Editorial Editorial: Pelvic Floor Imaging by G.A. Santoro and P. Wieczoreck
Recent
milestones in surgical techniques and the development of new operative materials
and implants for use in coloproctology and urogynaecology, together with advances
in molecular diagnostics and laboratory testing have revolutionized the management
of patients with pelvic floor disorders. The assessment of urogynaecological
and coloproctological operations, the surgical techniques themselves and the
outcomes of these treatments are areas of great interest in the literature. [More]
Full Text 
Pdf
Recent
milestones in surgical techniques and the development of new operative materials
and implants for use in coloproctology and urogynaecology, together with advances
in molecular diagnostics and laboratory testing have revolutionized the management
of patients with pelvic floor disorders. The assessment of urogynaecological
and coloproctological operations, the surgical techniques themselves and the
outcomes of these treatments are areas of great interest in the literature. [More] Full Text Pdf Original
ArticleHistotopographic
study of the pubovaginalis muscle
by Veronica Macchi et al.
The levator ani muscle is considered the most important supportive
system of the pelvic floor and has been divided into many portions,
according to their attachments or physiological functions. Standring et
alsubdivide the levator ani muscle into the ischiococcygeus, iliococcygeus
and pubococcygeus portions. The pubococcygeus muscle is often subdivided
into separate parts according to the pelvic viscera to which they relate,
i.e. pubourethralis and puborectalis in the male, pubovaginalis (PVM) and
puborectalis in the female. At the level of the vagina and the rectum, the
muscle bundles of the pubococcygeus muscle are continuous with those controlateral,
forming a sling (pubovaginalis and puborectalis). [More]
Full Text Pdf
The levator ani muscle is considered the most important supportive
system of the pelvic floor and has been divided into many portions,
according to their attachments or physiological functions. Standring et
alsubdivide the levator ani muscle into the ischiococcygeus, iliococcygeus
and pubococcygeus portions. The pubococcygeus muscle is often subdivided
into separate parts according to the pelvic viscera to which they relate,
i.e. pubourethralis and puborectalis in the male, pubovaginalis (PVM) and
puborectalis in the female. At the level of the vagina and the rectum, the
muscle bundles of the pubococcygeus muscle are continuous with those controlateral,
forming a sling (pubovaginalis and puborectalis). [More] Full Text Pdf
Original Article
Posterior intravaginal slingplasty Feasibility and preliminary results
by Peter Von Theobald - Emmanuel Labbé
Adequate
treatment of genital prolapse requires a defect specific approach. Repair of
upper compartment prolapse (vaginal vault, hysterocoele, enterocoele) can involve
abdominal or laparoscopic techniques such as sacrocolpopexy the Kapandji type
operation, combined abdominal/vaginal techniques or techniques using the vaginal
route, such as spinofixation or MacCall type culdoplasty. Peter Petros described
a new technique using a sling of polypropylene mesh for suspension of upper
compartment organs which have prolapsed, called “Posterior Intra Vaginal
Slingplasty” (PIVS), and for which a more detailed name would be “infracoccygeal
translevatorial colpopexy”. [More]
Full Text Pdf
Adequate
treatment of genital prolapse requires a defect specific approach. Repair of
upper compartment prolapse (vaginal vault, hysterocoele, enterocoele) can involve
abdominal or laparoscopic techniques such as sacrocolpopexy the Kapandji type
operation, combined abdominal/vaginal techniques or techniques using the vaginal
route, such as spinofixation or MacCall type culdoplasty. Peter Petros described
a new technique using a sling of polypropylene mesh for suspension of upper
compartment organs which have prolapsed, called “Posterior Intra Vaginal
Slingplasty” (PIVS), and for which a more detailed name would be “infracoccygeal
translevatorial colpopexy”. [More] Full Text Pdf Original
ArticleMaterial
and type of suturing of perineal muscles used in episiotomy repair
in Europe by
Vladimir Kalis et al.
Episiotomy,
the incision of the perineum during the last part of the second stage
of labour or delivery is still considered a controversial procedure.
Long-term complications after episiotomy repair are common. A large
proportion of women suffer short-term perineal pain and up to 20%
have longer-term problems (e.g. dyspareunia). Other complications
involve the removal of suture material, extensive dehiscence and
the need for resuturing. According to an Italian study, episiotomy
is associated with significantly lower values in pelvic floor functional
tests, both in digital tests and in vaginal manometry, in comparison
with women with intact perineum and first- and second-degree spontaneous
perineal lacerations.3 In another prospective trial of 87 patients,
the pelvic floor muscle strength, assessed with the aid of vaginal
cones, was significantly weaker in the episiotomy subgroup compared
to a subgroup with spontaneous laceration. [More]
Full Text Pdf
Episiotomy,
the incision of the perineum during the last part of the second stage
of labour or delivery is still considered a controversial procedure.
Long-term complications after episiotomy repair are common. A large
proportion of women suffer short-term perineal pain and up to 20%
have longer-term problems (e.g. dyspareunia). Other complications
involve the removal of suture material, extensive dehiscence and
the need for resuturing. According to an Italian study, episiotomy
is associated with significantly lower values in pelvic floor functional
tests, both in digital tests and in vaginal manometry, in comparison
with women with intact perineum and first- and second-degree spontaneous
perineal lacerations.3 In another prospective trial of 87 patients,
the pelvic floor muscle strength, assessed with the aid of vaginal
cones, was significantly weaker in the episiotomy subgroup compared
to a subgroup with spontaneous laceration. [More] Full Text Pdf Original
Article A
preliminary report on the use of a partially absorbable mesh in pelvic reconstructive
surgery by Achim Niesel et al.
