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

Six hundred and twenty-one hysterectomies were performed at National Women's Hospital, Auckland, during 1975. Abnormal vaginal bleeding was the clinical indication in 50.72% of the cases. Fibroids, pelvic mass, prolapse, stress incontinence and cervical neoplasia were the indication for 45.88% of the cases. Total hysterectomy was performed in 618 (99.5%) patients whilst sub-total hysterectomy was done in only three cases. Histopathological studies revealed that 567 (91.30%) specimens were pathological and there was multiple pathology in 55.87% of the specimens. Leiomyomas were present in 278 cases (44.76%); microleiomyomatosis in 178 specimens (22.66%); endometrial hyperplasia in 139 specimens (22.33%) adenomyosis in 87 cases (14.00%); malignant diseases in 76 cases (12.23%); and endometriosis in 40 specimens (6.44%). There were no histological abnormalities in 54 specimens, 8.69% of this series.
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PMID:The pathology of hysterectomy specimens. 28 33

To evaluate the prevalence and risk factors for adenomyosis, the clinical records of consecutive women undergoing hysterectomy during a 3 year period were retrieved. Data were collected on indication for the intervention, general sociodemographic characteristics of the patients, age at menarche, parity, abortions, and menopausal status at surgery. Adenomyosis was diagnosed in 332 of the 1334 cases (24.9%). The condition was present in 146 of the 627 patients (23.3%) with fibroids and menorrhagia, 68 of the 265 (25.7%) with prolapse, 21 of the 98 (21.4%) with ovarian cysts, 19 of the 100 (19%) with cervical cancer, 31 of the 110 (28.2%) with endometrial cancer, 16 of the 57 (28.1%) with ovarian cancer, and 19 of the 77 (24.7%) with miscellaneous indications. These differences were not statistically significant (chi 2(6) = 11.14). In comparison with nulliparous women, the odds ratio was 1.3 and 1.5 respectively in women with one and > or = two births (chi 2(1) trend = 5.76 P < 0.05). No relationship was found between age at surgery, age at menarche, indications for surgery, menopausal status at intervention, and presence of endometriosis. Our findings do not support the notion that adenomyosis is more frequently related to particular clinical conditions, and suggest that parity may be associated with an increased frequency of adenomyosis.
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PMID:Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics. 765 58

Short TI inversion recovery magnetic resonance imaging (STIR-MRI) with spin echo (SE) T1-and T2-weighted images of the pelvis was investigated to evaluate its usefulness in detecting and characterizing endometriosis. Thirty-one women suspected of having the disease were studied in detail. MR findings with and without STIR-MRI were correlated with the results of laparotomy (27 women) and laparoscopy (4 women). Surgery revealed endometriosis in 29 women (17 ovarian chocolate cysts, 22 intestinal adhesions, 14 cul-de-sac obliterations and 12 adenomyosis). The other two women did not have endometriosis (uterine prolapse in one and submucosal leiomyoma in one). An ovarian chocolate cyst was diagnosed when a T1-elongated lesion showed shading, loculus or a low intensity rim on SE MR images, and a low intensity rim on STIR-MRI. Only 12 of the 17 chocolate cysts and neither of the two hemorrhagic corpus lutein cysts were correctly diagnosed on SE MR images, whereas 18 of these 19 cysts were correctly diagnosed because of the low intensity rim on STIR-MRI. In the pathological analysis, the rim was found to be a fibrous capsule and there were many macrophages which phagocytized hemosiderin. For the assessment of ovarian chocolate cysts, accuracy improved from 63.2% to 94.7%. As for the adhesion between the intestine and the uterus, specificity improved from 61.9% to 90.5% and accuracy improved from 67.7% to 93.5% when STIR-MRI was used. For the assessment of the cul-de-sac obliteration, accuracy improved from 67.7% to 83.8%, although chi 2 analysis showed no significance. The major factors for the improved accuracy with STIR-MRI are the decrease of the motion artifact owing to the suppression of the fat signal, decreased chemical shift artifact and accurate differentiation of fat from hemorrhagic component. Therefore, STIR-MRI is a useful and reliable procedure and should be used together with SE T1-, T2-weighted images for the assessment of endometriosis.
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PMID:[Detection and characterization with short TI inversion recovery MR imaging]. 780 15

The results of the first twelve cases of Laparoscopic Assisted Vaginal Hysterectomy, are presented. The indications for hysterectomy were myomatosis, suspicion of adenomyosis and endometriosis. The surgical technique is described in detail in which a combination of bipolar Kleppinger forceps and reusable scissors were employed. There were two intraoperative accidents. One subcutaneous emphysema of the left half of the abdominal wall, thorax, neck, face and upper limb. The second case was a damage to a branch of the left epigastric artery. The average time was 4 hours 31 minutes which includes 9 patients to which another surgical procedure was practiced. There was no significant bleeding in any of the patients. The postoperative complications were 1 hyponatremia that needed the use of an Intensive Care Unit and the other was periumbilical hematoma of 3 cm. of diameter. The patient was discharged on the one to three postoperative day with an average of two days. The average hospital fee was 35% higher than an abdominal hysterectomy. All the surgery were videotaped and later viewed by the patients. It was concluded that the laparoscopic assistance that is offered to the vaginal hysterectomy is particularly advantageous for hysterectomy especially in the cases where absence of genital prolapse, when uni or bilateral Adnexectomy is required, previous past history of abdomino-pelvic surgery, endometriosis and adhesions. This procedure should be included in the armamentarium of the Gynecological Surgeons but only after and appropriate training.
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PMID:[Laparoscopic hysterectomy. Initial experience]. 816 16

