MedWorm: Anterior Vaginal Wall Repair

Subjective and objective results of anterior vaginal wall repair in an outpatient clinic: a 5-year follow-up

International Urogynecology Journal — Tue, 31 Jan 2012 07:11:01 +0100

Conclusions At 5-year follow-up 78 % was relieved from their bulge symptoms by an operation using local anesthesia. Eleven percent of the women had been reoperated. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00192-012-1663-9Authors S. Greisen, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, DenmarkM. Glavind-Kristensen, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, DenmarkK. M. Bek, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, DenmarkS. M. Axelsen, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark Journal International Urogynecology JournalOnline ISSN 1433-3023Print ISSN 0937-3462 (Source: International Urog...

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The effect of posterior colporrhaphy on anorectal function

International Urogynecology Journal — Wed, 23 Nov 2011 17:43:42 +0100

Conclusions Bowel evacuation and continence improve significantly 3–6 months following posterior colporrhaphy and are associated with parallel improvement in QoL. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00192-011-1603-0Authors Anupreet Dua, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, S10 2SF UKStephen Radley, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, S10 2SF UKSteven Brown, Northern General Hospital, Sheffield, UKSwati Jha, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, S10 2SF UKGeorgina Jones, Sheffield University, Sheffield, UK Journal Inte...

Feasibility and outcome of vaginal paravaginal repair using the Capio suture-capturing device

International Urogynecology Journal — Tue, 20 Sep 2011 05:46:30 +0100

Conclusions VPVR performed using the Capio device is associated with minimal dissection of the tissues, blood loss, and operating time and has low recurrence rate at 2-year follow-up. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00192-011-1566-1Authors Umberto Leone Roberti Maggiore, Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, Largo Rosanna Benzi 1, Genoa, 16132 ItalySimone Ferrero, Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, Largo Rosanna Benzi 1, Genoa, 16132 ItalySara Mancuso, Department of Obstetrics and Gynecology, San Martino Hospital and University of Genoa, Largo Rosanna Benzi 1, Genoa, 16132 ItalySergio Costantini, Department of Obstetrics and ...

Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review

International Urogynecology Journal — Sat, 17 Sep 2011 05:43:21 +0100

Conclusion The inclusion of new randomised controlled trials showed that the use of mesh at the time of anterior vaginal wall repair reduced the risk of recurrent anterior vaginal wall prolapse on examination. However, this was not translated into improved functional or quality of life outcomes. The value of a continence procedure in addition to a prolapse operation in women who are continent pre-operatively remains uncertain. Adequately powered randomised controlled trials are needed and should particularly include women's perceptions of prolapse symptoms and functional outcome. Content Type Journal ArticleCategory Original ArticlePages 1-13DOI 10.1007/s00192-011-1542-9Authors Christopher M. Maher, Royal Brisbane and Wesley Hospitals Brisbane, Brisbane, Australia...

Urogynecology Training and Practice Patterns After Residency

Journal of Surgical Education — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: Recent graduates from this program are comfortable making the diagnosis of prolapse and incontinence. The most commonly performed surgical procedures in residency and in practice include anterior and posterior colporrhaphy and cystoscopy. (Source: Journal of Surgical Education)

Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar‐guided transobturator anterior mesh

BJOG: An International Journal of Obstetrics and Gynaecology — Sun, 21 Aug 2011 23:00:00 +0100

Conclusions Primary cystocele repair with trocar‐guided transobturator mesh resulted in a statistically significant better anatomical outcome compared with the anterior colporrhaphy. However, functional outcome was similar between groups. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

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Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh.

BJOG : An International Journal of Obstetrics and Gynaecology — Sun, 21 Aug 2011 23:00:00 +0100

Conclusions Primary cystocele repair with trocar-guided transobturator mesh resulted in a statistically significant better anatomical outcome compared with the anterior colporrhaphy. However, functional outcome was similar between groups. PMID: 21864325 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

Treatment of recurrent vaginal eversion after previous Le Fort colpocleisis

International Journal of Gynaecology and Obstetrics — Sun, 12 Jun 2011 23:00:00 +0100

An 89-year-old woman was referred to the Department of Obstetrics and Gynecology, University Hospital Tuebingen, Tuebingen, Germany, with extreme discomfort and voiding problems due to a large mass protruding through the introitus, which had significantly limited her physical and social activities. She had undergone vaginal hysterectomy in 1966, followed by 2 operations for prolapse: an anterior and posterior colporrhaphy with perineorrhaphy and sacrospinous vaginal vault suspension in 2003; and a modified Le Fort colpocleisis in 2004, which was performed using the technique described by LeFort but without a perineorrhaphy. Recurrent vaginal eversion following the second operation was treated unsuccessfully via multiple pessaries. The women herself applied topical estrogens for 3months. (S...

