Publications by authors named "S Walker Nickles"

6 Publications

  • Page 1 of 1

Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal.

J Urol 2016 Aug 17;196(2):484-9. Epub 2016 Mar 17.

Department of Urology, Medical University of South Carolina, Charleston, South Carolina. Electronic address:

Purpose: We reviewed the outcomes of the autologous fascial pubovaginal sling as a salvage procedure for recurrent stress incontinence after intervention for polypropylene mesh erosion/exposure and/or bladder outlet obstruction in patients treated with prior transvaginal synthetic mesh for stress urinary incontinence.

Materials And Methods: In a review of surgical databases at 2 institutions between January 2007 and June 2013 we identified 46 patients who underwent autologous fascial pubovaginal sling following removal of transvaginal synthetic mesh in simultaneous or staged fashion. This cohort of patients was evaluated for outcomes, including subjective and objective success, change in quality of life and complications between those who underwent staged vs concomitant synthetic mesh removal with autologous fascial pubovaginal sling placement.

Results: All 46 patients had received at least 1 prior mesh sling for incontinence and 8 (17%) had received prior transvaginal polypropylene mesh for pelvic organ prolapse repair. A total of 30 patients underwent concomitant mesh incision with or without partial excision and autologous sling placement while 16 underwent staged autologous sling placement. Mean followup was 16 months. Of the patients 22% required a mean of 1.8 subsequent interventions an average of 6.5 months after autologous sling placement with no difference in median quality of life at final followup. At last followup 42 of 46 patients (91%) and 35 of 46 (76%) had achieved objective and subjective success, respectively. There was no difference in subjective success between patients treated with a staged vs a concomitant approach (69% vs 80%, p = 0.48).

Conclusions: Autologous fascial pubovaginal sling placement after synthetic mesh removal can be performed successfully in patients with stress urinary incontinence as a single or staged procedure.
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http://dx.doi.org/10.1016/j.juro.2016.02.2976DOI Listing
August 2016

Simple vs complex urethral diverticulum: presentation and outcomes.

Urology 2014 Dec;84(6):1516-9

Department of Urology, Medical University of South Carolina, Charleston, SC.

Objective: To determine whether complex anatomic configurations of urethral diverticula (UD), namely circumferential UD (cUD), present differently or confer a worse prognosis as compared with simple UD (sUD).

Methods: After institutional review board approval, a retrospective review of patients who underwent transvaginal urethral diverticulectomy at a single institution over an 8-year period was performed. A total of 43 patients were identified, of which 11 were found to have cUD. These lesions were repaired with complete division of the urethra to access the dorsally located portion of the UD, followed by end-to-end anastomosis for urethral reconstruction with a Martius flap and/or autologous fascial pubovaginal sling performed as needed. Presenting symptoms and surgical outcomes were reviewed.

Results: Mean age was 50.9 years in the cUD vs 52.7 years in the sUD. Patients with cUD were more likely to present with stress urinary incontinence than those with sUD (90.9% vs 56.3%; P = .04). There was no statistical difference in the rate of preoperative urgency, pelvic pain and/or dyspareunia, postvoid dribbling, and urinary tract infection. Postoperatively, patients with cUD were more likely to have a urinary tract infection (27% vs 3%; P = .2); otherwise, rates of postoperative results were similar.

Conclusion: Urethral transection and end-to-end anastomosis for the repair of complex UD is a feasible approach and results in similar clinical outcomes compared with the repair of sUD.
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http://dx.doi.org/10.1016/j.urology.2014.07.070DOI Listing
December 2014

Primary hepatic gastrinoma: an unusual case of zollinger-ellison syndrome.

Gastroenterol Hepatol (N Y) 2010 Jan;6(1):53-6

Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886446PMC
January 2010

Prepubertal Skene's abscess.

J Pediatr Adolesc Gynecol 2009 Feb;22(1):e21-2

University of South Carolina, Columbia, South Carolina 29203, USA.

Background: Skene's glands are believed to be homologues of the prostate gland derived from the urogenital sinus.(1) Complications of Skene's glands occur most often in the third and fourth decades and are rarely seen in premenarchal females.

Case: A 3-year-old presented to her pediatrician with a 9-day complaint of vulvar pain. Both pediatric and gynecologic office examination revealed an enlarged right labium majus and an erythematous area adjacent to the urethra. Examination under anesthesia revealed a Skene's gland abscess that was treated with incision and drainage. The patient experienced complete resolution of symptoms.

Conclusion: A Skene's gland abscess is rare among premenarchal girls. An abscess presenting in a patient complaining of pain can be successfully managed with incision and drainage.
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http://dx.doi.org/10.1016/j.jpag.2007.11.004DOI Listing
February 2009

Source and specificity of chemical cues mediating shelter preference of Caribbean spiny lobsters (Panulirus argus).

Biol Bull 2006 Oct;211(2):128-39

Brains and Behavior Program, Center for Behavioral Neuroscience, Department of Biology, Georgia State University, P.O. Box 4010, Atlanta, Georgia 30302-4010, USA.

Caribbean spiny lobsters display a diversity of social behaviors, one of the most prevalent of which is gregarious diurnal sheltering. Previous research has demonstrated that shelter selection is chemically mediated, but the source of release and the identity of the aggregation signal are unknown. In this study, we investigated the source and specificity of the aggregation signal in Caribbean spiny lobsters, Panulirus argus. We developed a relatively rapid test of shelter choice in a 5000-l laboratory flume that simulated flow conditions in the spiny lobster's natural environment, and used it to examine the shelter preference of the animals in response to a variety of odorants. We found that both males and females associated preferentially with shelters emanating conspecific urine of either sex, but not with shelters emanating seawater, food odors, or the scent of a predatory octopus. These results demonstrate specificity in the cues mediating sheltering behavior and show that urine is at least one source of the aggregation signal.
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http://dx.doi.org/10.2307/4134587DOI Listing
October 2006

Neurophysiological and nutritional considerations of pain control.

J Manipulative Physiol Ther 1984 Dec;7(4):219-29

Pain is a phenomenon experienced by all forms of life. Many theories exist to explain how it is perceived. This paper examines several of those theories, particularly as they relate to nutritional and neurophysiological implications in the production and management of pain. An explanation of how certain chiropractic treatment modalities operate is provided.
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December 1984