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Pelvic floor surgery

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https://www.readbyqxmd.com/read/29339299/is-there-a-difference-in-the-outcome-of-mid-urethral-sling-operations-performed-by-urogynecologists-as-compared-to-supervised-residents
#1
Osnat Elyashiv, Noa Mevorach Zussman, Masha Ben-Zvi, Jacob Bar, Ron Sagiv, Alexander Condrea, Shimon Ginath
STUDY OBJECTIVE: To compare the operative results of midurethral sling (MUS) surgeries for stress urinary incontinence (SUI) performed by residents under the guidance of an attending specialist in urogynecology, to those done by attendings. DESIGN: Retrospective chart review DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING: University hospital PATIENTS: A retrospective analysis of all MUS's performed between January 2009 to December 2013, in a single public tertiary medical center, was carried out...
January 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29333592/3d-models-of-female-pelvis-structures-reconstructed-and-represented-in-combination-with-anatomical-and-radiological-sections
#2
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/29314096/formats-of-responsibility-elective-surgery-in-the-era-of-evidence-based-medicine
#3
Ariel Ducey, Shoghi Nikoo
This article illustrates what pragmatic sociology refers to as investments in form, by examining the formats created and used by a group of surgeons to determine when elective surgery for pelvic floor disorders could be responsibly undertaken. Drawing upon ethnographic observations of surgical consultations at an academic medical centre in Canada, we show how two specific formats - that the patient is sufficiently bothered and the patient accepts the risks of surgery - allow for justifiable action in conditions of uncertainty and contingency and in light of the demands of dominant imperatives in medicine and health care, especially evidence-based medicine (EBM)...
January 3, 2018: Sociology of Health & Illness
https://www.readbyqxmd.com/read/29313107/treatment-possibilities-for-low-anterior-resection-syndrome-a-review-of-the-literature
#4
REVIEW
Audrius Dulskas, Edgaras Smolskas, Inga Kildusiene, Narimantas E Samalavicius
AIM: Up to 80% of patients after low anterior resection, experience (low) anterior resection syndrome (ARS/LARS). However, there is no standard treatment option currently available. This systemic review aims to summarize treatment possibilities for LARS after surgical treatment of rectal cancer in the medical literature. METHODS: Embase, PubMed, and the Cochrane Library were searched using the terms anterior resection syndrome, low anterior resection, colorectal/rectal/rectum, surgery/operation, pelvic floor rehabilitation, biofeedback, transanal irrigation, sacral nerve stimulation, and tibial nerve stimulation...
January 8, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29308963/pelvic-floor-symptoms-physical-and-psychological-outcomes-of-patients-following-surgery-for-colorectal-cancer
#5
Kuan-Yin Lin, Linda Denehy, Helena C Frawley, Lisa Wilson, Catherine L Granger
BACKGROUND: Little has been published regarding general and pelvic floor-related health status in patients who have undergone surgery for colorectal cancer (CRC). OBJECTIVE: The objective of the study was to assess changes in pelvic floor symptoms, physical activity levels, psychological status, and health-related quality of life (HRQoL) in patients with CRC from pre- to 6 months postoperatively. METHODS: Pelvic floor symptoms, physical activity levels, anxiety and depression, and HRQoL of 30 participants who were undergoing surgery for stages I-III CRC were evaluated pre- and 6 months postoperatively...
January 8, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29305254/pelvic-floor-functional-outcomes-after-total-abdominal-versus-total-laparoscopic-hysterectomy-for-endometrial-cancer
#6
Peta Higgs, Monika Janda, Rebecca Asher, Val Gebski, Peta Forder, Andreas Obermair
BACKGROUND: Pelvic floor functioning is an important concern for women requiring a hysterectomy for endometrial cancer. The incidence of pelvic floor symptoms has not been reported in women who have undergone a hysterectomy for early-stage endometrial cancer. OBJECTIVES: To evaluate pelvic floor function in women who have had surgical treatment for early stage endometrial cancer as part of the multinational Laparoscopic Approach to Cancer of the Endometrium (LACE) trial and to compare patients' outcomes who had total abdominal total versus total laparoscopic hysterectomy...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29300253/anterior-colporrhaphy-with-and-without-dermal-allograft-a-randomized-control-trial-with-long-term-follow-up
#7
Shilpa Iyer, Miriam Seitz, Alexis Tran, Renata Scalabrin Reis, Carolyn Botros, Svjetlana Lozo, Sylvia Botros, Peter Sand, Janet Tomezsko, Chi Wang, Adam Gafni-Kane
OBJECTIVE: The objective of this study was to determine whether anterior colporrhaphy plus insertion of anterior dermal allograft reduces anterior prolapse recurrence at 1 and 7 to 10 years postoperatively compared with anterior colporrhaphy alone. METHODS: We present a nonblinded randomized controlled trial with 1- and 7- to 10-year follow-up. Subjects were randomized between 2005 and 2008 to anterior colporrhaphy or ultralateral anterior colporrhaphy plus insertion of a dermal allograft spanning the anterior compartment between the arcus tendineus fascia pelvis on each side...
