Laparoscopic bilateral subperitoneal correction of apical prolapse with titanium mesh implants

2021 ◽  
Vol 20 (3) ◽  
pp. 19-27
Author(s):  
A.I. Ishchenko ◽  
◽  
A.A. Ishchenko ◽  
A.A. Kazantsev ◽  
L.S. Aleksandrov ◽  
...  
Keyword(s):  
Vaginal Wall ◽  
Surgical Correction ◽  
Questionnaire Data ◽  
Intraoperative Blood Loss ◽  
Apical Prolapse ◽  
Titanium Mesh ◽  
Early Postoperative Complications ◽  
Pelvic Organs ◽  
Duration Of Surgery

Objective. To study the efficacy and to assess the safety of the use of titanium ribbon-like implants for surgical correction of various forms of apical prolapse. Patients and methods. 23 patients with apical prolapse (stage III–IV) aged 29 to 74 years were examined. Surgical correction of various forms of apical prolapse was performed using titanium ribbon-like mesh implants, which are more inert to the surrounding tissues than polypropylene scaffold systems. Dynamic outpatient observation of the patients was carried out after 3, 6, 12, 15 months after surgery. Results. The duration of surgery varied from 55 to 80 minutes, on average 74 ± 11.5 minutes. Intraoperative blood loss ranged from 50 to 150 mL (100 ± 35.7 mL). Of the early postoperative complications, only hematomas in the projection of the posterior vaginal wall of small sizes (up to 10 ml) – 2 (8.7%) were noted. Comparison of the questionnaire data from patients in the preand postoperative period showed an improvement in the quality of life of patients, an increase in their social and sexual activity. There was no significant displacement of the pelvic organs, and there were no mesh-associated complications. Conclusion. Laparoscopic bilateral subperitoneal hystero-, cervico-, colposuspension to the aponeurosis using titanium mesh ribbon-like implants improves the efficiency of surgical treatment of various forms and severity of apical prolapse. Key words: apical prolapse, hysterosuspension, titanium mesh implants

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

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

scholarly journals POSSIBILITIES OF THE IMPLEMENTATION OF SURGICAL INTERVENTIONS AIMED AT CORRECTING THE PROLAPSE OF PELVIC ORGANS, IN THE CONDITIONS OF THE GYNECOLOGICAL DEPARTMENT OF THE MUNICIPAL MATERNITY HOSPITAL

2018 ◽  
Vol 5 (2) ◽  
pp. 83-87
Author(s):  
Anton A. Ishchenko ◽  
A. I Ishchenko ◽  
L. S Aleksandrov ◽  
A. V Gilyadova
Keyword(s):  
Surgical Treatment ◽  
Maternity Hospital ◽  
Anterior Wall ◽  
Vaginal Wall ◽  
Surgical Correction ◽  
Actual Problem ◽  
Surgical Interventions ◽  
Pelvic Organs ◽  
Cervical Stump ◽  
The Impact

Introduction. Prolapse of pelvic organs is a polyethological disease, manifested by the displacement of the uterus and the walls of the vagina to the vulvar ring or out of it. At the base of this pathology, there is the functional inconsistency of the ligament apparatus of internal genital organs and pelvic floor musclesoccurring due to the impact of various physical, genetic, psychological, age, hormonal, iatrogenic etiological factors. Prolapse of the pelvic organs is an actual problem due to the high incidence of both reproductive and elderly women. This article considers the effectiveness of criteria for selection patients with different degrees of prolapse of the genitals for the implementation of surgical correction in conditions of the gynecological department of the municipal maternity hospital. Material and methods. The sample included patients with initial, post-hysterectomic, recurrent anterior and apical prolapse of the genitalia of II-IV degree according to POP-Q classification in the age cohort of 45-70 years who do not have systemic diseases, or with a compensated systemic disease that does not introduce significant limitations in physical and social activity. Depending on the severity of pelvic prolapse, patients underwent various types of surgical treatment. In 5 patients with incomplete uterine prolapse, there was performed laparoscopic extraperitoneal ligature hysterosuspension and vaginal wall plasty using reticular implants, and in the 1 patient with the complete prolapse of the uterus, there was made the vaginal extirpation of the uterus with extraperitoneal colposuspension vaginal walls plasty using a reticular implant. Women with adjacent gynecological pathology (24 patients) underwent laparoscopic (22) and laparotomic (2) operations for the main disease and the plasty of the vaginal walls (including 19 patients using reticular implants). In one case, a patient with elongation of the cervix and the lowering of the anterior wall of the vagina there was performed a modification of the Manchester operation using a reticular implant. In 3 patients with the isolated prolapse of the anterior wall of the vagina, the vaginal wall plasty was made with the installation of a reticular implant. Results. After the surgical interventions, no intraoperative, as well as early or late postoperative complications were noted. The evaluation of the effectiveness of the performed surgical treatment according to follow up in the period of from 12 months to 5 years, revealed 1 case of the recurrence of the disease in the form of cervical stump prolapse in a 58-year-old patient managed with succeed promonofixation of the cervical stump with a reticular implant. Conclusion. The high anatomical (94.4%) and functional (96.8%) efficacy of the surgical treatment of the prolapse of pelvic organs allow judging the persuasiveness of selection criteria for surgical correction of the genital prolapse in conditions of the gynecological department of the maternity hospital.

