By Schlomo Raz
This quantity offers a accomplished, step-by-step description of the surgical options that the writer has utilized in greater than 13,000 vaginal reconstructive techniques. Chapters disguise surgical procedure for incontinence, prolapse, urethral diverticula, vaginal fistula, reconstruction, surgical procedure for urethral obstruction and vaginal cysts and much, and finally, problems of vaginal surgical procedure. every one surgical bankruptcy covers a succinct precis of analysis, symptoms for surgical procedure, and the surgery itself. Sequential operative photos, drawings, and video clips advisor also are incorporated to steer the reader during the procedural steps.
The Atlas of Vaginal Reconstructive Surgery will function a necessary source for urologists, gynecologists and different experts with an curiosity in vaginal reconstructive surgery.
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This quantity offers a finished, step-by-step description of the surgical concepts that the writer has utilized in greater than 13,000 vaginal reconstructive systems. Chapters hide surgical procedure for incontinence, prolapse, urethral diverticula, vaginal fistula, reconstruction, surgical procedure for urethral obstruction and vaginal cysts and lots more and plenty, and finally, issues of vaginal surgical procedure.
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Extra info for Atlas of Vaginal Reconstructive Surgery
To provide normal introital size and improved posterior vaginal support, corrective surgery of the posterior vaginal wall should address all the defects: correction of the rectocele by reinforcement of the attenuated prerectal and pararectal fasciae, repair of the defect of the levator muscles by reapproximation of the widened perineal membrane, restoration of the horizontal supporting plate for the proximal vagina, and repair of the fascia and musculature of the perineum, when defective. 20 a 1 The Anatomy of Pelvic Support c b d Fig.
7). a Surgery for Stress Incontinence Surgical transfer of the proximal urethra to a more supported position will restore some of the urethral compensatory mechanisms against sudden changes in abdominal pressures (Fig. 8). Sling procedures provide dynamic support of the urethra without increasing urethra pressures (Fig. 9). b c Fig. 6 (a) Lateral cystogram in a patient with significant urethral mobility. During straining, the urethra is moved away from its normal close proximity to the inferior ramus of the symphysis into a low position, owing to weakness of the pubourethral and urethropelvic fascia.
E) Sagittal MRI of a patient with posterior vaginal prolapse. The vaginal axis and the levator muscle are more vertical, the rectum protrudes from the vaginal canal, and there is disappearance of the levator notch. 4 Support of Pelvic Organs 21 e Fig. 15 (continued) a b A B Fig. 16 (a) Exposure of the posterior vaginal wall in a patient with a large rectocele and widening of the levator hiatus. (b) Diagram depicting the anatomy of pelvic floor relaxation. The levator plate descends, losing its horizontal axis, and the levator hiatus widens.