78 results on '"Christl Reisenauer"'
Search Results
2. A retrospective analysis of perioperative complications associated with retropubic tension-free vaginal tape in 960 women
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Janosch Jahn, Christl Reisenauer, Sara Y. Brucker, Birgitt Schoenfisch, Bastian Amend, and Juergen Andress
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Stress incontinence ,medicine.medical_specialty ,Urinary Incontinence, Stress ,Overweight ,Cohort Studies ,Postoperative Complications ,medicine ,Humans ,Aged ,Retrospective Studies ,Suburethral Slings ,Urinary retention ,business.industry ,Tension free vaginal tape ,Obstetrics and Gynecology ,General Medicine ,Perioperative ,Urinary Retention ,medicine.disease ,Surgery ,Treatment Outcome ,Child, Preschool ,Female ,medicine.symptom ,Complication ,business ,Body mass index ,Cohort study - Abstract
Purpose The purpose is to analyse perioperative complications associated with the retropubic tension-free vaginal tape (TVT) procedure and their management. Methods This retrospective, monocentric cohort study included 960 women after retropubic TVT procedure performed by one surgeon from 2011 to 2016. Complications were identified up to 6 weeks after the procedure, divided into specific and general complications and classified based on the Clavien–Dindo (CD) Classification. A visit 6 weeks after the surgical procedure was attended by all patients. Results 77 complications, of which 74 occurred postoperatively and 3 intraoperatively, affecting 72 (7.5%) out of 960 women. Urinary retention and voiding problems were the most common complication. The mean age of women suffering complications was 3.4 years higher in comparison to the mean age of women without complications (p = 0.036). The Body Mass Index (BMI) of the group of women with perioperative complications had an average BMI which was 0.5 kg/m2 lower than the average BMI of the women without complications. 22 (12.8%) out of 172 women with recurrent stress incontinence had postoperative complications, of which 21 were related to the TVT. Conclusion The retropubic TVT is a surgical procedure associated with a low number of perioperative complications, even in the group of elderly and overweight women, as well as in cases of recurrent stress incontinence.
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- 2021
3. Retrospective analysis of secondary resection of the cervical stump after subtotal hysterectomy: why and when?
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Christl Reisenauer, Sara Y. Brucker, Bernhard Kraemer, Felix Neis, and Philipp Wagner
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medicine.medical_specialty ,Metrorrhagia ,medicine.medical_treatment ,Subtotal hysterectomy ,Hysterectomy ,Gynaecological disease ,Resection ,medicine ,Retrospective analysis ,Humans ,Cervical stump ,Abdominal hysterectomy ,Secondary resection of the cervical stump ,Retrospective Studies ,business.industry ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Resection of the cervix ,Supracervical hysterectomy ,Surgery ,Cervical stump resection ,Dysplasia ,Female ,General Gynecology ,business - Abstract
Purpose The rates of hysterectomy are falling worldwide, and the surgical approach is undergoing a major change. To avoid abdominal hysterectomy, a minimally invasive approach has been implemented. Due to the increasing rates of subtotal hysterectomy, we are faced with the following questions: how often does the cervical stump have to be removed secondarily, and what are the indications? Methods This was a retrospective, single-centre analysis of secondary resection of the cervical stump conducted from 2004 to 2018. Results Secondary resection of the cervical stump was performed in 137 women. Seventy-four percent of the previous subtotal hysterectomy procedures were performed in our hospital, and 26% were performed in an external hospital. During the study period, 5209 subtotal hysterectomy procedures were performed at our hospital. The three main indications for secondary resection of the cervical stump were prolapse (31.4%), spotting (19.0%) and cervical dysplasia (18.2%). Unexpected histological findings (premalignant and malignant) after subtotal hysterectomy resulted in immediate (median time, 1 month) secondary resection of the cervical stump in 11 cases. In four patients, the indication was a secondary malignant gynaecological disease that occurred more than 5 years after subtotal hysterectomy. The median time between subtotal hysterectomy and secondary resection of the cervical stump was 40 months. Secondary resection of the cervical stump was performed vaginally in 75.2% of cases, laparoscopically in 20.4% of cases and abdominally in 4.4% of cases. The overall complication rate was 5%. Conclusion Secondary resection of the cervical stump is a rare surgery with a low complication rate and can be performed via the vaginal or laparoscopic approach in most cases. The most common indications are prolapse, spotting and cervical dysplasia. If a secondary resection of the cervical stump is necessary due to symptoms, 66.6% will be performed within the first 6 years after subtotal hysterectomy.
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- 2021
4. Save our surgeons (SOS) – an explorative comparison of surgeons’ muscular and cardiovascular demands, posture, perceived workload and discomfort during robotic vs. laparoscopic surgery
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Bernhard Krämer, Felix Neis, Christl Reisenauer, Christina Walter, Sara Brucker, Diethelm Wallwiener, Robert Seibt, Julia Gabriel, Monika A. Rieger, and Benjamin Steinhilber
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Obstetrics and Gynecology ,General Medicine - Abstract
Purpose Conventional laparoscopic surgery (CLS) imposes an increased risk of work-related musculoskeletal disorders. Technical innovations, such as robotic-assisted laparoscopic surgery (RALS), may provide ergonomic benefits. We compare the surgeon`s work-related demands of CLS vs RALS for benign hysterectomies. Methods Five specialists (3 females, 2 males) each performed four RALS and four CLS as part of their daily clinical routine. During the surgical procedures, muscular demands were assessed by bipolar surface electromyograms of the descendent trapezius, extensor digitorum and flexor carpi radialis muscles as well as cardio-vascular demands by electrocardiography, and neck, arm and torso posture by gravimetrical position sensors. Additionally, the subjects rated their level of perceived workload (NASA TLX questionnaire with 6 dimension) and musculoskeletal discomfort (11-point Likert-scale, 0–10). Results Muscular demands of the trapezius and flexor carpi radialis muscles were lower with RALS but extensor digitorum demands increased. Cardiovascular demands were about 9 heart beats per minute (bpm) lower for RALS compared to CLS with a rather low median level for both surgical techniques (RALS = 84 bpm; CLS 90 bpm). The posture changed in RALS with an increase in neck and torso flexion, and a reduction in abduction and anteversion position of the right arm. The perceived workload was lower in the physical demands dimension but higher in the mental demands dimension during RALS. Subjective musculoskeletal discomfort was rare during both surgical techniques. Conclusions This explorative study identified several potential ergonomic benefits related to RALS which now can be verified by studies using hypothesis testing designs. However, potential effects on muscular demands in the lower arm extensor muscles also have to be addressed in such studies.
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- 2022
5. Obturator nerve entrapment after retropubic tension-free vaginal tape insertion
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Christl Reisenauer and Bernhard Kraemer
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Obstetrics and Gynecology ,General Medicine - Published
- 2022
6. Therapy of pessary-induced rectovaginal fistula and pelvic organ prolapse in elderly patients by vaginal approach and modified LeFort colpocleisis: a case series
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Claudius Falch, Andreas Kirschniak, Christl Reisenauer, Peter Wilhelm, and Jens Rolinger
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Vaginal approach ,Pessary ,medicine.medical_specialty ,Pelvic organ ,030219 obstetrics & reproductive medicine ,business.industry ,Fistula ,Perforation (oil well) ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Rectovaginal fistula ,030220 oncology & carcinogenesis ,Colpocleisis ,Medicine ,business - Abstract
Pelvic organ prolapse (POP) presents a common benign condition in women associated with reduced quality of life (QoL). The use of pessaries is considered a first-line treatment of POP. However, pessaries can cause perforations into adjacent organs resulting in fistulas. We present a series of three cases of rectovaginal fistulas (RVF) due to pessary perforation. Three consecutive cases of pessary-induced RVF in patients with POP stage IV were assessed between September 2016 and September 2019. Consensus for therapeutic strategy was reached by an interdisciplinary board. The RVF were located in the posterior vaginal wall and had a diameter of up to 60 mm. In one of three patients, a two-step approach was chosen with the ostomy being performed at the same time as fistula closure and modified LeFort colpocleisis. It was followed by ostomy closure 3 months later. In two patients, a three-step approach was chosen with the ostomy performed separately due to a local tissue inflammation around RVF. Neither fistula nor POP recurrences have occurred so far. Combined temporary gastrointestinal diversion, RVF closure and POP therapy can be performed as a two- or three-stage approach. Lack of evidence and standardized algorithms in RVF therapy make further clinical studies essential. We encourage the preoperative assessment of any case of complex rectovaginal fistula by an interdisciplinary board for determining an individualized treatment.
