1) Lower urinary tract symptoms (LUTS) are common in women both before and after pelvic organ prolapse (POP) surgery, with up to 86% experiencing urgency or frequency before surgery.
2) POP surgery has been shown to improve LUTS like overactive bladder (OAB) symptoms in up to 69% of women, though the effect on detrusor overactivity is smaller.
3) While POP is not a direct cause of OAB, there appears to be a link, with women having a 2.1-5.8 times higher relative risk of OAB if they have POP. Surgical correction of POP often improves OAB symptoms.
Rectal prolapse: Do we really have a perfect surgical solution? pptx copyDr Amit Dangi
Ventral rectopexy has gained worldwide acceptance for surgical correction of rectal prolapse and high-grade internal rectal intussusception. The technique is based on correcting the descent of the posterior and middle compartments combined with reinforcement of the vaginal septum and elevation of the pelvic floor. anterior mobilization of the distal rectum and mesh suspension performed during VR can correct full-thickness rectal prolapse, rectoceles, and internal rec- tal prolapse and can be combined with vaginal prolapse procedures, such as sacrocolpopexy, in patients with multicompartment pelvic floor defects.
Rectal prolapse: Do we really have a perfect surgical solution? pptx copyDr Amit Dangi
Ventral rectopexy has gained worldwide acceptance for surgical correction of rectal prolapse and high-grade internal rectal intussusception. The technique is based on correcting the descent of the posterior and middle compartments combined with reinforcement of the vaginal septum and elevation of the pelvic floor. anterior mobilization of the distal rectum and mesh suspension performed during VR can correct full-thickness rectal prolapse, rectoceles, and internal rec- tal prolapse and can be combined with vaginal prolapse procedures, such as sacrocolpopexy, in patients with multicompartment pelvic floor defects.
Revitalize! Indications for Surgery in Pelvic InfectionsHelen Madamba
This was a lecture given during the POGS Cebu chapter 39th Foundation Day Celebration and Postgraduate Course with theme: "POGS Cebu at 39: Revitalize, Reinvigorate, Rejuvenate!" at the Grand Ballroom of the Cebu Country Club
Overactive bladder, DR Sharda Jain Lifecare Centre Lifecare Centre
OAB OAB is not synonymous with detrusor overactivity as the former is a symptom based diagnosis whilst the latter is an urodynamic diagnosis.
It has been estimated that 64% of patients with OAB have urodynamically proven detrusor overactivity and that 83% of patient with detrusor overactivity have symptoms suggestive of OAB.
Rectal Prolapse - Cedars Sinai Medical Center - Medicine Resident TalkTheSurgeryGroupofLA
Presentation by Yossef Nasseri, M.D.
Yosef Nasseri, M.D., is a founding member of The Surgery Group of Los Angeles, a Los Angeles based physician group providing a comprehensive approach to surgical care through advanced technology, long-term patient follow-up, and direct physician access. Dr. Nasseri is double board-certified in general and colorectal surgery and specializes in cutting-edge robotic and minimally invasive techniques for the treatment of colon and rectal cancers, inflammatory bowel disease, benign anorectal diseases, a variety of hernias, and general surgery.
GERD is most common gastric problem in community affecting large number of people. Diagnosis and management is very simple with understanding.
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
https://drdhavalmangukiya.com/
Revitalize! Indications for Surgery in Pelvic InfectionsHelen Madamba
This was a lecture given during the POGS Cebu chapter 39th Foundation Day Celebration and Postgraduate Course with theme: "POGS Cebu at 39: Revitalize, Reinvigorate, Rejuvenate!" at the Grand Ballroom of the Cebu Country Club
Overactive bladder, DR Sharda Jain Lifecare Centre Lifecare Centre
OAB OAB is not synonymous with detrusor overactivity as the former is a symptom based diagnosis whilst the latter is an urodynamic diagnosis.
It has been estimated that 64% of patients with OAB have urodynamically proven detrusor overactivity and that 83% of patient with detrusor overactivity have symptoms suggestive of OAB.
Rectal Prolapse - Cedars Sinai Medical Center - Medicine Resident TalkTheSurgeryGroupofLA
Presentation by Yossef Nasseri, M.D.
Yosef Nasseri, M.D., is a founding member of The Surgery Group of Los Angeles, a Los Angeles based physician group providing a comprehensive approach to surgical care through advanced technology, long-term patient follow-up, and direct physician access. Dr. Nasseri is double board-certified in general and colorectal surgery and specializes in cutting-edge robotic and minimally invasive techniques for the treatment of colon and rectal cancers, inflammatory bowel disease, benign anorectal diseases, a variety of hernias, and general surgery.
GERD is most common gastric problem in community affecting large number of people. Diagnosis and management is very simple with understanding.
