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Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:

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Laparoscopic Non-Mesh Cerclage Pectopexy with Uterine Preservation for Pelvic Organ Prolapse
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Sling plication for recurrent stress urinary incontinence.

Danielle Patterson1, Sujatha Rajan, Neeraj Kohli

  • 1From the Division of Urogynecology, Brigham and Women's Hospital, Boston, MA.

Female Pelvic Medicine & Reconstructive Surgery
|March 29, 2012
PubMed
Summary

Recurrent stress urinary incontinence (SUI) after synthetic mid-urethral sling placement can be effectively managed with midline sling plication. This minimally invasive procedure offers a safe solution for SUI treatment, achieving high patient improvement rates.

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Area of Science:

  • Urology
  • Female Pelvic Medicine and Reconstructive Surgery

Background:

  • Recurrent stress urinary incontinence (SUI) following synthetic mid-urethral sling placement presents a significant clinical challenge.
  • Existing treatment options for recurrent SUI after sling failure are limited and often invasive.

Purpose of the Study:

  • To describe a safe and minimally invasive treatment for recurrent SUI after failed primary synthetic mid-urethral sling procedures.
  • To evaluate the efficacy and safety of midline sling plication in managing recurrent SUI.

Main Methods:

  • A case series of 20 women with recurrent SUI post-synthetic mid-urethral sling placement.
  • Sling plication performed using 2-0 polyester suture under intravenous sedation with intra-operative cough stress testing.
  • Retrospective chart review for preoperative and postoperative data collection.

Main Results:

  • Overall, 85% of patients reported subjective improvement in SUI after sling plication.
  • Patients with prior retropubic slings showed a 100% improvement rate, versus 72% for transobturator slings.
  • Subjective cure rates were 88% for retropubic slings and 45% for transobturator slings, with no reported complications.

Conclusions:

  • Midline plication of synthetic mid-urethral slings is a safe and effective treatment for recurrent SUI.
  • This minimally invasive approach offers a viable option for managing SUI recurrence after initial sling surgery.