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Transvaginal sling

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https://www.readbyqxmd.com/read/28285399/surgeons-views-on-sling-tensioning-during-surgery-for-female-stress-urinary-incontinence
#1
Ali Borazjani, Javier Pizarro-Berdichevsky, Jianbo Li, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Little is known regarding the use of various techniques for sling tensioning. Our objective was to determine which techniques are most commonly used by surgeons and surgeons' views on sling tensioning. METHODS: An Internet-based survey designed to assess the use of various tensioning evaluation methods, different sling tensioning techniques, and views and beliefs regarding the importance of tensioning was sent to members of major sub-specialty professional organizations...
March 11, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28277472/transvaginal-repair-of-complex-rectovaginal-fistulas-using-the-porcine-urinary-bladder-matrix-as-an-augmenting-graft
#2
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: After the US Food and Drug Administration issued a safety warning concerning vaginal mesh implants in 2008, their use in correction of pelvic floor defects have decreased in the United States (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm479732.htm). However, we are still treating patients who have had complications associated with their use, rectovaginal fistulas (RVFs) being one of them. Rectovaginal fistulas are considered complex if greater than 2.5 cm, recurrent, associated with inflammatory bowel disease, or if they are proximal in location...
March 9, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28267602/management-of-urinary-incontinence-following-sub-urethral-sling-removal
#3
Nirmish Singla, Himanshu Aggarwal, Jeannine Foster, Feras Alhalabi, Gary E Lemack, Philippe E Zimmern
PURPOSE: To evaluate urinary incontinence outcomes following synthetic sub-urethral sling removal (SSR) in women. METHODS: We reviewed a prospectively-maintained database of 360 consecutive women who underwent transvaginal SSR from 2005-2015. We excluded patients with neurogenic bladder, non-synthetic or multiple slings, prior mesh for prolapse, concomitant surgery during sling excision, urethral erosion or fistula, post-operative retention, or <6 months follow-up...
March 3, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28230614/characteristics-of-providers-performing-urogynecologic-procedures-on-medicare-patients-2012-2014
#4
Daniel E Stone, Benjamin J Barenberg, Stephanie D Pickett, Dena E OʼLeary, Lieschen H Quiroz
OBJECTIVE: To analyze the characteristics of providers performing stress urinary incontinence (SUI) and pelvic organ prolapse (POP) procedures in the United States. METHODS: The Centers for Medicare Services public database, released for years 2012 through 2014, was queried for SUI-related and POP-related Healthcare Common Procedure Coding System. Providers were categorized as Female Pelvic Medicine and Reconstructive Surgery (FPMRS) providers and non-FPMRS providers, using a list of FPMRS board-certified providers compiled through the American Board of Medical Subspecialties website...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28230566/the-effect-of-preoperative-phenazopyridine-on-urinary-retention-following-midurethral-sling
#5
Omar Felipe Dueñas-Garcia, Tania Sierra, Erica Nicasio, Katherine Leung, Cynthia D Hall, Michael K Flynn
OBJECTIVE: The aim of this study was to determine the effect of preoperative oral phenazopyridine on short-term voiding dysfunction in patients undergoing a retropubic midurethral sling. METHODS: We conducted a retrospective cohort study in subjects undergoing a retropubic midurethral sling comparing those who received preoperative oral phenazopyridine with those who did not. We included all women who underwent a retropubic midurethral sling without concomitant procedures under general anesthesia at our institution...
February 23, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27980522/ultrasound-imaging-in-urogynecology-state-of-the-art-2016
#6
Michał Bogusiewicz
The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue...
November 2016: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/27902825/association-between-the-amount-of-vaginal-mesh-used-with-mesh-erosions-and-repeated-surgery-after-repairing-pelvic-organ-prolapse-and-stress-urinary-incontinence
#7
Bilal Chughtai, Matthew D Barber, Jialin Mao, James C Forde, Sharon-Lise T Normand, Art Sedrakyan
Importance: Mesh, a synthetic graft, has been used in pelvic organ prolapse (POP) repair and stress urinary incontinence (SUI) to augment and strengthen weakened tissue. Polypropylene mesh has come under scrutiny by the US Food and Drug Administration. Objective: To examine the rates of mesh complications and invasive reintervention after the placement of vaginal mesh for POP repair or SUI surgery. Design, Setting, and Participants: This investigation was an observational cohort study at inpatient and ambulatory surgery settings in New York State...
