Biomedical subjects

Chahin Achtari

Publications and source records attributed to Chahin Achtari.

4 recordsLinked to original sources

PubMed2006

[Bulking agents and their place in the treatment of urinary stress incontinence].

Bulking agents are used in the treatment of urinary stress incontinence associated with intrinsic sphincter deficiency. Bovine collagen remains the gold standard despite problems such as allergic reaction and absorption of the injected material. Several new products are being evaluated or used clinically to try and overcome problems linked with bovine collagen. The aim of this paper is to review the bulking agents available and to put in prospect use of these products with the recent progress made in the treatment of urinary stress incontinence. The gold standard treatment for intrinsic sphincter deficiency is suburethral autologous or synthetic suburethral slings. Bulking agents are indicated for multi-operated patients with urinary stress incontinence and intrinsic sphincter deficiency. Bladder neck hypermobility is not a contraindication.

Biocompatible Materials↗

PubMed2005

Anatomical study of the obturator foramen and dorsal nerve of the clitoris and their relationship to minimally invasive slings.

OBJECTIVES: The objective of the study is to clarify potential risks to the dorsal nerve of the clitoris (DNC) and obturator canal using different minimally invasive slings. STUDY DESIGN: Ten embalmed hemipelves were dissected to demonstrate the course of the DNC and the obturator canal. On each cadaver, tension-free vaginal tape (TVT), transobturator in-out (TVT-O) and transobturator out-in (Monarc) procedures were performed. Distances between the DNC and the obturator canal to the different devices were measured. RESULTS: The DNC passes beneath the pubic bone at a distance of 14.3 +/- 4.7 mm of the midline. The distances of the different devices to the DNC were similar. The distance to the obturator canal was significantly different, with TVT being the furthest (40.1 +/- 3.7 mm) and TVT-O the closest (19.3 +/- 3.1 mm; p < 0.0001). CONCLUSION: Given the course of the DNC along the medial aspect of the ischiopubic ramus, the out-in technique may be safer. The in-out technique is the closest to the obturator canal.

Cadaver↗

PubMed2005

Sexual function and pelvic floor disorders.

Sexual wellbeing is an important aspect of women's health. Female sexual dysfunction is multifactorial and involves physical, social and psychological dimensions. Dysfunction may result from lack of sexual desire, sexual pain or arousal, and orgasmic problems. Sexual dysfunction is common and increases with age and pelvic floor disorders such as urinary incontinence and pelvic organ prolapse. Surgical treatment of pelvic floor disorders has been poorly studied but has the potential to improve sexual satisfaction or to cause sexual difficulties. New instruments such as condition-specific sexual questionnaires have recently been developed and will help us to better evaluate the results of incontinence and prolapse surgery on sexual function.

Female↗

PubMed2005

Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene/polyglactin 910 (Vypro II) mesh.

The objective of this study was to identify the risk factors associated with the occurrence of mesh erosion (ME) during the first 6 post-operative months in patients having undergone transvaginal repair of pelvic organ prolapse (POP) with Atrium or Vypro II mesh. We retrospectively reviewed the records of 198 consecutive patients who underwent vaginal reconstructive surgery reinforced either by Atrium or Vypro II mesh between February 1999 and July 2003. Univariable and multivariable logistic regression was performed to assess associations between measured covariates and ME. Fourteen patients [7.1%, 95% confidence interval (CI): 3.9-11.6] developed vaginal ME. We found that, in the Vypro II mesh patients, the surgeon experienced in the technique had less erosions than less experienced surgeons (2.9 vs 15.6%, p=0.02). There was no statistically significant difference between the monofilament polypropylene (Atrium) and the composite polypropylene/polyglactin 910 (Vypro II) mesh (7.2 vs 6.9%, p=0.41) when adjusted for surgeon experience and patient age. There was no association between mesh type (Atrium or Vypro II) and vaginal ME following transvaginal repair of POP. Surgeon experience and patient age were associated with ME.

Female↗