scholarly journals Atypical vaginal location of endometriosis following repeated urogynaecological surgery

2021 ◽  
Vol 14 (8) ◽  
pp. e244186
Author(s):  
Anna Elisabet Christensen ◽  
Jens Jorgen Kjer ◽  
Dorthe Hartwell ◽  
Signe Perlman
Keyword(s):  
Vaginal Surgery ◽  
Surgical Excision ◽  
Scar Tissue ◽  
Pelvic Organ ◽  
Urethral Diverticulum ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Urinary Flow ◽  
Prolapse Symptoms ◽  
One Year

We outline a case of vaginal endometriosis in scar tissue located in the distal part of the anterior vaginal wall close to the urethra following repeated urogynaecological surgery. Our case presents a 45-year-old woman diagnosed with pelvic endometriosis in her youth. She underwent several vaginal surgeries due to pelvic organ prolapse, symptoms of stress incontinence and decreased urinary flow. One year after her most recent vaginal surgery, she developed a tender lump in the lower part of the anterior vaginal wall. A urethral diverticulum was suspected, but a diagnostic puncture and biopsy unexpectedly showed histologically verified endometriosis. As the cyst recurred, surgical excision of all visible endometriosis tissue was performed. After 3 years of follow-up, the patient remained without recurrence. This case illustrates the risk of atypical implantation of endometriosis related to repeated urogynaecological surgery and that treatment requires surgery with thorough removal of all visible tissues.

scholarly journals Changes of Pelvic Organ Prolapse Symptoms and Quality of Life One Year After Pessary Fitting

2021 ◽  
Author(s):  
Tahereh Eftekhar ◽  
Zinat Ghanbari ◽  
Leila Pourali ◽  
Maryam Deldar Pesikhani ◽  
Soodabeh Darvish ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Significant Proportion ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Sexually Active ◽  
Sexual Symptoms ◽  
Before And After ◽  
Prolapse Symptoms ◽  
One Year

Pelvic organ prolapse (POP) is the descend of pelvic organs, including the uterus, bladder, and rectum, to the vaginal wall. Patients with POP may present with symptoms such as vaginal bulging with other symptoms like urinary, defecatory, or sexual dysfunction. This study was conducted to evaluate the changes of POP symptoms one year after pessary fitting. Patients with symptomatic pelvic organ prolapse who presented to the pelvic floor clinic of an academic hospital between August 2016 and April 2019 were considered. Pelvic organ prolapse symptoms, including urinary, defecatory, sexual, and bulging symptoms, were recorded before and one year after pessary fitting. Pelvic floor distress inventory (PFDI)-20 and pelvic floor impact questionnaire-7 (PFIQ-7) were evaluated before and after treatment for all subjects. We analyzed the characteristics of 110 patients who used the pessary for 12 months. At the baseline, the most common prolapse symptoms were vaginal bulging and pelvic pressure. All urinary, defecatory, and sexual symptoms significantly improved one year after regular pessary use (P<0.001). Changes in PFDI-20 and PFIQ-7 before and after pessary use showed a significant improvement in both frequency and satisfaction of sexual function (P<0.001). The study showed significant improvement in bulging, urinary, and defecatory symptoms. Although the majority of patients were not sexually active, a significant proportion of sexually active patients reported an increase in sexual satisfaction.

Influence of Toileting Behaviour on Anterior Vaginal Wall Prolapse Natural Course

2021 ◽  
Author(s):  
Osman Kose ◽  
Yavuz Tarik Atik ◽  
Deniz Gul ◽  
Burak Uysal ◽  
Haci Ibrahim Cimen ◽  
...  
Keyword(s):  
Symptom Control ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Natural Course ◽  
Sitting Position ◽  
Anterior Vaginal Wall Prolapse ◽  
Initial Symptoms ◽  
Group 2 ◽  
Group 1

Abstract Background: Many risk factors have been proposed for POP, and the cause seems most plausible to be multifactorial. This study aimed to investigate the effect of toileting behaviors on the anterior vaginal wall prolapse (AVWP) natural course.Methods: The data of 75 women who had been operated for symptomatic AVWP were recorded. The patients with grade ³II AVWP were included in this study, and they were divided into two groups according to voiding and defecation position. The volunteers who were voiding in the sitting position defined as Group 1, and Group 2 included the volunteers who were voiding in squatting position. The Colo-Rectal-Anal Impact Questionnaire (CRAIQ), Pelvic Floor Impact Questionnaire (PFIQ), Pelvic Organ Prolapse Impact Questionnaire (POPIQ), Urinary Impact Questionnaire (UIQ) and visual analog pain scores were used for evaluation of patients’ symptoms. Results: 44 patients enrolled in group 1 (sitting position) and 31 patients enrolled in group 2 (squatting position). BMI, number of parity, menopause duration, topical estrogen using, comorbidities, presence of constipation and urinary incontinence, and ped count for incontinence were similar in both groups. The time from initial symptoms to surgery was demonstrated shorter in group 2, 12 (3-73) and 24 (2-182) months, respectively (p=0.001). The PFIQ and POPIQ scores and the POP-related VAS score were statistically higher in patients who were voiding and defecating in squatting positions. Conclusion: Questioning the toileting position of patients with AVWP may be effective on the treatment option of the patient and may be beneficial on symptom control.

