PMID: 9657174Jul 10, 1998Paper

Development of generic models for ambulatory vaginal surgery--a preliminary report

International Urogynecology Journal and Pelvic Floor Dysfunction
P E Papa Petros

Abstract

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 ...Continue Reading

References

Nov 1, 1976·American Journal of Obstetrics and Gynecology·A C RichardsonN L Williams
Jan 1, 1990·Acta Obstetricia Et Gynecologica Scandinavica. Supplement·P E PetrosJ Papadimitriou
Nov 1, 1980·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·T N Salthouse
Nov 1, 1996·The Australian & New Zealand Journal of Obstetrics & Gynaecology·P P Petros
Jan 1, 1997·International Urogynecology Journal and Pelvic Floor Dysfunction·P E Papa Petros, U Ulmsten
Jan 1, 1997·International Urogynecology Journal and Pelvic Floor Dysfunction·P E Petros, U Ulmsten
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Jul 1, 1952·The British Journal of Surgery·D M DOUGLAS
Jan 1, 1908·Proceedings of the Royal Society of Medicine·R H Paramore

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Citations

Apr 12, 2002·Acta Obstetricia Et Gynecologica Scandinavica·Marianne OttesenBent Ottesen
Aug 2, 2005·Best Practice & Research. Clinical Obstetrics & Gynaecology·Suranjan Ghoshal, Anthony R B Smith

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