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

In 322 cases of lumbar PID proved by myelography the radiologically recognizeable malalignment of the lumbar spine was related to site and direction of the prolaps. Scoliosis towards the side of the prolapse was seen in about 70 per cent. Scoliosis convex towards the normal side was significantly more common with right-sided than with left-sided prolapses. Scoliosis was the more pronounced the higher the site of prolapse. The degree of lumbar lordosis, too, appeared to depend on the level of prolapse. The lower the prolapse the less the lordosis. In the individual case one cannot draw any conclusions as to site or direction of a prolapse from radiologically detectable malalignment.
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PMID:[Malalignment of lumbar spine with lumbar PID (author's transl)]. 12 47

For the diagnosis of lumbar P.I.D. discography is much superior to myelography. The risks of both techniques are the same, but the side-effects of discography are clearly less. Higher lesions remain a problem if they do not show up neurologically (s. the prolapsed disc at L 2/3). Here segmental blocking, posterior gaping of the intervertebral space and displacement of the dural sac show clearly the posterior prolapse. In the standard discogram of the lower 3 discs it would have been missed. In spite of this our present experience with lumbar discography is so positive, that we are about to test a long term series, whether and to which extend discography could replace myelography in cases where there is no hint at a space-occupying lesion, other than a disc or whether the order of these investigations should be reversed.
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PMID:[Comparison between myelography and discography for lumbar prolapsed intervertebral discs (author's transl)]. 95 33

Endometrial tissue from uteri of 35 nonpregnant, premenopausal women was assayed for prostaglandin E2 and F2 alpha binding site content as a function of the phase of the menstrual cycle and the pathologic state. For all specimens, tritium-labeled prostaglandin F2 alpha, binding was very low (less than 8 fmol/mg of protein) or undetectable regardless of the phase of the menstrual cycle or pathologic state or in the presence or absence of 10 mumol/L of indomethacin, a prostaglandin synthetase inhibitor. However, tritium-labeled prostaglandin E2 binding was detected in every specimen and was independent of the presence or absence of indomethacin. Binding of tritium-labeled prostaglandin E2, as determined by Scatchard analyses, was biphasic (dissociation constant approximately 1 nmol/L; dissociation constant for low-affinity sites approximately 10 nmol/L) for both proliferative and secretory endometrial tissue. However, the total number of prostaglandin E2 binding sites, determined from Scatchard or single-point analyses, was significantly higher (p less than 0.01) in proliferative endometrium compared to secretory endometrium. In addition, for endometrium from the proliferative phase of the menstrual cycle, the diagnosis of abnormal uterine bleeding was associated with higher (p less than 0.01) tritium-labeled prostaglandin E2 binding than diagnosis of dysmenorrhea, stress urinary incontinence and uterine prolapse, or pelvic inflammatory disease. Endometrial specimens with the last four diagnoses did not differ significantly (p greater than 0.1) from each other.
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PMID:Human endometrial prostaglandin E2 binding sites and their profiles during the menstrual cycle and in pathologic states. 285 25

A review of 493 cases was undertaken to identify which patients undergoing hysterectomy for benign disease had received a preoperative intravenous pyelogram (IVP), an abnormality identified by IVP, and intraoperative ureteral injuries. Intravenous pyelograms were performed on 299 patients (60.6%). Factors significantly associated with obtaining a preoperative IVP included an abdominal approach, uterine size of 12 weeks or greater, and uterine prolapse. Seventy-seven patients (27%) had an abnormal IVP; factors likely to be associated with abnormality included uterine size of 12 weeks or larger or an adnexal mass of 4 cm or larger. Endometriosis, pelvic inflammatory disease, pelvic relaxation, and previous intra-abdominal surgery were not associated with an increased prevalence of abnormal IVP findings. Two ureteral injuries were documented, one in the IVP group (0.3%) and one in the non-IVP group (0.5%). Clinical findings may be used to select for a preoperative IVP those patients who are likely to have abnormalities of importance to the pelvic surgeon.
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PMID:Who should have intravenous pyelograms before hysterectomy for benign disease? 382 94

Health planners and policymakers in India had virtually no information about reproductive morbidity and its determinants on which to base efforts to improve the reproductive health of women and the acceptance of family planning programs. Thus, a study of self-reported symptoms of reproductive morbidity was undertaken in 1993 in the state of Karnataka as part of a larger research project investigating the pathways through which maternal education affects child survival. Data were gathered through a cross-sectional survey of women living in one subdistrict who were younger than 35 and had at least one child younger than five. Eligibility was limited to 3600 women living in the town and 48 villages with a population over 500. Experienced female interviewers achieved a more than 95% response rate. Disorders associated with the reported symptoms included: menstrual disorders, dyspareunia, hemorrhoids, prolapse, fistula, lower reproductive tract infection (RTI), urinary tract infection, acute pelvic inflammatory disease (PID), infertility, and anemia. Bivariate analysis revealed the significant variations in reports made by women of different socioeconomic, cultural, and demographic backgrounds; a parallel analysis was performed on the proportions seeking treatment for each condition; and logistic regression analysis estimated the net effect of each factor on the likelihood of reporting specific symptoms and the probability of seeking treatment. Independent variables were composed of socioeconomic background, demographic, last live birth and contraceptive usage, and cognitive and behavioral factors. A third of the women reported symptoms of at least one gynecological morbidity, and about half of these sought treatment. A tenth of menstruating women reported menstrual problems, a sixth reported symptoms of lower RTI, 5% reported symptoms indicative of acute PID, and 23% reported symptoms of anemia. Morbidity was influenced by the presence of complications during the pregnancy, delivery, or postpartum period of the last live birth; the location of the last delivery, with less problems reported by those who delivered in a private institution; and whether or not a woman had undergone tubectomy, which increased reporting of all symptom categories except menstrual problems. This points to the urgent need for longterm follow-up studies of sterilized women. Since most women sought private medical treatment, the primary health care facilities should be subject to a radical review and the private sector should undergo systematic evaluation.
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PMID:Self-reported symptoms of gynecological morbidity and their treatment in south India. 748 78

According to a 3-year collaborative study estimating maternal mortality rates from 41 hospitals affiliated with teaching centers in India, maternal mortality was 721 per 100,000 live births. Community studies in rural areas of Sirur, Pachod, and Ambula reported maternal mortality as 210-253 per 100,000. Cohort studies conducted by the Indian Council of Medical Research reported maternal mortality as 530 per 100,000 based on data from rural areas of Varanasi, 460 per 100,000 in urban Delhi, and 450 per 100,000 in urban Madras. The Ministry of Health gave the rate as 460 per 100,000 in 1984, while UNICEF gave a figure of 400 per 100,000 for 1980-91. India has 1 out of 4 of the world's maternal deaths, or 1 every 6 minutes. The risk of maternal death has been calculated to be one in 64. Risk is unevenly distributed geographically. Risk is low in Kerala compared to Uttar Pradesh or Madya Pradesh. In 1992 maternal mortality was calculated to be 1320 per 100,000 births based on 5 district hospitals. The cause of maternal deaths was anemia in 25% of cases. 75% of cases were accounted for by eclampsia, sepsis, hemorrhage, and abortion. Anemia (pre-existing the pregnancy) is acerbated by the demands of pregnancy and causes congestive heart failure and death. Blood losses of greater than 150 ml (due to hemorrhages of pregnancy and labor) can be fatal. During 1982-89 anemia was responsible for 17-24% of all maternal deaths in rural areas. Morbidity from pregnancy-related causes included obstetric fistulae, pelvic inflammatory disease, anemia, genital prolapse, and urinary incontinence. Quality of maternal care is an important factor in reducing maternal mortality and morbidity. Societal factors such as illiteracy and malnutrition, early marriage, poorly supervised pregnancies, and lack of transportation during emergencies are other determinants of mortality and morbidity. About 10% of maternal deaths are attributed to unsafe abortion. The government aim for the year 2000 of 100% prenatal care and care during delivery will require professional commitment and thousands more midwives in rural areas.
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PMID:How safe motherhood in India is. 765 33

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

Hysterectomy is the commonest major operation performed by gynaecologists and is the definitive cure for many of it's indications which include dysfunctional uterine bleeding, fibroids, utero-vaginal prolapse, endometriosis and adenomyosis, pelvic inflammatory disease, pelvic pain, gynaecological cancers and obstetric complications. It is a successful operation in terms of relieving women of their presenting symptoms and high levels of satisfaction are reported by patients. However, it has a high risk of complications, involves a prolonged convalescence, is expensive and to some women represents a loss of femininity. It should only be employed after trying conservative treatments first if appropriate. If this fails, currently only endometrial ablation and myomectomy are valid alternatives to hysterectomy. If ultimately hysterectomy is required, there is considerable evidence that patient care can be improved by increasing the proportion of operations that are done vaginally and laparoscopically and decreasing the number of laparotomies.
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PMID:Indications and alternatives to hysterectomy. 915 36

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

The association between acupuncture (AP) and pain relief is so strong that it has tended to obscure any other potentially significant clinical results. This review indicates the wealth of data from around the world on various aspects of AP treatment for low back syndromes related to lumbar intervertebral disk prolapse (PID). Although plentiful, the research is variable in quality, especially with respect to design, consistency, and follow-up. Even so, the large number of patients who appear to have been treated successfully (i.e., given a high degree of symptomatic relief) supports a potential role for AP. This is further supported by studies on patients who had previously had unsuccessful treatment with conservative methods. The role envisaged for AP, in cases of lumbar PID and sciatica, is at least of a supplementary therapy capable of reducing the requirement of more invasive forms of treatment. No such role is envisaged in cases of cauda equina compression where surgery must remain the treatment of choice. AP should be explored more fully, using appropriate designs, so that this discipline may achieve its full therapeutic potential in the West.
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PMID:A review of research on acupuncture for the treatment of lumbar disk protrusions and associated neurological symptomatology. 939 94


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