Hysterectomy, the most common major nonobstetric operation, is performed in more than 570,000 women in the United States each year. Although the number of hysterectomies has decreased in recent years, many authorities believe that hysterectomy is often unnecessary and unjustified. There is no universally accepted set of criteria regarding the appropriate indications for hysterectomy. The main indications for hysterectomy include the following conditions: uterine leiomyomas, dysfunctional uterine bleeding, endometriosis/adenomyosis, chronic pelvic pain and genital prolapse. Current literature, however, routinely recommends conservative management of most nonmalignant gynecologic conditions, with hysterectomy reserved for refractory cases. Several nonmedical factors, such as patient race, age, geographic location, medical history and background, as well as health care provider characteristics, such as time since completion of training, gender, and affiliation with teaching hospitals, are also associated with hysterectomy rates.
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PMID:Hysterectomy: indications, alternatives and predictors. 933 35

In order to estimate the frequency and risk factors for adenomyosis, the clinical records of 594 women undergoing hysterectomy were retrieved. Data were collected on indications for the intervention, age at surgery, age at menarche, parity, abortions, mode of delivery, abnormal uterine bleeding, dysmenorrhea, and menopausal status at surgery. Adenomyosis was found in 116 of the 594 patients (19.5%). A pathologic condition was present in 63 patients with fibroids (20.5%), 11 with genital prolapse (25.6%), 11 with benign ovarian tumors (17.8%), six with endometrial hyperplasia (13.6%), two with cervical cancer (18.2%), ten with endometrial cancer (16.1%), and 13 with ovarian cancer (21.3%). No relationship was found between adenomyosis and endometriosis. On the contrary, a strong relationship was found between adenomyosis and parity, cesarean section, induced abortions, dysmenorrhea, abnormal uterine bleeding, and late age at menarche. These results show that adenomyosis is a common pathologic finding, significantly related to reproductive and menstrual characteristics of the patients.
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PMID:Adenomyosis at hysterectomy: prevalence and relationship to operative findings and reproductive and menstrual factors. 910 56

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

The medical records of all women who underwent hysterectomy for benign disease performed between 1986 and 1995 were reviewed to ascertain the incidence of morbidity and mortality of abdominal, vaginal, and laparoscopically assisted vaginal hysterectomy at a university teaching hospital. A total of 1940 hysterectomies were performed during this period; 74% of hysterectomies were performed abdominally, 24% vaginally and 2% were laparoscopically assisted. In 80% of the patients uterine leiomyomas, adenomyosis, dysfunctional uterine bleeding or uterine prolapse were the indications for hysterectomy The overall complication rate was 44% for abdominal hysterectomy (AH) and 27.3% for vaginal hysterectomy (VH). An unintended major surgical procedure was required in 3% and 1% of women undergoing AH and VH respectively The rate of return to the operating room for haemostasis was 0.6% for AH and 0.2% for VH. The AH group was four times more likely than the VH group to require surgical intervention (36% versus 9%) at readmission. Vaginal hysterectomy was associated with a lower febrile morbidity and minor complication rate. Prophylactic antibiotics reduced the febrile morbidity for VH and AH by 50% (Student's t-test, p = 0.02) and 40% (Student's t-test, p < 0.001) respectively The overall mortality rate was 1.5 per 1000.
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PMID:Ten-year review of hysterectomy morbidity and mortality: can we change direction? 1178 36

A randomised study of 100 cases undergoing hysterectomy in the age group of 20-70 years was carried out and clinicopathological correlation was done. Maximum number of women who underwent hysterectomy were in the age group of 31-50 years. Abnormal menstrual flow was the most common complaint (66%). Clinically main indications for hysterectomy were fibroid (34%), dysfunctional uterine bleeding (DUB) (26%) and uterine prolapse (24%). Abdominal hysterectomy was the procedure of choice in conditions other than uterovaginal prolapse. Out of 34 cases, clinically diagnosed as fibroid uterus, leiomyoma was found on histopathology in 25 cases and adenomyosis in 3 cases. In 3 cases, both leiomyoma and adenomyosis were present. Out of 26 cases, clinically diagnosed as DUB, histopathological examination revealed leiomyoma in 6 cases, adenomyosis in 9 cases, endometrial polyp in 3 cases. Hence, after exclusion of organic pathology, DUB was confirmed in 8 cases.
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PMID:Clinicopathological study of hysterectomies. 1240 32

Uterine prolapse is a benign and common condition, especially in older women. In this study, we investigated the frequency and implications of incidental findings in uteri removed for prolapse. We found a high frequency of incidental findings that was greater than previously reported and a correlation between the occurrence of leiomyomata and adenomyosis. As long as all grossly visible lesions are sampled, two routine sections were found to be sufficient to identify all significant lesions.
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PMID:Incidental findings in uterine prolapse specimen: frequency and implications. 1466 46


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