Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_894_Библиотеки_им_академика_М_И_Перельмана.pdf
214
D. R. Sands et al.
vaginal wall support, posterior vaginal wall support, or both. In the rst multicenter case series
of 110 patients, recurrence occurred in 4.7% of
patients and mesh exposure in 4.7% at 3months
[37]. Rapid adoption of the use of these kits
occurred. As the number of patients undergoing these procedures increased dramatically,
reports of complications such as chronic pain,
dyspareunia, and vaginal bleeding increased
[38]. In 2008, the FDA issued a Public Health
Notication due to an increase in the number of
adverse events reported. As the rates of reported
complications reported with transvaginal mesh
continued to increase substantially, the FDA
issued an Updated Safety Notication stating
that serious adverse events are “not rare” and
“transvaginal POP repair with mesh may not
be more effective than traditional non-mesh
repair” [39]. The FDA notication was supported by a large randomized trial by the Nordic
Transvaginal Mesh Group, which involved 389
patients undergoing a transvaginal mesh kit
or traditional anterior colporrhaphy. At 1year
60.8% of women were considered a success by
a composite score in comparison with 34.5% in
the traditional group. The group concluded that
the trocar-guided mesh kit for cystocele repair
resulted in a higher short-term success but also
had higher rates of surgical complications and
postoperative adverse events [40]. These results
have led both the Society of Gynecological
Surgeons and the International Urogynecolgical
Society to publish papers weighing the risks and
benets of mesh augmentation. Unfortunately,
both societies concluded that there was insufcient evidence to guide surgeons in deciding whether the use of graft augmentation was
benecial in the anterior vaginal wall [41, 42].
Since the FDA advisory, numerous companies
halted the production of their rst generation
transvaginal mesh kits. New kits have come to
market from the same process as before while
some companies have halted all production of
transvaginal mesh for prolpase. In 2016, the
FDA again has made changes and now requires
post-market surveillance and has reclassied
these devices from class II to class III based
upon these devices providing a “potential unreasonable risk of illness or injury” [43]. The optimal approach for surgical repair of the anterior
vaginal wall has yet to be determined.
Apical Prolapse
Apical prolapse can occur with the uterus in
situ or after hysterectomy. Per the ICS/IUGA
Joint Terminology, a uterine prolapse is dened
as observation of descent of the uterus or cervix. A vaginal vault prolapse (cuff scar) is
dened as observation of descent of the vaginal vault or cuff scar after hysterectomy [1]. As
described earlier, the levator muscles contribute
to POP. Additionally, the uterosacral ligament
(USL) plays an integral role in providing apical
support. DeLancey labeled this as Level 1 support [29]. The USLs are composed of smooth
muscle cells and collagenous connective tissue
with higher rates of collagen type 3 expression in patients with POP [44]. Compared to
both the round and cardinal ligaments, the USL
is the most rigid pelvic ligament at both low
and high deformation [45]. Distally, the USL
attaches to the cervix posteriorly and laterally
at the level of the internal os. Proximally, the
USL attaches to the presacral fascia between
S2 to S4 [46].
Similarly to anterior vaginal wall prolapse,
non-surgical management should be offered to
all patients which includes observation, pelvic
oor muscle exercises, and pessary placement.
When surgical management is preferred, surgery may be performed vaginally, open, laparoscopically, or robotically. For elderly women
who no longer desire to be sexually active, an
obliterative procedure may be offered. This can
be done with uterine preservation known as a
LeFort colpocleisis. A rectangle of tissue is
removed from both the anterior and posterior
vaginal wall and sewn together creating 2 channels for drainage while elevating the uterus.
When a vaginal vault prolapse is present, the
entire mid and proximal vaginal tissue can be
removed known as a colpectomy. Often the
12 Pelvic Organ Prolapse andPerineal Hernias
215
anterior wall is again sewn to the posterior wall
whereas others may use pursestring sutures. An
aggressive perineorrhaphy is often performed.
Both procedures will leave a normal appearance externally while creating a very narrow
and short vagina. Rates of success have been
reported to be as high as 98% ([47], This is
the largest retrospective study to date, which
reported high anatomical success and patient
satisfaction with LeFort colpocleisis with minimal complication rates.).
