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Pelvic organ prolapse

Tilemachos Kavvadias, Birgitt Schoenfisch, Markus Huebner, Sara Y Brucker, Diethelm Wallwiener, Christl Reisenauer
OBJECTIVE: To report the perioperative adverse events associated with nerve-preserving sacropexy for pelvic organ prolapse (POP) repair and to identify risk factors that could predict possible adverse events. MATERIALS AND METHODS: A total of 768 women who underwent sacropexy for POP repair performed by one surgeon using the same technique, beyond the learning curve, over a 10-year period, between January 1st 2007 and December 31st 2016. METHODS: The medical records of 768 women were reviewed for age, body mass index (BMI), tobacco use, previous surgeries (for POP and incontinence, abdominal surgeries in general), operating time, duration of hospitalization and perioperative events at time of surgery and 6 weeks postoperatively...
June 21, 2018: Archives of Gynecology and Obstetrics
Chin-Ru Ker, Kun-Ling Lin, Zi-Xi Loo, Yung-Shun Juan, Cheng-Yu Long
Hysterectomy is the empirical treatment for female pelvic organ prolapse (POP) without robust evidence to prove its efficacy. Uphold transvaginal mesh (TVM) system is an innovated device with smaller area, superior anterior/apical support with single incision to treat POP. The prospective cohort study aims to evaluate Uphold TVM's performance with or without concomitant hysterectomy. Inclusion criteria specify patients suffering from stage 2 or more anterior/apical prolapse without previous hysterectomy. Exclusion criteria specify those with contraindications to uterine preservation, such as leiomyomas, adenomyosis, endometrial hyperplasia, abnormal uterine bleeding, postmenopausal bleeding, cervical dysplasia, receiving tamoxifen treatment, family history of gynecology cancer, or colon cancer and incapability to be routinely followed...
June 21, 2018: Scientific Reports
Marianne H Gillam, Mhairi Kerr, Nicole L Pratt, Renly Lim, Elizabeth E Roughead
BACKGROUND: Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common conditions. The use of mesh in the surgical treatment of these conditions in Australia is unclear. AIM: To examine the use of mesh in POP and SUI procedures in an Australian national cohort of older women. METHODS: We conducted a population-based cohort study using data from the Australian Government Department of Veterans' Affairs (DVA) database. The cohort consisted of older women who had POP and SUI procedures between 1 July, 2005 and 31 December, 2016...
June 21, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Michael Heit, Janet S Carpenter, Chen X Chen, Ryan Stewart, Jennifer Hamner, Kevin L Rand
OBJECTIVES: Our aim was to identify sociodemographic/clinical, surgical, and psychosocial predictors of postdischarge surgical recovery after laparoscopic sacrocolpopexy. METHODS: Study participants (N = 171) with at least stage 2 pelvic organ prolapse completed a preoperative survey measuring hypothesized sociodemographic/clinical, surgical, and psychosocial recovery predictors followed by a postoperative survey at 4 time points (days 7, 14, 42, and 90) that included the Postdischarge Surgical Recovery 13 scale...
June 19, 2018: Female Pelvic Medicine & Reconstructive Surgery
Huei-Kai Huang, Dah-Ching Ding
INTRODUCTION AND HYPOTHESIS: Hysterectomy and pelvic organ prolapse (POP) surgeries are two of the most common gynecologic surgeries conducted for benign conditions. This nationwide retrospective cohort study explored the risk of subsequent POP surgery following hysterectomy without simultaneous POP surgery. METHODS: This study identified 7298 patients who underwent hysterectomy between January 1, 2000, and December 31, 2012, from the Taiwan National Health Insurance (NHI) Research Database...
June 19, 2018: International Urogynecology Journal
Brendan J Miller, Elvis I Seman, Robert T O'Shea, Paul H Hakendorf, Tran T T Nguyen
OBJECTIVE: To compare current practice in the management of female pelvic organ prolapse in Australia and New Zealand with that in 2007, and assess the impact on practice of the withdrawal of Prolift® and Prosima® mesh kits in 2015. MATERIALS AND METHODS: In early 2015, two invitations to participate in a survey, including a link to Surveymonkey, were emailed to 2506 Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees and fellows...
