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Pelvic reconstruction prolapse

Danilo Italo Pio Buca, Marco Liberati, Eleonora Falò, Martina Leombroni, Maria Di Giminiani, Marta Di Nicola, Alessandro Santarelli, Franco Frondaroli, Francesco Fanfani
Female pelvic organ prolapse (POP) is a common condition and the correction of prolapse remains a major challenge for the surgical community. A retrospective study of women with POP undergoing pelvic reconstructive surgery with the Elevate System followed-up for 48 months. A total of 138 women with POP were included in the study. We observed an objective cure rate of 94.9% for the anterior wall after 4 years' follow-up. The subjective cure rate was 97.1%. Improvement in the urinary symptoms was seen after the surgery: the number of asymptomatic patients increased from 14...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Daniel Altman, Kirk Geale, Christian Falconer, Edward Morcos
INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the use of a generic and globally accessible instrument for assessing health-related quality of life (HR-QoL) in pelvic organ prolapse (POP) surgery. METHODS: In a prospective multicenter setting, 207 women underwent surgery for apical prolapse [stage ≥2, Pelvic Organ Prolapse Quantificcation (POP-Q) system] with or without anterior wall defect. Demographic and surgical characteristics were collected before surgery...
March 6, 2018: International Urogynecology Journal
Chunbo Li, Zhiyuan Dai, Huimin Shu
BACKGROUND: Pelvic organ prolapse (POP) is a common health problem. The lifetime risk of undergoing surgery for prolapse is 11%. POP significantly affects the effects on quality of life and activities of daily living. Laparoscopic sacrocolpopexy (LSC) has been viewed as the gold standard treatment for women with POP who desire reconstructive surgery. However, LSC is associated with technical difficulties, resulting in a long learning curve and operative time. Recently, our team introduced a new laparoscopic technique of inguinal ligament suspension (LILS) and had confirmed its safety and efficacy in treating vaginal vault prolapse...
March 5, 2018: Trials
Patrick J Culligan, Sean Haughey, Christa Lewis, Jennifer Priestley, Charbel Salamon
OBJECTIVES: This study aimed to compare the preoperative and postoperative sexual satisfaction reported by male sexual partners of women undergoing surgical correction of pelvic organ prolapse. METHODS: This was a single-center prospective cohort study. Heterosexual, sexually active English-speaking couples in which the women were planning to undergo robotic-assisted laparoscopic sacrocolpopexy for correction of pelvic organ prolapse were eligible for enrollment in the study...
March 1, 2018: Female Pelvic Medicine & Reconstructive Surgery
Marcella G Willis-Gray, Katherine E Husk, Taylor J Brueseke, Jennifer M Wu, Alexis A Dieter
OBJECTIVES: Our primary objective was to evaluate age as a predictor of postanesthesia care unit (PACU) opioid administration in women undergoing reconstructive pelvic surgery. Our secondary objective was to identify additional predictors of PACU opioid administration. METHODS: We conducted a retrospective cohort study of women undergoing outpatient urogynecologic surgery for pelvic organ prolapse and/or stress urinary incontinence between September 2015 to October 2016 at 1 academic medical center...
February 27, 2018: Female Pelvic Medicine & Reconstructive Surgery
Yu Song, Xiao-Juan Wang, Yi-Song Chen, Ke-Qin Hua
Background: The effectiveness of an anti-incontinence procedure concomitant with prolapse reconstruction for pelvic organ prolapse (POP) in preventing urinary incontinence (UI) after surgery remains controversial. Our study aimed to describe the incidence of pre- and postoperative UI for pelvic reconstructive surgery and evaluate the management of POP associated with UI. Methods: A total of 329 patients who underwent total pelvic reconstruction between June 2009 and February 2015 at a single institution were identified...
March 5, 2018: Chinese Medical Journal
Melissa R Kaufman
PURPOSE OF REVIEW: Classic bladder exstrophy (BE) remains one of the most demanding reconstructive challenges encountered in urology. In female BE patients, the long-term sequela of both primary and revision genitoplasty, as well as intrinsic pelvic floor deficits, predispose adult women to significant issues with sexual function, pelvic organ prolapse (POP), and complexities with reproductive health. RECENT FINDINGS: Contemporary data suggest 30-50% of women with BE develop prolapse at a mean age of 16 years...
