Female Genitourinary and Pelvic Floor Reconstruction

Foreword
Foreword
	References
Preface
Acknowledgments
Contents
About the Editors
Contributors
Part I: History, Basic Science, and Epidemiology
	1 Historical Milestones in Female Genitourinary and Pelvic Floor Reconstruction
		Introduction
		Antiquity
		Medieval Era
		The Renaissance
		The Seventeenth Century
		The Eighteenth Century
		The Nineteenth Century Before Asepsia
		The Nineteenth Century: The Birth of Asepsia
		The Twentieth and Twenty-First Centuries: The Evolution of a Specialty
		Conclusion
		References
	2 Embryology and Development of Congenital Anomalies of the Pelvis and Female Organs
		Introduction
		The Early Zygote and Embryogenesis
		Cloacal Division
		Primitive Mullerian Duct Development
		Development of the Genital Ducts
		Development of the Uterus and Vagina
		Sexual Differentiation
		The Array of Relevant Anomalies Which May Present in the Clinical Setting
			Vaginal and Uterine Anomalies
				Class 1
				Class 2
				Class 3
				Class 4
				Class 5
				Class 6
				Class 7
			Ureteric Bud Anomalies
				Vesicoureteric Reflux
				Renal Calculi
				Malignancy
		Gartner´s Duct Cyst (GDC)
		Mayer–Rokitansky–Küster–Hauser syndrome (MRHK)
		McKusick-Kaufman Syndrome (MKKS)
		Pelvic Anomalies
		Conclusion
		References
	3 Neuroanatomy and Neurophysiology
		Introduction
		Bladder Biomechanics
			Bladder Architecture
				Urothelium
				Lamina Propria
				Detrusor
				Extracellular Matrix
			Neuropharmacology of Bladder Storage and Emptying
				Adrenergic Stimulation: Storage
				Cholinergic Stimulation
				Urinary Symptoms/Signs Associated with Signaling Changes in the Bladder
				Knowledge Gap: Animal Models for Bladder Biomechanics
		Peripheral Nervous System
			Afferent Communication
				Anatomy
				Aδ and C Fibers
			Sympathetic/Parasympathetic/Somatic Efferent Coordination
				Sympathetic
				Pudendal
				Parasympathetic
				Bladder Outlet Coordination
			Therapeutics
				Knowledge Gap: Peripheral Neurologic Assessment for Understanding Bladder Physiology
		Central Nervous System
			Storage
				PAG
				ACC
				Prefrontal Cortex
			Voiding
				PMC
				Locus Coeruleus
			Knowledge Gap: Cell Replacement
		Conclusion
		References
	4 Pathophysiology of Female Micturition Disorders
		Introduction
		Micturition
			Pelvic Anatomy and Clinical Correlations
			Neuroanatomy of the Urinary Tract
			Physiology of Urinary Storage and Emptying (Fig. 8)
			Physiology of Stress Urinary Continence
			Pathophysiology of Micturition Dysfunction
		Conclusion
		References
	5 The Epidemiology and Socioeconomic Impact of Female GU and Pelvic Floor Disorders
		Introduction
		Pelvic Organ Prolapse
			Epidemiology
			Risk Factors
			Race/Ethnicity
			Socioeconomic Burden
		Urinary Incontinence
		Stress Urinary Incontinence
			Epidemiology
			Risk Factors
			Race/Ethnicity
			Socioeconomic Impact
		Overactive Bladder
			Epidemiology
			Risk Factors
			Socioeconomic Impact
		Mixed Urinary Incontinence
		Conclusion
		References
	6 Measurement of Urinary Symptoms, Health-Related Quality of Life, and Outcomes of Treatment of Genitourinary and Pelvic Floor...
		Introduction
		Patient-Reported Outcome (PRO) Data Via Validated Questionnaire
		How Do we Develop a Questionnaire?
			Theorization and Item Development
			Scale Development
			Scale Evaluation with Psychometric Analysis
		Ideal Properties of a Validated Questionnaire
		Validation Via Psychometric Analysis
			Linguistic and Cultural Validation
		Grading System
		Factors to Consider for Research [6]
		Conclusion
		Cross-References
		References
Part II: Diagnostic Evaluation
	7 Clinical Evaluation of the Female Lower Urinary Tract and Pelvic Floor
		Introduction
		History
			Focused Urologic History
				General Voiding Patterns
				Incontinence
				Overactive Bladder
				Prolapse
				Pelvic Pain
			General Medical History
				Medications
		Physical Exam
			External Genitalia
			Urethra
			Pelvic Floor
			Vaginal Vault
			Cervix, Uterus, and Adnexa
			Rectal Exam
		Void Diary
		Pad Test
		Self-Reported Questionnaires
		Urinalysis
		Post-Void Residual
		Dye Testing
		Conclusion
		References
	8 Ultrasound Imaging of the Female Lower Urinary Tract and Pelvic Floor
		Introduction
		Pelvic Floor Ultrasound: Imaging Modalities
		Use of Ultrasound as the Imaging Modality for Video Urodynamics
		Dynamic Imaging
		Pelvic Floor Ultrasound in the Evaluation of Sling and Mesh Complications
			Sling Failure
			Obstructive Sling
			Sling Erosion
			The Patient with Multiple Slings
			Assessment of Pain
		Pelvic Floor Ultrasound in the Assessment of Pelvic Organ Prolapse
		Conclusion
		Tips
		Cross-References
		References
	9 Electrophysiologic Evaluation of the Pelvic Floor
		Clinical Introduction
		Tests of Function: An Overview
		Electromyography: An Overview
		Pelvic Floor Muscle EMG: An Overview
		The Motor Unit and the EMG
		Motor Control and the EMG
		The Concentric Needle EMG Electrode
		Placement of Electrodes
		EMG Findings in the Normal Muscle
		EMG Findings Due to Muscle Denervation
		EMG Findings Due to Muscle Reinnervation
		EMG in Practice
			EMG Changes After Vaginal Delivery: EMG in Idiopathic Incontinence
			EMG in Women with Urinary Retention
		EMG Changes in Primary Muscle Disease
		Testing Conduction Across Nerves and Nervous Pathways: An Overview
		Testing Motor Conduction in the Pelvic Area: An Overview
		Testing Sensory Conduction in the Pelvic Area: An Overview
		Testing Reflexes in the Pelvic Area: An Overview
		Testing Autonomic Reflexes in the Pelvic Area: An Overview
		The Sympathetic Skin Response
		Usefulness of Uroneurophysiology
		Conclusion
		References
	10 Urodynamic Evaluation: Traditional, Video, and Ambulatory Approaches
		Introduction
			Urodynamics in the Female Setting
		Bladder Diaries and Pad Testing
			Voiding Diaries
			Pad Testing
		Uroflowmetry
			Flow Patterns
				Normal Flow
				Detrusor Overactivity
