Principles and Practice of Urogynaecology

Transcription

1 Principles and Practice of Urogynaecology

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3 A Tamilselvi Ajay Rane Editors Principles and Practice of Urogynaecology

4 Editors A Tamilselvi, MRCOG Reproductive Medicine and Women s Health Chennai India Ajay Rane, OAM, FRANZCOG, FRCOG Department of Obstetrics and Gynaecology James Cook University Townsville Australia ISBN ISBN (ebook) DOI / Springer New Delhi Heidelberg New York Dordrecht London Library of Congress Control Number: Springer India 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 Dedicated to my family and the quietly suffering women the world over. Ajay Rane This book is dedicated to my parents my father, whose only dream has been to see me as a doctor, and my mother, supporting me all the way through and to all my teachers. A Tamilselvi

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7 Foreword Urogynaecology as a subspecialty is a relatively new field in India. Approximately one-third of gynaecological practice involves women presenting with complaints relating to pelvic floor problems. Urogynaecology involves not only vaginal surgery but conservative and medical management of pelvic organ dysfunction as well. An understanding of both the anatomy and physiology of pelvic organs is essential for optimal management of patients presenting with these problems. There has been a plethora of textbooks relating to other subspecialty topics in Gynaecology such as Reproductive Medicine, Laparoscopy and Gynaecological Oncology. Books in Urology cover the topics of Bladder Physiology, Neurourology and Urodynamics in detail, with minor emphasis on complex features of pelvic organ prolapse and anal incontinence. Similarly, most textbooks on Gynaecology give minimal details on subjects such as Neurourology and Urodynamics. There is an immediate need for comprehensive textbooks on urogynaecology, which spans the entire spectrum of female pelvic floor dysfunction. In this regard, this textbook, Principles and Practice of Urogynaecology, is a timely and welcome step by the authors. This book not only provides basic anatomical and physiological concepts of female pelvic floor disorders but also covers evidence-based and up-to-date clinical and surgical principles. I believe that this book will help both postgraduates and practising Gynaecologists and Urologists understand the fundamental concepts of female pelvic floor disorders and apply them in clinical practice. Each chapter in this book is written by authors with extensive experience in their particular field. The arrangement of chapters is logically designed to start from basics and take the readers to complex topics, which can be easily understood. I congratulate the authors for this monumental work and wish them the best in their endeavours and contribution to the field of Urogynaecology. N. Rajamaheshwari, MD, DGO, MCh President Urogynaecology and Reconstructive Pelvic Surgery Society of India (URPSSI), Former Professor of Urogynaecology and HOD Department of Urogynaecology, Government Kasthurbha Gandhi Hospital Chennai, India vii

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9 Preface The faction of general gynaecologists is gradually reducing in numbers, with various sub-specializations in Gynaecology. The truth however is that most gynaecologists encounter women with pelvic floor problems irrespective of their sub-specialization. It therefore becomes vital to be armed with knowledge on important aspects of Urogynaecology in caring for these women. Acquisition of knowledge usually starts with understanding basic principles and moving on to evidence-based assessment and management. This textbook, Principles and Practice of Urogynaecology, is designed to meet this need in Urogynaecology. The textbook attempts to achieve a level where everybody students, trainees, specialists and sub-specialists will benefit from the collective wisdom of the authors. The book initially deals with both the structural and neurological anatomy of the pelvic floor to provide a better understanding of basic principles. The subsequent divisions on pelvic organ dysfunctions elaborate on the evidence-based management of these problems. The highlight of the book is an almost East meets West flavour, with a blend of contributing authors from around the globe who are most respected in their fields. We would sincerely like to thank the contributing authors for their professionalism, clarity in their chapters and patience with us. We hope that readers of this textbook will find it useful in their clinical practice both in the outpatient setting as well as in operating theatres. We also trust that students will benefit from the illustrations employed to make the concepts easier to assimilate. We would like to thank our colleagues for providing their feedback, proofreading the chapters with patience and providing any assistance as deemed necessary. Sincere thanks to our publishers Springer (India) for their conviction in bringing out the textbook in Urogynaecology. Particular thanks are expressed to Ryan Bishal Faruque, sixth-year medical student at James Cook University, Australia, and Mr. Rajan Babu, Chennai for the illustrations. A Tamilselvi Ajay Rane ix

