal speculum to objectively evaluate pelvic floor muscle (PFM) function as it relates to SUI pathology...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28499536/recognizing-and-managing-common-urogynecologic-disorders
#9
REVIEW
Denise M Elser
Many women experience urogynecologic or pelvic floor disorders, especially urinary incontinence and pelvic organ prolapse. The obstetrician/gynecologist is often the first health care professional to evaluate and treat these disorders. Treatments include pelvic floor muscle training, behavioral therapies, oral medications, neuromodulation, intradetrusor medications, and surgery. When approaching the woman with symptomatic prolapse, familiarity with pessaries and various surgical procedures aid in counseling...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28472172/outcome-of-vaginal-mesh-reconstructive-surgery-in-multiparous-compared-with-grand-multiparous-women-retrospective-long-term-follow-up
#10
Gil Levy, Yoav Peled, Anat From, Irena Fainberg, Sarit Barak, Amir Aviram, Haim Krissi
We aimed to compare the long-term surgical outcome and complications of multiparous and grand multiparous women undergoing reconstructive surgery with vaginal mesh implants for repair of pelvic organ prolapse. This retrospective, long-term follow-up (28.17±20.7 months) comprised 113 women who underwent surgical reconstructive surgery with vaginal polypropylene mesh in a high parity rate population medical center. The women were divided into 2 groups (multiparous and grand multiparous) and each group was evaluated for objective and subjective surgical outcome...
2017: PloS One
https://www.readbyqxmd.com/read/28407297/short-term-complications-associated-with-the-use-of-transvaginal-mesh-in-pelvic-floor-reconstructive-surgery-results-from-a-multi-institutional-prospectively-maintained-dataset
#11
Maxx Caveney, Devin Haddad, Catherine Matthews, Gopal Badlani, Majid Mirzazadeh
AIMS: Vaginal reconstructive surgery can be performed with or without mesh. We sought to determine comparative rates of perioperative complications of native tissue versus vaginal mesh repairs for pelvic organ prolapse. METHODS: Using the National Surgical Quality Improvement Program (NSQIP) database, we concatenated surgical data from vaginal procedures for prolapse repair, including anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and vaginal colpopexy using Current Procedural Terminology (CPT) coding...
April 13, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28303850/incidence-and-risk-factors-of-de-novo-stress-urinary-incontinence-after-pelvic-floor-reconstruction-a-nested-case-control-study
#12
Shi-Yan Wang, Ting-Ting Cao, Run-Zhi Wang, Xin Yang, Xiu-Li Sun, Jian-Liu Wang
BACKGROUND: Some patients with pelvic organ prolapse may suffer from lower urinary tract symptoms (LUTS), especially stress urinary incontinence (SUI) named de novo SUI after pelvic floor reconstruction. This study aimed to investigate the incidence and risk factors of de novo SUI. METHODS: This is a nested case-control study of 533 patients who underwent pelvic floor reconstruction due to pelvic organ prolapse (POP) at the Department of Gynecology in Peking University People's Hospital from January 2011 to March 2013...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28277355/activity-restriction-recommendations-and-outcomes-after-reconstructive-pelvic-surgery-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
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/28252312/-management-of-recurrent-stress-urinary-incontinence-after-anti-incontinence-surgery
#14
A Martan, J Mašata, K Švabík
OBJECTIVE: The review article describes the possibilities of procedures for failed anti-incontinence surgery - sling procedure or "bulking agent"? DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Medical Faculty, Charles University, Prague. MATERIALS AND METHODS: The correct choice of procedure type to treat persistent SUI (Stress Urinary Incontinence) which persists or soon reoccurs after anti-incontinence surgery is often problematic...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28247326/reconstructive-management-options-of-delayed-complications-following-bladder-outlet-surgery
#15
REVIEW
Nora Baker, Carmen Tong, Jay Simhan
PURPOSE OF REVIEW: Technological advancements in urologic endoscopy within the last decades have improved outcomes following bladder outlet reduction surgery while minimizing risks of short- and intermediate-term complications. This review aims to examine late complications of endoscopic reduction of the prostate and the various treatment options available. RECENT FINDINGS: Urinary incontinence, ejaculatory dysfunction, urethral strictures, bladder neck contractures, and fistula formations are the most common delayed complications following bladder outlet reduction surgery...
