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Minimally Invasive Therapy for Urinary Incontinence and Pelvic Organ Prolapse provides a detailed insight into “when, why, what and how” of various minimally invasive surgical procedures for surgical management of SUI, OAB & POP. The volume provides detailed diagrammatic and pictorial step-by-step descriptions of the techniques and management of complications related to these procedures. This book also presents an up to date, one-stop reference for anything pertaining to MIT of these pelvic disorders. Written by experts in the field, Minimally Invasive Therapy for Urinary Incontinence and Pelvic Organ Prolapse is a comprehensive resource designed for both the urologist and urogynecologist treating patients with urinary disorders and pelvic organ prolapsed, as well as for residents in training.
This text provides a central resource for physicians, entrepreneurs, and the MBA students about how innovation occurs in medical device industry. The book uses the rise and fall of vaginal mesh kits to highlight the evolution of responses by the physicians, patients and the regulatory bodies. There are specific chapters reviewing the US regulatory issues and business practices that were consequential to withdrawal of most vaginal mesh kits from the US market. The book is meant to be concise, evidence-based, and practical for the first time readers to understand the innovation forces. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving medical device industry. The case study chapters fully elucidate the anatomical basis that led to conceptualization of vaginal mesh kits, their introduction into the market, medicolegal and business implications followed with innovation that occurred by the surgeons to utilize ultrasound for and innovative surgeries to overcome device complications. With a luxurious number of well-marked pictures, readers will gain a clear understanding of the medical device innovation and evolution. Innovation and Evolution of Medical Devices: The vaginal Mesh Kits provides a rich practical resource written in a simple a step-by- step approach for all readers in their approach to new medical devices and technologies.
An Unusual Case of Sudden Complete Urinary Incontinence 20 Days After Pelvic Floor Surgery and Tension-Free Vaginal TapeHaemmerle B., Schmid S., Keller N.Gynaecology and Obstetrics, Grabs, Switzerland.Problem statement: Tension-free midurethral synthetic slings are a minimal invasive treatment of stress urinary incontinence. If urinary incontinence occurs in combination with pelvic floor disorder, a combined treatment must be considered.We describe a case of sudden complete urinary incontinence 20 days after pelvic floor surgery and mid-urethral sling operation.Methods and Results: An 81-year-old woman presented herself with disturbing stress urinary incontinence and symptomatic pelvic organ prolapse in our outpatient clinic. In the past her stress urinary incontinence was treated with an incontinence ring pessary until the pelvic organ prolapse increased and the pessary dislocated. 30 years before she had had an abdominal hysterectomy and presumably a colposuspension. During the examination a further pelvic floor disorder comprising of vaginal vault prolapse, cystocele, enterocele, distal rectocele and anterior rectocele with stool-outlet-obstruction was diagnosed. In a urodynamic study the stress urinary incontinence could be confirmed. To repair the symptomatic pelvic floor disorder the patient required an anterior and posterior colporrhaphy, vaginal repair of enterocele and anterior rectocele. Additionally a tension-free midurethral sling (retropubic tension-free vaginal tape, TVT) was implanted because of stress urinary incontinence. Seven days after the operation the patient restarted taking acetylsalicylic acid (100mg) because of cardiac indication. After an uneventful first follow-up examination 14 days after the surgery with sonographic correct position of the TVT, the patient reported 20 days later with suddenly occurred complete urinary incontinence. The clinical and sonographic examinations showed a new haematoma of the vaginal vault and the anterior vaginal wall with consequent dislocation of the TVT. Four months later the haematoma had slightly become smaller and the urinary incontinence had improved.Conclusion: The occurrence of vaginal vault haematoma 20 days after pelvic floor repair is unusual even in combination with the intake of acetylsalicylic acid. The volume of the haematoma caused the dislocation of the TVT, which resulted in complete urinary incontinence. But when the haematoma absorbed, the incontinence improved. Once the TVT dislocated by haematoma, it might not be correctly placed anymore after its absorption. If there is still some incontinence after the entire absorption of the haematoma, the placement of a new TVT could be considered.
