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)

This study compares 2 groups of sterilized women: 1) a group of 118 sterilized women who requested reversal between 1978 and 1984 at the Radboud University Hospital in the Netherlands and 2) 116 matched controls, who did not request reversal. The reason for the request for reversal in 89 cases (75%) was a new partner and in 26 cases (22%) the wish for more children with the same partner. Women who regret being sterilized usually do so soon after the procedure. The mean length of time between sterilization and request for reversal was 3.8 years, measured from the date the patient presented for reversal. In 20% of the patients, the sterilization took place in combination with another gynecologic or obstetric procedure, such as abortion, prolapse operation, cesarean section, or an operation for ectopic pregnancy. This combination, although clearly arranged to save the patient another anesthesia, bears the risk of making the sterilization not a well-considered and free choice. 27 of the patients reported that their relationship at the time of sterilization was already poor; some of the women said they had kept silent about their marital problems fearing that otherwise they would not be sterilized. Another alarming discovery was that 12 of the patients were sterilized after their divorce under the age of 30 years. The reason for requesting a reversal of sterilization was a divorce and a new partner in 3/4 of the cases.
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PMID:Women regretting their sterilization. 375 96

Feelings of regret seem to occur frequently after sterilization, but are mostly short-lived. Women in a test group who asked for reversal did so, on the average, after 3.8 years. This is a major operation and should be discussed thoroughly and, if possible, avoided, to keep requests from increasing. 118 patients who asked for reversal were compared with 116 control patients matched by sterilization date. The reversal group was sterilized at a much younger age, and over 8 times as many had other gynecological procedures at the same time as the control group. The reversal group altered their marital status after sterilization at a higher rate than the control group; both groups had the same number of children at the time of sterilization. Out of the control group, only 1 patient out of 88 reported guilt feelings to the family doctor after a child died. 1/5 of the reversal patients were operated on at the time of other gynecological or obstetrical surgery: 12 abortions, 6 prolapse operations, 4 cesarean sections, and 2 operations due to extrauterine pregnancy. These occurred in only 3 women in the control group. This combination of sterilization and gynecological problems should be avoided, with patients following their doctors' advice. However, patients should have more time to think things over and should not be pressured into sterilization, especially since sterilization can be performed in a clinic under local anesthesia. Reversal should not be encouraged.
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PMID:[Regret after sterilization in women]. 396 Jan 88

This paper reports a case of ectopic abdominal pregnancy following total hysterectomy and reviews the literature. Pregnancy following total hysterectomy is a rare event. Ectopic pregnancy following supracervical hysterectomy can be explained in view of the remaining patent cervical canal. In cases of total hysterectomy (abdominal or vaginal) two important factors to be considered are the persistence of a fistulous tract from the vaginal apex to the peritoneum and the prolapse of the fallopian tube into the vagina, creating a patent tract for spermatozoa. As long as some ovaries remain, the possibility of ectopic pregnancy must be entertained in the differential diagnosis of acute abdomen in a female.
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PMID:Abdominal pregnancy following total hysterectomy. 666 40

Efforts are underway to reduce the incidence of maternal mortality in the world, and concern is increasingly being expressed about the incidence of maternal morbidity. Maternal morbidity can be classified as 1) obstetric morbidity (direct, indirect, or psychological); 2) gynecological morbidity (direct, indirect, or psychological); and 3) contraceptive morbidity. Maternal morbidity has a debilitating effect on families and, thus, on entire societies. The complications leading to morbidity include ectopic pregnancy, spontaneous abortion, obstructed labor, abruptio placentae, severe postpartum hemorrhage, and uterine rupture. The longterm effects of these complications include uterine prolapse, urinary fistulas, and Sheehan syndrome (amenorrhea, failure of lactation, and infertility). In addition to conducting research to determine the extent and varieties of morbidity encountered in a population, a program to combat morbidity should 1) include an educational program for potential clients, 2) improve client confidence through the provision of necessary services like sanitation and of screening services, 3) network with other organizations providing services, and 4) incorporate proper epidemiological and record-keeping procedures.
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PMID:Reproductive morbidity. 765 38

