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Uterine prolapse

Kelsey L Shnaekel, Michael P Wendel, Nader Z Rabie, Everett F Magann
Objective: The aim of this review was to describe the risk factors, clinical and radiographic criteria, and management of this rare complication of pregnancy. Methods: A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched. Results: There were 60 articles identified, with 53 articles being the basis of this review. Multiple risk factors have been suggested in the literature including retroverted uterus in the first trimester, deep sacral concavity with an overlying sacral promontory, endometriosis, previous abdominal or pelvic surgery, pelvic or uterine adhesions, ovarian cysts, leiomyomas, multifetal gestation, uterine anomalies, uterine prolapse, and uterine incarceration in a prior pregnancy...
October 2016: Obstetrical & Gynecological Survey
Ayaka Kawabe, Liangcheng Wang, Atsuko Kikugawa, Yuko Shibata, Kenichi Kuromaki, Akiyoshi Takagi
OBJECTIVE: Uterine rupture is a rare but serious obstetric complication. However, prediction and diagnosis at an early stage remain difficult. Herein, we report a case of primary uterine rupture found earlier by a specific symptom. CASE REPORT: A 29-year-old patient was scheduled to undergo a cesarean section (CS) due to placenta previa. However, at Week 35, she began experiencing abdominal pain and uterine contractions. Subsequently, she began experiencing severe pain, which was enhanced by fetal movements...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Maurizio Serati, Diaa Rizk, Stefano Savatore
Based on the available urogynecological literature, the role of hysterectomy in the surgical strategy of pelvic organ prolapse (POP) repair remains controversial. Currently, there are no data to favor either the removal or preservation of the uterus in women with POP. The findings that hysterectomy may contribute to a higher success rate and to the development of urinary incontinence and/or female sexual dysfunction are not supported by evidence. It is not clear why both hysteropexy was sometimes performed in the presence of overt uterine prolapse and/or concomitant vaginal hysterectomy was often included in vaginal prolapse repair in the absence of uterine prolapse...
October 4, 2016: International Urogynecology Journal
Amanda Marie Hill, K Meryl David, Lindsay Clark-Donat, Lee Marvin Hammons, Masoud Azodi, Dan-Arin Silasi
OBJECTIVE: To determine whether vertical versus horizontal closure of the vaginal cuff during laparoscopic hysterectomy has an effect on postoperative vaginal length and pelvic organ prolapse. DESIGN: Prospective randomized controlled trial. Subjects were randomly assigned to vertical or horizontal vaginal cuff closure at the time of total laparoscopic hysterectomy. POP-Q tests were performed before surgery, two to four weeks after surgery, and three to four months after surgery...
October 1, 2016: Journal of Minimally Invasive Gynecology
Christopher Maher, Benjamin Feiner, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Julie Brown
BACKGROUND: Apical vaginal prolapse is a descent of the uterus or vaginal vault (post-hysterectomy). Various surgical treatments are available and there are no guidelines to recommend which is the best. OBJECTIVES: To evaluate the safety and efficacy of any surgical intervention compared to another intervention for the management of apical vaginal prolapse. SEARCH METHODS: We searched the Cochrane Incontinence Group's Specialised Register of controlled trials, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials...
October 1, 2016: Cochrane Database of Systematic Reviews
A T Yoldemir, C Cimsit, M Guclu, I N Akpinar
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
H Kuo, K Wu, C Lee
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Ciprian-Andrei Ober, Cosmin Petru Peștean, Lucia Victoria Bel, Marian Taulescu, Cornel Cătoi, Sidonia Bogdan, Joshua Milgram, Guenter Schwarz, Liviu Ioan Oana
BACKGROUND: True vaginal prolapse is a rare condition in dogs and it is occasionally observed in animals with constipation, dystocia, or forced separation during breeding. If a true prolapse occurs, the bladder, the uterine body and/or distal part of the colon, may be present in the prolapse. CASE PRESENTATION: A 2-year-old intact non pregnant Central Asian Shepherd dog in moderate condition, was presented for a true vaginal and rectal prolapse. The prolapses were confirmed by physical examination and ultrasonography...
