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

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

We describe the case of a 68-year-old woman who presented with an acute onset spontaneous vaginal vault rupture and intestinal prolapse through the vagina. Results of a literature survey are presented and the causes of vaginal vault rupture are discussed.
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PMID:Intestinal prolapse through the vagina. 829 Apr 18

There are several equally effective but different operative procedures to correct uterine procidentia; the technique and operative approach must be chosen according to the specific needs of the patient. The surgeon must be able to dissect, identify, resect, and approximate the appropriate supporting structures. To preserve a functional vagina in a patient with complete procidentia, the surgeon must have a full understanding of the principles of pelvic support. If a functional vagina is unimportant, then a tight, coned-down vagina (one finger in depth and diameter) offers the best long-term results.
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PMID:Vaginal hysterectomy with repair of enterocele, cystocele, and rectocele. 829 97

The existence of combined rectal and vaginal prolapse is more common than the literature would suggest. This paper outlines a further development in the operative management which has been applied to 24 patients with this problem. All had had a hysterectomy and most had had in addition one or more vaginal repairs. The common mode of presentation was one of pelvic pain (19 patients), sometimes severe, crippling and intractable and some form of protrusion (14 patients), difficult or unsatisfied defaecation and rectal incontinence (9 patients). The vaginal prolapse which always involved the vault and usually involved the lower vagina was usually found to be incomplete and the rectal prolapse complete (but occult). The operative procedure essentially consists of a Wells type rectopexy which has a new modification in which the sling is extended to anchor the vaginal vault after correction of the enterocele by the abdominal approach. A vaginal repair is subsequently performed at the same operation where anterior or posterior vaginal prolapse persists. Important points in the procedure are the avoidance of sepsis (the vaginal vault is not opened during the procedure) and protection of the ureters by careful assessment of the lateral margins of the vaginal vault which is illuminated by transvaginal vault endoscopy. At this early stage operative morbidity has been minimal, relief of the pelvic symptoms has been most encouraging, but the length of follow-up is short (range 6-30 months, average 15.6) and long-term evaluation will be necessary as with all surgery for prolapse.
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PMID:Posthysterectomy rectal and vaginal prolapse, a commonly overlooked problem. 830 99

Abnormalities of the tubular reproductive tract are responsible for decreased fertility in the cow. Typically, these are related to congenital defects such as segmental aplasia or to acquired conditions resulting from infections or trauma caused during breeding or parturition. Infection of the tubular tract may result in vaginitis, cervicitis, metritis, endometritis, pyometra, or salpingitis. Trauma to the tract may result in urovagina, pneumovagina, or prolapse of the vagina or uterus. Retained placenta may result in metritis. Potentially, all of these conditions, unless properly treated, may result in reduced fertility or, in the extreme, sterility. Judicial and properly timed use of antibiotics and ecbolic agents should return the tract to proper function with little or no reduction in fertility. Some conditions, such as prolapse, retained placenta, and pneumovagina, may call for manual or surgical intervention for successful resolution.
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PMID:Abnormalities of the tubular genital organs. 834 74

Management of gynecologic problems in women aged 75 and over can be challenging. Appropriate examination and evaluation differs from that for younger women, and these patients are often poor surgical candidates. The most common presenting conditions include stress incontinence, atrophic changes of the vulva and vagina, and pelvic relaxation with uterine prolapse. Several techniques for nonsurgical management are available, including topical and systemic drug therapy and use of products and aids that increase comfort and encourage independence.
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PMID:Common gynecologic problems after age 75. 846 82

The paper is a description of prolapse of small intestine through vagina in 66 year old woman, who had hysterectomy by laparotomy four years earlier. The intestines were repositioned by the vaginal route and then the opening at the top of vagina was sutured by laparatomy. In the next stage colpo-perineoplasty with formation of very high perineum was made.
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PMID:[Eventration of the small intestine through the vagina]. 852 45

The standard technique for total laparoscopic hysterectomy is characterised by two essential points. The first is that all instruments are reusable and the second is that hemostasis is ensured by bipolar coagulation. It is a safe technique with a cost comparable to that of vaginal or abdominal hysterectomies. The routine use of disposable material and automatic disposable staplers for laparoscopic hysterectomies is debatable, as the considerable increase in cost is not accompanied by benefit for the patient or the community. Although laparoscopic hysterectomy is a feasible technique, all hysterectomies should not be performed by this route. If the operation is feasible quickly and under good conditions via the vaginal route, laparoscopic surgery is not indicated. Laparoscopic surgery is only indicated when vaginal surgery is difficult and/or contra-indicated. The elective indications for total laparoscopic hysterectomy are severe adhesions, deep endometriosis and especially a limited vaginal accessibility associated with a narrow vagina and a fixed or non prolapsed uterus. While a average of three quarters of hysterectomies (excluding cases of uterogenital prolapse) are currently performed via a laparotomy, laparoscopic surgery can reduce this rate to approximately 10 to 20 per cent.
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PMID:[Total hysterectomy for benign pathologies. Conventional celiosurgical technique]. 855 73

According to whether uterine artery treatment takes place vaginally or laparoscopically, laparoscopy for hysterectomy can be considered according to two modalities: laparoscopically assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH). The indications for laparoscopy are defined by the limits and/or contraindications of the vaginal route. LAVH is indicated in the following situations: pelvic pain syndrome where diagnosis and treatment can be made at the same time as hysterectomy; minimal endometriosis; past surgical history favouring adhesions formation; necessity to perform an oophorectomy; existence of an ovarian pathology. The elective indications for TLH are the severe pelvic adhesions, deep endometriosis and especially a limited vaginal accessibility associating with a narrow vagina and a fixed or non prolapsed uterus. Laparoscopy thus allows to reduce the number of laparotomies. When on overage three quarters of the hysterectomies (excluding cases of uterogenital prolapse) were up till now performed abdominally, laparoscopy could reduce this rate to approximately 10%.
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PMID:[Complete hysterectomy for benign pathology and laparoscopy: respective indications of laparoscopic preparation and an exclusively laparoscopic approach]. 855 73

A 60-year-old woman with past history of perineorrhaphy due to vaginal prolapse; squamous cell carcinoma of the uterine cervix stage IIB, treated with radiation theraphy at doses of 7500 rads administered as teletherapy and brachytherapy with Cesium 137. Ten weeks later a Piver II hysterectomy was performed, her posoperative morbidity was a vaginal abscess. Twelve years later, she developed a pulmonary metastasis. One year thereafter she had vaginal discharge of cetrinous fluid and prolapse of greater omentum through the vagina. She was treated by a midle exploratory celiotomy, primary closure of the vaginal defect and the pelvic floor was covered with an omental pedicle flap. The postoperative period was unremarkable.
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PMID:[Vaginal evisceration following radiotherapy and surgery for cervico-uterine cancer. Report of a case]. 871 67


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