The Pelvic Floor Disorders Consortium (PFDC) is a multidisciplinary organization of colorectal surgeons, urogynecologists, urologists, gynecologists, gastroenterologists, radiologists, physiotherapists, and other advanced care practitioners. Because all these specialists are dedicated to the care of patients with pelvic floor disorders, but sometimes approach evaluation and treatment of patients with pelvic floor complaints with differing perspectives, the PFDC was formed to arrange collaboration between these specialties. The PFDC’s goal is to collaborate to develop and evaluate educational programs, create clinical guidelines and algorithms, and promote overall quality of care in this unique population. The following recommendations arising from this effort represent the work product of the PFDC Working Group on Fluoroscopic Imaging of Pelvic Floor Disorders. The objective was to generate inclusive, rather than prescriptive, guidance for all practitioners, irrespective of discipline, in the care and treatment of patients with pelvic floor disorders. This process was intended to clarify which domains of fluoroscopic defecography have consensus among multidisciplinary experts, and which areas deserve further dedicated research.
Paquette, Ian M.D.1; Rosman, David M.D.2; El Sayed, Rania M.D.3; Hull, Tracy M.D.4; Kocjancic, Ervin M.D.5; Quiroz, Lieschen M.D.6; Palmer, Susan M.D.7; Shobeiri, Abbas M.D., M.B.A.8; Weinstein, Milena M.D.9; Khatri, Gaurav M.D.10; Bordeianou, Liliana M.D., M.P.H.11; Members of the Expert Workgroup on Fluoroscopic Imaging of Pelvic Floor Disorders Consensus Definitions and Interpretation Templates for Fluoroscopic Imaging of Defecatory Pelvic Floor Disorders, Diseases of the Colon & Rectum: January 2021 - Volume 64 - Issue 1 - p 31-44 doi: 10.1097/DCR.0000000000001829
Surgeries for pelvic organ prolapse (POP) are common, but standardization of surgical terms is needed to improve the quality of investigation and clinical care around these procedures. The American Urogynecologic Society and the International Urogynecologic Association convened a joint writing group consisting of 5 designees from each society to standardize terminology around common surgical terms in POP repair including the following: sacrocolpopexy (including sacral colpoperineopexy), sacrocervicopexy, uterosacral ligament suspension, sacrospinous ligament fixation, iliococcygeus fixation, uterine preservation prolapse procedures or hysteropexy (including sacrohysteropexy, uterosacral hysteropexy, sacrospinous hysteropexy, anterior abdominal wall hysteropexy, Manchester procedure), anterior prolapse procedures (including anterior vaginal repair, anterior vaginal repair with graft, and paravaginal repair), posterior prolapse procedures (including posterior vaginal repair, posterior vaginal repair with graft, levator plication, and perineal repair), and obliterative prolapse repairs (including colpocleisis with hysterectomy, colpocleisis without hysterectomy, and colpocleisis of the vaginal vault). Each of these terms is clearly defined in this document including the required steps of the procedure, surgical variations, and recommendations for procedural terminology. The final publication is available at http://www.link.springer.com Int Urogynecol J (2020). https://doi.org/10.1007/s00192-020-04236-1
Standardized terminology for surgical procedures commonly performed to treat stress urinary incontinence in women is needed to facilitate research, clinical care, and teaching in female pelvic medicine and reconstructive surgery. This report combines the input of members of the American Urogynecologic Society and the International Urogynecological Association, assisted by external referees. Extensive searches of the literature were performed, including Instructions for Use brochures and original source documents where possible. Historical context was considered along with procedural modifications, and expert opinion was included when appropriate. A terminology report for the procedures commonly performed to treat stress urinary incontinence in women was produced. Included procedures are midurethral sling, retropubic colposuspension, pubovaginal sling, urethral bulking, and artificial urinary sphincter. Appropriate figures have been included to supplement and help clarify the text. Ongoing review will be performed periodically to keep the document updated and widely acceptable. This document is a literature and consensus-based terminology report for surgical procedures to treat stress urinary incontinence in women. Future publications in female pelvic medicine and reconstructive surgery should use this standardized terminology whenever possible. The final publication is available at http://www.link.springer.com Int Urogynecol J (2020). https://doi.org/10.1007/s00192-020-04237-0
The scientific approach to categorizing mesh complications and optimal methods to address them have been complicated by the rapid proliferation and evolution of materials and techniques that have been used over the past 20 years in surgical treatment of pelvic floor disorders. In addition, terminology used to diagnose and categorize mesh complications and the descriptions of surgical procedures to manage them have been adopted inconsistently, further hampering the development of a collective experience with a standardized lexicon. Finally, much of the high-quality data on management of mesh complications is based on materials that are rarely used or not commercially available today. The final publication is available at http://www.link.springer.com Int Urogynecol J (2020). https://doi.org/10.1007/s00192-020-04248-x
The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction.
The UK Clinical Guideline for best practice in the use of vaginal pessaries for pelvic organ prolapse is an evidence-based consensus document for healthcare professionals and women seeking information about pessary use for prolapse. The aim of the Guideline is to provide guidance and information about best practice in pessary use for prolapse for multidisciplinary healthcare professionals and includes a training framework which can be used to plan and monitor competencies in pessary management.
The IUGA Terminology and Standardisation and ICS Standardisation Steering Committees are pleased to announce that a ‘Joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction’ is now available for early view in both the International Urogynecology Journal and the Neurourology & Urodynamics Journal.
The document presents recommended terms and definitions for the assessment – including history and physical examination and investigations; diagnosis; prevention and conservative treatment of pelvic floor dysfunction. The emphasis in this document is on management commonly undertaken by clinicians or researchers involved in conservative management, i.e. non-surgical and non-pharmacological management.
This terminology document builds on previous terminology documents in conservative management of pelvic floor dysfunction and aligns with current terminology documents addressing related aspects of pelvic floor dysfunction.
The IUGA Terminology and Standardization and ICS Standardisation Steering Committees are pleased to announce that a 'Joint report on the terminology for female anorectal dysfunction' is now available for early view in both the International Urogynecology Journal and the Neurourology & Urodynamics Journal.
The document presents recommended terms and definitions for the assessment – including history and physical examination and investigations; diagnosis; treatment of female anorectal dysfunction.
This terminology document builds on previous terminology documents in female pelvic floor dysfunction and aligns with current terminology documents addressing related aspects of pelvic floor dysfunction.