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Pelvic floor 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
Marian Wiegersma, Chantal M C R Panman, Marjolein Y Berger, Henrica C W De Vet, Boudewijn J Kollen, Janny H Dekker
BACKGROUND: The Pelvic Floor Distress Inventory-20 is used to evaluate symptoms and treatment effects in women with pelvic floor disorders. To interpret changes in the scores of this inventory, information is needed on what patients and clinicians perceive as the minimal important (meaningful) change. Although this change in the inventory score has previously been investigated in women undergoing pelvic floor surgery, the results could not be generalized to women with milder symptoms (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Jan Keller, Amelie U Wiedemann, Diana Hilda Hohl, Urte Scholz, Silke Burkert, Mark Schrader, Nina Knoll
OBJECTIVES: Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person's health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons' and partners' perspectives, we examine these predictor domains in the context of prostate cancer patients' rehabilitative pelvic floor exercise (PFE) following radical prostatectomy...
October 15, 2016: British Journal of Health Psychology
G Cucinella, G Calagna, G Romano, G Di Buono, G Gugliotta, S Saitta, G Adile, M Manzone, G Accardi, A Perino, A Agrusa
The apical prolapse has always been considered the most complex of the defects of the pelvic floor, for both the difficulty of the surgical corrective technique and for the high post-surgical recurrence rate. Today, the laparoscopic sacrocolpopexy can be considered the standard treatment for apical prolapse. In the last years, several author performed robotic sacrocolpopexy, obtaining positive results. So, we developed a casecontrol study in order to compare the surgical outcome of robotic group with a control group of laparoscopic approach in patients with symptomatic apical pro-lapsed between January 2015 and December 2015 at University Hospital Policlinico "P...
May 2016: Il Giornale di Chirurgia
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
Amanda Marie Hill, K Meryl David, Lindsay Clark-Donat, Lee Marvin Hammons, Masoud Azodi, Dan-Arin Silasi
OBJECTIVE: To determine whether vertical versus horizontal closure of the vaginal cuff during laparoscopic hysterectomy has an effect on postoperative vaginal length and pelvic organ prolapse. DESIGN: Prospective randomized controlled trial. Subjects were randomly assigned to vertical or horizontal vaginal cuff closure at the time of total laparoscopic hysterectomy. POP-Q tests were performed before surgery, two to four weeks after surgery, and three to four months after surgery...
October 1, 2016: Journal of Minimally Invasive Gynecology
Jeannine Marie Miranne, Robert Eric Gutman, Andrew Ian Sokol, Amy Josephine Park, Cheryl Bernadette Iglesia
OBJECTIVE: To determine whether use of a new personalized risk calculator increases patient satisfaction with the decision whether or not to have a prophylactic midurethral sling (MUS) during pelvic organ prolapse (POP) surgery. METHODS: We performed a randomized controlled trial involving English-speaking women without symptoms of stress urinary incontinence (SUI) with ≥ stage 2 POP who planned to undergo POP surgery with 1 of 4 fellowship-trained urogynecologists at a single academic center...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
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
Khelifa Ait Said, Yannick Leroux, Benjamin Menahem, Arnaud Doerfler, Arnaud Alves, Xavier Tillou
BACKGROUND: Few studies have established that obesity promotes all types of urinary incontinence and disorders of the pelvic floor. The role of bariatric surgery in urinary incontinence remains poorly studied. OBJECTIVE: To determine the effect of bariatric surgery on urinary incontinence, dysuria, and fecal incontinence before and 1 year after bariatric surgery. SETTING: University hospital expert in bariatric surgery METHODS: This was an observational cohort study of 140 patients who underwent bariatric surgery between September 2013 and September 2014...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Jamie M Bartley, Verity Ramirez, Kim A Killinger, Judith A Boura, Priyanka Gupta, Natalie Gaines, Jason P Gilleran, Kenneth M Peters
OBJECTIVES: The aim of this study was to evaluate the efficacy of sacral neuromodulation in patients with prior stress urinary incontinence (SUI) or pelvic organ prolapse (POP) surgery. METHODS: Women in our prospective neuromodulation database were evaluated. Patients with a history of prior SUI/POP surgery were compared to those without. Medical records at baseline were reviewed, and primary outcome was defined as moderate/marked improvement on Global Response Assessment (GRA) at 3 months...
September 15, 2016: Female Pelvic Medicine & Reconstructive Surgery
Corina Christmann-Schmid, Annemijn Philine Annette Wierenga, Eveline Frischknecht, Christopher Maher
OBJECTIVE: The aim of this prospective observational study was to obtain a better understanding of the anatomy and to classify the observed different perineal presentations at the time of posterior colporrhaphy and to describe specific surgical techniques used. METHODS: To classify the observed perineal findings, the Pelvic Organ Prolapse Quantification System with a newly introduced additional measurement of the perineal ridge (PR) was taken intraoperatively and postoperatively in 121 consecutive women undergoing posterior colporrhaphy...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
Emanuel C Trabuco, Christopher J Klingele, Roberta E Blandon, John A Occhino, Amy L Weaver, Michaela E McGree, Maureen A Lemens, John B Gebhart
OBJECTIVE: To compare efficacy and safety of retropubic Burch urethropexy and a midurethral sling in women with stress urinary incontinence (SUI) undergoing concomitant pelvic floor repair with sacrocolpopexy. METHODS: Women were randomly assigned to Burch retropubic urethropexy (n=56) or retropubic midurethral sling (n=57) through dynamic allocation balancing age, body mass index, history of prior incontinence surgery, intrinsic sphincter deficiency, preoperative incontinence diagnosis, and prolapse stage...