				Prolonged Flow
				Intermittent Flow
				Plateau Flow
			PVR Assessment
		Cystometry and Pressure-Flow Studies
			Patient and Equipment Setup
				Free Uroflowmetry and PVR Determination
				Filling Cystometry
					Bladder Sensation
					Bladder Compliance
					Bladder Capacity
					Detrusor Activity
					Urethral Function
				Pressure-Flow Study
					Detrusor Activity
					Urethral Function
			End of the Study
			Clinical Application
		Videourodynamics
			Filling Phase/Full at Rest
			Voiding
		Ambulatory Urodynamics
			Equipment and the Study
			Indications
		Urethral Pressure Profile
		Neurophysiology
		Conclusion
		References
	11 Endoscopic Evaluation
		Introduction
		Historical Perspective
		Types of Endoscopes and Equipment
			Rigid Cystourethroscopy
			Flexible Cystourethroscopy
			Personnel and Preparation
			Technique
		Indications
		Contraindications
		Complications
		Normal Endoscopic Findings
		Pathologic Urethral Findings
		Pathologic Bladder Findings
		Conclusions
		Cross-References
		References
Part III: Bladder Storage and Emptying Disorders
	12 Idiopathic Urinary Retention in the Female
		Introduction
		Etiology and Physiology of Urinary Retention
			Idiopathic Urinary Retention-Related Syndrome
				Fowler´s Syndrome
				Dysfunctional Voiding
				Primary Bladder Neck Obstruction
				Idiopathic Detrusor Underactivity
				Chronic Intestinal Pseudo-Obstruction
		Pathophysiology of Urinary Retention
		Diagnosis and Management
			Diagnostic Workup
				History and Physical Exam
				Investigations
			Management
				Bladder Drainage
				Oral Pharmacotherapy
				Surgical Therapy
		Conclusion
		Cross-References
		References
	13 Overview of Diagnosis and Pharmacological Treatment of Overactive and Underactive Bladder Disorders
		Introduction
		Definitions
		Epidemiology
		Bladder Neurophysiology
		Etiopathogenesis of OAB and UAB
		Diagnosis
			History
			Examination
			Investigations
				Assessing Detrusor Contraction Strength
		Management
			Overactive Bladder
				Conservative
				Pharmacological
					Anticholinergics
					B3 Agonists
					Botulinum Toxin
					Sacral Neuromodulation
					PTNS
			Underactive Bladder
				Conservative Management
				Pharmacotherapies
				Electrical Stimulation
				Surgical Options
					Intrasphincteric Botulinum Toxin
				Reconstructive Surgery
		Conclusion
		References
	14 Behavioral Modification and Conservative Management of Overactive Bladder and Underactive Bladder Disorders
		Overactive Bladder
			Lifestyle Interventions
				Smoking
				Obesity
				Impact of Food and Dietary Habits
				Fluid Intake
				Caffeine
				Bladder Irritants
				Nutriments
			Behavioral Therapy
				Bladder Training, Frequency Volume Charts
				Habit Training and Scheduled Voiding Regimens
			Complementary and Alternative Medicine
			Pelvic Floor Muscle Training
			Urgency Inhibition and Suppression Techniques
			Biofeedback Therapy
				Summary of the Scientific Evidence for Biofeedback Therapy
			Electrical Stimulation
				Electrical Stimulation: Office Therapy
					Summary of the Scientific Evidence for Office Therapy
			Electrical Stimulation: At Home
				Transcutaneous Electrical Nerve Stimulation
			Percutaneous Tibial Nerve Stimulation (PTNS)
				Summary of the Scientific Evidence for TENS and PTNS
			Self-Rehabilitation at Home
			Conclusion
		Underactive Bladder
			Conservative Management
			Conclusion
		References
	15 Bladder Dysfunction and Pelvic Pain: The Role of Sacral, Tibial, and Pudendal Neuromodulation
		Introduction
		Sacral Plexus
			Surgical Technique
			Percutaneous Nerve Evaluation (PNE)
			Complications
			Programming
			Indications
			Overactive Bladder (OAB)
			Urinary Retention
			Chronic Pelvic Pain
		Pudendal Nerve
			Surgical Technique
			Complications
			Indications
		Tibial Nerve
			Surgical Technique
			Complications
			Indications
		Conclusion
		Cross-References
		References
	16 Voiding Dysfunction After Female Pelvic Surgery
		Introduction
		Surgical Anatomy of the Pelvic Nervous System
		Surgical Anatomy of the Pelvic Floor
		Pathophysiology of Voiding Dysfunction After Pelvic Surgery
		Evaluation of Voiding Dysfunction
			History and Physical Exam
			Urinalysis
			Postvoid Residual (PVR)
			The Role of Urodynamics
			The Role of Cystoscopy
		Voiding Dysfunction After Radical Hysterectomy
		Voiding Dysfunction After Surgery for Stress Urinary Incontinence
		Voiding Dysfunction and Pelvic Organ Prolapse Surgery
			Anterior Prolapse
			Apical Prolapse
			Posterior Prolapse
		Voiding Dysfunction After Endometriosis Surgery
		Voiding Dysfunction After Colorectal Surgery
		Conclusion
		References
	17 Bladder Augmentation and Urinary Diversion
		Introduction
		Indications and Options for Bladder Augmentation and Urinary Diversion
			Indications and Patient Selection
			Options
		Preoperative Investigations
		Bladder Augmentation
			Surgical Technique
			Postoperative Care, Outcome, and Complications
		Continent Catheterizable Channel and Combinations
			Mitrofanoff CCC
			Transversely Tubularized Bowel Segments (TTBS): Yang-Monti Channel and Modifications
			Continent Cutaneous/Catheterizable Ileocecocystoplasty (CCIC)
			Hemi-Kock CCC and Cystoplasty
		Supravesical Urinary Diversion
			Continent Cutaneous Urinary Diversion
			Incontinent Urinary Diversion
				Cutaneous Ureterostomy
				Ureteroileal Conduit
		Pregnancy
		Cross-References
		References
	18 Pathophysiology and Diagnostic Evaluation of Stress Urinary Incontinence: Overview
		Introduction
		Epidemiology of Stress Urinary Incontinence
			Terminology
			Prevalence and Risk Factors
				Age
				Pregnancy
				Race
				Comorbid Conditions
					Smoking Status
					Obesity
					POP
		Pathophysiology
			Normal Physiology and Continence
				Neural Control
				Musculofascial Control
			Abnormal Physiology
				SUI on Prolapse Reduction (Occult or Latent SUI)
		Diagnostic Evaluation
			History
