Pelvic Reconstructive Surgery - Science topic

Two systems are worldwide accepted for the classification of pelvic ring lesions – the classification of Marvin Tile, adopted by ASIF/OTA, and of J. W. Young and A. Burgess. Both classification systems do not describe bony lesions only, but also take injuries to soft-tissue structures such as dislocations of the symphysis pubis, of the sacroiliac joint as well as disruptions of the ligamentous structures of the pelvic bottom and the iliolumbar ligament into account.

Fragility fractures of the pelvic ring represent a spectrum of pathologies. But there is an important difference with the pelvic ring lesions of the younger adults. In elderly patients with fragile bone, the strength of the bony structures of the pelvis is lower than this of the surrounding ligaments. Fragility fractures of the pelvis are mainly characterized by a disruption of bony structures only. As a consequence, the amount of instability in fragility fractures of the pelvis is not comparable with that of an open book or vertical shear lesion on younger adults. Some fragility fracture patterns of the pelvis therefore do not fit into the classification systems of Tile or Young-Burgess.

How do you classify fragility fractures of the pelvis? Do you think we need a new classification taking into account some specific features of these entities?

Is it possible to induce vaginal prolapse in dogs or in lab animals?

What are some reports in the literature about what the risk factors are for the recurrence for POP surgery? What is the most recurrent area in POP surgery? Little about ideal procedure for recurrent POP surgery.