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vNOTES as a salvage method for adnexectomy and high uterosacral ligament suspension after vaginal hysterectomy under epidural anesthesia: A feasibility and safety study.
Eur J Obstet Gynecol Reprod Biol
January 2025
Objective: To evaluate the feasibility and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for performing adnexectomy and high uterosacral ligament suspension (HUSLS) after vaginal hysterectomy (VH) under epidural anesthesia.
Method: This was a retrospective case series of 42 women who underwent VH for stage II or greater apical prolapse according to pelvic organ prolapse quantification (POP-Q); however, adnexectomy could not performed and replace the vNOTES technique. The procedure continued with vNOTES adnexectomy and bilateral HUSLS under epidural anesthesia.
Relationship Between the PERFECT Scheme, Vaginal Manometry, and Transperineal Ultrasound in Women With and Without Stress Urinary Incontinence: A Cross-Sectional Study.
Int Urogynecol J
December 2024
Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
Article Synopsis
- The study aimed to compare three assessment methods for pelvic floor function—PERFECT scheme, vaginal manometry, and transperineal ultrasound—in women with and without stress urinary incontinence (SUI).
- It involved a cross-sectional analysis of 51 women with SUI and 47 without, evaluating various pelvic floor metrics while excluding those with severe conditions.
- Results showed strong correlations among some measures of the PERFECT scheme and vaginal manometry in the SUI group, but no correlation between ultrasound variables and the other assessment methods.
vNOTES versus Laparoscopic Uterosacral Ligament Suspension for Apical Pelvic Organ Prolapse: Perioperative and Short-Term Outcomes.
Int Urogynecol J
September 2024
Division of Urogynecology, Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada.
Article Synopsis
- The study compares the outcomes of Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) and laparoscopic surgery in treating pelvic organ prolapse through uterosacral ligament suspension (USLS).
- Data was gathered from women who underwent both procedures between 2017 and 2023, analyzing factors like operative outcomes, complication rates, and symptom improvement.
- While both techniques showed similar postoperative success rates, vNOTES achieved a higher anatomical success rate at 6 weeks, although the difference was not significant after corrections for other factors.
Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy.
J Pers Med
August 2024
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul 06135, Republic of Korea.
In this study, we aimed to demonstrate the feasibility and safety of navigating the ureters, middle sacral artery (MSA), and superior hypogastric nerve (SHN) using indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging during robot-assisted sacrocolpopexy (RSCP). Overall, 15 patients who underwent RSCP for apical vaginal prolapse were retrospectively enrolled. All patients underwent cystoscopic intraureteric instillation of 5 cc ICG (2.
View Article and Find Full Text PDFOutcomes of uterosacral ligaments suspension for uterovaginal prolapse native-tissue repair: Over 1000-patient single-center study.
Eur J Obstet Gynecol Reprod Biol
October 2024
Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Article Synopsis
- - The study evaluated the effectiveness and complications of high uterosacral ligament (USL) suspension as a surgery for managing pelvic organ prolapse (POP) in a large group of patients over a 12-year period.
- - Out of 1,099 patients, the surgery had a low complication rate of 3.4% and a recurrence rate of 12.4%, with only 0.9% requiring reoperation due to prolapse recurrence.
- - Postoperative results showed significant improvements in various pelvic dysfunctions, indicating that high USL suspension is a safe and effective primary treatment for POP.
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