1/2. Incarceration of bowel through opening of a 5-mm port.An 85-year-old woman presented with genital prolapse (rectocele and cystocele) with stress urinary incontinence. Three days after laparoscopic promonto fixation, bowel became incarcerated in the opening of a 5-mm port site. This clinical case forces us to reconsider the harmlessness of 5-mm ports. We recommend making sure that their openings are well closed.- - - - - - - - - - ranking = 1keywords = urinary incontinence, incontinence, urinary (Clic here for more details about this article) |
2/2. A 2-year anatomical and functional assessment of transvaginal rectocele repair using a polypropylene mesh.This study reports the 2-year results of an original technique for rectocele repair by the vaginal route, using a combined sacrospinous suspension and a polypropylene mesh. Twenty-six women were successively operated between October 2000 and February 2003. Mean age was 63.7 years [range 35-92]. 19 women had had previous pelvic surgery for prolapse and/or urinary incontinence (73.1%), but none had had a previous rectocele repair. patients underwent physical examination staging of prolapse in the international pelvic organ prolapse staging system. Eleven women had stage 2 posterior vaginal wall prolapse (42.3%), seven had stage 3 (26.9%) and eight had stage 4 (30.8%). The procedure included a bilateral sacrospinous suspension and a polypropylene mesh (GyneMesh, Gynecare, Ethicon france) attached from the sacrospinous ligaments to the perineal body. We did not perform any associated posterior fascial repair, nor myorraphy. patients were followed up for 10-44 months, with a median follow-up ( /- SD) of 22.7 /- 9.2 months. Functional results and sexual function were evaluated using the PFDI, the PFIQ and the PISQ-12 self-questionnaires. Twenty-five women returned for follow-up (96.2%). At follow-up, 24 women were cured (92.3%) and one had asymptomatic stage 2 rectocele. All the patients but one had symptoms and impact on quality of life improved. No postoperative infection of the mesh or rectovaginal fistula was found, but there were three vaginal erosions (12%) and one out of 13 had de novo dyspareunia (7.7%).- - - - - - - - - - ranking = 1keywords = urinary incontinence, incontinence, urinary (Clic here for more details about this article) |