Often reconstructive surgery is performed vaginally. The 2 most common native tissue repairs
are the uterosacral ligament suspension (USLS)
and the sacrospinous ligament xation (SSLF).
The USLS is performed by suturing the USL at
the level of the ischial spine or higher. One to
three permanent or delayed absorbable sutures
are used to attach the USL to the vaginal cuff on
each side, therefore suspending the vaginal apex
(Fig. 12.9a). If sutures are brought across from
USL to USL posteriorly, the technique is referred
to as a McCall’s culdoplasty. Success rates range
from 66.8 to 92.4% [48]. Complications related
to this procedure include ureteral occlusion,
which has been reported to vary from 1 to 11%
[49, 50].
The SSLF is performed unilaterally or bilaterally with either permanent or absorbable sutures.
With this approach, the sacrospinous ligament
(SSL) is dissected out via an anterior or posterior vaginal approach. One or more sutures are
then passed under direct visualization or with a
suture-capturing device. In a large study comparing SSLF to USLS, there was no statistically signicant difference with success rates
of 63.1% and 64.5% respectively at 2years as
dened by the apex within the upper 1/3 of the
vaginal length, anterior or posterior wall to the
hymen or within, no bulge symptoms, and no
re-operation for prolapse [51]. Complications of
this procedure include buttock pain, hemorrhage,
ab
Fig. 12.9 Uterosacral ligament suspension (USLS).
(a)One to three permanent or delayed absorbable sutures
are used to attach the USL to the vaginal cuff on each
side, therefore suspending the vaginal apex; (b) A synthetic Y-shaped mesh or two separate strips of monolament polypropylene mesh is commonly used; (c) The
c
mesh is then secured to the vaginal wall with either permanent or delayed absorbable sutures and then secured
to the anterior longitudinal ligament at the sacral promontory or below. Reprinted with permission, Cleveland
Clinic Center for Medical Art & Photography © 2017. All
Rights Reserved
216
D. R. Sands et al.
and recurrent anterior vaginal wall prolapse [52].
Vaginal mesh may also be used to anchor to the
SSL to suspend the vaginal apex while supporting
the anterior vaginal wall. However as described
previously, there is controversy as to whether the
current reported success rates justify the rate of
complications.
Apical vaginal suspension may also be performed via an abdominal approach. This was
begun in 1962 where a graft was used to suspend the vaginal apex to the anterior longitudinal
ligament via a laparotomy [53]. This technique
is now often performed in a minimally invasive
fashion either by laparoscopy or robotic assistance. A synthetic Y-shaped mesh or 2 separate
strips of monolament polypropylene mesh is
commonly used (Fig. 12.9b). Deep dissection
into the vesicovaginal and rectovaginal space is
often performed. The mesh is then secured to the
vaginal wall with either permanent or delayed
absorbable sutures and then secured to the anterior longitudinal ligament at the sacral promontory or below (Fig. 12.9c). Early studies have
shown superior success rates when compared
to vaginal approaches [54]. Although there is a
lack of randomized-controlled trials comparing the minimally invasive sacrocolpopexy to
vaginal approaches, several studies have shown
comparable success rates between open and minimally invasive approaches [55]. Mesh exposure
rates in larger case series have varied. In a comprehensive review it was 3.4% [56].
Enteroceles
Enteroceles are dened as a hernia of peritoneum
and possibly abdominal contents often occurring
after reconstructive surgery. Often this occurs with
widening of the rectovaginal septum. Enteroceles
are associated with other defects in pelvic organ
support. Symptoms of enteroceles often include
pelvic pain, heaviness, or pressure. Many patients
also complain of incomplete emptying of their
bowels [57]. Some patients will complain of a
vaginal bulge whereas others may not.
On physical examination, an enterocele may
be palpated in the rectovaginal septum as the
patient bears down noting widening of the rectovaginal septum. It may also be distinguished
from a rectocele by rectal exam during straining.
Compression of the anterior vaginal wall may
also be appreciated. This may be more noticeable
with the patient in a standing position. Physical
examination may not always detect the presence of an enterocele. Imaging such as dynamic
evacuation proctography (DEP) has been considered the gold standard for functional imaging especially to assess the posterior pelvic oor
compartment. However, dynamic pelvic oor
MRI and dynamic ultrasound are 2 other imaging
modalities that are also proving to be useful in
understanding functional disorders and diagnosing enteroceles [58].
