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https://www.readbyqxmd.com/read/29677302/effect-of-uterosacral-ligament-suspension-vs-sacrospinous-ligament-fixation-with-or-without-perioperative-behavioral-therapy-for-pelvic-organ-vaginal-prolapse-on-surgical-outcomes-and-prolapse-symptoms-at-5-years-in-the-optimal-randomized-clinical-trial
#1
J Eric Jelovsek, Matthew D Barber, Linda Brubaker, Peggy Norton, Marie Gantz, Holly E Richter, Alison Weidner, Shawn Menefee, Joseph Schaffer, Norma Pugh, Susan Meikle
Importance: Uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF) are commonly performed pelvic organ prolapse procedures despite a lack of long-term efficacy data. Objective: To compare outcomes in women randomized to (1) ULS or SSLF and (2) usual care or perioperative behavioral therapy and pelvic floor muscle training (BPMT) for vaginal apical prolapse. Design, Setting, and Participants: This 2 × 2 factorial randomized clinical trial was conducted at 9 US medical centers...
April 17, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29676809/prevalence-of-maternal-birth-trauma-in-nepali-women
#2
Friyan Turel, Delena Caagbay, Hans Peter Dietz
OBJECTIVES: Pelvic organ prolapse is very common among women in Nepal, especially uterine prolapse. This would suggest a high rate of levator trauma, which is a strong predictor of such prolapse in the Western world. Hence, we decided to study the prevalence of maternal birth trauma in Nepali women. METHODS: In November 2016, we offered an interview, clinical examination, and 4-dimensional translabial sonography to women attending a gynecology clinic. Of 129 women seen, 5 were excluded due to previous pelvic surgery...
April 20, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29675427/transvaginal-bilateral-sacrospinous-fixation-after-second-recurrence-of-vaginal-vault-prolapse-efficacy-and-impact-on-quality-of-life-and-sexuality
#3
Salvatore Giovanni Vitale, Antonio Simone Laganà, Marco Noventa, Pierluigi Giampaolino, Brunella Zizolfi, Salvatore Butticè, Valentina Lucia La Rosa, Giuseppe Gullo, Diego Rossetti
Objective: Our aim was to study the efficacy of transvaginal bilateral sacrospinous fixation (TBSF) and its impact on quality of life (QoL) and sexual functions in women affected by second recurrences of vaginal vault prolapse (VVP). Materials and Methods: We performed a prospective observational study on 20 sexually active patients affected by second recurrence of VVP, previously treated with monolateral sacrospinous fixation. TBSF was performed in all the patients...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29673679/trans-vaginal-mesh-surgery-for-management-of-recurrent-pelvic-organ-prolapse-following-abdominal-sacrocolpopexy
#4
Tsia-Shu Lo, Rami Ibrahim, Nazura Bt Karim, Enie Akhtar Nawawi, Ma Clarissa Uy-Patrimonio
OBJECTIVE: To evaluate the outcome of transvaginal mesh surgery as a management of recurrent pelvic organ prolapse, in patients previously treated with sacrocolpopexy. CASE REPORT: A series of three patients who developed recurrent pelvic organ prolapse more than 9 years after sacrocolpopexy. A 50-year-old and two 77-year-old patients who presented with recurrent pelvic organ prolapse at 9, 15 and 17 years, respectively after the primary abdominal sacrocolpopexy were managed by transvaginal mesh surgery...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29673382/risk-of-synchronous-endometrial-disorders-in-women-with-endometrioid-borderline-tumors-of-the-ovary
#5
Shuang-Zheng Jia, Jun-Ji Zhang, Jun-Jun Yang, Yang Xiang, Zhiyong Liang, Jin-Hua Leng
BACKGROUND: Synchronous endometrial disorders have been poorly studied in women with endometrioid borderline ovarian tumors (EBOT). The aims of this study were to investigate the risk of endometrial disorders among women with EBOT and associated factors, as well as their oncological and fertility outcomes. RESULTS: This retrospective study included 33 women with EBOT. Their mean age was 41.9 years, and endometria were evaluated in 25 of these patients. The prevalence of synchronous endometrial disorders was 52...
