Publications by authors named "Deborah R Karp"
Objectives: Obstetric anal sphincter injury (OASIS) is a potentially serious complication of vaginal delivery and can lead to both short-term and long-term sequelae. This study sought to identify health care seeking patterns of women who developed pelvic floor symptoms including pelvic pain after OASIS. It also identified demographic and clinical factors associated with seeking subspecialty care from a pelvic floor specialist and demographic and clinical factors associated with seeking care for pelvic pain after OASIS.
View Article and Find Full Text PDFStudy Objective: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal.
Design: This was a retrospective study.
Article Synopsis
- The study aimed to evaluate sling removal reasons, pain locations, and surgical approaches for synthetic mesh slings across three types: retropubic (RP), transobturator (TOT), and single incision (SIS).
- A retrospective review covered 337 sling complications from 2011 to 2013, showing vaginal pain as the top removal reason, with TOT slings posing a higher groin pain risk and RP slings linked to more suprapubic pain.
- The findings indicate that RP slings had a higher risk of suprapubic pain, while TOT showed the highest intraoperative complication rate and a greater incidence of groin pain.
Article Synopsis
- - The study aimed to compare the levels of certain neuropeptides (NGF, BDNF, SP, CGRP) in urine between women with overactive bladder (OAB) and those without, to identify factors influencing their expression.
- - It involved 67 women (38 with OAB, 29 controls) and found that while both groups were similar in demographics, women with OAB reported more pelvic pain and surgeries; however, neurotrophic factor levels were similar between the two groups.
- - The results indicated that older age and higher BMI were associated with increased urinary levels of BDNF and NGF, respectively, but there was no strong link between neurotrophin levels and OAB, suggesting further research
Objective: To evaluate trends in annual rates of vaginal birth, cesarean delivery, and obstetric anal sphincter injury at a single institution before and after the designation of obstetric anal sphincter injury as a measure of obstetric quality and safety.
Methods: This was a retrospective cohort study of women undergoing a singleton vaginal delivery and diagnosed with obstetric anal sphincter injury over a 16-year period. International Classification of Diseases, 9th Revision codes for perineal lacerations were used as identifiers.
Introduction And Hypothesis: The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications.
Methods: This was a retrospective chart review of all patients who underwent surgical removal of sling, transvaginal mesh, and sacrocolpopexy for mesh-related complications from 2011 to 2013 at three tertiary referral centers. The International Urogynecological Association (IUGA)/International Continence Society (ICS) classification system was utilized.
Article Synopsis
- The study investigates the rate of apical suspensory procedures in women with anterior vaginal wall prolapse undergoing surgery in 2011, finding that only 31.9% received such procedures despite their importance in reducing reoperation rates.
- Analyzing data from 2,900 women, the research identifies factors associated with the likelihood of receiving these procedures, such as age over 50, being Caucasian, having a concomitant hysterectomy, and being treated in an urban teaching hospital.
- The findings suggest that while surgical restoration of apical support is crucial for recovery, many women do not receive it, indicating an opportunity to enhance the quality of care in treating anterior vaginal prolapse
Apical Suspension at the Time of Hysterectomy for Uterovaginal Prolapse: A Comparative Analysis of 2001 and 2011.
Female Pelvic Med Reconstr Surg
August 2016
Article Synopsis
- The study aimed to compare the rates of concomitant apical procedures in women undergoing hysterectomy for uterovaginal prolapse between 2001 and 2011, along with identifying factors influencing these procedures.
- A significant increase in the proportion of women receiving concomitant apical procedures was observed, rising from 26.9% in 2001 to 48.2% in 2011, with certain demographics like age over 50 and abdominal hysterectomy route being linked to this increase.
- Despite the rise in procedures over the decade, the overall uptake remains low, highlighting a need for improved integration of apical repair during hysterectomies for prolapse.
Article Synopsis
- The presacral space is rich in nerves that impact the pelvic organs and is often involved in surgery for pelvic floor issues like sacrocolpopexy and rectopexy.
- Various procedures in this area, including presacral neurectomy and tumor resections, can lead to complications such as constipation and urinary problems.
- A review revealed insufficient quality data on the rates of bowel and bladder dysfunction after surgeries in the presacral space, highlighting the need for further research.
Outcomes of robotic sacrocolpopexy: a systematic review and meta-analysis.
Female Pelvic Med Reconstr Surg
May 2015
Article Synopsis
- A systematic review analyzed the outcomes of robotic sacrocolpopexy, focusing on studies with over 6 months of follow-up data.