Female Genital Cosmetic and Plastic Surgery: A Review

The Journal of Sexual Medicine — Wed, 13 Apr 2011 23:00:00 +0100

Conclusion. Women requesting labiaplasty and reduction of their clitoral hoods do so for both cosmetic and functional (chafing, interference with coitus, interference with athletic activities, etc.) reasons, while patients requesting VP and/or PP do so in order to increase friction and sexual satisfaction, occasionally for aesthetic reasons. Patients appear generally happy with outcomes. The majority of patients undergoing genital plastic surgery report overall satisfaction and subjective enhancement of sexual function and body image, but the literature is retrospective. Female genital plastic surgery procedures appear to fulfill the majority of patient's desires for cosmetic and functional improvement, as well as enhancement of the sexual experience. Little information is available reg...

Quality of life after treatment with midurethral sling and concomitant prolapse repair in patients with mixed versus stress urinary incontinence

Neurourology and Urodynamics — Thu, 31 Mar 2011 23:00:00 +0100

ConclusionsPatients with MUI compared with SUI demonstrated a greater improvement in quality of life after midurethral sling placement and concomitant pelvic organ prolapse repair as assessed by a disease‐specific quality of life questionnaire (UDI‐6). Neurourol. Urodynam. © 2011 Wiley‐Liss, Inc. (Source: Neurourology and Urodynamics)

Re: Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up

American Journal of Obstetrics and Gynecology — Thu, 31 Mar 2011 23:00:00 +0100

We read with great interest the article by Nieminen et al and recommend that the authors further investigate the efficacy of anterior colporrhaphy with and without a mesh. The study design was good and obtained important evidence about synthetic mesh. However, we feel that Table 2 is flawed in its statistical method. (Source: American Journal of Obstetrics and Gynecology)

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The UK national prolapse survey: 5 years on

International Urogynecology Journal — Tue, 22 Feb 2011 06:58:21 +0100

Conclusions Basic trends in prolapse surgery remain unchanged. The increase in the use of grafts is in patients with recurrent prolapse. Content Type Journal ArticlePages 1-12DOI 10.1007/s00192-011-1379-2Authors Swati Jha, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire UKPaul Moran, Worcestershire Royal Hospital, Charles Hastings Way, WR 5 1DD Worcester, UK Journal International Urogynecology JournalOnline ISSN 1433-3023Print ISSN 0937-3462 (Source: International Urogynecology Journal)

Delayed onset advanced pelvic organ prolapse after pelvic trauma in a nulliparous young female: case report

International Urogynecology Journal — Wed, 15 Dec 2010 19:06:53 +0100

We report the case of a 21-year-old nulliparous, premenopausal, non-overweight woman with no predisposing factors for prolapse who developed stage IV massive pelvic organ prolapse and stress urinary incontinence 4 years after a severe pelvic traumatic accident. Most likely, the pelvic trauma, as a single factor, was the causative factor for the massive procidentia. The onset on the prolapse was delayed until 4 years after the pelvic accident. The patient was managed with sacrospinous ligament hysteropexy along with anterior and posterior vaginal wall repair and perineorrhaphy. Despite satisfactory surgical management, long-term regular follow-up is still required. Content Type Journal ArticleDOI 10.1007/s00192-010-1320-0Authors Po-Chun Ko, Department of Obstetrics and...

Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up

American Journal of Obstetrics and Gynecology — Sun, 23 May 2010 23:00:00 +0100

Conclusion: At 3 year follow-up, anterior colporrhaphy with mesh reinforcement significantly reduced anatomic recurrences of anterior vaginal prolapse, but no difference in symptomatic recurrence were noted and the mesh erosion rate was high. The use of mesh was not associated with an increase in dyspareunia. (Source: American Journal of Obstetrics and Gynecology)

Surgical management of pelvic organ prolapse in women.

