Editorial Editorial: Politics in the Pelvis

Cover All around the world doctors and allied professionals are holding meetings and organizing educational courses that emphasize a multidisciplinary approach to the problems of the pelvic floor. Unfortunately fragmentation and tribalisation of our specialties have led to rival societies forming that aim to capture the attentions of the many interested specialists. [More]

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Original ArticleIntravaginal posterior sling procedure (PIVS)for the treatment of uterine descensus and vaginal vault prolapse:retrospective analysis of efficacy, safety, complications and patient satisfaction in 150 cases by Kim M. Haest - Tom H. Hasaart - Ilknur Sanli - Ed T. Gondrie Martin G. Bergmans

intravaginal posterior sling The posterior intravaginal sling procedure (PIVS) is a surgical technique for the treatment of vaginal wall prolapse or descensus uteri. It was described by Petros in 1997 and is considered to be less invasive when compared to classical surgical procedures. The goal of the present retrospective study is to evaluate efficacy and safety of PIVS for the treatment of vaginal wall prolapse or descensus uteri, as well as patient satisfaction. [More]

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Case Report Urinary retention in women with isolated Stage 3 rectocele by Elena Andretta - Lisa Pola - Mauro Pastorello

cystocolpodefecographyUterine prolapse and cystocoele can cause bladder outlet obstruction, due to kinking or compression of urethra while rectocele can sometimes cause incomplete evacuation of stools. Three cases are presented where an isolated 3rd stage rectocele led to urinary retention. [More]

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Original ArticleA pilot study: The anal sphincter support procedure for the treatment of anal incontinence by Maxwell E. Haverfield

anorectal anatomyFaecal incontinence is a significant and a very debilitating condition. The true prevalence of which is unknown but up to 3% of the general population have stool incontinence which increases with age. Faecal incontinence is much more common in women, increases with parity with up to 30% having associated urinary incontinence and/or pelvic organ prolapse. [More]

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Review Colonic manometry and sacral nerve stimulation in patients with severe constipation by Philip G. Dinning

predefecatory sequenceConstipation, a common cause of morbidity, is estimated to affect between 15 and 27% of the western world. The prevalence increases to 30-40% of people aged over 65. Direct and indirect costs and resource utilisation are substantial. Chronic constipation in the US accounts for 13.7 million days of restricted activity and 3.4 million days of bed disability. [More]

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Original ArticleReducing mesh exposure in Posterior Intra-Vaginal Slingplasty (PIVS) for vaginal apex suspension by Menahem Neuman - Yuval Lavy

PIVSUrogynecologists are constantly looking for simple, safe and effective ways to cure vaginal apex supportive defects. A novel surgical technique, Posterior Intra-vaginal Slingplasty (PIVS), was described recently to concomitantly achieve a high therapeutic efficiency with a low complication rate. Mesh exposure was reported to complicate up to 16% of the operations. [More]

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Original ArticleTVT-SECUR:100 teaching operations with a novel anti-incontinence procedure by Menahem Neuman

TVT-SECURThe Tension-free Vaginal Tape (TVT) procedure is a well-established surgical procedure for the treatment of female stress urinary incontinence. The operation, described by Ulmsten in 1996, which is based on a mid-urethral Prolene tape support, is accepted worldwide as an easy-to-learn, effective and safe surgical technique. [More]

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Clinical auditPersonal evolution of surgical technique using mesh for severe prolapse - a prospective audit of outcomes in 172 cases by Philip Paris-Browne

prolapse surgical techniqueThis paper is a clinical audit of the pelvic reconstructive surgery of a consultant gynaecologist since commencement of private specialist practice in 1995. Initial techniques for management of utero-vaginal prolapse were vaginal hysterectomy anterior and posterior repair and sacrospinous colpopexy. [More]

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Original ArticleStapler-assisted trans-anal surgery for the treatment of outlet obstruction syndrome by Giuliano Reboa - Marco Gipponi - Matteo Ligorio Paolo Marino - Massimo Costantini

transobturator approach for sling placement Outlet obstruction syndrome (OOS) is related to anatomic alterations, such as rectocele, enterocele and distal intussusception which may be associated with functional disorders, such as paradoxical puborectalis contraction. Patients unresponsive to conservative treatment are eligible for surgical correction of the specific anatomic defect. [More]

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Original ArticlePersistent dyschezia after double stapled transanal rectal resection for outlet obstruction: four case reports by Filippo Pucciani - Maria Novella Ringressi - Jacopo Giani

bowel dysfunctionDyschezia, which presents with symptoms of outlet obstruction and difficult defecation including straining, feeling of incomplete evacuation after defecation, and manual manoeuvres to facilitate defecation, is sometimes due to an intussusception extending into the anal canal (i.e. recto-anal intussusception) and/or to anterior rectocele.  [More]

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Letter to EditorRe Posterior IVS for vault suspension: A re-evaluation by Peter Petros

Posterior IVS Dr Farnsworth is to be complimented on an excellent historical summation. He has played a central role in simplifying the teaching of this technique. I endorse his comments on method and sterile technique, and would add, it is absolutely necessary to create a fascial layer below the tape. Approximation of suburethral or rectovaginal fascia will give a better symptomatic result, and vastly reduce tape rejections.  [More]

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EditorialPerineology Or Pelviperineology: The Same Goal But Different Approaches by Jacques Beco - Jack Mouchel

ringsThe name perineology was used for the first time in 1990 by Giuseppe Dodi. This colo-proctological surgeon used the name in an editorial of the journal Rivista Italiana di Colon-proctologia to speak about a new speciality dedicated to the management of all the functional pelvic floor disorders. [More]

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Pelvic Floor Digest This Issue Pelvic Floor Digest read_pdf [673 kb]

pelvic floor digestThis section presents a small sample of the Pelvic Floor Digest (September 2007), an online publication (www.pelvicfloordigest.org) that reproduces titles and abstracts from over 200 journals. The goal is to increase interest in all the compartments of the pelvic floor and to develop an interdisciplinary culture in the reader. [PDF]

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