2025 AUGS Clinical Meeting-Difficult Cases Panel

Video Transcription

Video Summary

During a panel discussion at a medical meeting, a series of complex surgical cases were presented and discussed by doctors and faculty. The session began with Medeha Malik, a third-year medical student, presenting a challenging case of recurrent stage four vaginal prolapse, highlighting various surgical interventions over the years. The patient's case involved multiple surgeries, including hysterectomy, native tissue repair, and issues with the placement of Y-mesh for prolapse support. The panel discussed the suitability of using mesh in cases with complicated surgical history and debated strategies for cyst prevention.<br /><br />The second case involved a patient with a sacral colpopexy mesh infection leading to discitis and osteomyelitis. Despite the patient's resistance to removing the mesh due to beneficial outcomes, panelists recommended removal to prevent severe complications, possibly suggesting a staged procedure for managing prolapse.<br /><br />A third case, raised by an audience member, concerned a patient with a long-standing peritoneal fluid drainage issue, posing challenges for potential peritoneal dialysis. Suggestions included using biologic grafts and different surgical approaches to effectively address the tissue defect.<br /><br />Discussion extended into managing mesh exposures and effective use of estrogen in treatment plans. The session concluded with thoughts on balancing surgical durability and safety, emphasizing a cautious approach in handling complex cases.

Asset Subtitle

A panel of experts will discuss with the audience how they have dealt with some of their most challenging cases including an international lecture on “The ABCs of Fistula Repair” by Dr. Fekade Ayenachew Aklilu.

Panelists:

Patrick Culligan, MD, FACOG, FACS
Roger Goldberg, MD, MPH
Cara King, MD
Stephanie Molden, MD
Miles Murphy, MD, MSPH
Holly E. Richter, PhD, MD, FACOG, FACS
Nazema Y. Siddiqui, MD, MHSc

Keywords

surgical cases

vaginal prolapse

mesh complications

sacral colpopexy

peritoneal fluid

biologic grafts

estrogen treatment