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

In 22 patients with anterior bladder suspension defect as judged by colpocysto-urethrography (CCU) a vaginal repair was undertaken. In 14 patients urinary stress or urge and stress incontinence was the indication for operation, and in 8, genital prolapse. At follow-up more than 6 months postoperatively the CCU was repeated and a clinical evaluation undertaken. A normalization of the CCU was obtained in only 6 patients and 10 showed a less severe suspension defect. Nine of 14 patients were cured of incontinence. Only 3 of these had a normal follow-up CCU. Improvement of bladder suspension defect was not the sole responsible factor for postoperative continence. Urinary incontinence developed postoperatively in 2 of 8 patients operated on solely because of symptomatic genital prolapse. Very high cure rates for urinary incontinence have been reported following a colposuspension operation. A vaginal repair is not recommended as first-choice operation in incontinent females with anterior bladder suspension defects, if a CCU may be undertaken and the colposuspension technique is mastered.
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PMID:The effects of vaginal repair on anterior bladder suspension defects. A radiological and clinical evaluation. 406 Oct 61

40 cases of recurrent incontinence after cure of incontinence or secondary to cure of a prolapse were investigated 6 months or more after the initial operation by means of uroflowmetry, cystometry and resting and stress urethral profile. A hyperactive bladder was observed in 20 per cent of cases, 50 per cent of cases presented sphincter incompetence and 75 per cent had a defect of transmission. In 37 per cent of cases, the post-operative incontinence was due to persistent defect in transmission and required a second operation, while in 40 per cent of cases, the cause of this incontinence was complex and required medical treatment associated with re-training. 2 cases of incontinence were also associated with severe disorders of micturition. Urodynamic investigations appear to be essential for the analysis of the frequently complex problem of post-operative incontinence. When compared with the pre-operative data, they provide a better understanding of the mechanism of action of each type of operation and guide the surgical indications.
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PMID:[Urodynamic analysis of postoperative urinary incontinence in women. Apropos of 40 cases of incontinence recurring after treatment for incontinence or secondary to treatment for prolapse]. 408 1

The surgical treatment of 409 patients with genital prolapse is described. The procedure, which invariably included hysterectomy, concentrated upon one of the major complaints of these patients, i.e., their stress-incontinence. Special care was taken not to shorten the urethral length. Two hundred of these patients were available for a relatively long follow-up period ranging from 7 to 13 yr. Within the first post-operative year, stress-incontinence appeared to have been cured in 90% of the patients. The long-term results show that the percentage of continent women has diminished to 81, which is an important finding probably not attributable to the surgical technique. In the long term, the second most frequent complaint of low back pain has recurred in 29% of our patients.
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PMID:A vaginal approach to the treatment of genital prolapse. 636 80

From 1953 to 1982, 257 patients with complete rectal prolapse were operated upon. To the procedure described by Orr, we have added mobilization of the rectum prior to its suspension and eliminated the pouch of Douglas, and nylon strips have been used for suspension in most patients. There were 57 male and 200 female patients. Ages ranged from 11 to 90 years. Sixty-one patients had already undergone surgery for rectal prolapse with another procedure and prolapse had recurred. The postoperative course was uneventful in 96 per cent of patients. Two patients, aged 79 to 83 years, died of cardiac failure. Follow-up of 115 patients ranged from five to 23 years. Recurrent rectal prolapse was observed in 4.3 per cent of the patients in whom nylon strips were used to suspend the rectum. In 136 patients anal incontinence was associated with rectal prolapse. Normal continence was restored in 84.1 per cent of 107 patients with rectopexy alone and in 64.2 per cent of 14 patients who underwent rectopexy and anal sphincter repair. It is concluded that rectopexy to the promontory with nylon strips after mobilization of the rectum is a safe and efficient procedure for the treatment of rectal prolapse.
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PMID:Rectopexy to the promontory for the treatment of rectal prolapse. Report of 257 cases. 637 1

We have investigated changes in colonic motility and anorectal function in 6 continent patients with a rectal prolapse; in 10 incontinent patients with rectal prolapse and in 16 patients with idiopathic faecal incontinence compared with 26 age and sex match controls. A history of incontinence, irrespective of a prolapse, was associated with significantly lower anal squeeze pressures (P less than 0.05), a deficient anorectal angle (P less than 0.05), failure to retain a balloon containing more than 250 cm3 of air in the rectum (P less than 0.01) and increased sigmoid motility (P less than 0.02) compared with controls. By contrast patients with rectal prolapse and no incontinence had normal anal pressures, a normal anorectal angle and normal sigmoid motility, but transit was delayed. These results indicate that abnormal sigmoid motility is commonly associated with faecal incontinence and that slow transit constipation is frequent in patients with rectal prolapse who are continent.
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PMID:Abnormalities of colonic function in patients with rectal prolapse and faecal incontinence. 649 61

