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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 determine posterior compartment topography 1-year after sacrocolpopexy (SC). Women who had SC without concomitant anterior or posterior repairs for symptomatic pelvic organ prolapse (POP) were included. Vaginal topography was assessed at baseline and 1-year postoperatively using POP quantification (POPQ). At baseline, 24% had stage IV POP, 68% stage III, and 8% stage II. One year after surgery, 75% had stage 0/I POP, 24% stage II, and 1% stage III. 112 (75%) were objectively cured (stage 0 or I POP). Anterior compartment was the most common site of POP persistence or recurrence (Ba >/= stage II in 23 women) followed by posterior compartment (Bp >/= stage II in 12 women) and apex (C >/= stage II in 2 women). In 1-year follow-up, SC without concomitant posterior repair restores posterior vaginal topography in the majority of women with undergoing SC.
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PMID:Sacrocolpopexy without concomitant posterior repair improves posterior compartment defects. 1849 36

The objective of this study was to evaluate anatomic, functional, short- and long-term outcome of vaginal surgery for pelvic organ prolapse. This was a prospective observational study of 185 consecutive women planned for vaginal prolapse reconstructive surgery. Stage of prolapse, urinary incontinence (UI), bowel and mechanical symptoms were assessed preoperatively and at 1, 3 and 5 years postoperatively. The mean follow-up time was 53 months. The anatomic recurrence rate was 41.1% but less than half of them were symptomatic. Anterior compartment was most prone for recurrence and the majority of the recurrences took place within the first year. UI remained at the same level at 1-year follow-up. De novo urge occurred in 22.6% and de novo stress incontinence in 6.0%. An improvement was seen in difficulty in emptying bowel 1 year after surgery (54%). Patients were primarily cured from mechanical symptoms. Re-operation rate was 9.7%; if additional operation for incontinence was included, it was13.5%.
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PMID:A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse. 1869 2

The objective of this study was to estimate the anatomical and functional outcome of Prolift Anterior C. All patients presenting with symptomatic stage II or greater anterior vaginal wall prolapse were considered to enter this prospective observational study. Patient characteristics and surgical parameters were prospectively documented. Anatomical outcome, as measured by the Pelvic Organ Prolapse Quantification (POP-Q) score, and functional outcome, as assessed by the King's College Health Questionnaire, was considered primary outcome measures. Complications constituted the secondary outcome measures. Fifty-one patients met the inclusion criteria, and 48 underwent a transobturator anterior vaginal wall mesh. Objective cure was realized in 46 out of 48 (95.8%) patients. Postoperatively, 5 out of 48 (10.4%) patients developed an erosion which required surgical intervention in 2 (4.3%) patients. Subjective cure was achieved in 40 out of 42 (95.2%) patients. Urgency symptoms persisted in 3 out of 21 (14%). De novo urgency and frequency developed in only 1 patient. De novo stress incontinence developed in 4 out of 30 (13%). In 9 out of 29 (31%) of sexually active patients, dyspareunia due to the prolapse was present before surgery and disappeared in all; 3 out of 20 (15%) reported de novo dyspareunia. In conclusion, we state that transobturator anterior vaginal wall mesh kits provide a surgical tool with an acceptable but real morbidity to treat anterior vaginal wall prolapse with a favorable objective and subjective outcome.
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PMID:A prospective study to evaluate the anatomic and functional outcome of a transobturator mesh kit (prolift anterior) for symptomatic cystocele repair. 1872 74

An 83-year-old man underwent penetrating keratoplasty for pseudophakic bullous keratopathy in the left eye. Postoperatively, a thin transparent membrane in the anterior chamber was noted. The differential diagnosis included vitreous prolapse, retained capsule, fibrinous anterior chamber membrane, and retained Descemet's membrane in the anterior chamber, but the diagnosis was uncertain due to corneal edema and Descemet's membrane folds. Anterior segment optical coherence tomography was used to determine the diagnosis of retained host Descemet's membrane. This case report demonstrates that anterior segment optical coherence tomography is a useful and noninvasive instrument for diagnosing and following complications from penetrating keratoplasty.
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PMID:Double Descemet's membranes after penetrating keratoplasty with anterior segment optical coherence tomography. 1883 30

The author considered the following important points:(1) Anterior capsular synechia to a corneal incision (made by a keratome) after the evacuation of a traumatic cataract. This might be detached early by the use of a blunt-ended knife following a perforation of the cornea with a sharp-pointed knife, much like a tenotome.(2) The involuntary prolapse of capsule with a cataract incision.(a) The danger of this was demonstrated as the cause of glaucoma, especially if it be found necessary to divide opaque capsular membrane after the extraction.(b) The danger of sympathetic ophthalmia.Prolapse might be prevented:(a) By intracapsular extraction.(b) By extracting the lens through an intact pupil, after the use of capsule forceps, followed either by a partial or total iridectomy.(3) The treatment of opaque after-cataract.Various types of opaque capsule membrane were described.(a) Opaque lens fibres imprisoned between anterior and posterior remains of capsule.(b) Grey membrane made of new lens fibres from proliferating subcapsular cells.(c) Elschnig's cells.(d) Much thickened capsular membrane following an extensive haemorrhage into the anterior chamber occurring about the fifth day after extraction.(e) A thick membrane formed of fibrous tissue following the invasion of the coloboma of the iris after infection at the time of operation. The fibrous tissue comes from the undersurface of the conjunctival flap and causes an updrawn coloboma which is also made narrower by its contraction.When performing a capsulotomy thickened bands should be avoided and an incision made in thin capsule, parallel to thick bands.If the membrane is very thick and shows signs of being torn from its peripheral attachment when a single needle is used, then(1) Two needles may be used after the method of Bowman;(2) A Wheeler operation may be performed (Wheeler, 1939, Collected Papers, New York, 197);(3) Thick capsule may be divided by means of a Ziegler knife, as described by the author, but not in the manner described by Ziegler.The danger of performing a capsulotomy in the presence of soft lens matter was pointed out.The occasional occurrence of localized vitreous opacification at the site of a capsulotomy, even in the absence of iridocyclitis, was mentioned.
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PMID:The capsular complications of cataract extraction. 1886 98

