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Vaginal reconstruction

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https://www.readbyqxmd.com/read/28213799/the-hybrid-technique-of-pelvic-organ-prolapse-treatment-apical-sling-and-subfascial-colporrhaphy
#1
Dmitry Shkarupa, Nikita Kubin, Alexey Pisarev, Anastasiya Zaytseva, Ekaterina Shapovalova
INTRODUCTION AND HYPOTHESIS: The majority of patients with cystocele undergoing reconstructive surgery have combined defects of pubocervical fascia and uterosacral/cardinal ligament complex. In this regard, the simultaneous correction of both defects is rational. Furthermore, decreasing the use of synthetic materials in pelvic floor surgery is an important goal. The aim was to evaluate the objective and subjective cure rate of a hybrid technique: bilateral sacrospinous fixation using modern monofilament synthetic tape (apical sling) combined with the original technique of subfascial colporrhaphy...
February 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28213796/the-manchester-repair-an-instructional-video
#2
Caroline E Walsh, Lin L Ow, N Rajamaheswari, Peter L Dwyer
OBJECTIVE: The Manchester repair, developed in the UK by Donald, described in 1908, and later modified by Fothergill, is a well-studied and proven surgical treatment for uterovaginal prolapse when uterine preservation is desired. This operation is currently not widely performed in parts of the world (USA) but is becoming increasing popular in Europe. The objective of this video is to demonstrate our surgical technique and recommendations for successful completion of the procedure. METHODS: This patient is a 39-year-old woman with two previous vaginal deliveries who presented with a 1-year history of vaginal protrusion...
February 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28191788/full-thickness-skin-mesh-graft-vaginoplasty-a-skin-sparing-technique
#3
Guilherme Lang Motta, Patric Machado Tavares, Gabriel Veber Moisés Silva, Milton Berger, Brasil Silva Neto, Tiago Elias Rosito
INTRODUCTION: The ideal vaginoplasty method should promote good cosmetic and functional results with low morbidity. We describe a new technique for congenital vaginal agenesis using a full-thickness perforated skin graft. MATERIALS AND METHODS: We report an 18 year old patient with vaginal agenesis (Morris syndrome) that undergone a modified version of McIndoe vaginoplasty. Patient is set in a low lithotomy position and lateral traction sutures are placed in labia and a 16Fr urethral catheter inserted...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28169915/vaginal-estrogen-a-dual-edged-sword-in-postoperative-healing-of-the-vaginal-wall
#4
Christopher M Ripperda, Pedro Antonio Maldonado, Jesus F Acevedo, Patrick W Keller, Yucel Akgul, John M Shelton, Ruth Ann Word
OBJECTIVE: Reconstructive surgery for pelvic organ prolapse is plagued with high failure rates possibly due to impaired healing or regeneration of the vaginal wall. Here, we tested the hypothesis that postoperative administration of local estrogen, direct injection of mesenchymal stem cells (MSCs), or both lead to improved wound healing of the injured vagina in a menopausal rat model. METHODS: Ovariectomized rats underwent surgical injury to the posterior vaginal wall and were randomized to treatment with placebo (n = 41), estrogen cream (n = 47), direct injection of MSCs (n = 39), or both (n = 43)...
February 6, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28160508/transvaginal-management-of-severe-pelvic-organ-prolapse-in-nulliparous-women
#5
Tsia-Shu Lo, Sukanda Jaili, Ma Clarissa Uy-Patrimonio, Nazura Bt Karim, Rami Ibrahim
AIM: The aim of this study was to evaluate the management outcomes of advanced pelvic organ prolapse (POP) in nulliparous women. METHODS: Eight nulliparous women diagnosed with POP ≥ stage 3 between January 2005 and August 2013, according to the Pelvic Organ Quantification System (POPQ), were reviewed. Seven were managed surgically and one was managed with pessary. Primary outcome was surgical objective cure (POP-Q ≤ 1) and subjective cure, defined as negative response to questions 2 and 3 on Pelvic Organ Prolapse Distress Inventory 6...
February 4, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28150258/-the-life-impacts-and-symptom-distress-in-women-with-pelvic-organ-prolapse-syndrome-before-pelvic-reconstruction-surgery
#6
I-Chen Ko, Tsia-Shu Lo, Yu-Ying Lu, Lee-Ing Tsao
BACKGROUND: The decision whether or not to undergo pelvic reconstructive surgery is difficult for women suffering from pelvic organ prolapse. However, little research has examined the symptom distress and life impacts that these women face prior to this surgery. Thus, it is crucial that gynecology nurses learn about these life impacts and symptom distresses in order to help these women make the best decisions with regard to surgery. PURPOSE: To explore the life impacts and degree of symptom distress in pre-surgery women with pelvic organ prolapse; to explore the relationships between demographic data and the variables of life impact and degree of symptom distress; and to identify the factors that relate to the explainable variance in the life impacts of these women...
