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

The occlusion of the vagina by a shirodkar type string suture is an emergency procedure. As a temporary measure in old patients with procedentia this procedure relieves the symptoms of the prolapse during the time needed to prepare the patient for surgery or the time needed by the patient to decide to have the operation performed. For severely ill in-operable patients the purse string occlusion of the vagina is a simple method to eliminate the discomfort of the procedentia. The procedure can be done under local anaesthesia and can be repeated.
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PMID:[Vaginal closure using the purse string suture method in elderly women with total prolapse]. 634 63

Vaginal vault prolapse is an infrequent complication after abdominal and vaginal hysterectomy. Current surgical methods of repair include transvaginal fixation of the vault to the sacrospinous ligament, repositioning of the vagina over the levator plate by a synchronous abdominoperineal procedure, and transabdominal sacral colpopexy. Because each method results in a durable repair and restores a functional vagina, sacral colpopexy is considered the preferred procedure because of its technical simplicity. The proposed advantages using dura mater as the prosthesis are detailed.
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PMID:Posthysterectomy vault prolapse: sacral colpopexy with dura mater graft. 636 66

The authors report on 70 cases of prolapse following hysterectomy (52 cases after subtotal hysterectomy, 13 after total abdominal hysterectomy, and 5 after vaginal hysterectomy). These cases of prolapse following hysterectomy represent 11,7 p. cent of all surgery performed to correct prolapse over the same period (70/599). It is desirable to repair the vagina as anatomically as possible, preserve normal function (70% of patients desire to remain sexually active), and correct if necessary urinary incontinence also present in 47 p. cent of patients in our series. Once the decision to operate has been made, we believe the best procedure is a pubosacral suspension (double hemi-hammock) using a Mersilence strap, which treats the associated stress incontinence and preserves sexual function.
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PMID:[Prolapse after a hysterectomy. A study of 70 cases]. 654 75

Genuine prolapse of the vaginal stump following total hysterectomy, which must be differentiated from the relatively frequent vaginal descent after hysterectomy usually not requiring additional surgery, is generally a rare positional anomaly of the female genitalia and is by no means easy to correct. This phenomenon requires special surgery to restore or preserve the ability to have intercourse. The article discusses the surgical techniques described in international literature which are suitable for correcting a prolapse of the vaginal stump. Basing on 31 patients treated by the authors, the advantages offered by vaginopexy after Williams and Richardson in the treatment of vaginal inversion following hysterectomy are discussed. In spite of the relatively limited number of patients, the results followed up about three years after surgical correction justify recommending this still rarely employed procedure. Its advantages are: secure fixation of the prolapsed vault of the vagina with nearly optimal anatomic and functional restoration of the vagina, maintained or regained ability to have intercourse, considerable and nearly complete freedom from subjective complaints, and obviously also a low likelihood of relapse.
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PMID:[The Williams-Richardson vaginopexy as a surgical therapy in vaginal inversion in vaginal stump prolapse]. 655 73

Forty-one women with primary or recurrent prolapse of the vagina following either vaginal or abdominal hysterectomy were treated with a vaginal operation. The retroperitoneal approach of utilization of the perirectal fascia to support the vault of the vagina is described and illustrated. This technique may also be used in selected patients to prevent this complication after vaginal hysterectomy and repair.
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PMID:Repair of vaginal prolapse after hysterectomy. 661 93

This paper reports a case of ectopic abdominal pregnancy following total hysterectomy and reviews the literature. Pregnancy following total hysterectomy is a rare event. Ectopic pregnancy following supracervical hysterectomy can be explained in view of the remaining patent cervical canal. In cases of total hysterectomy (abdominal or vaginal) two important factors to be considered are the persistence of a fistulous tract from the vaginal apex to the peritoneum and the prolapse of the fallopian tube into the vagina, creating a patent tract for spermatozoa. As long as some ovaries remain, the possibility of ectopic pregnancy must be entertained in the differential diagnosis of acute abdomen in a female.
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PMID:Abdominal pregnancy following total hysterectomy. 666 40

