Vaginal vault prolapse is a well known entity occurring mostly after hysterectomy. It has recently attained a higher focus in medical practice and literature due to the changes in lifestyle and life expectation amongst Western women. Segev et al in their present review describe the various surgical and conservative approaches toward dealing with the problem. Whilst one can appreciate the vast spectrum of treatments available, there is concurrent understanding that there is no optimal option that suits all patients. This phenomenon is due, in part, to the differences amongst patients but may also point to a lack of definite anatomic and pathophysiologic understanding as to the cause of the prolapse. Therefore, future advances in this field depend not solely on refined surgical technique but also on basic research towards the causes of this condition. With improved understanding, one may expect new surgical and medical modalities that will allow better results and improved quality of life for women suffering from this disabling condition.
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Int J Womens Health
December 2024
Department of Urology, Università "la Sapienza", ICOT, Latina, Italy.
Purpose: Surgical repair is considered the mainstay of genital prolapse management. Several procedures are available both by vaginal and abdominal route, with and without mesh augmentation. The Italian UroGynecology Association (AIUG) promoted this survey with the aim of evaluating current variations in the surgical management of various types of prolapse in different clinical settings and to compare practice amongst practitioners working in high- and medium/low-volume centers.
View Article and Find Full Text PDFTech Innov Patient Support Radiat Oncol
December 2024
University Hospital Galway, Radiation Oncology Department, Newcastle Rd., Galway H91YR71, Ireland.
Aims: An advanced practice radiation therapist (APRT) role in vaginal vault brachytherapy (VBT) was first introduced in 2015. The aim of this manuscript was to clarify how the introduction of an APRT can improve efficiencies within service delivery while maintaining non inferior clinical outcomes of recurrence.
Materials And Methods: This was a single-centred retrospective comparative service evaluation of stage 1 endometrial cancer patients treated with postoperative high dose rate VBT alone.
BMJ Case Rep
December 2024
Department of Surgery, Post Graduate Institute of Medical Education and Research and Capital Hospital, Bhubaneswar, Odisha, India
Spontaneous transvaginal small bowel evisceration, without recent trauma or surgery, is extremely rare. Complications include bowel obstruction, perforation, gangrene, septicaemia and death, requiring urgent surgical intervention. We report a case of a woman in her late 60s, who presented with 70-75 cm of small intestine eviscerated through the vagina, alongside a long history of uterine and rectal prolapse.
View Article and Find Full Text PDFInt Urogynecol J
December 2024
Sydney Women's Endosurgery Centre (SWEC), St George Private Hospital, Kogarah, Sydney, NSW, Australia.
Introduction And Hypothesis: Sacrocolpopexy (SCP) is a recognized treatment for apical pelvic organ prolapse (POP). However, mesh erosion remains a concern, particularly when performed with concomitant hysterectomy. This video presents data on one case of a modified technique aimed at potentially minimizing mesh erosion in robotic SCP.
View Article and Find Full Text PDFMinerva Urol Nephrol
November 2024
Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy.
Introduction: It has been reported that approximately 80-90% of apical prolapse repair is through reconstructive or obliterative vaginal surgery. Although several procedures have been described, to date there is a lack of consensus on the best surgical procedure. The aim of this study was to perform a thorough review of the current literature on the efficacy and safety of the iliococcygeus fixation technique for the treatment of vaginal vault prolapse.
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