The Australian & New Zealand journal of obstetrics & gynaecology, 2018
The use of neuromodulation is growing and it is an established therapy for conditions such as bla... more The use of neuromodulation is growing and it is an established therapy for conditions such as bladder dysfunction. It is an increasingly used therapy for the management of chronic perineal pain but little research is currently available looking at its efficacy. We present a series of 52 patients who underwent placement of a neuromodulator, the majority of whom suffered from perineal pain, with most placements via the sacral hiatus. Patients were asked to complete a survey recalling their symptoms prior to implantation and describing their symptoms and experience after. The majority had two leads placed via the sacral hiatus. Fifty-two patients had implantation of a permanent neuromodulator and 44 completed at least part of the survey. Forty-eight had leads placed via the sacral hiatus, 29 of whom had these leads only. Forty patients had perineal pain as an indicator and 32 reported that their pain improved; this difference was statistically significant (95% CI: 2.60-4.27, P < 0.0...
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2016
To assess the gastrointestinal functional outcomes and symptoms of low anterior resection syndrom... more To assess the gastrointestinal functional outcomes and symptoms of low anterior resection syndrome after disc resection for deeply infiltrative endometriosis (DIE) using a validated scoring system. Retrospective study to assess the gastrointestinal functional outcomes after rectal disc resection for DIE using a validated scoring system. University tertiary referral centre. Women who underwent disc resection for endometriosis at Royal Hospital for Women and Prince of Wales Private Hospital between January 2012 and December 2013 were included. Low anterior resection syndrome (LARS) score using a validated questionnaire. Forty-one women met the inclusion criteria. The mean age was 40 ± 10 years (range 22-75 years). All procedures were performed laparoscopically. Eleven women (27%) underwent a hysterectomy in addition to rectal disc resection and endometriosis surgery. Mean operative time for the entire cohort was 158 ± 64 minutes, and mean length of hospital stay was 5 ± 2 days. Completed questionnaires were received from 31 women, a response rate of 76%. The mean length of follow-up was 17 ± 10 months (range 3-34 months). The LARS scores ranged from 0 to 34 (median 15, interquartile range 0-24). Eight women (26%) had a LARS score of 0. Nineteen women (61%) had a LARS score less than 21 (the threshold for LARS). Conservative treatment of DIE with rectal disc resection is safe and feasible and is associated with mild gastrointestinal dysfunction in the medium to long term.
To evaluate placement efficacy and reliability of a an intratubal occlusion device for permanent ... more To evaluate placement efficacy and reliability of a an intratubal occlusion device for permanent contraception and to assess tolerability and overall satisfaction. Seven hundred seventy women with known parity were recruited to participate in a prospective, multicenter study. Bipolar, low-level radiofrequency energy delivery and porous silicon inserts were used. Inserts were placed bilaterally in the fallopian tube lumen. Subsequent bilateral occlusion was assessed with hysterosalpingography. Overall, bilateral placement success was achieved in 611 of 645 women (95%). Bilateral occlusion was confirmed in 570 of 645 (88.4%). The 1-year pregnancy prevention rate as derived with life-table methods was 98.9%. This transcervical sterilization system offers an effective contraceptive method, which was well tolerated and had a high satisfaction rate. III.
The Australian & New Zealand journal of obstetrics & gynaecology, 2018
The use of neuromodulation is growing and it is an established therapy for conditions such as bla... more The use of neuromodulation is growing and it is an established therapy for conditions such as bladder dysfunction. It is an increasingly used therapy for the management of chronic perineal pain but little research is currently available looking at its efficacy. We present a series of 52 patients who underwent placement of a neuromodulator, the majority of whom suffered from perineal pain, with most placements via the sacral hiatus. Patients were asked to complete a survey recalling their symptoms prior to implantation and describing their symptoms and experience after. The majority had two leads placed via the sacral hiatus. Fifty-two patients had implantation of a permanent neuromodulator and 44 completed at least part of the survey. Forty-eight had leads placed via the sacral hiatus, 29 of whom had these leads only. Forty patients had perineal pain as an indicator and 32 reported that their pain improved; this difference was statistically significant (95% CI: 2.60-4.27, P < 0.0...
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2016
To assess the gastrointestinal functional outcomes and symptoms of low anterior resection syndrom... more To assess the gastrointestinal functional outcomes and symptoms of low anterior resection syndrome after disc resection for deeply infiltrative endometriosis (DIE) using a validated scoring system. Retrospective study to assess the gastrointestinal functional outcomes after rectal disc resection for DIE using a validated scoring system. University tertiary referral centre. Women who underwent disc resection for endometriosis at Royal Hospital for Women and Prince of Wales Private Hospital between January 2012 and December 2013 were included. Low anterior resection syndrome (LARS) score using a validated questionnaire. Forty-one women met the inclusion criteria. The mean age was 40 ± 10 years (range 22-75 years). All procedures were performed laparoscopically. Eleven women (27%) underwent a hysterectomy in addition to rectal disc resection and endometriosis surgery. Mean operative time for the entire cohort was 158 ± 64 minutes, and mean length of hospital stay was 5 ± 2 days. Completed questionnaires were received from 31 women, a response rate of 76%. The mean length of follow-up was 17 ± 10 months (range 3-34 months). The LARS scores ranged from 0 to 34 (median 15, interquartile range 0-24). Eight women (26%) had a LARS score of 0. Nineteen women (61%) had a LARS score less than 21 (the threshold for LARS). Conservative treatment of DIE with rectal disc resection is safe and feasible and is associated with mild gastrointestinal dysfunction in the medium to long term.
To evaluate placement efficacy and reliability of a an intratubal occlusion device for permanent ... more To evaluate placement efficacy and reliability of a an intratubal occlusion device for permanent contraception and to assess tolerability and overall satisfaction. Seven hundred seventy women with known parity were recruited to participate in a prospective, multicenter study. Bipolar, low-level radiofrequency energy delivery and porous silicon inserts were used. Inserts were placed bilaterally in the fallopian tube lumen. Subsequent bilateral occlusion was assessed with hysterosalpingography. Overall, bilateral placement success was achieved in 611 of 645 women (95%). Bilateral occlusion was confirmed in 570 of 645 (88.4%). The 1-year pregnancy prevention rate as derived with life-table methods was 98.9%. This transcervical sterilization system offers an effective contraceptive method, which was well tolerated and had a high satisfaction rate. III.
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