scholarly journals New “Wrinkle Method” for Intracorporeal Anterior Vaginal Wall Plication during Sacrocolpopexy

2021 ◽  
Vol 10 (9) ◽  
pp. 1822
Author(s):  
Sa Ra Lee ◽  
Ju Hee Kim ◽  
Sung Hoon Kim ◽  
Hee Dong Chae
Keyword(s):  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Mesh Erosion ◽  
Perioperative Outcomes ◽  
Complication Rates ◽  
Robotic Sacrocolpopexy ◽  
Estimated Blood Loss

In this study, we introduce a new wrinkle method for intracorporeal anterior vaginal wall plication during sacrocolpopexy for pelvic organ prolapse (POP) aiming to decrease POP recurrence and postoperative vaginal wall mesh erosion. The wrinkle method was performed using robotic sacrocolpopexy (RSC) on 57 symptomatic POP patients. Sixty-six patients underwent conventional RSC before the development of the wrinkle method. Feasibility and perioperative outcomes were compared. The wrinkle method is not time consuming. The total operative time was shorter in the wrinkle group than in the non-wrinkle group; however, this was attributed to lower adhesiolysis in the wrinkle group. No differences were recorded in the mean estimated blood loss and complication rates between the two groups. In conclusion, although we were unable to confirm that the wrinkle method decreased POP recurrence and vaginal wall mesh erosion after RSC because of the short follow-up period, our preliminary findings are positive in terms of safety. Further long-term well designed randomized controlled trials are required to elucidate the benefits of the wrinkle method.

No mesh versus mesh in the treatment of anterior vaginal wall prolapse: prospective, randomised, controlled trial, long-term follow-up

2020 ◽  
Vol 52 (10) ◽  
pp. 1839-1844
Author(s):  
José Tadeu Nunes Tamanini ◽  
Leonardo Oliveira Reis ◽  
Mirce Milhomem da Mota Tamanini ◽  
Rodrigo Aquino Castro ◽  
Marair Gracio Ferreira Sartori ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Anterior Vaginal Wall Prolapse ◽  
Long Term Follow Up ◽  
Randomised Controlled

Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique

2016 ◽  
Vol 8 (2) ◽  
pp. 130-135
Author(s):  
Urmila Sharma ◽  
Ritu Agarwal ◽  
Nilesh L Goraniya ◽  
Sumesh D Choudhary ◽  
Pradeep J Bandwal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stage Iv ◽  
Anterior Wall ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Stage Ii ◽  
Novel Technique

ABSTRACT Introduction Prolapse of anterior vaginal wall is a common problem in both perimenopausal and postmenopausal women. In past 200 years, surgical management of cystocele has undergone many changes from Kelly's plication to mesh reinforcement but none of these procedures proved to be 100% effective. Modified two-corner Raz suspension procedure (MTCRSP) can be used for the treatment of POP-Q (pelvic organ prolapse quantification) stage II to IV anterior vaginal wall prolapse (AVP). Objectives To assess the effectiveness of modified two-corner Raz suspension procedure (MTCRSP) in long-term success for cystocele repair and its effect on quality of life. Study design A hospital-based prospective study. Materials and methods Twelve patients underwent modified two-corner Raz procedure and were followed postoperatively for a period of 1 year at regular intervals. During follow-up, we assessed the degree of prolapse by POP-Q, quality of life, and sexual dysfunction. Results Preoperatively, 3 out of 12 (25%) patients had stage II, five had (41.66%) stage III, and four (33.33%) had stage IV prolapse. Postoperatively, at 1 month follow-up, one (8.33%) patient developed stage II anterior wall prolapse, which progressed to stage IV prolapse at 3 months. Two more patients developed stage II prolapse at 3-month follow-up. Failure rate at the end of 1 year was 25% (3/12). Prolapse quality of life (PQOL) improved in 10 out of 12 (83.33%) patients. While PGII (patient global impression of improvement) score improved in 11 out of 12 (91.66%) women. Conclusion Modified two-corner Raz suspension procedure is an effective technique with long-term success in stage II and III prolapse but a limited success in stage IV AVP. How to cite this article Mishra VV, Goraniya NL, Choudhary SD, Sharma U, Bandwal PJ, Tanvir T, Agarwal R. Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique. J South Asian Feder Obst Gynae 2016;8(2):130-135.

