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Transvaginal mesh

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
Nahid Punjani, Jennifer Winick-Ng, Blayne Welk
OBJECTIVE: To determine if post-operative urinary retention and urinary tract infections (UTI) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). METHODS: Administrative data in Ontario, Canada between 2002 and 2013 was used to identify all women who underwent a mesh-based MUS. The primary outcome was revision of the transvaginal mesh sling (including mesh erosion/removal, fistula or urethrolysis). Two potential risk factors were analyzed: post-operative retention (within 30 days of procedure) and number of post-operative emergency room visits or hospital admissions for UTI symptoms...
October 20, 2016: Urology
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
Stavros Kontogiannis, Evangelia Goulimi, Konstantinos Giannitsas
Awareness and reporting of mesh-related complications of pelvic organ prolapse repairs have increased in recent years. As a result, deciding whether to use a mesh or not has become a difficult task for urogynecologists. Our aim was to summarize reasons for and against the use of mesh in prolapse repair based on a review of relevant literature. Scopus and PubMed databases were searched for papers reporting on the efficacy and safety of native tissue versus non-absorbable, synthetic mesh prolapse repairs. Randomized controlled trials, systematic reviews, and meta-analyses were included...
October 18, 2016: Advances in Therapy
Christopher Maher, Benjamin Feiner, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Julie Brown
BACKGROUND: Apical vaginal prolapse is a descent of the uterus or vaginal vault (post-hysterectomy). Various surgical treatments are available and there are no guidelines to recommend which is the best. OBJECTIVES: To evaluate the safety and efficacy of any surgical intervention compared to another intervention for the management of apical vaginal prolapse. SEARCH METHODS: We searched the Cochrane Incontinence Group's Specialised Register of controlled trials, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials...
October 1, 2016: Cochrane Database of Systematic Reviews
K S Williams, D F Shalom, J R Hill, H A Winkler, P S Finamore
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Tsia-Shu Lo, Nagashu Shailaja, Wu-Chiao Hsieh, Ma Clarissa Uy-Patrimonio, Faridah Mohd Yusoff, Rami Ibrahim
INTRODUCTION AND HYPOTHESIS: The objective of this study was to identify the predictors of postoperative voiding dysfunction in women following extensive vaginal pelvic reconstructive surgery. METHODS: We enrolled 1,425 women who had pelvic organ prolapse of POP-Q stage III or IV and had undergone vaginal pelvic reconstructive surgery with or without transvaginal mesh insertion from January 2006 to December 2014. All subjects were required to complete a 72-h voiding diary, and the IIQ-7, UDI-6, POPDI-6 and PISQ-12 questionnaires...
September 19, 2016: International Urogynecology Journal
Dani Zoorob, Mickey Karram, Anna Stecher, Rose Maxwell, James Whiteside
OBJECTIVES: To identify litigation predictors among women with complications of transvaginal mesh. METHODS: Chart review and patient survey were conducted among women who had undergone a complication-related explant of a transvaginal prolapse or incontinence sling mesh. Trained study personnel administered a 57-question survey addressing subjective complaints related to bowel, bladder, sexual dysfunction, and development of pain or recurrent prolapse. These data were analyzed with respect to the subject's reported pursuit of litigation related to the mesh complication...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
Wan Song, Tae Heon Kim, Jin Woo Chung, Won Jin Cho, Ha Na Lee, Young Suk Lee, Kyu-Sung Lee
OBJECTIVES: To evaluate anatomical and functional outcomes of the Prolift Transvaginal Mesh for treatment of pelvic organ prolapse (POP) with regard to safety and satisfaction. METHODS: We reviewed the medical records of 163 patients who underwent POP repair with Prolift Transvaginal Mesh between December 2005 and March 2012. An "optimal" anatomic outcome was defined as Pelvic Organ Prolapse Quantification System (POP-Q) stage 0, and a "satisfactory" anatomic outcome was defined as POP-Q stage 1...
September 2016: Lower Urinary Tract Symptoms
Kazuaki Nishimura, Kazuaki Yoshimura, Kaori Hoshino, Toru Hachisuga
INTRODUCTION AND HYPOTHESIS: Transvaginal ipsilateral uterosacral ligament colpopexy for pelvic organ prolapse (POP), which was reported by Shull et al. (Shull's colpopexy) in 2000, is one of the most frequently performed non-mesh pelvic floor reconstructive surgical procedures. Despite its excellent anatomical outcomes, ureteral injury and difficulty in uterosacral ligament detection (especially in patients with severe POP) are typical issues with this procedure. METHOD: This video demonstrates the procedure in a 58-year-old woman, gravida 2 para 2, with POP-Q stage II uterine prolapse and stage I cystocele...
September 10, 2016: International Urogynecology Journal
D Carracedo, L López-Fando, M D Sánchez, M Á Jiménez, J M Gómez, I Laso, M Á Rodríguez, F J Burgos
OBJECTIVES: The objective of this study is to compare direct costs of repairing pelvic organ prolapse by laparoscopic sacrocolpopexy (LS) against vaginal mesh (VM). Our hypothesis is the correction of pelvic organ prolapse by LS has a similar cost per procedure compared to VM. MATERIAL AND METHODS: We made a retrospective comparative analysis of medium cost per procedure of first 69 consecutive LS versus first 69 consecutive VM surgeries. We calculate direct cost for each procedure: structural outlays, personal, operating room occupation, hospital stay, perishable or inventory material and prosthetic material...