January 3, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29290220/diagnosis-and-management-of-vulvodynia-in-postmenopausal-women
#8
REVIEW
Pedro Vieira-Baptista, Gilbert Donders, Lynnette Margesson, Libby Edwards, Hope K Haefner, Faustino R Pérez-López
Vulvodynia, defined as vulvar pain or burning sensation for more than 3 months, without an identifiable cause, can occur at any age. In this paper, the authors address the classification, epidemiology, etiology, diagnosis, and treatment of this condition, focusing on postmenopausal women. In postmenopausal women, vulvar pain and dyspareunia can often be attributed to low levels of estrogen resulting in vulvovaginal atrophy. While correction of vulvovaginal atrophy is an important part of the management of these patients, it will usually be insufficient to manage vulvodynia...
February 2018: Maturitas
https://www.readbyqxmd.com/read/29289624/laparoscopic-approach-for-shull-repair-of-pelvic-floor-defects
#9
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/29273316/quantitative-assessment-and-interpretation-of-vaginal-conditions
#10
Vladimir Egorov, Miles Murphy, Vincent Lucente, Heather van Raalte, Sonya Ephrain, Nina Bhatia, Noune Sarvazyan
INTRODUCTION: Few means exist to provide quantitative and reproducible assessment of vaginal conditions from biomechanical and functional standpoints. AIM: To develop a new approach for quantitative biomechanical characterization of the vagina. METHODS: Vaginal tactile imaging (VTI) allows biomechanical assessment of soft tissue and function along the entire length of the anterior, posterior, and lateral vaginal walls. This can be done at rest, with applied vaginal deformation, and with pelvic muscle contraction...
December 19, 2017: Sexual Medicine
https://www.readbyqxmd.com/read/29245259/efficacy-of-pudendal-nerve-block-for-alleviation-of-catheter-related-bladder-discomfort-in-male-patients-undergoing-lower-urinary-tract-surgeries-a-randomized-controlled-double-blind-trial
#11
Li Xiaoqiang, Zhang Xuerong, Liu Juan, Bechu Shelley Mathew, Yin Xiaorong, Wan Qin, Luo Lili, Zhu Yingying, Luo Jun
BACKGROUND: Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle...
December 2017: Medicine (Baltimore)
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
#12
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/29232268/pelvic-organ-prolapse-repair-using-the-uphold-vaginal-support-system-5-year-follow-up
#13
Päivi Rahkola-Soisalo, Tomi S Mikkola, Daniel Altman, Christian Falconer
OBJECTIVE: This study aimed to assess the long-term (5 years) outcomes of the Uphold Vaginal Support System for symptomatic vaginal apical prolapse with or without anterior colporraphy. METHODS: In total, 164 (81.2%) of 202 women operated on in 24 centers were reached for follow-up. Outcomes were assessed by using the Pelvic Organ Prolapse Quantification, the Pelvic Floor Distress Inventory 20, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire questionnaires...