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- 2020
7. Management of rectovaginal fistulas at high risk for failure or vaginal stenosis in women of childbearing age: an innovative concept
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Christl Reisenauer, Harald Abele, Sara Yvonne Brucker, and Juergen Andress
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Obstetrics and Gynecology ,General Medicine - Published
- 2022
8. Vaginal therapy of mild and moderate stress urinary incontinence using Er:YAG laser: a real treatment option
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Christl Reisenauer, Felix Neis, Sara Y. Brucker, Sebastian Hartlieb, and Birgitt Schoenfisch
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Adult ,medicine.medical_specialty ,business.industry ,Urinary Incontinence, Stress ,Obstetrics and Gynecology ,Treatment options ,Urinary incontinence ,Lasers, Solid-State ,General Medicine ,Middle Aged ,Single Center ,Surgery ,Laser therapy ,Quality of life ,Vagina ,Quality of Life ,medicine ,Humans ,Female ,Medical history ,Prospective Studies ,medicine.symptom ,business ,Prospective cohort study ,Er:YAG laser - Abstract
To evaluate the effectiveness of vaginal Er:YAG laser as treatment in patients with mild or moderate stress urinary incontinence. The study was a prospective, non-randomised, single center study of 33 women treated with two Er:YAG laser applications on an interval of four weeks. Follow-up evaluations were performed 4 and 8 weeks and 6 months after the first vaginal Er:YAG laser application (4 weeks and 5 months after the second vaginal Er:YAG laser application, respectively). The subjective outcomes were assessed using the International Consultation of Incontinence Modular Questionnaire Short Form (ICIQ-SF) and medical history. Patients rated their quality of life on a scale from 0 to 10. The average quality of life (QoL) showed a significant improvement 5 months after both Er:YAG laser applications. The mean QoL score was 6.0 (SD 2.4) and improved to a mean of 7.6 (SD 1.8) (p = 0.004). The mean ICIQ-SF score changed significantly from 12.3 (SD 3.2, median 13, range 8-18) before treatment to 6.8 (SD 4.0, median 7, range 0–15) 6 months after treatment (p
- Published
- 2019
9. Überaktive Blase – aktuelle diagnostische und therapeutische Aspekte
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Christl Reisenauer
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,030232 urology & nephrology ,Obstetrics and Gynecology ,Medicine ,business - Abstract
Die Pravalenz der uberaktiven Blase betragt bei Erwachsenen 16–17 %, ein Drittel der Betroffenen leidet zugleich unter einer Dranginkontinenz. Die Symptome der uberaktiven Blase (Pollakisurie, Nykturie und imperativer Harndrang mit oder ohne Inkontinenz) treten ohne pathologische Veranderungen des Harntraktes auf. Die Basisdiagnostik umfasst: eine ausfuhrliche Anamnese, eine klinische sowie urogynakologische Untersuchung, eine Urinuntersuchung und das Fuhren eines Miktionstagebuchs. Zur weiterfuhrenden Diagnostik gehoren: die Urodynamik, die Urethrozystoskopie und die bildgebenden Verfahren. Neurologische und internistische Untersuchungen konnen differenzialdiagnostisch hilfreich sein. Die Therapie erfolgt individualisiert. Zusammengefasst stehen folgende konservative Behandlungsoptionen zur Verfugung: Lifestyle-Anderungen, Verhaltenstherapie, Beckenbodentraining und die medikamentose Therapie. Bei therapierefraktarer Dranginkontinenz werden sowohl die Injektion von Onabotulinumtoxin A (100 Einheiten) als auch die sakrale Neuromodulation gleichrangig empfohlen. Die Patientenpraferenz und der Allgemeinzustand sind hierfur entscheidend. Die Blasenaugmentation stellt die Ultima Ratio der operativen Behandlung dar. Die Zufriedenheit mit der Behandlung korreliert mit den an die Therapie gestellten Erwartungen. Demzufolge sind die Aufklarung, die Motivation und die Begleitung der Patientinnen wahrend der Therapie essenziell.
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- 2019
10. Comparison of two retropubic tension-free vaginal tape procedures in women with stress urinary incontinence: a randomized controlled multicenter trial
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Markus Huebner, Christl Reisenauer, Frank J. Schwab, Juliane Marschke, Tomi S. Mikkola, and Ralf Tunn
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medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Tension free vaginal tape ,Obstetrics and Gynecology ,Treatment options ,Urinary incontinence ,General Medicine ,Perioperative ,Surgery ,03 medical and health sciences ,Catheter ,0302 clinical medicine ,Retropubic sling ,030220 oncology & carcinogenesis ,Multicenter trial ,Clinical endpoint ,Medicine ,medicine.symptom ,business - Abstract
Midurethral slings are a well-established treatment option in women suffering stress urinary incontinence. Various different products and methods are used, therefore, the aim of our study was to compare two inside-out retropubic slings (TVT exact® vs. RetroArc®) inserted in two different ways regarding perioperative and mid-term outcomes. In this prospective randomized controlled non-inferiority multicentre trial, primary endpoint was postoperative cure rate, both objective (negative cough test) and subjective (absence of leakage during physical activity using the UDI-6 questionnaire). Secondary endpoints were patients’ satisfaction (Likert scale; ICIQ-UI-SF questionnaires). In addition, intra-and postoperative complications were evaluated. The TVT®-group was operated with an empty bladder, a 18 CH catheter was used with a straight inserter as instructed. Patients randomized into the RetroArc®-group were operated without inserter leading to a reduced catheter size (14 CH), bladder was filled (200 ml) during the procedure. Of the 303 women, 152 were randomized to the TVT® and 151 to the RetroArc® operation. At 3 months, n = 288 (95.0%) and at 12 months n = 229 (75.6%) were assessed. In postoperative objective cure the RetroArc®-procedure was not inferior to TVT® (p = 0.144). In subjective cure, however, the TVT exact® procedure achieved significant better results (TVT® 76.1%, RetroArc® 54.3%, p = 0.002). Perioperative complications were in majority voiding difficulties and lower after the TVT exact®-procedure. Retropubic sling procedures are safe and successful to treat female stress urinary incontinence. However, different materials and techniques result in differences between outcomes also experienced surgeons should be aware of.
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- 2019
11. Demographic changes and effects on the mode of delivery: a retrospective analysis of a large birth registry containing 27,729 singleton deliveries in a level I center
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Sara Y. Brucker, Birgitt Schoenfisch, Philipp Wagner, Markus Huebner, Christl Reisenauer, Markus Hoopmann, Jan Pauluschke-Froehlich, Katharina Rall, Karl O. Kagan, and Harald Abele
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Adult ,medicine.medical_specialty ,Forceps ,Urogynecology ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Risk Factors ,medicine ,Retrospective analysis ,Humans ,Registries ,Demography ,Retrospective Studies ,Labor, Obstetric ,030219 obstetrics & reproductive medicine ,Singleton ,Obstetrics ,Vaginal delivery ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Delivery, Obstetric ,medicine.disease ,030220 oncology & carcinogenesis ,Cohort ,Female ,business ,Body mass index - Abstract
To characterize and understand the demographics (age and body mass index, BMI) of a cohort of women who delivered at a single institution over an 11-year period. The purpose of this analysis is to look for effects over time of demographic characteristics on mode of delivery. Retrospective analysis of singleton deliveries between 2004–2014, n = 27,729; level 1 perinatal center, university hospital setting. Data were extracted from the digital birth registry. All statistical analyses were done using R version 3.5.1. Variables analyzed were: age, BMI, and mode of delivery (in the current and any prior pregnancies). Mean age increased from 31.1 ± 5.2 years in 2004 to 31.5 ± 5.0 years in 2014 (p
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- 2019
12. The preferred mode of delivery of medical professionals and non-medical professional mothers-to-be and the impact of additional information on their decision: an online questionnaire cohort study
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Stephanie Wallwiener, Sara Y. Brucker, Philipp Wagner, Markus Huebner, Gert Naumann, Christl Reisenauer, Ralf Tunn, Jan Pauluschke-Froehlich, Katharina Rall, Julia Bihler, Christof Sohn, Giselle E. Kolenic, Markus Wallwiener, and Harald Abele
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Adult ,medicine.medical_specialty ,Vaginal birth ,Health Personnel ,Decision Making ,Mothers ,Computer-assisted web interviewing ,Cohort Studies ,Education, Distance ,Urogynecology ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Surveys and Questionnaires ,Humans ,Medicine ,Internet ,Risk Management ,030219 obstetrics & reproductive medicine ,Cesarean Section ,business.industry ,Vaginal delivery ,Obstetrics and Gynecology ,Prevention aspects ,General Medicine ,Delivery, Obstetric ,University hospital ,Mode of delivery ,030220 oncology & carcinogenesis ,Family medicine ,Female ,business ,Cohort study - Abstract
It was the aim to evaluate the personal preference of mode of delivery and to analyze differences between medical professionals and non-medical professionals. Interest in participating in a risk stratification system was evaluated. We hypothesized that gaining information about risk stratification provided in the survey could potentially change participants’ decision regarding the preferred mode of delivery; therefore, subjects were asked twice (before and after providing information). Five cohorts [four professionals (MP) including participants of the German Urogynecology Congress 2017, employees of two major university hospitals in Germany, and members of the German Society of Gynecology and Obstetrics, and one non-professional group (NP) including pregnant women] were invited online to participate in this survey. Vaginal delivery was the preferred mode of delivery in both groups (MP 90.4% vs. NP 88.8%; p = 0.429). MP are more likely to opt for CS due to concerns regarding pelvic floor disorders (MP 56.6% vs. NP 9.1%; p
- Published
- 2018
13. Absorbable versus non-absorbable sutures for vaginal mesh attachment during sacrocolpopexy: a randomized controlled trial
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Birgitt Schoenfisch, Ralf Tunn, Sara Y. Brucker, Christl Reisenauer, Jürgen Andress, Kathrin Beilecke, Andrea Lippkowski, Juliane Marschke, and Markus Huebner
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medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Pelvic Organ Prolapse ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Gynecologic Surgical Procedures ,Randomized controlled trial ,Suture (anatomy) ,law ,Medicine ,Humans ,Vicryl ,Pelvic examination ,030219 obstetrics & reproductive medicine ,Pelvic floor ,medicine.diagnostic_test ,Sutures ,business.industry ,Obstetrics and Gynecology ,Perioperative ,Surgical Mesh ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Vagina ,Female ,business ,Vaginal Vault Prolapse - Abstract
The purpose of the study was to analyze anatomical and functional outcomes after sacrocolpopexy (SCP) for vaginal vault prolapse pelvic organ prolapse quantification (POPQ) II–III by random use of absorbable (Vicryl) and non-absorbable sutures (Ethibond) for vaginal mesh fixation. This study was designed as a two-center randomized controlled study (RCT). The primary objective was to evaluate the anatomical outcome. Success was defined when the vaginal apex (point C; POPQ) did not descend more than 50% of the total vaginal length (tvl) during Valsalva. Patients completed a pelvic examination incorporating the POPQ and questionnaires (the German pelvic floor questionnaire and the PISQ-12 questionnaire) at baseline and 6 months postsurgery. Perioperative adverse events (AE) were recorded. Sample size calculations, based on a 10% non-inferiority limit required 100 participants per group, with power = 90%. In 190 out of 195 women (ETH group n = 96; VIC group n = 94) anatomical success was achieved. The relative risk of anatomical success failure in the VIC group versus the ETH group was 0.69, with a 95% confidence interval 0.12–4.02. The change in the symptom scores did not differ significantly between the ETH and the VIC group. In the ETH group, three suture penetrations into the vagina were observed, and none in the VIC group 6 months postoperatively. Anatomical success after SCP for vaginal vault prolapse POPQ II–III is not affected by suture type for vaginal monofilament mesh attachment. Moreover, we did not see any differences in functional outcomes between the two groups. Three suture penetrations into the vagina were observed in the ETH group, and none in the VIC group 6 months postoperatively.
