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Tomas L Griebling
No abstract text is available yet for this article.
May 2017: Journal of Urology
Alex Mowat, Declan Maher, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Christopher Maher
BACKGROUND: Posterior vaginal wall prolapse (also known as 'posterior compartment prolapse') can cause a sensation of bulge in the vagina along with symptoms of obstructed defecation and sexual dysfunction. Interventions for prevention and conservative management include lifestyle measures, pelvic floor muscle training, and pessary use. We conducted this review to assess the surgical management of posterior vaginal wall prolapse. OBJECTIVES: To evaluate the safety and effectiveness of any surgical intervention compared with another surgical intervention for management of posterior vaginal wall prolapse...
March 5, 2018: Cochrane Database of Systematic Reviews
Teagan L Brown, Steve Petrovski, Hiu Tat Chan, Michael J Angove, Joseph Tucci
The delivery of phages to epithelial surfaces for therapeutic outcomes is a realistic proposal, and indeed one which is being currently tested in clinical trials. This paper reviews some of the known research on formulation of phages into semi-solid dosage forms such as creams, ointments and pastes, as well as solid dosage forms such as troches (or lozenges and pastilles) and suppositories/pessaries, for delivery to the epithelia. The efficacy and stability of these phage formulations is discussed, with a focus on selection of optimal semi-solid bases for phage delivery...
February 26, 2018: Pharmaceuticals
José Luis Dueñas, Alessio Miceli
INTRODUCTION AND HYPOTHESIS: There is considerable variation in the clinical management of pessaries. This study was aimed at exploring the efficacy of the continuous use of ring pessaries without support for the treatment of advanced pelvic organ prolapse (POP) in nonhysterectomized postmenopausal women. METHODS: We conducted this prospective study of fitted pessaries between January 2013 and June 2015 in the Department of Obstetrics and Gynecology at Macarena Hospital, Seville University, Spain...
February 24, 2018: International Urogynecology Journal
Fang-Fang Ai, Meng Mao, Ye Zhang, Jia Kang, Lan Zhu
INTRODUCTION AND HYPOTHESIS: Our aim was to evaluate the impact of generalized anxiety disorders (GAD) on the effectiveness of pessary treatment for pelvic organ prolapse (POP) in postmenopausal women. METHODS: One-hundred and ten women with symptomatic POP who underwent pessary treatment were enrolled in this prospective study. Subjective evaluations of pelvic floor symptoms were assessed using the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), both at baseline and at the 3-month follow-up visit after pessary use...
February 24, 2018: International Urogynecology Journal
Nicole J Fregosi, Deslyn T G Hobson, Casey L Kinman, Jeremy T Gaskins, J Ryan Stewart, Kate V Meriwether
OBJECTIVE: The aim of the study was to describe the effect of frequency of pessary removal on the vaginal microenvironment. METHODS: We performed a secondary analysis of a multicenter randomized trial of hydroxyquinoline gel in women presenting for pessary fitting. Patients had vaginal secretions analyzed at baseline, 2 weeks, and 3 months. Patients were stratified by frequency of pessary removal at least once daily, at least once weekly, and less often than once weekly...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Janneke van 't Hooft, Johanna H van der Lee, Brent C Opmeer, Aleid G van Wassenaer-Leemhuis, Anneloes L van Baar, Dick J Bekedam, Leonie J P Steenis, Sophie Liem, Ewoud Schuit, Cuny Cuijpers, Elise Bleeker, Margot E Vinke, Noor Simons, Irene M de Graaf, Ben Willem J Mol, Cornelieke van de Beek
OBJECTIVE: We recently found in a randomized clinical trial (ProTWIN) that cervical pessary prevented preterm birth and improved neonatal outcome in women with a multiple pregnancy and a cervical length (CL) <38mm. In this follow-up study we evaluated long-term developmental outcomes in the offspring of these women at three years corrected age. METHODS: We conducted a follow-up study of the ProTWIN trial, a trial in which between 2009 and 2012 asymptomatic women with a multiple pregnancy had been randomized to pessary or no pessary...
February 22, 2018: Ultrasound in Obstetrics & Gynecology
Berna Haliloglu Peker, Erdin Ilter, Hakan Peker, Aygen Celik, Ali Gursoy, Onur Gunaldi
STUDY OBJECTIVE: To demonstrate laparoscopic sacrohysteropexy for a case of uterine prolapse in a 12 weeks and 3 days pregnant woman. To our knowledge, this is the first case of laparoscopic sacrohysteropexy performed at 12th weeks of gestation to be reported in literature. DESIGN: A step-by-step explanation of the surgical procedure (Canadian Task Force classification III) SETTING: Uterine prolapse is very rare condition manifesting in an estimated 10000 to 15000 pregnancies (1)...
February 12, 2018: Journal of Minimally Invasive Gynecology
Stefania Palmieri, Alice Cola, Rodolfo Milani, Stefano Manodoro, Matteo Frigerio
No abstract text is available yet for this article.
February 13, 2018: Minerva Ginecologica
Megan S Bradley, Amy L Askew, Monique H Vaughan, Amie Kawasaki, Anthony G Visco
BACKGROUND: Currently, the decision to perform a concurrent posterior repair/perineoplasty at the time of robotic-assisted sacrocolpopexy is not standardized. OBJECTIVE: To compare anatomic failure after robotic-assisted sacrocolpopexy among three groups of patients categorized by their pre- and post-operative genital hiatus size. STUDY DESIGN: We performed a retrospective cohort study of women who underwent robotic-assisted sacrocolpopexy, from 1/2013 to 9/2016...