Conventional
procedures for reconstructive vaginal surgery are burdened with recurrence
rates of up to 30%. Many of these operations can result in a poor anatomical
result and loss of the physiological vaginal axis. This may lead to secondary
pelvic defects and functional pelvic problems. Since the introduction of mesh
in pelvic organ prolapse (POP) surgery good anatomical restoration appears
to be associated with lower recurrence rates and good functional outcome. Polypropylene
tapes have proven to have good biocompatibility in vaginal tissues, but there
are complications such as mesh erosion and extrusion. [More]
Full Text Pdf
Conventional
procedures for reconstructive vaginal surgery are burdened with recurrence
rates of up to 30%. Many of these operations can result in a poor anatomical
result and loss of the physiological vaginal axis. This may lead to secondary
pelvic defects and functional pelvic problems. Since the introduction of mesh
in pelvic organ prolapse (POP) surgery good anatomical restoration appears
to be associated with lower recurrence rates and good functional outcome. Polypropylene
tapes have proven to have good biocompatibility in vaginal tissues, but there
are complications such as mesh erosion and extrusion. [More] Full Text PdfCase Report A
simple technique for intravesical tape removal by
Stavros Charalambous et al.
63-year-old
woman presented with recurrent urinary tract infections and dysuria, six months
following a TVT procedure performed elsewhere. A physical examination revealed
no abnormalities. A cystoscopy was performed and an intravesical mesh was identified
entering just behind the right ureteral orifice and exiting from the right
side of the bladder dome. The patient was then prepared for mesh removal. A
26 Fr resectoscope was introduced into the bladder and subsequently reached
the tape. The mesh was resected in the same way as a deep resection of a bladder
tumor, with the loop in constant contact with the bladder wall. [More]
Full Text Pdf
63-year-old
woman presented with recurrent urinary tract infections and dysuria, six months
following a TVT procedure performed elsewhere. A physical examination revealed
no abnormalities. A cystoscopy was performed and an intravesical mesh was identified
entering just behind the right ureteral orifice and exiting from the right
side of the bladder dome. The patient was then prepared for mesh removal. A
26 Fr resectoscope was introduced into the bladder and subsequently reached
the tape. The mesh was resected in the same way as a deep resection of a bladder
tumor, with the loop in constant contact with the bladder wall. [More] Full Text Pdf Case Report Unusual
vulvar cystic mass - suspected metastasis by
Charlotte Ngo - Richard Villet
This
73 year old caucasian woman with a previous history of breast and colon adenocarcinomas
was complaining about a growing vulvar mass, with hypoaesthesia of the glans
clitoridis. Examination found a tender vulvar mass located deeply in the anterior
part of the left labium majora, above the urethral meatus, close to the clitoris
and pubic symphysis.There was no local inflammation. MRI showed a 3cm independent
cystic mass with a thick wall between the pubic symphysis and the urethra.
Surgical excision was done with a longitudinal incision between the hymen and
the labium minor. [More]
Full Text Pdf
This
73 year old caucasian woman with a previous history of breast and colon adenocarcinomas
was complaining about a growing vulvar mass, with hypoaesthesia of the glans
clitoridis. Examination found a tender vulvar mass located deeply in the anterior
part of the left labium majora, above the urethral meatus, close to the clitoris
and pubic symphysis.There was no local inflammation. MRI showed a 3cm independent
cystic mass with a thick wall between the pubic symphysis and the urethra.
Surgical excision was done with a longitudinal incision between the hymen and
the labium minor. [More] Full Text Pdf Original
ArticleThe
T.A.P.E. (Three Axes Perineal Evaluation) freeware: a good tool to introduce
you to Perineology by Jacques Beco
In
the past each specialist of the perineum, the gynecologist, the urologist
and the colo-proctologist, has to deal with two main symptoms: one which
reflects a failure to maintain the door closed (incontinence) and one
which is linked to a difficulty to open the way (obstruction). In this
old approach the only problem of the specialist is to treat “his
incontinence” without creating “his obstruction” and
reverse. For example, the urologist working only on “his axis” has
to treat urinary incontinence without creating dysuria or to treat dysuria
without inducing urinary incontinence. [More]
Full Text Pdf
In
the past each specialist of the perineum, the gynecologist, the urologist
and the colo-proctologist, has to deal with two main symptoms: one which
reflects a failure to maintain the door closed (incontinence) and one
which is linked to a difficulty to open the way (obstruction). In this
old approach the only problem of the specialist is to treat “his
incontinence” without creating “his obstruction” and
reverse. For example, the urologist working only on “his axis” has
to treat urinary incontinence without creating dysuria or to treat dysuria
without inducing urinary incontinence. [More] Full Text Pdf Pelvic
Floor Digest March
Issue Pelvic Floor Digest [535
kb]
This
section presents a small sample of the Pelvic Floor Digest (March 2008),
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]
Pdf
[535
kb]This
section presents a small sample of the Pelvic Floor Digest (March 2008),
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] Pdf