Vaginal reconstruction with a greater omentum–pedicled graft combined with a vicryl mesh after anterior pelvic exenteration. Surgical approach with long-term follow-up

2007 ◽  
Vol 17 (2) ◽  
pp. 536-542 ◽  
Author(s):  
A. H. Elaffandi ◽  
H. H. Khalil ◽  
H. A. Aboul Kassem ◽  
M. El Sherbiny ◽  
E. H. El Gemeie
Keyword(s):  
Pelvic Exenteration ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Greater Omentum ◽  
Vaginal Reconstruction ◽  
Long Term Follow Up ◽  
The Mean ◽  
Vicryl Mesh

Resection of anterior vaginal wall that occurs with some cases of anterior pelvic exenteration leaves the patient with a small and narrow vagina. This affects their sexual life leading to major psychologic problems, especially in young women. The aim of this study is to evaluate a new technique of vaginal reconstruction following anterior pelvic exenteration with clinical and cytohistologic follow-up. Between March 2002 and November 2004, ten sexually active female patients underwent vaginal reconstruction after radical cystectomy that required en bloc removal of the anterior vaginal wall, with a pedicle graft of greater omentum combined with a vicryl mesh. The mean age of the patients was 38 years. The mean operative time of the reconstructive procedure was 50 min. There were no complications regarding the reconstructive procedure. On follow-up, the neovagina accepted two fingers easily and showed a pink-colored smooth lining. Seven patients reported successful attempts of sexual intercourse. It was concluded that reconstruction of vagina after anterior pelvic exenteration in sexually active women can be done safely with the use of vicryl mesh combined with a pedicled omental graft. It is a simple, reliable, and not time-consuming technique. The long-term follow-up was very beneficial in detection of complete healing, postoperative infections, and hormonal activity of the graft and recurrence of malignancy.

Comparison of Perioperative Outcomes and Parental Satisfaction Outcomes of Strip Craniectomy with Postoperative Helmet versus Spring-Mediated Remodeling in Sagittal Craniosynostosis

2021 ◽  
pp. 1-8
Author(s):  
Luke G.F. Smith ◽  
Varun Shah ◽  
Helen Duenas ◽  
Amanda Onwuka ◽  
Anne E. Graver ◽  
...  
Keyword(s):  
Parental Satisfaction ◽  
Outcome Data ◽  
Perioperative Outcomes ◽  
Long Term Outcomes ◽  
Sagittal Craniosynostosis ◽  
Estimated Blood Loss ◽  
Age At Surgery ◽  
Strip Craniectomy

<b><i>Introduction:</i></b> We sought to compare outcomes and parental satisfaction between 2 approaches for sagittal craniosynostosis: strip craniectomy with spring-mediated skull remodeling (SMSR) and strip craniectomy with postoperative helmet (SCH). <b><i>Methods:</i></b> Perioperative and outcome data for SMSR or SCH patients between September 2010 and July 2019 were retrospectively reviewed. A telephone survey was administered to parents of children who underwent both procedures. <b><i>Results:</i></b> A total of 62 children were treated for sagittal craniosynostosis by either SMSR (<i>n</i> = 45) or SCH (<i>n</i> = 17). The SCH group had a lower estimated blood loss (27 vs. 47.06 mL, <i>p</i> = 0.021) and age at surgery (13.0 vs. 19.8 weeks) than the SMSR group. Three patients underwent early springs removal due to trauma or dislodgement, all of whom converted to helmeting. Of the 62 children initially identified, 59 were determined to have an adequate follow-up time to assess long-term outcomes. The mean follow-up time was 30.1 months (<i>n</i> = 16) in the SCH group and 32.0 months in the SMSR group (<i>n</i> = 43, <i>p</i> = 0.39). Two patients in the SCH group and one in the SMSR group converted to open cranial vault reconstruction. Thirty parents agreed to respond to the satisfaction survey (8 SCH, 22 SMSR) based on a Likert scale of responses (0 being most dissatisfied possible, 4 most satisfied possible). Average satisfaction was 3.86/4.0 in the SCH group and 3.45/4.0 in the SMSR group. No parents in the SCH group would change to SMSR, while 3 of the 22 SMSR survey responders would have changed to SCH. <b><i>Conclusions:</i></b> Perioperative outcomes and average parental satisfaction were similar in both groups. Importance of helmet wear compliance and risk of spring dislodgement should be discussed with parents.

