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Vaginal reconstruction

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https://www.readbyqxmd.com/read/28422365/successful-vaginal-delivery-at-term-after-vaginal-reconstruction-with-labium-minus-flaps-in-a-patient-with-vaginal-atresia-a-rare-case-report
#1
Yu Liu, Yi-Feng Wang
We report a case of successful vaginal delivery after vaginal reconstruction with labium minus flaps in a 23-year-old patient with congenital vaginal atresia. The patient primarily presented with amenorrhea and cyclic abdominal pain; transabdominal ultrasonography revealed an enlarged uterus due to hematometra and absence of the lower segment of the vagina. Eight years ago, she had undergone an unsuccessful attempt at canalization at a local hospital. Upon referral to our hospital, she underwent vaginal reconstruction with labium minus flaps...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28413306/urogenital-management-in-cloaca-an-alternative-approach
#2
Harshjeet Singh Bal, Sudipta Sen, Cenita Sam, Jacob Chacko, John Mathai, S R Regunandan
INTRODUCTION: In the management of cloaca, there is concern that dissection of the urogenital sinus in early childhood with the aim of total anatomical correction is hazardous. Avoiding such mobilization and providing mitrofanoff channel, when needed, till peripubertal period reduces complications and is technically easier. MATERIALS AND METHODS: Forty-three cases of cloaca were managed in the period 2004-2016. Case records and radiology were reviewed retrospectively...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28412085/in-vivo-evidence-of-significant-levator-ani-muscle-stretch-on-mr-images-of-a-live-childbirth
#3
Nikhil Sindhwani, Christian Bamberg, Nele Famaey, Geertje Callewaert, Joachim W Dudenhausen, Ulf Teichgräber, Jan Deprest
OBJECTIVE: Vaginal childbirth is believed to be a significant risk factor for the development of pelvic floor dysfunction later in life. Previous studies have explored the use of medical imaging and simulations of childbirth to determine the stretch in the levator ani muscle. Bamberg et al, 2012, have recorded MR images of a live childbirth of a 24 year old woman giving birth vaginally for the second time, using a 1.0 Tesla open high-field scanner. Our objective was to determine the stretch ratios in the levator muscle using these MR images of live childbirth...
April 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28407297/short-term-complications-associated-with-the-use-of-transvaginal-mesh-in-pelvic-floor-reconstructive-surgery-results-from-a-multi-institutional-prospectively-maintained-dataset
#4
Maxx Caveney, Devin Haddad, Catherine Matthews, Gopal Badlani, Majid Mirzazadeh
AIMS: Vaginal reconstructive surgery can be performed with or without mesh. We sought to determine comparative rates of perioperative complications of native tissue versus vaginal mesh repairs for pelvic organ prolapse. METHODS: Using the National Surgical Quality Improvement Program (NSQIP) database, we concatenated surgical data from vaginal procedures for prolapse repair, including anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and vaginal colpopexy using Current Procedural Terminology (CPT) coding...
April 13, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28371369/peri-vulvar-reconstruction-using-internal-pudendal-artery-perforator-flap-in-female-fournier-s-gangrene
#5
Sang O Baek, Seong H Park, Jong W Rhie, Hyun H Han
Fournier's gangrene in female patients has low incidence rate but high mortality rate compared with that in males, with many cases resulting in death at acute phase. This is due to the differences in male and female genital anatomy, which should be fully understood by physicians to increase the patient's survival rate. After crossing the acute phase of the disease by an appropriate treatment, it is important to reconstruct vaginal or vulvar defects according to the patient's three-dimensional anatomical structures...
March 29, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28371283/outcomes-in-patients-undergoing-robotic-reconstructive-uterovaginal-anastomosis-of-congenital-cervical-and-vaginal-atresia
#6
Ying Zhang, Yisong Chen, Keqin Hua
OBJECTIVE: To introduce our experience of robotic surgery of reconstructive uterovaginal anastomosis and operative outcomes in congenital cervical and vaginal atresia patients. METHODS: Clinical observation and follow-up of four patients with congenital cervical and vaginal atresia who underwent robotic reconstruction of cervix and vagina by SIS (small intestinal submucosa, SIS) graft. RESULTS: Average patient age was 13.8 ± 2.2. Patients complained of severe periodic abdominal pain...
