The Experts below are selected from a list of 1920 Experts worldwide ranked by ideXlab platform
Jean L Jorion - One of the best experts on this subject based on the ideXlab platform.
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endoscopic treatment of Bladder Perforation after tension free vaginal tape procedure
The Journal of Urology, 2002Co-Authors: Jean L JorionAbstract:The tension-free vaginal tape procedure is a new technique for the treatment of female stress urinary incontinence.1 It is a simple, minimally invasive procedure performed with the patient under local or regional anesthesia and offers a 90% cure rate.2 However, despite its apparent simplicity, the procedure remains difficult to perform, and the blind passage of needles can be associated with significant complications. The most frequent complication associated with this procedure is Bladder Perforation. In a recent series of 404 cases a 6% rate of Bladder Perforation was noted.2 Usually, cystoscopic examination during surgery reveals the Perforation and allows reorientation of the needle to a more lateral location. Leaving the Bladder catheter indwelling for 48 hours permits the Bladder to heal without consequences. However, in some cases, the Perforation may be missed perioperatively, especially if the cystoscopic examination is not conducted with a 70 degree lens. In such cases solving the problem postoperatively may be difficult. An open operation to excise the tape has been described recently.3 Herein, a case of Bladder Perforation repaired by endoscopy is reported.
Clifford F Melick - One of the best experts on this subject based on the ideXlab platform.
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Bladder Perforation during tension free vaginal tape procedures analysis of learning curve and risk factors
Obstetrics & Gynecology, 2005Co-Authors: Mary T Mclennan, Clifford F MelickAbstract:OBJECTIVE To estimate whether rates of Bladder Perforation decrease with increasing surgical experience. METHODS We performed a review of all patients undergoing a tension-free vaginal tape procedure performed by senior resident physicians under the guidance of a single surgeon. Physician experience was assessed by sequentially assigning case numbers to each procedure for each resident. For analysis of learning curve, cases were grouped in fives (ie, first five representing cases 1 to 5, second five cases 6 to 10). RESULTS Twenty-three residents performed 278 procedures. The median number of cases performed was 13 (range 3 - 22); mean number was 12.1 (sd = +/- 5.6). The rate of Perforation was 34.2% (95/278, 95% confidence interval 28.8-39.9%). Age and weight were significantly associated with Perforation. The cystotomy group was, on average 4.5 years younger (P = .007) and 7.86 kg (17.3 lb) lighter (P < .001). Rate of injury in the first five series was 40.9%, 30.7% in second series of five, and 25.9% in the third series of five and was statistically significant (linear-by-linear association chi(2) = 4.286, df = 1, P = .038). The relationship between the incidence of cystotomy and the cumulative number of cases performed was inversely correlated. As the number of cases a resident completed increased, there was a slight tendency for cystotomy to decrease (P.033). On cystoscopic examination, residents missed 35 of the 95 injuries (37%, 95% confidence interval 27.8-46.9%). CONCLUSION A learning curve exists for tension-free vaginal tape procedures. Many injuries are missed on initial resident cystoscopic inspection, highlighting the need for comprehensive cystoscopic training during residency. LEVEL OF EVIDENCE II-3.
Luca Paolino - One of the best experts on this subject based on the ideXlab platform.
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Laparoscopic repair of intraperitoneal Bladder Perforation due to indwelling urethral catheter
Journal of surgical case reports, 2012Co-Authors: Mt Suffee, Christophe Barrat, Corinne Vons, Gérard Champault, Luca PaolinoAbstract:Intraperitoneal Perforation can occur as a rare but life threatening complication of indwelling urethral catheters. Computed tomography (CT) revealed the Bladder Perforation by the Foley catheter. The injury could not be managed conservatively due to the presence of systemic infection. We present the case of a successful laparoscopic repair of the Bladder due to indwelling urethral catheter.
Mary T Mclennan - One of the best experts on this subject based on the ideXlab platform.
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Bladder Perforation during tension free vaginal tape procedures analysis of learning curve and risk factors
Obstetrics & Gynecology, 2005Co-Authors: Mary T Mclennan, Clifford F MelickAbstract:OBJECTIVE To estimate whether rates of Bladder Perforation decrease with increasing surgical experience. METHODS We performed a review of all patients undergoing a tension-free vaginal tape procedure performed by senior resident physicians under the guidance of a single surgeon. Physician experience was assessed by sequentially assigning case numbers to each procedure for each resident. For analysis of learning curve, cases were grouped in fives (ie, first five representing cases 1 to 5, second five cases 6 to 10). RESULTS Twenty-three residents performed 278 procedures. The median number of cases performed was 13 (range 3 - 22); mean number was 12.1 (sd = +/- 5.6). The rate of Perforation was 34.2% (95/278, 95% confidence interval 28.8-39.9%). Age and weight were significantly associated with Perforation. The cystotomy group was, on average 4.5 years younger (P = .007) and 7.86 kg (17.3 lb) lighter (P < .001). Rate of injury in the first five series was 40.9%, 30.7% in second series of five, and 25.9% in the third series of five and was statistically significant (linear-by-linear association chi(2) = 4.286, df = 1, P = .038). The relationship between the incidence of cystotomy and the cumulative number of cases performed was inversely correlated. As the number of cases a resident completed increased, there was a slight tendency for cystotomy to decrease (P.033). On cystoscopic examination, residents missed 35 of the 95 injuries (37%, 95% confidence interval 27.8-46.9%). CONCLUSION A learning curve exists for tension-free vaginal tape procedures. Many injuries are missed on initial resident cystoscopic inspection, highlighting the need for comprehensive cystoscopic training during residency. LEVEL OF EVIDENCE II-3.
Ziya Akbulut - One of the best experts on this subject based on the ideXlab platform.
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the actual incidence of Bladder Perforation following transurethral Bladder surgery
The Journal of Urology, 2005Co-Authors: Derya M Balbay, Ersin Cimentepe, Ali Unsal, Omer Bayrak, Akif Koc, Ziya AkbulutAbstract:ABSTRACTPurpose: In this prospective study we evaluated the incidence of Bladder Perforation after transurethral Bladder tumor resection.Materials and Methods: A total of 36 patients (33 male, 3 female, mean age ± SD 65.6 ± 11.43 [range 26 to 81]) with a solid mass in the Bladder (mean 20.3 ± 8.7 mm, range 5 to 40) were included in the study. Transurethral resections were performed with a 24Fr resectoscope. After the procedure an 18Fr Foley catheter was inserted into the Bladder and 400 ml of 1/4 saline diluted contrast solution was instilled under gravity from 60 cm above the Bladder. Complete filling and post-drainage radiographs were taken and examined for any evidence of extravasation. Regular evaluations with cystoscopy and ultrasound/computerized tomography were done to detect possible tumor recurrence and perivesical seeding.Results: Histopathological examination of the tumors showed transitional cell carcinoma in 35 patients and chronic eosinophilic cystitis in 1. Review of the cystograms revealed...