Vaginally Assisted Laparoscopic Urethrolysis and Mesh Excision after Tension-free Vaginal Tape (TVT)
Publication date: Available online 3 July 2021Source: Journal of Minimally Invasive GynecologyAuthor(s): Evrim Erdemoglu, Volkan Öztürk, İlyas Turan, Ebru Erdemoglu
To present technique of vaginally assisted laparoscopic urethrolysis and mesh excision after tension-free vaginal tape.
Stress urinary incontinence (SUI) is caused by hormonal deficiencies, vaginal birth, changes in collagen fibres and external sphincter inadequacy . The condition affects 15% of the female population . Variable treatment options for SUI including behavioural and pharmacologic therapy (alpha and beta adrenergic agonists and antagonists, oestrogen, SNRIs, artificial sphincters, urinary diversion etc.) have been described before . Surgical management includes tension-free vaginal tape (TVT), transobturator and pubovaginal sling operations, and laparoscopic Burch colposuspension1.
CONCLUSIONS: The data indicate that, in terms of subjective cure of incontinence within 18 months, there is probably little difference between laparoscopic colposuspension and open colposuspension, or between laparoscopic colposuspension and midurethral sling procedures. Much of the evidence is low quality, meaning that a considerable degree of uncertainty remains about laparoscopic colposuspension. Future trials should recruit adequate numbers, conduct long-term follow-up and measure clinically important outcomes. A brief economic commentary identified three studies. We have not quality-assessed them and they should be in...
To demonstrate a modified technique of performing a laparoscopic colposuspension in a patient with a failed tension-free vaginal tape (TVT).
Abstract Urogynaecology is a highly specialised interdisciplinary medical field. It aims to investigate and treat functional, static, endocrine and sexual disorders of the genitourinary system and pelvic area in a sustainable and holistic manner.The "Urological Functional Diagnostics and Female Urology" working group of the German Urologist Academy was founded in 1977. It focuses on developing and updating diagnostics and clinical therapy, contributing to urogynaecological guidelines as well as establishing programmes for further education.Urinary incontinence and other pelvic floor disorders are increas...
Publication date: November–December 2018Source: Journal of Minimally Invasive Gynecology, Volume 25, Issue 7, SupplementAuthor(s): D.H. Conrad, S. Pacquee, T.D. Saar, S. Choi, D. Chou, G. Cario, D. Rosen
Objective: Synthetic mesh mid urethral slings (MUS) are considered the current gold standard treatment for stress urinary incontinence (SUI). Since it was first described by Ulmsted et al. in 1996, the retropubic tension free vaginal tape (TVT) has been extensively researched, with numerous high-quality trials demonstrating a good safety profile with high long-term efficacy. Nevertheless, recent high profile lawsuits and subsequent media attention surrounding vaginal mesh produc ts for treatment of prolapse has placed pressure to ban all mesh products including the MUS.
ConclusionThe safety of the use of mesh in pelvic floor surgery is a matter of debate owing to the occurrence of mesh-related complications. Based on the current literature, mesh-related complications seem to be lower in transabdominal mesh surgery than in transvaginal mesh surgery. In this study, a low mesh exposure rate was observed in robot-assisted abdominal pelvic floor surgery for POP.
Publication date: Available online 11 July 2018Source: Journal of Minimally Invasive GynecologyAuthor(s): Haider Jan, Vishalli Ghai, Ranee ThakarABSTRACTStudy ObjectiveTo demonstrate laparoscopic colposuspension for recurrent stress incontinence after failed tension-free vaginal tape (TVT).DesignA technical video showing laparoscopic colposuspension for previously surgically treated stress incontinence (Canadian Task Force classification III).SettingA university hospital.PatientA 58-year-old woman with previous TVT presents with recurrent stress urinary incontinence.Measurements and Main ResultsMidurethral slings have equi...