surgeons perform pelvic organ prolapse surgery

Australia Bans Use of Vaginal Mesh Implants for Prolapse

An Australian watchdog has banned the use of controversial vaginal mesh implants for prolapse after a review found “the benefits do not outweigh the risks these products pose to patients”.  The Therapeutic Goods Administration has decided to remove the use of mesh products in the treatment of pelvic organ prolapse and single incision mini-slings which is used to treat urinary incontinence. This move follows the news that NICE, the health watchdog in the UK, will recommend that mesh should be banned as a routine treatment for prolapse, a condition when organs such as the vagina, uterus or bowel fall down or slip out of place. The draft guidance, seen by Sky News and due to be published next month, states that mesh implants for prolapse should now only be used for research purposes. It does not affect the use of mesh for incontinence which accounts for the majority of operations. Read more.

Source: Sky News, November 29, 2017

operating room

Majority of Incontinence Treatments Deliver Poor Results

Surgery is the most reliable method of treatment for incontinence – curing the condition in just over eight in ten cases; other types of treatment, meanwhile, do not deliver the same kind of success. These are the findings of a comprehensive systematic overview of cure rates for the treatment of incontinence around the world during the last ten years. “Unfortunately we are not actually curing the condition in that many cases. Surgery aside, the results delivered are poor. And the problems are only going to get worse in the future because the population, as we know, is aging,” says Ian Milsom, Professor of Gynecology and Obstetrics at the Sahlgrenska Academy and Head of the Gothenburg Continence Research Center (GCRC). Read more.

Source: Science Daily, April 4, 2017

Artificial Sphincter Surgery for Bowel Incontinence

external sphincter muscle squeezing

This shows the external sphincter muscle properly squeezing and keeping fecal matter inside until he proper time.

Everyone has a pelvic floor: it is a hammock of muscles that lies in your pelvis, supporting your internal organs in that area (bowel, bladder, and – in women – the uterus) and keeping them in the correct place. In your pelvic floor are a few muscles that are called “sphincters”.  There is an internal and external sphincter surrounding the anus. These anal sphincter muscles naturally contract around the rectum and keep the fecal matter inside your body until you relax the sphincters at a socially-acceptable time (generally when you’re using a toilet).  As the urge to defecate increases, you can contract (or squeeze) your sphincters to gain more control.  When you cannot control these sphincter muscles, bowel incontinence (also called accidental bowel leakage or fecal incontinence) may happen.

Surgery to implant an artificial sphincter involves placing an inflatable sphincter around the anus. A pump (placed inside the body in the labia or scrotum) is used to deflate the device, allowing fecal matter to pass through at the appropriate time. The device automatically refills after ten minutes, once again closing off the rectum.Continue reading