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Byard RW, Behnia-Willison F. Female genital mutilation - An overview for forensic practitioners. J Forensic Leg Med 2024; 101:102624. [PMID: 38011766 DOI: 10.1016/j.jflm.2023.102624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/12/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023]
Abstract
Female genital mutilation (FGM) refers to all procedures that partially or totally remove the external female genitalia, or to all other deliberate injuries to the female genital organs for non-medical reasons. It is thought that over 200 million girls and women have had some form of FGM, with more than three million girls being at risk annually. The procedure varies in severity from partial or complete removal of the clitoris (Type 1) to oversewing of the vaginal opening, so-called infibulation (Type 3). There are no medical benefits from FGM, with complications increasing with the amount of tissue damage that has been inflicted. Side effects may be psychological and physical including excessive scarring, pain, infections, sexual dysfunction with significant obstetrical complications such as fistulas and increased risks of stillbirth, as well as increased neonatal and maternal morbidity and mortality. Although primarily originating in countries in Africa, the Middle East and Asia, mass migrations in recent years have made FGM a feature in most societies. For this reason, forensic practitioners and pathologists should be aware of the anatomical features of FGM and the potential medical and psychological side effects. Accurate recording of cases is required to enable appropriate resources to be allocated for instituting preventive measures.
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Affiliation(s)
- Roger W Byard
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5000, Australia.
| | - Fariba Behnia-Willison
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, South Australia, 5000, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, 5042, Australia; Desert Flower South Australia, Ashford, South Australia, 5035, Australia; FBW Gynaecology Plus, Ashford, South Australia, 5035, Australia
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McPhail C, Carey R, Nambiar S, Willison N, Bahadori S, Aryan P, Nguyen T, Behnia-Willison F. The Investigation of Percutaneous Tibial Nerve Stimulation (PTNS) as a Minimally Invasive, Non-Surgical, Non-Hormonal Treatment for Overactive Bladder Symptoms. J Clin Med 2023; 12:jcm12103490. [PMID: 37240596 DOI: 10.3390/jcm12103490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Overactive bladder (OAB) syndrome affects 10-15% of women, severely impacting their quality of life. First-line treatments include behavioural and physical therapy, and second-line medical treatments include medications such as vaginal oestrogen, anticholinergic medications, and ß3-adrenergic agonists-with potential adverse side effects including dizziness, constipation, and delirium, particularly affecting elderly populations. Third-line treatments include more invasive measures, including intradetrusor botulinum injections or sacral nerve modulation, with percutaneous tibial nerve stimulation (PTNS) being a potential alternative treatment. AIMS The aim of this study was to explore the long-term efficacy of PTNS treatment for OAB in an Australian cohort. MATERIALS AND METHODS This is a prospective cohort study. Patients underwent Phase 1 treatment, whereby women received PTNS treatment once per week for 12 weeks. Following Phase 1, women entered Phase 2, whereby they received 12 PTNS treatments over 6 months. Their response to treatment was measured by obtaining data before and after each phase using ICIQ-OAB and the Australian Pelvic Floor Questionnaire (APFQ). RESULTS Phase 1 included 166 women, with 51 completing Phase 2. There was a statistically significant reduction in urinary urgency (29.8%), nocturia (29.8%), incontinence (31.0%), and frequency (33.8%) compared to the baseline. Patients who completed Phase 2 also showed a statistically significant reduction in urinary frequency (56.5%). CONCLUSIONS Overall, the results from this study are positive and support that PTNS is a minimally invasive, non-surgical, non-hormonal, and effective treatment for OAB. These results suggest that PTNS may be a second-line treatment for patients with OAB not responding to conservative management or for patients aiming to avoid surgical approaches.
