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Pelvic surgery

M Ortega Escudero, J M Gutiérrez Dueñas, C Hernández Díaz, C Ruiz Hierro, R Chamorro Juárez, E Ardela Díaz
OBJECIVES: The aim of this study is to assess the outcome of surgery (Lynn's myectomy) in patients with chronic persistent constipation and failure of medical treatment. MATERIAL AND METHODS: Descriptive study of patients with severe chronic constipation treated by posterior anorectal myectomy (Lynn's technique). We report data from the last 15 years, with a minimum postoperative follow-up of one year. Patients included in the study suffered from a long-term constipation refractory to medical management...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Elizabeth J Geller, Emma Babb, Andrea G Nackley, Denniz Zolnoun
STUDY OBJECTIVE: Our aim was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation. DESIGN: This is a retrospective study of women with no baseline pelvic pain who underwent surgery with mesh implant for the treatment of prolapse and/or incontinence at least one year prior to study period. DESIGN: Classification: Canadian Task Force Level II-2 SETTING: Single university hospital PATIENTS: Women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor disorders including prolapse and incontinence INTERVENTIONS: Telephone interviews to assess pain, sexual function and general health...
October 20, 2016: Journal of Minimally Invasive Gynecology
Debjyoti Karmakar, Peter L Dwyer
INTRODUCTION AND BACKGROUND: Vaginal surgery for the treatment of urinary stress incontinence (USI) and pelvic organ prolapse (POP) using a synthetic polypropylene mesh is going through a time of unprecedented turmoil and debate. This review focuses on vaginal surgery for vaginal prolapse and looks at the current scientific literature on issues surrounding surgery including consent and expectations. SAFETY AND EFFECTIVENESS OF SURGICAL OPTIONS: Synthetic mesh has been used both abdominally and vaginally to improve the effectiveness of POP surgery...
December 2016: Current Urology Reports
Zai-Shang Li, Chuang-Zhong Deng, Kai Yao, Yong Tang, Nan Liu, Peng Chen, Bin Wang, Xiang Li, Xiao-Feng Chen, Hong Liao, Qi-Wu Mi, Yong-Hong Lei, Qi Zhao, Pei-Zhen Zhao, Xue-Ying Li, Jie-Ping Chen, Qiang-Hua Zhou, Zi-Ke Qin, Zhuo-Wei Liu, Yong-Hong Li, Yun-Lin Ye, Hua Tu, Zi-Jun Zou, Xing Bi, Feng Yang, Ying-Ming Xiao, Jing Li, Xiang-Tian Lin, Wei-Cong Liang, Hui Han, Fang-Jian Zhou
BACKGROUND: Current guidelines recommend pelvic lymphadenectomy (PLND) for patients with pelvic lymph node metastasis and special state. However, these data and recommendations do not distinguish the role of PLND in different patient groups and confirm the final benefits. The aim of this study was to confirm the efficacy of pelvic lymphadenectomy (PLND) for the different groups of patients. METHODS: Data obtained from 7 centers were retrospectively analyzed. Of the patients, 190 pN2-3 penile carcinoma patients confirmed by bilateral inguinal lymph node excision were included in this study...
October 22, 2016: Journal of Cancer Research and Clinical Oncology
Fredrik Liedberg, Georg Jancke, Anne Sörenby, Päivi Kannisto
Radical cystectomy with neoadjuvant chemotherapy is the gold standard for treating muscle-invasive bladder cancer. Women subjected to radical cystectomy are frequently postmenopausal, and the median age for bladder cancer diagnosis in women in Sweden is currently 73 yr (Swedish National Bladder Cancer Register). Traditionally, most women treated with radical cystectomy have undergone simultaneous bilateral oophorectomy and hysterosalpingectomy to diminish the risk of later ovarian disease and ovarian bladder cancer recurrence, but also the belief that there is no impact on health or health-related quality of life associated with oophorectomy and the fact that it might be easier surgery to take the ovarian pedicles, rather than sparing the ovaries...
October 19, 2016: European Urology
Kelsey L Shnaekel, Michael P Wendel, Nader Z Rabie, Everett F Magann
Objective: The aim of this review was to describe the risk factors, clinical and radiographic criteria, and management of this rare complication of pregnancy. Methods: A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched. Results: There were 60 articles identified, with 53 articles being the basis of this review. Multiple risk factors have been suggested in the literature including retroverted uterus in the first trimester, deep sacral concavity with an overlying sacral promontory, endometriosis, previous abdominal or pelvic surgery, pelvic or uterine adhesions, ovarian cysts, leiomyomas, multifetal gestation, uterine anomalies, uterine prolapse, and uterine incarceration in a prior pregnancy...