				History of Present Illness
				Past Medical History
				Past Surgical History
				Medications, Family History, Social History, and Review of Systems
			Physical Exam
				General
				Vaginal
			Ancillary Studies
				Voiding Diary
				Pad Weight
				Urinalysis
				Post-Void Residual
				UDS
				Cystoscopy
		Conclusion
		Cross-References
		References
	19 Pudendal Nerve Entrapment Syndrome: Clinical Aspects and Laparoscopic Management
		Introduction
		Anatomy
		Differential Diagnosis (Fig. 4)
		Epidemiology
		Pathophysiology
			Compression
			Stretching
		Etiology (Fig. 5)
			External Factors
			Local Condition
			Myofascial Syndrome (Fig. 6)
				Localized Pelviperineal Muscle Contraction
				Postural Disorder and Global Myofascial Syndrome
			Trigger Factors
		Clinical Aspects
			Neurological Aspects
				Sympathetic Fibers
				Sensory Fibers
				Motor Fibers
			Arterial Aspects
			Venous Aspects
			Associated Pathology
		Diagnosis
			Patient History
			Clinical Exam of a Pudendal Pathology
			Complementary Exams
			Nantes Criteria
		Treatment
			Conservative Treatment
				Postural Control and Postural Physiotherapy
				Drugs
				Pudendal Nerve Infiltration
				Psychiatric Support
			Laparoscopic Pudendal Decompression
				Technique (Movies Available on YouTube; Renaud Bollens or Fabienne Absil Channels)
				Postoperative Recovery
				Outcomes and Explanation of Failure
					Myofascial Pain
					Contralateral Decompensation
					Descending Perineum Syndrome
					Hypersensitivity of Neurons
		Conclusion
		Cross-References
		References
	20 Retropubic Suspension Operations for Stress Urinary Incontinence
		Introduction
			Pathophysiology and Anatomy as it Relates to Female Incontinence and Retropubic Suspensions
		Patient Selection for Retropubic Suspension Operations
			Indications for Retropubic Suspension
			Contraindications to Retropubic Suspension
			Patient Factors
				Age
				Comorbidities
				Obesity
				Previous SUI Surgeries
				Concomitant Detrusor Overactivity
				Concomitant Prolapse
		Retropubic Suspension Operation Types
			Operative Types (Fig. 2)
				Paravaginal Repair and Vagino-obturator Shelf Repair
				Marshall-Marchetti-Krantz Repair
				Burch Colposuspension
			Outcomes and Complications of the MMK Repair and Burch Colposuspensions
		Current Role of the Open Burch Colposuspension
			Burch Colposuspension Compared to Mid-Urethral Sling
				Efficacy
				Complications
			Burch Colposuspension Compared to Pubovaginal Sling
				Efficacy
				Complications
			Burch Colposuspension: Open Compared to Laparoscopic
		Steps of the Open Burch Colposuspension Operation (Fig. 3)
		Cross-References
		References
	21 Sling Operations for Stress Urinary Incontinence and Their Historical Evolution: Autologous, Cadaveric, and Synthetic Slings
		Introduction
		The History of Stress Incontinence Management
		The History of Slings in Stress Urinary Incontinence
		Autologous Slings
		Cadaveric Slings
		Xenografts
		Synthetic Slings
		Conclusions
		Take-Home Message
		Cross-References
		References
	22 Complications of Stress-Urinary Incontinence Surgery
		Introduction
		Urethral Bulking Agents
			Individual Analyses of UBAs
		Midurethral Sling
			Intraoperative Complications
			Postoperative Complications
			Retreatment Rates
		Autologous Fascia Pubovaginal Sling
		Burch Colposuspension
		Anti-incontinence Procedure at the Time of Prolapse Repair
		Artificial Urinary Sphincter
			Early Postoperative Complications
			Late Postoperative Complications
		Urethrolysis
		Mesh Removal
		Conclusion
		Cross-References
		References
	23 Artificial Urinary Sphincter for Female Stress Urinary Incontinence
		Introduction
		History and Development of Devices
		Mechanism of Device Action
		Evaluation and Diagnosis
			History
			Patient-Reported Measures
			Physical Examination
			Paraclinical Testing
			Cystoscopy
			Urodynamic Studies
			Imaging
		Indications for Surgery
			Indications
			Contraindications
			The Place of AUS for Female Non-neurologic Stress Incontinence in the Guidelines
		Technique of Device Implantation
			Patient Preparation
			Material
			Open Transabdominal Implantation
			Open Transvaginal Implantation
			Laparoscopic Implantation
			Robotic-Assisted Implantation
			Postoperative Care
		Complications
			Perioperative Complications
			Early Postoperative Complications
			Long-Term Complications
		Results
		Evaluation of Persistent or Recurrent Urinary Incontinence After AUS Implantation
		Future Perspectives
		Summary
		Cross-References
		References
	24 Urethral Bulking Agents
		Introduction
		History of Urethral Bulking Agents
		Mechanism of Action
		Injection Techniques
		Bulkamid
			Results
			Adverse Events
		Durasphere
			Results
			Adverse Events
		Coaptite
			Results
			Adverse Events
		Urolastic
			Results
			Adverse Events
		Macroplastique
			Results
			Adverse Events
		Conclusion
		Cross-References
		References
	25 Laparoscopic Burch
		Introduction
		Stress Urinary Incontinence
		History of Burch Colposuspension
		Surgical Technique
		Outcomes of Burch Colposuspension
		Complications
		Conclusion
		References
	26 Management of Urinary Incontinence in the Female Neurologic Patient
		Introduction
		Neurologic Control of Micturition
		Lower Urinary Tract Dysfunction After Nervous System Damage
			Suprapontine Lesions
			Suprasacral Cord Lesions
			Sacral Lesions
		Epidemiology
			Suprapontine Lesions
				Cerebrovascular Accidents (CVA)
				Dementia
				Parkinson´s Disease (PD)
				Cerebral Palsy
			Suprasacral Lesions
				Spinal Cord Injury (SCI)
				Spina Bifida/Myelomeningocele (SB/MM)
			Sacral and Peripheral Nervous System Lesions
				Diabetes
				Lumbar Disc Herniation
				Cauda Equina Syndrome (CES)
			Disseminated Central Disease: Multiple Sclerosis
		Evaluation of the Female Neurologic Patient
			History
			Questionnaires
			Physical Examination
			Diagnostic Workup
				Low-Risk Patients
				Unknown-Risk Patients