Cochrane Database of Systematic Reviews — Sat, 17 Apr 2010 08:22:03 +0100

CONCLUSIONS: Abdominal sacral colpopexy was associated with a lower rate of recurrent vault prolapse and dyspareunia than with vaginal sacrospinous colpopexy. These benefits must be balanced against a longer operating time, longer time to return to activities of daily living and increased cost of the abdominal approach. The use of mesh or graft inlays at the time of anterior vaginal wall repair reduces the risk of recurrent anterior wall prolapse, on examination. Posterior vaginal wall repair may be better than transanal repair in the management of rectoceles in terms of recurrence of prolapse. The value of the addition of a continence procedure to a prolapse repair operation in women who are dry before operation remains to be assessed. Adequately powered randomised controlled clinical tri...

Survey of current management of prolapse in Australia and New Zealand

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 31 Mar 2010 23:00:00 +0100

Conclusions: Australian/New Zealand gynaecologists used fewer traditional transvaginal procedures and more vaginal grafts than their UK colleagues in all compartments. Most respondents favoured permanent mesh (eg mesh kits) and many are missing an opportunity to gather valuable prospective data on these new procedures. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

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Surgical Repair of Pelvic-Floor Prolapse: Lessons Learned from Longitudinal Follow-Up of Quality-of-Life Survey.

Aktuelle Urologie — Fri, 01 Jan 2010 00:00:00 +0100

CONCLUSIONS: Although surgical repair of pelvic floor prolapse can achieve acceptable results with intermediate-term durability as well as improving the QOL, preoperative patients' HR-QOL may be considered in the decision making process for treatment. PMID: 20094949 [PubMed - as supplied by publisher] (Source: Aktuelle Urologie)

Prospective assessment of overactive bladder symptoms in women who have undergone transvaginal surgery for advanced vaginal wall prolapse: A preliminary report

Journal of Obstetrics and Gynaecology Research — Mon, 24 Aug 2009 23:00:00 +0100

Conclusion: This preliminary report reveals that the Perigee procedure is an efficient and effective surgical approach for the treatment of anterior vaginal wall prolapse. It can also improve the subjective symptoms of OAB. (Source: Journal of Obstetrics and Gynaecology Research)

Transobturator Tape Procedure With and Without Concomitant Vaginal Surgery

The Journal of Urology — Mon, 20 Jul 2009 23:00:00 +0100

Conclusions: Transobturator tape is safe and effective for stress urinary incontinence. Voiding dysfunction is more prevalent after concomitant vaginal surgery but that surgery does not affect the transobturator tape continence outcome. (Source: The Journal of Urology)

Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial

BJOG: An International Journal of Obstetrics and Gynaecology — Mon, 06 Jul 2009 23:00:00 +0100

Conclusion In this study, vaginal surgery augmented by mesh did not result in significantly less recurrent prolapse than traditional colporrhaphy 12 months following surgery. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial.

BJOG : An International Journal of Obstetrics and Gynaecology — Mon, 06 Jul 2009 23:00:00 +0100

Conclusion In this study, vaginal surgery augmented by mesh did not result in significantly less recurrent prolapse than traditional colporrhaphy 12 months following surgery. PMID: 19583714 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

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Postoperative Pubic Symphysis Osteomyelitis after Laparoscopic Two-team Sling with Anterior and Posterior Colporrhaphy

The Journal of Minimally Invasive Gynecology — Tue, 30 Jun 2009 23:00:00 +0100

Abstract: A 53 year-old woman, who previously had a Burch colposuspension, developed osteomyelitis of the pubic symphysis about 1 month after undergoing a laparoscopic 2-team sling with anterior and posterior colporrhaphy. The diagnosis was made on the basis of computed tomography–guided aspiration of the pubic symphysis, which was positive for group B Streptococcus sp. To our knowledge, this is the first case report of osteomyelitis after a laparoscopic retropubic sling procedure. Osteomyelitis is a rare postoperative complication in female pelvic reconstructive surgery but has been reported in cases where the pubic bone is used for anchoring. It is especially unusual in this case because the pubic symphysis was not used for securing the sling. (Source: The Journal of Minimally Invasiv...

Transabdominal uterosacral suspension: outcomes and complications

American Journal of Obstetrics and Gynecology — Mon, 23 Mar 2009 00:00:00 +0100

Conclusion: An AUSS successfully suspends the cuff for treatment of prolapse and may be offered prophylactically to women who are undergoing abdominal hysterectomy for nonprolapse indications. Alternative sutures may reduce the suture erosion rate. (Source: American Journal of Obstetrics and Gynecology)

Transabdominal uterosacral suspension: outcomes and complications.

