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Transvaginal sling

Tsia-Shu Lo, Nagashu Shailaja, Wu-Chiao Hsieh, Ma Clarissa Uy-Patrimonio, Faridah Mohd Yusoff, Rami Ibrahim
INTRODUCTION AND HYPOTHESIS: The objective of this study was to identify the predictors of postoperative voiding dysfunction in women following extensive vaginal pelvic reconstructive surgery. METHODS: We enrolled 1,425 women who had pelvic organ prolapse of POP-Q stage III or IV and had undergone vaginal pelvic reconstructive surgery with or without transvaginal mesh insertion from January 2006 to December 2014. All subjects were required to complete a 72-h voiding diary, and the IIQ-7, UDI-6, POPDI-6 and PISQ-12 questionnaires...
September 19, 2016: International Urogynecology Journal
Dani Zoorob, Mickey Karram, Anna Stecher, Rose Maxwell, James Whiteside
OBJECTIVES: To identify litigation predictors among women with complications of transvaginal mesh. METHODS: Chart review and patient survey were conducted among women who had undergone a complication-related explant of a transvaginal prolapse or incontinence sling mesh. Trained study personnel administered a 57-question survey addressing subjective complaints related to bowel, bladder, sexual dysfunction, and development of pain or recurrent prolapse. These data were analyzed with respect to the subject's reported pursuit of litigation related to the mesh complication...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
Vani Dandolu, Megumi Akiyama, Gayle Allenback, Prathamesh Pathak
OBJECTIVE: Our objective was to quantitate the extent of complications and failure rate for apical prolapse repair with transvaginal mesh (TVM) use versus sacrocolpopexy over a minimum of 2 years of follow-up. METHODS: Truven CCAE and Medicare Supplemental databases 2008-2013 were used for analysis. Patients with apical prolapse repair via transvaginal mesh (TVMR), abdominal sacrocolpopexy (ASCP), laparoscopic sacrocolpopexy (LSCP), or native tissue repair (NTR) and continuously enrolled for years were in the study cohort...
August 25, 2016: International Urogynecology Journal
Marisa M Clifton, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Complications of synthetic midurethral sling surgery include bladder outlet obstruction, mesh extrusion, and vaginal pain. A treatment of these complications is transvaginal mesh removal. The objectives of this video are to present cases of complications after sling placement and describe techniques to help with successful sling removal. METHODS: Three patients are presented in this video. One experienced urinary hesitancy and was found to have bladder outlet obstruction on urodynamic study...
August 16, 2016: International Urogynecology Journal
Marisa M Clifton, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: In the developed world, urethrovaginal fistulas are most the likely the result of iatrogenic injury. These fistulas are quite rare. Proper surgical repair requires careful dissection and tension-free closure. The objective of this video is to demonstrate the identification and surgical correction of an urethrovaginal fistula. METHODS: The case presented is of a 59-year-old woman with a history of pelvic organ prolapse and symptomatic stress urinary incontinence who underwent vaginal hysterectomy, anterior colporrhaphy, posterior colporrhaphy, and synthetic sling placement...
August 15, 2016: International Urogynecology Journal
Javier Pizarro-Berdichevsky, Michelle P Goldman, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Urethral perforations after synthetic midurethral sling (MUS) placement are uncommon. Transvaginal removal is an option. The objective of this English and Spanish video is to demonstrate removal of an MUS that had perforated the urethra and the concomitant urethral reconstruction. METHODS: A 66-year-old woman with a history of an anterior and posterior colporrhaphy and a retropubic MUS 12 years earlier presented with difficulty voiding, recurrent urinary tract infections, and mild stress incontinence (SUI)...
August 15, 2016: International Urogynecology Journal
Michael J Ehlert, Priyanka Gupta, Jonathan Park, Larry T Sirls
OBJECTIVES: To evaluate the hospital realized cost difference between transvaginal mesh prolapse repair and robot assisted sacrocolpopexy. METHODS: Consecutive transvaginal mesh prolapse surgery and robot assisted sacrocolpopexy cases from 1/2012 to 12/2013 were evaluated. Patient clinical and operative data were recorded. The total institutional costs (direct and indirect) for each procedure were obtained and sub-categorized by area. Independent samples t-test and Chi squared analysis were performed...