June 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Philippe Ferry, Pauline Bertherat, Anne Gauthier, Richard Villet, Francesco Del Piano, David Hamid, Hervé Fernandez, Pierre-Louis Broux, Delphine Salet-Lizée, Etienne Vincens, Pierre Ntshaykolo, Philippe Debodinance, Philippe Pocholle, Yannick Thirouard, Renaud de Tayrac
Vaginal mesh safety information is limited, especially concerning single incision techniques using ultra lightweight meshes for the treatment of anterior pelvic organ prolapse (POP). Objective To determine the intraoperative and postoperative complication rates after anterior POP repair involving an ultralight mesh (19kg/m2 ): Restorelle® Direct Fix™. Methods A case series of 218 consecutive patients, operated on between January 2013 and December 2016 in ten tertiary and secondary care centres, was retrospectively analysed...
June 16, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Charelle M Carter-Brooks, Angela L Du, Kristine M Ruppert, Anna L Romanova, Halina M Zyczynski
OBJECTIVES: ERAS protocols were developed for colorectal surgery to hasten post-op recovery. Variations of the protocol are being adopted for gynecologic procedures despite limited population and procedure-specific outcome data. Our objective was to evaluate if implementation of an ERAS pathway would facilitate reduced length of admission in an urogynecology population. MATERIALS AND METHODS: In this retrospective analysis of patients undergoing pelvic floor reconstructive surgery by 7 female pelvic medicine and reconstructive surgeons we compared same day discharge, length of admission and post-op complications before and after implementation of an ERAS pathway at a tertiary-care hospital...
June 15, 2018: American Journal of Obstetrics and Gynecology
Radhika Patnam, Autumn Edenfield, Steven Swift
INTRODUCTION AND HYPOTHESIS: The purpose of this study is to reanalyze data from the original 2005 Pelvic Organ Support Study (POSST) data set to define normal values for apical Pelvic Organ Prolapse Quantification (POP-Q) points C and D and total vaginal length (TVL) in an asymptomatic population of women. METHODS: In this retrospective observational data-set review, patient were >18 years presenting for annual gynecologic exams to six centers in the United States...
June 16, 2018: International Urogynecology Journal
Claudia R Kowalik, Mariëlle M E Lakeman, Alyde T de Kraker, Jan Paul W R Roovers
INTRODUCTION AND HYPOTHESIS: Vaginal mesh surgery is subject of debate due to the impact of mesh-related complications on patient's lives. Not all of these complications are symptomatic. Restoration of the anatomy and improvement of pelvic floor function as a result may counter the experienced discomfort related to adverse events. We hypothesized that health-related quality of life (HR-QoL) is comparable in women after vaginal mesh surgery regardless of the presence or absence of a mesh-specific complication...
June 16, 2018: International Urogynecology Journal
Pauliina Aukee, Niina Humalajärvi, Matti V Kairaluoma, Antti Valpas, Beata Stach-Lempinen
OBJECTIVE: The aim of this study was to evaluate the effect of hysterectomy with or without concomitant prolapse surgery on subject-reported pelvic floor disorders (PFD) with a 5-year follow-up. STUDY DESIGN: This prospective longitudinal study was carried out in two Finnish central hospitals among 286 women who had undergone hysterectomy for benign reasons. The presence of urinary incontinence, urinary frequency, feeling of vaginal bulging, constipation and anal incontinence was evaluated at baseline, 1 and 5 years postoperatively...
June 8, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
H Aydogmus, U S Demirdal
OBJECTIVE: The association of vitamin D deficiency and pelvic floor dysfunction has been examined by numerous studies. Lower urinary tract symptoms (LUTS) associated with bladder filling and voiding functions are common in both sexes. A recent study reports a higher incidence of LTUS in men over 50 years old with vitamin D deficiency. The aim of the study is to investigate whether there is a difference in the Lower Urinary Tract Symptoms frequency between women with vitamin D deficiency and the control group or not...
June 9, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Bernhard Liedl, Klaus Goeschen, Suzette E Sutherland, Jean-Paul Roovers, Alexander Yassouridis
OBJECTIVE: The objective of this interventional study was to examine extent and intensity of the coexistence of overactive bladder (OAB) symptoms in women with pelvic organ prolapse (POP) and to evaluate the likelihood of OAB symptom improvement after surgical POP reconstruction in a period of two years. PATIENTS AND METHODS: The effectiveness of the transvaginal, single-incision Elevate@ technique for anatomical cure of anterior/apical and posterior/apical vaginal prolapse has been previously reported following a prospective, multicenter study...
