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

Clinical experience with soft synthetic pessary in the conservative treatment of genital prolapse is discussed. No local inflammation or laceration of the vagina, or cervix was seen.
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PMID:[Conservative treatment of descensus and genital prolapse by means of pessaries from permanent-soft plastic]. 95 37

In a review of the effect of gynecological operations on sexual function, difficulties resulting from operative technique and from psychological side effects were discussed. In repair of prolapse of the vagina, operative technique has been considered of crucial importance in influencing the sexual life of the patient. Preoperative clinical assessment rarely gives an accurate picture but can prepare the operator for some unforeseen difficulties. Patients with recurrent prolapse may have to sacrifice a functional vagina in the interest of surgical cure. However, the patient's views on coitus must be sought before surgery. Vaginal hysterectomy as an alternative to abdominal surgery can result in a rapid return to normal sexual function. Anterior colporrhaphy, the most commonly performed prolapse repair, may narrow the vagina from a too wide excision of vaginal epithelium. Some degree of shortening was thought to be almost invariable. Posterior colpoperineorrhaphy has been the major cause of vaginal stenosis after prolapse repair. The operation should be avoided but a technique by Simmons avoids the useless skin bridge, the main cause of postoperative dyspareunia. In anticipation of continuing postmenopausal atrophy, undue tightening of the vagina should be avoided. Sexual difficulties resulting from episiotomy frequently result from inaccuracy of siting and repair in favor of speed and dispatch. However, some postpartum difficulties in return to sexual function can result from emotional factors. Relief from postoperative contracture after vaginal operations may be obtained by several means including William's operation for vaginal atresia. Other gynecological procedures were considered outside the scope of this article. Therapeutic abortion and sterilization represent a different kind of operation because of emotional impact. However, it is suggested that many sexual problems are the result of poor preoperative explanation and postoperative instructions.
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PMID:Sexual life after gynaecological operations--II. 113 77

After colpohysterectomy and myorrhaphy of the levator ani muscles for prolapse, there persists a weak point between the utero-sacral ligaments attached behind the pubic symphysis and the levator ani muscles. The author describes a technical device permitting one to fill this gap by suturing the two fascia on each side of the vagina.
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PMID:[Technical modification in colpohysterectomies for prolapsus: reinforcement of perineorrhaphy by paravaginal suture]. 122 37

Twenty-five women (mean age 72.8 years) with massive eversion of the vagina were treated with transvaginal sacrospinous ligament colpopexy between 1986 and 1990. Nine of them had a posthysterectomy vaginal prolapse; 16 had complete genital prolapse and coincident vaginal hysterectomy was performed. The operation was performed under spinal anesthesia in all cases except one with general anesthesia. Simultaneous anterior colporrhaphy was done in 88%, repair of enterocele in 72% and posterior colpoperineorrhaphy in 88% of all cases. There were no intra- or post-operative complications. Vaginal vault prolapse did not recur during a mean follow-up period of 2.8 years in 22 cases. Three patients developed asymptomatic cystocele or enterocele, and 5 (23%) women had a curtailed vagina. Sacrospinous ligament colpopexy under regional anesthesia is an effective and suitable operation for aged women with vaginal vault and complete genital prolapse. The operation is also a safe and fairly simple procedure if the anatomic relationship of the nearby structures is known.
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PMID:Transvaginal sacrospinous colpopexy for vaginal vault and complete genital prolapse in aged women. 132 14

Genital prolapses are regularly constituted by multiple disorders such as primary stress incontinence anterior and posterior colpocele enterocele. All of these must be taken into account during the treatment by abdominal approach. The principles of treatment consist into a fixation of prolapse with mersilene mesh to the promontory. It could be laid on the anterior wall of the vagina and sometimes on posterior, if it's necessary. Uterus could be preserved but subtotal or total hysterectomy might be done; in this case, aseptic conditions are absolutely imperative. Vaginal section with stapling instrument and absorbable staples is useful. A colpopexy is always made.
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PMID:[Treatment of prolapse using the abdominal approach]. 141 34