Laparoscopic surgery appears now to be not just a series of simple modifications to operative techniques, but more truly a revolution. This is due to three factors: the simultaneous diagnosis of lesions, establishment of the prognosis and actual treatment: greater respect for the anatomy and physiological processes; the shift in the theatre of operations which is now represented by the pelvis itself and not the operating room we were used to. This surgical revolution has achieved a number of indisputable advances, especially where the adnexa are concerned. Tubo-peritoneal infertility, of course, for which Raoul Palmer developed laparoscopy; the approach relies on a thorough knowledge of the tubal condition. Ectopic pregnancy where laparoscopic treatment has become the standard. Ovarian cysts which raise the specific problems of discovering, and even more important, overlooking malignancy. Endometriosis for which surgical treatment has become appropriate again thanks to endoscopy. This revolutionary cycle is not yet complete for subperitoneal surgery is now being addressed. Hysterectomy, so highly symbolic for the gynecologist, is now regularly carried out in this manner. Even cancer surgery may now employ endoscopy, with second-look laparoscopy for ovarian cancer and above all lymphadenectomy techniques which were developed for a large part in France and will no doubt bring about a total change in the strategies for surgical treatment of cancer. Once the technical difficulties have been resolved radical hysterectomy has the potential to become the reference thanks to its precision and radicality. Prolapse too can draw benefit from endoscopic surgery. This is already the case for colpocervical suspension and other factors concerning prolapse are under study. We must not forget that this surgery must not only comply with the standard rules for surgery, but must also benefit from regulated and rigorous training. Collaboration with the engineers and equipment manufacturers is yet another new element with which French medicine is not yet very familiar.
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PMID:[Operative laparoscopy: genuine surgical advance or simple temptation by the feasible?]. 803 2

One encounters a variety of radiopaque foreign objects when reviewing plain film radiographs of the abdomen. Recognizing such devices can offer important clues about a patient's medical history. Accordingly, intrauterine contraceptive devices (IUCD), tubal sterilization, varicoceles, inferior vena cava (IVC) filtration, and vaginal pessaries are discussed with reference made to an IUD, tubal sterilization clips, embolization coils for bilateral varicoceles, an IVC filter, and a vaginal pessary in five attached anteroposterior radiographs of the lower abdomen and pelvis for five different patients. IUCDs confer long-term, passive, reversible, and inexpensive protection against unwanted pregnancy. They may, however, induce menstrual complications as well as an increased risk of pelvic inflammatory disease and ectopic pregnancy. They can also be spontaneously expelled from the uterus without being noticed by the client. An IUCD increases the risk of spontaneous abortion unless removed in cases where intrauterine pregnancy occurs. Complications at the time of insertion include pain, syncope, and uterine perforation. Tubal sterilization is an effective, though largely irreversible method of contraception. Complications include an increased risk of ectopic gestation in the event of pregnancy and the usual risks of hemorrhage, infection, injury to adjacent structures, and anesthesia-related complications. A varicocele is a dilation of the pampiniform venous plexus of the scrotum. They are more often unilateral than bilateral, occurring in up to 20% of men most often on the left side. Although most cases are probably insignificant, varicoceles can decrease sperm count and motility and cause abnormal morphology. Correction of varicoceles has been shown to improve sperm quality and can increase the chances of fertility. Percutaneous venous embolization techniques have recently been developed to that end. Procedural risks include perforation of the vein, intimal dissection, inadvertent embolization of vessels via collateral channels, and reactions to contrast media. IVC filters are a feasible alternative treatment for deep venous thrombosis and pulmonary embolism among patients in whom anticoagulants are contraindicated or for those in whom anticoagulation therapy has failed. Introduced via the femoral or jugular veins, they are permanent metallic devices placed within the lumen of the IVC to filter thrombi which migrate from the deep veins of the lower extremities. Contraindications to IVC filter insertion include severe coagulopathy and thrombosis involving all venous access routes, while complications include hematoma at the insertion site, migration or tilting of the device due to poor anchoring in the IVC wall, and vena cava obstruction. A pessary is a prosthetic device used to support pelvic structures when their natural support is lacking. They are usually made of plastic or rubber and inserted into the vagina to aid in the non-operative treatment of uterine prolapse, proctoceles, and cystoceles. They must be properly fitted and removed every few months for cleaning.
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PMID:Radiology rounds. Intrauterine contraceptive device. 821 57

Acute pelvic pain in the female patient can have myriad presentations and, depending on the diagnosis, profound consequences. In the pregnant patient with pelvic pain or bleeding, an ectopic pregnancy must be first excluded. Ultrasound is important in determining the size and location of the ectopic pregnancy, and presence of bleeding, which in turn helps guide treatment decisions. Subchorionic or subplacental bleeds in an intrauterine pregnancy may also present with vaginal bleeding with consequences dependent on gestational age and size of bleed. In the postpartum female suspected to have retained products of conception, sonographic findings may vary from a thickened endometrial stripe to an echogenic mass with associated marked vascularity, often mimicking an arterial-venous malformation. In the nonpregnant patient, early diagnosis and treatment of ovarian torsion can preserve ovarian function. Other causes of peritoneal irritation may also cause acute pelvic pain including a ruptured hemorrhagic cyst or ruptured endometrioma. When pelvic inflammatory disease is suspected, imaging is used to evaluate for serious associated complications including the presence of a tuboovarian abscess or peritonitis. While leiomyomas of the uterus are largely asymptomatic, a leiomyoma that undergoes necrosis, torsion or prolapse through the cervix may be associated with acute severe pain or bleeding. The imaging features of these and other important clinical entities in the female pelvis will be presented.
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PMID:Emergency gynecologic imaging. 1885 41