Document Detail

Development of generic models for ambulatory vaginal surgery--a preliminary report.
MedLine Citation:
PMID:  9657174     Owner:  NLM     Status:  MEDLINE    
Generic guidelines are applied to reconstructive vaginal operations, so as to convert them to ambulatory procedures. Prototype operations are described and analyzed. These included conceptualizing vaginal prolapse as a type of intussusception caused by vaginal and ligamentous laxity in the middle or posterior parts of the vagina; the avoidance of vaginal excision, excessive tension, and refashioning excess vaginal tissue from width to length or into a partial double-layered repair; the creation of artificial neoligaments; the prevention of urinary retention by avoiding tightness in the bladder neck area; local anesthetic infiltration; and buttressing vaginal tissue during wound healing. A total of 108 patients underwent vaginal surgery on an ambulatory or overnight stay basis, 72 under local anesthesia/midazolam. Minimal postoperative pain and the absence of catheterization reduced hospital stay from a statewide mean of 8 days to 1 day, and return to normal activities from 6 weeks to 7-10 days. Cure rates (18 months) were: uterovaginal prolapse 22/22, infracoccygeal sacropexy 21/23, rectocele 36/38, cystocele/anterior vaginal wall prolapse 21/25. Applied as prototypes to reconstructive vaginal surgery, the operations appear to be as effective as traditional techniques but far less invasive. They have the potential to assist working mothers, the old and infirm, and save the community up to $5,500 per patient. It is hoped that the generic models presented may act as a basis for the future development of ambulatory vaginal surgical techniques.
P E Papa Petros
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International urogynecology journal and pelvic floor dysfunction     Volume:  9     ISSN:  -     ISO Abbreviation:  Int Urogynecol J Pelvic Floor Dysfunct     Publication Date:  1998  
Date Detail:
Created Date:  1998-09-09     Completed Date:  1998-09-09     Revised Date:  2011-08-18    
Medline Journal Info:
Nlm Unique ID:  9514583     Medline TA:  Int Urogynecol J Pelvic Floor Dysfunct     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  19-27     Citation Subset:  IM    
Royal Perth Hospital, Western Australia.
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MeSH Terms
Aged, 80 and over
Ligaments / surgery
Middle Aged
Postoperative Complications
Reconstructive Surgical Procedures
Treatment Outcome
Uterine Prolapse / surgery*
Vagina / surgery*

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