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Medical and Advanced Surgical Management of Pelvic Floor Disorders, An Issue of Obstetrics and Gynecology, E-Book

Medical and Advanced Surgical Management of Pelvic Floor Disorders, An Issue of Obstetrics and Gynecology, E-Book

Cheryl B. Iglesia

(2016)

Additional Information

Book Details

Abstract

Dr. Iglesia has created an issue devoted to pelvic floor disorders that has a strong focus on the evidence behind current treatments and diagnostic methods. The authors are top experts in their areas and have contributed reviews on the most important topics in pelvic floor disorders, including Stress Urinary Incontinence; Urge Urinary Incontinence; Pelvic Organ Prolapse Native Tissue repairs; Pelvic Organ Prolapse Vaginal and Laparoscopic Mesh; Fecal Incontinence; PFDR Pelvic Floor Disorders Registry; Ultrasound Imaging of the Pelvic Floor; and Childbirth/Pelvic Floor Epidemiology to name a few.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Medical and Advanced Surgical Management \rof Pelvic Floor Disorders i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Foreword: Keeping Informed About Management Options for Pelvic Floor Disorders\r vii
Preface: Medical and Advanced Surgical Management of Pelvic Floor Disorders\r vii
The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update\r vii
Pelvic Organ Prolapse: New Concepts in Pelvic Floor Anatomy\r vii
Anatomy of the Vulva and the Female Sexual Response\r vii
Stress Urinary Incontinence: Comparative Efficacy Trials\r viii
Overactive Bladder\r viii
Native Tissue Prolapse Repairs: Comparative Effectiveness Trials\r viii
Pelvic Organ Prolapse---Vaginal and Laparoscopic Mesh: The Evidence\r viii
Evidence-Based Update on Treatments of Fecal Incontinence in Women\r ix
Registries as Tools for Clinical Excellence and the Development of the Pelvic Floor Disorders Registry\r ix
Informed Consent for Reconstructive Pelvic Surgery\r ix
Ultrasound Imaging of the Pelvic Floor\r ix
OBSTETRICS AND GYNECOLOGY CLINICS x
FORTHCOMING ISSUES x
June 2016 x
September 2016 x
December 2016 x
RECENT ISSUES x
December 2015 x
September 2015 x
June 2015 x
Foreword: Keeping Informed About Management Options for Pelvic Floor Disorders \r xi
Preface: \rMedical and Advanced Surgical Management of Pelvic Floor Disorders xiii
The Epidemiology of Pelvic Floor Disorders and Childbirth 1
Key points 1
PREVALENCE AND PUBLIC HEALTH BURDEN OF PELVIC FLOOR DISORDERS 2
PELVIC FLOOR DISORDERS AS CHRONIC DISEASE 2
PHASE I: PREDISPOSING FACTORS FOR PELVIC FLOOR DISORDERS 4
Genetic Predisposition 4
Race 5
PHASE II: INCITING FACTORS FOR PELVIC FLOOR DISORDERS 5
Mechanism of Injury 7
PHASE III: INTERVENING FACTORS FOR PELVIC FLOOR DISORDERS 8
Age 8
Obesity 8
SUMMARY 9
REFERENCES 9
Pelvic Organ Prolapse 15
Key points 15
INTRODUCTION 15
FUNDAMENTALS OF PELVIC ANATOMY 16
APICAL COMPARTMENT 17
ANTERIOR COMPARTMENT 19
POSTERIOR COMPARTMENT 21
SUMMARY/DISCUSSION 23
ACKNOWLEDGMENTS 23
REFERENCES 24
Anatomy of the Vulva and the Female Sexual Response 27
Key points 27
INTRODUCTION 27
VULVA 28
Mons 28
Labia Majora 28
Labia Minora 29
Vestibule 29
Innervation 30
Vascular Supply 32
CLITORIS 32
Glans, Prepuce, and Frenulum 32
Body and Crura 34
Suspensory Ligament 34
Root 35
Bulbs 35
Innervation 35
Vascular Supply 36
G-SPOT 36
FEMALE SEXUAL RESPONSE 38
Desire 38
Arousal 38
Orgasm 38
Resolution 39
SUMMARY 39
REFERENCES 39
Stress Urinary Incontinence 45
Key points 45
INTRODUCTION 45
NONSURGICAL MANAGEMENT FOR STRESS URINARY INCONTINENCE 46
Weight Loss 46
Bladder Training 47
Pelvic Floor Muscle Therapy Versus No Treatment 48
Pelvic Floor Muscle Therapy Versus Incontinence Pessary 49