scholarly journals Cemented versus Uncemented Hemiarthroplasty for Femoral Neck Fractures in Patients with Neuromuscular Diseases: A Minimum of 2 Years Follow-Up Study

2021 ◽  
Author(s):  
Yuchuan Wang ◽  
Zhongzheng Wang ◽  
Siyu Tian ◽  
Zhanchao Tan ◽  
Yanbin Zhu ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Neuromuscular Diseases ◽  
Femoral Neck Fractures ◽  
Intraoperative Blood Loss ◽  
Uncemented Hemiarthroplasty ◽  
Duration Of Surgery ◽  
The Mean ◽  
Uncemented Group

Abstract Background The aim of this study is to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between 2015 and 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan-Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 minutes shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

scholarly journals Transvaginal mesh surgery for anterior apical prolapse of the pelvic organs in women

2020 ◽  
Vol 21 (2) ◽  
pp. 44-50
Author(s):  
О. V. Snurnitsina ◽  
M. V. Lobanov ◽  
I. Sh. Inoyatov ◽  
A. Nikitin ◽  
B. A. Slobodyanyuk ◽  
...  
Keyword(s):  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Vaginal Mucosa ◽  
Apical Prolapse ◽  
Prolapse Repair ◽  
Study Objective ◽  
Pelvic Organs ◽  
Mesh Surgery ◽  
Long Time

The study objective is to evaluate the effectiveness and safety of the 6-arm mesh OPUR implant in treatment of anterior apical prolapse. Materials and methods. Three hundred patients with anterior apical prolapse (grade III–IV cystocele, grade II–IV hysteroptosis) underwent surgery. Prolapse repair was performed using the 6-arm mesh OPUR implant.Results. In 290 patients, the intended result was achieved (full prolapse elimination or stage I prolapse per the POP-Q (Pelvic Organ Prolapse Quantification System)). However, in 6 cases recurrences of hysteroptosis, in 4 cases recurrences of cystocele were diagnosed. The following postoperative complications were observed: hematoma of the anterior vaginal wall with spontaneous resorption in 12 patients; acute urinary retention resolved in 3–7 days after the surgery in 5.8 % cases; vaginal mucosa erosion in 4 cases (in 2 cases, fragment resection was necessary); intraoperative injury of the bladder in 3 patients (in 2 cases, prolapse repair after defect suturing was finished with transvaginal contralateral sacrospinous hysteropexy supplemented by anterior colporrhaphy; in 1 case, bladder defect was sutured prior to implantation). Conclusion. Transvaginal repair of anterior apical prolapse of the pelvic organs in women using the 6-arm implant is effective and relatively safe. Satisfactory anatomical results persisting for a long time (4–5 years) after implantation were achieved.

scholarly journals Cemented versus uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular diseases: a minimum of 2 years’ follow-up study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuchuan Wang ◽  
Zhongzheng Wang ◽  
Siyu Tian ◽  
Zhanchao Tan ◽  
Yanbin Zhu ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Neuromuscular Diseases ◽  
Femoral Neck Fractures ◽  
Intraoperative Blood Loss ◽  
Uncemented Hemiarthroplasty ◽  
Duration Of Surgery ◽  
The Mean ◽  
Uncemented Group

