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https://www.readbyqxmd.com/read/28808931/robotic-total-pelvic-exenteration-video-illustrated-technique
#1
Ioannis T Konstantinidis, William Chu, Federico Tozzi, Clayton Lau, Mark Wakabayashi, Kevin Chan, Byrne Lee
BACKGROUND: Robotic-assisted total pelvic exenteration (TPE) can offer a minimally invasive approach to a major multi-organ operation. METHODS: In this video, we summarize a stepwise approach to robotic TPE in a 70 year-old female Jehovah's witness with a history of cervical cancer post-chemoradiation and radical hysterectomy who experienced local recurrence at the vaginal cuff involving the rectum and bladder. RESULTS: The patient was placed in the lithotomy position...
August 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28803112/in-vivo-documentation-of-shape-and-position-changes-of-mri-visible-mesh-placed-in-rectovaginal-septum
#2
Urbankova Iva, Sindhwani Nikhil, Callewaert Geertje, Turri Alice, Rinkijevic Rita, Hympanova Lucie, Feola Andrew, Deprest Jan
BACKGROUND AND OBJECTIVE: Large deformations in synthetic meshes used in pelvic organ prolapse surgery may lead to suboptimal support for the underlying tissue, graft-related complications as well as recurrence. Our aim was to quantify in vivo longitudinal changes in mesh shape and geometry in a large animal model. We compare two commonly used mesh shapes, armed and flat, that are differently affixed. The secondary outcomes were active and passive biomechanical properties. METHODS: A total of 18 animals were used...
August 5, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28798831/an-in-house-composix%C3%A2-based-pubovaginal-sling-trial-for-female-stress-urinary-incontinence-five-year-comparative-followup-to-tension-free-and-transobturator-vaginal-tapes
#3
Tal Ben-Zvi, Katherine Moore, Nadim Haidar, Mireille Gregoire
INTRODUCTION: We compared the efficacy of three slings in the long-term treatment of stress urinary incontinence (SUI): tension-free vaginal tape (TVT), vaginal tape-obturator (TVT-O), and an in-house two-layered polypropylene mesh with a submicronic polytetrafluoroethylene (Composix™). Our primary endpoint was the objective measurement of continence (24-hour pad test). Secondarily, we measured the satisfaction and complication rates. METHODS: This prospective, non-randomized study included 128 patients with SUI...
August 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28780651/hysteropreservation-versus-hysterectomy-in-the-surgical-treatment-of-uterine-prolapse-systematic-review-and-meta-analysis
#4
REVIEW
Sofia Andrade de Oliveira, Marcelo C M Fonseca, Maria A T Bortolini, Manoel J B C Girão, Matheus T Roque, Rodrigo A Castro
INTRODUCTION AND HYPOTHESIS: The efficacy and safety of removing or preserving the uterus during reconstructive pelvic surgery is a matter of debate. METHODS: We performed a systematic review and meta-analysis of studies that compared hysteropreservation and hysterectomy in the management of uterine prolapse. PubMed, Medline, SciELO and LILACS databases were searched from inception until January 2017. We selected only randomized controlled trials and observational cohort prospective comparative studies...
August 5, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28777192/sexual-function-after-prolapse-repair
#5
Abigail Shatkin-Margolis, Rachel N Pauls
PURPOSE OF REVIEW: The purpose of this review is to summarize available literature (from the last 18 months) assessing sexual function following pelvic reconstructive surgery for pelvic organ prolapse (POP). We include vaginal native tissue repair, abdominal/laparoscopic sacrocolpopexy, transvaginal mesh repair, and obliterative procedures. The goal is to assist providers in counseling patients and to identify areas needed for further research. RECENT FINDINGS: When compared with pessary management, women who undergo POP surgical repair achieve their sexual function goals more often...
August 1, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28770896/six-arms-mesh-implant-application-with-organ-preserving-in-a-young-patient-with-total-pelvic-organ-prolapse
#6
Gokmen Sukgen, Adem Altunkol, Deniz Abat
Pelvic Organ Prolapse (POP) is defined as the prolapse of the pelvic organs toward or through the vaginal opening as a result of the weakening of the combination of nerves, muscles and fascia, which normally protect and support the physical position of pelvic organs. In this case report, the 30-year old patient who applied with the pelvic prolapse through the vaginal opening was treated with Sacro Uterine Ligamentopexy and anterior 6 arms mesh implant, without applying hysterectomy. In the short follow-up period of three months, both anatomic improvement and positive developments in sexual and social life have been recorded in the patient's life...
