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SPEC - Urogynecology and Reconstructive Pelvic Surgery

SPEC - Urogynecology and Reconstructive Pelvic Surgery

Mark D. Walters | Mickey M. Karram | Mark D. Walters | Mickey M. Karram

(2014)

Additional Information

Book Details

Abstract

Edited and authored by some of the most respected figures in the field, Urogynecology and Reconstructive Pelvic Surgery presents definitive, state-of-the-art guidance on every aspect of Female Pelvic Medicine and Reconstructive Surgery (FPMRS), equipping you to make the best clinical decisions and optimize outcomes. It’s easily accessible format is uniquely organized to reflect a physician's decision-making process -- from basic concepts through to clinical and urodynamic evaluation, management, and treatment. This practical, clinically oriented text is an ideal resource for OB/GYNs and Urologists as well as subspecialists in FPMRS, providing the latest information on procedures and available research regarding the evaluation and treatment of the growing number of patients presenting with these types of conditions.

  • Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
  • Glean all essential, up-to-date, need-to-know information with a new section on surgical complications and their management; important new discussions on the psychosocial issues associated with treating patients with female pelvic floor disorders; and a new focus on female sexual function and dysfunction.
  • Prevent and plan for complications prior to a procedure thanks to a step-by-step approach to each procedure, complete with personal techniques and tips from leading experts.
  • Put concepts into practice. Case presentations from leading experts in FPMRS allow the reader to apply the information presented to everyday clinical situations.
  • Effectively detect, prevent and treat common female pelvic floor disorders including stress incontinence, overactive bladder, pelvic organ prolapse, defecation disorders, painful bladder and irritative voiding disorders, and urinary tract infection.
  • Get a true-to-life view of each procedure through full-color, crisp illustrations that illuminate every detail and nuance.
  • Stay current the latest advancements and developments with sweeping updates and 9 NEW chapters: Congenital Anomalies of the Female Genital and Urinary Tracts l Physiology of the Pelvic Muscles, Vagina and Ano-Rectum l Female Sexual Function and Dysfunction l Multichannel-Urodynamics: Indications, Techniques and Interpretation with Case Studies l Video and Ambulatory Urodynamics: Indications, Techniques and Interpretation with Case Studies l Hysteropexy l Avoiding and Managing Lower Urinary Tract Injuries During Pelvic Surgery l Managing Mesh and other Vaginal Complications after Surgeries for Incontinence and Prolapse l and Surgical Management of Detrusor Compliance Abnormalities.
  • Master urodynamic testing with step-by-step instructions on basic evaluation as well as the evaluation of complex cases with videourodynamics.
  • Know what to do and expect with algorithmic approaches to common complaints, evidence-based assessments of appropriate therapies, and clear full-color surgical illustrations as well as evidence-based assessments of appropriate therapies.