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Affiliation(s)
| | - Robert Carey
- Department of Obstetrics & Gynaecology, Flinders Medical Centre, Bedford Park 5042, Australia
| | | | | | - Saghi Bahadori
- Adelaide Medical School, University of Adelaide, Adelaide 5005, Australia
| | - Pouria Aryan
- FBW Gynaecology Plus, Adelaide 5035, Australia
- School of Electrical & Electronic Engineering, University of Adelaide, Adelaide 5005, Australia
| | - Tran Nguyen
- FBW Gynaecology Plus, Adelaide 5035, Australia
- Adelaide Medical School, University of Adelaide, Adelaide 5005, Australia
| | - Fariba Behnia-Willison
- FBW Gynaecology Plus, Adelaide 5035, Australia
- Department of Obstetrics & Gynaecology, Flinders Medical Centre, Bedford Park 5042, Australia
- Flinders University, Adelaide 5042, Australia
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Asgari Z, Enzevaei A, Hosseini R, Behnia-Willison F. Predictive factors of the need to morcellate in total laparoscopic hysterectomy. Aust N Z J Obstet Gynaecol 2021; 61:759-764. [PMID: 34060074 DOI: 10.1111/ajo.13378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Specimen extraction is a major challenge in total laparoscopic hysterectomy (TLH) and tissue morcellation may be needed to extract a large uterus. AIMS The study aims to determine preoperative factors that could predict the need for uterine morcellation in TLH, and also find the best cut-off values of each measured parameter leading to optimum sensitivity and specificity. MATERIALS AND METHODS This was a cross-sectional study of women from August 2019 to May 2020 who underwent TLH, with or without salpingo-oophorectomy in our department. We performed bimanual exams preoperatively to estimate the uterine size and recorded the uterine ultrasonographic dimensions and myoma size in myomatous uteri. Receiver operating characteristic (ROC) were used to establish cut-offs that maximised the sensitivity and specificity of each factor in predicting the need for morcellation. Poisson regression was used to calculate the relative risks (RR) of each cut-off. RESULTS One hundred and sixty-two women were recruited in the study. ROC curves demonstrated maximum sensitivities and specificities with a cross-sectional area of 36.5 cm2 , the largest leiomyoma dimension of 40 mm, uterine length of 10 cm, and bimanual uterine size of 13 weeks. Multiple modified Poisson regression revealed that the strongest predictors of morcellation were the largest leiomyoma diameter of >40 mm (RR: 3.58), the uterine cross-sectional area of >36.5 cm2 (RR: 6.38), and uterine size in the bimanual exam of >13 weeks pregnancy (RR: 3.57). CONCLUSION The largest leiomyoma diameter, uterine cross-sectional area, and size on a bimanual exam can all be used to predict needing morcellation preoperatively in TLH.
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Affiliation(s)
- Zahra Asgari
- Department of Obstetrics and Gynaecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Enzevaei
- Department of Obstetrics and Gynaecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reihaneh Hosseini
- Department of Obstetrics and Gynaecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Behnia-Willison
- Senior endo-gynaecologist at Flinders Medical Centre and Senior lecturer at Flinders University, Adelaide, South Australia, Australia
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Behnia-Willison F, Nguyen TT, Norbury AJ, Mohamadi B, Salvatore S, Lam A. Promising impact of platelet rich plasma and carbon dioxide laser for stress urinary incontinence. Eur J Obstet Gynecol Reprod Biol X 2020; 5:100099. [PMID: 32021973 PMCID: PMC6994399 DOI: 10.1016/j.eurox.2019.100099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 09/17/2019] [Accepted: 10/14/2019] [Indexed: 12/30/2022] Open
Abstract
Objectives To evaluate the safety, feasibility and efficacy of trans-vaginal fractional micro-ablative CO2 laser therapy in combination with platelet rich plasma (PRP) for the treatment of stress urinary incontinence (SUI) in women. Study design Participants with SUI underwent three sessions of transvaginal CO2 laser and PRP treatment, administered at 4-6-week intervals. Outcomes were assessed using the bladder function section of the Australian Pelvic Floor Questionnaire (APFQ). The primary outcome was changes in the participants’ symptoms of SUI. Secondary outcomes were related to general bladder function. Outcome differences from baseline (T1) to 3 months (T2) and 12 months (T3) were analysed using Wilcoxon signed-rank tests. Subjective verbal scales were used to assess the degree of pain associated with PRP injections and laser treatment. Results Sixty-two women with SUI were enrolled into this study. There were 66% (41/62) of participants who reported improved SUI symptoms from T1 to T2 (p < 0.001) and at T3, 62% (23/37) of patients reported improved SUI symptoms (p < 0.001). From T1 to T2, all bladder function variables were improved significantly (p < 0.002). At T3, significant improvements (p < 0.03) were maintained for all bladder function variables, except pad usage (p = 0.073). Conclusions Combining transvaginal fractional CO2 laser with PRP might be a beneficial treatment for SUI. It may have the potential to be a minimally-invasive and low-risk alternative to surgery, with reduced recovery time.
