Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study is to explore the relationship between measured postvoid residual urine volumes (PVR) and self-reported bother from obstructive voiding symptoms (OS) using a retrospective chart review of patients presenting to our clinic from 2004 to 2005. Demographic, primary clinical diagnoses, PVR, and responses to the short form of the Pelvic Floor Distress Inventory (PFDI-20) were recorded. We considered a PVR > 150 ml to be elevated or consistent with urinary retention. We used Spearman's for correlations and Mann-Whitney test for independent groups. Six hundred thirty-six patients were included in the study. Individual PFDI-20 items, which inquire about obstructive voiding symptoms, had poor sensitivity (13-57%) and specificity (18-38%) for elevated PVR. Using logistic regression, age (beta = 0.04, p < 0.001) and stage > or = III prolapse (beta = 0.78, p < 0.05) were predictive factors for elevated PVR. Obstructive voiding symptoms have poor sensitivity and specificity for elevated PVR in women with pelvic floor disorders.
 ...
PMID:Obstructive voiding symptoms are not predictive of elevated postvoid residual urine volumes. 1807 67

The aim of this study was to evaluate the efficacy of the Contiform intravaginal device for stress incontinence after the addition of a fourth size. We offered the device to a cohort of 73 women with a main complaint of stress incontinence but no prolapse. Of the 73 women invited to participate, 65 enrolled, of whom 52 were fitted. Of these 52 women, 37 (71%) completed the study protocol. Outcome measures were the 24-h pad test, St George score, and quality of life tests. Urine loss on pad test was significantly reduced from a median 6.6 g (interquartile range [IQR] = 4.3-22.6) to 2.2 g (IQR = 0.5-8.2; P = 0.0016) after 4 weeks with significant benefit seen on the Incontinence Impact Questionnaire and Urinary Distress Inventory. The insertion technique was quickly learnt, and the device was well tolerated. The recently developed medium/large size of Contiform was used by 6/37 (16%) women.
 ...
PMID:Update: the "Contiform" intravaginal device in four sizes for the treatment of stress incontinence. 1818 42

Advanced obstetric anal sphincter tears are often associated with a high incidence of fecal and flatus incontinence. We aimed to assess the clinical outcome of these repairs when done by the overlapping sphincteroplasty technique with reconstruction of the internal anal sphincter and perineum. Between August 2005 and December 2006, all grades 3 and 4 obstetric anal sphincter tears in our department were repaired by a reconstructive pelvic surgeon, primarily using the overlapping sphincteroplasty technique with reconstruction of the internal anal sphincter and perineum. All women were followed every 6 months using the Colorectal Anal Distress Inventory and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire, a physical examination of the anal sphincter, anal manometry, and transperineal anal sonography. There were 3,478 deliveries of which 22 (0.63%) anal sphincter tears were repaired in women aged 22-41 years. Two women were diagnosed with Royal College of Obstetricians and Gynecologists grade 3a, eight with grade 3b, nine with grade 3c, and three with grade 4 anal sphincter tears. Postoperatively, 21 patients attended the outpatient clinic, with an average follow-up time of 9.2+/-1.4 months. Only two women (9.5%) complained of flatus incontinence and fecal urgency and had mildly decreased anal sphincter squeeze pressure and a small sonographic anal sphincter defect. None of the women complained of fecal incontinence. Two women (9.5%) reported on transient perineal pain and one (4.8%) on transient dyspareunia. All other women were asymptomatic and had normal anal manometry and sonographic evaluation. Repair of obstetric anal sphincter tears using the overlapping sphincteroplasty technique with reconstruction of the internal anal sphincter and perineum seems to carry favorable clinical outcome and reduced risk for anal incontinence, perineal pain, and sexual dysfunction.
 ...
PMID:Primary repair of advanced obstetric anal sphincter tears: should it be performed by the overlapping sphincteroplasty technique? 1838 17

