The treatment of posterior compartment vaginal defects

2004 ◽  
Vol 12 (2) ◽  
pp. 233-241 ◽  
Author(s):  
R. Duane Cespedes
Keyword(s):  
Posterior Compartment

scholarly journals Pelvic organ prolapse surgery and overactive bladder symptoms—a population-based cohort (FINPOP)

2021 ◽  
Author(s):  
Päivi K. Karjalainen ◽  
Anna-Maija Tolppanen ◽  
Nina K. Mattsson ◽  
Olga A.E. Wihersaari ◽  
Jyrki T. Jalkanen ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Overactive Bladder ◽  
Symptom Severity ◽  
Pelvic Organ ◽  
Population Based ◽  
Urinary Frequency ◽  
Posterior Compartment ◽  
Posterior Repair ◽  
Apical Compartment ◽  
Bothersome Symptom

Abstract Introduction and hypothesis It is unclear how compartment of pelvic organ prolapse (POP) impacts overactive bladder (OAB) symptom severity or improvement after POP surgery. We hypothesized that anterior and apical prolapse are more strongly associated with OAB symptoms than posterior compartment prolapse. Methods A total of 2933 POP surgeries from a prospective population-based cohort were divided into two groups: (1) anterior and/or apical compartment surgery (± posterior repair), N = 2091; (2) posterior repair only, N = 478. Urinary frequency and urgency urinary incontinence (UUI) were evaluated using PFDI-20 (bothersome symptom: score 3–4) at baseline, 6, and 24 months. Association between degree of POP in specific compartments and symptoms at baseline was estimated with generalized linear models and between compartment of surgery and symptom improvement with generalized estimating equations. Results At least one bothersome symptom was reported by 40% at baseline, 14% at 6, and 19% at 24 months. At baseline, urinary frequency was associated with degree of anterior and apical and UUI with anterior compartment prolapse. Women undergoing surgery for anterior/apical compartment started with worse symptoms and experienced greater improvement than women undergoing posterior compartment surgery. Bothersome frequency resolved in 82% after anterior/apical and in 63% after posterior compartment surgery. Bothersome UUI resolved in 75% after anterior/apical and in 61% after posterior compartment surgery. After surgery, symptom severity was comparable between groups. Bothersome de novo symptoms occurred in 1–3%. Conclusions OAB symptoms are more strongly related to anterior and apical than to posterior compartment prolapse, but improvement is seen after surgery for any vaginal compartment.

scholarly journals Modified laparoscopic lateral suspension with a five-arm mesh in pelvic organ prolapse surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eren Akbaba ◽  
Burak Sezgin
Keyword(s):  
Pelvic Organ Prolapse ◽  
De Novo ◽  
Pelvic Organ ◽  
Laparoscopic Technique ◽  
Life Questionnaire ◽  
Advanced Stage ◽  
Posterior Compartment ◽  
Anterior Compartment ◽  
Mesh Graft ◽  
Laparoscopic Lateral Suspension

Abstract Background Laparoscopic lateral suspension (LLS) is a laparoscopic technique used to treat pelvic organ prolapse (POP) in apical and anterior compartment defect with the use of a synthetic T-shaped mesh graft. The posterior compartment is repaired using a second mesh or a procedure along with LLS, such as posterior colporrhaphy. The aim of this study was to evaluate the clinical results of LLS for POP using a five-arm mesh instead of a T-shaped mesh graft to repair the defect of the posterior compartment in addition to the apical and anterior compartments. Methods Data from 37 patients with a diagnosis of advanced-stage (≥ 3) POP undergoing LLS with the use of a five-arm mesh were retrospectively analysed. Pre-operative and post-operative examinations and, surgical outcomes were determined. The results of measurements and examinations, reoperation rates, erosion rates, lower urinary tract symptoms, and complications were analysed. The Prolapse Quality of Life Questionnaire (P-QOL) was also used. Results The median post-operative follow-up was 20 (13–34) months. There was a significant improvement in POP-Q scores in all treated compartments, with overall objective cure rates of 94.5% for the apical compartment, 86.4% for the anterior compartment, and 91.8% for the posterior compartment. The median operative time was 96 (76–112) minutes. The median length of hospitalization was 2 (1–3) days. A significant improvement in vaginal bulge, urinary urgency, incomplete voiding, urinary frequency, and constipation was observed after surgery. The sexuality among patients increased from 13 (35.1%) preoperatively to 22 (59.4%) post-operatively. De novo stress urinary incontinence developed in 7 (18.9%) patients. The P-QOL scores improved significantly after surgery. Conclusions In advanced-stage POP patients, the posterior compartment damage can also be repaired in LLS with the use of a single five-arm mesh without the need for an additional procedure, and the recurrence rate can be reduced.

