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

Hysterectomy is the second most commonly performed major operation in the United States. Approximately one in three women will have this operation, resulting in 590,000 procedures per year. The most common indications for hysterectomy are leiomyomata uteri, abnormal uterine bleeding, endometriosis, pelvic pain, and pelvic organ prolapse. Although hysterectomy is an appropriate therapeutic option for some women with these conditions, in many instances less radical alternatives may be offered. Leiomyomata may be managed expectantly if symptoms are not bothersome; for women with troubling leiomyomata symptoms, alternatives to hysterectomy include: endoscopic removal or destruction of myomas, arterial embolization, or hormonal therapy to inhibit or modify bleeding. Endometriosis and abnormal uterine bleeding of leiomyomata are both amenable to hormonal therapy. Pelvic pain is most effectively approached with a thorough evaluation (particularly for nongynecologic illness), with specific therapy directed at the cause of the pain. Pelvic organ prolapse may respond symptomatically to pelvic floor exercises, or to the use of a pessary. After alternatives to removal of the uterus are discussed, the informed woman may decide that hysterectomy is the option best suited to her. It is unusual for hysterectomy to be her only option.
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PMID:Alternatives to hysterectomy for benign conditions. 972 46

BACKGROUND: Fallopian tube prolapse as a complication of abdominal hysterectomy is a rare occurrence. A case with fallopian tube prolapse was managed by a combined vaginal and laparoscopic approach and description of the operative technique is presented. CASE PRESENTATION: A 39-year-old woman with vaginal prolapse of the fallopian tube after total abdominal hysterectomy presented with an incorrect diagnosis of adenocarcinoma of the vaginal apex. The prolapsed tube and cystic ovary were removed by vaginal and laparoscopic approach. The postoperative course went well. CONCLUSIONS: Early or late fallopian tube prolapse can occur after total abdominal hysterectomy and vaginal hysterectomy. Symptoms consist of persistent blood loss or leukorrhea, dyspareunia and chronic pelvic pain. Vaginal removal of prolapsed tube with laparoscopic surgery may be a suitable treatment. The abdominal or vaginal approach used in surgical correction of prolapsed tubes must be decided in each case according to the patient's individual characteristics.
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PMID:Laparoscopic management of fallopian tube prolapse masquerading as adenocarcinoma of the vagina in a hysterectomized woman. 1181 35

The infracoccygeal sacropexy, or posterior intravaginal slingplasty, was first reported by Petros as a minimally invasive procedure for the treatment of vault prolapse. This report is a prospective observational study that confirms the efficacy and safety of this new procedure. In this operation the IVS Tunneller (Tyco Healthcare, USA) is used to insert an 8 mm polypropylene tape between the perineum and the vaginal vault. The resulting artificial neoligament reinforces the atrophied uterosacral ligaments. The rectovaginal fascia and perineal body are then repaired by a technique that includes using a bridge of vaginal epithelium to strengthen the central vaginal epithelium at the point of maximum weakness. The symptomatic cure rates for prolapse were 91%, urgency 79%, nocturia 82% and pelvic pain 78%. All patients were discharged home within 24 hours. There were minimal surgical complications and no transfusions were required. The technique is safe, minimally invasive, has a short learning curve, and the skills needed are those of any competent pelvic surgeon.
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PMID:Posterior intravaginal slingplasty (infracoccygeal sacropexy) for severe posthysterectomy vaginal vault prolapse--a preliminary report on efficacy and safety. 1199 4

The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had their cervix removed.
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PMID:Total versus subtotal hysterectomy: an observational study with one-year follow-up. 1573 Mar 68

This study of 30 patients evaluated the effectiveness and safety of the posterior sling (infracoccygeal sacropexy) in the surgical treatment of vaginal vault prolapse. The patients were reevaluated 3 months, 6 months and yearly postoperatively. Coexisting preoperative symptoms of pelvic pain, urgency, nocturia and 'obstructed' micturition feeling were followed-up. There was remarkable improvement in vault prolapse and in coexisting symptoms.
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PMID:Posterior sling (infracoccygeal sacropexy): an alternative procedure for vaginal vault prolapse. 2373 Oct 97