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- 2021
14. A rare cause for urinary incontinence: fistulous communication between a urethral diverticulum and the vagina
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Madalina Sandru and Christl Reisenauer
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medicine.medical_specialty ,business.industry ,Urology ,Perforation (oil well) ,Obstetrics and Gynecology ,Urinary incontinence ,Surgery ,Diverticulum ,medicine.anatomical_structure ,Urinary Incontinence ,Urethral Diseases ,Vagina ,Urethral diverticulum ,Medicine ,Dysuria ,Humans ,Female ,medicine.symptom ,business - Published
- 2020
15. The burden of incontinence in a real-world data environment—insights from a digital patient companion
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Sarah Brugger, Christl Reisenauer, Stephanie Wallwiener, Lina Maria Matthies, Benjamin Friedrich, Alexandra von Au, Markus Wallwiener, and Sabine Keim
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Adult ,Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Urinary incontinence ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Surveys and Questionnaires ,medicine ,Humans ,Child ,030219 obstetrics & reproductive medicine ,Pelvic floor ,business.industry ,Incidence (epidemiology) ,Obstetrics and Gynecology ,Odds ratio ,Pelvic Floor ,Digital health ,ddc ,Conservative treatment ,medicine.anatomical_structure ,Urinary Incontinence ,Physical therapy ,Quality of Life ,Female ,medicine.symptom ,business ,Real world data - Abstract
Introduction and hypothesis Urinary incontinence (UI) has a potentially devastating effect on women’s quality of life (QoL). Conservative treatment by means of pelvic floor muscle training is the first-choice treatment modality. Nowadays, this can be supported by digital apps like pelvina©—a digital health companion pelvic floor course. Methods Using pelvina©, UI symptoms and QoL are regularly examined through the questionnaires QUID and SF-6D. Subsequently, we analyzed the incidence and degree of UI and its impact on QoL in 293 users in a real-world environment. Results The 293 patients included in this study had a median age of 36 years and a median of two children. Patients were slightly to moderately affected by UI with a QUID of 6 (2–11, maximum 24). Age and number of children were independently associated with the incidence of UI with an adjusted odds ratio (aOR) of 1.06 (95% CI 1.01–1.12) and aOR of 1.86 (95% CI 1.12–3.08). The severity of UI strongly correlated with impairment of QoL (ρ = 0.866, P Conclusions The use of real-world data generated by digital health solutions offers the opportunity to gain insight into the reality of patients’ lives. In this article, we corroborate the known associations between number of children and UI as well as the great influence UI has on QoL. This study shows that, in the future, the use of digital apps can make an important contribution to scientific data acquisition and, for example, therapy monitoring.
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- 2020
16. Management of Urethral Lesions and Urethrovaginal Fistula Formation Following Placement of a Tension-Free Suburethral Sling: Evaluation From a University Continence and Pelvic Floor Centre
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Sara Y. Brucker, Christl Reisenauer, and Dorit Schöller
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medicine.medical_specialty ,Sling (implant) ,Vaginal fistula ,030232 urology & nephrology ,urethral lesion ,Urinary incontinence ,urethrovaginale Fistel ,TVT-Erosion ,Vesicovaginal fistula ,03 medical and health sciences ,0302 clinical medicine ,Urethraläsion ,Urethrovaginal fistula ,TVT erosion ,Maternity and Midwifery ,Martius-Flap ,Medicine ,GebFra Science ,Martius flap ,030219 obstetrics & reproductive medicine ,Pelvic floor ,business.industry ,Obstetrics and Gynecology ,Original Article/Originalarbeit ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Urethra ,urethrovaginal fistula ,medicine.symptom ,business ,Complication - Abstract
Introduction The complication of tape erosion in the urethra following placement of a retropubic (TVT) or transobturator (TOT) tension-free suburethral vaginal sling or an accidental iatrogenic transurethral tape position can result in the formation of a urethrovaginal or vesicovaginal fistula. The objective of the investigation is the evaluation of the management of such rare complications. Patients and Methods Retrospective analysis of 14 patients who were treated for a urethral lesion or urethrovaginal fistula formation status post TVT/TOT placement between June 2011 and February 2018 in the Tübingen University Department of Gynaecology. Results As surgical therapy, 57.1% (n = 8) cases underwent vaginal fistula closure using a Martius flap of the labium majus and in 21.4% (n = 3) using a vaginal rotation skin flap. In 21.4% (n = 3), exclusively vaginal suture reconstruction of the urethra following excision of the tape running transurethrally or tape erosion was performed. 50% (n = 7) of the patients had lasting continence postoperatively without any further need for therapy. In 28.6% (n = 4), there was ongoing stress urinary incontinence, in 21.4% (n = 3) mixed urinary incontinence. Six of the 7 patients with persistent incontinence underwent new placement of a tension-free suburethral retropubic sling (TVT) an average of 8.8 months (5 – 13 months) postoperatively which was uncomplicated in all patients and achieved satisfactory continence. The 3 patients with mixed urinary incontinence and persistent urgency components additionally received anticholinergic medication. During the time period investigated, there were no long-term complications, in particular no recurrent fistulas. Conclusion The rare but relevant complications of a urethral erosion, transurethral tape position or urethrovaginal fistula formation status post TVT/TOT placement can be successfully managed via vaginal surgery. Persistent postoperative urinary incontinence with the need for a two-phase repeat TVT placement following sufficient wound healing must be preoperatively clarified.
- Published
- 2018
17. Pathologies of the ischio-anal fossa: of gynaecological relevance?
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Berhard Kraemer, Felix Neis, and Christl Reisenauer
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medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,General surgery ,MEDLINE ,Obstetrics and Gynecology ,General Medicine ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Ischio-anal fossa ,medicine ,Relevance (information retrieval) ,business - Published
- 2018
18. Magnetic resonance imaging of vaginal support structure before and after Vecchietti procedure in women with Mayer-Rokitansky-Küster-Hauser syndrome
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Heike Preibsch, Sabrina Fleischer, John O.L. DeLancey, Diana Stefanescu, Katharina Rall, Sara Y. Brucker, Dorit Schoeller, Christl Reisenauer, and Markus Huebner
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medicine.medical_specialty ,46, XX Disorders of Sex Development ,030232 urology & nephrology ,Surgically-Created Structures ,Article ,Congenital Abnormalities ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Mayer-Rokitansky-Kuster-Hauser Syndrome ,Prospective Studies ,Prospective cohort study ,Mullerian Ducts ,030219 obstetrics & reproductive medicine ,Pelvic floor ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Perineum ,Müllerian agenesis ,Treatment Outcome ,Levator ani ,medicine.anatomical_structure ,Vagina ,Female ,Laparoscopy ,business - Abstract
Introduction It is unclear how pelvic floor supporting structures might be affected by the absence of the vagina. It was the aim of this prospective study to analyze the magnetic resonance imaging morphology of pelvic support prior and after a Vecchietti procedure in women suffering Mullerian agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome). Material and methods 26 women with a diagnosis of Mayer-Rokitansky-Kuster-Hauser syndrome associated vaginal agenesis were recruited prospectively prior to the laparoscopic creation of a neovagina according to the Vecchietti procedure. The primary outcome measure was the magnetic resonance imaging morphology of supporting structures. Secondary outcome measures were anatomical and functional vaginal length. Follow up was conducted six months after surgery. Results Twenty-six women were analyzed. Mean age was 19.8 ± 4.4 years (±SD) and mean body mass index was 23.7 ± 4.3 kg/m2 (±SD). All were Caucasian. Supporting structures consistent with cardinal and uterosacral ligaments were visible on magnetic resonance imaging in all cases (100%). There were no levator ani defects. The vaginal apex could be visualized postoperatively in 12 women (46.2%) reaching up to Level I. The vagina was visible in both Level II and III with normal relations to the pelvic walls in all cases. On gynecological examination, vaginal length was 8.8 ± 2.1 cm (mean ± SD) anatomically and 10.2 ± 2.2 cm (mean ± SD) functionally. Conclusions The preoperative presence of pelvic support structures into which the vagina is lengthened by the surgery likely explains the uncommon occurrence of vaginal prolapse in women who had the Vecchietti procedure.
