Anatomically-Based Resources for Health Professionals

Anatomically-Based Resources for Health ProfessionalsPeter Petros2024-10-09T09:46:49+10:00

Documents

Discovery development and practical applications of the Integral Theory System 1990-2021

Pelvic Floor Rehabilitation according to the Integral Theory

Click to view image: Pictorial Diagnostic Algorithm

Click to view image: Clinical Assessment Sheet

Patient Questionnaire

Pain

The Intravaginal Slingplasty Operation, a Minimally Invasive Technique for Cure of Urinary Incontinence in the Female

Severe Chronic Pelvic Pain in Women May Be Caused By Ligamentous Laxity in the Posterior Fornix of the Vagina

Pathways to causation and surgical cure of chronic pelvic pain of unknown origin, bladder and bowel dysfunction

Pelviperineology – A Multidisciplinary Pelvic Floor Journal

Is Chronic Pelvic Pain in the female surgically curable by uterosacral/cardinal ligament repair?

Cure of Interstitial Cystitis and Non-Ulcerating Hunner’s Ulcer by Cardinal/Uterosacral Ligament Repair

Synergistic non-surgical management of pelvic floor dysfunction: second report

Are ‘psychiatric’ findings in patients with Chronic Pelvic Pain primary or secondary?

Vulvodynia: a neuroinflammatory pain syndrome originating in pelvic visceral nerve plexuses due to mechanical factors

Vulvar vestibulitis maybe a referred pain arising from laxity in the uterosacral ligaments (1)

Vulvar vestibulitis maybe a referred pain arising from laxity in the uterosacral ligaments (2)

Anatomy

Role of the Pelvic Floor in Bladder Neck Opening and Closure I: Muscle Forces

Role of the Pelvic Floor in Bladder Neck Opening and Closure II: Vagina

Cardinal ligament: a live anatomical study

Defecation 1: testing a hypothesis for pelvic striated muscle action to open the anorectum

Defecation 2: Internal anorectal resistance is a critical factor in defecatory disorders

Anatomy and surgical cure of descending perineal syndrome

New Ambulatory Surgical Methods Using an Anatomical Classification of Urinary Dysfunction Improve Stress, Urge and Abnormal Emptying

Live anatomy of the perineal body in patients with third-degree rectocele

The Pubourethral Ligaments – an Anatomical and Histological Study in the Live Patient

Fistula

Prevention and cure of post vesico-vaginal fistula repair incontinence by insertion of skin graft in the bladder neck area of vagina. Update on hypothesis and interim report

Skin flap vaginal augmentation helps prevent and cure post obstetric fistula repair urine leakage: a critical anatomical analysis

The integral theory and its tethered vagina syndrome revisited: vaginal scarring may cause massive urinary incontinence

Post vesico-vaginal fistula repair incontinence – A new hypothesis and classification potentially guide prevention and cure

Integral Theory

An Integral Theory and its method for the diagnosis and management of female urinary incontinence

Acta Obstetricia et Gynecologica Scandinavica – An integral theory of female urinary incontinence

The Integral System

A new theory of ano-rectal function

Update of the Integral Theory and System for Management of Pelvic Floor Dysfunction in Females

Current treatment of pelvic organ prolapse correlated with chronic pelvic pain, bladder and bowel dysfunction

Mesh

Should surgeons continue to implant mesh sheets behind the vagina?

An anatomical basis for mesh complications and prevention thereof

Midurethral Sling Surgery

Basis for Long-Term Midurethral Tape Complications

The mechanics of urethral closure, incontinence and midurethral sling repair. Part 1 original experimental studies. (1990)

The mechanics of urethral closure, incontinence and midurethral sling repair. Part 2 further experimental validation (1993-2003)

The mechanics of urethral closure, incontinence, and midurethral sling repair Part 3 surgical applications (1990-2016)

Anchoring the midurethra restores bladder-neck anatomy and continence

Can the mini-sling become the golden standard for treating stress urinary incontinence? Comment: The TFS retropubic tensioned minisling for SUI—a 14 year experience with high long-term RCT cure

Origin of the midurethral sling operation

Midurethral slings: evidence-based medicine vs the medicolegal system

Tissue Fixation System posterior sling for repair of uterine/vault prolapse – A preliminary report

Neurourology

Bladder Instability in Women: A Premature Activation of the Micturition Reflex

Detrusor Instability and Low Compliance May Represent Different Levels of Disturbance in Peripheral Feedback Control of the Micturition Reflex

Female urethra is actively opened out by an external striated muscle mechanism during micturition, exponentially reducing intraurethral resistance to flow

The same posterior muscle vectors act to open urethra and anus during micturition and defecation

Competent uterosacral ligaments are required for normal bladder evacuation – testing a hypothesis evolving from finite element studies on micturition mechanisms in the female

Rapid nonlinear bladder and bowel evacuation: an evolutionary survival mechanism?