February 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28146426/ex-vivo-2d-and-3d-hsv-2-infection-model-using-human-normal-vaginal-epithelial-cells
#7
Yaqi Zhu, Yan Yang, Juanjuan Guo, Ying Dai, Lina Ye, Jianbin Qiu, Zhihong Zeng, Xiaoting Wu, Yanmei Xing, Xiang Long, Xufeng Wu, Lin Ye, Shubin Wang, Hui Li
Herpes simplex virus type 2 (HSV-2) infects human genital mucosa and establishes life-long latent infection. It is unmet need to establish a human cell-based microphysiological system for virus biology and anti-viral drug discovery. One of barriers is lacking of culture system of normal epithelial cells in vitro over decades. In this study, we established human normal vaginal epithelial cell (HNVEC) culture using co-culture system. HNVEC cells were then propagated rapidly and stably in a defined culture condition...
January 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28145916/hydronephrosis-presenting-6-months-after-sacral-colpopexy-case-report-and-literature-review
#8
Emily Weber LeBrun, Estefania Santamaria, Louis Moy
OBJECTIVES: The aim of this study was to describe a case of uterovaginal prolapse managed with robotic-assisted sacral colpopexy complicated by severe right-sided hydronephrosis despite normal intraoperative cystoscopy. METHODS: A 68-year-old woman presented with a worsening vaginal bulge over the past 2 years. Tricompartment stage 2 uterovaginal prolapse, with dominant cystocele and skin erosion at the posterior fourchette from prolapse friction, was identified on physical examination, and the patient underwent pelvic reconstructive surgery, including sacral colpopexy...
January 31, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28124074/mri-visible-fe3o4-polypropylene-mesh-3d-reconstruction-of-spatial-relation-to-bony-pelvis-and-neurovascular-structures
#9
Luyun Chen, Florian Lenz, Céline D Alt, Christof Sohn, John O De Lancey, Kerstin A Brocker
INTRODUCTION AND HYPOTHESIS: To demonstrate mesh magnetic resonance imaging (MRI) visibility in living women, the feasibility of reconstructing the full mesh course in 3D, and to document its spatial relationship to pelvic anatomical structures. METHODS: This is a proof of concept study of three patients from a prospective multi-center trial evaluating women with anterior vaginal mesh repair using a MRI-visible Fe3O4 polypropylene implant for pelvic floor reconstruction...
January 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28067743/comparative-perioperative-pain-and-recovery-in-women-undergoing-vaginal-reconstruction-versus-robotic-sacrocolpopexy
#10
Lauren B Westermann, Catrina C Crisp, Donna Mazloomdoost, Steven D Kleeman, Rachel N Pauls
BACKGROUND: In this study of patients undergoing vaginal hysterectomy with either robotic or vaginal prolapse repair, there was no difference in quality of life in the weeks following surgery; however, less narcotics were used, less pain was documented by nurses and Surgical Pain Scale (SPS), and better performance on voiding trials was noted in those undergoing robotic sacrocolpopexy. OBJECTIVES: Minimally invasive surgery for pelvic organ prolapse is the preferred surgical route for optimal recovery...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28057125/-treatment-and-outcome-of-polypropylene-mesh-or-tape-related-pain-after-reconstructive-pelvic-surgery
#11
Y Q Wang, X Yang, J L Wang
Objective: To investigate clinical treatment and outcome of mesh-related pain after pelvic floor reconstruction. Methods: Twelve patients were referred to Peking University People's Hospital for post-operation pain related to polypropylene mesh or tape used in pelvic floor reconstruction and received reoperation from January 2007 to December 2014. The demographic characteristics, clinical manifestation, operation method and follow-up outcome were retrospectively analyzed, and current literature was also reviewed...
December 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28048088/su-f-t-47-mri-t2-exclusive-based-planning-using-the-endocavitary-interstitial-gynecological-benidorm-applicator-a-proposed-tps-library-and-preplan-efficient-methodology
#12
J Richart, A Otal, S Rodriguez, M Santos, J Perez-Calatayud
PURPOSE: ABS and GEC-ESTRO have recommended MRI T2 for image guided brachytherapy. Recently, a new applicator (Benidorm Template, TB) has been developed in our Department (Rodriguez et al 2015). TB is fully MRI compatible because the Titanium needles and it allows the use of intrauterine tandem. Currently, TPS applicators library are not currently available for non-rigid applicators in case of interstitial component as the TB.The purpose of this work is to present the development of a library for the TB, together with its use on a pre-planning technique...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047374/su-f-t-55-reproducibility-of-interstitial-hdr-brachytherapy-plans
#13
S Lee, R Ellis, B Traughber, T Podder
PURPOSE: Treating gynecological cancers with interstitial high-dose-rate (HDR) brachytherapy requires precise reconstruction of catheter positions to obtain accurate dosimetric plans. In this study, we investigated the degree of reproducibility of dosimetric plans for Syed HDR brachytherapy. METHODS: We randomly selected five patients having cervix-vaginal cancer who were recently treated in our clinic with interstitial HDR brachytherapy with a prescription dose of 25-30 Gy in five fractions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28034651/patient-surgeon-and-hospital-disparities-associated-with-benign-hysterectomy-approach-and-perioperative-complications
#14
Ambar Mehta, Tim Xu, Susan Hutfless, Martin A Makary, Abdulrahman K Sinno, Edward J Tanner, Rebecca L Stone, Karen Wang, Amanda N Fader
BACKGROUND: Hysterectomy is among the most common major surgical procedures performed in women. Approximately 450,000 hysterectomy procedures are performed each year in the United States for benign indications. However, little is known regarding contemporary U.S. hysterectomy trends for women with benign disease with respect to operative technique and perioperative complications, and the association between these two factors with patient, surgeon, and hospital characteristics. OBJECTIVES: To describe contemporary hysterectomy trends and explore associations between patient, surgeon, and hospital characteristics with surgical approach and perioperative complications...