American Journal of Obstetrics and Gynecology — Sat, 21 Mar 2009 04:00:00 +0100

CONCLUSION: An AUSS successfully suspends the cuff for treatment of prolapse and may be offered prophylactically to women who are undergoing abdominal hysterectomy for nonprolapse indications. Alternative sutures may reduce the suture erosion rate. PMID: 19306967 [PubMed - as supplied by publisher] (Source: American Journal of Obstetrics and Gynecology)

Clinical outcome of transobturator tape concomitant with vaginal hysterectomy plus anterior posterior colporrhaphy

Archives of Gynecology and Obstetrics — Fri, 16 Jan 2009 12:46:54 +0100

Conclusion Transobturator tape procedure could be accompanied safely with prolapse surgery. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00404-008-0920-0Authors Ali Ayhan, Baskent University Faculty of Medicine Department of Obstetrics and Gynecology Sihhiye Ankara TurkeyN. Utku Dogan, Hacettepe University Faculty of Medicine Department of Obstetrics and Gynecology Sihhiye Ankara TurkeySuleyman Guven, Karadeniz Technical University Department of Obstetrics and Gynecology, Faculty of Medicine 61080 Trabzon TurkeyO. Tolga Guler, Hacettepe University Faculty of Medicine Department of Obstetrics and Gynecology Sihhiye Ankara TurkeyF. Kubra Boynukalin, Hacettepe University Faculty of Medicine Department of Obstetrics and Gynecology Sihhiye Ankara TurkeyM...

Transvaginal closure of urethra and correction of uterovaginal prolapse in neurologically impaired patient with chronic indwelling catheter

International Urogynecology Journal — Tue, 13 Jan 2009 08:15:20 +0100

We report the case of a 38-year-old neurologically impaired woman with continuous urinary incontinence as a result of a chronic indwelling catheter for neurogenic bladder. Long-term catheter resulted in dilatation of urethra and pressure necrosis of urethra, with subsequent incontinence despite the catheter. She also had a stage 3 uterovaginal prolapse. She underwent cystoscopy, closure of urethra and bladder neck by transvaginal route (Feneley procedure), insertion of a suprapubic catheter, sacrospinous fixation and posterior colporrhaphy with prolene mesh (Apogee™). Vaginal hysterectomy was declined by the patient and her family. She remained dry at follow-up visit and is happy with the outcome. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00192-008-0797-2Author...

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The repair of rectovaginal fistulas using a bulbocavernosus muscle-fat flap

Archives of Gynecology and Obstetrics — Sat, 01 Nov 2008 07:00:06 +0100

Abstract A 50-year-old woman developed a rectovaginal fistula after a posterior colporrhaphy for rectocele repair. Her vagina was scarred and narrowed after radiotherapy for cervical cancer 20 years earlier. A second patient with a 23-year history of Crohn’s disease presented with a small low rectovaginal fistula. The latter appeared spontaneously. Both complained of passing faeces and flatus through the vagina. Clinical examination confirmed the symptoms and revealed no signs of sphincter disturbance. As both patients had no other medical problems, we operated on the fistulas by a vaginal approach using a bulbocavernosus muscle-fat flap from the right labia majora. A temporary ileo- or colostomy could be avoided. Following successful healing, the anatomical and fun...

Clinical Practice Guidelines on Vaginal Graft Use From the Society of Gynecologic Surgeons.

Obstetrics and Gynecology — Sat, 01 Nov 2008 04:00:00 +0100

CONCLUSION: Based on the overall low quality of evidence, only weak recommendations could be provided. This highlights the need for practitioners to fully explain the relative merits of each alternative and carefully consider patients' values and preferences to arrive at an appropriate decision. Future research is likely to change the estimates in the net benefit and risk and the confidence around these assessments. PMID: 18978115 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)

[Surgical management of pelvic organ prolapse in women: Laparoscopic or vaginal sacrocolpopexy?]

