The human being is the only mammal capable of walking and simultaneously maintaining an upright position. This fact, implies somewhat unfavorable repercussions for the pelvic region that must support the weight of the abdominal organs. A prime example of the aforementioned adverse effects of the standing position are pelvic organ prolapses (POP). POP surgery is an increasingly important therapeutic aspect in clinical practice due to the aging of our population, and is increasingly prevalent as a therapeutic option. Surgical techniques can be performed using an abdominal or vaginal approach, depending on the medical history, physical examination, and experience of the surgeon. Laparoscopic sacrocolpopexy is an adequate therapeutic option with a high success rate in 80–100% of cases. However, this technique is not always appropriate, especially for patients who are at high risk for anesthesia, a multi-operated abdomen, or in recurrent prolapse. In these cases, a vaginal approach offers an interesting surgical alternative. In this review, we added our experience with transvaginal single-incision mesh under locoregional anesthesia for correction of female POP. We retrospectively analyzed 78 patients showing a success rate of 92% after more than 12 months of follow up. Transvaginal mesh was developed to maintain the advantage of a vaginal procedure, while reducing the risk of recurrent prolapse compared to native tissue repair and simplifying the surgery compared to sacrocolpopexy.
Part of the book: Pelvic Floor Dysfunction
Circumcision is one of the surgical interventions with the longest historical tradition for various medical or non-medical, religious and social, reasons. Due to a high demand for this surgery, in recent years, a large number of plastic and disposable devices have emerged in order to optimize the technique. Although they were initially used in newborns and children, their use in recent years has been expanding to adults. The main objectives of these devices are to shorten the surgical time, simplify the technique, and maintain an adequate safety profile compared to the classic suture technique. All reviewed devices for adult circumcision appear to achieve these goals, making them a safe, fast, and feasible option for use in an outpatient setting or in high-demand areas.
Part of the book: Circumcision