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Current Trends in Urogynecology and Pelvic Floor Surgery
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Current Trends in Urogynecology and Pelvic Floor Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (25 December 2023) | Viewed by 4400

Special Issue Editor

Dr. Barbara Bodner-Adler

E-Mail Website
Guest Editor
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
Interests: pelvic floor surgery; native tissue repair; basic science in urogynecology; incontinence treatment; objective outcome parameters and success definition in PFDs; risk factors for PFDs; urinary microbiota
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues，

Pelvic floor disorders, such as pelvic organ prolapse, urinary incontinence, fecal incontinence, etc., are surprisingly common and represent a growing health problem in women across the globe. These types of diseases impose obvious symptoms, which adversely affect the lives of millions of women both physically and psychologically.

The therapeutic approaches to treat these disorders include non-surgical and surgical treatments. Over the past few decades, pelvic floor surgery has experienced significant improvements and continues to evolve. In addition, it can be tailored to suit the individual needs of each patient. In addition to the traditional approach, minimally invasive and robot surgeries have also become more common.

This Special Issue aims to collect state-of-art research on urogynecology and pelvic floor surgery. Original articles, reviews, and communications are welcome. We look forward to receiving your contributions.

Dr. Barbara Bodner-Adler
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pelvic organ prolapse
  • urinary incontinence
  • pelvic prolapse repair
  • pelvic floor reconstruction

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Published Papers (3 papers)

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Research

12 pages, 939 KiB  
Article
A Randomized Clinical Trial Comparing Dubuisson Laparoscopic Lateral Suspension with Laparoscopic Sacropexy for Pelvic Organ Prolapse: Short-Term Results
by Ewelina Malanowska-Jarema, Andrzej Starczewski, Mariia Melnyk, Dulce Oliveira, Matteo Balzarro and Emanuel Rubillota
J. Clin. Med. 2024, 13(5), 1348; https://doi.org/10.3390/jcm13051348 - 27 Feb 2024
Cited by 3 | Viewed by 1407
Abstract
Background: Laparoscopic sacrocolpopexy (LSC) is the gold standard for the treatment of apical prolapse, although dissection of the promontory may be challenging. Laparoscopic lateral suspension (LLS) with mesh is an alternative technique for apical repair with similar anatomical and functional outcomes, according to [...] Read more.
Background: Laparoscopic sacrocolpopexy (LSC) is the gold standard for the treatment of apical prolapse, although dissection of the promontory may be challenging. Laparoscopic lateral suspension (LLS) with mesh is an alternative technique for apical repair with similar anatomical and functional outcomes, according to recent studies. The purpose of this study was to compare these operative techniques. Methods: Women with uterine Pelvic Organ Prolapse Quantification (POP-Q) stage 2 were enrolled in this prospective study and were randomly allocated to the LLS or LSC group. At the 12-month follow-up, primary measures included both anatomical and functional outcomes. Perioperative parameters and complications were recorded. Results: A total of 93 women were randomized, 48 in the LLS group and 45 in the LSC group, with 2 women lost to follow-up in both groups. LSC anatomic success rates were 81.82% for the apical compartment and 95.22% for the anterior compartment. LLS anatomic success rates for the apical and anterior compartments were 90% and 92.30%, respectively. The mean operative time for LLS was 160.3 min, while for LSC it was 168.3 min. The mean blood loss was 100 mL in both procedures. Conversion to laparotomy was necessary in three women. Mesh erosion was not observed in any of the cases. In terms of the complication, Clavien–Dindo grade 1 was observed in two patients in the LLS group and a complication rated grade 3b was observed in one patient in LSC group. Conclusions: LLS is a good alternative to LSC, with promising anatomical and quality-of-life results. Full article
(This article belongs to the Special Issue Current Trends in Urogynecology and Pelvic Floor Surgery)
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11 pages, 828 KiB  
Article
Continence Is Not Affected after Sling Revision with Transvaginal Tape Elongation for Post-Sling Voiding Dysfunction
by Ching-Pei Tsai, Chih-Ku Liu, Evelyn Yang, Tsung-Ho Ying, Gin-Den Chen and Man-Jung Hung
J. Clin. Med. 2024, 13(2), 637; https://doi.org/10.3390/jcm13020637 - 22 Jan 2024
Cited by 1 | Viewed by 1305
Abstract
Voiding dysfunction (VD) after sling operation is not uncommon. Sling revisions by incision/excision are usually effective; however, they may result in recurrent stress urinary incontinence (SUI). We aimed to evaluate continence status after an innovative sling revision procedure that preserves the integrity of [...] Read more.
Voiding dysfunction (VD) after sling operation is not uncommon. Sling revisions by incision/excision are usually effective; however, they may result in recurrent stress urinary incontinence (SUI). We aimed to evaluate continence status after an innovative sling revision procedure that preserves the integrity of the sling. Patients who underwent either a single-incision (AJUST) or a trans-obturator (TVT-O) mid-urethral sling were studied. Transvaginal tape elongation (i.e., sling midline incision and mesh interposition) was performed on patients with post-sling VD. Factors that may affect recurrent SUI were investigated by statistical analyses. Of 119 patients, 90 (75.6%) (45 AJUST and 45 TVT-O) were available for long-term (median 9; 8–10 years) follow-up. A significantly higher rate (17.2% vs. 3.3%, p = 0.014) of VD was noted after AJUST (N = 10) than after TVT-O (N = 2). After sling revision, four (33%) of the 12 cases reported recurrent SUI, which was not significantly different (p = 1.000) from the rate (37%, 29/78) of patients who did not undergo sling revision. Further statistical analyses revealed no significant predisposing factors affecting the recurrence of SUI. Surgical continence did not seem to be affected by having had sling revision with transvaginal tape elongation for post-sling VD. Full article
(This article belongs to the Special Issue Current Trends in Urogynecology and Pelvic Floor Surgery)
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Graphical abstract