scholarly journals Assessment of Overactive Bladder after Laparoscopic Lateral Suspension for Pelvic Organ Prolapse

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ewelina Malanowska ◽  
Andrzej Starczewski ◽  
Włodzimierz Bielewicz ◽  
Matteo Balzarro
Keyword(s):  
Quality Of Life ◽  
Overactive Bladder ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Wall Defect ◽  
Pop Surgery ◽  
Laparoscopic Lateral Suspension

Background. Pelvic organ prolapses (POP) and overactive bladder (OAB) may coexist and both negatively impact quality of life in women. The correlation between POP and OAB remains unclear, but these patients may have the OAB resolution after the surgical treatment of POP. Aim of our study was to assess the anatomical results and the effect on OAB symptoms in women who underwent laparoscopic lateral suspension for POP. Materials and Methods. This prospective study included all women with apical POP who underwent surgical repair with laparoscopic uterine lateral suspension from January 2016 to December 2017. The baseline and the 1-year follow-up included post-void residual measurement, urinalysis, vaginal examination, OAB symptoms evaluation, and administration of questionnaires (PFDI-20, UDI 6). Results. 64 women underwent laparoscopic lateral suspension for uterine prolapse and 78.1% had concomitant anterior vaginal wall defect. At 1-year follow-up the anatomic success rates were 84.4% for the apical and 76.2% for the anterior compartment. The comparison between OAB symptoms before and after the surgical procedure showed the resolution of OAB in 76% of the women, while de novo OAB was present in 2.6%. With the questionnaires 95.3% (61/64) of our patients were satisfied after the POP repair. We documented a trend in ameliorating of OAB regardless of the POP-Q stage. However, the Pearson test showed this correlation as statistically significant only in women with anterior vaginal wall defect stage III and apical stage II. No patient had vaginal exposure of the polypropylene mesh. Conclusion. Our data show how laparoscopic lateral suspension is an effective procedure for apical and anterior vaginal wall defects. This study provides further evidence for the concept that OAB in women with POP >II stage improves after a successful POP surgery. These women may benefit from a resolution of OAB and POP symptoms with the improvement of patient’s quality of life.

scholarly journals Three-port approach vs standard laparoscopic radical cystectomy with an ileal conduit: a single-centre retrospective study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhouting Tuo ◽  
Ying Zhang ◽  
Jinyou Wang ◽  
Huan Zhou ◽  
Youlu Lu ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Operative Time ◽  
Ileal Conduit ◽  
Oncological Outcome ◽  
Perioperative Outcomes ◽  
Post Surgery ◽  
Estimated Blood Loss ◽  
Muscle Invasive

Abstract Background This study aimed to evaluate the effect of the three-port approach and conventional five-port laparoscopic radical cystectomy (LRC) with an ileal conduit. Methods Eighty-four patients, who were diagnosed with high-risk non-muscle-invasive and muscle-invasive bladder carcinoma and underwent LRC with an ileal conduit between January 2018 and April 2020, were retrospectively evaluated. Thirty and fifty-four patients respectively underwent the three-port approach and five-port LRC. Clinical characteristics, pathological data, perioperative outcomes, and follow-up data were analysed. Results There were no differences in perioperatively surgical outcome, including pathology type, prostate adenocarcinoma incidence, tumour staging, and postoperative creatinine levels between the two groups. The operative time (271.3 ± 24.03 vs. 279.57 ± 48.47 min, P = 0.299), estimated blood loss (65 vs. 90 mL, P = 0.352), time to passage of flatus (8 vs. 10 days, P = 0.084), and duration of hospitalisation post-surgery (11 vs. 12 days, P = 0.922) were no clear difference between both groups. Compared with the five-port group, the three-port LRC group was related to lower inpatient costs (12 453 vs. 14 134 $, P = 0.021). Our follow-up results indicated that the rate of postoperative complications, 90-day mortality, and the oncological outcome did not show meaningful differences between these two groups. Conclusions Three-port LRC with an ileal conduit is technically safe and feasible for the treatment of bladder cancer. On comparing the three-port LRC with the five-port LRC, our technique does not increase the rate of short-term and long-term complications and tumour recurrence, but the treatment costs of the former were reduced.

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