WorldWideScience

Sample records for relevant pelvic organ

  1. Pelvic Organ Prolapse: New Concepts in Pelvic Floor Anatomy.

    Science.gov (United States)

    Maldonado, Pedro A; Wai, Clifford Y

    2016-03-01

    As the field of reconstructive pelvic surgery continues to evolve, with descriptions of new procedures to repair pelvic organ prolapse, it remains imperative to maintain a functional understanding of pelvic floor anatomy and support. The goal of this review was to provide a focused, conceptual approach to differentiating anatomic defects contributing to prolapse in the various compartments of the vagina. Rather than provide exhaustive descriptions of pelvic floor anatomy, basic pelvic floor anatomy is reviewed, new and historical concepts of pelvic floor support are discussed, and relevance to the surgical management of specific anatomic defects is addressed.

  2. PELVIC ORGAN PROLAPES

    Directory of Open Access Journals (Sweden)

    Ketut Yoga Mira Pratiwi

    2013-04-01

    Full Text Available Pelvic organ prolapse (POP is defined as a decrease in abnormal or herniation of the pelvic organs out of place attached to its normal position or in the pelvic cavity. As for the anatomy of the pelvic organs consists of bones, muscles, and nerves. The presence of damage to the pelvic connective tissue and visceral attachment pelvic organs the cause occurs. The symptoms that appear in patients POP not specific to distinguish prolapse of some compartments but can reflect the degree of prolapse as a whole. Physical examination focused on pelvic examination, beginning with inspection on the vulva and vagina to identify the presence of erosion, ulceration, or other lesions. As for the existing therapy options include observation, non-operative management, and operative management.

  3. Pelvic organ prolapse - a review

    National Research Council Canada - National Science Library

    Dietz, Hans Peter

    2015-01-01

    Background: Female pelvic floor dysfunction encompasses a number of prevalent clinical conditions including urinary and faecal incontinence, obstructed defaecation, sexual dysfunction and female pelvic organ prolapse (FPOP...

  4. Management of pelvic organ prolapse.

    Science.gov (United States)

    Ahmed, Faisal; Sotelo, Tiffany

    2011-12-01

    Symptomatic pelvic organ prolapse can afflict up to 10% of women. Urinary incontinence, voiding dysfunction or difficulty possibly related to bladder outlet obstruction are common symptoms. Infrequently hydronephrosis or defecatory dysfunction can be seen. The management of pelvic organ prolapse (POP) should start with adequate assessment of all pelvic floor complaints. If a patient is not symptomatic, surgical intervention is usually not indicated. While the use of a variety of graft materials are available today including porcine, dermal and synthetic grafts, that are used in some surgical approaches to pelvic organ prolapse, other more conservative approaches may prove beneficial to many patients. This article describes our approach to the patient with pelvic organ prolapse.

  5. Surgery for Pelvic Organ Prolapse

    Science.gov (United States)

    ... organs. Targeting specific symptoms may be another option. Kegel exercises may be recommended in addition to symptom- ... Inability to control bodily functions such as urination. Kegel Exercises: Pelvic muscle exercises that assist in bladder ...

  6. Vaginal parity and pelvic organ prolapse.

    Science.gov (United States)

    Quiroz, Lieschen H; Muñoz, Alvaro; Shippey, Stuart H; Gutman, Robert E; Handa, Victoria L

    2010-01-01

    To investigate whether the odds of pelvic organ prolapse vary significantly with the number of vaginal births and whether cesarean birth is associated with prolapse. In this cross-sectional study of women over the age of 40, pelvic organ prolapse was defined as descent to or beyond the hymen. Logistic regression was used to estimate the relative odds of pelvic organ prolapse for each vaginal birth or cesarean birth, controlling for confounders. Two hundred ninety women underwent a pelvic organ prolapse quantification POPQ examination, and 72 were found to have pelvic organ prolapse. A single vaginal birth significantly increased the odds of prolapse (OR 9.73, 95% CI 2.68-35.35). Additional vaginal births were not associated with a significant increase in the odds of prolapse. Cesarean births were not associated with prolapse (OR 1.31, 95% CI 0.49-3.54). The odds of pelvic organ prolapse were almost 10 times higher after a single vaginal birth. The marginal impact of additional births on this association was small.

  7. Pelvic organ prolapse and overactive bladder.

    NARCIS (Netherlands)

    Boer, T.A. de; Salvatore, S.; Cardozo, L.; Chapple, C.; Kelleher, C.; Kerrebroeck, P. van; Kirby, M.G.; Koelbl, H.; Espuna-Pons, M.; Milsom, I.; Tubaro, A.; Wagg, A.; Vierhout, M.E.

    2010-01-01

    AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms

  8. Pelvic organ prolapse and overactive bladder.

    NARCIS (Netherlands)

    Boer, T.A. de; Salvatore, S.; Cardozo, L.; Chapple, C.; Kelleher, C.; Kerrebroeck, P. van; Kirby, M.G.; Koelbl, H.; Espuna-Pons, M.; Milsom, I.; Tubaro, A.; Wagg, A.; Vierhout, M.E.

    2010-01-01

    AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms d

  9. Prevention and management of pelvic organ prolapse

    Science.gov (United States)

    Giarenis, Ilias

    2014-01-01

    Pelvic organ prolapse is a highly prevalent condition in the female population, which impairs the health-related quality of life of affected individuals. Despite the lack of robust evidence, selective modification of obstetric events or other risk factors could play a central role in the prevention of prolapse. While the value of pelvic floor muscle training as a preventive treatment remains uncertain, it has an essential role in the conservative management of prolapse. Surgical trends are currently changing due to the controversial issues surrounding the use of mesh and the increasing demand for uterine preservation. The evolution of laparoscopic and robotic surgery has increased the use of these techniques in pelvic floor surgery. PMID:25343034

  10. Obesity and pelvic organ prolapse: a systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Giri, Ayush; Hartmann, Katherine E; Hellwege, Jacklyn N; Velez Edwards, Digna R; Edwards, Todd L

    2017-07-01

    Studies evaluating the association between obesity and pelvic organ prolapse report estimates that range from negative to positive associations. Heterogeneous definitions for pelvic organ prolapse and variable choices for categorizing obesity measures have made it challenging to conduct meta-analysis. We systematically evaluated evidence to provide quantitative summaries of association between degrees of obesity and pelvic organ prolapse, and identify sources of heterogeneity. We searched for all indexed publications relevant to pelvic organ prolapse up until June 18, 2015, in PubMed/MEDLINE to identify analytical observational studies published in English that reported risk ratios (relative risk, odds ratio, or hazard ratio) for body mass index categories in relation to pelvic organ prolapse. Random effects meta-analyses were conducted to report associations with pelvic organ prolapse for overweight and obese body mass index categories compared with women in the normal-weight category (referent: body mass index obesity and pelvic organ prolapse, 22 eligible studies provided effect estimates for meta-analysis of the overweight and obese body mass index categories. Compared with the referent category, women in the overweight and obese categories had meta-analysis risk ratios of at least 1.36 (95% confidence interval, 1.20-1.53) and at least 1.47 (95% confidence interval, 1.35-1.59), respectively. Subgroup analyses showed effect estimates for objectively measured clinically significant pelvic organ prolapse were higher than for self-reported pelvic organ prolapse. Other potential sources of heterogeneity included proportion of postmenopausal women in study and reported study design. Overweight and obese women are more likely to have pelvic organ prolapse compared with women with body mass index in the normal range. The finding that the associations for obesity measures were strongest for objectively measured, clinically significant pelvic organ prolapse further

  11. Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Pelvic Organ Prolapse Women

    OpenAIRE

    Ying, Tao; Li, Qin; Xu, Lian; Liu, Feifei; Hu, Bing

    2012-01-01

    The present study investigated the morphology and structure of pelvic floor in 50 nulliparous and 50 pelvic organ prolapse (POP) women using translabial three-dimensional (3D) ultrasound. The levator hiatus in POP women was significantly different from that in nullipara women. In POP women, the size of pelvic floor increased, with a circular shape, and the axis of levator hiatus departed from the normal position in 36 (72%) cases. The puborectalis was avulsed in 18 (36%) cases and the pelvic ...

  12. Pelvic reconstruction improves pelvic floor strength in pelvic organ prolapse patients

    Directory of Open Access Journals (Sweden)

    Zhong Guan

    2015-10-01

    Conclusion: The modified pelvic reconstruction procedure could improve pelvic floor muscle strength in POP patients, which remains lower when compared with the normal population. Pelvic floor muscle strength should be included in the assessment of surgical outcomes in POP.

  13. Mechanical devices in pelvic organ prolapsed

    Directory of Open Access Journals (Sweden)

    Raja AM, Seema SR

    2013-07-01

    Full Text Available Pelvic organ prolapse (POP is a common condition, up to 50% of women will have some degree of prolapse and many are asymptomatic. The pessaries are intended to decrease the symptoms of prolapse and are valid options for patients with stress incontinence. Generally pessaries are safe to use. There are two types of pessaries, support type and space occupying type. Ring pessary is very commonly used, as it is easy to insert and remove. Pessaries can make a significant difference in the quality of life of the patients and even can differ surgical management. As the aging population is increasing in developed and developing countries, pessaries can be of considerable help in managing the pelvic organ prolapse.

  14. Validation of the Pelvic Floor Distress Inventory-20 and the Pelvic Floor Impact Questionnaire-7 in Danish women with pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2013-01-01

    To translate the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) and to evaluate their psychometric properties in Danish women with symptomatic pelvic organ prolapse.......To translate the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) and to evaluate their psychometric properties in Danish women with symptomatic pelvic organ prolapse....

  15. Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Pelvic Organ Prolapse Women

    Directory of Open Access Journals (Sweden)

    Tao Ying, Qin Li, Lian Xu, Feifei Liu, Bing Hu

    2012-01-01

    Full Text Available The present study investigated the morphology and structure of pelvic floor in 50 nulliparous and 50 pelvic organ prolapse (POP women using translabial three-dimensional (3D ultrasound. The levator hiatus in POP women was significantly different from that in nullipara women. In POP women, the size of pelvic floor increased, with a circular shape, and the axis of levator hiatus departed from the normal position in 36 (72% cases. The puborectalis was avulsed in 18 (36% cases and the pelvic organs arranged abnormally in 23 (46% cases. In summary, 3D ultrasound is an effective tool to detect the pelvic floor in POP women who presented with abnormalities in the morphology and structure of pelvic floor.

  16. Pelvic Organ Prolapse-Associated Cystitis

    OpenAIRE

    2014-01-01

    Pelvic organ prolapse (POP) and urinary tract infection (UTI) are important problems, estimated to affect around 14 and 40 % of women, respectively, at some point in their lives. Positive urine culture in the presence of symptoms is the cornerstone of diagnosis of UTI and should be performed along with ultrasound assessment of postvoid residual (PVR) in all women presenting with POP and UTI. PVR over 30 mL is an independent risk factor for UTI, although no specific association with POP and UT...

  17. Levator trauma is associated with pelvic organ prolapse

    National Research Council Canada - National Science Library

    Dietz; Simpson

    2008-01-01

    .... Design Retrospective observational study. Setting Tertiary urogynaecological unit. Sample A total of 934 women seen for interview, examination using the pelvic organ prolapse quantification (POP-Q...

  18. Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. METHODS: This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized...

  19. Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse

    NARCIS (Netherlands)

    M.C.P. Slieker-ten Hove (Marijke); A.L. Pool-Goudzwaard (Annelies); M.J.C. Eijkemans (René); R.P.M. Steegers-Theunissen (Régine); C.W. Burger (Curt); M.E. Vierhout (Mark)

    2010-01-01

    textabstractIntroduction and hypothesis: This study aims to examine the relationship between pelvic floor muscle function (PFMF) and pelvic organ prolapse (POP) in a general female population. Methods: Cross-sectional study on women aged 45-85 years. Validated questionnaires were used to assess pelv

  20. Demonstration of Pelvic Anatomy by Modified Midline Transection that Maintains Intact Internal Pelvic Organs

    Science.gov (United States)

    Steinke, Hanno; Saito, Toshiyuki; Herrmann, Gudrun; Miyaki, Takayoshi; Hammer, Niels; Sandrock, Mara; Itoh, Masahiro; Spanel-Borowski, Katharina

    2010-01-01

    Gross dissection for demonstrating anatomy of the human pelvis has traditionally involved one of two approaches, each with advantages and disadvantages. Classic hemisection in the median plane through the pelvic ring transects the visceral organs but maintains two symmetric pelvic halves. An alternative paramedial transection compromises one side…

  1. Can I prevent Pelvic Organ Prolapse

    Science.gov (United States)

    ... Prolapse POP Symptoms & Types Can I Prevent POP? Kegel Exercises POP Diagnosis Find a Provider Talking with ... developing POP. Pelvic Muscle Exercises Pelvic muscle exercises (Kegel) strengthen or retrain the nerves and muscles of ...

  2. Economics of pelvic organ prolapse surgery.

    Science.gov (United States)

    Cheon, Cecilia; Maher, Christopher

    2013-11-01

    The aim was to review the economic costs associated with pelvic organ prolapse surgery. Every 4 years and as part of the Fifth International Collaboration on Incontinence we reviewed the English-language scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] or systematic reviews), level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies) and level 4 (case reports). The highest level of evidence was utilised by the committee to make evidence based recommendations based upon the Oxford grading system. Grade A recommendation usually depends on consistent level 1 evidence. Grade B recommendation usually depends on consistent level 2 and/or 3 studies, or "majority evidence" from RCTs. Grade C recommendation usually depends on level 4 studies or "majority evidence" from level 2/3 studies or Delphi processed expert opinion. Grade D "no recommendation possible" would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without a formal analytical process, such as by Delphi. The annual economic costs of pelvic organ prolapse surgeries are significant and over the next decades will grow at twice the rate of population growth because of our aging population. In a single institution study vaginal reconstructive surgery and pessary use were more cost-effective than expectant management, traditional abdominal sacral colpopexy (ASC) or robot-assisted sacral colpopexy (RSC; grade C). Two studies have demonstrated that ASC incurs lower inpatient costs than LSC or RSC (grade C). Data from a single RCT demonstrated the LSC to incur lower inpatient costs than RSC specifically relating to shorter operating times in the LSC group (grade B). Data from a single RCT demonstrated LSC to be a more effective cost-minimising surgery

  3. Current treatment of pelvic organ prolapse correlated with chronic pelvic pain, bladder and bowel dysfunction.

    Science.gov (United States)

    Liedl, Bernhard; Goeschen, Klaus; Durner, Leopold

    2017-05-01

    The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years. Laxity in ligaments and/or vaginal membrane due to damaged connective tissue may prevent the normal opening and closure mechanism of urethra and anus, because muscles need finite lengths to contract properly. Hypermobility of the apex can irritate the pelvic plexus causing chronic pelvic pain. In consequence, dysfunctions as abnormal emptying of the bladder, urgency, pelvic pain, fecal incontinence and obstructed defecation can occur in women with different degrees of POP. In conclusion, it has to be recognized that women bothered by these symptoms should be examined for POP and appropriately advised for possibility of cure by pelvic floor surgery after careful selection. VIDEO ABSTRACT.

  4. Pelvic Organ Prolapse : Conservative treatments in primary care

    NARCIS (Netherlands)

    Panman, Chantal; Wiegersma, Marian

    2017-01-01

    Pelvic organ prolapse is defined as descent of the anterior or posterior vaginal wall, the uterus, or the vaginal vault (after hysterectomy). Pelvic floor muscle training (PFMT) and pessaries are commonly used in the conservative treatment of prolapse. Although both treatments could typically be

  5. Body image and sexuality in women with pelvic organ prolapse.

    Science.gov (United States)

    Zielinski, Ruth; Low, Lisa Kane; Tumbarello, Julie; Miller, Janis M

    2009-01-01

    The effect of physical changes associated with pelvic organ prolapse on a woman's body image and how that may influence sexuality has not been well studied. The goal of this study was to assess the implementation and utility of a body image questionnaire in women with pelvic organ prolapse. Two research questions were asked: (1) What is the impact of pelvic organ prolapse on women's body image and how does this affect their sexual health?, and (2) Does the Vaginal Changes Sexual and Body Esteem (VSBE) Scale show utility for use in assessing body image and sexual health in women with pelvic organ prolapse? A qualitative design was used for this study. Telephone interviews were conducted using a semi-structured questionnaire and an adapted body image and sexuality questionnaire specific to genital body image. Thirteen women with pelvic organ prolapse completed the study. Eight women were classified as sexually active, and 5 women were not sexually active. Data showed women with pelvic organ prolapse, classified as sexually active, scored significantly lower on the VSBE scale than women who were not sexually active. There was a positive correlation between severity of prolapse and VSBE scores. The VSBE scale questionnaire showed utility and potential for demonstrating change in body image in women with pelvic organ prolapse. This tool may assist clinicians in a more thorough assessment of body image and sexuality in this population of women.

  6. Surgical Updates in the Treatment of Pelvic Organ Prolapse

    Directory of Open Access Journals (Sweden)

    Julia Geynisman-Tan

    2017-04-01

    Full Text Available Pelvic organ prolapse affects approximately 8% of women, and the demand for pelvic organ prolapse surgery is expected to increase by nearly 50% over the next 40 years. The surgical techniques used to correct pelvic organ prolapse have evolved over the last 10 years, with multiple well-designed studies addressing the risks, outcomes, reoperation rates, and optimal surgical approaches. Here we review the most recent evidence on the route of access, concomitant procedures, and synthetic materials for augmenting the repair. Ultimately, this review highlights that there is no optimal method for correcting pelvic organ prolapse and that the risks, benefits, and approaches should be discussed in a patient-centered, goal-oriented approach to decision-making.

  7. Surgical Updates in the Treatment of Pelvic Organ Prolapse

    Science.gov (United States)

    Geynisman-Tan, Julia; Kenton, Kimberly

    2017-01-01

    Pelvic organ prolapse affects approximately 8% of women, and the demand for pelvic organ prolapse surgery is expected to increase by nearly 50% over the next 40 years. The surgical techniques used to correct pelvic organ prolapse have evolved over the last 10 years, with multiple well-designed studies addressing the risks, outcomes, reoperation rates, and optimal surgical approaches. Here we review the most recent evidence on the route of access, concomitant procedures, and synthetic materials for augmenting the repair. Ultimately, this review highlights that there is no optimal method for correcting pelvic organ prolapse and that the risks, benefits, and approaches should be discussed in a patient-centered, goal-oriented approach to decision-making. PMID:28467763

  8. How do delivery mode and parity affect pelvic organ prolapse?

    Science.gov (United States)

    Yeniel, A Özgür; Ergenoglu, A Mete; Askar, Niyazi; Itil, Ismaıl Mete; Meseri, Reci

    2013-07-01

    To determine the association between mode of delivery, parity, and pelvic organ prolapse, as assessed by the pelvic organ prolapse quantification system. Cross-sectional study. Tertiary referral center, Turkey. A total of 1964 women with benign gynecological disorders who presented between October 2009 and July 2011. Evaluation using the pelvic organ prolapse quantification system and questionnaire assessing previous obstetrics and medical history. Difference in pelvic organ prolapse stages between nulliparous and multiparous women, impact of parity and mode of delivery. In the study population, 86.4, 7.2 and 6.4% had pelvic organ prolapse of stages 0-I, II, and III-IV, respectively, and 7.9% had significant prolapse beyond the hymen. The mean age, parity, and number of vaginal deliveries were significantly higher in the prolapse than in the non-prolapse group. Vaginal delivery was associated with an odds ratio of 2.92 (95% confidence interval 1.19-7.17) for prolapse when compared with nulliparity. Each vaginal delivery increased the risk of prolapse (odds ratio 1.23; 95% confidence interval 1.12-1.35) after controlling for all confounding factors. Cesarean delivery had no impact on the odds for prolapse. Vaginal delivery was an independent risk factor for prolapse, and additional vaginal deliveries significantly increased the risk. However, cesarean delivery had no effect on the development of prolapse in this material. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. The 3D Pelvic Inclination Correction System (PICS): A universally applicable coordinate system for isovolumetric imaging measurements, tested in women with pelvic organ prolapse (POP).

    Science.gov (United States)

    Reiner, Caecilia S; Williamson, Tom; Winklehner, Thomas; Lisse, Sean; Fink, Daniel; DeLancey, John O L; Betschart, Cornelia

    2017-07-01

    In pelvic organ prolapse (POP), the organs are pushed downward along the lines of gravity, so measurements along this longitudinal body axis are desirable. We propose a universally applicable 3D coordinate system that corrects for changes in pelvic inclination and that allows the localization of any point in the pelvis at rest or under dynamic conditions on magnetic resonance images (MRI) of pelvic floor disorders in a scanner- and software independent manner. The proposed 3D coordinate system called 3D Pelvic Inclination Correction System (PICS) is constructed utilizing four bony landmark points, with the origin set at the inferior pubic point, and three additional points at the sacrum (sacrococcygeal joint) and both ischial spines, which are clearly visible on MRI images. The feasibility and applicability of the moving frame was evaluated using MRI datasets from five women with pelvic organ prolapse, three undergoing static MRI and two undergoing dynamic MRI of the pelvic floor in a supine position. The construction of the coordinate system was performed utilizing the selected landmarks, with an initial implementation completed in MATLAB. In all cases the selected landmarks were clearly visible, with the construction of the 3D PICS and measurement of pelvic organ positions performed without difficulty. The resulting distance from the organ position to the horizontal PICS plane was compared to a traditional measure based on standard measurements in 2D slices. The two approaches demonstrated good agreement in each of the cases. The developed approach makes quantitative assessment of pelvic organ position in a physiologically relevant 3D coordinate system possible independent of pelvic movement relative to the scanner. It allows the accurate study of the physiologic range of organ location along the body axis ("up or down") as well as defects of the pelvic sidewall or birth-related pelvic floor injuries outside the midsagittal plane, not possible before in a 2D

  10. Treatment of Endometrial Cancer in Association with Pelvic Organ Prolapse

    Science.gov (United States)

    Vanichtantikul, Asama; Tharavichitkul, Ekkasit; Chitapanarux, Imjai

    2017-01-01

    Background. Uterine malignancy coexistent with pelvic organ prolapse (POP) is uncommon and standardized treatment is not established. The objective of this case study was to highlight the management of endometrial cancer in association with pelvic organ prolapse. Case Report. An 87-year-old woman presented with POP Stage IV combined with endometrioid adenocarcinoma of the uterus: clinical Stage IV B. She had multiple medical conditions including stroke, deep vein thrombosis, and pulmonary embolism. She was treated with radiotherapy and pessary was placed. Conclusion. Genital prolapse with abnormal uterine bleeding requires proper evaluation and management. Concurrent adenocarcinoma and POP can be a difficult clinical situation to treat, and optimum management is controversial.

  11. Pelvic Organ Prolapse Quantification System (POP-Q) - a new era in pelvic prolapse staging.

    Science.gov (United States)

    Persu, C; Chapple, C R; Cauni, V; Gutue, S; Geavlete, P

    2011-01-01

    The prolapse of one or several pelvic organs is a condition that has been known by medicine since its early days, and different therapeutic approaches have been proposed and accepted. But one of the main problems concerning the prolapse of pelvic organs is the need for a universal, clear and reliable staging method.Because the prolapse has been known and recognized as a disease for more than one hundred years, so are different systems proposed for its staging. But none has proved itself to respond to all the requirements of the medical community, so the vast majority were seen coming and going, failing to become the single most useful system for staging in pelvic organ prolapse (POP).The latest addition to the group of staging systems is the POP-Q system, which is becoming increasingly popular with specialists all over the world, because, although is not very simple as a concept, it helps defining the features of a prolapse at a level of completeness not reached by any other system to date. In this vision, the POP-Q system may reach the importance and recognition of the TNM system use in oncology.This paper briefly describes the POP-Q system, by comparison with other staging systems, analyzing its main features and the concept behind it.

  12. Pelvic organ prolapse and collagen-associated disorders.

    NARCIS (Netherlands)

    Lammers, K.; Lince, S.L.; Spath, M.A.; Kempen, L.C.L.T. van; Hendriks, J.C.M.; Vierhout, M.E.; Kluivers, K.B.

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) and other disorders, such as varicose veins and joint hypermobility, have been associated with changes in collagen strength and metabolism. We hypothesized that these various disorders were more prevalent in both POP patients and their family

  13. Incidence of pelvic organ prolapse repair subsequent to hysterectomy

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the incidence of subsequent pelvic organ prolapse (POP) repair in women following radical hysterectomy versus total abdominal hysterectomy. METHODS: From the Danish National Patient Registry, we collected data on all radical...

  14. Urinary incontinence after surgery for pelvic organ prolapse

    NARCIS (Netherlands)

    Lensen, E.J.M.; Withagen, M.I.J.; Kluivers, K.B.; Milani, A.L.; Vierhout, M.E.

    2013-01-01

    AIMS: This study focused on the changes in urinary incontinence (UI) rates pre- and postoperatively and identified risk factors which predict the presence of symptoms of urgency urinary incontinence (UUI) or stress urinary incontinence (SUI) after surgery for pelvic organ prolapse (POP) without conc

  15. Factors influencing success of pelvic organ prolapse repair using porcine dermal implant Pelvicol.

    NARCIS (Netherlands)

    Boer, T.A. de; Gietelink, D.A.; Hendriks, J.C.M.; Vierhout, M.E.

    2010-01-01

    OBJECTIVE: To evaluate factors influencing pelvic organ prolapse (POP) recurrence after repair surgery with a porcine dermal collagen implant (Pelvicol). STUDY DESIGN: From December 2003 to August 2005, 78 patients with mainly stage 3 pelvic organ prolapse by the Pelvic Organ Prolapse Quantification

  16. Is Cervical Elongation Associated with Pelvic Organ Prolapse?

    Science.gov (United States)

    Berger, Mitchell B.; Ramanah, Rajeev; Guire, Kenneth E.; DeLancey, John O. L.

    2012-01-01

    Introduction and Hypothesis It is commonly believed that pelvic organ prolapse is associated with cervical elongation. However, cervical lengths have not been formally compared between women with prolapse and those with normal support. Methods Cervix and uterine corpus lengths were measured on magnetic resonance images in a case-control study of 51 women with prolapse and 46 women with normal support determined by pelvic organ prolapse (POP) quantification (POP-Q) examination. Group matching ensured similar demographics in both groups. Ranges for normal cervical lengths were determined from the values in the control group in order to evaluate for cervical elongation amongst women with prolapse. Results The cervix is 36.4% (8.6 mm) longer in women with prolapse than in women with normal pelvic support (p uterine descent (POP-Q point C). Approximately 40% of women with prolapse have cervical elongation. 57% of cervical elongation in prolapse can be explained by a logistic-regression based model including POP-Q point C, body mass index and menopausal status. Conclusion Cervical elongation is found in one-third of women with pelvic organ prolapse, with the extent of elongation increasing with greater degrees of uterine descent. PMID:22527546

  17. Pathophysiology of pelvic organ prolapse and stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Payal D Patel

    2006-01-01

    Full Text Available Although they may present with significant morbidity, pelvic organ prolapse and stress urinary incontinence are mainly afflicitions that affect quality of life. To appropiately treat these entities, comprehension of the various theories of pathophysiology is paramount. Utilizing a Medline search, this article reviews recent data concerning intrinsic (i.e., genetics, postmenopausal status and extrinsic factors (i.e., previous hysterectomy, childbirth leading to organ prolapse or stress incontinence

  18. Giant Ectopic Ureter Mimicking Pelvic Organ Prolapse: A Case Report

    Directory of Open Access Journals (Sweden)

    Adnan Simsir

    2011-01-01

    Full Text Available Ectopic ureter is one of the most common urinary tract anomalies. We, herein, present a case of a giant ureter with ectopic orifice, mimicking pelvic organ prolapse, which is the first in the literature. A 59-year-old female patient presenting with frequently recurrent urinary tract infection had grade 3 pelvic organ prolapse. On examination, the organ producing the appearance of prolapse was found to be a right ureter of giant size and was obstructed by a large stone at the distal segment. The proximal end of the ureter ended blindly. After exploration, the stone was removed, the ureter was detached from the urethra, and the lumen was tied off and cut 5 cm proximally. At 6 months postoperatively, the patient is being followed up without any clinical problems. In such cases with nonfunctioning renal segment draining proximally, the chance of cure can be obtained without a need for a comprehensive intervention such as total abdominal ureterectomy.

  19. Treatment of Endometrial Cancer in Association with Pelvic Organ Prolapse

    Directory of Open Access Journals (Sweden)

    Asama Vanichtantikul

    2017-01-01

    Full Text Available Background. Uterine malignancy coexistent with pelvic organ prolapse (POP is uncommon and standardized treatment is not established. The objective of this case study was to highlight the management of endometrial cancer in association with pelvic organ prolapse. Case Report. An 87-year-old woman presented with POP Stage IV combined with endometrioid adenocarcinoma of the uterus: clinical Stage IV B. She had multiple medical conditions including stroke, deep vein thrombosis, and pulmonary embolism. She was treated with radiotherapy and pessary was placed. Conclusion. Genital prolapse with abnormal uterine bleeding requires proper evaluation and management. Concurrent adenocarcinoma and POP can be a difficult clinical situation to treat, and optimum management is controversial.

  20. Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bruno Teixeira Bernardes

    Full Text Available CONTEXT AND OBJECTIVE: Previous studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse. DESIGN AND SETTING: Prospective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI; a hypopressive exercise group (GII; and a control group (GIII. The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS: The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001, but not in relation to GIII (P = 0.816. CONCLUSIONS: The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.

  1. Pelvic organ support several years after a first birth.

    Science.gov (United States)

    Ferreira, Caroline W S; Atan, Ixora K; Martin, Andrew; Shek, Ka Lai; Dietz, Hans Peter

    2017-03-11

    Female pelvic organ prolapse is highly prevalent and childbirth has been shown to be an important risk factor. The study was carried out to observe if pelvic organ support deteriorates over time following a first birth. This is a retrospective review using archived data sets of women seen in the context of two prospective perinatal imaging studies. All subjects had undergone a standardised interview, a clinical examination and 4D translabial ultrasound, 3 months and 2-5 years post-partum. Main outcome measures were pelvic organ descent and hiatal area at maximum Valsalva manoeuvre. Means at the two time points were compared using paired Student's t test. Predictors of change over time in continuous variables were explored using linear modelling methods. A total of 300 women had at least two postnatal follow-ups. They were first seen on average 0.39 (SD 0.2, range 0.2-2.1) years and again 3.1 (SD 1.5, range 1.4-8) years after the index delivery, with a mean interval of 2.71 (SD 1.5, range 0.7-7.7) years, providing a total of 813 (300 × 2.71) woman-years of observation. On univariate analysis, there was a significant decrease in mobility over time of the bladder neck, bladder, and rectal ampulla (P = < 0.004) and hiatal area (P = 0.012). The degree of improvement was less marked in women with levator avulsion. A significant reduction in pelvic organ descent and hiatal area was noted over a mean of 2.7 years after a first birth.

  2. Evaluation of the female pelvic floor in pelvic organ prolapse using 3.0-Tesla diffusion tensor imaging and fibre tractography

    Energy Technology Data Exchange (ETDEWEB)

    Zijta, F.M. [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Amsterdam and Department of Radiology, Amsterdam (Netherlands); Academic Medical Center, Department of Radiology, Amsterdam, AZ (Netherlands); Lakeman, M.M.E.; Roovers, J.P. [University of Amsterdam the Netherlands and Biomedical NMR, Amsterdam and Department of Gynaecology, Academic Medical Centre, Amsterdam (Netherlands); Froeling, M. [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Eindhoven University of Technology, Department of Biomedical Engineering, Eindhoven (Netherlands); Paardt, M.P. van der; Borstlap, C.S.V.; Bipat, S.; Nederveen, A.J.; Stoker, J. [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Montauban van Swijndregt, A.D. [Onze Lieve Vrouwe Gasthuis, Amsterdam and Department of Radiology, Amsterdam (Netherlands); Strijkers, G.J. [Eindhoven University of Technology, Department of Biomedical Engineering, Eindhoven (Netherlands)

    2012-12-15

    To prospectively explore the clinical application of diffusion tensor imaging (DTI) and fibre tractography in evaluating the pelvic floor. Ten patients with pelvic organ prolapse, ten with pelvic floor symptoms and ten asymptomatic women were included. A two-dimensional (2D) spin-echo (SE) echo-planar imaging (EPI) sequence of the pelvic floor was acquired. Offline fibre tractography and morphological analysis of pelvic magnetic resonance imaging (MRI) were performed. Inter-rater agreement for quality assessment of fibre tracking results was evaluated using weighted kappa ({kappa}). From agreed tracking results, eigen values ({lambda}1, {lambda}2, {lambda}3), mean diffusivity (MD) and fractional anisotropy (FA) were calculated. MD and FA values were compared using ANOVA. Inter-rater reliability of DTI parameters was interpreted using the intra-class correlation coefficient (ICC). Substantial inter-rater agreement was found ({kappa} = 0.71 [95% CI 0.63-0.78]). Four anatomical structures were reliably identified. Substantial inter-rater agreement was found for MD and FA (ICC 0.60-0.91). No significant differences between groups were observed for anal sphincter, perineal body and puboperineal muscle. A significant difference in FA was found for internal obturator muscle between the prolapse group and the asymptomatic group (0.27 {+-} 0.05 vs 0.22 {+-} 0.03; P = 0.015). DTI with fibre tractography permits identification of part of the clinically relevant pelvic structures. Overall, no significant differences in DTI parameters were found between groups. circle Diffusion tensor MRI offers new insights into female pelvic floor problems. (orig.)

  3. Triphasic MRI of pelvic organ descent: sources of measurement error

    Energy Technology Data Exchange (ETDEWEB)

    Morren, Geert L. [Bowel and Digestion Centre, The Oxford Clinic, 38 Oxford Terrace, Christchurch (New Zealand)]. E-mail: geert_morren@hotmail.com; Balasingam, Adrian G. [Christchurch Radiology Group, P.O. Box 21107, 4th Floor, Leicester House, 291 Madras Street, Christchurch (New Zealand); Wells, J. Elisabeth [Department of Public Health and General Medicine, Christchurch School of Medicine, St. Elmo Courts, Christchurch (New Zealand); Hunter, Anne M. [Christchurch Radiology Group, P.O. Box 21107, 4th Floor, Leicester House, 291 Madras Street, Christchurch (New Zealand); Coates, Richard H. [Christchurch Radiology Group, P.O. Box 21107, 4th Floor, Leicester House, 291 Madras Street, Christchurch (New Zealand); Perry, Richard E. [Bowel and Digestion Centre, The Oxford Clinic, 38 Oxford Terrace, Christchurch (New Zealand)

    2005-05-01

    Purpose: To identify sources of error when measuring pelvic organ displacement during straining using triphasic dynamic magnetic resonance imaging (MRI). Materials and methods: Ten healthy nulliparous woman underwent triphasic dynamic 1.5 T pelvic MRI twice with 1 week between studies. The bladder was filled with 200 ml of a saline solution, the vagina and rectum were opacified with ultrasound gel. T2 weighted images in the sagittal plane were analysed twice by each of the two observers in a blinded fashion. Horizontal and vertical displacement of the bladder neck, bladder base, introitus vaginae, posterior fornix, cul-de sac, pouch of Douglas, anterior rectal wall, anorectal junction and change of the vaginal axis were measured eight times in each volunteer (two images, each read twice by two observers). Variance components were calculated for subject, observer, week, interactions of these three factors, and pure error. An overall standard error of measurement was calculated for a single observation by one observer on a film from one woman at one visit. Results: For the majority of anatomical reference points, the range of displacements measured was wide and the overall measurement error was large. Intra-observer error and week-to-week variation within a subject were important sources of measurement error. Conclusion: Important sources of measurement error when using triphasic dynamic MRI to measure pelvic organ displacement during straining were identified. Recommendations to minimize those errors are made.

  4. The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION: We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. MATERIAL AND METHODS: This study was a 12-month follow up...... with baseline on single-item analysis (p = 0.01). The training and lifestyle group had significantly improved pelvic organ prolapse symptoms on single-item analysis (p = 0.02) and of bowel-related quality of life (p = 0.04). No significant between-group differences were found in the symptom and quality of life...... surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. CONCLUSIONS: At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were...