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Daniels S, Robson D, Palacz M, Howell S, Nguyen T, Behnia-Willison F. Success rates and outcomes of laparoscopic mesh sacrohysteropexy. Aust N Z J Obstet Gynaecol 2019; 60:244-249. [PMID: 31840811 DOI: 10.1111/ajo.13104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/05/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Uterovaginal prolapse is a prevalent gynaecological issue, which can have a negative impact on the quality of life of women. Hysterectomy and vaginal repair are conventional treatments to address apical prolapse; however, women are increasingly requesting uterine-preserving alternatives. AIMS This study aimed to evaluate the impact of laparoscopic mesh sacrohysteropexy on symptomatic prolapse from an Australian experience. MATERIALS AND METHODS This retrospective cohort study presents outcomes of 157 patients who underwent laparoscopic mesh sacrohysteropexy at a private practice in South Australia during 2007-2017. Primary outcome is the success rate according to the pelvic organ prolapse quantification (POP-Q) system. Secondary measures included complication rates and patients identified as having Stages III-IV prolapse and their outcomes. RESULTS The median age was 58 years (27-86 years), median parity was 2 (0-6), and median body mass index was 26.8 (23-29.9). One hundred and thirty-four women had a laparoscopic hysteropexy and concurrent vaginal prolapse repair and four women had an isolated laparoscopic hysteropexy. The mean pre-operative point C was 0.60. The mean change from pre-operative point C to post-operative point C was 7.6 cm (P < 0.01). Of the 136 patients (98.6%) seen at post-operative 4-6 weeks, all had Stage 0 POP-Q scores. Prolapse recurrence was observed in 22 patients, while 116 patients remained cured at their last follow-up. Prolapse recurrence was associated with anterior vaginal mesh, previous prolapse surgery, pre-operative Stage III-IV disease and number of vaginal deliveries. CONCLUSIONS Laparoscopic mesh sacrohysteropexy is an effective and safe procedure with a high success rate comparable to available international data.
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Affiliation(s)
- Samuel Daniels
- Department of Gynaecology, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Danielle Robson
- Department of Obstetrics & Gynaecology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Magdalena Palacz
- Department of Gynaecology, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Stuart Howell
- Basil Hetzel Institute, Adelaide, South Australia, Australia
| | - Tran Nguyen
- Department of Obstetrics & Gynaecology, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Fariba Behnia-Willison
- Department of Obstetrics & Gynaecology, Flinders Medical Centre, Adelaide, South Australia, Australia
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Behnia-Willison F, Nguyen TTT, Lam AM, Šeman EI. 1395 Treatment of Vaginal Mesh Exposure with Platelet Rich Plasma and CO2 Laser. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Behnia-Willison F, Nguyen TTT, Mohamadi B, Vancaillie TG, Lam A, Willison NN, Zivkovic J, Woodman RJ, Skubisz MM. Fractional CO 2 laser for treatment of stress urinary incontinence. Eur J Obstet Gynecol Reprod Biol X 2019; 1:100004. [PMID: 31396591 PMCID: PMC6683978 DOI: 10.1016/j.eurox.2019.100004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 10/11/2018] [Accepted: 01/07/2019] [Indexed: 12/04/2022] Open
Abstract
Objectives To evaluate the impact of trans-vaginal fractional CO2 laser treatment on symptoms of stress urinary incontinence (SUI) in women. Study design Women clinically diagnosed with SUI preferring non-surgical treatment were recruited to the study. Fractional CO2 laser system (MonaLisa T, DEKA) treatments were administered trans-vaginally every 4–6 weeks for a total of three treatments. Response to treatment was assessed at baseline (T1), at 3 months after treatment completion (T2) and at 12–24-month follow-up (T3) using the Australian Pelvic Floor Questionnaire (APFQ). The primary outcome was changes in reported symptoms of SUI. Secondary outcomes assessed included bladder function, urgency, urge urinary incontinence (UUI), pad usage, impact of urinary incontinence on quality of life (QOL) and degree of bothersome bladder. Results Fifty-eight women were recruited and received the study treatment protocol. Eighty-two percent of participants reported an improvement in symptoms of SUI at completion of treatment (mild to no SUI) (p = <0.01). Treatment effect waned slightly when assessed at follow-up. Nevertheless, 71% of participants reported ongoing improvement in SUI symptoms at 12–24 months (p < 0.01). All secondary outcome measures were improved after treatment compared to baseline. Conclusions This study suggests that fractional CO2 laser is a safe, feasible, and beneficial treatment for SUI and may have a role as a minimally-invasive alternative to surgical management.
