Cases reported "Uterine Prolapse"

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11/35. Non-puerperal incomplete lateral uterine inversion with submucous leiomyoma: a case report.

    A perimenopausal, multiparous woman presented with prolapse. Clinically, there was a doubt between prolapsed submucous leiomyoma and uterine inversion. laparoscopy showed an unusual pattern of uterine inversion restricted to the left cornual region with a submucous leiomyoma. A vaginal hysterectomy with due considerations for alterations of anatomical relationships minimized operative morbidity.
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ranking = 1
keywords = operative
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12/35. Sacrocervicopexy and combined operations involving cases of total uterine prolapse. case reports.

    OBJECTIVE: To determine the outcome of sacrocervicopexy and combined operations in the treatment of uterovaginal prolapse in women with desire to preserving both uterus and fertility. CLINICAL PRESENTATION AND INTERVENTION: Sacrocervicopexy with Prolene mesh and combined operations were performed in 3 women with total uterine prolapse because of the patient's desire to retain fertility in 2 cases and refusal of hysterectomy in the 3rd patient. The 1st case was a 38-year-old woman, gravida 2, parity 1; the 2nd case a 42-year-old woman, gravida 3, parity 2, and the 3rd a 39-year-old woman, gravida 1, parity 1. Douglas pouch was obliterated with Moschcowitz operation. All of the women underwent sacrocervicopexy with Prolene mesh. The repair of a paravaginal defect and prophylactic Burch urethropexy were accomplished through entering Retzius' space. Genital hiatus was narrowed via approximating levator muscles transvaginally. No serious intraoperative complications occurred and no recurrence was detected during the follow-up period. There was no postoperative complication except for some degree of pain in the 1st postoperative month in 1 case. CONCLUSION: The results indicate that sacrocervicopexy and repair of all concomitant defects in the pelvic floor are effective procedures in the treatment of uterovaginal prolapse in cases where there is a desire to retain fertility and uterus.
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ranking = 3
keywords = operative
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13/35. Abdominal sacral colpopexy mesh erosion resulting in a sinus tract formation and sacral abscess.

    BACKGROUND: Complications associated with the use of synthetic mesh during an abdominal sacral colpopexy procedure include mesh infection and erosion into the vaginal vault and sacral osteomyelitis. CASE: This case report describes the management of an abdominal sacral colpopexy procedure that was complicated by postoperative vaginal mesh erosion, formation of a fistulous tract from the vaginal apex to the sacrum, and development of diskitis, osteomyelitis, and a sacral abscess. CONCLUSION: Treatment of a vaginal mesh erosion complicated by the formation of a sinus tract after abdominal sacral colpopexy should include extensive sinus tract resection in addition to complete mesh removal.
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ranking = 1
keywords = operative
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14/35. Small bowel obstruction associated with tension-free vaginal tape.

    A 73-year-old woman with stress urinary incontinence and uterine prolapse underwent vaginal hysterectomy followed by tension-free vaginal tape (TVT) placement. Postoperatively, she presented with low-grade fever and abdominal distension. Abdominal computed tomography revealed bowel distension and abrupt cutoff of the distended small bowel and normal bowel caliber. Transperitoneal laparotomy demonstrated perforation of the mesentery by the TVT without other injury. The tape was cut in its intraperitoneal portion. The patient resumed normal bowel function and, at last follow-up, remained continent. We advocate that when performing TVT placement in conjunction with vaginal hysterectomy, TVT placement should be performed at the beginning of the procedure.
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ranking = 1
keywords = operative
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15/35. Persistent urinary retention after tension-free vaginal tape: a new surgical solution.

    The most common post-operative problems seen with the tension-free vaginal tape (TVT) are voiding difficulties. A small subset of patients develops persistent urinary retention, often associated with vaginal pain and dyspareunia. We describe a surgical solution to these complications that involves cutting of the prolene sling just below the urethra and individualised prologation with an additional piece of prolene-mesh.
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ranking = 1
keywords = operative
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16/35. Inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair.