  5. Expression of estrogen receptors in the pelvic floor of pre- and post-menopausal women presenting pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Marie Laure Kottler

    2011-10-01

    Full Text Available The precise role of estrogen in the pathogenesis of pelvic organ prolapse (POP is still unclear, while the results concerning the effect of selective estrogen receptor modulators on pelvic organ prolapse are contradictory. Our aim was to test whether alteration in the expression of estrogen receptors in the pelvic floor of preand post-menopausal women is related to genital prolapse status. The mRNA levels of ERα and ERβ in 60 biopsy specimens were measured. Significantly higher expression of ERα and higher ERα/ERβ ratio were demonstrated in post-menopausal women compared to pre-menopausal women. Higher expression of ERα and higher ERα/ERβ ratio were detected in all studied groups with POP, thus it did not reach significance in the post-menopausal group. Pre-menopausal and post-menopausal women presenting pelvic organ prolapse had no difference in the ERα expression. Our preliminary study may indicate that pelvic organ prolapse is associated with higher expression of ERα/ERβ in the pelvic floor of both pre- and post-menopausal women; thus not reaching statistical significance in the post-menopausal women was probably due to the group’s size. We believe that the inevitable changes in the estrogen receptor expression over women’s different lifetimes may affect the risk of genital prolapse progression, and might contribute to the further search for appropriate selective estrogen receptor modulators as a treatment for women with pelvic organ prolapse. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 521–527

  6. Incidental Dose to Pelvic Nodes in Bladder-Only Radiotherapy: Is It Clinically Relevant?

    Science.gov (United States)

    Lewis, Shirley; Murthy, Vedang; Mahantshetty, Umesh; Shrivastava, Shyam Kishore

    2017-06-01

    Although there is a strong biological rationale to electively treat the pelvic nodes during bladder preservation, its clinical benefit is uncertain. This may be explained by the incidental dose received by the nodal regions when treating the bladder alone. This study was conducted to investigate the doses received by the different pelvic nodal regions when the bladder alone is treated by standard conformal radiotherapy. The computed tomography data sets of 20 patients with node-negative muscle-invasive bladder cancer treated in a bladder preservation protocol were studied. Patients were originally treated with conformal radiotherapy to the bladder alone. Replanning was done with additional delineation of the pelvic nodal regions namely common iliac (upper and lower), presacral, internal iliac, obturator, and external iliac. Dose volume parameters such as Dmean, Dmax, D100%, D66%, D33%, V40, and V50 to each of the nodal regions were estimated for all patients. The obturator nodes received the highest dose among all nodal regions. The mean dose received by obturator, external iliac, and internal iliac regions was 59, 45, and 36 Gy, respectively. The dose received by these 3 regions in the full bladder state was 63, 52, and 47 Gy, respectively. The dose received by all other pelvic nodal regions was low and not clinically relevant. The incidental dose received by obturator and external iliac nodes is clinically significant in bladder-only radiation, possibly enough to influence micrometastatic disease. This may be a reason for the lack of clear benefit seen with nodal irradiation in bladder cancer. Advances in Knowledge: This study highlights that the incidental dose received by obturator and external iliac nodes is clinically significant in bladder-only radiation. The obturator nodes received the highest dose among all nodal regions with mean dose of 59 Gy.

  7. Vaginal Symptoms after Reconstructive Surgery for Prolapsed Pelvic Organ

    Directory of Open Access Journals (Sweden)

    Tahereh Eftekhar

    2010-09-01

    Full Text Available Objective: Pelvic organ prolapse is a common disorder in women over the world and its general treatment is surgery. Therefore it is important to consider if vaginal symptoms, quality of life and sexual function after surgery improve. The purpose of this study was to assess vaginal symptoms in women 3 months after surgery for pelvic organ prolapse.Materials and methods: In this study 50 eligible women were evaluated between March 2007 and May 2008. These women underwent physical examination for prolapse staging and medical status and completed the ICIQ–VS questionnaire pre– and post operation 3 months later.Results: Mean age was 44.86 (31–74 years and %72 were premenopausal. Vaginal symptoms, sexual function and quality of life scores improved in order (8.88 Vs 18.04, 17.16 Vs 34.48, 2.76 Vs 4.8, all P<0.05.Conclusion: Vaginal symptoms, sexual function and quality of life after surgery improved. It appears that in Iranian patients, the performance of reconstruction surgery alone results in satisfaction.

  8. Uterine sparing surgical methods in pelvic organ prolapse

    Science.gov (United States)

    Tola, Esra Nur; Erdemoğlu, Evrim; Erdemoğlu, Ebru

    2015-01-01

    Pelvic organ prolapse (POP) is defined as the protrusion of pelvic organs to the vagen and is an important health problem in patients of older age. Today, most women with POP prefer uterine sparing surgery due to the changes in lifestyle, beliefs, pregnancy desire, and understanding the role of the uterus and cervix in sexual function. Therefore, the need for newer surgical procedures that involve less invasive surgery, reduced intraoperative and postoperative risks, and a faster healing time in POP surgery have gained importance. Vaginal, abdominal, laparoscopic, and robotic methods are defined in uterine preserving surgery but there is not yet a consensus on which of them should be chosen. In choosing the proper technique, the patient’s general status, accompanying disease, correct indication, and the surgeon’s experience are all important. In our practice we prefer laparoscopic mesh sacrohysteropexy in patients who prefer to preserve their uterus because of the lower costs and high success rates compared with abdominal and robotic techniques. PMID:28913063

  9. Screening of the pelvic organ prolapse without a physical examination; (a community based study

    Directory of Open Access Journals (Sweden)

    Tehrani Fahimeh

    2011-11-01

    Full Text Available Abstract Background Pelvic organ prolapse (POP is a silent disorder with a huge impact on women's quality of life. There is limited data from community-based studies conducted to determine the prevalence of POP as its assessment needs a pelvic examination. We aimed to develop a simple screening inventory for identification of pelvic organ prolapse and then evaluate its sensitivity and specificity. Methods This study had two phases. In the first phase in order to develop a simple inventory for assessment of POP, the Pelvic Floor Disorder Inventory (PFDI was completed for a convenience sample of 200 women, aged 18-45 years, referred for annual gynecologic examination, and their pelvic organ prolapse was assessed using the standard protocol. The most sensitive and specific questions were selected as pelvic organ prolapse simple screening inventory (POPSSI. In the second phase, using a stratified multistage probability cluster sampling method, the sensitivity and specificity of the POPSSI was investigated in a non selected sample of 954 women recruited from among reproductive aged women living in four randomly selected provinces of Iran. Results The sensitivity and specificity of POPSSI for identification of pelvic organ prolapse in the general population were 45.5 and 87.4% respectively; these values were 96.7 and 20% among those women who were aware of their pelvic dysfunction. Conclusion Community based screening studies on pelvic organ prolapse could be facilitated by using the POPSSI, the sensitivity of which would be enhanced through conducting of public awareness programs.

  10. Laparoscopic sacrocolpopexy versus transvaginal mesh for recurrent pelvic organ prolapse.

    Science.gov (United States)

    Iglesia, Cheryl B; Hale, Douglass S; Lucente, Vincent R

    2013-03-01

    Both expert surgeons agree with the following: (1) Surgical mesh, whether placed laparoscopically or transvaginally, is indicated for pelvic floor reconstruction in cases involving recurrent advanced pelvic organ prolapse. (2) Procedural expertise and experience gained from performing a high volume of cases is fundamentally necessary. Knowledge of outcomes and complications from an individual surgeon's audit of cases is also needed when discussing the risks and benefits of procedures and alternatives. Yet controversy still exists on how best to teach new surgical techniques and optimal ways to efficiently track outcomes, including subjective and objective cure of prolapse as well as perioperative complications. A mesh registry will be useful in providing data needed for surgeons. Cost factors are also a consideration since laparoscopic and especially robotic surgical mesh procedures are generally more costly than transvaginal mesh kits when operative time, extra instrumentation and length of stay are included. Long-term outcomes, particularly for transvaginal mesh procedures, are lacking. In conclusion, all surgery poses risks; however, patients should be made aware of the pros and cons of various routes of surgery as well as the potential risks and benefits of using mesh. Surgeons should provide patients with honest information about their own experience implanting mesh and also their experience dealing with mesh-related complications.

  11. Risk factors for pelvic organ prolapse and its recurrence: a systematic review

    NARCIS (Netherlands)

    Vergeldt, T.F.; Weemhoff, M.; IntHout, J.; Kluivers, K.B.

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) is a common condition with multifactorial etiology. The purpose of this systematic review was to provide an overview of literature on risk factors for POP and POP recurrence. METHODS: PubMed and Embase were searched with "pelvic organ

  12. Pessary treatment for pelvic organ prolapse and health-related quality of life: A review

    NARCIS (Netherlands)

    B.H.C. Lamers (Babet); B.M.W. Broekman (Bart); A.L. Milani (Alfredo)

    2011-01-01

    textabstractPessaries have been used to treat women with pelvic organ prolapse (POP) since the beginning of recorded history. This review aims to assess the effect of pessary treatment on the disease-specific, health-related quality of life in women with pelvic organ prolapse. After a Medline search

  13. Identification of six Loci associated with pelvic organ prolapse using genome-wide association analysis.

    NARCIS (Netherlands)

    Allen-Brady, K.; Cannon-Albright, L.; Farnham, J.M.; Teerlink, C.; Vierhout, M.E.; Kempen, L.C.L.T. van; Kluivers, K.B.; Norton, P.A.

    2011-01-01

    OBJECTIVE: : There is evidence that both environmental and genetic factors contribute to pelvic organ prolapse. We conducted a genome-wide association study to investigate whether common genetic variants modify the risk of pelvic organ prolapse. METHODS: : We recruited women who had been evaluated

  14. Surgery for pelvic organ prolapse in women of 80 years of age and older.

    NARCIS (Netherlands)

    Schweitzer, K.J.; Vierhout, M.E.; Milani, A.L.

    2005-01-01

    BACKGROUND: To investigate the long-term results of women over 80 years of age following surgery for pelvic organ prolapse. Design. Retrospective, descriptive study. METHODS: We reviewed all records of women of 80 years and older operated for pelvic organ prolapse; all patients alive were contacted

  15. Tissue engineering as a potential alternative or adjunct to surgical reconstruction in treating pelvic organ prolapse

    DEFF Research Database (Denmark)

    Boennelycke, M; Gräs, Søren; Lose, G

    2013-01-01

    Cell-based tissue engineering strategies could potentially provide attractive alternatives to surgical reconstruction of native tissue or the use of surgical implants in treating pelvic organ prolapse (POP).......Cell-based tissue engineering strategies could potentially provide attractive alternatives to surgical reconstruction of native tissue or the use of surgical implants in treating pelvic organ prolapse (POP)....

  16. Pessary treatment for pelvic organ prolapse and health-related quality of life: A review

    NARCIS (Netherlands)

    B.H.C. Lamers (Babet); B.M.W. Broekman (Bart); A.L. Milani (Alfredo)

    2011-01-01

    textabstractPessaries have been used to treat women with pelvic organ prolapse (POP) since the beginning of recorded history. This review aims to assess the effect of pessary treatment on the disease-specific, health-related quality of life in women with pelvic organ prolapse. After a Medline search

  17. Risk factors for pelvic organ prolapse and its recurrence: a systematic review

    NARCIS (Netherlands)

    Vergeldt, T.F.; Weemhoff, M.; IntHout, J.; Kluivers, K.B.

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) is a common condition with multifactorial etiology. The purpose of this systematic review was to provide an overview of literature on risk factors for POP and POP recurrence. METHODS: PubMed and Embase were searched with "pelvic organ prolapse

  18. The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse

    DEFF Research Database (Denmark)

    Hulbæk, Mette; Primdahl, Jette; Nielsen, Jesper Bo

    2017-01-01

    The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse.......The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse....

  19. Urethral pressure reflectometry in women with pelvic organ prolapse

    DEFF Research Database (Denmark)

    Khayyami, Yasmine; Lose, Gunnar; Klarskov, Niels

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: The mechanism of continence in women with pelvic organ prolapse (POP) before and after surgery remains unknown. Urethral pressure reflectometry (UPR) separates women with stress urinary incontinence (SUI) from continent women by measuring urethral opening pressure...... at an abdominal pressure of 50 cmH2O (P O-Abd 50). UPR can help identify women with POP at risk of postoperative de novo SUI. The aim of this study was to investigate the reproducibility of UPR in women with POP. METHODS: Women with anterior or posterior vaginal wall prolapse were recruited for this prospective...... to determine the level of agreement between measurements. Paired t tests were used to estimate the difference; a two-tailed P value of prolapse and 11 women with posterior vaginal wall prolapse. There were...

  20. Physiologically relevant organs on chips.

    Science.gov (United States)

    Yum, Kyungsuk; Hong, Soon Gweon; Healy, Kevin E; Lee, Luke P

    2014-01-01

    Recent advances in integrating microengineering and tissue engineering have generated promising microengineered physiological models for experimental medicine and pharmaceutical research. Here we review the recent development of microengineered physiological systems, or also known as "ogans-on-chips", that reconstitute the physiologically critical features of specific human tissues and organs and their interactions. This technology uses microengineering approaches to construct organ-specific microenvironments, reconstituting tissue structures, tissue-tissue interactions and interfaces, and dynamic mechanical and biochemical stimuli found in specific organs, to direct cells to assemble into functional tissues. We first discuss microengineering approaches to reproduce the key elements of physiologically important, dynamic mechanical microenvironments, biochemical microenvironments, and microarchitectures of specific tissues and organs in microfluidic cell culture systems. This is followed by examples of microengineered individual organ models that incorporate the key elements of physiological microenvironments into single microfluidic cell culture systems to reproduce organ-level functions. Finally, microengineered multiple organ systems that simulate multiple organ interactions to better represent human physiology, including human responses to drugs, is covered in this review. This emerging organs-on-chips technology has the potential to become an alternative to 2D and 3D cell culture and animal models for experimental medicine, human disease modeling, drug development, and toxicology.

  1. Pelvic organ prolapse (POP) surgery: the evidence for the repairs.

    Science.gov (United States)

    Gomelsky, Alex; Penson, David F; Dmochowski, Roger R

    2011-06-01

    What is known on the subject? and What does the study add? Substantial experience of the outcomes has been gathered regarding the acute and sub-acute experience with various types of corrective procedures for POP. These include long-term POP correction as well as more recent recognition of improvement in functional disorders associated with POP such as UI, colorectal dysfunction, and sexual dysfunction. Long-term follow-up is available for some of the older types of interventions and current multicentre trials are being accrued with longer term follow-up for new interventions including mesh-type repairs. The study adds a condensed and summarized version of the current literature regarding the various interventions for POP and also provides an overview of the current controversies and areas where knowledge is incomplete and in need of further elaboration for definitive answers regarding optimization of surgical care for POP. Our aim is to summarise the available data on the transvaginal placement of synthetic mesh for pelvic organ prolapse (POP) repair, with a focus on the outcomes and complications of commercial POP-repair kits. As the stability and durability of autologous tissues may be questionable, nonabsorbable, synthetic materials are an attractive alternative for providing additional support during POP surgery. These materials are not novel, and most have been used for many years in surgical applications, e.g. hernia repairs. While theoretically appealing, the implantation of synthetic mesh in the pelvis may be associated with inherent adverse consequences, such as erosion, extrusion, and infection. Additionally, the routine use of these materials may carry potential long-term complications, such as dyspareunia, chronic pelvic pain, and vaginal distortion. The success and failure of mesh-augmented POP repair is related not only to the synthetic material itself, but also to patient- and surgeon-related factors. Recent warnings by the USA Food and Drug

  2. Objective comparison of subtotal vs. total abdominal hysterectomy regarding pelvic organ prolapse and urinary incontinence

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Alling; Gimbel, Helga Margrethe Elisabeth

    2015-01-01

    OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total......, total: 100), the PFDI-20 questionnaire was answered by 140 (46.1%) (subtotal: 68, total: 72). We found no difference between subtotal and total abdominal hysterectomy in the PFDI-20 scores or regarding objectively assessed urinary incontinence or pelvic organ prolapse. In the subtotal hysterectomy group......, 31 (59.6%) women had objective stage 2 pelvic organ prolapse compared with 33 (70.2%) in the total hysterectomy group (P=0.27); however, only 6/31 and 9/33 had symptoms (P=0.45). There were more anterior pelvic organ prolapses in the total hysterectomy group (N=10) than in the subtotal hysterectomy...

  3. Functional characteristics of vaginal fibroblastic cells from premenopausal women with pelvic organ prolapse

    NARCIS (Netherlands)

    Ruiz-Zapata, A.M.; Kerkhof, M.H.; Zandieh-Doulabi, B.; Brölmann, H.A.M.; Smit, T.H.; Helder, M.N.

    2014-01-01

    Pelvic organ prolapse (POP) remains a great therapeutic challenge with no optimal treatment available. Tissue maintenance and remodelling are performed by fibroblasts, therefore altered cellular functionality may influence tissue quality. In this study, we evaluated functional characteristics of fib

  4. [Lesion of pelvic organs in secondary varicose veins of the small pelvis].

    Science.gov (United States)

    Tsukanov, Yu T; Tsukanov, A Yu; Levdansky, E G

    2015-01-01

    The authors studied peculiarities of pelvic organs lesions in patients presenting with secondary small pelvic varicose veins (SPVV) induced by endured thrombosis of iliac veins. The study included a total of 70 patients after endured thrombosis of iliac veins verified by radiodiagnostic methods. The average duration of thrombosis amounted to 3.8 years. The patients were subdivided into two groups. The Study Group comprised 48 patients presenting with small pelvic varicose veins revealed by duplex scanning; the Control Group was composed of 22 patients with no varicose pelvic veins. It was determined that characteristic features of patients with secondary SPVV having developed after iliac veins thrombosis included chronic pelvic pain, dilatation of cavernous veins of the rectum, inguinal vein varicosity and varicose veins of the groin and anterior abdominal wall. Formation of secondary SPVV after endured iliac vein thrombosis leads to disorders of pelvic organs, similar to those in primary varicosity, but more often being functional. Endured iliac veins thrombosis in formation of secondary SPVV leads to urination impairments with prevalence of moderately pronounced symptomatology. Small pelvic organs dysfunction in women with secondary SPVV due to endured iliac veins thrombosis manifests itself in dyspareunia, leukorrhea, and dysmenorrhea.

  5. Trends in use of surgical mesh for pelvic organ prolapse.

    Science.gov (United States)

    Jonsson Funk, Michele; Edenfield, Autumn L; Pate, Virginia; Visco, Anthony G; Weidner, Alison C; Wu, Jennifer M

    2013-01-01

    Limited data exist on the rates of pelvic organ prolapse procedures utilizing mesh. The objective of this study was to examine trends in vaginal mesh prolapse procedures (VMs), abdominal sacrocolpopexy (ASC), and minimally invasive sacrocolpopexy (MISC) from 2005 to 2010. We utilized deidentified, adjudicated health care claims data from across the United States from 2005 to 2010. Among women 18 years old or older, we identified all mesh prolapse procedures based on current procedural terminology codes (57267 for VM, 57280 for ASC, and 57425 for MISC). VM procedures included all vaginal prolapse surgeries in which mesh was placed, whether in the anterior, apical, or posterior compartment. We estimated rates per 100,000 person-years (100,000 py) and 95% confidence intervals (CIs). During 78.5 million person-years of observation, we identified 60,152 mesh prolapse procedures, for a rate of 76.0 per 100,000 py (95% CI, 73.6-78.5). Overall, VMs comprised 74.9% of these surgeries for an overall rate of 56.9 per 100,000 py (95% CI, 55.0-58.9). Rates of ASC and MISC were considerably lower at 12.0 per 100,000 py (95% CI, 11.6-12.5) and 9.5 per 100,000 py (95% CI, 9.2-9.9), respectively. Among sacrocolpopexies, ASC was more common than MISC in 2005-2007; however, since 2007, the rate of MISC has increased, whereas the rate of ASC has decreased. Regarding trends by age, VM was considerably more common than sacrocolpopexies at all ages, and ASC was more common than MISC in women older than 50 years. From 2005 to 2010, the rate of mesh prolapse procedures has increased, with vaginal mesh surgeries constituting the vast majority. Copyright © 2013 Mosby, Inc. All rights reserved.

  6. 女性盆腔器官膨出疾病%Female pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    郎景和; 朱兰

    2005-01-01

    郎景和教授 女性盆底功能障碍性疾病(pelvic floor dysfunction,PFD)又称为盆底缺陷(pelvic floor defects)或盆底支持组织松弛(relaxation of pelvic supports),表现为子宫脱垂等盆腔器官膨出(pelvic organ prolapse,POP)和压力性尿失禁(stress urinary incontinence,SUI)等疾病。随着人口的老龄化和对生活质量要求的提高,PFD的发病率逐年增高,在世界范围内被妇产科同道们重视,

  7. Long-term Outcomes Following Abdominal Sacrocolpopexy for Pelvic Organ Prolapse

    Science.gov (United States)

    Nygaard, Ingrid; Brubaker, Linda; Zyczynski, Halina M.; Cundiff, Geoffrey; Richter, Holly; Gantz, Marie; Fine, Paul; Menefee, Shawn; Ridgeway, Beri; Visco, Anthony; Warren, Lauren Klein; Zhang, Min; Meikle, Susan

    2013-01-01

    Importance Over 225,000 surgeries are performed annually in the U.S. for pelvic organ prolapse (POP). Abdominal sacrocolpopexy is considered the most durable POP surgery, but little is known about long-term effectiveness and adverse events. Objective To describe anatomic and symptomatic outcomes up to 7 years after abdominal sacrocolpopexy, and to determine whether these are affected by concomitant anti-incontinence surgery (Burch urethropexy). Design, setting, participants Long-term follow-up of the randomized, masked 2-year CARE trial (Colpopexy And urinary Reduction Efforts). Participants were stress continent women undergoing abdominal sacrocolpopexy between 2002–5 for symptomatic POP randomized to concomitant urethropexy or not. 92% (215/233) of eligible 2-year CARE trial completers enrolled into this extended study with 181 (84%) and 126 (59%) completing 5 and 7 years follow-up, respectively. Median follow-up was 7 years. Main Outcome Measures POP: Symptomatic failure: POP retreatment or reporting bulge on Pelvic Floor Distress Inventory (PFDI); Anatomic failure: POP retreatment or Pelvic Organ Prolapse Quantification demonstrating descent of the vaginal apex descend below upper third of the vagina or anterior or posterior vaginal wall prolapse beyond the hymen. Urinary incontinence (UI): Stress UI: more than 1 stress urinary incontinence symptom on PFDI or interval treatment; Overall UI: score ≥ 3 on Incontinence Severity Index. Results By year 7, the estimated probabilities of failure (POP, SUI, UI) from parametric survival modeling for the urethropexy and no urethropexy groups respectively were were 0.27 and 0.22 for anatomic POP (difference 0.050; 95% CI −0.161, 0.271), 0.29 and 0.24 for symptomatic POP (0.049; −0.060, 0.162), 0.48 and 0.34 for composite POP (0.134; −0.096, 0.322), 0.62 and 0.77 for SUI (−0.153; −0.268, 0.030) 0.75 and 0.81 for overall UI (−0.064; −0.161, 0.032). Mesh erosion probability estimated by Kaplan-Meier method

  8. How accurate is preoperative evaluation of pelvic organ prolapse in women undergoing vaginal reconstruction surgery?

    Directory of Open Access Journals (Sweden)

    Haim Krissi

    Full Text Available OBJECTIVE: To evaluate the differences between the in-office and intraoperative techniques used to evaluate pelvic organ prolapse. MATERIALS AND METHODS: A prospective study included 25 women undergoing vaginal reconstruction surgery including vaginal hysterectomy for pelvic organ prolapse. The outpatient pelvic and site-specific vaginal examination was performed in the lithotomy position with the Valsalva maneuver. Repeated intraoperative examination was performed under general anesthesia with standard mild cervical traction. The Pelvic Organ Prolapse Quantification system (POPQ was used for both measurements and staging. The values found under the two conditions were compared. RESULTS: The intraoperative POPQ-measurements values were significantly higher than the outpatient values for apical wall prolapse in 17/25 (68% women and for anterior wall prolapse in 8/25 (32% women. There was not a significant difference in the posterior wall where increase in staging was shown in 3/25 (12% patients. CONCLUSIONS: Clinicians and patients should be alert to the possibility that pelvic organ measurements performed under general anesthesia with mild traction may be different from preoperative evaluation.

  9. Effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training in older women with pelvic organ prolapse : 2-year follow-up of a randomized controlled trial in primary care

    NARCIS (Netherlands)

    Panman, Chantal M. C. R.; Wiegersma, Marian; Kollen, Boudewijn J.; Berger, Marjolein Y.; Lisman-van Leeuwen, Yvonne; Vermeulen, Karin M.; Dekker, Janny H.

    2016-01-01

    Objective: We investigated the effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training (PFMT) in women with pelvic organ prolapse over a 2-year period. Methods: Randomized controlled trial with women (>= 55 y) with symptomatic pelvic organ prolapse, ident

  10. Effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training in older women with pelvic organ prolapse : 2-year follow-up of a randomized controlled trial in primary care

    NARCIS (Netherlands)

    Panman, Chantal; Wiegersma, Marian; Kollen, Boudewijn; Berger, Marjolein Y.; Lisman-van Leeuwen, Yvonne; Vermeulen, Karin; Dekker, Janny H

    2016-01-01

    Objective: We investigated the effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training (PFMT) in women with pelvic organ prolapse over a 2-year period. Methods: Randomized controlled trial with women (>= 55 y) with symptomatic pelvic organ prolapse,

  11. Pelvic organ prolapse in women: how is it diagnosed and treated currently?

    Directory of Open Access Journals (Sweden)

    Paweł Milart

    2015-09-01

    Full Text Available The aim of the paper was to summarize the current opinions about the management of pelvic organ prolapse in women. Food and Drug Administration safety announcements from 2008 and 2011 triggered the discussion about the methods of treatment of pelvic organ prolapse and the used materials and a partial return to the methods which had been totally criticized before the implementation of meshes. The decrease in mesh usage is also observed. The studies did not demonstrate the prevalence of any particular surgical procedure. The amount of studies concerning the evaluation and the treatment of pelvic organ prolapse ensures that the quality of care provided to women with urogynecological problems is continuously increasing.

  12. Assessment of degree of trauma and levator ani muscle contraction function after pelvic floor reconstruction and traditional surgical treatment of pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    Chun-Hua Zhu; Yu-Fei Ni

    2016-01-01

    Objective:To study the degree of trauma and levator ani muscle contraction function after pelvic floor reconstruction and traditional surgical treatment of pelvic organ prolapse. Methods:Patients with III-IV pelvic organ prolapse who received surgical treatment in our hospital between May 2011 and October 2015 were randomly divided into observation group who received vaginal hysterectomy combined with pelvic floor reconstruction and control group who received vaginal hysterectomy combined with colporrhaphy, and then the degree of trauma, urodynamics and levator ani muscle contraction function were compared between two groups of patients.Results: Operating time, intraoperative blood loss as well as serum CRP, IL-1β, TNF-α, Ins, NE and E content were not significantly different between two groups (P>0.05); 2 weeks after operation, maximum bladder volume and QMax of observation group were significantly higher than those of control group, PdetQMax, PdetMax and PVR were significantly lower than those of control group (P0.05), LAT under Valsalva maneuver was significantly more than that of control group while LHS under Valsalva maneuver was significantly less than that of control group (P<0.05).Conclusions:Pelvic floor reconstruction treatment of pelvic organ prolapse has equivalent degree of surgical trauma to traditional surgery, and has better effect on improving the urination function and levator ani muscle contraction function than traditional surgery.

  13. Large Nabothian Cyst: Manifestation with Pelvic Organ Prolapse in a Nulliparous Patient

    Directory of Open Access Journals (Sweden)

    Tayfur Cift

    2016-07-01

    Full Text Available Pelvic organ prolapse (POP is described as the herniation of pelvic organs. POP generally occurs at postmenopausal age. Multiparity, increased intraabdominal pressure (e.g., bearing heavy weights, exerting physical effort, obesity, advanced age, menopause, prolonged labor, and smoking constitute prevailing risk factors of POP. It is seen rarely in nulliparous women. The main risk factors in nulliparous women are inherent defects in pelvic support. Nabothian cysts are benign entities in nature. They usually dissolve spontaneously and do not cause any clinical symptoms in routine practice. Nabothian cysts that cause POP are very rare in clinical practice. In this case report, we present the management of a large nabothian cyst causing POP in a 20-year-old patient without any prior intercourse.

  14. The effectiveness of two different laparoscopic surgeries for apical support of pelvic organ prolapse.

    Science.gov (United States)

    Li, Shunshuang; Ji, Mei; Zhao, Zhao

    2015-05-01

    To evaluate the efficacy of laparoscopic colpo-uterine butterfly suspension and compare it to laparoscopic sacrocervicopexy for apical support in sexually active patients of pelvic organ prolapse. Twenty-there women with symptomatic prolapse of apical prolapse underwent laparoscopic colpo-uterine butterfly suspension and forty-five underwent laparoscopic sacrocervicopexy at the first affiliated of Zhengzhou University between January 2010 and June 2013. They all presented with at least a stage 2 apical prolapse. Pre- and post-operative data referring to pelvic organ prolapse quantification (POP-Q) system were compared. At the same time, validated questionnaire of the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Pelvic organ prolapse urinary Incontinence Sexual Questionnaire (PISQ-12) were included. From 2010 to 2013, 68 patients were included. Only 3 cases lost the follow-up in the Laparoscopic sacrocervicopexy. In the laparoscopic colpo-uterine butterfly suspension, there was no recurrence versus in five the laparoscopic sacrocervicopexy. When considered the operating time and blood loss, the laparoscopic colpo-uterine butterfly suspension was more favorable. Erosion was higher in the laparoscopic sacrocervicopexy compared to the other group (0% vs 21.4%). There was no difference in the postoperative PFDI-20 score (P=0.3079), and PFIQ-7 score (P=0.8889) between the two groups, while the PISQ-12 score was much higher in the laparoscopic colpo-uterine butterfly suspension than the other group (P=0.0076). Laparoscopic colpo-uterine butterfly suspension is a more effective option for sexually active women with pelvic organ prolapse. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Relationship between the Pelvic Organ Prolapse Quantification system (POP-Q), the Pelvic Floor Impact Questionnaire (PFIQ-7), and the Pelvic Floor Distress Inventory (PFDI-20) before and after anterior vaginal wall prolapse surgery

    DEFF Research Database (Denmark)

    Rudnicki, Martin

    2015-01-01

    weak correlations between POP-Q and PFIQ-7, including subscales (r 0.173-0.324, p Pelvic Organ Prolapse Distress Inventory (POPDI) subscale (r 0.180-0.211, p ...The aim of this study was to investigate the degree of correlation between the Pelvic Organ Quantification system (POP-Q) measurements and symptom questionnaire scores before and after surgery. This was a part of a randomized controlled study comparing conventional colporrhaphy with mesh repair...... surgery. METHODS: The correlation between POP-Q measurements and Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20) scores was investigated in 164 women 55 years or older scheduled for primary anterior vaginal wall prolapse surgery at baseline and the correlation...

  16. Prevalence of severe pelvic organ prolapse in relation to job description and socioeconomic status: a multicenter cross-sectional study.

    Science.gov (United States)

    Woodman, Patrick J; Swift, Steven E; O'Boyle, Amy L; Valley, Michael T; Bland, Deirdre R; Kahn, Margie A; Schaffer, Joseph I

    2006-06-01

    The aim of this study was to determine if certain occupations or socioeconomic levels are associated with pelvic organ prolapse. Investigators at six American sites performed pelvic organ prolapse quantification examinations on women presenting for routine gynecologic care. Between September 1999 and March 2002, 1,004 patients were examined. Severe pelvic organ prolapse was defined as the leading edge being 1 cm or more beyond the hymeneal ring. The data was analyzed with the Kruskal-Wallis analysis of variance, Bonferroni test, multiple logistic regression, and descriptive statistics. The prevalence of severe pelvic organ prolapse in our group was 4.3%. Women who were laborers/factory workers had significantly more severe prolapse than the other job categories (p 30, and smoking status (all p jobs and an annual household income of Dollars 10,000 or less are associated with severe pelvic organ prolapse.

  17. Contribution of Primary Pelvic Organ Prolapse to Micturition and Defecation Symptoms

    NARCIS (Netherlands)

    A.G. Groenendijk (Annette); E. Birnie (Erwin); J-P.W. Roovers (Jan-Paul); G.J. Bonsel (Gouke)

    2012-01-01

    textabstractObjective. To investigate the contribution of Pelvic Organ Prolapse (POP) to micturition and defecation symptoms. Method. Cross-sectional study including 64 women presenting with POP symptoms and 50 controls without POP complaints. Subjects were evaluated using POP-Quantification system,

  18. A systematic review of clinical studies on hereditary factors in pelvic organ prolapse.

    NARCIS (Netherlands)

    Lince, S.L.; Kempen, L.C.L.T. van; Vierhout, M.E.; Kluivers, K.B.

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: There is growing evidence that pelvic organ prolapse (POP) is at least partly caused by underlying hereditary risk factors. The aim of our study was to provide a systematic literature review and meta-analysis of clinical studies on family history of POP as a risk factor

  19. Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery. METHODS: We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women...

  20. The indication for hysterectomy as a risk factor for subsequent pelvic organ prolapse repair

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate whether the indication for hysterectomy was itself a risk factor for subsequent pelvic organ prolapse (POP) in Danish women who underwent hysterectomy from 1977 to 2009. METHODS: Data from 154,882 women who underwent hysterectomy...

  1. Pelvic organ prolapse symptoms in relation to POPQ, ordinal stages and ultrasound prolapse assessment.

    NARCIS (Netherlands)

    Kluivers, K.B.; Hendriks, J.C.M.; Shek, C.; Dietz, H.P.

    2008-01-01

    Adequate staging of pelvic organ prolapse is important in clinical practice and research. The ability of the POPQ, ordinal stages and ultrasound prolapse assessment were evaluated for their ability to discriminate between women with and without prolapse symptoms. The leading edge of the predominant

  2. Fibroblasts from women with pelvic organ prolapse show differential mechanoresponses depending on surface substrates

    NARCIS (Netherlands)

    Ruiz-Zapata, A.M.; Kerkhof, M.H.; Zandieh-Doulabi, B.; Brölmann, H.A.M.; Smit, T.H.; Helder, M.N.

    2013-01-01

    Introduction and hypothesis Little is known about dynamic cell-matrix interactions in the context of pathophysiology and treatments for pelvic organ prolapse (POP). This study sought to identify differences between fibroblasts from women with varying degrees of prolapse in reaction to mechanical sti

  3. Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery.

    NARCIS (Netherlands)

    Boer, T.A. de; Kluivers, K.B.; Withagen, M.I.J.; Milani, A.L.; Vierhout, M.E.

    2010-01-01

    INTRODUCTION AND HYPOTHESIS: This study focussed on the factors which predict the presence of symptoms of overactive bladder (OAB) after surgery for pelvic organ prolapse (POP). METHODS: Consecutive women who underwent POP surgery with or without the use of vaginal mesh materials in the years 2004-2

  4. Surgical management of pelvic organ prolapse and uterine descent in the Netherlands

    NARCIS (Netherlands)

    Detollenaere, R.J.; Boon, J. den; Kluivers, K.B.; Vierhout, M.E.; Eijndhoven, H.W. van

    2013-01-01

    INTRODUCTION AND HYPOTHESIS: To evaluate current practice in the surgical treatment of uterine descent among members of the Dutch Urogynecological Society and to analyze possible trends in the surgical treatment of pelvic organ prolapse in the Netherlands during the last decade. METHODS: A

  5. Practice pattern variation in surgical management of pelvic organ prolapse and urinary incontinence in The Netherlands

    NARCIS (Netherlands)

    Ijsselmuiden, M.N.; Detollenaere, R.J.; Kampen, M.Y.; Engberts, M.K.; Eijndhoven, H.W. van

    2015-01-01

    INTRODUCTION: Practice pattern variation (PPV) is the difference in care that cannot be explained by the underlying medical condition. The aim of this study was to describe PPV among Dutch gynecologists regarding treatment of pelvic organ prolapse (POP) and urinary incontinence (UI). MATERIALS AND

  6. Surgical treatment of pelvic organ prolapse: a historical review with emphasis on the anterior compartment

    NARCIS (Netherlands)

    Lensen, E.J.M.; Withagen, M.I.J.; Kluivers, K.B.; Milani, A.L.; Vierhout, M.E.

    2013-01-01

    INTRODUCTION AND HYPOTHESIS: The objective of this work was to collect and summarize a detailed historical review of the surgical treatment of pelvic organ prolapse (POP) in which we specifically focused on the anterior compartment. METHODS: A literature search in English, Dutch, and German was carr

  7. Utilization of surgical procedures for pelvic organ prolapse: a population-based study in Olmsted County, Minnesota, 1965-2002.

