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Urethral Prolapse

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1. Opioid Prescription and Usage in Sacral Neuromodulation, Mid-Urethral Sling, and Pelvic Organ Prolapse Surgery: An Educational Intervention to Avoid Overprescribing. (PubMed)

Opioid Prescription and Usage in Sacral Neuromodulation, Mid-Urethral Sling, and Pelvic Organ Prolapse Surgery: An Educational Intervention to Avoid Overprescribing. The opioid problem has reached epidemic proportions and the prescription of opioids after surgery can lead to chronic use. We explored prescribing patterns and opioid use after 3 pelvic floor surgeries (sacral neuromodulation, prolapse repair and mid urethral sling) before and after an educational intervention to reduce opioid (...) the intervention. A multiple regression model was used to identify factors associated with variability in opioid use.Our retrospective review showed that the 122 patients were prescribed 149%, 165% and 136% more mean morphine mg equivalents than were actually used for sacral neuromodulation, mid urethral sling and prolapse repair, respectively. After the educational intervention there was a significant reduction in morphine mg equivalents prescribed for all 3 surgeries in 78 patients (p <0.001). Diabetes (p

2019 Journal of Urology

2. Changes in urethral mobility and configuration after prolapse repair. (PubMed)

Changes in urethral mobility and configuration after prolapse repair. To evaluate changes in urethral mobility and configuration after prolapse repair.This was a retrospective study of 92 patients who were examined between 2005 and 2016 before and after surgery for pelvic organ prolapse (POP) without concomitant anti-incontinence surgery. All patients were assessed with an interview, POP quantification and translabial four-dimensional ultrasound. Urethral mobility was evaluated using semi (...) -automated urethral motion profile software in which x- and y-coordinates of six equidistant points along the length of the urethra were determined both at rest and on Valsalva, relative to the posteroinferior margin of the pubic symphysis. Urethral kinking was measured by placing tangents distal and proximal to any visually identified change in the urethral axis. Imaging data obtained before and after prolapse surgery were compared.Mean age was 58 years and mean follow-up was 5.8 months. Prolapse

2018 Ultrasound in Obstetrics and Gynecology

3. Urinary incontinence and pelvic organ prolapse in women: management

(https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 11 of 72urge-predominant mixed urinary incontinence or urinary incontinence in which the type is unclear symptoms suggestive of voiding dysfunction anterior or apical prolapse a history of previous surgery for stress urinary incontinence. [2019] [2019] T o find out why the committee made the 2019 recommendations on urodynamic testing and how they might affect practice, see rationale and impact. Other tests of urethr Other tests (...) . [2006] [2006] Indications for referr Indications for referral to a specialist service al to a specialist service 1.3.20 In women with urinary incontinence, indications for consideration for referral to a specialist service include: persisting bladder or urethral pain palpable bladder on bimanual or abdominal examination after voiding clinically benign pelvic masses associated faecal incontinence Urinary incontinence and pelvic organ prolapse in women: management (NG123) © NICE 2019. All rights

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

4. Urethral Prolapse

Urethral Prolapse Urethral Prolapse Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Urethral Prolapse Urethral Prolapse Aka: Urethral (...) Prolapse , Prolapsed Urethral Mucosa II. Epidemiology Typically occurs in girls, at ages 2-5 years old More common in african american children III. Pathophysiology Low state at and vagina IV. Symptoms l bleeding Provocative ( , cough) V. Signs appears beefy red and friable VI. Differential Diagnosis VII. Management Manual reduction is NOT needed Treat Apply daily a small amount olf (e.g. , ) to l area Similar management as VIII. References Claudius and Willner in Herbert (2019) EM:Rap 19(1): 2-4

2019 FP Notebook

5. Urethral prolapse corrected by microsurgery in a cat: a case report (PubMed)

Urethral prolapse corrected by microsurgery in a cat: a case report Urethral prolapse is a rare condition in dogs and cats. A 7-month-old male cat presented with intermittent penile bleeding and a red mass protruding from the tip of the penis. Urethral prolapse was diagnosed by using a surgical microcamera to examine the genital area. Urethroplasty and preputial advancement surgery were performed using a surgical microscope, to successfully correct the urethral prolapse.

