Pelvic organ prolaps

OBJECTIVES: To present anterior abdominal fixation - a new surgical technique for the treatment of pelvic organ prolaps (POP) and to evaluate the results of the treatment of patients with stage III and IV POP operated using this technique. MATERIAL AND METHODS: Anterior abdominal fixation for treating stage III and IV POP was carried out in 42 women, who were qualified according to the Pelvic Organ Prolapse Quantification System (POP-Q) scale at baseline and after 12 months...

INTRODUCTION: Laparoscopic sacral colpopexy (LSC) is the gold standard treatment for apical pelvic organ prolapse (POP). Artificial urinary sphincter (AUS) has a high success rate in treating recurrent stress urinary incontinence (SUI). OBJECTIVE: To describe the first simultaneous LSC and AUS implantation through a vesicovaginal approach to the bladder neck. MATERIAL AND METHODS: Operation is performed through a transperitoneal approach. The rectovaginal space is created and the posterior mesh is fixed...

Sexual function is an important component of quality of life for women. Midlife poses several challenges to optimal sexual function and intimacy for women. In addition to anatomic factors related to estrogen deficiency, such as genitourinary syndrome of menopause, vulvovaginal atrophy, and pelvic organ prolaps, psychosocial factors, including prior sexual trauma, play an important role in sexual function in women. Several treatments have emerged for female sexual dysfunction; long-term studies and head-to-head comparisons are lacking...

OBJECTIVE: The aim of this study is to investigate the effect of robot assisted laparoscopic sacrohysteropexy (RALS), with preservation of the uterus, in patients with pelvic organ prolapse on short and long term outcome. We report on (anatomical) status of the prolaps and the associated health related quality of life of women treated with RALS before and five years after surgery. STUDY DESIGN: A prospective cohort study in a teaching hospital in The Netherlands was performed...

INTRODUCTION: The never ending debate over the surgical approach of genital prolapse repair (abdominal versus vaginal route) is as passionate as ever. The available literature may support a multidisciplinary analysis of our expert daily practice. OBJECTIVE: Our purpose was to define selection criteria for surgical approach between abdominal and vaginal route in the management of genital prolapse by reviewing the literature. MATERIAL AND METHODS: Systematically review of the literature concerning comparative anatomical and functionnal results of surgery of pelvic organ prolaps by vaginal or abdominal route...

OBJECTIVE: Provide guidelines for clinical practice concerning hysterectomy during surgical treatment of pelvic organ prolaps, with or without mesh. METHODS: Systematically review of the literature concerning anatomical and functionnal results of uterine conservation or hysterectomie during surgical treatment of pelvic organ prolaps. RESULTS: Sacrospinous hysteropexy is as effective as vaginal hysterectomy and repair in retrospective comparative studies and in a meta-analysis with reduced operating time, blood loss and recovery time (NP2)...

INTRODUCTION: Pelvic organ prolape is not uncommon in multi-parous or elderly women. It is one of the rare but important causes of obstructive uropathy. Herein, we report two cases of severe procidentia that were referred with obstructive uropathy due to prolapsed bladder and ureters. PRESENTATION OF CASE: The first case was a 78-year-old woman, with severe pelvic organ prolape and secondary bilateral hydroureteronephrosis and post-renal failure. She was treated successfully by bilateral nephrostomy insertion and then pessary insertion...

BACKGROUND: To evaluate prolapse-related symptoms, quality of life and sexuality of patients with validated questionnaires before and after surgery for genital prolapse and assess relevance of such an evaluation to select women for surgery. METHODS: From November 2009 to April 2010, 16 patients operated on for genital prolapse of grade greater than or equal to 2 (POP-Q classification) were evaluated prospectively by three questionnaires of quality of life Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Organ Prolaps/Urinary Incontinence Sexual Questionnaire (PISQ-12)...

BACKGROUND/AIM: Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA). METHODS: A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who underwent vaginal repair with implatation of a soft mesh manufactured by Gynecare, Ethicon, USA...

