Pelvic Organ Prolapse

Ad lib postoperative activity and return to work recommendations

Expedited postoperative activity instructions

Standard conservative postoperative activity and return to work recommendations

Standard postoperative activity restructions

Duke University Medical Center

Expedited Versus Restrictive: Limitations on Activity Following Surgical Treatment of Prolapse

Most distal point of pelvic organ support (in centimeters) based on Pelvic Organ Prolapse Quantification system

Pelvic Organ Prolapse Distress Inventory (POPDI) at 3 months

Time to resumption of >90% of baseline activity, measured with ActiGraph accelerometer worn pre- and 6 weeks postoperatively

HRQOL as measured by the PROMIS short form subscales of physical function, anxiety, depression, fatigue, satisfaction with social role, and pain interference

Functional aerobic capacity as measured by the 6 Minute Walk Test

Functional strength as measured by the Chair Stand Test

Postoperative day at which patient returned to work

Measured by the Pelvic Floor Distress Inventory-20

Measured by the Pelvic Floor Impact Questionnaire-7

As measured by the Activities Assessment Scale

As measured by Patient Global Impression of Improvement

Postoperative morbidity following surgery

Duke University

Randomized controlled non-inferiority trial

Surgical treatment teams and outcome assessors will be blinded to patient's treatment arm.

Patients were admitted to the treatment as day visitors. Vagus nerve stimulation is carried out with a TENS device, which has specially designed surface electrodes in the shape of earphones, the size of which can be selected according to ear size. Electrodes were placed to correspond with the inner and rear surfaces of the tragus and the concha for both ears . The application is carried out, for 30 minutes, using a biphasic, asymmetrical waveform with a pulse duration that is less than 500 microseconds and a frequency of 10 Hertz.

The exercise group was assigned a program, which consisted of strengthening, stretching, isometric and posture exercises, targeting the body and upper and lower extremities. That program was home-based and the program was requested to be completed. Patients were asked to attend weekly face to face sessions with a total of 4 of these sessions in the study duration.

Fibromyalgia

Myofascial Pain Syndrome

Vagus nerve stimulation is carried out with a TENS device, which has specially designed surface electrodes in the shape of earphones, the size of which can be selected according to ear size. Electrodes were placed to correspond with the inner and rear surfaces of the tragus and the concha for both ears (Figure 1). The application is carried out, for 30 minutes, using a biphasic, asymmetrical waveform with a pulse duration that is less than 500 microseconds and a frequency of 10 Hertz.

Vagus nerve stimulator

exercise

Bahcesehir University

Auricular Vagus Nerve Stimulation For Fibromyalgia Syndrome

The Impact Of Auricular Vagus Nerve Stimulation On Pain And Life Quality In Patients With Fibromyalgia Syndrome

Life quality of patients was evaluated using the SF-36 life quality scale. The Turkish validity and reliability of this scale was carried out by Koçyiğit et al. Investigating life quality regarding overall health, this questionnaire contains 36 questions in 8 different categories.
The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability. To calculate the scores it is necessary to purchase special software. Pricing depends on the number of scores that the researcher needs to calculate.

hasan kerem alptekin

director of health sciences institute

Bahçeşehir University

Open haemorrhoidectomy is performed using an anal retractor, exposed haemorrhoids at 3 - 7- 11 hours are excised using cautery. The arteries are ligated or cauterized. Open or closed technique is used (the choice of the surgeon). The Spongostan plug is then introduced

Haemorrhodal pedicle ligation is performed using operating proctoscope. The pedicle of symptomatic haemorrhoid is suture ligated with absorbable Vycril 2/0. Mucopexy is performed simultaneously if the prolapse is noticed. No tissue removal is performed

Intrahaemoroidal laser coagulation is performed using disposable THD kit [Biolitec Co]. The haemorrhoidal pedicle is sutured. 1mm opening is created at the external haemorrhoid (skin level). Laser is then introduced up to pedicle and coagulation performed. This is repeated to all the piles. The procedure is finished with placing Spongostan plug into anal canal

Hemorrhoids Second Degree

Hemorrhoids Third Degree

for treatment of symptomatic 2 to 3 degree haemorrhoids

Haemorrhoidectomy operations

Center of Abdominal Surgery, Vilnius University Hospital Santariskiu Clinics, Lithuania, 2 Santariskiu Street,

Randomized Trial :Hemorrhoidal Pedicle Ligation vs Laser vs Open Hemorrhoidectomy

Hemorrhoidal Pedicle Ligation vs Laser Hemorrhoidectomy vs Open Hemorrhoidectomy: Randomized, Double Blind, Multicenter Trial

Visual rectal prolapse during postoperative anoscopy requiring any kind of medical attention or treatment (visit to the doctor or pharmacy, medical, invasive or surgical treatment).

Intensity and frequency of postoperative bleeding requiring any kind of medical attention or treatment (visit to the doctor or pharmacy, medical, invasive or surgical treatment).

Using Wexner fecal incontinence score (Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993; 36:77-97)

Evalluation by abdominal surgeon: pain, bleeding, external haemorrhoids, etc

Time to return to work or regular activity, in days, reported by the patient

Intensity and duration of perianal pain after the operation (in days) based on visual analogue scale during after first 7 days of the operation

Quality of life based on Short-form (SF)-36 questionnaire (https://www.rand.org/health/surveys_tools/mos/36-item-short-form.html )

Fecal incontinence quality of life (FIQOL) score at 1 year (Rockwood TH, Church JM, Fleshman JW. Fecal incontinence quality of life scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 2000; 43:9-17)

Evaluation of the operation by the patient on visual analogue scale from 1 to 10 at 1-year visit.

prolapse/cansancio

Expedited Versus Restrictive: Limitations on Activity Following Surgical Treatment of Prolapse

Auricular Vagus Nerve Stimulation For Fibromyalgia Syndrome

Randomized Trial :Hemorrhoidal Pedicle Ligation vs Laser vs Open Hemorrhoidectomy

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