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

Forty-four women were examined to assess the incidence of rectocele and enterocele in asymptomatic patients, to establish a normal range for the dimensions of the rectovaginal pouch and septum in nulliparas, and to ascertain the effect of parturition on these measurements. The relationship between the depth of the rectovaginal pouch and the presence of enterocele was also studied. Seventeen patients (38%) had rectocele and/or enterocele. In nulliparas the mean depth of the rectovaginal pouch was 5.3 cm and the mean length of the rectovaginal septum was 2.1 cm. Neither parturition nor prolapse altered the depth of the rectovaginal pouch, but parity was associated with an increase in the length of the rectovaginal septum. There was no relationship between the depth of the rectovaginal pouch and the presence of enterocele.
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PMID:Observations on the anatomy of the rectovaginal pouch and septum. 707 95

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

Sacrospinous colpopexy is a useful procedure in the cure of pulsion enterocele, high rectocele, and posthysterectomy vault prolapse. It allows the surgeon to correct coincident cystocele and rectocele and permits restoration of a relatively normal and comfortable vaginal depth and axis. It is a quick procedure, avoids intraabdominal trauma, has a high success rate and a low complication rate (1) and is useful in the management of patients who wish to maintain coital function. This paper retrospectively reviews the techniques, results and complications of 107 sacrospinous colpopexies performed in 104 patients over an 8-year interval.
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PMID:Sacrospinous colpopexy. 777 10

A 72-year-old diabetic women presented with a large left labial mass following multiple prior vaginal surgeries to correct vaginal vault prolapse, including two failed right-sided sacrospinalis fixation procedures and a near total colpocleisis. After failure of conservative management, a translabial repair of this pudendal hernia containing bladder was performed. Return of the labial mass 9 months later prompted a more extensive abdominal approach. To close the defect in the urogenital diaphragm and prevent its recurrence, an absorbable mesh was used. Then, to prevent enterocele recurrence, vaginal vault suspension to the sacral promontory and closure of the Douglas pouch were performed. A review of the literature is presented, with an analysis of risk factors and corrective surgical techniques.
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PMID:Pudendal enterocele with bladder involvement. 798 25

Thirty women experiencing posthysterectomy prolapse of the vaginal vault were treated with abdominal sacral colpopexy between 1984 and 1991. Lyodura (lyophilized cerebral dura mater allograft transplant) was used as the suspensory material in 81 percent and Gore-Tex (reinforced polytetrafluoroethylene) in 16 percent of the operations. There were no perioperative or postoperative complications. At the follow-up examination (mean, three years), good vaginal vault support was observed in 85 percent of the patients. Significant cystocele were seen in 18 percent, and vault prolapse, enterocele, rectocele and chronic perineal laceration each in 15 percent of the patients. At follow-up study, 22 percent of the patients experienced dyspareunia and 41 percent had decreased sexual interest and coital events. Development of stress urinary incontinence in 18 percent of patients was noted. Concomitant Burch colposuspension will cure and prevent stress incontinence and anterior vaginal relaxation. Abdominal sacral colpopexy appears to be a safe and effective method in the treatment of posthysterectomy prolapse of the vaginal vault. In our experience, it seems that coexistent cystocele and rectocele should be corrected in the connection with sacral colpopexy.
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PMID:Outcome of thirty patients who underwent repair of posthysterectomy prolapse of the vaginal vault with abdominal sacral colpopexy. 814 22

A technique has been described for performing a modified form of the McCall culdeplasty at the time of abdominal hysterectomy. The use of such techniques during abdominal, as well as vaginal, hysterectomy, should help decrease the incidence of posthysterectomy vaginal vault prolapse and enterocele formation.
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PMID:A technique for modified McCall culdeplasty at the time of abdominal hysterectomy. 816 89

Massive vaginal prolapse in ten post-hysterectomy women was treated by expanded polytetrafluoroethylene graft along the course of the round ligaments to anchor the vaginal vault to the lateral abdominal wall. Concurrent enterocele repair was done as well as other indicated abdominal or vaginal operations. Satisfactory coitus was reported in all cases. The procedure is technically simple and provides an alternative to sacral suspension or sacrospinous ligament suspension of the prolapsed vaginal vault.
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PMID:Round ligament synthetic graft colpopexy. 819 Apr 25

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

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


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