Treatment often involves performing a culdoplasty where the posterior cul-de-sac is
closed often with permanent sutures. Vaginally,
a McCall’s culdoplasty can be performed by
including the vaginal cuff and USL.One or more
sutures are then reefed across the posterior peritoneum through the contralateral USL and other
side of the vaginal cuff. When tied, the cul-desac is obliterated. A Moschowitz culdolplasty
involves a purse-string closure of the peritoneum.
This can be performed abdominally or vaginally
though the original technique is done abdominally as it incorporates the posterior vaginal
wall, peritoneum and taenia of the rectum. Care
must be taken to avoid the ureters. In contrast, a
Halban culdoplasty uses several vertical rows of
sutures starting at the each uterosacral ligament
laterally and traveling distally to the cul-de-sac
incorporating the peritoneum then travelling
back up caudally including the posterior vaginal wall. Several more medial rows of sutures
are placed in a similar fashion including peritoneum or the taenia of the rectum. Figure 12.10
depicts a 41year-old patient with an obstructive
enterocele causing fecal staining and rectal pressure. No vaginal prolapse was noted on exam.
A laparoscopic culdoplasty was performed to
obliterate the cul-de-sac. The patient experienced
12 Pelvic Organ Prolapse andPerineal Hernias
217
Fig. 12.11 Perineal hernia post abdominoperineal resection. Copyright © 2009 by JSLS, Journal of the Society of
Laparoendoscopic Surgeons [60]
Fig. 12.10 A 41-year-old patient with an obstructive
enterocele causing fecal staining and rectal pressure
good functional improvement with at least 1year
of follow-up. Unfortunately, data is lacking in
regards to long-term functional improvement and
anatomic success.
Perineal Hernia
Denition
A perineal hernia is a protrusion of an intraabdominal organ or intraperitoneal tissue through a
defect in the pelvic oor. Perineal hernias can be
congenital, acquired (primary) or postoperative
(secondary) [14, 59].
Primary Perineal Hernia
Primary perineal hernias bulge through congenital weaknesses in the pelvic oor. Their location
can be described as either anterior or posterior
based upon the relation to paired supercial
transverse perineal muscles (Figs. 12.11 and
12.12). Anterior primary perineal hernias occur
only in females and most commonly present as a
mass in the labium majorus. Their contents may
contain small bowel, bladder and colon. Posterior
primary perineal hernias protrude through weakness in the levator plane or between the levator
and coccygeus muscles. Their contents often
contain a portion of sigmoid colon, small bowel
or omentum. Obstruction is a rare occurrence and
occurs as a result of the elasticity of surrounding
tissues and a wide hernia neck. The patient will
present with symptoms such as pain, perineal
pressure and difculty with urination or bowel
movements. On physical examination, there may
be a lump below the lower margin of the gluteus
maximus or a swelling between the anus and
ischial tuberosity [14, 59].
Computer tomography (CT) is especially
important in diagnosis to distinguish between
obturator, sciatic and perineal hernias, in addition
to identifying hernia contents. In a perineal hernia, a CT shows protrusion through the ishiorectal fossa or the labia majora [62].
Secondary Perineal Hernia
Secondary perineal hernia is a weakness in the
endopelvic fascia due to surgically manipulated
218
D. R. Sands et al.
a
c
Fig. 12.12 (a) Preoperative picture showing the perineal
hernia defect; (b) X-ray of the abdominal orthostatic showing hernia; (c) Computed tomography (CT) scan showing
b
the small bowel sliding through the pelvic oor into the perineal area. CT image showing perineal hernia [61]. Copyright
© 2015 by authors and Scientic Research Publishing Inc.
pelvic oor musculature. Herniation of intraabdominal and pelvic organs such as small bowel,
colon and bladder can migrate through this defect
(Fig.12.12) [60, 63].
Contributing factors include multiple pelvic
oor surgeries, therapy or excessive length of
small bowel mesentery. Peri-operative pelvic
radiation is one of the most commonly cited
contributory factors [64]. The reported incidence of postoperative perineal hernia requiring
surgical repair is less than 1% after APR and 3%
after pelvic exenteration [63]. However, prevalence in the literature is variable and ranges
from 0.6–7% [64].
