Feasibility and outcome of vaginal paravaginal repair using the Capio suture-capturing device.

INTRODUCTION AND HYPOTHESIS: This investigation describes the feasibility and outcome of vaginal paravaginal repair (VPVR) performed using the Capio suture-capturing device. METHODS: This prospective study included 36 women with paravaginal fascial defects, symptomatic stage II to IV anterior vaginal wall prolapse, and uterine prolapse equal or more than stage 2. VPVR was performed using the Capio device. In addition, anterior colporrhaphy, posterior colporrhaphy, and vaginal hysterectomy were performed. RESULTS: The mean time required to perform the VPVR was 12.9 min (range, 11-18 min). The median blood loss during the VPVR was 35 ml (range, 20-65 ml). There were no major intraoperative complications. At 2-year follow-up, the rate of recurrent anterior vaginal wall prolapse (stage ≥ 2) was 8.6%. CONCLUSIONS: VPVR performed using the Capio device is associated with minimal dissection of the tissues, blood loss, and operating time and has low recurrence rate at 2-year follow-up.

Rising use of synthetic mesh in transvaginal pelvic reconstructive surgery: a review of the risk of vaginal erosion.

Recently, the use of surgical mesh in pelvic floor surgery has become increasingly popular. While the reduction of surgical failure rates in vaginal reconstructive surgery is of critical importance, the addition of graft materials must be shown to improve anatomical outcomes and at least maintain, if not improve, lower urinary tract, bowel, and sexual function, as well as quality of life for the patient. Synthetic materials still have several disadvantages including vaginal erosion. Several factors contribute to the wide range of vaginal erosion rates, including patient characteristics such as age and estrogen deficiency; operative technique; implant size; and the specific properties of the graft material, such as pore size, stiffness, elasticity, and basic tissue compatibility. It is the aim of this article to present a critical review of the risk of vaginal erosion with use of synthetic grafts during vaginal reconstructive surgery.

Does water delivery affect pelvic floor? Ultrasound evaluation of perineal function.

OBJECTIVE: The aim of the study is to analyse urethral mobility and excursion of the pubo-rectal angle, using perineal ultrasound, after normal vaginal delivery and water delivery. MATERIALS AND METHODS: A total of 52 primiparous women were enrolled: 25 who had delivery in water (W Group), 27 who had delivery without using water (NW Group). Every woman underwent perineal ultrasound assessment at 6 months after having given birth. The following parameters were assessed: urethral mobility during Valsalva's manoeuvre, movement of the puborectal sling angle during contraction of the levator ani muscle. RESULTS: Data obtained show that the urethral mobility during Valsalva's manoeuvre is higher in the W Group (34.9 degrees) in comparison to the NW Group (29.5 degrees), without statistically significant differences. The excursion of the pubo-rectal sling angle resulted lower in the W Group (8.7 degrees) than in the NW Group (11.0 degrees), without statistically significant differences. CONCLUSION: The present study found no statistically differences in pelvic floor, using perineal ultrasound, between water and "non-water" delivery.