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- 2018
19. Selecting living donors for uterus transplantation: lessons learned from two transplantations resulting in menstrual functionality and another attempt, aborted after organ retrieval
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Peter Rosenberger, Falko Fend, Christl Reisenauer, Mats Brännström, Christian Grasshoff, Dorit Schöller, Pernilla Dahm-Kähler, Markus Hoopmann, Eckhard Heim, Alfred Königsrainer, Karl Oliver Kagan, Melanie Henes, Bernhard K. Krämer, Konstatin Nikolaou, Niclas Kvarnström, Florin-Andrei Taran, Silvio Nadalin, Hans Bösmüller, Katharina Rall, Diethelm Wallwiener, Mike Notohamiprodjo, and Sara Y. Brucker
- Subjects
Adult ,Graft Rejection ,medicine.medical_specialty ,Uterus ,030230 surgery ,Uterine Agenesis ,Menstruations ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Uterus transplantation ,Living Donors ,medicine ,Humans ,Longitudinal Studies ,Treatment Failure ,030219 obstetrics & reproductive medicine ,Donor selection ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,medicine.disease ,Thrombosis ,Surgery ,Transplantation ,medicine.anatomical_structure ,Urogenital Abnormalities ,Tissue and Organ Harvesting ,Female ,business - Abstract
To contribute to establishing donor selection criteria based on our experience with two successful living-donor human uterus transplantations (UTx) and an aborted attempt. This interventional study included three patients with uterine agenesis, aged 23, 34, and 23 years, scheduled for UTx, and their uterus-donating mothers, aged 46, 61, and 46 years, respectively. Interventions included preoperative investigations, donor surgery, back-table preparation, and recipient surgery. Preoperative imaging, surgical data, histopathology, menstrual pattern, and uterine blood flow were the main outcome measures. In the first case (46-year-old mother/23-year-old daughter), donor/recipient surgery took 12.12/5.95 h. Regular spontaneous menstruations started 6-week post-transplantation, continuing at 24–28-day intervals throughout the 6-month observation period. Repeated follow-up cervical biopsies showed no signs of rejection. In the second case (61-year-old donor), surgery lasted 13.10 h; attempts to flush the retrieved uterus failed due to extreme resistance of the left uterine artery (UA) and inability to perfuse the right UA. Transplantation was aborted to avoid graft vessel thrombosis or insufficient blood flow during potential pregnancy. Histopathology revealed intimal fibrosis and initial sclerosis (right UA), extensive intimal fibrosis (parametric arterial segments), and subtotal arterial stenosis (myometrial vascular network). In the third case (46-year-old mother/23-year-old daughter), donor/recipient surgery took 9.05/4.52 h. Menstruations started 6-week post-transplantation. Repeated cervical biopsies showed no signs of rejection during the initial 12-week follow-up period. Meticulous preoperative evaluation of potential living uterus donors is essential. This may include selective contrast-enhanced UA angiograms and limitation of donor age, at least in donors with risk factors for atherosclerosis. ClinicalTrials.gov Identifier: NCT03048396.
- Published
- 2017
20. Koloproktologie als wichtiger Baustein eines Beckenbodenzentrums
- Author
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M. Braun, Claudius Falch, Steffen Axt, Christl Reisenauer, A. Kirschniak, and Peter Wilhelm
- Subjects
Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Gastroenterology ,medicine ,Obstetrics and Gynecology ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
Proktologische Erkrankungen und Symptome werden haufig im Rahmen der gynakologischen Untersuchung erstmalig benannt; neben Hamorrhoiden als haufigster proktologischer Erkrankung sind dies prolabierende Erkrankungen (Anal- und Rektumprolaps), Perianalvenenthrombosen, Obstipation und Stuhlinkontinenz sowie malignen Erkrankungen, z. B das Analkarzinomen. Neben einer ausfuhrlichen Anamnese und klinischen Untersuchung umfasst die koloproktologische Diagnostik die Evakuationsproktographie, die dynamische Magnetresonanztomographie (MRT), die Rektoskopie und die Proktoskopie, die flexible Koloskopie, die Kolontransitzeit, die Endoanalsonographie und die Sphinktermanometrie. Die wichtigsten Krankheitsbilder aus dem koloproktologischen Bereich werden zusammengefasst, Blickdiagnosen und Diagnosen, die sich durch eine digital rektale Untersuchung abgrenzen lassen, stehen im Vordergrund. Des Weiteren werden weiterfuhrende diagnostische und therapeutische Masnahmen orientierend dargestellt.
- Published
- 2017
21. Physiotherapy and behavior therapy for the treatment of overactive bladder syndrome: a prospective cohort study
- Author
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Sabine Hahn, Sara Y. Brucker, Martina Wolz-Beck, Christl Reisenauer, Giselle E. Kolenic, and Markus Huebner
- Subjects
Adult ,medicine.medical_specialty ,Visual Analog Scale ,Visual analogue scale ,030232 urology & nephrology ,Urology ,Urination ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Behavior Therapy ,Humans ,Medicine ,Nocturia ,Prospective Studies ,Multivariable model ,Prospective cohort study ,Physical Therapy Modalities ,Aged ,Prior treatment ,030219 obstetrics & reproductive medicine ,Urinary Bladder, Overactive ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,Overactive bladder syndrome ,Physical therapy ,Female ,medicine.symptom ,business ,Body mass index - Abstract
To determine the efficacy of physiotherapy and behavior therapy and to find specific subgroups of women with overactive bladder syndrome that might gain increased benefit from this therapy. Women with ≥10 micturitions per 24-h period were included. Six to nine therapy sessions were held within a 14-day interval. Efficacy end point was a reduction in micturitions and in episodes of nocturia. Secondary outcomes included ICIQ-OAB, ICIQ-OABqol and visual analog scales. Follow-up was 6 months. Levene test, Student’s t test, Pearson´s and Spearman’s correlations were utilized as well as the Friedman test and a multivariable-multilevel model. 32 women were included. Mean age was 51 ± 15.9 (years ± standard deviation, sd). Mean body mass index (BMI) was 24.4 ± 4.8 (kg/m2 ± sd). There was a 22.9% reduction in the number of micturitions per 24 h (11.7 ± 1.6 vs. 9.0 ± 1.3 p
- Published
- 2017
22. Management of device-related complications after sacral neuromodulation for lower urinary tract disorders in women: a single center experience
- Author
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Sara Y. Brucker, Tilemachos Kavvadias, Christl Reisenauer, and Markus Huebner
- Subjects
Adult ,Urologic Diseases ,medicine.medical_specialty ,030232 urology & nephrology ,Electric Stimulation Therapy ,Single Center ,Tertiary Care Centers ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Lead (electronics) ,Aged ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Sacrococcygeal Region ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Perioperative ,Middle Aged ,medicine.disease ,Urinary tract disorder ,Surgery ,Treatment Outcome ,Overactive bladder ,Sacral nerve stimulation ,Urologic Surgical Procedures ,Female ,Test phase ,business ,Complication - Abstract
This study is aimed at presenting and discussing the device-related complication management during a 5-year period, of the sacral nerve modulation (SNM), in a tertiary-care university unit. This is a retrospective chart review of all women, who received SNM in our department between May 2011 and May 2016. All two-stage procedures were performed by the same experienced surgeon and according to our strict protocol of patients’ selection and follow-up. Data of perioperative and postoperative complications and their management were collected. The test stimulation was positive in 59 out of 64 patients (92%), who then received the permanent implantation after a mean test phase duration of 9 days. Mean overall follow-up was 16.5 (±10.9) months. We recorded 20 complications (31%) in 15 patients, after a mean follow-up time of 160 days. These comprise: lead migration (13.8%), infection (8.6%), pain (5.2%), wound healing disorders (5.2%) and lead fibrosis (10%). The event/patient ratio was significantly reduced from 0.6 in the beginning of our experience with SNM to 0.2 at the second period of the study (p = 0.005). All complications could be successfully resolved after surgical intervention without influence on the treatment effect. Complications after SNM are common and may require additional surgical intervention for full resolution but without affecting the treatment effect. Also, due to a learning curve, a lower events/patient ratio over time is to be expected.
- Published
- 2017
23. Intrapartal pelvic floor protection: a pragmatic and interdisciplinary approach between obstetrics and urogynecology
- Author
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Sara Y. Brucker, Gert Naumann, Ralf Tunn, Harald Abele, Markus Huebner, and Christl Reisenauer
- Subjects
Anesthesia, Epidural ,Episiotomy ,medicine.medical_specialty ,Vacuum Extraction, Obstetrical ,medicine.medical_treatment ,Anatomical structures ,Levator ani muscle ,Anal Canal ,Pelvic Floor Disorders ,Obstetrical Forceps ,Urogynecology ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,030212 general & internal medicine ,030219 obstetrics & reproductive medicine ,Pelvic floor ,Cesarean Section ,business.industry ,Vaginal delivery ,Obstetrics ,Obstetrics and Gynecology ,Pelvic Floor ,General Medicine ,Delivery, Obstetric ,Obstetric Labor Complications ,medicine.anatomical_structure ,Female ,business ,Anal sphincter - Abstract
Pelvic floor protection is an issue of increasing relevance. This article sought to summarize the session at last year's annual meeting of the German Society of Gynecology and Obstetrics (DGGG) in Stuttgart (10/2016) called "Urogynecology 2020-what is the optimal rate of cesarean section-does urogynecology have to deal with Obstetrics?". The main focus was set on the two important anatomical structures, the levator ani muscle and the anal sphincters. Operative vaginal delivery, epidural anesthesia, and episiotomy are subject to discussion.
