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Carcinoma of the Vagina and Vulva
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Sadaf Ghaem-Maghami, Kostas Lathouras
The most common complication is wound breakdown and infection. With the modified surgical techniques referred to in the foregoing text, this is seldom more than a minor problem. Conservative therapy with Eusol and liquid honey packs is all that is required. Lymphocyst formation can be very troublesome. Resolution usually occurs spontaneously. Osteitis pubis is a rare but very serious complication that requires intensive and prolonged antibiotic therapy. Secondary hemorrhage occurs from time to time. Leg edema may be expected in approximately 30% of patients. Numbness and paresthesia over the anterior thigh are common due to the division of small cutaneous branches of the femoral nerve. Loss of body image and impaired sexual function undoubtedly occur, but the patients’ responses to surgery are enormously variable.
Carcinoma of the vagina and vulva
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2014
Sadaf Ghaem-Maghami, William Patrick Soutter
The most common complication is wound breakdown and infection. With the modified surgical techniques referred to in the foregoing text, this is seldom more than a minor problem. Conservative therapy with Eusol and liquid honey packs is all that is required. Lymphocyst formation can be very troublesome. Resolution usually occurs spontaneously. Osteitis pubis is a rare but very serious complication that requires intensive and prolonged antibiotic therapy. Secondary haemorrhage occurs from time to time. Leg oedema may be expected in approximately 30% of women. Numbness and paraesthesia over the anterior thigh is common due to the division of small cutaneous branches of the femoral nerve. Loss of body image and impaired sexual function undoubtedly occur but the patients’ responses to surgery are enormously variable.
Biological Grafts in Reconstructive Pelvic Surgery
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
recurrence rAtes with AdjuvAnt synthetic meshes compAred to porcine dermis. nAtAle et Al. reported A 72% AnAtomic success rAte (less thAn or equAl to stAge 2) with polypropylene vs. A 56% in the porcine dermAl grAft group. extrusion wAs only seen in the synthetic mesh group (6.3%). both groups reported improvement in QoL [22]. Menefee et Al. compAred success between polypropylene, porcine dermis, And nAtive tissue Anterior colporrhAphy in A rAndomized controlled triAl with blinded postoperAtive outcomes [23]. They reported the highest success rAte with polypropylene (82%) versus porcine dermis (54%) And 42% with nAtive tissue repAirs. extrusion rAtes were higher in the polypropylene group (14%) versus 4% in the porcine dermAl group And with none in the nAtive tissue group. Higher extrusion rAtes hAve Also been noted in other triAls with synthetic grAfts [17]. When Anterior colporrhAphy with nAtive tissue repAir wAs compAred to using An AdjuvAnt porcine dermAl grAft in three rAndomized triAls, the objective fAilure wAs significAntly higher in the nAtive tissue group (27%) compAred to the porcine dermis group (16%) [20,21,23]. When used in the Anterior compArtment for vAginAl reconstructive surgery, it seems thAt how AllogrAfts Are implAnted mAy impAct their success of preventing recurrence. In A prospective, rAndomized, controlled triAl, GAndhi et Al. reported thAt A 2 × 4 cm cAdAveric fAsciA lAtA grAft overlAy did not reduce the rAte of recurrent cystocele. At 13 months, the objective (>stAge 2) And subjective fAilure rAtes of the Anterior colporrhAphy were not stAtisticAlly significAntly different: 29% And 21% from the 10.5% And 10.9% noted in the fAsciAl pAtch group, respectively [15]. In A study using AdjuvAnt cAdAveric fAsciA lAtA grAfts, which were AttAched using trAnsvAginAl bone Anchors, only 2 out of 132 pAtients At 12 months hAd recurrent cystoceles of greAter thAn second degree. only one cAse of osteitis pubis wAs reported [24]. A rAndomized controlled triAl of stAndArd nAtive tissue Anterior colporrhAphy compAred to utilizing AdjuvAnt smAll intestine submucosA grAfts reported A 59.3% AnAtomic cure rAte vs. 86.2%, with the AdjuvAnt smAll intestine submucosA intestine grAfts. no differences were noted in QoL meAsures or subjective outcomes [25]. no inflAmmAtory complicAtions were reported–As hAd been reported in single cAse with porcine smAll intestine submucosA trAnsobturAtor slings [26]. Guerette et Al. compAred nAtive tissue repAirs with bovine pericArdium grAft–reinforced repAirs in the Anterior compArtment. They reported A 78.4% versus 85.7% success rAte, respectively At 1 yeAr. At 2 yeArs, the bovine pericArdium grAft group's success rAte dropped to 76.5% vs. 63% with nAtive tissue. both groups demonstrAted improvements in subjective outcomes. no stAtisticAlly significAnt differences in subjective or objective outcomes were noted with use of bovine pericArdium AdjuvAnt grAfts in the Anterior compArtment [27]. reAnAlysis by bArber et Al. of the originAl work suggested thAt when subjective outcomes Are considered, the fAilure rAtes of grAft-Augmented repAirs Are compArAble to nAtive tissue. surgicAl success defined As AnAtomic support proximAl to the hymen hAd the lowest treAtment success (19.2%–57.6%).
Management of a nonathlete with a traumatic groin strain and osteitis pubis using manual therapy and therapeutic exercise: A case report
Published in Physiotherapy Theory and Practice, 2020
Kyle Feldman, Carla Franck, Christine Schauerte
Pubic joint dysfunction can also drive groin pain. Osteitis pubis typically occurs in runners and soccer players, and can occur concomitantly with a groin strain (Ekberg et al., 1988; Morelli and Smith, 2001). Repetitive stress on the joint from shear forces of the pubic bones, pelvic muscle imbalances, and limited hip internal rotation have all been shown as mechanisms for this joint pathology (Fricker, Taunton, and Ammann, 1991; Williams, 1978). Patient presentation typically includes pain in regions of the adductors, pubic symphysis, and scrotum as well as pain with active adductor muscle contraction and sit-ups (Fricker, Taunton, and Ammann, 1991; Morelli and Smith, 2001). This pathology is self-limiting but the typical average healing time has been reported as long as 9.6 months (Fricker, Taunton, and Ammann, 1991).