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2017 The Journal of Veterinary Medical Science

6. Giant Ureteral Fibroepithelial Polyp with Intermittent Prolapse Reaching the Urethral Meatus: A Case Report (PubMed)

Giant Ureteral Fibroepithelial Polyp with Intermittent Prolapse Reaching the Urethral Meatus: A Case Report Ureteral fibroepithelial polyps (UFPs) are rare non-epithelial benign tumors of the urinary tract. Treatment of such cases ranges from conservative management to surgical resection of the polyp. Hereby, we present a rare case of a 37-year-old female patient with giant 14 cm UFP of the distal left ureter, successfully resected by ureteroscopic electrocauterization. Several cases of UFPs (...) have been previously reported in world literature describing polyps extending into the bladder; yet, our case is the first to present a giant UFP that extends beyond the bladder cavity protruding outside the urethral meatus as a red fleshy mass.

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2017 Urology case reports

7. Diagnosis and treatment of urethral prolapse in children: 16 years’ experience with 89 Chinese girls (PubMed)

Diagnosis and treatment of urethral prolapse in children: 16 years’ experience with 89 Chinese girls To review our experience and results in the diagnosis and treatment of urethral prolapse (UP) in Chinese girls.We conducted a retrospective chart review of 89 consecutive girls (aged <16 years) with UP and without other complications, who received treatment for UP from January 1999 to January 2015 (a study period of 16 years) at the Children's Hospital of Chongqing Medical University, China (...) . Data analysed included: age, symptoms, clinical findings, predisposing factors, management, and outcomes.The presenting symptoms in the 89 girls were: mass (54 girls), bleeding (34), and dysuria/straining at micturition (one). In all, 14 patients received conservative treatment as their symptoms were mild, and 75 were successfully treated by excision of the prolapsed urethral mucosa or ligation over a Foley catheter, as their symptoms were severe and recurred too frequently to be managed

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2017 Arab journal of urology

8. A Very Unlikely Finding in a Male Child: Urethral Prolapse (PubMed)

A Very Unlikely Finding in a Male Child: Urethral Prolapse Urethral prolapse is a disease of prepubertal black girls and postmenopausal women with an unknown cause. It may be congenital in origin or an acquired condition. It has never been reported in males. We report a 10-year-old Caucasian boy who presented because of recurrent right undescended testis. He had been operated on for bilateral undescended testes 7 years ago in another hospital, and circumcision was done during the same operation (...) . The boy complained of a weak urinary stream during voiding. The physical examination was consistent with recurrent right undescended testis. Penile examination showed a circumferential urethral prolapse around the meatus. The urethral meatal appearance was apparent right after the circumcision. An orchiopexy operation as well as circumferential excision of the perimeatal urethral tissue with primary repair was done. The pathological examination of the specimen revealed keratinized stratified squamous

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2017 European Journal of Pediatric Surgery Reports

9. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. (PubMed)

Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. Pelvic organ prolapse (POP) is common in women and is frequently associated with stress urinary incontinence (SUI). In many cases however, SUI is present only with the prolapse reduced (occult SUI) or may develop after surgical treatment for prolapse (de novo SUI).To determine the impact on postoperative bladder function of surgery for symptomatic pelvic organ prolapse with or without concomitant (...) blinding of outcome assessors), indirectness and imprecision associated with low event rates and small samples.POP surgery in women with SUIVaginal repair with vs without concomitant mid-urethral sling (MUS)A concomitant MUS probably improves postoperative rates of subjective SUI, as the evaluated clinical effect appears large (risk ratio (RR) 0.30, 95% confidence interval (CI) 0.19 to 0.48; 319 participants, two studies; I² = 28%; moderate-quality evidence), and probably decreases the need for further

2018 Cochrane

10. A Case of Strangulated Urethral Prolapse in a Premenopausal Adult Female (PubMed)

A Case of Strangulated Urethral Prolapse in a Premenopausal Adult Female Urethral prolapse in a premenopausal adult female is exceedingly rare. This paper describes a case of strangulated urethral prolapse presenting as a urethral mass in an unusual demographic and reviews the literature on etiology and management. Only a few cases have occurred in women of reproductive age. The etiology is likely multifactorial. Treatment with surgical excision provides good results in the majority of cases.

