Walters & Karram Urogynecology and Reconstructive Pelvic Surgery

5th Edition - September 1, 2021
Editors: Matthew D. Barber, Mark D. Walters, Mickey M. Karram, Catherine Bradley
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 9 7 8 3 - 5
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 2 6 1 7 - 4

Uniquely designed to reflect the physician’s decision-making process, Walters & Karram Urogynecology and Reconstructive Pelvic Surgery presents definitive, state-of-the-a… Read more

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Uniquely designed to reflect the physician’s decision-making process, Walters & Karram Urogynecology and Reconstructive Pelvic Surgery presents definitive, state-of-the-art guidance on every aspect of female pelvic medicine and reconstructive surgery. This practical, atlas-style resource covers everything from basic concepts through to clinical and urodynamic evaluation, management, and treatment, equipping you to make the best clinical decisions and optimize outcomes. Edited and authored by renowned experts in the field, this updated 5th Edition is an ideal resource for urogynecology fellows and practitioners, urologists, and OB/GYNs who need a step-by-step, comprehensive reference on the latest procedures and research to evaluate and treat female pelvic floor disorders.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Acknowledgments
List of Illustrations
List of Tables
Part 1. Basic Science
1. Anatomy of the lower urinary tract, pelvic floor, and rectum
Pelvic anatomy
Surgical spaces
Pelvic organ support
Bibliography
2. Embryology and congenital anomalies of the urinary tract, rectum, and female genital system
Embryology
Congenital anomalies of the female genital system
Summary
Bibliography
3. Neurophysiology and pharmacology of the lower urinary tract
Introduction
General nervous system arrangements
Sensory innervation
Central nervous system modulation
Bladder filling and storage
Voiding
Innervation of lower urinary tract outlet
Clinical pharmacology of the lower urinary tract
Therapy to facilitate bladder emptying
Therapy to facilitate urine storage
Bibliography
4. Physiology of the pelvic muscles, vagina, and anorectum
Pelvic floor
Vagina
Anorectum
Summary
Bibliography
5. Pathophysiology of pelvic floor disorders
Introduction
Stress urinary incontinence
Pelvic organ prolapse
Fecal incontinence
Bibliography
Stress urinary incontinence
Pelvic organ prolapse
Fecal incontinence
6. Epidemiology and psychosocial impact of female pelvic floor disorders
Epidemiology
Causes and prevention of pelvic floor disorders
Psychosocial impact of pelvic floor disorders
Bibliography
7. Synthetic mesh and biologic grafts: Properties and biomechanics
Introduction
Synthetic meshes
Biologic grafts
Future outlook for synthetic meshes and biologic grafts
Bibliography
8. Description and classification of lower urinary tract dysfunction and pelvic organ prolapse
Introduction
Classification systems of lower urinary tract dysfunction
Differential diagnosis of urinary incontinence
Description and staging of pelvic organ prolapse
Classification system of vaginal prostheses and graft complications
Bibliography
Classification of complications related to vaginal prostheses and grafts
Classification of pelvic organ prolapse
Classification of urinary incontinence
Part 2. Evaluation
9. Evaluation of pelvic floor disorders: History, physical examination, and diagnostic testing
Introduction
History for pelvic floor disorders
Physical examination
Diagnostic testing
Summary
Bibliography
Introduction
History of pelvic floor disorders
Physical examination
Diagnostic testing
10. Female sexual function and dysfunction: Assessment and treatment
Introduction
Models of female sexual response
Physiology
Female sexual disorders
Variables that can affect sexual function
Screening and evaluation for sexual dysfunction
Treatment of female sexual disorders
Conclusion
Bibliography
11. Urodynamics: Indications, techniques, interpretation, and clinical utility
Introduction to urodynamics
Urodynamic equipment
Performing a urodynamic evaluation
Interpretation of specific tests
Urodynamics and specific conditions
Video urodynamics
Case discussions
American urological association/society of urodynamics, female pelvic medicine & urogenital reconstruction guidelines on urodynamic studies in adults
Conclusion
Bibliography
