The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
H Fernandez - One of the best experts on this subject based on the ideXlab platform.
-
comparison between trans obturator trans Vaginal mesh and traditional anterior colporrhaphy in the treatment of anterior Vaginal Wall prolapse results of a french rct
International Urogynecology Journal, 2013Co-Authors: R De Tayrac, Arnaud Cornille, Georges Eglin, O Guilbaud, Aslam Mansoor, Sandrine Alonso, H FernandezAbstract:Introduction and hypothesis To compare the efficacy of a collagen-coated polypropylene mesh and anterior colporrhaphy in the treatment of stage 2 or more anterior Vaginal Wall prolapse.
-
comparison between trans obturator trans Vaginal mesh and traditional anterior colporrhaphy in the treatment of anterior Vaginal Wall prolapse results of a french rct
International Urogynecology Journal, 2013Co-Authors: R De Tayrac, Arnaud Cornille, Georges Eglin, O Guilbaud, Aslam Mansoor, Sandrine Alonso, H FernandezAbstract:To compare the efficacy of a collagen-coated polypropylene mesh and anterior colporrhaphy in the treatment of stage 2 or more anterior Vaginal Wall prolapse. Prospective, randomized, multicenter study conducted between April 2005 and December 2009. The principal endpoint was the recurrence rate of stage 2 or more anterior Vaginal Wall prolapse 12 months after surgery. Secondary endpoints consisted of functional results and mesh-related morbidity. One hundred and forty-seven patients were included, randomized and analyzed: 72 in the anterior colporrhaphy group and 75 in the mesh group. The anatomical success rate was significantly higher in the mesh group (89 %) than in the colporrhaphy group (64 %) (p = 0.0006). Anatomical and functional recurrence was also less frequent in the mesh group (31.3 % vs 52.2 %, p = 0.007). Two patients (2.8 %) were reoperated on in the colporrhaphy group for anterior Vaginal Wall prolapse recurrence. No significant difference was noted regarding minor complications. An erosion rate of 9.5 % was noted. De novo dyspareunia occurred in 1/14 patients in the colporrhaphy group and in 3/13 patients in the mesh group. An analysis of the quality of life questionnaires showed an overall improvement in both groups, with no statistical difference between them. Satisfaction rates were high in both groups (92 % in the colporrhaphy group and 96 % in the mesh group). Trans-obturator Ugytex® mesh used to treat anterior Vaginal Wall prolapse gives better 1-year anatomical results than traditional anterior colporrhaphy, but with small a increase in morbidity in the mesh group.
-
tension free polypropylene mesh for Vaginal repair of anterior Vaginal Wall prolapse
Journal of Reproductive Medicine, 2005Co-Authors: Renaud De Tayrac, Amelie Gervaise, Aurelia Chauveaud, H FernandezAbstract:Objective To study the ongoing results of the repair of anterior Vaginal Wall prolapse reinforced with tension-free polypropylene mesh (GyneMesh, Gynecare, Ethicon, Issy-Les-Moulineaux, France). Study design A case series of 87 consecutive women with anterior Vaginal Wall prolapse who underwent a transVaginal procedure using polypropylene mesh between October 1999 and August 2002. The mean age (+/-SD) was 62.4+/-13.4 years. Before the operation, patients underwent physical examination staging of the prolapse with the International Pelvic Organ Prolapse staging system. Thirteen women had stage 2 anterior Vaginal Wall prolapse (14.9%), 59 had stage 3 (67.9%), and 15 had stage 4 (17.3%). The polypropylene mesh was placed from the retropubic space to the inferior part of the bladder in a tension-freefashion. Patients were followed for 9-43 months, with a median follow-up (+/-SD) of 24+/-9.6 months. We defined "cure" as satisfactory (stage 1) or optimal (stage 0) outcome for point Ba in the staging system. Results Eighty-four patients returned for follow-up (96.6%). At follow-up, 77 women were cured (91.6%), 5 women had asymptomatic stage 2 anterior Vaginal Wall prolapse, and 2 had a recurrent stage 3 (2.4%). There were no postoperative infections. There were a total of 7 Vaginal erosions of the mesh (8.3%); 4 necessitated a second procedure for partial excision of the mesh. Conclusion Vaginal repair of anterior Vaginal Wall prolapse reinforced with tension-free polypropylene mesh is effective and relatively safe. Vaginal erosion occurred in 8.3% of the study population but was easily manageable, with no sequelae.