July 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28762694/pelvic-organ-prolapse
#7
REVIEW
Cheryl B Iglesia, Katelyn R Smithling
Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is primarily associated with pregnancy and vaginal delivery, which lead to direct pelvic floor muscle and connective tissue injury. Hysterectomy, pelvic surgery, and conditions associated with sustained episodes of increased intra-abdominal pressure, including obesity, chronic cough, constipation, and repeated heavy lifting, also contribute to prolapse...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28759459/anterior-compartment-prolapse-what-s-new
#8
Patrick Lang, James L Whiteside
PURPOSE OF REVIEW: The purpose of this review is to summarize the treatment options for anterior compartment prolapse, describe the role that apical suspension plays in the correction of anterior vaginal wall prolapse, and assess the risks and benefits of biologic and synthetic graft use in anterior compartment repair. RECENT FINDINGS: In 2016, The Cochrane Review published a review of 37 trials including 4023 participants finding that compared to native tissue repair, the use of synthetic mesh resulted in reduced symptomatic prolapse recurrence, anatomic recurrence, and repeat prolapse surgery...
July 29, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28746980/single-incision-sling-operations-for-urinary-incontinence-in-women
#9
REVIEW
Arjun Nambiar, June D Cody, Stephen T Jeffery, Patricia Aluko
BACKGROUND: Urinary incontinence has been shown to affect up to 50% of women. Studies in the USA have shown that up to 80% of these women have an element of stress urinary incontinence. This imposes significant health and economic burden on society and the women affected. Colposuspension and now mid-urethral slings have been shown to be effective in treating patients with stress incontinence. However, associated adverse events include bladder and bowel injury, groin pain and haematoma formation...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28723372/how-to-deal-with-pain-following-a-vaginal-mesh-insertion
#10
Konstantinos Giannitsas, Elisabetta Costantini
Pain as an isolated complication of vaginal mesh insertion is uncommon, and its pathophysiology not well understood. Management is complex and involves technically demanding surgical mesh removal. Results are reported as good in the majority of cases.
August 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723371/complications-of-transvaginal-mesh-for-pelvic-organ-prolapse-and-stress-urinary-incontinence-tips-for-prevention-recognition-and-management
#11
REVIEW
Susan MacDonald, Ryan Terlecki, Elisabetta Costantini, Gopal Badlani
CONTEXT: Mesh-related complications following transvaginal management of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) have received significant attention in the last decade. OBJECTIVE: We sought to identify patient, product, and technical factors associated with an increased risk of complications after mesh-based transvaginal repair of anterior POP and SUI. In this review we clarify the different pattern of complications after POP and SUI repairs...
August 2016: European Urology Focus
https://www.readbyqxmd.com/read/28718906/a-retrospective-analysis-of-the-effectiveness-of-anterior-pelvic-organ-prolapse-repair-with-prolift-versus-elevate-vaginal-mesh
#12
Isabel Barros-Pereira, Alexandre Valentim-Lourenço, Andreia Fonseca, Bruna Melo, Alexandra Henriques, Ana Ribeirinho
OBJECTIVE: To compare the effectiveness of anterior pelvic organ prolapse (POP) repair using Prolift (Ethicon, Somerville, NJ, USA) or Elevate (American Medical Systems, Minnetonka, MN, USA) vaginal mesh at 12 months of follow-up. METHODS: A retrospective study was undertaken using the records for the first 50 Prolift procedures in 2007-2009 and the first 50 Elevate procedures in 2013-2015 performed at a tertiary urogynecology unit in Lisbon, Portugal. Postoperative follow-up occurred at 3, 6, and 12 months...
July 18, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28710784/pregnancy-after-laparoscopic-ventral-mesh-rectopexy-implications-and-outcomes
#13
A M Hogan, P Tejedor, I Lindsey, O Jones, R Hompes, K J Gorissen, C Cunningham
AIM: Surgical management of rectal prolapse varies considerably. Most surgeons are reluctant to use ventral mesh rectopexy in young women until they have completed their family. The aim of the present study was to review outcomes of pregnancy following laparoscopic ventral mesh rectopexy (LVMR) from a tertiary referral centre over a 10 year period (2006-2016) and to review the impact on pelvic floor symptoms. METHOD: We undertook a retrospective review of a prospectively compiled database of patients who had undergone laparoscopic ventral rectopexy in a single centre over a 10 years period...
July 15, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28710613/self-retaining-support-implant-an-anchorless-system-for-the-treatment-of-pelvic-organ-prolapse-2-year-follow-up
#14
Gil Levy, Anna Padoa, Zoltan Fekete, George Bartfai, Laszlo Pajor, Mauro Cervigni
INTRODUCTION AND HYPOTHESIS: The search for an improved vaginal mesh prompted the development of a new anchorless implant. The objective was to report on outcome after 2 years of a technique using a self-retaining support (SRS) implant. METHODS: Patients with anterior vaginal wall prolapse, with/without apical prolapse, were recruited. Participants underwent surgical repair using the SRS device. Demographic data, pre-surgical Pelvic Organ Prolapse Quantification (POP-Q) scoring, quality of life (QoL) questionnaires (Pelvic Floor Distress Inventory Short Form 20 [PFDI-20], Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire 12 [PISQ-12]), and surgical data were collected...