The objective was to study the effect of colpocleisis on pelvic support, symptoms, and quality of life and report-associated morbidity and postoperative satisfaction. Women undergoing colpocleisis for treatment of pelvic organ prolapse (POP) were recruited at six centers. Baseline measures included physical examination, responses to the Pelvic Floor Distress Inventory, and Pelvic Floor Impact Questionnaire. Three and 12 months after surgery we repeated baseline measures. Of 152 patients with mean age 79 (+/-6) years, 132 (87%) completed 1 year follow-up. Three and 12 months after surgery, 90/110 (82%) and 75/103 (73%) patients following up had POP stage < or = 1. All pelvic symptom scores and related bother significantly improved at 3 and 12 months, and 125 (95%) patients said they were either 'very satisfied' or 'satisfied' with the outcome of their surgery. Colpocleisis was effective in resolving prolapse and pelvic symptoms and was associated with high patient satisfaction.
 ...
PMID:Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis. 1869 Apr 2

The aim of this study was to design and validate an interviewer-administered pelvic floor questionnaire that integrates bladder, bowel and sexual function, pelvic organ prolapse, severity, bothersomeness and condition-specific quality of life. Validation testing of the questionnaire was performed using data from 106 urogynaecological patients and a separately sampled community cohort of 49 women. Missing data did not exceed 2% for any question. It distinguished community and urogynaecological populations regarding pelvic floor dysfunction. The bladder domain correlated with the short version of the Urogenital Distress Inventory, bowel function with an established bowel questionnaire and prolapse symptoms with the International Continence Society prolapse quantification. Sexual function assessment reflected scores on the McCoy Female Sexuality Questionnaire. Cronbach's alpha coefficients were acceptable in all domains. Kappa coefficients of agreement for the test-retest analyses varied from 0.5 to 1.0. The interviewer-administered pelvic floor questionnaire assessed pelvic floor function in a reproducible and valid fashion in a typical urogynaecological clinic.
 ...
PMID:Australian pelvic floor questionnaire: a validated interviewer-administered pelvic floor questionnaire for routine clinic and research. 1895 82

A retrospective study was carried out to evaluate which mesh (cadaveric fascia lata (Tutoplast or Prolene mesh) is associated with the best outcome of laparoscopic sacrocolpopexy for vaginal vault prolapse. Nineteen women who had surgery with Tutoplast and 20 who underwent surgery with Prolene were followed and asked to complete the Urogenital Distress Inventory and Defecation Distress Inventory to measure disease-specific quality of life. The women were invited for a follow-up visit for pelvic examination at a mean time of 45 months. There were no significant differences in operating time, blood loss or hospital stay between the groups. The risk of re-intervention because of recurrent prolapse was higher in the Tutoplast group than in the Prolene group (relative risk 2.9 (95% Confidence interval 0.9-9.5)). Women in the Prolene group were significantly more satisfied with the operative result.
 ...
PMID:Laparoscopic sacrocolpopexy: a comparison of Prolene and Tutoplast mesh. 1935 30

Between August 2007 and May 2009, 28 patients with uterovaginal prolapse, stage 2 or greater, and who desired uterine preservation, underwent laparoscopic extraperitoneal uterine suspension to the anterior abdominal wall bilaterally using mesh. The primary outcome was recurrence, which was evaluated using point C. Secondary outcomes were effects on quality of life (Pelvic Floor Distress Inventory [PFDI-20] and Pelvic Floor Impact Questionnaire [PFIQ-7]) and sexual symptom (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire [PISQ-12]) scores, operative time, blood loss, duration of hospitalization, and adverse events. After surgery, there was significant improvement in all pelvic organ prolapse quantification (POP-Q) measurements. The POP-Q score for point C was significantly farther from the hymen at 6-months and 1-year follow-up compared with the preoperative value (-7.8 and -8.0 vs 2.6, respectively; p < .001). The objective cure rates at 6 months and 1 year were 96.4% and 94.1%, respectively. There were no major intraoperative or postoperative complications. However, all patients reported postoperative dragging pain at the points of puncture ports where the mesh was fixed to the abdominal wall. The mean visual analog scale decreased from a mean (SD) 3-day score of 2.61 (1.26) to 0 at 1 month follow-up. Baseline PISQ-12 score changed significantly compared with the value at 6 months after operation (28.4 [2.7] vs 29.3 [2.9]; p < .001). The PFDI-20 and PFIQ-7 scores at 6 and 12 months after surgery improved significantly compared with the baseline scores (p < .001). The subjective success rates at 6 months and 1 year were 96.4% and 94.1%. respectively. Laparoscopic extraperitoneal uterine suspension to the anterior abdominal wall using mesh is a simple, safe, and effective procedure for treating uterovaginal prolapse. However, further studies of the long-term efficiency and reliability of this technique are needed to evaluate its value.
 ...
PMID:Laparoscopic extraperitoneal uterine suspension to anterior abdominal wall bilaterally using synthetic mesh to treat uterovaginal prolapse. 2059 51