- Published
- 2017
24. Comment on 'A meta-analysis of the predictive values of intraoperative cough test for postoperative outcomes in women undergoing sling procedures' by Wang et al
- Author
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Frank J. Schwab, Juliane Marschke, Tomi S. Mikkola, Ralf Tunn, Markus Huebner, and Christl Reisenauer
- Subjects
Suburethral Slings ,medicine.medical_specialty ,Sling (implant) ,business.industry ,Urinary Incontinence, Stress ,General surgery ,MEDLINE ,Obstetrics and Gynecology ,General Medicine ,Predictive value ,Treatment Outcome ,Cough ,Meta-analysis ,Humans ,Medicine ,Female ,Postoperative Period ,business - Published
- 2020
25. Vaginal prolapse with ulceration and intestinal involvement
- Author
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Christl Reisenauer, Sara Y. Brucker, and Madalina Sandru
- Subjects
Gynecology ,medicine.medical_specialty ,Vaginal ulceration ,business.industry ,medicine ,Obstetrics and Gynecology ,General Medicine ,business ,Human genetics - Published
- 2020
26. Perivaginal benign masses: diagnosis and therapy in a series of 66 women
- Author
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Sara Y. Brucker, Markus Huebner, Christl Reisenauer, Hans Boesmueller, and Anna-Lena Liaci
- Subjects
Adult ,medicine.medical_specialty ,Vaginal Diseases ,Endometriosis ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Transvaginal surgery ,Urethral Diseases ,parasitic diseases ,medicine ,Urethral diverticulum ,Humans ,030219 obstetrics & reproductive medicine ,Cysts ,business.industry ,General surgery ,Obstetrics and Gynecology ,General Medicine ,Magnetic Resonance Imaging ,Surgery ,Diverticulum ,Dyspareunia ,Female ,medicine.symptom ,business - Abstract
Benign perivaginal masses (PVM) are relatively rare. The aim of this study is, to create a higher awareness for these entities and to point out reliable diagnostics and an accurate treatment.The medical records of the Department of Obstetrics and Gynecology Tuebingen were searched for number and type of urogynecological surgery in general, and a surgery, which took place particularly owing to benign PVM, over a period of 5 years. Diagnostics, treatment, histology and postoperative management were summarized and analyzed. Vaginal endometriosis manifestations were not considered.Between 2011 and 2015 a total number of 4.157 women underwent urogynecological surgery, 65 (1.6%) of these particularly because of benign PVM. The benign PVM in the patient cohort were composed as follows: urethral diverticula (UD), squamous epithelial inclusion cysts, periurethral cysts, Gartner's duct cysts, Müllerian cysts, pseudocysts, abscesses, epidermal inclusion cysts, angiofibromas, angiomyofibroblastomas, leiomyomas, solitary fibrous tumor and masses due to alloplastic materials. The PVM occurred singly or multiply. They were asymptomatic or accompanied by symptoms. Case history, clinical examination, pelvic floor sonography, urethrocystoscopy and MRI are essential tools for diagnostics. PVM simulated cystoceles and recto/enteroceles, were cause of an overactive bladder, dyspareunia, pain or were concomitants in women with stress urinary incontinence. The PVM were excised in 65 out of 66 cases, in one case an infected UD regressed completely under conservative antibiotic therapy.The awareness for benign PVM is helpful for their diagnostics and management. As secondary pathology, intradiverticular stones and malignancy have to be considered.
- Published
- 2016
27. What uro-gynecologists should know about sacral neuromodulation (SNM) for the treatment of refractory overactive bladder
- Author
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Mustapha Addali, Christl Reisenauer, and Matthias Oelke
- Subjects
medicine.medical_specialty ,Sacrum ,Urology ,Female sexual dysfunction ,Electric Stimulation Therapy ,Pregnancy ,Medicine ,Fecal incontinence ,Humans ,Adverse effect ,business.industry ,Urinary Bladder, Overactive ,Obstetrics and Gynecology ,General Medicine ,Implantable Neurostimulators ,medicine.disease ,Botulinum toxin ,Overactive bladder ,Gynecology ,Concomitant ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
To inform uro-gynecologists about the current standards and latest developments of sacral neuromodulation (SNM) in women with overactive bladder (OAB). Literature search in the PubMed database for articles published between 1988 and 2019 on SNM for OAB in women. In total, 361 articles were identified and 51 articles retrieved for the review. SNM shows an objective success rate of 70–80%, OAB cure rate of 17–47% and a subjective satisfaction rate of 80–90%. These benefits have to be weighed against an adverse event rate of approx. 40%. SNM is significantly more successful than switching to another antimuscarinic after failed antimuscarinic drug therapy. Efficacy of SNM is slightly lower compared to bladder wall injections with 200 U botulinum toxin in the first months but efficacy of both treatments appears to be similar after 24 months. MRI examinations of patients with a sacral neurostimulator should only be performed after radiologist consultation. Sacral neurostimulators in patients with another pacemaker system should only be implanted after interdisciplinary consultation. The sacral neuromodulator should be turned off during pregnancy and delivery. SNM for OAB in patients with concomitant female sexual dysfunction or fecal incontinence seems to be beneficial. SNM is a successful and recommended second-line treatment of OAB. Sacral neurostimulators should preferably be implanted in SNM-centers because complications and the frequency of revisions are significantly reduced with increasing experience of the surgeon.
- Published
- 2019
28. Zukunftsperspektiven der Urogynäkologie
- Author
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Christl Reisenauer, T. Dimpfl, and Ralf Tunn
- Subjects
Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,medicine ,Obstetrics and Gynecology ,030212 general & internal medicine ,business - Abstract
In einer der weltweit grosten epidemiologischen Erhebungen im Rahmen der norwegischen EPICONT-Studie, in der 28.000 Frauen zur Harninkontinenz befragt wurden, gaben 25 % der Frauen unfreiwilligen Harnverlust an. Die Haufigkeit stieg mit wachsendem Alter. Die Altersstruktur der Bevolkerung in Deutschland andert sich dramatisch. In 2005 waren 19 % der Bevolkerung alter als 65 Jahre. In 2020 wird der Anteil der uber 65-Jahrigen bei 23 % erwartet. Durch die hohe Pravalenz von Kontinenz- und Beckenbodenproblemen bei Frauen ergeben sich daher ein enormer Versorgungsauftrag und eine vielversprechende Perspektive fur die Subspezialitat Urogynakologie vergleichbar mit der Onkologie. Vor diesem Hintergrund ist es unerlasslich, die Urogynakologie als vierte Saule in der Frauenheilkunde zu etablieren, wie dies bereits in der Schweiz und auf europaischer Ebene (EBCOG) vollzogen ist.
- Published
- 2016
29. Three studies in the focus of pelvic organ prolapse research
- Author
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Christl Reisenauer and Heinz Koelbl
- Subjects
medicine.medical_specialty ,Pelvic organ ,Focus (computing) ,030219 obstetrics & reproductive medicine ,business.industry ,Urology ,Obstetrics and Gynecology ,General Medicine ,Human genetics ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Medical physics ,030212 general & internal medicine ,business - Published
- 2017
30. Screening and evaluation of potential recipients and donors for living donor uterus transplantation: results from a single-center observational study
- Author
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Konstantin Nikolaou, Falko Fend, Stephan Zipfel, Dorit Schöller, Katharina Rall, Florin-Andrei Taran, Karl Oliver Kagan, Eckhard Heim, Mike Notohamiprodjo, Christian Grasshoff, Tamam Bakchoul, Diethelm Wallwiener, Melanie Henes, Hans Bösmüller, Silvio Nadalin, Bernhard K. Krämer, Mats Brännström, Alfred Königsrainer, Nils Heyne, Christl Reisenauer, Markus Hoopmann, Norbert Schäffeler, Martina Guthoff, and Sara Y. Brucker
- Subjects
0301 basic medicine ,Infertility ,Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Single Center ,Living donor ,03 medical and health sciences ,0302 clinical medicine ,Uterus transplantation ,medicine ,Living Donors ,Humans ,030219 obstetrics & reproductive medicine ,Hysterectomy ,business.industry ,Obstetrics ,Patient Selection ,Uterus ,Obstetrics and Gynecology ,Organ Transplantation ,Middle Aged ,medicine.disease ,Transplant Recipients ,030104 developmental biology ,Reproductive Medicine ,Donation ,Cohort ,Observational study ,Female ,business ,Infertility, Female - Abstract
Objective To report our experience with the screening and selection of potential recipients and living donors of our uterus transplantation (UTx) program. Design Part of an observational program. Setting University hospital. Patient(s) Patients with absolute uterine factor infertility (AUFI). Intervention(s) Screening by e-mail and telephone, selection during surgical consultation, and preoperative investigations according to a multistep procedure for living donation. Main Outcome Measure(s) Age, cause of AUFI, exclusion reasons, and preoperative workup. Result(s) A total of 212 potential recipients expressed interest in participation. Among the 46 potential recipients and 49 directed donors were 4 potential recipients, each with 2 directed donors. Mean (range) age of potential recipients was 29.6 (19–41) years. Of the potential recipients, 39 (84.8%) had congenital AUFI and 7 (17.3%) had acquired AUFI. Ultimately, 15 potential recipients with 16 directed donors were selected for participation, with 1 potential recipient having 2 directed donors. Mean age of included potential recipients was 28.9 (22–35) years, and mean donor age was 51.3 (37–62) years. Fourteen potential recipients (93.3%) had congenital AUFI, and one potential recipient (6.7%) had undergone hysterectomy for obstetric complications. Conclusion(s) The number of potential candidates for UTx is not inconsiderable, with congenital AUFI being the leading cause of AUFI in our cohort. However, our findings highlight that large numbers of AUFI patients need to be screened, considering our exclusion rates were >50%, owing to ABO incompatibility, unavailability of a directed donor, and self-withdrawal. Moreover, meticulous preoperative screening, including in-depth psychological assessment, is mandatory to maximize living donor safety and UTx success.
