Medical and advanced surgical management of pelvic floor disorders
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| Format: | Buch |
| Sprache: | English |
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Philadelphia, Pennsylvania
Elsevier
[2016]
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| Schriftenreihe: | Obstetrics and gynecology clinics of North America
March 2016, volume 43, number 1 |
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| 245 | 1 | 0 | |a Medical and advanced surgical management of pelvic floor disorders |c editor Cheryl B. Iglesia |
| 264 | 1 | |a Philadelphia, Pennsylvania |b Elsevier |c [2016] | |
| 300 | |a xiv, 164 Seiten |b Illustrationen | ||
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| 490 | 1 | |a Obstetrics and gynecology clinics of North America |v March 2016, volume 43, number 1 | |
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| 700 | 1 | |a Iglesia, Cheryl B. |0 (DE-588)1098461088 |4 edt | |
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| adam_text | Titel: Medical and advanced surgical management of pelvic floor disorders
Autor: Iglesia, Cheryl B
Jahr: 2016
Medical and Advanced Surgical Management of Pelvic Floor Disorders
Contents
Foreword: Keeping Informed About Management Options for Pelvic
Floor Disorders xi
William F. Rayburn
Preface: Medical and Advanced Surgical Management of Pelvic Floor Disorders xiii
Cheryl B. Iglesia
The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update 1
Jennifer L. Hallock and Victoria L. Handa
Using a lifespan model, this article presents new scientific findings
regarding risk factors for pelvic floor disorders (PFDs), focusing on the
role of childbirth in the development of single or multiple coexisting
PFDs. Phase I of the model includes predisposing factors, such as genetic
predisposition and race. Phase II includes inciting factors, such as obstet-
ric events. Prolapse, urinary incontinence (Ul), and fecal incontinence (Fl)
are more common among vaginally parous women, although the impact
of vaginal delivery on risk of Fl is less dramatic than prolapse and Ul. Phase
III includes intervening factors, such as age and obesity.
Pelvic Organ Prolapse: New Concepts in Pelvic Floor Anatomy 15
Pedro A. Maldonado and Clifford Y. Wai
As the field of reconstructive pelvic surgery continues to evolve, with
descriptions of new procedures to repair pelvic organ prolapse, it remains
imperative to maintain a functional understanding of pelvic floor anatomy
and support. The goal of this review is to provide a focused, conceptual
approach to differentiating anatomic defects contributing to prolapse in
the various compartments of the vagina. Rather than provide exhaustive
descriptions of pelvic floor anatomy, basic pelvic floor anatomy is re-
viewed, new and historical concepts of pelvic floor support are discussed,
and relevance to the surgical management of specific anatomic defects is
addressed.
Anatomy of the Vulva and the Female Sexual Response 27
Jennifer Yeung and Rachel N. Pauls
The female vulva is an intricate structure comprising several compo-
nents. Each structure has been described separately, but the interplay
among them and physiologic significance remain controversial. The
structures extend interiorly from the pubic arch and include the mons
pubis, labia majora, labia minora, vestibule, and clitoris. The clitoris is
widely accepted as the most critical anatomic structure to female sexual
arousal and orgasm. The female sexual response cycle is also very com-
plex, requiring emotional and mental stimulation in addition to end organ
stimulation.
viii Contents
Stress Urinary Incontinence: Comparative Efficacy Trials 45
Erin Seifert Lavelle and Halina M. Zyczynski
Women seeking relief from symptoms of stress urinary incontinence (SUI)
may choose from a broad array of treatment options. Therapies range from
lifestyle/behavioral modification to surgical interventions, and differ in
terms of both effectiveness and risk. Individualized treatment plans can
be developed to address a patient s expectations and goals for treatment,
as well as her tolerance for potential adverse events. This article reviews
the highest-quality clinical trials comparing contemporary treatment op-
tions for women with SUI. Clinicians and patients can use this compen-
dium to inform their treatment selection.
Overactive Bladder 59
Nicola White and Cheryl B. Iglesia
Overactive bladder (OAB) is a condition affecting millions of individuals in
the United States. Anticholinergics are the mainstay of treatment. Bladder
botulinum toxin injections have shown an improvement in symptoms of
OAB equivalent to anticholinergic therapy. Percutaneous tibial nerve
stimulation can decrease symptoms of urinary frequency and urge incon-
tinence. Sacral neuromodulation for refractory patients has been approved
by the Food and Drug Administration for treatment of OAB, urge inconti-
nence, and urinary retention. Few randomized, head-to-head comparisons
of the different available alternatives exist; however, patients now have
increasing options to manage their symptoms and improve their quality
of life.