- The meta-analysis found a high anatomic success rate of 98.6%, with manageable complication rates including mesh exposure at 4.1% and reoperation at 1.7%.
- The study concludes that robotic sacrocolpopexy is an effective and safe surgical option for treating apical prolapse, characterized by a high cure rate and low complication risk.
Complete transvaginal surgical management of multiple bladder calculi and obstructed uterine procidentia.
Female Pelvic Med Reconstr Surg
September 2014
Background: Bladder calculi are rare in women and are associated with irreducible pelvic organ prolapse. We report a case of irreducible uterine procidentia and bladder calculi that was surgically managed with a complete transvaginal approach.
Case: A 76-year-old woman presented with irreducible complete uterine procidentia.
Introduction And Hypothesis: Our goal was to compare outcomes of repeat vs. primary synthetic slings in patients with stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD).
Materials And Methods: We reviewed patients who underwent a sling for SUI with ISD from 2003 to 2010.
Objective: To evaluate the use and effect of early administration of vaginal estrogen via a continuous low-dose estradiol vaginal ring placed immediately after pelvic reconstructive surgery.
Methods: This was a randomized controlled trial of 65 postmenopausal women undergoing vaginal reconstructive surgery. The subjects were randomly assigned to receive an estradiol-releasing vaginal ring, placebo vaginal ring, or control without vaginal ring for 12 weeks immediately after vaginal reconstructive surgery.
Predictors of successful salpingo-oophorectomy at the time of vaginal hysterectomy.
J Minim Invasive Gynecol
May 2012
Study Objective: To determine prognostic factors related to successful salpingo-oophorectomy in menopausal women at the time of vaginal hysterectomy.
Design: Retrospective cohort study (Canadian Task Force Classification II-2).
Setting: Tertiary care center.
Article Synopsis
- Rectovaginal fistula is a rare but serious complication that can arise from procedures like the excision of a Bartholin gland, often occurring in women with a history of recurrent abscesses.
- A 43-year-old woman experienced flatus per vagina immediately following her Bartholin gland surgery, which led to the discovery of a rectovaginal fistula during examination.
- The case illustrates the importance of awareness around potential complications from common gynecologic surgeries, highlighting the successful repair of the fistula through a transvaginal approach.
Introduction And Hypothesis: This study aims to evaluate clinical outcomes of concomitant suburethral sling with LeFort colpocleisis including its effect on postoperative voiding.
Methods: We performed a retrospective review of all LeFort colpocleisis procedures from our institution. We reviewed demographics, symptoms of stress urinary incontinence, incontinent events/day, pads usage/day, urodynamic parameters, and presence of voiding dysfunction.
Abdominal pseudocyst formation is a rare adult complication associated with ventriculoperitoneal (VP) shunts. Presenting symptoms are primarily abdominal and include distention, pain and anorexia, and secondarily neurological with signs and symptoms of shunt malfunction. We describe a case of VP shunt-related pseudocyst formation presenting as symptomatic pelvic organ prolapse with stage 4 enterocele 4 years after VP shunt placement.
View Article and Find Full Text PDFIntroduction And Hypothesis: This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication.
Methods: Women with symptomatic anterior prolapse who underwent transvaginal repair, using biologic graft via transobturator approach, were retrospectively studied. An initial cohort had the graft placed without fascial plication.
Introduction And Hypothesis: This study aimed to validate a symptom questionnaire to assess presence and patient bother as related to common pelvic floor disorders.
Methods: The validation of the Pelvic Floor Bother Questionnaire (PFBQ) included evaluation of internal reliability, test-retest reliability, and validity of the items.
Results: A total of 141 patients with mean age of 61.
Article Synopsis
- The study aimed to compare visual estimation versus measurement in assessing pelvic organ prolapse using the Pelvic Organ Prolapse Quantification (POP-Q) method.
- Women with pelvic organ prolapse were examined by two trained professionals using both estimation and measurement techniques in a randomized order.
- The results showed that both methods produced highly correlated POP-Q stage results, indicating no significant difference in accuracy between visual estimation and measurement among experienced examiners.
Introduction And Hypothesis: We set out to evaluate anatomical outcomes of recurrent vs. primary prolapse surgery, focusing on anterior colporrhaphy (AC).
Methods: A retrospective study was performed comparing patients who underwent AC for recurrent cystocele (group I) and a matched control group who underwent primary AC (group II).