Cystometry
Leak point pressures
Urethral pressure profilometry
Flow studies
Video urodynamics
12. Endoscopic assessment of the lower urinary tract
Historical perspective
Indications
Instrumentation
Cystourethroscopic technique
Cystourethroscopic findings
Bibliography
Historical perspective
Instrumentation
Cystourethroscopic technique
Cystourethroscopic findings
13. Radiologic studies of the lower urinary tract and pelvic floor
Introduction
Plain film of the abdomen
Intravenous pyelography, computed tomography urogram, and retrograde pyelography
Cystography and voiding cystourethrography
Fluoroscopy and defecography
Ultrasound
Applications of ultrasound in evaluating disorders of the lower urinary tract and pelvic floor
Magnetic resonance imaging
Bibliography
Part 3. Management of Stress Urinary Incontinence and Pelvic Organ Prolapse
14. Stress urinary incontinence and pelvic organ prolapse: Nonsurgical management
Introduction
The bladder diary: A valuable clinical tool
Behavioral intervention: Pelvic floor muscle training and exercise
Weight loss and urinary incontinence
Complementary and alternative therapies for urinary incontinence
Estrogen and stress urinary incontinence
Other pharmacologic therapies for stress urinary incontinence
Urethral devices
The ins and outs of pessary use
Conclusion
Bibliography
Introduction
The bladder diary: A valuable clinical tool
Behavioral intervention: Pelvic floor muscle training and exercise
Weight loss and urinary incontinence
Complementary and alternative therapies for urinary incontinence
Estrogen and stress urinary incontinence
Other pharmacologic therapies
Urethral devices
Ins and outs of pessary use
15. Retropubic operations for stress urinary incontinence
Introduction
Indications for retropubic procedures
Surgical techniques
Clinical results
Mechanisms of cure
Complications
Role of hysterectomy in the treatment of incontinence
Pregnancy after retropubic surgery
Bibliography
Surgical technique
Results and mechanism of cure
Complications
16. Biologic bladder neck slings for stress urinary incontinence
Introduction
Indications
Sling materials
Surgical techniques
Outcomes
Complications
Bibliography
17. Synthetic midurethral slings for stress urinary incontinence
Introduction
Retropubic midurethral slings
Transobturator midurethral slings
Single-incision minislings
Outcomes
Avoiding and managing complications
Perioperative pelvic muscle exercises
Pregnancy after midurethral slings
Conclusion
Bibliography
18. Urethral injection of bulking agents for intrinsic sphincter deficiency
Introduction
Indications and contraindications
Evaluation
Materials
Techniques
Complications and safety
Future considerations
Bibliography
19. Surgical treatment of anterior vaginal wall prolapse
Introduction
Anatomy and pathology
Evaluation
Surgical repair techniques
Results
Complications
Bibliography
20. Surgical treatment of posterior vaginal wall prolapse
Anatomy and pathophysiology
Evaluation
Surgical repair techniques
Analysis of outcomes
Complications
Conclusion
Bibliography
Anatomy and pathophysiology
Evaluation
Surgical techniques, complications, and recurrence
21. Surgical treatment of vaginal apex prolapse
Introduction
Anatomic considerations
Transvaginal native tissue suture repairs
Transvaginal mesh procedures
Sacrocolpopexy
Choosing approach of surgery
Bibliography
22. Uterine preservation in pelvic organ prolapse surgery
Introduction
Historical perspective
Considerations for uterine preservation
Vaginal approach
Abdominal approach
Comparing approaches to hysteropexy
Summary and future questions
Bibliography
23. Obliterative procedures for pelvic organ prolapse
Introduction
Historical perspectives
Preoperative evaluation
Le fort partial colpocleisis
Total colpectomy and colpocleisis
Levator plication and perineorrhaphy
Urinary and bowel function following obliterative procedures
Quality of life and regret of loss of sexual function
Conclusion
Bibliography
Historical perspectives
Evaluation, surgical treatment, and complications
Part 4. Surgical Complications and their Management
24. Avoiding and managing lower urinary tract injuries during pelvic surgery
Introduction
Incidence
Prevention of injuries
Recognition and management of injuries
Postoperative evaluation of suspected genitourinary fistulas
Bibliography
25. Managing mesh complications after surgeries for urinary incontinence and pelvic organ prolapse