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2016 Case reports in urology

11. Urethral Anomalies and Urethral Prolapse (Follow-up)

Urethral Anomalies and Urethral Prolapse (Follow-up) Urethral Anomalies and Urethral Prolapse in Children Treatment & Management: Medical Care, Surgical Care, Complications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTAxNTkxMi10cmVhdG1lbnQ= processing > Urethral Anomalies and Urethral Prolapse in Children Treatment & Management Updated: Sep 27, 2017 Author: Jyoti Upadhyay, MD, FAAP; Chief Editor: Marc Cendron, MD Share Email Print Feedback Close Sections Sections Urethral Anomalies and Urethral Prolapse in Children Treatment Medical Care Treatment of urethral prolapse ranges from conservative therapy (eg, applications of antibiotic ointments, estrogen creams, sitz baths, herbal remedies, oral antibiotics) to various surgical

2014 eMedicine Pediatrics

12. Urethral Anomalies and Urethral Prolapse (Treatment)

Urethral Anomalies and Urethral Prolapse (Treatment) Urethral Anomalies and Urethral Prolapse in Children Treatment & Management: Medical Care, Surgical Care, Complications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTAxNTkxMi10cmVhdG1lbnQ= processing > Urethral Anomalies and Urethral Prolapse in Children Treatment & Management Updated: Sep 27, 2017 Author: Jyoti Upadhyay, MD, FAAP; Chief Editor: Marc Cendron, MD Share Email Print Feedback Close Sections Sections Urethral Anomalies and Urethral Prolapse in Children Treatment Medical Care Treatment of urethral prolapse ranges from conservative therapy (eg, applications of antibiotic ointments, estrogen creams, sitz baths, herbal remedies, oral antibiotics) to various surgical

2014 eMedicine Pediatrics

13. Urethral Anomalies and Urethral Prolapse (Overview)

Urethral Anomalies and Urethral Prolapse (Overview) Urethral Anomalies and Urethral Prolapse in Children: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTAxNTkxMi1vdmVydmlldw== processing > Urethral Anomalies and Urethral Prolapse in Children Updated: Sep 27, 2017 Author: Jyoti Upadhyay, MD, FAAP; Chief Editor: Marc Cendron, MD Share Email Print Feedback Close Sections Sections Urethral Anomalies and Urethral Prolapse in Children Overview Background This article discusses various urethral anomalies observed in male infants and children and the distinct entity of urethral prolapse in prepubescent females. [ , ] Urethral prolapse is a protrusion of urethral mucosa

2014 eMedicine Pediatrics

14. Urethral Anomalies and Urethral Prolapse (Diagnosis)

Urethral Anomalies and Urethral Prolapse (Diagnosis) Urethral Anomalies and Urethral Prolapse in Children: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTAxNTkxMi1vdmVydmlldw== processing > Urethral Anomalies and Urethral Prolapse in Children Updated: Sep 27, 2017 Author: Jyoti Upadhyay, MD, FAAP; Chief Editor: Marc Cendron, MD Share Email Print Feedback Close Sections Sections Urethral Anomalies and Urethral Prolapse in Children Overview Background This article discusses various urethral anomalies observed in male infants and children and the distinct entity of urethral prolapse in prepubescent females. [ , ] Urethral prolapse is a protrusion of urethral mucosa

2014 eMedicine Pediatrics

15. Sacrocolpopexy using mesh to repair vaginal vault prolapse

Sacrocolpopexy using mesh to repair vaginal vault prolapse Sacrocolpope Sacrocolpopexy using mesh to repair vaginal xy using mesh to repair vaginal vault prolapse vault prolapse Interventional procedures guidance Published: 28 June 2017 nice.org.uk/guidance/ipg583 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take (...) #notice-of-rights). Page 1 of 111 1 Recommendations Recommendations 1.1 Current evidence on the safety of sacrocolpopexy using mesh to repair vaginal vault prolapse shows there are serious but well-recognised safety concerns. The evidence on efficacy is adequate in quantity and quality. Therefore, this procedure can be used provided that standard arrangements are in place for clinical governance, consent and audit. 1.2 During the consent process, clinicians should ensure patients understand

2017 National Institute for Health and Clinical Excellence - Interventional Procedures

16. Infracoccygeal sacropexy using mesh to repair vaginal vault prolapse

is sutured to the top of the vagina to act as a tension-free sling that aims to support the vaginal vault. The procedure is sometimes described as posterior intravaginal slingplasty. Infracoccygeal sacropexy using mesh to repair vaginal vault prolapse (IPG581) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 83.2 This procedure can be combined with surgery for stress urinary incontinence, such as a sub-urethral sling (...) Infracoccygeal sacropexy using mesh to repair vaginal vault prolapse Infr Infracoccygeal sacrope acoccygeal sacropexy using mesh to repair xy using mesh to repair vaginal vault prolapse vaginal vault prolapse Interventional procedures guidance Published: 28 June 2017 nice.org.uk/guidance/ipg581 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare

