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  1. Article ; Online: Long-term pelvic organ prolapse recurrence and mesh exposure following sacrocolpopexy.

    Thomas, Tonya N / Davidson, Emily R W / Lampert, Erika J / Paraiso, Marie F R / Ferrando, Cecile A

    International urogynecology journal

    2020  Volume 31, Issue 9, Page(s) 1763–1770

    Abstract: Introduction and hypothesis: Large, long-term studies are needed to compare pelvic organ prolapse (POP) recurrence and mesh exposure following all modes of sacrocolpopexy (open, robotic, and laparoscopic). We hypothesized that the prevalence of ... ...

    Abstract Introduction and hypothesis: Large, long-term studies are needed to compare pelvic organ prolapse (POP) recurrence and mesh exposure following all modes of sacrocolpopexy (open, robotic, and laparoscopic). We hypothesized that the prevalence of recurrent POP and mesh exposure does not differ between modes of sacrocolpopexy.
    Methods: This is a retrospective cohort study with a cross-sectional, prospective survey. Participants were surveyed regarding complications, retreatments, and symptoms following sacrocolpopexy. Baseline characteristics, POP recurrence, mesh exposure, and survey responses were compared.
    Results: A total of 709 participants met the criteria. Median time from sacrocolpopexy to last follow-up for all participants was 0.5 years (2 days to 13.4 years). 15.0% experienced recurrent stage 2 or greater POP or underwent retreatment (open 11.7% [95% CI 7.8-17.2%]; robotic 21.1% [95% CI 15.6-27.9%]; laparoscopic 13.8% [95% CI 10.6-17.9%]; p = 0.03). After adjusting for baseline differences there was no significant difference among groups (p = 0.30). 5.3% experienced mesh and/or suture exposure (mesh n = 19, suture n = 10, mesh and suture n = 8) with no significant difference among groups (open 7.7% [95% CI 4.6-12.5%]; robotic 3.6% [95% CI 1.7-7.6%]; laparoscopic 4.9% [95% CI 3.1-7.7%]; p = 0.20). Median time from sacrocolpopexy to survey completion was 6.5 (1.6-13.4) years. 9.2% reported evaluation or treatment for recurrent POP (open 6.3% [95% CI 2.1-16.8%]; robotic 12.5% [95% CI 6.9-21.5%]; laparoscopic 8.5% [5.1-13.8%]; p = 0.44). 6.9% reported evaluation or treatment for mesh exposure (open 6.0% [95% CI 2.1-16.2%]; robotic 3.9% [95% CI 1.3-10.7%]; laparoscopic 8.6% [5.2-13.9%]; p = 0.38).
    Conclusions: Objective and patient-reported long-term prevalence of POP recurrence and mesh exposure are low following all modes of sacrocolpopexy.
    MeSH term(s) Cross-Sectional Studies ; Female ; Gynecologic Surgical Procedures/adverse effects ; Humans ; Laparoscopy ; Pelvic Organ Prolapse/surgery ; Prospective Studies ; Retrospective Studies ; Surgical Mesh/adverse effects ; Treatment Outcome
    Language English
    Publishing date 2020-04-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1050631-7
    ISSN 1433-3023 ; 0937-3462
    ISSN (online) 1433-3023
    ISSN 0937-3462
    DOI 10.1007/s00192-020-04291-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Laparoscopic management of ureteric obstruction after uterosacral vaginal vault suspension.

    Stepp, Kevin J / Paraiso, Marie F R

    Journal of minimally invasive gynecology

    2005  Volume 12, Issue 1, Page(s) 70–72

    Abstract: The uterosacral ligaments commonly are used to correct pelvic organ prolapse. For experienced surgeons, the rate of ureteral injury with uterosacral vaginal vault suspensions is 2%-4%. Exploratory laparotomy and ureterolysis has been used to treat ... ...

    Abstract The uterosacral ligaments commonly are used to correct pelvic organ prolapse. For experienced surgeons, the rate of ureteral injury with uterosacral vaginal vault suspensions is 2%-4%. Exploratory laparotomy and ureterolysis has been used to treat iatrogenic ureteral injury. A 64-year-old woman with stage III pelvic organ prolapse underwent surgical correction with an uterosacral vaginal vault suspension. On postoperative day 1, the patient was diagnosed with partial ureteral obstruction. She underwent laparoscopic ureterolysis and stent placement. A follow-up intravenous pyelogram showed no evidence of damage or obstruction. With proper patient selection, ureteral obstruction after vault suspension procedures can be managed with laparoscopic ureterolysis, avoiding the morbidity associated with laparotomy.
    MeSH term(s) Adnexa Uteri/surgery ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparoscopy ; Middle Aged ; Postoperative Complications/surgery ; Stents ; Ureteral Obstruction/etiology ; Ureteral Obstruction/surgery ; Uterine Prolapse/surgery
    Language English
    Publishing date 2005-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2186934-0
    ISSN 1553-4669 ; 1553-4650
    ISSN (online) 1553-4669
    ISSN 1553-4650
    DOI 10.1016/j.jmig.2004.12.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery.

    Barber, Matthew D / Amundsen, Cindy L / Paraiso, Marie F R / Weidner, Alison C / Romero, Audrey / Walters, Mark D

    International urogynecology journal and pelvic floor dysfunction

    2006  Volume 18, Issue 7, Page(s) 799–806

    Abstract: The objective of this study was to determine if obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse improve quality of life in elderly women. Women age 65 years or older with stage 3 or 4 pelvic organ prolapse who desired ... ...

    Abstract The objective of this study was to determine if obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse improve quality of life in elderly women. Women age 65 years or older with stage 3 or 4 pelvic organ prolapse who desired surgical correction were prospectively enrolled. The subjects underwent either obliterative or reconstructive vaginal surgery based on their personal preference and sexual expectations. The subjects received a pelvic organ prolapse quantitation examination and completed the pelvic floor distress inventory (PFDI), the pelvic floor impact questionnaire (PFIQ), the SF-36, and the Beck depression inventory preoperatively, 6 and 12 months after surgery. Seventy-nine subjects were enrolled, 70 of whom completed follow-up: 30 in the obliterative group and 40 in the reconstructive group. Both groups demonstrated significant improvements in the pelvic organ prolapse, urinary, and colorectal scales of the PFDI and PFIQ 6 and 12 months after surgery with no differences between the two treatment groups. In addition, there were significant and clinically important improvements noted in the bodily pain, vitality, social functioning, role-emotional, and mental health summary scales of the SF-36 in both groups after surgery, with no significant difference between groups. In appropriately selected elderly women, both obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse significantly improved health-related quality of life.
    MeSH term(s) Aged ; Aged, 80 and over ; Female ; Humans ; Patient Participation ; Prospective Studies ; Quality of Life/psychology ; Uterine Prolapse/surgery ; Vagina/surgery
    Language English
    Publishing date 2006-11-17
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1050631-7
    ISSN 1433-3023 ; 0937-3462
    ISSN (online) 1433-3023
    ISSN 0937-3462
    DOI 10.1007/s00192-006-0240-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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