July 14, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28696949/procedure-choice-in-primary-versus-recurrent-prolapse-a-study-of-fellowship-trained-surgeons
#15
Rachel High, Alex Kavanagh, Rose Khavari, Julie Stewart, Danielle D Antosh
OBJECTIVE: This retrospective study describes procedures of choice in management of patients with primary prolapse compared with recurrence prolapse patients by fellowship-trained surgeons. METHODS: Surgically managed primary and recurrent prolapse cases from 2012 to 2015 at Houston Methodist Hospital were reviewed. Baseline characteristics, compartment defects, and stage were compared. Mean interval from the index surgeries to management of prolapse recurrence was recorded...
July 10, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28695345/is-pain-relief-after-vaginal-mesh-and-or-sling-removal-durable-long-term
#16
Karen Jong, Shreeya Popat, Alana Christie, Philippe E Zimmern
INTRODUCTION AND HYPOTHESIS: This study was to review our experience of pain relief durability in women who experienced initial pain resolution after vaginal mesh and/or sling removal (VMSR). METHODS: A retrospective chart review of consecutive, nonneurogenic women who underwent VMSR for pain and reported persistent pain relief at the 6-month postoperative follow-up visit were assessed. Pre- and postoperative data collected were self-reported chief complaints, physical examination, other medical conditions associated with chronic pain, use of pain medications, Urogenital Distress Inventory-6 (in which question 6 specifically addresses pain), and the Numerical Pain Rating Scale (NPRS)...
July 10, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28658857/application-of-a-mixed-material-graft-to-posterior-intravaginal-slingoplasty-procedure-preliminary-pilot-series
#17
Birol Vural, Yigit Çakıroglu, Fisun Vural, Sule Köpük Yıldırım
Good anatomic outcomes have been achieved with transvaginal synthetic materials in pelvic organ prolapse, but mesh-related complications are a major health concern. Therefore, developing new synthetic or biological materials with increased tissue strength and decreased complications are major challenges. This paper presents preliminary pilot series of Posterior Intravaginal Slingoplasty (PIVS) procedure performed with mixed material graft containing both autologous tissue and a synthetic material. Six women with symptomatic Utero-Vaginal Prolapse (UVP) ≥ stage 2 underwent the PIVS procedure...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28657987/polypropylene-mesh-predicts-mesh-suture-exposure-after-sacrocolpopexy-independent-of-known-risk-factors-a-retrospective-case-control-study
#18
Paula J Durst, Michael H Heit
OBJECTIVE(S): The aim of this study was to determine if ultralightweight polypropylene mesh reduced the risk of mesh/suture exposure after sacrocolpopexy compared with heavier-weighted polypropylene. METHODS: Bivariate and multivariate analyses were used to interpret data from 133 cases and 261 control subjects to evaluate independent predictors of mesh/suture exposure after sacrocolpopexy from 2003 to 2013. RESULTS: Multivariate logistic regression revealed that prior surgery for incontinence (odds ratio [OR], 2...
June 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28653332/transvaginal-mesh-removal-with-native-tissue-repair-for-mesh-shrinkage-and-recurrent-uterovaginal-prolapse-following-vaginal-mesh-augmented-surgery
#19
Rodolfo Milani, Matteo Frigerio, Stefania Palmieri, Stefano Manodoro
Vaginal mesh-related complications can be difficult to treat and can often require several surgical interventions. In the case of pelvic pain or dyspareunia related to transobturator mesh tension or shrinkage, surgical treatment is indicated with the aim of mobilizing the mesh by dividing the central graft from the arms and excising all the areas of mesh contraction [1]. Removal of transobturator arms should be avoided because neovascularization can lead to bleeding that is difficult to control [2]. This article is protected by copyright...
June 27, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28647959/-re-treatments-of-recurrence-after-pelvic-floor-repair-surgery
#20
S X Fan, F M Wang, L S Lin, Y F Song
Objective: To analyze re-treatments of recurrence after the pelvic floor repair surgery. Methods: The protocol and the effect of re-treatments were investigated by reviewing and analyzing the clinical data of 81 recurrent patients (grade Ⅱ and above), who had received the pelvic floor repair surgery from January 2011 to January 2016. Pelvic organ prolapse quantitation system (POP-Q) and two questionnaires about quality of life [pelvic floor distress inventory-short form 20 (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7)] were used to evaluate objective and subjective efficacy, respectively...
June 25, 2017: Zhonghua Fu Chan Ke za Zhi
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