A hypothesis for urinary stream divergence in the female: unilateral dislocation of the pubovisceral muscle

Non Linearity

Chaos theory in obstetrics and gynaecology

Detrusor Instability and Low Compliance May Represent Different Levels of Disturbance in Peripheral Feedback Control of the Micturition Reflex

Lancet Art & Science of Medicine

Non-linearity, a dilemma and opportunity for clinical research in urogynecology

Nonlinearity in pelvic floor medicine and surgery

Some thoughts on the effect of non–linearity on innovation in urological surgery

Non-linearity – the mission continues

OAB Challenges

Bladder Instability in Women: A Premature Activation of the Micturition Reflex

Central European Journal of Urology (CEJU) – Desmopressin

CEJU – Knowledge of urethral closure mechanics helps to optimize surgical methodology of the midurethral sling operation

CEJU – Diagnostic and therapeutic recommendations for patients with nocturia

CEJU – Is overactive bladder in the female surgically curable by ligament repair?

An anatomical pathogenesis of lower urinary tract definitions from the 2002 ICS report symptoms, conditions, syndromes, urodynamics

Pathogenesis of OAB and surgical treatment according to the Integral Theory Paradigm

Overactive bladder (OAB): a failed concept needing revision to accommodate an external anatomical control system

PFR Exercises

CEJU – A four month squatting-based pelvic exercise regime cures day/night enuresis and bowel dysfunction in children aged 7–11 years

Synergistic non-surgical management of pelvic floor dysfunction: second report

Are ‘psychiatric’ findings in patients with Chronic Pelvic Pain primary or secondary?

Surgery

New Ambulatory Surgical Methods Using an Anatomical Classification of Urinary Dysfunction Improve Stress, Urge and Abnormal Emptying

CEJU – A low cost artisan tension-free tape technique cures pelvic organ prolapse and stress urinary incontinence – proof of concept

CEJU – Knowledge of urethral closure mechanics helps to optimize surgical methodology of the midurethral sling operation

Anatomy and surgical cure of descending perineal syndrome

CEJU – Tissue Fixation System ligament repair cures major pelvic organ prolapse in ageing women with minimal complications – a 10-year Japanese experience in 960 women

Understanding the mechanics of closure is key to optimal midurethral sling technique

Labium Majus Martius Skin Graft with Vascular Fat Pedicle

Perineal body repair in patients with third degree rectocele: a critical analysis of the tissue fixation system

A simplified biomechanical perspective of the Integral Theory System

Repair of damaged ligaments with tissue fixation system minisling is sufficient to cure major prolapse in all three compartments: 5-year data

The Integral Theory System. A simplified clinical approach with illustrative case histories

Study No. 11: Ligamentous repair using the Tissue Fixation System confirms a causal link between damaged suspensory ligaments and urinary and fecal incontinence

Tissue Fixation System (TFS) neoligament pelvic organ repair procedures – 12 and 24 month results

The TFS minisling restores major pelvic organ prolapse and symptoms in aged Japanese women by repairing damaged suspensory ligaments – 12 – 48 month data

Retropubic tissue fixation system tensioned mini-sling carried out under local anesthesia cures stress urinary incontinence and intrinsic sphincter deficiency: 1-year data

Retropubic TFS Minisling for Postprostatectomy Male Incontinence: First Report

Midurethral Tissue Fixation System sling – a ‘micromethod’ for cure of stress incontinence – preliminary report

Reinforcement of suspensory ligaments under local anesthesia cures pelvic organ prolapse: 12-month results

TFS posterior sling improves overactive bladder, pelvic pain and abnormal emptying, even with minor prolapse. A prospective urodynamic study

Outpatient mid-urethral tissue fixation system sling for urodynamic stress urinary incontinence: 3-year surgical and quality of life results

Can the mini-sling become the golden standard for treating stress urinary incontinence? Comment: The TFS retropubic tensioned minisling for SUI—a 14 year experience with high long-term RCT cure

UAB Cure

Surgical repair of uterosacral/cardinal ligaments in the older female using the Tissue Fixation System improves symptoms of obstructed micturition and residual urine

A finite element model validates an external mechanism for opening the urethral tube prior to micturition in the female

On the flow through the human female urethra

CEJU – Retention of urine in women is alleviated by uterosacral ligament repair: implications for Fowler’s syndrome

A Mathematical Model for Micturition Gives New Insights into Pressure Measurement and Function

Videos

Normal Function

US 3 directional forces https://www.youtube.com/watch?v=3vJx2OvUYe0
Micturition. Relaxation of the forward muscle force (m.pubococcygeus) allows the posterior vectors to open out the posterior urethral wall. The bladder contracts as a spasm to empty.

VIDEO Micturition animation of X Ray (1678 KB)

Micturition https://www.youtube.com/watch?v=eiF4G1mk6EA

Simulated Operations

Testing for pubourethral ligament defect
VIDEO Testing for pubourethral ligament defect (4365 KB)
Simulated operations for control of stress and urge incontinence

VIDEO Testing for pubourethral ligament integrity in USI (4365 KB)

VIDEO Activation of micturition reflex by pressure on bladder base stretch receptors (530 KB)

Surgery

Native tissue USL repair

https://www.youtube.com/watch?v=MGLdYHtqxzg
Integral Theory Systems – 16 Case Studies

Further Videos