June 16, 2018: BJU International
Merga Dheresa, Alemayehu Worku, Lemessa Oljira, Bizatu Mengiste, Nega Assefa, Yemane Berhane
BACKGROUND: Hundreds of millions of women suffer from pelvic floor disorders globally, often in silence. Women in developing countries do not disclose their problems due to associated social stigma or lack of access to services. Thus, the extent of the problem remains largely unknown. This study was conducted to assess the magnitude of pelvic floor disorders in Kersa district Eastern Ethiopia. METHOD: We conducted a community-based cross-sectional study among ever married women who reside in Kersa district, Eastern Ethiopia...
June 15, 2018: BMC Women's Health
Jessica C Lloyd, Juan Guzman-Negron, Howard B Goldman
INTRODUCTION: Robotic surgical procedures have become more common in female pelvic reconstruction. Purported benefits of robotic assisted pelvic floor reconstruction (RAPFR) procedures include shorter hospital stay, faster recovery, lower blood loss, and decreased postoperative pain. Following RAPFR procedures, the current accepted practice is discharge after a one-night hospitalization. We assessed whether same day discharge (SDD) affects the short term safety of and patient satisfaction with robotic assisted pelvic floor reconstructive procedures, relative to those who remain hospitalized overnight...
June 2018: Canadian Journal of Urology
Levent Ozcan, Emre Can Polat, Efe Onen, Alper Otunctemur, Emin Ozbek, Adnan Somay, Nurver Ozbay
PURPOSE: Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are common medical problems, particularlyamong older women. In this study, we aim to explore the relationship between the neurotransmitter nNOS in the vaginal epithelium, and the occurrence of SUI and changes of nNOS levels according to menopausal status.Matherials and Methods: Fourty women were enrolled. The patients were divided into four groups according to menstruaiton status and SUI. The vagina specimens were taken during transobturator tape application...
June 14, 2018: Urology Journal
Christina Tso, Wah Lee, Tammy Austin-Ketch, Harvey Winkler, Bruce Zitkus
Pelvic organ prolapse is a medical condition that can cause pelvic discomfort as well as urinary and bowel complications. Approximately 25% of women in the United States and roughly 50% of women worldwide develop this condition. Although pelvic organ prolapse is usually a non-life-threatening condition, it can result in decreased self-confidence and negative body image. Physical and emotional sequelae can limit physical activity, and decreased productivity could be a consequence. Evidence from the literature indicates that pessary use and pelvic floor muscle training are effective options when conservative treatment is desired...
June 2018: Nursing for Women's Health
I M A van Gruting, K Kluivers, A H Sultan, R De Bin, A Stankiewicz, H Blake, R Thakar
OBJECTIVE: To establish the diagnostic test accuracy of both two-dimensional (2D) and four-dimensional (4D) transperineal ultrasound, to assess if 4D ultrasound imaging provides additional value in the diagnosis of posterior pelvic floor disorders in women with obstructed defaecation syndrome. METHODS: In this prospective cohort study, 121 consecutive women with obstructed defaecation syndrome were recruited. Symptoms of obstructed defaecation and signs of pelvic organ prolapse were assessed using validated methods...
June 8, 2018: Ultrasound in Obstetrics & Gynecology
Ching-Chung Liang, Yi-Hao Lin, Wu-Chiao Hsieh, Lulu Huang
OBJECTIVE: To investigate urinary and psychological symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical hyaluronic acid (HA) treatment. MATERIALS AND METHODS: Thirty patients with newly diagnosed with IC/BPS undergoing 4 weekly intravesical HA instillations followed by 5 monthly instillations were recruited. Pre-treatment evaluation included a urinalysis and urinary culture, a 3-day voiding diary, and cystoscopy with hydrodistention of the bladder...
June 2018: Taiwanese Journal of Obstetrics & Gynecology
Cássia Colla, Luciana L Paiva, Lia Ferla, Maria J B Trento, Isadora M P de Vargas, Bianca A Dos Santos, Charles F Ferreira, José G L Ramos
OBJECTIVE: To identify and assess postpartum pelvic floor dysfunction (PFD) between vaginal delivery, elective cesarean delivery (ECD), and intrapartum cesarean delivery (ICD). METHODS: The present prospective observational study included women aged at least 18 years with no history of pelvic surgery or lower urinary tract malformation, and who had not undergone pelvic floor muscle (PFM) training in the preceding 12 months, who underwent delivery at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil between August 1, 2016, and May 31, 2017...
June 7, 2018: International Journal of Gynaecology and Obstetrics
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