April 19, 2018: Journal of Ovarian Research
https://www.readbyqxmd.com/read/29671032/sitting-versus-standing-makes-a-difference-in-musculoskeletal-discomfort-and-postural-load-for-surgeons-performing-vaginal-surgery
#6
Ruchira Singh, Ladin A Yurteri-Kaplan, Melissa M Morrow, Amy L Weaver, Michaela E McGree, Xinhui Zhu, Victor L Paquet, John B Gebhart, Susan Hallbeck
INTRODUCTION AND HYPOTHESIS: We compared musculoskeletal discomfort and postural load among surgeons in sitting and standing positions during vaginal surgery. MATERIALS AND METHODS: Assessment of discomfort and posture of the primary surgeons in both positions was performed at two institutions. The primary outcome was an increase in body discomfort score after surgery as determined from subjective responses using validated tools. The secondary outcome was the percentage of time spent in awkward body postures measured objectively and stratified into awkward postures for neck, trunk, and bilateral shoulder angles...
April 18, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29666026/cervical-cancer-state-of-the-science-from-angiogenesis-blockade-to-checkpoint-inhibition
#7
REVIEW
Lindsey E Minion, Krishnansu S Tewari
Vascular endothelial growth factor (VEGF) has emerged as a therapeutic target in several malignancies, including cervical cancer. Chemotherapy doublets combined with the fully humanized monoclonal antibody, bevacizumab, now constitute first-line therapy for women struggling with recurrent/metastatic cervical carcinoma. Regulatory approval for this indication was based on the phase III randomized trial, GOG 240, which demonstrated a statistically significant and clinically meaningful improvement in overall survival when bevacizumab was added to chemotherapy: 17...
March 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29664801/the-rectal-cancer-female-sexuality-score-development-and-validation-of-a-scoring-system-for-female-sexual-function-after-rectal-cancer-surgery
#8
Anne Thyø, Katrine J Emmertsen, Søren Laurberg
BACKGROUND: Sexual dysfunction and impaired quality of life is a potential side effect to rectal cancer treatment. OBJECTIVE: The objective of this study was to develop and validate a simple scoring system intended to evaluate sexual function in women treated for rectal cancer. DESIGN: This is a population-based cross-sectional study. SETTINGS: Female patients diagnosed with rectal cancer between 2001 and 2014 were identified by using the Danish Colorectal Cancer Group's database...
April 16, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29664135/clinical-outcomes-of-detrusor-underactivity-in-female-with-advanced-pelvic-organ-prolapse-following-vaginal-pelvic-reconstructive-surgery
#9
Tsia-Shu Lo, Sandy Chua, Ma Clarissa Uy-Patrimonio, Chuan C Kao, Chih H Lin
AIM: To determine the impact of vaginal pelvic reconstructive surgery (PRS) on detrusor underactivity (DU) patients having advanced pelvic organ prolapse (POP). METHODS: A retrospective study of patients who underwent PRS for advanced POP (POP-Q ≥ 3) with DU. Data regarding preoperative evaluation, surgical procedure, and post-operative management were collated. Patients were considered to have DU when detrusor pressure at maximum flow (Pdet Qmax ) was ≤10 cmH2 0 and peak flow rate (Qmax ) of ≤12 mL/s...
April 17, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29661236/clinical-analysis-of-50-patients-with-heterotopic-pregnancy-after-ovulation-induction-or-embryo-transfer
#10
Zaigui Wu, Xinmei Zhang, Ping Xu, Xiufeng Huang
OBJECTIVES: The purpose of this study was to evaluate the clinical characteristics, prenatal diagnosis, and management of patients with heterotopic pregnancy after ovulation induction or embryo transfer. METHODS: This was a retrospective study of fifty cases with heterotopic pregnancy, in which the fertilization way, type and number of embryo transferred, gestational age, clinical presentation and outcome of intrauterine, ultrasound presentation and site of ectopic pregnancy, bilateral fallopian tube and treatment were evaluated...