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
https://drdhavalmangukiya.com/
Recent evidence based guideline regarding Ovarian drilling very helpful for Gynaecologist, laparoscopic surgeon, Infertility specialist, Post doctoral fellows and post graduates
STARR Surgery for ODS | Defecography in Pune | Healing Hands Clinic Punehealinghandsclinic Pune
Healing Hands Clinic is a unique and speciality clinic for constipation,piles, hernia & prevention of Lifetstyle diseases. Apart from its heart of the city location, expert consultation, state of the art technology and well qualified staff are few of its assets. It is the first clinic in the city to deliver facility of Defecography for constipation. Our focus, dedication and inner feeling of curing or treating the patients with care have given us many satisfied patients.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
13. OABand POP
• OAB & POP are both common
conditions
• POP is not a causative factor of OAB
but is a coincidental finding…
• ...but there is a causal link
14. OABand POP
• Relative Risk (RR) of OAB in women with
POP is 2.1-5.8
• Conflicting data about relationship
between stage/compartment POP and OAB
symptoms
• In all studies there was an improvement in
OAB after POP surgery (up to 69%)
• Thus the strong link between POP and
OAB seems quite compelling
18. OABafterPOPsurgery without SUI
surgery
Different risk patterns for different OAB
symptoms:
• Post-op frequency and urgency less common
in women with higher pre-op POP-Q stages
• Use of vaginal mesh material had a favorable
effect on urgency
• Previous hysterectomy predictor for
bothersome post-op urgency
Evidence emerging by studies without UD:
22. OABafterPOPsurgery without SUI
surgery
Evidence emerging by studies with UD:
• Improvement of the flow rate and fall of the
opening pressure related to improvement
• Relationship between preoperative DO(OR
0.2) and bladder trabeculation (OR 6.1) and
improvement of UUI after surgery
• Higher preoperative detrusor pressure was
associated with persistence of symptoms
24. Effect of POPsurgery on DO
• Most studies showed an improvement
after POP surgery but the effect is not of
the same magnitude as for OAB symptoms
(RR>1)
27. De novo OABafterPOPsurgery
• Prevalence: 5-22 %
• Older age, BMI and SUI surgery were risk
factors for de novo OAB and UUI
• After correction for age and BMI, only
concomitant SUI surgery was predictor for de
novo OAB and UUI
28. Effect of POPsurgery on voiding
• Placement of vaginal ring pessary led to a
normal free-flow rate in 94% of women with
grade 3 or 4 cystocele
• Vaginal ring pessary mimics the surgical
correction of prolapse and improve voiding
by relieving urethral kinking caused by
cystocele
29. Effect of POPsurgery on voiding
• It has been hypothesized that women with
significant POP, particularly of the anterior
vaginal wall, may have impaired bladder
emptying owing to a “kink” in the normal
urethral mechanism
• Because of this, these women may also
have voiding dysfunction
30. Effect of POPsurgery on voiding
• Distinction between detrusor underactivity
and bladder outlet obstruction in women is
very difficult:
Cystometry and pressure flow studyCystometry and pressure flow study
• not well validated methods to evaluate detrusor
contractility
• controversial urodynamic definition of obstructiion
• useful relationship pressure/flow for the diagnosis
of obstruction (high Pdet/low Qmax)
• nomograms validated only in male patients
31. Effect of POPsurgery on voiding
• The cause of this obstruction or outlet
resistance is not fully understood
• Mechanical urethral kinking
• Urethral and/or bladder neck compression
by the cystocele
• Alteration of urethral innervation affecting
urethral relaxation, detrusor contraction and
efficient bladder emptying
32. Effect of POPsurgery on voiding
• Women with proven voiding dysfunction on
free flowmetry were more likely to have a
cystocele and an intact retrovesical angle on
ultrasound
33. Effect of POPsurgery on voiding
• An enterocele was consistently associated
with low flow rate, indicating that repair of
posterior vaginal wall may solve voiding
dysfunction
34. Effect of POPsurgery on voiding
• Hence voiding dysfunction is not only related
to the anterior vaginal wall prolapse and repair
of other prolapsed compartment may also
result in resolution of voiding dysfunction and
possibly OAB
• The ultrasound appearance of the bladder
neck and retrovesical angle may be more
important in function than the stage of prolapse
seen clinically
• The use of ultrasound to assess the bladder
and voiding function is worthy of more
research
35. Occult stress urinary incontinence
(OSUI) and POP
• OSUI prior POP surgery: 5-30%
• Due to the lack of randomised controlled
trials there are not clearly defined treatment
strategies for POP and OSUI
• Positive association between OSUI and post
operative SUI (15% subjective SUI)
• However OSUI does not adequately identify
individual women in need of prophylactic anti-
incontinence surgery undergoing POP repair
36. Occult stress urinary incontinence
(OSUI) and POP
• “. . . in wo m e n with O SIand PO P, a clinician
wo uld have to inse rt 1 0 TVT to pre ve nt 1
wo m an fro m re q uiring a sling 2-4 ye ars po st-
o pe rative ly”
