Surgical correction of prolapse of anterior wall of the vagina and cervix using titanium mesh implants

Background: Regardless of a variety of surgical techniques and hi-tech materials for pelvic prolapse treatment, there is no decrease in the disease recurrences. Aims: Evaluation of the efficacy of the developed method of surgical correction of IIIV degree colpoptosis anterior combined with IIIII degree C-prolapse with the use of titanium mesh implants in reproductive, pre- and postmenopausal female patients. Methods: Female patients (group I, n = 25) with colpoptosis anterior and cervical prolapse were examined and operated on according to the developed know-how technique with the use of titanium mesh implants. Evaluation of the efficacy of surgical correction of the disease was performed using questioning, pelvic exam with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI. The findings were compared with the result of surgical treatment of 46 (group II) and 32 (group III) female patients operated on without the use of titanium implants. After surgical treatment according to the three-stage surgical program that provides for multifocal fixation of anatomical formations with the use of titanium implants, the case follow-up was performed in 321 months. Results: Questioning the patients in group I demonstrated their satisfaction with the surgical treatment results that positively affected the quality of life, mood, and contributed to an increase in sexual activity and community commitment. Check-up showed that the surgical correction of prolapse was completely preserved in the patients of group I during 1821 months. Pelvic exam at rest and with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI did not reveal any significant extrusion of the pelvic organs or titanium implants. No mesh-associated complications were observed during the follow-up. Recurrence of genital prolapse was diagnosed in 12 (26%) patients of group II, mesh-associated complications were detected in 6 (18.8%) women of group III. Conclusions: The preserving three-stage surgical program, developed by us, contributed to optimize the results of surgical treatment, decrease the rate of the disease recurrence, and reduce the risk of the development of mesh-associated complications.

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Results of surgical treatment of patients with carpal tunnel syndrome depending on the severity of the disease

Genij Ortopedii ◽

10.18019/1028-4427-2021-27-1-24-31 ◽

2021 ◽

Vol 27 (1) ◽

pp. 24-31

Author(s):

O.M. Semenkin ◽

◽

S.N. Izmalkov ◽

A.N. Bratiichuk ◽

E.B. Solopikhina ◽

...

Keyword(s):

Surgical Treatment ◽

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Functional Improvement ◽

Group Iii ◽

Group I ◽

Tunnel Syndrome ◽

Wrist Function

Introduction Although surgical treatment of carpal tunnel syndrome (CTS) is known to be highly effective outcomes may not be equally satisfactory for the patients due to severity of clinical presentation and objectifying assessment of the condition. Purpose Provide clinical evaluation of outcomes of surgical treatment of CTS using questionnaires and electroneuromyography (ENMG) findings depending on baseline severity of the condition. Material and methods The review included 161 patients who underwent 189 operations of open decompression of the median nerve using mini-access. The patients were assigned to three groups with mild (Group I), moderate (Group II) and severe (Group III) CTS. Evaluations were produced at 6 weeks, 3, 6 and 12 months following the surgery. Results The majority of patients showed positive dynamics, and delayed recovery of the wrist function was noted in Group III at a 12-month follow-up. Patients of Group III exhibited spasmodic improvement of the wrist function at 6-week-to-3-month follow-up. Conclusion Open decompression of the median nerve performed for patients with CTS using mini-approach facilitated substantial clinical and functional improvement in most cases. However, the most favorable results could be provided for mild and moderate CTS.

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A new method of organ-preserving surgical correction of cervical elongation using titanium mesh implants. The “Moscow” surgery

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2021-4-84-92 ◽

2021 ◽

Vol 20 (4) ◽

pp. 84-92

Author(s):

A.I. Ishchenko ◽

◽

V.V. Ivanova ◽

A.A. Ishchenko ◽

I.D. Khokhlova ◽

...

Keyword(s):

