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

Renal ptosis is the caudal acquired displacement of one or both of the kidneys, with different degree and etiology, considered as a urological pathology because of its urodynamic changes and, in the last years, almost completely neglected. The aim of the work is to research a parenchymal involvement, through a close examination of our outpatient record of cases, compared with data from the literature about renal ptosis. The literature reports the largest incidence in females; in our record of cases, instead, the incidence is nearly the same. Second degree ptosis is the most frequent, but, in females, bilateral ptosis is prevalent (77%). We agree with the literature about urinary symptoms; actually, the most of the patients shows urinary colics or lumbar pain. We also noticed UTI (62%), urinary lithiasis (26%) and pyelocalyceal ectasia (46%). A lot of patients suffer from microscopic haematuria (77%) and, in 12%, we noticed gross haematuria. Hypertension affects about half of the patients (46%) and proteinuria too (42%). Echography highlights a reduced cortex (12%), cysts (14%) and other changes (8%). GFR is decreased in 30% of cases, to a different degree. The patients show different changes, according to their age. In conclusion, considering that the incidence and the anatomic and functional changes are remarkable, we think it opportune to take renal ptosis into account as a cause of chronic renal damage, also because it is included among the causes of obstructive nephrophaty, which according to some researches, can cause severe glomerular and tubular-intestinal changes, triggered off by a short urinary stasis and evident in the controlateral kidney too.
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PMID:[Renal ptosis: nephrologic consequences of an organ malposition]. 770 5

The purpose of this study was to examine the association between pessary use, smoking and changes in the vaginal flora. Patients using pessaries were age matched with non-pessary using controls. All candidates examined were women attending the Mount Sinai Hospital, Toronto, for genitourinary problems. Vaginal cultures were routinely performed on all women attending the unit, irrespective of symptoms. Forty-four pessary users were age matched with 176 controls (4 controls per case). The mean age was 60.1 +/- 12.6 years, and 15% of these were premenopausal. The duration of pessary use ranged from 0.5 to 8 years (mean 3.3 +/- 1.7). Weight, parity, smoking status, diabetes mellitus, thyroid disease, UTI and postvoid residual urine volume were not significantly different between pessary users and controls. Bacterial vaginosis (BV) was noted in 32% of pessary users, versus 10% of controls. The relative risk of developing BV in pessary users was 3.3 (OR, 4.37; 95% CI, 2.15-9.32), P = 0.0002. Smoking independently affected the vaginal flora, increasing the relative risk of developing BV to 2.9 (OR, 3.78; 95% CI, 2.05-8.25), P = 0.0013. It was concluded that pessary use is a very effective and conservative method for the treatment of genital prolapse. However, we found that the presence of a foreign body was associated with changes in the vaginal flora, thereby increasing the odds of developing bacterial vaginosis to 4.37; this was further compounded by smoking.
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PMID:Bacterial vaginosis increases in pessary users. 1100 73

Urinary incontinence is a common symptom that can affect women of all ages. It has been estimated that there are more than 3.5 million sufferers in the UK alone. History taking guides the investigation and management of patients by evaluating symptoms, their progression and the impact of symptoms on lifestyle. The onset of urinary symptoms, their duration and their severity should be recorded. The predominant bother symptom, e.g., urgency, urge incontinence or stress incontinence, should be identified. The clinician should also enquire about colorectal symptoms and genitourinary prolapse. Accompanying symptoms that may indicate the possibility of a more serious diagnosis and which require referral, such as haematuria, persistent bladder or urethral pain, or recurrent UTI, can also be identified when taking a urinary history. Clinical examination should include an abdominal examination to exclude abdominal mass or palpable bladder, a bimanual examination to exclude pelvic mass, and a vaginal examination. Neurological assessment of the lower limbs and perineum is required if a neurological cause is suspected. Patients are categorised according to their symptoms into those with stress, mixed or urge incontinence. Women with mixed urinary incontinence, who have an involuntary leakage associated with urgency and also with exertion, are treated according to the symptom they report to be the most troublesome.
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PMID:Urinary incontinence in women: diagnosis and management. 2040 30

Pelvic organ prolapse (POP) surgery can be associated with early postoperative morbidity resulting in significant service utilisation. This study aimed to investigate whether different suture materials cause different rates of early postoperative morbidity by comparing two cohorts using case-control methodology. A total of 100 women undergoing POP surgery with vaginal closure with 1 Vicryl (polyglycolic acid) multifilament sutures were matched by operation with a cohort in which 2/0 Monocryl (poliglecaprone 25) monofilament sutures were used. The multifilament suture group had significantly higher rates of offensive discharge (p<0.001), vaginal bleeding (p<0.001) and vaginal pain (p=0.004). They were more likely to receive medical advice (0.007). Patients in the multifilament group were no more likely to suffer from a UTI (p=1.000) or to be readmitted postoperatively (p=1.000). Size 1 multifilament sutures result in higher levels of postoperative morbidity when compared with 2/0 monofilament sutures.
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PMID:Short-term complications after vaginal prolapse surgery: do suture characteristics influence morbidity? 2307 55