Symptoms include perineal pressure, fullness,
discomfort, bowel obstruction, skin breakdown
or evisceration. The most commonly reported
symptom of secondary perineal hernia is discomfort during sitting.
Physical examination should demonstrate
a perineal bulge with bowel sounds. If the
examination is not as straightforward, CT imaging can be helpful to establish a diagnosis and
differentiate a perineal hernia from a locally
recurrent tumor (Fig. 12.12). There are many
operative techniques for repair of perineal hernias including perineal, open and combined
abdominoperineal approach, and lapaoroscopic
transabdominal repair. The repair is challenging,
as the recurrence rate has been reported to be as
high as 37% [64].
Types ofRepair (Table12.1) [73]
Transabdominal Repair
This approach is best for those with recurrent
hernias, or in those that merit a laparotomy for
12 Pelvic Organ Prolapse andPerineal Hernias
Table 12.1 Overview of the literature on perineal hernia repair
Author No patients Perineal Abdominal Combined Mesh Recurrence (%) Preference
So etal. 1997 [65] 21 13 3 3 5 14 Perineal
Ego-Aguirre etal. 1964 [66] 9 8 1 0 4 44 Perineal
Aboian etal. 2006 [67] 8 4 4 0 4 0 No
Beck etal. 1987 [68] 8 2 6 0 6 37 Abd
Dulucq etal. 2006 [69] 4 0 4 (lap) 0 4 25 Abd (lap)
De Campos etal. 2005 [70] 3 1 2 0 0 0 No
Villar etal. 2003 [71] 3 0 3 0 3 33 No
Veenhof etal. 2007 [72] 2 0 2 0 2 0 Abd
Rayhanabad etal. 2009 [60] 2 0 2 (lap) 0 1 0 Abd (lap)
Abbas etal. 2014 [64] 7 1 6 (lap 5) 0 4 0 Abdominal
(Lap)
Abd abdominal, lap laparoscopic
219
some other reason. In this approach, the patient
is placed in Lloyd-Davies position and a midline laparotomy is performed. Herniated organs,
including small bowel or bladder are dissected
and freed from their adhesions. The ureters, bladder and prostate (or vagina) are identied and
protected.
A large nonabsorbable propylene mesh is
placed across the defect and xed to the lateral
sacrotuberal ligaments with interrupted sutures.
Care is taken to avoid the large pelvic vessels.
During this process, an obturator may be placed
into the vagina through the perineum to help identify the vaginal cuff. Any remaining omentum is
placed over the mesh. This reduces the chance of
bowel adhering to or eroding into the mesh. Many
different sources describe where anatomically to
anchor sutures. There is currently no consensus
agreement. Beck & Wexner describe the attachment of posterior mesh to Waldeyer’s fascia and
sacral periosteum at or below level of S3; anteriorly, the mesh is sutured to the vagina or prostatic
capsule, and laterally fascia of the pelvic sidewall
and ligamentous structures are used to anchor the
mesh (Fig.12.13) [14, 67, 73].
The laparoscopic transabdominal approach
can offer some advantages over the open transabdominal approach, however there are few reports
describing this technique. The anatomic structures can be seen more clearly, and with this better
visualization, tumor recurrence is easier to iden-
tify. Dulucq etal. describe a prospective study of
four patients undergoing a laparoscopic transabdominal approach, where patients were able to be
fed orally and were completely mobile the day
following the procedure. Technique described
includes pneumoperitoneum established through
a hasson trocar. The rst trocar placed at the right
mammarian line. The camera port should be
placed 3cm below the umbilicus, and three additional 5mm trocars placed suprapubic, umbilicus
and right lower abdomen. After the abdomen was
surveyed for tumor recurrence, the defect was
repaired using a mesh arranged in the shape of
the pelvic outlet by suturing the edges. The mesh
is xed laterally to the border of the levator muscle, anteriorly to the posterior face of the vagina
with nonabsorbable sutures, and posteriorly with
tacks to the sacral periosteum [69]. Abbas et al.
reviewed 7 perineal hernias after abdominoperineal resection over 6year time period, 6 treated
with transabdominal approach and one perineal
approach. They concluded that the laparoscopic
mesh repair was the preferred approach with no
recurrences noted [64].
