P12.03: Saline infusion vaginography [SIV]: a novel technique for sonographic assessment of the vaginal wall and pelvic floor

2012 ◽  
Vol 40 (S1) ◽  
pp. 217-217
Author(s):  
O. Rotenberg ◽  
P. Dar
Keyword(s):  
Pelvic Floor ◽  
Vaginal Wall ◽  
Saline Infusion ◽  
Novel Technique ◽  
Sonographic Assessment

Possibilities of using neodymium laser (Nd:YAG) in patients with concomitant diseases which are accompanied by pathological discharge from the genital tract

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 75-81
Author(s):  
Olga A. Pauzina ◽  
Inna A. Apolikhina ◽  
Darya A. Malyshkina
Keyword(s):  
Drug Therapy ◽  
Pelvic Floor ◽  
Genital Tract ◽  
Vaginal Discharge ◽  
Muscle Tone ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Vaginal Wall ◽  
Neodymium Laser ◽  
Frequent Relapses

Background. Pathological vaginal discharge is the most common disorder in women after giving birth who have vaginal relaxation syndrome and vaginal wall prolapse, as well as in women during menopause. To date, there are no clear treatment regimens for mixed vulvovaginal infections, and the use of only drug therapy in patients with pelvic organ prolapse and genitourinary syndrome of menopause in combination with diseases which are accompanied by pathological vaginal discharge does not give a long lasting result and is characterized by frequent relapses. In this regard, the use of laser methods in combination with drug therapy may lead to the recovery of vaginal microbiocenosis and a decrease in the number of relapses of diseases which are accompanied by pathological discharge from the genital tract. Results. Description. This article presents a clinical case and description of the experience of using a neodymium laser for the treatment of a patient with recurrent mixed vulvovaginitis, 2nd- degree vaginal wall prolapse, loss of pelvic floor muscle tone, vaginal relaxation syndrome and sexual dysfunction using neodymium laser. The woman received 3 procedures of exposure to a neodymium laser with an interval of 2830 days. After 3 procedures of exposure to a neodymium laser, the patient has a good clinical efficacy in the recovery of vaginal microbiocenosis. Conclusions. An innovative technique of exposure to Nd:YAG neodymium laser in the practice of a gynecologist has shown high clinical efficiency in the treatment of not only pelvic floor dysfunction, but also mixed vulvovaginitis. And, despite this aspect of the use of laser technologies requires further study, we can use a neodymium laser in combination with traditional drug therapy to treat diseases which are accompanied by pathological discharge from the genital tract in cases of ineffective drug monotherapy and frequent relapses.

scholarly journals Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christl Reisenauer ◽  
Bastian Amend ◽  
Claudius Falch ◽  
Harald Abele ◽  
Sara Yvonne Brucker ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Developed Countries ◽  
Vaginal Wall ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Anterior Position ◽  
Multiparous Women ◽  
Uncommon Condition ◽  
Rectovaginal Fistulas ◽  
Vesicovaginal Fistulas

Abstract Background Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre. Methods Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively. Results Eleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure. Conclusions In developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out. Trial registration Retrospectively registered, DRKS 00022543, 28.07.2020.

scholarly journals Development of anatomically based customizable three-dimensional finite-element model of pelvic floor support system: POP-SIM1.0

2019 ◽  
Vol 9 (4) ◽  
pp. 20190022 ◽  
Author(s):  
Mark T. Gordon ◽  
John O. L. DeLancey ◽  
Aaron Renfroe ◽  
Andrew Battles ◽  
Luyun Chen
Keyword(s):  
Finite Element ◽  
Magnetic Resonance ◽  
Pelvic Floor ◽  
Support System ◽  
Structural Parameters ◽  
Vaginal Wall ◽  
Abdominal Pressure ◽  
Fe Model ◽  
Vaginal Length ◽  
Pelvic Floor Support