    Science.gov (United States)

    Babalola, Ebenezer O; Bharucha, Adil E; Melton, L Joseph; Schleck, Cathy D; Zinsmeister, Alan R; Klingele, Christopher J; Gebhart, John B

    2008-09-01

    To describe trends in the utilization of surgical procedures for pelvic organ prolapse among women in Olmsted County, MN, we retrospectively identified all county residents undergoing pelvic organ prolapse repair from January 1, 1965 through December 31, 2002. From 1965 to 2002, 3,813 women had pelvic organ prolapse surgeries: 3,126 had hysterectomy combined with pelvic floor repair (PFR) procedures and 687 had PFR alone. The age-adjusted utilization of hysterectomy plus PFR and of PFR alone decreased by 62% (P PFR and women aged 70 years and older undergoing PFR only. The most common indication for PFR was uterovaginal prolapse. Among women in the community, the rate of utilization and age distribution of pelvic organ prolapse surgery changed substantially between 1965 and 2002.

  8. Vaginal Fibroblastic Cells from Women with Pelvic Organ Prolapse Produce Matrices with Increased Stiffness and Collagen Content

    NARCIS (Netherlands)

    Ruiz-Zapata, A.M.Kerkhof, M.H.; Ghazanfari, S.; Zandieh-Doulabi, B.; Stoop, R.; Smit, T.H.; Helder, M.N.

    2016-01-01

    Pelvic organ prolapse (POP) is characterised by the weakening of the pelvic floor support tissues, and often by subsequent prolapse of the bladder outside the body, i.e. cystocele. The bladder is kept in place by the anterior vaginal wall which consists of a dense extracellular matrix rich in collag

  9. Actinomyces-like organisms in cervical smears: the association with intrauterine device and pelvic inflammatory diseases

    OpenAIRE

    2014-01-01

    Objective To investigate the incidence of actinomyces-like organisms in routine cervical smears of Korean women and to evaluate its association with the development of pelvic inflammatory disease (PID) in these women. Methods The results of cervical smears between 2011 and 2012 at a single university hospital were searched. If positive for actinomyces-like organisms, the medical record of the patient was searched and development of PID was followed. If the data were not available in the medic...

  10. [Epidemiology and treatment for urinary incontinence and pelvic organ prolapse in women].

    Science.gov (United States)

    Starczewski, Andrzej; Brodowska, Agnieszka; Brodowski, Jacek

    2008-07-01

    Urinary incontinence (UI) is defined as uncontrolled urine leakage through an urethra. At present, the following types of UI can be specified: stress incontinence (SI), urge incontinence (UI), mixed incontinence (MI), overflow incontinence (OI) in which the bladder becomes too full because it cannot be fully emptied, and functional incontinence (FI). Incontinence is one of the most common chronic diseases in women and is found in 17-60% of the whole population. In most patients, SI is combined with pelvic organ prolapse. The basic risk factors mentioned as contributing to these two conditions are obstetrical past and gynaecological history and atrophic changes in the urogenital area. There are also a number of diseases related to the increase in intra-abdominal pressure, such as obesity chronic constipation and diseases associated with persistent cough. Other factors leading to pelvic organ prolapse include hard physical work, some professional sports, connective tissue disorders, neuropathy and disturbed innervation of the pelvic floor. To deal with stress incontinence (SI), conservative and surgical treatment is employed. In the first degree intensity, it is mainly physiotherapy, electrical stimulation of the pelvic floor muscles, lifestyle modification and reduction of body mass. When the SI symptoms are more severe, surgical treatment is usually preferred. From among many methods, these presently used are Burch and sling operations. On the other hand, surgical treatment for pelvic organ prolapse involves colpoperineoplasty with the use of polypropylene mesh (Prolift), colporrhaphy by double TOT approach method, median colporrhaphy, Cooper's ligament or sacrospinous ligament colpopexy, and attachment of the uterus to the sacrum. The results of surgical treatment depend on co-occurrence of risk factors, the surgical method chosen, the lapse of time from the surgery and the type of the applied biomedical material.

  11. Pelvic Arterial Anatomy Relevant to Prostatic Artery Embolisation and Proposal for Angiographic Classification

    Energy Technology Data Exchange (ETDEWEB)

    Assis, André Moreira de, E-mail: andre.maa@gmail.com; Moreira, Airton Mota, E-mail: motamoreira@gmail.com; Paula Rodrigues, Vanessa Cristina de, E-mail: vanessapaular@yahoo.com.br [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil); Harward, Sardis Honoria, E-mail: sardis.harward@merit.com [The Dartmouth Center for Health Care Delivery Science (United States); Antunes, Alberto Azoubel, E-mail: antunesuro@uol.com.br; Srougi, Miguel, E-mail: srougi@usp.br [University of Sao Paulo Medical School, Urology Department (Brazil); Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil)

    2015-08-15

    PurposeTo describe and categorize the angiographic findings regarding prostatic vascularization, propose an anatomic classification, and discuss its implications for the PAE procedure.MethodsAngiographic findings from 143 PAE procedures were reviewed retrospectively, and the origin of the inferior vesical artery (IVA) was classified into five subtypes as follows: type I: IVA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery (SVA); type II: IVA originating from the anterior division of the IIA, inferior to the SVA origin; type III: IVA originating from the obturator artery; type IV: IVA originating from the internal pudendal artery; and type V: less common origins of the IVA. Incidences were calculated by percentage.ResultsTwo hundred eighty-six pelvic sides (n = 286) were analyzed, and 267 (93.3 %) were classified into I–IV types. Among them, the most common origin was type IV (n = 89, 31.1 %), followed by type I (n = 82, 28.7 %), type III (n = 54, 18.9 %), and type II (n = 42, 14.7 %). Type V anatomy was seen in 16 cases (5.6 %). Double vascularization, defined as two independent prostatic branches in one pelvic side, was seen in 23 cases (8.0 %).ConclusionsDespite the large number of possible anatomical variations of male pelvis, four main patterns corresponded to almost 95 % of the cases. Evaluation of anatomy in a systematic fashion, following a standard classification, will make PAE a faster, safer, and more effective procedure.

  12. Pelvic organ function before and after laparoscopic bowel resection for rectosigmoid endometriosis

    DEFF Research Database (Denmark)

    Riiskjaer, M; Greisen, S; Glavind-Kristensen, M;

    2016-01-01

    OBJECTIVE: To assess urinary, sexual, and bowel function before and after laparoscopic bowel resection for rectosigmoid endometriosis. DESIGN: Prospectively collected data regarding the function of the pelvic organs. SETTING: Tertiary endometriosis referral unit, Aarhus University Hospital. SAMPLE...... and after surgery. Non-invasive urodynamic testing was performed. MAIN OUTCOME MEASURES: Pre- and postoperative function of the pelvic organs was compared, and risk factors for improved/impaired function were identified. RESULTS: A total of 96.1% of the women completed the 1-year follow-up. A significant...... decrease (P = 0.002) in bladder filling problems (F-score) was observed 1 year after surgery, primarily caused by a significant decrease in bladder pain (P = 0.0001). No change for urodynamic parameters was observed. A significant increase in overall sexual satisfaction (P = 0.0001) and decrease in worries...

  13. Pelvic Organ Distribution of Mesenchymal Stem Cells Injected Intravenously after Simulated Childbirth Injury in Female Rats

    Directory of Open Access Journals (Sweden)

    Michelle Cruz

    2012-01-01

    Full Text Available The local route of stem cell administration utilized presently in clinical trials for stress incontinence may not take full advantage of the capabilities of these cells. The goal of this study was to evaluate if intravenously injected mesenchymal stem cells (MSCs home to pelvic organs after simulated childbirth injury in a rat model. Female rats underwent either vaginal distension (VD or sham VD. All rats received 2 million GFP-labeled MSCs intravenously 1 hour after injury. Four or 10 days later pelvic organs and muscles were imaged for visualization of GFP-positive cells. Significantly more MSCs home to the urethra, vagina, rectum, and levator ani muscle 4 days after VD than after sham VD. MSCs were present 10 days after injection but GFP intensity had decreased. This study provides basic science evidence that intravenous administration of MSCs could provide an effective route for cell-based therapy to facilitate repair after injury and treat stress incontinence.

  14. Relevance of discrete traits in forensic anthropology: From the first cervical vertebra to the pelvic girdle.

    Science.gov (United States)

    Verna, Emeline; Piercecchi-Marti, Marie-Dominique; Chaumoitre, Kathia; Adalian, Pascal

    2015-08-01

    In forensic anthropology, identification begins by determining the sex, age, ancestry and stature of the individuals. Asymptomatic variations present on the skeleton, known as discrete traits, can be useful to identify individuals, or at least contribute to complete their biological profile. We decided to focus our work on the upper part of the skeleton, from the first vertebra to the pelvic girdle, and we chose to present 8 discrete traits (spina bifida occulta, butterfly vertebra, supraclavicular nerve foramen, coracoclavicular joint, os acromiale, suprascapular foramen, manubrium foramen and pubic spine), because they show a frequency lower than 10%. We examined 502 anonymous CT scans from polytraumatized individuals, aged 15 to 65 years, in order to detect the selected discrete traits. Age and sex were known for each subject. Thin sections in the axial, coronal and sagittal planes and 3D volume rendering images were created and examined for the visualization of the selected discrete traits. Supraclavicular foramina were found only in males and only on the left clavicle. Coracoclavicular joints were observed only in males. The majority of individuals with a suprascapular foramen were older than 50 years of age. Pubic spines were observed mostly in females. Other traits did not present significant association with sex, age and laterality. No association between traits was highlighted. Better knowledge of human skeletal variations will help anthropologists come closer to a positive identification, especially if these variations are rare, therefore making them more discriminant. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Frequency of recurrent urinary tract infection in patients with pelvic organ prolapse

    OpenAIRE

    2015-01-01

    Emrah Töz,1 Sefa Kurt,2 Çagdas Sahin,1 Mehmet Tunç Canda3 1Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey; 2Department of Obstetrics and Gynecology, Izmir Dokuz Eylül University, Izmir, Turkey; 3Department of Obstetrics and Gynecology, Kent Hospital, Izmir, Turkey Purpose: The aim of the study was to investigate the existence of a relationship between pelvic organ prolapse (POP) and recurrent urinary trac...

  16. Management of recto-vaginal fistulas after prosthetic reinforcement treatment for pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    Mehdi; Ouassi; Silvia; Cresti; Urs; Giger; Igor; Sielezneff; Nicolas; Pirrò; Bruno; Berthet; Philippe; Grandval; Bernard; Consentino; Bernard; Sastre

    2010-01-01

    AIM: To communicate our findings on successful treat-ment of recto-vaginal fistulas (RVFs) after prosthetic reinforcement surgery of pelvic organ prolapse (POP). METHODS: A retrospective single center study between 1998 and 2008 was performed. A total of 80 patients with RVF were identified, of which five patients (6%), with a mean age of 65 years (range: 52-73), had undergone previous surgery for POP with pros-thetic reinforcement. RESULTS: All patients complained about ongoing vaginal infections and febri...

  17. Localization of cholecystokininlike immunoreactivity in the rat spinal cord, with particular reference to the autonomic innervation of the pelvic organs

    DEFF Research Database (Denmark)

    Schrøder, H D

    1983-01-01

    . It thus appears that the unique lumbosacral cholecystokinin is related to nuclei influencing pelvic structures, pointing to a special need for regulation of the organs involved in evacuation and sexual functions. Moreover, it is demonstrated that the caudal part of the spinal sympathetic system differs...... tracing and immunocytochemistry revealed that the two cholecystokinin terminal fields characteristic for L1-L2 and that surrounding the intermediolateral nucleus in L6-S1 were situated corresponding to preganglionic neurons innervating pelvic organs through the hypogastric nerve or the pelvic nerves...

  18. Obliterative LeFort colpocleisis for pelvic organ prolapse in elderly women aged 70 years and over

    Directory of Open Access Journals (Sweden)

    Soo-Cheen Ng

    2016-02-01

    Conclusion: Colpocleisis should be considered as one of the surgical options for treating advanced pelvic organ prolapse in elderly patients who do not wish to preserve vaginal function for sexual intercourse.

  19. Abnormal spinal curvature as a risk factor for pelvic organ prolapse.

    Science.gov (United States)

    Melli, Manizheh Sayyah; Alizadeh, Mahasti

    2007-12-01

    To determine the relationship between pelvic organ prolapse and spinal curvature changes, a cross-sectional study was done in Gynecologic and Obstetrics educational hospitals and clinics in North West of Iran. One hundred patients were classified as cases based on the presence of abnormality at the spinal curvature and 100 patients classified as controls with no abnormality. The POP-Q (pelvic organ prolapse quantitation) staging system was used for assessment of prolapse stage and a flexi-curve malleable rod for measurement of thoracic and lumbar length and width, respectively. Main outcome was the stage of prolapses. The stage of prolapse was higher in cases compared to controls. There was a significant statistical difference between prolapse stage in two groups (p-value = 0.035). Among cases, grade II prolapse was the most prevalent abnormally (56%) and the grade III, I and IV were observed in 32, 5 and 7%, respectively. These observations underline the importance of taking into account the abnormal changes in spine curvature of patients when investigating risk factors for development of pelvic organs prolapse.

  20. Cost analysis of surgical treatment for pelvic organ prolapse by laparoscopic sacrocolpopexy or transvaginal mesh.

    Science.gov (United States)

    Carracedo, D; López-Fando, L; Sánchez, M D; Jiménez, M Á; Gómez, J M; Laso, I; Rodríguez, M Á; Burgos, F J

    2017-03-01

    The objective of this study is to compare direct costs of repairing pelvic organ prolapse by laparoscopic sacrocolpopexy (LS) against vaginal mesh (VM). Our hypothesis is the correction of pelvic organ prolapse by LS has a similar cost per procedure compared to VM. We made a retrospective comparative analysis of medium cost per procedure of first 69 consecutive LS versus first 69 consecutive VM surgeries. We calculate direct cost for each procedure: structural outlays, personal, operating room occupation, hospital stay, perishable or inventory material and prosthetic material. Medium cost per procedure were calculated for each group, with a 95% confidence interval. LS group has a higher cost related to a longer length of surgery, higher operating room occupation and anesthesia; VM group has a higher cost due to longer hospital stay and more expensive prosthetic material. Globally, LS has a lower medium cost per procedure in comparison to VM (5,985.7 €±1,550.8 € vs. 6,534.3 €±1,015.5 €), although it did not achieve statistical signification. In our midst, pelvic organ prolapse surgical correction by LS has at least similar cost per procedure compared to VM. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The impact of pelvic organ prolapse on sexual function in women with urinary incontinence.

    Science.gov (United States)

    Ozel, Begüm; White, Terry; Urwitz-Lane, Rebecca; Minaglia, Steven

    2006-01-01

    The aim of the study is to evaluate the impact of pelvic organ prolapse (POP) on sexual function in women with urinary incontinence (UI). In this retrospective, case-cohort study, we reviewed the medical records of all women evaluated for UI between March and November 2003. All patients completed the short forms of the Urogenital Distress Inventory, Incontinence Impact Questionnaire, and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. Women with stage two or greater POP, as determined by the pelvic organ prolapse quantification (POPQ) system, were compared to women with stage 0 or 1 POP. Sixty-nine women with POP and 47 women without POP were included. Patient demographics did not differ between the two groups. Women with POP were significantly more likely to report absence of libido (53% versus 30%, P=0.02), lack of sexual excitement during intercourse (46% versus 27%, P=0.05), and that they rarely experienced orgasm during intercourse (49% versus 30%, P=0.05). In conclusion, women with POP in addition to UI are more likely to report decreased libido, decreased sexual excitement, and difficulty achieving orgasm during intercourse when compared to women with UI alone.

  2. Surgical management of pelvic organ prolapse and uterine descent in the Netherlands.

    Science.gov (United States)

    Detollenaere, R J; den Boon, J; Kluivers, K B; Vierhout, M E; van Eijndhoven, H W F

    2013-05-01

    To evaluate current practice in the surgical treatment of uterine descent among members of the Dutch Urogynecological Society and to analyze possible trends in the surgical treatment of pelvic organ prolapse in the Netherlands during the last decade. A questionnaire, including case scenarios, was sent to the members of the Dutch Urogynecological Society. Using a nationwide registry from the Netherlands, we assessed the number and type of surgical procedures performed for pelvic organ prolapse between 1997 and 2009. The response rate was 73%, with 161 questionnaires completed. Vaginal hysterectomy, sacrospinous hysteropexy, and the Manchester Fothergill procedure were the most frequently performed surgical interventions for uterine descent. In the case of lower stage uterine descent, uterus preservation was preferred, but in the case of higher stage there was wide variation. Two thirds of the respondents stated that in recent years they tended to save the uterus more often. The registered number of hospital admissions for uterine descent increased by 30% between 1997 and 2009 and the number of surgical procedures almost doubled. The number of vaginal hysterectomies performed because of uterine descent increased by only 15% in this period. In the Netherlands, surgical policy in the case of uterine descent is very variable, with no clear preference for either hysterectomy or uterus preservation. There was a high increase in hospital admissions and pelvic organ prolapse procedures in the last decade. The number of vaginal hysterectomies performed because of uterine descent did not follow this change, which reflects a trend toward preserving the uterus.

  3. Neuromuscular morphometry of the uterine ligaments and vaginal wall in women with pelvic organ prolapse.

    Science.gov (United States)

    Kaplan, Petek Balkanli; Usta, Ufuk; Inal, Hasan Ali; Tastekin, Ebru; Tastekin, Tugba; Tokuc, Burcu

    2011-01-01

    The aim of this study was to compare neuromuscular histomorphometry of the uterine ligaments and vaginal wall in women with and without pelvic organ prolapse. Biopsies were obtained from the round, uterosacral, and cardinal ligaments of the uterus and apical vaginal wall of women having pelvic organ prolapse repaired (stage ≥ II; prolapse group, 37) and the same location in patients with no prolapse (stage prolapse than in women without. In round ligament, mean smooth muscle percentage was lower than in women with normal support (81.63 ± 8.2 vs. 51.63 ± 16, P=0.000). Mean distance of the smooth muscle fibers from surface epithelium of the vaginal epithelium of the women with prolapse were significantly higher than the control group (1.679 ± 0.34 vs. 2.240 ± 0.33, P = 0.000). PGP 9.5 stained area percentage of uterine ligaments and vaginal wall tissue samples were significantly lower in women with prolapse. Both total innervation of the anterior vaginal epithelium and uterine ligaments, and muscular percentage of the round ligament and vaginal wall were decreased in women with pelvic organ prolapse. Copyright © 2010 Wiley-Liss, Inc.

  4. Re: The Effect of Pelvic Organ Prolapse Repair on Vaginal Sensation

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    Lowenstein L

    2016-03-01

    Full Text Available The association between the pelvic organ prolapse (POP and sensory functioning of the genital region has not been studied well. It is not also obvious whether the changes occurring at the same time are the cause or the result. In this study, the authors investigated the quantitative sensory changes one day before and 6 months after the surgical repair of POP by robotic sacrocolpopexy. They also used the Pelvic Organ Prolapse Distress Inventory-6 which quantifies the bother and distress caused by the pelvic symptoms. By this method, the initial perception of a sensation of temperature (hot or cold and vibration was measured. After six months, sensitivity to thermal stimuli was found to be significantly improved, but there was no significant change in the vaginal and clitoral vibratory sensory thresholds. The value of reduced sensation in the genitals is not a well-known issue. We know that the thermal and vibratory sensations are diminished in female sexual dysfunction and they can be important in orgasmic function also. It is a well-designed study although it has some limitations. The anatomic correction in POP surgery could improve the genital sensation. Prevention or, at least, early correction of POP can provide serious advantages not only for urinary system but also for the genital functions of women.

  5. Pelvic organ prolapse: review of the aetiology, presentation, diagnosis and management.

    Science.gov (United States)

    Machin, Sarah Elizabeth; Mukhopadhyay, Sambit

    2011-12-01

    Pelvic organ prolapse is a common condition affecting a large number of women. Incidence increases after the menopause. Age, parity and obesity are the most consistently reported risk factors. Many women can be asymptomatic of prolapse but common symptoms include a sensation of a bulge or fullness in the vagina or urinary, bowel or sexual dysfunction. Management depends upon symptoms and the type and grade of the prolapse as well as any associated medical co-morbidities. Management options include expectant, conservative or surgical approaches. Up to 10% of women having a surgical procedure for prolapse will require a second procedure. It is, therefore, important to consider lifestyle modifications such as weight loss and conservative measures including pelvic floor muscle training, topical estrogens and pessaries as initial management options.

  6. Diagnosis and Therapy of Female Pelvic Organ Prolapse. Guideline of the DGGG, SGGG and OEGGG (S2e-Level, AWMF Registry Number 015/006, April 2016)

    Science.gov (United States)

    Baeßler, K.; Aigmüller, T.; Albrich, S.; Anthuber, C.; Finas, D.; Fink, T.; Fünfgeld, C.; Gabriel, B.; Henscher, U.; Hetzer, F. H.; Hübner, M.; Junginger, B.; Jundt, K.; Kropshofer, S.; Kuhn, A.; Logé, L.; Nauman, G.; Peschers, U.; Pfiffer, T.; Schwandner, O.; Strauss, A.; Tunn, R.; Viereck, V.

    2016-01-01

    Aims: The aim was to establish an official interdisciplinary guideline, published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). The guideline was developed for use in German-speaking countries. In addition to the Germany Society of Gynecology and Obstetrics, the guideline has also been approved by the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). This is a guideline published and coordinated by the DGGG. The aim is to provide evidence-based recommendations obtained by evaluating the relevant literature for the diagnostic, conservative and surgical treatment of women with female pelvic organ prolapse with or without stress incontinence. Methods: We conducted a systematic review together with a synthesis of data and meta-analyses, where feasible. MEDLINE, Embase, Cinahl, Pedro and the Cochrane Register were searched for relevant articles. Reference lists were hand-searched, as were the abstracts of the Annual Meetings of the International Continence Society and the International Urogynecological Association. We included only abstracts of randomized controlled trials that were presented and discussed in podium sessions. We assessed original data on surgical procedures published since 2008 with a minimum follow-up time of at least 12 months. If the studies included descriptions of perioperative complications, this minimum follow-up period did not apply. Recommendations: The guideline encompasses recommendations for the diagnosis and treatment of female pelvic organ prolapse. Recommendations for anterior, posterior and apical pelvic organ prolapse with or without concomitant stress urinary incontinence, uterine preservation options, and the pros and cons of mesh placements during surgery for pelvic organ prolapse are presented. The recommendations are based on an extensive and systematic review and evaluation of the current literature and include the experiences and specific

  7. Questionnaires in the assessment of sexual function in women with urinary incontinence and pelvic organ prolapse.

    Science.gov (United States)

    Mestre, M; Lleberia, J; Pubill, J; Espuña-Pons, M

    2015-04-01

    Integrating sexual health in clinical practice is important. In women with pelvic floor disorders, the evaluation of the anatomical defects, lower urinary tract function and the anorectal function often receives more attention than the sexual function. Review of Medline using defined search terms to identify articles related to sexual health assessment in urogynecology and manual analyses was performed. Only articles published in English or Spanish were included. Only 50% of women attending urogynecological clinics are sexually active. Of those, 60% present with some sort of sexual sexual dysfunction (FSD). Questionnaires and sexuality scales would facilitate discussion of sexual matters between the Health Care professionals and the women, and may increase the likelihood of FSD being diagnosed. The Pelvic Organ Prolapse Incontinence Sexual Questionnaire (PISQ) and the PISQ-IR (IUGA-Revised) are the only female sexual function specific questionnaires currently validated and developed specifically to assess sexual function in women with urinary incontinence and/or pelvic organ prolapse. Furthermore, the PISQ-IR also allows evaluation of the outcomes of women who are not sexually active when requiring urogynecologic care. PISQ-IR is also designed for international validation. In order to use the PISQ-IR in Spain, a proper interpretation and validation of the questionnaire is needed. The evaluation of sexual function through specific questionnaires facilitates the identification of the sexual dysfunctions associated to the pelvic floor disorders. The inclusion of sexuality questionnaires as an outcome measure allows to analyze the impact in the sexual life of women treated for an urogynecological problem. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. To mesh or not to mesh: a review of pelvic organ reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Dällenbach P

    2015-04-01

    Full Text Available Patrick Dällenbach Department of Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, Geneva, Switzerland Abstract: Pelvic organ prolapse (POP is a major health issue with a lifetime risk of undergoing at least one surgical intervention estimated at close to 10%. In the 1990s, the risk of reoperation after primary standard vaginal procedure was estimated to be as high as 30% to 50%. In order to reduce the risk of relapse, gynecological surgeons started to use mesh implants in pelvic organ reconstructive surgery with the emergence of new complications. Recent studies have nevertheless shown that the risk of POP recurrence requiring reoperation is lower than previously estimated, being closer to 10% rather than 30%. The development of mesh surgery – actively promoted by the marketing industry – was tremendous during the past decade, and preceded any studies supporting its benefit for our patients. Randomized trials comparing the use of mesh to native tissue repair in POP surgery have now shown better anatomical but similar functional outcomes, and meshes are associated with more complications, in particular for transvaginal mesh implants. POP is not a life-threatening condition, but a functional problem that impairs quality of life for women. The old adage “primum non nocere” is particularly appropriate when dealing with this condition which requires no treatment when asymptomatic. It is currently admitted that a certain degree of POP is physiological with aging when situated above the landmark of the hymen. Treatment should be individualized and the use of mesh needs to be selective and appropriate. Mesh implants are probably an important tool in pelvic reconstructive surgery, but the ideal implant has yet to be found. The indications for its use still require caution and discernment. This review explores the reasons behind the introduction of mesh augmentation in POP surgery, and aims to

  9. Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall.

    Directory of Open Access Journals (Sweden)

    Kathleen Chin

    Full Text Available Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5 during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO mice were generated in which doxycycline (dox treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO. Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-. In controls, perineal body length (PBL and bulge increased significantly after delivery but declined to baseline values within 6-8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5

  10. 盆腔脏器术后致盆腔痛%Postoperative pelvic pain due to pelvic organs surgery

    Institute of Scientific and Technical Information of China (English)

    车艳辞; 戴淑真

    2013-01-01

    各种盆腔脏器术后均有可能引起盆腔疼痛,其中部分患者在术后短时间内即表现为疼痛,主要原因有:术后感染、盆腔血肿、肠梗阻等;另外一部分患者可能造成慢性盆腔痛,主要原因有:粘连、残余卵巢综合征、卵巢残余综合征.文章分别进行阐述.%Pelvic pain is one of the chief complaints of women who have a history of pelvic surgery. Many diseases can lead to pelvic pain. Here we talk about some causes of pelvic surgery including infection, hematoma, intestinal obstruction, adhesion, residual o-vary syndrome and ovarian remnant syndrome. How to prevent and treat these cases is the key point.

  11. Organization of lumbosacral motoneuronal cell groups innervating hindlimb, pelvic floor, and axial muscles in the cat.

    Science.gov (United States)

    Vanderhorst, V G; Holstege, G

    1997-05-26

    In a study on descending pathways from the nucleus retroambiguus (NRA) to hindlimb motoneurons (see accompanying paper), it appeared impossible, using data from the literature, to precisely determine which muscles were innervated by the motoneurons receiving the NRA fibers. This lack of data made it necessary to produce a detailed map of the lumbosacral motoneuronal cell groups in the cat. Therefore, 50 different muscles or muscle compartments of hindlimb, pelvic floor and lower back were injected with horseradish peroxidase (HRP) in 135 cases. The respective muscles were divided into ten groups: I, sartorius and iliopsoas; II, quadriceps; III, adductors; IV, hamstrings; V, gluteal and other proximal muscles of the hip; VI, posterior compartment of the distal hindlimb; VII, anterior compartment of the distal hindlimb; VIII, long flexors and intrinsic muscles of the foot; IX, pelvic floor muscles; and X, extensors of the lower back and tail. The L4-S2 segments were cut and incubated, and labeled motoneurons were counted and plotted. A new method was developed that made it possible, despite variations in size and segmental organization between the different cases, to compare the results of different cases. The results show that the spatial interrelationship between the hindlimb and pelvic floor lumbosacral motoneuronal cell groups remains constant. This finding enabled the authors to compose an accurate overall map of the location of lumbosacral motoneuronal cell groups. The general distribution of the motoneuronal cell groups is also discussed in respect to their dorsoventral, mediolateral, and rostrocaudal position within the lumbosacral ventral horn.

  12. [Robotic assisted laparoscopic colposacropexy in the treatment of pelvic organ prolapse].

    Science.gov (United States)

    Moreno Sierra, Jesús; Galante Romo, Isabel; Ortiz Oshiro, Elena; Núñez Mora, Carlos; Silmi Moyano, Angel

    2007-05-01

    Laparoscopic colposacropexy has become a substitute for open surgery in the treatment of pelvic organ prolapse. In the same way, robotic assisted surgery is a new step in the evolution of the procedure. In this paper we intend to show our surgical technique and preliminary results. From November 2006 to date, 10 patients have undergone this procedure at the Hospital Clinico San Carlos. The main indication for the operation was existence of symptomatic pelvic prolapse. Both patients with or without hysterectomy have been operated, without making significant differences between them. Preoperative evaluation workout included: cystogram, urinary tract ultrasound and urodynamics in all cases; urinary tract MRI was performed only in selected cases. All patients underwent surgery under general anesthesia, with at least three robotic trocars (8 mm) and one conventional trocar for the assistant; 2 accessory trocars were necessary in some cases, mainly at the beginning of the series. Most procedures in our series were associated with a transobturator suburethral sling for the treatment of stress urinary incontinence or prevention of its appearance after prolapse repair. Our results are comparable to those reported in other larger series in terms of operative time, hospital stay and early or late complications. Pending an evaluation on the long term with larger series, we can include robot assisted colposacropexy among the therapeutic options for symptomatic pelvic floor prolapse repair.

  13. The role of the MR-fluoroscopy in the diagnosis and staging of the pelvic organ prolapse

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    Etlik, Oemer E-mail: omeretlik@hotmail.com; Arslan, Halil; Odabasi, Oner; Odabasi, Hulya; Harman, Mustafa; Celebi, Hacer; Sakarya, M. Emin

    2005-01-01

    Introduction: The aim of the study is to investigate the efficacy of the magnetic resonance fluoroscopy in the diagnosis and staging of the pelvic prolapse. Materials and methods: The study consisted of 46 patients who were known to have pelvic prolapses from their vaginal examination. Thirty women who underwent vaginal exam and shown not have pelvic prolapse were selected as a control group. Firstly, pelvic sagittal FSE T2 weighted images of all the women were acquired in 0.3 T open MR equipment than sagittal MR-fluoroscopic images using spoiled gradient echo sequences were obtained during pelvic strain. Physical examination and MR-fluoroscopic findings were compared. The relationship between the stages of prolapse established by both of the methods was evaluated statistically with Pearson's correlation analysis. Results: Physical examination and MR findings were very concordant in the diagnosis of pelvic prolapse and statistical correlations in the stages of prolapse were established between both of the methods (P<0.01 for anterior and middle comportment, P<0.05 for posterior comportment). Conclusion: We conclude that MR-fluoroscopy is a non-invasive, easily applied, dynamic useful method without contrast agent in the diagnosis and staging of pelvic organ prolapse.

  14. Porcine Small Intestinal Submucosa Mesh for Treatment of Pelvic Organ Prolapsed

    Institute of Scientific and Technical Information of China (English)

    Ting-Ting Cao; Xiu-Li Sun; Shi-Yan Wang; Xin Yang; Jian-Liu Wang

    2016-01-01

    Background:Pelvic organ prolapse (POP) is a major health concern that affects women.Surgeons have increasingly used prosthetic meshes to correct POP.However,the most common used is synthetic mesh,and absorbable mesh is less reported.This research aimed to evaluate the clinical effectiveness of porcine small intestinal submucosa (SIS).Methods:Consecutive forty POP patients who met the inclusion criteria underwent pelvic reconstruction surgery with SIS between March 2012 and December 2013.The patients' clinical characteristics were recorded preoperatively.Surgical outcomes,measured by objective and subjective success rates,were investigated.We evaluated the quality of life (QOL) using the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7).Sexual QOL was assessed by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (P1SQ-12).Results:At postoperative 12 months,the subjective recurrence rate (7.5%) was much lower than the objective recurrence rate (40.0%).Postoperatively,no erosion was identified.One underwent a graft release procedure because of urinary retention,and one had anus sphincter reconstruction surgery due to defecation urgency.Another experienced posterior vaginal wall infection where the mesh was implanted,accompanied by severe vaginal pain.Estrogen cream relieved the pain.One patient with recurrence underwent a secondary surgery with Bard Mesh because of stage 3 anterior vaginal wall prolapse.Scoring system of PFDI-20 was from 59.150 ± 13.143 preoperatively to 8.400 ± 4.749 postoperatively and PFIQ-7 was from 73.350 ± 32.281 to 7.150 ± 3.110,while PISQ-12 was from 15.825 ± 4.050 to 12.725 ± 3.471.Conclusions:QOL and the degree of subjective satisfaction were significantly improved postoperatively.Anterior repair deserves more attention because of the higher recurrence rate.The long-term follow-up of the patient is warranted to draw firm conclusion.

  15. Actinomyces-like organisms in cervical smears: the association with intrauterine device and pelvic inflammatory diseases

    Science.gov (United States)

    Kim, Yeo Joo; Youm, Jina; Kim, Jee Hyun

    2014-01-01

    Objective To investigate the incidence of actinomyces-like organisms in routine cervical smears of Korean women and to evaluate its association with the development of pelvic inflammatory disease (PID) in these women. Methods The results of cervical smears between 2011 and 2012 at a single university hospital were searched. If positive for actinomyces-like organisms, the medical record of the patient was searched and development of PID was followed. If the data were not available in the medical record, the patient was contacted by telephone. Results The incidence of actinomyces-like organisms in cervical smears was 0.26% (52/20,390). Forty-two women (80.8%) were intrauterine device (IUD) users: the copper-IUD in 25 women and the levonorgestrel-releasing intrauterine system in 13 women (type unknown in 4 women). The majority (71.4%, 30/42) of the IUD users maintained the IUD. Prophylactic antibiotics were prescribed to 12 women. Two continuous IUD users were later diagnosed with PID, but these cases were not pelvic actinomycosis. Conclusion It would be a reasonable option to choose the expectant management for asymptomatic women who incidentally showed actinomyces-like organisms in their cervical smear. PMID:25264530

  16. Impact of surgical training on the performance of proposed quality measures for hysterectomy for pelvic organ prolapse.

    Science.gov (United States)

    Adams-Piper, Emily R; Guaderrama, Noelani M; Chen, Qiaoling; Whitcomb, Emily L

    2017-06-01

    Recent healthcare reform has led to increased emphasis on standardized provision of quality care. Use of government- and organization-approved quality measures is 1 way to document quality care. Quality measures, to improve care and aid in reimbursement, are being proposed and vetted in many areas of medicine. We aimed to assess performance of proposed quality measures that pertain to hysterectomy for pelvic organ prolapse stratified by surgical training. The 4 quality measures that we assessed were (1) the documentation of offering conservative treatment of pelvic organ prolapse, (2) the quantitative assessment of pelvic organ prolapse (Pelvic Organ Prolapse-Quantification or Baden-Walker), (3) the performance of an apical support procedure, and (4) the performance of cystoscopy at time of hysterectomy. Patients who underwent hysterectomy for pelvic organ prolapse from January 1 to December 31, 2008, within a large healthcare maintenance organization were identified by diagnostic and procedural codes within the electronic medical record. Medical records were reviewed extensively for demographic and clinical data that included the performance of the 4 proposed quality measures and the training background of the primary surgeon (gynecologic generalist, fellowship-trained surgeon in Female Pelvic Medicine and Reconstructive Surgery, and "grandfathered" Female Pelvic Medicine and Reconstructive Surgery). Data were analyzed with the use of descriptive statistics. Inferential statistics with chi-squared tests were used to compare performance rates of quality measures that were stratified by surgical training. Probability values trained surgeons performed 302 hysterectomies for pelvic organ prolapse; grandfathered Female Pelvic Medicine and Reconstructive Surgery surgeons performed 98 hysterectomies, and gynecologic generalist surgeons performed 230 hysterectomies. Fellowship-trained surgeons had the highest performance rates for individual quality measures (91

  17. Association between ICS POP-Q coordinates and translabial ultrasound findings: implications for definition of 'normal pelvic organ support'.

