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

Rehabilitative therapy of the perineum (FKT, SEF and biofeedback) represents an efficient method in the treatment of urinary stress incontinence without resorting to a complete uro-genital prolapse, as in patients with urethral instability and/or incontinence. One hundred twenty-one women, 55 with urinary stress incontinence (USI), 20 with urge incontinence (UI) and 46 suffering from both types of incontinence, underwent rehabilitative therapy. On each patients the following tests were carried out: an internal test, a urodynamic test (uroflowmeter, PPU, cystomanometry and pessure/flow study), a meter UEC, situated at the bladder neck, anterior and posterior urethra, both clinostatic and orthostatic, urine test with urinoculture and a pap-test. The aim of this study is that of establishing if it is possible a) to simplify the rehabilitative sitting using only FKT with weekly treatment; b) to treat women suffering from urge incontinence or from both types, but with bladder stability (standard cystomanometria) with FKT and Ditropan (1 tablet 3 times daily for weeks therapy). One group of patients underwent rehabilitative therapy while another group underwent traditional therapy, for a minimum of 12 sitting, using also electric functional stimulation (SEF). Of 121 women who underwent rehabilitative therapy, 90 (74.4%) were healed, 30 (24.7%) improved and one (0.9%) showed no signs of improvement. Patients treated with FKT, or FKT and made as good if not better grogress than those who attended more sittings and/or underwent SEF.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Rehabilitation therapy in the treatment of female urinary incontinence. Our experience with 121 patients]. 770 13

From May 1986 to May 1992, 55 patients with genitourinary prolapse were treated by total hysterectomy, sacral fixation using a prosthetic band and colposuspension. The mean age was 55.5 years (range: 38-78 years). Ten patients (18.8%) developed early postoperative complications: 2 wall haematomas, one surgical revision for haemorrhage, one case of haematemesis secondary to a duodenal ulcer, one intestinal obstruction due to dehiscence of the peritonealisation, two cases of acute urinary retention, one case of complete urinary incontinence, one septic shock and one wall abscess. Three patients (5.4%) developed late postoperative complications: intestinal obstruction secondary to a mesenteric band, one incisional hernia, and one case of pelvic pain. The mean length of hospital stay was 8.9 days (range: 7-25 days) and the mean follow-up was 36 months (range: 6-72 months). The anatomical result was excellent (complete correction of the prolapse and absence of recurrence) in 96.4% of cases. In terms of the functional results, 3 patients (5.4%) remained dysuric and 5 (9.1%) have persistent stress incontinence, either moderate (3 cases) or disabling (2 cases). Marked sphincter insufficiency was demonstrated on the urethral pressure profile in these last two cases. The combination of total hysterectomy with vaginal opening and sacral fixation using a prosthetic band prevents the risk of subsequent disease of the remaining cervix and does not appear to increase the risk of infection or the postoperative morbidity. Without advocating systematic hysterectomy in the sacral fixation technique, we nevertheless believe that it is preferable to perform total hysterectomy rather than supraisthemic hysterectomy when this procedure is indicated.
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PMID:[The treatment of genito-urinary prolapse with promonto-fixation using a prosthetic material combined with complete hysterectomy: complications and results apropos of a series of 55 cases]. 771 68

Perineal rehabilitation is an appropriate alternative to surgery in the treatment of urinary female incontinence. The most important factors influencing the success of this technique is the ability of the patient to identify correctly the muscles of the pelvic floor, to strengthen this muscles using exercises, electrical stimulation and biofeedback, to contract voluntarily the pelvic floor musculature during stress or sensation of voiding for having a preventive effect on loss of urine, and also to change, if necessary, the micturitional and drinking customs. Some conditions are required to complete a good result: strong motivation of the woman, ability of the physiotherapist or the midwife, quality of care and follow-up of the physician who must clearly know the place of this conservative treatment in selected patients, particularly in moderate stress incontinence, without important prolapse, urge incontinence, pregnancy and post-partum, two conditions in which this technique must have a preventive and curative efficiency.
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PMID:[Rehabilitation of female urinary incontinence]. 772 36

A series of 203 abdominal operations for correction of genital prolapse performed between 1985 and 1992 is reviewed. We performed abdominal sacral colpopexy systematically associated with a Burch retropubic uretropexy. Resection of the peritoneum of the pouch of Douglas, and myorraphy of the levator ani were performed according to the findings of the clinical examination. 94 patients underwent a sacral colpopexy using a single suture of the cervix to the promontory, 41 had an anterior mesh, 33 had a suture associated with an anterior mesh, and 35 had 2 meshes (anterior and posterior). 96% of the patients were between 41 and 65 years old, and 90% were perimenopausal. 78.6% were multiparous and 32% had a neonate weighting 4kg or more. Urinary stress incontinence was isolated in 38%, and associated with another disorder in 57.8%. Urodynamic studies revealed detrusor instability in 12.3% of patients, and sphincter incompetence in 15.2%. Urinary tract insection was the most frequent postoperative complication (61.5%). One month post-surgical evaluation showed good anatomic results in 94.2 to 100% of cases, and good functional results in 56 to 70.5%. The longterm results were anatomically good in 86.7 to 100% of the patients, and functionally good in 53.3 to 80.5% (mean follow-up = 32.5 months). Results were not significantly different between the 4 surgical procedures.
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PMID:[Surgical treatment of genito-urinary prolapses by abdominal approach. Results in a continuous series of 203 operations]. 773 98

