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Venous thromboembolism in reconstructive pelvic surgery.

OBJECTIVE: We sought to determine the incidence and risk factors for venous thromboembolism (VTE) in women undergoing reconstructive pelvic surgery (RPS). STUDY DESIGN: Using the American College of Surgeons National Surgical Quality Improvement Program registry, we identified patients who underwent RPS from 2006 through 2010 based on Current Procedural Terminology codes. We defined 2 cohorts: women with any RPS performed, with concomitant surgery from other specialties allowed (RPS + other), and women whose only procedure was RPS. VTE was defined as deep vein thrombosis or pulmonary embolism

[PET-CT studies of the support system and continence function of pelvic organs. The pivotal importance of Denonvilliers' fascia for surgical procedures].

Like all other organs in the chest or abdominal cavities, pelvic organs are not suspended by specialized ligaments such as those in the skeletomuscular system. In spite of this, the organs of the pelvis remain well suspended within their cavity even during evacuation. This support system for these organs consists of inconspicuous smooth muscle elements scattered throughout pelvic structural fat tissue and fascial structures, in particular Denonvilliers' fascia. We used PET-CT studies to identify spontaneous muscle activity in the pelvis, which is strongest at Denonvilliers' fascia. We were abl

Levator ani and puborectalis muscle rupture: diagnosis and repair for perineal instability.

BACKGROUND: Puborectalis muscle rupture usually arises from peri-partum perineal trauma and may result in anterior, middle compartment prolapses, posterior compartment prolapse which includes rectocele and rectal prolapse, with or without associated anal sphincter damage. Patients with puborectalis muscle and levator ani rupture may present some form of incontinence or evacuation disorder, sexual dysfunction or pelvic organ descent. However, the literature on this subject is scarce. The aim of our study was to evaluate management and treatment of functional disorders associated with puborectal…

[Experience of using an individual approach in the anal fissures treatment].

AIM: To objectify the criteria for choosing the method of treatment of anal fissures, to determine the indications for surgery and sphincter … At the same time, 6 patients out of 14 belonged to the older age groups, and in 9 women there was a rectocele, pelvic floor prolapse. Postoperative incontinence was not observed. Recovery with complete epithelialization of the anoderm defect and the absence of complaints was achieved in 191 (92.7%) patients, satisfactory results (healing of fissures in the …

Stapled hemorrhoidectomy: initial experience of a Latin American group.

The purpose of the present study was to determine the value of circular hemorrhoidectomy (procedure for prolapse and hemorrhoids [PPH]) on t … (74%) and fourth degree in 45 patients (25.4%). Skin tags were detected in 86 patients (48.8%) and rectocele in 14 patients (7.9%). Data collected included patient demographics, type of anesthesia, and specific details of the surgery such as duration of the operation, distance from the staple line to the dentate line, need for complementary hemostasis, and …

Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem.

PURPOSE: The clinical impact of rectal compliance and sensitivity measurement is not clear. The aim of this study was to measure the rectal … tipation had a larger volume at first sensation and urge (P < 0.0001 and P < 0.01). Patients with a rectocele had a larger volume at first sensation (P = 0.004). Patients with rectal prolapse did not differ from controls; after rectopexy, rectal compliance decreased (P < 0.0003). Patients with inflammatory bowel disease had a lower rectal compliance, most p …

Peritoneocele. A radiological study with defaeco-peritoneography.

REPORT STUDY: Defaecography reports from 2816 patients were evaluated. Twenty-three percent of the investigations were considered normal, 31% showed rectal intussusception, 13% rectal prolapse, 27% rectocele, and 19% enterocele. A standardised protocol is suggested to ensure a complete evaluation of defaecography. One hundred and ten reports were unclear and reviewed. The unclear reports usually concerned an unexplained widening of the rectovaginal space, and gave incitement to further studies. TECHNIQUE STUDY: Twelve patients with an unexplained widening of the rectovaginal space at defaecogr…

Robotic radical prostatectomy in 93 cases: Outcomes of the first ERUS robotic urology curriculum trained surgeon in Turkey.