2016: Acta Veterinaria Scandinavica
Catherine A Matthews
Sacrocolpopexy remains the "gold standard" procedure for management of posthysterectomy vaginal vault prolapse with improved anatomic outcomes compared to native tissue vaginal repair. Despite absence of clinical data, sacrocolpopexy is increasingly being offered to women as a primary treatment intervention for uterine prolapse. While reoperation rates remain low, recurrent prolapse and vaginal mesh exposure appear to increase over time. The potential morbidity associated with sacrocolpopexy is higher than for native tissue vaginal repair with complications including sacral hemorrhage, discitis, small bowel obstruction, port site herniation, and mesh erosion...
November 2016: Current Urology Reports
Nitin Joseph, Chidambara Krishnan, B Ashish Reddy, Nurul Afiqah Adnan, Low Mei Han, Yeoh Jing Min
BACKGROUND: Uterine prolapse is a common problem among women in developing countries. It is known to cause physical and psychosocial problems affecting the quality of life of patients. This study was done to determine the risk factors, clinical features, and management practices in uterine prolapse (UP). METHODS: A review of 350 case records of UP cases admitted between 2009 and 2014 was done in tertiary care hospitals. RESULTS: Mean age at presentation of UP was 52...
October 2016: Journal of Obstetrics and Gynaecology of India
Gerda Trutnovsky, Ixora Kamisan Atan, Daniela Ulrich, Andrew Martin, Hans P Dietz
INTRODUCTION: The study aimed to analyze the relation between the degree of puborectalis muscle trauma and subjective symptoms and objective findings of pelvic organ prolapse (POP), comparing two continuous scoring systems with a discrete scoring system for translabial ultrasound imaging. MATERIAL AND METHODS: In this retrospective observational study the records of patients attending a tertiary urogynecological unit between January 2012 and December 2014 were analyzed...
September 13, 2016: Acta Obstetricia et Gynecologica Scandinavica
Carolyn W Swenson, Tovia M Smith, Jiajia Luo, Giselle E Kolenic, James A Ashton-Miller, John O DeLancey
BACKGROUND: It is unknown how initial cervix location and cervical support resistance to traction, which we term "apical support stiffness," compare in women with different patterns of pelvic organ support. Defining a normal range of apical support stiffness is important to better understand the pathophysiology of apical support loss. OBJECTIVE: The aims of our study were to determine whether: (1) women with normal apical support on clinic Pelvic Organ Prolapse Quantification, but with vaginal wall prolapse (cystocele and/or rectocele), have the same intraoperative cervix location and apical support stiffness as women with normal pelvic support; and (2) all women with apical prolapse have abnormal intraoperative cervix location and apical support stiffness...
September 8, 2016: American Journal of Obstetrics and Gynecology
Kazuaki Nishimura, Kazuaki Yoshimura, Kaori Hoshino, Toru Hachisuga
INTRODUCTION AND HYPOTHESIS: Transvaginal ipsilateral uterosacral ligament colpopexy for pelvic organ prolapse (POP), which was reported by Shull et al. (Shull's colpopexy) in 2000, is one of the most frequently performed non-mesh pelvic floor reconstructive surgical procedures. Despite its excellent anatomical outcomes, ureteral injury and difficulty in uterosacral ligament detection (especially in patients with severe POP) are typical issues with this procedure. METHOD: This video demonstrates the procedure in a 58-year-old woman, gravida 2 para 2, with POP-Q stage II uterine prolapse and stage I cystocele...
September 10, 2016: International Urogynecology Journal
K Grimminck, S L Mourik, F Tjin-Asjoe, J Martens, M Aktas
OBJECTIVE: The aim of this study is to investigate the effect of robot assisted laparoscopic sacrohysteropexy (RALS), with preservation of the uterus, in patients with pelvic organ prolapse on short and long term outcome. We report on (anatomical) status of the prolaps and the associated health related quality of life of women treated with RALS before and five years after surgery. STUDY DESIGN: A prospective cohort study in a teaching hospital in The Netherlands was performed...