John O L Delancey - One of the best experts on this subject based on the ideXlab platform.
-
structural failure sites in posterior Vaginal Wall prolapse stress 3d mri based analysis
International Urogynecology Journal, 2021Co-Authors: Luyun Chen, James A Ashtonmiller, Dee E Fenner, Bing Xie, Mary Duarte E Thibault, John O L DelanceyAbstract:The objective was to identify structural failure sites in rectocele by comparing women with and those without posterior Vaginal Wall prolapse and accessing their relative contribution to rectocele size based on stress MRI-based measurements. We studied three-dimensional stress MRI at maximal Valsalva of 25 women with (cases) and 25 without (controls) posterior Vaginal prolapse of similar age and parity. Vaginal Wall factors (posterior Wall length and width); attachment factors (paraVaginal posterior Wall location, posterior fornix height, and perineal height); and hiatal factors (hiatal size and levator ani defects) were measured using Slicer 4.3.0® and a custom Python program. Stepwise linear regression was used to assess the relative contribution of all factors to the posterior prolapse size. We identified three primary factors with large effect sizes of 2 or greater: two attachment factors—posterior paraVaginal descent and perineal height; and one hiatal factor—genital hiatus size. These were the strongest predictors of the presence and size of rectocele, the most common failure sites, found in 60–76% of cases; and highly correlated with one another (r = 0.72–0.84, p < .001). Longer Vaginal length, wider distal vagina, lower posterior fornix, and larger levator ani hiatus had smaller effect sizes and were less likely to fall outside the norm (20–24%) than the three primary factors. When considering all the supporting factors, the combination of perineal height, posterior fornix height, and Vaginal length explained 73% of the variation in rectocele size. Lower perineal and lateral posterior Vaginal location and enlarged genital hiatus size were strong predictors of rectocele occurrence and size and correlated highly.
-
comparison of measurement systems for posterior Vaginal Wall prolapse on magnetic resonance imaging
International Urogynecology Journal, 2019Co-Authors: Luyun Chen, James A Ashtonmiller, Dee E Fenner, Bing Xie, Zhuowei Xue, Emily M English, Kara Gaetkeudager, Giselle E Kolenic, John O L DelanceyAbstract:A wide variety of reference lines and landmarks have been used in imaging studies to diagnose and quantify posterior Vaginal Wall prolapse without consensus. We sought to determine which is the best system to (1) identify posterior Vaginal Wall prolapse and its appropriate cutoff values and (2) assess the prolapse size. This was a secondary analysis of sagittal maximal Valsalva dynamic MRI scans from 52 posterior-predominant prolapse cases and 60 comparable controls from ongoing research. All eight existing measurement lines and a new parameter, the exposed Vaginal length, were measured. Expert opinions were used to score the prolapse sizes. Simple linear regressions, effect sizes, area under the curve, and classification and regression tree analyses were used to compare these reference systems and determine cutoff values. Linear and ordinal logistic regressions were used to assess the effectiveness of the prolapse size. Among existing parameters, “the perineal line-internal pubis,” a reference line from the inside of the pubic symphysis to the front tip of the perineal body (cutoff value 0.9 cm), had the largest effect size (1.61), showed the highest sensitivity and specificity to discriminate prolapse with area under the curve (0.91), and explained the most variation (68%) in prolapse size scores. The exposed Vaginal length (cutoff value 2.9) outperformed all the existing lines, with the largest effect size (2.09), area under the curve (0.95), and R-squared value (0.77). The exposed Vaginal length performs slightly better than the best of the existing systems, for both diagnosing and quantifying posterior prolapse size. Performance characteristics and evidence-based cutoffs might be useful in clinical practice.
