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Native Tissue Repair After Failed Synthetic Materials

  • A. Lenore Ackerman
  • Seth A. Cohen
  • Shlomo RazEmail author
Chapter

Abstract

In the setting of an emerging patient population suffering from recurrent pelvic floor symptoms after mesh removal, the principles and practices of native tissue repair have taken on a new, ever-important position in vaginal reconstructive surgery. This chapter provides a case-study of a patient who undergoes complex mesh removal, with improvement in her constellation of presenting symptoms. Although she improves significantly, she goes on to develop recurrent prolapse in the setting of persistent stress urinary incontinence (SUI). Description of her management details techniques for surgical intervention that we have used successfully after mesh removal to treat deficient, attenuated, atrophied, and scarred pelvic floor tissues.

Keywords

Double-pronged passer Omega sling Spiral sling Fascia lata Perivesical fascia Periurethral fascia Four-corner suspension 

Supplementary material

Video 20.1

Autologous fascia lata cystocele repair (MP4 250475 kb)

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • A. Lenore Ackerman
    • 1
  • Seth A. Cohen
    • 2
  • Shlomo Raz
    • 3
    Email author
  1. 1.Department of Surgery, Division of UrologyUrologic Reconstruction, Urodynamics, and Female Urology, Cedars-Sinai Medical CenterBeverly HillsUSA
  2. 2.Division of Urology and Urologic Oncology, Department of SurgeryPelvic Medicine and Reconstructive SurgeryHopeUSA
  3. 3.Division of Pelvic Medicine and Reconstructive SurgeryFellowship Program in Pelvic Medicine and Reconstructive SurgeryLos AngelesUSA

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