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Berlin Brandenburg

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  • 1
    In: Obstetrics & Gynecology, 2015, Vol.126(5), pp.1102-1105
    Description: This month we focus on current research in pelvic organ prolapse. Dr. Kenton discusses five recent publications, which are concluded with a “bottom line” that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts.
    ISSN: 0029-7844
    E-ISSN: 1873233X
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  • 2
    Language: English
    In: American Journal of Obstetrics and Gynecology, August 2017, Vol.217(2), pp.108-109
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2017.06.017 Byline: Kimberly S. Kenton Author Affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL Article History: Received 15 June 2017; Accepted 15 June 2017 Article Note: (footnote) Supported by grant funding from the National Institute of Diabetes and Digestive and Kidney Diseases and Boston Scientific., Ethicon was an expert witness.
    Keywords: Medicine
    ISSN: 0002-9378
    E-ISSN: 1097-6868
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  • 3
    Language: English
    In: International Urogynecology Journal, 2012, Vol.23(7), pp.913-917
    Description: Byline: Olga Ramm (1), Jonathan L. Gleason (2), Saya Segal (3), Danielle D. Antosh (4), Kimberly S. Kenton (1) Keywords: Endometrial biopsy; Endometrial cancer; Endometrial hyperplasia; Pelvic organ prolapse; Unanticipated malignancy Abstract: Introduction and hypothesis Uterine morcellation during laparoscopy for pelvic floor repair has prompted adoption of uterine screening tests by some surgeons. We report a case series of uterine malignancy incidentally diagnosed at the time of pelvic floor surgery. Methods We reviewed records from patients undergoing hysterectomy for pelvic organ prolapse (POP) and/or urinary incontinence (UI) from January 2004 to December 2009 and abstracted preoperative screening trends and final pathologic diagnoses. Results Of the 708 women in the study, 125 (18%) had preoperative endometrial biopsy (EB), 43 (6%) had pelvic ultrasound (US), and 21 (3%) had EB and US. Surgical route included vaginal (58%), abdominal (23%), and laparoscopic (18%). Most (97.1%) final pathologic diagnoses were benign. Five cancers (0.6%) were detected four of these women had normal preoperative screening, including EB (2), US (1), or both tests (1). Conclusions Screening with EB + US was found to be ineffective in our cohort of patients due to the low prevalence of undetected uterine cancer in asymptomatic women planning POP/UI surgery. Author Affiliation: (1) Division of Female Pelvic Medicine & Reconstructive Surgery, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL, 60153, USA (2) Division of Women's Pelvic and Reconstructive Surgery, University of Alabama-Birmingham, Birmingham, AL, USA (3) Division of Urogynecology and Pelvic Reconstructive Surgery, University of Pennsylvania Health Systems, Philadelphia, PA, USA (4) Washington Hospital Center, National Center for Advanced Pelvic Surgery, Washington, DC, USA Article History: Registration Date: 10/02/2012 Received Date: 26/07/2011 Accepted Date: 09/02/2012 Online Date: 08/03/2012
    Keywords: Endometrial biopsy ; Endometrial cancer ; Endometrial hyperplasia ; Pelvic organ prolapse ; Unanticipated malignancy
    ISSN: 0937-3462
    E-ISSN: 1433-3023
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  • 4
    Language: English
    In: American Journal of Obstetrics and Gynecology, July 2002, Vol.187(1), pp.233-234
    Description: Synthetic materials are frequently used in gynecologic surgical procedures to repair pelvic floor hernias and prolapse and to form barriers to adhesion formation. Mesh erosion into the vagina and lower urinary tract are known complications. We report 2 cases of polytetrafluoroethylene mesh erosion into the rectum. (Am J Obstet Gynecol 2002;187:233-4.)
    Keywords: Graft Erosion ; Sacrocolpopexy ; Medicine
    ISSN: 0002-9378
    E-ISSN: 1097-6868
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  • 5
    Language: English
    In: American Journal of Obstetrics and Gynecology, March, 2006, Vol.194(3), p.722(7)
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2005.08.043 Byline: Sangeeta T. Mahajan (a), Eman A. Elkadry (a), Kimberly S. Kenton (a), Susan Shott (b), Linda Brubaker (a) Abstract: The purpose of this study was to assess factors that influence patient satisfaction 1 year after pelvic reconstructive surgery. Author Affiliation: (a) Loyola University Medical Center, Division of Female Pelvic Medicine and Reconstructive Surgery, Maywood, IL (b) Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL Article History: Received 26 May 2005; Revised 15 August 2005; Accepted 18 August 2005
    Keywords: Urinary Incontinence ; Plastic Surgery ; Patient Satisfaction
    ISSN: 0002-9378
    Source: Cengage Learning, Inc.
