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Vaginal reconstruction

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https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#1
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
#2
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
#3
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 multi-step 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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