Gynecologie, Obstetrique & Fertilite — Thu, 25 Sep 2008 04:00:00 +0100

CONCLUSION: The two techniques must coexist, ideally without competing with each other but rather complementarily, as the overall rate of recurrence, requiring additional procedure does not exceed 2%. It is therefore important that surgeons, who support prolapse, have a good comprehensive training of the laparoscopic and vaginal techniques. PMID: 18823810 [PubMed - as supplied by publisher] (Source: Gynecologie, Obstetrique & Fertilite)

Symptom resolution and sexual function after anterior vaginal wall repair with or without polypropylene mesh

International Urogynecology Journal — Thu, 21 Aug 2008 09:23:23 +0100

Abstract To evaluate whether symptom resolution and sexual function is better after reinforcement with polypropylene mesh than with traditional anterior repair. Ninety-seven patients were randomized to anterior colporrhaphy and 105 to an operation with mesh. Participants were evaluated up to 24 months by physical examination, standard questions, and questionnaire. The overall symptom rate did not differ between the groups, but a sensation of vaginal bulge was reported less frequently in the mesh group, the figures being 17 versus 5 (p = 0.003). The recurrence rate for the no-mesh group was 41% and for the mesh group 11% (p < 0.001). The dyspareunia score was statistically significantly lower in the mesh group (p = 0.015). The mesh exposure rate was 8%. Se...

Change of sexual function after midurethral sling procedure for stress urinary incontinence

International Journal of Urology — Thu, 24 Jul 2008 04:00:00 +0100

Conclusions: There is no significant change in overall sexual function in women undergoing the midurethral sling procedure. Posterior colporrhaphy and operative methods do not affect overall sexual function. (Source: International Journal of Urology)

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Wide genital hiatus is a risk factor for recurrence following anterior vaginal repair.

International Journal of Gynaecology and Obstetrics — Mon, 21 Jan 2008 05:00:00 +0100

CONCLUSION: The rate of recurrent anterior vaginal wall prolapse is higher in patients with a wide genital hiatus. PMID: 18215663 [PubMed - as supplied by publisher] (Source: International Journal of Gynaecology and Obstetrics)

Vaginal topography does not correlate well with visceral position in women with pelvic organ prolapse

International Urogynecology Journal — Mon, 03 Dec 2007 18:06:24 +0100

The objective was to determine whether vaginal topography accurately predicts the location of the pelvic viscera on fluoroscopy in women with pelvic organ prolapse. Eighty-nine women undergoing preoperative evaluation for reconstructive pelvic surgery at a tertiary care referral practice formed the study population. Each woman completed a comprehensive urogynecologic history and physical examination, which included a quantified (POP-Q) assessment of her vaginal topography, as described by Bump et al. In addition each woman underwent pelvic floor fluoroscopy (PFF). Visceral sites were selected which corresponded clinically to the vaginal sites measured by the POP-Q. The most dependent portion of the bladder, small intestine, rectum and urethrovesical junction was measured. Twenty-five...

Posterior compartment defect repair in vaginal surgery: Update on surgical techniques

Current Urology Reports — Tue, 11 Sep 2007 07:29:30 +0100

Abstract Posterior colporrhaphy has been the most common surgical technique for the repair of posterior compartment defects. Traditional posterior colporrhaphy involves plication of the levator ani, which may result in dyspareunia related to narrowing of the introitus. Current posterior compartment repairs either plicate the midline fascia or repair the specific site of fascial weakness. Despite insubstantial data, the use of grafts to reinforce posterior repairs has gained popularity. Grafts such as allografts, xenografts, and synthetic meshes have been used to reinforce the posterior wall. Complications include infection and erosion, as well as recurrence of prolapse. Minimally invasive techniques have been developed to recreate the apical support of the vaginal vault an...

Efficacy and outcome of anterior vaginal wall repair using polypropylene mesh (Gynemesh)

Journal of Obstetrics and Gynaecology Research — Fri, 07 Sep 2007 01:56:29 +0100

Journal of Obstetrics and Gynaecology Research Volume 33, Issue 5, Page 700-704, Oct 2007. Abstract Aim: The aim of the present study was to assess the safety and efficacy of anterior vaginal wall repair using polypropylene mesh for the correction of anterior vaginal wall prolapse. Methods: From May 2001 to March 2005, 38 patients with cystoc... (Source: Journal of Obstetrics and Gynaecology Research)

Rectal erosion of synthetic mesh used in posterior colporrhaphy requiring surgical removal

International Urogynecology Journal — Tue, 17 Jul 2007 06:57:00 +0100

Abstract Treatment of pelvic organ prolapse with transvaginally placed synthetic mesh has recently increased. Several reports of complications have surfaced raising the overall question of safety regarding its use for vaginal prolapse repair. This case report describes a rectal erosion and dyspareunia that resulted from mesh placed into the posterior vaginal wall. A 47-year-old woman underwent a laparoscopic supracervical hysterectomy and a posterior repair with polypropylene mesh resulting in a rectal erosion. Despite removal of all of the mesh that could be excised rectally resulting in a healed rectal mucosa, the patient had persistent dyspareunia and pain requiring complete removal of the mesh using a vaginal approach. After surgery, the patient had resolution of all h...