March 29, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28370456/predictors-for-detrusor-overactivity-following-extensive-vaginal-pelvic-reconstructive-surgery
#7
Tsia-Shu Lo, Shailaja Nagashu, Wu-Chiao Hsieh, Ma Clarissa Uy-Patrimonio, Lin Yi-Hao
AIM: This study aims to identify the predictors for detrusor overactivity (DO) in women following extensive vaginal pelvic reconstructive surgery (PRS) for advanced pelvic organ prolapse (POP). METHODS: We enrolled 1503 women who had prolapse POP-Q stage ≥ 3 and underwent vaginal PRS with or without MUS from January 2006 to December 2015. All subjects completed a 72-h voiding diary, IIQ-7, UDI-6, POPDI-6, and PISQ-12. Urodynamics (UDS) was performed pre- and post-operatively...
March 31, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28367207/mclndoe-neovagina-in-patients-with-mullerian-agenesis-a-single-center-experience
#8
Abdulrahim Gari
OBJECTIVES: To evaluate the surgical feasibility and the long-term anatomical and functional results and complication rates in patients with Mullerian aplasia who underwent vaginal reconstruction. METHODS: A retrospective observational case series study over 8 years was conducted in King Faisal Specialist Hospital & Research Centre - Jeddah, Saudi Arabia. All cases diagnosed as Mullerian aplasia and who underwent surgical correction were included. Painless and satisfactory vaginal intercourse after surgery were the main outcome measured...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#9
REVIEW
Gunhilde M Buchsbaum, Toy Gee Lee
Importance: Pelvic organ prolapse is a common condition, the prevalence of which is likely to increase with the aging of our population. Also changing are parameters by which outcomes are assessed, shifting toward patient-centered care. Objective: To review vaginal obliterative procedures for surgical treatment of advanced pelvic organ prolapse historically and to discuss evidence on indications for colpocleisis, outcomes, and complications, as well as review pros and cons for concomitant vaginal hysterectomy and anti-incontinence procedures...
March 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28295403/toward-a-3d-transrectal-ultrasound-system-for-verification-of-needle-placement-during-high-dose-rate-interstitial-gynecologic-brachytherapy
#10
Jessica Robin Rodgers, Kathleen Surry, Eric Leung, David D'Souza, Aaron Fenster
PURPOSE: Treatment for gynecologic cancers, such as cervical, recurrent endometrial, and vaginal malignancies, commonly includes external-beam radiation and brachytherapy. In high-dose-rate (HDR) interstitial gynecologic brachytherapy, radiation treatment is delivered via hollow needles that are typically inserted through a template on the perineum with a cylinder placed in the vagina for stability. Despite the need for precise needle placement to minimize complications and provide optimal treatment, there is no standard intra-operative image-guidance for this procedure...
March 15, 2017: Medical Physics
https://www.readbyqxmd.com/read/28294563/a-new-material-for-tissue-engineered-vagina-reconstruction-acellular-porcine-vagina-matrix
#11
Jing-Kun Zhang, Run-Xuan Du, Lin Zhang, Ya-Nan Li, Ming-Le Zhang, Shuo Zhao, Xiang-Hua Huang, Yan-Fang Xu
Acellular matrix materials have been widely used to repair various tissues and organs. According to the plastic principle, when a part of the body is lost, it should be replaced with a similar material. Therefore, the use of a homologous organ-specific acellular vaginal tissue in vagina reconstruction repair surgery may show good results. However, the acellular vagina matrix (AVM) form large vertebrates is difficult to isolate. In this study, we described a multistep method to prepare porcine AVM and evaluated the efficacy of acellularization...
