Volume 18, Number 3Case ReviewA Case of Pelvic Organ Prolapse in the Setting of Cirrhotic AscitesNima M ShahNatasha GinzburgKristene WhitmoreAscites is commonly found in patients with liver cirrhosis. Although conservative therapy is often the ideal choice of care with these patients who also have symptomatic pelvic organ prolapse, this may fail and surgical methods may be needed. Literature is limited regarding surgical repair of prolapse in the setting of ascites. The authors present the surgical evaluation and management of a 63-year-old woman with recurrent ascites from liver cirrhosis who failed conservative therapy. With adequate multidisciplinary care and medical optimization, this patient underwent surgical therapy with resolution of her symptomatic prolapse and improved quality of life. [Rev Urol. 2016;18(3):178-180 doi: 10.3909/riu0702] © 2016 MedReviews®, LLCAscitesCirrhosisProlapseColpocleisis
Volume 18, Number 3Case ReviewA Novel Approach to Mesh Revision After SacrocolpopexyNima M ShahMelissa L DawsonRebecca RinkoKristene E WhitmorePelvic organ prolapse (POP) is the herniation of pelvic organs to or beyond the vaginal walls. POP affects 50% of parous women; of those women, 11% will need surgery based on bothersome symptoms. Transvaginal mesh has been used for vaginal augmentation since the 1990s. Complications from mesh use are now more prominent, and include chronic pelvic pain, dyspareunia, vaginal mesh erosion, and urinary and defecatory dysfunction. Presently, there is no consensus regarding treatment of these complications. Reported herein are two cases of women with defecatory dysfunction and pain after sacrocolpopexy who underwent mesh revision procedures performed with both urogynecologic and colorectal surgery. [Rev Urol. 2016;18(3):174-177 doi: 10.3909/riu0698] © 2016 MedReviews®, LLCVaginal meshMesh erosionOmental flap mobilization