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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The value of colpo-cysto-urethrography (CCU) in female stress- and urge incontinence was measured. In a prospective series of 172 consecutive females with stress- or urge incontinence, CCU was performed and assessed with regard to no suspension defects, anterior defects, or posterior defects, respectively. Six months following operative repair for stress incontinence, CCU was repeated in 97 patients and compared with operative success. CCU was of minor value in the differentiation between stress- and urge incontinence. In stress incontinence, CCU was of greater value for the preoperative planning of operative technique, vaginal or abdominal, but could be omitted when pelvic examination did not disclose genital prolapse, as this excluded posterior suspension defects at CCU. Postoperative CCU was of minor value, and poorly correlated to operative success or failure. Stress incontinence with anterior suspension defects was best treated by abdominal colposuspension, even when complicated by genital prolapse. With no suspension defect at CCU, vaginal and abdominal repair were equally good alternatives. Posterior suspension defects had the lowest cure rate.
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PMID:The value of colpo-cysto-urethrography in female stress- and urge incontinence and following operation. 377 82

In an epidemiological health survey, 515 45-year-old women were interviewed about urological problems, particularly incontinence. A pelvic examination was also conducted on 509 of the women. Twenty-two per cent or 114 women stated that they experienced incontinence, which took the form of stress incontinence in 75%, urge incontinence in 11% and a mixture of the two in 14%. Only 14 women, 3% of all the women interviewed, desired medical treatment for incontinence. In the incontinent women, the pelvic examination significantly more often revealed a cystocele, uterine prolapse or impaired function of the levator muscles. No correlation was found between an enlarged uterus and incontinence. In 211 women with one or more of these findings at the gynaecological examination, the frequency of incontinence was 35%; in 298 women with no pathological findings, the frequency was 15%. The frequency of urinary incontinence was not increased in women with higher parity or in postmenopausal women.
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PMID:Urinary incontinence in 45-year-old women. An epidemiological survey. 378 95

Twenty-one patients were reviewed five to 12 years after silicone rubber perianal suture for rectal prolapse. Sixteen patients (76 percent) were continent with control of prolapse and two patients (9 percent) suffered only from occasional prolapse or incontinence. Rebanding for silicone cutout or fracture was required in four patients and a second rebanding operation was needed in two. Silicone rubber perianal suture for rectal prolapse stands the test of time and might be recommended for more widespread use in younger patients.
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PMID:Late results of silicone rubber perianal suture for rectal prolapse. 380 26

Rectal prolapse occurs mostly in the geriatric female patient and can be a very disabling condition. The etiology is intussusception of the rectosigmoid secondary to excessive and prolonged straining. Medical therapy for this disease process is not helpful and patients will require a surgical procedure. The two best surgical procedures for the correction of rectal prolapse are low anterior resection of the rectosigmoid and proctopexy. A few patients who are unfit for laparotomy may require the Thiersch Wire procedure. Two unresolved problems after surgical therapy are continuing constipation and incontinence. Constipation is treated by dietary measures, stool softeners, and periodic enemas. Laxatives are to be discouraged. Incontinence in patients with rectal prolapse improves in most patients after a procedure to correct the prolapse. In those patients in which incontinence persists, no form of therapy has been found to be uniformly successful.
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PMID:Rectal prolapse. 383 Mar 77

Most of the surgical procedures proposed for the treatment of fecal incontinence associated with prolapse are associated with considerable morbidity and mortality. We used a modified Thiersch procedure with a Silastic mesh implant (Dow-Corning 501-3) on a series of 12 patients over a period of 2 1/2 years. Nine patients obtained excellent control of the prolapse and incontinence. Only one patient was dissatisfied with her operation. The excellent results reported by other authors using a Silastic mesh implant have been reproduced in this small series of patients. This relatively safe and simple operation may still be the procedure of choice for fecal incontinence and rectal prolapse.
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PMID:Modified Thiersch procedure with silastic mesh implant: a simple solution for fecal incontinence and severe prolapse. 395 40

