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

Authors studied the application of vaginal hysterectomies performed on 790 patients, and abdominal hysterectomies performed on 892 patients over 15 years. The age of the patients was 41 to 60. In 233 cases the reason for the operation was a severe prolapse of the uterus in middle-aged and elderly women. 170 women underwent hysterectomy because of recidivist and persisting uterine hemorrhages. 67 elderly patients had a vaginal hysterectomy because of endometrial cancer. Vaginal hysterectomies were also performed on 58 patients with preclinical cancer of the cervix; these women were all over 40 years old. It appears that vaginal hysterectomies were mostly performed because of uterus mobility. These operations were done under lcoal infiltration anesthesia. No other operation was required for 217 patients. 237 cases necessitated plastic surgery on the vagina and on the peritoneum. 52 women had plastic surgery against frequent irretention of urine, and plastic surgery on the peritoneum. Meyo's procedure was used on 175 patients. 11 women suffered some complications after vaginal hysterectomy: severe hemorrhage, rectal injury, injury of the wall of the bladder. 15 women suffered complications after abdominal hysterectomy. It is concluded that vaginal hysterectomy is better tolerated by patients than abdominal hysterectomy. (Summary in ENG).
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PMID:[Application of vaginal hysterectomy in surgical gynecology]. 60 74

Report on 2309 vaginal hysterectomies. The leading indication for vaginal hysterectomy was benign disease of the uterus (54.4%). Utero-vaginal prolapse was the indication in approximately 32% of the patients. In 71.1% of the hysterectomies, the vaginal approach for removal of the uterus was selected in malignant and pre-malignant diseases. Of these cases 11.9% had carcinoma in situ and 2.7% had micro-invasive carcinoma of the cervix. 2.6% of these cases had carcinoma of the endometrium. In 69.9% of the cases the vaginal hysterectomy was combined with a colporrhaphy. Previous genital operations or laparotomies where no contra-indication to vaginal hysterectomy. Trauma to the urinary tract or the rectum occurred in 26 cases (1.02%). Post-operatively 3 urinary tract fistulas and 3 rectovaginal fistulas developed. The mortality was 0.51%. Among 272 cases of carcinoma in situ and 62 cases of micro-invasive carcinoma of the cervix treated by vaginal hysterectomy, one case developed a recurrent carcinoma in situ of the vaginal vault eight years after vaginal hysterectomy for carcinoma in situ. One patient treated for micro-invasive carcinoma of the cervix died four years following vaginal hysterectomy in another hospital of suspected pulmonary metastases. The diagnosis was not confirmed by autopsy. Simple total hysterectomy whenever possible by the vaginal approach is at present the maximal treatment in the University Department in Graz for carcinoma in situ and micro-invasive carcinoma of the uterine cervix.
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PMID:[Vaginal hysterectomy at the department of gynecology of the university of Graz from 1955 to 1970 (author's transl)]. 118 93

Six patients with Paget's disease of the vulva, four after local excision of the gross lesion, one after multiple biopsies, and one after a radical vulvectomy, were successfully treated using the CO2 laser. Biopsy specimens 2 cm peripheral to the excised gross lesion were used in four of the patients in planning subsequent laser treatment. Two patients were admitted to the hospital because they had hysterectomies necessitated by endometrial cancer at the time of the wide local excision. A third patient was admitted twice: initially for a radical vulvectomy and subsequently for laser vaporization and simple hysterectomy for vaginal prolapse. Local excision and the subsequent laser treatment can usually be done on an outpatient basis. Use of skin grafts was avoided in all cases. There have been no recurrences in follow-up periods ranging from 4 months to 4 1/2 years.
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PMID:Paget's disease of the vulva treated by combined surgery and laser. 166 Apr 32