December 26, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28025684/utility-of-anterior-vaginal-wall-length-measurement-in-vaginal-reconstructive-surgery
#15
Amy F Collins, Paula J Doyle, Smitha Vilasagar, Gunhilde M Buchsbaum
INTRODUCTION AND HYPOTHESIS: The pelvic organ prolapse quantification system (POP-Q) is the most commonly used method to quantify the extent of pelvic organ prolapse. However, it does not include assessment of anterior vaginal wall length (AVL). The objectives of this study were to characterize AVL and distance to the sacrospinous ligament (SSL), and to examine associations between total vaginal length (TVL), AVL, body mass index (BMI) and age. METHODS: This was a retrospective chart review of 139 patients with cervix in situ presenting during an 8-month period for initial evaluation to the University of Rochester Medical Center Urogynecology practice...
December 26, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27988170/assessing-resident-surgical-volume-before-and-after-initiation-of-a-female-pelvic-medicine-and-reconstructive-surgery-fellowship
#16
Zaid Chaudhry, Christopher M Tarnay
OBJECTIVES: The effect of fellowship programs on resident training for gynecologic surgery volume has not been clearly defined. The purpose of our study is to assess resident surgical volume for laparoscopic and vaginal hysterectomy before and after initiation of a female pelvic medicine and reconstructive surgery (FPMRS) fellowship. DESIGN: A retrospective review of Accreditation Council for Graduate Medical Education Resident Case Logs of obstetrics and gynecology residents who graduated in the 3 years before and after initiation of a FPMRS fellowship was performed...
December 14, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27958629/prosthetic-materials-for-treating-posterior-vaginal-wall-prolapse-and-rectocele-own-experience
#17
Honorata Stadnik, Tomasz Maciej Kościński
OBJECTIVES: This report describes results of posterior vaginal wall prolapse and rectocele treatment performing tension free reconstruction method with polypropylene mesh implantation. MATERIAL AND METHODS: In years 2001 to 20015, 71 female patients in age of 42-82 years were surgically treated. Besides difficult emptying they complained of feeling of heaviness in the pelvis (38%) and dyspareunia (16.9%). Defecography and magnetic resonance proved the presence of rectocele in 84...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27935547/flap-design-and-perfusion-are-keys-of%C3%A2-success-axial-fasciocutaneous-posterior-thigh-flaps-for-deep-small-pelvic-defect-reconstruction
#18
Andreas Kehrer, Philipp Lamby, Benjamin H Miranda, Lukas Prantl, Juergen H Dolderer
BACKGROUND AND OBJECTIVES: Radical excisions of the rectum often result in large perineal and intrapelvic defects. Compromised wound healing can delay adjuvant therapies and limit the patient's prognosis. With current treatment, integrity of the abdominal wall may be maintained. The defect geometry is unique and requires extensive volume for reconstruction. This study describes the surgical technique and reports clinical outcomes of fasciocutaneous posterior thigh flaps as preliminary data for this indication...
2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27918338/female-pelvic-medicine-and-reconstructive-surgery-in-canada-a-survey-of-obstetrician-gynecologists-and-urologists
#19
Marie K Christakis, Eliane M Shore, Ariel Pulver, Colleen D McDermott
OBJECTIVE: The aim of this study was to assess the current status of female pelvic medicine and reconstructive surgery (FPMRS) in Canada, including level of training, practice patterns, barriers to practice and opinions among obstetrician-gynecologists (OB/GYNs) and urologists. METHODS: Electronic surveys were distributed to 737 OB/GYNs through the Society of Obstetricians and Gynaecologists of Canada and to 489 urologists through the Canadian Urological Association...
December 1, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27908366/urologic-sequelae-following-phalloplasty-in-transgendered-patients
#20
REVIEW
Dmitriy Nikolavsky, Yuka Yamaguchi, Jamie P Levine, Lee C Zhao
In recent years, the issues of the transgender population have become more visible in the media worldwide. Transgender patients at various stages of their transformation will present to urologic clinics requiring general or specialized urologic care. Knowledge of specifics of reconstructed anatomy and potential unique complications of the reconstruction will become important in providing urologic care to these patients. In this article, we have concentrated on describing diagnosis and treatment of the more common urologic complications after female-to-male reconstructions: urethrocutaneous fistulae, neourethral strictures, and symptomatic persistent vaginal cavities...
February 2017: Urologic Clinics of North America
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