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Vaginal reconstruction

Jeffrey S Schachar, Hemikaa Devakumar, Laura Martin, Sara Farag, Eric A Hurtado, G Willy Davila
INTRODUCTION AND HYPOTHESIS: Native tissue vaginal repairs are associated with relatively high levels of recurrence. Systematic reviews have noted that preoperative pelvic floor muscle strength was associated with increased risk of recurrence in the short term. METHODS: This is a retrospective review of patients who underwent a primary reconstructive surgery for anterior compartment vaginal prolapse between 2001 and 2015. Patients were divided into "absent," "weak" and "good" preoperative PFM strength (aPFM, wPFM and gPFM, respectively) based on a modified Oxford scale...
March 19, 2018: International Urogynecology Journal
Marjan Waterloos, Tom Claeys, Maxime Sempels, Erik Van Laecke, Piet Hoebeke, Anne-Françoise Spinoit
The adrenogenital syndrome is an autosomal recessive disorder in which an enzyme defect in the steroid pathway leads to excessive prenatal exposure of androgens. In the female fetus, masculinization of the external genitalia is observed. Surgery aims for functional and aesthetical reconstruction. Many techniques have been described. A video of our modified pull-through reconstruction technique is hereby presented. A retrospective descriptive database was created with patients who underwent genitoplasty for a CAH-associated genital condition...
March 8, 2018: Journal of Pediatric Urology
Ivan Mañero, Trinidad Labanca
BACKGROUND: Clitoral reconstruction after genital mutilation is a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore vulvar appearance. TECHNIQUE: We describe a novel surgical technique for clitorolabial reconstruction using a vaginal graft. EXPERIENCE: We present a series of 32 consecutive women who underwent this procedure at Iván Mañero Clinic, Barcelona, Spain, and were prospectively followed...
March 8, 2018: Obstetrics and Gynecology
Ömer Özkan, Özlenen Özkan, Anı Çinpolat, Nasuh Utku Doğan, Gamze Bektaş, Kemal Dolay, Alihan Gürkan, Cumhur Arıcı, Selen Doğan
Although vaginal reconstructions with intestinal segments require particularly complex surgical procedures, this technique has become popular with respect to fairly good functional and esthetic outcomes. This study describes cases of vaginal reconstruction performed using a modified rectosigmoid colon held in an ischemic state in order to reduce secretion and denervated in order to prevent defecation problems. Vaginal reconstructions with rectosigmoid colon were performed on 43 patients. In this retrospective study, 34 patients had Müllerian agenesis, while nine had undergone male to female sex reassignment surgery in which adequate vaginal depth had not been achieved...
March 8, 2018: Journal of Plastic Surgery and Hand Surgery
Chunbo Li, Zhiyuan Dai, Huimin Shu
BACKGROUND: Pelvic organ prolapse (POP) is a common health problem. The lifetime risk of undergoing surgery for prolapse is 11%. POP significantly affects the effects on quality of life and activities of daily living. Laparoscopic sacrocolpopexy (LSC) has been viewed as the gold standard treatment for women with POP who desire reconstructive surgery. However, LSC is associated with technical difficulties, resulting in a long learning curve and operative time. Recently, our team introduced a new laparoscopic technique of inguinal ligament suspension (LILS) and had confirmed its safety and efficacy in treating vaginal vault prolapse...
March 5, 2018: Trials
Yu Song, Xiao-Juan Wang, Yi-Song Chen, Ke-Qin Hua
Background: The effectiveness of an anti-incontinence procedure concomitant with prolapse reconstruction for pelvic organ prolapse (POP) in preventing urinary incontinence (UI) after surgery remains controversial. Our study aimed to describe the incidence of pre- and postoperative UI for pelvic reconstructive surgery and evaluate the management of POP associated with UI. Methods: A total of 329 patients who underwent total pelvic reconstruction between June 2009 and February 2015 at a single institution were identified...
March 5, 2018: Chinese Medical Journal
Jing Ding, Qin Han, Mou Deng, Xiao-Chen Song, Chun Chen, Fang-Fang Ai, Lan Zhu, Robert Chun-Hua Zhao
HUMSCs were isolated, differentiated and characterized in vitro. Both HUMSCs and smooth muscle cells differentiated from HUMSCs were used to fabricate tissue-engineered fascia equivalents. Forty-eight mature female Sprague Dawley rats were randomly assigned to four groups: group A (GynemeshTMPS, n = 12), group B (GynemeshTMPS + HUMSCs; n = 12), group C (GynemeshTMPS + smooth muscle cells differentiated from HUMSCs; n = 12) and group D (GynemeshTMPS + HUMSCs + smooth muscle cells differentiated from HUMSCs; n = 12)...