This is a review article about the colposacropexy and the colpopromontoriopexy in the treatment of vaginal prolapse. We reviewed the literature through the eyes of a urologist dealing with genuine stress incontinence. The treatment of genuine stress incontinence without sphincterdeficiency consists in the correction of the anterior compartment prolapse. Preoperative it is important to examen the middle and the posterior compartment of the vagina in order to achieve good postoperative results. Most urologists cure genuine stress incontinence with an abdominal approach. The combination of a colposuspension and a colpopromontoriopexy is an operation that corrects anterior, middle and posterior compartment prolapse by the same approach without significant more complications or bloodloss.
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PMID:Colpopromontoriopexy. 778 40

The own method of uterine prolapse treatment with the use of beeswax pessary is presented. The described method is applied in cases where general health conditions do not allow to perform the surgery. The study revealed that the beeswax is a good material to make a vaginal pessary. It's great plasticity allows individual modelling in compliance with anatomical conditions of treated patient. That provides the proper stability of uterine position. The risk of possible urinary stress incontinence due to uterine reposition is also diminished.
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PMID:[Beeswax pessary in conservative treatment of uterine prolapse]. 778 62

Four significant complications of Teflon injections for stress urinary incontinence are reported in 22 women and eight men. Three of the complications included periurethral abscess, urethral diverticulum, and periurethral Teflon granuloma with urethral wall prolapse occurred in women. These complications needed surgical excision and further surgery for stress incontinence, in two patients the outcome was good. Among the female patients the cure rate for stress incontinence with Teflon injection was only 18% in the 5-year follow-up. One other complication, a Teflon cyst, occurred in a male who had previously undergone radical retropubic prostatectomy. Only two of the eight men (25%) who received Teflon injections had maintained improvement after 1 year.
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PMID:Complications of Teflon injection for stress urinary incontinence. 792 Jun 69

The authors describe a new surgical technique to reduce the prolapse of genitals and urinary organs. In retrospect, we studied 36 women--between the ages of 59 and 85--who had been hospitalized from 1988 through 1990 at the Ospedale di S. Anna of Rome and from 1991 through May 1994 at the Ospedale Sandro Pertini of Rome. Twenty-eight out of 36 patients presented a III prolapse of the uterus with cystorectocele; 4 patients had a prolapse of the cupola vaginae after hysterectomy; 4 patients presented a prolapse of the residual stump after sub-total hysterectomy. In addition, 8 out of 36 patients presented a stress incontinence. The technique described adopts a special nylon lace to fix prolapsed organs to the fascia musculorum rectorum abdominis. Its ease and brief execution time, together with the complete lack of relapse, have convinced the authors to promote the diffusion of this technique, which allows relief from these extremely distressing complaints often not fully cured with traditional techniques.
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PMID:[A new surgical technique to reduce genital-urinary prolapse]. 798 26

Laparoscopic surgery for genuine stress incontinence (GSI) and vaginal vault prolapse is in an early stage of development. There is a great deal of talk about the subject at meetings and postgraduate courses; however, very little has been written on the subject and there are virtually no controlled studies to compare outcomes with the conventional surgical methods that will be mentioned in this review. Most laparoscopic surgeons will emphasize that laparoscopic repairs are performed either 'exactly like' or in a similar fashion to open abdominal techniques, but there is still a need for data to prove that outcomes are equivalent.
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PMID:Laparoscopic procedures for incontinence and prolapse. 803 8

It is difficult to make a choice among the many surgical procedures designed for the correction of stress urinary incontinence by the vaginal route because their results have not been correctly compared. The Bologna (B) operation uses two flaps from the anterior vaginal wall that are anchored to the abdominal wall; the Ingelman-Sundberg (IS) operation is a suburethral sling made from two transplants from the pubococcygeus muscle. A prospective randomized study has been carried out in order to compare these two procedures. A selection of cases has been based upon the presence of genuine or potential stress incontinence, genital prolapse and available tissues (anterior vaginal wall excess and palpable pubococcygeus muscles) for both procedures. No significant difference was noted for clinical results (91.7% and 93.7% of patients cured by the B and IS operations, respectively) or for transmission rate gain at 3 months and 1 year. Maximum urethral closing pressure was maintained in both treatment arms. No significant postoperative complication or persistent dysuria occurred. The Bologna procedure is best indicated in case of frank anterior vaginal excess, and the Ingelman-Sundberg procedure when strong anterior parts of pubococcygeus muscles are available. Both are excellent in the cure of stress incontinence associated with genital prolapse.
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PMID:Comparison of the Bologna and Ingelman-Sundberg procedures for stress incontinence associated with genital prolapse: prospective randomized study. 811 72


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