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

Seventeen cases of spontaneous, partial or total vaginal rupture, in pregnant ewes, involving the dislocation and herniation of the intestines and uterus, were studied. Four of them also had a uterine torsion, and three of these recovered after treatment. In the remaining 13 cases the condition of the uterus was unknown. The lesion always consisted of a dorsolateral tear in the vagina with a partial or total perforation of the wall close to the uterine cervix. The affected animals were all in normal body condition. Their average age was just under five years, and most were carrying twins. Most cases occurred approximately one week before expected lambing. None of the cases was observed to have a vaginal prolapse before the vaginal rupture. Histological examination of one case revealed scar formation in the vaginal wall close to the rupture, which appeared to be due to an earlier inflammatory process or injury. The circulatory disturbance in the reproductive organs caused by the uterine torsion potentially weakens the vaginal wall. This weakness, in combination with excessive tenesmus resulting from increased tension in the uterine ligaments, and in some cases possibly with a lower vaginal resistance due to previous scarring, may be of aetiological significance in spontaneous vaginal rupture.
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PMID:Spontaneous vaginal rupture in pregnant ewes. 1002 83

The authors, after of the different techniques mostly used in surgery to correct the urinary incontinence, illustrate their original technique adapted for UI caused by genital prolapse. At present, the Marchall-Marchetti-Krantz's and Goebell-Stoeckel's techniques are commonly used in this field. Since uterus lowering is the main cause of cystocele and subsequent urinary incontinence, their new technique has the principal purpose of holding the uterus permanently in it natural position. The authors limited experience is actually of only five cases; all the patients underwent an intervention of cystopexy according to their new technique described. The results obtained encourage and promote the usage of such a method, consenting them to go on with their experience.
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PMID:[Surgical methods in the management of urinary incontinence caused by genital prolapse: a review]. 1005 16

Dynamic MRI of the pelvis was performed in 16 young nulliparous, normally continent women. The examinations were performed in the dorsal decubitus position. Using Turbo-Flash scans (acquisition time: 2.1 sec), sagittal images were obtained at rest and with maximal pelvic straining. The sacral promontory-subpubic (PSP) and the subpubic-subsacral axes (SPSS) measured respectively 80.5 degrees and 30 degrees in relation to the horizontal plane, without a statistically significant difference between rest and straining. A marked deformation of the posterior wall of the bladder was observed in 13 cases and the bladder neck was frontally deformed in 10 cases. With straining, the base of the bladder did not descend beyond 15 mm below the SPSS, and the cervix stayed at least 14 mm above the SPSS. These were established as the normal criteria for pelvic assessment. 20 multiparous patients (mean age 65 years), referred for urinary stress incontinence and/or prolapse, were investigated using the criteria previously established. The PSP, SPSS, and vaginal angle measured 80.95 degrees, 30.57 degrees, and 69.69 degrees respectively in relation to the horizontal. No statistically significant difference was detected between straining and rest conditions. The angle of the uterus in relation to the horizontal was 57.36 degrees at rest and 65.90 degrees in straining with a difference that was statistically significant. In six patients, the base of the bladder descended more than 1.5 cm while straining and in seven patients the cervix descended at least 1.4 cm below the SPSS while straining, both statistically significant differences. Overall, between our control and study populations, there were no significant differences between PSP and SPSS measured on straining and at rest. However, differences were detected in the vaginal angle, bladder-base position, and cervical position. These results suggest the potential substitution of MRI for colpocystography.
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PMID:Dynamic magnetic resonance imaging of the female pelvis: radio-anatomy and pathologic applications. Preliminary results. 1039 14

We report eight cases of benign uterine smooth muscle neoplasms with unusual growth patterns and intramural dissection. All the patients in our series were of reproductive age or perimenopausal (range, 36-51 years) and had an enlarged uterus or a pelvic mass, with the exception of one lesion that was found incidentally in a patient treated for uterine prolapse. Three also had abnormal uterine bleeding. On gross examination, the lesions had an unusual appearance and were often lobulated and irregular with indistinct margins. On microscopic examination of all the lesions in this study, a dominant benign smooth muscle tumor was associated with intramural dissection of the myometrium by fascicles of neoplastic smooth muscle. Of the eight cases showing intramural dissection, four were intramural dissecting leiomyomas; three were examples of intravenous leiomyomatosis; and one was a multinodular leiomyoma with hydropic degeneration. We excluded cotyledonoid dissecting leiomyomas from the study. In two of the three cases of intravenous leiomyomatosis, extrauterine extensions in continuity with the intramural components were noted at surgery and on gross examination. Intramural dissection of the myometrium by a benign smooth muscle tumor is one additional possibility to be considered in the differential diagnosis of leiomyosarcoma and low-grade stromal sarcoma.
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PMID:Dissecting leiomyomas of the uterus other than cotyledonoid dissecting leiomyomas: a report of eight cases. 1047 62

Among all the emergency situations which may arise across the field of obstetrics and gynaecology, there are a small number which call for urgent practical steps to be taken in order to safeguard the life of the mother or the baby or both. The three such complications dealt with in this chapter consist of one prior to delivery--prolapse of the umbilical cord; one during delivery--shoulder dystocia; one following delivery--acute inversion of the uterus. All of the above require prompt action by well-trained staff and may involve the active and efficient co-operation of a range of different health care professionals. It is critically important that staff are fully aware of the procedures to be followed and the chain of command which will ensure that they are followed as efficiently and successfully as possible.
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PMID:Emergencies in operative obstetrics. 1078 59