Laparoscopic Repair
The use of laparoscopic transabdominal technique offers several advantages in comparison to
the two alternative techniques (Table12.2). This
approach facilitates a clear view of anatomic
structures, helps to exclude tumor recurrence, and
220
ab
D. R. Sands et al.
c
Fig. 12.13 Perineal hernia. (a) Sagital section of the
pelvis demonstrating a perineal hernia with incarcerated small bowel. (b) Sagital section of the pelvis with
Table 12.2 Review of Laparoscopic Repairs
Author/year No of patients Type of mesh Recurrence (%)
Dulucq etal. 2006 [69] 4 Composite polypropylene 25
Rayhanabad etal. 2009 [60] 2 Composite ½ 0
Casasanta etal. 2012 [74] 1 Marlex 0
Svabe etal. 2012 [75] 1 Permacol biological 0
Abbas etal. 2014 [64] 5 Composite mesh 0
patients enjoyed a hasty recovery. In a case series
of 4 patients undergoing laparoscopic repair of
postoperative perineal hernia from 2003–2004.
Their approach involved a 12 mm trocar at the
right mammarian line, 3cm below the umbilicus,
mesh in place. (c) View of the pelvis from above with
mesh in place (A, common iliac artery; V, common iliac
vein; U, ureter)
which served as the camera port. In addition, 3
additional 5mm trocars were placed; one suprapubic and the other trocars in the right lower
quadrant. The defect was repaired with a composite mesh shaped into a concave form by sutur-
12 Pelvic Organ Prolapse andPerineal Hernias
221
ing the edges to the t the shape of the pelvic
outlet. The mesh was sutured laterally to the levator muscle, anteriorly to the posterior surface of
the vagina with nonabsorbable sutures, and posteriorly with tacks (Protack Norwalk, CT) to the
sacral periostium. Patients in their case series did
well with minimal blood loss, average length of
hospital satay was 4days and at 6months, their
results showed no hernia recurrence [69].
Perineal Repair
Other techniques of perineal hernia repair include
the perineal approach.
The patient is placed in lithotomy or trendelenburg position and a skin incision is created over
the perineal bulge. Once the sac is entered, its
contents are reduced and the sac is excised. The
hernia defect is then closed using nonabsorbable
sutures [59]. Many critics of this approach argue
that exposure is limited. Not only is there the risk
of missing a tumor recurrence, but if bleeding or
bowel injury is encountered, it becomes much
more challenging to x [14, 59, 64].
Many other techniques have been described to
repair the pelvic defect and further strengthen the
weakened pelvic oor. So etal. advocated for a
simple closure of the pelvic defect by approximating the levators with a nonabsorbable suture [65,
69]. One of the editors (SDW) prefers a perineal
repair with mesh as shown in (Fig. 12.14). Gluteal
aps are mobilized to cover the mesh [76].
Hansen et al. describes reinforcement with a
gracilis myocutaneous ap [77]. Other ap options
include vertical rectus abdominis myocutaneous
(VRAM) ap (Figs.12.15, 12.16, and 12.17) [78,
79] or gluteal ap (Fig.12.18) [80].
Fig. 12.15 VRAM myocutaneous ap being delivered
Fig. 12.14 Perineal view
Fig. 12.16 VRAM myocutaneous ap in place
222
Fig. 12.17 VRAM ap without a cutaneous component
being placed
Fig. 12.18 Medical portions of the gluteal muscles being
harvested with the patient in the prone-jackknife position
Summary
The pelvic oor represents a complex anatomic
region, which is prone to laxity, herniation and
prolapse. Often, treatment will require a multidisciplinary approach with input from colorectal surgeons, urogynecologists and urologists.
D. R. Sands et al.
A thorough understanding of the anatomic
decit combined with its functional signicance is imperative when contemplating invasive interventions. Excellent functional results
are incumbent on the surgeon correlating the
patients symptoms with the anatomic ndings.
Numerous approaches are available to correct pelvic oor decits and should be tailored
to the individual patient taking into account
the need for a team approach and also their
comorbidities.
