This book demonstrates knowledge on tissue-based procedures for stress urinary incontinence and other pelvic floor related topics. As the field shifts away from using synthetic material for repair, this work presents a new perspective on native tissue repair from the opinions and research of the authors. Written by a panel of expert authors in the field, this text provides high quality, focused information that is complimented by illustrations and videos. With established track records the authors illustrate how to perform the procedure vaginally or through open surgery, and inclusion of live surgeries via online video, makes this an invaluable tool for busy surgeons and specialists interested in pelvic floor reconstruction.

This book provides a comprehensive and up-to-date overview of the surgical treatment of pelvic organ prolapse, focusing especially on issues that continue to arouse controversy. In the first section, leading experts present detailed information on the surgical anatomy, pathophysiology, and epidemiology of prolapse and also the impact of concomitant functional disorders. The second section focuses on diagnostic work-up and the third is dedicated to the various treatment options aimed at resolution of the condition. The closing chapters discuss outcome measures and analyze the effects of prolapse surgery on urinary, bowel, and sexual symptoms. In 1966 Richard TeLinde stated that, “Every honest surgeon of extensive and long experience will have to admit that he is not entirely and absolutely satisfied with his long-term results of all his operations for prolapse and allied conditions.” Although many uncertainties in the field have since been resolved, some major issues still require clarification. Often it can be difficult to find the right balance between treatment effectiveness in the long term and risk reduction, including with respect to complications. This book will help trainees and less experienced surgeons to make appropriate treatment choices and achieve optimal outcomes.

Dr. Iglesia has created an issue devoted to pelvic floor disorders that has a strong focus on the evidence behind current treatments and diagnostic methods. The authors are top experts in their areas and have contributed reviews on the most important topics in pelvic floor disorders, including Stress Urinary Incontinence; Urge Urinary Incontinence; Pelvic Organ Prolapse Native Tissue repairs; Pelvic Organ Prolapse Vaginal and Laparoscopic Mesh; Fecal Incontinence; PFDR Pelvic Floor Disorders Registry; Ultrasound Imaging of the Pelvic Floor; and Childbirth/Pelvic Floor Epidemiology to name a few.

Internationally known experts offer multidisciplinary guidance on the diagnosis and management of the full spectrum of pelvic floor disorders. It covers the diagnosis and clinical assessment of continence mechanisms and sexual dysfunction, as well as conservative management of the lower urinary tract, disorders of anorectal functions and sexual functions, exploring techniques such as electrical stimulation, anti-incontinence devices, and biofeedback. This valuable text also provides information on the management and treatment of a full range of disorders, from childbirth damage and post-prostatectomy incontinence, to neuropathic voiding dysfunction. Reviews normal anatomy and physiology as well as pathophysiology, providing an in-depth understanding of how and why various pelvic floor disorders occur. Covers the complete spectrum of pelvic floor disorders, including childbirth damage · lower urinary tract dysfunction in the female and male · urinary incontinence in the elderly · pelvic organ prolapse · post-prostatectomy incontinence · neurogenic voiding dysfunction · fecal incontinence · defecatory disorders · pediatric urology · male and female sexual dysfunction. Discusses all types of diagnostic approaches, including urodynamics · imaging · MRI · endoscopy · and electrodiagnosis. Conservative treatment is based on different techniques: pelvic floor muscles training · behavioral therapy · biofeedback · electrical stimulation and anti-continence devices. Represents a practical approach to surgery and conservative treatment for the physician and health care professionals and provides practical suggestions on these techniques. Features contributions from urologists, gynecologists, coloproctologists, continence specialists, specialist physical therapists, and nurses, for exceptionally multidisciplinary, well-rounded coverage of every aspect of the field.

Biomechanics of the Female Pelvic Floor, Second Edition, is the first book to specifically focus on this key part of women’s health, combining engineering and clinical expertise. This edited collection will help readers understand the risk factors for pelvic floor dysfunction, the mechanisms of childbirth related injury, and how to design intrapartum preventative strategies, optimal repair techniques, and prostheses. The authors have combined their expertise to create a thorough, comprehensive view of female pelvic floor biomechanics in order to help different disciplines discuss, research, and drive solutions to pressing problems. The book includes a common language for the design, conduct, and reporting of research studies in female PFD, and will be of interest to biomechanical and prosthetic tissue engineers and clinicians interested in female pelvic floor dysfunction, including urologists, urogynecologists, maternal fetal medicine specialists, and physical therapists. Contains contributions from leading bioengineers and clinicians, and provides a cohesive multidisciplinary view of the field Covers causes, risk factors, and optimal treatment for pelvic floor biomechanics Combines anatomy, imaging, tissue characteristics, and computational modeling development in relation to pelvic floor biomechanics

Edited and authored by some of the most respected figures in the field, this newly revised book is your comprehensive guide to all areas of urogynecology, including urinary and fecal incontinence, urodynamic testing, management of genuine stress incontinence, pelvic organ prolapse, overactive bladder, and much more. Uniquely organized to reflect a physician's decision-making process, this practical, clinically oriented text moves from basic concepts through to clinical and urodynamic evaluation, management, and treatment. Inside, you'll find evidence-based assessments of appropriate therapies, along with algorithmic approaches to common complaints, and clear surgical illustrations. Exclusive to the third edition is a section addressing painful and irritative voiding disorders, including overactive bladder, as well as 20 new case presentations that offer opinions from the leading experts in urogynecology and urology. Features step-by-step instructions for urodynamic testing. Addresses all urogynecologic disorders, including genuine stress incontinence · pelvic organ prolapse · defecation disorders · painful and irritative voiding disorders · and specific conditions such as urinary tract infection. Presents vital information on urethral injections, covering the newest treatment options available. Examines the use of autologous materials and mesh in reconstructive pelvic surgery. Uses over 300 crisp illustrations to illuminate every detail. Contains a new section on painful and irritative voiding disorders, including a discussion of overactive bladder and the latest treatment options available. Discusses urodynamics and the most up-to-date testing available for urethral sphincteric function. Features 20 all new case presentations with expert commentary.

The initial objective of this work was to reduce stress incontinence surgery from a major surgical procedure (requiring up to ten days in hospital) to a minor day-care operation. From the beginning it was clear that the two major impediments to achieving this goal were post operative pain and urinary retention. Addressing these problems became a long and winding road and culminated in the Integral Theory. The IVS 'tension-free' tape operation was inspired by Dr Robert Zacharin's anatomical studies. Though Zacharin suggested that the ligaments and muscles around the urethra were important for urinary continence control, he did not say how. The observation that implanted foreign materials created scar tissue led to the hypothesis that a plastic tape inserted in the position of the pubourethrallig ament, would leave behind sufficient scar tissue to reinforce that ligament, which would then anchor the muscles for urethral closure. In September 1986, two prototype Intravaginal Sling operations were per formed. A Mersilene tape was inserted with neither tension nor elevation, in the position of the pubourethral ligament. Restoration of continence was immediate and both patients were discharged on the day following surgery without require ment for catheterization. There was minimal pain, and immediate restoration of continence. After six weeks the tapes were removed. Both patients were still conti nent at last review 10 years later. The results appeared to confirm the importance of a midurethral anchoring point.