A New Surgical Method of Suprapubic and Extraperitoneal Approach with Uterine Preservation for Pelvic Organ Prolapse: Kurt Extraperitoneal Ligamentopexy

Kurt, Sefa; Canda, Mehmet Tunç; Taşyurt, Abdullah

doi:10.1155/2013/748232

Cited by 5 publications

(9 citation statements)

References 17 publications

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“…Secondly, recreation of the cardinal ligament is impractical, as most suspending procedures including LSH/LSC require the uterosacral ligament to be rebuilt. Thirdly, suturing the round ligament to the fascia had been tried previously and a certain efficacy achieved, but the procedure did not match any integral theory and also changed the axis of the vagina. We took the above practical factors into consideration, integrating them into our design, and thus created a permanent and non‐elastic ligament from the cervical ring to the anterior abdominal fascia to elevate the uterus to a more physiological axis of the vagina.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Liang

Chen

Deng

et al. 2017

BJOG

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Objective To compare the safety and effectiveness of two different materials (mesh and suture line) used in laparoscopic extraperitoneal uterine suspension.Design A retrospective observational study.Setting Gynaecology departments in two hospitals in China.Population Women with symptomatic pelvic organ prolapse (POP) of stage II or higher.Methods The women were divided into two groups according to the two different materials for laparoscopic extraperitoneal uterine suspension: mesh or suture line. The baseline characteristics, perioperative details, complications, objective and subjective indexes of the two groups were compared.Main outcome measures The primary outcome was subjective satisfaction rate based upon validated questionnaires. The secondary outcome was objective anatomic assessment with the POP-Q system.Results No difference was found in baseline characteristics and perioperative details except that there were more cases of cardiovascular disease (CVD) and associated other surgeries in the Line than the Mesh group (36 versus 19, P < 0.05; 12 versus 2, P < 0.05). Statistically significant improvements were found in anatomical measures of points Aa, Ba, Ap, Bp, C and TVL (P < 0.01), as well as functional and quality-of-life measures (P < 0.01 for PFDI-20 and PFIQ-7) between both groups. The postoperative PFDI-20, PFIQ-7 and PGI-I scores were not different between two groups (P > 0.05). Two cases of deep wound infection were observed in Mesh group at 3-month follow up.Conclusions Laparoscopic extraperitoneal linear uterine suspension is easy to perform and is associated with fewer meshrelated complications. It is more secure, especially in elderly women and in those with physical complications.Keywords Laparoscopic, mesh, uterine prolapse, uterine suspension.Tweetable abstract Laparoscopic extraperitoneal linear uterine suspension is safe, with fewer mesh-related complications.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Liang

Chen

Deng

et al. 2017

BJOG

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“…Approximately 260 000 women underwent incontinence surgery, with 80% of repairs performed using a mesh device, with a direct cost of over $1 billion dollars annually in the United States [45,[47][48][49][50]. The likelihood of a woman requiring surgery for pelvic organ prolapse or urinary incontinence in her lifetime is 10-20% [51][52][53]. Evidence of efficacy for these mesh products is lacking, and rates of complications such as erosions, pain, infections, and vaginal shrinkage are unacceptably high at around 10 % [54][55][56][57][58][59].…”

Section: Disorders Affecting the Vaginamentioning

confidence: 99%

Surgical Correction of Genitourinary Disorders Using the Self-Assembly Tissue Engineering