Vaginal hysterectomy, as currently performed at the University of Vienna, was first described by Halban in 1932. From 1955 to 1985, a total of 9,967 hysterectomies were performed. The vaginal route was used for 6,078 (60.9 per cent) of these procedures. Sixty-four per cent of the women operated upon were multiparous, 27 per cent were uniparous and 8 per cent were nulliparous. A comparison of the periods 1955 to 1975 and 1976 to 1985 revealed the following trends: the incidence of uterine myomas (30.6 to 27.1 per cent), in situ carcinoma of the cervix (6.5 to 7.9 per cent) and endometrial carcinoma (1.4 to 0.6 per cent) remained largely constant. In the past decade, indications for positional abnormalities (uterine descent and prolapse) were encountered more often (27.6 to 41.6 per cent) than in the first observation period, while the incidence of recurrent metrorrhagia was found to decline (33.9 to 22.8 per cent). The most common complications included hemorrhage during the operation, lesions of the bladder, hemorrhage until 48 hours after surgical treatment and hemorrhage from days 2 to 14 postoperatively (around 0.5 per cent, respectively). During the second observation period, no postoperative fistulas developed. Two instances of tubal prolapse were seen. Laparotomy was done in four of 6,078 instances. Two patients died of septic complications. Whenever possible, we prefer vaginal hysterectomy because of its low complication rate, low mortality rate and low postoperative morbidity.
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PMID:Trends in thirty years of vaginal hysterectomy. 199 96

Between 1982 and 1984 330 women in postmenopause for at least one year were admitted to the First Clinic of Obstetrics and Gynecology, Catania University Medical School, Catania, Italy, with a frequency of 10.04% of gynecological admissions. The most frequent pathologies were metrorrhagia (32.72%; 108 cases) from an atrophic endometrium or glandular hyperplasia of the endometrium, vaginoperineal lacerations with cystorectocoele with or without urinary incontinence (10.90%; 36 cases), cancer (11.21%; 37 cases) and ovarian cystoma (11.21%; 37 cases), uterine prolapse (9.30%; 31 cases), and endometrial polyps (9.09%; 30 cases). Uterine fibromyoma (3.93%; 13 cases) and carcinoma of the portio (3.93%; 13 cases) were among the rare pathologies. Uterine pathologies were the most prevalent (68.78%; 227 cases), followed by ovarian (15.15%; 50 cases), pathology of involving the pelvic and perineal containment (10.90%; 36 cases), vulvar pathology (2.72%; 6 cases), and vaginal pathology (1.51%; 5 cases). Malignant neoplastic pathology was reported in 25.45% of cases (84 cases) consisting only of uterine cancer (47.61%; 40 cases) and ovarian cancer (45.23%; 38 cases). In comparison with the study performed by Cetroni in 1952 one notes a net reduction in the frequency of uterine prolapse (by about three times), and a smaller reduction in cancer of the uterine cervix with a slight increase in cervical polyps, endometrial cancer, and above all in metrorrhagia from atrophic endometrium or glandular hyperplasia of the endometrium.
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PMID:Current aspects of gynecological pathology in postmenopause. 340 88

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

Despite literature documenting ureteral obstruction associated with certain gynecological conditions, the occurrence of diuresis among posthysterectomy patients has not been examined. This nonexperimental exploratory study investigated whether diuresis was greater following hysterectomy for conditions that could potentially cause obstruction of the urinary tract than for other conditions requiring hysterectomy. Roy's adaptation model was used to emphasize the importance of expedient detection and intervention of the resultant fluid volume deficit. A retrospective chart review of 140 posthysterectomy patients was conducted. Four strata were used to divide the sample records into one nonobstructive and three potentially obstructive conditions for surgery. A ratio of total intake divided by total output was formulated for each patient and compared between the groups. Statistically significant differences were shown by one-way analysis of variance between two of the obstructive groups and the nonobstructive group (F = 5.182; P < .05). Results of this research showed that certain obstructive conditions--uterine prolapse/endometrial cancer and leiomyomas greater than 15 week size--were linked with substantially higher postoperative urine outputs, which increase the risk of hypovolemia.
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PMID:Incidence of diuresis following hysterectomy. 870 34

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

Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare inherited disorder with characteristic oculofacial affection of the eyelid region. Recent results of genetic analysis of the causative gene, as well as a hitherto unknown association with hormone-dependent endometrial carcinoma, motivated us to review this syndrome.
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PMID:Cutaneous peculiarities in blepharophimosis-ptosis-epicanthus inversus syndrome: report of a case. 1118 77

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


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