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

Of 421 patients with posthysterectomy enterocele and vault prolapse, 190 cases are reported for the first time. These 190 patients had 197 operations, 90% were vaginal procedures and 10% were abdominal-presacral suspension procedures; 88% of the operations provided good vaginal support and a satisfactory result. A vaginal repair is advocated for this condition because it provides an excellent result with minimal exposure of the frequently elderly patient to serious risk or disability. An abdominal-presacral suspension is advised only for those patients who are anxious to preserve vaginal function, in whom there is an inversion of an already much-operated-on, snug vagina.
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PMID:Posthysterectomy enterocele and vaginal vault prolapse. 727 May 96

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

Of 420 female patients examined by means of colpo-cysto-urethrography 51 patients presented posterior bladder suspension defects. Two distinct forms were seen:1. Trigonocele (22 patients)--a downward herniation of the trigone between the postero-inferiorly displaced vagina and the bladder neck, which is retained in a nearly normal position by muscle fibers from the pubococcygeal muscle and the pubovesical ligaments. Symptoms were mostly those associated with prolapse. Stress incontinence was rare, while urge incontinence, cystitis and retention of urine were seen. The morphology varied from cases where the herniation disappeared during detrusor contraction (compensated trigonocele) through typical forms to transitional forms between trigonocele and posterior bladder descent. 2. Posterior bladder descent (29 patients) comprises postero-inferior displacement of the vagina and bladder base together. Two subgroups are discernible: A. Bladder descent even at rest (16 patients). B. Bladder descent only during micturition (13 patients). Symptoms were varied, but stress incontinence was found in 31 per cent in group A, and 62 per cent in group B. Morphological forms varied from two cases that were normalized in position during detrusor contraction (compensated descent) to total prolapse during micturition.
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PMID:Posterior bladder suspension defects in the female. A radiological classification with urodynamic and clinical evaluation. 745 99

Forty-five women were treated with a sacrospinous ligament fixation of the vaginal apex between 1979 and 1993. The patients had a complete vaginal prolapse following abdominal or vaginal hysterectomy or in three cases a combined uterine and vaginal prolapse. The sacrospinous ligament fixation was carried out as described by Amreich, Sederl and Richter. The fixation of the vagina was successful performed in 43 women. These results were obtained using absorbable suture material. A sciatic nerve damage was observed in two patients for a short time with spontaneous recovery, coincident with suture absorption and nerve regeneration. We consider and recommend fixation of the vaginal apex to the sacrospinous ligament as the technique preferred for the operative treatment of a vaginal prolapse and for the rare cases of uterine prolapse, which cannot be corrected otherwise.
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PMID:[Surgical treatment of vaginal prolapse after hysterectomy]. 760 79

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

In August 1991 in rural central Bangladesh, researchers conducted focus group discussions with mothers of all ages and trained and untrained traditional birth attendants (TBAs) to examine the experiences of childbirth, postpartum morbidity, local beliefs, and practices. They intended to use the information to design a prospective study of postpartum morbidity and its relation to delivery practices. Postpartum morbidity was common. Most frequently described postpartum conditions were breast problems, perineal problems, infections, and prolapse. Participants mentioned a wide range of local treatments, but few mentioned antibiotics as a treatment for infections. They believed in supernatural causes of disease. Training did not substantially change the belief systems or practices of TBAs. Harmful traditional practices included internal manipulations and massage, introduction of oils into the vagina, use of fundal pressure or tight abdominal bands during labor, pulling on the umbilical cord, choking or inducing vomiting in the mother to facilitate placental delivery, and not using uterine massage to prevent and treat postpartum hemorrhage. Beneficial practices were adopting an upright position and walking during labor, squatting for delivery, noninterferring with the membranes, having psychological support from attendants, and being in familiar surroundings. The custom of seclusion was a key obstacle to health-care seeking after delivery. Thus, home visits during the first two weeks after delivery are needed. Relatives rather than TBAs performed many deliveries. Food taboos were not as significant as earlier believed. These discussions revealed that the preventive aspect of modern prenatal care has not been incorporated into the women's belief system. They also suggest that the need for health care is not being addressed.
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PMID:Beliefs and practices regarding delivery and postpartum maternal morbidity in rural Bangladesh. 778 65

This is a review article about the colposacropexy and the colpopromontoriopexy in the treatment of vaginal prolapse. We reviewed the literature through the eyes of a urologist dealing with genuine stress incontinence. The treatment of genuine stress incontinence without sphincterdeficiency consists in the correction of the anterior compartment prolapse. Preoperative it is important to examen the middle and the posterior compartment of the vagina in order to achieve good postoperative results. Most urologists cure genuine stress incontinence with an abdominal approach. The combination of a colposuspension and a colpopromontoriopexy is an operation that corrects anterior, middle and posterior compartment prolapse by the same approach without significant more complications or bloodloss.
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PMID:Colpopromontoriopexy. 778 40

An 89-year-old woman had small intestinal prolapse through the vagina while straining at stool. She had had a vaginal hysterectomy 24 years earlier. Resuscitation, reduction, and repair resulted in survival.
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PMID:Vaginal evisceration. 788 37

During a 20 year study period from 1969 to 1991, 62 patients underwent abdominal colpopexy between a prolapsed vaginal vault and the cartilage of the promontory. A simple surgical operation technique introduced in 1954 was modified and tested on these women. Hysterectomy, either transabdominal or vaginal, had previously been performed upon all of these patients. In some instances, short lyodura loops were used to suspend the vagina. In all operations, the suspension was covered with peritoneum of the lumbosacral area. Functional and cosmetic results were excellent and urinary stress incontinence could often be improved. It is suggested that this type of procedure is indicated in subtotal and total prolapse of the vagina after hysterectomy in patients who desire to preserve sexual function.
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PMID:Pelvic promontory fixation of the vaginal vault in sixty-two patients with prolapse after hysterectomy. 815 22

An enterocele is a hernia of the small intestine into the vagina. First described in 1736, it is an uncommon but potentially quite symptomatic clinical entity. Despite increased interest in enterocele during the past 50 years, there are few large series reported, and follow-up on surgical results has generally been poor. Many enteroceles follow vaginal or abdominal hysterectomy. Various surgical techniques for repair of enterocele are presented herein, including the classical repairs by Ward and Moschcowitz. Because enterocele frequently coexists with vaginal vault prolapse, contemporary procedures for simultaneous repair are described. Emphasis is placed upon prophylactic vaginal vault suspension and cul-de-sac obliteration at the time of abdominal or vaginal hysterectomy. The complications of failure to recognize enterocele are spontaneous vaginal evisceration, although rare, and progressive symptomatology. Attempted repair may also engender complications, some life-threatening.
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PMID:Enterocele: a review. 820 2


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