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Peng J, Li S, Wang L, Yang L, Nai M, Xu Q, Jin Y, Liu P, Li L. Comparison of efficacy between laparoscopic pectopexy and laparoscopic high uterosacral ligament suspension in the treatment of apical prolapse-short term results. Sci Rep 2023; 13:18519. [PMID: 37898708 PMCID: PMC10613309 DOI: 10.1038/s41598-023-45871-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023] Open
Abstract
To compare the clinical efficacy of laparoscopic pectopexy and laparoscopic high uterosacral ligament suspension in women suffering from apical prolapse. The clinical data of 170 patients with apical prolapse (POP-Q score ≥ II) treated in the Third Affiliated Hospital of Zhengzhou University from January 2018 to July 2020 were retrospectively analyzed to assess the clinical efficacy of three surgical methods [laparoscopic pectopexy with uterine preservation, laparoscopic pectopexy with hysterectomy, laparoscopic high uterosacral ligament suspension (LHUSLS) with hysterectomy]. Patients were divided into three groups depending on Surgical methods: laparoscopic uterine pectopexy group (n = 23), laparoscopic pectopexy with hysterectomy group (n = 78) and LHUSLS with hysterectomy group (n = 69). The POP-Q points before and after operation were analyzed. The operation-related indices, perioperative periods and post-operative complications were compared. 1. The operation time of laparoscopic uterine pectopexy group was the shortest (p < 0.05). There was no significant difference in the incidence of apical prolapse and new stress urinary incontinence among the three groups during the follow-up period (p > 0.05). 2. The POP-Q points (Aa, Ba, C) in the three groups were better than those before operation (p < 0.05). Laparoscopic pectopexy with hysterectomy group had better Ap, Bp and C points and a longer TVL than LHUSLS with hysterectomy group (p < 0.05). 3. The postoperative PFDI-20, PFIQ-7 and PISQ-12 scores of the three groups were significantly improved than those before operation (p < 0.05). The PISQ-12 scores in laparoscopic uterine pectopexy group were significantly higher than that in the other two groups one year after operation (p < 0.05). The study concludes that laparoscopic pectopexy and LHUSLS can significantly improve the quality of life and sexual function for patients with apical prolapse. One year after operation, laparoscopic pectopexy has a more satisfactory anatomical reduction than LHUSLS with hysterectomy. The laparoscopic uterine pectopexy group had lower postoperative complications and better sexual function than that with hysterectomy group. Laparoscopic pectopexy should be used for the treatment of apical prolapse (POP-Q score ≥ II) patients who aim to better clinical efficacy and sexual function improvement.
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Affiliation(s)
- Juan Peng
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Zhengzhou Key Laboratory of Endometrial Disease Prevention and Treatment, Zhengzhou, China
| | - Shuqing Li
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Luwen Wang
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Yang
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Zhengzhou Key Laboratory of Endometrial Disease Prevention and Treatment, Zhengzhou, China
| | - Manman Nai
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qingqing Xu
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuxi Jin
- The Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peng Liu
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Li
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Hampel GA, Shekhawat D, Chaiyamoon A, Cardona JJ, Carrera A, Reina F, Anadkat S, Iwanaga J, Tubbs RS. The superior vesical artery: A review of conflicting definitions and how these could affect invasive procedures. Clin Anat 2023; 36:958-962. [PMID: 37366060 DOI: 10.1002/ca.24084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
Since the superior umbilical artery is the only functioning branch of the patent umbilical artery, some anatomical and surgical books/atlases fail to clarify that it is a branch of the umbilical artery and not a direct branch of the anterior division of the internal iliac artery and so specifically state that it is a direct branch of the internal iliac artery. This discrepancy in nomenclature can obviously affect invasive procedures and communication between physicians. Therefore, the present review is intended to highlight this issue. The term "superior vesical artery" was searched using standard search engines, for example, PubMed and Google Scholar. Several standard and specialized anatomy textbooks were also examined to ascertain how the superior vesical artery was described. Thirty-two articles were identified that used the terms "superior vesical artery" or "superior vesical arteries." After applying exclusion criteria, in 28 papers, the definition of the superior vesical artery was undetermined in eight, described as a direct branch of the internal iliac artery in 13, described as a branch of the umbilical artery in six, and defined as being equivalent to the umbilical artery in one. Of the sampled textbooks, some defined the superior vesicle artery as a branch of the umbilical artery, some as a direct branch of the internal iliac artery and some as both. Taken all together, most define the superior vesical artery as a branch of the umbilical artery. As the superior vesical artery is described as a branch of the umbilical artery in the internationally accepted terminology (Terminologia Anatomica), we recommend that this definition be used by anatomists and physicians alike so that communication is clear.