			Surveillance
		Management
			Reversible Causes of Incontinence
			Management of Storage Dysfunction
				Overactive Bladder
					Conservative Measures
					Pharmacology
						Antimuscarinic Agents
						Beta-3-Adrenergic Receptor Agonists
						Other Drugs
					Catheterization
					Chemodenervation
					Neuromodulation
						Transcutaneous/Percutaneous Options
						Sacral Neuromodulation
				Underactive Bladder
				End-Stage Bladder Dysfunction
			The Bladder Outlet
				Underactive Outlet
					Pharmacologic Therapies
					Surgical Management
						Urethral Bulking
						Urethral Slings
						Adjustable Continence Devices
						Artificial Urinary Sphincters (AUS)
						Bladder Neck Closure
				Overactive Outlet
					Pharmacologic Therapies
					Intrasphincteric Botox
					Transurethral Incision of the Bladder Neck (TUIBN)
			Combined Storage and Emptying Disorders
			Other Considerations
				Cognition
				Social Support and Caregivers
				Manual Dexterity
				Obesity
				Perioperative Considerations
		Conclusions
		Cross-References
		References
	27 Stem Cell and Tissue Engineering in Female Urinary Incontinence
		Introduction
		Current Management of Stress Urinary Incontinence
		Cell-Based Therapy for Stress Urinary Incontinence in Women
			Types of Stem Cells
			Animal Models for the Study of Stress Urinary Incontinence
			Cell-Based Therapies for Female Stress Urinary Incontinence
				Autologous Muscle-Derived Cells for Urethral Sphincter Regeneration
					Background
					Animal Studies
					Human Trials on Autologous Muscle-Derived Cells for Urethral Sphincter Regeneration
					Other Case Series in Humans on Autologous Muscle-Derived Cells
				Autologous Adipose-Derived Stem Cells
				Bone Marrow-Derived Stem Cells
				Amniotic Fluid Stem Cells
				Umbilical Cord Blood Stem Cells
				Autologous Ear Chondrocytes
		Conclusions
		References
Part IV: Pelvic Organ Prolapse
	28 Etiology, Diagnosis, and Management of Pelvic Organ Prolapse: Overview
		Introduction
		Definition
			Classification
			Staging
		Etiology
			Incidence and Prevalence
			Risk Factors
		Diagnosis
			Symptoms/Presentation
			Workup
		Management
			Observation
			Pelvic Floor Muscle Exercises
			Pessaries
			Surgery
				Abdominal Versus Vaginal Approach
				Grafts
					Mesh Complications
				Hysterectomy or Hysteropexy
				Colpocleisis
		Conclusion
		Cross-References
		References
	29 Transvaginal Repair of Cystocele
		Introduction
		Anatomy and Etiology
		Presentation and Diagnosis
		Additional Preoperative Evaluation
			Dynamic Imaging
			Urodynamics
			Cystoscopy
		Transvaginal Surgical Techniques
			Anterior Colporrhaphy
			Transverse Defect Repair
			Paravaginal Repair
		Outcomes of Repair
		Complications
		Conclusion
		References
	30 Laparoscopic Paravaginal Repair
		Introduction
		Anatomy of Pelvic Floor Support
		Pathogenesis of Anterior Vaginal Wall Defects
		Evolution of the Procedure
		Preoperative Assessment and Considerations
			History
			Clinical Examination
			Diagnostic Tests
			Patient Counselling
		Description of the Procedure
			Preoperative Steps
			Cystoscopic Insertion of Ureteric Catheters
			Entry into the Peritoneal Cavity
			Evaluation of the Abdominal Cavity and Concomitant Abdominal or Apical Prolapse Surgery
			The Technique of Paravaginal Repair
			Repeat Cystoscopy and Abdominal Closure
			Postoperative Care
		Efficacy and Safety of Laparoscopic Paravaginal Repair
		Alternative Surgical Approaches to Anterior Compartment Prolapse
			Apical Suspension Procedures
			Anterior Colporrhaphy With or Without Graft Reinforcement
		Conclusion
		Cross-References
		References
	31 Minimally Invasive Approaches in the Treatment of Pelvic Organ Prolapse: Laparoscopic and Robotic
		Introduction/Background
		Open Abdominal Prolapse Surgery Versus Minimally Invasive Prolapse Surgery
		Laparoscopic Versus Robotic Surgery for Pelvic Organ Prolapse
		Prevalence of Laparoscopic and Robotic Surgeries for Pelvic Organ Prolapse
		Trends in the Usage of Minimally Invasive Surgery
		Laparoscopic and Robotic Procedures for Pelvic Organ Prolapse
		Patient Selection
		Minimally Invasive Prolapse Surgery in Older Women
		Cost-Effectiveness
		Availability, Access, and Efficiency of Robotic Versus Laparoscopic Surgery
		Ergonomics for Surgeons
		ERAS Protocols for Minimally Invasive Approaches for Pelvic Organ Prolapse Surgery
		Laparoscopic and Robotic Paravaginal Repair for Anterior Vaginal Wall Prolapse
		Laparoscopic and Robotic Uterosacral Ligament Suspension
		Laparoscopic Pectopexy
		Laparoscopic and Robotic Supracervical Hysterectomy and Total Hysterectomy
		Trends and Future Directions in Utilization of Laparoscopy and Robotics in POP Surgery
		Conclusions
		References
	32 Complications of the Use of Synthetic Mesh Materials in Stress Urinary Incontinence and Pelvic Organ Prolapse
		Introduction
			A Note on Terminology
		Overview of Synthetic Mesh Materials Used for SUI and POP
			A Brief History of Synthetic Mesh Materials and Rationale for Use in Pelvic Organ Prolapse
			Current State of Synthetic Mesh Materials for SUI and POP Internationally
				United States and Canada
				Australia, New Zealand, and the United Kingdom
				European Union
				Worldwide
			Types of Synthetic Mesh and Mesh Characteristics Used in SUI and POP Surgery
				Pore Size
				Mesh Weight
				Polypropylene Mesh in SUI and POP Surgery
				Risk Factors for Mesh-Related Complications
		Use and Trends of Synthetic Mesh Materials for POP
			Vaginally Inserted Transvaginal Mesh for Repair of POP
				Anterior Compartment Mesh
				Posterior Compartment Mesh
				Vaginal Mesh Trends
			Abdominally Inserted Synthetic Mesh for POP
				Unique Complications of Sacrocolpopexy: Osteomyelitis/Spondylodiscitis
		Synthetic Mesh Materials for Stress Urinary Incontinence
			Complications of Synthetic Midurethral Slings: Urinary Tract Infection and Voiding Dysfunction