September 7, 2016: Actas Urologicas Españolas
F Cour, L Le Normand, G Meurette
OBJECTIVE: The aim was to review the safety and efficacy of surgery for posterior vaginal wall prolapse by vaginal route, in order to identify a therapeutic algorithm based on benefit/risk evaluation of each surgical procedure. MATERIAL AND METHODS: We performed a review of the litterature published up to september 2015 (PubMed, Medline, Cochrane library, Cochrane database of systemactic reviews) according to the HAS methodology. Level evidence (1 to 4) was determined for each study as well as evidence based recommendations (A, B, C or professional agreement)...
July 2016: Progrès en Urologie
Vani Dandolu, Megumi Akiyama, Gayle Allenback, Prathamesh Pathak
OBJECTIVE: Our objective was to quantitate the extent of complications and failure rate for apical prolapse repair with transvaginal mesh (TVM) use versus sacrocolpopexy over a minimum of 2 years of follow-up. METHODS: Truven CCAE and Medicare Supplemental databases 2008-2013 were used for analysis. Patients with apical prolapse repair via transvaginal mesh (TVMR), abdominal sacrocolpopexy (ASCP), laparoscopic sacrocolpopexy (LSCP), or native tissue repair (NTR) and continuously enrolled for years were in the study cohort...
August 25, 2016: International Urogynecology Journal
Shilpa Iyer, Sylvia M Botros
INTRODUCTION: Transvaginal mesh usage has been at the forefront of popular media and academic debate for the past 10 years. Several US Food and Drug Administration (FDA) communications, society statements, and research articles have been written in an attempt to define and articulate the classification system, safety data, and efficacy of this approach to transvaginal surgery. In this review, we explore the history of transvaginal mesh surgery for pelvic organ prolapse (POP), review FDA and society statements, and research current practice in the United States...
August 22, 2016: International Urogynecology Journal
Marisa M Clifton, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Complications of synthetic midurethral sling surgery include bladder outlet obstruction, mesh extrusion, and vaginal pain. A treatment of these complications is transvaginal mesh removal. The objectives of this video are to present cases of complications after sling placement and describe techniques to help with successful sling removal. METHODS: Three patients are presented in this video. One experienced urinary hesitancy and was found to have bladder outlet obstruction on urodynamic study...
August 16, 2016: International Urogynecology Journal
Marisa M Clifton, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: In the developed world, urethrovaginal fistulas are most the likely the result of iatrogenic injury. These fistulas are quite rare. Proper surgical repair requires careful dissection and tension-free closure. The objective of this video is to demonstrate the identification and surgical correction of an urethrovaginal fistula. METHODS: The case presented is of a 59-year-old woman with a history of pelvic organ prolapse and symptomatic stress urinary incontinence who underwent vaginal hysterectomy, anterior colporrhaphy, posterior colporrhaphy, and synthetic sling placement...
August 15, 2016: International Urogynecology Journal
Javier Pizarro-Berdichevsky, Michelle P Goldman, Howard B Goldman
INTRODUCTION AND HYPOTHESIS: Urethral perforations after synthetic midurethral sling (MUS) placement are uncommon. Transvaginal removal is an option. The objective of this English and Spanish video is to demonstrate removal of an MUS that had perforated the urethra and the concomitant urethral reconstruction. METHODS: A 66-year-old woman with a history of an anterior and posterior colporrhaphy and a retropubic MUS 12 years earlier presented with difficulty voiding, recurrent urinary tract infections, and mild stress incontinence (SUI)...
August 15, 2016: International Urogynecology Journal
Rui Liang, Katrina Knight, Steve Abramowitch, Pamela A Moalli
PURPOSE OF REVIEW: Polypropylene mesh has been widely used in the surgical repair of pelvic organ prolapse. However, low but persistent rates of complications related to mesh, most commonly mesh exposure and pain, have hampered its use. Complications are higher following transvaginal implantation prompting the Food and Drug Administration to release two public health notifications warning of complications associated with transvaginal mesh use (PHN 2008 and 2011) and to upclassify transvaginal prolapse meshes from Class II to Class III devices...
October 2016: Current Opinion in Obstetrics & Gynecology
Vineet V Mishra, Tanvir Tanvir, Sumesh Choudhary, Nilesh Goraniya
Vesicovaginal fistula (VVF) is a devastating social problem. It can either result from obstetric trauma or following gynecological surgeries, malignancy, or radiation. We present a case of a 70-year-old woman who had a VVF following mesh augmentation surgery for anterior compartment prolapse. She required a transvaginal removal of the eroded mesh followed by a transvaginal repair of VVF using a Martius flap, 6 weeks later. Transvaginal removal of mesh is technically feasible and a good approach. Timing and route of surgery should be individualized...
April 2016: Journal of Mid-life Health
Michael J Ehlert, Priyanka Gupta, Jonathan Park, Larry T Sirls
OBJECTIVES: To evaluate the hospital realized cost difference between transvaginal mesh prolapse repair and robot assisted sacrocolpopexy. METHODS: Consecutive transvaginal mesh prolapse surgery and robot assisted sacrocolpopexy cases from 1/2012 to 12/2013 were evaluated. Patient clinical and operative data were recorded. The total institutional costs (direct and indirect) for each procedure were obtained and sub-categorized by area. Independent samples t-test and Chi squared analysis were performed...
August 2, 2016: Urology
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