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

The authors describe a new per vaginam method devised to treat both uterine prolapse and associated or latent urinary incontinence in menopausal women. After amputation of the cervix, the uterine isthmus is brought down below the urethra and kept in this position by the uterosacral ligaments, which are separated from the uterus and sutured to the subpelvic fibrous tissues. This is followed by the subtotal colpectomy in women who have given up sexual intercourse and by partial colpectomy of a special design in those who wish to pursue sexual activity. Thirty-one operations of this kind have been performed with immediate success in 29 and delayed success in 12.
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PMID:[Treatment of genital prolapse by transposition of the uterine isthmus below the urethra (author's transl)]. 719 20

The Neugebauer-Le Fort operation or partial colpocleisis is a safe, simple and rapid procedure for the repair of uterine prolapse in elderly women who are poor surgical risks. The operation was performed in 188 women with total procidentia. Good anatomic results were obtained in 90.7% of the women. Late complications were rare, including recurrence of prolapse (3 patients), and urinary incontinence (12 patients). Immediate postoperative complications were not common. The main disadvantage is the inaccessibility of the uterus in case of postmenopausal bleeding (2 patients). Partial colpocleisis has a place in the armamentarium of the gynecologist treating isolated cases of prolapse of the uterus, and may be indicated in the elderly women with total procidentia who is a poor surgical risk an in whom general anesthesia is contraindicated, and who is certain she wants to forego sexual intercourse.
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PMID:The Neugebauer-Le Fort operation: a review of 118 partial colpocleises. 719 40

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

Six women with advanced uterine prolapse underwent examination by drip infusion urography. A new hypothesis is proposed for the pathogenesis of bilateral hydroureteronephrosis: the ureters are entrapped by the hiatus genitalis, not against the bladder but against the fundus of the fully prolapsed uterus. Drip infusion urography should include an exposure area of about 15 centimeters below the pubis, and at least one exposure should be taken with the patient in the standing position. Thus, the hourglass appearance of the prolapsed bladder will not be overlooked and would be helpful in explaining the cause of the hydroureteronephrosis.
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PMID:Total uterine prolapse causing hydroureteronephrosis. 736 55

This study determines whether or not fibrin deposits occur more frequently in patients who had gynecologic surgical procedures for prolapse of uterus and treated with estrogens than in those in a control group. 11 women were given 50 ug of ethinyl estradiol daily for 3 weeks while 8 women were given 200 ug ethinyl estradiol daily for 12 days. The remaining 157 women who received no hormonal treatment served as controls. The women were examined postoperatively by the Iodine fibrinogen uptake test and phlebography according to the method of Nylander. The chi-square test with Yate's correction was used for data analysis. Fibrin deposits were found in 6 of the 11 women who received 50 ug ethinyl estradiol for 3 weeks and in 4 of 8 women receiving 200 ug for 12 days. Corresponding figures for the control group were 18 of 157, p 0.001. Estrogens should not prescribed to patients preoperatively. Estrogen therapy should be discontinued in patients who are about to be operated.
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PMID:Estrogens and postoperative thrombosis evaluated by the radioactive iodine method. 740 6

At reversal of sterilization, the results of microsurgical efforts appear very consistent with most surgeons reporting similar or better results. In this discussion of reversal of tubal sterilization, focus is on standard techniques for mid-tubal anastomosis and special problems encountered during anastomosis (ampullary anastomosis with major luminal disparity, prolapse of ampullary mucosal folds, tubal clamps, difficulties in passing a splint into the isthmus, fimbrial anastomosis, serious peritoneal defects, tubes ligated at 2 or 3 sites, and the difficult anastomosis). After the appendages and uterus have been mobilized and stabilized on a plastic platform in the pouch of Douglas, the tubes can be inspected and carefully measured. Recently, in procedures at the Hammersmith Hospital in London all tubal anastomoses have been performed during the early luteal phase in the attempt to collect an ovum from the tube. Presence of an egg in the tube may be regarded as an indication that the ovum pickup mechanism is intact. Prior to beginning any tubal dissection, the cervix is occluded using a modified Shirodkar clamp and sufficient dye is injected transfundally to achieve isthmic filling without overdistension of the tube. The fundal needle is disconnected, but it is left in situ in the uterus. This is because the fundal needle is also used to demonstrate adequate tubal patency at the conclusion of the procedure. Following injection of the dye, the operating microscope is moved into position, and the entire length of the tube is examined under low-power magnification. The mobility of the tube and any pathologic change are reassessed.
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PMID:Reversal of tubal sterilization. 744 4