Transvaginal Ultrasound ◽

Vaginal Wall ◽

Titanium Implants ◽

Surgical Correction ◽

Stage I ◽

Perineal Pain ◽

Titanium Mesh ◽

Cervical Elongation ◽

Original Technique

Objective. To study the efficacy and safety of the original technique for surgical correction of cervical elongation with vaginal wall prolapse (stage I–II) in patients of reproductive and menopause age. Patients and methods. The study included 17 patients aged 30 to 56 years with cervical elongation and vaginal wall prolapse. All patients underwent the original surgery – cervical amputation along with combined transobturator and sacrospinous TiMeshligature cervical suspension. Results. The patients were observed 1, 6, 12 and 18 months after surgery. Comparison of the patients’ questionnaire data in the pre- and postoperative periods showed an improvement in their quality of life, an increase in their social and sexual activity. During the first month, 10 (58.8%) patients noted intermittent episodes of perineal pain and 3 (17%) – frequent urination. Comprehensive clinical examination after 6, 12, and 18 months revealed complete preservation of surgical correction of prolapse in all patients. Gynecological and rectal examinations, transperineal and transvaginal ultrasound revealed no displacement of pelvic organs and titanium implants. There were no mesh-associated complications during follow-up. Conclusion. The developed original technique for surgical correction of cervical elongation with vaginal wall prolapse (stage I–II) using a combination of titanium mesh implants and non-absorbable ligatures with two-lateral suture anchor was shown to be effective and safe, as evidenced by normalization of the uterus position in the pelvis and absence of pelvic organ displacement and mesh-associated complications during follow-up. Key words: cervical elongation, stage I–II vaginal wall prolapse, titanium mesh implants, mesh-ligature correction of prolapse

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Vaginal extirpation of the uterus using implants made of titanium silk to prevent recurrence of the disease

V F Snegirev Archives of Obstetrics and Gynecology ◽

10.17816/2313-8726-2021-8-2-101-108 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Anatoliy I. Ishchenko ◽

Tat'yana V. Gavrilova ◽

Anton A. Ishchenko ◽

Oksana Y. Gorbenko ◽

Teya A. Dzhibladze ◽

...

Keyword(s):

Surgical Treatment ◽

Uterine Prolapse ◽

Titanium Implants ◽

New Method ◽

Vaginal Examination ◽

Titanium Mesh ◽

Surgical Method ◽

Pelvic Organs ◽

Reliable Tool

INTRODUCTION: The frequency of post-hysterectomy prolapse of the vaginal dome reaches 43% in patients after surgical treatment for complete uterine prolapse. Goal ― improving the effectiveness of surgical treatment with titanium mesh implants in pre- and postmenopausal patients with complete uterine prolapse. MATERIALS AND METHODS: The study involved 21 patients with complete uterine prolapse who underwent the proposed new method of transvaginal surgical prevention of post-hysterectomy prolapse of the vaginal dome. The result of surgical treatment was evaluated by analyzing the data of vaginal examination and ultrasound. RESULTS: Patients were observed for 2 years ― after 1, 6, 12 and 24 months. Analysis of vaginal examination and ultrasound data showed no displacement of the vaginal dome, pelvic organs and deformation of titanium implants. There were no mesh-associated complications during follow-up. CONCLUSIONS: The use of the developed surgical method for the correction of post-hysterectomy prolapse of the vaginal dome with the use of implants made of titanium silk is a reliable tool that provides anatomical efficiency in pre- and postmenopausal patients.

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Analysis of postoperative strokes in patients after resection or suturing of the left atrial appendage

EP Europace ◽

10.1093/europace/euab116.121 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

D Volkov ◽

D Gorbunov ◽

A Anohina ◽

E Shulga ◽

D Rygalov ◽

...

Keyword(s):

Surgical Treatment ◽

Cerebral Circulation ◽

Myocardial Revascularization ◽

Functional Class ◽

Cardiac Pathology ◽

Group Iii ◽

Group I ◽

Blood Clots ◽

Group Ii

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In 30%, the cause of strokes is AF. 90% of cases, thromboembolism occurs in the cerebral arteries, condemning the patient not only to disability, but also to death. Considering that the formation of blood clots occurs in hemodynamically inactive areas of the LA, which is the apendege of the LA, it is advisable to combine surgical treatment of AF with its exclusion from systemic blood flow. Purpose Analyze the frequency of strokes in the follow up period in patients who have undergone surgical treatment of AF in combination with LAA resection. Materials and Methods 364 patients were divided into 3 groups depending on the volume of operative treatment and the rhythm of the controlling strategy, 105 dropped out of the study due to the lack of data collection capability. • Group I included 80 patients who underwent surgical AF treatment with LAA resection combined with valvular pathology correction or myocardial revascularization. Lethal outcome in this group was recorded in 6 (7.5%) patients caused by non-cardiac pathology. Surgical treatment of AF was performed by MAZE IV and left side MAZE. • Group II - 140 people who performed valve pathology correction, without surgical treatment of AF and without LAA resection. • Group III included 39 patients with a persistent form of AF who performed only LAA resection in combination with correction with another cardiac pathology. Group II and III mortality were 23 patients. All patients in group I and III underwent LAA resection to exclude a possible source of blood clots. The stump was sutured with a continuous two-row suture on the base up to 2 mm from the LA wall. After 36 months, patients from group I underwent echocardiography, electrocardiography, Holter monitoring, and a cardiologist examination. Group II and III analyses were performed by patient telemetry. Results • Long-term three-year results showed complete 100% freedom from acute cerebral circulation disorder in group I, where surgical treatment of AF was performed in combination with LAA resection; • In group I with a persistent form of AF without LAA resection - acute cerebral circulation disorder occurred in 36 patients, which was 28.8%; • In group III with permanent fibrillation with LAA resection, of the 31 patients, thromboembolic complication occurred in 4 patients (12.9%). It is worth noting that after surgery in the distant period, patients of group I increased the average value of the ejection fraction by 4%, decreased volumes of the LA, and the functional class on NYHA changed from III to II, I. Conclusion The study performed the highest degree of absence of stroke in group I in early and follow up period. First of all, this is due to a comprehensive approach to the treatment of cardiac pathology, the preservation of sinus rhythm and LAA resection. Which, in addition to absence of stroke, leads to an improvement in the quality of life and a decrease in the functional class of heart failure.