scholarly journals Changes in muscularis propria of anterior vaginal wall in women with pelvic organ prolapse

2016 ◽  
Vol 60 (1) ◽  
Author(s):  
A. Vetuschi ◽  
A. D'Alfonso ◽  
R. Sferra ◽  
D. Zanelli ◽  
S. Pompili ◽  
...  
Keyword(s):  
Risk Factors ◽  
Smooth Muscle ◽  
Pelvic Organ Prolapse ◽  
Smooth Muscle Cells ◽  
Muscularis Propria ◽  
Muscle Cells ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Collagen Iii

<p>The objective<strong> </strong>of this study was to evaluate the morphological and immunohistochemical alterations of tissue removed from the upper third of anterior vaginal wall in a sample group of the female population presenting homogenous risk factors associated with Pelvic Organ Prolapse (POP). The case study consisted of 14 patients with POP and there were 10 patients in the control group. Patient selection was carried on the basis of specific criteria and all of the patients involved in the study presented one or more of the recognized POP risk factors. Samples were taken from POP patients during vaginal plastic surgery following  colpohysterectomy, and from control patients during closure of the posterior fornix following hysterectomy. Samples were processed for histological and  immunohistochemical analyses for Collagen I and Collagen III, α-Smooth Muscle Actin (α-SMA), Platelet-Derived-Growth-Factor (PDGF), matrix metalloproteinase 3 (MMP3), Caspase3. Immunofluorescence analyses for Collagen I and III and PDGF were also carried out. In prolapsed specimens our results show a disorganization of smooth muscle cells that appeared to have been displaced by an increased collagen III deposition resulting in rearrangement of the muscularis propria architecture. These findings suggest that the increase in the expression of collagen fibers in muscularis could probably due to a phenotypic switch resulting in the dedifferentiation of smooth muscle cells into myofibroblasts. These alterations could be responsible for the compromising of the dynamic functionality of the pelvic floor.</p><p><strong> </strong></p>

scholarly journals EXPERIENCE OF USING SYNTHETIC PROSTHESES PROLIFT ® (GYNECARE) FOR CORRECTION OF GENITAL PROLAPSE

2010 ◽  
Vol 1 (3) ◽  
pp. 32-37
Author(s):  
S A Levakov ◽  
N S Wanke ◽  
O R Shablovskiy ◽  
A G Kedrova ◽  
V N Shirshov ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Prospective Observational Study ◽  
Vaginal Surgery ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Safe Procedure ◽  
Prolapse Repair ◽  
Specific Outcome ◽  
One Year

The aim was to evaluated anatomical and symptom specific outcome measures of prolapse repair with PROLIFT ® (Gynecare). In this longitudinal prospective observational study we collected data on a total of 85 women with pelvic organ prolapse stage 2 or more. Objective success rate was 85.9% at 6 months respectively. Patients required a blood more 500 ml - 7,1% and need transfusion. The mesh erosion rate or the displacement of the mesh were 3,5%. Vaginal surgery with prolift mesh® is an effective and safe procedure to correct pelvic organ prolapse over one year follow up.

Morphometric analysis of smooth muscle in the anterior vaginal wall of women with pelvic organ prolapse

2002 ◽  
Vol 187 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Muriel K. Boreham ◽  
Clifford Y. Wai ◽  
Rodney T. Miller ◽  
Joseph I. Schaffer ◽  
R.Ann Word
Keyword(s):  
Smooth Muscle ◽  
Pelvic Organ Prolapse ◽  
Morphometric Analysis ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall

Comparative histological analysis of anterior vaginal wall in women with pelvic organ prolapse or control subjects. A pilot study

2008 ◽  
Vol 19 (5) ◽  
pp. 723-729 ◽  
Author(s):  
Wassim Badiou ◽  
Guillaume Granier ◽  
Philippe-Jean Bousquet ◽  
Xavier Monrozies ◽  
Pierre Mares ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pilot Study ◽  
Histological Analysis ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Control Subjects

scholarly journals A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Osman Köse ◽  
Hasan S. Sağlam ◽  
Şükrü Kumsar ◽  
Salih Budak ◽  
Öztuğ Adsan
Keyword(s):  
Stress Test ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
New Technique ◽  
Anterior Vaginal Wall Prolapse ◽  
Cough Stress Test ◽  
Arcus Tendineus ◽  
Mucosal Erosion ◽  
A New Technique

Aim. The aim of this study is to introduce a new technique,anterior vaginal wall darn(AVWD), which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women.Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1 cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP) was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized.Results. Data were collected six months after operation. Cough stress test (CST), Pelvic Organ Prolapse Quantification (POP-Q) evaluation, Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected.Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

Urethral diverticulum presenting as anterior vaginal wall cyst

2002 ◽  
Vol 22 (6) ◽  
pp. 700-700
Author(s):  
A. S. Parveen ◽  
R. Gonsalves ◽  
J. V. M. Mariasiluvai
Keyword(s):  
Urethral Diverticulum ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall
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