March 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27866958/use-of-concomitant-stress-incontinence-surgery-at-time-of%C3%A2-pelvic-organ-prolapse-surgery-since-release-of-the-2011-fda-health-notification-on-serious-complications-associated-with-transvaginal-mesh
#8
Alice Drain, Aqsa Khan, Erin L Ohmann, Benjamin M Brucker, Scott Smilen, Nirit Rosenblum, Victor W Nitti
PURPOSE: There is controversy regarding the performance of concomitant anti-incontinence procedures at the time of pelvic organ prolapse repair. Data support improvement in stress urinary incontinence with a concomitant sling but increased adverse events. We assessed trends in preoperative stress urinary incontinence evaluation, concomitant anti-incontinence procedure at pelvic organ prolapse surgery and postoperative anti-incontinence procedures at our institution before and after the 2011 FDA (Food and Drug Administration) Public Health Notification pertaining to vaginal mesh...
November 17, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27780347/indications-and-complications-associated-with-the-removal-of-506-pieces-of-vaginal-mesh-used-in-pelvic-floor-reconstruction-a-multicenter-study
#9
John R Miklos, Orawee Chinthakanan, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
STUDY OBJECTIVE: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. DESIGN: This was a retrospective study...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27773810/incidence-and-risk-factors-for-pelvic-pain-after-mesh-implant-surgery-for-the-treatment-of-pelvic-floor-disorders
#10
Elizabeth J Geller, Emma Babb, Andrea G Nackley, Denniz Zolnoun
STUDY OBJECTIVE: Our aim was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation. DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: Single university hospital. PATIENTS: Women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor disorders including prolapse and incontinence. INTERVENTIONS: Telephone interviews to assess pain, sexual function, and general health...
January 1, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27773649/postoperative-urinary-retention-and-urinary-tract-infections-predict-midurethral-sling-mesh-complications
#11
Nahid Punjani, Jennifer Winick-Ng, Blayne Welk
OBJECTIVE: To determine if postoperative urinary retention and urinary tract infections (UTIs) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). MATERIALS AND METHODS: Administrative data in Ontario, Canada, between 2002 and 2013 were used to identify all women who underwent a mesh-based MUS. The primary outcome was revision of the transvaginal mesh sling (including mesh removal/erosion/fistula, or urethrolysis)...
January 2017: Urology
https://www.readbyqxmd.com/read/27647467/predictors-of-voiding-dysfunction-following-extensive-vaginal-pelvic-reconstructive-surgery
#12
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
https://www.readbyqxmd.com/read/27636217/analysis-of-surgical-outcomes-and-determinants-of-litigation-among-women-with-transvaginal-mesh-complications
#13
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
https://www.readbyqxmd.com/read/27562466/mesh-complications-and-failure-rates-after-transvaginal-mesh-repair-compared-with-abdominal-or-laparoscopic-sacrocolpopexy-and-to-native-tissue-repair-in-treating-apical-prolapse
#14
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...
February 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27530521/transvaginal-sling-excision-tips-and-tricks
#15
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...
January 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27525690/urethrovaginal-fistula-closure
#16
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...
January 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27525688/removal-of-obstructing-synthetic-sling-from-a-urethra-english-and-spanish-version
#17
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)...
December 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27496298/detailed-cost-analysis-of-robotic-sacrocolpopexy-compared-to-transvaginal-mesh-repair
#18
Michael J Ehlert, Priyanka Gupta, Jonathan Park, Larry T Sirls
OBJECTIVE: 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 January 2012 to December 2013 were evaluated. Patient clinical and operative data were recorded. The total institutional costs (direct and indirect) for each procedure were obtained and subcategorized by area. Independent sample t tests and chi-squared analysis were performed...
November 2016: Urology
https://www.readbyqxmd.com/read/27460448/stress-urinary-incontinence-surgery-trends-in-academic-female-pelvic-medicine-and-reconstructive-surgery-urology-practice-in-the-setting-of-the-food-and-drug-administration-public-health-notifications
#19
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
https://www.readbyqxmd.com/read/27423455/transvaginal-repair-of-a-urethrovaginal-fistula-using-the-latzko-technique-with-a-bulbocavernosus-martius-flap
#20
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...
December 2016: International Urogynecology Journal
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