scholarly journals Role of static and dynamic MRI in evaluation of pelvic posterior compartment pathologies: prospective case series

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Dina G. Abdelzaher ◽  
Mahmoud Abdelatif ◽  
Waleed M. Thabet ◽  
Amr M. Elshafei ◽  
Magda M. Shady
Keyword(s):  
Case Series ◽  
Dynamic Mri ◽  
Posterior Compartment ◽  
Prospective Case Series

scholarly journals What Happens to the Posterior Compartment and Bowel Symptoms After Sacrocolpopexy? Evaluation of 5-Year Outcomes From E-CARE

2014 ◽  
Vol 20 (5) ◽  
pp. 261-266 ◽  
Author(s):  
Cara L. Grimes ◽  
Emily S. Lukacz ◽  
Marie G. Gantz ◽  
Lauren Klein Warren ◽  
Linda Brubaker ◽  
...  
Keyword(s):  
Posterior Compartment ◽  
Bowel Symptoms

scholarly journals Is evacuation proctography still the gold standard for the diagnosis of posterior compartment pelvic floor disorders?

2017 ◽  
Vol 211 ◽  
pp. 202
Author(s):  
Isabelle van Gruting ◽  
Aleksandra Stankiewicz ◽  
Kirsten Kluivers ◽  
Helena Blake ◽  
Ranee Thakar ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Gold Standard ◽  
Pelvic Floor Disorders ◽  
Posterior Compartment ◽  
Evacuation Proctography

Regeneration from duplicating fragments of the Drosophila wing disc

Development ◽  
1981 ◽  
Vol 66 (1) ◽  
pp. 117-126
Author(s):  
Jane Karlsson ◽  
R. J. Smith
Keyword(s):  
Imaginal Disc ◽  
General Rule ◽  
Wing Disc ◽  
The Other ◽  
Posterior Compartment ◽  
Drosophila Wing ◽  
Polar Coordinate ◽  
New Type ◽  
Coordinate Model

It is a general rule that of two complementary Drosophila imaginal disc fragments, one regenerates and the other duplicates. This paper reports an investigation of an exception to this rule. Duplicating fragments from the periphery of the wing disc which lacked presumptive notum were found to regenerate notum structures during and after duplication. The propensity for this was greatest in fragments lying close to the presumptive notum, with the exception of a fragment confined to the posterior compartment, which did not regenerate notum. Structures were added sequentially, and regeneration stopped once most of the notum was present. These results are not easily explained by the polar coordinate model, which states that regeneration cannot occur from duplicating fragments. Since compartments appear to be involved in this type of regeneration as in others, it is suggested that a new type of model is required, one which permits simultaneous regeneration and duplication, and assigns a major role to compartments.

Positional signaling by hedgehog in Drosophila imaginal disc development

Development ◽  
1995 ◽  
Vol 121 (1) ◽  
pp. 1-10 ◽  
Author(s):  
A.L. Felsenfeld ◽  
J.A. Kennison
Keyword(s):  
Hedgehog Signaling ◽  
Imaginal Disc ◽  
Ectopic Expression ◽  
Posterior Compartment ◽  
Anterior Compartment ◽  
Segment Polarity ◽  
Wing Structures ◽  
Wing Discs ◽  
Segment Polarity Gene ◽  
Polarity Gene

We describe a dominant gain-of-function allele of the segment polarity gene hedgehog. This mutation causes ectopic expression of hedgehog mRNA in the anterior compartment of wing discs, leading to overgrowth of tissue in the anterior of the wing and partial duplication of distal wing structures. The posterior compartment of the wing is unaffected. Other imaginal derivatives are affected, resulting in duplications of legs and antennae and malformations of eyes. In mutant imaginal wing discs, expression of the decapentaplegic gene, which is implicated in the hedgehog signaling pathway, is also perturbed. The results suggest that hedgehog protein acts in the wing as a signal to instruct neighboring cells to adopt fates appropriate to the region of the wing just anterior to the compartmental boundary.

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