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Affiliation(s)
| | | | | | | | - Alan Lam
- University of Sydney, Sydney, NSW
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Behnia-Willison F, Sarraf S, Miller J, Mohamadi B, Care AS, Lam A, Willison N, Behnia L, Salvatore S. Safety and long-term efficacy of fractional CO 2 laser treatment in women suffering from genitourinary syndrome of menopause. Eur J Obstet Gynecol Reprod Biol 2017; 213:39-44. [PMID: 28419911 DOI: 10.1016/j.ejogrb.2017.03.036] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/08/2017] [Accepted: 03/25/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To evaluate the safety and long-term efficacy of fractional CO2 laser treatment in reducing the severity of symptoms of genitourinary syndrome of menopause (GSM) in menopausal women. STUDY DESIGN 102 women presenting with symptomatic GSM were treated with the fractional CO2 laser (MonaLisa Touch, DEKA) system across a series of treatments delivered at intervals of six or more weeks. The Australian Pelvic Floor Questionnaire was used to gather data on sexual function and side-effects at three time-points across the study period (prospective panel design study). Wilcoxon signed-rank tests were used to detect statistically and clinically significant changes in sexual function and side-effects occurring from pre- to post-treatment. The primary outcome of this study was an improvement of the symptoms of GSM. The secondary outcome included bladder function and prolapse symptoms. RESULTS A total of 102 women suffering from moderate to severe GSM were recruited. Eighty-four percent experienced significant improvement in their symptoms after CO2 laser treatment. Scores on measures of sexual function, dyspareunia, and bothersomeness of sexual issues were improved from pre-treatment to long-term (12-24 month) follow-up. Furthermore, there were improvements on measures of bladder function (P=0.001), prolapse (P=0.001), vaginal sensation (P=0.001), vaginal lubrication (P<0.001) and urge incontinence (P=0.003) from the pre-treatment assessment to the second assessment (i.e. after the third treatment). CONCLUSIONS In this study, fractional microablative CO2 laser treatment was associated with an improvement in symptoms of GSM and sexual function.
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Affiliation(s)
| | - Sara Sarraf
- Virginia Women's Center, St. Francis Medical Center, Memorial Regional Medical Center, St. Mary's Hospital, United States
| | | | | | - Alison S Care
- The University of Adelaide, Australia; Robinson Research Institute, The University of Adelaide, Australia
| | - Alan Lam
- Centre for Advanced Reproductive Endosurgery, Australia
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O'Shea R, Bedford N, Seman E, Behnia-Willison F, Keirse M, Cook J. Laparoscopic Paravaginal Repair – Objective Outcomes at Five Years and beyond. J Minim Invasive Gynecol 2012. [DOI: 10.1016/j.jmig.2012.08.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Behnia-Willison F, Foroughinia L, Sina M, McChesney P. Single incision laparoscopic surgery (SILS) in gynaecology: Feasibility and operative outcomes. Aust N Z J Obstet Gynaecol 2012; 52:366-70. [DOI: 10.1111/j.1479-828x.2012.01443.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 03/25/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - Leila Foroughinia
- Department of Obstetrics and Gynecology, School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Maryam Sina
- FBW gynaecology plus; Adelaide South Australia Australia
| | - Phil McChesney
- Obstetrics & Gynaecology; Flinders Medical Centre; Adelaide South Australia Australia
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Olakkengil SA, Norwood MG, Strickland AD, Behnia-Willison F, Mohan Rao M, Hewett PJ. Perspectives of Laparoscopic Donors Toward a New Procedure: Transvaginal Donor Nephrectomy. J Laparoendosc Adv Surg Tech A 2010; 20:803-6. [DOI: 10.1089/lap.2010.0291] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Santosh Antony Olakkengil
- Departments of Renal Transplant, Surgery, and Gynaecology, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Michael G.A. Norwood
- Departments of Renal Transplant, Surgery, and Gynaecology, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew D. Strickland
- Departments of Renal Transplant, Surgery, and Gynaecology, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Fariba Behnia-Willison
- Departments of Renal Transplant, Surgery, and Gynaecology, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Manchala Mohan Rao
- Departments of Renal Transplant, Surgery, and Gynaecology, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Peter J. Hewett
- Departments of Renal Transplant, Surgery, and Gynaecology, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
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Strickland AD, Norwood MGA, Behnia-Willison F, Olakkengil SA, Hewett PJ. Transvaginal natural orifice translumenal endoscopic surgery (NOTES): a survey of women's views on a new technique. Surg Endosc 2010; 24:2424-31. [PMID: 20224999 DOI: 10.1007/s00464-010-0968-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 02/03/2010] [Indexed: 12/16/2022]
Abstract
BACKGROUND Laparoscopic and minimally invasive surgery has changed the surgical landscape irrevocably. Natural orifice translumenal endoscopic surgery (NOTES) offers the possibility of surgery without visible scars. Transvaginal entry offers potential benefits because it gains access to the peritoneal cavity without the need to open an abdominal viscus. Much of the discussion pertaining to NOTES focuses on technical and training issues, with little attention to date paid to the opinions of women. The perceptions of female health care workers and patients were sought in relation to their views on transvaginal NOTES. METHODS This study surveyed 300 women using a 12-point questionnaire devised by a multidisciplinary group of surgeons interested in minimally invasive surgery. The questionnaire was designed to establish the opinions of women with respect to NOTES surgery versus standard laparoscopic procedures. Responses were de-identified. RESULTS Three-fourths of the women surveyed were neutral or unhappy about the prospect of a NOTES procedure, and this remained constant even when it was stipulated that laparoscopic cholecystectomy and NOTES had equivalent safety and efficacy. Younger nulliparous women were most concerned about the potential negative effect of NOTES on sexual function. A minority were concerned about the cosmetic effect of surgery, although surgical scars were perceived as more important to younger respondents. CONCLUSIONS Potentially, NOTES surgery offers women a scarless operation with the possibility of less pain than experienced in standard laparoscopic surgery. Few women, however, were troubled about the cosmetic effect of surgery. The effect of NOTES on sexual function was expressed as a particular concern by younger women. In all groups and across all ages, peritoneal access using the transvaginal route was met by significant scepticism. In Australia, women remain to be convinced about the potential advantages of the emerging NOTES technology.