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  • 6
    Language: English
    In: The Journal of Urology, February 2018, Vol.199(2), pp.528-535
    Description: The primary objective of this study was to evaluate reasons for seeking care among men and women with lower urinary tract symptoms. Participants were recruited from urology and urogynecology clinics, and the community. The sample was enriched with persons expected to have abnormal or diminished bladder sensations (eg participants with lower back surgery and participants 65 years old or older). Interviews were performed in person beginning with an open-ended assessment of urinary symptoms and associated bother followed by more directed questions, including reasons for seeking or not seeking treatment. We also examined the relationship between symptom frequency and bother using the LUTS (Lower Urinary Tract Symptoms) Tool. A total of 88 participants, including 38 men and 50 women, with a mean ± SD age of 52.2 ± 14.3 years provided information about urinary symptoms, including a range of quality of life consequences and coping behaviors. They sought treatment mostly because of new, continuing or bothersome symptoms. Factors associated with not seeking treatment included low symptom severity and concerns about the costs vs the benefits of treatment (eg side effects of medication). Symptom frequency and bother were associated with each other across symptoms assessed by the LUTS Tool. In this large qualitative study we obtained useful insights into the impact of lower urinary tract symptoms from the perspective of the person with the symptoms. Removing barriers and misconceptions about the treatment of lower urinary tract symptoms may increase the number of people who seek clinical care and improve the clinical course of men and women who experience lower urinary tract symptoms.
    Keywords: Urinary Bladder ; Lower Urinary Tract Symptoms ; Quality of Life ; Patient Reported Outcome Measures ; Patient Acceptance of Health Care ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 7
    Language: English
    In: The Journal of Urology, October 2018, Vol.200(4), pp.848-855
    Description: We examined how mental health measures, sleep and physical function are associated with the presence and type of urinary incontinence and severity in women seeking treatment for lower urinary tract symptoms. This baseline cross-sectional analysis was performed in treatment seeking women with lower urinary tract symptoms. All participants completed the LUTS (Lower Urinary Tract Symptoms) Tool (Pfizer, New York, New York), which was used to classify women based on urinary incontinence symptoms and measure severity. The PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaire for depression, anxiety, sleep disturbance and physical function, the PSS (Perceived Stress Scale) and the IPAQ-SF (International Physical Activity Questionnaire Short Form) were administered. Multivariable regression modeling was done to assess associations with urinary symptom presence, type and severity. We studied 510 women with a mean ± SD age of 56 ± 14 years. Of the women 82% were Caucasian, 47% were obese and 14% reported diabetes. Urinary incontinence was reported by 420 women (82.4%), including stress urinary incontinence in 70, urgency urinary incontinence in 85, mixed urinary incontinence in 240 and other urinary incontinence in 25. On adjusted analyses there was no difference in any mental health, sleep or physical function measure based on the presence vs the absence of urinary incontinence. Among women with urinary incontinence PROMIS anxiety and sleep disturbance scores were higher in those with mixed urinary incontinence than stress urinary incontinence. Increasing urinary incontinence severity was associated with higher PROMIS depression and anxiety scores, and higher PSS scores. However, higher urinary incontinence severity was not associated with a difference in sleep or physical function. Among treatment seeking women with lower urinary tract symptoms, increasing urinary incontinence severity rather than the presence or type of urinary incontinence was associated with increased depression, anxiety and stress.
    Keywords: Urinary Bladder ; Urinary Incontinence ; Patient Reported Outcome Measures ; Depression ; Anxiety ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 8
    Language: English
    In: Annals of Biomedical Engineering, 2013, Vol.41(1), pp.185-194
    Description: Stress urinary incontinence is a condition that affects mainly women and is characterized by the involuntary loss of urine in conjunction with an increase in abdominal pressure but in the absence of a bladder contraction. In spite of the large number of women affected by this condition, little is known regarding the mechanics associated with the maintenance of continence in women. Urodynamic measurements of the pressure acting on the bladder and the pressures developed within the bladder and the urethra offer a potential starting point for constructing computational models of the bladder and urethra during stress events. The measured pressures can be utilized in these models to provide information to specify loads and validate the models. The main goals of this study were to investigate the feasibility of incorporating human urodynamic pressure data into a computational model of the bladder and the urethra during a cough and determine if the resulting model could be validated through comparison of predicted and measured vesical pressure. The results of this study indicated that simplified models can predict vesical pressures that differ by less than 5 cmH 2 O (〈10%) compared to urodynamic pressure measurements. In addition, varying material properties had a minimal impact on the vesical pressure and displacements predicted by the model. The latter finding limits the use of vesical pressure as a validation criterion since different parameters can yield similar results in the same model. However, the insensitivity of vesical pressure predictions to material properties ensures that the outcome of our models is not highly sensitive to tissue material properties, which are not well characterized.