- Published
- 2018
31. Does applying postoperative suprapubic catheterisation in urogynecology benefit patients?
- Author
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Markus Huebner, Andreas Gild, Sara Y. Brucker, Diethelm Wallwiener, Birgitt Schoenfisch, and Christl Reisenauer
- Subjects
Adult ,medicine.medical_specialty ,Urinary Incontinence, Stress ,Urinary system ,030232 urology & nephrology ,Urinary incontinence ,Urologic Surgical Procedure ,Pelvic Organ Prolapse ,Catheterization ,Urogynecology ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Humans ,Medicine ,Postoperative Period ,Aged ,030219 obstetrics & reproductive medicine ,Catheter insertion ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,Surgical Mesh ,Surgery ,Urodynamics ,Catheter ,Treatment Outcome ,Surgical mesh ,Concomitant ,Urinary Tract Infections ,Drainage ,Urologic Surgical Procedures ,Female ,medicine.symptom ,business - Abstract
The aim of this study was to define groups of women that are at particular risk for postoperative voiding dysfunction (PVD) after surgery for stress urinary incontinence (SUI) and/or pelvic organ prolapse (POP) and to focus on the question if these specific groups would benefit from suprapubic catheter (SPC) insertion. Complications associated with SPC were identified. Between 06/2005 and 01/2013, the medical records of N = 4463 patients who underwent POP and/or SUI surgery were reviewed for suprapubic bladder drainage, duration of suprapubic catheterisation and SPC associated complications. 35 women suffering from vesicovaginal (28) and urethrovaginal (7) fistulas at the same time span were enrolled additionally. The results obtained revealed that patients after isolated anterior colporrhaphy, isolated anterior colporrhaphy and TVT, isolated cystocele repair using mesh and TVT, as well as patients with concomitant posterior and/or middle compartment prolapse surgery are at increased risk of developing PVD. Thus, postoperative suprapubic bladder drainage is beneficial. Complications occurred in 4.9 % of patients who received an SPC: urinary tract infection (UTI) (35), catheter dislocation (21), infection at the catheter insertion (2) and small bowel perforation (1). For the patients treated for fistulas we noticed a complication rate related to SPC of 11.4 %: UTI (2) and small bowel perforation (2). Patients should be counselled about the risk of developing PVD after POP and/or SUI surgery and should be informed about postoperative bladder drainage options related to their surgery.
- Published
- 2015
32. Vesicovaginal fistulas: a gynecological experience in 41 cases at a German pelvic floor center
- Author
-
Christl Reisenauer
- Subjects
medicine.medical_specialty ,Hysterectomy ,Pelvic floor ,genetic structures ,business.industry ,medicine.medical_treatment ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Vesicovaginal fistula ,language.human_language ,Surgery ,body regions ,German ,Urogenital Surgical Procedure ,medicine.anatomical_structure ,Hysterectomy vaginal ,medicine ,Etiology ,language ,Center (algebra and category theory) ,business - Abstract
Purpose Etiology, diagnosis and management of vesicovaginal fistulas in women referred to the German pelvic floor center Tuebingen over a 9-year period of time were analyzed.
- Published
- 2015
33. Interdisciplinary S2k Guideline: Sonography in Urogynecology
- Author
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C. Lindig-Knopke, A. Kuhn, N Schwertner-Tiepelmann, S. Albrich, V Bjelic Radisic, Jacek Kociszewski, Christl Reisenauer, K. Beilecke, Oliver Schwandner, Volker Viereck, D. Kölle, R. Lange, W. Bader, W. Umek, and Ralf Tunn
- Subjects
Urogynecology ,medicine.medical_specialty ,business.industry ,Maternity and Midwifery ,medicine ,MEDLINE ,Obstetrics and Gynecology ,Medical physics ,Guideline ,business - Published
- 2014
34. Personal Preference of Mode of Delivery. What do Urogynaecologists choose? Preliminary Results of the DECISION Study
- Author
-
Sara Y. Brucker, Harald Abele, Christl Reisenauer, Jan Pauluschke-Fröhlich, M. Hübner, Julia Bihler, Markus Wallwiener, Ralf Tunn, Gert Naumann, Philipp Wagner, and Katharina Rall
- Subjects
Pessary ,medicine.medical_specialty ,mode of delivery ,medicine.medical_treatment ,Population ,elective caesarean section ,Computer-assisted web interviewing ,03 medical and health sciences ,pessary therapy ,0302 clinical medicine ,Maternity and Midwifery ,Risikostratifizierung ,Childbirth ,Medicine ,Caesarean section ,030212 general & internal medicine ,GebFra Science ,education ,Rückbildung ,Pessartherapie ,Postpartum Recovery ,education.field_of_study ,030219 obstetrics & reproductive medicine ,Pelvic floor ,elektive Sectio ,business.industry ,Vaginal delivery ,Obstetrics ,Obstetrics and Gynecology ,postpartum recovery ,Original Article/Originalarbeit ,Geburtsmodus ,medicine.anatomical_structure ,Family medicine ,business ,risk stratification - Abstract
Introduction Currently, almost every third child in Germany is delivered by caesarean section. Apart from straightforward and clear indications for caesarean section which account for approx. 10%, the large proportion of relative indications in particular needs to be critically reviewed if the current C-section rate is to be effectively lowered. It is more than doubtful, however, whether this can be a realistic goal in Germany, especially in the context of international developments. All studies on this topic demonstrate that the personal attitude of the obstetric team has a considerable influence on the pregnant womanʼs personally preferred mode of delivery. Therefore, in the first part of the DECISION study, the personal preferences of urogynaecologists were evaluated regarding the best suitable mode of delivery. Material and Methods All 432 delegates at the 9th German Urogynaecology Congress in Stuttgart in April 2017 were invited to participate in an online questionnaire study. The questionnaire was developed especially for this study. Results Of the 432 registered delegates, 189 (43.8%) participated in the survey. 84.7% (n = 160) of the study participants would prefer a vaginal delivery, in an otherwise uncomplicated pregnancy. Only 12.2% (n = 23) opted for an elective caesarean section. The main reasons stated for this decision were concerns about incontinence (87.5%) and pelvic floor trauma (79.2%). Amongst the study participants, 83.6% would like to be part of a risk stratification system presented in the questionnaire which, with the aid of specific parameters, is intended to allow early identification of a population with a high risk of developing pelvic floor disorders. There was also great interest in postpartum pelvic floor recovery (97.8%) and an associated optional pessary therapy (64.4%). The type of delivery already experienced (vaginal delivery vs. primary caesarean section) and parity also reveals to have a significant influence on the personal preferred mode of delivery as well. Conclusions Urogynaecologists prefer vaginal delivery for themselves. There is a great interest to participate in a risk stratification process in order to approach childbirth in an individualized and risk-adapted manner.
- Published
- 2017
35. Presentation and management of vesicovaginal fistulae after delivery at a German women's hospital
- Author
-
Christl Reisenauer
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Vesicovaginal fistula ,German ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Germany ,medicine ,Childbirth ,Humans ,Caesarean section ,In patient ,Forceps delivery ,030219 obstetrics & reproductive medicine ,Vesicovaginal Fistula ,business.industry ,Obstetrics ,Cesarean Section ,Parturition ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,language.human_language ,Obstetric Labor Complications ,030220 oncology & carcinogenesis ,language ,Female ,Presentation (obstetrics) ,business ,Developed country - Abstract
Vesicovaginal fistulae are rarely seen after childbirth in developed countries. This article deals with the causes, presentation, and management of obstetric vesicovaginal fistulae in patients treated at a German women’s hospital.