References
1. Haylen BT, Maher CF, Barber MD, Camargo S,
Dandolu V, Digesu A, Goldman HB, Huser M,
Milani AL, Moran PA, Schaer GN, Withagen
MI.An International Urogynecological Association
(IUGA)/International Continence Society (ICS)
joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J.
2016;27(2):165–94.
2. Wu JM, Vaughan CP, Goode PS, Redden DT, Burgio
KL, Richter HE, Markland AD.Prevalence and trends
of symptomatic pelvic oor disorders in U.S. women.
Obstet Gynecol. 2014;123:141–8.
3. Swift SE. The distribution of pelvic organ support
in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol.
2000;183:277–85.
4. Olsen AL, Smith VJ, Bergstrom JO, Colling JC,
Clark AL.Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet
Gynecol. 1997;89:501–6.
5. Dietz HP.The aetiology of prolapse. Int Urogynecol J
Pelvic Floor Dysfunct. 2008;19:1323–9.
6. Jelovsek JE, Maher C, Barber MD.Pelvic organ pro-
lapse. Lancet. 2007;369:1027–38.
7. Baden W. Surgical repair of vaginal defects. In:
Book surgical repair of vaginal defects. Philadelphia:
Lippincott; 1992.
8. Bump RC, Mattiasson A, Bo K, etal. The standardiza-
tion of terminology of female pelvic organ prolapse
and pelvic oor dysfunction. Am J Obstet Gynecol.
1996;175:10–7.
9. Beck D, Allen N.Rectocele. Clin Colon Rectal Surg.
2010;23:90–8.
10. Evetts B, Billingham R. Current Therapy in colon
and rectal surgery. 2nd ed. St. Louis: Mosby; 2005.
p.148–51.
11. Lefevre R, Davila GW. Functional disorders: recto-
cele. Clin Colon Rectal Surg. 2008;21:129–37.
12. Mellgren A, etal. Recocele. In: Wexner SD, Zbar AP,
Pescatori M, editors. Complex anorectal disorders:
12 Pelvic Organ Prolapse andPerineal Hernias
223
investigation and management. London: Springer;
2005. p.446–60.
13. Persu C, et al. Pelvic Organ Prolapse Quantication
System (POP-Q)—a new era in pelvic prolapse staging. J Med Life. 2001;4(1):75–81.
14. Beck DE, Wexner SD, editors. Fundamentals of anorectal surgery. NewYork: McGraw-Hill; 1992.
15. Mimura T, et al. Treatment of impaired defecation
associated with rectocele by behavioral training. Dis
Colon Rectum. 2000;43(9):1267–72.
16. Paraiso MF, Barber MD, Muir TW, Walters
MD.Rectocele repair: a randomized trial of 3 surgical
techniques including graft augmentation. Am J Obstet
Gynecol. 2006;195(6):1962–771.
17. Kahn MA, Stanton SL. Posterior colporrhaphy: its
effects on bowel and sexual dysfunction. Br J Obstet
Gynaecol. 1997;104(1):82–6.
18. Glavind K, Madsen H. A prospective study of the
discrete fascial defect rectocele repair. Acta Obstet
Gynecol Scan. 2000;79:145–7.
19. Singh K, Cortes E, Reid WM. Evaluation of the
fascial technique for surgical repair of isolated
posterior vaginal wall prolapse. Obstet Gynecol.
2003;101:320–4.
20. Farid M, et al. Randomized controlled trial between
perineal and anal repairs in obstructed defecation.
World J Surg. 2010;34:822–9.
21. Hammond K, Ellis N.Outcome after transanal repair
of rectoceles. Dis Colon Rectum. 2010;53:1.
22. Maher C, Feiner B, Baessler K, Schmid C. Surgical
management of pelvic organ prolapse in women.
Cochrane Database Syst Rev. 2013;4:CD004014.
23. Thornton M, Lam A, King D.Laparoscopic or transanal repair of rectocele? A retrospective matched
cohort study. Dis Colon Rectum. 2005;48:792–8.
24. Cystocele. Collins English Dictionary—complete &
unabridged, 10th ed. n.d. Dictionary.com. Retrieved 5
Mar 2016.
25. Chen L, etal. Interaction among apical support, levator ani impairment, and anterior vaginal wall prolapse.
Obstet Gynecol. 2006;108(2):324–32.