February 26, 2018: Cell and Tissue Research
Abigail Shatkin-Margolis, Catrina C Crisp, Christopher Morrison, Rachel N Pauls
OBJECTIVES: An ability to anticipate individuals at increased risk of postoperative pain would improve coordination of care and patient satisfaction. We sought to describe predictive factors of postoperative pain following vaginal reconstructive surgery. METHODS: This institutional review board-approved, retrospective study used previously collected data from research performed at 1 center from 2009 to 2015. Eligible trials enrolled subjects undergoing vaginal reconstructive surgery for pelvic organ prolapse...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
James Tankel, Shlomo Yellineck, Petachia Reissman
Formation of a colonic J-pouch with anastomosis to the rectal stump is an accepted form of reconstruction after low anterior resection (LAR) for rectal carcinoma. It is thought this can help prevent the onset of LAR syndrome as well as improve the quality of life in the first two years following surgery. Rectovaginal fistulation is a recognised complication of this form of surgery usually occurring because of technical failure leading to inclusion of the vaginal wall into the stapled anastomosis. We present an as of yet unreported case of fistulation between the upper horizontal staple line of a colonic J-pouch-the tip of the 'J'-which was formed extracorporeally with the posterior vaginal fornix...
February 16, 2018: BMJ Case Reports
Yisong Chen, Junwei Li, Keqin Hua
STUDY OBJECTIVE: To describe new technique of pelvic reconstruction with Y-shaped mesh assisted by transvaginal single-port laparoscopy for multiple compartments Pelvic Organ Prolapse (POP). DESIGN: Step-by-step explanation of the procedure using video. SETTING: It is more and more prudent for pelvic floor reconstruction with mesh because of mesh related complications. Learning from sacrocolpopexy with lower rate of mesh erosion (3.5%), new method of pelvic reconstruction with natural orifice transluminal endoscopic surgery is feasible...
February 9, 2018: Journal of Minimally Invasive Gynecology
Isabelle Joy Lang, Margit Fisch, Luis Alex Kluth
BACKGROUND:  Vesico- and ureterovaginal fistulas are defined as abnormal connections between the urinary tract, on the one side, and the female genital system, on the other. Despite being highly prevalent as an acquired pathology of the urogenital system, there has as yet been no standardized protocol in place for diagnosing and treating these fistulas. This review analyses the current literature concerning vesico- and ureterovaginal fistulas in order to profile common diagnostic and therapeutic concepts...
February 2018: Aktuelle Urologie
Wouter B van der Sluis, Nicola Pavan, Giovanni Liguori, Stefano Bucci, Marta R Bizic, Vladimir Kojovic, Jochen Hess, Wilhelmus J H J Meijerink, Margriet G Mullender, Müjde Özer, Jan Maerten Smit, Marlon E Buncamper, Susanne Krege, Miroslav L Djordjevic, Carlo Trombetta, Mark-Bram Bouman
OBJECTIVES: To describe surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). PATIENTS AND METHODS: Transgender women and DSD patients, who underwent ileal vaginoplasty at the VU University Medical Center Amsterdam, University Hospital Trieste, University Hospital Essen and Belgrade University Hospital, were retrospectively identified. A chart review was performed, recording surgical technique, intraoperative characteristics, complications and reoperations...
February 1, 2018: BJU International
Kamal Seyed-Forootan, Hamid Karimi, Nazilla-Sadat Seyed-Forootan
BACKGROUND: Plastic surgeons have used several methods for the construction of neo-vaginas, including the utilization of penile skin, free skin grafts, small bowel or recto-sigmoid grafts, an amnion graft, and cultured cells. PURPOSE: The aim of this study is to compare the results of amnion grafts with amnion seeded with autograft fibroblasts. MATERIALS AND METHODS: Over 8 years, we compared the results of 24 male-to-female transsexual patients retrospectively based on their complications and levels of satisfaction...