    Science.gov (United States)

    Dietz, H P; Kamisan Atan, I; Salita, A

    2016-03-01

    Female pelvic organ prolapse is quantified on clinical examination using the pelvic organ prolapse quantification system of the International Continence Society (ICS POP-Q). Pelvic organ descent on ultrasound is strongly associated with symptoms of prolapse, but associations between clinical and ultrasound findings remain unclear. This study was designed to compare clinical examination and imaging findings, especially regarding cut-offs for the distinction between normal pelvic organ support and prolapse. This was a retrospective study using 839 archived datasets of women referred to a tertiary urogynecological center for symptoms of lower urinary tract and pelvic floor dysfunction between June 2011 and May 2013. The main outcome measures were the maximum downward displacement of the anterior vaginal wall (point Ba), the cervix (point C) and the posterior vaginal wall (point Bp), the length of the genital hiatus (Gh) and the length of the perineal body (Pb), as defined by the ICS POP-Q; explanatory parameters were measures of pelvic organ descent on translabial ultrasound, ascertained by offline volume data analysis at a later date, by an operator blinded to all other data. Full datasets were available for 825 women. On clinical examination, 646 (78.3%) were found to have prolapse of at least POP-Q Stage 2. All coordinates on clinical examination were strongly associated with the ultrasound measurements of pelvic organ descent (P POP-Q (Ba ≥ -0.5 and cystocele ≥ 10 mm below the symphysis pubis, C ≥ -5 and uterine position of 15 mm above the symphysis pubis, Bp ≥ -0.5 and rectocele ≥ 15 mm below the symphysis pubis) are plausible and mutually consistent. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  18. Frequency of recurrent urinary tract infection in patients with pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Töz E

    2015-01-01

    Full Text Available Emrah Töz,1 Sefa Kurt,2 Çagdas Sahin,1 Mehmet Tunç Canda3 1Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey; 2Department of Obstetrics and Gynecology, Izmir Dokuz Eylül University, Izmir, Turkey; 3Department of Obstetrics and Gynecology, Kent Hospital, Izmir, Turkey Purpose: The aim of the study was to investigate the existence of a relationship between pelvic organ prolapse (POP and recurrent urinary tract infection (UTI. Materials and methods: The hospital database was searched for women diagnosed with pelvic floor disorders and all medical records were reviewed for recurrent UTI, diagnosed by two or more positive urine cultures taken within 12 months of each other. The control group was created using one-to-one matching for age and menopausal status. The prevalence of recurrent UTI in these patients were compared. Results: The mean age of the 210 participants was 54.64±5.15 years. We found no association between POP and recurrent UTI. In the prolapse group, 22 women (21% had recurrent UTI compared with 19 women (18% in the control group (P=0.316. Post-void residual (PVR volumes >50 mL were associated with increased prevalence of recurrent UTI. Conclusion: POP is not a risk factor for recurrent UTI, but women with POP are more likely to have high PVR volumes. High PVR volumes increase the risk of recurrent UTI. Clinical examination and ultrasound assessment of PVR should be performed in all women presenting with prolapse and UTI. Elevated PVR is the most significant risk factor, linking POP with recurrent UTI. Keywords: recurrent urinary tract infection, pelvic organ prolapse, post-void residual

  19. Uterine preservation in pelvic organ prolapse using robot assisted laparoscopic sacrohysteropexy: quality of life and technique.

    Science.gov (United States)

    Mourik, Sarah L; Martens, Jolise E; Aktas, Mustafa

    2012-11-01

    Measuring quality of life of women with disorders of the pelvic floor is crucial when evaluating a therapy. The aim of this study is to profile health related quality of life of women with pelvic organ prolapse who are treated with robot assisted laparoscopic sacrohysteropexy (RALS). We also compare the operative characteristics and learning curve in this study with the current literature and describe the surgical technique. A prospective cohort study in a teaching hospital in The Netherlands. Fifty women with uterovaginal prolapse were treated with RALS. This study presents the largest cohort in Europe treated by RALS to date. Quality of life was assessed pre- and post-operatively using the UDI/IIQ validated self-questionnaire designed for Dutch-speaking patients. Clinical and operative data were prospectively collected up to 29 months. RALS was performed with preservation of the uterus. Statistical analysis of categorical data was performed with the paired T-test. Descriptive statistics were computed with the use of standard methods for means, median and proportions. Before operation, overall wellbeing was scored at 67.7% and after surgery this improved to 82.1% (p=0.03). Feelings of nervousness, frustration and embarrassment reduced significantly. Sexual functioning improved, but not significantly. The mean operative time was 223 (103-340) min. Operative time decreased significantly with gained experience and became comparable to the operative time for abdominal sacrocolpopexy and classic laparoscopy. Average blood loss was less than 50 ml and patients had a mean hospital stay of 2 days. Of all women, 95.2% were very satisfied with the result after RALS. Health related quality of life improves significantly after RALS. There are high rates of patient satisfaction. RALS proves to be a safe and effective treatment of pelvic organ prolapse. Operative time is comparable to abdominal sacrocolpopexy and classic laparoscopy in the current literature. Copyright © 2012

  20. Endometrial mesenchymal stem cells as a cell based therapy for pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    Stuart; J; Emmerson; Caroline; E; Gargett

    2016-01-01

    Pelvic organ prolapse(POP) occurs when the pelvic organs(bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman’s quality of life. POP affects 25% of all women and results from childbirth injury. For 19% of all women, surgical reconstructive surgery is required for treatment, often augmented with surgical mesh. The surgical treatment fails in up to 30% of cases or results in adverse effects, such as pain and mesh erosion into the bladder, bowel or vagina. Due to these complications the Food and Drug Administration cautioned against the use of vaginal mesh and several major brands have been recently been withdrawn from market. In this review we will discuss new cell-based approaches being developed for the treatment of POP. Several cell types have been investigated in animal models, including a new source of mesenchymal stem/stromal cells(MSC) derived from human endometrium. The unique characteristics of endometrial MSC, methods for their isolation and purification and steps towards their development for good manufacturing practice production will be described. Animal models that could be used to examine the potential for this approach will also be discussed as will a rodent model showing promise in developing an endometrial MSC-based therapy for POP. The development of a preclinical large animal model for assessing tissue engineering constructs for treating POP will also be mentioned.

  1. Endometrial mesenchymal stem cells as a cell based therapy for pelvic organ prolapse.

    Science.gov (United States)

    Emmerson, Stuart J; Gargett, Caroline E

    2016-05-26

    Pelvic organ prolapse (POP) occurs when the pelvic organs (bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman's quality of life. POP affects 25% of all women and results from childbirth injury. For 19% of all women, surgical reconstructive surgery is required for treatment, often augmented with surgical mesh. The surgical treatment fails in up to 30% of cases or results in adverse effects, such as pain and mesh erosion into the bladder, bowel or vagina. Due to these complications the Food and Drug Administration cautioned against the use of vaginal mesh and several major brands have been recently been withdrawn from market. In this review we will discuss new cell-based approaches being developed for the treatment of POP. Several cell types have been investigated in animal models, including a new source of mesenchymal stem/stromal cells (MSC) derived from human endometrium. The unique characteristics of endometrial MSC, methods for their isolation and purification and steps towards their development for good manufacturing practice production will be described. Animal models that could be used to examine the potential for this approach will also be discussed as will a rodent model showing promise in developing an endometrial MSC-based therapy for POP. The development of a preclinical large animal model for assessing tissue engineering constructs for treating POP will also be mentioned.

  2. Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse.

    Science.gov (United States)

    Rogers, G R; Villarreal, A; Kammerer-Doak, D; Qualls, C

    2001-01-01

    The sexual function of women with and without urinary incontinence and/or pelvic organ prolapse (UI/POP) was compared using a condition-specific validated questionnaire, the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). Eighty-three women with UI/POP and 56 without agreed to participate. PISQ scores were significantly lower among women with UI/POP than in those without (P = 0.003). No differences in the stages of sexual excitement were noted between groups. The frequency of intercourse was less with UI/POP than without (P= 0.04). Women with UI/POP restricted sexual activity for fear of losing urine more frequently than did those without (P = 0.005). No differences were reported in patients' or partners' sexual satisfaction. This study found that women with UI/POP have poorer sexual functioning than those without, as measured by the PISQ, and report less frequent sexual activity. In addition, women with UI/POP are more likely to restrict sexual activity for fear of incontinence, although they report similar levels of satisfaction with their sexual relationships as do women without UI/POP.

  3. An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP)

    NARCIS (Netherlands)

    Haylen, Bernard T; Maher, Christopher F; Barber, Matthew D; Camargo, Sérgio; Dandolu, Vani; Digesu, Alex; Goldman, Howard B; Huser, Martin; Milani, Alfredo L; Moran, Paul A; Schaer, Gabriel N; Withagen, Mariëlla I J

    2016-01-01

    INTRODUCTION: The terminology for female pelvic floor prolapse (POP) should be defined and organized in a clinically-based consensus Report. METHODS: This Report combines the input of members of two International Organizations, the International Urogynecological Association (IUGA) and the Internatio

  4. [Primary Pelvic Cystic Echinococcosis].

    Science.gov (United States)

    Yaman, İsmail; İnceboz, Ümit; İnceboz, Tonay; Keyik, Bahar; Uzgören, Engin

    2015-06-01

    Cystic echinococcosis caused by Echinococcus granulosus is still an important health problem in endemic areas. Cystic echinococcosis may involve different organs or areas with the most common sites being the liver and the lungs. Pelvic involvement has previously been reported and was mainly accepted as secondary to cystic echinococcosis in other organs, isolated pelvic involvement is very rare. In this case report, we aimed to present the case with pelvic cystic mass that was finally diagnosed with isolated pelvic cystic echinococcosis in and after the operation, and we would like to draw attention to include "cystic echinococcosis" in the differential diagnosis of pelvic masses.

  5. Positional pelvic organ prolapse (POP) evaluation using open, weight-bearing magnetic resonance imaging (MRI).

    Science.gov (United States)

    Friedman, Boris; Stothers, Lynn; Lazare, Darren; Macnab, Andrew

    2015-01-01

    Magnetic resonance imaging (MRI) of patients with pelvic organ prolapse (POP) is completed in the supine position. Open magnetic resonance imaging (MRO) uses vertical magnets, allowing imaging in a variety of upright postures. This pilot study used MRO to evaluate the change of prolapse in different positions compared to non-prolapsed images. In total, 11 women (6 POP, 5 controls) aged 24 to 65 years had 12 MRO images (midline sagittal pelvic line) consecutively when supine, sitting and standing with a full and empty bladder. Lengths between the lowest point of the bladder to the pubococcygeal (PC) and pubopromontoreal (PP) lines in each image were compared, and the ratio of bladder area under the PC and PP lines to the total bladder area. Significant elongation between the PC line and lowest point of the bladder was evident in subjects with POP comparing supine and standing images (p = 0.03), but not controls (p = 0.07). Similarly, this axis was significantly longer in cystocele subjects versus controls only in the standing position. Bladder area under the PC line was significantly increased between supine and standing positions only among subjects with cystocele (p bearing on the staging of POP. Imaging patients when sitting and standing identified that significant changes occur in the maximal descent of the bladder.

  6. Clinical Outcomes and Urodynamic Effects of Tailored Transvaginal Mesh Surgery for Pelvic Organ Prolapse

    Directory of Open Access Journals (Sweden)

    Ting-Chen Chang

    2015-01-01

    Full Text Available Objective. To evaluate the clinical outcomes and urodynamic effects of tailored anterior transvaginal mesh surgery (ATVM and tailored posterior transvaginal mesh surgery (PTVM. Methods. We developed ATVM for the simultaneous correction of cystocele and stress urinary incontinence and PTVM for the simultaneous correction of enterocoele, uterine prolapse, vaginal stump prolapse, and rectocele. Results. A total of 104 women enrolled. The median postsurgical follow-up was 25.5 months. The anatomic cure rate was 98.1% (102/104. Fifty-eight patients underwent urodynamic studies before and after surgeries. The pad weight decreased from 29.3 ± 43.1 to 6.4 ± 20.9 g at 3 months. Among the 20 patients with ATVM, 13 patients had objective stress urinary incontinence (SUI at baseline while 8 patients came to have no demonstrated SUI (NDSUI, and 2 improved after surgery. Among the 38 patients who underwent ATVM and PTVM, 24 had objective SUI at baseline while 18 came to have NDSUI, and 2 improved after surgery. Mesh extrusion (n = 4, vaginal hematoma (n = 3, and voiding difficulty (n = 2 were noted postoperatively. Quality of life was substantially improved. Conclusions. Our findings document the advantages of these two novel pelvic reconstructive surgeries for pelvic organ prolapse, which had a positive impact on quality of life. ATVM surgery additionally provided an anti-incontinence effect. This clinical trial is registered at ClinicalTrials.gov (NCT02178735.

  7. Relationship between the Pelvic Organ Prolapse Quantification system (POP-Q), the Pelvic Floor Impact Questionnaire (PFIQ-7), and the Pelvic Floor Distress Inventory (PFDI-20) before and after anterior vaginal wall prolapse surgery.

    Science.gov (United States)

    Teleman, P; Laurikainen, E; Kinne, I; Pogosean, R; Jakobsson, U; Rudnicki, M

    2015-02-01

    The aim of this study was to investigate the degree of correlation between the Pelvic Organ Quantification system (POP-Q) measurements and symptom questionnaire scores before and after surgery. This was a part of a randomized controlled study comparing conventional colporrhaphy with mesh repair surgery. The correlation between POP-Q measurements and Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20) scores was investigated in 164 women 55 years or older scheduled for primary anterior vaginal wall prolapse surgery at baseline and the correlation between the change in point Ba and scores following surgery. Statistical analyses used McNemar's and Wilcoxon signed-rank tests, Spearman's rank-order correlation, and multiple linear regression. Surgery significantly improved POP-Q, PFIQ-7, and PFDI-20 scores, including subscales. We observed weak correlations between POP-Q and PFIQ-7, including subscales (r 0.173-0.324, p POP-Q and urogenital symptoms based on questionnaire scores suggests that neither scoring system is optimal.

  8. Spontaneous pregnancy after pessary placement in a patient with infertility and advanced pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Tsia-Shu Lo

    2016-02-01

    Full Text Available To highlight possible association of advanced pelvic organ prolapse with infertility and its successful outcome following conservative management. We report herein a 38-year-old para 1, non-overweight woman who presented with secondary infertility without any factors for infertility except for an advanced POP. She had intrauterine insemination (IUI performed twice at a local clinic and in vitro fertilization-embryo transfer (IVF-ET program twice in our institute unsuccessfully. She conceived spontaneously after vaginal pessary placement and delivered, vaginally, a healthy female baby weighing 3,365 g at the 38th week of gestation. Advanced POP appears to be an important risk factor for infertility. After completing an infertility workup, pessary application can be the first-line treatment modality for women with unexplained infertility due to advanced POP.

  9. Incidence and lifetime risk of pelvic organ prolapse surgery in Denmark from 1977 to 2009

    DEFF Research Database (Denmark)

    Papsøe Løwenstein, Ea; Ottesen, Bent; Gimbel, Helga

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The purpose of the study was to describe the incidence of pelvic organ prolapse (POP) surgeries in Denmark during the last 30 years, age distribution over time, and the lifetime risk of undergoing POP surgery. METHODS: We carried out a population-based registry study....... The setting was the Danish National Patient Registry. The sample consisted of Danish women of all ages undergoing prolapse surgery during the period 1977-2009. Data were retrieved from the Danish National Patient Registry. Prolapse surgery included surgery for any type of genital prolapse including...... hysterectomy due to prolapse. The main outcome measures were incidence of POP, age distribution over time, and lifetime risk of undergoing POP surgery. RESULTS: Surgical interventions for POP decreased by 47 % from 1977 (288 procedures/100,000 women) to 1999 (153 procedures/100,000 women). Subsequently...

  10. Patient reported outcome measures in women undergoing surgery for urinary incontinence and pelvic organ prolapse in Denmark, 2006-2011

    DEFF Research Database (Denmark)

    Sørensen, Rikke Guldberg; Kesmodel, Ulrik Schiøler; Hansen, Jesper Kjær

    2012-01-01

    surgery for urinary incontinence (UI) or pelvic organ prolapse (POP) from 2006 to 2011. Using frequency of symptoms and a visual analogue scale (VAS) both pre- and postoperatively, their severity of symptoms and quality of life were measured by questionnaires. RESULTS: During the study period, 20...

  11. The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse

    DEFF Research Database (Denmark)

    Hulbæk, Mette; Primdahl, Jette; Nielsen, Jesper Bo

    2017-01-01

    Background and aims In Denmark app. 4-5000 women annually have surgery for their pelvic organ prolapse (POP). More than one treatment option for symptoms from POP exists, and it can be challenging to establish to what extent these symptoms fully originate from the objective prolapse and what impact...

  12. A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands: identifying needs for further research

    NARCIS (Netherlands)

    J. Velzel (Joost); J.P. Roovers (Jan Paul); C.H. Van der Vaart; B.M.W. Broekman (Bart); A. Vollebregt (Astrid); R. Hakvoort (Robert)

    2015-01-01

    textabstractIntroduction and hypothesis: To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). Methods: A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. Results: The response rate was 59 %. Of

  13. A nationwide survey concerning practices in pessary use for pelvic organ prolapse in The Netherlands : identifying needs for further research

    NARCIS (Netherlands)

    Velzel, Joost; Roovers, Jan Paul; van der Vaart, C. H.; Broekman, Bart; Vollebregt, Astrid; Hakvoort, Robert

    2015-01-01

    Introduction and hypothesis: To identify practice variation in management of patients with a vaginal pessary for pelvic organ prolapse (POP). Methods: A nationwide survey was sent to all Dutch gynecologists with a special interest in urogynecology. Results: The response rate was 59 %. Of the

  14. Anorectal function testing and anal endosonography in the diagnostic work-up of patients with primary pelvic organ prolapse

    NARCIS (Netherlands)

    A.G. Groenendijk (Annette); E. Birnie (Erwin); G.E. Boeckxstaens (Guy); J-P.W. Roovers (Jan-Paul); G.J. Bonsel (Gouke)

    2008-01-01

    textabstractAIM: To study the pathophysiology of defecation disorders in patients with primary pelvic organ prolapse (POP) and the diagnostic potential of anorectal function testing (AFT) including endosonography in the work-up of these patients. METHODS: 59 Patients were evaluated with a validated

  15. Anorectal function testing and anal endosonography in the diagnostic work-up of patients with primary pelvic organ prolapse

    NARCIS (Netherlands)

    A.G. Groenendijk (Annette); E. Birnie (Erwin); G.E. Boeckxstaens (Guy); J-P.W. Roovers (Jan-Paul); G.J. Bonsel (Gouke)

    2009-01-01

    textabstractAIM: To study the pathophysiology of defecation disorders in patients with primary pelvic organ prolapse (POP) and the diagnostic potential of anorectal function testing (AFT) including endosonography in the work-up of these patients. METHODS: 59 Patients were evaluated with a validated

  16. Sustainable Enterprise Excellence and the Continuously Relevant and Responsible Organization

    DEFF Research Database (Denmark)

    Edgeman, Rick; Bøllingtoft, Anne; Eskildsen, Jacob Kjær

    2013-01-01

    issues surrounding enterprise innovation and sustainability efforts and capabilities. Innovation and sustainability of the necessary trajectory, scale, and velocity are strategically integrated to deliver what we refer to as innovating sustainability. This provides an accelerated means path toward...... sustainable enterprise excellence, and hence toward the asymptotic aspiration of being a continuously relevant and responsible organization. Introduced are the concepts of innovating sustainability, sustainable enterprise excellence (SEE), and continuously relevant and responsible organizations (CRRO)....

  17. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology.

    Science.gov (United States)

    Roussouly, Pierre; Pinheiro-Franco, João Luiz

    2011-09-01

    Standing in an erect position is a human property. The pelvis anatomy and position, defined by the pelvis incidence, interact with the spinal organization in shape and position to regulate the sagittal balance between both the spine and pelvis. Sagittal balance of the human body may be defined by a setting of different parameters such as (a) pelvic parameters: pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS); (b) C7 positioning: spino-pelvic angle (SSA) and C7 plumb line; (c) shape of the spine: lumbar lordosis. In case of pathological kyphosis, different mechanical compensations may be activated. When the spine remains flexible, the hyperextension of the spine below or above compensates the kyphosis. When the spine is rigid, the only way is rotating backward the pelvis (retroversion). This mechanism is limited by the value of PI. Hip extension is a limitation factor of big retroversion when PI is high. Flexion of the knees may occur when hip extension is overpassed. The quantity of global kyphosis may be calculated by the SSA. The more SSA decreases, the more the severity of kyphosis increases. We used Roussouly's classification of lumbar lordosis into four types to define the shape of the spine. The forces acting on a spinal unit are combined in a contact force (CF). CF is the addition of gravity and muscle forces. In case of unbalance, CF is tremendously increased. Distribution of CF depends on the vertebral plate orientation. In an average tilt (45°), the two resultants, parallel to the plate (sliding force) or perpendicular (pressure), are equivalent. If the tilt increases, the sliding force is predominant. On the contrary, with a horizontal plate, the pressure increases. Importance of curvature is another factor of CF distribution. In a flat or kyphosis spine, CF acts more on the vertebral bodies and disc. In the case of important extension curvature, it is on the posterior elements that CF acts more. According to the shape of the spine, we may

  18. Sacrohysteropexy performed as uterus conserving surgery for pelvic organ prolapse: Review of case files

    Science.gov (United States)

    Khan, Ayesha; Jaleel, Riffat; Nasrullah, Farah Deeba

    2016-01-01

    Objective: To assess the outcome and safety of sacrohysteropexy as uterus conserving surgery for pelvic organ prolapse in young women and to assess patients’ satisfaction with the procedure. Methods: This is a case series of patients operated at Sind Government Lyari General Hospital and Civil Hospital Karachi, between January, 2007 to October, 2015. Data of the patients who had sacrohysteropexy were reviewed. Complications during surgery and post-operative period including haemorrhage, visceral injury, paralytic ileus and peritonitis were studied. Success of procedure, need of blood transfusion, hospital stay and condition on discharge and six weeks follow-up were noted. Data were analyzed using SPSS version 16. Mean ± SD was calculated for numerical, while frequencies were computed for categorical variables. Results: Data of 60 patients were reviewed. Early post-operative success was 100%. Duration of surgery was less than two hours in 57 (95%) patients. Blood loss was negligible in majority of cases. Out of all 60 cases, 52 (86.7%) did not suffer any complication. One patient had ureteric injury, while one patient sustained bowel injury. Two patients had paralytic ileus. Four patients suffered from abdominal wound infection. All patients were managed satisfactorily. Mean duration of stay in hospital was four days. Upon follow up 96.7% patients were satisfied with results of operative procedure. Sixteen (26.7%) patients complained of backache on follow-up visit. Conclusion: This review concludes that sacrohysteropexy was successful in all cases in early post-operative period. It is a safe procedure and should be considered as an option for the treatment of pelvic organ prolapse in young women, in whom uterine conservation is required. PMID:27882016

  19. Sacrohysteropexy performed as uterus conserving surgery for pelvic organ prolapse: Review of case files.

    Science.gov (United States)

    Khan, Ayesha; Jaleel, Riffat; Nasrullah, Farah Deeba

    2016-01-01

    To assess the outcome and safety of sacrohysteropexy as uterus conserving surgery for pelvic organ prolapse in young women and to assess patients' satisfaction with the procedure. This is a case series of patients operated at Sind Government Lyari General Hospital and Civil Hospital Karachi, between January, 2007 to October, 2015. Data of the patients who had sacrohysteropexy were reviewed. Complications during surgery and post-operative period including haemorrhage, visceral injury, paralytic ileus and peritonitis were studied. Success of procedure, need of blood transfusion, hospital stay and condition on discharge and six weeks follow-up were noted. Data were analyzed using SPSS version 16. Mean ± SD was calculated for numerical, while frequencies were computed for categorical variables. Data of 60 patients were reviewed. Early post-operative success was 100%. Duration of surgery was less than two hours in 57 (95%) patients. Blood loss was negligible in majority of cases. Out of all 60 cases, 52 (86.7%) did not suffer any complication. One patient had ureteric injury, while one patient sustained bowel injury. Two patients had paralytic ileus. Four patients suffered from abdominal wound infection. All patients were managed satisfactorily. Mean duration of stay in hospital was four days. Upon follow up 96.7% patients were satisfied with results of operative procedure. Sixteen (26.7%) patients complained of backache on follow-up visit. This review concludes that sacrohysteropexy was successful in all cases in early post-operative period. It is a safe procedure and should be considered as an option for the treatment of pelvic organ prolapse in young women, in whom uterine conservation is required.

  20. Uterus preserving vaginal surgery versus vaginal hysterectomy for correction of female pelvic organ prolapse.

    Science.gov (United States)

    Iliev, Vasil N; Andonova, Irena T

    2014-01-01

    The objective of this study is to evaluate uterus preserving vaginal procedure of cervical amputation with uterosacral ligament plication (modified Manchester operation) and compare it to vaginal hysterectomy regard recurrence rate, duration of surgery, blood loses, intra and post-operative complications, duration of hospital stay. Consecutive women with pelvic organ prolapse who underwent either vaginal hyste-rectomy or a modified Manchester procedure were included. Assessments were made preoperatively and at 1-year follow-up, including physical examination with pelvic organ prolapse quantification standardized questionnaires. 66 patients were included in the study with a one year follow-up. We found no significant difference in: recurrence of POP and reintervention (recurrence with required treatment n (%): 3(10) vs. 5(15), p=0.28) and hospital stay (mean±SD days: 5±2 vs. 7±2, p=0.97). Significant less blood loses (250±210 ml. vs. 360±230 ml.) and shorter operation time (67±20 min. vs 102±22 min.) in modified Manchester group, but significant more urinary retention (cases: 8 vs 6) in modified Manchester group. The overall functional outcome was acceptable for both procedures. We found an excellent performance of both procedures regarding recurrences and intra and post-operative complications. A high degree of acceptance-satisfaction shows the modified Manchester operation and is good option for the treatment of uterine prolapse in younger women who wish to keep their uterus and in all cases of genital prolapse with elongation of uterine cervix (when there is not other uterine pathology). Shorter operation time and lower blood lose are another factors for stronger recommendation of the modified Manchester operation for patients with concomitant diseases and/or older age patients with elevated risk from anesthesia and/or surgery.

  1. Systematic classification of uterine cervical elongation in patients with pelvic organ prolapse.

    Science.gov (United States)

    Mothes, Anke R; Mothes, Henning; Fröber, Rosemarie; Radosa, Marc P; Runnebaum, Ingo B

    2016-05-01

    To define and classify cervical elongation, to compare uterine measurements after prolapse hysterectomy with a non-prolapse control group, and to associate stage of prolapse and degree of cervical elongation. This was a single-centre retrospective case-control study conducted at the University Hospital, Urogynaecological Unit, with a certified urogynaecological surgeon. Data were collected from patients with and without pelvic organ prolapse (POP) who underwent laparoscopically assisted vaginal hysterectomy. Post-hysterectomy uterine cervical elongation was examined using the corpus/cervix ratio (CCR), calculated from measurements taken on photographs. Cervical elongation was classified as physiological (grade 0, CCR>1.5) grade I (CCR>1 and ≤1.5) grade II (CCR>0.5 and ≤1), and grade III (CCR≤0.5). Cervical elongation was detected in 288/295 (97.6%) patients in the prolapse group (grade I, 44/288 [15.2%]; grade II, 212 [73.6%]; grade III, 32 [11.1%]). Mean CCR was greater among those with stage II/III than among those with stage IV prolapse (1.0±0.4 vs. 0.8±0.2; pprolapse stages were associated (pprolapse group compared to the control group (puterine length did not differ between the prolapse and control groups (8.0±1.6 vs. 8.2±1.3cm), but mean calculated cervical length was greater in the prolapse group than in the control group (4.4±1.1 vs. 3.1+0.8cm; pUterine cervical elongation is found in patients undergoing hysterectomy for pelvic organ prolapse. Cervical elongation grades and prolapse stages are correlated. Defining uterine cervical elongation based on corpus/cervix ratio with grades I-III could be a valuable basic tool for further research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Surgical Outcomes and Safety of Robotic Sacrocolpopexy in Women With Apical Pelvic Organ Prolapse

    Science.gov (United States)

    2017-01-01

    Purpose This study aimed to investigate the surgical outcomes and safety of robotic sacrocolpopexy (RSC) in patients with uterine/vaginal vault prolapse. Methods Between January 2009 and June 2015, 16 women with apical prolapse underwent RSC. Pelvic organ prolapse quantification (POP-Q) examination was performed, and treatment success was defined as the presence of grade 0 or I apical prolapse upon POP-Q examination at the final follow-up. Pelvic floor distress inventory-short form 20 (PFDI-SF 20) was administered at every follow-up. A treatment satisfaction questionnaire was administered by telephone to evaluate patient satisfaction with the operation. Results Median age was 65 years (interquartile range [IQR], 56–68 years), and follow-up duration was 25.3 months (IQR, 5.4–34.0 months). Thirteen women (81.3%) had ≥grade III apical prolapse. Operation time was 251 minutes (IQR, 236–288 minutes), and blood loss was 75 mL (IQR, 50–150 mL). Median hospital stay was 4 days (IQR, 3–5 days). At the final follow-up, treatment success was reported in all patients, who presented grade 0 (n=8, 57.1%) and grade I (n=6, 42.9%) apical prolapse. Dramatic improvements in PFDI-SF 20 scores were noted after RSC (from 39 to 4; P=0.001). Most patients (12 of 13) were satisfied with RSC. An intraoperative complication (sacral venous plexus injury) was reported in 1 patient, and there was no conversion to open surgery. Mesh erosion was not reported. Conclusions RSC is an efficient and safe surgical option for apical prolapse repair. Most patients were satisfied with RSC. Thus, RSC might be one of the best treatment options for apical prolapse in women. PMID:28361513

  3. Goal attainment after treatment in patients with symptomatic pelvic organ prolapse

    Science.gov (United States)

    Mamik, Mamta M; Rogers, Rebecca G; Qualls, Clifford R; Komesu, Yuko M

    2017-01-01

    OBJECTIVE The objectives of this study were to: (1) assess differences in goal attainment of self-described goals after treatment of symptomatic pelvic organ prolapse (POP) for women who chose surgery compared to women who chose pessary; and (2) compare patient global improvement between groups. STUDY DESIGN Women who had symptomatic stage ≥ II prolapse presenting for care of POP to the urogynecology clinic at the University of New Mexico were recruited. Patients listed up to 3 goals they had for their treatment. In addition, they completed the short forms of the Pelvic Floor Distress Inventory (PFDI-20), the POP/Urinary Incontinence Sexual Questionnaire, and the Body Image Scale. Goals listed by patients were then categorized into 10 categories. Each of the listed goals was categorized based on a consensus of 5 providers. At 3 months’ follow-up patients listed if they had met their self-described goals on a scale of 0–10 and also answered the Patient Global Improvement Index (PGI-I). RESULTS There were no significant differences between the 2 groups’ baseline characteristics. Surgery patients ranked their goal attainment higher than pessary patients for all the 3 goals listed. Similarly, PGI-I scores were also higher in the surgical (2.4 ±1.1) than the pessary (1.93 ± 0.8) treatment groups (P < .04). Patients in the surgery group also had better symptom improvement as measured by the PFDI-20 (P < .02). CONCLUSION Patients who chose surgery had better global improvement and met their goals better compared to patients who chose pessary. PMID:23770473

  4. Measuring the quality of care provided to women with pelvic organ prolapse

    Science.gov (United States)

    Alas, Alexandriah N.; Bresee, Catherine; Eilber, Karyn; Toubi, Karen; Rashid, Rezoana; Roth, Carol; Shekelle, Paul; Wenger, Neil; Anger, Jennifer T.

    2016-01-01

    OBJECTIVE Health care providers are increasingly being evaluated by the quality of care they provide. Our aim was to assess the feasibility of recently developed quality indicators (QIs) for pelvic organ prolapse (POP) and identify possible deficits in care. STUDY DESIGN A panel ranked 14 QIs based on the RAND appropriateness method assessing screening and diagnosis, pessary management, and surgery for POP. Retrospective chart abstraction was performed after identifying patients with a diagnosis of POP evaluated within a hospital-based multispecialty group using International Classification of Diseases, ninth edition, diagnosis codes. RESULTS Of 283 patients identified, 98% of those with a new complaint of vaginal bulge had a pelvic examination. The POP was described but not staged in 6% and not documented at all in 25.1%. Among those managed with pessaries, 98% had vaginal examinations at least every 6 months. Forty-nine percent of the patients who had surgery had complete preoperative POP staging. Only 20% of women undergoing apical surgery had documentation of counseling regarding different surgical options, and of the women who underwent a hysterectomy for POP, only 48% had a concomitant vault suspension. Although 71% had documentation about the risk of postoperative stress incontinence, only 14.5% had documented counseling regarding risks of mesh. Only 37% of patients implanted with mesh for POP had documented follow-up at 1 year. An intraoperative cystoscopy was performed in 86% undergoing cystocele repair or apical surgery. CONCLUSION The quality of care for women with POP can be feasibly measured with QIs. Processes of care were deficient in many areas, and our findings can serve as a basis for quality improvement interventions. PMID:25448523

  5. Laparoscopic Reconstructive Surgery is Superior to Vaginal Reconstruction in the Pelvic Organ Prolapse

    Science.gov (United States)

    Park, Young-Han; Yang, Seong Cheon; Park, Sung Taek; Park, Sung Ho; Kim, Hong Bae

    2014-01-01

    Background: Our purpose was to provide the clinical advantages of the laparoscopic approach compare to the vaginal approach in correcting uterine and vaginal vault prolapse. Methods: Between June 2007 and June 2011, 174 women were admitted to HUMC (Hallym University Medical Center) and underwent pelvic reconstructive surgery for prolapsed vaginal vault and uterus. Upon retrospective review of the medical records, 174 of the patients who had symptoms of pelvic organ prolapsed and Baden-Walker prolapse grade ≥ 2 were selected and divided into two groups as follows: vaginal approach group (n=120) and laparoscopic approach group (n=54). We compared the results of clinical outcome by analyzing Student's t-test and χ2-test or the Fisher exact test as appropriate. Results: There were significant difference in success rates without reoperation for recurrence as 91.7% (vaginal approach group, n=110) vs 100% (laparoscopic approach group, n=54), p=0.032. Mean follow-up duration was 31.3 ± 7.6 months for vaginal approach group and 29.7 ± 9.7 months for laparoscopic approach group. The Foley catheter indwelling duration (4.7± 1.9 vs 3.4±2.1 days, p< 0.001) and the length of postoperative hospitalization (6.4 ± 2.1 vs 5.0 ± 1.9 days, p <0.001) were significantly longer in vaginal approach group, whereas the operative time was significantly longer (108.2 ± 38.6 vs 168.3 ± 69.7 minutes, p <0.001) in laparoscopic approach group. Conclusions: Our result suggest there is significantly lower recurrence rate requiring reoperation and less catheterization time but increased operative time for laparascopic sacrocolpopexy. PMID:25170290

  6. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population

    NARCIS (Netherlands)

    M.C.P. Slieker-ten Hove (Marijke); A.L. Pool-Goudzwaard (Annelies); M.J.C. Eijkemans (René); R.P.M. Steegers-Theunissen (Régine); C.W. Burger (Curt); M.E. Vierhout (Mark)

    2009-01-01

    textabstractIntroduction and hypothesis: In selected populations, pelvic organ prolapse (POP) was associated with bladder/bowel symptoms, but data on the general female population are lacking. Our aim was to obtain normative data on the prevalence of POP and pelvic floor dysfunction (PFD) symptoms

  7. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population.

    NARCIS (Netherlands)

    Slieker-ten Hove, M.C.; Pool-Goudzwaard, A.; Eijkemans, M.J.; Steegers-Theunissen, R.P.M.; Burger, C.W.; Vierhout, M.E.

    2009-01-01

    INTRODUCTION AND HYPOTHESIS: In selected populations, pelvic organ prolapse (POP) was associated with bladder/bowel symptoms, but data on the general female population are lacking. Our aim was to obtain normative data on the prevalence of POP and pelvic floor dysfunction (PFD) symptoms and signs and

  8. [Hemomicrocirculation channel and mastocyte population in outer oblique aponeurosis stomach muscles and uterus ligament in women with small pelvic organ prolapses].