April 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28213799/the-hybrid-technique-of-pelvic-organ-prolapse-treatment-apical-sling-and-subfascial-colporrhaphy
#16
Dmitry Shkarupa, Nikita Kubin, Alexey Pisarev, Anastasiya Zaytseva, Ekaterina Shapovalova
INTRODUCTION AND HYPOTHESIS: The majority of patients with cystocele undergoing reconstructive surgery have combined defects of pubocervical fascia and uterosacral/cardinal ligament complex. In this regard, the simultaneous correction of both defects is rational. Furthermore, decreasing the use of synthetic materials in pelvic floor surgery is an important goal. The aim was to evaluate the objective and subjective cure rate of a hybrid technique: bilateral sacrospinous fixation using modern monofilament synthetic tape (apical sling) combined with the original technique of subfascial colporrhaphy...
February 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28124074/mri-visible-fe3o4-polypropylene-mesh-3d-reconstruction-of-spatial-relation-to-bony-pelvis-and-neurovascular-structures
#17
Luyun Chen, Florian Lenz, Céline D Alt, Christof Sohn, John O De Lancey, Kerstin A Brocker
INTRODUCTION AND HYPOTHESIS: To demonstrate mesh magnetic resonance imaging (MRI) visibility in living women, the feasibility of reconstructing the full mesh course in 3D, and to document its spatial relationship to pelvic anatomical structures. METHODS: This is a proof of concept study of three patients from a prospective multi-center trial evaluating women with anterior vaginal mesh repair using a MRI-visible Fe3O4 polypropylene implant for pelvic floor reconstruction...
August 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28095995/pelvic-floor-reconstruction-by-modified-rectus-abdominis-myoperitoneal-mram-flap-after-pelvic-exenterations
#18
D Cibula, M Zikan, D Fischerova, R Kocian, A Germanova, A Burgetova, L Dusek, Z Fartáková, M Schneiderová, K Nemejcová, J Slama
OBJECTIVE: To describe the technique and report experiences with pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after extensive pelvic procedures. METHODS: Surgical technique of MRAM harvest and transposition is carefully described. The patients in whom pelvic floor reconstruction with MRAM after either infralevator pelvic exenteration and/or extended lateral pelvic sidewall excision was carried out were enrolled into the study (MRAM group, n=16)...
March 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28057125/-treatment-and-outcome-of-polypropylene-mesh-or-tape-related-pain-after-reconstructive-pelvic-surgery
#19
Y Q Wang, X Yang, J L Wang
Objective: To investigate clinical treatment and outcome of mesh-related pain after pelvic floor reconstruction. Methods: Twelve patients were referred to Peking University People's Hospital for post-operation pain related to polypropylene mesh or tape used in pelvic floor reconstruction and received reoperation from January 2007 to December 2014. The demographic characteristics, clinical manifestation, operation method and follow-up outcome were retrospectively analyzed, and current literature was also reviewed...
December 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27918338/female-pelvic-medicine-and-reconstructive-surgery-in-canada-a-survey-of-obstetrician-gynecologists-and-urologists
#20
Marie K Christakis, Eliane M Shore, Ariel Pulver, Colleen D McDermott
OBJECTIVE: The aim of this study was to assess the current status of female pelvic medicine and reconstructive surgery (FPMRS) in Canada, including level of training, practice patterns, barriers to practice and opinions among obstetrician-gynecologists (OB/GYNs) and urologists. METHODS: Electronic surveys were distributed to 737 OB/GYNs through the Society of Obstetricians and Gynaecologists of Canada and to 489 urologists through the Canadian Urological Association...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
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