August 2, 2016: Urology
Goran Rac, Austin Younger, James Q Clemens, Kathleen Kobashi, Aqsa Khan, Victor Nitti, Ilana Jacobs, Gary E Lemack, Elizabeth T Brown, Roger Dmochowski, Lara MacLachlan, Arthur Mourtzinos, David Ginsberg, Michelle Koski, Ross Rames, Eric S Rovner
AIMS: To investigate the possible effects of the Food and Drug Administration (FDA) Public Health Notifications in 2008 and 2011 regarding surgical trends in transvaginal mesh (TVM) placement for stress urinary incontinence (SUI) and related mesh revision surgery in Female Pelvic Medicine & Reconstructive Surgery (FPMRS) practice in tertiary care academic medical centers in the United States. METHODS: Surgical volume for procedures performed primarily by FPMRS surgeons at eight academic institutions across the US was collected using Current Procedural Terminology (CPT) codes for stress urinary incontinence repair and revision surgeries from 2007 to 2013...
July 26, 2016: Neurourology and Urodynamics
Ariel Zilberlicht, Yuval Lavy, Ron Auslender, Yoram Abramov
INTRODUCTION AND HYPOTHESIS: Urethrovaginal fistula is a rare disorder that may occur following sling procedures for stress urinary incontinence, excision of a urethral diverticulum, anterior vaginal wall repair, radiation therapy, and prolonged indwelling urethral catheter. The most common clinical manifestation is continuous urinary leakage through the vagina, aggravated by an increase in the intra-abdominal pressure. Appropriate management, including timing of the surgical intervention and the preferred technique, remains controversial...
July 16, 2016: International Urogynecology Journal
M Denancé, E Quiboeuf, C Hocké
OBJECTIVE: To assess at 6 months the efficiency, the safety and the satisfaction of a lightweight polypropylene mesh used for the transvaginal repair of cystocele by bilateral anterior sacrospinous ligament fixation (NUVIA™ SI). MATERIEL AND METHODS: A prospective cohort study was performed from January 2014 to June 2015. Preoperative assessment included an evaluation using the Pelvic Organ Prolapse Quantification system (POP-Q) and 3 questionnaires about symptoms, quality of life and quality of sex life (PFDI-20, PFIQ7, PISQ-12)...
September 2016: Progrès en Urologie
Charles W Nager
Midurethral sling procedures are minimally invasive surgeries for stress urinary incontinence that use a trocar system to place a narrow ribbon of polypropylene mesh under the midurethra. The peer-reviewed scientific literature on these procedures is abundant and midurethral slings are the most well-studied incontinence procedure ever. Systematic reviews of the literature demonstrate that midurethral slings are safer and more (or equally) effective as traditional procedures. The midurethral sling is the worldwide standard for the treatment of female stress urinary incontinence and >3 million procedures have been performed...
June 2016: American Journal of Obstetrics and Gynecology
Andrew Colhoun, David E Rapp
OBJECTIVES: The literature lacks long-term evaluation of outcomes after repair of transurethral midurethral sling (MUS) perforation. METHODS: We prospectively followed 5 patients undergoing repair of urethral perforation (International Continence Society-International Urogynecological Association classification 4B) after MUS (mean follow-up, 54 months). Outcomes assessment was composed of validated measures of urinary (International Consultation on Incontinence Questionnaire [ICIQ]-Female Lower Urinary Tract Symptoms), vaginal (ICIQ-Vaginal Symptoms), and quality of life (Incontinence Impact Questionnaire, Short Form) symptoms...
July 2016: Female Pelvic Medicine & Reconstructive Surgery
Alexandriah N Alas, Ines Pereira, Neeraja Chandrasekaran, Hemikaa Devakumar, Luis Espaillat, Eric Hurtado, G Willy Davila
INTRODUCTION AND HYPOTHESIS: This video demonstrates a transvaginal technique for vaginal vault suspension using an apical sling suspended from the sacrospinous ligaments. METHODS: This was a retrospective review of apical sling procedures performed from July 2013 to November 2014. The technique is started by marking the vaginal apex. A posterior dissection is performed and the sacrospinous ligaments are identified after dissection into the pararectal space. A 10-cm piece of monofilament, inelastic polypropylene tape is attached to the underside of the vaginal apex...