				Urinary Tract Infection after Midurethral Sling Placement: Acute and Recurrent
				Voiding Dysfunction
		Evaluation of Women Who Present with Mesh Complications
			History
			Physical Examination
			Cystoscopy
			Imaging Studies
		Management of Mesh Complications
			Dyspareunia and Pain
			Vaginal Mesh Exposure
				Asymptomatic
				Symptomatic
			Infection
			Visceral Injury
				Bladder and Urethra
				Endoscopic Management of Midurethral Sling Exposure
				Vaginal Approaches for Midurethral Sling Exposure in the Urethra
				Vaginal Approaches for Transvaginal Mesh Exposure in the Bladder
				Abdominal Removal of Mesh Exposure in the Bladder
			Ureter
				Ureteral Injury at Time of Mesh Removal
			Mesh Exposure into Rectum
		Complications After Mesh Removal
			Recurrent SUI After Synthetic Midurethral Sling Removal
			Persistent or Worsening Pain
			Recurrent Prolapse
			Recurrent Vaginal Mesh Exposure
			Loss of Vaginal Length or Vaginal Canal Stenosis
				Vaginal Dilation
				Surgical Management Options
		Future Directions
		Conclusions
		Cross-References
		References
	33 Vaginal Vault Prolapse: Options for Transvaginal Surgical Repair
		Introduction
		Anatomic Considerations
		Indication for Vaginal Approach
		Common Techniques for Transvaginal Native Tissue Repair
			4a. Sacrospinous Ligament Fixation
				4ai. Surgical Technique
				4aii. Complications
			4b. Uterosacral Ligament Suspension
				4bi. Surgical Technique
				4bii. Complications
			4c. Comparison of Surgical Outcomes
				4ci. Impact of the Uterus
				4cii. Impact of Genital Hiatus
		Alternative Surgical Options
			5a. Iliococcygeus Suspension
			5b. McCall´s Culdoplasty
			5c. Augmentation with Vaginal Mesh Kits
		Conclusion
		Cross-References
		References
	34 Role of Vaginal Hysterectomy in the Treatment of Vaginal Middle Compartment Prolapse
		Introduction
		Uterine Preservation and Pelvic Organ Prolapse Surgery
		Vaginal Hysterectomy and Pelvic Organ Prolapse
		Prevention of Genital Prolapse in Hysterectomy Due to Benign Disease
		Sexual Function and Uterine Management in Pelvic Organ Prolapse Surgery
		Conclusion
		References
	35 Minimally Invasive Sacrocolpopexy
		Introduction
		Patient Selection and Preoperative Evaluation
		Surgical Technique
		Port Placement
		Steps of the Procedure
			Dissection of the Sacral Promontory
			Creation of a Sub-peritoneal Tunnel
			Anterior Vaginal Dissection
			Posterior Vaginal Dissection
			Vaginal Fixation of the Graft
			Sacral Fixation of the Graft
			Retroperitonealization of the Graft
			Additional Procedures
		Outcomes
		Complications
		Cost
		Future Directions
		Cross-References
		References
	36 Open Abdominal Sacrocolpopexy
		Introduction
		Indications
		Patient Evaluation
		Historical Background of the Sacrocolpopexy
		Preoperative Preparation
		Surgical Technique
		Postoperative Care
		Use of Mesh
		Outcomes
		Complications
		Alternative Approaches
		Conclusion
		References
	37 Management of Vaginal Posterior Compartment Prolapse: Is There Ever a Case for Graft/Mesh?
		Introduction
		Types of Surgical Repair for Rectoceles
			Traditional Posterior Colporrhaphy with Midline Plication
			Site-Specific Posterior Colporrhaphy
			Graft-Augmented Posterior Colporrhaphy
			Ventral Rectopexy at the Time of Abdominal Sacrocolpopexy
		Surgical Outcomes: Comparative Data
			Native Tissue Versus Augmented Posterior Colporrhaphies: Biologic Graft
			Native Tissue Versus Augmented Posterior Colporrhaphies: Synthetic Delayed-Absorbable Mesh
			Native Tissue Versus Augmented Posterior Colporrhaphies: Synthetic Permanent Mesh and Biologic Graft
			Augmented Posterior Colporrhaphies: Synthetic Permanent Polypropylene Mesh Versus Biologic Graft
			Recurrent Prolapse: Native Tissue Posterior Colporrhaphy Versus Synthetic Permanent Mesh
			Concomitant Intussusception or Rectal Prolapse
		Discussion
		Conclusion
		Cross-References
		References
	38 Vaginal Surgery Complications
		Introduction
		Vaginoplasty
		Urethrovaginal/Vesicovaginal Fistula Repair
		Diverticulectomy
		Urethral Prolapse/Caruncle Repair
		Slings
		Complications of Vaginal Mesh Surgery
		Vaginal Hysterectomy
		Vaginal Prolapse Repair
			Complications of Apical Repair
			Complications of Posterior Repair
			Complications of Anterior Repair
		References
Part V: Urethral Reconstruction: Fistulae, Diverticula, and Strictures
	39 Overview, Epidemiology, and Etiopathogenetic Differences in Urogenital Fistulae in the Resourced and Resource-Limited Worlds
		Introduction
		Anatomical Overview and Classification of Urogenital Fistulae
		Etiology and Epidemiology of Fistulae in the Resourced and Resource-Limited World
		Consequences of Urogenital Fistulae in Resource-Limited Countries
			Presenting Symptoms of Urogenital Fistulae
		Diagnosis of Urogenital Fistulae
		Treatment of Urogenital Fistulae
			Outcomes of Urogenital Fistula Repair
		Conclusion
		References
	40 Urethrovaginal Fistula Repair
		Introduction
		Epidemiology
		Anatomy of the Female Urethra
		Risk Factors
		Etiology/Pathogenesis
			Obstetric
			Radiation Therapy
			Inflammatory
			Traumatic (Non-obstetric)
			Postsurgical (Iatrogenic)
		Prevention
		Clinical Presentation
		Diagnosis
		Treatment and Outcomes
			Primary Closure with Vaginal Flap
				Martius Flap
				Reconstruction for Recurrent or Complex Fistulas with Myofascial Flaps
			Rectus Abdominis Muscle Flap
			Gracilis Muscle Flap
		Conclusion
		Cross-References
		References
	41 Reconstruction of the Absent or Severely Damaged Urethra
		Introduction
		Anatomy and Function of the Female Urethra
		Mechanisms of Severe Female Urethral Injury
			Iatrogenic
			Trauma
		Preoperative Evaluation
			Diagnosis
			Timing of Reconstructive Surgery
		Surgical Management
			Techniques for Urethral Reconstruction
				Primary Closure or Anastomotic Repair
				Vaginal Flaps
					Anterior Proximal Vaginal Flap Urethroplasty
					Tubularized Vaginal Flap Urethroplasty
					Outcomes of Vaginal Flap Reconstructions
				Labial Pedicle Grafts
				Bladder Flaps
				Flaps for Tissue Interposition or Alternative Vaginal Closures
			Bladder Neck Closure or Urinary Diversion
				Bladder Neck Closure
					Transvaginal Approach
					Abdominal Approach
					Outcomes of Bladder Neck Closure
				Urinary Diversion
			Repair after Eroded Synthetic Sling
			Autologous Fascial Pubovaginal Sling for Associated Stress Urinary Incontinence
		Conclusions
		Cross-References
		References
	42 Vesicovaginal Fistula Repair: Minimally Invasive Approach
		Introduction
		Etiology and Epidemiology
		Evaluation and Diagnosis
			History
			Physical Exam
			Diagnostic Investigations
		Timing of Repair
		Conservative Management Options
		Surgical Repair Options
		Comparing Laparoscopic and Robotic Approaches to the Open Vesicovaginal Fistula Repair
		Perioperative Considerations
			Getting Started: Positioning and Entry
			Transvesical Approach
			Extravesical Approach
			Transvesical Versus Extravesical Approach
			Bladder Layer Closure
			Retrograde Filling of the Bladder
			Vaginal Closure
			Interposing Tissue Layer
		Postoperative Catheterization
		Modified Laparoscopic Approaches
		Robotic Approach
			Cost of Robotics: Is It Worth  It?
