During recent decades, more than 100 surgical procedures have been proposed to treat pelvic organ prolapse, and surgeons are still searching for the ideal approach. Although generally accepted guidelines and algorithms are still lacking, careful preoperative work-up and patient selection can serve as a sound basis for tailored surgery. In this comprehensive book, leading experts from around the world provide a detailed, up-to-date overview of the diagnostic and surgical approaches employed in patients with prolapse of the middle or posterior pelvic floor compartment. Each surgical technique is explained step by step with the aid of instructive figures. Guidance is also included on the management of surgical complications and of recurrent disease – aspects that are too frequently overlooked in the scientific literature. This book will prove essential reading for all who are interested in functional colorectal disorders of the pelvic floor and will represent a unique and invaluable source of knowledge for general surgeons, colorectal surgeons, and urogynecologists, whether in training or practice.
Spis treści
SECTION 1: OVERVIEW The multidisciplinary view of a pelvic floor unit.- Epidemiology and prevalence.- SECTION 2: PATIENT’S EVALUTATION CRITERIA Pelvic floor anatomy and physiology.- Urodynamics.- Radiological imaging.- Anorectal physiology.- Pelvic floor ultrasound.- Functional assessment.- SECTION 3: CLINICAL SYNDROMES Fecal incontinence.- Obstructed defecation.- Chronic anorectal pain.- Solitary rectal ulcer.- SECTION 4: TREATMENTS Conservative treatment. – Biofeedback training and physiokinetic therapy.- SECTION 5: PERINEAL APPROACHES The STARR and TRANSTARR procedures.- The Delorme procedure.- The Altemeier procedure.- The express procedure Abdominal approaches.- Mesh rectopexy.- Rectopexy without mesh.- Laparoscopic ventral recto-colpo-pexy.- Pelvic Organ Prolapse Suspension.- SECTION 6: MISCELLANEA Complications: Prevention and Management.- Surgical treatment of recurrent rectal prolapse.- Management of concomitant middle compartment disorders.- Management of concomitant pelvic disorders: the urology prospective, synthetic and biologic meshes for pelvic floor disorders.
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