A 7-year-old Brahman cow was diagnosed as suffering from chronic foetal mummification of unknown aetiology, concurrent cystic ovarian disease, prolapse of the 2nd cervical ring and chronic cervicitis. Repeated treatment with prostaglandin F2alpha and oestrogen failed to resolve the mummification. A hysterotomy was performed via an incision in the dorsolateral vaginal wall. Good exposure of the uterine horn was achieved and mild post-operative complications were observed. Colpotomy can be regarded as an alternative surgical approach to the moderately enlarged bovine uterus.
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PMID:Hysterotomy by a colpotomy approach for treatment of foetal mummification in a cow. 1085 83

Congenital bladder exstrophy affects 1 in 125,000 to 250,000 females. Consisting of absence of the anterior abdominal wall with exposure of the ureteral orifices, failure of pubic symphysis fusion, and deficient anterior pelvic diaphragm musculature, bladder exstrophy is frequently associated with genital prolapse. Pregnancy may be complicated by recurrent urinary tract infections, preterm labor, mild procidentia, and malpresentation. Due to the rarity of the condition, there is a corresponding scarcity of obstetric literature regarding management during pregnancy. We report the case of a young woman with surgically repaired bladder exstrophy who developed genital prolapse. The uterus was suspended using a sacral colpopexy utilizing a Gore-Tex graft. Subsequently, the patient became pregnant and delivered a healthy male infant at 35 weeks' gestation via cesarean section (without recurrence of the genital prolapse postpartum). Sacral colpopexy to correct genital prolapse associated with bladder exstrophy may preserve fertility in young patients.
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PMID:Uterine prolapse associated with bladder exstrophy: surgical management and subsequent pregnancy. 1090 32

Lines of turkeys selected for rapid growth and high meat yield have an increased incidence of prolapse of the oviduct compared with unselected or traditional strains of turkeys. The development of the reproductive system and changes in plasma estrogen concentrations were compared in sire line and traditional turkeys with the aim of identifying any morphological or hormonal differences that could be associated with the high incidence of prolapse in the male line. Four turkeys from each strain were killed weekly from 0 to 7 wk postphotostimulation, and samples from prolapsed birds were obtained from field cases. There were no differences in the rate of development of the ovary, oviduct, uterus, vagina, sphincter ani muscle, or muscular cord of the ventral ligament between the two strains that could predispose the sire line to prolapse. Histological investigation of the uterus, vagina, muscular cord of the ventral ligament, and sphincter ani muscle 5 wk postphotostimulation in traditional, sire line, and prolapsed sire line turkeys did not reveal any differences that could be associated with prolapse. No prelay peak in plasma estradiol concentration was observed in either strain, and there was no evidence to suggest that plasma estradiol was higher in the sire line compared with the traditional turkeys. It was concluded that prolapse of the oviduct in sire line turkeys was not associated with any anatomical abnormalities or high plasma estradiol during reproductive development.
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PMID:Development of the reproductive system in turkeys with a high or low susceptibility to prolapse of the oviduct. 1105 58

Rectoceles are best repaired via a perineal approach. The transperineovaginal approach provides access to the outer side of the rectocele: the rectal hernia is repaired with two or three purse-string sutures and suture of the rectal fascia. Levatorplasty, performed without narrowing of the vagina, reinforces the repair and strengthens the lax pelvic floor. Unilateral sacro-spinofixation of the vagina is a useful adjunct to restore normal anatomy. Rectocele repair via a perineovaginal approach has a low morbidity rate and achieves good functional results. Concomitant sphincteroplasty may be performed in the case of symptomatic rupture of the anal sphincter, treating as well urinary incontinence or prolapse of the uterus. Surgery is indicated in symptomatic rectocele when retraining the pelvic floor by biofeedback and medical therapy have failed to relieve symptoms. There are no clear predictive factors of outcome and the patient must be informed about the risk of persisting symptoms or failure.
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PMID:[Surgical treatment of anterior rectoceles in women. The perioneal-vaginal approach]. 1110 53

We retrospectively studied 77 laparoscopic sacral colpopexies performed from June 1996 to May 1998. Suspension was reinforced with two strips of synthetic mesh. Five patients had previously undergone hysterectomy and 4 others had experienced failure of surgery for prolapse of the uterus. Laparoscopy was performed in 83 women with symptomatic prolapse of the uterus. Six cases required conversion to laparotomy because of technical difficulties. All other 77 patients underwent laparoscopic sacropexy using anterior and posterior mesh reinforcement. Subtotal laparoscopic hysterectomy was associated in 60 cases, laparoscopic Burch colposuspension in 74 and levator myorraphy using the vaginal approach in 55. Operative time decreased from 292 to 180 minutes as the surgeon gained experience. The main operative complications were one rectal and two bladder injuries. Three patients required reoperations for haematoma or hemorrhage. One patient complained of chronic inflammation of the cervix and another experienced rejection of the posterior mesh 6 months after the operation. Mean follow up was 343 days. Three other patients required reoperation: one for a 3(rd) degree cystocele and two for recurrent stress incontinence. The conclusion of this study is that laparoscopic sacrocolpopexy is feasible. Operative time and postoperative complications are related to the surgeon's experience but remain comparable to those noted in laparotomy. Long term assessment is required to confirm the results of this procedure.
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PMID:[Laparoscopic sacral colpopexy: short-term results and complications in 83 patients]. 1113 10


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