December 11, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29232267/concomitant-anterior-repair-preoperative-prolapse-severity-and-anatomic-prolapse-outcomes-after-vaginal-apical-procedures
#14
Charles W Nager, Cara L Grimes, Tracy L Nolen, Clifford Y Wai, Linda Brubaker, Peter C Jeppson, Tracey S Wilson, Anthony G Visco, Matthew D Barber, Gary Sutkin, Peggy Norton, Charles R Rardin, Lily Arya, Dennis Wallace, Susan F Meikle
OBJECTIVE: The aim of the study was to compare anterior and overall prolapse prevalence at 1 year in surgical participants with or without concomitant anterior repair (AR) at the time of sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (ULS). METHODS: This is a secondary analysis of two surgical trials; concomitant AR was performed at surgeon's discretion. Anterior anatomic success was defined as pelvic organ prolapse quantification of prolapse point Ba ≤0 and overall success was defined as pelvic organ prolapse quantification points Ba, Bp, and C ≤0 at 12 months...
December 11, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29221180/pelvic-recurrence-after-definitive-surgery-for-locally-advanced-rectal-cancer-a-retrospective-investigation-of-implications-for-precision-radiotherapy-field-design
#15
Chao Li, Yinju Zhu, Tong Tong, Ye Xu, Yun Guan, Jingwen Wang, Huankun Wang, Ji Zhu
Background: To analyze the local distribution of pelvic recurrence after total mesorectal excision, with a view to simplifying the formulation of optimal individualized radiotherapy plans. Methods: We retrospectively investigated the data of 168 patients diagnosed with recurrent pelvic cancer treated at Fudan University Shanghai Cancer Center between January 2008 and December 2012. The following were collected depending on availability: operative report, histological report, specimen photographs, initial preoperative images, images confirming local recurrence, and clinical history...
November 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29219859/in-search-of-mobile-applications-for-patients-with-pelvic-floor-disorders
#16
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/29191471/nerve-sparing-approach-improves-outcomes-of-patients-undergoing-minimally-invasive-radical-hysterectomy-a-systematic-review-and-meta-analysis
#17
REVIEW
Giorgio Bogani, Diego Oreste Rossetti, Antonino Ditto, Mauro Signorelli, Fabio Martinelli, Lavinia Mosca, Cono Scaffa, Umberto Leone Roberti Maggiore, Valentina Chiappa, Ilaria Sabatucci, Domenica Lorusso, Francesco Raspagliesi
Few studies investigated the efficacy and safety of nerve sparing approach via minimally invasive surgery for the treatment of cervical cancer. We aimed to review the current evidence comparing nerve sparing minimally invasive radical hysterectomy (NS-MRH) and conventional minimally invasive radical hysterectomy (MRH). This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD#57655). Overall, 675 patients were included: 350 (51.9%) and 325 (48.1%) patients undergoing MRH and NS-MRH, respectively...
November 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29184791/comprehensive-pelvic-floor-physical-therapy-program-for-men-with-idiopathic-chronic-pelvic-pain-syndrome-a-prospective-study
#18
Thomas A Masterson, John M Masterson, Jessica Azzinaro, Lattoya Manderson, Sanjaya Swain, Ranjith Ramasamy
Background: Male chronic pelvic pain syndrome (CPPS) is a heterogeneous constellation of symptoms that causes significant impairment and is often challenging to treat. In this prospective study, we evaluated men with CPPS who underwent comprehensive pelvic floor physical therapy (PFPT) program. We used the previously validated Genitourinary Pain Index (GUPI) to measure outcomes. Methods: We included 14 men who underwent physical therapy for idiopathic CPPS from October 2015 to October 2016...
October 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29178955/cost-evaluation-quality-of-life-and-pelvic-organ-function-of-three-approaches-to-hysterectomy-for-benign-uterine-conditions-study-protocol-for-a-randomized-controlled-trial
#19
Chanil Ekanayake, Arunasalam Pathmeswaran, Sanjeewa Kularatna, Rasika Herath, Prasantha Wijesinghe
BACKGROUND: Hysterectomy is the commonest major gynaecological surgery. Although there are many approaches to hysterectomy, which depend on clinical criteria, certain patients may be eligible to be operated in any of the several available approaches. However, most comparative studies on hysterectomy are between two approaches. There is also a relative absence of data on long-term outcomes on quality of life and pelvic organ function. There is no single study which has considered quality of life, pelvic organ function and cost-effectiveness for the three main types of hysterectomy...
November 25, 2017: Trials
https://www.readbyqxmd.com/read/29166313/the-perineal-turnover-perforator-flap-a-new-and-simple-technique-for-perineal-reconstruction-after-extralevator-abdominoperineal-excision
#20
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
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