    Graft augmentation for repair of recurrent pelvic organ prolapse is commonly used in reconstructive pelvic surgery. The reported complications are mainly late onset. We report a case of early-onset inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair. A 49-year-old presented with a recurrent and symptomatic posterior vaginal wall defect. She underwent an uneventful site-specific repair and bovine graft augmentation. Her early postoperative course was complicated by inflammatory response to the graft presenting as intense pelvic floor spasm and urinary retention. The condition was managed conservatively and resolved subsequently. One year later, the patient continues to be asymptomatic. Transient intense pelvic floor spasm and urinary retention can be the result of inflammatory reaction following graft augmentation with bovine pericardium for posterior vaginal wall defect repair.
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ranking = 1
keywords = operative
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17/35. Mucinous cystadenocarcinoma of the appendix with pseudomyxoma peritonei presenting as total uterine prolapse. A case report.

    Mucinous cystadenocarcinoma of the appendix occurred with symptoms limited only to a total uterovaginal prolapse. Preoperative intravenous pyelogram and pelvic ultrasonography demonstrated the presence of a large pelvic mass. Exploratory laparotomy revealed the mass to be appendiceal adenocarcinoma, which was treated with extirpation of all the visible tumor and repair of the anatomic defect.
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ranking = 1
keywords = operative
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18/35. Surgical management of vaginal vault prolapse in a woman with a neovagina and pelvic kidneys.

    BACKGROUND: women with Mayer-Rokitansky-Kuster-Hauser syndrome have congenital absence of the uterus and upper two-thirds of the vagina, which is frequently accompanied by skeletal and renal anomalies. Mechanical dilation or surgical creation of a vagina allows for function but does not provide endopelvic fascial support of the vagina. Vaginal prolapse may occur. CASE: A 32-year-old woman presented with pelvic kidneys and a 5-year history of prolapse of her mechanically created neovagina. She underwent a sacrospinous ligament suspension with a cadaveric fascia lata bridge. The apex of the neovagina was 5 cm above the hymen 30 months postoperatively. CONCLUSION: An allograft colpopexy to the sacrospinous ligament is an effective method of surgical treatment of women with a prolapsed shortened vagina and an inaccessible presacral space.
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ranking = 1
keywords = operative
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19/35. Postoperative ureteral obstruction after confirmed ureteral patency: a case report.

    Ureteral injury after pelvic floor surgery and anti-incontinence surgery is a well-known risk. It is common practice to evaluate ureteral patency immediately after surgery prior to leaving the operating theater to assure that the ureters are open and functional. In this report we discuss the case of a patient who was admitted 9 days after surgery with acute onset of ureteral obstruction after having patent ureters documented at the time of surgery. A literature search failed to show any documented cases.
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ranking = 4
keywords = operative
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20/35. Subtotal uterine prolapse and pregnancy.

    THE AIM: A successful reposition of a subtotal gravid uterus of an 29 year old patient and prevention of a spontaneous abortion is presented. methods AND RESULTS: An 29 year old patient was admitted to the clinic due to pains in the lower abdomen, miction difficulties and a subtotal uterine prolapse. During the examination in the gynecological position upon disinfection completed, a manual reposition of a gravid uterus was performed. During the reposition, we found the uterus in contraction and the cervical channel one-finger size opened up to the internal cervical os. We introduced Mikulitz tampon as a support while the patient undergone laboratory and anesthesiology pre-operative program. In a short OET anesthesia, the uterine reposition was performed by Smith-Hodge pessary 85 mm and cerclage sec. McDonald in order to prevent a spontancous abortion caused by cervical insufficiency. The postoperative status of the patient was regular/normal. We recommended a bed rest and diazcpam (Apaurin) tbl a 3 mg 3 x 1. CONCLUSION: Complete treatment was performed under the short OET anesthesia, and a recovery of the patient was successful. All parameters of the pregnancy were normal.
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ranking = 2
keywords = operative
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