This is a retrospective study evaluating 179 patients with complete rectal prolapse operated on at the University of Minnesota affiliated hospitals from 1953 to 1983 with no mortality. One hundred and two of 138 patients who underwent abdominal proctopexy and sigmoid resection were followed from six months to 30 years with a recurrence rate of 1.9 percent. Twenty-two of the 33 patients who underwent perineal rectosigmoidectomy were followed from six months to three years with no recurrence. Nine patients who underwent abdominal proctopexy and subtotal colectomy because of colonic inertia associated with procidentia were followed from one to six years with no recurrence. Patient interviews revealed that 72 to 80 percent considered their results as excellent or good. Incontinence or persistent constipation caused the remaining patients to consider their results fair or poor, despite anatomic correction of the prolapse. Abdominal proctopexy and sigmoid resection was more likely to result in improvement of continence than was perineal rectosigmoidectomy.
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PMID:The management of procidentia. 30 years' experience. 397 14

The results of abdominal mobilization of the rectum and repair of the pelvic floor behind the anorectal junction are reported in 23 patients with rectal prolapse, being accompanied by some form of anal incontinence in 12. Within 20 months, on the average, three patients had recurrent prolapse. Two thirds of the patients with incontinence for solid and/or fluid feces were cured for prolapse as well as incontinence. Seven became constipated, while 14 were fully satisfied. Seven of eight patients with a highly reduced tone of the external sphincter before surgery had a marked improvement after surgery. The results do not differ greatly from those after the suspension operation or repair of the pelvic floor in front of the rectum, despite being more physiologic, but suggest that simultaneous suspension and abdominal repair of the pelvic floor may avoid the need for a secondary postanal repair from below in patients with persistent incontinence after suspension surgery. A controlled, randomized trial is advocated.
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PMID:Rectal prolapse and anal incontinence treated with a modified Roscoe Graham operation. 401 21

Urinary stress incontinence was treated by the Marshall-Marchetti-Kranz (MMK) procedure in 42 and by Burch coloposuspension in 44 women. All were assessed preoperatively and for greater than 1 year postoperatively, both clinically and by urodynamic tests. Cure of incontinence was achieved to a similar extent by both procedures, in 71% after the MMK and 79% after the Burch operation. Results were better than average if there was no prolapse and if the bladder was stable preoperatively.
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PMID:Marshall-Marchetti-Krantz procedure and Burch colposuspension in the surgical treatment of female urinary incontinence. 405 46

Sixteen selected patients with rectal procidentia, anal incontinence, or both were treated by the insertion of a Dacron impregnated Silastic sling at the Lahey Clinic between 1981 and 1984. The indications for operation were incontinence in 14 patients, procidentia with incontinence in one patient, and procidentia alone in one patient. No operative deaths occurred. Immediate complications included urinary retention in the three patients and hematoma in one patient. Late complications included infection, requiring removal of the Silastic sling in four patients; however, two of these patients underwent subsequent successful reinsertion of the sling after control of local sepsis. Among patients for whom follow-up data were available, satisfaction with the results of this procedure were excellent in two patients, good in six, fair in two, and poor in one. Sphincter repair with a Silastic sling is a safe, reliable alternative in the treatment of selected patients with anal incontinence or rectal procidentia.
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PMID:Sphincter repair with a Silastic sling for anal incontinence and rectal procidentia. 405 2

A pessary is rarely needed to treat prolapse or incontinence. In certain cases, the anatomical conditions are unsuitable for the use of this device which is sometimes poorly tolerated in the long term. The authors propose an original solution of a vaginal cast made from silastic foam. The technique of making the cast, its advantages and disadvantages are described together with the modifications which it is able to induce on the urodynamic parameters. This technique will certainly be useful in certain rare indications.
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PMID:[Technic and use of a silastic vaginal mold: urodynamic evaluation]. 405 78


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