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Rectocele repair evolves.

Unfortunately, as an avid endoscopic surgeon and infertility specialist, I must admit that the most exciting arena in gynecologic surgery at present belongs to the urogynecologist. Until now, there has been little innovation within the subspecialty, even though it was well known that long-term results were compromised by weakened tissue and external factors. However, on the heels of our increased knowledge of the anatomy of the pelvic floor and the pathophysiology of incontinence and prolapse, techniques are being introduced that attempt to increase efficiency and thus decrease recurrence and the necessity of a second surgery.

I have asked Dr. Neeraj Kohli, chief of the urogynecology division at Brigham and Women's Hospital, Boston, to discuss the nuances of the use of mesh or grafts to augment rectocele repairs. A urogynecologist in the department of obstetrics, gynecology, and reproductive biology at Harvard Medical School. Dr. Kohli will make the case for the use of mesh or grafts in selected patients who in the past would have been treated via site-specific defect repair. I am certain that you will find Dr. Kohli's Master Class in gynecologic surgery to be both intriguing and thought provoking.

BY CHARLES E. MILLER, M.D.

DR. MILLER, a reproductive endocrinologist in private practice in Arlington Heights, Ill., and Naperville, Ill., is the medical editor of this column.
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Title Annotation:MASTER CLASS; narratives; column
Author:Miller, Charles E.
Publication:OB GYN News
Article Type:Brief article
Geographic Code:1USA
Date:Jun 1, 2006
Words:219
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