2017 National Institute for Health and Clinical Excellence - Interventional Procedures

17. Advanced Genital Prolapse Surgery With and Without Mid Urethral Sling to Prevent Stress Urinary Incontinence

Advanced Genital Prolapse Surgery With and Without Mid Urethral Sling to Prevent Stress Urinary Incontinence Advanced Genital Prolapse Surgery With and Without Mid Urethral Sling to Prevent Stress Urinary Incontinence - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (...) (100). Please remove one or more studies before adding more. Advanced Genital Prolapse Surgery With and Without Mid Urethral Sling to Prevent Stress Urinary Incontinence The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02578056 Recruitment Status : Enrolling by invitation First Posted : October 16

2015 Clinical Trials

18. The value of the preoperative 1-h pad test with pessary insertion for predicting the need for a mid-urethral sling following pelvic prolapse surgery: a cohort study. (PubMed)

The value of the preoperative 1-h pad test with pessary insertion for predicting the need for a mid-urethral sling following pelvic prolapse surgery: a cohort study. Part of the patients with pelvic organ prolapse but without symptoms of stress urinary incontinence (SUI) may demonstrate SUI after prolapse surgery (occult SUI), and no optimal preoperative screening method is currently available for it. The aim of this study was to estimate the value of the preoperative 1-h pad test with pessary (...) insertion for predicting the need for a mid-urethral sling (MUS) following prolapse surgery.Two hundred and six patients were enrolled for advanced prolapse without complaining of urinary incontinence (UI) in this prospective cohort study. Exclusion criteria included prior or concomitant anti-incontinence surgery. Preoperatively, a stress test, the 1-h pad test and uroflowmetry were performed with prolapse reduction. Primary outcome was postoperative de novo UI. Median follow-up was 31 months (range 12

2015 World journal of urology

19. Post-Hysterectomy Vaginal Vault Prolapse

for concomitant surgery for PHVP and overt SUI? Colposuspension at the time of ASC does not appear to be effective treatment for SUI. [New 2015] Concomitant mid-urethral sling surgery may be considered when vaginal surgical approaches are used for the treatment of PHVP. [New 2015] What is the optimal treatment of recurrent vault prolapse? The management of recurrent vault prolapse should be through a specialist MDT with experience and training in this field. [ New 2015] Clinical governance National databases (...) Post-Hysterectomy Vaginal Vault Prolapse Post-Hysterectomy Vaginal Vault Prolapse Green-top Guideline No. 46 RCOG/BSUG Joint Guideline | July 2015RCOG/BSUG Green-top Guideline No. 46 © Royal College of Obstetricians and Gynaecologists 2 of 21 Post-Hysterectomy Vaginal Vault Prolapse This is the second edition of this guideline, previously published in 2007 as a joint guideline with the British Society of Urogynaecology as ‘The Management of Post Hysterectomy Vaginal Vault Prolapse’. Executive

2015 Royal College of Obstetricians and Gynaecologists

20. Vaginal Swab Test Compared With the Urethral Q-tip Test for Urethral Mobility Measurement: A Randomized Controlled Trial. (PubMed)

Vaginal Swab Test Compared With the Urethral Q-tip Test for Urethral Mobility Measurement: A Randomized Controlled Trial. To assess whether use of a vaginal cotton-tipped swab is equivalent to the standard Q-tip test regarding urethral mobility. Secondarily, to examine whether both tests agree in hypermobility diagnosis, discomfort level, and patients' preference.In this randomized crossover trial, women with stress urinary incontinence without prolapse beyond the hymen were randomized (...) to undergo either a vaginal or urethral mobility test first followed by the alternate approach. The primary outcome was the difference in rotation angle, from resting to maximum strain, between tests. The equivalence margin was ±10°. The secondary outcome was agreement in hypermobility diagnosis using two definitions: 1) maximum straining angle of 30° or greater from the horizontal plane; and 2) rotation angle 30° or greater. Discomfort was assessed using a 0-10 visual analog scale. Using 90% power

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2016 Obstetrics and Gynecology

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