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This volume provides a comprehensive account of the use of MRI and CT cross-sectional imaging techniques to identify and characterize developmental anomalies and acquired diseases of the female genital tract. Benign and malignant diseases are considered, and attention is also paid to normal anatomical findings and variants. Emphasis is on the most recent diagnostic and technical advances, and the text is complemented by detailed illustrations.
The initial objective of this work was to reduce stress incontinence surgery from a major surgical procedure (requiring up to ten days in hospital) to a minor day-care operation. From the beginning it was clear that the two major impediments to achieving this goal were post operative pain and urinary retention. Addressing these problems became a long and winding road and culminated in the Integral Theory. The IVS 'tension-free' tape operation was inspired by Dr Robert Zacharin's anatomical studies. Though Zacharin suggested that the ligaments and muscles around the urethra were important for urinary continence control, he did not say how. The observation that implanted foreign materials created scar tissue led to the hypothesis that a plastic tape inserted in the position of the pubourethrallig ament, would leave behind sufficient scar tissue to reinforce that ligament, which would then anchor the muscles for urethral closure. In September 1986, two prototype Intravaginal Sling operations were per formed. A Mersilene tape was inserted with neither tension nor elevation, in the position of the pubourethral ligament. Restoration of continence was immediate and both patients were discharged on the day following surgery without require ment for catheterization. There was minimal pain, and immediate restoration of continence. After six weeks the tapes were removed. Both patients were still conti nent at last review 10 years later. The results appeared to confirm the importance of a midurethral anchoring point.
A comparative discussion of the contribution made by the various imaging techniques employed in the diagnosis and assessment of diseases of the female pelvic organs. Particular emphasis is placed on the role of such newer modalities as MRI, CT, and ultrasonography, including color Doppler. Due attention is also given to interventional procedures and to the evaluation of the effectiveness of different therapies. Each chapter includes carefully selected illustrations, providing an extensive repository of material that will be of great use in evaluating patients.
Biomechanics of the Female Pelvic Floor, Second Edition, is the first book to specifically focus on this key part of women's health, combining engineering and clinical expertise. This edited collection will help readers understand the risk factors for pelvic floor dysfunction, the mechanisms of childbirth related injury, and how to design intrapartum preventative strategies, optimal repair techniques, and prostheses. The authors have combined their expertise to create a thorough, comprehensive view of female pelvic floor biomechanics in order to help different disciplines discuss, research, and drive solutions to pressing problems. The book includes a common language for the design, conduct, and reporting of research studies in female PFD, and will be of interest to biomechanical and prosthetic tissue engineers and clinicians interested in female pelvic floor dysfunction, including urologists, urogynecologists, maternal fetal medicine specialists, and physical therapists. - Contains contributions from leading bioengineers and clinicians, and provides a cohesive multidisciplinary view of the field - Covers causes, risk factors, and optimal treatment for pelvic floor biomechanics - Combines anatomy, imaging, tissue characteristics, and computational modeling development in relation to pelvic floor biomechanics
The fully updated edition of this text provides a state-of-the-art surgical review of female pelvic surgery, and will serve as a valuable resource for clinicians and surgeons dealing with, and interested in the treatment of pelvic floor disorders. The book reviews the basic indications for treatment and details the many surgical approaches to the management of all pelvic floor disorders, including stress urinary incontinence, transvaginal prolapse, transabdominal sacrocolpopexy, robotic/laparoscopic sacrocolpopexy, vaginal and vulvar cysts, and interstitial cystitis/bladder pain syndrome. In addition to step-by-step descriptions, the text is augmented with illustrations and photographs of surgical techniques demonstrating the major repairs described in each section. Written by experts in their fields, the second edition of Female Pelvic Surgery provides a concise and comprehensive review of all surgical approaches to female pelvic surgery.
Based on the experience of two Italian referral centers, the book depicts the characteristic findings obtained when using MR imaging to study the male and female pelvis including the obstetric applications. Each chapter provides a comprehensive account of the use of the imaging technique of examination, including the most recent advances in MR imaging, the anatomy and MR possibilities in the identification, characterization and staging of the different pelvic diseases highlighting its diagnostic possibilities. The advances in fetal MRI, representing the cutting edge of pelvic MR imaging, will also be depicted. The text is complemented by numerous illustrations, as well as clinical cases that make this a very practice-oriented work, presenting the role of diagnostic imaging in every-day clinical activity. The volume will prove an invaluable guide for both residents and professionals with core interest in gynecology, obstetrics and urology.
This concise yet comprehensive guide is focused on the curriculum and current exam style of the MRCOG Part 1 examination. It integrates clinical knowledge with basic science, providing readers with a deeper understanding of pathophysiology of medical disorders in obstetrics and gynaecology. The lead editor is a member of the Part 1 Examination Committee and her insights are skilfully woven into the book's revision notes, sample Single Best Answer (SBA) question and answer explanations, and tips on exam technique. The book encourages a structured thought process to develop, making it easier for clinicians to make differential diagnoses and conduct relevant investigations and treatment plans. The focus on basic sciences also endows readers with the ability to develop research ideas and evaluate findings. Featuring easy-to-read text, highlighted key points, illustrations, and plenty of practice papers, this succinct guide is essential preparation reading for trainee obstetricians and gynaecologists taking the challenging Part 1 MRCOG exam.
With mesh surgery for prolapse sometimes proving problematic, there has been a resurgence of professional medical interest in more traditional methods for the management of prolapse and of stress urinary incontinence. This concise guide to the practical aspects of pessary use will be of interest to all gynecologists involved in the clinical management of the patient with these problems. Contents: Historical review * Pessaries for pelvic organ prolapse * Incontinence pessaries * Pessary fitting * Pessary care * Outcomes of pessary use * Current clinical studies on vaginal pessaries Cover image of vaginal pessaries © 2019 Rick Hicaro, Jr., Chicago, IL 60647, USA
The foundation needed for the understanding and hence the treatment of a disease is a knowledge of the natural morphology and physiology of the affected organ and the system to which it belongs. In describing the anatomy of the pelvis and its organs in relation to medical practice, attention will be paid to defensive, reproduc tive, metabolic and excretory systems as well as to describing physical features and surgical approaches. The disposition of the pelvic organs in the body framework merits particular attention. The pelvis and its organs undergo considerable sexual differentiation, the functions of those with opening and closing mechanisms require training, and the pelvis is the keystone of the lower limbs and the spine. Disorders of pelvic organs cause distressing illnesses. Deliberate limitation of the scope of this volume excludes description of the anatomic foundations of pregnancy, childbirth and the puerperium. These will be dealt with in a separate volume. Not only are the anatomic foundations of medical practice the starting point of the account, they are also constantly kept in view. The illustrations and text combine to provide a visual synopsis. The illustrations are based on original dissections and are drawn true to scale as far as possible. No use has been made of special means of visualizing organs or their vasculature, such as roentgenography, computed tomog raphy, arteriography, phlebography, lymphography and sonography. Technical stan dards change rapidly and individual findings inevitably receive overmuch attention. Relevant publications are named in the list of references.