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

During the past nine years 70 enteroceles were observed. There were 27 primary and 43 secondary enteroceles. Etiologic factors were multiparity, advanced age, general lack of elasticity, obestiy, constipation and increased intra-abdominal pressure. The pathogenesis of primary enteroceles was usually to do a genital prolapse, tissue atrophy, a distended pouch of Douglas due to a tumour. The pathogenesis of secondary enterocele following previous uterine surgery was that at times the pre-existent enterocele had not been observed and the space between the uterosacral ligament and the rectum not been closed, or the patients had vaginal hysterectomies and anterior and posterior colporrhaphies, or the patients had previous uterine suspensions or abdominal hysterectomies. The interval between uterine surgery and enterocele was a mean 1.5 years for vaginal hysterectomies and a mean 15 years for the other operations. Different operative procedures for enterocele are discussed. In 90% of the cases the enteroceles were repaired vaginally by the method of Shaw O'Sullivan.
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PMID:[The problem of enterocele (author's transl)]. 71 Aug 76

This report describes a new surgical technic for vaginal vault reconstruction performed on 116 patients either at the time of vaginal hysterectomy or in cases of post-hysterectomy vault suspension for vault prolapse. The repair maintains and restores proper vaginal vault support, preserves or increases overall vaginal length and preserves the proper angle of the vaginal canal. High extraperitoneal plication of the uterosacral ligaments is used to prevent enterocele, and provides hammock-like support of the vaginal vault. The paracervical fascia of the vaginal cuff is closed transversely in the midline rather than anterior-posteriorly.
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PMID:Vaginal vault reconstruction. 85 8

A brief discussion of the history of techniques for the surgical management of prolapse of the vaginal vault is presented. The author's method for the abdominal procedure, sacral colpopexy, is presented together with a summary of twelve patients in whom it was used. The author's modification of the technique of the vaginal operation, "the anterior approach," is presented because it appears to make resection of the enterocele sac and identification of uterosacral ligaments easier and their utilization more effective.
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PMID:Prolapse of the vaginal vault. Improved techniques for management of the abdominal approach or vaginal approach. 93 2

Complete prolapse of the rectum is essentially an enterocele which emerges through the anus as a sliding hernia of the rectum. In women, this condition can be operated radically by a simple technique which causes only little stress to the patient, entirely in conformity with the principles of the hernia operation, as advocated by Graham (Ann. Surg., 1942, 115 (1007), by the abdominal approach.
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PMID:Treatment of complete prolapse of the rectum by the vaginal approach. 93 59

A description of a composite procedure is offered as a further effort to have a safe, relatively easy, and dependable surgical operation for complete vaginal prolapse in the sexually active woman. The fact is generally accepted that the combination vaginal and surgical approach done at the same sitting gives a better chance for cure where either single approach has proved to be less dependable. Nothing startling new is claimed, but the selection of the homologous fascia lata as the suspending material used technically in a simple, safe manner is outlined. Twelve patients have had this procedure done in the past 4 years with no recurrence of the prolapsed vault and no complaint of dyspareunia by either partner. One patient has had recurrent enterocele even though effort had been made to prevent this. There has been no death in this series.
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PMID:A composite vaginal vault suspension using fascia lata. 98 31

A series of 90 patients with intussusception of the rectum (internal procidentia) has been studied. In 11 per cent of the patients there was also an enterocele and in 3 per cent, a large proctocele. Forty patients were operated upon by the Ripstein procedure. Indications for operation were, in most cases, incontinence for gas and/or feces. Seventy-five per cent of the preoperatively incontinent patients were, at follow-up 2 to 10 years after operation, continent. When indications for surgery were pain and or a sensation of obstruction, the results were poor; most of these patients had unchanged symptoms postoperatively, and some even had increased symptoms. There was one postoperative death. Of 50 patients treated conservatively during a period of 2 to 10 years, only two had to be operated upon: one due to the development of a rectal prolapse and the other due to severe pain and an increased sensation of obstruction.
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PMID:Intussusception of the rectum-internal procidentia: treatment and results in 90 patients. 114 81

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

A urethrocystohysterography (UCHG) and a prolapse scoring system (PSS) have been used to assess the types of uterine prolapse and postoperative outcomes since 1979. UCHG was useful in identifying the type of uterine prolapse and in selecting operative procedure. UCHG was done by injecting contrast medium into the bladder and uterine cavity and inserting a metallic bead chain into the urethra. A lateral pelvic X-ray was then taken at rest and during straining. The length of the uterus (UL), distance from the pelvic outlet (PO) to the bladder base (BB), distance from PO to the uterine fundus (UF), and distance from the ischial spine (IS) to UF were measured on the UCHG. We found that there were three types of uterine prolapse on the UCHG findings, type 1: cervical elongation without descent of uterine fundus and cystocele, type 2: uterine prolapse with moderate descent of uterine fundus and cystocele, and type 3: giant vaginal eversion including completely prolapsed uterus, marked cystocele, enterocele and rectocele. The operative time of vaginal hysterectomy with anterior and posterior colporthaphy (VH with AP repair) correlated well with UL and PO-UF distance on UCHG, and blood loss. Operating time was significantly shorter and amount of blood loss was significantly smaller in cases of Machester operation (cervical amputation, fixation of cardinal ligament stumps to the anterior wall of the remaining cervix and AP repair) than in those of VH with AP repair.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Individualization of operative procedures for uterine prolapse based on categorization using X-ray urethrocystohysterography and postoperative outcomes evaluated with a scoring system]. 140 22

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

Sacrospinous ligament fixation of the prolapsed vaginal vault has proved very useful, but the complications of failure, hemorrhage, infection, nerve damage, incontinence and dyspareunia are reported. Experience with 51 operations performed by staff, and residents with supervision, has shown the value of certain preoperative and technical steps to avoid complications, including candidate selection; repair of enterocele; retropubic positioning of the bladder neck; repair of all pelvic support defects, and perineorrhaphy. Technical modifications are described. Results in these instances are tabulated: no recurrent prolapse; no transfusions; four narrow vaginas; two with stress incontinence; one pelvic cellulitis, and one ventricular fibrillation on the third postoperative day. We believe that most complications are preventable.
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PMID:Success with sacrospinous suspension of the prolapsed vaginal vault. 144 Jan 69


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