To assess female sexual function (FSF) and health-related quality of life (HRQOL) following anterior vaginal wall surgeries for stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The retrospective study consisted of 116 patients. Chinese translations of the modified Lemack Questionnaire (not validated) and Pelvic Floor Distress Inventory-Short Form 20 were used to assess FSF and HRQOL, 3 months pre-operatively and 12-24 months (mean 16.8 months) post-operatively. Sixty-one (52.6%, 29 in SUI group and 32 in POP group) of patients were sexually active before and after the operation. Overall, 12 (19.7%, six in SUI group and six in POP group) reported an improvement in overall intercourse satisfaction, 21 (34.4%, 8 in the SUI and 13 in the POP group) were decreased and 28 (45.9%, 15 in SUI group and 13 in POP group) were unchanged. Incidence of coital incontinence decreased significantly in SUI group. Frequency of intercourse decreased, vaginal dryness and pain due to it and asymptomatic vaginal narrowing increased significantly, following the surgery in POP group. There were no statistically significant differences in the frequency of intercourse in SUI group, patients' perception of intercourse, frequency of orgasm and the importance of sex life in both groups. Partner discomfort remained unchanged. HRQOL improved significantly after the operation in both groups. There was no association between HRQOL and FSF in the post-operative period. In most patients, overall FSF did not impaired. All trans-anterior vaginal wall surgery positively impacted on the patients' HRQOL. A prospective study with validated questionnaire is necessary in future.
 ...
PMID:Sexual function and health-related quality of life following anterior vaginal wall surgery for stress urinary incontinence and pelvic organ prolapse. 2165 11

Objective. To investigate the contribution of Pelvic Organ Prolapse (POP) to micturition and defecation symptoms. Method. Cross-sectional study including 64 women presenting with POP symptoms and 50 controls without POP complaints. Subjects were evaluated using POP-Quantification system, Urinary Distress Inventory, and Defecation Distress Inventory. The MOS SF-36 health survey and the Center for Epidemiological Studies Depression scale were used to measure self-perceived health status and depressive symptoms, respectively. Results. POP in terms of POP-Q had a moderate impact on the symptom observing vaginal protrusion (explained variance 0.31). It contributed modestly to obstructive voiding and overactive bladder symptoms (explained variance 0.09, resp., 0.14) but not to urinary incontinence. Constipation was more likely explained by clinical depression than by pelvic floor defects (explained variance 0.13, resp., 0.05). Conclusion. Stage of POP and specific prolapse symptoms are associated but such a strong association does not exist between POP and micturition or defecation symptoms.
 ...
PMID:Contribution of primary pelvic organ prolapse to micturition and defecation symptoms. 2196 31

Genital prolapse is a functional pathology presenting with numerous urinary, genito-sexual, and anorectal symptoms. These symptoms are responsible for an alteration of the quality of life, sometimes associated to a real anxiety-depressive syndrome. Because of these complex intricacies, the management of these disorders became multidisciplinary. Tools to measure the impact of prolapse symptoms on the quality of life became a necessity. Such instruments should allow a correlation of the functional symptomatology at the anatomic stage, raise a surgical indication based on the functional disturbance and evaluate the effectiveness and tolerance of the various therapeutic procedures. Two validated self-questionnaires in French (short versions of the Pelvic Floor Distress Inventory [PFDI-20] and the Pelvic Floor Impact Questionnaire [PFIQ-7]) are presently available. Moreover, the physician has the legal obligation to provide detailed presurgical information on frequent and severe hazards, expected benefits, functional consequences, therapeutic alternatives and the consequences of nonintervention. Before surgery takes place, the surgical approach, the benefit of using synthetic prostheses, the possibility of uterine and/or ovarian conservation, and some risky conditions such as smoking, obesity and estrogen deficiency should be discussed.
 ...
PMID:[Objective assessment of symptoms and informing patients of surgical risks]. 2426 Aug 38


<< Previous 1 2 3 4 Next >>