Vaginal Fistula Repairs
Fig. 10.1 The peritoneum is located near a post hysterectomy vesicovaginal fistula (Copyright © Shlomo Raz, MD) Fig. 10.2 Martius flap based on its inferior pedicle, posterior labial branches of…
GYNECOLOGY
Obliterative Vaginal Procedures
Fig. 6.1 Stage 4 vaginal vault prolapse Some type of preoperative evaluation for stress urinary incontinence (SUI), even in patients that report continence, is recommended due to the high rate…
Surgical Management of Stress Urinary Incontinence
Fig. 3.1 Burch colposuspension: The initial suture is at the urethrovesical junction and the second suture is approximately 1 cm caudal. Care is taken to place these sutures at least…
Botulinum Toxin Therapy for Voiding Dysfunction and the Female Pelvic Floor
Fig. 17.1 (a, b) (a) Normal cholinergic transmission at the synaptic cleft. (Copyright © Allergan, Inc., Irvine, CA. Used with permission 2013.) (b) Onabotulinum toxin A works by inhibiting vesicle-mediated…
Urethroplasty for Female Urethral Stricture
Fig. 13.1 Voiding cystourethrogram showing proximal urethral dilatation with distal urethra narrowing and distortion of bladder morphology from spherical to oblong (Both: Used with permission from Groutz A, Blaivas JG,…
Open Transabdominal Sacrocolpopexy
Fig. 7.1 Sagittal view of enterocele in post-hysterectomy patient. (Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 2009–2013. All Rights Reserved) Given the results of the…
Transvaginal Urethrolysis for Urethral Obstruction
Fig. 9.1 (a) Blaivas–Groutz nomogram for bladder outlet obstruction. (b) Urodynamic tracing shows severe urethral obstruction (Type 2 in Blaivas-Groutz nomogram). Q max: maximum flow rate; P det@Q max: detrusor…
Sacral Neuromodulation
Fig. 4.1 PNE components. (a) Prep kit which includes drapes and prepping materials. (b) Test stimulation kit: foramen needles, syringe, and needle for local anesthetic, test stimulation lead, marking pen,…
Augmentation Cystoplasty
Indications Congenital Myelodysplasia Tethered spinal cord Exstrophy (classic, cloacal, epispadias) Sacral agenesis Caudal regression Posterior urethral valves Acquired neurogenic Spinal cord injury Spinal tumors Myelitis Multiple sclerosis Idiopathic Acquired…
Transvaginal Closure of Bladder Neck
Fig. 15.1 Urethral erosion as demonstrated by a wide, patulous urethra Management options for these patients are limited. Unfortunately many of these patients are debilitated secondary to their medical comorbidities…