-
the long and short of it anterior Vaginal Wall length before and after anterior repair
International Urogynecology Journal, 2015Co-Authors: Carolyn W Swenson, Mitchell B Berger, Angela Simmen, Daniel M Morgan, John O L DelanceyAbstract:Anterior Vaginal Wall length (AVL) is on average 6.1 ± 1.3 cm in women with normal support and lengthened in women with cystocele. We hypothesize that AVL is reduced after anterior repair and that women with larger cystoceles will have greater reduction in AVL. Demographic, clinical, and surgical data were collected for women undergoing hysterectomy and anterior repair in whom intraoperative Vaginal Wall measurements had been made between November 2009 and April 2014. In the operating room, AVL was defined preoperatively as the distance from the hymenal ring to the anterior cervicoVaginal junction at the hysterectomy incision site, and postoperatively, from the hymenal ring to the same location on the anterior cuff. During the anterior repair the fibromuscular tissues were plicated using an interrupted technique. Measurements were available for 40 women. Average age was 61.7 ± 10 years, median parity was 2.5 and median preoperative Pelvic Organ Prolapse Quantification System (POP-Q) point Ba was 3 cm distal to the hymen. On average, AVL was reduced after surgery by 2.5 cm. Mean postoperative AVL was similar to mean AVL in women with normal pelvic support (6.4 ± 0.8 cm vs 6.1 ± 1.3 cm, p = 0.15). Longer preoperative AVLs had greater AVL change (R 2 = 0.78, p = <0.0001). In women undergoing anterior repair, mean AVL was reduced by 28 % and returned to the normal range after surgery. These data highlight a rarely discussed effect of anterior repair, which is restoration of normal anterior Vaginal Wall length.
-
the long and short of it anterior Vaginal Wall length before and after anterior repair
Journal of Minimally Invasive Gynecology, 2015Co-Authors: Carolyn W Swenson, Daniel M Morgan, John O L DelanceyAbstract:Introduction and hypothesis Anterior Vaginal Wall length (AVL) is on average 6.1 ± 1.3 cm in women with normal support and lengthened in women with cystocele. We hypothesize that AVL is reduced after anterior repair and that women with larger cystoceles will have greater reduction in AVL.
-
a 3d finite element model of anterior Vaginal Wall support to evaluate mechanisms underlying cystocele formation
Journal of Biomechanics, 2009Co-Authors: Luyun Chen, James A Ashtonmiller, John O L DelanceyAbstract:Objectives To develop a 3D computer model of the anterior Vaginal Wall and its supports, validate that model, and then use it to determine the combinations of muscle and connective tissue impairments that result in cystocele formation, as observed on dynamic magnetic resonance imaging (MRI).
John O.l. Delancey - One of the best experts on this subject based on the ideXlab platform.
-
structural failure sites in anterior Vaginal Wall prolapse identification of a collinear triad
Obstetrics & Gynecology, 2016Co-Authors: Luyun Chen, James A Ashtonmiller, Kindra Larson, Sean Lisse, Mitchell B Berger, John O.l. DelanceyAbstract:OBJECTIVE To test the null hypothesis that six factors representing potential fascial and muscular failure sites contribute equally to the presence and size of a cystocele: two Vaginal attachment factors (apical support and paraVaginal defects), two Vaginal Wall factors (Vaginal length and width), and two levator ani factors (hiatus size and levator ani defects). METHODS Thirty women with anterior-predominant prolapse (women in a case group) and 30 women in a control group underwent three-dimensional stress magnetic resonance imaging. The location of the anterior Vaginal Wall at maximal Valsalva was identified with the modified Pelvic Inclination Coordinate System and the six factors measured. Analysis included repeated-measure analysis of variance, logistic regression, and stepwise linear regression. RESULTS We identified a collinear triad consisting of apical location, paraVaginal location, and hiatus size that were not only the strongest predictors of cystocele size, but were also highly correlated with one another (r=0.84-0.89, P<.001) for the presence and size of the prolapse. Together they explain up to 83% of the variation in cystocele size. Among the less significant Vaginal factors, Vaginal length explained 19% of the variation in cystocele size, but no significant difference in Vaginal width existed. Women in the case group were more likely to have abnormalities in collinear triad factors (up to 80%) than Vaginal Wall factors (up to 23.3%). Combining the strongest collinear triad with the Vaginal factors, the model explained 92.5% of the variation in cystocele size. CONCLUSION Apical location, paraVaginal location, and hiatus size are highly correlated and are strong predictors of cystocele presence and size.