OBJECTIVE: This study presents the surgical, oncological, and functional outcomes of the first 93 robotic radical prostatectomy (RARP) proce … respectively. During the perioperative period (0-30 days), five minor (prolonged drain output, n=3; rectocele, n=1; gout arthritis, n=1) and six major (inguinal hernia, n=1; incisional hernia, n=2; anastomotic urinary leakage, n=2; myocardial infarction, n=1) complications were identified. No complication was detected during postoperative days 31-90. Postop …

Safety of Synthetic Glue Used for Laparoscopic Prolapse Treatment.

STUDY OBJECTIVE: We detected mesh erosion and serious postoperative complications in 3 women after performing laparoscopic promontofixation … previous hysterectomy consulted for a bulging feeling in her vagina (classification: cystocele +2; rectocele +3 stage). An LPF was performed using polypropylene soft nonabsorbable mesh and glue. One month later, an apical defect of vaginal epithelialization was detected; she received long estrogenic local treatment but had to undergo surgery when presentin …

Laparoscopic ventral rectopexy for obstructed defecation syndrome.

INTRODUCTION: Obstructed defecation remains a serious syndrome. Several procedures have been applied to treat it. A concomitant enterocele excludes some of these procedures, because of potential threat of damaging the bowel. The aim of this study was to assess the outcome of patients who underwent laparoscopic nerve sparing ventral rectopexy for obstructed defecation syndrome with concomitant enterocele. METHODS: Seventeen patients were included. Data about clinical history, physical examination and a defecogram were collected. All patients underwent a laparoscopic ventral rectopexy. Complica

Surgical management of pelvic organ prolapse in women.

BACKGROUND: Pelvic organ prolapse may occur in up to 50% of parous women. A variety of urinary, bowel and sexual symptoms may be associated … posterior vaginal repair and transanal repair for the treatment of posterior compartment prolapse (rectocele). The posterior vaginal repair had fewer recurrent prolapse symptoms (RR 0.4, 95% CI 0.2 to 1.0) and lower recurrence on examination (RR 0.2, 95% CI 0.1 to 0.6) and on defecography (MD -1.2 cm, 95% CI -2.0 to -0.3).Sixteen trials included significan …

[Pelvic floor dyssynergia: videoproctographic analysis and pathologic associations in defecation obstruction syndrome].

INTRODUCTION: Pelvic floor dyssynergia is included pathophysiologically in the functional dyschezia group. It is characterized by the parado … 6 patients; median age: 52 +/- 14 years) with mixed pathophysiological patterns such as megarectum, rectocele, intrarectal intussusception, mucosal prolapse and perineal descent; group D (18 patients; median age: 52 +/- 16 years) with the same characteristics as in group C but also with hemorrhoids and anal fissures. DISCUSSION AND CONCLUSIONS: At first (d …

Risk factor analysis and predictive model for the alleviation of postpartum stress urinary incontinence: a retrospective cohort study.

BACKGROUND: Postpartum stress urinary incontinence (SUI) can substantially affect women's daily functioning, psychosocial well-being, and re … higher BMI, gestational diabetes mellitus, parity >=2, perineal tear, cystocele, uterine prolapse, rectocele, and levator ani hiatus defect were associated with higher odds of persistent SUI. Cesarean delivery and greater postpartum BMI loss were associated with lower odds of persistent SUI. The nomogram demonstrated good discrimination, with an AUC of 0.8 …

Ovarian low-grade serous carcinoma involving the cervix mimicking a cervical primary.

We describe the clinicopathologic and immunohistochemical features of the first reported case of an ovarian low-grade serous carcinoma metastatic to the cervix mimicking a cervical primary. The patient, a 55-year-old woman, was found to have an abnormal cervix and an abnormal Pap smear during a preoperative workup for a rectocele repair. A subsequent cervical biopsy contained moderately differentiated adenocarcinoma and the patient underwent a cold knife conization. An infiltrating adenocarcinoma was found in the anterior cervical lip, the neoplasm reached the surface of the endocervical canal…

[Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis versus laparoscopic total colectomy with ileorectal anastomosis for slow transit constipation: a multicenter retrospective cohort study].