Pregnancy is often associated with ocular changes which may be more commonly transient but occasionally, permanent. It may be associated with the development of new ocular conditions, or can exacerbate pre-existing conditions. The ocular effects of pregnancy may be physiological or pathological or may be modifications of pre-existing conditions. Adnexial changes include chloasma, spider angiomas and ptosis. Anterior segment changes include a decrease in conjunctival capillaries and an increase in the granularity of conjunctival venules and in corneal curvature, changes in corneal thickness, refractive index, accommodation and refractive errors, and a decrease in intraocular pressure. Posterior segment changes include worsening of diabetic retinopathy, central serous chorioretinopathy, increased risk of peripheral vitreochorioretinal dystrophies and retinal detachment, and a beneficial effect on non-infectious uveitis. Systemic disorders of importance include preeclampsia, Graves disease and multiple sclerosis. Intracranial disorders with ocular effects in pregnancy include Pseudotumor cerebri, prolactinomas and Sheehan's syndrome.
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PMID:A review of the changes in the ophthalmic and visual system in pregnancy. 1943 22

This study was designed to compare the objective failure rate after vaginal paravaginal repair for anterior vaginal wall prolapse using either porcine or human cadaveric dermal implants. A retrospective, repeated-measures cohort study compared 72 women who underwent repair using porcine tissue implants with 45 women using cadaveric dermal implants. Anterior vaginal wall prolapse was staged preoperatively and every 6 months postoperatively. Objective failure was defined as recurrent anterior vaginal wall prolapse, stage II or greater. Life table analysis was performed. The median length of follow-up was 25 months in the cadaveric and 21 months in the porcine dermal group. The relative risk for objective failure for the porcine dermal group was 0.45 (95% confidence interval, 0.1-0.8) compared with the cadaveric dermal group. The rate of postoperative complications was similar in the two groups. The risk of recurrence of anterior vaginal prolapse is lower after surgical repair using porcine compared with cadaveric dermal implants.
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PMID:Vaginal paravaginal repair using porcine or human cadaveric dermal implant: a survival analysis. 2048 Aug 49

Quadrangular resection is the gold standard in the treatment of posterior leaflet prolapse. Anterior leaflet prolapse has been considered a more challenging problem; several techniques are available to treat it, all with the same goal - mitral valve competency. Nowadays, good long-term results are reported, similar to those for posterior leaflet prolapse. Certain improvements may explain these results, especially improvements in transesophageal echocardiography (including three-dimensional echocardiography), which allow the detection of atypical mitral regurgitation and its mechanism.
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PMID:Is an anterior mitral leaflet prolapse still a challenge? 2041 51

Anterior cervical discectomy and fusion is a commonly performed procedure for prolapse of cervical intervertebral disc. It involves retraction of soft tissue of neck for adequate exposure of anterior spinal canal. Increased cuff pressure with retractor application may affect the postoperative vocal cord function. Cuff pressures of tracheal tube were measured continuously in 37 patients using air-filled pressure transducer connected to the pilot balloon. Changes of pressure from baseline values were noted after application of cervical retractor. At the end of procedure, vocal cord movement was observed using fibreoptic bronchoscope. Significant increase in cuff pressure (168% of baseline values) and airway pressure of tracheal tube during cervical retraction was observed. The vocal cord function was assessed using fibreoptic laryngoscope. One patient developed right vocal cord palsy (2.7%) and two patients had postoperative hoarseness of voice (5.4%). All these complications improved over a period of time. It is suggested that the cuff of tracheal tube should be inflated to achieve 'just seal', with adequate cuff pressure monitoring. Intermittent release of cervical retraction may help to prevent laryngeal morbidities.
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PMID:Effects of retractor application on cuff pressure and vocal cord function in patients undergoing anterior cervical discectomy and fusion. 2088 69

Anterior and posterior repair are standard surgical techniques for treatment of vaginal prolapse. These procedures are performed traditionally under general anaesthetic or spinal anaesthetic and usually require overnight admission in the hospital. We describe our case series of 40 patients who underwent anterior (18/40), posterior (20/40) or combined repair (2/40) under local anaesthetic and conscious sedation (Remifentanyl). The majority (35/40) were performed in the day-case surgery unit and 95% patients were discharged within 6 hours of the operation, with no complications. All the patients were satisfied with the anaesthetic technique. We concluded that our technique of vaginal repair avoids the risk of general and spinal anaesthetic. The majority of operations can be performed as day cases with good patient satisfaction and without increasing risks to the patients. This technique has potential significant financial saving for the hospitals.
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PMID:The success of 6-hour hospital discharge on patients having vaginal repair operations using a new conscious sedation technique. 2128 Oct 32


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