Inaugural Pelvic Floor Forum Meeting
April first marked the first meeting of the Kitsap Pelvic Floor Forum.
Representatives of all the disciplines that treat pelvic floor disorders
(gynecology, urology, colorectal surgery, and pelvic floor therapy) met
over dinner at Harrison Silverdale. Two gynecologists came from as far as
Port Angeles. The meeting was co-sponsored by Advanced Medical Imaging,
Bard Urologic and Ethicon Endosurgery.
This initial meeting was dedicated to pelvic floor prolapse, since that
topic was most often mentioned in pre-meeting questionnaires. Pelvic floor
prolapse represents the often combined late sequellae of childbirth:
perineal descent, rectocele, enterocele, rectal prolapse (full thickness,
internal and mucosal only) and cystocele. Symptoms of pelvic prolapse
include pressure, mass effect, constipation, fecal and urinary
incontinence and retention.
Dr. Tim Gleason, of Advanced Medical Imaging, talked about indications and
benefits of cystodefecography in the diagnosis of pelvic floor prolapse,
along with excellent video examples. Dr. Gleason and his assistant Carol
have now done over 300 cystodefecography studies.
Dr. Green talked about total mesh repair of combined pelvic floor prolapse
(enterocele, rectocele, rectal prolapse and cystocele). Total mesh repair
re-suspends the pelvic floor, rectum and vaginal apex from the sacrum
while repairing the defect in the rectovaginal septum that allows a
rectocele. A study with over 200 patients shows no recurrence with over
80% of patients considering the results “good” or “excellent”.
|
|
Some patients will have persistent mucosal prolapse after
anterior rectopexy since the mucosa is not well anchored to the deeper
layers secured with rectopexy. A good exchange about defecography, pelvic
prolapse and differing approaches ensued, including an alternative
approach to pelvic prolapse with abdominal rectopexy with colporrhaphy
combined with transvaginal anterior (or paravaginal) and posterior repair.
Discussions then turned to how often the Pelvic Floor Forum should meet,
optimal meeting times and the desired upcoming topics. The consensus was
for a twice yearly meeting in early October and early March. The Harrison
Silverdale location seems central and allows for excellent audio visual
support. The next meeting will be October 7th, in the Iris room at
Harrison-Silverdale. The topic will be Pelvic Floor Training, focusing on
the use of biofeedback. The March 2005 meeting will be focused on urinary
incontinence and contacts are being made to arrange a guest speaker from
UW.
Invitations to the initial Pelvic Floor Forum were directed to
gynecologists, urologists, gastroenterologists and family practitioners
doing obstetrics. However, the meeting is open to any physician, nurse
practitioner or physician’s assistant interested in pelvic floor problems.
If you would like to be notified about the Pelvic Floor Forum meetings
please call Kathleen at KCRS: 377-4717 ext 7. Reminders will be mailed
about a month before the meeting.
REMEMBER: COLORECTAL CANCER IS PREVENTABLE!!! |
Kitsap ColoRectal Surgery, Johnny B. Green, MD, FACS, FASCRS
Eastwood Building, 2528 Wheaton Way, #103, Bremerton, WA 98310
Voice:
(360) 377-4717 -- Fax: (360) 377-4134
www.kitsapcolorectal.com
|