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THE PECULIARITIES OF PERIOPERATIVE CLINICAL CHARACTERISTICS OF PATIENTS WITH GENITAL ENDOMETRIOSIS ASSOCIATED WITH HYPOTHYROSIS

Клінічна та профілактична медицина ◽

10.31612/2616-4868.1(11).2020.05 ◽

2020 ◽

Vol 1 (1) ◽

pp. 40-50

Author(s):

T. Struk ◽

O. Gordeichuk ◽

O. Nikitinа ◽

O. Lytvak

Keyword(s):

Surgical Treatment ◽

Clinical Characteristics ◽

Clinical Laboratory ◽

Reproductive Function ◽

Surgical Approaches ◽

Complete Relief ◽

Surgical Interventions ◽

Female Patients ◽

Group I

Purpose: to elucidate the peculiarities of perioperative clinical characteristics of female patients with genital endometriosis associated with hypothyrosis. To attain our object, the following tasks had to be accomplished: to determine the localization of endometrioid heterotopia and severity of endometriosis in patients with hypothyrosis; to study the types of surgical interventions in patients with endometriosis associated with hypothyrosis; to assess the frequency of endometriosis recurrence after surgical treatment in patients with endometriosis associated with hypothyrosis. Material and methods. We examined 100 female patients: 40 patients – with endometriosis associated with hypothyrosis (main group – group I); 60 patients – with endometriosis and without thyroid pathology (group of comparison – group II). We analyzed the results of clinical, laboratory and instrumental examination, including radiological methods (CT-scan, X-ray). The diagnosis in all the patients was based on pathohistological verification. All surgical interventions were performed by the use of endovideosurgical technology. Results and discussion. According to the results of patients` examination, we identified the following localization of endometrioid heterotopia and severity of endometriosis: Stage I – 38,0 % of patients with ovarian endometrial cysts and adenomiosis; Stage II – 27,0 % of patients with peritoneal endometriosis and adenomiosis; Stage III – 23,0 % of patients with ovarian endometrial cysts, adenomiosis, peritoneal and urinary tract endometriosis; Stage IV – 12,0 % of patients with ovarian endometrial cysts, adenomiosis, peritoneal and retrocervical endometriosis. The 80,0 % of patients underwent organ-preserving procedures, and radical surgery was performed in 20,0 % of cases. We used the following surgical approaches to the endometrial lesions: 56,0 % − combined laparoscopy and hysteroscopy; 42,0 % − transvaginal laparoscopy; and only in 2,0 % of cases – conversion to laparotomy. The frequency of endometriosis recurrence after surgical treatment in patients with hypothyrosis was established: 4,0 % − at 6-month follow-up; 6,0 % − at 9-month follow-up; and 10,0% − at 12-month follow-up. We observed complete relief from the endometriosis symptoms in 80,0 % of patients after the surgical procedure. Additionally, the reproductive function was recovered in 24,0 % of females. Conclusions. The surgical treatment of patients with endometriosis associated with hypothyrosis should be based on the principle of radical removal of endometriotic lesions, particularly through the combined simultaneous procedures in case of advanced extragenital endometriosis. Additionally, several aspects should be taken into account, namely: localization of endometrioid heterotopia and severity of endometriosis; the age of patients and their interest in the preservation of reproductive function; the presence of the highly qualified surgeons (gynecologists, general surgeons, urologists), as well the high level of anesthetic support with thorough postoperative monitoring.