To develop an anatomically based customizable finite-element (FE) model of the pelvic floor support system to simulate pelvic organ prolapse (POP): POP-SIM1.0. This new simulation platform allows for the construction of an array of models that objectively represent the key anatomical and functional variation in women with and without prolapse to test pathomechanism hypotheses of the prolapse formation. POP-SIM1.0 consists of anatomically based FE models and a suite of Python-based tools developed to rapidly construct FE models by customizing the base model with desired structural parameters. Each model consists of anatomical structures from three support subsystems which can be customized based on magnetic resonance image measurements in women with and without prolapse. The customizable structural parameters include presence of levator ani (LA) avulsion, hiatus size, anterior vaginal wall dimension, attachment fascia length and apical location in addition to the tissue material properties and intra-abdominal pressure loading. After customization, the FE model was loaded with increasing intra-abdominal pressure (0–100 cmH 2 O) and solved using ABAQUS explicit solver. We were able to rapidly construct anatomically based FE models with specific structural geometry which reflects the morphology changes often observed in women with prolapse. At maximum loading, simulated structural deformations have similar anatomical characteristics to those observed during clinical exams and stress magnetic resonance images. Simulation results showed the presence of LA muscle avulsion negatively impacts the pelvic floor support. The normal model with intact muscle had the smallest exposed vaginal length of 11 mm, while the bilateral avulsion produced the largest exposed vaginal length at 24 mm. The unilateral avulsion model had an exposed vaginal length of 18 mm and also demonstrated a tipped perineal body similar to that seen in clinical observation. Increasing the hiatus size, vaginal wall length and fascia length also resulted in worse pelvic floor support, increasing the exposed vaginal length from 18 mm in the base model to 33 mm, 54 mm and 23.5 mm, respectively. The developed POP-SIM1.0 can simulate the anatomical structure changes often observed in women with prolapse. Preliminary results showed that the presence of LA avulsion, enlarged hiatus, longer vaginal wall and fascia length can result in larger prolapse at simulated maximum Valsalva.

Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique

2016 ◽  
Vol 8 (2) ◽  
pp. 130-135
Author(s):  
Urmila Sharma ◽  
Ritu Agarwal ◽  
Nilesh L Goraniya ◽  
Sumesh D Choudhary ◽  
Pradeep J Bandwal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stage Iv ◽  
Anterior Wall ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Stage Ii ◽  
Novel Technique

ABSTRACT Introduction Prolapse of anterior vaginal wall is a common problem in both perimenopausal and postmenopausal women. In past 200 years, surgical management of cystocele has undergone many changes from Kelly's plication to mesh reinforcement but none of these procedures proved to be 100% effective. Modified two-corner Raz suspension procedure (MTCRSP) can be used for the treatment of POP-Q (pelvic organ prolapse quantification) stage II to IV anterior vaginal wall prolapse (AVP). Objectives To assess the effectiveness of modified two-corner Raz suspension procedure (MTCRSP) in long-term success for cystocele repair and its effect on quality of life. Study design A hospital-based prospective study. Materials and methods Twelve patients underwent modified two-corner Raz procedure and were followed postoperatively for a period of 1 year at regular intervals. During follow-up, we assessed the degree of prolapse by POP-Q, quality of life, and sexual dysfunction. Results Preoperatively, 3 out of 12 (25%) patients had stage II, five had (41.66%) stage III, and four (33.33%) had stage IV prolapse. Postoperatively, at 1 month follow-up, one (8.33%) patient developed stage II anterior wall prolapse, which progressed to stage IV prolapse at 3 months. Two more patients developed stage II prolapse at 3-month follow-up. Failure rate at the end of 1 year was 25% (3/12). Prolapse quality of life (PQOL) improved in 10 out of 12 (83.33%) patients. While PGII (patient global impression of improvement) score improved in 11 out of 12 (91.66%) women. Conclusion Modified two-corner Raz suspension procedure is an effective technique with long-term success in stage II and III prolapse but a limited success in stage IV AVP. How to cite this article Mishra VV, Goraniya NL, Choudhary SD, Sharma U, Bandwal PJ, Tanvir T, Agarwal R. Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique. J South Asian Feder Obst Gynae 2016;8(2):130-135.