    Science.gov (United States)

    Novruzov, R M

    2008-11-01

    The aim of the research was histochemical and morphometric investigation of microcirculation channel and study of mastocytes in outer oblique aponeurosis stomach muscles and sacrouterine ligaments. The study was carried out on 36 patients with small pelvic organs prolapse and on 22 patients without such. Patients with different forms and severity of small pelvic organs prolapse displayed the reduction of aponeurosis microcirculatory channel, sacrouterine and round ligament of the uterus (pchannel and local aponeurosis secretor regulator apparatus of the outer oblique aponeurosis stomach muscles and the sacrouterine ligaments must be considered in choosing the most suitable method of suspension and fixations of small pelvic organs prolapse.

  9. Prolapso de órganos pélvicos The pelvic organs prolapse

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    Antonio José García López

    2002-01-01

    Full Text Available El prolapso de órganos pélvicos se constituye en una de las indicaciones más frecuentes de cirugía ginecológica y se calcula que se han realizado más de 0.5 millones de procedimientos al año en Estados Unidos. El prolapso de órganos pélvicos a menudo no se hace sintomático hasta que el segmento descendido atraviesa el introito, y en otras ocasiones no se reconoce hasta que está en etapa terminal. Existen múltiples factores que favorecen el prolapso entre los que se encuentran el parto, los trastornos del tejido conectivo, neuropatías, factores congénitos y todos aquellos que conduzcan a un aumento de la presión intraabdominal como la obesidad, tos, ejercicio, etc. Cada uno de los componentes del prolapso de órganos pélvicos, bien sea del compartimiento anterior, medio o posterior, se clasifica por etapas o grados y la sintomatología de cada uno de ellos está directamente relacionada con la epata, siendo más sintomáticos aquellos con un grado más avanzado. La historia clínica, el examen ginecológico y las diversas ayudas diagnósticas se constituyen en la base primordial que darán las pautas para identificar el problema, seleccionar el tratamiento adecuado para cada paciente y lograr el éxito deseado por el médico y esperado por la paciente. The pelvic organs prolapse is constituted in one of the indications most frequently happen in gynaecological surgery and is calculated than they have been accomplished more than 0.5 million of procedures per year in The United States. The pelvic organs prolapse often is not made symptomatic until the descended segment crosses the introito, and in other occasions is not recognized until it is in terminal stage. Exist multiple factors that favor for the prolapse between those which are found the delivery, the disorders of the conective structure, damage to the innervation, congenital factors and all those that drive to an increase in the pressure intraabdominal as the obesity, cough

  10. Pelvic laparoscopy

    Science.gov (United States)

    ... nearby lymph nodes or tissue Chronic (long-term) pelvic pain, if no other cause has been found Ectopic ( ... pregnant or having a baby (infertility) Sudden, severe pelvic pain A pelvic laparoscopy may also be done to: ...

  11. Autocatalytic, bistable, oscillatory networks of biologically relevant organic reactions

    Science.gov (United States)

    Semenov, Sergey N.; Kraft, Lewis J.; Ainla, Alar; Zhao, Mengxia; Baghbanzadeh, Mostafa; Campbell, Victoria E.; Kang, Kyungtae; Fox, Jerome M.; Whitesides, George M.

    2016-09-01

    Networks of organic chemical reactions are important in life and probably played a central part in its origin. Network dynamics regulate cell division, circadian rhythms, nerve impulses and chemotaxis, and guide the development of organisms. Although out-of-equilibrium networks of chemical reactions have the potential to display emergent network dynamics such as spontaneous pattern formation, bistability and periodic oscillations, the principles that enable networks of organic reactions to develop complex behaviours are incompletely understood. Here we describe a network of biologically relevant organic reactions (amide formation, thiolate-thioester exchange, thiolate-disulfide interchange and conjugate addition) that displays bistability and oscillations in the concentrations of organic thiols and amides. Oscillations arise from the interaction between three subcomponents of the network: an autocatalytic cycle that generates thiols and amides from thioesters and dialkyl disulfides; a trigger that controls autocatalytic growth; and inhibitory processes that remove activating thiol species that are produced during the autocatalytic cycle. In contrast to previous studies that have demonstrated oscillations and bistability using highly evolved biomolecules (enzymes and DNA) or inorganic molecules of questionable biochemical relevance (for example, those used in Belousov-Zhabotinskii-type reactions), the organic molecules we use are relevant to metabolism and similar to those that might have existed on the early Earth. By using small organic molecules to build a network of organic reactions with autocatalytic, bistable and oscillatory behaviour, we identify principles that explain the ways in which dynamic networks relevant to life could have developed. Modifications of this network will clarify the influence of molecular structure on the dynamics of reaction networks, and may enable the design of biomimetic networks and of synthetic self-regulating and evolving

  12. Exome sequencing identifies a novel gene, WNK1, for susceptibility to pelvic organ prolapse (POP).

    Science.gov (United States)

    Rao, Shuquan; Lang, Jinghe; Zhu, Lan; Chen, Juan

    2015-01-01

    Pelvic organ prolapse (POP) is a common gynecological disorder; however, the genetic components remain largely unidentified. Exome sequencing has been widely used to identify pathogenic gene mutations of several diseases because of its high chromosomal coverage and accuracy. In this study, we performed whole exome sequencing (WES), for the first time, on 8 peripheral blood DNA samples from representative POP cases. After filtering the sequencing data from the dbSNP database (build 138) and the 1000 Genomes Project, 2 missense variants in WNK1, c.2668G > A (p.G890R) and c.6761C> T (p.P2254L), were identified and further validated via Sanger sequencing. In validation stage, the c.2668G > A (p.G890R) variant and 8 additional variants were detected in 11 out of 161 POP patients. All these variants were absent in 231 healthy controls. Functional experiments showed that fibroblasts from the utero-sacral ligaments of POP with WNK1 mutations exhibited loose and irregular alignment compared with fibroblasts from healthy controls. In sum, our study identified a novel gene, WNK1, for POP susceptibility, expanded the causal mutation spectrums of POP, and provided evidence for the genetic diagnosis and medical management of POP in the future.

  13. Are hypertension and diabetes mellitus risk factors for pelvic organ prolapse?

    Science.gov (United States)

    Isık, Hatice; Aynıoglu, Oner; Sahbaz, Ahmet; Selimoglu, Refika; Timur, Hakan; Harma, Muge

    2016-02-01

    Pelvic organ prolapse (POP) is an important problem for women with multifactorial etiology. This study aims to determine the role of hypertension (HT) and diabetes mellitus (DM) in POP. The study included 586 women admitted to Bulent Ecevit University Hospital between September 2013 and April 2015 for hysterectomy, comprising 186 patients with POP and 400 patients without. The demographic characteristics, age, body mass index (BMI), obstetrical history, type of delivery, associated medical diseases, and benign gynecological diseases were recorded. HT, DM, or both together were particularly considered as coexisting medical diseases. Median gravida, parity, and live birth numbers were significantly higher in POP patients (4 vs. 3, 3 vs. 2, and 3 vs. 2 respectively, p0.05). There was a significant difference between groups regarding comorbid diseases (p<0.001). Logistic regression analysis for risk factors of POP revealed age, BMI, vaginal parturition, and co-morbidity with HT+DM together significantly increased POP risk (p<0.05). HT+DM together significantly increased risks with OR of 1.9 (1.1-3.16). In addition to multiple factors increasing POP risk, comorbidities as HT+DM together should be considered as risk factors. Patients with these comorbidities should be encouraged to change their lifestyles to prevent POP. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Body image perceptions in women with pelvic organ prolapse: a qualitative study.

    Science.gov (United States)

    Lowder, Jerry L; Ghetti, Chiara; Nikolajski, Cara; Oliphant, Sallie S; Zyczynski, Halina M

    2011-05-01

    To describe perceptions of prolapse-specific body image in women with symptomatic prolapse. Women with symptomatic pelvic organ prolapse quantification stage ≥ II prolapse participated in semistructured focus groups or self-report questionnaire. Transcripts were independently reviewed and body image themes were identified and confirmed by consensus. Twenty-five women participated in focus groups and 27 in online questionnaires. Transcript analysis revealed 3 central themes and 25 body-image related subthemes. Women living with prolapse were more likely to feel self-conscious, isolated, "different," less feminine, and less attractive. Women often changed sexual intimacy practices because of embarrassment or discomfort, and many avoided intimacy all together. Prolapse greatly affected women's personal and professional activities causing some women to adjust routines or stop activities. Women reported loss of interest in activities, distraction while performing daily/work-related tasks, and embarrassment when asking for help with activities. Themes identified in this qualitative study demonstrate the profound effect of prolapse on a woman's body image. Copyright © 2011 Mosby, Inc. All rights reserved.

  15. Uterine preservation for advanced pelvic organ prolapse repair: Anatomical results and patient satisfaction.

    Science.gov (United States)

    Fink, Keshet; Shachar, Inbar Ben; Braun, Naama Marcus

    2016-01-01

    The aims of the current study were to evaluate outcomes and patient satisfaction in cases of uterine prolapse treated with vaginal mesh, while preserving the uterus. This is a retrospective cohort study that included all patients operated for prolapse repair with trocar-less vaginal mesh while preserving the uterus between October 2010 and March 2013. Data included: patients pre-and post-operative symptoms, POP-Q and operative complications. Success was defined as prolapse prolapse stage 3, including uterine prolapse of at least stage 2 (mean point C at+1.4 (range+8-(-1)) were included. Mean follow-up was 22 months. Success rate of the vaginal mesh procedure aimed to repair uterine prolapse was 92% (61/66), with mean point C at -6.7 (range (-1) - (-9)). No major intra-or post-operative complication occurred. A telephone survey questionnaire was conducted post-operatively 28 months on average. Ninety-eight percent of women were satisfied with the decision to preserve their uterus. Eighteen patients (34%) received prior consultation elsewhere for hysterectomy due to their prolapse, and decided to have the operation at our center in order to preserve the uterus. Uterine preservation with vaginal mesh was found to be a safe and effective treatment, even in cases with advanced uterine prolapse. Most patients prefer to keep their uterus. Uterus preservation options should be discussed with every patient before surgery for pelvic organ prolapse. Copyright© by the International Brazilian Journal of Urology.

  16. Misconceptions and miscommunication among Spanish-speaking and English-speaking women with pelvic organ prolapse.

    Science.gov (United States)

    Wieslander, Cecilia K; Alas, Alexandriah; Dunivan, Gena C; Sevilla, Claudia; Cichowski, Sara; Maliski, Sally; Eilber, Karyn; Rogers, Rebecca G; Anger, Jennifer T

    2015-04-01

    Limited data exist on women's experience with pelvic organ prolapse (POP) symptoms. We aimed to describe factors that prevent disease understanding among Spanish-speaking and English-speaking women. Women with POP were recruited from female urology and urogynecology clinics in Los Angeles, California, and Albuquerque, New Mexico. Eight focus groups were conducted, four in Spanish and four in English. Topics addressed patients' emotional responses when noticing their prolapse, how they sought support, what verbal and written information was given, and their overall feelings of the process. Additionally, patients were asked about their experience with their treating physician. All interview transcripts were analyzed using grounded theory qualitative methods. Qualitative analysis yielded two preliminary themes. First, women had misconceptions about what POP is as well as its causes and treatments. Second, there was a great deal of miscommunication between patient and physician which led to decreased understanding about the diagnosis and treatment options. This included the fact that women were often overwhelmed with information which they did not understand. The concept emerged that there is a strong need for better methods to achieve disease and treatment understanding for women with POP. Our findings emphasize that women with POP have considerable misconceptions about their disease. In addition, there is miscommunication during the patient-physician interaction that leads to further confusion among Spanish-speaking and English-speaking women. Spending more time explaining the diagnosis of POP, rather than focusing solely on treatment options, may reduce miscommunication and increase patient understanding.

  17. Application effect of pelvic floor three-dimensional ultrasound in the fe-male pelvic organ prolapse%盆底三维超声在盆底器官脱垂女性中的应用效果

    Institute of Scientific and Technical Information of China (English)

    谭玉珍; 曾淑娟

    2015-01-01

    Objective To study the application effect of pelvic floor three-dimensional ultrasound in the female pelvic organ prolapse to provide theoretical basis for clinical diagnosis and therapy. Methods From January to December 2014,50 females with pelvic organ prolapse treated in our hospital and 50 nulliparous healthy women were selected as study objects, the ultrasonic image of two groups were compared and analyzed,and the sonogram of cross section in pelvic floor of two groups was compared,and the morphology and size characteristics of the tissue and organ of pelvic floor were observed. Results Compared with nullipara,pelvic diaphragm crack hole of female pelvic organ prolapse in-creased significantly (P<0.05),and morphological difference was significant,and the mainly performance was nullipara with normal diamond and female pelvic organ prolapse with similar circle,while pubic visceral muscle and synchon-droses pubis cracked in female pelvic organ prolapse and the structure around the vagina was defective. Conclusion Pelvic three-dimensional ultrasound can quickly and effectively sweep of female pelvic floor structure,and patients with pelvic organ prolapse exists abnormality of size,shape and structure of pelvic diaphragm crack hole which has important significance for clinical diagnosis.%目的:探讨盆底三维超声在盆底器官脱垂女性中的应用效果,为临床诊断和治疗提供理论根据。方法选取本院2014年1~12月收治的50例盆底器官脱垂女性与50例未产的健康妇女作为研究对象,对比、分析两组的超声图像结果,比较两组盆底横断面的声像图,观察盆底各组织、器官的形态及大小特点。结果盆底器官脱垂妇女较未产妇的盆膈裂孔明显增大(P<0.05),且形态差异明显,主要表现为未产妇为正常的菱形而盆底脱垂妇女为类圆形,盆底脱垂妇女的耻骨内脏肌与耻骨联合断裂,且阴道周围结构有缺损。结论盆底三维

  18. VOLUNTARY SURGICAL CONTRACEPTION OF WOMEN OF LATE REPRODUCTIVE AGE SUFFERING FROM PELVIC ORGAN PROLAPSE – FEATURES AND BENEFITS

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    Nigina Nasimova

    2015-02-01

    Full Text Available In recent years there has been a noticeable "rejuvenation" of pelvic organ prolapse. Inconsistency of the pelvic floor muscles, including the omission of sexual organs, is extremely common pathology, observed almost a third of women of reproductive age. The search for effective, convenient methods of contraception for this category of patients is an important problem of modern gynecology.We proposed a method of transvaginal voluntary surgical contraception, produced in conjunction with surgical treatment of descent and prolapse of the vaginal walls. Studied the nearest and long-term results of surgery in 50 women to which, during the surgical treatment of genital prolapse at the same time was performed transvaginal occlusion of the fallopian tubes. Control groups consisted of 30 women to which in the first step before surgical correction of pelvic organ prolapse have been performed minilaparotomy and voluntary surgical sterilization (VSS. Our method consists in penetrating into the abdominal cavity through the anterior vaginal vault, downgrading the fallopian tubes with a hook of Ramathibodi and tubal sterilization by Pomeroy method. Intra - and postoperative complications were not observed. In the late postoperative periods - the effectiveness of the method was 100%. Marked tendency to improve the quality of sexual life tells about the positive impact of elimination of genital prolapse with simultaneous DCA on the quality of life of women.

  19. Comparison of connective tissue components in the uterine ligaments between women with and without pelvic organ prolapse.

    Science.gov (United States)

    Bildircin, D; Kokcu, A; Celik, H; Sagir, D; Kefeli, M

    2014-04-01

    Aim of the study was the comparison of the connective tissue components in the uterine ligaments between the women with and without pelvic organ prolapse. This study included 15 postmenopausal women without pelvic organ prolapse who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for benign pathologies (control group) and 15 postmenopausal women who underwent vaginal hysterectomy because of pelvic organ prolapse (POP group). During the operation, samples for histological examination were taken from the cardinal and sacrouterine ligaments. The contents of collagen type I, collagen type III and elastin, and number and mitotic activity of fibroblasts in uterine ligaments were histopatholocially determined. The collagen type I content for the POP group was significantly higher than that of the control group. Collagen type III content, elastin content, and number and mitotic activity of fibroblasts were not significantly different between the control and POP groups. Collagen type I was found to be increased in the uterine ligaments of the POP group. The other connective tissue components did not differ between the two groups.

  20. Pelvic ultrasonography.

    Science.gov (United States)

    Phelan, M B; Valley, V T; Mateer, J R

    1997-11-01

    Pelvic ultrasonography is a valuable tool for the emergency physician in the evaluation of the wide spectrum of pelvic complaints presenting to the emergency department. The goal of this article is to outline pelvic problems that can be readily identified by the emergency physician using pelvic sonography early in the patient's evaluation. A special emphasis is placed on the sonographic diagnosis of ectopic pregnancy.

  1. Evaluation of the Entrance Surface Dose (ESD and Radiation Dose to the Radiosensitive Organs in Pediatric Pelvic Radiography

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    Vahid Karami

    2017-06-01

    Full Text Available Background Patients' dosimetry is crucial in order to enhance radiation protection optimization and to deliver low radiation dose to the patients in a radiological procedure. The aim of this study was to assess the entrance surface dose (ESD and radiation dose to the radiosensitive organs in pediatric pelvic radiography. Materials and Methods The studied population included 98 pediatric patients of both genders referred to anteroposterior (AP projection of pelvic radiography. The radiation dose was directly measured using high radiosensitive cylindrical lithium fluoride thermo-luminescent dosimeters (TLD-GR200. Two TLDs were placed at the center point of the radiation field to measure the ESD of pelvis. Moreover for each patient, 2 TLDs were placed upon each eyelid, 2 TLDs upon each breast, 2 TLDs upon the surface anatomical position of the thyroid gland and finally 2 TLDs at the surface anatomical position of the gonads to measure the received dose. Results The ESD ± standard deviation for AP pelvic radiography was obtained 591.7±76 µGy. Statistically significant difference was obtained between organs located outside and inside of the radiation field with respect to dose received (P

  2. Anorectal and pelvic floor anatomy

    NARCIS (Netherlands)

    J. Stoker

    2009-01-01

    The anorectum and pelvic floor are crucial in maintaining continence, facilitating evacuation, providing pelvic organ support while in females the pelvic floor is part of the birth canal. The anal sphincter is a multilayered cylindrical structure, including the smooth muscle internal sphincter and t

  3. Re: Prevalence of Hydronephrosis in Women with Advanced Pelvic Organ Prolapse

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    Lokman İrkılata

    2015-09-01

    Full Text Available In pelvic organ prolapse (POP patients, hydronephrosis may develop and obstructive uropathy may be encountered as a result. Though the development mechanism of hydronephrosis is not fully known, the most frequently blamed mechanism is voiding dysfunction and bladder outlet obstruction (BOO. This year, Dancz et al. included 180 female patients with POP in their study and determined the prevalence of hydronephrosis with POP and the clinical and urodynamic parameters relating to hydronephrosis. The study was designed as a prospective, observational cohort study researching hydronephrosis in women with advanced degrees of POP. Women with at least +1 points for C, Aa and Ba points on POP-Q investigation were assessed for hydronephrosis. The presence of diabetes mellitus was found to be related to hydronephrosis to a significant degree (8% to 21%, p=0.009. A greater degree of hydronephrosis was observed in those with high mean values of POP degree at Aa, Ba, C and D for anterior and apical POP (p<0.01, however, no such relationship was found for posterior POP. On multi-channel urodynamic tests, hydronephrosis patients had higher residual urine amounts, lower mean first leak volume and higher mean maximum cystometric capacity compared to patients without hydronephrosis. The prevalence of hydronephrosis among women with advanced POP was identified as 30.6%. The authors concluded that diabetes mellitus and the degree of anterior or apical POP were related to hydronephrosis. Urodynamically, increased post voiding residue, higher cystometric capacity and lower volume at first leak were related to hydronephrosis. This study contains important data revealing the relationship between POP and hydronephrosis.

  4. Anatomic outcomes after pelvic-organ-prolapse surgery: comparing uterine preservation with hysterectomy.

    Science.gov (United States)

    Marschalek, Julian; Trofaier, Marie-Louise; Yerlikaya, Guelen; Hanzal, Engelbert; Koelbl, Heinz; Ott, Johannes; Umek, Wolfgang

    2014-12-01

    Pelvic organ prolapse (POP) is of growing importance to gynecologists, as the estimated lifetime risk of surgical interventions due to prolapse or incontinence amounts to 11-19%. Conflicting data exist regarding the effectiveness of POP surgery with and without uterine preservation. We aimed to compare anatomic outcomes in patients with and without hysterectomy at the time of POP-surgery and identify independent risk factors for symptomatic recurrent prolapses. In this single-centre retrospective analysis we analyzed 96 patients after primary surgical treatment for POP. These patients were followed up with clinical and vaginal examination six months postoperatively. For comparison of the groups, the chi-squares test were used for categorical data and the u-test for metric data. A logistic regression model was calculated to identify independent risk factors for recurrent prolapse. Of 96 patients, 21 underwent uterus preserving surgery (UP), 75 vaginal hysterectomy (HE). Median operating time was significantly shorter in the UP group (55 vs. 90min; p=0.000). There was no significant difference concerning postoperative urinary incontinence or asymptomatic relapse (p>0.05), whereas symptomatic recurrent prolapses were significantly more common in the UP group (23.8% vs. 6.7%; p=0.023). However, in multivariate analysis, only vaginal parity and sacrospinous ligament fixation were identified as independent risk factors for recurrent prolapse after POP surgery. Uterus-preservation at time of POP-surgery is a safe and effective alternative for women who wish to preserve their uterus but is associated with more recurrent symptomatic prolapses. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. [Study on the treatment of pelvic organ prolapse complicated with uterine myoma].

    Science.gov (United States)

    Teramoto, Sakiko; Narushima, Masahiro; Kojima, Ippei; Takagi, Yasuharu; Shimoji, Toshio

    2014-10-01

    We studied the association between uterine myoma and recurrent pelvic organ prolapse (POP) after transvaginal mesh (TVM) repair. Between June 2010 and January 2012, 103 female patients (mean age 67.8 years, mean parity 2.3, mean body mass index (BMI) 23.7) with POP underwent TVM procedures at our hospital. Sixtynine patients were qualified as stage 3 according to the POP quantification (POP-Q) system and 34 patients were stage 4. Twenty-six patients underwent anterior TVM (A-TVM) and 77 patients underwent anterior and posterior TVM (AP-TVM). All patients underwent a physical examination using the POP-Q system before and 6 month after surgery. Recurrence of prolapse was defined according to the International Continence Society by a measured value ≥ - 1, as most dependent portion of POP stage 2 or greater. One hundred-three patients were divided into group with uterine myoma larger than 5 cm in diameter and group without uterine myoma. Anatomical outcomes before and after TVM repair were compared between two groups. Preoperative Aa value, Ba value and gh value in group with uterine myoma were greater than in group without uterine myoma. Postoperative Aa value and Ba value in group with uterine myoma were greater than in group without uterine myoma, too. Postoperative recurrence of prolapse of stage 2 or greater was not found a statistical difference between two groups. The risks of anterior vaginal wall descent seem to be high in POP with uterine myoma. Therefore it should be kept in mind on treatment choice.

  6. Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse.

    Science.gov (United States)

    Korbly, Nicole B; Kassis, Nadine C; Good, Meadow M; Richardson, Monica L; Book, Nicole M; Yip, Sallis; Saguan, Docile; Gross, Carey; Evans, Janelle; Lopes, Vrishali V; Harvie, Heidi S; Sung, Vivian W

    2013-11-01

    The purpose of this study was to describe patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse symptoms and to describe predictors of preference for uterine preservation. This multicenter, cross-sectional study evaluated patient preferences for uterine preservation vs hysterectomy in women with prolapse symptoms who were being examined for initial urogynecologic evaluation. Before meeting the physician, the women completed a questionnaire that asked them to indicate their prolapse treatment preference (uterine preservation vs hysterectomy) for scenarios in which the efficacy of treatment varied. Patient characteristics that were associated with preferences were determined, and predictors for uterine preservation preference were identified with multivariable logistic regression. Two hundred thirteen women participated. Assuming outcomes were equal between hysterectomy and uterine preservation, 36% of the women preferred uterine preservation; 20% of the women preferred hysterectomy, and 44% of the women had no strong preference. If uterine preservation was superior, 46% of the women preferred uterine preservation, and 11% of the women preferred hysterectomy. If hysterectomy was superior, 21% of the women still preferred uterine preservation, despite inferior efficacy. On multivariable logistic regression, women in the South had decreased odds of preferring uterine preservation compared with women in the Northeast (odds ratio [OR], 0.17; 95% CI, 0.05-0.66). Women with at least some college education (OR, 2.87; 95% CI, 1.08-7.62) and those who believed that the uterus is important for their sense of self (OR, 28.2; 95% CI, 5.00-158.7) had increased odds for preferring uterine preservation. A higher proportion of women with prolapse symptoms who were examined for urogynecologic evaluation preferred uterine preservation, compared with hysterectomy. Geographic region, education level, and belief that the uterus is important for

  7. Uterine sparing robotic-assisted laparoscopic sacrohysteropexy for pelvic organ prolapse: safety and feasibility.

    Science.gov (United States)

    Lee, Ted; Rosenblum, Nirit; Nitti, Victor; Brucker, Benjamin M

    2013-09-01

    The aim of this study was to describe the surgical technique and report the safety and feasibility of robotic-assisted laparoscopic sacrohysteropexy, a uterine sparing procedure to correct pelvic organ prolapse (POP). Hysterectomy at the time of POP surgery has yet to be proven to improve the durability of repair. Nevertheless, the leading indication for hysterectomy in postmenopausal women is POP. We reviewed the medical records of a consecutive case series of uterine sparing prolapse repair procedures from 2005 to 2011. Fifteen women were identified. Procedures utilized a type I polypropylene mesh securing the posterior uterocervical junction to the sacral promontory. This was later modified to utilize a Y-shaped strip that was inserted through the broad ligaments to include the anterior uterocervical junction. Objective success was defined as Baden Walker grade 0 uterine prolapse and subjective success was defined as no complaint of vaginal bulge or pressure. The mean age of women was 51.8 years (28-64 years). No intraoperative complications were noted. The mean operating time was 159.4 minutes (130-201 minutes) and mean estimated blood loss was 35 mL (0-100 mL). The mean length of stay was 1.6 days (1-4 days) and mean length of follow-up was 10.8 months. Uterine prolapse improved in all 15 patients. Objective success was 93% (14/15) and subjective success was 80% (12/15). Robotic-assisted laparoscopic sacrohysteropexy was found to be a safe and feasible surgical treatment option for POP patients who desire uterine preservation.

  8. Changes in female sexual function after pelvic organ prolapse repair: role of hysterectomy.

    Science.gov (United States)

    Costantini, Elisabetta; Porena, Massimo; Lazzeri, Massimo; Mearini, Luigi; Bini, Vittorio; Zucchi, Alessandro

    2013-09-01

    Incontinence and pelvic organ prolapse (POP) have an impact on sexuality. Few studies evaluate the impact of hysterectomy on sexual function. We designed the present observational prospective longitudinal cohort study in order to evaluate the impact of uterus preservation after POP repair on sexual function. Between January 2006 and January 2011, 107 patients with POP, mean age 58 ± 8.9 years, underwent colposacropexy with or without hysterectomy. All the women without uterine disease were offered the chance to preserve the uterus. All patients gave written informed consent and completed the Female Sexual Function Index (FSFI) questionnaire, before and after surgery, provided detailed case history, underwent urogynaecological examination and urodynamic assessment and completed the Urogenital Distress Inventory short form (UDI-6) and Incontinence Impact on Quality of Life short form (IIQ-7) questionnaires, and the satisfaction Visual Analogue Scale (VAS). One year after surgery patients repeated the FSFI questionnaire and underwent a clinical check-up. The primary end-point was post-operative sexual function as evaluated by the FSFI, the secondary end-points were objective anatomical and subjective success, defined respectively as no prolapse and no incontinence-related symptoms. Sixty-eight patients were included: 32 underwent uterus-sparing surgery and 36 hysterectomy plus colposacropexy. After surgery both groups had significant improvements in the total FSFI score and in the domains of desire, arousal and orgasm. The median post-operative scores of desire, arousal, and orgasm domains showed significant improvements in the uterus-sparing group compared with the hysterectomy group. None of the women had a uterine or vault prolapse recurrence. Our data demonstrate that POP plays a role in female sexual dysfunction and uterus sparing surgery is associated with a greater improvement in sexual function.

  9. Medium-term comparison of uterus preservation versus hysterectomy in pelvic organ prolapse treatment with Prolift™ mesh.

    Science.gov (United States)

    Huang, Li-Yi; Chu, Li-Ching; Chiang, Hsin-Ju; Chuang, Fei-Chi; Kung, Fu-Tsai; Huang, Kuan-Hui

    2015-07-01

    We conducted a medium-term assessment of clinical outcomes and complications after surgical repair of pelvic organ prolapse (POP) using Prolift™ mesh, and sought to determine whether concomitant hysterectomy clinically influenced the outcome of pelvic reconstruction in patients without a prior history of urogenital surgery. Patients diagnosed with POP-Q stage 3/4 uterine prolapse at a tertiary referral urogynecology unit in South Taiwan who had undergone POP repair with Prolift mesh from May 2007 to July 2010 were identified by chart review. Concomitant hysterectomy was performed in 24 patients (hysterectomy group), and uterus-sparing surgery in 78 (uterus-sparing group) Preoperative and postoperative subjective assessments of urinary and prolapse symptoms, objective POP-Q score, urodynamic examination, and postoperative adverse events were compared between the groups. The mean follow-up periods were 25.7 months (range 6.2 - 73.1 months) and 31.7 months (range 6.0 - 78.4 months) in the concomitant hysterectomy and uterus-sparing groups, respectively. There were no between-group differences in functional and anatomic outcomes after surgery. No statistically significant differences were found in postoperative adverse events between the groups. Pelvic reconstruction using Prolift with concomitant hysterectomy and uterus-sparing surgery have similar anatomic and functional results at 2.5 years. Therefore, we consider uterus-sparing surgery to be an alternative to hysterectomy in uterine prolapse repair.

  10. Nursing experience of PROSIMA GYNECARE pelvic floor reconstruction in the treatment of pelvic organ prolapse%GYNECARE PROSIMA盆底重建术治疗盆腔脏器脱垂的护理体会

    Institute of Scientific and Technical Information of China (English)

    蒲静

    2015-01-01

    总结了我院对7例盆腔脏器脱垂患者实施GYNECARE PROSIMA盆底重建术,通过充分的术前准备和术后护理,无并发症发生,因此恰当的护理是GYNECARE PROSIMA盆底重建术成功的重要因素之一。%Summarizes our hospital on 7 cases of pelvic organ prolapse implementation GYNECARE PROSIMA pelvic floor reconstruction, by sufficient preoperative preparation and postoperative nursing care, no complications occurred, so proper care is one of the important factors in success of the operation GYNECARE PROSIMA pelvic floor reconstruction Abstract.

  11. Comparison of the anogenital distance and anthropometry of the perineum in patients with and without pelvic organ prolapse.

    Science.gov (United States)

    Sánchez-Ferrer, M L; Moya-Jiménez, L C; Mendiola, J

    2016-12-01

    To determine whether there are differences in the anthropometric measures of the perineum for women with symptomatic pelvic organ prolapse who are candidates for surgery, with or without urinary incontinence, and for patients without pelvic floor dysfunction. The main objective was to measure the anogenital distance in its 2 variants: anoclitoral and anofourchette. The anogenital distance appears to be determined prenatally and is influenced by the intrauterine hormonal environment. The secondary objective was to measure the length of the genital hiatus, the perineal body and the distance between the 2 ischial tuberosities. An observational case-control study was conducted with 58 patients. The cases (n=22) were patients with stages >II 2 in the Baden-Walker classification system. The controls were patients with normal pelvic floors. Measurements were performed with a digital calliper. The patients' tocogynecological history, lifestyle habits and risk factors were recorded. The case patients had a significantly shorter anogenital anofourchette distance than that of the control patients (P=.001), a significantly longer anogenital anoclitoral distance than the control patients (P=.0001) and a significantly longer genital hiatus length than the control patients (P=.02). This was an observational study with a small sample. We cannot determine whether the difference in these distances are caused by or are the result of this disease. Given that the anogenital distance appears to be determined prenatally, we question whether this changed distance could be a risk factor for developing pelvic floor dysfunction. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Quality of life assessment in women after cervicosacropexy with polypropylene mesh for pelvic organ prolapse: a preliminary study

    Directory of Open Access Journals (Sweden)

    Wojciech Majkusiak

    2015-06-01

    Full Text Available Aim of the study was to assess the changes in the subjective perception of quality of life in patients who underwent abdominal cervicosacropexy for pelvic organ prolapse. Material and methods: Forty patients with diagnosed pelvic organ prolapse (Pelvic Organ Prolapse – Quantification [POPQ] stage IV or IIIC underwent abdominal supracervical hysterectomy and cervicosacropexy. The questionnaire concerning the quality of life was filled in before and 6 months after the surgery. Results: In all patients, an accurate prolapse correction was achieved. In 42% of patients, stress urinary incontinence (SUI was diagnosed prior to surgery, while after the surgery in 38.24% (p > 0.05. In 50% of women, symptoms of overactive bladder (OAB occurred pre-surgery. These symptoms were reported by 17.65% of patients postoperatively (p < 0.05. Urinary retention was observed in 32.36% before and in 2.5% after the surgery (p < 0.05. The average score of the quality of sexual life was 5.75 (SD 2.52, 95% CI: 4.41-7.1 before and increased to 7.93 (SD 1.77, 95% CI: 6.9-8.95 after the procedure (p < 0.05. The mean score of the overall quality of life in relation to POP before and after the procedure was 2.77 (SD 2.39, 95% CI: 1.87-8.64 and 9.03 (SD 1.08, 95% CI: 8.66-9.43, respectively (p < 0.001. Conclusions: These results show a highly significant improvement of the quality of life in patients who underwent abdominal cervicosacropexy for POP. The change in quality of their sexual life, reduced OAB and urinary retention rates, as well as improvement of the esthetic self-perception may have contributed to this positive effect.

  13. Reduced BMP Signaling Results in Hindlimb Fusion with Lethal Pelvic/Urogenital Organ Aplasia: A New Mouse Model of Sirenomelia

    Science.gov (United States)

    Suzuki, Kentaro; Adachi, Yasuha; Numata, Tomokazu; Nakada, Shoko; Yanagita, Motoko; Nakagata, Naomi; Evans, Sylvia M.; Graf, Daniel; Economides, Aris; Haraguchi, Ryuma; Moon, Anne M.; Yamada, Gen

    2012-01-01

    Sirenomelia, also known as mermaid syndrome, is a developmental malformation of the caudal body characterized by leg fusion and associated anomalies of pelvic/urogenital organs including bladder, kidney, rectum and external genitalia. Most affected infants are stillborn, and the few born alive rarely survive beyond the neonatal period. Despite the many clinical studies of sirenomelia in humans, little is known about the pathogenic developmental mechanisms that cause the complex array of phenotypes observed. Here, we provide new evidences that reduced BMP (Bone Morphogenetic Protein) signaling disrupts caudal body formation in mice and phenocopies sirenomelia. Bmp4 is strongly expressed in the developing caudal body structures including the peri-cloacal region and hindlimb field. In order to address the function of Bmp4 in caudal body formation, we utilized a conditional Bmp4 mouse allele (Bmp4flox/flox) and the Isl1 (Islet1)-Cre mouse line. Isl1-Cre is expressed in the peri-cloacal region and the developing hindimb field. Isl1Cre;Bmp4flox/flox conditional mutant mice displayed sirenomelia phenotypes including hindlimb fusion and pelvic/urogenital organ dysgenesis. Genetic lineage analyses indicate that Isl1-expressing cells contribute to both the aPCM (anterior Peri-Cloacal Mesenchyme) and the hindlimb bud. We show Bmp4 is essential for the aPCM formation independently with Shh signaling. Furthermore, we show Bmp4 is a major BMP ligand for caudal body formation as shown by compound genetic analyses of Bmp4 and Bmp7. Taken together, this study reveals coordinated development of caudal body structures including pelvic/urogenital organs and hindlimb orchestrated by BMP signaling in Isl1-expressing cells. Our study offers new insights into the pathogenesis of sirenomelia. PMID:23028455

  14. Reduced BMP signaling results in hindlimb fusion with lethal pelvic/urogenital organ aplasia: a new mouse model of sirenomelia.