-
the length of anterior Vaginal Wall exposed to external pressure on maximal straining mri relationship to urogenital hiatus diameter and apical and bladder location
International Urogynecology Journal, 2014Co-Authors: Aisha Yousuf, Kindra A Larson, Luyun Chen, James A Ashtonmiller, John O.l. DelanceyAbstract:Introduction and hypothesis In cystoceles, the distal anterior Vaginal Wall (AVW) bulges out through the introitus and is no longer in contact with the posterior Vaginal Wall or perineal body, exposing the pressure differential between intra-abdominal pressure and atmospheric pressure. The goal of this study is to quantify the length of the exposed Vaginal Wall length and to investigate its relationship with other factors associated with the AVW support, such as most dependent bladder location, apical location, and hiatus diameter, demonstrating its key role in cystocele formation.
-
anterior Vaginal Wall length and degree of anterior compartment prolapse seen on dynamic mri
International Urogynecology Journal, 2007Co-Authors: Yvonne Hsu, Luyun Chen, James A Ashtonmiller, Aimee Summers, John O.l. DelanceyAbstract:The objective of the study was to determine the relationship between midsagittal Vaginal Wall geometric parameters and the degree of anterior Vaginal prolapse. We have previously presented data indicating that about half of anterior Wall descent can be explained by the degree of apical descent present (Summers et al., Am J Obstet Gynecol, 194:1438-1443, 2006). This led us to examine whether other midsagittal Vaginal geometric parameters are associated with anterior Wall descent. Magnetic resonance (MR) scans of 145 women from the prior study were suitable for analysis after eight were excluded because of inadequate visibility of the anterior Vaginal Wall. Subjects had been selected from a study of pelvic organ prolapse that included women with and without prolapse. All patients underwent supine dynamic MR scans in the midsagittal plane. Anterior Vaginal Wall length, location of distal Vaginal Wall point, and the area under the midsagittal profile of the anterior Vaginal Wall were measured during maximal Valsalva. A linear regression model was used to examine how much of the variance in cystocele size could be explained by these Vaginal parameters. When both apical descent and Vaginal length were considered in the linear regression model, 77% (R (2) = 0.77, p < 0.001) of the variation in anterior Wall descent was explained. Distal Vaginal point and a measure anterior Wall shape, the area under the profile of the anterior Vaginal Wall, added little to the model. Increasing Vaginal length was positively correlated with greater degrees of anterior Vaginal prolapse during maximal Valsalva (R (2) = 0.30, p < 0.01) determining 30% of the variation in anterior Wall decent. Greater degrees of anterior Vaginal prolapse are associated with a longer Vaginal Wall. Linear regression modeling suggests that 77% of anterior Wall descent can be explained by apical descent and midsagittal anterior Vaginal Wall length.
-
interaction among apical support levator ani impairment and anterior Vaginal Wall prolapse
Obstetrics & Gynecology, 2006Co-Authors: Luyun Chen, James A Ashtonmiller, Yvonne Hsu, John O.l. DelanceyAbstract:OBJECTIVE: To use a biomechanical model to explore how impairment of the pubovisceral portion of the levator ani muscle, the apical Vaginal suspension complex, or both might interact to affect anterior Vaginal Wall prolapse severity. METHODS: A biomechanical model of the anterior Vaginal Wall and its support system was developed and implemented. The anterior Vaginal Wall and its main muscular and connective tissue support elements, namely the levator plate, pubovisceral muscle, and cardinal and uterosacral ligaments were included, and their geometry was based on midsagittal plane magnetic resonance scans. Material properties were based on published data. The change in the sagittal profile of the anterior Vaginal Wall during a maximal Valsalva was then predicted for different combinations of pubovisceral muscle and connective tissue impairment. RESULTS: Under raised intra-abdominal pressure, the magnitude of anterior Vaginal Wall prolapse was shown to be a combined function of both pubovisceral muscle and uterosacral and cardinal ligament (“apical supports”) impairment. Once a certain degree of pubovisceral impairment was reached, the genital hiatus opened and a prolapse developed. The larger the pubovisceral impairment, the larger the anterior Wall prolapse became. A 90% impairment of apical support led to an increase in anterior Wall prolapse from 0.3 cm to 1.9 cm (a 530% increase) at 60% pubovisceral muscle impairment, and from 0.7 cm to 2.4 cm (a 240% increase) at 80% pubovisceral muscle impairment. CONCLUSION: These results suggest that a prolapse can develop as a result of impairment of the muscular and apical supports of the anterior Vaginal Wall. LEVEL OF EVIDENCE: II-2
Janpaul W R Roovers - One of the best experts on this subject based on the ideXlab platform.