February 6, 2018: American Journal of Obstetrics and Gynecology
Michael Barsky, Robert Kelley, Faiz Y Bhora, Anne Hardart
BACKGROUND: Pessaries are a treatment option for pelvic organ prolapse, stress urinary incontinence (SUI), and cervical incompetence. An effective pessary is comfortable, corrects the presenting problem, does not cause adverse effects, and is easy to remove. Discomfort and poor fit limit the usefulness of pessaries for many women. Each patient presents with unique anatomy and thus the effectiveness of commercially available pessaries may be limited by lack of customization. METHOD: A patient presenting with SUI and failed commercial pessary fittings desired nonsurgical treatment...
March 2018: Obstetrics and Gynecology
L Story, J Hutter, T Zhang, A H Shennan, M Rutherford
Preterm birth, defined as birth occurring prior to 37 weeks gestation is a common obstetric complication affecting 8% of pregnancies and is associated with significant morbidity and mortality. Infection/inflammation has been implicated in both the aetiology of preterm birth itself and associated neonatal pulmonary and neurological morbidity. Treatment options are currently limited to prolongation of the pregnancy using cervical cerclage, pessaries or progesterone or administration of drugs including steroids to promote lung maturity and neuroprotective agents such as magnesium sulphate, the timing of which are highly critical...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Francis Brako, Bahijja Tolulope Raimi-Abraham, Suntharavathanan Mahalingam, Duncan Q M Craig, Mohan Edirisinghe
Recent evidence has continued to support the applicability of progesterone in preventing preterm birth, hence the development of an appropriate vaginal delivery system for this drug would be of considerable interest. Here, we describe the development of progesterone-loaded bioadhesive nanofibers using pressurized gyration for potential incorporation into a vaginal insert, with a particular view to addressing the challenges of incorporating a poorly water-soluble drug into a hydrophilic nanofiber carrier. Polyethylene oxide and carboxymethyl cellulose were chosen as polymers to develop the carrier systems, based on previous evidence of their yielding mucoadhesive nanofibers using the pressurized gyration technique...
February 2, 2018: International Journal of Pharmaceutics
F-F Ai, L Zhu, M Mao, Y Zhang, J Kang
OBJECTIVE: This study aimed to investigate the impact of depressive symptoms on successful pessary treatment for postmenopausal women with symptomatic pelvic organ prolapse (POP). METHODS: We performed a prospective study involving postmenopausal women with POP who visited our clinic seeking pessary treatment. Demographic information and medical histories were collected. The participants completed the following questionnaires at baseline and after 3 months of successful pessary use: (1) the Pelvic Floor Impact Questionnaire-7 (PFIQ-7); (2) the Pelvic Floor Distress Inventory (PFDI-20); and (3) the Patient Health Questionnaire-9 (PHQ-9)...
February 3, 2018: Climacteric: the Journal of the International Menopause Society
Jin-Sung Yuk, Jung Hun Lee, Jun-Young Hur, Jung-Ho Shin
The study aim was to evaluate the prevalence of pelvic organ prolapse using claim data of South Korea and to evaluate treatment patterns. The Korea National Health Insurance Corporation pay medical costs for most diseases. This study used Health Insurance Review & Assessment Service-National Inpatient Sample (HIRA-NIS) 2009-2015. Pelvic organ prolapse was defined by diagnostic code (N81.x). Of the approximately 4.5 million women included in HIRA-NIS 2009-2015, 10,305 women were selected as having pelvic organ prolapse, and the mean age of the pelvic organ prolapse group was 63...
January 22, 2018: Scientific Reports
Rachel Y K Cheung, Loreta L L Lee, Tony K H Chung, Symphorosa S C Chan
OBJECTIVES: To identify clinical risk factors for dislodgment of vaginal pessary within one year in women with symptomatic pelvic organ prolapse. STUDY DESIGN: This was a prospective observational study which recruited consecutive women with symptomatic pelvic organ prolapse in a tertiary urogynecology center. Basic demographics, clinical symptoms and staging of pelvic organ prolapse were assessed. A vaginal pessary was offered where appropriate. MAIN OUTCOME MEASURES: Demographics and clinical parameters were compared between women who were able to use a vaginal pessary for one year and those whose pessaries were dislodged within one year...
February 2018: Maturitas
Deborah Garratt, Joseph V Turner
INTRODUCTION: Abortion is often a difficult and traumatic decision for a woman to make. Perhaps greater distress occurs when a woman commences a medical abortion but then changes her mind and wishes to keep the now-threatened pregnancy. One published case series detailed a potential method to counter/reverse the abortifacient effect of mifepristone by administering parenteral progesterone in such situations. OBJECTIVES: The present report details cases of women in similar circumstances who have been treated with progesterone...
December 20, 2017: European Journal of Contraception & Reproductive Health Care
Gabriele Saccone, Giuseppe Maria Maruotti, Antonia Giudicepietro, Pasquale Martinelli
Importance: Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. Objective: To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation...
December 19, 2017: JAMA: the Journal of the American Medical Association
Robert M Silver, D Ware Branch
No abstract text is available yet for this article.
December 19, 2017: JAMA: the Journal of the American Medical Association
Kerry Buckley, Jami Gann, Heather Barbier, Joy Greer
BACKGROUND: Few researchers have studied symptomatic younger to middle-aged women with pelvic organ prolapse. The association between highly strenuous activity and prolapse symptoms is largely theoretical. It is also known that a genetic component likely contributes to early-onset pelvic organ prolapse, but prevention and treatment with respect to this has not been explored. Service restrictions differ for active duty women who are diagnosed with symptomatic pelvic organ prolapse. CASE REPORT: We present a case of a 33-yr-old Gravida 1 Para 1 fighter pilot who developed symptomatic pelvic organ prolapse after a vaginal delivery...
January 1, 2018: Aerospace Medicine and Human Performance
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