February 26, 2018: Current Urology Reports
Abigail Shatkin-Margolis, Catrina C Crisp, Christopher Morrison, Rachel N Pauls
OBJECTIVES: An ability to anticipate individuals at increased risk of postoperative pain would improve coordination of care and patient satisfaction. We sought to describe predictive factors of postoperative pain following vaginal reconstructive surgery. METHODS: This institutional review board-approved, retrospective study used previously collected data from research performed at 1 center from 2009 to 2015. Eligible trials enrolled subjects undergoing vaginal reconstructive surgery for pelvic organ prolapse...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Susan A Barr, Catrina C Crisp, Amanda B White, Shazia A Malik, Kimberly Kenton
OBJECTIVE: The aims of this study are to identify screening, treatment, and referral practices of primary care physicians (PCPs) for patients with pelvic floor disorders (PFDs) and evaluate awareness of the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) subspecialty. METHODS: We conducted a cross-sectional survey of PCPs using a random sample of 1005 American College of Physicians members, stratified by demographic region. Electronic survey content included awareness of FPMRS certification, comfort diagnosing and treating PFDs, and PFD referral patterns for PCPs...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Julia Geynisman-Tan, Oluwateniola Brown, Margaret Mueller, Katarzyna Bochenska, Sarah Collins, Christina Lewicky-Gaupp, Kimberly Kenton
OBJECTIVES: This study aimed to determine if personnel handoffs or number of learners in the operating room (OR) are associated with longer OR times in women having pelvic organ prolapse surgery. METHODS: A retrospective review of women undergoing prolapse surgery in 2016 was conducted. Demographics; procedure; OR, anesthetic, and surgical time; number of handoffs between anesthesia members, circulators, and surgical technologies; and number of learners were abstracted...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Yisong Chen, Junwei Li, Keqin Hua
STUDY OBJECTIVE: To describe new technique of pelvic reconstruction with Y-shaped mesh assisted by transvaginal single-port laparoscopy for multiple compartments Pelvic Organ Prolapse (POP). DESIGN: Step-by-step explanation of the procedure using video. SETTING: It is more and more prudent for pelvic floor reconstruction with mesh because of mesh related complications. Learning from sacrocolpopexy with lower rate of mesh erosion (3.5%), new method of pelvic reconstruction with natural orifice transluminal endoscopic surgery is feasible...
February 9, 2018: Journal of Minimally Invasive Gynecology
Céline D Alt, Laura Benner, Theresa Mokry, Florian Lenz, Peter Hallscheidt, Christof Sohn, Hans-Ulrich Kauczor, Kerstin A Brocker
Background Dynamic magnetic resonance imaging (dMRI) captures the entire pelvis during Valsalva maneuver and helps diagnosing pelvic floor changes after reconstructive surgery. Purpose To evaluate therapeutic outcome five years after reconstructive surgery using clinical examination, dMRI, and quality-of-life (QOL) questionnaire. Material and Methods Clinical examination, dMRI, and QOL questionnaire were conducted before surgery and in the follow-ups at 12 weeks, one year, and five years in women with pelvic organ prolapse (POP) stage ≥2...
January 1, 2018: Acta Radiologica
Casey G Kowalik, Joshua A Cohn, Andrea Kakos, Patrick Lang, W Stuart Reynolds, Melissa R Kaufman, Mickey M Karram, Roger R Dmochowski
INTRODUCTION AND HYPOTHESIS: Urethral injury resulting from transvaginal mesh slings is a rare complication with an estimated incidence of <1%. Our objective was to review the surgical management and functional outcomes of women presenting with urethral mesh perforation following midurethral sling (MUS) placement. METHODS: This was a retrospective multicenter review of women who from January 2011 to March 2016 at two institutions underwent mesh sling excision for urethral perforation with Female Pelvic Medicine and Reconstructive Surgery fellowship-trained surgeons...