26. Lowder JL, etal. The role of apical vaginal support in
the appearance of anterior and posterior vaginal prolapse. Obstet Gynecol. 2008;111(1):152–7.
27. Lamblin G, et al. Cystocele and functional anatomy
of the pelvic oor: review and update of the various
theories. Int Urogynecol J. 2016;27:1297–305.
28. De Landsheere L, Munaut C, Nusgens B, Maillard C,
Rubod C, Nisolle M, etal. Histology of the vaginal
wall in women with pelvic organ prolapse: a literature
review. Int Urogynecol J. 2013;24:2011–20.
29. DeLancey JO. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol.
1992;166:1717–24.
30. Petros P, Ulmsten U. An integral theory of female
urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand. 1990;153:
7–31.
31. Weber AM, Walters MD, Piedmonte MR, Ballard
LA. Anterior colporrhaphy: a randomized trial of
three surgical techniques. Am J Obstet Gynecol.
2001;185(6):1299–304. discussion 1304–6.
32. Sand PK, Koduri S, Lobel RW, Winkler HA,
Tomezsko J, Culligan PJ, Goldberg R.Prospective
randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J
Obstet Gynecol. 2001;184(7):1357–62. discussion
1362–4.
33. Maher C. Anterior vaginal compartment surgery. Int
Urogynecol J. 2013;24(11):1791–802. https://doi.
org/10.1007/s00192-013-2170-3.
34. Hurtado EA, Bailey HR, Reeves KO. Rectal erosion
of synthetic mesh used in posterior colporrhaphy
requiring surgical removal. Int Urogynecol J Pelvic
Floor Dysfunct. 2007;18(12):1499–501.
35. Yamada BS, Govier FE, Stefanovic KB, Kobashi
KC. Vesicovaginal stula and mesh erosion after
Perigee (transobturator polypropylene mesh anterior
repair). Urology. 2006;68(5):1121. e5–7.
36. Hiltunen R, Nieminen K, Takala T, Heiskanen E,
Merikari M, Niemi K, Heinonen PK. Low-weight
polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol.
2007;110(2 Pt 2):455–62.
37. Fatton B, Amblard J, Debodinance P, Cosson M,
Jacquetin B.Transvaginal repair of genital prolapse:
preliminary results of a new tension-free vaginal
mesh (Prolift technique)—a case series multicentric study. Int Urogynecol J Pelvic Floor Dysfunct.
2007;18(7):743–52.
38. Hurtado EA, Appell RA.Management of complications arising from transvaginal mesh kit procedures: a
tertiary referral center's experience. Int Urogynecol J
Pelvic Floor Dysfunct. 2009;20(1):11–7.
39. Jacoby VL, Subak L, Waetjen LE.The FDA and the
vaginal mesh controversy-further impetus to change
the 510(k) pathway for medical device approval.
JAMA Intern Med. 2016;176(2):277–8.
40. Väyrynen T, Engh ME, Axelsen S, Falconer C, Nordic
Transvaginal Mesh Group. Anterior colporrhaphy
versus transvaginal mesh for pelvic-organ prolapse. N
Engl J Med. 2011;364(19):1826–36.
41. Sung VW, Rogers RG, Schaffer JI, Balk EM, Uhlig
K, Lau J, Abed H, Wheeler TL 2nd, Morrill MY,
Clemons JL, Rahn DD, Lukban JC, Lowenstein
L, Kenton K, Young SB, Society of Gynecologic
Surgeons Systematic Review Group. Graft use in
transvaginal pelvic organ prolapse repair: a systematic review. Obstet Gynecol. 2008;112(5):1131–42.
42. Davila GW, Baessler K, Cosson M, Cardozo
L.Selection of patients in whom vaginal graft use
may be appropriate. Consensus of the 2nd IUGA
grafts roundtable: optimizing safety and appropriateness of graft use in transvaginal pelvic reconstructive surgery. Int Urogynecol J. 2012;23(Suppl
1):S7–14.
43. Food and Drug Administration, HHS.Obstetrical and
gynecological devices; reclassication of surgical
mesh for transvaginal pelvic organ prolapse repair;
nal order. Fed Regist. 2016;81(2):353–61.