A rare case of urinary retention due to tuberculous pyometra is presented. A 70-year-old woman visited our hospital complaining of dysuria and pollakisuria on January 26, 1990. In spite of medication of cholinergic agents, urinary retention developed on April 6, 1990. Cystoscopy revealed elevation of the urethra and bladder neck. Physical examinations disclosed a child-head-sized tumor in the lower abdomen, which persisted following catheterization. Excretory urogram showed a large retrovesical mass. Chain urethrocystogram revealed anterior dislocation of the bladder neck and the proximal portion of the urethra. CT scan and MRI demonstrated a fluid-filled pelvic mass, which positioned above the vagina and compressed the urinary bladder anteriorly. Total hysterectomy was performed on August 6, 1990. Pathological diagnosis was tuberculous endometritis. Urinary symptoms disappeared immediately after the operation. Postoperative chain urethrocystography revealed complete cure of the dislocation of the bladder neck and urethra. We collected 34 cases of urinary retention due to gynecological disease in Japan, and 110 cases in English literature. Among the frequent diseases were retroverted gravid uterus, prolapse uteri, uterine leiomyomas, ovarian cyst, imperforated hymen and vaginal atresia. The mechanisms of urinary retention in gynecological disease are discussed. No case of urinary retention due to tuberculous pyometra was found in the literature.
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PMID:[A case of urinary retention due to tuberculous pyometra]. 149 6

Alternations of the pelvic structure with an emphasis on those of the levator ani muscle, associated with uterine prolapse, were studied using sagittal magnetic resonance images obtained from 19 subjects without and 14 with uterine or vaginal prolapse of varied degree and 3 patients with Rokitansky syndrome who had undergone a McIndoe operation. Two additional patients with a grade III uterine prolapse were also studied before and 2-3 months after corrective surgery consisting of vaginal hysterectomy combined with anterior colporrhaphy and posterior colpoperineorrhaphy. Absence or presence of prolapse, irrespective of its grade, was found to be related to whether or not a reference line extrapolated from the levator plate crossed the pubis on sagittal images. This was the case as well in patients with Rokitansky syndrome with a neovagina and loss of such crossings was restored in patients with prolapse after surgery. Backward bending of the upper vagina noted in nonprolapse conditions was usually absent in patients with uterine prolapse. These results document that topographical changes involving the levator ani muscle and the vagina occur in association with uterine prolapse.
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PMID:Study of uterine prolapse by magnetic resonance imaging: topographical changes involving the levator ani muscle and the vagina. 152 30

The most common causes of vaginal/vestibular masses in the bitch are vaginal prolapse, vaginal neoplasia, and urethral neoplasia protruding into the vaginal vault. Other possible causes are clitoral enlargement, vaginal polyps, uterine prolapse, and vaginal abscessation or hematoma. Vaginal prolapse usually can be distinguished from neoplasia by the age of the patient, the time of occurrence during the estrous cycle, and the site of origin of the mass. Prolapse usually occurs in bitches under 4 years of age during proestrus, estrus, or at the end of diestrus and usually arises from the floor of the vagina, except for urethral tumors that protrude from the external urethral orifice. Appropriate diagnostic workup of bitches with vaginal vestibular masses includes complete history and physical examination, vaginal cytologic and vaginoscopic examination, retrograde vaginography or urethrocystography, serum progesterone and estradiol concentrations, and, in the case of suspect neoplasms, surgical or excision biopsy of the mass.
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PMID:Clinical approach to vaginal/vestibular masses in the bitch. 185 46

The authors, in this article, have reviewed the different proofs that confirm that Halban's fascia does exist. The authors have been able to find, separate out and use Halban's fascia in a series of 263 vaginal operations for genital prolapse taking the anatomo-surgical approach. From the histological approach, they have shown that Halban's fascia is constituted by fibro-connective tissue strips between which there are large numbers of blood vessels and muscles and nerve endings. From the point of view of embryogenesis, they believe that Halban's fascia comes from the same mesenchyme layer as that which gives rise to the corpus spongiosus of the penis. As far as sexual physiology is concerned, the authors review the various clinical experiments that have been carried out throughout the world medical literature which shows that there is an erogenous zone in the upper anterior part of the vagina and they believe that Halban's facia, which is homologous with the corpus spongiosus, is the site of origin of vaginal orgasm. Finally, as far as physiology and biology of reproduction is concerned, they believe that the vaginal fluid that is secreted by Halban's fascia during intercourse plays an important role for the survival of spermatozoa.
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PMID:[The reality and usefulness of Halban's fascia]. 201 19

Complete genital or vaginal prolapse affects a large number of middle-aged to elderly females. Satisfactory correction of prolapse with maintenance of vaginal patency has been a challenge to the pelvic surgeon for many years. We present a retrospective review of 147 patients undergoing abdominal sacral colpopexy using dacron graft or expanded polytetrafluoroethylene. The anatomical basis of repair, operative technique, and results are described. Ninety-three percent of the patients experienced long-term success over 5 years, including those with previous failed repairs. Both short- and long-term complication rates were acceptable. Only four patients experienced graft erosion, and only one of those had recurrent prolapse. Abdominal sacral colpopexy offers those affected with genital prolapse an opportunity for long-term relief, with maintenance of a patent vagina.
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PMID:Abdominal-retroperitoneal sacral colpopexy for the correction of vaginal prolapse. 192 81


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