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

Six hundred and twenty-one hysterectomies were performed at National Women's Hospital, Auckland, during 1975. Abnormal vaginal bleeding was the clinical indication in 50.72% of the cases. Fibroids, pelvic mass, prolapse, stress incontinence and cervical neoplasia were the indication for 45.88% of the cases. Total hysterectomy was performed in 618 (99.5%) patients whilst sub-total hysterectomy was done in only three cases. Histopathological studies revealed that 567 (91.30%) specimens were pathological and there was multiple pathology in 55.87% of the specimens. Leiomyomas were present in 278 cases (44.76%); microleiomyomatosis in 178 specimens (22.66%); endometrial hyperplasia in 139 specimens (22.33%) adenomyosis in 87 cases (14.00%); malignant diseases in 76 cases (12.23%); and endometriosis in 40 specimens (6.44%). There were no histological abnormalities in 54 specimens, 8.69% of this series.
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PMID:The pathology of hysterectomy specimens. 28 33

The authors use an autocolpotransplantate in the surgery of the genitale prolapse with urinary stress incontinence (vaginale colpohysterectomy, Manchester-Fothergill-Operation anterior and posterior colporrhaphy). The autocolpotransplantate functions as a subvesical belt which is able to avoid recidivs and also favours the formation of new tissue in the urethro-vesico-vaginale area. The newly formed scarplate is the basis to prevent postoperative vesical continence disorders.
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PMID:[Use of an autocolpotransplant in surgery for genitalia prolapse with urinary incontinence]. 33 25

The most important factors in the management of recurrent stress incontinence in the absence of genital prolapse are proper case selection and the proper choice of surgical intervention. All suitable patients at the Alfred Hospital, Melbourne, since 1965 have been managed by the technic of abdominoperineal urethral suspension, which involves passing two aponeurotic bands, cut from the anterior abdominal wall, through the paraurethral attachment of the posterior pubourethral ligament on either side. It is our conviction that urinary continence control in the human female is effected by this upper urethral anatomy and that for a technic to be successful it must exert its influence at this precise point. It is suggested that this technic is the procedure of choice in the management of recurrent stress incontinence.
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PMID:Abdominoperineal urethral suspension: a ten-year experience in the management of recurrent stress incontinence of urine. 55 84

As in different types of stress incontinence the mechanism of the destroyed urethral support is not the same, the principles of their surgical treatment are bound to differ. Generally speaking, the surgical intervention in stress incontinence aims at securing adequate mobility of the lower urinary organs, forming an effective suburethral support, and correcting the elements of the prolapse. Applying these principles in 508 women with stress incontinence having been surgically treated at the University Hospital Department of Gynecology and Obstetrics in Skopje from 1968 to 1976 and followed up at least two years afterwards, the global rate of relapses was 6.1%, by which the best results were obtained by Burch's modified method (2.1%), while after operations after Bonney or Barnett the frequency of relapses was relatively higher (7.1%). Analysing technical details in the carrying out of the above mentioned procedures, the authors plead for a most adequate preoperative preparation of patients, so as to determine and categorize the type of stress incontinence in question and allow the choice of the most appropriate surgical intervention in any given case.
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PMID:[Pathogenesis of urinary stress incontinence and principles of its surgical treatment]. 57 14

Twenty-one women, 11 suffering from both prolapse and stress incontinence and 10 with prolapse only were investigated before and at different intervals after surgical repair of the disorders. The investigations comprised a gynaecological examination, urine culture, observation of residual urine and simultaneous urethro-cystometry including measurement of the urethral pressure profile.--The prolapse patients were operated upon by conventional Manchester technique. The patients suffering from both prolapse and stress incontinence were operated with a combined vaginal-abdominal repair using Lyodura slings.--It was found that the pre-operative urethral pressure at rest was lower in the inconinent-prolapse patients compared with that in patients suffering from prolapse only. After surgery the urethral pressure at rest was significantly decreased in the incontinent-prolapse patients whereas it did not change in patients operated because of prolaspe only.--Prior to the operation, all incontinent-prolapse women had a negative urethral closure pressure at stress. After surgery the closure pressure became positive in all patients and none complained about urinary incontinence. In all patients suffering from prolapse only the urethral closure pressure was positive at stress before as well as after surgery. The functional and the absolute urethral lengths increased in both categories of patients after the operation.
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PMID:Urodynamic studies of women with prolapse and stress incontinence before and after surgical repair. 57 39