In the last 110 cases of genital prolapse examined, IVU formed part of the prior urological investigation. 14 cases of ureteropelvic distension were thus discovered (13.6% of cases). In ten cases the prolapse was sufficiently largee as to exterioris the uterus or bring it to of the vulva. In 13 cases out of 15 a larg cystocoele was visible at the vulva with a full bladder. The precise urological consequences of these prolapses was greater than had been expected: 13 cases of incomplete vesical retention, 4 of unilateral ureteropelvic distension and 10 bilateral, including 3 only symmetrical. Bilateral high distension was in general associated with a large cystocoele. Severe renal insufficiency was seen in only one case, and 5 moderate elevations in blood urea, in 5 cases. The mechanism of such ureteropelvicalyceal distension is not clear, but the prolapse is directly responsible, since mechanical (insertion of a pessary) or surgical reduction of the prolapse restores the upper excretory tract to normal. Renal function recovered all the more rapidly when the prolapse had been present for a shorter time.
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PMID:[Genital prolapse and ureteropelvic distension]. 745 43

The "Vidoson 635-S" high-speed ultrasonographic unit was used by the authors to examine 465 women pregnant in the second and third trimenons for the occurrence of bleeding. The following findings were obtained: NAD (no abnormality discovered), Placenta praevia totalis, Placenta praevia partialis lateralis, Placenta praevia partialis marginalis, deep adherence of placenta, early detachment of placenta, and uterus rupture. - Placental displacement was observed by repeated checking in 57 of 196 placentas with pathological findings. Placental prolapse observed between the twelfth and 20th weeks of pregnancy was defined as "early" Placenta praevia, and the birth canal was left in about 50 per cent of those cases. The authors' view about such phenomenon was that while the point of placental adherence was unchanged, some change was undergone by the uterus wall of which that part changed position to which the placenta adhered, the latter dislocation being caused by enlargement of the upper third of the passive uterus region and its part in the formation of the uterus cavity.
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PMID:[Use of high-speed ultrasonography for differential diagnosis of gestational haemorrhage, following formation of placenta (author's transl)]. 746 26

We report on a patient with a total prolapse of the uterus and extensive local vaginal carcinoma. The different therapeutic possibilities are discussed with reference to the case in hand. The primary therapeutic considerations encompass surgery, radiotherapy or chemotherapy. Surgery is preferred in early cases especially when the tumor is located high in the vagina. Due to early invasion of bladder or rectum and particularly in older patients primary radiotherapy is very common. In this case radiotherapy and not surgery was performed in spite of total uterine prolapse, thus achieving a NED-stage of tumor together with retraction of the prolapse.
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PMID:[Extensive vaginal carcinoma with total prolapse--a therapeutic problem]. 774 Aug 52

At B.Y.L. Nair Hospital in Bombay, India, physicians compared data on 10 women who had received 252 mg quinacrine in pellet form transcervically followed by a total hysterectomy within 6 weeks of quinacrine insertion with data on 23 women who had received 324 mg quinacrine in pellet form transcervically followed by a total hysterectomy 6-20 weeks after insertion. All the women were already scheduled for a hysterectomy for nonmalignant conditions. The researchers also included data on seven other women who had received 100 mg quinacrine earlier. They wanted to examine the effect on tubal occlusion of intrauterine quinacrine by dose and time. They conducted hysterosalpinograms before insertion, prior to hysterectomy, and on the fresh surgical specimens of the tubes and uterus. Women receiving the 324 mg dose had a much higher tubal closure rate than those receiving a 252 mg dose (100% vs. 50%; p = 0.01). With the 325 mg dose, all intramural tubal segments and 58.8% of isthmic segments had histologic stage II or III closure. With the 252 mg dose, 55% of intramural tubal segments and 5.9% of isthmic segments had stage III closure. A quinacrine-hysterectomy interval of at least seven weeks resulted in a better tubal closure rate than that of less than seven weeks (22/24 vs. 9/16; p = 0.01). Clinical conditions (pooled data; myomas, dysfunctional uterine bleeding, cervical intraepithelial neoplasia, and prolapse) were positively associated with tubal closure (31/40 vs. 9/40; p = 0.02). Quinacrine dose had a more significant effect on tubal closure than quinacrine-hysterectomy interval (standard discriminant function coefficient, 0.55 vs. 0.35).
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PMID:Clinicopathologic study of fallopian tube closure after single transcervical insertion of quinacrine pellets. 774 35


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