Conventional incontinence surgery was performed in 41 consecutive female patients despite the finding of motor urge incontinence. The patients were reinvestigated 6 months to more than 2 years after operation. Twenty-eight of the patients also had the symptom stress incontinence. Seventeen patients had coexisting symptomatic genital prolapse and were operated on without prior pharmacological treatment. The remaining 24 patients were all resistant to parasympatholytic treatment. The choice of operative procedure was based on vaginal examination as well as bladder suspension defect as demonstrated on voiding-colpo-cysto-urethrography. Subjective cure and improvement rate was 73%. At follow-up, 30% of the patients had normal detrusor reflex control, and a significant improvement in urge incontinence as well as frequency of micturition and nocturia was observed. Probably the primary treatment in females with motor urge incontinence should be pharmacological. However, in patients with symptomatic genital prolapse as well as in patients with ineffective medical treatment, conventional incontinence surgery seems to be well indicated in the absence of neurological disease-providing the patient has an associated bladder suspension defect.
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PMID:Incontinence surgery in female motor urge incontinence. 663 11

The anatomy and pathophysiology of epispadic urethra and bladder is presented. The operative procedures used for correction of the genital deformity and coexisting incontinence are described. The controversial points concerning the staging of procedures, the choice of optimal time and technic is discussed, with the results reported in recent series. In the Surgical Clinic of the Institute of Mother and Child 15 children with epispadias were treated during 1969-1979. There were 12 males and 3 females. 13 children had complete peno -pubic epispadias, with prolapse of bladder mucosa in two of them. Thery were totally incontinent. Amongst two boys with partial penile deformity 1 had bladder control. IVP showed no abnormalities, excluding solitary kidney in one boy. Cystography revealed wide bladder neck and short urethra with dilation of its posterior part; transient vesico-ureteral reflux was observed in 2 patients. Two children with prolapsing bladder mucosa were operated on when 6 and 14 months old. The age of remaining 13 children at the time of surgery was: between 3,5 and 6 years in 7, 6-9 years in four, the oldest two were 10 and 12. The Cantwell -Young reconstruction of the urethera was usually performed, with mobilizing of corpora cavernosa. In 5 children it was combined with wedge resection of anterior bladder neck and in 4 with infra-pubic wedge excision of dilated anterior urethera and Mayo plasty of external sphincter. The Young- Dees operation was performed twice, as a secondary procedure for treatment of total incontinence. During follow up the gradual improvement of bladder control was observed. Continence was achieved in 5, including 2 children after Young- Dees plasty. 3 children have stress incontinence, another 3 are dry at night and at rest, but wet during normal activities, 1 is totally incontinent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Surgical treatment of epispadias]. 667 81

Thirty-four patients with complete rectal prolapse were treated by Lahaut's operation in which the mobilised rectosigmoid was implanted in the posterior rectus sheath. There were no prolapse recurrences, but one patient died postoperatively. Of the 12 patients with incontinence, 11 were improved by the procedure. Lahaut's operation is a simple and effective procedure which avoids the potential problems associated with a surgical implant of Ivalon or Teflon.
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PMID:Lahaut's operation for rectal prolapse. 669 93

Difficulty in rectal emptying, incontinence, solitary ulcer with bleeding, physical finding of lax puborectalis musculature, obtuseness of the anorectal angle, and bulging of the anterior rectal wall into the proctoscope suggest incontinence amenable to puborectalis plication. Puborectalis plication sphincteroplasty is useful in correcting patulousness and incontinence attendant with rectal procidentia, as well as certain cases of lax or nonresponsive puborectalis muscle related to idiopathic collagen disorders. Anorectal burning after correction of patulousness is related to irritable bowel aggravation, as occurred in one of my nine patients. Despite the short follow-up, preliminary results seem to warrant puborectalis sphincteroplasty in selected patients.
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PMID:Puborectalis sphincteroplasty for anal incontinence. 671 Jan 96

Prophylactic gynecologic examinations were carried out in 218 women-workers of a cement plant. The most frequent diseases were: retroflexion of the uterus (55.5%), inflammation of the ovary (50.45%), erosion of the vaginal part of the uterus (41.8%), prolapse of the vaginal walls (39.45%), incontinence (35.32%) and Trichomonas vaginalis (18.7%). The extensive prevalence of the diseases imposes a need to carry on preventive examinations of women employed in cement industry. The authors indicate that certain diseases are obviously due to deficient hygiene.
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PMID:[Preventive gynecological examinations of women employed in the cement industry]. 686 41


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