-
effects of non ablative er yag laser on the skin and the Vaginal Wall systematic review of the clinical and experimental literature
International Urogynecology Journal, 2020Co-Authors: Janpaul W R Roovers, Lucie Hympanova, Katerina Mackova, Moetaz Eldomyati, Eva Vodegel, Jan Bosteels, L Krofta, Jan DeprestAbstract:Er:YAG laser is frequently used in dermatology and gynecology. Clinical studies document high satisfaction rates; however, hard data on the effects at the structural and molecular levels are limited. The aim of this systematic review was to summarize current knowledge about the objective effects of non-ablative Er:YAG laser on the skin and Vaginal Wall. We searched MEDLINE, Embase, Cochrane, and the Web of Science. Studies investigating objectively measured effects of non-ablative Er:YAG laser on the skin or Vaginal Wall were included. Studies of any design were included. Owing to the lack of methodological uniformity, no meta-analysis could be performed and therefore results are presented as a narrative review. We identified in vitro or ex vivo studies on human cells or tissues, studies in rats, and clinical studies. Most studies were on the skin (n = 11); the rest were on the vagina (n = 4). The quality of studies is limited and the settings of the laser were very diverse. Although the methods used were not comparable, there were demonstrable effects in all studies. Immediately after application the increase in superficial temperature, partial preservation of epithelium and subepithelial extracellular matrix coagulation were documented. Later, an increase in epithelial thickness, inflammatory response, fibroblast proliferation, an increase in the amount of collagen, and vascularization were described. Er:YAG laser energy may induce changes in the deeper skin or Vaginal Wall, without causing unwanted epithelial ablation. Laser energy initiates a process of cell activation, production of extracellular matrix, and tissue remodeling.
-
validation of noninvasive focal depth measurements to determine epithelial thickness of the Vaginal Wall
Menopause, 2019Co-Authors: Arnoud W Kastelein, Chantal M Diedrich, Charlotte H J R Jansen, Sandra E Zwolsman, Can Ince, Janpaul W R RooversAbstract:OBJECTIVE: This study investigates whether noninvasive focal depth (FD) measurements correlate with Vaginal Wall epithelial thickness (ET). If FD accurately reflects ET of the Vaginal Wall, this would allow noninvasive longitudinal assessment of (newly developed) treatment modalities aiming to increase ET, without the need for invasive biopsies. METHODS: Fourteen women, median age 62 years (inter quartile ranges: 57-65), undergoing Vaginal prolapse surgery because of anterior and/or posterior compartment pelvic organ prolapse were included. We used the CytoCam, a handheld video microscope based on incident dark field imaging, and performed FD measurements of the Vaginal Wall before surgery. Histology was performed on tissue that was removed during the surgical procedure, and ET was measured in stained sections. We compared ET with FD interindividually, and determined the expected linear correlation and agreement between the two measurements. RESULTS: Seventeen ET measurements (mean 125 μm ± 38.7, range 48-181 μm) were compared with 17 FD measurements (mean 128 μm ± 34.3, range 68-182 μm). The lineair correlation between the two measurements was strong (r = 0.902, P < 0.01). Bland-Altman analysis demonstrated a mean difference of 13.5 μm when comparing ET to FD. CONCLUSIONS: The results demonstrate good agreement between ET and FD measurements. We consider the mean difference demonstrated with Bland-Altman analysis acceptable for these measurements. This suggests that FD accurately reflects ET, which further supports the use of FD to measure ET of the Vaginal Wall. For a complete assessment of the Vaginal Wall, FD measurements are preferably combined with the assessment of Vaginal angioarchitecture.