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Computed Tomography of Ovarian Carcinoma

Acta Radiologica Diagnosis ◽

10.1177/028418518402500308 ◽

1984 ◽

Vol 25 (3) ◽

pp. 203-208 ◽

Cited By ~ 13

Author(s):

A. Kalovidouris ◽

A. Gouliamos ◽

Gr. Pontifex ◽

K. Gennatas ◽

K. Dardoufas ◽

...

Keyword(s):

Computed Tomography ◽

Radiation Therapy ◽

Surgical Treatment ◽

Ovarian Carcinoma ◽

Therapy Group ◽

Group Iii ◽

Abdominal Organs ◽

Group I ◽

Laparotomy Group

Forty-seven patients with ovarian carcinoma were examined with computed tomography (CT). Fourteen were evaluated before laparotomy (group I), 25 following surgical treatment (group II), and 8 were followed by CT in the course, or following chemotherapy with or without radiation therapy (group III). CT provided accurate estimates of the size, shape and structure of the ovarian tumor in 8 patients in group I and contributed to diagnosis in 3 others. Primary ovarian tumors were incorrectly diagnosed in 3 cases. CT examination was valuable for detection of metastases in the mesenterium, omentum, peritoneum, abdominal organs and lymph nodes. The detection of small (1 cm diameter) metastatic implants on the peritoneal surface, omentum and liver capsule was facilitated by the presence of ascites. CT proved useful for patient follow-up, either after surgical treatment or when chemotherapy with or without radiation therapy was used.

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Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

Vojnosanitetski pregled ◽

10.2298/vsp0808627k ◽

2008 ◽

Vol 65 (8) ◽

pp. 627-631

Author(s):

Tamara Kljakovic-Avramovic ◽

Miroslav Vukosavljevic ◽

Sinisa Avramovic

Keyword(s):

Surgical Treatment ◽

Prospective Study ◽

Children And Adolescents ◽

Deviation Angle ◽

Group Iii ◽

Military Medical Academy ◽

Group I ◽

Medical Academy ◽

Group Ii ◽

Common Manifestation

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .

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Osteoporosis - a risk factor for cardiovascular diseases: A follow-up study

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1502028t ◽

2015 ◽

Vol 143 (1-2) ◽

pp. 28-34 ◽

Cited By ~ 2

Author(s):

Ivan Tasic ◽

Marina Rasic-Popovic ◽

Sonja Stojanovic ◽

Bojana Stamenkovic ◽

Svetlana Kostic ◽

...

Keyword(s):

Bone Density ◽

Postmenopausal Women ◽

Bone Fractures ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Group Iii ◽

Normal Bone ◽

Group I ◽

Standard Assessment

Introduction. Cardiovascular (CV) diseases and bone fractures due to osteoporosis are the leading causes of death in the elderly. Objective. The aim of this study was to demonstrate a correlation between the overall risk for CV events, and low bone density in postmenopausal women, and its impact on the incidence of serious CV events. Methods. Our prospective study involved 300 postmenopausal women. All the examinees were divided into three groups based on their measured bone density: Group I - 84 examinees with osteoporosis; Group II - 115 examinees with osteopenia; and Group III - 101 examinees with normal bone density. In all examinees the overall ten-year risk for a fatal CV event was calculated using the SCORE system tables. Results. After a 36-month follow-up, CV events occurred in 19 (6.3%) examinees. Significant differences in the incidence of CV events were demonstrated between the patients with osteoporosis, osteopenia, and normal bone density (?2=28.7; p<0.001), as well as between those with a high and low CV risk (?2=22.6; p<0.001). Multivariate logistic regression analysis showed that smoking (OR: 2.23; 95% CI: 1.02 to 6.19; p=0.035), and increase of overall CV score (OR: 1.36; 95% CI: 1.17 to 1.58; p<0.001) are associated with increased CV event risk, while the increase of T score value is associated with decreased risk of CV event (OR: 0.42; 95% CI: 0.25 to 0.73; p=0.002). Conclusion. Measurement of bone density with a standard assessment of the total CV risk could be useful for selecting women who need intensive prevention and treatment of atherosclerosis.

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Surgery of cholesteatoma: Surgical technique and cholesteatoma recurrences

Acta chirurgica iugoslavica ◽

10.2298/aci0401103a ◽

2004 ◽

Vol 51 (1) ◽

pp. 103-107

Author(s):

Nenad Arsovic ◽

Radomir Radulovic ◽

Snezana Jesic ◽

S. Krejovic-Trivic ◽

P. Stankovic ◽

...

