Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-five patients have been referred for the assessment and treatment of faecal incontinence. Incontinence was associated with previous anal trauma in 49 cases: 13 occurred after vaginal delivery, 32 were associated with anal operations and in 4 severe perineal trauma occurred after road accidents. Other causes were: idiopathic incontinence in 18, persistent incontinence despite successful rectopexy for prolapse in 10, diabetic neuropathy in 5 and in 13 the cause was not identified. Conservative treatment by control of diarrhoea, physiotherapy or electrical therapy was often successful in patients with minor incontinence. Fifty-six patients have been treated surgically. Complete continence was achieved in 67 per cent of patients treated by postanal repair and in 61 per cent by sphincter reconstruction. We believe that postanal repair is the treatment of choice for idiopathic incontinence and incontinence after rectopexy or anal dilatation. Sphincter repair should only be performed with a covering colostomy and is the treatment of choice for recent or long standing division of the external sphincter ring.
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PMID:Management of faecal incontinence and results of surgical treatment. 687 36

The classical abnormalities found in patients with complete rectal prolapse--wide deep pelvic peritoneal pouch, unsupported redundant rectum with long mesorectum, weak pelvic floor and anal sphincters--are probably effects rather than causes. "Pelvic floor weakness" must explain few cases, since old age, multiparity, uterine prolapse, are found in a minority. The fact that operations which do no more than fix the rectum in the sacral hollow are most successful and often cure incontinence if present is the best evidence that lack of support of the rectum is a prime cause of prolapse--but it is equally likely that such operations work by preventing intussusception, now regarded as the likely mechanism (rather than sliding herniation) of complete rectal prolapse. It is suggested that rectal prolapse is usually due to straining at defaecation against a closed levator-ani--anal-sphincter mechanism, producing prolapse of the rectum rather than incontinence of faeces. Such straining may be obsessive on the part of patients with psychosocial problems and reduced awareness that the rectum is empty; or it may be due to attempted defaecation with a full rectum in patients with reduced rectal sensation, failure of the afferent arc of the ano-rectal reflex and consequent absence of levator-ani--anal-sphincter relaxation.
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PMID:Observations upon the aetiology and treatment of complete rectal prolapse. 693 Feb 24

Fifty-six patients were treated for rectal prolapse or incontinence. Rectal prolapse was present in 32 patients and was associated with fecal incontinence in 24 (75 per cent). Incontinence without prolapse was present in 24 patients, 12 of whom were less than 40 years old. Rectopexy was used for treatment of rectal prolapse. Surgical treatment of fecal incontinence was by postanal repair; external sphincter reconstruction and surgery was advised only if control of diarrhea and electrical therapy had been of no benefit. Rectopexy was completely successful at controlling rectal prolapse in all cases, and only four of the 20 (20 per cent) patients with incontinence and prolapse remained incontinent after rectopexy alone. Incontinence was completely controlled by postanal repair in 58 per cent of patients and by external sphincter repair alone or in combination with postanal repair in 67 per cent. Using a combination of therapies 45 of 48 patients who were initially incontinent were improved (94 per cent), and 42 of the patients have complete control of defecation (87 per cent).
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PMID:Results of treatment for rectal prolapse and fecal incontinence. 702 89

Clinical examination, cystometry, combined pressure-flow studies and colpocysto-urethrography were used to investigate 369 consecutive patients referred with symptoms of genital prolapse or urinary incontinence. The incidence of urinary incontinence in women seeking hospital investigation and therapy was 240/100 000 women per year. Three hundred and three complained of urinary incontinence, 21% of these had urge incontinence, 36% both urge and stress incontinence and 43% stress incontinence. There was no correlation between previous obstetric history and present symptoms, the severity and objective signs of incontinence or the urodynamic findings. Correlation was found between urge incontinence and the cystometric finding of overactive detrusor function. Stress incontinence as a symptom was well correlated with low-pressure micturition. Pelvic examination did not differentiate between patients with different types of urinary incontinence. Cystometry was essential for the investigation of vesical dysfunction. Urodynamic studies and colpocysto-urethrography were useful in the diagnosis of outlet disorders and suspension defects.
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PMID:Urinary incontinence and genital prolapse in the female: clinical, urodynamic and radiological examinations. 708 96

The clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy were studied in 73 patients, of whom 29 had incontinence due to urethral sphincter incompetence. Pre-and post-operative urodynamic assessment was made and follow-up continued for 2 years. Symptoms of urge incontinence, stress incontinence and prolapse were significantly reduced following surgery. Urodynamic data showed no significant change. The incidence of detrusor instability and voiding difficulties was not increased.
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PMID:Clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy for prolapse with and without incontinence. 708 3

Fifty patients with uterovaginal prolapse were treated by transvaginal retropubic urethropexy to correct the anatomic defect of their urethrovesical axis. Urodynamic studies were routine in the preoperative assessment. Forty patients had anatomic sphincteric incontinence. Forty-one (82% of the 50 patients treated were totally continent of urine after a follow-up of 12 to 36 months. The complications and results of this procedure are comparable to those of other abdominal retropubic procedures for urinary incontinence. The suggestion is made that, in the surgical management of symptomatic uterovaginal prolapse, this procedure, which can be easily performed in conjunction with any vaginal operation, may be an alternative to a combined vaginal and abdominal approach.
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PMID:Transvaginal retropubic urethropexy. The "revised Pereyra procedure": report of 50 cases. 719 16

The study has resulted from comparing urethral pressure curves measured with the use of a catheter with two micropressure gauges in 34 continent and 100 incontinent women. Two types of tracing were obtained: first of all at rest and then with the woman coughing repeatedly. Of the different parameters that were measured at rest only one seems to be advantageous over the others. That is the pressure at the maximum closure which becomes less with incontinence and with ageing. The curves that have been produced with effort make it possible to analyse what happens to this pressure when maximum closure is effected. This always rises in patients who are continent and always lessens in patients who are incontinent. The ratio of these two values, Pc with maximum effort over Pc at maximum rest, allows an index of continence (IC) to be drawn; and which conveys the ability of the sphincter apparatus to adapt itself, and which gives a quantitative value to female continence. Its practical application makes if possible to confirm the diagnosis and adapt the therapy to be used in many incontinent patients in whom other tests have been unrevealing, and to unmask incontinences that have been masked by prolapse and to identify possible future incontinent patients.
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PMID:[An urethromanometric study using micro-pressures gauges for female urinary incontinence. A definition of the index of continence. Applications (author's transl)]. 720 Jan 5

Sixty-three patients with complete rectal prolapse and/or faecal incontinence have undergone anal manometry and the results have been compared with an equal number of age- and sex-matched controls. Maximal basal pressure (MBP) and maximum squeeze pressure (MSP) were measured before and at four months and a year after treatment. The anal pressures of normal subjects are presented. Patients with rectal prolapse alone had normal anal pressures, whereas patients with incontinence with or without prolapse had significantly lower basal and squeeze pressures than controls. Successful surgical treatment of prolapse or incontinence did not produce significant change in anal canal pressures, whereas the combination of pelvic floor exercises and a continence aid was associated with a significant rise in MSP.
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PMID:Manometric evaluation of rectal prolapse and faecal incontinence. 721 42

Intermittent transcardial prolapse and/or gastroesophageal invagination take place in some 16% of upper digestive tract endoscopies. The clinical picture may correspond to episodic epigastric symptomatology, massive digestive haemorrhage, and recurrent paroxystic heart rhythm disturbances. Prolapse can be recorded with a spot camera by means of an easy technique, so that its association with hiatal hernia, gastroesophageal reflux, peptic oesophagitis, etc. can be studied. Treatment is that applicable to cardiac incontinence and peptic oesophagitis.
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PMID:[Intermittent retrograde transcardial gastroesophageal prolapse. Clinical picture. Endoscopic aspects. Radiographic study]. 724 19

Vaginaefixatio sacrospinalis vaginalis is an operative procedure whereby the vaginal stump is affixed to the sacrospinal ligament of one side of the vaginal route. Intercourse is not inhibited by this operative method. This technique was performed on 81 patients, starting in 1959, with a follow-up period of up to 10 years. In 78 cases the indication for operation was a true vaginal vault prolapse following hysterectomy; in three cases it was a prolapse of the uterus and the vagina because of complete incompetence of the visceral fascia of the pelvis. The vaginal vault prolapse was alleviated by the colpopexy technique in all patients. However, coexisting cystocele, rectocele, and enterocele and related incontinence remained in a few instances.
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PMID:Long-term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis). 731 7


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