October 2016: Obstetrical & Gynecological Survey
Gavish Munbauhal, Thomas Seisen, Florie D Gomez, Benoit Peyronnet, Olivier Cussenot, Shahrokh F Shariat, Morgan Rouprêt
The sentinel lymph node dissection (SLND) concept relies on the accurate detection of primary nodal landing sites and could represent a major advancement towards accurate, non-invasive pelvic staging in prostate cancer (PCa). Different iterations of the technique have now been validated and reproduced mostly in large-volume centres. The existing evidence denotes the feasibility and sensitivity of SLND, with encouraging pre- and intraoperative detection rates of 98% and 96%. Yet, current surgical practice mandates a backup template dissection due to a false negative rate, up to 7...
October 6, 2016: Cancer Treatment Reviews
Alexander A Theologis, Gregory M Mundis, Stacie Nguyen, David O Okonkwo, Praveen V Mummaneni, Justin S Smith, Christopher I Shaffrey, Richard Fessler, Shay Bess, Frank Schwab, Bassel G Diebo, Douglas Burton, Robert Hart, Vedat Deviren, Christopher Ames
OBJECTIVE The aim of this study was to evaluate the utility of supplementing long thoracolumbar posterior instrumented fusion (posterior spinal fusion, PSF) with lateral interbody fusion (LIF) of the lumbar/thoracolumbar coronal curve apex in adult spinal deformity (ASD). METHODS Two multicenter databases were evaluated. Adults who had undergone multilevel LIF of the coronal curve apex in addition to PSF with L5-S1 interbody fusion (LS+Apex group) were matched by number of posterior levels fused with patients who had undergone PSF with L5-S1 interbody fusion without LIF (LS-Only group)...
October 21, 2016: Journal of Neurosurgery. Spine
E B Thorgersen, M A Goscinski, M Spasojevic, A M Solbakken, A B Mariathasan, K Boye, S G Larsen, K Flatmark
BACKGROUND: High morbidity, increased mortality, and impaired long-term oncologic outcome have been reported after deep surgical site infection (SSI) in rectal cancer surgery. The rate, risk factors and consequences of deep SSI after (chemo)radiotherapy [(C)RT], and surgery for locally advanced rectal cancer (LARC) in a tertiary university hospital single centre cohort of 540 patients are presented. METHODS: Patients with LARC, operated between January 1, 2007 and December 31, 2015, were identified in the institutional prospective database...
October 20, 2016: Annals of Surgical Oncology
Robert Moore, Christopher Moriarty, Orawee Chinthakanan, John Miklos
INTRODUCTION AND HYPOTHESIS: There has been a trend toward robotic sacrocolpopexy in the United States despite longer operating times and higher costs compared with traditional laparoscopy. The current study objective was to evaluate incision to closure times of laparoscopic sacrocolpopexy in a urogynecologic practice with extensive experience in the laparoscopic approach for pelvic reconstruction. METHODS: We conducted a single-center retrospective evaluation of consecutive patients undergoing laparoscopic sacrocolpopexy for vaginal vault prolapse using a permanent polypropylene Y-mesh over a 1-year period...
October 20, 2016: International Urogynecology Journal
Dapeng Jiang, Bingqiang Tang, Maosheng Xu, Houwei Lin, Longhu Jin, Lei He, Guofeng Xu, Xiaoliang Fang, Hongquan Geng
OBJECTIVE: To evaluate changes in functional and morphological outcomes in children with prenatally diagnosed SFU grade 3-4 UPJO who underwent pyeloplasty at different ages. We also examined the effect of surgical wait time on recovery of renal function. MATERIALS AND METHODS: All patients (age, 0-12 months) with prenatally diagnosed SFU grade 3-4 UPJO who underwent pyeloplasty in a single center between January 2013 and December 2015 were reviewed. 133 children were enrolled in this study...
October 17, 2016: Urology
Tsuyoshi Goto, Toshinori Sakai, Tetsuya Enishi, Nori Sato, Koji Komatsu, Koichi Sairyo, Shinsuke Katoh
Neurogenic intermittent claudication is a main symptom in lumbar spinal stenosis (LSS), and postural change is often observed during walking. This study aimed to identify the changes in posture and muscle activity in the trunk and legs during walking in patients with LSS by examining 6 patients who had undergone decompression surgery. None of them had significant paralysis. Gait analysis using Vicon motion capture system(®) with electromyographic recordings of the paravertebral muscles (PVM) and vastus lateralis muscle (VL) was performed preoperatively and 2 weeks postoperatively...
October 6, 2016: Gait & Posture
S Shreshtha
A 70 year old lady presented to surgery emergency with small bowel obstruction without any obvious etiology. On exploration she was found to have an obstructed obturator hernia, which is a rare pelvic hernia with an incidence of 0.07-1.4% of all intra-abdominal hernias. Diagnosis is often delayed until laparotomy for bowel obstruction. Strangulation is frequent and mortality remains high (25%). Early diagnosis and surgical treatment contributes greatly to reduce the mortality and morbidity rates. A variety of techniques have been described, however surgical repair has not been standardized...