August 31, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Mustafa Gazi Uçar, Tolgay Tuyan İlhan, Fatih Şanlıkan, Çetin Çelik
OBJECTIVE: To evaluate sexual function in women before and after vaginal hysterectomy (VH) and to compare the effects of horizontal and vertical vaginal cuff closure on sexual function. STUDY DESIGN: Women with uterine prolapse of stage 2 or higher were included to this prospective, randomized study. All patients underwent VH with McCall Culdoplasty and patients were randomized into two groups in terms of the vaginal cuff closure technique employed which is either vertically (group 1, right to left) or horizontally (group 2, anterior to posterior)...
August 31, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Cathryn Glazener, Lynda Constable, Christine Hemming, Suzanne Breeman, Andrew Elders, Kevin Cooper, Robert Freeman, Anthony R B Smith, Suzanne Hagen, Alison McDonald, Gladys McPherson, Isobel Montgomery, Mary Kilonzo, Dwayne Boyers, Beatriz Goulao, John Norrie
BACKGROUND: One in three women who have a prolapse operation will go on to have another operation, though not necessarily in the same compartment. Surgery can result in greater impairment of quality of life than the original prolapse itself (such as the development of new-onset urinary incontinence, or prolapse at a different site). Anterior and posterior prolapse surgery is most common (90 % of operations), but around 43 % of women also have a uterine (34 %) or vault (9 %) procedure at the same time...
2016: Trials
Sunil Balgobin, Cherine A Hamid, Kelley S Carrick, T Ignacio Montoya, Joseph I Schaffer, Marlene M Corton
OBJECTIVE: To quantify the distance of the dissection plane from the cervicovaginal junction to the anterior peritoneal reflection for vaginal hysterectomy. METHODS: This is a descriptive study examining the dissection plane for anterior colpotomy in 22 surgical patients undergoing vaginal hysterectomy and in nine cadaver specimens. Intraoperatively, the distance from the vaginal incision to the anterior peritoneal reflection was measured on the uterus after removal...
October 2016: Obstetrics and Gynecology
Robert E Gutman, Charles R Rardin, Eric R Sokol, Catherine Matthews, Amy J Park, Cheryl B Iglesia, Roxana Geoffrion, Andrew I Sokol, Mickey Karram, Geoffrey W Cundiff, Joan L Blomquist, Matthew D Barber
BACKGROUND: There is growing interest in uterine conservation at the time of surgery for uterovaginal prolapse, but limited data compare different types of hysteropexy. OBJECTIVE: We sought to compare 1-year efficacy and safety of laparoscopic sacral hysteropexy and vaginal mesh hysteropexy. STUDY DESIGN: This multicenter, prospective parallel cohort study compared laparoscopic sacral hysteropexy to vaginal mesh hysteropexy at 8 institutions...
September 3, 2016: American Journal of Obstetrics and Gynecology
M Cayrac, S Warembourg, L Le Normand, B Fatton
OBJECTIVE: Provide guidelines for clinical practice concerning hysterectomy during surgical treatment of pelvic organ prolaps, with or without mesh. METHODS: Systematically review of the literature concerning anatomical and functionnal results of uterine conservation or hysterectomie during surgical treatment of pelvic organ prolaps. RESULTS: Sacrospinous hysteropexy is as effective as vaginal hysterectomy and repair in retrospective comparative studies and in a meta-analysis with reduced operating time, blood loss and recovery time (NP2)...
July 2016: Progrès en Urologie
Katja Stenström Bohlin, Maud Ankardal, Håkan Lindkvist, Ian Milsom
BACKGROUND: Studies on the influence of body mass index, smoking, and mode of delivery on the occurrence of urinary incontinence after hysterectomy are required to provide women with information about how these factors influence continence after a hysterectomy. OBJECTIVE: The aim was to assess the impact of lifestyle factors such as body mass index, smoking, and delivery mode (vaginal/cesarean) on the incidence and remission of urinary incontinence after hysterectomy...
September 1, 2016: American Journal of Obstetrics and Gynecology
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