D: The ectopic ureter is inserting towards the paravaginal
For more than 100 years, gynecologic surgeons have been taught that the vaginal defects causing anterior and posterior vaginal prolapse result either from generalized midline stretching or thinning of the pubocervical fascia, or from lateral or paravaginal
The 14 chapters describe the etiology and epidemiology of urinary incontinence; selecting interventions for the diagnosed type; anatomy; standard retropubic operations, including the Burch and paravaginal
repairs; bladder neck biologic pubovaginal slings and aspects of tissue harvest and selection; synthetic midurethral slings; voiding dysfunction and retention after procedures; the current status of bulking agents, especially techniques for implantation; surgical interventions for detrusor compliance abnormalities, especially sacral nerve stimulation, botulinum toxin therapy, and bladder augmentation; and the management of mixed incontinence and that associated with pelvic organ prolapse and how to avoid and manage complications related to procedures for stress incontinence.
repair of anterior prolapse with synthetic mesh is associated with a higher anatomic success rate than is xenograft repair; both of these interventions were more successful than standard colporrhaphy, based on interim results of a double-blind, randomized, controlled study.
Anterior Sacrospinous Ligament Fixation Associated with Paravaginal
Repair Using the Pinnacle Device: An Anatomical Study - Renaud de Tayrac, M.
This was followed by paravaginal
repair and lastly use of synthetic mesh for correcting the defects.
The complaint alleges that due to the defective nature of the Gynemesh transvaginal mesh product, she was forced to undergo a second surgery in October 2011 to perform a paravaginal
dissection and to remove the Gynemesh product from the anterior vaginal wall and the paravaginal
However, it is associated with a 40% recurrence rate, and up to 32% even after using concomitant paravaginal
repair with anterior colporrhaphy.
Currently, the Marshall-Marchetti-Krantz (MMK), the needle suspension procedure and paravaginal
defect repair are not recommended for SUI (grade A).
LOUIS - A new surgical approach that addresses the anatomical cause of anterior vaginal wall prolapse has much higher success rates than do standard midline and paravaginal
repairs that simply reduce the bulge, preliminary results in more than 500 patients suggest.
If you have loss of 'rugation' there's a good chance the patient has a lateral compartment defect, a paravaginal
Laparoscopic Colposuspension and Paravaginal