Introduction
US food and drug administration warnings
Professional society guidelines
Avoiding synthetic mesh complications
Managing complications
Conclusion
Bibliography
26. Complications of pelvic reconstructive surgery
Evaluating comorbidities and perioperative risk
Enhanced recovery
Pulmonary complications
Venous thromboembolism
Delirium
Fever and perioperative infections
Small bowel obstruction
Small bowel injury
Rectal injury
Nerve injury
Iatrogenic complications of vaginal surgery
Conclusion
Bibliography
Part 5. Fecal Incontinence and Defecation Disorders
27. Fecal incontinence
Epidemiology
Etiology
Evaluation
Nonsurgical treatment
Procedures and surgery
Additional treatment considerations
Conclusion
Bibliography
28. Constipation
Definition and etiology
Epidemiology
Evaluation
Nonsurgical treatment
Surgical treatment
Conclusion
Bibliography
29. Rectovaginal fistula and perineal breakdown
Anatomy of the perineal body, distal vagina, rectum, and anus
Classification and presentation of perineal breakdown and rectovaginal fistula
Etiologies of rectovaginal fistula and perineal breakdown
Diagnosis and preoperative evaluation
Surgical treatment of rectovaginal fistula
Perineal breakdown
Conclusion
Bibliography
30. Full-thickness rectal prolapse
Introduction
Etiology
Epidemiology
Clinical features
Evaluation
Nonsurgical options for prolapse
Common surgical repairs for prolapse
Outcomes and choice of procedure
Bibliography
Part 6. Lower Urinary Tract Disorders
31. Overactive bladder syndrome, polyuria, and nocturia
Overactive bladder syndrome
Polyuria
Nocturia
Summary
Bibliography
32. Refractory overactive bladder
Introduction
Botulinum toxin
Sacral neuromodulation
Factors associated with success of botulinum toxin and sacral neuromodulation
Percutaneous tibial nerve stimulation
Cost effectiveness of therapies
Emerging therapies
Final conclusions
Bibliography
33. Neurourology and compliance abnormalities
Introduction
Compliance and changes in bladder neurophysiology
Types of neurogenic bladder
Urodynamics and bladder compliance
Urodynamic findings in neurogenic bladder
Patient evaluation
Management of impaired compliance
Conclusion
Bibliography
34. Voiding dysfunction in women
Introduction
Neurophysiology of micturition
Classification of voiding dysfunction
Evaluation of female voiding dysfunction
Diagnosis and management
Neurogenic voiding dysfunction
Conclusion
Bibliography
35. Interstitial cystitis/bladder pain syndrome
Introduction
Nomenclature
Epidemiology
Etiology
Clinical phenotyping
Flares
Evaluation
Management of interstitial cystitis/bladder pain syndrome
Bibliography
Nomenclature and epidemiology
Etiology
Clinical phenotyping and flares
Evaluation
Management of interstitial cystitis/bladder pain syndrome
Part 7. Specific Conditions
36. Lower urinary tract infection
Introduction
Acute, symptomatic, uncomplicated lower urinary tract infection
Complicated urinary tract infections
Recurrent symptomatic urinary tract infection
Asymptomatic bacteriuria
Special circumstances
Conclusions
Bibliography
37. Urethral diverticula
Introduction
Incidence
Etiology
Presentation
Diagnosis
Radiologic imaging
Urethral and urethral diverticular pathology
Management of female urethral diverticula
Complications
Summary
Bibliography
38. Lower urinary tract fistulas
Historic perspectives
Epidemiology and etiology
Presentation and diagnosis
Conservative management
Timing of surgical repair
Presurgical management
Surgical repair
Urinary diversion
Complications of fistula repair
Prevention
Bibliography
39. Bladder drainage and urinary protective methods
Introduction
Bladder drainage
Urine loss appliances and absorptive products
Bibliography
40. Urology for the urogynecologist
Basics of urinary stone disease
Bladder cancer
Retrograde ureterogram and stent placement
Bibliography
Part 8. Research Methods
41. Outcomes and quality-of-life measures in pelvic floor research
Introduction
Symptom diaries
Pad testing
Anatomic outcomes
Physiologic testing
Questionnaires
Socioeconomic outcomes
Defining treatment success
Bibliography
Introduction
Symptom diaries and pad testing
Anatomic and physiologic outcomes
Questionnaires
Patient-selected goals
Defining treatment success
Index

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Matthew D. Barber

Mark D. Walters

Mickey M. Karram

Catherine Bradley