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

Short TI inversion recovery magnetic resonance imaging (STIR-MRI) with spin echo (SE) T1-and T2-weighted images of the pelvis was investigated to evaluate its usefulness in detecting and characterizing endometriosis. Thirty-one women suspected of having the disease were studied in detail. MR findings with and without STIR-MRI were correlated with the results of laparotomy (27 women) and laparoscopy (4 women). Surgery revealed endometriosis in 29 women (17 ovarian chocolate cysts, 22 intestinal adhesions, 14 cul-de-sac obliterations and 12 adenomyosis). The other two women did not have endometriosis (uterine prolapse in one and submucosal leiomyoma in one). An ovarian chocolate cyst was diagnosed when a T1-elongated lesion showed shading, loculus or a low intensity rim on SE MR images, and a low intensity rim on STIR-MRI. Only 12 of the 17 chocolate cysts and neither of the two hemorrhagic corpus lutein cysts were correctly diagnosed on SE MR images, whereas 18 of these 19 cysts were correctly diagnosed because of the low intensity rim on STIR-MRI. In the pathological analysis, the rim was found to be a fibrous capsule and there were many macrophages which phagocytized hemosiderin. For the assessment of ovarian chocolate cysts, accuracy improved from 63.2% to 94.7%. As for the adhesion between the intestine and the uterus, specificity improved from 61.9% to 90.5% and accuracy improved from 67.7% to 93.5% when STIR-MRI was used. For the assessment of the cul-de-sac obliteration, accuracy improved from 67.7% to 83.8%, although chi 2 analysis showed no significance. The major factors for the improved accuracy with STIR-MRI are the decrease of the motion artifact owing to the suppression of the fat signal, decreased chemical shift artifact and accurate differentiation of fat from hemorrhagic component. Therefore, STIR-MRI is a useful and reliable procedure and should be used together with SE T1-, T2-weighted images for the assessment of endometriosis.
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PMID:[Detection and characterization with short TI inversion recovery MR imaging]. 780 15

In southern India, obstetricians conducted a retrospective study of 33 destructive obstetric operations performed between 1981 and 1991 at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) in Pondicherry. The mothers were all under 40 years old. The operations included 27 craniotomies, 2 decapitations, 3 eviscerations, and 1 cleidotomy (surgical division of the fetus' clavicle to facilitate delivery). Women with shoulder presentation and hand or cord prolapse tended to arrive at the hospital before full cervical dilatation so obstetricians preferred performing a cesarean section, regardless of viability of the fetus, explaining the low rate of decapitation and evisceration. Yet, obstetricians and primary health center physicians referred most women with cephalic presentation rather late in labor with indications of an important rupture or ruptured uterus. Reasons for craniotomy were hydrocephalus (52%), obstructed labor (19%), arrest of aftercoming head (7%), cord prolapse (5%), persistent meuto-transverse position (4%), and placental abruption (4%). 3 cases had to undergo Cesarean section after other procedures failed. 6% of the women suffered vaginal laceration. 3% experienced fever, urinary tract infection, episiotomy, wound infections, or paralytic ileus. 1 woman died from postpartum hemorrhage and another died from severe postoperative shock after undergoing lower segment cesarean section. The incidence rate of destructive operations was lower than that of other Indian hospitals (all deliveries, .094% vs. .24-.283%). These findings suggested that obstetricians and primary healthy center physicians need to be trained in doing confidentially performed craniotomy, decapitation, or evisceration in rural areas so they do not refer mothers at high risk of ruptured uterus and subsequent death while in transmit to a referral center.
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PMID:Destructive operations in modern obstetrics in a developing country at tertiary level. 794 38

Trends in hospitalizations for selected gynecologic diagnoses per 100,000 women/year associated with hysterectomy were analyzed using the Finnish hospital discharge register data, including each inpatient episode in all Finnish hospitals, from 1971 to 1986. The diagnoses selected were uterine leiomyoma, genital prolapse, the group 'other disorders of the uterus' including endometriosis, and bleeding disorders. These were the most common indications for hysterectomy in Finland from 1987 to 1989, when national data on surgical procedures were included in the hospital discharge register. Trends in the incidence of hospitalizations for malignant neoplasms were also analyzed, although < 10% of hysterectomies are due to gynecological malignancies. Hospitalizations for leiomyoma, endometriosis and bleeding disorders have statistically increased, significantly, among women aged 45 years or more between 1971 and 1986, whereas hospitalizations for prolapse and malignant neoplasms did not show a significant change. Probable incidence of hysterectomy before 1986 was estimated on the basis of the annual incidence of hospitalization for leiomyoma, and hysterectomy for leiomyomas was estimated from the hospital discharge register data of 1988. According to hospital discharge data in 1988, 90% of the hospitalized women with leiomyoma underwent hysterectomy and half of the hysterectomies were performed for leiomyoma. The estimated incidence of hysterectomy increased from 311/100,000 women to approximately 400/100,000 from 1971 to 1986 (slope = 6.5 hysterectomies/100,000/year; 95% C.I. for slope (4.8:8.2)). As the epidemiology of most of the underlying disorders for indications leading to hysterectomy is poorly known, epidemiological studies should consider the determinants of the occurrence of indications independently whether hysterectomy has been performed or not.
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PMID:Five gynecologic diagnoses associated with hysterectomy--trends in incidence of hospitalizations in Finland, 1971-1986. 796 47