September 2016: International Urogynecology Journal
Chun-Hou Liao, Chung-Cheng Wang, Yuan-Hong Jiang
Overactive bladder (OAB) symptoms increase with age and involve several comorbidities. OnabotulinumtoxinA (BoNT-A) intravesical injection is a treatment choice for patients who are intolerant of or refractory to antimuscarinics. However, the increased risk of urinary tract infection and elevated post-void residual (PVR) volume post-treatment require resolution. Male sex, baseline PVR > 100 mL, and comorbidities are independent risk factors of adverse events (AEs) such as acute urinary retention (AUR). Intravesical BoNT-A injection is safe and effective for OAB patients with frailty, medical comorbidities such as Parkinson's disease (PD), chronic cerebrovascular accidents (CVA), dementia, or diabetes, or a history of prior lower urinary tract surgery (prostate or transvaginal sling surgery)...
April 2016: Toxins
Olugbemisola McCoy, Taylor Vaughan, S Walker Nickles, Matt Ashley, Lara S MacLachlan, David Ginsberg, Eric Rovner
PURPOSE: We reviewed the outcomes of the autologous fascial pubovaginal sling as a salvage procedure for recurrent stress incontinence after intervention for polypropylene mesh erosion/exposure and/or bladder outlet obstruction in patients treated with prior transvaginal synthetic mesh for stress urinary incontinence. MATERIALS AND METHODS: In a review of surgical databases at 2 institutions between January 2007 and June 2013 we identified 46 patients who underwent autologous fascial pubovaginal sling following removal of transvaginal synthetic mesh in simultaneous or staged fashion...
August 2016: Journal of Urology
Shieh-Ling Bang, Mohammed Belal
Stress urinary incontinence (SUI) is an under-diagnosed problem affecting up to 50% of women worldwide. SUI is a source of psychological distress to the individual and also imposes a financial burden to the individual and the health care system. The role of surgery in the treatment in SUI has evolved steadily in the last two decades. The synthetic mid-urethral sling and its different insertion methods have gained widespread popularity and are now the most frequently used surgical interventions for women with SUI in Europe...
2016: Research and Reports in Urology
Lee A Richter, Amy J Park, Jenine E Boileau, Megan Janni, Sameer Desale, Cheryl B Iglesia
OBJECTIVES: The best predictors for postoperative anatomic apical success after transvaginal uterosacral ligament suspension remain unknown. The aim of this study was to determine if there is a correlation between the preoperative D point and anatomic outcomes for apical prolapse after 1 year. METHODS: This retrospective cohort study included subjects undergoing transvaginal uterosacral ligament suspension from 2008 through 2013 who had at least 1 year follow-up...
May 2016: Female Pelvic Medicine & Reconstructive Surgery
Jens Christian Prien-Larsen, Thomas Prien-Larsen, Lars Cieslak, Ram B Dessau
INTRODUCTION AND HYPOTHESIS: Although there is clear consensus on the use of monofilament polypropylene tapes for treating stress urinary incontinence (SUI), tapes differ in weight, stiffness, and elasticity. In this study, we compared outcomes of two tape types: high-stiffness Intramesh SOFT L.I.F.T versus low-stiffness Intramesh L.I.F.T. tape. Our null hypothesis was that in terms of performance, SOFT tape equaled L.I.F.T. tape. METHODS: Six hundred and sixty women underwent prospective transvaginal tape (TVT) surgery for SUI: 210 had the SOFT tape placed and 450 the L...
July 2016: International Urogynecology Journal
John R Miklos, Orawee Chinthakanan, Robert D Moore, Gretchen K Mitchell, Sheena Favors, Deborah R Karp, Gina M Northington, Gladys M Nogueiras, G Willy Davila
INTRODUCTION AND HYPOTHESIS: The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications. METHODS: This was a retrospective chart review of all patients who underwent surgical removal of sling, transvaginal mesh, and sacrocolpopexy for mesh-related complications from 2011 to 2013 at three tertiary referral centers. The International Urogynecological Association (IUGA)/International Continence Society (ICS) classification system was utilized...
June 2016: International Urogynecology Journal
Mohamed Teleb, Emad A Salem, Mohamed Naguib, Mostafa Kamel, Usama Hasan, Abdel Rahman Elfayoumi, Hussein M Kamel, Mahmoud El Adl
PURPOSE: To evaluate tailored polypropylene (prolene) mesh, anterior rectus sheath, and vaginal wall slings positioned under the mid-urethra, to treat stress urinary incontinence (SUI) in women, as SUI is a common pathological condition causing considerable distress and compromising social, physical, psychological, and sexual health, and for which surgical treatment remains controversial. PATIENTS AND METHODS: This prospective randomised study included 32 patients with SUI, evaluated by SEAPI (Stress, Emptying, Anatomy, Protection, and Instability) symptom score and urodynamics...
December 2011: Arab Journal of Urology
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