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Bowel symptoms 1 year after surgery for prolapse: further analysis of a randomized trial of rectocele repair.

American Journal of Obstetrics and Gynecology — Sun, 01 Jul 2007 04:00:00 +0100

CONCLUSION: Resolution or improvement in bowel symptoms can be expected in the majority of women after rectocele repair and pelvic reconstruction. While all symptoms improved after surgery, a reduction in bothersome postoperative straining and incomplete emptying were specifically associated with cure of posterior vaginal wall prolapse. PMID: 17618766 [PubMed - in process] (Source: American Journal of Obstetrics and Gynecology)

Results of tension-free vaginal tape procedure in patients with or without colporrhaphy

Gynecological Surgery — Sat, 26 May 2007 11:16:57 +0100

Abstract We investigated the clinical results and the ultrasonic morphological characteristics of tension-free vaginal tape (TVT) surgery combined with anterior or posterior colporrhaphy in relation to the results after TVT procedure without prolapse repair. Seventy-two women with stress incontinence and other pelvic floor defects underwent the tension-free vaginal tape procedure in conjunction with anterior or posterior colporrhaphy. Another 212 patients with stress incontinence without genital prolapse underwent TVT procedure alone. The study was designed as a prospective investigation. The follow-up was performed 3 months after surgery. The protocol included a standardized questionnaire, gynecological examination, stress test and pad test. The position of the tape ...

Laparoscopic ventral rectopexy, posterior colporrhaphy and vaginal sacrocolpopexy for the treatment of recto-genital prolapse and mechanical outlet obstruction

Colorectal Disease — Thu, 10 May 2007 07:34:35 +0100

Colorectal Disease Volume 0, Issue 0, Page ???-???. (Source: Colorectal Disease)

The natural history of posterior vaginal wall support after abdominal sacrocolpopexy with and without posterior colporrhaphy.

American Journal of Obstetrics and Gynecology — Tue, 01 May 2007 04:00:00 +0100

CONCLUSIONS: For ASC with concomitant posterior colporrhaphy, POP-Q point Ap significantly improved and persisted at 34 months after surgery. Ten months after surgery, descent of POP-Q point Bp returned to preoperative levels and was the same regardless of whether a site-specific posterior colporrhaphy was performed at the time of an abdominal sacrocolpopexy. PMID: 17466678 [PubMed - in process] (Source: American Journal of Obstetrics and Gynecology)

Use of synthetic mesh in pelvic reconstructive surgery: a survey of attitudes and practice patterns of urogynecologists

International Urogynecology Journal — Wed, 25 Apr 2007 07:06:13 +0100

This study surveyed attitudes and practice patterns of urogynecologists regarding the use of synthetic mesh in pelvic reconstructive surgery. A web-based survey was administered to members of the American Urogynecologic Society. The survey evaluated the use of the mesh for sacrocolpopexy, suburethral sling, and vaginal pelvic reconstructive surgery. The survey had a 30.5% response rate. One hundred one (39%) respondents were women, and 158 (61%) were men. One hundred forty-seven (56.8%) participated in fellowship training. Two hundred forty-seven (99.5%) currently perform procedures using synthetic mesh, including 93% who perform sacrocolpopexy and 93% who perform suburethral slings. In a logistic regression model including gender, fellowship training, and practice setting, male surg...

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National survey on the management of prolapse in the UK

Neurourology and Urodynamics — Mon, 29 Jan 2007 07:00:00 +0100

To assess trends in the surgical management of pelvic organ prolapse (POP) amongst UK practitioners, and compare practice between urogynaecologists (tertiary centres), gynaecologists with a special interest in urogynaecology and general gynaecologists.A postal questionnaire survey was sent to practising consultant gynaecologists in UK Hospitals. They included urogynaecologists in tertiary centres, gynaecologists with a designated special interest in urogynaecology and general gynaecologists. The questionnaire included case scenarios encompassing contentious issues in the surgical management of POP.Four hundred fifty-eight responses were received and 398 were completed. For anterior vaginal wall prolapse, anterior colporrhaphy was the procedure of choice in 77% of respondents. With concomit...