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Affiliation(s)
- Andrew D Strickland
- Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville Road, Woodville, Adelaide, SA, 5011, Australia
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O'Shea R, Seman E, Cook J, Behnia-Willison F, Lam C, Vanspauwen R, Gibberd S, Kierse M. Anterior Compartment Prolapse – Laparoscopic Paravaginal Repair. J Minim Invasive Gynecol 2009. [DOI: 10.1016/j.jmig.2009.08.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seman E, O'Shea R, Cook J, Behnia-Willison F, Lam C, Vanspauwen R. Posterior Compartment Pelvic Organ Prolapse – Laparoscopic Supralevator Repair. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Seman E, O'Shea R, Cook J, Behnia-Willison F, Lam C, Vanspauwen R. Laparoscopic Paravaginal Repair for Anterior Compartment Pelvic Organ Prolapse. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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O’Shea R, Cook J, Behnia-Willison F, Lam C. 220: Laparoscopic Supralevator Repair Posterior Compartment Pelvic Organ Prolapse. J Minim Invasive Gynecol 2007. [DOI: 10.1016/j.jmig.2007.08.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Behnia-Willison F, Seman EI, Cook JR, O'Shea RT, Keirse MJNC. Laparoscopic paravaginal repair of anterior compartment prolapse. J Minim Invasive Gynecol 2007; 14:475-80. [PMID: 17630166 DOI: 10.1016/j.jmig.2006.12.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2006] [Revised: 11/29/2006] [Accepted: 12/05/2006] [Indexed: 11/21/2022]
Abstract
STUDY OBJECTIVE To assess the results of laparovaginal repair of anterior vaginal prolapse in terms of perioperative morbidity and repair durability. DESIGN Longitudinal study of a consecutive series of women assessed with the pelvic organ prolapse quantification (POPQ) system before and after laparoscopic paravaginal repair of anterior vaginal prolapse (Canadian Task Force classification II-2). SETTING University hospital in South Australia. PATIENTS Two hundred twelve women undergoing laparoscopic paravaginal repair for anterior compartment prolapse, with average follow-up of 14.2 months and 10 (4.7%) lost to follow-up. INTERVENTIONS All women underwent bilateral laparoscopic paravaginal repair that was combined with uterosacral hysteropexy or colpopexy in women with concomitant level I defects (n = 42) and supralevator repair in those with posterior fascia defects (n = 47). Recurrences were treated with graft-reinforced anterior colporrhaphy (n = 18). MEASUREMENTS AND MAIN RESULTS Nine women (4.2%) had major complications, and there were 61 minor complications. The POPQ assessment on follow-up (mean 14.2 months) gave a prolapse cure of the laparoscopic repair of 76% (95% CI 70.7%-82.1%). Eighteen of 23 women with a residual central defect subsequently had a graft-reinforced anterior colporrhaphy, after a mean interval of 14 months, which increased the cure rate to 84% (95% CI 79.6%-89.3%). CONCLUSION Laparoscopic paravaginal repair followed by graft-reinforced anterior colporrhaphy for central defects, when necessary, is associated with a low morbidity rate and achieves an anatomic cure rate greater than 80%.
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Affiliation(s)
- Fariba Behnia-Willison
- Department of Obstetrics, Gynecology and Reproductive Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia
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