April 16, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29651788/sphincter-preserving-surgery-for-recurrent-pelvic-malignancy-using-a-hybrid-procedure-of-open-laparotomy-and-transanal-endoscopic-approach
#11
Seiji Ishiguro, Shunichiro Komatsu, Kenichi Komaya, Takuya Saito, Takashi Arikawa, Kenichiro Kaneko, Tsuyoshi Sano
BACKGROUND: Surgery for the treatment of recurrent pelvic malignancy is challenging. Sphincter-preserving surgery (SPS) has been applied in limited cases. Transanal endoscopic approach (TEA) has been used for primary rectal cancer, predominantly for hybrid transabdominal-transanal total mesorectal excision. Here, we describe the use of TEA as a hybrid approach in a case of recurrent ovarian cancer. CASE PRESENTATION: A 59-year-old woman had recurrence of serous ovarian adenocarcinoma in the vaginal stump, near the site of anastomosis from a rectal resection 18 months previously...
April 12, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29644476/reconstructive-management-pearls-for-the-transgender-patient
#12
REVIEW
Geolani W Dy, Jeff Sun, Michael A Granieri, Lee C Zhao
PURPOSE OF REVIEW: A growing number of transgender patients are seeking gender-affirming genital reconstructive surgery (GRS). These complex procedures have high complication rates. We describe common surgical pitfalls in GRS and approaches for minimizing complications. RECENT FINDINGS: Penile inversion vaginoplasty has been associated with excellent cosmetic and functional outcomes. A robotic-assisted dissection may minimize risk of rectal injury. As a younger transgender population chooses pubertal suppression, alternative sources for lining the vaginal canal, such as enteric vaginoplasties, may be more widely utilized...
April 11, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29644383/optimizing-resident-operative-self-confidence-through-competency-based-surgical-education-modules-are-we-there-yet
#13
Roxana Geoffrion, Nicole A Koenig, May S Sanaee, Terry Lee, Nicole J Todd
INTRODUCTION AND HYPOTHESIS: Self-confidence is the belief in one's ability to perform and can be enhanced by training. Surgical education should aim to optimize trainee confidence. We designed three procedure-specific competency-based modules to teach vaginal hysterectomy (VH), anterior (AR) and posterior repair (PR) to novice gynecology residents. We hypothesized each module would improve self-confidence and satisfaction during index procedure performance in the operating room. METHODS: This was an ancillary analysis of a larger randomized-controlled trial of gynecologic educational interventions...
April 11, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29644382/prolapse-reduction-deteriorates-the-urethral-closure-mechanism
#14
Yasmine Khayyami, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) reduction is often performed in the preoperative assessment of women before POP surgery. Using urethral pressure reflectometry (UPR), we sought to investigate how POP reduction affects the urethral closure mechanism. METHODS: Women with anterior or posterior vaginal wall prolapse stage ≥II with and without POP reduction were examined with a speculum. We performed prolapse staging according to the Pelvic Organ Prolapse Quantification system, UPR measurements at rest and during squeezing, and standardized stress tests with 300 ml saline...
April 11, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29644381/autologous-rectus-fascia-sling-placement-in-the-management-of-female-stress-urinary-incontinence
#15
Adam R Miller, Brian J Linder, Deborah J Lightner
INTRODUCTION AND HYPOTHESIS: Autologous pubovaginal sling placement remains a treatment option in index patients, given high, long-term success rates. This video reviews the technical considerations for performing an autologous rectus fascia sling. METHODS: The patient is a 47-year-old woman with stress urinary incontinence (SUI) refractory to conservative management. First, a 10-cm rectus fascial segment is harvested and prepped with placement of nonabsorbable stay sutures for later sling passage...