-
is pelvic organ prolapse associated with altered microcirculation of the Vaginal Wall
Neurourology and Urodynamics, 2016Co-Authors: Maaike A Weber, Can Ince, Dan M J Milstein, Janpaul W R RooversAbstract:Department of Translational Physiology, Academic Medical Center, Amsterdam, The NetherlandsAims: Vascularisation of the vagina is necessary for optimal function and support of the surrounding organs. Weevaluated whether Vaginal microcirculation, as representative of vascularisation, differs between women with andwithout pelvic organ prolapse (POP). Methods: In 17 women with POP-Q stage 2 and 10 women without POPmeasurements wereperformedusing sidestreamdark-fieldimaging(groups werenotmatched).POPandnon-POPsiteswere compared in women with a single compartment prolapse (n¼7). Morphology of the microvessels was scored usingthe microcirculatory architecture and capillary tortuosity scores at four regions of the Vaginal Wall. Capillary densitymeasurements were performed and microvascular flow was assessed according to the microvascular flow index (MFI)score. Results: Architecture and tortuosity scores were similar for each anatomical region between women with andwithout POP and betweenthe POPand non-POP site.A statistically significant difference in capillarydensity in theleftVaginal Wall between women with and without POP was observed (25.8 vs. 34.0, P¼0.049). No significant differences incapillarydensitywereobservedbetweenthePOPandnon-POPsite.AverageMFIscoresrevealedacontinuousflowforallfour regions in patients with and without POP. Conclusions: Vaginal microcirculatory architecture, capillary density,and microvascular flow are similar in women with and without POP. Our method to assess the microcirculation of theVaginal Wall is consistent in women with POP, which generates an opportunity to assess Vaginal microcirculation in the(surgical) treatments of POP. Neurourol. Urodynam. © 2015 Wiley Periodicals, Inc.Key words: pelvic organ prolapse; physiology; SDF imaging; Vaginal microcirculation
-
focal depth measurements of the Vaginal Wall a new method to noninvasively quantify Vaginal Wall thickness in the diagnosis and treatment of Vaginal atrophy
Menopause, 2016Co-Authors: Maaike A Weber, Chantal M Diedrich, Can Ince, Janpaul W R RooversAbstract:OBJECTIVE The aim of the study was to evaluate if Vaginal focal depth measurement could be a noninvasive method to quantify Vaginal Wall thickness. METHODS Postmenopausal women undergoing topical estrogen therapy because of Vaginal atrophy (VA) were recruited. VA was diagnosed based on the presence of symptoms and Vaginal pH at least 5.5. The control group consisted of women above 40 years without VA. Focal depth measurements were performed before and after treatment using the Cytocam-Incident Dark Field device assessing the distance between the subepithelial microcirculation and the epithelial surface. Measurements were performed before and after treatment in the intervention group and at two different time points in the control group. Vaginal pH was measured. Symptoms were evaluated using the most bothersome symptom approach. RESULTS Eight women with VA and nine controls were included. Pretreatment median focal depth was not significantly different between both groups. Pretreatment focal depth more than doubled after a median of 7 weeks of topical estrogen treatment (80 μm [interquartile range 80-120 μm] vs 220 μm [148-248 μm], P = 0.02), whereas the measurements in the control group did not change. Pretreatment Vaginal pH differed between both groups (5.5 vs 5.1, respectively, P < 0.01). Vaginal pH did not change after treatment. CONCLUSIONS Using in vivo microscopy we introduced a new noninvasive measure of Vaginal Wall thickness. A significant increase in Vaginal focal depth was observed in participants with VA treated with topical estrogens. This innovative measurement of Vaginal Wall thickness could become the preferred objective measure to evaluate treatment effect. Moreover, it has great potential for other applications in the field of urogynecology.
