Complex Cases in Urogynecology: Expert Insights_OnDemand-Recording: Complex Cases in Urogynecology: Expert Insights

Video Transcription

Video Summary

In this video transcript, a panel of experts discusses several cases related to pelvic organ prolapse. The first case involves a patient with a perianal abscess, which is drained and left to heal by secondary intention. The second case is a patient who has recurrent prolapse after sacral colpopexy. The panel discusses options for addressing the prolapse, including transvaginal mesh placement or a repeat sacral colpopexy. In the third case, a patient who has undergone sacral neuromodulation develops a C. difficile infection and the panel discusses the timing of the stage two procedure. In the fourth case, a patient with end-stage liver disease and ascites presents with stage 4 uterovaginal prolapse. The panel discusses the challenges of managing prolapse in this patient population and suggests an extraperitoneal approach, such as a sacrospinous hysteropexy. Finally, in the fifth case, a patient awaiting a liver transplant presents with hydranephrosis and stage 4 uterovaginal prolapse. The panel discusses conservative management options, such as hormonal therapy or an aggressive perineoplastic procedure. Overall, the panel provides valuable insights into the complex management and treatment options for patients with pelvic organ prolapse in various clinical scenarios.

Keywords

pelvic organ prolapse

perianal abscess

recurrent prolapse

sacral colpopexy

transvaginal mesh placement

sacral neuromodulation

end-stage liver disease

uterovaginal prolapse

conservative management