Browsing by Subject "Pelvic Organ Prolapse"
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Item 3D Animated Video Series for Patient Education of Pelvic Organ Prolapse and Sacrocolpopexy Surgery(2012-12-20) Sumner, Elizabeth; Calver, Lewis E.The objective of this video series was to present a comprehensive three-dimensional patient education video series that described basic female pelvic anatomy, types of pelvic organ prolapse, basic procedural steps for a sacrocolpopexy, and complications of the procedure. A survey of currently available patient education materials was conducted to assess possible areas for improvement. A storyboard and script were then developed and presented to several members of the Female Pelvic Medicine and Reconstructive Surgery Division and the Biomedical Communications Graduate School Program. Three-dimensional computer animations were created from CT data and compiled into video segments. The videos were embedded into a web platform and tested on a group of current and former patients. The result was that the test group correctly answered content questions and had an increased confidence with discussing the material. This may mean that patients have a better understanding of prolapse and sacrocolpopexy procedure after viewing this video series.Item Efficacy and Safety Comparison of Robotic-Assisted Sacrocolpopexy Using Light-Weight and Heavy-Weight Polypropylene Mesh(2020-05-01T05:00:00.000Z) Huang, Emily You; Carmel, Maude; Lemack, Gary; Zimmern, Philippe E.AIMS: This study compares long-term surgical outcomes of light-weight polypropylene mesh (LWPPM) and heavy-weight polypropylene mesh (PPM) for robotic sacrocolpopexy (RSC). METHODS: Following IRB approval, a 2-surgeon POP database of women who underwent RSC at a single institution was reviewed. Minimum follow-up time was 6 months. Patients were stratified by mesh weight: Boston Scientific MarlexTM natural Trelex mesh or AtriumTM ProLite mesh (PPM) versus Caldera Medical Vertessa(r) Lite Y Polypropylene Mesh (LWPPM). Success was defined using a composite of absence of prolapse symptoms at the patient's most recent visit, no POP-Q point beyond the hymen, and no reoperation for POP. RESULTS: From 2007 to 2018, 110 patients met study criteria: 67 with LWPPM and 43 with PPM. The success rate of RSC using LWPPM at 12 months was 91.0% versus 90.7% for RSC with PPM (p =1). Over time, the mean follow-up length was 23.3 months in the LWPPM groups compared to 44.7 months in the PPM group (p <0.0002). The success rate at the last follow-up of RSC using LWPPM was significantly higher than that of RSC with PPM - 89.6% versus 72.1% (p =0.0221). Regarding complications, mesh extrusion rates varied (3.0% for LWPPM versus 11.6% for PPM at the last follow-up); however, this difference was not statistically significant (p=0.11) nor was the difference in management (p=0.15). CONCLUSIONS: RSC using LWPPM is a safe and effective procedure. Success rates using LWPPM are not inferior to those using PPM. Complication rates were low with either mesh.Item High Midline Levator Myorrhaphy for Vaginal Vault Prolapse: Long-Term Results(2016-01-19) Wu, Yuefeng (Rose); Christie, Alana; Alhalabi, Feras; Zimmern, Philippe E.INTRODUCTION AND OBJECTIVE: To review long-term outcomes following a vaginal native tissue repair (High Midline Levator Myorrhaphy, HMLM) in women with symptomatic vault prolapse.1, 2 METHODS: Following IRB-approval, a prospectively maintained database of women who underwent HMLM for symptomatic vault prolapse (VP) alone or associated with other POP was reviewed for demographic data, history of prior POP, physical examination, hospital stay length, and long-term outcomes. Patients with <6 months follow up and no retrievable operative notes were excluded. Data was reviewed by a third party investigator not involved in patient care. Failure was defined as same compartment POP ≥ stage 2 or POP reoperation. Descriptive statistics and Kaplan-Meier curves were obtained. RESULTS: Between 1996 and 2014, 94 women who underwent HMLM were studied. Mean follow-up time was 7.7 (0.6-18.4) years, mean age was 69.6 (36-91), and 89% were Caucasian. Patients were grouped by POP indications: VP (6), vault and anterior (26), vault and posterior (35), and all 3 compartments (27) (Table 1). No intra-operative complications were reported. Ten (11%) early complications (<30 days) were noted (Clavien I/II). Sixty-seven (71%) women were cured of VP. Ten women (11%) had failure in a non-apical compartment and 17 (18%) had apical failure. Reoperation rate was 14% (13/94) and 5% (5/94) for vault and non-vault recurrences, respectively. VP recurrence-free probability between women with ≤ 2 versus 3 POP compartments was statistically significant (p = 0.0128). CONCLUSIONS: At a mean follow-up of 7-8 years, HMLM was successful in two thirds of women. Best outcome was noted in women with VP and one associated compartment prolapse. REFERENCES: 1. Lemack, G. E., et al. Urology, 56: 50, 2000. 2. Natale, F. et al. J Urol, 180: 2047, 2008Item [UT Southwestern Medical Center News](2011-05-24) Russell, RobinItem [UT Southwestern Medical Center News](2012-06-20) Jarvis, Janice