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Affiliation(s)
- Gilad A Hampel
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Devendra Shekhawat
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Arada Chaiyamoon
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Juan J Cardona
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Ana Carrera
- Medical Sciences Department, Clinical Anatomy, Embryology and Neurosciences Research Group, University of Girona, Girona, Spain
| | - Francisco Reina
- Medical Sciences Department, Clinical Anatomy, Embryology and Neurosciences Research Group, University of Girona, Girona, Spain
| | - Samir Anadkat
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- University of Queensland, Brisbane, Queensland, Australia
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Indraccolo U, Losavio E, Carone M. Applying graph theory to improve the quality of scientific evidence from textual information: Neural injuries after gynaecologic pelvic surgery for genital prolapse and urinary incontinence. Neurourol Urodyn 2023; 42:669-679. [PMID: 36648454 DOI: 10.1002/nau.25133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/07/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023]
Abstract
AIMS To provide the overall rate for all types of neurologic iatrogenic injuries during urogynaecologic surgery from textual data. METHODS Systematic research focused on complications of gynaecologic surgery and neurologic injuries in abstracts. Keywords concerning complications (cluster A), unspecific; neurologic issues (cluster B); surgery (generic words) (cluster C); specific gynaecologic operations (cluster D); and specific gynaecologic operations for pelvic organ prolapse and urinary incontinence (cluster E) were extracted. Associations among clusters of keywords were assessed by using multiple runs of text-mining software Semantic Brand Score (SBS, https://semanticbrandscore.com/#primary). Association scores were converted into probabilities. The rate of neurologic complications in urogynaecologic surgery was calculated ("a priori" probability) by applying Bayes' theorem. Textual estimates of neurological injuries in urogynaecologic surgery are 0.035554 (95% confidence intervals 0.019607-0.0515001; no quantitative data were found). To test if the probability calculated on textual information was the same as quantitative data reports ("a posteriori" probability), the rate of neurologic complication of all gynaecologic surgery was calculated using a meta-analytics approach and was compared with the textual analysis value. RESULTS The rate of neurologic complications in gynaecologic surgery after meta-analytic data synthesis has been 0.016489 (95% confidence intervals 0.012163-0.022320), which is equal to the textual estimate (0.016889, 95% confidence intervals 0.019607-0.051501). Therefore, 0.035554 is a reliable likelihood to observe a neurologic complication in urogynaecologic surgery. CONCLUSION Iatrogenic nerve injuries in urogynaecologic surgery are higher than whole gynaecologic surgery. Text-mining software SBS and probability conversion can provide reliable answers from overall scholars' opinions on unsolved clinical questions when better evidence is lacking.
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Affiliation(s)
- Ugo Indraccolo
- Maternal-Infantile Department, "Alto Chiascio" Hospital of Gubbio-Gualdo Tadino, Complex Operative Unit of Obstetrics and Gynecology, ASL 1 Umbria, Perugia, PG, Italy
| | - Ernesto Losavio
- IRCCS di Bari, Istituti Clinici Scientifici Maugeri, SPA SB, Pavia, Italy
| | - Mauro Carone
- IRCCS di Bari, Istituti Clinici Scientifici Maugeri, SPA SB, Pavia, Italy
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Henyš P, Ramezani M, Schewitz D, Höch A, Möbius D, Ondruschka B, Hammer N. Sacrospinous and sacrotuberous ligaments influence in pelvis kinematics. J Anat 2022; 241:928-937. [PMID: 35986644 PMCID: PMC9482702 DOI: 10.1111/joa.13739] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/24/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
The alteration in mechanical properties of posterior pelvis ligaments may cause a biased pelvis deformation which, in turn, may contribute to hip and spine instability and malfunction. Here, the effect of different mechanical properties of ligaments on lumbopelvic deformation is analyzed via the finite element method. First, the improved finite element model was validated using experimental data from previous studies and then used to calculate the sensitivity of lumbopelvic deformation to changes in ligament mechanical properties, load magnitude, and unilateral ligament resection. The deformation of the lumbopelvic complex relative to a given load was predominant in the medial plane. The effect of unilateral resection on deformation appeared to be counterintuitive, suggesting that ligaments have the ability to redistribute load and that they play an important role in the mechanics of the lumbopelvic complex.
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Affiliation(s)
- Petr Henyš
- Institute of New Technologies and Applied Informatics, Faculty of Mechatronics, Informatics and Interdisciplinary Studies Technical University of Liberec Liberec Czech Republic
| | - Maziar Ramezani
- Department of Mechanical Engineering Auckland University of Technology Auckland New Zealand
| | - Daniel Schewitz
- Department of Mechanical Engineering Auckland University of Technology Auckland New Zealand
| | - Andreas Höch
- Department of Trauma, Orthopedic and Plastic Surgery University Hospital of Leipzig Leipzig Germany
| | - Dustin Möbius
- Institute of Legal Medicine University Medical Centre Hamburg‐Eppendorf Hamburg Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine University Medical Centre Hamburg‐Eppendorf Hamburg Germany
| | - Niels Hammer
- Department of Trauma, Orthopedic and Plastic Surgery University Hospital of Leipzig Leipzig Germany
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center Medical University of Graz Graz Austria
- Fraunhofer Institute for Machine Tools and Forming Technology Dresden Germany
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