&NA; The aim of this study was to determine if the method of collection effects preoperative ... more &NA; The aim of this study was to determine if the method of collection effects preoperative antibiotic use. Five hundred fifty (550) patients were included in the study. This retrospective chart review found no difference in antibiotic use based on method of urine collection.
The aim of this study was to investigate factors associated with long-term pessary use in patient... more The aim of this study was to investigate factors associated with long-term pessary use in patients with advanced pelvic organ prolapse (POP). This was a retrospective chart review of patients with POP of stage ≥2 managed with a pessary. Patients were excluded if the date of fitting or follow-up was unavailable. Long-term use was defined as more than 1 year. Patient demographics, pessary fitting, and follow-up visit dates were collected. The primary end point was the duration of use and the prognostic impact of pessary type. Secondary objectives addressed other influencing factors including age, estrogen use, and prolapse stage. The data were analyzed using SPSS version 21. The final analysis included 311 patients. The mean (± standard deviation, SD) duration of pessary use was 7.0 ± 0.72 years (median 5.7 years). Long-term use was found in 76 % (164) of these patients. Factors associated with longer use were age >65 years (p = 0.004) and estrogen use (p = 0.048). The estimated me...
To determine the association between advanced pelvic organ prolapse and changes in lumbar lordosi... more To determine the association between advanced pelvic organ prolapse and changes in lumbar lordosis and/or pelvic inlet orientation. Lateral lumbosacral spine/pelvic x-rays were taken of women with grade 2 or greater uterovaginal prolapse and women with grade 1 or less prolapse standing in their usual upright posture. The angles of lumbar lordosis and the pelvic inlet were measured by a radiologist who was masked to the pelvic examination findings. Twenty women with prolapse were matched with 20 women without significant prolapse. There were no significant differences in the mean (+/- standard deviation [SDI) age (55.3 +/- 9.0 years compared with 53.4 +/- 9.5 years), body mass index (BMI) (28.9 +/- 5.6 compared with 28.4 +/- 5.2), gravidity (5.6 +/- 3.5 compared with 5.0 +/- 2.7), and vaginal parity (4.65 +/- 3.3 compared with 4.5 +/- 2.9) between the prolapse and nonprolapse groups, respectively. All participants were vaginally parous. The mean lumbar lordotic angle in women with pelvic organ prolapse (32.0 degrees +/- 9.8 degrees) was significantly lower than that of controls (42.4 degrees +/- 10.9 degrees) (P < .003). The mean angle of the pelvic inlet in women with pelvic organ prolapse (37.5 degrees +/- 7.0 degrees) was significantly larger than that of controls (29.5 degrees +/- 7.3 degrees) (P < .001). The differences in the mean angles of lumbar lordosis and the pelvic inlet, between the case and control groups, remained significant after multivariable logistic regression was performed. Women with advanced uterovaginal prolapse have less lumbar lordosis and a pelvic inlet that is oriented less vertically than women without prolapse.
A disposable suturing instrument is used in our surgical method for sacrospinous vault suspension... more A disposable suturing instrument is used in our surgical method for sacrospinous vault suspension to facilitate suture placement and retrieval. The pararectal space is dissected and the suturing device is placed just medial to the lateral third of the sacrospinous ligament-coccygeus muscle complex. Depression of the device's firing button advances a standard needle in a controlled circular path through the sacrospinous ligament-coccygeus muscle complex. The needle is retrieved with a straight-needle holder at a consistent location, 3 mm from the shaft of the instrument. A second suture is placed 0.5-1 cm medial to the first suture. If the holding strength for either suture is considered inadequate, the device is reloaded with the same suture and subsequent bites are taken. The procedure is completed using standard methods. In ten women treated for vaginal vault eversion, lateral dissection was completed in less than 10 minutes, and passage of two sutures through the sacrospinous...
Osteomyelitis associated with using synthetic mesh for laparoscopic sacral colpopexy is rare. We ... more Osteomyelitis associated with using synthetic mesh for laparoscopic sacral colpopexy is rare. We present a patient who developed Staphylococcus sacral osteomyelitis after sacral colpopexy with synthetic mesh and titanium tack fixation to the sacral promontory in the absence of mesh erosion or fistula formation. The patient presented with low back pain 6 weeks postoperatively. Magnetic resonance imaging, bone aspirate, and culture confirmed sacral osteomyelitis and discitis 10 weeks after surgery. The patient underwent 8 weeks of outpatient antibiotic treatment. Six months after surgery, serial laboratory values have demonstrated excellent response to antibiotic treatment, and the patient has clinically improved without the need for mesh removal. We recommend a high index of suspicion for osteomyelitis in patients who present with back pain after sacral colpopexy. Osteomyelitis can occur as a complication of laparoscopic, robotic sacral colpopexy using mesh in the absence of abscess or fistula formation.
... J. Miklos, RD Moore, N. Kohli; Speaker's Bureau: Pfizer: RD Moore, J. Miklos, N. Kohli; ... more ... J. Miklos, RD Moore, N. Kohli; Speaker's Bureau: Pfizer: RD Moore, J. Miklos, N. Kohli; Yamanouchi: RD Moore, J. Miklos; Odyssey: RD Moore, J. Miklos; Ortho McNeil: RD Moore, J. Miklos; Other: Medical Advisory Board-AMS: GW Davila. ... 2005 Lippincott Williams & Wilkins, Inc. ...
... This study was supported by a restricted educational grant from Boston Scientific Corporation... more ... This study was supported by a restricted educational grant from Boston Scientific Corporation. Conflict of Interest: Scott Serels and Lawrence R Lind: speakers and consultants for Boston Scientific Corporation. ... PubMed; CrossRef; Palma P, Riccetto C, Reges R, et al. ...