Objective: To compare postoperative anal function recovery between laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomos … eria: (1) patients undergoing open surgery; (2) exclusion of outlet obstruction constipation (e.g., rectocele, rectal prolapse, puborectalis spasm) by functional defecation MRI; (3) comorbid psychiatric disorders; (4) missing clinical data or loss to follow-up (postoperative follow-up <24 months). Based on these criteria, clinical and follow-up data were co …

The clinical value of magnetic resonance defecography in males with obstructed defecation syndrome.

BACKGROUND: The aim of the present study was to assess the relationship between symptoms of obstructed defecation and findings on magnetic r … l data using a hierarchical log-linear model. MR imaging findings included lateral and/or posterior rectocele, rectal prolapse, intussusception, ballooning of levator hiatus with impingement of pelvic organs and dyskinetic puborectalis muscle. RESULTS: There were 21 males with ODS due to anismus (Group 1) and 15 with ODS due to rectal prolapse/intussuscept …

Obesity definition, diagnosis, bias, standard operating procedures (SOPs), and telehealth: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022.

BackgroundThe Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) regarding definition, diagnosis, bias, standard operating procedures (SOPs) and telehealth is intended to provide clinicians an overview of obesity medicine and provide basic organizational tools towards establishing, directing, managing, and maintaining an obesity medical practice.MethodsThis CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by Obesity Medicine Association leadership.ResultsOMA has defined obesity as: "A chronic, progressive, relapsing, and

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… Table 9 • Hypoandrogenemia • Urinary stress incontinence • Hyperestrogenemia • Infertility • Erectile dysfunction • Buried or hidden penis • Low sperm count • Psychological barriers to sexual behavior • Pelvic organ prolapse (e.g., cystocele, rectocele) • Benign prostatic hypertrophy with urinary hesitancy … • Acne • Preeclampsia • Polycystic ovary syndrome • Increased miscarriage and stillbirth • Menstrual disorders, anovulation, & infertility • Overdue pregnancy • Psychological barriers to sexual behavior • Increased need for induction • Urinary stress incontinence • Pelvic prolapse (e.g., cystocele, rectocele …

[Single center study of short-term and 10-year efficacy of performing the Jinling procedure on 3 310 patients with refractory mixed constipation].

Objective: To evaluate the safety, effectiveness, and long-term efficacy of the Jinling procedure for management of refractory mixed constip … norganic salt, which did not change significantly. By 6-12 months after surgery, the proportions of rectocele, mucosal prolapse, internal rectal intussusception, visceral ptosis, perineal descent, pelvic floor spasm, and puborectalis syndrome assessed by defecography were all significantly lower than before surgery (all P < 0.05). By 3 months after surgery, …

[Prolene mesh sling in the treatment of stress urinary incontinence. Integral treatment of pelvic floor anomalies. Long-term results].

OBJECTIVES: To evaluate the results of a comprehensive treatment of female stress urinary incontinence combining prolene mesh sling and prop … and urgency-incontinence), as well as gynaecological examination evaluating and grading cystocele, rectocele, uterine prolapse, enterocele and dome prolapse. Complete urodynamics were performed before and after surgery. Surgery was indicated as a complete pelvic floor dysfunction repair including prolene mesh sling in all cases with urinary stress incontin …

A Rare Case of Severe Pelvic Organ Prolapse with Massive Perineal Hernia in a Nulliparous Woman: A Case Report and Literature Review.

Background and Clinical Significance: Advanced pelvic organ prolapse (POP) associated with perineal herniation of pelvic and abdominal organs is a sporadic occurrence in gynaecological practice. Generally, POP affects up to 50% of multiparous women at some point during their lives. Advanced forms (grade III or IV) represent less than 10% of all cases, with severe grade IV prolapse occurring in fewer than 2% of patients. Case Presentation: We report the case of a 48-year-old nulliparous woman with no prior surgical history and no known medical conditions at presentation. The patient presented w

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… Time/ Recurrence Mahmoudnejad et al., 2024 [ 35 ] | 65 | 0 (virgin) | Stage IV POP (procidentia) | - | Vaginal sacrospinous ligament fixation + partial vaginal resection | 4 years/ No recurrence Ai et al., 2018 [ 36 ] | 29 | 0 (virgin) | Stage II cystocele, stage III uterine prolapse, and stage II rectocele …