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

Two patients were treated for fallopian tube prolapse after abdominal hysterectomy. This rare complication is usually seen after vaginal hysterectomy. Our patients presented with a profuse, blood-tinged vaginal discharge and lower abdominal pain two and three months after hysterectomy. The tender, fimbriated end of the fallopian tube must be distinguished from common cuff granulation tissue, one patient underwent painful cautery treatments for over a year before the correct diagnosis was made. Biopsy of the prolapsed tissue in both cases failed to provide the correct diagnosis. In cases reported on previously, repair of the prolapsed tube usually was accomplished transvaginally, but in one of our patients laparotomy was required to control bleeding from the retracted proximal tube. The other patient had her prolapsed tube diagnosed and resected laparoscopically. This technique, described in detail, has the advantage of avoiding more-extensive surgery in selected cases.
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PMID:Fallopian tube prolapse after hysterectomy. A report of two cases. 338 1

During November 1989 to July 1990 in two villages in Giza Governate, Egypt, medical and social scientists compared self-reports of 509 ever married women with medical diagnoses to determine the feasibility of using a questionnaire for a community diagnosis. The assumption was that a questionnaire is an inexpensive data collection method to identify women's health problems in developing countries. Based on self-reports, 77% of the women had vaginal discharge. 68% of these women considered the discharge as unusual. When the researchers compared self-reports with medical diagnoses of the presence of reproductive tract infection (RTI), they found a relatively high sensitivity (79%) but a low specificity (26%) for presence of discharge. The positive predictive value and percentage of agreement were 53% and the Kapp statistic was only 5%, indicating little agreement between self-reported symptoms and clinical or laboratory diagnostic status. Comparison of self-reports of at least one of the two symptoms of genital prolapse with clinical diagnoses of genital prolapse revealed a rather low sensitivity (36-50%, depending on severity of the prolapse) and relatively high specificity (76%). The positive predictive value and percentage of agreement were 66% and 54%, respectively, and the Kapp statistic was 11%, indicating poor agreement between self-reported symptoms and clinical or laboratory diagnostic status. 90% of the 40 women with uterine prolapse had first degree prolapse, but all 40 also had some vaginal prolapse. Women with more severe anterior vaginal prolapse or posterior and anterior vaginal prolapse plus uterine prolapse were more likely to report symptoms than those having posterior vaginal prolapse and uterine prolapse (56% vs. 17%; p 0.05). These findings show that vaginal discharge, considered as a symptom or sign, is not a good predictor of RTIs.
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PMID:Comparing women's reports with medical diagnoses of reproductive morbidity conditions in rural Egypt. 778 64

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

Urogenital symptoms associated with estrogen loss can occur episodically throughout a woman's life (e.g. during lactation, during treatment with GnRH agonists, etc.) but it is most common and chronic in duration in postmenopausal women. More than 50% of postmenopausal women experience lack of vaginal lubrication and frequent vaginal infections [1]. These urogenital complaints were associated with a diminished frequency of all forms of sexual behaviour. Complaints associated with urogenital ageing include vaginal dryness, irritation and pressure, vaginal discharge and infection, vulvo-vaginal pruritus, dyspareunia, post-coital bleeding, urinary frequency, urgency and incontinence and recurrent urinary tract infections. Although these symptoms have affected women for centuries, they are now becoming more widely recognized by health professionals and society in general because of the increased life expectancy, the acceptance of open discussion of this topic, and the advent of effective therapy. Urogenital ageing is a public health issue because of its high prevalence and because early detection and pharmacological intervention may prevent the development of serious conditions such as uterine prolapse and urinary incontinence. Although systemic hormone replacement therapy is frequently used for the treatment of urogenital atrophy, recent attention has also focused on local delivery of estrogen to the affected urogenital tissue. In this era of fiscal constraint, intervention to maintain urogenital health by the use of estrogen must be considered for all postmenopausal women.
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PMID:Urogenital ageing: an old problem newly recognized. 877 70

An assessment of gynecological morbidity among 385 married mothers of children 6-12 months of age from a district in South India's Karnataka State revealed a high burden of reproductive tract infections. Research methods included clinical examination, laboratory tests, and self-reports. A total of 152 women reported 226 gynecological complaints to a social worker, primarily vaginal discharge with bad odor and itching or irritation (22%), lower abdominal pain or vaginal discharge with fever (16%), and menstrual bleeding disorders or pain (15%). Under more extensive probing by a gynecologist, the proportion of women reporting menstrual problems rose to 62%. At medical examination, 36% of women had at least one clinically diagnosed reproductive tract infection, including pelvic inflammatory disease (11%), cervical ectopy (10%), and genital prolapse (3%). More than half had endogenous infections. The two most common infections, identified by laboratory tests, were bacterial vaginosis (18%) and mucopurulent cervicitis (37%). Sexually transmitted diseases, primarily trichomonal vaginalis, were diagnosed in 10%. Women residing in town, those with 6 or more years of schooling, and women with 4 or more pregnancies were significantly more likely to report menstrual problems. Laboratory-detected vaginosis was significantly higher among urban and sterilized women. There were no significant associations between demographic/socioeconomic status variables and the other reproductive health problems analyzed. Finally, severe anemia was present in 17% and chronic energy deficiency in 12%. The combination of widespread undernutrition/malnutrition and reproductive tract infections revealed in this study indicates an urgent need to take steps to implement the reproductive health strategy outlined at the 1994 Cairo Conference in South India.
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PMID:Levels and determinants of gynecological morbidity in a district of south India. 921 30