SURGICAL MANAGEMENT 50
Retropubic Versus Transobturator Midurethral Sling 50
Fascial Pubovaginal Sling Versus Midurethral Slings 51
Burch Colposuspension Versus Midurethral Sling 51
Fascial Pubovaginal Slings Versus Burch Colposuspension 53
Full-length Midurethral Slings Versus Single-incision Minislings 54
Periurethral Bulking Injections 54
SUMMARY 55
REFERENCES 55
Overactive Bladder 59
Key points 59
INTRODUCTION 59
ETIOLOGY OF OVERACTIVE BLADDER 60
DIAGNOSIS OF OVERACTIVE BLADDER 60
MANAGEMENT OF OVERACTIVE BLADDER 61
Behavioral Modifications and Pelvic Floor Muscle Retraining/Physical Therapy 61
Medications 62
Botulinum Toxin 63
Percutaneous Tibial Nerve Stimulation 64
Sacral Neuromodulation 65
SUMMARY 66
REFERENCES 66
Native Tissue Prolapse Repairs 69
Key points 69
INTRODUCTION 69
DEFINING SUCCESS OF SURGERY FOR PELVIC ORGAN PROLAPSE 70
VAGINAL APEX 71
ANTERIOR COMPARTMENT 73
POSTERIOR COMPARTMENT 74
UTERINE PRESERVATION 76
DISCUSSION 77
REFERENCES 80
Pelvic Organ Prolapse---Vaginal and Laparoscopic Mesh 83
Key points 83
INTRODUCTION 83
BACKGROUND ON ABDOMINAL MESH 84
INTRODUCTION OF MINIMALLY INVASIVE SACRAL COLPOPEXY 85
LEVEL 1 EVIDENCE FOR LAPAROSCOPIC SACROCOLPOPEXY 85
COMPARISON OF SACRAL COLPOPEXY APPROACHES 85
LEVEL 1 EVIDENCE COMPARING ROBOTIC VERSUS LAPAROSCOPIC SACROCOLPOPEXY 86
LAPAROSCOPIC MESH CONCLUSIONS 87
BACKGROUND ON TRANSVAGINAL MESH 87
TRANSVAGINAL MESH FOR ANTERIOR WALL SUPPORT 88
TRANSVAGINAL MESH FOR POSTERIOR PROLAPSE 89
TRANSVAGINAL MESH FOR APICAL AND MULTICOMPARTMENT PROLAPSE 89
TRANSVAGINAL MESH CONCLUSIONS 90
SUMMARY 90
REFERENCES 91
Evidence-Based Update on Treatments of Fecal Incontinence in Women 93
Key points 93
INTRODUCTION 93
MANAGEMENT 94
Dietary Considerations 94
Avoid offending foods 94
Fiber supplementation 94
Medications 95
Pelvic Floor Muscle Exercises and Biofeedback 97
Surgical Management 97
Traditional approaches 97
Sphincteroplasty 97
Special population: obstetric anal sphincter injuries 98
Neosphincter construction 99
Graciloplasty 99
Artificial bowel sphincter 99
Neuromodulation 100
Sacral neurostimulation 100
Percutaneous tibial nerve stimulation 101
Perianal Injectables 104
Radiofrequency Ablation Therapy 106
Fecal Diversion 107
Recently Available Treatment Options: Devices 107
Anal plugs 107
Vaginal bowel control system 107
Investigational Treatment Options 109
Autologous myoblast injection 109
Magnetic anal sphincter 109
Sling for fecal incontinence 110
SUMMARY/DISCUSSION 111
REFERENCES 111
Registries as Tools for Clinical Excellence and the Development of the Pelvic Floor Disorders Registry 121
Key points 121
INTRODUCTION 121
HISTORY OF SURGICAL INNOVATION 122
REGISTRIES: THE POWER OF POOLING DATA 122
INCREASING PREVALENCE OF PELVIC FLOOR DISORDERS 124
SURGICAL TREATMENT OF PELVIC ORGAN PROLAPSE 124
THE COLLAPSE OF THE TRANSVAGINAL MESH AND BUILDING OF NEW BRIDGES 125
BUILDING A UNIVERSAL PELVIC FLOOR DISORDERS REGISTRY 126
SUMMARY 128
REFERENCES 129
Informed Consent for Reconstructive Pelvic Surgery 131
Key points 131
OBJECTIVES 132
INFORMED CONSENT 132
Determining Capacity 133
Freely Consenting 133
Disclosing Information 133
Patient Understanding 135
Decision 135
SURGICAL APPROACH 135
CONTROVERSY OF VAGINAL MESH 136
CURRENT LEGAL ENVIRONMENT 137
SUMMARY 137
REFERENCES 138
Ultrasound Imaging of the Pelvic Floor 141
Key points 141
INTRODUCTION 141
PELVIC FLOOR ANATOMY 141
ULTRASOUND TECHNIQUE 143
Transperineal Ultrasound 143
Endoluminal Ultrasound 143
Endoanal Ultrasound 144
CLINICAL UTILITY 144
Anterior Compartment 144
Central Compartment 145
Posterior Compartment 145
Lateral Compartments 146
Implanted Vaginal Material 147
Endoanal Imaging 147
SUMMARY 149
REFERENCES 150
Index 155