			Comparing Laparoscopic to Robotic Vesicovaginal Fistula Repair
		Other Outcomes
			Other Urinary Symptoms
			Long-Term Sexual Function
		Future Directions
		Conclusion
		Cross-References
		References
	43 Vesicovaginal Fistula Repair: Vaginal Approach
		Etiology and Incidence
		Classification Systems
		Clinical Presentation and Evaluation
			Risk Factors
			Physical Examination
		Preoperative Management
		Timing of Repair
		Surgical Approach
		Transvaginal Approaches
			Vaginal Flap/Flap-Splitting Technique
			Latzko Technique
		Radiation-Associated and Complex VVF Repair
			Martius Flap
			Peritoneal Flap
			Omental Flap
			Gracilis Flap
			Amniotic Membrane
		Postoperative Management
		Surgical Outcomes
		Summary
		Cross-References
		References
	44 Vesicovaginal Fistula Repair: Abdominal Approach
		Introduction
		Etiology
		Classification
		Clinical Evaluation
		Preoperative Workup
		Management
			Conservative Management
			Transabdominal Versus Transvaginal Approach
			Outcomes
			Transabdominal Repair: A Step-by-Step Guide
				Patient Positioning
				Cystoscopy
				Abdominal Incision
			Excision of the Fistula Tract
				Extravesical
				Transvesical
			Interposition Tissue Flap
			Omental Pedicle Flap
			Closure
				Vaginal Closure
				Bladder Closure
			Leak Testing
			Drains
		Minimally Invasive Approach (Laparoscopic/Robotic)
			Postoperative Care
		Special Considerations
			Radiation-Induced Fistulae
			Palliative Procedures
		Conclusion
		Cross-References
		References
	45 Rectovaginal Fistula
		Introduction
		Background/Statistics
		Causes of Rectovaginal Fistula
			Obstetric
			Inflammatory Bowel Disease
			Infectious
			Surgical
			Cancer and Radiation
			Miscellaneous
		Classification
			Size
			Location
			Etiology
			Other
		Presentation
		Workup/Diagnosis
			Physical Exam
			Imaging
		Conservative Treatment (Non-primary Repair)
			Expectant Management
			Medical Management
			Seton Placement
			Miscellaneous
		Surgical Repair
			Introduction
			Optimization Prior to Surgical Repair
			Methods of Rectovaginal Fistula Repair
			Tissue Flaps
			Abdominal Approach
			Novel and Future Approaches
		Postsurgical Considerations and Complications
			Postsurgical Care and Expectations
			Postoperative Complications
		Conclusion
		Cross-References
		References
	46 Ureterovaginal Fistula Repair
		Introduction
		Definition and Etiology
		Diagnosis
			Clinical Features
			Exam Findings
			Imaging Studies
		Management
			Endoscopic Management
			Surgical Management
		Conclusion
		References
	47 Female Urethral Reconstruction
		Introduction
		Diagnosis
		Anatomy
		Management
			Urethral Diverticulum
			Urethral Stricture
			Vesico-Vaginal Fistula
		Preoperative Planning
		Prep and Patient Positioning
		Procedural Approach (Our Techniques)
			Urethral Diverticulum
			Urethral Stricture
			Vesico-Vaginal Fistula
		Recovery and Rehabilitation
		Outcomes
			Urethral Diverticulum
			Urethral Stricture
			Vesico-Vaginal Fistula
		Summary
		Conflicts of Interest
		Cross-References
		References
	48 Surgical Reconstruction of Pelvic Fracture Urethral Injuries in Females
		Introduction
		Evaluation
		Treatment
			Anastomotic Urethroplasty for Female Pelvic Fracture Urethral Injury
				Surgical Approach
				Transection at Bladder Neck
				Transection at Proximal Urethra Level
				Transection at Mid-Urethral Level
				Transection at Meatus
				Results
				Discussion
			Total Urethral Loss in Female Pelvic Fracture Urethral Injury
				Procedure
		Conclusion
		References
	49 Surgical Repair of Urethral Diverticula
		Introduction
		Etiopathogenesis
		Diagnosis
			Clinical Presentation
			Evaluation
				Urine Studies
				Cystourethroscopy
				Magnetic Resonance Imaging (MRI)
				Voiding Cystourethrogram (VCUG)
				Ultrasonography
				Double Balloon Positive Pressure Urethrography (PPU)
			Classification
			Management
				Conservative
			Surgical
				Preoperative Preparation
				Operative Technique
			Outcomes
		Conclusion
		References
Part VI: Ureteral Reconstruction
	50 Surgical Reconstruction of Ureteral Defects: Strictures, External Trauma, Iatrogenic, and Radiation Induced
		Introduction
		Etiology
			Nephrolithiasis
			Radiation
			Trauma
			Malignancy
			Iatrogenic
		Diagnosis
		Timing of Repair
		Preoperative Stenting
		Treatment
			Endoscopic
				Outcomes
			Ureteroureterostomy
			Ureteroneocystostomy
			Psoas Hitch
			Boari Flap
				Outcomes
			Transureteroureterostomy
				Outcomes
			Ileal Ureter
				Outcomes
			Robotic and Laparoscopic Approaches
			Robotic Ureteroureterostomy
				Outcomes
			Ureteroneocystostomy
				Outcomes
		Horizons
		Conclusion
		References
	51 Techniques of Ureteral Reimplantation
		Introduction
		Endoscopic Management
		Open Ureteral Reimplant Techniques
			Indications and Preoperative Considerations
			General Approach
			Open Ureteral Reimplant (Fig. 1)
			Psoas Hitch (Fig. 2)
			Boari Flap (Fig. 3)
			Minimally Invasive Ureteral Reimplant
			Special Consideration: Ureteroneocystostomy with Tapering (Fig. 5)
			Postoperative Management
			Complications
		Anti-Refluxing Techniques
			Indications and Preoperative Considerations
			Intravesical Techniques
			Patient Positioning
			Initial Dissection
			Mobilizing the Ureter
			Cross-Trigonal (Cohen) Ureteral Reimplantation (Fig. 6)
			Intraextravesical (Politano-Leadbetter) Technique
			Ureteral Advancement (Glenn-Anderson) Technique
			Other Techniques
				Sheath Approximation (Gil-Vernet) Technique
			Spatulated Nipple Technique
			Closing the Bladder
			Extravesical Ureteral Reimplantation
			Patient Positioning and Dissecting Down to the Bladder
			Open Lich-Gregoir Technique (Fig. 7)
			Using a Laparoscopic or Robotic Approach for Extravesical Reimplantation (Fig. 8)
			External Tunnel (Barry) Technique
			Detrusorrhaphy (Hodgson-Firlit-Zaontz) Technique
			Intraextravesical Technique (Paquin)
			Postoperative Management
			Complications
			Obstruction
			Persistent or Recurrent Vesicoureteral Reflux
		Special Considerations
			Reoperation
			Duplication Anomalies
			Transplant Kidney Ureteroneocystostomy
			Reimplant into Bowel Segment
		References
Part VII: Pelvic Pain, Irritative Voiding Disorders, and Female Sexual Dysfunction
	52 Pathophysiology and Clinical Evaluation of Chronic Pelvic Pain
		Introduction: Why Treat Chronic Pelvic Pain?