April 11, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29627828/two-year-follow-up-results-of-transobturator-tape-procedure-with-and-without-concomitant-vaginal-surgery
#16
Fatih Celik, Mine Kanat Pektas, Mesut Kose, Dagistan Tolga Arioz, Evren Yesildager, Mehmet Yilmazer
OBJECTIVE: This study aims to evaluate the subjective and objective outcomes of the transobturator tape (TOT) procedure performed to treat stress urinary incontinence and to determine the efficacy and safety of the TOT procedure when used along with vaginal surgery. METHODS: This is a prospective review of 24 women who had the TOT procedure done only due to stress incontinence; 22 women who underwent concomitant TOT and pelvic floor repair; and 20 women who received concurrent TOT, transvaginal hysterectomy, and sacrospinous ligament fixation...
April 6, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29626286/multidetector-ct-of-expected-findings-and-complications-after-hysterectomy
#17
REVIEW
Massimo Tonolini
Indicated to manage a variety of disorders affecting the female genital tract, hysterectomy represents the second most common gynaecological operation after caesarean section. Performed via an open, laparoscopic or vaginal approach, hysterectomy is associated with non-negligible morbidity and occasional mortality. Iatrogenic complications represent a growing concern for gynaecologists and may result in prolonged hospitalisation, need for interventional procedures or repeated surgery, renal impairment and malpractice claims...
April 6, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29624638/medical-management-of-miscarriage-predictive-factors-of-success
#18
Vanessa Lusink, Clare Wong, Bradley de Vries, Joanne Ludlow
Medical management of miscarriage is an acceptable option available to women, and has advantages of providing timely treatment, while avoiding exposure to surgery and anaesthesia. This retrospective cohort study aimed to determine factors predictive of successful medical management, utilising a single dose protocol of 800 µg vaginal misoprostol. In this cohort, the success rate was 67% (199/296), and smaller mean gestational sac diameter independent of gestational age predicted success (P = 0.046). Success is not significantly related to parity, miscarriage type, pelvic pain or vaginal bleeding at the outset of treatment...
April 6, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29621612/laparoscopic-anterior-pelvic-exenteration-with-super-radical-parametrectomy-for-a-recurrent-low-grade-endometrial-sarcoma-that-is-resistant-to-hormone-therapy-and-chemotherapy
#19
Hiroyuki Kanao, Tsuyoshi Hisa, Makiko Omi, Minoru Nagashima, Shuhei Okamoto, Yoichi Aoki, Terumi Tanigawa, Maki Matoda, Sanshiro Okamoto, Hidetaka Nomura, Kohei Omatsu, Kazuyoshi Kato, Kuniko Utsugi, Nobuhiro Takeshima
STUDY OBJECTIVE: To show total laparoscopic complete resection of a recurrent low grade endometrial sarcoma. DESIGN: Step-by-step demonstration of the technique of laparoscopic anterior pelvic exenteration with super radical parametrectomy, including the explanation of a detail pelvic anatomy. (Canadian Task Force Classification III) SETTING: Low grade endometrial stromal sarcoma (LGESS) is a rare malignancy that makes around 0.2% of all uterine malignancies [1]...
April 2, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29619489/causes-and-management-of-urogenital-fistulas-a-retrospective-cohort-study-from-a-tertiary-referral-center-in-saudi-arabia
#20
Somia A Osman, Ahmad H Al-Badr, Ola T Malabarey, Ashraf M Dawood, Badr N AlMosaieed, Diaa E E Rizk
OBJECTIVES: To reviewe the etiology and management of urogenital fistulas at a tertiary care referral center. METHODS: We retrospectively identified all patients with urogenital fistula referred to the King Fahad Medical City, Riyadh, Saudi Arabia, between January 2005 and July 2016 from electronic records. We collected data on age, parity, etiology and type of fistula, radiologic findings, management, and outcome. Results: Of the 32 patients with urogenital fistula identified, 17 (53...
April 2018: Saudi Medical Journal
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