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11 Contents Part I Anatomy and Physiology 1 Current Concepts in Pelvic Anatomy Arjunan Tamilselvi 2 Neuroanatomy of the Female Pelvis Stephanie Pickett and S. Abbas Shobeiri 3 Physiology of Urinary Continence Maya Basu and Jonathan Duckett Part II Lower Urinary Tract Dysfunction 4 Evaluation of Urinary Incontinence Pranathi Reddy 5 Urodynamics: The Practical Aspects Kalaivani Ramalingam 6 Overactive Bladder Karen L. Noblett 7 Management of Stress Urinary Incontinence Aswini Balachandran and Jonathan Duckett 8 Management of Sling Surgery Complications Jay Iyer and Ajay Rane 9 Neurogenic Bladder Krishnamurthy Sairam 10 Voiding Dysfunction Sanjay Sinha 11 Bladder Pain Syndrome Arjunan Tamilselvi Part III Pelvic Floor Dysfunction 12 Evaluation of Pelvic Organ Prolapse Paul Riss and Marianne Koch xi

12 xii Contents 13 Conservative Management of Pelvic Organ Prolapse George Ralph and Karl Tamussino 14 Anterior and Posterior Pelvic Organ Prolapse Aparna Hegde 15 Surgical Management of Apical Prolapse Arjunan Tamilselvi 16 Mesh in Prolapse Surgery Jay Iyer and Ajay Rane Part IV Ano-rectal Dysfunction 17 Obstetric Anal Sphincter Injuries Aparna Hegde 18 Fecal Incontinence Karen L. Noblett and Jessica Hammett

13 Contributors Aswini Balachandran, MRCOG Department Obstetrics and Gynaecology, Medway Hospital, Gillingham, Kent, UK Maya Basu, MRCOG Department Obstetrics and Gynaecology, Medway Hospital, Gillingham, Kent, UK Jonathan Duckett, MD, FRCOG Department Obstetrics and Gynaecology, Medway Hospital, Gillingham, Kent, UK Jessica Hammett, MD Division of Urogynecology, Department of Obstetrics and Gynaecology, University of California, Orange, CA, USA Aparna Hegde Division of Urogynecology, Urogynecology and Pelvic Health Institute, (UPHI), Gurgaon, Delhi NCR, India Jay Iyer, FRANZCOG Department of Obstetrics and Gynaecology, James Cook University, Townsville, Queensland, Australia Marianne Koch, MD Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria Karen L. Noblett, MD Department of Obstetrics and Gynaecology, UC Riverside School of Medicine, University of California, Oakland, CA, USA Stephanie Pickett, MD Female Pelvic Medicine and Reconstructive Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA George Ralph, MD Department of Obstetrics and Gynecology, Public Hospital Loeben, Leoben, Austria Kalaivani Ramalingam, MRCOG Department of Obstetrics and Gynaecology, Apollo Hospitals, Chennai, India Ajay Rane, OAM, FRANZCOG, FRCOG Department of Obstetrics and Gynaecology, James Cook University, Townsville, Queensland, Australia Pranathi Reddy, FRCOG Department of Obstetrics and Gynaecology, Rainbow Hospital for Women and Children, Hyderabad, India Paul Riss, MD Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria xiii

14 xiv Contributors Krishnamurthy Sairam, FRCS (Urol) Department of Urology, Canadian Specialist Hospital, Dubai, UAE S. Abbas Shobeiri, MD Female Pelvic Medicine and Reconstructive Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA Sanjay Sinha, MS, MCh Department of Urology, Apollo Hospitals, Hyderabad, India Arjunan Tamilselvi, MRCOG Institute of Reproductive Medicine and Women s Health, Madras Medical Mission Hospital, Chennai, India Karl Tamussino, MD Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria