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Pubic symphysis and prolapse

S Albrich, J Steetskamp, K Rommens, S Porta, M Battista, G Hoffmann, C Skala
This case report shows that 3D perineal ultrasound can be superior to clinical examination and routine 2D perineal ultrasound in the detection of an unusual subpubic tumor. A 73-year-old female patient was referred to our urogynecological outpatient unit complaining of over-active bladder symptoms and voiding dysfunction for 3 years. Gynecological examination found no signs of pelvic organ prolapse or abnormality in the vaginal cavity. Routine 2D perineal ultrasound showed substantial residual urine (ca...
July 2015: Geburtshilfe und Frauenheilkunde
Ran Li, Yanfeng Song, Ming Ma
The aim of this study was to assess the morphological features of the levator ani and bony pelvis in women with different grades of prolapse. Ninety Chinese women with different grades of uterine prolapse were studied, 18 in each stage of prolapse from I to IV, and 18 asymptomatic nulliparous volunteers as normal controls. Three-dimensional (3D) models that included the pelvic bones, levator ani, pubic symphysis, sacrum, and coccyx were generated from magnetic resonance (MR) images. The width and length of the levator hiatus and levator symphysis gap, the width of the iliococcygeus, and the iliococcygeal angle were measured to quantify levator ani morphology; the intertuberous diameter, interspinous diameter, subpubic angle, and pubococcygeal line were measured to characterize the morphology of the bony pelvis...
September 2015: Clinical Anatomy
Sunil Balgobin, Meadow M Good, Shena J Dillon, Marlene M Corton
OBJECTIVE: To determine the variation in vaginal axis and posterior cul-de-sac depth when the lowest suture used to attach the sacrocolpopexy mesh to the anterior longitudinal ligament is anchored at different levels. STUDY DESIGN: At five lumbosacral mesh attachment sites, the anterior vaginal wall axis angle was measured relative to a line between the lowest border of the pubic symphysis and fourth sacral (S4) foramen in 9 unembalmed cadavers. The vertical distance from S4 to the posterior mesh was measured as a surrogate of cul-de-sac depth...
June 2013: American Journal of Obstetrics and Gynecology
Alexandros Derpapas, Alessandro G Digesu, Mohamad Hamady, Pasquale Gallo, Chiara Dell'Utri, Gopalan Vijaya, Vik Khullar
AIMS: To calculate the prevalence of pubovisceral muscle (PM) avulsion in a cohort of women presenting at a university hospital for non-urogynecological conditions. METHODS: Women with or without symptoms of PFD were studied in a tertiary referral urogynecology center between February and October 2010. Women were recruited from the Department of Radiology, where they were referred for a CT pelvis scan due to various pathologies. Assessment of participants included a detailed clinical interview, completion of King's Health and Prolapse-Quality of Life (P-QOL) questionnaires and spiral CT scan of the pelvis...
April 2013: Neurourology and Urodynamics
N Rajamaheswari, Archana Bharti Chhikara, Sugandha Agarwal
Pelvic organ prolapse (POP) in a nulliparous woman is a rare sequela of high-energy pelvic trauma. We report a case of a 26-year-old nulliparous woman who developed stage III pelvic organ prolapse two decades after pelvic ring disruption. Abdominal wall cervicopexy was performed as a primary procedure by her attending local gynecologist. Recurrence occurred in early postoperative period following which she was referred to our institute. Examination revealed 5-cm pubic symphysis widening and stage III pelvic organ prolapse with deficient perineal body...
July 2013: International Urogynecology Journal
Silvio Roberto Consonni, Renata Giardini Rosa, Maria Amália Cavinato Nascimento, Cristiane Mendes Vinagre, Olga Maria Szymanski Toledo, Paulo Pinto Joazeiro
It has been observed that parturition has a significant effect on female skeletal architecture and that age alters musculoskeletal tissues and their functions. We therefore hypothesized that multiparity affects the recovery of the pubic symphysis in senescent mice at postpartum and the morphology of the interpubic tissues. The pubic symphysis of primiparous young, virgin senescent (VS) and multiparous senescent (MS) Swiss mice was examined by light microscopy, transmission electron microscopy, morphometric analysis and immunohistochemistry...