-
the effects of prolapse surgery on Vaginal Wall sensibility Vaginal vasocongestion and sexual function a prospective single centre study
Neurourology and Urodynamics, 2014Co-Authors: Marielle M E Lakeman, Ellen Laan, Janpaul W R RooversAbstract:Aims Prolapse surgery has been shown to positively alter body image and decrease pelvic floor symptoms, hereby possibly improving sexual function. However, the surgical trauma itself may adversely affect sexual function, by damaging Vaginal innervation and vascularization. The aim of this study is to evaluate the effects of Vaginal prolapse surgery on Vaginal vasocongestion, Vaginal Wall sensibility, and sexual function. Methods A prospective study was performed, including patients scheduled for Vaginal prolapse surgery. Participants underwent measurements before and 6 months after surgery, during non-erotic and erotic visual stimuli. Measurements were performed using a Vaginal combi-probe which includes Vaginal photoplethysmography to assess Vaginal pulse amplitude (VPA) (representing Vaginal vasocongestion), and four pulse-generating electrodes to measure Vaginal Wall sensibility (representing Vaginal innervation). Sexual function was assessed using validated questionnaires (FSFI, FSDS-R, SSAQ). Results Twenty-nine women were included, 24 (83%) completed the 6 months follow-up. VPA analysis showed a significant reduction in Vaginal vasocongestion during sexual stimulation post-operatively (pre-op 2.4 mV (SD 2.5) vs. post-op 1.7 mV (SD 2.4), P = 0.05). Vaginal Wall sensibility in the cranial posterior Vaginal Wall was significantly reduced after surgery (pre-op 13.3 mA vs. post-op 17.5 mA, P < 0.05). Vaginal Wall sensibility in the other three locations was not affected by surgery. Sexual function as assessed with questionnaires, was not significantly affected. Conclusion Prolapse surgery negatively impacted levels of Vaginal vasocongestion during erotic stimuli as well as Vaginal Wall sensibility in the cranial posterior Wall. Future studies are needed to tease out if these changes in physiological factors are relevant for subjective sexual function. Neurourol. Urodynam. 33:1217–1224, 2014. © 2013 Wiley Periodicals, Inc.
R De Tayrac - One of the best experts on this subject based on the ideXlab platform.
-
comparison between trans obturator trans Vaginal mesh and traditional anterior colporrhaphy in the treatment of anterior Vaginal Wall prolapse results of a french rct
International Urogynecology Journal, 2013Co-Authors: R De Tayrac, Arnaud Cornille, Georges Eglin, O Guilbaud, Aslam Mansoor, Sandrine Alonso, H FernandezAbstract:To compare the efficacy of a collagen-coated polypropylene mesh and anterior colporrhaphy in the treatment of stage 2 or more anterior Vaginal Wall prolapse. Prospective, randomized, multicenter study conducted between April 2005 and December 2009. The principal endpoint was the recurrence rate of stage 2 or more anterior Vaginal Wall prolapse 12 months after surgery. Secondary endpoints consisted of functional results and mesh-related morbidity. One hundred and forty-seven patients were included, randomized and analyzed: 72 in the anterior colporrhaphy group and 75 in the mesh group. The anatomical success rate was significantly higher in the mesh group (89 %) than in the colporrhaphy group (64 %) (p = 0.0006). Anatomical and functional recurrence was also less frequent in the mesh group (31.3 % vs 52.2 %, p = 0.007). Two patients (2.8 %) were reoperated on in the colporrhaphy group for anterior Vaginal Wall prolapse recurrence. No significant difference was noted regarding minor complications. An erosion rate of 9.5 % was noted. De novo dyspareunia occurred in 1/14 patients in the colporrhaphy group and in 3/13 patients in the mesh group. An analysis of the quality of life questionnaires showed an overall improvement in both groups, with no statistical difference between them. Satisfaction rates were high in both groups (92 % in the colporrhaphy group and 96 % in the mesh group). Trans-obturator Ugytex® mesh used to treat anterior Vaginal Wall prolapse gives better 1-year anatomical results than traditional anterior colporrhaphy, but with small a increase in morbidity in the mesh group.
-
comparison between trans obturator trans Vaginal mesh and traditional anterior colporrhaphy in the treatment of anterior Vaginal Wall prolapse results of a french rct
International Urogynecology Journal, 2013Co-Authors: R De Tayrac, Arnaud Cornille, Georges Eglin, O Guilbaud, Aslam Mansoor, Sandrine Alonso, H FernandezAbstract:Introduction and hypothesis To compare the efficacy of a collagen-coated polypropylene mesh and anterior colporrhaphy in the treatment of stage 2 or more anterior Vaginal Wall prolapse.