Rectocele repair: a randomized trial of three surgical techniques including graft augmentation.

American Journal of Obstetrics and Gynecology — Mon, 22 Jan 2007 16:20:03 +0100

CONCLUSION: Posterior colporraphy and site-specific rectocele repair result in similar anatomic and functional outcomes. The addition of a porcine-derived graft does not improve anatomic outcomes. All 3 methods of rectocele repair result in significant improvements in symptoms, quality of life, and sexual function. PMID: 17132479 [PubMed - indexed for MEDLINE] (Source: American Journal of Obstetrics and Gynecology)

A long-term review of posterior colporrhaphy with Vypro 2 mesh

International Urogynecology Journal — Wed, 10 Jan 2007 07:54:33 +0100

The objective is to study the long-term outcomes of posterior colporrhaphy with composite polyglactin 910-polypropylene mesh (Vypro 2, Ethicon, Somerville, NJ, USA) utilizing an overlay technique. Seventy-eight patients involved in our previous study were contacted 3?years after their initial operation for follow-up (Lim YN, Rane A, Muller R, Int Urogynecol J 16:126?131, 2005). Thirty-seven (47%) returned for follow-up and completed a standardized questionnaire survey, whereas a further 16 (20%) returned their postal questionnaires. Mean age was 61.3 (SD 10.8)?years, and follow-up was 35.7 (SD 4.5)?months. There were statistically significant improvements in vaginal lump sensation and constipation (p?<?0.001) but no differences with defecatory difficulties or dyspareunia. De novo dyspar...

A randomized trial of local anesthesia with intravenous sedation vs general anesthesia for the vaginal correction of pelvic organ prolapse

International Urogynecology Journal — Wed, 22 Nov 2006 18:03:07 +0100

Abstract The purpose of this study is to compare the feasibility of local anesthesia with IV sedation versus general anesthesia for vaginal correction of pelvic organ prolapse. Patients with pelvic organ prolapse who were scheduled for an anterior or posterior colporrhaphy, or an obliterative procedure, and who did not have a contraindication or preference to type of anesthesia were randomized to one of the two anesthesia groups. Nineteen patients were randomized to the general group and 21 patients were randomized to the local group. Mean operating room, anesthesia, and surgical time were similar in each group, and 10 patients in the local group bypassed the recovery room. Requests and doses of antiemetics, postoperative verbal numerical pain scores and length of hospital stay were simila...

Biomesh (Pelvicol®) erosion following repair of anterior vaginal wall prolapse

International Urogynecology Journal — Wed, 11 Oct 2006 19:39:22 +0100

We report two cases of erosion following anterior vaginal wall repair. In both cases, the operation was performed as a standard cystocele repair where the collagen Pelvicol® mesh was anchored to the pubocervical fascia. Both patients had signs of erosion shortly after the operation, and both had the mesh removed. In one patient, the vaginal epithelium healed spontaneously, whereas the other patient had a delayed healing process. The graft was rejected due to intolerance to the biomesh or an infection. Our study shows that an erosion following implantation of a biomesh may be complicated. Content TypeJournal Article JournalInternational Urogynecology JournalOnline ISSN 1433-3023Print ISSN 0937-3462 (Source: International Urogynecology Journal)

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New surgical technique for the treatment of urinary incontinence in Clinic of Obstetrics and Gynecology of Kaunas University of Medicine.

Medicina (Kaunas) — Tue, 10 Oct 2006 15:37:05 +0100

CONCLUSION. TVT operation is a minimal invasive, fast, safe and very effective surgical procedure for the treatment of urinary stress incontinence, which has to be implemented in Lithuania as a routine outpatient procedure. PMID: 17028470 [PubMed - as supplied by publisher] (Source: Medicina (Kaunas))

Primary surgery of genital prolapse: a shift in treatment tradition.

PubMed: Acta Obstetricia et Gynecologica Scandinavica — Mon, 11 Sep 2006 14:16:05 +0100

Conclusion. The surgery for genital prolapse seems to have changed from complete repairs towards selective repairs and posterior colporrhaphy was more often avoided in the second period. The implication of this shift in surgical treatment on pelvic floor function is not known. Further studies are needed to disclose the effect of the surgery on pelvic floor function and dysfunction in the long term. PMID: 16929416 [PubMed - in process] (Source: PubMed: Acta Obstetricia et Gynecologica Scandinavica)