Search PubMed⌕ Search

Biomedical subjects

Patrick J Woodman

Publications and source records attributed to Patrick J Woodman.

7 recordsLinked to original sources
PubMed2006

From the simple to the sublime: incorporating surgical models into your surgical curriculum.

Financial and time constraints have limited graduating residents' operative experience, making the use of models a necessary adjunct to a complete surgical curriculum. Models are useful tools to teaching surgical skills outside the operating room. They can be very realistic and complex, or they can be simple and economical. Models are developed to represent the anatomic arrangements seen in human patients, and to reproduce the biomechanical tasks necessary to complete a surgical case. Bench model laboratories are well-received by trainees and steepen the learning curve in the operating room.

Female↗
PubMed2005

Prevalence of severe pelvic organ prolapse in relation to job description and socioeconomic status: a multicenter cross-sectional study.

The aim of this study was to determine if certain occupations or socioeconomic levels are associated with pelvic organ prolapse. Investigators at six American sites performed pelvic organ prolapse quantification examinations on women presenting for routine gynecologic care. Between September 1999 and March 2002, 1,004 patients were examined. Severe pelvic organ prolapse was defined as the leading edge being 1 cm or more beyond the hymeneal ring. The data was analyzed with the Kruskal-Wallis analysis of variance, Bonferroni test, multiple logistic regression, and descriptive statistics. The prevalence of severe pelvic organ prolapse in our group was 4.3%. Women who were laborers/factory workers had significantly more severe prolapse than the other job categories (p < 0.001). Women with annual income of Dollars 10,000 or less had significantly more severe pelvic organ prolapse than other income groups (p < 0.001). These differences persisted even when controlling for age, race, number of deliveries, body mass index >30, and smoking status (all p < 0.001). Laborers/factory worker jobs and an annual household income of Dollars 10,000 or less are associated with severe pelvic organ prolapse.

Adolescent↗
PubMed2005

Pelvic Organ Support Study (POSST) and bowel symptoms: straining at stool is associated with perineal and anterior vaginal descent in a general gynecologic population.

OBJECTIVE: The purpose of this study was to evaluate the association of constipation symptoms and anal incontinence with vaginal wall and pelvic organ descent in a general gynecologic population. STUDY DESIGN: In this multicenter, cross-sectional study, 1004 women attending routine gynecologic healthcare underwent pelvic organ prolapse quantification (POPQ) measurements, and were surveyed regarding anal incontinence, digitation, < 2 bowel movements (BMs)/week, and > 25% frequency of: straining, hard/lumpy stools, and incomplete emptying. Constipation scores reflected the sum of positive responses. Associations between POPQ measurements (Ba, C, Bp, gh+pb), constipation scores, and anal incontinence were evaluated using multivariable regression. RESULTS: Of 119 women with Bp > or = -1.00, 47% reported no constipation symptoms. Hard/lumpy stools (26%), incomplete emptying (24%), and straining (24%) were more prevalent; fewer women reported < 2 BMs/week (15%) or digitation (7%). Constipation scores were weakly correlated with Bp, gh+pb (both r < .1, P < .02). Women reporting > or = 2 symptoms had greater gh+pb measurements than women reporting 0 or 1 symptom (P = .03). Women with anal incontinence had greater gh+pb and gh values than women without anal incontinence (P < .01). POPQ measurements were regressed separately onto (1) total constipation scores, (2) dichotomized scores, and (3) individual symptoms, with BMI, age, number of vaginal deliveries (NVD), weight of largest vaginal delivery (WLVD), race, hysterectomy, study site, and income included as covariates. Total constipation scores and dichotomized scores were nonsignificant in all models. With regard to individual symptoms, straining at stool was significant in the models for Ba and gh+pb, with greater Ba and gh+pb measurements among strainers relative to nonstrainers. CONCLUSION: Most associations between bowel symptoms and vaginal or pelvic organ descent were weak. After controlling for important covariates, straining at stool remained associated with anterior vaginal wall and perineal descent.

Adult↗
PubMed2004

Retropubic urethrolysis without resuspension for the management of posturethropexy urinary retention and voiding dysfunction.

OBJECTIVE: The goal of this study was to determine the efficacy of retropubic urethrolysis without resuspension for the surgical treatment of postoperative urinary retention. METHODS: A retrospective chart review was done of six women with posturethropexy urinary retention or voiding dysfunction who underwent retropubic urethrolysis between July 1999 and June 2000. RESULTS: An average of 27.0 (+/- 19.6) months elapsed between obstructive incontinence procedure and urethrolysis. The mean maximum detrusor pressure during voiding was elevated at 52.7 (+/- 31.7) cm H2O. The mean maximum flow rate during voiding was decreased at 16.3 (+/- 10.8) cm H2O. The average postvoid residual volume was 152.9 +/- 71.6 mL, significantly decreased postoperatively to 36.9 +/- 40.0 mL (t = 3.37, p = 0.043). Postoperative cystourethroscopy showed a completely free and mobile urethra. In the short-term, all patients had resolution of their symptoms. No patient had return of stress incontinence in a mean clinical follow-up of 3.3 +/- 2.3 months. CONCLUSIONS: Our results are comparable to other series of urethrolyses, despite omission of resuspension. Retropubic urethrolysis offers favorable relief of persistent postoperative urinary retention and voiding dysfunction, particularly after retropubic urethropexy.

Adult↗
PubMed2002

Anatomy and physiology of the female perineal body with relevance to obstetrical injury and repair.

The female perineal body is a mass of interlocking muscular, fascial, and fibrous components lying between the vagina and anorectum. The perineal body is also an integral attachment point for components of the urinary and fecal continence mechanisms, which are commonly damaged during vaginal childbirth. Repair of injuries to the perineal body caused by spontaneous tears or episiotomy are topics too often neglected in medical education. This review presents the anatomy and physiology of the female perineal body, as well as clinical considerations for pelvic reconstructive surgery.

Autonomic Nervous System↗
PubMed2002

Pelvic organ support in nulliparous pregnant and nonpregnant women: a case control study.

OBJECTIVE: Our purpose was to compare pelvic organ support in nulliparous pregnant and nonpregnant women at a single institution. STUDY DESIGN: This was a case-control study. Pregnant patients and nonpregnant control subjects were matched according to age and race. Subjects underwent pelvic organ support evaluation by use of the pelvic organ prolapse quantification (POPQ) examination as part of routine prenatal or gynecologic care. The Pearson chi(2) statistic was used for statistical analysis, with a P value of 5% set for significance. RESULTS: A total of 21 pregnant and 21 nonpregnant nulliparous women between the ages of 18 and 29 years were included. All patients in the nonpregnant group had a POPQ stage of 0 or 1, whereas 47.6% of the pregnant subjects had POPQ stage 2 (P <.001). Individual components of the POPQ examination were compared. Significant differences were noted for points Aa and Ba, Ap and Bp, and PB and TVL. CONCLUSIONS: In nulliparous women, pregnancy is associated with increased POPQ stage compared with nonpregnant control subjects.

Adolescent↗