- Published
- 2017
36. Recto-vaginal fistula after pessary therapy
- Author
-
Christl Reisenauer and Markus Huebner
- Subjects
Gynecology ,Pessary ,03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,Recto-vaginal fistula ,030220 oncology & carcinogenesis ,Obstetrics and Gynecology ,Medicine ,General Medicine ,business - Published
- 2017
37. Vesico-uterine fistula in pregnancy
- Author
-
Markus Hoopmann and Christl Reisenauer
- Subjects
Gynecology ,medicine.medical_specialty ,Pregnancy ,030219 obstetrics & reproductive medicine ,business.industry ,MEDLINE ,Obstetrics and Gynecology ,General Medicine ,Uterine Fistula ,medicine.disease ,Human genetics ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,business - Published
- 2017
38. Presence of relaxin-2, oxytocin and their receptors in uterosacral ligaments of pre-menopausal patients with and without pelvic organ prolapse
- Author
-
Christian Busch, Christl Reisenauer, and Sarah Schott
- Subjects
Adult ,Sacrum ,medicine.medical_specialty ,genetic structures ,Uterosacral ligament ,Population ,Urology ,Oxytocin ,behavioral disciplines and activities ,Pelvic Organ Prolapse ,Receptors, G-Protein-Coupled ,Internal medicine ,medicine ,Humans ,education ,Receptor ,Relaxin ,education.field_of_study ,Ligaments ,urogenital system ,business.industry ,Uterus ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,Immunohistochemistry ,Pathophysiology ,body regions ,medicine.anatomical_structure ,Endocrinology ,Premenopause ,Receptors, Oxytocin ,Vasa vasorum ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Relaxin receptor - Abstract
Objective Pelvic organ prolapse (POP) is a major health concern for women. Its pathophysiology is yet not fully understood. We reported an impaired functional state of the smooth muscle compartment in uterosacral ligaments from patients with POP, which was cholinergic, stimulated by oxytocin and modulated by relaxin-2. The current study investigated the presence of oxytocin and relaxin-2 and their receptors in the uterosacral ligament from POP/non-POP patients. Design Translational investigation on clinical samples. Setting University hospital departments. Population and samples Fourty-three samples of uterosacral ligament from pre-menopausal patients with (n = 20) and without POP (n = 23). Methods Presence of relaxin-2, its receptors RXFP1 and RXFP2, and of oxytocin and its receptor were analysed by immunohistochemistry and classified using a staining score. Additionally, Western blot analysis was performed. Main outcome measures Presence patterns with respect to POP and non-POP uterosacral ligament samples for pathophysiological understanding of POP. Results Relaxin-2, oxytocin and their receptors were expressed in endothelial cells, the smooth muscle compartment and vasa vasorum in the arteries and veins of the uterosacral ligament, in the smooth muscle compartment present in the ground reticulum and in nerves running through the uterosacral ligament. The presence level of relaxin-2 was higher in the uterosacral ligament of the POP cohort (p
- Published
- 2014
39. Genital epidermal horn cyst (atheroma) after female genital mutilation WHO type III b
- Author
-
Christl Reisenauer and Dorit Schöller
- Subjects
Female circumcision ,Atheroma ,Horn (anatomy) ,business.industry ,medicine ,Obstetrics and Gynecology ,Sex organ ,Cyst ,General Medicine ,Anatomy ,medicine.disease ,business - Published
- 2018
40. Laparoscopic Nerve-Preserving Colposacropexy for Surgical Management of Neovaginal Prolapse
- Author
-
Verena Henninger, Sara Y. Brucker, Christl Reisenauer, and Katharina Rall
- Subjects
Adult ,medicine.medical_specialty ,46, XX Disorders of Sex Development ,Pelvic Organ Prolapse ,Congenital Abnormalities ,Suture (anatomy) ,Humans ,Medicine ,Surgical treatment ,Mullerian Ducts ,Colposacropexy ,business.industry ,Standard treatment ,Obstetrics and Gynecology ,Prostheses and Implants ,General Medicine ,Surgical Mesh ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Vagina ,Vaginoplasty ,Female ,Laparoscopy ,Vaginal agenesis ,business - Abstract
Background Neovaginal prolapse occurs rarely, and a standard treatment has not yet been defined. Case We report 2 cases of patients with vaginal agenesis with a symptomatic neovaginal prolapse; one occurring 25 years after self-dilation and another occurring 24 years after sigmoid vaginoplasty. At 48 and 18 months after surgical treatment with laparoscopic nerve-preserving colposacropexy using 2 types of mesh and 2 kinds of sutures to anchor the mesh at the neovaginal wall, both women are asymptomatic and highly satisfied with the result, without prolapse recurrence or mesh/suture erosion. Summary and Conclusion For the surgical management of neovaginal prolapse after sigmoid vaginoplasty and vagina creation after self-dilation, we recommend the nerve-preserving sacrocolpopexy as a safe method to achieve durable functional outcomes and good anatomic vaginal level I and II support.
- Published
- 2015
41. Interdisciplinary S2e Guideline for the Diagnosis and Treatment of Stress Urinary Incontinence in Women
- Author
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S. Soeder, Ursula Peschers, D. Schultz-Lampel, N Schwertner-Tiepelmann, Christl Reisenauer, Ulla Henscher, C. Muche-Borowski, D. Finas, C. Klingler, A. Strauss, Ralf Tunn, K. Lobodasch, U. Steigerwald, C. Anthuber, Volker Viereck, Ruth Kirschner-Hermanns, Karl Tamussino, A. Kuhn, A. Köwing, Gert Naumann, Bärbel Junginger, T Aigmüller, D. Kölle, M. Hübner, Matthias Oelke, K. Höfner, T. Fink, S. Kropshofer, B. Gabriel, and E. Petri
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medicine.medical_specialty ,business.industry ,Maternity and Midwifery ,Alternative medicine ,medicine ,Obstetrics and Gynecology ,Urinary incontinence ,Guideline ,medicine.symptom ,Intensive care medicine ,business - Published
- 2013
42. The rectovaginal septum: visible on magnetic resonance images of women with Mayer-Rokitansky-Küster-Hauser syndrome (Müllerian agenesis)
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Sara Y. Brucker, John O.L. DeLancey, Katharina Rall, Markus Huebner, KC Siegmann-Luz, and Christl Reisenauer
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46, XX Disorders of Sex Development ,Adolescent ,Urology ,Urinary Bladder ,Rectum ,Article ,Congenital Abnormalities ,Young Adult ,Humans ,Medicine ,Mayer-Rokitansky-Kuster-Hauser Syndrome ,Fascia ,Mullerian Ducts ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Magnetic resonance imaging ,Anatomy ,medicine.disease ,Magnetic Resonance Imaging ,Sagittal plane ,Müllerian agenesis ,medicine.anatomical_structure ,Vagina ,Female ,Vaginal agenesis ,business - Abstract
Introduction and hypothesis Ongoing debate exists about whether the rectovaginal septum (Denonvilliers’ fascia) is myth or reality. This study evaluates magnetic resonance images (MRI) of women with Mullerian agenesis for the presence of fascial layers between the rectum and the bladder to test the hypothesis that this layer exists in the absence of the vagina. Methods This isa secondary analysisof astudy describing MRI aspects in women with vaginal agenesis before and after laparoscopic Vecchietti procedure. Study participants (n=16) had a multiplanar pelvic MR scan. Images were evaluated independently by two investigators (MH, JOLD) for the appearance of layers separate from the bladder and rectum in the area of interest, with characteristic anatomical features of the septum. Results Participants’meanagewas19.4±2.6years± standard deviation (SD). In 12 of 16 patients (75 %) a distinct layer between rectum and bladder was identified in either the axial (4/16; 25 %) or sagittal (12/16; 75 %) scan or both. Characteristic anatomical features included lateral attachment to the levator ani muscle, cranial fusion to the cul-de-sac peritoneum, and caudal insertion into the perineal body. Conclusions Three quarters of women with Mullerian agenesis have a visible layer between bladder and rectum. As none of the participants hadavagina,theseresults support the existence of a rectovaginal septum, separate from a vaginal adventitia.
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- 2013
43. Modified LeFort colpocleisis: clinical outcome and patient satisfaction
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Birgitt Schoenfisch, Christl Reisenauer, E Oberlechner, Diethelm Wallwiener, and Markus Huebner
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medicine.medical_specialty ,Urinary Incontinence, Stress ,Treatment outcome ,MEDLINE ,Urinary incontinence ,Outcome (game theory) ,Pelvic Organ Prolapse ,Gynecologic Surgical Procedures ,Patient satisfaction ,Colpocleisis ,medicine ,Humans ,Aged ,Aged, 80 and over ,business.industry ,General surgery ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,Surgery ,Treatment Outcome ,Patient Satisfaction ,Vagina ,Female ,medicine.symptom ,business - Abstract
The purpose of this study was to determine the anatomical and functional outcomes, as well as patients' satisfaction and morbidity associated with modified LeFort colpocleisis.Between 7/2007 and 6/2011 58 patients underwent a modified LeFort colpocleisis. Thirty-eight were available for follow-up visit. Records were reviewed for patients' characteristics, operative data and incidence of complications. The follow-up visit comprised a medical history and a gynecological examination. A visual-analog-scale to assess patients' quality of life after surgery was used. The patients were asked: "Would you again choose to have this surgery performed?" and "Do you regret choosing to have a vaginal closure procedure?" Statistical analysis was performed using R version 2.12.1, R Foundation for Statistical Computing, Vienna, Austria.There were no treatment failures within a mean follow-up of 14 months (range 3-41 months). 89% of patients reported an improved quality of life postoperatively. No complications occurred intraoperatively and none of the patients regretted the loss of sexual function. All patients stated that they would choose to have the colpocleisis procedure again. Postoperatively 8 urinary tract infections, 2 hematomas and 1 pyometra occurred. Two patients complained about stress urinary incontinence and another one about an overactive bladder.The study highlights an additional safe and effective option for an individualized treatment of pelvic organ prolapse.