    Directory of Open Access Journals (Sweden)

    Kentaro Suzuki

    Full Text Available Sirenomelia, also known as mermaid syndrome, is a developmental malformation of the caudal body characterized by leg fusion and associated anomalies of pelvic/urogenital organs including bladder, kidney, rectum and external genitalia. Most affected infants are stillborn, and the few born alive rarely survive beyond the neonatal period. Despite the many clinical studies of sirenomelia in humans, little is known about the pathogenic developmental mechanisms that cause the complex array of phenotypes observed. Here, we provide new evidences that reduced BMP (Bone Morphogenetic Protein signaling disrupts caudal body formation in mice and phenocopies sirenomelia. Bmp4 is strongly expressed in the developing caudal body structures including the peri-cloacal region and hindlimb field. In order to address the function of Bmp4 in caudal body formation, we utilized a conditional Bmp4 mouse allele (Bmp4(flox/flox and the Isl1 (Islet1-Cre mouse line. Isl1-Cre is expressed in the peri-cloacal region and the developing hindimb field. Isl1Cre;Bmp4(flox/flox conditional mutant mice displayed sirenomelia phenotypes including hindlimb fusion and pelvic/urogenital organ dysgenesis. Genetic lineage analyses indicate that Isl1-expressing cells contribute to both the aPCM (anterior Peri-Cloacal Mesenchyme and the hindlimb bud. We show Bmp4 is essential for the aPCM formation independently with Shh signaling. Furthermore, we show Bmp4 is a major BMP ligand for caudal body formation as shown by compound genetic analyses of Bmp4 and Bmp7. Taken together, this study reveals coordinated development of caudal body structures including pelvic/urogenital organs and hindlimb orchestrated by BMP signaling in Isl1-expressing cells. Our study offers new insights into the pathogenesis of sirenomelia.

  15. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...

  16. [PELVIC FLOOR RECONSTRUCTION AFTER PELVIC EVISCERATION USING GRACILIS MUSCULOCUTANEOUS FLAP].

    Science.gov (United States)

    Pavlov, V N; Bakirov, A A; Kabirov, I R; Izmajlov, A A; Kutlijarov, L M; Safiullin, R L; Urmancev, M F; Sultanov, I M; Abdrahimov, R V

    2015-01-01

    Evisceration of the pelvic organs (EPO) is a fairly uncommon surgical treatment that removes all organs from a patient's pelvic cavity. We use gracilis musculocutaneous flap to repair pelvic floor after EPO. Over the period from November 2013 to December 2014 we carried out EPO with reconstructive repair of the pelvic floor with gracilis musculocutaneous flap in 10 patients with locally advanced pelvic tumors. We describe the surgical procedure and surgical outcomes in these patients. Mean age of the patients was 55 years. Mean duration of EPO with the pelvic floor repair was 285 min., mean blood loss--595 mL and the average length of hospital stay--19 days. Gracilis musculocutaneous flap has a sufficient arterial supply and mobility for pelvic floor reconstruction. Necrosis of flap's distal edge occurred in one of the 10 clinical cases, while the remaining flaps were fully preserved. Complete healing of wounds with no signs of weakening of the pelvic floor muscles was observed in all cases. Pelvic floor reconstruction is an essential procedure in order to reduce complications associated with the evisceration of the pelvic organs. The Gracilis musculocutaneous flap is the logical alternative to repair pelvic floor defect. It does not contribute to complications like functional deficiency of the lower limbs, complications of stoma formation or weakening of the muscles of the anterior abdominal wall.

  17. Role of different childbirth strategies on pelvic organ prolapse and stress urinary incontinence: a prospective study

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence (SUI) and pelvic organ prolapse (POP).The aim of this study was to prospectively investigate the role of different childbirth strategies on POP and SUI.Methods A total of 120 selected pregnant women were recruited and divided into two groups:vaginal delivery group (n=72)and selective cesarean delivery group(n=48).The women were questioned with SUI sheet and estimated with POP quantification (POP-Q) within 6-8 weeks after delivery.The correlations of SUI and results of POP-Q with the strategies of delivery were analyzed.ttest,X2 test,and the Mann-Witney test were used for statistical analysis.Results Among the 120 women,SUI was developed during 29-30 gestational weeks in 20 patients (16.6%),of whom 14 (70%) had symptoms of SUI till 6 weeks postpartum. Totally 20 (16.6%) women had SUI symptoms after delivery.The prevalence of postpartum SUI was positively correlated with the occurrence of SUI during 29-30 gestational weeks (P<0.001).In the vaginal delivery group,100% of the women suffered form urinary prolapse 6 weeks postpartum,while 87.5% of those in the selective cesarean delivery group developed POP (P<0.01). The percentages of the first-and second-degree urinary prolapse in the vaginal delivery group were 20.8% and 79.2% respectively,which were significantly different from those in the selective cesarean delivery group (64.6% and 22.9%;both P=0.000).Conclusions Pregnancy and delivery play an etiologic role in the development of SUI and POP. The onset of SUI during late pregnancy implies a significant risk of postpartum SUI symptoms.The prevalence of POP is significantly higher after vaginal delivery than after cesarean delivery.

  18. Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse-A prospective multicenter study

    DEFF Research Database (Denmark)

    Rahkola-Soisalo, Päivi; Altman, Daniel; Falconer, Christian

    2017-01-01

    OBJECTIVE: To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold™ System. STUDY DESIGN: In this prospective cohort study, women (n=207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold™ Vaginal......-year follow-up majority of women experienced an overall postoperative improvement in quality of life (pprolapse related bother as compared to Uphold™ combined with anterior colporraphy (POP-IQ-7; OR 2.1; 95% CI 1...... no significant changes. CONCLUSION: Apical prolapse repair using Uphold™ improved quality of life among our patients but worsened overall sexual function postoperatively....

  19. Water Remedial Gymnastics as a Component of Preconception Training of Patients with Chronic Inflammatory Diseases of Pelvic Organs

    Directory of Open Access Journals (Sweden)

    K.V. Gordon

    2012-06-01

    Full Text Available The article considers medical and preventive efficiency of remedial gymnastics in fresh water swimming pool and thalassotherapy in the course of preconception training of 370 gynecological patients, suffering from chronic inflammatory diseases of pelvic organs and planning pregnancy. Combination of water remedial gymnastics, as well as natural and preformed physical therapeutic factors for complex preconception training enables to normalize women psycho-vegetative and immune status, increases chances of pregnancy by 10 % and has a positive impact on gestation process, helping to reduce risk of pathologic pregnancy and perinatal diseases.

  20. Current Concepts of Pelvic Congestion and Chronic Pelvic Pain

    Science.gov (United States)

    2001-01-01

    Chronic pelvic pain in women is a common and disabling illness caused by numerous organic pathologies usually accompanied by varying psychological dysfunctions. Many patients may receive misdiagnosis, misdirected therapies, or do not seek help at all. Pelvic congestion may be responsible for pain in patients without more common diseases, such as endometriosis and pelvic adhesions, among others. Our view of this condition is evolving. In the United States, this medical condition remains controversial. More recent research from the United Kingdom has caused a fresh look at the diagnosis and treatment of chronic pelvic pain produced by pelvic congestion. Potentially, many patients may benefit from a reconsideration of this approach. PMID:11394421

  1. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case–control study

    Directory of Open Access Journals (Sweden)

    Asresie A

    2016-12-01

    Full Text Available Ayalnesh Asresie,1 Eleni Admassu,2 Tesfaye Setegn2 1Hamlin Fistula Center, Amhara National Regional State, Bahir Dar, Ethiopia; 2Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia Introduction: Pelvic organ prolapse (POP is a significant public health problem in developing countries including Ethiopia. However, less has been documented on risk factors of POP. Therefore, the aim of this study was to identify the determinants factors of POP. Methods: An unmatched case–control study was conducted among gynecologic patients in Bahir Dar city, North West Ethiopia, from July to October 2014. A total of 370 women (selected from outpatient departments were included in the study. Cases (clients with stage III or IV POP and controls (who declared free of any stages of POP were identified by physicians using the Pelvic Organ Prolapse Quantitative Examination tool. Data analysis was carried out by SPSS version 20.0. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Statistical differences were considered at P<0.05, and the strength of association was assessed by odds ratio (OR and respective confidence intervals (CIs. Results: This study revealed that determinants such as age of women (>40 years (adjusted OR [AOR] =3.0 [95% CI: 1.59–5.89], sphincter damage (AOR =8.1 [95% CI: 1.67–39.7], family history of POP (AOR =4.9 [95% CI: 1.94–12.63], parity (≥4 (AOR =4.5 [95% CI: 2.26–9.10], nonattendance of formal education (AOR =4.3 [95% CI: 1.25–14.8], carrying heavy objects (AOR =3.1 [95% CI: 1.56–6.30], body mass index (BMI <18.5 kg/m2 (AOR =3.1 [95% CI: 1.22–7.82], and delivery assisted by nonhealth professionals (AOR =2.6 [95% CI: 1.24–5.56] were significantly associated with POP. Conclusion: In our study, sphincter damage, family history of POP, being uneducated, having ≥4 vaginal

  2. Pelvic radiation - discharge

    Science.gov (United States)

    Radiation of the pelvis - discharge; Cancer treatment - pelvic radiation; Prostate cancer - pelvic radiation; Ovarian cancer - pelvic radiation; Cervical cancer - pelvic radiation; Uterine cancer - pelvic radiation; Rectal cancer - pelvic radiation

  3. [Utilize the simplified POP-Q system in the clinical practice of staging for pelvic organ prolapse: comparative analysis with standard POP-Q system].

    Science.gov (United States)

    Zhang, H; Zhu, L; Xu, T; Lang, J H

    2016-07-25

    To determine the association between simplified pelvic organ prolapse quantification system(S-POP-Q)and the standard pelvic organ prolapse quantification system(POP-Q)in describing pelvic organ prolapse. This was an observational study. From Jan. 2010 to Jan. 2014, 256 subjects with pelvic floor disorder symptoms underwent two exams: a POP-Q exam and a S-POP-Q exam. For the S-POP-Q system, vaginal segments of the exam were defined using points Ba, Bp, C, and D. For the POP-Q system vaginal segments of the exam were defined using points Aa, Ba, Ap, Bp, C, and D. The inter-system consistency between the overall ordinal stages, the anterior vaginal wall stages, the posterior vaginal wall stages, the cervix stages, the posterior fornix or vaginal cuff stages from each two kind of exam were compared. The Kendall tau-b correlation coefficient for overall stage was 0.81, the Kendall tau-b correlation coefficients were 0.81, 0.81, 0.85, 0.88 for the anterior vaginal wall, for the posterior vaginal wall, for the cervix, for the posterior fornix or vaginal cuff, respectively. There is almost perfect association between S-POP-Q and POP-Q in describing pelvic organ prolapse.

  4. An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP).

    Science.gov (United States)

    Haylen, Bernard T; Maher, Christopher F; Barber, Matthew D; Camargo, Sérgio; Dandolu, Vani; Digesu, Alex; Goldman, Howard B; Huser, Martin; Milani, Alfredo L; Moran, Paul A; Schaer, Gabriel N; Withagen, Mariëlla I J

    2016-02-01

    The terminology for female pelvic floor prolapse (POP) should be defined and organized in a clinically-based consensus Report. This Report combines the input of members of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by external referees. Appropriate core clinical categories and a sub-classification were developed to give a coding to definitions. An extensive process of fourteen rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). A Terminology Report for female POP, encompassing over 230 separate definitions, has been developed. It is clinically-based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction and POP. Female-specific imaging (ultrasound, radiology and MRI) and conservative and surgical managements are major additions and appropriate figures have been included to supplement and clarify the text. Emerging concepts and measurements, in use in the literature and offering further research potential, but requiring further validation, have been included as an appendix. Interval (5-10 year) review is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based Terminology Report for female POP has been produced to aid clinical practice and research. © 2016 Wiley Periodicals, Inc., and The International Urogynecological Association.

  5. Symptomatic and quality of life outcomes after site-specific fascial reattachment for pelvic organ prolapse repair.

    Science.gov (United States)

    Fayyad, Abdalla M; Redhead, Emma; Awan, Noveen; Kyrgiou, Maria; Prashar, Sanjeev; Hill, Simon R

    2008-02-01

    The aim of this study was to assess symptomatic and quality of life outcome scores following site specific fascial reattachment surgery for pelvic organ prolapse using the validated Prolapse Quality of Life (P-QOL) questionnaires. One hundred and ninety two women underwent surgery for pelvic organ prolapse; ninety four underwent anterior repair (thirty four of them had vaginal hysterectomy), and ninety eight had posterior repair. Patients filled P-QOL questionnaires 24 hours prior to surgery and a postal P-QOL questionnaire six months post operatively. Pre and post operative questionnaires were paired. Quality of life and symptoms scores were calculated using Wilcoxon signed rank test. One hundred and one women returned their questionnaires and were suitable to include in the study. Forty nine underwent anterior repair (fifteen had vaginal hysterectomy) and 52 underwent posterior repair. Quality of life scores showed significant improvement in the anterior and posterior repair groups with the exception of general health in the anterior repair group and general health and prolapse impact in the posterior repair group. Anterior repair significantly improved urinary voiding and storage symptoms. Posterior repair group showed significant improvement in defecatory symptoms. Both groups showed improvement in sexual function and general prolapse symptoms. Prolapse repair with site specific fascial reattachment results in significant improvement in quality of life scores six months after surgery. Anterior repair improves urinary voiding and storage symptoms and posterior repair improves defecatory dysfunction and urinary voiding. Sexual function improves following prolapse repair with site specific fascial reattachment.

  6. Patient beliefs regarding hysterectomy in women seeking surgery for pelvic organ prolapse: findings in a predominantly Hispanic population.

    Science.gov (United States)

    Wong, Keri; Jakus-Waldman, Sharon; Yazdany, Tajnoos

    2014-01-01

    This study aimed to determine the proportion of women who opt for hysterectomy when seeking care for pelvic organ prolapse and the factors important in their decision making. One hundred twenty-four patients from July 2011 through August 2012 seeking care for pelvic organ prolapse were recruited to complete a questionnaire regarding their beliefs about uterine preservation at the time of prolapse repair, as well as the PFDI-7 and PSIQ-12. Patients completed a questionnaire before physician consultation that included demographic data, beliefs regarding the social, sexual, and emotional impact of hysterectomy, and sources of information. The women were predominantly Hispanic (77.4%), postmenopausal (65.3%), and sexually active (42.7%). Almost half of the women had a limited education level, defined as no high school degree (49.2%), and the majority of the women had an annual income of less than $25,000 (66.9%). Thirty-one percent of patients desired to retain their uterus at the time of prolapse repair when given the choice. Most patients received information from their health care provider and family members, very few from the Internet or media sources. Thirty-one percent of the largely Hispanic women with lower income in this study would choose to preserve their uterus at the time of prolapse repair, a proportion lower than what was reported from previous studies performed in white women with higher income.

  7. Erratum to: An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP)

    NARCIS (Netherlands)

    Haylen, Bernard T.; Maher, Christopher F.; Barber, Matthew D.; Camargo, Sérgio; Dandolu, Vani; Digesu, Alex; Goldman, Howard B.; Huser, Martin; Milani, Alfredo L.; Moran, Paul A.; Schaer, Gabriel N.; Withagen, Mariëlla I J

    2016-01-01

    Introduction: The terminology for female pelvic floor prolapse (POP) should be defined and organized in a clinically-based consensus Report. Methods: This Report combines the input of members of two International Organizations, the International Urogynecological Association (IUGA) and the Internatio

  8. Myofascial pelvic pain.

    Science.gov (United States)

    Kotarinos, Rhonda

    2012-10-01

    Myofascial pelvic pain is fraught with many unknowns. Is it the organs of the pelvis, is it the muscles of the pelvis, or is the origin of the pelvic pain from an extrapelvic muscle? Is there a single source or multiple? In this state of confusion what is the best way to manage the many symptoms that can be associated with myofascial pelvic pain. This article reviews current studies that attempt to answer some of these questions. More questions seem to develop as each study presents its findings.

  9. In vivo properties of uterine suspensory tissue in pelvic organ prolapse.

    Science.gov (United States)

    Luo, Jiajia; Smith, Tovia M; Ashton-Miller, James A; DeLancey, John O L

    2014-02-01

    The uterine suspensory tissue (UST), which includes the cardinal (CL) and uterosacral ligaments (USL), plays an important role in resisting pelvic organ prolapse (POP). We describe a technique for quantifying the in vivo time-dependent force-displacement behavior of the UST, demonstrate its feasibility, compare data from POP patients to normal subjects previously reported, and use the results to identify the properties of the CL and USL via biomechanical modeling. Fourteen women with prolapse, without prior surgeries, who were scheduled for surgery, were selected from an ongoing study on POP. We developed a computer-controlled linear servo actuator, which applied a continuous force and simultaneously recorded cervical displacement. Immediately prior to surgery, the apparatus was used to apply three "ramp and hold" trials. After a 1.1 N preload was applied to remove slack in the UST, a ramp rate of 4 mm/s was used up to a maximum force of 17.8 N. Each trial was analyzed and compared with the tissue stiffness and energy absorbed during the ramp phase and normalized final force during the hold phase. A simplified four-cable model was used to analyze the material behavior of each ligament. The mean ± SD stiffnesses of the UST were 0.49 ± 0.13, 0.61 ± 0.22, and 0.59 ± 0.2 N/mm from trial 1 to 3, with the latter two values differing significantly from the first. The energy absorbed significantly decreased from trial 1 (0.27 ± 0.07) to 2 (0.23 ± 0.08) and 3 (0.22 ± 0.08 J) but not from trial 2 to 3. The normalized final relaxation force increased significantly with trial 1. Modeling results for trial 1 showed that the stiffnesses of CL and USL were 0.20 ± 0.06 and 0.12 ± 0.04 N/mm, respectively. Under the maximum load applied in this study, the strain in the CL and USL approached about 100%. In the relaxation phase, the peak force decreased by 44 ± 4% after 60 s. A servo actuator apparatus and intraoperative

  10. Functional imaging of the pelvic floor

    Energy Technology Data Exchange (ETDEWEB)

    Lienemann, Andreas E-mail: andreaslienemann@web.de; Fischer, Tanja

    2003-08-01

    Introduction/Objective: Pelvic floor dysfunction and associated pelvic organ prolapse represent a major problem in our present-day society, mostly afflicting parous women. Magnetic resonance imaging (MRI) is assuming an increasingly important role in the more accurate delineation of the extent of the problem. This article briefly reviews one of the main radiological methods for the dynamic evaluation of the pelvic floor: functional cine MRI. Methods and Material: Out of the literature the smallest common denominator for functional cine MRI can be defined as follows: high field system; patient either in supine or sitting position; fast gradient echo sequence; midsagittal slice orientation; either a stack of slices or repeated measurements at the same slice position with the patient at rest or straining; image analysis using the pubococcygeal reference line. Results: All except two publications stress the usefulness of functional cine MRI in the evaluation of patients with organ descent and prolapse. This well accepted method allows for the visualization of all relevant structures in the anterior, middle and posterior compartment. It is especially useful in the detection of enteroceles, and provides a reliable postoperative follow-up tool. Isolated urinary or stool incontinence are not an indication for functional cine MRI, as is the case in patients with equivocal clinical findings. To date it does not allow for real 3D imaging of the pelvic floor or sufficient determination of fascial defects. Discussion: Functional cine MRI of the pelvic floor is a promising new imaging method for the detection of organ descent and prolapse in patients with equivocal clinical findings. The combination of function and morphology allows for an innovative view of the pelvic floor, and thus adds to our understanding of the various interactions of the structures.

  11. 盆腔器官脱垂患者全盆底悬吊术后生活质量调查%Investigationon of life quality in patients with pelvic organ prolapse suspension after pelvic floor suspension surgery

    Institute of Scientific and Technical Information of China (English)

    热孜万古丽·艾尼; 丁岩; 万晓慧; 马涛

    2014-01-01

    Objective To evaluate the quality of life for patient with pelvic organ prolapse after the whole pelvic floor suspension surgery.Methods A total of 80 patients with POP-Q stage II and above underwent the whole pelvic floorsuspension surgery were enrolled.According to the incontinence quality of life questionnaire (I-QOL),the sexual life quality questionnaire,pelvic floor functional impact questionnaire Short Form-7 (PFIQ-7),pelvic floor dys-function questionnaire (PFDI-20),the quality of life questionnaire was produced,and quality of life ofthe preopera-tive,postoperative in patient with pelvic floor prolapsed were compared.Results There were significant difference in the quality of life at the 6 months and 1 year after operation(F=1837.685,P<0.05).Conclusion The pelvic floor sling surgery significantly improve the short-term quality of life in patients with POP.%目的:评价盆腔脏器脱垂的患者行全盆底悬吊术后的生活质量的改善状况。方法对80例POP-Q分期II度及以上的盆腔脏器脱垂的患者行全盆底悬吊术。根据尿失禁生活质量问卷(I-QOL)、性生活质量问卷、盆底功能影响问卷-短表7(PFIQ-7)、盆底功能障碍问卷(PFDI-20)制作全盆悬吊术后生活质量调查表来比较患者术前、术后的生活质量。结果患者术后6个月及术后1年生活质量较术前明显提高(F=1837.685,P<0.05)。结论全盆底悬吊术可明显改善POP患者的近期生活质量。

  12. Dynamic magnetic resonance imaging for assessment of minimally invasive pelvic floor reconstruction with polypropylene implant

    Energy Technology Data Exchange (ETDEWEB)

    Siegmann, Katja C., E-mail: katja.siegmann@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Reisenauer, Christl, E-mail: christl.reisenauer@med.uni-tuebingen.de [Department of Obstetrics and Gynaecology, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen (Germany); Speck, Sina, E-mail: sina.speck@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Barth, Sonja, E-mail: sonja.barth@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Kraemer, Bernhard, E-mail: bernhard.kraemer@med.uni-tuebingen.de [Department of Obstetrics and Gynaecology, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen (Germany); Claussen, Claus D., E-mail: claus.claussen@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)

    2011-11-15

    Introduction: The purpose of the study was to assess the usefulness of dynamic MRI in patients with pelvic organ prolapse after pelvic floor repair with polypropylene mesh. Materials and methods: Fifteen consecutive patients (mean age 66.5 years) who were scheduled for either anterior (n = 9) or posterior (n = 6) pelvic floor repair were prospectively evaluated by clinical assessment and dynamic MRI 1 day before and 3 months after surgery. MRI diagnoses and MRI measurements of relevant anatomical points at rest and on straining were analysed before and after surgery. Results: At follow-up assessment 93.3% of all patients were clinically cured. Dynamic MRI showed newly developed (n = 6) or increased (n = 6) pelvic organ prolapse in 80% (n = 12) of all patients 3 months after pelvic floor repair. Most of them (n = 11; 91.7%) affected the untreated pelvic floor compartment. On straining anatomical points of reference in the anterior pelvic floor compartment were significantly (p < 0.05) elevated after anterior repair and rectal bulging was significantly (p = 0.036) reduced after posterior pelvic floor repair. Conclusions: In this study dynamic MRI could verify the effective support of anterior and posterior pelvic floor structures by anterior and posterior polypropylene implant respectively. But dynamic MRI demonstrates if one compartment of the pelvic floor is repaired another compartment frequently (73.3%) develops dysfunction. These results did not correspond to clinical symptoms on short-term follow-up (3 months). Studies with long-term follow-up are necessary to prove if dynamic MRI can reliably identify clinically significant pelvic organ prolapse after pelvic floor repair before the onset of symptoms.

  13. Changes of glycoprotein and collagen immunolocalization in the uterine artery wall of postmenopausal women with and without pelvic organ prolapse.

    Science.gov (United States)

    Goepel, Christian; Johanna Kantelhardt, Eva; Karbe, Ina; Stoerer, Sandra; Dittmer, Juergen

    2011-05-01

    Pelvic organ prolapse (POP) is accompanied by an altered composition of the extracellular matrix (ECM). However, it is unclear whether the changed ECM is the cause or the consequence of POP, as stretching of the tissue may have an effect on the composition of the ECM. To address this question, we analyzed the connective tissues of the uterine artery wall of postmenopausal women with and without POP. The uterine artery wall is stretched in patients with POP, but this stretching is unlikely to cause the POP. Twenty-one women (13 with POP and 8 without POP) hospitalized for hysterectomy were included in this study. Tissue samples from the uterine artery were analyzed for collagen (types I, III, IV, V and VI) and other ECM proteins (fibronectin, laminin, tenascin, vitronectin and elastin) using immunofluorescence microscopy. Results revealed that uterine artery samples of women with prolapse showed a significantly weaker immunoreactivity to type VI collagen, vitronectin and elastin and a stronger immunostaining for type III collagen and tenascin as compared to control samples. Our results suggest that the ECM may be altered in response to mechanical stretch. Changes in the ECM composition as observed in POP may not necessarily be the reason for the development of pelvic floor relaxation in postmenopausal women. Copyright © 2010 Elsevier GmbH. All rights reserved.

  14. Verification of the Chromosome Region 9q21 Association with Pelvic Organ Prolapse Using RegulomeDB Annotations

    Directory of Open Access Journals (Sweden)

    Maryam B. Khadzhieva

    2015-01-01

    Full Text Available Pelvic organ prolapse (POP is a common highly disabling disorder with a large hereditary component. It is characterized by a loss of pelvic floor support that leads to the herniation of the uterus in or outside the vagina. Genome-wide linkage studies have shown an evidence of POP association with the region 9q21 and six other loci in European pedigrees. The aim of our study was to test the above associations in a case-control study in Russian population. Twelve SNPs including SNPs cited in the above studies and those selected using the RegulomeDB annotations for the region 9q21 were genotyped in 210 patients with POP (stages III-IV and 292 controls with no even minimal POP. Genotyping was performed using the polymerase chain reaction with confronting two-pair primers (PCR–CTPP. Association analyses were conducted for individual SNPs, 9q21 haplotypes, and SNP-SNP interactions. SNP rs12237222 with the highest RegulomeDB score 1a appeared to be the key SNP in haplotypes associated with POP. Other RegulomeDB Category 1 SNPs, rs12551710 and rs2236479 (scores 1d and 1f, resp., exhibited epistatic effects. In this study, we verified the region 9q21 association with POP in Russians, using RegulomeDB annotations.

  15. 盆底重建手术对盆腔器官脱垂患者生活质量及盆底肌肌电的影响%The effect of pelvic floor reconstruction operation to pelvic organ prolapsed patients’ lives qualities and pelvic floor myoelectricity

    Institute of Scientific and Technical Information of China (English)

    赵丹阳; 杨建梅; 季梅英; 易艳

    2016-01-01

    Objective :To observe the effect of pelvic floor reconstruction operation to pelvic organ pro‐lapsed patients’ lives qualities and pelvic floor myoelectricity ,in further to explore effective curative measures . Methods :Randomly divided 118 patients into observation group and control group ,observation group patients were adopted total pelvic floor reconstruction ,control group patients were adopted the traditional vaginal operation ,we observed operation relax indexes ,pelvic floor myoelectricities and lives qualities at different time stages .Results :Compared with control group ,observation group patients’ operation time ,operative blood loss ,indwelling catheter time and hospital time all obvious decreased ,the differences had statistical significances .post operation ,compared with control group ,observation group patients’ pelvic floor myoelectricity and post operation 6 months PFDI‐20 , PFIQ‐7 scores obviously decreased ,sex life qualities scores obviously increased ,the differences had statistical signif‐icances .Conclusion :Pelvic floor reconstruction operation can relatively improve pelvic organ prolapsed patients ’ life qualities ,but haven’t obvious effect on pelvic floor myoelectricity .%目的:观察盆底重建手术对盆腔器官脱垂患者生活质量及盆底肌肌电的影响效果,以期探索有效治疗措施。方法:将118例盆腔器官脱垂患者,随机分为观察组与对照组,其中观察组予以全盆底重建术,对照组予以传统的阴式手术,观察手术相关指标、盆底肌肌电以及不同时间段的生活质量评分。结果:与对照组比较,观察组患者的手术时间、术中出血量、留置尿管时间以及住院时间均减少明显,差异具统计学意义。术后6个月,与对照组比较,观察组患者的 PFDI‐20、PFIQ‐7评分则降低明显,而性生活质量评分则升高明显。结论:盆底重建手术可较好的改善盆腔器官脱垂

  16. Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh.

    Science.gov (United States)

    Gyang, Anthony N; Feranec, Jessica B; Patel, Rakesh C; Lamvu, Georgine M

    2014-03-01

    In 2001, the US Food and Drug Administration (FDA) approved the first transvaginal mesh kit to treat pelvic organ prolapse (POP). Since the introduction of vaginal mesh kits, some vaginal meshes have been associated with chronic pelvic pain after reconstructive pelvic floor surgery. Pelvic pain results in between 0 % and 30 % of patients following transvaginal mesh placement. Common causes of chronic pelvic pain include pelvic floor muscle spasm, pudendal neuralgia, and infection. Paucity of data exists on the effective management of chronic pelvic pain after pelvic reconstructive surgery with mesh. We outline the management of chronic pelvic pain after transvaginal mesh placement for reconstructive pelvic floor repair based on our clinical experience and adaptation of data used in other aspects of managing chronic pelvic pain conditions.

  17. Organization of the motoneurons innervating the pelvic muscles of the male rat

    DEFF Research Database (Denmark)

    Schrøder, H D

    1980-01-01

    The cytoarchitecture of the motoneuron pool of the male rat was studied at the lumbo-sacral transition area, particularly in L6. In the latter segment a dorso-medial (DM), ventral (V), dorso-lateral (DL), and retrodorso-lateral group (RDL) could be defined. The DL group was associated with a prom......The cytoarchitecture of the motoneuron pool of the male rat was studied at the lumbo-sacral transition area, particularly in L6. In the latter segment a dorso-medial (DM), ventral (V), dorso-lateral (DL), and retrodorso-lateral group (RDL) could be defined. The DL group was associated......, and sphincter ani were each innervated by two populations of neurons that were situated in separate areas which had different histochemical properties, and which thus probably have different compositions of their afferent inputs. The duality in the motoneuron pool that innervates the pelvic mucscle might...

  18. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case–control study

    Science.gov (United States)

    Asresie, Ayalnesh; Admassu, Eleni; Setegn, Tesfaye

    2016-01-01

    Introduction Pelvic organ prolapse (POP) is a significant public health problem in developing countries including Ethiopia. However, less has been documented on risk factors of POP. Therefore, the aim of this study was to identify the determinants factors of POP. Methods An unmatched case–control study was conducted among gynecologic patients in Bahir Dar city, North West Ethiopia, from July to October 2014. A total of 370 women (selected from outpatient departments) were included in the study. Cases (clients with stage III or IV POP) and controls (who declared free of any stages of POP) were identified by physicians using the Pelvic Organ Prolapse Quantitative Examination tool. Data analysis was carried out by SPSS version 20.0. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Statistical differences were considered at P40 years) (adjusted OR [AOR] =3.0 [95% CI: 1.59–5.89]), sphincter damage (AOR =8.1 [95% CI: 1.67–39.7]), family history of POP (AOR =4.9 [95% CI: 1.94–12.63]), parity (≥4) (AOR =4.5 [95% CI: 2.26–9.10]), nonattendance of formal education (AOR =4.3 [95% CI: 1.25–14.8]), carrying heavy objects (AOR =3.1 [95% CI: 1.56–6.30]), body mass index (BMI) <18.5 kg/m2 (AOR =3.1 [95% CI: 1.22–7.82]), and delivery assisted by nonhealth professionals (AOR =2.6 [95% CI: 1.24–5.56]) were significantly associated with POP. Conclusion In our study, sphincter damage, family history of POP, being uneducated, having ≥4 vaginal deliveries, carrying heavy objects, BMI <18.5 kg/m2, age ≥40 years, and having delivery assisted by nonhealth professional were the independent determinants of POP. Therefore, skilled delivery, further promoting family planning and girls’ education, early pelvic floor assessment, and counseling on avoidance of carrying heavy objects are recommended. PMID:28003773

  19. Voluntary surgical contraception women of late reproductive age suffering from pelvic organ prolapse – features and benefits

    Directory of Open Access Journals (Sweden)

    Nigina Nasinova

    2014-07-01

    Full Text Available We have proposed the method of transvaginal Voluntary Surgical Contraception, conducted in conjunction with surgical treatment of descent and prolapse of the vaginal walls. Were studied the early and late results of the surgery in 50 women to which during the surgical treatment of genital prolapse simultaneously was carries out transvaginal occlusion of the fallopian tubes. Control groups consisted of 30 women to which in the first step before surgical correction of pelvic organ prolapse have been performed minilaparotomy and DCA. Our method consists in penetrating into the abdominal cavity through the front vaginal vault, to downgrade the fallopian tubes with a hook Ramatibodi and tubal sterilization method Pomeroy. Intra - and postoperative complications were not recognized. In the long-term period after surgery - the effectiveness of the method was 100%. Marked tendency to improve the quality of sexual life tells about the positive impact of removing the genital prolapse with simultaneous DCA on the quality of life of women.

  20. Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy

    DEFF Research Database (Denmark)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy...

  1. Chronic Pelvic Pain

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Pelvic Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  2. Chronic Pelvic Pain

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Chronic Pelvic Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  3. [Pelvic floor muscle training and pelvic floor disorders in women].

    Science.gov (United States)

    Thubert, T; Bakker, E; Fritel, X

    2015-05-01

    Our goal is to provide an update on the results of pelvic floor rehabilitation in the treatment of urinary incontinence and genital prolapse symptoms. Pelvic floor muscle training allows a reduction of urinary incontinence symptoms. Pelvic floor muscle contractions supervised by a healthcare professional allow cure in half cases of stress urinary incontinence. Viewing this contraction through biofeedback improves outcomes, but this effect could also be due by a more intensive and prolonged program with the physiotherapist. The place of electrostimulation remains unclear. The results obtained with vaginal cones are similar to pelvic floor muscle training with or without biofeedback or electrostimulation. It is not known whether pelvic floor muscle training has an effect after one year. In case of stress urinary incontinence, supervised pelvic floor muscle training avoids surgery in half of the cases at 1-year follow-up. Pelvic floor muscle training is the first-line treatment of post-partum urinary incontinence. Its preventive effect is uncertain. Pelvic floor muscle training may reduce the symptoms associated with genital prolapse. In conclusion, pelvic floor rehabilitation supervised by a physiotherapist is an effective short-term treatment to reduce the symptoms of urinary incontinence or pelvic organ prolapse.

  4. The clinical effect of total pelvic floor reconstruction in the treatment of severe pelvic organ prolapse%全盆底重建术治疗重度盆腔器官脱垂临床效果观察

    Institute of Scientific and Technical Information of China (English)

    刘金敏

    2016-01-01

    目的 探讨全盆底重建手术治疗重度盆腔器官脱垂的临床效果.方法 选择我院治疗的重度盆腔器官脱垂患者102例采取随机数字表法分为观察组和对照组,对照组给予传统阴式修补手术治疗,观察组给予全盆底重建手术治疗,记录两组治疗情况.结果 两组手术时间、术中出血量、留置尿管时间、住院时间、残余尿量组间对比差异有统计学意义(P<0.05).观察组术后盆底疾病生活影响问卷评分(10.37±3.21),盆底功能障碍性疾病相关问卷评分(22.18±2.32);对照组术后盆底疾病生活影响问卷评分(21.37士5.68),盆底功能障碍性疾病相关问卷评分(31.36±4.15),组间对比差异有统计学意义(P<0.05).两组术后性生活质量评分对比差异无统计学意义(P>0.05).结论 全盆底重建手术治疗重度盆腔器官脱垂能够缩短手术时间,减少术中出血量,缩短住院天数,提升患者术后生活质量,但对性生活质量无改善,值得在临床大力推广使用.%Objective To investigate the clinical effect of total pelvic floor reconstruction in the treatment of severe pelvic organ prolapse.Methods 102 cases of severe pelvic organ prolapse treated in our hospital were chosen and divided into observation group and control group with the random number table.Control group was given traditional vaginal repair surgery,while observation group was given total pelvic floor reconstruction surgery.Recorded the treatment condition of two groups.Results There were statistically significant differences in operation time,intraoperative bleeding volume,indwelling catheter time,hospitalization time,and residual urine volume between two groups (P<0.05).Postoperative pelvic floor disease life impact questionnaire score of observation group was (10.37±3.21),pelvic floor dysfunction related questionnaire score was (22.18±2.32),those of control group were (21.37±5.68) and (31.36±4.15),with statistically significant

  5. Self-organizing ontology of biochemically relevant small molecules

    Directory of Open Access Journals (Sweden)

    Chepelev Leonid L

    2012-01-01

    Full Text Available Abstract Background The advent of high-throughput experimentation in biochemistry has led to the generation of vast amounts of chemical data, necessitating the development of novel analysis, characterization, and cataloguing techniques and tools. Recently, a movement to publically release such data has advanced biochemical structure-activity relationship research, while providing new challenges, the biggest being the curation, annotation, and classification of this information to facilitate useful biochemical pattern analysis. Unfortunately, the human resources currently employed by the organizations supporting these efforts (e.g. ChEBI are expanding linearly, while new useful scientific information is being released in a seemingly exponential fashion. Compounding this, currently existing chemical classification and annotation systems are not amenable to automated classification, formal and transparent chemical class definition axiomatization, facile class redefinition, or novel class integration, thus further limiting chemical ontology growth by necessitating human involvement in curation. Clearly, there is a need for the automation of this process, especially for novel chemical entities of biological interest. Results To address this, we present a formal framework based on Semantic Web technologies for the automatic design of chemical ontology which can be used for automated classification of novel entities. We demonstrate the automatic self-assembly of a structure-based chemical ontology based on 60 MeSH and 40 ChEBI chemical classes. This ontology is then used to classify 200 compounds with an accuracy of 92.7%. We extend these structure-based classes with molecular feature information and demonstrate the utility of our framework for classification of functionally relevant chemicals. Finally, we discuss an iterative approach that we envision for future biochemical ontology development. Conclusions We conclude that the proposed methodology

  6. Role of MR imaging in surgical planning and prediction of successful surgical repair of pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Ebtesam Moustafa Kamal

    2013-09-01

    Conclusion: Magnetic resonance imaging can accurately localize pelvic floor defects, evaluate success or failure of surgical procedures, predict the need for more extensive reconstruction, and identify complications.

