Limits...
The integral system.

Petros P - Cent European J Urol (2011)

Bottom Line: With more severe cases, polypropylene tapes applied through "keyhole" incision using special instruments reinforce the damaged ligaments, restoring structure and function.Organ prolapse and symptoms are related, and both are mainly caused by laxity in the four main suspensory ligaments and perineal body.Restoration of ligament/fascial length and tension is required to restore anatomy and function.

View Article: PubMed Central - PubMed

Affiliation: Honorary Professor, Faculty of Medicine, University of New South Wales, Kensington, Sydney, Australia.

ABSTRACT

Unlabelled: The Integral System is a total care management system based on the Integral Theory which states 'prolapse and symptoms of urinary stress, urge, abnormal bowel & bladder emptying, and some forms of pelvic pain, mainly arise, for different reasons, from laxity in the vagina or its supporting ligaments, a result of altered connective tissue'.

Normal function: The organs are suspended by ligaments against which muscles contract to open or close the their outlet tubes, urethra and anus. These ligaments fall naturally into a three-zone zone classification, anterior, middle, and posterior.

Dysfunction: Damaged ligaments weaken the force of muscle contraction, causing prolapse and abnormal bladder and bowel symptoms.

Diagnosis: A pictorial diagnostic algorithm relates specific symptoms to damaged ligaments in each zone.

Treatment: In mild cases, new pelvic floor muscle exercises based on a squatting principle strengthen the natural closure muscles and their ligamentous insertions, thereby improving the symptoms predicted by the Theory. With more severe cases, polypropylene tapes applied through "keyhole" incision using special instruments reinforce the damaged ligaments, restoring structure and function. Problems that can be potentially addressed by application of the Integral SystemUrinary stress incontinenceUrinary urge incontinenceAbnormal bladder emptyingFacal incontinence and "obstructed evacuation" ("constipation")Pelvic pain, and some types of vulvodynia and interstitial cystitisOrgan prolapse.

Conclusions: Organ prolapse and symptoms are related, and both are mainly caused by laxity in the four main suspensory ligaments and perineal body. Restoration of ligament/fascial length and tension is required to restore anatomy and function.

No MeSH data available.


Related in: MedlinePlus

TFS repair of rectocele. The TFS sling restores the anatomy of the posterior vaginal wall by shortening the uterosacral (USL) ligaments and fascia, and re-approximating the laterally displaced perineal body (PB).
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Figure 0014: TFS repair of rectocele. The TFS sling restores the anatomy of the posterior vaginal wall by shortening the uterosacral (USL) ligaments and fascia, and re-approximating the laterally displaced perineal body (PB).

Mentions: The TFS uses only small sections of monofilament tape, Figs. 10–14, so it causes less tissue irritation. It uses a bioengineering principle similar to that of a domestic ceiling for cystocele and rectocele repair [41, 44]. The tape acts as the ceiling joist, and the vagina the plaster board. The TFS system for pelvic organ prolapse repair, Figs. 11–14, avoids the spaces between rectum, bladder and vagina, and so it is not subject to the adhesive complications seen with large mesh such as dyspareunia and pain with defecation. As with all polypropylene implantations, the main complication is rejection of the tape by the body's immune mechanisms. However, this occurs only in a small percentage of patients, as only very small segments of tape are used, and the anchor prevents “slippage” into the wound, a major cause of erosion.


The integral system.

Petros P - Cent European J Urol (2011)

TFS repair of rectocele. The TFS sling restores the anatomy of the posterior vaginal wall by shortening the uterosacral (USL) ligaments and fascia, and re-approximating the laterally displaced perineal body (PB).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921723&req=5

Figure 0014: TFS repair of rectocele. The TFS sling restores the anatomy of the posterior vaginal wall by shortening the uterosacral (USL) ligaments and fascia, and re-approximating the laterally displaced perineal body (PB).
Mentions: The TFS uses only small sections of monofilament tape, Figs. 10–14, so it causes less tissue irritation. It uses a bioengineering principle similar to that of a domestic ceiling for cystocele and rectocele repair [41, 44]. The tape acts as the ceiling joist, and the vagina the plaster board. The TFS system for pelvic organ prolapse repair, Figs. 11–14, avoids the spaces between rectum, bladder and vagina, and so it is not subject to the adhesive complications seen with large mesh such as dyspareunia and pain with defecation. As with all polypropylene implantations, the main complication is rejection of the tape by the body's immune mechanisms. However, this occurs only in a small percentage of patients, as only very small segments of tape are used, and the anchor prevents “slippage” into the wound, a major cause of erosion.

Bottom Line: With more severe cases, polypropylene tapes applied through "keyhole" incision using special instruments reinforce the damaged ligaments, restoring structure and function.Organ prolapse and symptoms are related, and both are mainly caused by laxity in the four main suspensory ligaments and perineal body.Restoration of ligament/fascial length and tension is required to restore anatomy and function.

View Article: PubMed Central - PubMed

Affiliation: Honorary Professor, Faculty of Medicine, University of New South Wales, Kensington, Sydney, Australia.

ABSTRACT

Unlabelled: The Integral System is a total care management system based on the Integral Theory which states 'prolapse and symptoms of urinary stress, urge, abnormal bowel & bladder emptying, and some forms of pelvic pain, mainly arise, for different reasons, from laxity in the vagina or its supporting ligaments, a result of altered connective tissue'.

Normal function: The organs are suspended by ligaments against which muscles contract to open or close the their outlet tubes, urethra and anus. These ligaments fall naturally into a three-zone zone classification, anterior, middle, and posterior.

Dysfunction: Damaged ligaments weaken the force of muscle contraction, causing prolapse and abnormal bladder and bowel symptoms.

Diagnosis: A pictorial diagnostic algorithm relates specific symptoms to damaged ligaments in each zone.

Treatment: In mild cases, new pelvic floor muscle exercises based on a squatting principle strengthen the natural closure muscles and their ligamentous insertions, thereby improving the symptoms predicted by the Theory. With more severe cases, polypropylene tapes applied through "keyhole" incision using special instruments reinforce the damaged ligaments, restoring structure and function. Problems that can be potentially addressed by application of the Integral SystemUrinary stress incontinenceUrinary urge incontinenceAbnormal bladder emptyingFacal incontinence and "obstructed evacuation" ("constipation")Pelvic pain, and some types of vulvodynia and interstitial cystitisOrgan prolapse.

Conclusions: Organ prolapse and symptoms are related, and both are mainly caused by laxity in the four main suspensory ligaments and perineal body. Restoration of ligament/fascial length and tension is required to restore anatomy and function.

No MeSH data available.


Related in: MedlinePlus