October 2016: Journal of Postgraduate Medicine
Akemi Koshiba, Taisuke Mori, Fumitake Ito, Yukiko Tanaka, Osamu Takaoka, Akiko Takahata, Jo Kitawaki
AIM: To assess and compare the uterine volume and endometrium length between women with and without endometriosis, using pelvic magnetic resonance imaging scans. METHODS: In this case-control study, a total of 75 nulligravid women (aged 20-45 years) with regular menstrual cycles whose uterus were free of any surgically confirmed lesions were enrolled. The endometriosis group underwent surgery for endometrioma (n = 39), and the control group underwent surgery for non-endometrioma ovarian cysts (n = 36)...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Xianghua Liang, Lili Zhang, Yanwei Lv
AIM: A complete and non-splice porcine small-intestine submucosa (SIS) patch was used for total pelvic anatomical repair of organ prolapse. METHODS: This study included a total of 17 patients with severe total pelvic organ prolapse, including five patients with combined stress urinary incontinence (SUI). Panhysterectomy was performed, and then a porcine SIS patch was placed on the anterior (posterior) vaginal wall. The top of the vaginal wall was moved to the corresponding side of the vaginal wall, and the patch was sutured to bilateral uterosacral ligaments, the sacrospinous ligament, and arcus tendineus fasciae pelvis...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Tsia-Shu Lo, Yi-Hao Lin, Hsiao-Chien Chu, Eileen Feliz M Cortes, Leng Boi Pue, Yiap Loong Tan, Ma Clarissa Uy-Patrimonio
AIM: By investigating the association of urodynamics and urogenital nerve growth factor (NGF) levels in vaginal mesh surgery, we may be able to associate the likelihood of postoperative lower urinary tract symptoms developing as a result of synthetic mesh implanted for pelvic floor reconstructive surgery. METHODS: Thirty-eight female Sprague-Dawley rats were divided into three groups: mesh, sham (no mesh), and control. Urodynamic study and NGF analysis of the urogenital tissues were done and results were compared among all groups...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
H Weiss, R Zorron, K-H Vestweber, B Vestweber, L Boni, W Brunner, C Sietses, S Morales Conde, O Bulut, K Gash, A R Dixon, C Mittermair, A Klaus, O Stanger, M Weiss, A Muratore, T Hell
BACKGROUND: The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. METHODS: Consecutive patients undergoing single-port colorectal surgery were enrolled from 11 European centres between March 2010 and March 2014. Data were analysed to assess patient-, technique- and procedure-dependent parameters...
October 20, 2016: British Journal of Surgery
Brandon-Luke L Seagle, Megan Dayno, Anna E Strohl, Stephen Graves, Wilberto Nieves-Neira, Shohreh Shahabi
OBJECTIVE: To determine overall survival (OS) and factors associated with OS after pelvic exenteration for uterine cancer. METHODS: Women with uterine cancer who underwent exenteration (n=1160) were identified from the 1998-2011 National Cancer Data Base. Kaplan-Meier and multivariate Cox proportional-hazards survival analyses were performed to test for associations of potential explanatory variables with OS. Analyzed confounders included age, comorbidity score, insurance status, income, distance from home to treatment center, stage, distant and nodal metastasis, tumor size, surgical margin status, exenteration type, and treatment with radiation and/or chemotherapy...
October 16, 2016: Gynecologic Oncology
S X Tang, H L Zhou, Y L Ding
Objective: To analyze the effectiveness of transurethral seminal vesiculoscopy in the treatment of persistent hematospermia, and oligoasthenozoospermia and azoospermia from ejaculatory duct obstruction. Methods: The clinical date of 56 cases of persistent hematospermia, or azoospermia/oligoasthenozoospermia from ejaculatory duct obstruction treated with transurethral seminal vesiculoscopy between November 2013 and January 2016 in the First Affiliated Hospital of Fujian Medical University were reviewed. A total of 30 cases were persistent hematospermia for 6 months to 3 years, with no response to routine antibiotic therapy for >4 weeks; 24 cases were obstructive azoospermia; and the other 2 cases were extreme oligoasthenozoospermia...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Nicole Yoder, Reshef Tal, J Ryan Martin
BACKGROUND: Ectopic pregnancy is the leading cause of maternal morbidity and mortality during the first trimester and the incidence increases dramatically with assisted-reproductive technology (ART), occurring in approximately 1.5-2.1 % of patients undergoing in-vitro fertilization (IVF). Abdominal ectopic pregnancy is a rare yet clinically significant form of ectopic pregnancy due to potentially high maternal morbidity. While risk factors for ectopic pregnancy after IVF have been studied, very little is known about risk factors specific for abdominal ectopic pregnancy...
October 19, 2016: Reproductive Biology and Endocrinology: RB&E
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