March 10, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28277355/activity-restriction-recommendations-and-outcomes-after-reconstructive-pelvic-surgery-a-randomized-controlled-trial
#12
Margaret G Mueller, Christina Lewicky-Gaupp, Sarah A Collins, Melinda G Abernethy, Alex Alverdy, Kimberly Kenton
OBJECTIVE: To assess the relationship between prescribed postoperative activity recommendations (liberal compared with restricted) after reconstructive prolapse surgery and patient satisfaction and pelvic floor symptoms. METHODS: In our multicenter, randomized, double-blind clinical trial, women undergoing reconstructive prolapse surgery were randomized to liberal compared with restricted postoperative activity recommendations. Liberal recommendations instructed women to resume postoperative activity at the woman's own pace with no restrictions on lifting or high-impact activities...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28274598/sexual-life-of-women-with-mayer-rokitansky-k%C3%A3-ster-hauser-syndrome-after-laparoscopic-vecchietti-vaginoplasty
#13
Zlatko Pastor, Jiří Froněk, Marta Nováčková, Roman Chmel
INTRODUCTION: Adequate anatomic and physiologic functions of the genitalia are fundamental prerequisites for sexual well-being and reproduction. Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) compromises female sexual life and makes reproduction impossible. AIM: To assess the psychosexual effect of vaginal reconstruction using the laparoscopic Vecchietti technique in patients with MRKHS. METHODS: Forty-two patients with MRKHS who underwent laparoscopic Vecchietti vaginoplasty were included...
March 5, 2017: Sexual Medicine
https://www.readbyqxmd.com/read/28266818/update-on-complications-of-synthetic-suburethral-slings
#14
Cristiano Mendes Gomes, Fabrício Leite Carvalho, Carlos Henrique Suzuki Bellucci, Thiago Souto Hemerly, Fábio Baracat, Jose de Bessa, Miguel Srougi, Homero Bruschini
Synthetic suburethral slings have become the most widely used technique for the surgical treatment of stress urinary incontinence. Despite its high success rates, significant complications have been reported including bleeding, urethral or bladder injury, urethral or bladder mesh erosion, intestinal perforation, vaginal extrusion of mesh, urinary tract infection, pain, urinary urgency and bladder outlet obstruction. Recent warnings from important regulatory agencies worldwide concerning safety issues of the use of mesh for urogynecological reconstruction have had a strong impact on patients as well as surgeons and manufacturers...
March 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28242962/female-cosmetic-genital-surgery-delivering-what-women-want
#15
REVIEW
Navneet Magon, Red Alinsod
Female cosmetic genital surgery (FCGS) is the latest and fastest growing sub-specialty in the broad specialty of gynecology. It encompasses procedures designed to change aesthetic and/or functional aspects of women's genitalia. In case of FCGS, there is difficulty in separating purely aesthetic concerns from medical concerns, because there is much overlap. The initial controversies over FCGS have almost settled down in the light of the mounting scientific evidence suggesting that a number of procedures that currently exist are safe, effective, and capable of treating to a considerable extent the suite of conditions associated with course-of-life vulvo-vaginal changes...
February 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28230615/the-effect-of-intravenous-acetaminophen-on-postoperative-pain-and-narcotic-consumption-after-vaginal-reconstructive-surgery-a-double-blind-randomized-placebo-controlled-trial
#16
Catrina C Crisp, Madiha Khan, Donna L Lambers, Lauren B Westermann, Donna M Mazloomdoost, Jennifer J Yeung, Steven D Kleeman, Rachel N Pauls
OBJECTIVE: This study aimed to determine the effect of intravenous acetaminophen versus placebo on postoperative pain, satisfaction with pain control, and narcotic use after vaginal reconstructive surgery. METHODS: This was an institutional review board-approved, double-blind placebo-controlled randomized trial. Women scheduled for reconstructive surgery including vaginal hysterectomy and vaginal vault suspension were enrolled. Subjects received 1000 mg of intravenous acetaminophen or 100 mL placebo every 6 hours for 24 hours...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28213799/the-hybrid-technique-of-pelvic-organ-prolapse-treatment-apical-sling-and-subfascial-colporrhaphy
#17
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
#18
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
#19
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
#20
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
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