Sir Astley P. Cooper, a British surgeon, first described Cooper's ligament in 1841; in 1949 this ligament was, to our knowledge, first used to support prolapse of the vaginal vault. The first preliminary report in 1965 was based on anatomical dissection of 60 autopsy cases and stressed mainly the length, thickness, width, and strength of the Cooper ligament strip and the adjacent fascia overlying the symphysis pubis. The preliminary report suggested that this was indeed a strong fascial support and would support the vaginal vault. Since 1965, some 85 cases have been treated and in each case, since 1965, every effort has been made to incorporate all of the available extra fascial planes in the pelvic structure to add further support to the vaginal vault prolapse. No major complications have been encountered. The risk of infection of Mersilene strips and synthetics is avoided by using homologous Cooper ligament strips and adjacent fascia. No postoperative stress incontinence was encountered in any of the 63 cases.
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PMID:Cooper ligament repair of vaginal vault prolapse twenty-eight years later. 64 93

In a classic article published in 1949 Marshall, Marchetti, and Krantz demonstrated that stress incontinence in women without uterine prolapse could be corrected by a simple vesicourethral suspension. Beginning in 1960 one of the authors (W.E.C.) became concerned about suturing the urethra to the periosteum of the pubis. It occurred to him that use of the upper sutures only to pull up the bladder and hold its anterior wall to the back of the rectus muscles might be just as effective, and this has proved to be so.
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PMID:Modification of Marshall-Marchetti-Krantz operation. 70 23

Thirty patients suffering from stress incontinence of urine following hysterectomy or operation for genital prolapse underwent operation after study of the colpocystogram. This examination, practically painless and free of risk, visualises pelvic visceral kinetics and is felt by the author to be essential. It confirms the existence of stress incontinence, reveals the usual cause, detects associated abnormalities and indicates the appropriate surgical technique. The method of treatment was paramedial or medial fixation of the uterus, vagina or residual cervix to the public promontory, complemented in some cases by excision of the pouch of Douglas or posterior myorraphy. Apart from in certain special cases (irritable tirgone syndrome) the cure of mictional problems can be guaranteed.
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PMID:[The surgical treatment of urinary stress incontinence following hysterectomy or operation for genital prolapse (author's transl)]. 87 23

The work from the School of Broca has made it possible to specify simple techniques which at one and the same time deal with genital prolapse and stress incontinence. These results, which for a long time had been disappointing, seem now to have improved in the last few years. The authors describe a triple operation which is particularly indicated in cases of large cystoceles found in patients suffering from the clinical condition of prolapse.
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PMID:[Our operative strategy in the cure of genital prolapse by high approach]. 88 73

The surgical procedures used, the complications encountered and the results obtained in 549 patients with urinary stress incontinence with or without prolapse and 50 patients with prolapse without urinary stress incontinence are presented. Incontinence was cured in 347 patients, improved in 126, unchanged in 66 and worsened in ten. Seven patients operated on for uterine prolapse developed urinary incontinence after surgery. The overall recurrence of SUI was 12.75%. The introduction of suprapubic bladder drainage has practically eliminated postoperative urinary tract infections and reduced the length of hospitalization from 9.1 to 7.2 days. My experience in 214 patients with suprabpubic drainage demonstratedthe superiority of the Ansari method over the cystocath. The addition of Cantor's bladder neck plication improved the results (cured plus improved) from 80% to 100% in the Marshall-Marchetti-Krantz operation and from 81% to 86% when the Marshall-Marchetti-Krantz operation was associated with an abdominal hysterectomy.
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PMID:A ten-year experience in the evaluation and management of patients with stress urinary incontinence. 96 72


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