Pellerin¹,

Christophe²,

Grammond³

et al. 2019

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Urologic and gynaecologic patients often manifest congenital and/or acquired tissue and organ dysfunctions that require surgical reconstruction to recreate the normal genitourinary system functions. Such reconstruction is still a challenge due to the limited availability of suitable tissues, especially for severe urethral and vaginal replacement. Traditional intervention methods have varying degrees of donor site morbidity or inherent side effects. Interestingly, tissue engineering is a growing field that aims to replace or regenerate these dysfunctional tissues and organs with autologous cells, biomaterials, or a combination of both. Experience gained from tissue engineering suggests that the use of acellular matrices alone is not successful in supporting tissue growth over large surfaces. Cellular constituents need to be isolated, cultured and grown in vitro on scaffolds, then transplanted in vivo, in order to achieve successful three-dimensional tissue regeneration. Biomaterials are the backbone for cell-seeded reconstruction of the genitourinary tissues. Several research teams have explored a different cell culture approach based on self-assembly. This innovative technique relies on the capacity of cells cultured in the presence of ascorbate to secrete and deposit their own extracellular matrix forming a tissue-like substance. The mechanical and physical strength properties of these reconstructed tissues are similar to that of natural native tissues in certain models. Tissue engineered substitutes for urethral and vaginal mucosa were produced and subcutaneously grafted with success opening the way to new therapeutic strategies to correct genitourinary defects.

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“…Pelvic organ prolapse commonly co‐exists with urinary incontinence, and is a significant global issue that represents a heavy economic burden . The risk of pelvic organ prolapse increases with age, and it is anticipated that the ageing global population is likely to precipitate a doubling of this global burden within the next quarter of a century . Prolapse often occurs secondary to childbirth or hysterectomy, and genetic, lifestyle, and geographic factors may all contribute to its development .…”

Section: Stem Cell Applications In Pelvic Medicinementioning

confidence: 99%

“…The risk of pelvic organ prolapse increases with age, and it is anticipated that the ageing global population is likely to precipitate a doubling of this global burden within the next quarter of a century . Prolapse often occurs secondary to childbirth or hysterectomy, and genetic, lifestyle, and geographic factors may all contribute to its development . The likelihood of a woman requiring surgery for pelvic organ prolapse or urinary incontinence in her lifetime is 10–20% …”

Section: Stem Cell Applications In Pelvic Medicinementioning

confidence: 99%

“…25 Prolapse often occurs secondary to childbirth or hysterectomy, and genetic, lifestyle, and geographic factors may all contribute to its development. 25,26 The likelihood of a woman requiring surgery for pelvic organ prolapse or urinary incontinence in her lifetime is 10-20%. 25,27 Biomaterials are increasingly being used to surgically repair pelvic organ prolapse and treat SUI.…”

Section: Sphincteric Weakness and Pelvic Organ Prolapsementioning

confidence: 99%

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Application of Tissue Engineering to Pelvic Organ Prolapse and Stress Urinary Incontinence

Chapple

Osman

Mangera

et al. 2015

LUTS

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Synthetic or biological materials can be used for the surgical repair of pelvic organ prolapse (POP) or stress urinary incontinence (SUI). While non-degradable synthetic mesh has a low failure rate, it is prone to complications such as infection and erosion, particularly in the urological/gynecological setting when subject to chronic influences of gravity and intermittent, repetitive strain. Biological materials have lower complication rates, although allografts and xenografts have a high risk of failure and the theoretical risk of infection. Autografts are used successfully for the treatment of SUI and are not associated with erosion; however, can lead to morbidity at the donor site. Tissue engineering has thus become the focus of interest in recent years as researchers seek an ideal tissue remodeling material for urogynecological repair. Herein, we review the directions of current and future research in this exciting field. Electrospun poly-L-lactic acid (PLA) and porcine small intestine submucosa (SIS) are two promising scaffold material candidates. Adipose-derived stem cells (ADSCs) appear to be a suitable cell type for scaffold seeding, and cells grown on scaffolds when subjected to repetitive biaxial strain show more appropriate biomechanical properties for clinical implantation. After implantation, an appropriate level of acute inflammation is important to precipitate moderate fibrosis and encourage tissue strength. New research directions include the use of bioactive materials containing compounds that may help facilitate integration of the new tissue. More research with longer follow-up is needed to ascertain the most successful and safe methods and materials for pelvic organ repair and SUI treatment.

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A New Surgical Method of Suprapubic and Extraperitoneal Approach with Uterine Preservation for Pelvic Organ Prolapse: Kurt Extraperitoneal Ligamentopexy

Cited by 5 publications

References 17 publications

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Surgical Correction of Genitourinary Disorders Using the Self-Assembly Tissue Engineering

Application of Tissue Engineering to Pelvic Organ Prolapse and Stress Urinary Incontinence

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