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Surgical treatment of female urinary incontinence using the uropatch sling
Abstracts
round ligaments, and uterine vessels in patients undergoing minilaparotomy and laparoscopic and vaginal hysterectomy with or without adnexectomy, and is useful in cases with limited and difficult surgical exposure.
follow-up was 84 days, with no patient developing recurrent prolapse. Conclusion. Laparoscopic uterine suspension appears to be safe and effective treatment for uterine prolapse in women who desire to preserve their uterus.
178. Surgical Treatment of Female Urinary Incontinence Using the Uropatch Sling
180. Experience with Laparoscopic Supracervical Hysterectomy
MA Pelosi III, MA Pelosi II. Pelosi Women's Medical Center, Bayonne, New Jersey.
F Perl, G Pregenzer, G Tweddel. Somerset Medical Center, Somerville, New Jersey.
Objective. To compare the efficacy and safety of laparoscopic supracervical hysterectomy (LSH) versus total LAVH. Measurements and Main Results. Of 24 women (age range 42-62 yrs) with abnormal uterine bleeding, 12 underwent LAVH and 12 LSH. Patients were matched for pathology; the only significant difference was surgical method. In all patients bipolar coagulation was used and all specimens were morcellated. Average operating time was 3 hours for LAVH and 3.5 hours for LSH. Specimen weight range was from 71 to 550 g. No significant morbidity was reported in the LAVH group, whereas in the LSH-treated group, one patient required 1 U blood, two cases of ileus resolved spontaneously to intravenous hydration, and two cuff hematomas and one left ureteral vaginal fistula occurred. Conclusion. LAVH appears more effective and has less morbidity than LSH; however, we have more experience with LAVH (>250 cases), and the LSH group represents the first 12 cases. Morbidities occurred in the first four patients, with no significant ones in the rest.
Objective. To assess the efficacy and safety of a suburethral sling made of bovine pericardium for treatment of primary or recurrent SUI. Measurements and Main Results. Fifteen patients had primary SUI due to intrinsic sphincter deficiency, urethral hypermobility, or both, and five had had previous incontinence (needle colposuspension, Burch or sling procedures). Laparoscopic-assisted sling placement was performed. All surgeries were completed successfully, no intraoperative or postoperative complications occurred, and no voiding difficulties or complications were associated with either the sling or bone metal anchors. Incontinence was cured in all but one woman at a minimum of 24 months' follow-up. Conclusion. The design of the sling eliminates curling during fixation and avoids delayed seroma or hematoma formation, reducing the possibility of infection and sling erosion. It is a promising alternative to current slings for treatment of all types of SUI in women.
179. Laparoscopic Uterine Suspension to Treat Apical Defects
181. Efficacy of the UPLIFT Technique for Uterine Suspension for Chronic Pelvic Pain
I Perez, CA Medina. University of Miami/Jackson Memorial Medical Center, Miami, Florida.
CP Perry. Brookwood Women's Medical Center.
Objective. To describe a laparoscopic surgical technique of uterine suspension and assess its safety and efficacy. Measurements and Main Results. Six women (age range 27-42 yrs) with uterine prolapse underwent laparoscopic suspension of the uterus to uterosacral ligaments. Additional procedures were performed in four women (67%). Mean operating time was 148.3 + 58.7 minutes. Mean blood loss was 87 + 125 ml. There were no intraoperative complications. Only one patient stayed more than 24 hours. The only postoperative complication was a wound seroma. Mean
Objective. To determine the benefit of uterine suspension by uterine suspension and positioning by ligament investment, fixation, and truncation (UPLIFT) method for women with CPR dysmenorrhea, and/or dyspareunia who had uterine retroversion. Measurements and Main Results. Thirty-five women had CPP and abnormal uterine position. They were included if they experienced CPP, dysmenorrhea, or deep-thrust dyspareunia (6 on a VAS of 0-10, 10 = worst imaginable). Each patient underwent laparoscopic UPLIFT.