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

Twenty-two cases of intravenous leiomyomatosis (IVL) of the uterus were examined at the Royal Women's Hospital, Melbourne, within a 22-year period. The mean age of the patients was 46 years (range, 23-66). Nine patients presented with a pelvic mass, nine with abnormal uterine bleeding, and one with prolapse of the uterus. In three cases, the presenting features were unknown. Surgical exploration confirmed the presence of a uterine mass (mean size, 7.8 cm) which in seven cases extended into the broad ligament. In only 11 cases was involvement of the myometrial vessels obvious on gross examination. However, no extension into the iliac veins or inferior vena cava was found. In seven cases, the tumor involved to a minimal degree the immediately adjacent or contiguous myometrial veins, and the diagnosis of IVL was made incidentally on microscropic examination. Of the 16 patients with follow-up (mean, 7.5 years) all are now disease free. Five years after the diagnosis of IVL, one patient (case 10) had a pulmonary smooth-muscle tumor resected. All 22 patients were treated by surgery alone, and to date none have died from disease. Our findings support the benign biologic behavior of IVL even in the presence of metastases.
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PMID:Intravenous leiomyomatosis of the uterus: a clinicopathologic study of 22 cases. 811 51

40 women (average age 65 years) who underwent vaginal hysterectomy and colpoperineoplasty for total prolapse of the uterus with (26) or without Stamey's procedure (14), were tested urodynamically before and 14 months after surgery. 6/14 (43%) women were clinically and urodynamically continent after vaginal hysterectomy and anterior and posterior repair, compared to 20/24 (83%) after an additional Stamey's procedure. The pressure transmission ratio was significantly improved after both procedures (p = 0.05). These results indicate that anatomic correction does not suffice to correct latent stress urinary incontinence in patients with uterovaginal prolapse. Endoscopic suspension of the bladder neck seems to be a successful method in these cases. The transmission ratio was improved by both operative procedures. The results show, that colpoperineoplasty alone cannot correct stress incontinence in patients with total prolapse of the uterus. In such cases Stamey's procedure is a successful method.
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PMID:[Treatment of stress incontinence with total prolapse of the uterus]. 811 71

Pergolide (LY127809, CAS 66104-23-2), a dopamine agonist for the treatment of Parkinson's disease, was evaluated for toxicity in acute, subchronic, and chronic studies. Acute toxicity tests using oral, intravenous and intraperitoneal routes were conducted in rats, mice, rabbits, and dogs. The acute oral median lethal doses (MLD) ranged from 8.4 to 33.6 mg/kg in Wistar and Fischer 344 rats, and from 54.0 to 87.2 mg/kg in ICR mice. Oral doses of 20 and 25 mg/kg produced no mortality in rabbits or dogs, respectively. The MLD by the iv route ranged from 0.59 to 0.87 mg/kg for Fischer 344 rats and from 11.6 to 37.1 mg/kg for ICR mice. The predominant signs of toxicity in the acute studies included hyperactivity, poor grooming, ptosis, aggressive behavior, increased gnawing activity, tremors, convulsions, and emesis. In the subchronic and chronic studies, Fischer 344 rats, B6C3F1 mice, and beagle dogs were administered pergolide either by gavage or in the diet for up to 1 year. Daily doses in these studies ranged up to 20 mg/kg for rats, 45 mg/kg for mice, and 5 mg/kg for dogs. The predominant treatment-related effects seen in these studies were attributable to the pharmacologic activity of pergolide. These consisted primarily of CNS-mediated clinical signs in rats and dogs, weight loss or decreased weight gain, emesis in dogs, and inhibition of lysis of corpora lutea with a corresponding increase in the weight of the uterus and ovaries. Pergolide treatment was not associated with any specific target organ toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Preclinical toxicology studies with the new dopamine agonist pergolide. Acute, subchronic, and chronic evaluations. 819 91

The objectives of this study were to determine if infants delivered with severe acidemia (cord umbilical arterial pH < 7.0) had short-term neurologic effects and whether infants with persistent bradycardia who received cardiopulmonary resuscitation (CPR) in the delivery room would be at greatest risk for subsequently developing neonatal seizures. Forty-seven infants (39 term, 8 preterm) delivered with severe fetal acidemia were studied. The mean (+/- S.D.) for pH, PaCO2, and base deficit for the 47 infants was 6.86 +/- 0.11, 97 +/- 22 mm Hg, and -17 +/- 4, respectively. Labor complications were common and included placental abruption in 8, ruptured uterus in 4, cord prolapse in 3, fetal heart rate decelerations in 12, and other (n = 14). Most infants were delivered via emergency cesarean section (n = 29). Delivery room interventions included oxygen and bag/mask ventilation only (n = 20) and intubation and ventilation (n = 22); 7 of 22 infants received CPR and epinephrine for persistent bradycardia (heart rate < 80 beats/min despite ventilatory support). Five infants required no intervention. Eight infants (17%) had seizures; 6 of these infants received CPR in the delivery room. Short-term outcomes were abnormal in 7 of 8 infants (i.e., death in 5, abnormal neurologic examination at discharge in 2). In 39 infants without seizures, 32 had transient neurologic abnormalities (i.e., irritability, hyperreflexia, proximal hypotonia) which resolved by discharge, and 2 had abnormal and 5 normal examinations.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Severe fetal acidemia: neonatal neurologic features and short-term outcome. 821 39

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

A case of primary squamous cell carcinoma in situ of the endometrium is reported here. The in-situ nature of the tumor, with involvement of the surface mucosa and extension into superficial endometrial glands and its incidental association with prolapse uterus are notable features.
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PMID:Primary squamous cell carcinoma-in-situ of the endometrium--a case report. 822 85


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