&NA; The aim of this study was to determine if the method of collection effects preoperative ... more &NA; The aim of this study was to determine if the method of collection effects preoperative antibiotic use. Five hundred fifty (550) patients were included in the study. This retrospective chart review found no difference in antibiotic use based on method of urine collection.
The aim of this study was to investigate factors associated with long-term pessary use in patient... more The aim of this study was to investigate factors associated with long-term pessary use in patients with advanced pelvic organ prolapse (POP). This was a retrospective chart review of patients with POP of stage ≥2 managed with a pessary. Patients were excluded if the date of fitting or follow-up was unavailable. Long-term use was defined as more than 1 year. Patient demographics, pessary fitting, and follow-up visit dates were collected. The primary end point was the duration of use and the prognostic impact of pessary type. Secondary objectives addressed other influencing factors including age, estrogen use, and prolapse stage. The data were analyzed using SPSS version 21. The final analysis included 311 patients. The mean (± standard deviation, SD) duration of pessary use was 7.0 ± 0.72 years (median 5.7 years). Long-term use was found in 76 % (164) of these patients. Factors associated with longer use were age >65 years (p = 0.004) and estrogen use (p = 0.048). The estimated me...
To determine the association between advanced pelvic organ prolapse and changes in lumbar lordosi... more To determine the association between advanced pelvic organ prolapse and changes in lumbar lordosis and/or pelvic inlet orientation. Lateral lumbosacral spine/pelvic x-rays were taken of women with grade 2 or greater uterovaginal prolapse and women with grade 1 or less prolapse standing in their usual upright posture. The angles of lumbar lordosis and the pelvic inlet were measured by a radiologist who was masked to the pelvic examination findings. Twenty women with prolapse were matched with 20 women without significant prolapse. There were no significant differences in the mean (+/- standard deviation [SDI) age (55.3 +/- 9.0 years compared with 53.4 +/- 9.5 years), body mass index (BMI) (28.9 +/- 5.6 compared with 28.4 +/- 5.2), gravidity (5.6 +/- 3.5 compared with 5.0 +/- 2.7), and vaginal parity (4.65 +/- 3.3 compared with 4.5 +/- 2.9) between the prolapse and nonprolapse groups, respectively. All participants were vaginally parous. The mean lumbar lordotic angle in women with pelvic organ prolapse (32.0 degrees +/- 9.8 degrees) was significantly lower than that of controls (42.4 degrees +/- 10.9 degrees) (P < .003). The mean angle of the pelvic inlet in women with pelvic organ prolapse (37.5 degrees +/- 7.0 degrees) was significantly larger than that of controls (29.5 degrees +/- 7.3 degrees) (P < .001). The differences in the mean angles of lumbar lordosis and the pelvic inlet, between the case and control groups, remained significant after multivariable logistic regression was performed. Women with advanced uterovaginal prolapse have less lumbar lordosis and a pelvic inlet that is oriented less vertically than women without prolapse.
A disposable suturing instrument is used in our surgical method for sacrospinous vault suspension... more A disposable suturing instrument is used in our surgical method for sacrospinous vault suspension to facilitate suture placement and retrieval. The pararectal space is dissected and the suturing device is placed just medial to the lateral third of the sacrospinous ligament-coccygeus muscle complex. Depression of the device's firing button advances a standard needle in a controlled circular path through the sacrospinous ligament-coccygeus muscle complex. The needle is retrieved with a straight-needle holder at a consistent location, 3 mm from the shaft of the instrument. A second suture is placed 0.5-1 cm medial to the first suture. If the holding strength for either suture is considered inadequate, the device is reloaded with the same suture and subsequent bites are taken. The procedure is completed using standard methods. In ten women treated for vaginal vault eversion, lateral dissection was completed in less than 10 minutes, and passage of two sutures through the sacrospinous...
Osteomyelitis associated with using synthetic mesh for laparoscopic sacral colpopexy is rare. We ... more Osteomyelitis associated with using synthetic mesh for laparoscopic sacral colpopexy is rare. We present a patient who developed Staphylococcus sacral osteomyelitis after sacral colpopexy with synthetic mesh and titanium tack fixation to the sacral promontory in the absence of mesh erosion or fistula formation. The patient presented with low back pain 6 weeks postoperatively. Magnetic resonance imaging, bone aspirate, and culture confirmed sacral osteomyelitis and discitis 10 weeks after surgery. The patient underwent 8 weeks of outpatient antibiotic treatment. Six months after surgery, serial laboratory values have demonstrated excellent response to antibiotic treatment, and the patient has clinically improved without the need for mesh removal. We recommend a high index of suspicion for osteomyelitis in patients who present with back pain after sacral colpopexy. Osteomyelitis can occur as a complication of laparoscopic, robotic sacral colpopexy using mesh in the absence of abscess or fistula formation.
... J. Miklos, RD Moore, N. Kohli; Speaker's Bureau: Pfizer: RD Moore, J. Miklos, N. Kohli; ... more ... J. Miklos, RD Moore, N. Kohli; Speaker's Bureau: Pfizer: RD Moore, J. Miklos, N. Kohli; Yamanouchi: RD Moore, J. Miklos; Odyssey: RD Moore, J. Miklos; Ortho McNeil: RD Moore, J. Miklos; Other: Medical Advisory Board-AMS: GW Davila. ... 2005 Lippincott Williams & Wilkins, Inc. ...
... This study was supported by a restricted educational grant from Boston Scientific Corporation... more ... This study was supported by a restricted educational grant from Boston Scientific Corporation. Conflict of Interest: Scott Serels and Lawrence R Lind: speakers and consultants for Boston Scientific Corporation. ... PubMed; CrossRef; Palma P, Riccetto C, Reges R, et al. ...
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