$54
round ligaments, and uterine vessels in patients undergoing minilaparotomy and laparoscopic and vaginal hysterectomy with or without adnexectomy, and is useful in cases with limited and difficult surgical exposure.
follow-up was 84 days, with no patient developing recurrent prolapse. Conclusion. Laparoscopic uterine suspension appears to be safe and effective treatment for uterine prolapse in women who desire to preserve their uterus.
178. Surgical Treatment of Female Urinary Incontinence Using the Uropatch Sling
180. Experience with Laparoscopic Supracervical Hysterectomy
MA Pelosi III, MA Pelosi II. Pelosi Women's Medical Center, Bayonne, New Jersey.
F Perl, G Pregenzer, G Tweddel. Somerset Medical Center, Somerville, New Jersey.
Objective. To compare the efficacy and safety of laparoscopic supracervical hysterectomy (LSH) versus total LAVH. Measurements and Main Results. Of 24 women (age range 42-62 yrs) with abnormal uterine bleeding, 12 underwent LAVH and 12 LSH. Patients were matched for pathology; the only significant difference was surgical method. In all patients bipolar coagulation was used and all specimens were morcellated. Average operating time was 3 hours for LAVH and 3.5 hours for LSH. Specimen weight range was from 71 to 550 g. No significant morbidity was reported in the LAVH group, whereas in the LSH-treated group, one patient required 1 U blood, two cases of ileus resolved spontaneously to intravenous hydration, and two cuff hematomas and one left ureteral vaginal fistula occurred. Conclusion. LAVH appears more effective and has less morbidity than LSH; however, we have more experience with LAVH (>250 cases), and the LSH group represents the first 12 cases. Morbidities occurred in the first four patients, with no significant ones in the rest.
Objective. To assess the efficacy and safety of a suburethral sling made of bovine pericardium for treatment of primary or recurrent SUI. Measurements and Main Results. Fifteen patients had primary SUI due to intrinsic sphincter deficiency, urethral hypermobility, or both, and five had had previous incontinence (needle colposuspension, Burch or sling procedures). Laparoscopic-assisted sling placement was performed. All surgeries were completed successfully, no intraoperative or postoperative complications occurred, and no voiding difficulties or complications were associated with either the sling or bone metal anchors. Incontinence was cured in all but one woman at a minimum of 24 months' follow-up. Conclusion. The design of the sling eliminates curling during fixation and avoids delayed seroma or hematoma formation, reducing the possibility of infection and sling erosion. It is a promising alternative to current slings for treatment of all types of SUI in women.
179. Laparoscopic Uterine Suspension to Treat Apical Defects
181. Efficacy of the UPLIFT Technique for Uterine Suspension for Chronic Pelvic Pain
I Perez, CA Medina. University of Miami/Jackson Memorial Medical Center, Miami, Florida.
CP Perry. Brookwood Women's Medical Center.
Objective. To describe a laparoscopic surgical technique of uterine suspension and assess its safety and efficacy. Measurements and Main Results. Six women (age range 27-42 yrs) with uterine prolapse underwent laparoscopic suspension of the uterus to uterosacral ligaments. Additional procedures were performed in four women (67%). Mean operating time was 148.3 + 58.7 minutes. Mean blood loss was 87 + 125 ml. There were no intraoperative complications. Only one patient stayed more than 24 hours. The only postoperative complication was a wound seroma. Mean
Objective. To determine the benefit of uterine suspension by uterine suspension and positioning by ligament investment, fixation, and truncation (UPLIFT) method for women with CPR dysmenorrhea, and/or dyspareunia who had uterine retroversion. Measurements and Main Results. Thirty-five women had CPP and abnormal uterine position. They were included if they experienced CPP, dysmenorrhea, or deep-thrust dyspareunia (6 on a VAS of 0-10, 10 = worst imaginable). Each patient underwent laparoscopic UPLIFT.
$54