1/127. Urosepsis associated with vaginal pessary use.Conservative management of genital prolapse in older women uses vaginal pessaries. Infectious complications of these devices, attributable in some instances to poor routine maintenance, are uncommonly reported. We present 2 cases of genitourinary sepsis associated with unsuspected pessary use and discuss the spectrum of complications reported with these appliances.- - - - - - - - - - ranking = 1keywords = prolapse (Clic here for more details about this article) |
2/127. Herpetic salpingitis and fallopian tube prolapse.AIM: We describe the unusual association of fallopian tubal prolapse and herpetic infection, an occurrence not previously reported to our knowledge. methods AND RESULTS: A 37-year-old woman presented with a small polypoid mass of the vaginal vault, 3 months after abdominal hysterectomy and abdominoplasty. The vaginal mass proved to be the fimbriated end of a fallopian tube, herniated into the vagina. Reintervention 3 months later with resection of a small vaginal 'polyp' revealed a residual portion of fallopian tube, with superimposed herpes simplex virus (HSV) infection and marked cytological atypia of surface epithelial cells. HSV-2 immunostaining of viral nuclear inclusions and of atypical cells confirmed the herpetic nature of the infection. CONCLUSION: Involvement of the genito-urinary tract by HSV may occur via an ascending infection from the cervix, but the fallopian tube, deeply located in the pelvis, is generally spared from herpetic infection. In the setting of fallopian tubal prolapse, direct exposure of the herniated fallopian tube to various pathogens in the vagina provides an unique clinical model for salpingitis. In herpetic tubal infections, special attention must be paid to cytological atypia of probable viral cytopathogenic origin, to avoid a misdiagnosis of malignancy.- - - - - - - - - - ranking = 6keywords = prolapse (Clic here for more details about this article) |
3/127. Prolapse of the neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome. A case report.BACKGROUND: Mayer-Rokitansky-Kuster-Hauser syndrome is a rare entity. The creation of a sigmoid vagina was performed in some patients with this syndrome in the past, though it is not widely used now. We report on a patient who developed prolapse of a sigmoid vagina 33 years after the operation. CASE: A 57-year-old woman presented with a "falling-out" sensation in the vagina, pain, leukorrhea and dyspareunia. She had undergone an operation for creation of a sigmoid vagina 33 years earlier in our hospital. She and her husband desired conservation of the ability for sexual intercourse. The transabdominal method of retroperitoneal sacropexy of the sigmoid vagina was performed. The patient has maintained a satisfactory sexual life with her husband since the operation. CONCLUSION: There are a few cases of prolapse of a sigmoid vagina in the literature, while the repair methods are not described in detail. To our knowledge, this is the first report of reconstruction of a sigmoid vaginal prolapse. Although the reasons for the neovaginal prolapse were not understood, the retroperitoneal sacropexy was successful in this case.- - - - - - - - - - ranking = 4keywords = prolapse (Clic here for more details about this article) |
4/127. uterine prolapse in pregnancy caused by a very large mucinous cyst.The literature review and a case report of a 25 years old patient who started to suffer from an extemely large abdomen, sever oedema, dyspnea, and uterine prolapse from the 30th week in her third pregnancy because of a very large mucinous cyst. The prolapsed uterus improved with bed rest. She delivered at term with no complication. The cyst was removed three weeks after the delivery with about ten litres of mucoid secretion in it. The patient left hospital on the tenth post operative day.- - - - - - - - - - ranking = 6keywords = prolapse (Clic here for more details about this article) |
5/127. Abdominal sacral colpopexy resulting in a retained sponge. A case report.BACKGROUND: During abdominal sacral colpopexy, a procedure used to correct vaginal vault prolapse, the vaginal cuff must be elevated intraabdominally to facilitate suturing. The use of a vaginal sponge stick to elevate the cuff can result in foreign body complications. CASE: A 70-year-old woman developed chronic pelvic pain and a vaginal discharge after undergoing abdominal sacral colpopexy. Radiographic films showed what appeared to be a retained surgical needle in the vaginal cuff. During an exploratory laparotomy to remove the foreign body, a fragment of the sponge used to elevate the vaginal cuff during abdominal sacral colpopexy was found to have been inadvertently incorporated into the apex of the vagina. CONCLUSION: An end-to-end anastomotic sizer should be used to elevate the vaginal cuff during abdominal sacral colpopexy to reduce the risk of foreign body complications.- - - - - - - - - - ranking = 1keywords = prolapse (Clic here for more details about this article) |