  7. [Pelvic floor and pregnancy].

    Science.gov (United States)

    Fritel, X

    2010-05-01

    Congenital factor, obesity, aging, pregnancy and childbirth are the main risk factors for female pelvic floor disorders (urinary incontinence, anal incontinence, pelvic organ prolapse, dyspareunia). Vaginal delivery may cause injury to the pudendal nerve, the anal sphincter, or the anal sphincter. However the link between these injuries and pelvic floor symptoms is not always determined and we still ignore what might be the ways of prevention. Of the many obstetrical methods proposed to prevent postpartum symptoms, episiotomy, delivery in vertical position, delayed pushing, perineal massage, warm pack, pelvic floor rehabilitation, results are disappointing or limited. Caesarean section is followed by less postnatal urinary incontinence than vaginal childbirth. However this difference tends to disappear with time and following childbirth. Limit the number of instrumental extractions and prefer the vacuum to forceps could reduce pelvic floor disorders after childbirth. Ultrasound examination of the anal sphincter after a second-degree perineal tear is useful to detect and repair infra-clinic anal sphincter lesions. Scientific data is insufficient to justify an elective cesarean section in order to avoid pelvic floor symptoms in a woman without previous disorders.

  8. The Perioperative Nursing of Patients with Pelvic Organ Prolapse undergoing Pelvic Floor Reconstruction%微创盆底重建术治疗盆腔器官脱垂患者的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    杨洋; 李晓玲

    2013-01-01

    目的 探讨加用网片盆底重建术(PROSIMA)治疗盆腔器官脱垂患者的围手术期护理方法.方法 对2010年6月-2011年6月收治的23例盆腔脏器脱垂患者施行的PROSIMA护理措施进行回顾性总结.结果 23例患者术后尿失禁症状明显好转,舒适感增加;仅1例发生尿潴留,予重置尿管后顺利排尿;治愈率达100%.术后6个月复查时均无阴道壁膨出或穹隆脱垂,未出现下尿路感染、网片侵蚀、下肢疼痛等并发症.结论 有效的护理措施可减少PROSIMA术后并发症,对提高手术成功率、促进患者康复有明显作用.%Objective To study the perioperative nursing for patients with pelvic organ prolapse undergoing Prosima devices pelvic floor reconstruction. Methods Twenty-three consecutive women with pelvic organ prolapse undergoing transvaginal placement of Prosima devices for pelvic floor reconstruction were enrolled retrospectively in this study from June 2010 to June 2011 in Urology Department of West China Hospital. All patients received distinctive nursing measures in support of the treatment. Results The cure rate of the surgical management was 100% with great symptoms relief and patients' well-being. Postoperative urinary retention occurred in one case which was cured by urinary catheterization in a few days. After six-month follow-up, there was no anterior vaginal or vault prolapse recurrence, no severe complication such as urinary tract infection, mesh erosion or groin pain. Conclusions Effective perioperative nursing measures can reduce the morbidity of postoperative complications after pelvic floor reconstruction. It is a significant way to assist surgical management and patients' recovery.

  9. Finite element simulation of interactions between pelvic organs: predictive model of the prostate motion in the context of radiotherapy.

    Science.gov (United States)

    Boubaker, Mohamed Bader; Haboussi, Mohamed; Ganghoffer, Jean-François; Aletti, Pierre

    2009-08-25

    The setting up of predictive models of the pelvic organ motion and deformation may prove an efficient tool in the framework of prostate cancer radiotherapy, in order to deliver doses more accurately and efficiently to the clinical target volume (CTV). A finite element (FE) model of the prostate, rectum and bladder motion has been developed, investigating more specifically the influence of the rectum and bladder repletions on the gland motion. The required organ geometries are obtained after processing the computed tomography (CT) images, using specific softwares. Due to their structural characteristics, a 3D shell discretization is adopted for the rectum and the bladder, whereas a volume discretization is adopted for the prostate. As for the mechanical behavior modelling, first order Ogden hyperelastic constitutive laws for both the rectum and bladder are identified. The prostate is comparatively considered as more rigid and is accordingly modelled as an elastic tissue undergoing small strains. A FE model is then created, accounting for boundary and contact conditions, internal and applied loadings being selected as close as possible to available anatomic data. The order of magnitude of the prostate motion predicted by the FE simulations is similar to the measurements done on a deceased person, accounting for the delineation errors, with a relative error around 8%. Differences are essentially due to uncertainties in the constitutive parameters, pointing towards the need for the setting up of direct measurement of the organs mechanical behavior.

  10. Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Wang, X-J; Xia, L-L; Xu, T-Y; Zhang, X-H; Zhu, Z-W; Zhang, M-G; Liu, Y; Xu, C; Zhong, S; Shen, Z-J

    2016-04-01

    There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats.

  11. [POP-Q indication points, Aa and Ba, involve in diagnosis and prognosis of occult stress urinary incontinence complicated with pelvic organ prolapse].

    Science.gov (United States)

    Liu, Cheng; Wu, Wenying; Yang, Qing; Hu, Ming; Zhao, Yang; Hong, Li

    2015-06-01

    To investigate the correlation between pelvic organ prolapse quantitation (POP-Q) indication points and the incidence of occult stress urinary incontinence (OSUI) and its impact on prognosis. Retrospective study medical records of 93 patients with pelvic organ prolapse (POP) staged at III-IV, of which underwent pelvic reconstruction operations with Prolift system from Jan. 2007 to Sept. 2012. None of these patients had clinical manifestations of stress urinary incontinence (SUI) before surgery, and in which 44 patients were included in study group (POP complicated with OSUI) because they were identified with OSUI, another 49 patients as control group (simple POP). Follow-up and collecting datas including POP-Q, stress test, urodynamic recordings, incidence of de novo SUI, statistic analyzing by logistic regression and receiver operating characteristic curve (ROC). (1) The study group had a much higher incidence of 30% (13/44) on de novo SUI than that of control group (4%, 2/49; P POP patients that complicated with OSUI, we chose a cutoff value of +1.5 cm for Aa point as the threshold to predicting incidence of de novo SUI according to ROC curve, area under the curve (AUC) was 0.889 (P POP patients. Aa and Ba points are correlated with preoperative OSUI, and it is worthy to be considered as a risk predictor on forecasting the incidence of de novo SUI post pelvic reconstruction surgery.

  12. Biomechanics of the pelvic floor musculature

    NARCIS (Netherlands)

    Janda, S.

    2006-01-01

    The present thesis was motivated by two main goals. The first research goal of the thesis was to understand the complex biomechanical behaviour of the pelvic floor muscles. The second goal was to study the mechanism of the pelvic organ prolapse (genital prolapse). The pelvic floor in humans is a ve

  13. Pelvic actinomycosis.

    Science.gov (United States)

    Gorisek, B; Rebersek-Gorisek, H; Kavalar, R; Krajnc, I; Zavrsnik, S

    1999-08-20

    Pelvic actinomycosis is a rare chronic infection caused by bacteria of the family Actinomycetaceae. Prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor. We report six patients with pelvic actinomycosis, all of whom had an IUD inserted for over six years. Diagnostic problems necessitated a laparotomy in all patients. The pathohistological diagnosis was based on the characteristic microscopic image and specific staining. The patients were treated with penicillin and amoxycillin for several months.

  14. Ultrasound Imaging of the Pelvic Floor.

    Science.gov (United States)

    Stone, Daniel E; Quiroz, Lieschen H

    2016-03-01

    This article discusses the background and appraisal of endoluminal ultrasound of the pelvic floor. It provides a detailed anatomic assessment of the muscles and surrounding organs of the pelvic floor. Different anatomic variability and pathology, such as prolapse, fecal incontinence, urinary incontinence, vaginal wall cysts, synthetic implanted material, and pelvic pain, are easily assessed with endoluminal vaginal ultrasound. With pelvic organ prolapse in particular, not only is the prolapse itself seen but the underlying cause related to the anatomic and functional abnormalities of the pelvic floor muscle structures are also visualized.

  15. 盆腔器官脱垂的动态MRI研究进展%Dynamic magnetic resonance imaging of pelvic organ prolapse: recent research progress

    Institute of Scientific and Technical Information of China (English)

    崔国策; 李华山; 王晓锋

    2011-01-01

    Pelvic organ prolapse (POP) refers to herniation of pelvic organs caused by the weak pelvic floor support structures. Magnetic resonance imaging (MRI) is a non-radioactive, non-invasive, fast, comprehensive, high-resolution imaging technique that has strong soft tissue contrast and can clearly show the changes of muscles and fascia structures of pelvic floor to the resting and dynamic position. It can help understand the state of pelvic organizations and provide objective imaging data for the clinical diagnosis. Dynamic MRI is commonly used for the diagnosis of bladder prolapse and swelling, uterine and vaginal prolapse, rectal prolapse and enterocele. Currently, there are no unified diagnostic criteria for POP in China. Although the US HMO system is frequently used for assessing the degree of POP, it needs to be further explored whether this sys-tem is fit for the Chinese population. In short, dynamic MRI permits a comprehensive evaluation of pelvic organ prolapse. It is an important way to study the living anatomy, shape and movement of pelvic floor. In addition to clinical evaluations, dynamic MRI (especially dynamic MRI defecog-raphy) plays a role in guiding the interdisciplinary treatment of pelvic floor dysfunction.%盆腔器官脱垂(pelvic organ prolapse,POP)是指由于盆底支持结构薄弱导致的盆腔器官疝出.动态MRI为无放射性、无创、快捷、全面、高分辨率的检查方法,其软组织对比性强,可清晰显示静息位及动态位时盆底肌肉和筋膜组织结构及功能上的变化,了解盆腔多组织器官的状况,为临床提供客观影像学数据.动态MRI常用于膀胱脱垂与膨出、子宫和阴道脱垂、直肠脱垂及肠疝的诊断,有多种检查技术和方法.目前国内还没有统一的POP诊断的影像标准,其诊断多参照美国UCLA的标准,采取HMO分度系统,但是否适合于我国人种,尚需进一步探讨.总之,动态MRI可综合评价盆腔器官脱垂,是研究活体盆底解

  16. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... to help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel and colon, such as: infections such as appendicitis , pyelonephritis or infected fluid collections, also known as abscesses. inflammatory bowel disease such as ulcerative colitis or Crohn's ...

  17. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Pelvic Inflammatory Disease (PID) Home For Patients Search FAQs Pelvic Inflammatory ... Inflammatory Disease (PID) FAQ077, September 2015 PDF Format Pelvic Inflammatory Disease (PID) Gynecologic Problems What is pelvic inflammatory disease ( ...

  18. Use of the Pelvic Organ Quantification System (POP-Q) in published articles of peer-reviewed journals.

    Science.gov (United States)

    Boyd, Sarah S; O'Sullivan, David; Tulikangas, Paul

    2017-04-29

    The Pelvic Organ Quantification (POP-Q) system is a standardized technique used for staging POP. This study aimed to examine POP-Q use in peer-reviewed publications. Nine journals representative of urogynecology were reviewed for articles describing POP staging from January to December 2012 and 2015. Review articles, editorials, letters and articles with or without retractions in manuscript form were excluded. The primary outcome was frequency of POP-Q use. Secondary outcomes were POP-Q use by journal specialty, specialty of primary author, country of origin, and an anatomic definition of failure. Data were evaluated using chi-square tests. Results yielding p POP-Q was used in 88.4% in 2012 and 80% in 2015(not significant; p = 0.296). Urologists used the POP-Q least frequently, although its use was greater in 2015 (63.6%) than in 2012 (50%). In 2012, a definition for anatomic failure was present in 27% of articles; 23% of authors in the 2012 time frame reported using the POP-Q, and 17.8% used a specific POP-Q point. Between 2012 and 2015, the use of a specific point significantly decreased (17.8 vs. 7.8%, p = 0.033). POP-Q is the most common staging system used in published articles across studied subgroups. When used as an outcome measure, a greater number of authors use the recommended staging system rather than specific points.

  19. Evaluation of internal organ variation for pelvic patients using CBCT;Avaliacao de variacoes anatomicas em neoplasias pelvicas utilizando CBCT

    Energy Technology Data Exchange (ETDEWEB)

    Gandini, G.B. [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Radioterapia; Lopes, C.P.; Sakuraba, R.K.; Goncalves, V.D.; Cruz, J.C. [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Servico de Fisica Medica; Chen, M.J. [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. Radioterapia. Radioterapia Oncologica

    2009-07-01

    To evaluate the organ at risk (OAR)variations for the bladder and rectum, the prostate or bed of prostate clinical target volume (CTV) movement, the external anatomy modification, using Image Guided Radiotherapy (IGRT) with Cone beam CT (CBCT) in pelvic patients. In 90 CBCTs the OR was drawn and the CTV in 41. The mean + sigma variation against the original volumes of the ORs, as well as, the overlapping regions between PTV and OR (Ov{sub r}eto and Ov{sub b}exiga) was analysed. It was also evaluated the patient external anatomy variation measuring the lateral-lateral (DLL) and antero-posterior (DAP) dimensions in CBCT against the reference CT. In average, 3,9 (1-9) CBCTs were acquired per patient. The bladder and rectum OR was in average -52%+-30% e -12%+-40% lower then the original. The overlapping volumes Ov{sub r}eto and Ov{sub b}exiga was in average 9%+-14% e 5%+-17% different then the original. The mean difference, in module, of the DAP and DLL was 0,4+-0,3 cm (maximum 1,2 cm) and -0,3+-0,4 cm (maximum 1,7 cm). (author)

  20. Chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Slawomir Wozniak

    2016-06-01

    Full Text Available [b][/b][b]Introduction. [/b]Chronic pelvic pain (CPP affects about 10–40% of women presenting to a physician, and is characterised by pain within the minor pelvis persisting for over 6 months. [b]Materials and method. [/b]The Medline database was searched using the key words ‘chronic pelvic pain’ and ‘pelvic congestion syndrome’, published in English during the past 15 years. The condition markedly deteriorates the quality of life of the affected. Its aetiology has not been fully described and elucidated, although organic, functional and psychosomatic factors are implicated. Pain associated with parametrial varices was defined as pelvis congestion syndrome (PCS. Since the aetiology of CPP is complex, multi-directional diagnostic procedures are required. [b]Results. [/b]The main diagnostic methods employed are imaging examinations (ultrasound, computer tomography, magnetic resonance. Advances in interventional radiology considerably contributed to the CPP treatment. Currently, embolization of parametrial vessels is one of the most effective methods to relieve pain associated with pelvic congestion syndrome. [b]Conclusions. [/b]Due to the complex aetiology of chronic pelvic pain, the most beneficial effects are obtained when the therapy is based on cooperation of the gynaecologist, physiotherapist, psychologist and interventional radiologist.

  1. Application of pelvic reconstruction in treatment of pelvic organ prolapse%盆底重建术在盆腔脏器脱垂中的临床应用

    Institute of Scientific and Technical Information of China (English)

    周密; 李均; 胡飞泉

    2011-01-01

    Objective To investigate the feasibility and effectiveness of pelvic reconstruction in treatment of pelvic organ prolapse ( POP). Methods Twenty-six patients with POP-Q Ⅱ ~ Ⅳ defects underwent prolfit reconstruction. Results The average operating time was 61 minutes and hemorrhage volume was 120mL. A follow-up visit for 3- 12 months; Complete cure; 2 examples have the anus bulge feeling, may endure. Odd patient non-near future complication. Conclusion Pelvic reconstruction is a safe and effective technique for treating POP. Worthy of application, but need to Long-term revisit.%目的 探讨盆底重建术治疗盆腔脏器脱垂(POP)的有效性与可行性.方法 根据国际尿控协会制定的POP-Q定量检查诊断标准,对26例Ⅱ~Ⅳ期盆腔脏器脱垂患者采用Gynecare Prolift网片进行盆底重建术.结果 手术时间平均61 min,术中出血平均120ml,随访3~12个月,全部治愈;2例有肛门胀感,可耐受,余患者无近期并发症.结论 采用盆底重建术治疗POP安全、有效,术后并发症少,值得推广,但仍需长期随访.

  2. Validation of the Pelvic Organ Prolapse Quantification Index (POP-Q-I): a novel interpretation of the POP-Q system for optimization of POP research.

    Science.gov (United States)

    Lemos, Nucélio Luiz de Barros Moreira; Auge, Antonio Pedro Flores; Lunardelli, Jacqueline Leme; Carramão, Silvia da Silva; Faria, Ana Luiza Antunes; Aoki, Tsutomu

    2008-07-01

    Even though very precise at describing pelvic organ position, our criticism to the Pelvic Organ Prolapse Quantification (POP-Q) system is its limited ability to quantify the prolapse itself, since it still classifies prolapse into four stages, almost the same way as Baden and Walker (Clin Obstet Gynecol 15(4):1070-1072, 1972) did in 1972. As a result, the same grade can include a wide prolapse intensity range. The objective of this study was to assess inter-observer reliability in the Pelvic Organ Prolapse Quantification Index (POP-Q-I; Lemos et al., Int Urogynecol J 18(6):609-611, 2007) on a prospective randomized trial. Fifty consecutive women were prospectively examined by two members of the urogynecology staff, blinded to each other's results. Spearman's rank correlation was used to assess inter-observer reliability. Excellent correlation coefficients were observed, with an overall coefficient of 96.5% (CI: 0.889-1.042; p POP-Q-I is a method that makes POP research more efficient by directly measuring prolapse as a continuous variable, which is statistically more powerful than the categorical variables proposed by the POP-Q system. This study suggests that the POP-Q-I is applicable to clinical POP research.

  3. Pelvic Actinomycosis

    Directory of Open Access Journals (Sweden)

    Alejandra García-García

    2017-01-01

    Full Text Available Introduction. Actinomycosis is a chronic bacterial infection caused by Actinomyces, Gram-positive anaerobic bacteria. Its symptomatology imitates some malignant pelvic tumours, tuberculosis, or nocardiosis, causing abscesses and fistulas. Actinomycoses are opportunistic infections and require normal mucous barriers to be altered. No epidemiological studies have been conducted to determine prevalence or incidence of such infections. Objective. To analyse the clinical cases of pelvic actinomycosis reported worldwide, to update the information about the disease. Methods. A systematic review of worldwide pelvic actinomycosis cases between 1980 and 2014 was performed, utilising the PubMed, Scopus, and Google Scholar databases. The following information was analysed: year, country, type of study, number of cases, use of intrauterine device (IUD, final and initial diagnosis, and method of diagnosis. Results. 63 articles met the search criteria, of which 55 reported clinical cases and 8 reported cross-sectional studies. Conclusions. Pelvic actinomycosis is confusing to diagnose and should be considered in the differential diagnosis of pelvic chronic inflammatory lesions. It is commonly diagnosed through a histological report, obtained after a surgery subsequent to an erroneous initial diagnosis. A bacterial culture in anaerobic medium could be useful for the diagnosis but requires a controlled technique and should be performed using specialised equipment.

  4. The Relevance of Organization Capital for Market Capital Returns

    DEFF Research Database (Denmark)

    Bleoca, Lavinia

    2014-01-01

    This paper extends the existing findings on the theory of “organization capital” proposed by Lev at al. (2009) through a reproduction analysis on newer data, with a different estimation method. A new empirical perspective is proposed, where the intrinsic relationship of the different profitability...... measures is analyzed in order to offer a survey over the average firm’s capacity of generating excess returns in relation to the closest neighbor, based on its uniqueness. Nevertheless, the analysis seeks to define how profitable unique skills and knowledge are in comparison to the companion portfolio...

  5. Pelvic Pain

    Science.gov (United States)

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  6. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    OpenAIRE

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and ...

  7. Validation of a visual analog scale form of the pelvic organ prolapse/urinary incontinence sexual function questionnaire 12.

    Science.gov (United States)

    Occhino, John A; Trabuco, Emanuel C; Heisler, Christine A; Klingele, Christopher J; Gebhart, John B

    2011-09-01

    : This study aimed to validate a visual analog scale (VAS) form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12). : This was a planned secondary analysis of a vaginal anatomy and sexual function study. All women undergoing vaginal reconstruction between October 2008 and December 2009 were asked to participate. We planned for an analysis of 30 women for this validation. Preoperatively, sexually active participants completed a questionnaire containing a PISQ-12 in Likert (0-4) and VAS (0-10) format. Within 30 days, participants completed a PISQ-12 in VAS form only for evaluation of test-retest reliability. At 6 months after surgery, participants completed the PISQ-12 in both the Likert and VAS forms. For each item on the PISQ-12, the Spearman rank correlation coefficient was used to estimate the correlation between the Likert and VAS formats using the responses from the same assessment period (before or after surgery). The intraclass correlation coefficient was estimated to assess the test-retest agreement. : A total of 43 women completed the preoperative questionnaire, 25 completed the retest, and 37 completed the postoperative questionnaire. When PISQ-12 scores were compared between the Likert and VAS forms, correlation values were 0.88 preoperatively and 0.91 postoperatively. Test-retest reliability was high with an intraclass correlation coefficient of 0.87. Most women preferred the Likert version (71.4% preoperatively and 55.0% postoperatively). : The VAS form of the PISQ-12 is both reliable and reproducible and avoids the limitations of the Likert scale.

  8. Non-surgical interventions for pelvic organ prolapse in rural Nepal: a prospective monitoring and evaluation study

    Science.gov (United States)

    Fitchett, Joseph R; Bhatta, Surya; Sherpa, Tenzing Y; Malla, Bishwo S; A Fitchett, Elizabeth J; Samen, Arlene

    2015-01-01

    Objectives Pelvic organ prolapse (POP) is a major cause of morbidity in Nepal, particularly affecting women in the rural communities. Women with POP in Nepal may suffer from symptoms for decades. At present, the Government of Nepal advocates surgical intervention but access to surgical care is inadequate. This report evaluated the feasibility of a non-surgical public health programme in rural Nepal, and describes risk factors associated with POP in this setting. Design Prospective monitoring and evaluation study of a new public health programme. Setting Baglung district, rural Nepal. Participants Women with gynaecological symptoms of POP. Main outcome measures Risk factors for disease progression were assessed using Fisher’s exact test, Pearson’s χ2-test and logistic regression analysis. Results Of the 74 women included in this analysis, 70.8% were diagnosed with stage 2 POP or greater. The majority of women did not have any further children following the onset of POP symptoms (63.5%). Duration of symptoms ranged from 2 months to 60 years, with 73.4% of women suffering for over 5 years and 28.4% suffering for over 20 years. Univariate analyses identified age at screening, age at onset of symptoms, the duration of symptoms and an associated rectocele as factors associated with increasing POP severity (p Kegel exercises were taught to 25 (33.8%) women with POP and ring pessaries were offered to 47 (63.5%) women with POP. Conclusions Non-surgical interventions may provide an opportunity to address the significant burden of POP in rural Nepal. PMID:26664731

  9. Optical Properties of Polymers Relevant to Secondary Organic Aerosols

    Science.gov (United States)

    Marrero-Ortiz, W.; Gomez-Hernandez, M. E.; Xu, W.; Guo, S.; Zhang, R.

    2014-12-01

    Atmospheric aerosols play a critical role in climate directly by scattering and absorbing solar radiation and indirectly by modifying the cloud formation. Currently, the direct and indirect effects of aerosols represent the largest uncertainty in climate predictions models. Some aerosols are directly emitted, but the majority are formed in the atmosphere by the oxidation of gaseous precursors. However, the formation of aerosols at the molecular level is not fully characterized. Certain category of secondary organic aerosols (SOA), which represent a significant fraction of the total aerosol burden, can be light-absorbing, also known as brown carbon. However, the overall contribution of SOA to the brown carbon and the related climate forcing is poorly understood. Such incomplete understanding is due in part to the chemical complexity of SOA and the lack of knowledge regarding SOA formation, transformation, and optical properties. Based on previous laboratory experiments, field measurements, and modeling studies, it has been suggested that the polymers and oligomers play an important role in the SOA formation. Atmospheric polymers could be produced by the hydration or heterogeneous reactions of epoxides and small α-dicarbonyls. Their aqueous chemistry products have been shown to give light-absorbing and high molecular weight oligomeric species, which increase the SOA mass production and alter the direct and indirect effect of aerosols. In this paper, the aerosol chemistry of small α-dicarbonyl compounds with amines is investigated and the associated optical properties are measured using spectroscopic techniques. The differences between primary, secondary and tertiary amines with glyoxal and methylglyoxal are evaluated in terms of SOA browning efficiency. Atmospheric implications of our present work for understanding the formation of light-absorbing SOA will be presented, particularly in terms of the product distribution of light-absorbing SOA formed by aqueous phase

  10. Transvaginal mesh in repair of pelvic organs prolapse as a minimally invasive surgical procedure

    Directory of Open Access Journals (Sweden)

    Argirović Rajka

    2011-01-01

    Full Text Available Background/Aim. Prolapse of genital organs with or without urinary stress incontinention is the most often health problem in the elderly female population tending to increase with ageing. The aim of this study was to assess the perioperative complications and short-term outcomes of prolaps repair using transvaginal polypropylene mesh (Prolift system, Gynecare, Ethicon, USA. Methods. A retrospective study was conducted evaluating 96 women from September 2006 to January 2010 who undewent vaginal repair with implatation of a soft mesh manufactured by Gynecare, Ethicon, USA. Results. All the patients had a stage 3 or stage 4 prolapse according to the POP-Q system of ICS. Total mesh was used in 12 (13% patients isolated anterior mesh in 52 (54% patients and isolated posterior mesh in 32 (33% patients. We reported one intra-operative bladder injury and no other serious complications. At 3 months, all 96 patients were available for follow-up. Vaginal erosion occured in 9 (9.3% patients, shrinkage of mesh in 6 (6.2% patients and de novo urinary incontinence in 5 (5.2% patients. Failure rate was 6.25% (recurrent prolapse stage 3 or 4 even asymptomatic. Conclusion. Our study suggests that transvaginal polypropylene mesh applied with a tensionfree technique is a safe and effective method with low intraoperative complications and low morbidity rates. However, some complications are serious and require highly specialised management.

  11. Towards Increased Relevance: Context-Adapted Models of the Learning Organization

    Science.gov (United States)

    Örtenblad, Anders

    2015-01-01

    Purpose: The purposes of this paper are to take a closer look at the relevance of the idea of the learning organization for organizations in different generalized organizational contexts; to open up for the existence of multiple, context-adapted models of the learning organization; and to suggest a number of such models.…

  12. Towards Increased Relevance: Context-Adapted Models of the Learning Organization

    Science.gov (United States)

    Örtenblad, Anders

    2015-01-01

    Purpose: The purposes of this paper are to take a closer look at the relevance of the idea of the learning organization for organizations in different generalized organizational contexts; to open up for the existence of multiple, context-adapted models of the learning organization; and to suggest a number of such models.…

  13. The role of affect in attitudes toward organ donation and donor-relevant decisions

    NARCIS (Netherlands)

    Berg, H. van de; Manstead, A.S.R.; Pligt, J. van der; Wigboldus, D.H.J.

    2005-01-01

    We argue that affect plays a vital role in attitudes toward organ donation and that reluctance to become an organ donor is likely to be related to the experience of affective ambivalence. Assessing the affect associated with organ donation could help to predict donor-relevant decisions. Results of a

  14. Climate-relevant physical properties of molecular constituents relevant for isoprene-derived secondary organic aerosol material

    Directory of Open Access Journals (Sweden)

    M. A. Upshur

    2014-06-01

    Full Text Available Secondary organic aerosol (SOA particles, formed from gas-phase biogenic volatile organic compounds (BVOCs, contribute large uncertainties to the radiative forcing that is associated with aerosols in the climate system. Reactive uptake of surface-active organic oxidation products of BVOCs at the gas–aerosol interface can potentially decrease the overall aerosol surface tension and therefore influence their propensity to act as cloud condensation nuclei (CCN. Here, we synthesize and measure some climate-relevant physical properties of SOA particle constituents consisting of the isoprene oxidation products α-, δ-, and cis- and {trans-β-IEPOX (isoprene epoxide, as well as syn- and anti-2-methyltetraol. Following viscosity measurements, we use octanol-water partition coefficients to quantify the relative hydrophobicity of the oxidation products while dynamic surface tension measurements indicate that aqueous solutions of α- and trans-β-IEPOX exhibit significant surface tension depression. We hypothesize that the surface activity of these compounds may enhance aerosol CCN activity, and that trans-β-IEPOX may be highly relevant for surface chemistry of aerosol particles relative to other IEPOX isomers.

  15. Synthetic biomaterials for pelvic floor reconstruction.

    Science.gov (United States)

    Karlovsky, Matthew E; Kushner, Leslie; Badlani, Gopal H

    2005-09-01

    Pelvic organ prolapse and stress urinary incontinence increase with age. The increasing proportion of the aging female population is likely to result in a demand for care of pelvic floor prolapse and incontinence. Experimental evidence of altered connective tissue metabolism may predispose to pelvic floor dysfunction, supporting the use of biomaterials, such as synthetic mesh, to correct pelvic fascial defects. Re-establishing pelvic support and continence calls for a biomaterial to be inert, flexible, and durable and to simultaneously minimize infection and erosion risk. Mesh as a biomaterial has evolved considerably throughout the past half century to the current line that combines ease of use, achieves good outcomes, and minimizes risk. This article explores the biochemical basis for pelvic floor attenuation and reviews various pelvic reconstructive mesh materials, their successes, failures, complications, and management.

  16. Does the Degree of Perihepatitis Have Any Relevance to the Severity of the Manifestations of Pelvic Inflammatory Disease on Multidetector Computed Tomography?

    Science.gov (United States)

    Kim, Ji Su; Kim, Hyun Cheol; Kim, Sang Won; Yang, Dal Mo; Rhee, Sun Jung; Shin, Jong Soo

    2015-01-01

    This study aimed to evaluate the relationship between the degree of perihepatitis and the severity of pelvic inflammatory disease (PID) on multidetector computed tomography (MDCT). A total of 177 women with PID who underwent biphasic abdominal computed tomography (CT) scans were enrolled. Two reviewers retrospectively reviewed the CT scans with consensus and subjectively categorized the severity of PID into 4 grades (normal, mild, moderate, and severe). Another reviewer independently assigned the extent (grades 0 to 4) and the depth (grades 0 to 4) of hepatic surface enhancement in terms of the degree of perihepatitis. Relationships between the degree of perihepatitis and the CT severity as well as each CT manifestation of PID were evaluated using the χ test or a cumulative logistic regression analysis. Of the 177 patients, 99 (55.9%) showed hepatic surface enhancement. The severity of PID on MDCT was significantly related with the degree of perihepatitis (all P pelvic fat haziness, complicated ascites, and omental/mesenteric fat infiltration were significantly related with the degree of perihepatitis (all P < 0.05). Among these variables, omental/mesenteric fat infiltration (odds ratio = 10.9) and salpingitis (odds ratio = 6.0) were the CT manifestations that were most associated with the presence of perihepatitis in PID. The degree of perihepatitis seems to show a relationship with the severity of PID on MDCT. Omental/mesenteric fat infiltration and salpingitis can be strongly related with perihepatitis in PID.

  17. 赖氨酰氧化酶与盆腔器官脱垂的研究%Research on lysyl oxidase and pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    吴慧恒; 陈信良; 童晓文

    2014-01-01

    Pelvic organ prolapse (POP)is a common gynecopathy,but the pathogenesis of POP is obscure up to now.Recent studies have shown an association between POP and the destroy of structural and functional integrity of pelvic connective tissue.The main proteins composing pelvic connective tissue extracellular matrix (ECM)are elastin and collagen.Elastin and collagen contents and structural changes can cause the decreasing of tissue elasticity and the relaxation of pelvic floor structure.Lysyl oxidase (LOX)can catalyze the polymerization of elastic fibers forming covalent crosslinking to increase the stability of EMC,so it is supposed that the change of LOX expression may make a certain contribution to the occurrence and development of POP.%盆腔器官脱垂(POP)是常见的妇产科疾病,但其发病机制尚不明确。目前研究表明,POP 的发生与盆底结缔组织结构及功能完整性被破坏有关,而盆底结缔组织细胞外基质(ECM)的主要成分是弹性蛋白和胶原蛋白,弹性蛋白和胶原蛋白的含量和结构的改变可引起组织弹性降低,盆底结构松弛。赖氨酰氧化酶(LOX)能催化弹性纤维的聚合形成共价交联,增加细胞外基质的稳定性,故推测 LOX 表达的改变在 POP 的发生、发展中可能起一定作用。

  18. Perception of the Relevance of Organic Chemistry in a German Pharmacy Students' Course.

    Science.gov (United States)

    Wehle, Sarah; Decker, Michael

    2016-04-25

    Objective. To investigate German pharmacy students' attitudes toward the relevance of organic chemistry training in Julius Maximilian University (JMU) of Würzburg with regard to subsequent courses in the curricula and in later prospective career options. Methods. Surveys were conducted in the second-year organic chemistry course (50 participants) as well as during the third-year and fourth-year lecture cycle on medicinal and pharmaceutical chemistry (66 participants) in 2014. Results. Students' attitudes were surprisingly consistent throughout the progress of the degree course. Students considered organic chemistry very relevant to the pharmacy study program (95% junior and 97% senior students), and of importance for their future pharmacy program (88% junior and 94% senior students). With regard to prospective career options, the perceived relevance was considerably lower and attitudes were less homogenous. Conclusions. German pharmacy students at JMU Würzburg consider organic chemistry of high relevance for medicinal chemistry and other courses in JMU's pharmacy program.

  19. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

    ... the ectopic pregnancy is not diagnosed early. Chronic pelvic pain —PID may lead to long-lasting pelvic pain. Who is at risk of PID? PID can ... lead to pelvic inflammatory disease and infertility. Chronic Pelvic Pain: Persistent pain in the pelvic region that has ...

  20. [Functional aspects of pelvic floor surgery].

    Science.gov (United States)

    Wagenlehner, F M E; Gunnemann, A; Liedl, B; Weidner, W

    2009-11-01

    Pelvic floor dysfunctions are frequently seen in females. The human pelvic floor is a complex structure and heavily stressed throughout female life. Recent findings in the functional anatomy of the pelvic floor have led to a much better understand-ing, on the basis of which enormous improvements in the therapeutic options have arisen. The pelvic floor activity is regulated by three main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor -organs, bladder and rectum. For different reasons laxity in the vagina or its supporting ligaments as a result of altered connective tissue can distort this functional anatomy. A variety of symptoms can derive from these pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, faecal incontinence, obstructive bowel disease syndrome and pelvic pain. Pelvic floor reconstruction is nowadays driven by the concept that in the case of pelvic floor symptoms restoration of the anatomy will translate into restoration of the physiology and ultimately improve the patients' symptoms. The exact surgical reconstruction of the anatomy is there-fore almost exclusively focused on the restoration of the lax pelvic floor ligaments. An exact identification of the anatomic lesions preoperatively is eminently necessary, to allow for an exact anatomic reconstruction with respect to the muscular forces of the pelvic floor.