Pelvic floor muscle weakness: a risk factor for anterior vaginal wall prolapse recurrence

2018 ◽  
Vol 29 (11) ◽  
pp. 1661-1667 ◽  
Author(s):  
Jeffrey S. Schachar ◽  
Hemikaa Devakumar ◽  
Laura Martin ◽  
Sara Farag ◽  
Eric A. Hurtado ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pelvic Floor ◽  
Muscle Weakness ◽  
Pelvic Floor Muscle ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Anterior Vaginal Wall Prolapse ◽  
Prolapse Recurrence ◽  
Pelvic Floor Muscle Weakness

scholarly journals HUBUNGAN PARITAS DENGAN DERAJAT LASERASI JALAN LAHIR DI POLINDES JETIS LOR KECAMATAN NAWANGAN KABUPATEN PACITAN

2019 ◽  
Vol 6 (1) ◽  
pp. 48-53
Author(s):  
Etika Desi Yogi
Keyword(s):  
Correlation Analysis ◽  
Pelvic Floor ◽  
Vaginal Wall ◽  
Labor Process ◽  
Birth Process ◽  
Birth Canal ◽  
Calculation Results ◽  
Independent Variable ◽  
Relationship Of ◽  
The Relationship

For women, the perineum is very important stretching and lubricating the perineum during labor can weaken the pelvic floor muscles in the vaginal wall, trauma to the perineum also causes discomfort and pain during sexual intercourse and an estimated 85% of maternal mothers experience birth canal lacerations (Kettle and Tohil 2008). One of the fears that are often felt by pregnant women, especially third timers, is fear of being torn and afraid of sewing. Especially for mothers who have experienced it, this can make their own trauma when facing the birth process later (USU, 2006). The purpose of this study was to determine the relationship of parity to the degree of laceration of the birth pathway in Jetis Lor Polindes, Nawangan District, Pacitan Regency. The design or design in this study is correlation analysis, with the "retrospective" approach. This study analyzed the relationship of parity with the degree of laceration of the birth path in Jetis Lor Polindes, Nawangan District, Pacitan Regency. In this study, the population was all mothers giving birth at Jetis Lor Polindes, Nawangan District, Pacitan Regency. The samples in this study were all mothers giving birth at Jetis Lor Polindes, Nawangan District, Pacitan Regency. In this study by looking at the last 1 year data. In this study the independent variable is parity. In this study the dependent variable is the degree of laceration of the birth canal. Based on the calculation results of SPSS 11.5 for Windows, it was found that there was no relationship between parity and laceration degrees in the Jetis Lor Polindes, Nawangan Subdistrict, Pacitan Regency, from the results of probability (sig. 2-tailed) 0.22 <0.05.The researcher hopes that the mother will seek information and increase knowledge about the labor process, so that with good knowledge will reduce lacerations on the birth canal

scholarly journals Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany

2020 ◽  
Author(s):  
Christl Reisenauer ◽  
Bastian Amend ◽  
Claudius Falch ◽  
Harald Abele ◽  
Sara Yvonne Brucker ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Developed Countries ◽  
Vaginal Wall ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Anterior Position ◽  
Uncommon Condition ◽  
Rectovaginal Fistulas ◽  
Vesicovaginal Fistulas ◽  
First Time

Abstract Background: Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre.Methods: Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified and their records were reviewed retrospectively.Results: 11 out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort the genitourinary fistulas were more common in multiparous (9/11) and the rectovaginal fistulas in primiparaous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65%. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended the fistula repair in context of a subsequent delivery. For the first time, pregnancy related changes of the vaginal wall were used to optimize the success rate of a fistula closure.Conclusions: In developed countries, the birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, their management has to be tailored to the underlying pathology and the surgeonʼs experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Even if vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient and a vesicovaginal fistula should be ruled out.Trial registration: retrospectively registered, DRKS 00022543, 28.07.2020

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