Current Concepts in Pelvic Anatomy

Jul 5, 2017 by in UROLOGY Comments Off on Current Concepts in Pelvic Anatomy

Fig. 1.1 Borders of the pelvic brim (Reproduced from: www.​teachmeanatomy.​com; with permission) Fig. 1.2 Pelvic outlet borders (Reproduced from: www.​teachmeanatomy.​com; with permission) The pelvic outlet is diamond shaped with the…

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Evaluation of Pelvic Organ Prolapse

Jul 5, 2017 by in UROLOGY Comments Off on Evaluation of Pelvic Organ Prolapse

Symptoms  Feeling of heaviness/descent  Bulge  Pain  Dyspareunia  Urinary incontinence  Anal/fecal incontinence  Need to replace bulge to void/pass stool Aspects of quality of life  Household work  Professional work  Leisure  Sexual activity…

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Conservative Management of Pelvic Organ Prolapse

Jul 5, 2017 by in UROLOGY Comments Off on Conservative Management of Pelvic Organ Prolapse

Fig. 13.1 Ring pessary Fig. 13.2 Space-filling Shelf and Gellhorn pessaries Fig. 13.3 Cube pessary The selection of a pessary depends on several factors. Efficacy is paramount, but most try…

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Urodynamics: The Practical Aspects

Jul 5, 2017 by in UROLOGY Comments Off on Urodynamics: The Practical Aspects

Fig. 5.1 A frequency-volume chart, with the amount of fluid intake and volume of urine emptied. “x” denotes the leak episodes Equipment The test needs to be scheduled in a…

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Fecal Incontinence

Jul 5, 2017 by in UROLOGY Comments Off on Fecal Incontinence

Advancing age Diabetes Obesity Neurological disorders Female gender Urinary incontinence Caucasian race Chronic diarrhea Multiple vaginal births Constipation Sphincter tear with delivery Pelvic organ prolapse Surgical procedures (colectomy, sphincterotomy) Gastrointestinal…

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Voiding Dysfunction

Jul 5, 2017 by in UROLOGY Comments Off on Voiding Dysfunction

History  Urinary tract: details of storage and voiding symptoms, urinary infections  Gastrointestinal tract: any constipation or encopresis  Neurological evaluation: neurological screening, lower limb and higher function assessment  Gynecological evaluation: assess…

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Physiology of Urinary Continence

Jul 5, 2017 by in UROLOGY Comments Off on Physiology of Urinary Continence

Fig. 3.1 Spinal cord neurons. The afferent and efferent neurons of the spinal cord and relation with interneurons Specific areas in the brain which are involved in control of micturition…

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Surgical Management of Apical Prolapse

Jul 5, 2017 by in UROLOGY Comments Off on Surgical Management of Apical Prolapse

Vaginal approach Abdominal approach Vaginal hysterectomy + McCall culdoplasty Abdominal sacrocolpopexy Sacrospinous ligament suspension Abdominal sacrohysteropexy High uterosacral ligament suspension Abdominal uterosacral suspension Iliococcygeus fixation High levator myorrhaphy Vaginal Approach In most…

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Anterior and Posterior Pelvic Organ Prolapse

Jul 5, 2017 by in UROLOGY Comments Off on Anterior and Posterior Pelvic Organ Prolapse

Fig. 14.1 Discrete defects of the anterior and posterior vaginal wall (midline, paravaginal, transverse and distal defects) Midline Defects Midline or central defects arise from defects in the pubocervical fascia…

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Mesh in Prolapse Surgery

Jul 5, 2017 by in UROLOGY Comments Off on Mesh in Prolapse Surgery

Fig. 16.1 Perigee system In response to safety concerns raised by the US Food and Drug Administration (FDA) advisory statement [6, 7], first-generation mesh kits that involved relatively blind needle…

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