Native Tissue Prolapse Repairs: Comparative Effectiveness Trials 69
Lauren N. Siff and Matthew D. Barber
This report reviews the success rates and complications of native
tissue (nonmesh) vaginal reconstruction of pelvic organ prolapse by
compartment. For apical prolapse, both uterosacral ligament suspensions
and sacrospinous ligament fixations are effective and provided similar out-
comes in anatomy and function with few adverse events. In the anterior
compartment, traditional colporrhaphy technique is no different than ultra-
lateral suturing. In the posterior compartment, transvaginal rectocele
repair is superior to transanal repair. For uterine preservation, sacrospi-
nous hysteropexy is not inferior to vaginal hysterectomy with uterosacral
ligament suspension for treatment of apical uterovaginal prolapse.
Pelvic Organ Prolapse—Vaginal and Laparoscopic Mesh: The Evidence 83
Lee A. Richter and Andrew I. Sokol
This report summarizes the current literature on abdominal, laparoscopic,
and transvaginal mesh for the treatment of pelvic organ prolapse. This
article reviews objective and subjective cure rates as well as complications
associated with synthetic mesh use for pelvic organ prolapse repair. The
focus is on the latest literature that provides evidence for when synthetic
mesh use is most appropriate. The use of mesh for the repair of urinary in-
continence is not reviewed in this article.
Evidence-Based Update on Treatments of Fecal Incontinence in Women
Isuzu Meyer and Holly E. Richter
Fecal incontinence is a highly prevalent and distressing condition that has
a negative impact on quality of life. The etiology is often multifactorial, and
the evaluation and treatment of this condition can be hindered by a lack of
understanding of the mechanisms and currently available treatment
options. This article reviews the evidence-based update for the manage-
ment of fecal incontinence.
Registries as Tools for Clinical Excellence and the Development of the Pelvic
Floor Disorders Registry
Emily E. Weber LeBrun
Surgical device innovation has been less regulated than drug development,
allowing integration of unproven techniques and materials into standard
practice. Successful device registries gather information on patient out-
comes and can provide postmarket surveillance of new technologies and
allow comparison with currently established treatments or devices. The Pel-
vic Floor Disorders Registry was developed in collaboration with the Food
and Drug Administration, device manufacturers, and other stakeholders to
serve as a platform for industry-sponsored postmarket device surveillance,
investigator-initiated research, and quality and effectiveness benchmarking,
all designed to improve the care of women with pelvic floor disorders.
Informed Consent for Reconstructive Pelvic Surgery
Pakeeza Alam and Cheryl B. Iglesia
Informed consent is the process in which a patient makes a decision about
a surgical procedure or medical intervention after adequate information is
relayed by the physician and understood by the patient. This process is
critical for reconstructive pelvic surgeries, particularly with the advent of
vaginal mesh procedures. In this article, we review the principles of
informed consent, the pros and cons of different approaches in recon-
structive pelvic surgery, the current legal issues surrounding mesh use
for vaginal surgery, and tips on how to incorporate this information when
consenting patients for pelvic floor surgery.
Ultrasound Imaging of the Pelvic Floor
Daniel E. Stone and Lieschen H. Quiroz
This article discusses the background and appraisal of endoluminal
ultrasound of the pelvic floor. It provides a detailed anatomic assessment
of the muscles and surrounding organs of the pelvic floor. Different
anatomic variability and pathology, such as prolapse, fecal incontinence,
urinary incontinence, vaginal wall cysts, synthetic implanted material,
and pelvic pain, are easily assessed with endoluminal vaginal ultrasound.
With pelvic organ prolapse in particular, not only is the prolapse itself seen
but the underlying cause related to the anatomic and functional abnormal-
ities of the pelvic floor muscle structures are also visualized.
Index
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| physical | xiv, 164 Seiten Illustrationen |
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| series | Obstetrics and gynecology clinics of North America |
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| spellingShingle | Medical and advanced surgical management of pelvic floor disorders Obstetrics and gynecology clinics of North America |
| title | Medical and advanced surgical management of pelvic floor disorders |
| title_auth | Medical and advanced surgical management of pelvic floor disorders |
| title_exact_search | Medical and advanced surgical management of pelvic floor disorders |
| title_full | Medical and advanced surgical management of pelvic floor disorders editor Cheryl B. Iglesia |
| title_fullStr | Medical and advanced surgical management of pelvic floor disorders editor Cheryl B. Iglesia |
| title_full_unstemmed | Medical and advanced surgical management of pelvic floor disorders editor Cheryl B. Iglesia |
| title_short | Medical and advanced surgical management of pelvic floor disorders |
| title_sort | medical and advanced surgical management of pelvic floor disorders |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=028955469&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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