Urogynecology: Evidence-Based Clinical Practice

ISBN-13: 9783030933661 / Angielski / Miękka / 2022

Kate H. Moore

Opis

This heavily revised third edition concisely covers the latest evidence-based treatment strategies for urinary incontinence and prolapse. Chapters cover methodologies relevant to continence procedures, prolapse management, and potential complications. New topics discussed include Colpocleisis, principles associated with managing Mesh complications and the Mirabegron mechanism.Urogynecology: Evidence-Based Clinical Practice 3rd Edition is a vital how-to guide, which is ideal for junior registrars assigned to work in a urogynecology department, as well as for those with no previous formal urogynecological training seeking to develop their understanding of the subject.

Spis treści

History taking.- Incontinence and Frequency, Urgency, Nocturia.- The Frequency Volume Char.- How bad is the problem? – assessing severity.- Voiding difficulty.- Prolapse.- Faecal Incontinence and Obstructive Defecation.- Surgical History.- Dyspareunia in relation to urogynaecology.- Assessment of Mesh Pain/ complications.- Recurrent bacterial cystitis.- Interstitial Cystitis/ Painful Bladder Syndrome.- History of Drug Therapy.- General Assessment of Precipitating Factors.- Physical examination.- Assess the abdomen.- Inspect the vulva.- Elicit a “stress leak”.- Speculum examination needs.- POPQ Scoring system of Prolapse.- Assess Pelvic Floor Muscle Contraction Strength – Oxford Score.- How to assess vagina/ pelvis in Mesh Pain, overview.- Do all patients need a rectal examination?.- Screening neurological examination.- How to manage the patient after history and examination.- Explaining the situation to the patient.- Treat precipitating factors.- Get old notes of any relevant surgery.- Begin basic management plan for incontinence/ prolapse/ UTI.- How to conduct  and interpret urodynamic tests.- Who needs urodynamic testing?.- Different types of urodynamics.- Practical advice about how to perform urodynamic tests.- Uroflowmetry.- Twin channel cystometry.- Urodynamic diagnoses available from the filling phase.- Videourodynamics.- “Occult” stress incontinence.- Ultrasound .- Voiding cystometry, diagnoses available after test.- Special tests: Urethral Pressure Profilometry and Leak Point Pressures.- 3D ultrasound and/or MRI.- Examples of reports – what do they mean?.- Outcome measures in assessing response to treatment.- Tests that measure patient’s symptoms.- The ICIQ-SF, Wexner Scale.- Tests that quantify patients symptom.- Micturition chart, Frequency Volume Chart, Urinary Diary.- The Pad Test; 1 hour and 24 hour.- Quality of Life.- Economic evaluation.- Conservative therapy of USI.- Managing chronic cough and obesity.- Treatment of constipation.- Treating postmenopausal urogenital atrophy .- Starting a home-based pelvic floor muscle training program.- The role of the Nurse Continence Advisor.- Who should be referred for physiotherapy?.- What does the physiotherapist do?.- The efficacy of physiotherapy techniques.- What if conservative therapy fails but patient does not want surgery? Rings.- Step by step guide to treatment of overactive bladder / detrusor overactivity.- Explain the condition – basic physiology review.- Step by step guide to bladder training.- Need section on Nocturia treatment.- How do anticholinergic drugs work, how do we use them?.- Mirabegron mechanism, effectiveness, risks.- Are these drugs effective? – need for long term therapy?.- Role of topical oestrogens in DO.- Alternative treatments.- TENS.- Acupuncture and SANS electro-acupunctur.- Hypnotherapy.- Electrostimulation and Extracorporeal Magnetic Stimulation.- Cystodistension.- Clam cystoplasty.- Implantation of S3 Sacral Nerve Root Stimulator.- Botox Therapy.- Intravesical Resiniferatoxin installation.- Faecal Incontinence and Disorders of Obstructive Defecation.- Basic Physiology of Anal Continence and Defecation for the Gynaecologist.- Overview of Anal Incontinence Tests and Treatment.- Overview of the Disorders of Obstructive Defecation.- Constipation, Outlet Obstruction.- Overview of Treatment of Disorders of Defecation.-  Surgery for US.- Bladder neck buttress.- Colposuspension, lap versus open.- Preoperative consent discussion.- Postoperative convalescence.- Technique.- Postoperative management.- Short term voiding difficulty.- Long term voiding dysfunction.- Abdominovaginal Sling, and “Sling on a String”.- Preoperative consent discussion.- Technique.- Historical note: Stamey/ Raz/Peyreyra/ Gittes procedures, Paravaginal repair.- Laparoscopic colposuspension.- The retropubic TVT needs total revision.- Preoperative consent discussion, risks.- Technique.- Postoperative instructions .- The transobturator tape; recent awareness of increased risk versus benefit.- Use of bulking agents: GAX collagen, Macroplastique, Durasphere.- Management of Prolapse.- Non surgical management options.- Surgery for cystocoele: four techniques.- Outline of controversies.- What is the value of Manchester repair- technique.- Preoperative consent discussion for anterior compartment repair.- Overview of the rationale for previous use of vaginal mesh in cystocoele.- Surgery for Rectocoele/ Deficient Perineum.- Outline of controversies.- Surgery for enterocoele.- Vaginal Sacrospinous Fixation technique.- Preoperative consent discussion, postop instructions/ issues.- Abdomino-sacro-colpopexy techniques.- Preoperative consent discussion, postop regime.- Uterine prolapse.- Colpocleisis.- Management of Mesh complications- basic principles.- Recurrent bacterial cystitis in wome.- Guide to Management.- Investigations.- Treatment.- Interstititial cystitis?.- How to diagnosis it.- Outline of aetiology.- Treatment.

 

O autorze

Professor Kate Moore is a urogynecologist and Director of the Pelvic Floor Unit at St George Hospital, University of New South Wales, a regional referral unit which serves all of NSW and ACT, conducting over 10,000 occasions of service annually. Professor Moore also runs the urogynecology clinics / surgical services at the Royal Hospital for Women and Sutherland Hospital in central and southern Sydney.

It is the largest urogynecology service in the southern hemisphere, and the only one in Australia which provides care under one roof for colorectal patients with faecal incontinence/ post partum anal sphincter injuries, as well as urology patients with incontinence. 

Her main research interests include the aetiology of detrusor overactivity (detrusor muscle contractility), and the economic implications of incontinence. Definition of objective outcome measures, including the costs of treatment are also important research interests. She has authored over 100 peer-reviewed publications / book chapters.