Table of Contents

Section Title Page Action Price
Front Cover Cover
IFC IFC
Urogynecology and Reconstructive Pelvic Surgery iii
Copyright iv
Dedication v
Contributors vi
Preface ix
Acknowledgments xi
Contents xii
Part 1 - HISTORY 1
Chapter 1 - Historical Milestones in Female Pelvic Surgery, Gynecology, and Female Urology 3
On the Shoulders of Giants 3
Gynecology in Antiquity 5
Medieval Medicine 5
The Renaissance 5
The Seventeenth Century 6
The Eighteenth Century 6
The Nineteenth Century Prior to the Aseptic Age 7
The Mid-Nineteenth Century: The Dawn of Aseptic Surgery 8
The Twentieth Century: A Specialty Evolves 13
Bibliography 15
Part 2 - BASIC SCIENCE 17
Chapter 2 - Anatomy of the Lower Urinary Tract, Pelvic Floor, and Rectum 19
Pelvic Anatomy 19
Pelvic Organ Support 28
Bibliography 31
Chapter 3 - Embryology and Congenital Anomalies of the Urinary Tract, Rectum, and Female Genital System 32
Embryology 32
Congenital Anomalies of the Female Genital System 38
Summary 51
Bibliography 51
Chapter 4 - Neurophysiology and Pharmacology of the Lower Urinary Tract 53
Introduction 53
General Nervous System Arrangements 54
Neural Control of the Lower Urinary Tract 54
Clinical Effects of Neurologic Disease on Lower Urinary Tract Function 61
Clinical Pharmacology of the Lower Urinary Tract 63
Bibliography 66
Chapter 5 - Physiology of the Pelvic Muscles, Vagina, and Anorectum 68
Pelvic Floor 68
Vagina 71
Anorectum 73
Acknowledgments 79
Bibliography 79
Chapter 6 - Female Sexual Function and Dysfunction: Assessment and Treatment 81
Introduction 81
Models of Female Sexual Response 82
Physiology 82
Female Sexual Disorders 83
Variables That Can Affect Sexual Function 86
Screening and Evaluation for Sexual Dysfunction 89
Treatment of Female Sexual Disorders 90
Conclusion 93
Bibliography 93
Chapter 7 - Epidemiology and Psychosocial Impact of Female Pelvic Floor Disorders 96
Epidemiology 96
Causes and Prevention of Pelvic Floor Disorders 99
Psychosocial Impact of Pelvic Floor Disorders 101
Bibligraphy 102
Chapter 8 - Description and Classification of Lower Urinary Tract Dysfunction and Pelvic Organ Prolapse 105
Classification Systems of Lower Urinary Tract Dysfunction 105
Differential Diagnosis of Urinary Incontinence 107
Description and Staging of Pelvic Organ Prolapse 108
Classification System of Complications Related to Insertion of Vaginal Prostheses and Grafts 111
Bibliography 112
Part 3 - EVALUATION 115
Chapter 9 - Evaluation of Urinary Incontinence and Pelvic Organ Prolapse: History, Physical Examination, and Office Tests 117
History and Physical Examination 118
Perineal Pad Tests 123
Diagnostic Tests 123
Making the Incontinence Diagnosis 125
Diagnostic Accuracy of Office Evaluations 126
Indications for Urodynamic Tests and Cystoscopy 127
Bibliography 127
Chapter 10 - Urodynamics: Indications, Techniques, Interpretation, and Clinical Utility 130
Introduction to Urodynamics 130
Urodynamic Equipment 132
Performing a Urodynamic Evaluation 133
Interpretation of Specific Tests 136
Urodynamics and Specific Conditions 148
American Urological Association/Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction Guidelines on Urod... 152
Conclusion 153
Bibliography 153
Chapter 11 - Video and Ambulatory Urodynamics 157
Video Urodynamics 157
Ambulatory Urodynamic Testing 167
Conclusion 168
Bibliography 168
Chapter 12 - Endoscopic Evaluation of the Lower Urinary Tract 170
Historical Perspective 170
Indications 171
Instrumentation 171
Cystourethroscopic Technique 174
Cystourethroscopic Findings 178
Bibliography 180
Chapter 13 - Radiologic Studies of the Lower Urinary Tract and Pelvic Floor 182
Plain Film of the Abdomen 182
Intravenous Pyelography 182
