Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A comparative study was made regarding the complications of abdominal and vaginal sterilization operations in order to evaluate the efficacy and safety of the 2 procedures. The cases were selected from outpatient departments and family planning clinics of the Patna Medical College (Patna, India) over the 1974-79 period. A preoperative assessment and investigation were performed in all cases. The operations were performed by modified Pomeroy's technique in 300 cases (Group A) by abdominal route and in 300 cases (Group B) by vaginal route. General anesthesia was administered in all cases. Subsequent follow-up was done at intervals of 6 weeks, 3 months, 6 months, 1 year, and up to 5 years. Follow-up attendance was unsatisfactory, but a comparative evaluation of the complications was done in both groups among patients who came for follow-up. Puerperal sterilization cases were excluded from the series. In Group A 149 sterilizations were done with medical termination of pregnancy (MTP) and the remaining were interval sterilizations. In Group B 148 were sterilizations with MTP and the remaining were interval sterilizations. The age varied between 28-42 years. The majority of the patients were more than 4 para in both groups. Pelvic sepsis was more common with vaginal sterilization operations. Complications were as follows in Group A: pyrexia, 30 cases; pain in abdomen, 75; urinary tract infection, 30; sore throat, cough, 60; stitch induration, 90; and wound disruption, 3. For Group B, complications were as follows: pyrexia, 90; pain in abdomen, 30; urinary tract infection, 75; sore throat, cough, 60; tuboovarian mass, 12; wound infection, 45; and persistent temperature rise, 12. The nature of complaints at follow-up for Group A were: leukorrhea, 30; menorrhagia, 60; irregular bleeding, 30; dysmenorrhea, 12; dyspareunia, 9; loss of libido, 9; and incisional hernia, 1. Complaints at follow-up were as follows for Group B: leukorrhea, 45; menorrhagia, 21; irregular bleeding, 60; dysmenorrhea, 75; dyspareunia, 60; loss of libido, 12; abdominal pain, 12; and stress incontinence, 3. In sum, the sterilization operation by abdominal route was much safer compared to the vaginal route.
 ...
PMID:Complications after abdominal and vaginal sterilization operation. 687 69

Uterine procidentia and pelvic-floor hernia are quite common among postmenopausal multiparous Caucasian women. Predisposing factors are age, obesity, childbirth trauma, neurologic disorders, and musculo-fascia weaknesses. Hysterectomy and pelvic floor repair constitute the definitive therapy for pelvic floor hernia and uterine prolapse, but vaginal pessaries made of rubber or plastic can also be of therapeutic value. Pessaries also facilitate preoperative healing of the vaginal or cervical ulcerations which are quite common in longstanding cases of uterine procidentia (third degree prolapse). Common complications of pessary use are vaginal irritation, allergic reactions, leukorrhea and bleeding. Hard pessaries have fewer associated complications. Proper fitting and continued post insertion care are necessary. Unless contraindicated, acid douches and or creams and estrogenic creams should be used with the pessaries. Pessaries should be removed every 6 weeks for cleansing; otherwise, ulceration, superimposed infections, and fistulas could develop. In cases of incarcerated pessaries, the use of estrogenic creams (which improve the condition of the vagina) will easily help remove the pessaries. 3 case reports are briefly discussed to illustrate the management of incarcerated pessaries in elderly women. The patients reported in these cases did not have follow-up care after insertion of the pessary, thus requiring intervention years later. Patients with bleeding problems despite normal cytologic findings should undergo fractional curettage later to rule out malignancy. Although incarcerated pessaries rarely occur, application of estrogenic creams will easily remove them.
 ...
PMID:Management of incarcerated vaginal pessaries. 724 Jun 22