Management of cervical dysplasia in the context of pregnancy

Petca, Aida; Oprescu, C.; Radu, D.; Petca, R.; Burnei-Russu, A.; Străjean, D.; Zvâncă, Mona Elena; Boț, Mihaela

doi:10.26416/gine.17.3.2017.1081

Cited by 2 publications

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“…In all cases with mesh extrusion, the biomechanical analysis revealed significant decrease in the effective porosity of the mesh due to excessive tensioning or folding of the mesh. [6], [7].…”

Section: Resultsmentioning

confidence: 99%

Synthetic Mesh Used in Gynecologic Reconstructive Surgery for Pelvic Floor Disorders

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Bratila

Comandaşu

et al. 2017

KEM

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Pelvic floor disorders including stress urinary incontinence and pelvic organ prolapse represent a challenge for gynecologist or urogynecologist even nowadays. Conservative treatment for these conditions proves its effectiveness only in few cases selected from early forms of incontinence or prolapse the most cases being solved surgically. The introduction of the procedure imagined by Petros and Ulmsten, known as TVT (Trans Vaginal Tape) in which the medium urethra is supported by a synthetic tape produced in 1996 a revolution in the surgical treatment of stress urinary incontinence. Radical changes also appeared in pelvic organ prolapse surgery extrapolating the hernia repair procedure by using synthetic mesh. After nearly 20 years of experience the mesh surgery is today a common practice in urogynecology. Between 2011 and 2015 we operated in private practice a total number of 297 cases of which 187 cases of stress urinary incontinence and 110 cases of pelvic organ prolapse. From these 86 (78,1%) cases were represented by cystoceles, associated with early apical prolapse or rectoceles, 18 (16,3%) cases by apical prolapse (grade III-IV) and 6 (5,4%) cases by posterior compartment prolapse alone. We performed mesh surgery in 32 (29%) cases represented mainly by anterior compartment prolapse. In 6 (18,7%) cases we founded mesh extrusion which required partially resection. In two cases we performed large resection of anterior vaginal wall required grafting with acellular second generation graft. In all cases with mesh extrusion the biomechanical analysis revealed significant decrease in effective porosity of the mesh due to excessive tensioning or folding of the mesh. The use of mesh in stress urinary incontinence and pelvic organ prolapse represent a justified alternative in selected cases. The specific complications due to meshes are more frequent in prolapse surgery compared to stress urinary incontinence. In all cases altered effective porosity due to technical defects in surgery represents the leading cause.

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Section: Resultsmentioning

confidence: 99%

Synthetic Mesh Used in Gynecologic Reconstructive Surgery for Pelvic Floor Disorders

Brătilă

Bratila

Comandaşu

et al. 2017

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“…Pelvic reconstructive surgical techniques using vaginal slings have diversified in recent years and there are many possibilities to treat the urinary incontinence depending on the morphological changes in the anterior vaginal wall and the degree of change of urethrovesical angle [1,2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Although the reconstructive treatment with vaginal slings proved to be revolutionary, we have to bring into discussion also the risk of developing complications related to their structure, fabric type and size, complications that could have a significant impact on the patient's quality of life, with increasing healthcare costs required for the treatment of these complications. Clinicians' understanding of the complications related to the structure of the synthetic grafts and their proper management would result in improved outcome [3].…”

Section: Introductionmentioning

confidence: 99%

Painful Complications after Pelvic Floor Reconstructive Surgery in Transobturator Suburethral Vaginal Slings

Boț

Vlădăreanu

et al. 2017

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Stress incontinence is a major social and health problem for middle-aged and elderly women, with an increasing prevalence as life expectancy increases. Reconstructive surgery techniques using vaginal mesh slings of polypropylene (synthetic grafts) have diversified in recent years, but at the same time various postoperative complications have been reported, among the frequent ones being pelvic pain, thigh pain and dyspareunia. The pain mechanism is not fully understood, but pathophysiological theories describe the pain as closely related to the structure, density, size and elasticity of the vaginal mesh, and the inflammatory response of the host.

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Management of cervical dysplasia in the context of pregnancy

Cited by 2 publications

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Synthetic Mesh Used in Gynecologic Reconstructive Surgery for Pelvic Floor Disorders

Synthetic Mesh Used in Gynecologic Reconstructive Surgery for Pelvic Floor Disorders

Painful Complications after Pelvic Floor Reconstructive Surgery in Transobturator Suburethral Vaginal Slings

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