Retrograde and Antegrade Pyelography 182
Cystography 183
Voiding Cystourethrography 183
Video-Cystourethrography 184
Ultrasound 185
Magnetic Resonance Imaging 191
Computed Tomography 192
Bibliography 193
Chapter 14 - Neurophysiologic Testing for Pelvic Floor Disorders 195
Electrodiagnostic Testing 196
Nerve Conduction Studies 202
Sacral Reflexes 204
Autonomic Testing 205
Pelvic Floor Disorders 205
Neurologic Conditions 207
Bibliography 209
Part 4 - MANAGEMENT OF STRESS URINARY INCONTINENCE AND PELVIC ORGAN PROLAPSE 213
Chapter 15 - Pathophysiology of Urinary Incontinence 215
Elements of Urinary Continence 215
Mechanisms of Female Urinary Continence and Incontinence 219
Conclusion 223
Bibliography 223
Chapter 16 - Obstetrics and Pelvic Floor Disorders 224
Introduction 224
Alterations of Pelvic Floor Anatomy and Physiology in Pregnancy 224
Impact of Childbirth on Anatomy and Physiology 230
Impact of Childbirth on Specific PFDs 234
The Debate about Elective Primary Cesarean Delivery 236
Fistulas 237
Conclusion 237
References 237
Chapter 17 - Stress Urinary Incontinence and Pelvic Organ Prolapse: Nonsurgical Management 241
Introduction 241
The Bladder Diary: A Valuable Clinical Tool 242
Behavioral Intervention: Pelvic Floor Muscle Training and Exercise 243
Behavioral Intervention: Bladder Training 245
Bowel Management 245
Weight Loss and Incontinence 245
Estrogen and Stress Incontinence 245
Other Pharmacologic Therapies for Stress Urinary Incontinence 246
Urethral Devices 247
The Ins and Outs of Pessary Use 248
Conclusions 251
Bibliography 251
Chapter 18 - Retropubic Operations for Stress Urinary Incontinence 253
Indications for Retropubic Procedures 253
Surgical Techniques 254
Clinical Results 256
Mechanisms of Cure 257
Complications 258
Role of Hysterectomy in the Treatment of Incontinence 259
Pregnancy after Retropubic Surgery 260
Bibliography 260
Chapter 19 - Biologic Bladder Neck Sling for Stress Urinary Incontinence 262
Introduction 262
Indications 262
Sling Materials 263
Outcomes 267
Complications 270
Bibliography 271
Chapter 20 - Synthetic Midurethral Slings for Stress Urinary Incontinence 272
Introduction 272
Synthetic Retropubic MUSs 272
Synthetic Transobturator MUSs 283
Synthetic Midurethral Single-Incision Mini-Slings 290
Pregnancy after MUSs 292
Conclusions 292
Bibliography 292
Chapter 21 - Laparoscopic and Robotic Surgery for Pelvic Organ Prolapse and Stress Urinary Incontinence 295
Introduction 295
Indications for Minimally Invasive Prolapse Surgery 296
Surgical Anatomy 296
Operative Technique for Laparoscopic Sacral Colpopexy 297
Robotic Sacral Colpopexy 301
Sacral Colpoperineopexy 307
Ventral Rectopexy 307
Laparoscopic Uterosacral Ligament Vaginal Vault Suspension 308
Moschcowitz and Halban Procedure 309
Laparoscopic Enterocele Repair 310
Laparoscopic and Robotic Retropubic Surgical Procedures 310
Cost of Minimally Invasive Prolapse and Continence Surgery 314
Discussion 315
Bibliography 315
Chapter 22 - Urethral Injection of Bulking Agents for Intrinsic Sphincter Deficiency 318
Introduction 318
Indications and Contraindications 318
Evaluation 319
Materials 319
Techniques 321
Complications and Safety 323
Effectiveness 323
Future Considerations 324
Bibliography 324
Chapter 23 - Surgical Treatment of Anterior Vaginal Wall Prolapse 326
Introduction 326
Anatomy and Pathology 326
Evaluation 327
Surgical Repair Techniques 329
Results 337
Complications 339
Bibliography 340
Chapter 24 - Surgical Treatment of Rectocele and Perineal Defects 342
Anatomy and Pathophysiology 342
Evaluation 345
Surgical Repair Techniques 347
Analysis of Outcomes 355
Complications 356
Recurrence 357
Conclusion 357
Bibliography 357