Abstract Background The aim of this study was to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between June 2015 and December 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan–Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 min. shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS, and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

Kualitas Hidup Pasien Tuberkulosis Paru yang Mengalami Stigma Diri (Quality of Life Pulmonary Tuberculosis Patients With Self Stigma))

2019 ◽  
Vol 3 (2) ◽  
pp. 17-27
Author(s):  
Yunita Sari
Keyword(s):  
Quality Of Life ◽  
Pulmonary Tuberculosis ◽  
Descriptive Study ◽  
Negative Influence ◽  
Questionnaire Data ◽  
Average Quality ◽  
Tuberculosis Patients ◽  
Pulmonary Tb ◽  
Life Score

Pulmonary tuberculosis (TB) is a chronic disease that can bring about the sufferer's self-stigma and also affect his quality of life. A number of studies report that living with TB has a negative influence on the quality of life of sufferers even with or without self-stigma. The purpose of this study was to identify the quality of life of TB patients who experienced self-stigma. This research is a descriptive study, sample were 31 pulmonary TB patients. Data was collected using a questionnaire. Data analyzed by using frequency distribution and percentage. The researcher first screened TB patients who experienced self-stigma. The results showed that 25 people (80.64%) respondents experienced mild self-stigma. A total of 9 respondents (36%) had a quality of life score in the good category and as many as 16 respondents (64%) had enough category with an average quality of life score is 56.57. While respondents who had moderate self-stigma were 6 people (19.36%) with a good quality of life score was 1 person (16.67%) and enough category quality of life score were 5 people (83.33%) with an average quality of life score is 49.92.

Diagnosis and surgical correction of isthmocele after caesarean section

2021 ◽  
Vol 20 (3) ◽  
pp. 56-62
Author(s):  
N.S. Mikhaelyan ◽  
◽  
D.V. Bryunin ◽  
I.D. Khokhlova ◽  
T.A. Dzhibladze ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Surgical Correction ◽  
Postoperative Rehabilitation ◽  
Double Row ◽  
Anatomical Structures ◽  
Group 3 ◽  
Group 2 ◽  
Uterine Scar ◽  
Group 1

Objective. To compare the efficacy of different methods of surgical correction of isthmocele after caesarean section. Patients and methods. The study included 56 patients aged 29–41 years, who were divided into three groups: group 1 (n = 16) – patients who underwent surgical laparoscopy with suturing the uterine wound with single-row separate muscularmuscular sutures; group 2 (n = 23) – patients after repair of the uterus with a double-row continuous seromuscular and muscular-muscular suture performed by laparoscopy; group 3 (n = 17) consisted of patients who underwent laparotomy and suturing the uterine wound with a double-row continuous suture. Results. We developed a three-stage plastic and reconstructive surgical laparotomic and laparoscopic program in case of the uterine scar incompetence, which improved the quality of life in all patients. Pregnancy occurred 9–14 months after plastic and reconstructive surgery on the uterus and resulted in timely surgical delivery in 4 (25%) patients in group 1, in 7 (30.4%) patients in group 2 and in 3 (17.6%) patients in group 3. Two (12.5%) patients in group 1 and three (13.04%) patients in group 2 were observed during pregnancy with a period of 10–28 weeks. Conclusion. The use of laparoscopy ensured better visualization of anatomical structures (vessels, nerves, ureters, bladder), which led to a decrease in intraoperative blood loss, in the risk of damage to adjacent organs and in the development of adhesions, and to accelerated postoperative rehabilitation of patients. Key words: double-row suture, istmocele, laparoscopy, metroplasty

scholarly journals Early postoperative complications have long-term impact on quality of life after restorative proctocolectomy

Medicine ◽  
2016 ◽  
Vol 95 (27) ◽  
pp. e3966 ◽  
Author(s):  
Andrew McCombie ◽  
Yun Lee ◽  
Rutvik Vanamala ◽  
Richard Gearry ◽  
Frank Frizelle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Restorative Proctocolectomy ◽  
Early Postoperative Complications ◽  
Long Term Impact
Sign in / Sign up

Export Citation Format

Share Document