6/127. Extension of extramammary Paget disease of the vulva to the cervix.Extramammary Paget disease of the vulva was found in association with vulval adenocarcinoma in an elderly woman who also had a uterine prolapse. The characteristic histological appearances of extramammary Paget disease were masked by striking reactive changes in the squamous epithelium. Primary excision of both the intraepithelial and invasive disease appeared complete. However, a subsequent hysterectomy with repair of the prolapse revealed extramammary Paget disease in the upper vaginal mucosa and cervix, a finding which is very rarely described. Pathogenesis and diagnosis of extramammary Paget disease is discussed, with differential diagnosis and reference to immunohistochemical methods.- - - - - - - - - - ranking = 2keywords = prolapse (Clic here for more details about this article) |
7/127. The relationship of the in-situ advancing vaginal wall sling to vaginal epithelial inclusion cyst.Epithelial inclusion cyst is an under recognized complication of the in-situ advancing vaginal wall sling. A 63-year-old woman with stage I pelvic organ prolapse and mixed incontinence underwent in-situ sling placement in November 1997. In February 1998 she presented with a painful recurrent inflammatory anterior vaginal wall mass. The mass was cystic and drained spontaneously four times over the period of conservative management. The patient underwent resection of a clinical and pathological vaginal epithelial inclusion cyst in September 1998. At 6-month follow-up the patient remains continent and the cyst has not reformed. The vaginal surgeon should be aware of the potential for epithelial inclusion cyst formation after in-situ sling placement, and actively search for them at postoperative examination.- - - - - - - - - - ranking = 1keywords = prolapse (Clic here for more details about this article) |
8/127. rupture of the rectosigmoid colon with evisceration of the small bowel through the anus.Spontaneous rupture of the rectosigmoid colon and herniation of the small intestine through the rupture site and eventual evisceration through the anus is a very rare event. In the literature, only 42 cases have been reported. The majority of them occurred in patients with rectal prolapse and one case was reported in association with a third-degree uterine prolapse. We experienced an 81-year-old female patient with rectal prolapse and second-degree uterine prolapse complicated by spontaneous perforation of the rectosigmoid colon and anal evisceration of the small intestine. Segmental resection of the nonviable small intestine, primary repair of the ruptured rectosigmoid colon, and sigmoid loop colostomy were performed, and the patient recovered well. In our patient, both rectal and uterine prolapses cooperatively damaged the anterior wall of the rectosigmoid colon and resulted in perforation. So, rectal and uterine prolapses should be treated before the complication develops. In this patient, uterine prolapse should be treated because of the recurrence of this rare episode.- - - - - - - - - - ranking = 7keywords = prolapse (Clic here for more details about this article) |
9/127. uterine prolapse associated with bladder exstrophy: surgical management and subsequent pregnancy.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. We report the case of a young woman with surgically repaired bladder exstrophy who developed genital prolapse. The uterus was suspended using a sacral colpopexy utilizing a Gore-Tex graft. Subsequently, the patient became pregnant and delivered a healthy male infant at 35 weeks' gestation via cesarean section (without recurrence of the genital prolapse postpartum). Sacral colpopexy to correct genital prolapse associated with bladder exstrophy may preserve fertility in young patients.- - - - - - - - - - ranking = 8keywords = prolapse (Clic here for more details about this article) |
10/127. Vaginal subtotal hysterectomy and sacrospinous colpopexy: an option in the management of uterine prolapse.Interest in vaginal hysterectomy is rising. Controversy remains regarding the value of conservation of the cervix at hysterectomy. Subtotal vaginal hysterectomy is a simple procedure that carries a low risk of morbidity. In combination with sacrospinous fixation it can be an option in the management of patients with marked uterine prolapse who desire retention of the cervix. The technique is described, and a case is reported.- - - - - - - - - - ranking = 5keywords = prolapse (Clic here for more details about this article) |
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