October 2016: Obstetrics and Gynecology
Robert E Gutman, Charles R Rardin, Eric R Sokol, Catherine Matthews, Amy J Park, Cheryl B Iglesia, Roxana Geoffrion, Andrew I Sokol, Mickey Karram, Geoffrey W Cundiff, Joan L Blomquist, Matthew D Barber
BACKGROUND: There is growing interest in uterine conservation at the time of surgery for uterovaginal prolapse, but limited data compare different types of hysteropexy. OBJECTIVE: We sought to compare 1-year efficacy and safety of laparoscopic sacral hysteropexy and vaginal mesh hysteropexy. STUDY DESIGN: This multicenter, prospective parallel cohort study compared laparoscopic sacral hysteropexy to vaginal mesh hysteropexy at 8 institutions...
September 3, 2016: American Journal of Obstetrics and Gynecology
Anna Lindgren, G Dunberger, A Enblom
PURPOSE: The purpose of the present study is to describe how gynaecological cancer survivors (GCS) experience incontinence in relation to quality of life, their possibilities for physical activity and exercise and their perceptions and experiences of pelvic floor muscle training. METHOD: This qualitative interview content analysis study included 13 women (48-82 age) with urinary (n = 10) or faecal (n = 3) incontinence after radiation therapy (n = 2), surgery (n = 5) and surgery and radiation therapy (n = 6) for gynaecological cancer, 0...
September 5, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Jennifer Hrabe, Brooke Gurland
Rectal prolapse is associated with debilitating symptoms and leads to both functional impairment and anatomic distortion. Symptoms include rectal bulge, mucous drainage, bleeding, incontinence, constipation, tenesmus, as well as discomfort, pressure, and pain. The only cure is surgical. The optimal surgical repair is not yet defined though laparoscopic rectopexy with mesh is emerging as a more durable approach. The chosen approach should be individually tailored, taking into account factors such as presence of pelvic floor defects and coexistence of vaginal prolapse, severe constipation, surgical fitness, and whether the patient has had a previous prolapse procedure...
September 2016: Clinics in Colon and Rectal Surgery
Floor J Backes, Adam C ElNaggar, Michael Ryan Farrell, Lorna A Brudie, Sarfraz Ahmad, Ritu Salani, David E Cohn, Robert W Holloway, Jeffrey M Fowler, David M O'Malley
OBJECTIVE: This study aimed to compare outcomes of endometrial cancer (EMCA) staging in elderly patients performed either robotically or via laparotomy. METHODS: A retrospective, multi-institutional chart review was conducted of all robotic and laparotomy staging surgeries for EMCA between 2003 and 2009. Charts were reviewed for intraoperative and postoperative complications and morbidities. RESULTS: Seven hundred forty-six women were identified who had undergone EMCA staging either robotically or via laparotomy; 89 and 93 patients 70 years or older underwent staging for EMCA via robotic and laparotomy, respectively...
August 29, 2016: International Journal of Gynecological Cancer
Mikkel Fode, Ege C Serefoglu, Maarten Albersen, Jens Sønksen
INTRODUCTION: Radical prostatectomies can result in urinary incontinence and sexual dysfunction. Traditionally, these issues have been studied separately, and the sexual problem that has received the most focus has been erectile dysfunction. AIM: To summarize the literature on sexually related side effects and their consequences after radical prostatectomy and focus on the occurrence and management of problems beyond erectile dysfunction. METHODS: The literature on sexuality after radical prostatectomy was reviewed through a Medline search...
August 24, 2016: Sexual Medicine Reviews
Thomas Frieling
Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available...
August 2016: Deutsche Medizinische Wochenschrift
Anja Løvvik, Stig Müller, Hitendra R H Patel
Urinary incontinence is a common and debilitating problem, and post-prostatectomy incontinence (PPI) is becoming an increasing problem, with a higher risk among elderly men. Current treatment options for PPI include pelvic floor muscle exercises and surgery. Conservative treatment has disputable effects, and surgical treatment is expensive, is not always effective, and may have complications. This article describes the prevalence and causes of PPI and the current treatment methods. We conducted a search of the PUBMED database and reviewed the current literature on novel medical treatments of PPI, with special focus on the aging man...
August 2016: Drugs & Aging
Moez Kdous, Jad Diari, Monia Ferchiou, Fethi Zhioua
AIM: To evaluate the anatomical and functional outcomes of laparoscopic sacrocolpopexy using an anterior and a posterior prolen mesh, for the cure of genital prolapse. STUDY METHODS: This is a consecutive five year prospective observational study in which 80 patients presented with at least a Stage 2 apical prolapsed (Baden and Walker), with an anterior or a posterior vaginal wall prolapse, who underwent a double sacrocolpopexy. Two prolen prosthesis (Pro-swing® - Textile Hi-Tec™, Fr) were used for this technique...
February 2016: La Tunisie Médicale
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