		Causes of Chronic Pelvic Pain
			Initial Assessment of Chronic Pelvic Pain
				Validation
				Medical History
				Physical Examination
		Special Populations
		Laboratory and Imaging Studies
		Differential Diagnosis by Organ System
			Gynecological System
			Male Genitalia
			Urological
			Musculoskeletal
			Gastrointestinal
			Vascular
			Neurological
		Multifocal Pain and Other Conditions
		Treatment
		Conclusion
		Guidelines and Resources for Providers and Patients
		Cross-References
		References
	53 Bladder Pain Syndrome: Interstitial Cystitis
		Introduction
		Terminology
		Epidemiology
		Etiology
		Pathology
		Diagnosis
			History Including Emotional Problems and Bowel and Sexual Dysfunction
			Physical Examination
			Laboratory Tests and Urodynamics
			Cystoscopy and Bladder Biopsy
			Biomarkers
			Phenotyping BPS/IC Patients
		Management
			Conservative Measures
			Interventional Pharmacotherapy
			Oral Pharmacotherapy
			Intravesical Pharmacotherapy
			Intramural Treatments
			Surgical Treatments
		Future Developments in Terms of Animal Studies
		Cross-References
		References
	54 Female Sexual Dysfunction
		Introduction
		Definition
		Consensus Classification Systems
		Incidence, Prevalence, and Risk Factors
		Female Pelvic Anatomy
			The Vagina
			The G-Spot
			The Vulva
				The Mons Pubis
				The Labia Majora
				Labia Minora
				The Vestibule
			The Clitoris
				The External Clitoris
				The Internal Clitoris
			Innervation
			Vascular Supply
			The Female Sexual Response Cycle
				Desire
				Arousal
				Orgasm
		Physiology and Biochemistry of Female Sexual Response Cycle
			Mechanisms of Sexual Arousal
		Etiology and Pathophysiology of Female Sexual Dysfunction
		Female Sexual Dysfunction in Specific Settings
			FSD in the Post-Partum Period
			FSD and Pelvic Organ Prolapse and/or Urinary Incontinence
			FSD After Pelvic Surgeries
				Anti-Stress Urinary Incontinence Surgery
				Anterior Vaginal Repair
				Posterior Vaginal Repair
				Apical Vaginal Prolapse
				Vaginal Repair Using Mesh
				Hysterectomy for Benign Conditions
				FSD After Treatment of Pelvic Malignancies
				FSD with Aging
		Evaluation of Female Sexual Dysfunction
		Treatment Options
		Conclusion
		References
Part VIII: Fecal Incontinence and Defecatory Dysfunction
	55 Pathophysiology, Diagnosis, and Treatment of Defecatory Dysfunction
		Introduction
		Definitions
		Epidemiology
		Physiology
		Approach to Care
		Anatomy
		Differential Diagnosis
		Evaluation
			History Taking
			Physical Exam
			Correlation Between Anatomy and Function
			Testing
				Colonoscopy
				Motility Studies
				Defecography
				Colonic Transit Studies
				Others
		Management
			Behavioral Modification and Biofeedback
				Medications
				Surgery
				Others
		Conclusion
		Cross-References
		References
	56 Management of Fecal Incontinence, Constipation, and Rectal Prolapse
		Introduction
		Multidisciplinary Approach
		Pathophysiological Considerations During Workup
		Taking the Patient History
		Clinical Examination by Nonspecialists
		Clinical Examination by the Proctologist
		Imaging
		Special Investigations
			The Use of Special Investigations
		Primary Treatment
		Further Treatment Options in Incontinence
		Further Treatment Options in Constipation
		Rectal Prolapse
		Conclusion
		Cross-References
		References
Part IX: Use of Bowel in Genitourinary and Pelvic Reconstruction and Other Complex Scenarios
	57 Indications and Use of Bowel in Female Lower Urinary Tract Reconstruction: Overview
		Introduction
		Historical Perspective
		Physics of Bowel
		Surgical Anatomy and Bowel Selection
			Stomach
			Jejunum
			Ileum
			Ileocolonic Segment
			Colon
		Evaluation of Patient
		Preoperative Preparation
		Surgical Techniques
			Bowel Anastomosis
			Ureterointestinal Anastomosis
			Urinary Stoma
		Urinary Diversion
			Malignancy
				Bladder Cancer
				Nonurological Pelvic Tumor
			Bladder Dysfunction
				Urogenital Tuberculosis
				Urogenital Schistosomiasis
				Drugs and Radiation-Induced Cystitis
			Congenital Urogenital Anomaly
			Other Conditions
		Conduit
			Ileal Conduit
			Jejunal Conduit
			Colon Conduit
		Cutaneous Catheterizing Pouch
		Orthotopic Neobladder
			Continence
			Urinary Retention
			Quality of Life
		Ureterosigmoidostomy
		Augmentation Cystoplasty
			Non-neurogenic
			Neurogenic
				Bladder Compliance
				Bladder Capacity
				Detrusor Overactivity
		Ureter Substitution
		Neovaginal Reconstruction (Vaginoplasty)
		Complications of Bowel Use in Female Genitourinary Reconstruction
			Early Complications
				Anastomotic Leakage
				Fluid Collection
				Alteration in Bowel Function
				Urinary Obstruction
				Fistula
			Late Complications
				Urolithiasis
				Urinary Tract Infection
				Renal Deterioration
				Development of Secondary Malignancy
				Metabolic Complications
					Electrolyte Abnormalities
						Stomach
						Jejunum
						Ileum and Colon
					Nutritional Abnormalities
					Drug Metabolism Abnormalities
					Altered Sensorium
					Osteomalacia and Growth Retardation
		Conclusion
		References
	58 Options for Surgical Reconstruction of the Heavily Irradiated Pelvis
		Introduction
		Epidemiology and Clinical Presentation
		Pathophysiology of Radiation-Induced Cellular Injury
		Pelvic Radiation and Genitourinary Toxicity
		Genitourinary Complications of Pelvic Radiation
			Acute Complications
				Lower Urinary Tract Symptoms (LUTS)
				Hemorrhagic Cystitis
			Chronic Complications
				Urinary Fistulae
				Urinary Strictures and Fibrosis
				Sexual Dysfunction
				Secondary Malignancy
		Initial Evaluation and Management of the Heavily Irradiated Pelvis
			Evaluation
				Urology
				Plastic Surgery
			Management
				Conservative/Non-reconstructive
		Urinary Tract Reconstruction
		Organ-Sparing Reconstruction
			Bladder Neck Reconstruction and Urethroplasty
			Anti-Iincontinence Surgery
			Bladder Neck Closure
			Bladder Augmentation
			Incontinent Urinary Channels
				Incontinent Ileovesicostomy
			Continent Urinary Channels
				Mitrofanoff Appendicovesicostomy
				Yang-Monti Channel
				Kock Nipple Valve
				Continent Catheterizable Ileal Cecocystoplasty (CCIC)
			Supravesical Diversion
		Non-organ-Sparing Reconstruction
			Pelvic Exenteration
			Urinary Diversion
		Abdominal Wall, Pelvic, and Genital Reconstruction
			Intraoperative Considerations
				Abdominal Wall
				Pelvic Dead Space
				Vaginal Reconstruction
				Perineal Repair
				Vulvar Repair
			Postoperative Considerations
				Sitting Protocols
				Drains
				Lifting and Strenuous Activity
				Vaginal Dilation and Sexual Activity
				Postoperative Revisions
		Conclusion
		Cross-References
		References
	59 Use and Complications of Neobladder and Continent Urinary Diversion in Female Pelvic Cancer
		Introduction
		Indications and Forms of Female Cystectomy
		Specific Surgical Aspects of the Ablative Part Related to an Orthotopic or Heterotopic Urinary Diversion
		Patient Selection for Continent Urinary Diversion
		Preoperative Patient Preparation
		Important Intraoperative Surgical Steps
			General Aspects of Reservoirs
			Orthotopic Neobladder
			Continent Cutaneous Reservoir
		Types of Orthotopic Neobladders
			Studer Neobladder
			I-Pouch