- Published
- 2013
44. Diagnostik und Management von paravaginalen benignen Raumforderungen am Beispiel von 69 Fällen. Was sollte ein (Uro) Gynäkologe wissen?
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Als Liaci, Sara Y. Brucker, M. Hübner, Christl Reisenauer, and A Stäbler
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Maternity and Midwifery ,Obstetrics and Gynecology - Abstract
Zielsetzung: Benigne paravaginale Raumforderungen (PVRF) sind relativ selten. Ziel unserer Studie ist es, ein Bewusstsein hierfur zu schaffen und eine sichere Diagnostik sowie eine akkurate operative Versorgung aufzuzeigen. Materialien und Methoden: Aus den OP-Buchern unserer Klinik wurden die Anzahl und die Art der durchgefuhrten urogynakologischen Eingriffe im Allgemeinen und die aufgrund einer benignen PVRF erfolgten Eingriffe im Speziellen, uber einen Zeitraum von 5 Jahren, erhoben. Aus den Krankenunterlagen wurden Diagnostik, Therapie, Histologie und postoperatives Management zusammengefasst und analysiert. Vaginale Endometriosemanifestationen fanden keine Berucksichtigung. Ergebnisse: Im Zeitraum 2011 – 2015 wurden an unserer Klinik 4161 Frauen einer urogynakologischen Operation unterzogen, 69 davon aufgrund einer PVRF. In unserem Patientinnenkollektiv setzten sich die PVRF wie folgt zusammen: Zysten der paraurethralen Drusen und Vestibulardrusen, Urethradivertikel, mesonephrische Zysten (Gartner-Gang-Zysten) und paramesonephrische Zysten (Mullersche Epithelzysten), Epithelzysten, Leiomyome, Angiofibrome, Angiomyofibroblastome und fremdmaterialbedingte Raumforderungen (intraurethrale und intravesikale Fremdmaterial-Penetrationen). Grose, Konfiguration und Komplexitat variierten erheblich. Die groste PVRF betrug 10 cm. Die PVRF traten einzeln oder multipel auf. Sie waren asymptomatisch oder gingen mit Inkontinenz, Harnwegsinfekten, Schmerzen, Fremdkorpergefuhl, Blasenentleerungsstorungen, Defakationsstorungen, und Dyspareunie einher. Anamnese, klinische Untersuchung, Introitussonografie, Urethrozystoskopie und MRT waren fur die Diagnostik entscheidend. PVRF tauschten Zystozelen und Rektozelen/Enterozelen vor, waren Ursache einer uberaktiven Blase, Dyspareunie, Schmerzen oder Begleiterscheinungen bei Frauen mit Belastungsinkontinenz. In allen Fallen wurde die PVRF exzidiert. Bei gleichzeitig vorliegender Belastungsinkontinenz, Dranginkontinenz oder eines Descensus genitalis erfolgte die Therapie zweizeitig. Zusammenfassung: Das Bewusstsein um die PVRF ist hilfreich in deren Diagnostik und Management. Als Sekundarpathologie muss auf Divertikelsteine und auf eine maligne Entartung geachtet werden.
- Published
- 2016
45. Das präoperativ nicht erkannte Endometriumkarzinom: Häufigkeit und Charakteristika nach Hysterektomie aus benigner Indikation
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Bernhard K. Krämer, Sara Y. Brucker, Christl Reisenauer, Harald Abele, Andreas D. Hartkopf, D. Wallwiener, Florin-Andrei Taran, S Kommoss, Felix Neis, and Philipp Wagner
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Maternity and Midwifery ,Obstetrics and Gynecology - Published
- 2016
46. Physio- und Verhaltenstherapie zur Behandlung der Überaktiven Blase (OAB)
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Sara Y. Brucker, M. Hübner, M Wolz-Beck, S Hahn, and Christl Reisenauer
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Maternity and Midwifery ,Obstetrics and Gynecology - Published
- 2016
47. Indications and Route of Hysterectomy for Benign Diseases. Guideline of the DGGG, OEGGG and SGGG (S3 Level, AWMF Registry No. 015/070, April 2015)
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K. J. Neis, Martin Müller, Ioannis Mylonas, P. Gaß, W Kleine, W Stummvoll, Christl Reisenauer, Th. Römer, K Schwerdtfeger, Matthias David, Thoralf Schollmeyer, Bernd Holthaus, H Dieterich, Dietmar Schmidt, L-C Horn, B. Gabriel, A T Teichmann, M. Menton, I B Runnenbaum, Bernd Bojahr, A. Kuhn, Erich-Franz Solomayer, S Rimbach, A. Strauss, Karl Tamussino, P. Brandner, Felix Neis, Mathias K. Fehr, and W. Zubke
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medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Hysterectomy ,medicine.diagnostic_test ,business.industry ,Obstetrics ,medicine.medical_treatment ,Endometriosis ,MEDLINE ,Obstetrics and Gynecology ,610 Medicine & health ,Guideline ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,Systematic review ,Maternity and Midwifery ,medicine ,Adenomyosis ,030212 general & internal medicine ,Laparoscopy ,business - Abstract
Background: Official guideline “indications and methods of hysterectomy” to assign indications for the different methods published and coordinated by the German Society of Gynecology and Obstetrics (DGGG), the Austrian Society of Gynecology and Obstetrics (OEGGG) and the Swiss Society of Gynecology and Obstetrics (SGGG). Besides vaginal and abdominal hysterectomy, three additional techniques have been implemented due to the introduction of laparoscopy. Organ-sparing alternatives were also integrated. Methods: The guideline group consisted of 26 experts from Germany, Austria and Switzerland. Recommendations were developed using a structured consensus process and independent moderation. A systematic literature search and quality appraisal of benefits and harms of the therapeutic alternatives for symptomatic fibroids, dysfunctional bleeding and adenomyosis was done through MEDLINE up to 6/2014 focusing on systematic reviews and meta-analysis. Results: All types of hysterectomy led in studies to high rates of patient satisfaction. If possible, vaginal instead of abdominal hysterectomy should preferably be done. If a vaginal hysterectomy is not feasible, the possibility of a laparoscopic hysterectomy should be considered. An abdominal hysterectomy should only be done with a special indication. Organ-sparing interventions also led to high patient satisfaction rates, but contain the risk of symptom recurrence. Conclusion: As an aim, patients should be enabled to choose that therapeutic intervention for their benign disease of the uterus that convenes best to them and their personal life situation.
- Published
- 2016
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48. Inkontinenz der Frau
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Christl Reisenauer, T. Hagemeier, W. Bader, and T. Dimpfl
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Gynecology ,medicine.medical_specialty ,business.industry ,Tension free vaginal tape ,Obstetrics and Gynecology ,Medicine ,Electric stimulation therapy ,business - Abstract
Harninkontinenz ist ein medizinisches, soziales und okonomisches Problem. In Deutschland leiden rund 6–8 Mio. Menschen an Harninkontinenz, 88% an einer behandlungsbedurftigen Belastungsinkontinenz. Die Inzidenz dieser stark beeintrachtigenden Erkrankung steigt mit dem Alter an und ist einer der haufigsten Grunde fur eine Heimeinweisung. Harninkontinenz verlauft chronisch und ist mit einem hohen Risiko von Folgeerkrankungen wie Depressionen, Hauterkrankungen und Frakturen assoziiert. Die Erkrankung generiert immense Kosten – sowohl fur die Pflege als auch fur die Behandlung der Komplikationen. Bei fruher Diagnose und effektiver Behandlung kann die Kontinenz wiederhergestellt oder wenigstens die Inkontinenzsymptomatik reduziert werden. Bei Belastungsinkontinenz stellt die suburethrale Schlingenmethode die Therapie der Wahl dar. Bei einem gunstigen Nutzen-Risiko-Profil erreichen sie anhaltend hohe Heilungsraten von bis zu 90%.
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- 2012
49. Mesh-related complications in urogynecology - a multidisciplinary challenge
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Volker Viereck and Christl Reisenauer
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medicine.medical_specialty ,business.industry ,Pelvic pain ,Perforation (oil well) ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Surgery ,body regions ,Urogynecology ,medicine.anatomical_structure ,Urethra ,Overactive bladder ,medicine ,Dysuria ,Fecal incontinence ,medicine.symptom ,Buttocks ,business - Abstract
Diagnoses of complications in women who underwent pelvic floor surgery using meshes and the multidisciplinary management of these cases at two national referral urogynecological centers between January and June 2011 are presented in a series of cases of mesh complications, which provide an indication of the wide range of symptoms and, at times, the long time span over which they may be encountered. Complications included infection, erosion (extrusion/exposure), fistulas, perforation into the surrounding organs (such as urethra, bladder and/or bowel), chronic pelvic pain (often radiating into buttocks, groins and/or thighs), dysuria, dyschezia, voiding difficulties, constipation, stool evacuation difficulties, de novo overactive bladder, urinary and fecal incontinence and prolapse recurrences. Although meshes have the ability to provide adequate anatomical support, the emergence of such a multitude of complications has resulted in restrictions for their use, as well as being a multidisciplinary challenge.
- Published
- 2012
50. Urogynäkologie. Die operative Therapie der Belastungsharninkontinenz: Stellenwert der obturatorischen suburethralen Schlingen
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Christl Reisenauer and Tina Bernardi
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Maternity and Midwifery ,Obstetrics and Gynecology - Published
- 2012
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