The prolapse of a uterine tube is a rare event after hysterectomy with adnexal conservation. It is described in the literature after abdominal or vagina hysterectomy. We report two cases occurring after laparoscopic hysterectomy, and complicated by pyosalpingitis. Patients have presented with pelvic pain and vaginal discharge. Diagnosis was not easy, clinically suspected with the transvaginal ultrasonography, and confirmed by celioscopy. It may be helped by biopsy. The laparoscopic management was carried out without complications.
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PMID:[Pyosalpingitis after interadnexal laparoscopic hysterectomy. Two cases]. 1651 23

Gender-, age- and race-related generalised joint hypermobility (GJH) is elucidated, based on publications that have used validated criteria for GJH. Furthermore, we analysed the connection between GJH and the clinical criteria for benign joint hypermobility syndrome (BJHS), and we looked for literature on the treatment of BJHS. There seems to be evidence in support of an increased prevalence of hypermobility among children, females and certain races when the diagnosis of hypermobility is based on the Carter and Wilkinson criteria (> or =3 positive tests out of 5) and/or Beighton's tests (> or =4 positive tests out of 9). However, there are no unequivocal statements that hypermobility predisposes to the various clinical situations used as major or minor criteria for BJHS, e.g., arthralgia, low back and pelvic pain, joint luxation, soft tissue rheumatism, abnormal cutis or genitourinary prolapse, varicose veins and hernia. There have been no randomised controlled studies of the effect of treatment.
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PMID:[Generalised joint hypermobility and benign joint hypermobility syndrome. II: epidemiology and clinical criteria]. 1630 62

Genitourinary changes following childbirth and pregnancy are common, and include urinary and anal incontinence, pelvic pain, sexual dysfunction, and pelvic organ prolapse. At present, it is unclear whether or not these changes are a result of the pregnancy itself or the mode of delivery (cesarean section or vaginal birth). In this article, the authors aim to describe genitourinary postpartum pelvic floor changes, and review the literature regarding the impact of pregnancy or childbirth on these changes. Data is needed that compare the effects of pregnancy alone, cesarean delivery (labored and unlabored), and vaginal birth, so that physicians can better advise patients about the postpartum genitourinary tract changes they might expect.
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PMID:Postpartum genitourinary changes. 1714 56

Repeated deliveries might disturb the levator function and increase defecation disorders. In this prospective study, we determined the electric activity of the levator ani muscle (LAM) in nullipara, multipara, grand multipara, and great grand multipara (20 subjects for each group). Multiparity, grand multiparity, and great grand multiparity were defined as women having 2 - 5, 6 - 9, and 10 and over deliveries, respectively. The number of deliveries of multipara, grand multipara and great grand multipara were 4.05 +/- 1.14 (2 - 5), 7.55 +/- 1.23 (6 - 9) and 12.2 +/- 2.16 (10 - 17), respectively. All women were asked whether they had experienced constipation, fecal or urinary incontinence, and/or pelvic pain. All women were also evaluated for pelvic organ prolapse. Electromyography (EMG) of the LAM at rest and on contraction was recorded. EMG is an electrical recording of muscle activity. Constipation, incontinence and pelvic organ prolapse were encountered in multipara, grandmultipara and great grand multipara women. The LAM EMG at rest and on contraction in the nullipara was accepted as control. Both the resting and contractile activities of the LAM were as follows: nullipara > multipara > grand multipara > great grand multipara. These findings indicate that levator dysfunction and defecation disorders are increased with repeated deliveries because of pudendal and/or levator ani nerve injury and traumatic injury to the LAM occurred with the mechanical stresses of vaginal deliveries.
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PMID:Impaired function of the levator ani muscle in the grand multipara and great grand multipara. 1714 3

Fallopian tube prolapse through a ruptured vagina is a rare, but well-documented, gynaecological condition. The majority of cases reported in the literature complicated vaginal hysterectomy and presented with vaginal bleeding and pelvic pain. We report a case after abdominal hysterectomy, which presented with urinary symptoms, an unreported presentation, and was managed successfully via the vaginal route. An update on the cases reported in the literature is also presented.
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PMID:An unusual cause of postoperative detrusor overactivity. 1733 38


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