Online citations, reference lists, and bibliographies.
Referencing for people who value simplicity, privacy, and speed.
Get Citationsy
← Back to Search

New Ambulatory Surgical Methods Using An Anatomical Classification Of Urinary Dysfunction Improve Stress, Urge And Abnormal Emptying

P. E. Papa Petros
Published 1997 ·

Save to my Library
Download PDF
Analyze on Scholarcy Visualize in Litmaps
Share
Reduce the time it takes to create your bibliography by a factor of 10 by using the world’s favourite reference manager
Time to take this seriously.
Get Citationsy
The aim of the study was to introduce an anatomical classification for the management of urinary dysfunction based on the Integral Theory, a new connective tissue theory for female incontinence. Eighty-five unselected patients, aged 27–83 years, 12 with pure stress symptoms and 73 with mixed incontinence symptoms, were classified as having laxity in the anterior, middle or posterior zones of the vagina, using specific symptoms, signs and urodynamic parameters summarized in a pictorial algorithm. Special ambulatory surgical techniques, which included the creation of neoligaments, repaired specific connective tissue defects in the anterior (intravaginal slingplasty (IVS),n=85), middle (cystocele repair,n=6), or posterior zones (uterine prolapse repair,n=31, or infracoccygeal sacropexy,n=33). Almost all patients were discharged within 24 hours of surgery, without postoperative catheterization, returning to fairly normal activities within 7–14 days. At (mean) 21-month follow-up cure rates were: stress incontinence 88% (n=85), frequency 85% (n=42), nocturia 80% (n=30), urge incontinence 86% (n=74), emptying symptoms 50% (n=65). Mean objective urine loss (cough stress test) was reduced from 8.9 g preoperatively to 0.3 g postoperatively, and mean residual urine >50 ml from 110 ml to 63 ml,P=<0.02. Pre- and postoperative urodynamics indicated that detrusor instability was not associated with surgical failure. Two new directions, based on the Integral Theory, are presented for the management of female urinary dysfunction, an anatomical classification which delineates three zones of vaginal damage, and a series of ambulatory surgical operations which repair these defects. The operations are fairly simple, safe, effective and easily learnt by any practising gynecologist.



This paper is referenced by
10.3126/NJOG.V2I2.1446
Surgical treatment of vaginal vault prolapse
Mij Withagen (2008)
10.1007/s00192-004-1221-1
Voiding dysfunction after tension-free vaginal tape: a conservative approach is often successful
V. Mishra (2004)
10.1016/j.ejogrb.2010.12.005
Risk factors for surgical failure after posterior intravaginal slingplasty: a case series.
H. Chen (2011)
10.17816/JOWD66146-55
Vaginal vault reconstruction and apical sling in the treatment of post-hysterectomy prolapsE
D. Shkarupa (2017)
10.1007/s00192-006-0262-z
Conservation of the prolapsed uterus is a valid option: medium term results of a prospective comparative study with the posterior intravaginal slingoplasty operation
M. Neuman (2006)
10.1016/S0140-6736(05)73878-2
Nitric oxide in neonates
S. Dursun (2000)
Comparison to sacrospinous fixation versus infracoccygeal sacropexy in vaginal vault prolapse at 2-year follow-up
Edgardo Castillo-Pino (2019)
Tension-free tape IVS (intravaginal sling) in surgical treatment of urinary stress incontinence – first experience
E. Właźlak (2003)
10.1007/s10397-008-0388-8
Functional outcomes of posterior intravaginal slingplasty: report on its impact on urinary, bowel and psychosexual function
R. Oliver (2008)
10.1007/s00192-010-1322-y
Comparison of alpha-blocker, extracorporeal magnetic stimulation alone and in combination in the management of female bladder outlet obstruction
J. Koh (2010)
Pelviperineology September 2015 Issue
A. S. (2015)
10.4111/KJU.2006.47.3.263
Efficacy of Posterior IVS for the Patients with Vaginal Vault and Uterine Prolapse
D. Y. Kim (2006)
10.1007/s00192-010-1209-y
Pelvic organ prolapse quantification in women referred with overactive bladder
Zhengyong Yuan (2010)
10.17816/JOWD67355-63
Vaginal apical and anterior reconstruction using ultralight weight mesh: two-year follow-up
D. Shkarupa (2018)
10.1007/PL00004010
An Anatomical Classification – a New Paradigm for Management of Urinary Dysfunction in the Female
P. E. Papa Petros (1999)
10.1007/s00192-003-1060-5
The anatomy of midurethral slings and dynamics of neurovascular injury
S. Abbas Shobeiri (2003)
10.1007/s00192-004-1122-3
Synergistic non-surgical management of pelvic floor dysfunction: second report
P. M. Skilling (2004)
10.1007/s11255-005-8575-2
The surgical results of the pubovaginal sling procedure using Intravaginal Slingplasty (IVS) for stress urinary incontinence
Erem Kaan Basok (2005)
10.1007/s00192-007-0513-7
The surgical anatomy of rectocele and anterior rectal wall intussusception
B. Abendstein (2007)
10.1007/s00345-013-1150-z
The Integral Theory System Questionnaire: an anatomically directed questionnaire to determine pelvic floor dysfunctions in women
F. Wagenlehner (2013)
Chronic pelvic pain and uterosacral ligaments : a systematic review
D. Badiu (2019)
10.1097/MOU.0000000000000395
Current treatment of pelvic organ prolapse correlated with chronic pelvic pain, bladder and bowel dysfunction
B. Liedl (2017)
Clinical Study Posterior Intravaginal Slingplasty versus Unilateral Sacrospinous Ligament Fixation in Treatment of Vaginal Vault Prolapse
Virva Nyyssönen (2015)
10.1007/s00192-008-0647-2
Why do stress and urge incontinence co-occur much more often than expected?
V. Minassian (2008)
اینفرا کوکسیژئال ساکروپکسی در پرولاپسهای درجه ΙΙΙ و VΙ لگنی: یک مطالعه آیندهنگر
زینت قنبری (2007)
10.1007/s10397-005-0168-7
Posterior intravaginal slingplasty for vault and uterovaginal prolapse: an initial experience
R. Oliver (2005)
10.1007/s00192-011-1442-z
The comparison of the anatomical and symptomatic outcomes of sacrocolpopexy and posterior intravaginal slingoplasty
Ahmet Akin Sivaslioglu (2011)
10.4067/S0717-75262005000300007
PROMONTOFIJACIÓN VERSUS IVS POSTERIOR EN EL TRATAMIENTO DE LOS PROLAPSOS APICALES
Carlos Rondini F-D. (2005)
Surgical cure of chronic pelvic pain , associated bladder & bowel symptoms by posterior sling in 198 patients validates the Pescatori Iceberg principle of pelvic symptom co-occurrence
K. Goeschen (2016)
10.1007/s001920050059
Cure of Urinary and Fecal Incontinence by Pelvic Ligament Reconstruction Suggests a Connective Tissue Etiology for Both
P. Petros (1999)
10.1007/s00404-002-0429-x
Hypermobility syndrome in 105 women with pure urinary stress incontinence and in 105 controls
A. Karan (2004)
10.4067/S0717-75262004000600003
IVS POSTERIOR (POSTERIOR INTRAVAGINAL SLINGPLASTY) PARA EL TRATAMIENTO DE PROLAPSO DE CÚPULA VAGINAL O PROCIDENCIA DE ÚTERO: SERIE DE CASOS
R. AlfredoSilva (2004)
See more
Semantic Scholar Logo Some data provided by SemanticScholar