Keyword(s):

Surgical Treatment ◽

Surgical Technique ◽

Complete Removal ◽

Initial Surgery ◽

Group I ◽

Number Of Patients ◽

Significant Difference ◽

Diffuse Form ◽

Surgical Failure

Past experience with open and closed techniques of tympanoplasty in surgery of cholesteatoma has shown that recurring illness is one of the major causes of surgical failure. The literature has reported varying trend of surgical treatment of cholesteatoma. The objective of the study was to analyze the significance of surgical technique in relation to the incidence and most frequent localization of recurrent cholesteatoma. Our study analyzed 120 patients operated on for cholesteatoma. The patients were divided into two groups, group I (45) with recurring disease and group II (75) without any recurring condition, which were followed up three years. Statistical analysis was carried out by modified t-test. The largest number of patients was re-operated in the first two years from the initial surgery (50%), In the majority of patients (50%), recurrent cholesteatoma was most commonly localized (stage I) in attic (20%) and much rarely in mesotympanum (11,9%). Stage III recurrent cholesteatoma was verified in 35% of patients, most frequently diffuse form (13,4%). The involvement of attic by all three stages of disease accounted for over 60%. The analysis of the used techniques of surgical treatment in both groups revealed significant difference. Open techniques of tympanoplasty were used in 60% of patients with no recurrence. Closed techniques were used more frequently in patients with recurring disease, i.e. in over 90% of cases. Recurrent cholesteatoma develops, in the majority of cases, during the first two years after the surgical intervention. Attic is the most common localization of cholesteatoma. More frequent utilization of open technique of tympanoplasty for surgery of cholesteatoma significantly reduces the incidence of recurring condition. The indications for CWD technique are the initial spread of cholesteatoma, possibility of complete removal of cholesteatoma and postoperative follow-up of patients.

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Hormonal status of patients after surgical treatment of fibrocystic mastopathy and possibilityes of its corrections

HEALTH OF WOMAN ◽

10.15574/hw.2017.121.128 ◽

2017 ◽

pp. 128-131

Author(s):

Yu.Ya. Pryshash ◽

Keyword(s):

Surgical Treatment ◽

Standard Dose ◽

Treatment Phase ◽

Nodule Formation ◽

Double Dose ◽

Postoperative Rehabilitation ◽

Group Iii ◽

Group I ◽

Group Ii ◽

High Doses

The purpose of the study was to investigate the efficacy of Mastodynon in terms of indications in elevated doses versus the standard dose. Materials and methods. Data were analyzed for 60 patients after surgical treatment of fibro-cystic mastopathy. Depending on the postoperative therapy received by the patients, they were divided into three groups. Group I (n = 20): patients were observed in accordance with the standards established in mammal practice and did not receive special agents that affect hormonal homeostasis. Group II (n = 20): In addition to observation, patients received Mastodynon® (1 tablet or 30 drops 2 times a day) for 6 months. Group III (n = 20): Patients were given for a post-operative rehabilitation Mastodynon® in a double dose (2 tablets or 60 drops 2 times a day) for 6 months. Results Surgical treatment without conservative therapy eliminates organic changes in the thoracic glands (GH), but hormonal disorders that have led to pathologic and histological changes in the tissues of GZ continue to exist for a long time and can lead to repeated nodal formations. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. The use of Mastodynon® in standard doses (group II) for postoperative rehabilitation contributes to a significant improvement in hormonal homeostasis (normalization of prolactin, estradiol and progesterone levels), a 24.7 mm decrease in the degree of cyclic mastodynia according to the visual analog scale (VAS), and the improvement of ultrasound scan Pictures of GZ in 75% of patients. The most pronounced effect of this rehabilitation approach after the surgical treatment phase was noted for the use of Mastodynone in doble doses (2 tablets or 60 drops 2 times a day) in Group III. In these patients, the degree of reduction of cyclic mastodynia was 30 mm for VAS and positive changes in the tissues of GH were noted in 85% of patients. However, the highest incidence of adverse events was also noted in Group III, although they were temporary in nature and did not require withdrawal or dose reduction. Conclusion. Despite the presence of short-term side effects and rapid rebounding in the double-dose Mastodynon® group, our study showed better results than standard doses, faster and more stable therapeutic effect. Taking into account the results obtained, it can be argued that the use of high doses of Mastodynon® may be recommended to patients for the treatment of mastopathy. For a more complete study of such an important aspect as the tolerability of high doses of Mastodynon®, it is advisable to conduct more extensive studies, taking into account the dosage form and the use of other drugs. Key words: mastopathy, postoperative rehabilitation, Mastodynon®, mastodynia.

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