An interdisciplinary group of researchers developed a conceptual and methodological framework to determine the extent of the problem of reproductive morbidity at the community level in Middle Eastern society and then, in turn, to improve reproductive health conditions in women. It conducted an exploratory study in a family planning clinic in Cairo, Egypt; a medical workshop on clarification of the symptomatology of reproductive morbidity; and a focus group in a village in Giza, Egypt, to ensure that the reproductive morbidity questions of interview questionnaires were appropriate and complete. The group tested the accuracy of the questionnaires in 2 villages in rural Giza (509 women). Field workers went to the women's homes to administer the questionnaire on characteristics of the household during the first visit. During the second visit, they administered the questionnaire on reproductive morbidity, and then the social researcher went with the women to the health center so the women could undergo a gynecological examination. 50% of the women had reproductive tract infections, especially vaginitis. 56% had prolapse, and prevalence increased significantly with age. 63% had anemia, especially 14-19 year olds (76%). Just 24 women (5%) had no reproductive morbidity. About 50% had at least 3 reproductive conditions. The leading problems reported by the women were vaginal discharge (77%), dysmenorrhea (71%), perceived delay in conception (48%), stress incontinence (37%), and pain during intercourse (36%). Feeling of heaviness below, probably indicating prolapse, was the only symptom which increased with age (p = .03). 41% had been pregnant in the last 2 years. 77% delivered at home. Leading conditions during pregnancy were headache (59%) and discharge (45%), and those after delivery were fever and discharge/inflammation (30% for both). The interdisciplinary group proposed 3 mechanisms which are of utmost importance to policy: conducting similar research in other communities, expansion of reproductive health services at the community level, and implementing changes in the education and training programs of health professionals and social scientists.
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PMID:Concepts and measures of reproductive morbidity. 1014 96

Between 1982 and 1992, 32 patients with squamous cell vaginal cancer were treated. Fourteen patients had stage I, 11 stage II, two stage III and five stage IV disease. The mean age of stage I and II patients was 64, of stage III and IV patients 73. Six patients were pessary-bearing, two had a total procidentia, eight had been treated for cervical intraepithelial neoplasia (CIN), one for cervical cancer and one for vulvar cancer 5-21 years before diagnosis. One patient had had external irradiation for endometrial cancer 15 years before. Nine patients had no follow-up examinations after treatment for CIN, for vulvar cancer or after insertion of a pessary. In 14 patients doctors' or patients' delays were considerable. Most patients presented with vaginal discharge or bleeding, and urinary symptoms. Various treatment modalities were used. The selected patients who could be treated by surgery did best. Only patients with a stage I tumor or a stage II tumor with a diameter of at most 30 mm survived. Tumor stage and tumor diameter were the important prognostic factors. No patient died of disease after 33 months. Failure in obtaining local control was the usual cause of death. Recommendations for prevention or early diagnosis are formulated.
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PMID:Squamous cell carcinoma of the vagina: a report of 32 cases. 1157 39

Fallopian tube prolapse is a rare complication of hysterectomy, characterized by vaginal discharge, abdominal pain, pelvic inflammatory disease and vaginal bleeding. The diagnosis is often delayed, and is usually done after an histopathological examination identifies fallopian tube on biopsy. The advised treatment is surgical resection, which can be done through vaginal incision, abdominally or by laparoscopy. We report a case of fallopian tube prolapse after vaginal hysterectomy in 47-year-old patient in whom the prolapsed-tube was successfully resected vaginally, and review the presentation and surgical methods to correct this rare complication.
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PMID:[Fallopian tube prolapse after hysterectomy]. 1211 69

The authors examined the prevalence of vaginal discharge in a sample of sexually active women who spanned 3 different socioeconomic groups. They observed a prevalence of 0.0% in the high socioeconomic group, 21% in the middle group, and 45% in the low income group (rural area). They also studied the conditioning factors for these different prevalences and found that there were no significant differences for age, parity, abortions, or oral contraceptive use. They found significant differences with IUD use and uterine prolapse in 1 of the areas, but these results do not explain the other differences. They feel that further clinical and epidemiologic studies are necessary. It seems that significant differences were associated with genital hygiene which is dependent on socioeconomic level. (author's)
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PMID:[Vaginal discharge: conditioning factors in different socio-economic groups in Londrina, Parana (author's transl)]. 1226 91

This pilot study is the first to identify female genital schistosomiasis (FGS) in an Egyptian community setting. The year-long interdisciplinary study, in a small hamlet (ezba), combined clinical assessment with an in-depth study of the social context of reproductive health. Schistosoma haematobium ova were found in 16.7% of women in the study (21/126). Half of the women who agreed to a full gynecological examination (43 of 86) had evidence of reproductive morbidity due to schistosomiasis, either schistosome eggs in the cervix or sandy patches, tissue changes in the reproductive tract. Other reproductive tract morbidities included infections (vaginitis 40%, chronic cervicitis 75%, pelvic inflammation 9%) and prolapse (54%). FGS was associated with dysparunia, abnormal vaginal discharge, vaginal or cervical polyps, contact bleeding, vulval itching and chronic cervicitis. Community members recognized S. haematobium as a health problem, but did not believe that it affected reproductive health. Indeed, they had little awareness of reproductive health and the possible impact of reproductive morbity on women's arduous daily tasks. There was no discussion of any reproductive health issues (except infertility) between women or between spouses. The study identified a number of factors that would affect the identification and treatment of FGS, and reproductive health care in general; (1) the neglect of women's health: (2) misconceptions about reproductive health and family planning; and (3) limited access to, and use of formal health care. The paper ends with a brief discussion of the significance of our findings about FGS, strategies to increase awareness of FGS, and the need for future research.
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PMID:The social context of reproductive health in an Egyptian hamlet: a pilot study to identify female genital schistosomiasis. 1465 48


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