    Keywords: Stress urinary incontinence ; Finite element method ; Modeling ; Urodynamics
    ISSN: 0090-6964
    E-ISSN: 1573-9686
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  • 9
    In: Female Pelvic Medicine & Reconstructive Surgery, 2016, Vol.22(4), pp.267-271
    Description: OBJECTIVE: To report outcomes and complications in approximately 450 women who underwent isolated minimally invasive abdominal sacrocolpopexy (ASC) for the management of pelvic organ prolapse (POP). MATERIAL AND METHODS: We retrospectively reviewed the electronic medical records of women who underwent minimally invasive ASC (laparoscopic ASC [LASC] or robotic ASC [RASC]) for symptomatic POP at Loyola University Chicago Medical Center from 2007 to 2012. Polypropylene mesh was used and the decision to reperitonealize the mesh was left to surgeon discretion. Data collected included demographics, Pelvic Floor Distress Inventory questionnaire, intraoperative and postoperative details, and POP quantification. RESULTS: Four hundred twenty-eight women underwent minimally invasive ASC—232 LASC and 226 RASC. Most women (86%) did not undergo reperitonealization of the mesh. Median follow-up was 13 weeks (range, 2–268 weeks) for complications and 13 weeks (range, 2–104 weeks) for anatomic outcomes.Postoperatively, 88.6% of women had stage 0/I, 10.7% had stage II, and 2 women had stage III POP. Twelve (2.6%) underwent reoperation, 6 for POP (3 posterior repairs, 2 repeat ASC, 1 perineorrhaphy) and 6 for bowel complications. Fourteen women had postoperative bowel complications; half of which resolved with conservative treatment. There were no differences between anatomic and functional outcomes or bowel complications between LASC and RASC. Reoperation rates for bowel complications in women who underwent reperitonealization of the mesh were similar to those who did not (1.5% vs 1.0%, P = 0.86). CONCLUSIONS: Minimally invasive ASC without concomitant vaginal repair is an effective and safe procedure for the surgical management of POP with low rates of reoperation and complications.
    Keywords: Gynecologic Surgical Procedures -- Statistics & Numerical Data ; Pelvic Organ Prolapse -- Surgery;
    ISSN: 2151-8378
    E-ISSN: 21544212
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  • 10
    Language: English
    In: International Urogynecology Journal, Dec, 2013, Vol.24(12), p.2099(6)
    Description: Byline: Brook L. McFadden (1,6), Melissa L. Constantine (2), Sarah L. Hammil (1), Megan E. Tarr (3), Husam T. Abed (4), Kimberly S. Kenton (3), Vivian W. Sung (5), Rebecca G. Rogers (1) Keywords: Informed consent; Mesh; Midurethral sling Abstract: Introduction and hypothesis We aimed to determine patient recall of specific surgical risks and benefits discussed during consent for midurethral sling (MUS) surgery immediately after consent and at 6 weeks follow-up. Specifically we sought to determine whether or not women recalled specific risks related to the placement of mesh. Methods Surgeons consented patients for MUS in their usual fashion during audio recorded consent sessions. After consent and again at 6 weeks postoperatively, women completed a checklist of risks, benefits, alternatives, and general procedural items covered during consent. In addition, women completed the Decision Regret Scale for Pelvic Floor Disorders (DRS-PFD). Audio files were used to verify specific risks, benefits, alternatives, and procedural items discussed at consent. Recall of specific risks, benefits, and alternatives were correlated with DRS-PFD scores. Results Sixty-three women completed checklists immediately post consent and at 6 weeks postoperatively. Six-week recall of benefits, alternatives, and description of the operation did not change. Surgical risk recall as measured by the patient checklist deteriorated from 92 % immediately post consent to 72 % at 6 weeks postoperatively (p〈.001). Recall of the risk for mesh erosion declined from 91 to 64 % (p〈.001). Recall that mesh was placed during the MUS procedure declined from 98 to 84 % (p=.01). DRS-PFD scores were correlated with poorer surgical risk recall and surgical complications (r=.31, p=.02). Conclusions Recall of MUS surgery risks deteriorated over time. Specifically, women forgot that mesh was placed or might erode. Further investigations into methods and measures of adequate consent that promote recall of long-term surgical risks are needed. Author Affiliation: (1) Division of Urogynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA (2) Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA (3) Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL, USA (4) Division of Urogynecology, Henry Ford Health System, Detroit, MI, USA (5) Division of Urogynecology & Reconstructive Pelvic Surgery, Warren Alpert Medical School, Brown University, Providence, RI, USA (6) Department of Obstetrics and Gynecology, MSC 10 5580, 1 University of New Mexico, Albuquerque, NM, 87131, USA Article History: Registration Date: 15/05/2013 Received Date: 01/02/2013 Accepted Date: 14/05/2013 Online Date: 02/07/2013 Article note: Presented at the 38th Annual Meeting of the Society of Gynecologic Surgeons, Baltimore, MD, 13--15 April 2012
    ISSN: 0937-3462
    Source: Cengage Learning, Inc.
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