July 2012: Histology and Histopathology
F W Lone, R Thakar, A H Sultan, A Stankiewicz
INTRODUCTION AND HYPOTHESIS: We determined the relationship between clinical assessment of female pelvic organ prolapse (POP) using the validated Pelvic Organ Prolapse Quantification (POP-Q) and dynamic 2D transperineal ultrasound (TPUS). METHODS: Women attending the urogynecology clinics between July and October 2009 were recruited. Prolapse was assessed using the POP-Q. Points Ba, Bp and C (anterior, posterior and middle compartments, respectively) were measured...
November 2012: International Urogynecology Journal
Mohd S Ansari, John P Gearhart, Raimondo Maximilian Cervellione, Paul D Sponseller
OBJECTIVE: • To apply the technique of pelvic osteotomy to a select group of adult female patients with exstrophy, in view of the low complication rate and acceptable success rate of the technique. PATIENTS AND METHODS: • We applied this technique as an adjunct to uterovaginal suspension and abdominal wall repair after our prior success in treating patients with extreme pelvic diastasis. • Bilateral innominate (transverse) and vertical iliac osteotomies were done from an anterior approach and an external fixator was placed...
September 2011: BJU International
Ka Lai Shek, Athina Pirpiris, Hans Peter Dietz
OBJECTIVE: It is often assumed that stress urinary incontinence may be due to abnormal pelvic floor muscle function or anatomy. This may be mediated through urethral hypermobility. The aim of the study was to determine the association between major levator ani defects ('avulsion') and urethral mobility. STUDY DESIGN: Three hundred and five women were referred to a tertiary referral service for lower urinary tract and prolapse symptoms between December 2006 and July 2008...
December 2010: European Journal of Obstetrics, Gynecology, and Reproductive Biology
K J Dickie, K L Shek, H P Dietz
OBJECTIVE: Urethral mobility is associated with stress urinary incontinence (SUI) and urodynamic stress incontinence, and this is particularly true for mid-urethral mobility. The purpose of this study was to determine whether there is a significant relationship between segmental urethral mobility and vaginal parity in women undergoing urodynamic testing for prolapse or lower urinary tract symptoms. DESIGN: Retrospective study. SETTING Tertiary referral service for multichannel urodynamic testing...
September 2010: BJOG: An International Journal of Obstetrics and Gynaecology
Maria Chiara Colaiacomo, Gabriele Masselli, Elisabetta Polettini, Silvia Lanciotti, Emanuele Casciani, Luca Bertini, Gianfranco Gualdi
Pelvic floor dysfunctions involving some or all pelvic viscera are complex conditions that occur frequently and primarily affect adult women. Because abnormalities of the three pelvic compartments are frequently associated, a complete survey of the entire pelvis is necessary for optimal patient management, especially before surgical correction is attempted. With the increasing use of magnetic resonance (MR) imaging in assessing functional disorders of the pelvic floor, familiarity with normal imaging findings and features of pathologic conditions are important for radiologists...
May 2009: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Tamara A Stein, Gurpreet Kaur, Aimee Summers, Kindra A Larson, John O L DeLancey
OBJECTIVE: We sought to compare bony pelvis dimensions at the level of pelvic support in women with and without pelvic organ prolapse (POP). STUDY DESIGN: Pelvic floor dimensions of 42 white women with POP > 1 cm beyond the hymen were compared with 42 age- and parity-matched women with normal support. Bony landmarks relevant to connective tissue and levator attachments were identified on magnetic resonance imaging. Dimensions were independently measured by 2 examiners and averaged for each subject...