January 29, 2018: International Urogynecology Journal
Alin Petcharopas, Supreeya Wongtra-Ngan, Orawee Chinthakanan
INTRODUCTION AND HYPOTHESIS: Although colpocleisis is effective in selected women, the low-morbidity obliterative procedure for treating pelvic organ prolapse (POP) and its impact on postoperative quality of life (QOL) have rarely been studied. Our aim was to assess QOL in women after colpocleisis and compare it with that of women after reconstructive vaginal surgery. METHODS: This retrospective cohort study included women (aged 35-85 years) with POP who underwent obliterative or reconstructive surgical correction during 2009-2015...
January 27, 2018: International Urogynecology Journal
Tanya P Hoke, Howard Goldstein, Emily K Saks, Babak Vakili
STUDY OBJECTIVE: To evaluate surgical outcomes of a robotic sacrocolpopexy with and without a paravaginal repair for pelvic organ prolapse (POP) DESIGN: Retrospective cohort study with 3-month postoperative follow-up (Canadian Task Force II-3) SETTING: Academic-affiliated community hospital with a practice comprised of three surgeons board-certified in Female Pelvic Medicine and Reconstructive Surgery PATIENTS: Patients undergoing a robotic sacrocolpopexy for POP from April 2013 through November 2014...
January 22, 2018: Journal of Minimally Invasive Gynecology
Seth A Cohen, Cassandra L Carberry, Scott W Smilen
Injury to the urinary tract is a known risk of surgical repair of anterior and apical pelvic organ prolapse. Cystoscopy at the time of surgical prolapse repair is a low-risk procedure that can identify genitourinary tract injury by inspecting the bladder and urethra as well as by visualizing the ureters and ureteral efflux. There are several techniques to assist with visualization of ureteral efflux. Identifying injury intraoperatively may allow for mitigation of the morbidity of the injury. Universal cystoscopy should be performed at the time of all pelvic reconstructive surgeries, with the exception of operations solely for posterior compartment defects...
January 24, 2018: Female Pelvic Medicine & Reconstructive Surgery
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
Yonglei Cao, Yan Zhou, Congqing Jiang, Guiyi Yang, Hui Song, Lvfeng Liu, Xu Ai, Jing Zhong, Zhilin Gong, Jianhua Ding, Wei Fu, Qun Qian
OBJECTIVE: To evaluate the safety and efficacy of the perineal rectosigmoidectomy (Altemeier procedure) in the treatment of full thickness rectal prolapse. METHODS: Clinical and follow-up data of 52 patients with full thickness rectal prolapse undergoing Altemeier procedure in 9 hospitals from September 2010 to July 2016 were analyzed retrospectively. Of which 38 cases were from Zhongnan Hospital of Wuhan University, 1 case from Suizhou Central Hospital of Hubei province, 1 case from Jingzhou Second People's Hospital of Hubei province, 3 cases from Wuxue First People's Hospital of Hubei province, 1 case from Jingmen First People's Hospital of Hubei province, 1 case from Tuanfeng County Hospital of Hubei province, 4 cases from Jingzhou Central Hospital of Hubei province, 2 from PLA Rocket Army General Hospital, 1 case from the Affiliated Hospital of Xuzhou Medical University in Jiangsu province...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Casey L Kinman, Kate V Meriwether, Cayse M Powell, Deslyn T G Hobson, Jeremy T Gaskins, Sean L Francis
INTRODUCTION AND HYPOTHESIS: The goal of this study was to evaluate whether the addition of an iPad™ application to the informed consent process for pelvic organ prolapse (POP) surgery improves patient understanding and retention of information compared with standard verbal counseling (SVC) alone. METHODS: Patients scheduled for POP surgery were randomized to SVC alone or SVC augmented with an iPad™ application. Prior to counseling, immediately following counseling, and 6 weeks after surgery, patients completed a written quiz testing their understanding of POP and surgical repair (worst score 0; best score 20)...
November 22, 2017: International Urogynecology Journal
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
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