Chapter 25 - Surgical Treatment of Vaginal Apex Prolapse 360
Introduction 360
Prevalence, Demographics, and Risk Factors for Pelvic Organ Prolapse 360
Pathology of Pelvic Organ Prolapse 361
Transvaginal Native Tissue Suture Repairs 362
Transvaginal Mesh Procedures 374
Abdominal Procedures to Correct Enterocele and Suspend the Vaginal Apex 375
Conclusion 378
Bibliography 379
Chapter 26 - Uterine Conservation for the Surgical Treatment of Uterovaginal Prolapse 383
Introduction 383
Historical Perspective 383
Considerations for Uterine Preservation 385
Vaginal Approach 386
Abdominal Approach 392
Summary and Future Questions 397
Bibliography 398
Chapter 27 - Obliterative Procedures for Pelvic Organ Prolapse 400
Introduction 400
Historical Perspectives 400
Preoperative Evaluation 401
Le Fort Partial Colpocleisis 401
Total Colpectomy and Colpocleisis 403
Levator Plication and Perineorrhaphy 405
Urinary Function Following Obliterative Procedures 405
Quality of Life and Regret of Loss of Sexual Function 408
Conclusion 409
Bibliography 409
Chapter 28 - The Use of Biologic Tissue and Synthetic Mesh in Urogynecology and Reconstructive Pelvic Surgery 411
Introduction 411
Properties of the Ideal Graft Material 413
Biologic Properties of Host Tissue 414
Properties of Synthetic Material 414
Properties of Biologic Tissue 417
Urogynecologic Procedures Involving the Use of Synthetic Mesh and/or Biologic Tissue 419
Clinical Results and Complications Associated with Biologic Tissue 422
Conclusion 423
Bibliography 424
Part 5 - SURGICAL COMPLICATIONS AND THEIR MANAGEMENT 429
Chapter 29 - Avoiding and Managing Lower Urinary Tract Injuries During Pelvic Surgery 431
Incidence 431
Prevention of Injuries 432
Recognition and Management of Injuries 435
Postoperative Evaluation of Suspected Genitourinary Fistulas 441
Bibliography 441
Chapter 30 - Managing Mesh and Other Complications After Surgeries for Urinary Incontinence and Pelvic Organ Prolapse 443
Introduction 443
FDA Warnings 444
Professional Society Guidelines 445
Avoiding Synthetic Mesh Complications 446
Mesh Complications after Sacrocolpopexy 447
Mesh Complications after Synthetic Midurethral Slings 448
Complications after Transvaginal Mesh Placement for Pelvic Organ Prolapse 450
Management of Iatrogenic Complications after Native Tissue Suture Repair of Pelvic Organ Prolapse 454
Conclusion 457
References 457
Part 6 - FECAL INCONTINENCE AND DEFECATION DISORDERS 461
Chapter 31 - Fecal Incontinence 463
Epidemiology 463
Etiology 463
Evaluation 464
Nonsurgical Treatment 466
Minimally Invasive Treatments 468
Surgical Treatment 470
Future Treatment Options 474
Conclusion 474
Bibliography 475
Chapter 32 - Constipation 477
Definition and Etiology 477
Epidemiology 479
Evaluation 479
Nonsurgical Treatment 482
Surgical Treatment 485
Conclusion 486
Bibliography 487
Chapter 33 - Rectovaginal Fistula and Perineal Breakdown 489
Anatomy of the Perineal Body, Distal Vagina, Rectum, and Anus 489
Classification and Presentation of Perineal Breakdown and Rectovaginal Fistula 490
Etiologies of Rectovaginal Fistula and Perineal Breakdown 491
Diagnosis and Preoperative Evaluation 492
Surgical Treatment of Rectovaginal Fistula 493
Perineal Breakdown 497
Summary 499
Bibliography 499
Chapter 34 - Rectal Prolapse 500
Introduction 500
Etiology 500
Pathophysiology 501
Epidemiology 501
Clinical Features 501
Evaluation 501
Nonsurgical Options for Prolapse 502
Common Surgical Repairs for Prolapse 502
Outcomes and Choice of Procedure 509
Bibliography 509
Part 7 - PAINFUL AND IRRITATIVE VOIDING DISORDERS 511
Chapter 35 - Overactive Bladder Syndrome and Nocturia 513
Overactive Bladder Syndrome 513
Nocturia 533
Conclusion 536
Bibliography 536
