Sacral Neuromodulation
Fig. 28.1 2% Chlorhexidine gluconate cloth (Sage Products, Cary, IL, USA) for wiping area in pre-op Cefazolin pre-op if not serious PCN allergy, Vancomycin if allergy or specific concern for…
Cosmetic Gynecologic Surgery
Labia minora Simple resection – Delineate area to be resected prior to both initiating the incision and infiltration with anesthetic – Use interrupted not running sutures at skin edges – Avoid excessive resection…
Synthetic Midurethral Slings: Exposure and Perforation
Retropubic Transobturator Single incision Vaginal wall mesh exposure 1.5% [2] 0.4% [2] Higher than “inside-to-out” TO slings; RR 3.75, 95% CI 1.42 to 9.86 [5] Bladder injury 2.7–3.9% [2]…
Mini-Slings: Unique Issues
ALTIS™ AJUST™ MiniArc™ MiniArc Precise™ Needleless® Ophira™ Solyx™ SIS System TVT-Secur™ Manufacturer Coloplast (Humlebaek, Denmark) Bard (Covington, GA) Astora Women’s Health (Eden Prairie, MN) Astora Women’s Health (Eden Prairie,…
Vesicovaginal and Urethrovaginal Fistula Repair
Congenital Acquired Iatrogenic Postoperative Hysterectomy Abdominal Transvaginal Laparoscopic Incontinence procedures Transvaginal slings Retropubic Laparoscopic Prolapse procedures Anterior colporrhaphy Mesh kits Sacrospinous/uterosacral fixation Sacral colpopexy Urethral diverticulectomy Endoscopic procedures Bowel and…
Autologous Fascial Slings
Perioperative genitourinary • Bladder and urethral injury Gastrointestinal (GI) • Bowel injury Vascular • Bleeding complication (with and without surgical intervention) • Deep venous thrombosis Neurological • Nerve injury • Chronic pelvic pain Delayed genitourinary • Urethral…
Synthetic Midurethral Slings: Urinary Tract Sequelae
Fig. 16.1 Cystoscopic view of MUS trocar passed through the bladder wall. The offending trocar should be carefully withdrawn and repassed Postoperative Urinary Tract Infection Approximately 4–15 % of women…
Female Urethral Reconstructive Surgery
Fig. 19.1 Inspection of the anterior vaginal wall in a woman with a seemingly straightforward urethrovaginal fistula. She underwent a simple repair with vaginal wall flaps and a Martius flap,…
Posterior Compartment Repair
Fig. 6.1 The Miyazaki retractor is shown here (a). This retractor has a fiber optic light on the end (b) that is useful when the surgeon is working in a…
Urethral Diverticulectomy
Leiomyoma Skene’s gland abnormalities Gartner’s duct abnormalities Vaginal wall cysts Urethral mucosal prolapse Urethral caruncle Periurethral bulking agents Malignancy Endometriosis Fig. 20.1 Skene’s gland abscess clinically (top) and on MRI…