January 30, 2018: Aesthetic Plastic Surgery
Casey G Kowalik, Joshua A Cohn, Andrea Kakos, Patrick Lang, W Stuart Reynolds, Melissa R Kaufman, Mickey M Karram, Roger R Dmochowski
INTRODUCTION AND HYPOTHESIS: Urethral injury resulting from transvaginal mesh slings is a rare complication with an estimated incidence of <1%. Our objective was to review the surgical management and functional outcomes of women presenting with urethral mesh perforation following midurethral sling (MUS) placement. METHODS: This was a retrospective multicenter review of women who from January 2011 to March 2016 at two institutions underwent mesh sling excision for urethral perforation with Female Pelvic Medicine and Reconstructive Surgery fellowship-trained surgeons...
January 29, 2018: International Urogynecology Journal
Alin Petcharopas, Supreeya Wongtra-Ngan, Orawee Chinthakanan
INTRODUCTION AND HYPOTHESIS: Although colpocleisis is effective in selected women, the low-morbidity obliterative procedure for treating pelvic organ prolapse (POP) and its impact on postoperative quality of life (QOL) have rarely been studied. Our aim was to assess QOL in women after colpocleisis and compare it with that of women after reconstructive vaginal surgery. METHODS: This retrospective cohort study included women (aged 35-85 years) with POP who underwent obliterative or reconstructive surgical correction during 2009-2015...
January 27, 2018: International Urogynecology Journal
Tanya P Hoke, Howard Goldstein, Emily K Saks, Babak Vakili
STUDY OBJECTIVE: To evaluate surgical outcomes of a robotic sacrocolpopexy with and without a paravaginal repair for pelvic organ prolapse (POP) DESIGN: Retrospective cohort study with 3-month postoperative follow-up (Canadian Task Force II-3) SETTING: Academic-affiliated community hospital with a practice comprised of three surgeons board-certified in Female Pelvic Medicine and Reconstructive Surgery PATIENTS: Patients undergoing a robotic sacrocolpopexy for POP from April 2013 through November 2014...
January 22, 2018: Journal of Minimally Invasive Gynecology
Melanie R Meister, Joshua I Rosenbloom, Jerry L Lowder, Alison G Cahill
Importance: Obstetric anal sphincter injuries (OASISs) complicate up to 11% of vaginal deliveries; obstetricians must be able to recognize and manage these technically challenging injuries. Objective: The aim of this study was to share our approach for management of these challenging complications of childbirth based on a multidisciplinary collaboration between general obstetrician-gynecologists, maternal fetal medicine specialists, and female pelvic medicine and reconstructive surgeons established at our institution...
January 2018: Obstetrical & Gynecological Survey
J Waskowski, J C Schefold, F Stueber
BACKGROUND: Minimising perioperative bleeding is a key goal of "patient blood management" programs. One component of respective strategies includes preventive inhibition of fibrinolysis using protease inhibitors, such as tranexamic acid (TXA). TXA inhibits plasminogen activation and plasmin-induced fibrin degradation. OBJECTIVES: The present article provides an overview of the existing literature and TXA applications in the prophylaxis of perioperative bleeding...
January 24, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Joshua D Roth, Jessica T Casey, Benjamin M Whittam, Konrad M Szymanski, Martin Kaefer, Richard C Rink, Frank P Schubert, Mark P Cain, Rosalia Misseri
Objective To determine the outcomes of pregnancy and cesarean delivery (CD) delivery in women with neuropathic bladder (NB) and pediatric lower urinary tract reconstruction (LUTR) as these women often have normal fertility and may become pregnant. Methods We reviewed consecutive patients from July 2001 to June 2016 with NB due to spinal dysphraphism who underwent LUTR, became pregnant, and had a CD at our institution. We collected data on demographics, hydronephrosis, symptomatic urinary tract infection (UTI), continence and catheterization during pregnancy...
January 3, 2018: Urology
Stefano Restaino, Carlo Ronsini, Angelo Finelli, Alessandro Santarelli, Giovanni Scambia, Francesco Fanfani
Study Objective To prove the feasibility of Shull technique by a laparoscopy approach in patient affected by pelvic organ prolapse (POP) with apical loss of support. Design A step-by-step demonstration of the technique in a surgical video, including the fundamental steps for a laparoscopic uterosacral ligament suspension (USLS) (Canadian Task Force Classification III). Setting According to the National Health and Nutrition Examination Survey, approximately 3% of women in the United States report symptoms linked to POP...
December 28, 2017: Journal of Minimally Invasive Gynecology
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