Chapter 36 - Hypersensitivity Disorders of the Lower Urinary Tract 542
Interstitial Cystitis 542
Management of Interstitial Cystitis/Bladder Pain Syndrome 549
Bibliography 552
Chapter 37 - Surgical Management of Detrusor Compliance Abnormalities 555
Introduction and Definitions 555
Patient Evaluation 555
Surgical Treatments 556
Cost Effectiveness 564
Conclusion 564
Bibliography 564
Chapter 38 - Voiding Dysfunction and Urinary Retention 566
Neurophysiology of Micturition 566
Evaluation of Voiding Dysfunction 568
Classification of Voiding Dysfunction 569
Specific Causes of Voiding Dysfunction: Diagnosis and Management 570
Conclusion 578
Bibliography 579
Part 8 - SPECIFIC CONDITIONS 581
Chapter 39 - Lower Urinary Tract Infection 583
Epidemiology and Risk Factors 583
Microbiology 584
Pathogenesis 584
Diagnosis 584
Management 586
Bibliography 589
Chapter 40 - Urethral Diverticula 591
Incidence 591
Etiology 591
Presentation 592
Diagnosis 592
Radiologic Imaging 593
Urethral and Urethral Diverticular Pathology 595
Management of Female Urethral Diverticula 595
Complications 599
Summary 600
Bibliography 600
Chapter 41 - Lower Urinary Tract Fistulas 602
Historic Perspectives 602
Epidemiology and Etiology 603
Presentation and Investigation 605
Conservative Management 605
Timing of Surgical Repair 606
Presurgical Management 606
Surgical Repair 607
Urinary Diversion 618
Postoperative Bladder Drainage 618
Complications 618
Prevention 618
Bibliography 619
Chapter 42 - The Effects of Gynecologic Cancer on Lower Urinary Tract Function 622
The Effects of Intrafascial Hysterectomy on Lower Urinary Tract Function 623
The Effects of Radical Hysterectomy on Lower Urinary Tract Function 625
Genitourinary Fistula and Gynecologic Malignancy 627
The Effects of Chemotherapy on Lower Urinary Tract Function 627
The Effects of Radiotherapy on Lower Urinary Tract Function 628
Relation of Lower Urinary Tract Dysfunction to Female Genital Tract Tumors 629
Management of Hemorrhagic Cystitis 630
Conclusions 631
Bibliography 631
Chapter 43 - Bladder Drainage and Urinary Protective Methods 634
Introduction 634
Bladder Drainage 634
Urine Loss Appliances 639
Bibliography 640
Part 9 - RESEARCH METHODS 643
Chapter 44 - Outcomes and Quality-of-Life Measures in Pelvic Floor Research 645
Introduction 645
Pad Testing 647
Anatomic Outcomes 648
Physiologic Testing 649
Questionnaires 649
Socioeconomic Outcomes 655
Defining Treatment Success 655
Bibliography 659
Appendix A - The Standardization of Terminology of Lower Urinary Tract Function Recommended by the International Continence Society* e1
Clinical Assessment e1
Procedures Related to the Evaluation of Urine Storage e2
Classification of Lower Urinary Tract Dysfunction e9
Summary e11
Units of Measurement e11
Symbols e11
Bibliography e12
Appendix B - The Standardization of Terminology of Lower Urinary Tract Function: Report from the Standardization Subcommittee of the International Continence Society e1
Appendix C - Standardization Reports of the International Continence Society (ICS) e1
Appendix D - Classification System of Vaginal Prostheses and Graft Complications Recommended by the International Urogynecological Association (IUGA) and International Continence Society (ICS) e3
Appendix E - Sample Questionnaires for Several Recommended Outcome Measures for Women with Pelvic Floor Disorders e1
Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) e1
Incontinence Quality of Life (I-QOL) Instrument e1
Pelvic Floor Distress Inventory-Short Form 20 e1
Pelvic Floor Impact Questionnaire-Short Form 7 e1
Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) e1
International Consultation on Incontinence Questionnaire-Short Form e2
Index 661
IBC IBC