Ultrasonography is a cornerstone in the evaluation of gynecologic disease. This authoritative new book looks at the techniques of ultrasonography in both office and hospital settings, offering guidance on the optimal use of equipment and covering the full range of benign and malignant gynecologic disease as well as infertility. Ultrasonography in Gynecology offers extensive coverage of the diagnostic potential of ultrasound in gynecologic disease, from the moment the patient walks into the physician's office. All the different approaches in the ultrasonographic evaluation of disease – including 3D ultrasonography, 3D sonohysterography, Doppler imaging and pelvic floor imaging – are extensively covered, with color images throughout. Written and edited by leaders in the field of ultrasonography who have actively participated in national and international teaching courses, Ultrasonography in Gynecology is a must for all gynecologists dealing with infertility, endometriosis, uterine fibroids, gynecologic cancers, and many more gynecologic conditions.
This volume provides a comprehensive, step by step description of the surgical techniques that the author has used in more than 13,000 vaginal reconstructive procedures. Chapters cover surgery for incontinence, prolapse, urethral diverticula, vaginal fistula, reconstruction, surgery for urethral obstruction and vaginal cysts and masses, and lastly, complications of vaginal surgery. Each surgical chapter covers a succinct summary of diagnosis, indications for surgery, and the surgical procedure itself. Sequential operative photographs, drawings, and videos guide are also included to guide the reader through the procedural steps. The Atlas of Vaginal Reconstructive Surgery will serve as a valuable resource for urologists, gynecologists and other specialists with an interest in vaginal reconstructive surgery.
Practical Pelvic Floor Ultrasonography: A Multicompartmental Approach to 2D/3D/4D Ultrasonography of Pelvic Floor provides an introduction to pelvic floor imaging, as well as a resource to be used during initial and more advanced practice. The book helps readers gain competence in performing 2D/3D/4D transperineal, and 2D/3D endovaginal / endoanal ultrasound evaluation of the pelvic floor, including anal sphincter and levator ani complex. The text also shows interested clinicians how to obtain optimal images of pelvic floor muscles and organs, how to obtain useful images of the anal canal, levator ani complex, urethra, and how to interpret clinical implications of alterations of the anatomy. In addition, emerging techniques of “dynamic” pelvic floor ultrasound and 3D/4D ultrasound are introduced through step by step protocols that are aimed at optimizing sonographic images. Written entirely by experts in their fields, Practical Pelvic Floor Ultrasonography: A Multicompartmental Approach to 2D/3D/4D Ultrasonography of Pelvic Floor is a comprehensive resource that will be of great value to urogynecologists, colorectal surgeons, obstetrician and gynecologists, female urologists, ultrasonographers, radiologists, physiotherapists, as well as fellows in urogynecology and colorectal surgery.
This book demonstrates knowledge on tissue-based procedures for stress urinary incontinence and other pelvic floor related topics. As the field shifts away from using synthetic material for repair, this work presents a new perspective on native tissue repair from the opinions and research of the authors. Written by a panel of expert authors in the field, this text provides high quality, focused information that is complimented by illustrations and videos. With established track records the authors illustrate how to perform the procedure vaginally or through open surgery, and inclusion of live surgeries via online video, makes this an invaluable tool for busy surgeons and specialists interested in pelvic floor reconstruction.
With rising prevalence of urinary incontinence and prolapse in aging population in the Western world there is an increasing need for knowledge about this subject. This handy pocketbook summarizes the practical patient management, based upon the available evidence and author’s own clinical experience, and indicates controversial areas where we have insufficient evidence. All about urinary incontinence, prolapse and fecal incontinence - the only small book that does all three. Aimed at general practitioners and junior gynecology trainees, it will also be useful for consultant gynecologists with no previous formal urogynecological training.