7 pages, 225 KiB  
Article
Impact of Defined Risk Factors on Degree of Urinary Stress Incontinence and Sling Outcome: A Retrospective Cohort Analysis
by Janine N. Frey, Mélanie Zellweger, Jörg Krebs and Corina Christmann
J. Clin. Med. 2023, 12(16), 5422; https://doi.org/10.3390/jcm12165422 - 21 Aug 2023
Viewed by 1202
Abstract
Urinary stress incontinence is a distressing condition that has a severe impact on quality of life for most affected women. The insertion of the suburethral tension-free vaginal tape (TVT) is regarded as the gold-standard surgical treatment option. It is unclear whether all women [...] Read more.
Urinary stress incontinence is a distressing condition that has a severe impact on quality of life for most affected women. The insertion of the suburethral tension-free vaginal tape (TVT) is regarded as the gold-standard surgical treatment option. It is unclear whether all women with severe SUI benefit equally from TVT. Thus, the aim of our study was to identify risk factors for severe SUI and determine whether successful the resolution of incontinence after a TVT procedure was different in women with a higher degree of SUI. In total, 168 women were included in this retrospective cohort study. Women with severe SUI showed a significantly lower maximum urethral closure pressure (MUCP) (median 53 cmH2O in moderate vs. 39 cmH2O in severe, p = 0.001) and higher BMI (median 26.1 kg/m2 in moderate vs. 28.5 kg/m2 in severe, p = 0.045). Sonographic bladder neck funneling was detected significantly more often in women with severe SUI (27% in moderate vs. 57% in severe, p = 0.004). Lower MUCP and higher BMI were identified as significant predictors of severe SUI (p < 0.032). There was no difference in parity, age, functional urethral length and negative urethral stress pressure. Overall postoperative continence after the insertion of TVT was 91.9%. We found no significant difference in postoperative continence between women with severe vs. moderate SUI, suggesting that in our cohort the success of TVT was not significantly affected by the severity of SUI. In our cohort, low MUCP and high BMI were shown to be significant predictors of SUI severity. Nevertheless, treatment success of SUI with TVT did not differ substantially in women with more severe SUI. Full article
(This article belongs to the Special Issue Current Trends in Urogynecology and Pelvic Floor Surgery)
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