Atlas of Urogynecologic Surgery
Atlas of Urogynecologic Surgery
Editor
Tajnoos Yazdany MD FACOG FACS
Vice Chair of Education, Department of Obstetrics and Gynecology Chief and Program Director, Female Pelvic Medicine and Reconstructive Surgery Fellowship Associate Professor, David Geffen School of Medicine at UCLA Harbor-UCLA Medical Center Torrance, California, USA
Co-Editor
Donald R Ostergard MD
Professor Emeritus Department of Obstetrics and Gynecology University of California, Irvine Professor-in-Residence UCLA School of Medicine Division of Urogynecology
Foreword
Donald R Ostergard MD
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Atlas of Urogynecologic Surgery
First Edition: 2020
9789386056047
Printed at
This book is dedicated to my parents whose endless love and support carried me throughout my journey. My accomplished and inspirational sisters. To my loving husband and children who are everything. To all the resident and fellows who have crossed my path–it has been an honor to be part of your journey. And finally, to the patients we serve.
Tajnoos Yazdany MD
- Carolyn Botros DO
- Female Pelvic Medicine and Reconstructive Surgery
- LVPG Urogynecology
- Lehigh Valley Health Network Easton, Pennsylvania, USA
- Sylvia M Botros-Brey MD MSCI
- Associate Professor
- Director, Female Pelvic Medicine and Reconstructive Surgery Fellowship
- Department of Urology and Obstetrics and Gynecology
- Long School of Medicine
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Joy Brotherton MD
- Associate Professor
- Director, Minimally Invasive Surgery
- Harbor-UCLA Medical Center
- David Geffen School of Medicine at UCLA
- Los Angeles, California, USA
- Christina Dancz MD
- Assistant Professor
- Female Pelvic Medicine and Reconstructive Surgery
- Program Director, Obstetrics and Gynecology Residency
- University of Southern California
- Los Angeles, California, USA
- Gena Dunivan MD
- Associate Professor
- Program Director, Obstetrics and Gynecology Residency
- and Female Pelvic Medicine and Reconstructive Surgery Fellowship
- UNM Health Sciences, Clinical and Translational Science Center
- University of New Mexico School of Medicine
- Albuquerque, New Mexico, USA
- Patricia Hudson MD
- Clinical Instructor
- Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
- Vincent Obstetrics and Gynecology Department
- Division of Female Medicine and Reconstructive Surgery
- Massachusetts General Hospital
- Boston, Massachusetts, USA
- Sharon Jakus-Waldman MD
- Female Pelvic Medicine and Reconstructive Surgery
- Southern California Kaiser Permanente Medical Group
- Downey, California, USA
- Angel M Johnson MD FACOG
- Female Pelvic Medicine and Reconstructive Surgery
- Director, Women's Health
- Greater Boston Urology, LLC
- Boston, Massachusetts, USA
- Gregory I Kanter MD MS
- Female Pelvic Medicine and Reconstructive Surgery
- Salinas Valley Memorial Healthcare System
- Salinas, California, USA
- Ja-Hong Kim MD
- Associate Clinical Professor
- Division of Pelvic Medicine and Reconstructive Surgery
- Frank Clark Department of Urology
- David Geffen School of Medicine at UCLA
- Los Angeles, California, USA
- Tam Le MD
- Female Pelvic Medicine and Reconstructive Surgery
- Southern California Kaiser Permanente Medical Center
- Los Angeles Medical Center
- Los Angeles, California, USA
- Christina C Liao MD
- Female Pelvic Medicine and Reconstructive Surgery
- Southern California Kaiser Permanente Medical Group
- Downey, California, USA
- John J Navas MD
- Female Pelvic Medicine and Reconstructive Surgery
- Penn Medicine Lancaster General Health Lancaster, Pennsylvania, USA
- John N Nguyen MD
- Director Female Pelvic Medicine and Reconstructive Surgery
- Southern California Kaiser Permanente Medical Group
- Downey, California, USA
- Janine Oliver MD
- Assistant Professor
- Division of Surgery-Urology
- University of Colorado School of Medicine
- Aurora, Colorado, USA
- Amy Rosenman MD
- Health Sciences Clinical Professor
- Department of Obstetrics and Gynecology
- Female Pelvic Medicine and Reconstructive Surgery
- David Geffen School of Medicine at UCLA
- Los Angeles, California, USA
- Erica Stockwell DO MBA FACOG
- Assistant MIGS Fellowship Program Director
- Las Vegas Minimally Invasive Surgery and Women's Health Center
- Director of Innovation and Business Education
- DaVita HealthCare Partners
- Director of Simulation, HCA Obstetrics and
- Gynecology Residency Program
- Sunrise Hospital and Medical Center
- Las Vegas, Nevada, USA
- Chirisse Taylor MD MPH FACOG
- Director of Clinical Services
- HCA Obstetrics and Gynecology Residency Program
- Sunrise Hospital and Medical Center
- Las Vegas, Nevada, USA
- Christina M Truong MD
- Assistant Clinical Professor
- Female Pelvic Medicine and Reconstructive Surgery
- Harbor-UCLA Medical Center
- Torrance, California, USA
- Milena M Weinstein MD
- Associate Professor
- Director of Research, Female Pelvic Medicine