UNLABELLED: The study is based on Polizu's Clinic experience and is an comparative analysis between Dan Alessandrescu's technic of istmopexy and a technique imagined by the author used in surgical treatment of genital prolapse grad III with urinary incontinence and vaginal vault prolapse. MATERIAL AND METHOD: From 2168 cases with genital prolapse pathology associated or not with UEI, 129 formed the refference lot which was treated with the two techniques: 85 (Dan Alessandrescu's istmopexy) and 45 (author's technique) for grade III genital prolapse associated with UEI...

OBJECTIVE: To compare the morbidity, functional results and quality of life after laparoscopic promontofixation for the cure of genital prolapsed according with the type of fixation of the posterior mesh. PATIENTS AND METHOD: From 2001 to 2009, 89 patients with genital prolapse of grade greater than or equal to 2 (POP-Q classification) were operated on by laparoscopy including 47 patients with the suture of the posterior mesh (group suture) and 39 patients with staplin (group staples)...

OBJECTIVE: To evaluate the feasibility and morbidity of laparoscopic promontofixation in the cure of genital prolapse. PATIENTS AND METHOD: From March 2001 to January 2009, 101 patients with genital prolapse of grade greater than or equal to 2 (POPQ classification) were operated by laparoscopy. Complications per and postoperative as well as patient satisfaction were assessed. Quality of life was evaluated using the questionnaires Pelvic Floor Distress Inventory (PFDI 20), Pelvic Floor Impact Questionnaire (PISQ 7) and Pelvic Organ Prolaps/Urinary Incontinence Sexual Questionnaire (PISQ 12)...

BACKGROUND: Genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a low recurrence and complication rate. This study aimed to investigate the efficacy and safety of unilateral sacrospinous ligament fixation (SSLF) for the management of pelvic organ prolapse (POP). METHODS: Forty patients with severe prolapse of pelvic organ undergoing unilateral SSLF were retrospectively studied...

INTRODUCTION: The vaginal vault prolapse after hysterectomy is a complex disorder, which can be associated with the prolapse of anterior or posterior vaginal wall or cystorectocele. The exact incidence is unknown, and is within the range from 1 - 43% of operated patients. In order to achieve the complete surgical reconstruction of the pelvic floor disorder, a surgeon must have good knowledge of normal anatomic relations of pelvic organs. MATERIAL AND METHODS: Twenty-nine women with the vaginal vault prolapse after hysterectomy were operated at Clinic for Gynecology and Obstetrics in Novi Sad during the period fiom 1995 - 2007...

OBJECTIVE: The aim of this article is to review the incidence and prevalence of complications after prosthetic surgery for POP (pelvic organ prolaps) and USI (urodynamic stress incontinence) and to introduce diagnostic and therapeutic advice into clinical practice. DESIGN: Review article. SETTINGS: Gynecological and Obstetric Clinic, 1st LF UK and VFN, Prague. METHODS: Summary of complications, recent findings, opinions and specific diagnostic and therapeutic recommendations with special focus to vaginal erosion, post-operative voiding difficulties, persisting leakage of urine and de novo urgency...

Diagnosis of diaphragmatic rupture is often missed after blunt thoracic and abdominal injuries because diaphragmatic injury does not play an important role beside severe injuries of intrabdominal and/or thoracic organs. Between 1976 and 1993, 141 patients were treated for traumatic injury of the diaphragm. In 42 patients with penetrating injuries following stab or shot wounds diaphragmatic lesions were diagnosed by the emergent surgical therapy. 99 had diaphragmatic tears from blunt thoracic or abdominal trauma by accidents...

Preservation and reconstruction are the key principles for surgical therapy of the anorectal organ of continence. The occlusive strength of the sphincter system varies significantly among individuals. As a rule, women have weaker sphincter muscles than men. Both sexes experience a decrease in sphincter strength with age. The physiological weakness of the anorectal sphincters in females is explained by a relatively smaller amount of sphincter muscle mass and an asymmetric sphincter anatomy which is characteristic for the female pelvic floor...