Between 1969 and 1980 11 operations according to Williams-Richardson, 23 abdominal sacropexies according to Wagner-Kuestner and 4 operations according to Amreich-II were performed for the treatment of enteroceles and prolapse of the vaginal vault. The combination of these operative methods with colpoperineorraphies and Marshall-Marchetti-Krantz operations and lyodura ribbon operations according to Zoedler for the urethro-vesical angle is described. Continence an elevation of the vaginal fornix was obtained by the operation according to Williams-Richardson and by the fixation of the vagina to the sacrospinal ligament. With the Williams-Richardson operation 1 enterocele occurred which was corrected with the vaginal fixation to the sacro-spinal ligament. Following fixation to the promontary 2 enteroceles, 4 cystocele, and one rectocele occurred in 4 patients. Three of these had urinary incontinence. The complications are described. The vaginal fixation to the sacro-spinal ligament according to Amreich II at times combined with the lyodura sling operation of Zoedler is today the preferred operative method.
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PMID:[The operative treatment of enterocele and prolapse of the vaginal vault (author's transl)]. 691 91

A case of chronic inversion of the uterus, with involvement of bladder and ureters, due to the prolapse through the cervix and vagina of a submucous fibroid, is presented. A safe scheme of operative treatment is outlined.
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PMID:A large submucous fibroid polyp causing inversion of the uterus. 694 May 74

Uterine procidentia and pelvic-floor hernia are quite common among postmenopausal multiparous Caucasian women. Predisposing factors are age, obesity, childbirth trauma, neurologic disorders, and musculo-fascia weaknesses. Hysterectomy and pelvic floor repair constitute the definitive therapy for pelvic floor hernia and uterine prolapse, but vaginal pessaries made of rubber or plastic can also be of therapeutic value. Pessaries also facilitate preoperative healing of the vaginal or cervical ulcerations which are quite common in longstanding cases of uterine procidentia (third degree prolapse). Common complications of pessary use are vaginal irritation, allergic reactions, leukorrhea and bleeding. Hard pessaries have fewer associated complications. Proper fitting and continued post insertion care are necessary. Unless contraindicated, acid douches and or creams and estrogenic creams should be used with the pessaries. Pessaries should be removed every 6 weeks for cleansing; otherwise, ulceration, superimposed infections, and fistulas could develop. In cases of incarcerated pessaries, the use of estrogenic creams (which improve the condition of the vagina) will easily help remove the pessaries. 3 case reports are briefly discussed to illustrate the management of incarcerated pessaries in elderly women. The patients reported in these cases did not have follow-up care after insertion of the pessary, thus requiring intervention years later. Patients with bleeding problems despite normal cytologic findings should undergo fractional curettage later to rule out malignancy. Although incarcerated pessaries rarely occur, application of estrogenic creams will easily remove them.
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PMID:Management of incarcerated vaginal pessaries. 724 Jun 22

The authors report 45 cases of prolapse occurring after hysterectomy (26 after subtotal hysterectomy, 9 after total abdominal hysterectomy and 10 after total vaginal hysterectomy). These prolapses are rare and their incidence does not seem to vary with the type of hysterectomy that preceded them. although in some cases hysterectomy could be incriminated as the cause of the prolapse, in the majority of cases the reason was a prolapse that had been neglected when the hysterectomy had been carried out, or a prolapse that appeared a long time after hysterectomy because of the inevitable ageing of the supporting tissues of the pelvis. From the anatomical point of view it is important to distinguish those prolapses where the vaginal vault does not descend and those where there is total descent including the vault of the vagina. The prolapses give rise to difficult problems of therapy. The choice of operation has to take into account anatomical components of the prolapse, the functional repercussions, the urinary symptoms and whether the patient wishes to does not wish to continue sexual activity. If it is not necessary to keep the vagina open an operation that involves colpectomy or colpocervicectomy can give rise to very good anatomical and urinary results. When it is necessary to keep the vagina functioning as a vagina in the case of prolapse after subtotal hysterectomy, it is important to treat the case as though on was dealing with an ordinary prolapse. All the same, when dealing with procidentia it may be wiser to add a colpopexy procedure by the abdominal route. When dealing with a prolapse after total hysterectomy when the vaginal vault is in place, it is sufficient to carry out the usual form of perineal plastic operation general;y to obtain a good result, but when the vaginal vault has come down it is as well to carry out a colpopexy procedure by the abdominal route.
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PMID:[Prolapse after hysterectomy. A study of 45 cases (author's transl)]. 726 56


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