- and Reconstructive Surgery Fellowship
- Co-Director, Center for Pelvic Floor Disorders
- Division of Urogynecology and Pelvic Reconstructive Surgery
- Department of Obstetrics and Gynecology and Pelvic Floor Disorder Services Massachusetts General Hospital
- Boston, Massachusetts, USA
- Cecilia K Wieslander MD
- Associate Clinical Professor
- Associate Program Director
- Department of Obstetrics and Gynecology
- Division of Female Pelvic Medicine and Reconstructive Surgery
- Olive View-UCLA Medical Center
- David Geffen School of Medicine at UCLA
- Los Angeles, California, USA
- Tajnoos Yazdany MD FACOG FACS
- Associate Clinical Professor
- Vice Chair of Education
- Department of Obstetrics and Gynecology
- Program Director, Obstetrics and Gynecology Residency
- and Female Pelvic Medicine and Reconstructive Surgery Fellowship
- Chief, Division of Female Pelvic Medicine and Reconstructive Surgery
- Harbor-UCLA Medical Center
- David Geffen School of Medicine at UCLA
- Los Angeles, California, USA
- Aldene O Zeno MD
- Assistant Professor
- Female Pelvic Medicine and Reconstructive Surgery
- LAC + USC Medical Center
- Los Angeles, California, USA
- Jessica S Zigman MD
- Female Pelvic Medicine and Reconstructive Surgery
- Sutter Medical Group
- Palo Alto Medical Foundation
- Palo Alto, California, USA
In the year 2000, myself, Michael Berman and Bill Yee authored the surgical textbook entitled: Atlas of Gynecologic Surgery which covered all aspects of surgery in gynecology, including, oncology and infertility. This new text covers the urogynecology surgical field in detail. There was no mention of surgical mesh in this earlier text, since it had yet to be introduced for routine use in our surgical practice for repair of pelvic organ prolapse and stress incontinence.
With the introduction of mesh kits for these procedures, gynecologic surgery changed in their favor, since the procedures were dictated in detail by the kit manufacturers, so that any physician regardless of prior surgical experience and training could perform them. An added advantage was that much less time in the operating room was required to place the mesh and physicians were paid more to use mesh. Unfortunately, complications developed after mesh implantation which led the Federal Drug Administration (FDA) to change the classification for pelvic mesh to Class III which requires clinical trials before marketing. More recently the FDA removed all transvaginal mesh kits from the market, since safety and efficacy could not be established in the FDA mandated clinical studies. As a result, with the exception of mesh products meant for abdominal sacral colpopexy, the only mesh kits remaining on the market are those for the treatment of stress urinary incontinence.
Surgical procedures, using native tissue without mesh reinforcement, are now more important to learn to do correctly and efficiently to correct these pelvic floor defects.
The purpose of this text is to focus on urogynecology procedures using native tissue, with the exception of sacral colpopexy. This surgical reference text for the treatment of these conditions is intended for both novice and the experienced surgeons.
Donald R Ostergard MD
Preface
This book provides the opportunity to describe procedures in the field of Female Pelvic Medicine and Reconstructive Surgery (FPMRS) that have withstood the test of time. Over the past few years, our field has been subject to numerous controversies and uncertainties regarding what materials to use with federal and local regulations abounding. Our field continues to grow and expand, and comparative studies will further elucidate our understanding. However, the aim of this book is to describe FPMRS procedures that endure through time in a simplified, straight-forward way. I hope readers will enjoy the step-by-step approach of this illustrative book, and continue to help women with pelvic floor disorders (PFDs), one patient at a time. We worked to create a book that provided images, videos and tips that will be useful as trainees perfect their own surgical technique. By no means does this book attempt to be comprehensive in describing every possible way to perform a surgical procedure, but rather techniques, we have found to be efficient, safe and simple. This book is inspired by a patient that I met as a medical student in Honduras, who had waited over 15 years hoping that her complete procidentia would be fixed. Her strength and resilience, helped me understand the toll PFDs have on everyday women.
Tajnoos Yazdany MD
Acknowledgments
Thanks to Antonia Enriquez for her hard work, dedication and continual support throughout this process. Also we are thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Ms Prerna Bajaj (Development Editor) and the staff of M/S Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving a go-ahead at the very beginning and helping us in every way possible to bring out this book.