March 2009: American Journal of Obstetrics and Gynecology
Jean François Hermieu
INDICATIONS FOR URODYNAMIC ASSESSMENT IN WOMEN: Urodynamic assessment is not useful for the diagnosis of female urinary incontinence which remains a clinical diagnosis. Before any form of surgery for pure stress urinary incontinence, evaluation of bladder emptying by determination of maximum flow rate and residual urine is recommended. In the presence of pure stress urinary incontinence with no other associated clinical symptoms, a complete urodynamic assessment is not mandatory, but can be helpful to define the prognosis and inform the patient about her vesicosphincteric function...
November 2007: Progrès en Urologie
Ranjiv Mathews, John P Gearhart, Rishi Bhatnagar, Paul Sponseller
PURPOSE: Staged pelvic closure has been shown to be beneficial in achieving pubic approximation in children with the exstrophy-epispadias complex. We have continued to use this procedure in children with extreme pelvic diastasis and have updated our experience. MATERIALS AND METHODS: We performed closure of the pelvis in 15 patients 12 months to 14 years old presenting with a pubic diastasis of at least 8 cm (range 8 to 16). Of the patients 14 had cloacal exstrophy and 1 had classic exstrophy...
November 2006: Journal of Urology
Begüm Ozel
BACKGROUND: Acute urinary retention as a result of incarceration of a retroflexed, gravid uterus is a known phenomenon. However, prolapse as a risk factor has not been previously described. CASE: A 40-year-old woman, gravida 4, para 2, with an intrauterine gestation of 19 weeks presented to the emergency room complaining of inability to void for the previous 12 hours and difficulty voiding and constipation for the previous 6 weeks. She had a history significant for stage III uterine prolapse in early pregnancy...
August 2005: Journal of Reproductive Medicine
A D Baird, R I Mathews, J P Gearhart
PURPOSE: Despite widespread use of modern staged reconstruction for classic bladder exstrophy, there remains a role for combined bladder closure and epispadias repair when primary closure is delayed or initial reconstruction has failed. The principle of combining bladder and urethral closure in 1 operation was first proposed more than 40 years ago, and represents a demanding technical procedure. We recount our experience to date with this approach. MATERIALS AND METHODS: A total of 38 boys underwent combined bladder and epispadias repair using pelvic osteotomies...
October 2005: Journal of Urology
No abstract text is available yet for this article.
June 1964: Revista Médica de Costa Rica
P D Sponseller, M M Jani, R D Jeffs, J P Gearhart
BACKGROUND: Classic bladder exstrophy is a developmental defect presenting at birth with a wide pubic separation and an exposed bladder; cloacal exstrophy involves, in addition, intestinal prolapse. Reconstruction requires several surgical procedures. The use of anterior iliac osteotomies in this process has not been reviewed in a large series. METHODS: We reviewed the results of eighty-six anterior innominate osteotomies performed in conjunction with genitourinary repair of classic and cloacal bladder exstrophy in eighty-two patients...
February 2001: Journal of Bone and Joint Surgery. American Volume
C H Rose, T F Rowe, S M Cox, L R Malinak
Congenital bladder exstrophy affects 1 in 125,000 to 250,000 females. Consisting of absence of the anterior abdominal wall with exposure of the ureteral orifices, failure of pubic symphysis fusion, and deficient anterior pelvic diaphragm musculature, bladder exstrophy is frequently associated with genital prolapse. Pregnancy may be complicated by recurrent urinary tract infections, preterm labor, mild procidentia, and malpresentation. Due to the rarity of the condition, there is a corresponding scarcity of obstetric literature regarding management during pregnancy...
March 2000: Journal of Maternal-fetal Medicine
C Ozcan, I Ulman, S Kara, A Avanoglu, A Kapubagli, A Gökdemir
PURPOSE: We report our clinical experience with anterior diagonal iliac osteotomy in 10 patients who underwent surgery for bladder exstrophy. Technique and long-term results are discussed. MATERIALS AND METHODS: A total of 10 boys 1 month to 9 years old with bladder exstrophy underwent this procedure during a 2-year period. RESULTS: None of the patients had bladder closure dehiscence or prolapse after the operation. There were neither infectious complications nor injury to the vessels or nerves in any case...
June 2000: Journal of Urology
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