			Hautmann Neobladder
			Kock Ileal Neobladder
			T-Pouch
			Pouch of Abol-Enein and Ghoneim
			Padua Ileal Neobladder
		Types of Heterotopic Continent Urinary Diversions
			Mainz I Pouch: Mixed Augmentation Ileum and Cecum
			Ileal Heterotopic Continent Cutaneous Pouches
		Specific Aspects of Robot-Assisted Surgery
		Immediate Postoperative Patient Care
		Early Risks of Continent Urinary Diversions
		Long-Term Risks of Continent Urinary Diversions
			General Long-Term Risks after Continent Urinary Diversion
			Orthotopic Neobladder
			Continent Cutaneous Reservoirs
		Outcome
			Outcome of Orthotopic Neobladders
			Outcome of Continent Cutaneous Reservoirs
		Recommendations for Follow-Up
		Conclusion
		References
Part X: Genitourinary and Pelvic Trauma: Iatrogenic and Violent Causes (War and Civil Causes)
	60 Surgical Reconstruction of the Urinary Tract Following Obstetric and Pelvic Iatrogenic Trauma
		Introduction
		Anatomy
		Risk Factors
		Epidemiology of Ureteral Injuries
			Obstetric Injuries
			Gynecological Injuries
			Colorectal Surgery
			Vascular Surgery
			Spinal Surgery
			External Thermal Injuries
			Urological Injuries
		Epidemiology of Bladder Injuries
			Obstetric Injuries
			Gynecological Injuries
			Vascular Surgery Injuries
			Colorectal and General Surgery Injuries
			Urological Injuries
		Epidemiology of Urethral Injuries
			Urogynecological Surgery
			Urethral Diverticulum Repair
			Urethral Dilatation
		Prevention
		Investigations
			Intraoperative
			Postoperative
		Management
			Stability of the Patient
				Temporizing Procedures Include
				Types of and Principles of Definitive Ureteral Repairs
					Transureteroureterostomy
					Autotransplantation
					Ileal or Appendiceal Interposition Graft
				Types of and Principles of Definitive Bladder Repairs
					Ileal Conduit (Wallace 2 Technique)
		Timing, Position, and Level of the Injury
			Injury of the Ureter
				Proximal/Upper Ureter
				Distal/Lower Ureter
			Injury of the Bladder
				Injuries Involving the Trigone
				Injuries of the Urethra and Bladder Neck
			Obstetric Fistulae
			Injuries at Multiple Levels
		Extent of Injury
			Mucosal Ureteral Injuries
			Partial Tears
				Ureter
				Urethra
			Complete Tears/Transection
				Ureter
				Bladder
				Urethra
		Partial/Complete Occlusion of the Ureter with a Suture
		Damage or Excision of Tissue (Ureter/Bladder/Urethra)
			Ureter
			Bladder
			Urethra
		Associated Injuries
			Bowel
			Vagina
			Vascular
		Timing of Presentation
			Delayed Presentation
				Ureter
			Fistula Management
			Urethral Stricture Formation
		Mechanism of Injury
		Comorbidities and Functional Status
			History of Previous Radiotherapy
		Female Genital Mutilation (FGM)
		Conclusion
		References
	61 Female Genital Mutilation/Cutting
		Introduction
		Prevalence
		Epidemiology Trends
		Types of FGM/C
		Health Consequences
			Immediate Complications
			Short-Term Complications
			Long-Term Complications
			Dermatological Complications
			Urinary Tract Complications
			Sexual Health
			Neuropathic Clitoral Pain
			Gynecological Complications
			Obstetric and Perinatal Complications
			Psychological Disturbances
		Management of FGM/C
			Gynecological Care
				Defibulation
					Technique
			Obstetric Care
				Antenatal Care
				Intrapartum Care
			Sexual Health
				Clitoral Reconstruction
					Technique
		Prevention Strategies
		Conclusion
		Cross-References
		References
Part XI: Vaginoplasty and Neovagina Construction in Congenital Defects, Trauma, and Gender Affirming Surgery
	62 (Neo) Vaginoplasty in Female Pelvic Congenital Anomalies
		Introduction
		Nonobstructive Anomalies
			Mayer-Rokitansky-Kuster-Hauser Syndrome
				Pathophysiology
				Clinical Presentation
				Diagnosis
				Classification
				Treatment
					Psychological Counseling/Support
					Vaginal Elongation/Dilation
					(Neo) Vaginoplasty
				Abbé-McIndoe
					Technique
					Complications and Troubleshooting
					Follow-Up
				Vecchietti Procedure
					Transabdominal Vecchietti Technique
					Laparoscopic Vecchietti Technique
					Postoperative Invagination Phase
					Complications and Troubleshooting
					Outcomes
				Williams´ Neovaginoplasty
					Surgical Technique
					Technical Modifications
					Complications
					Outcomes
			Androgen Insensitivity Syndrome
				Physiopathology
				Diagnosis
				Treatment
					Gonadectomy
					Genital Reconstruction/(Neo)vaginoplasty
				Treatment
					Gonadectomy
					Feminizing Reconstructive Surgery
					Low Confluence UGS
					High Confluence UGS and Cloaca
						Hendren Technique
						Passerini-Gazel Technique (with Modifications)
					Posterior Sagittal Ano-Recto-Vagino-Urethroplasty (PSARVUP)
					TUM
			Longitudinal Vaginal Septum
		Obstructive Anomalies
			Imperforate Hymen
				Technique
			Transverse Vaginal Septum
		Congenital Adrenal Hyperplasia
			Management
		Conclusion
		Cross-References
		References
	63 Genital Reconstruction in Male-to-Female Gender Affirmation Surgery
		History
		Introduction
		Preoperative Clinical Evaluation
		Overview of Surgical Techniques
			Orchiectomy
			Penectomy
			Clitoral Reconstruction
			Vulvoplasty
			Urethroplasty
			Creation of the Neovaginal Canal
		Vaginoplasty Techniques
			Penile Inversion Vaginoplasty
			Bowel Vaginoplasty
			Peritoneal Pull-Through Vaginoplasty
			Zero-Depth Vaginoplasty (Feminizing Vulvoplasty)
		Postoperative Care
		Complications
		Early Postoperative Complications
			Bleeding
			Wound Dehiscence
			Skin Necrosis
			Clitoral Necrosis
			Urethral Flap Necrosis
		Late Complications
			Poor Cosmesis
			Corpora Cavernosa Remnants
			Formation of the Granulation Tissue
			Hair Growth Inside the Neovagina
			Neovaginal Prolapse
			Excessive Mucus Production and Foul Smell
			Diversion Colitis
			Meatal Stenosis and Dysuric Problems
			Corpus Spongiosum Bulging
			Introital Stenosis
			Vaginal Stenosis and Loss of Neovaginal Depth
			Urinary and Enteric Neovaginal Fistulas
		Sexual Function
		Conclusions
		Cross-References
		References
	64 Complications of Gender-Affirmation Surgery
		Introduction
		General Perspective on Complications of Gender-Affirmation Surgery
		Localization by Organ of the Urinary Tract System
			Anatomical
				Early: Bleeding
				Early: Urinary Retention
			Urethral Fistulas:
			Functional: Incontinence
		Localization/Organ System: Genital
			Infection
		Localization/Organ System: Gastro/Bowel
		Localization: Gender-Specific: Prostate Hyperplasia/Cancer, Venous thromboembolism
		Conclusion
		Cross-References
		References
	65 Functional and Aesthetic Surgery of Female Genitalia
		Introduction
		Anatomy of Female Genitalia and Changes with Aging
		Etiopathogenesis
		Genital Surgery for Congenital Adrenal Hyperplasia
		Genital Surgery for Vaginal Agenesis
			Creatsas Vaginoplasty
			Vecchietti Procedure
			Davydov Procedure
			Mcindoe Procedure
			Sigmoid Vaginoplasty
		Genital Surgery for Female Mutilation
		Genital Surgery for Lichen Sclerosus
		Aesthetical Genital Surgery
			Labiaplasty
			Techniques
		Labia Majora Augmentation
		Vaginal Rejuvenation
			Surgical Vaginal Rejuvenation
			Nonsurgical Vaginal Rejuvenation Procedures
		Hymenoplasty
		Conclusions
		References
Index