  1. Prolift盆底重建术后复发的处理%Strategy on recurrent pelvic organ prolapse after Prolift system surgery

    Institute of Scientific and Technical Information of China (English)

    刘小春; 朱兰; 郎景和; 史宏晖; 龚晓明

    2012-01-01

    目的:探讨Prolift盆底重建术后复发的处理方法.方法:回顾分析我科目前收治的Prolift盆底重建术后复发患者的临床资料,以盆腔器官脱垂定量分期法为指标评价解剖学疗效,用生活质量问卷及性生活问卷为指标评价功能学疗效.结果:复发病例中1例未保留子宫的Prolift盆底重建者术后2年复发,目前放置子宫托疗效满意.4例保留子宫的Prolift盆底重建术后患者短期内(2~6月)复发,且均发生宫颈延长,经子宫切除术结合阴道顶端坐骨棘筋膜固定术后,3例解剖恢复良好,问卷评分示生活质量显著提高,1例因再次复发而行阴道封闭术.2例存在明显的网片侵蚀及症状性皱缩,分次剪除配合局部雌激素后治愈.结论:Prolift盆底重建术后复发病例的进一步处理目前处于初步探索阶段.子宫托保守治疗可作为首选.手术治疗建议切除存在宫颈延长的子宫结合阴道顶端固定术.坐骨棘筋膜固定术是操作简便、费用低廉的顶端固定术式,初步临床结局尚可,远期疗效有待进一步观察.经上述处理再复发者建议行阴道封闭术.%Objective; To investigate the clinical strategy for recurrent pelvic organ prolapse after Prolift system surgery. Methods j Review retrospectively the clinical records of all cases of recurrent pelvic organ prolapse after Prolift system surgery. Anatomic effect( according to POP-Q score) , functional effect (according to Prolapse Quality of life) and sexual life (according to sexual life score) of each patient were assessed. Results: 1 case who was subjected to Prolift system surgery with concomitant hysterectomy recurred pelvic organ prolapse after 2 years, patient was satisfactory with treatment of pessary so far. 4 cases who were subjected to u-terus-sparing Prolift system surgery recurred pelvic organ prolapse in short term (2 ~ 6 months) ,and all were concurrent with prolonged cervix. After hysterectomy combined with

  2. Pelvic actinomycosis: urologic perspective

    Directory of Open Access Journals (Sweden)

    Venkata K. Marella

    2004-10-01

    Full Text Available PURPOSE: Actinomycosis is a chronic granulomatous infection caused by the gram-positive anaerobic bacteria, Actinomyces israelli. This paper reviews the etiology and clinical presentation associated with Actinomycosis that often presents as a pelvic mass that mimics a pelvic malignancy. MATERIALS AND METHODS: A combination of patients treated by the authors in the recent past and a literature review of patients with pelvic Actinomycosis were assessed for diographic, clinical and predisposing co-factors. An analysis is made of age distribution, gender, diagnostic methods and treatment concepts. RESULTS: Thirty-three patients were included in the study that included 2 current patients and 31 obtained from literature review. There were 27 fiales (age range 16 - 69 years, mean 38 years and 6 males (16 - 55 years, mean 36 years. Presenting signs and symptoms were lower abdominal mass in 28 (85%; lower abdominal pain in 21 (63%; vaginal discharge or hiaturia in 7 (22%. Two patients developed fistulae (entero-vesico 1; vesico-cutaneous 1. Nineteen (70% of the 27 fiale patients had intra-uterine contraceptive devices (IUD. Four patients (12.5% (3 males and 1 fiale had urachus or urachal rinants. Cystoscopy in 12 patients noted an extrinsic mass effect, bullous edia and in one patient vegetative proliferation proven to be a chronic inflammatory change. Exploratory laparotomy was performed in 32 of the 33 patients who had excision of mass and involved organs. Diagnosis was established by histologic examination of rioved tissue. Penicillin (6 weeks therapy was utilized to control infections. CONCLUSION: Pelvic actinomycosis mimics pelvic malignancy and may be associated with the long-term use of intra-uterine contraceptive devices, and persistent urachal rinants. Rioval of infected mass and antibiotic therapy will eradicate the inflammatory process.

  3. Pelvic Floor Disorders

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Pelvic Floor Disorders: Condition Information Skip sharing on social media links Share this: Page Content What is the pelvic floor? The term "pelvic floor" refers to the group ...

  4. Uterus-preserving laparoscopic lateral suspension with mesh for pelvic organ prolapse: a patient-centred outcome report and video of a continuous series of 245 patients.

    Science.gov (United States)

    Veit-Rubin, Nikolaus; Dubuisson, Jean-Bernard; Lange, Sören; Eperon, Isabelle; Dubuisson, Jean

    2016-03-01

    Changes in the psychological value of reproductive organs have led to a growing interest in uterine-preserving surgery for pelvic organ prolapse (POP). Sacral hysteropexy is considered as gold standard, although dissection of the promontory may be challenging. We show a video and present a report on a series of patients operated by laparoscopic lateral suspension with mesh as an alternative. Clinical evaluation was performed using the simplified Pelvic Organ Prolapse Quantification System (POP-Q). Primary outcomes were subjective and objective cure; secondary outcomes were rates for reoperation and complications. We assessed patient's satisfaction in a telephone interview using a visual analogue scale and the Patient Global Impression of Improvement Scale (PGI-I) scale. Two hundred and fifty-four patients were treated between 2004 and 2011 with a median follow-up of 7.5 years. At 1 year 82.7 % of patients were asymptomatic, and anatomic success rates were 88.2 % for the anterior, 86.1 % for the apical and 80.8 % for the posterior compartment; 1.2 % had mesh exposure, and the reoperation rate was 7.4 %. More than 80 % of patients were highly satisfied with the outcome. Uterine-preserving laparoscopic lateral suspension with mesh is a safe technique with promising results and low complication rates. It may be an alternative to sacral hysteropexy for high-morbidity patients.

  5. Vaginal childbirth and pelvic floor disorders

    OpenAIRE

    Memon, Hafsa U.; Handa, Victoria L.

    2013-01-01

    Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal deli...

  6. Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang-Wook; Kim, Kyoung Ah [Pochon CHA University Bundang CHA General Hospital, Department of Diagnostic Radiology, College of Medicine, Gyunggi-do (Korea); Lee, Chan; Na, Young-Jeong; Jung, Sang-Geun; Kim, Seung-Jo [Pochon CHA University Bundang CHA General Hospital, Comprehensive Gynecologic Cancer Center, College of Medicine, Gyunggi-do (Korea); Cha, Sun Hee [Pochon CHA University Bundang CHA General Hospital, Department of Obstetrics and Gynecology, College of Medicine, Gyunggi-do (Korea); Yu, Jeong-Sik [YongDong Severance Hospital, Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul (Korea)

    2008-12-15

    Uterine leiomyomas (fibroids), the most common benign tumor in women of childbearing age, can cause symptoms including dysmenorrhea, menorrhagia, urinary symptoms, pain and infertility. Hysterectomy is a common approach to treating uterine fibroids, and less invasive surgical approaches such as myomectomy and uterine artery embolization also have been shown to alleviate symptoms. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is the only totally non-invasive surgical approved method for treating uterine fibroids. In clinical trials, MRgFUS resulted in significant relief of uterine fibroid symptoms. The safe and effective use of MRgFUS is affected by fibroid type and location, position relative to adjacent anatomical structures and the presence of co-existent pelvic disease. Additionally, successful outcomes with MRgFUS have been correlated with the volume of fibroids ablated during the procedure. Thus, selection of patients in whom sufficient fibroid volumes can be treated safely using the MRgFUS system is critical for successful outcomes. The MR images in this pictorial essay provide examples of uterine fibroids for which MRgFUS should be considered and is designed to facilitate the selection of patients for whom MRgFUS is most likely to provide sustained symptom relief. (orig.)

  7. Differentiating rectal carcinoma by an immunohistological analysis of carcinomas of pelvic organs based on the NCBI Literature Survey and the Human Protein Atlas database.

    Science.gov (United States)

    Miura, Koh; Ishida, Kazuyuki; Fujibuchi, Wataru; Ito, Akihiro; Niikura, Hitoshi; Ogawa, Hitoshi; Sasaki, Iwao

    2012-06-01

    The treatments and prognoses of pelvic organ carcinomas differ, depending on whether the primary tumor originated in the rectum, urinary bladder, prostate, ovary, or uterus; therefore, it is essential to diagnose pathologically the primary origin and stages of these tumors. To establish the panels of immunohistochemical markers for differential diagnosis, we reviewed 91 of the NCBI articles on these topics and found that the results correlated closely with those of the public protein database, the Human Protein Atlas. The results revealed the panels of immunohistochemical markers for the differential diagnosis of rectal adenocarcinoma, in which [+] designates positivity in rectal adenocarcinoma and [-] designates negativity in rectal adenocarcinoma: from bladder adenocarcinoma, CDX2[+], VIL1[+], KRT7[-], THBD[-] and UPK3A[-]; from prostate adenocarcinoma, CDX2[+], VIL1[+], CEACAM5[+], KLK3(PSA)[-], ACPP(PAP)[-] and SLC45A3(prostein)[-]; and from ovarian mucinous adenocarcinoma, CEACAM5[+], VIL1[+], CDX2[+], KRT7[-] and MUC5AC[-]. The panels of markers distinguishing ovarian serous adenocarcinoma, cervical carcinoma, and endometrial adenocarcinoma were also represented. Such a comprehensive review on the differential diagnosis of carcinomas of pelvic organs has not been reported before. Thus, much information has been accumulated in public databases to provide an invaluable resource for clinicians and researchers.

  8. 初产妇产后盆底功能锻炼对盆腔器官脱垂影响的临床研究%Effect of postpartum pelvic floor muscle training on pelvic organ prolapse in primiparous women

    Institute of Scientific and Technical Information of China (English)

    李引弟; 雷侠; 晋雅凌; 王娟; 张利平

    2016-01-01

    目的:评估盆底功能锻炼对初产妇产后盆腔器官脱垂( POP)分期和症状的预防及治疗作用。方法将189例初产妇随机分为实验组和对照组,实验组在产后6~8周进行盆底功能锻炼,维持4个月,对照组未进行干预。结果实验组和对照组基线值(产后6周)的POP分期(χ2=2.372, P=0.640),POP-Q位点(P>0.05)和膀胱颈位置(P>0.05)差异无统计学意义;实验组和对照组确诊POP-QⅡ度的初产妇在产后6周和6个月的相对风险度无显著性变化(χ2=2.204,P=0.533;χ2=2.407,P=0.326);对照组在产后6个月阴道内膨胀症状的初产妇数量明显高于实验组(χ2=25.69,P=0.001)。结论产后盆底功能锻炼对初产妇产后盆腔器官脱垂没有影响;对于特定人群需要更多的随机对照性研究确定盆底功能锻炼对盆腔器官脱垂症状的影响。%Objective To evaluate the effect of pelvic floor muscle training ( PFMT) on prevention and treatment of stage and symptoms of pelvic organ prolapse ( POP) in primiparous postpartum women .Methods A total of 189 primiparous postpartum women were randomly divided into experimental group and control group .Patients in the experimental group participated in a 4-month PFMT starting at 6-8 week after delivery, and those in the control group were not treated .Results No significant differences were found in the POP stage (χ2 =2.372, P=0.640), pelvic organ prolapse quantitation (POP-Q) site (P>0.05) and bladder neck position (P>0.05) at baseline (6 week after delivery) between the experimental group and the control group .No significant change was found between two groups in relative risk of being diagnosed with POP-Q stage II at 6 week and 6 month after delivery (χ2 =2.204, P=0.533;χ2 =2.407,P=0.326).Number of women with symptoms of bulging inside vagina was significantly higher in the control group compared to the PFMT group

  9. 689例妇科检查者盆底脏器脱垂患病状况分析%Prevalence of pelvic floor organ prolapse in 689 women undergoing gynecological workup

    Institute of Scientific and Technical Information of China (English)

    刘晓瑛; 周维; 刘保华

    2014-01-01

    Objective:To investigate the prevalence of pelvic floor organ prolapse in outpatients with gynecological diseases, and to explore the risk factors of pelvic floor organ prolapse. Methods: Outpatients underwent gynecological examination by a gynecologist and completed questionnaires. Results: 689 complete questionnaires were collected.Patients who visited the clinic owing to symptoms of pelvic floor organ prolapse only accounted for 4.93% of all cases.184 cases were diagnosed as pelvic floor organ prolapse,accounting for 26.71%. With increasing age,the prevalence of pelvic floor organ prolapse in the degree I,II and III showed a rising trend. The factors such as pregnancy,childbirth,obesity and menopause could induce an increased prevalence of pelvic organ prolapse. Conclusions:Pelvic organ prolapse had become one of the diseases that affect women′s quality of life.However,not many women seek medical assistance because of pelvic floor organ prolapse,which prompts a health concern warranting the attention from medical professionals.%目的::了解门诊妇科患者中盆底脏器脱垂的发生情况,探讨盆底脏器脱垂的高危因素。方法:由妇科医生对门诊就诊者进行妇科检查并填写问卷。结果:收集689份完整问卷,因盆底脏器脱垂就诊只占4.93%,实际脱垂者184例,占26.71%,随着年龄的增加,Ⅰ度、Ⅱ度及Ⅲ度脱垂患病率呈增高趋势,妊娠、分娩、肥胖、绝经可引起盆腔脏器脱垂患病率增加。结论:盆底脏器脱垂已经成为影响女性生活质量的疾病之一,但因此而就诊的妇女比例少,我们医务工作者应该重视和关注。

  10. Effect of total pelvic floor reconstruction for the treatment of severe pelvic organ prolapse%全盆底重建术对重度盆腔器官脱垂的疗效分析

    Institute of Scientific and Technical Information of China (English)

    黄峥; 张晓薇; 叶明; 黄柳; 王一斌; 季冰

    2014-01-01

    Objective:To evaluate clinical efficiency and safety of total pelvic floor reconstruction with mesh for the treatment ofⅢ~Ⅳdegree pelvic organ prolapse (POP). Methods:12 patients withⅢ~Ⅳdegree POP underwent total pelvic floor reconstruction. The subjective and objective effects and incidence of complications were evaluated. Results:The mean operation time was (116±32) min;the blood loss during operation was (138 ±71) ml;catheter retention time was (3.2±3.4) d; residual urine after operation was (38±28) ml; days of hospitalization after operation was (10.0±3.6) d; mean hospitalization cost was 35312±6737 yuan. The mean follow-up period of all patients was 22.4 months (12~33 months). The subjective and objective cure rates were all 91.7% (11/12). Postoperative POP-Q stages were significantly improved comparing with preoperative POP-Q stages ( P0.05) . There was no significant difference between preoperative PISQ scores and postoperative PISQ scores after 1 year of the operation ( P>0.05) . During the operation, there were 1 with injury of bladder, and 2 with postoperation pain, who got spontaneous remission after half a year. After 3 months of the operation, there were 2 with mesh erosions, who were cured by conservative treatment. After 1 year of the operation, there was 1 with anterior prolapse recurrence, who need re-hospitalization for reoperation. And there was no newfound urinary incontinence. Conclusions:Total pelvic floor reconstruction with mesh is an effective technique for the treatment of POP. However, it remains high vaginal mesh erosion rate and postoperative pelvic pain rate. It’ s necessary to be cautious for its clinical application, which is more appropriate for the senile or sexually inactive patients with Ⅲ~Ⅳ degree POP or vault prolapse.%目的:评价使用网片的全盆底重建术用于Ⅲ~Ⅳ度盆腔器官脱垂(POP)的疗效及安全性。方法:对12例Ⅲ~Ⅳ度POP患者施行全盆底重建术,评估其主、

  11. Prolift盆底重建术对盆腔器官脱垂患者生活质量影响分析%Effect of prolift pelvic reconstructive surgery on patients with pelvic organ prolapse in quality of life

    Institute of Scientific and Technical Information of China (English)

    康红; 周利梅

    2014-01-01

    目的:探讨Prolift盆底重建术对盆腔器官脱垂(POP)患者生活质量影响。方法回顾性分析2011年1月至2012年9月在我院行Prolift盆底重建术患者的临床资料及排尿症状,采用ICI-Q-SF问卷评估尿失禁的严重程度,根据有无合并压力性尿失禁(SUI)分为POP+SUI组和POP组,结合PFIQ-7生活质量问卷评估术前及术后6个月患者的生活质量,比较两组患者生活质量恢复情况,结果用SPSS 19.0进行统计学分析。结果总共随访了87例患者, POP+SUI组35例,POP组52例。两组患者术前Aa点、Ba点评分有统计学差异(P<0.05),POP+SUI组高于POP组,术后无统计学差异(P>0.05)。ICI-Q-SF症状评分平均分术前POP+SUI组高于POP组,术后无统计学差异(P>0.05)。术前PFIQ-7生活质量评分膀胱及排尿症状方面POP+SUI组明显高于POP组(P<0.05),术后1个月两组排尿症状有缓解,术后6个月两组无统计学差异(P>0.05)。结论 Prolift盆底重建术可改善POP患者的生活质量,尤其是POP合并SUI患者。%ObjectiveTo research the effect of Prolift pelvic reconstructive surgery for pelvic organ prolapse (POP) patients.MethodsRetrospectively analyzed the patients with POP from January 2011 to September 2012, all the people were divided into two groups (POP+SUI, and POP) according to whether they were suffering SUI or not. ICI-Q-SF questionnaires were used to evaluate symptom, and PFDI-7 questionnaires were used to access the quality of life before, one month and six months after surgery. Data was analyzed by SPSS 19.0.ResultsThe total patients were 87, in which 35 with POP and SUI, 52 with POP. Only the score of Aa and Ba had significant differences, moreover POP+SUI group was higher than POP before surgery, there was no significant differences between the two groups after surgery. The mean score from ICI-Q-SF was higher in POP+SUI group before surgery, but not after

  12. A case of pelvic actinomycosis presenting as cutaneous fistula.

    Science.gov (United States)

    Tedeschi, Amando; Di Mezza, Giovanni; D'Amico, Odette; Ermann, Alfredo; Montone, Luigi; Siciliano, Marcello; Cobellis, Giovanni

    2003-05-01

    Actinomycosis of the female genital tract has greatly increased over the last two decades. A pelvic form of the disease, associated with the use of Intra-uterine Devices (IUD), can severely damage pelvic organs and even can lead to death. We report a case of pelvic actinomycosis presenting as cutaneous fistula.

  13. Total pelvic floor ultrasound for pelvic floor defaecatory dysfunction: a pictorial review.

    Science.gov (United States)

    Hainsworth, Alison J; Solanki, Deepa; Schizas, Alexis M P; Williams, Andrew B

    2015-01-01

    Total pelvic floor ultrasound is used for the dynamic assessment of pelvic floor dysfunction and allows multicompartmental anatomical and functional assessment. Pelvic floor dysfunction includes defaecatory, urinary and sexual dysfunction, pelvic organ prolapse and pain. It is common, increasingly recognized and associated with increasing age and multiparity. Other options for assessment include defaecation proctography and defaecation MRI. Total pelvic floor ultrasound is a cheap, safe, imaging tool, which may be performed as a first-line investigation in outpatients. It allows dynamic assessment of the entire pelvic floor, essential for treatment planning for females who often have multiple diagnoses where treatment should address all aspects of dysfunction to yield optimal results. Transvaginal scanning using a rotating single crystal probe provides sagittal views of bladder neck support anteriorly. Posterior transvaginal ultrasound may reveal rectocoele, enterocoele or intussusception whilst bearing down. The vaginal probe is also used to acquire a 360° cross-sectional image to allow anatomical visualization of the pelvic floor and provides information regarding levator plate integrity and pelvic organ alignment. Dynamic transperineal ultrasound using a conventional curved array probe provides a global view of the anterior, middle and posterior compartments and may show cystocoele, enterocoele, sigmoidocoele or rectocoele. This pictorial review provides an atlas of normal and pathological images required for global pelvic floor assessment in females presenting with defaecatory dysfunction. Total pelvic floor ultrasound may be used with complementary endoanal ultrasound to assess the sphincter complex, but this is beyond the scope of this review.

  14. Perception of the Relevance of Organic Chemistry in a German Pharmacy Students’ Course

    Science.gov (United States)

    Wehle, Sarah

    2016-01-01

    Objective. To investigate German pharmacy students’ attitudes toward the relevance of organic chemistry training in Julius Maximilian University (JMU) of Würzburg with regard to subsequent courses in the curricula and in later prospective career options. Methods. Surveys were conducted in the second-year organic chemistry course (50 participants) as well as during the third-year and fourth-year lecture cycle on medicinal and pharmaceutical chemistry (66 participants) in 2014. Results. Students’ attitudes were surprisingly consistent throughout the progress of the degree course. Students considered organic chemistry very relevant to the pharmacy study program (95% junior and 97% senior students), and of importance for their future pharmacy program (88% junior and 94% senior students). With regard to prospective career options, the perceived relevance was considerably lower and attitudes were less homogenous. Conclusions. German pharmacy students at JMU Würzburg consider organic chemistry of high relevance for medicinal chemistry and other courses in JMU’s pharmacy program. PMID:27170811

  15. 盆底重建术治疗盆底脏器脱垂的疗效观察%Observation on the curative effect of pelvic floor reconstruction operation for treatment of pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    鲁菊英; 梁新芳

    2012-01-01

    , complications, and clinical curative effects in the two groups were compared, the recurrence rates and life satisfaction indexes in the two groups were followed up. Results: The operation time, the amount of blood loss during operation, exhaust time, hospitalization time, and postoperative morbidity in reconstruction group were (75.4 ±20. 5) minutes, (69.2±17.7) ml, (27.1±6.3) hours, (6.7±0.3) days, and 2. 78% , respectively; while in routine group, the indexes were (138. 7 ±18. 6) minutes, (145. 2± 44. 7) ml, ( 44. 6 ±4. 8) hours, ( 11. 4 ±0.4) days, and 9. 38% ,respectively, there was statistically significant difference between the two groups (P<0.05) . The total effective rates in reconstruction group and routine group were 96. 78% and 76. 00% , respectively, the curative effect in reconstruction group was superior to that in routine group ( P < 0. 05 ) . In reconstruction group, the score of pelvic organ prolapse (POP) - Q index, the total length of healthy vagina, the effect of POP on the role, physical strength, social intercourse, personal relationship, emotion, sleeping, and sexual life, the degree of severity of POP after surgery were significantly better than those before surgery ( P = 0. 000 - 0. 007) . Conclusion; Uterus -preserved pelvic floor reconstruction operation plus TVT - O had the advantages of short time, less bleeding, good curative effect, low recurrence rate, and easy to operate for treatment of PFD, which are worthy to be popularized.

  16. Pelvic Mass Due to Transmigrated IUD

    Directory of Open Access Journals (Sweden)

    Nadereh Behtash

    2010-03-01

    Full Text Available Intrauterine device (IUD, a conventional method of contraception is rarely associated with uterine perforation and extra uterine dislocation. A 29 years old woman complaining of vaginal bleeding was referred for pelvic mass identified in ultrasound. The mass was confirmed with CT scan. In laparatomy we found an IUD in cul-de-sac and pelvic mass was apparently an organized hematoma. Transmigrated IUD can induce organized hematomas presenting as a pelvic mass."n© 2010 Tehran University of Medical Sciences. All rights reserved.

  17. Tension-free Polypropylene Mesh-related Surgical Repair for Pelvic Organ Prolapse has a Good Anatomic Success Rate but a High Risk of Complications

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Lan Zhu; Juan Chen; Tao Xu; Jing-He Lang

    2015-01-01

    Background:Food and Drug Administration announcements have highlighted the standard rate of mesh-related complications.We aimed to report the short-term results and complications of tension-free polypropylene mesh (PROSIMATM) surgical repair of pelvic organ prolapse (POP) using the standard category (C),timing (T),and site (S) classification system.Methods:A prospective cohort study of 48 patients who underwent PROSIMATM mesh kit-related surgical repairs were followed for two years at Peking Union Medical College Hospital.Recurrence was defined as symptomatic POP quantification (POP-Q) Stage Ⅱ or higher (leading edge ≥-1 cm).The Patient Global Impression of Change Questionnaire,the Chinese version of the Pelvic Floor Impact Questionnaire short-form-7 and POP/Urinary Incontinence Sexual Questionnaire short-form-12 were used to evaluate the self-perception and sexual function of each patient.Mesh-related complications conformed to the International Urogynecological Association/International Continence Society joint terminology.The paired-sample t-test,one-way analysis of variance,Fisher's exact test,Kaplan-Meier survival analysis and log-rank test were used to analyze data.Results:All patients were followed up for≥1 2 months; 30 (62.5%) patients completed the 24 months study.We observed a 93.8% (45/48) positive anatomical outcome rate at 12 months and 90.0% (27/30) at 24 months.Recurrence most frequently involved the anterior compartment (P < 0.05).Pelvic symptoms improved significantly from baseline (P < 0.05),although the patients' impressions of change and sexual function were not satisfying.Vaginal complication was the main complication observed (35.4%,17/48).The survival analysis did not identify any relationship between vaginal complication and anatomical recurrent prolapse (POP-Q ≥ Stage Ⅱ) (P =0.653).Conclusions:Tension-free polypropylene mesh (PROSIMATM)-related surgical repair of POP has better short-term anatomical outcomes at the

  18. Optical properties in the UV and visible spectral region of organic acids relevant to tropospheric aerosols

    Directory of Open Access Journals (Sweden)

    C. E. Lund Myhre

    2004-06-01

    Full Text Available Refractive and absorption indices in the UV and visible region of selected aqueous organic acids relevant to tropospheric aerosols are reported. The acids investigated are the aliphatic dicarboxylic acids oxalic, malonic, tartronic, succinic and glutaric acid. In addition we report data for pyruvic, pinonic, benzoic and phthalic acid. To cover a wide range of conditions we have investigated the aqueous organic acids at different concentrations spanning from highly diluted samples to concentrations close to saturation. The density of the investigated samples is reported and a parameterisation of the absorption and refractive index that allows the calculation of the optical constants of mixed aqueous organic acids at different concentrations is presented. The single scattering albedo is calculated for two size distributions using measured and a synthetic set of optical constants. The results show that tropospheric aerosols consisting of only these organic acids and water have a pure scattering effect.

  19. Optical properties in the UV and visible spectral region of organic acids relevant to tropospheric aerosols

    Directory of Open Access Journals (Sweden)

    C. E. Lund Myhre

    2004-01-01

    Full Text Available Refractive and absorption indices in the UV and visible region of selected aqueous organic acids relevant to tropospheric aerosols are reported. The acids investigated are the aliphatic dicarboxylic acids oxalic, malonic, tartronic, succinic and glutaric acid. In addition we report data for pyruvic, pinonic, benzoic and phthalic acid. To cover a wide range of conditions we have investigated the aqueous organic acids at different concentrations spanning from highly diluted samples to concentrations close to saturation. The density of the investigated samples is reported and a parameterisation of the absorption and refractive index that allows the calculation of the optical constants of mixed aqueous organic acids at different concentrations is presented. The single scattering albedo is calculated for two size distributions using measured and a synthetic set of optical constants. The results show that tropospheric aerosols consisting of only these organic acids and water have a pure scattering effect.

  20. Pelvic ultrasound - abdominal

    Science.gov (United States)

    ... tubes Abnormal vaginal bleeding Menstrual problems Problems becoming pregnant (infertility) Normal pregnancy Ectopic pregnancy , a pregnancy that occurs outside the uterus Pelvic pain Pelvic ultrasound is also used during ...

  1. Pelvic Pain: Other FAQs

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Pelvic Pain: Other FAQs Skip sharing on social media links ... more than one reason for my pain? Can pelvic pain affect my ability to become pregnant? Can alternative ...

  2. Two parallel, pragmatic, UK multicentre, randomised controlled trials comparing surgical options for upper compartment (vault or uterine) pelvic organ prolapse (the VUE Study): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Glazener, Cathryn; Constable, Lynda; Hemming, Christine; Breeman, Suzanne; Elders, Andrew; Cooper, Kevin; Freeman, Robert; Smith, Anthony R B; Hagen, Suzanne; McDonald, Alison; McPherson, Gladys; Montgomery, Isobel; Kilonzo, Mary; Boyers, Dwayne; Goulao, Beatriz; Norrie, John

    2016-09-08

    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. There is not enough evidence from randomised controlled trials (RCTs) to guide management of vault or uterine prolapse. The Vault or Uterine prolapse surgery Evaluation (VUE) study aims to assess the surgical management of upper compartment pelvic organ prolapse (POP) in terms of clinical effectiveness, cost-effectiveness and adverse events. VUE is two parallel, pragmatic, UK multicentre, RCTs (Uterine Trial and Vault Trial). Eligible for inclusion are women with vault or uterine prolapse: requiring a surgical procedure, suitable for randomisation and willing to be randomised. Randomisation will be computer-allocated separately for each trial, minimised on: requiring concomitant anterior and/or posterior POP surgery or not, concomitant incontinence surgery or not, age (under 60 years or 60 years and older) and surgeon. Participants will be randomly assigned, with equal probability to intervention or control arms in either the Uterine Trial or the Vault Trial. Uterine Trial participants will receive either a vaginal hysterectomy or a uterine preservation procedure. Vault Trial participants will receive either a vaginal sacrospinous fixation or an abdominal sacrocolpopexy. Participants will be followed up by postal questionnaires (6 months post surgery and 12 months post randomisation) and also reviewed in clinic 12 months post surgery. The primary outcome is the participant-reported Pelvic Organ Prolapse Symptom Score (POP-SS) at 12 months post randomisation

  3. Sexual function and health-related quality of life following anterior vaginal wall surgery for stress urinary incontinence and pelvic organ prolapse.

    Science.gov (United States)

    Shen, T; Song, L-J; Xu, Y-M; Gu, B-J; Lu, L-H; Li, F

    2011-01-01

    To assess female sexual function (FSF) and health-related quality of life (HRQOL) following anterior vaginal wall surgeries for stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The retrospective study consisted of 116 patients. Chinese translations of the modified Lemack Questionnaire (not validated) and Pelvic Floor Distress Inventory-Short Form 20 were used to assess FSF and HRQOL, 3 months pre-operatively and 12-24 months (mean 16.8 months) post-operatively. Sixty-one (52.6%, 29 in SUI group and 32 in POP group) of patients were sexually active before and after the operation. Overall, 12 (19.7%, six in SUI group and six in POP group) reported an improvement in overall intercourse satisfaction, 21 (34.4%, 8 in the SUI and 13 in the POP group) were decreased and 28 (45.9%, 15 in SUI group and 13 in POP group) were unchanged. Incidence of coital incontinence decreased significantly in SUI group. Frequency of intercourse decreased, vaginal dryness and pain due to it and asymptomatic vaginal narrowing increased significantly, following the surgery in POP group. There were no statistically significant differences in the frequency of intercourse in SUI group, patients' perception of intercourse, frequency of orgasm and the importance of sex life in both groups. Partner discomfort remained unchanged. HRQOL improved significantly after the operation in both groups. There was no association between HRQOL and FSF in the post-operative period. In most patients, overall FSF did not impaired. All trans-anterior vaginal wall surgery positively impacted on the patients' HRQOL. A prospective study with validated questionnaire is necessary in future.

  4. Health Care Disparities Among English-Speaking and Spanish-Speaking Women With Pelvic Organ Prolapse at Public and Private Hospitals: What Are the Barriers?

    Science.gov (United States)

    Alas, Alexandriah N; Dunivan, Gena C; Wieslander, Cecelia K; Sevilla, Claudia; Barrera, Biatris; Rashid, Rezoana; Maliski, Sally; Eilber, Karen; Rogers, Rebecca G; Anger, Jennifer Tash

    The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP). Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and reconstructive surgery. Standardized questions were asked regarding patients' emotions to when they initially noticed the POP, if they sought family support, and their response to the diagnosis and treatment. Transcripts were analyzed using grounded theory qualitative methods. Thirty-three women were Spanish-speaking and 25 were English-speaking. Spanish speakers were younger (P = 0.0469) and less likely to have a high school diploma (P speaking women had more concerns that the bulge or treatments could lead to cancer, were more resistant to treatment options, and were less likely to be offered surgery. Women in the private hospital desired more information, were less embarrassed, and were more likely to be offered surgery as first-line treatment. The concept emerged that patient care for POP varied based on socioeconomic status and language and suggested the presence of disparities in care for underserved women with POP. The discrepancies in care for Spanish-speaking women and women being treated at public hospitals suggest that there are disparities in care for POP treatment for underserved women. These differences may be secondary to profit-driven pressures from private hospitals or language barriers, low socioeconomic status, low health literacy, and barriers to health care.

  5. Pelvic fractures and mortality.

    OpenAIRE

    K.H. Chong; DeCoster, T.; Osler, T.; Robinson, B.

    1997-01-01

    A retrospective study of all patients (N = 343) with pelvic fractures admitted to our trauma service was conducted to evaluate the impact of pelvic fractures on mortality. All patients sustained additional injuries with an average Injury Severity Score (ISS) of twenty. Thirty-six patients died. This group had more severe pelvic fractures as graded by the Tile classification as well as a greater number and severity of associated injuries. Six patients died as a direct result of pelvic hemorrha...

  6. Anatomical and pathoanatomical studies on the spinal efferent systems innervating pelvic structures. 1. Organization of spinal nuclei in animals. 2. The nucleus X-pelvic motor system in man

    DEFF Research Database (Denmark)

    Schrøder, H D

    1985-01-01

    By means of the aluminum-formaldehyde (ALFA) fluorescence technique for monoamine visualization the distribution of catecholamines was studied in the caudal spinal cord, particularly in relation to motoneurons innervating pelvic structures. In the lumbosacral cord all parts of the spinal gray mat...

  7. Progress of Magnetic Resonance Imaging in Female Pelvic Organ Prolapse%盆底磁共振成像在女性盆腔器官脱垂中应用的研究进展

    Institute of Scientific and Technical Information of China (English)

    贾翔; 吴氢凯

    2016-01-01

    Pelvic floor dysfunction (PFD) is a kind of disease which is caused by the defects of the pelvic floor support structure. Pelvic organ prolapsed (POP) is an important part of PFD, the main clinical manifestations is the position of pelvic organs descent and the function abnormal, it can seriously affects the physical and mental health of adult women. It is necessary to study the mechanism of POP in female pelvic floor, which under the neural control, attached to the bony pelvis. It is a complex three-dimensional arrangement of muscle connective tissue and organs. Scholars use all kinds of physical examination and auxiliary examination to explore the anatomy and function of the pelvic floor, such as POP-Q score, ultrasound, defecography and magnetic resonance imaging (MRI). In recent years, the dynamic and static magnetic resonance imaging has the advantages of high resolution of flab, no radiation, multi planar imaging, no bone artifact interference etc, and has wide application prospect in the three-dimensional reconstruction of pelvic floor. Compare the advantages and disadvantages of magnetic resonance imaging with other methods in female pelvic floor imaging. Review the testing methods, application status and development prospects of magnetic resonance imaging in studying female pelvic floor diseases.%盆底功能障碍性疾病(pelvic floor dysfunction,PFD)是一类由盆底支持结构缺陷、损伤及功能障碍引起的疾病。盆腔器官脱垂(pelvic organ prolapse,POP)是PFD的重要组成部分,以盆腔器官位置下降并引发脏器功能异常为主要临床表现,严重影响成年女性的身心健康。明确女性盆底解剖结构是研究POP发病机制的必经之路,女性盆底的解剖结构是一个以骨盆为依托,由神经、肌肉、结缔组织和盆底器官共同构建的复杂的三维结构。学者们利用各种体格检查及辅助检查探索复杂的盆底解剖结构及功能,如

  8. 经会阴超声评价女性盆底器官的位置和运动%Position and Movement of Female Pelvic Floor Organs Using Translabial Ultrasound

    Institute of Scientific and Technical Information of China (English)

    刘菲菲; 徐莲; 陶均佳; 胡兵; 应涛

    2013-01-01

    Objective To dynamically observe and evaluate the position and movement of pelvic floor organs in pelvic organ prolapse (POP) women with translabial two-dimensional(2D) ultrasound,and to provide the imaging basis for the pathogenesis of POP. Methods Translabial 2D ultrasound was performed on 47 POP women and 30 normal women as control group to observe the position and movement of pelvic floor organs at rest, on pelvic muscle contraction and during maximum Valsalva maneuver. Results The location of urethrovesical junction and cervix were significantly lower in POP group compared with the control group at three stages, and the anorectal junction of 9 posterior compartment prolapse patients located lower than control group on pelvic muscle contraction and during maximum Valsalva maneuver. The movement of pelvic floor organs in vertical direction was greater in POP group than control group during maximum Valsalva maneuver, while was smaller on pelvic floor contraction. Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of pelvic floor organs. The pelvic floor organs of POP group located lower as compared to control group and the movement of POP group was greater than control group during maximum Valsalva maneuver, while was smaller on pelvic floor contraction.%目的 应用经会阴二维超声动态观察和评估盆底器官脱垂(POP)患者盆底器官的位置及运动情况,以期为POP的发病机制提供影像学依据.方法 POP组47例,对照组30例,经会阴超声分别在静息期、张力期和缩肛期观察盆底器官的位置及其运动,并进行两组比较.结果 POP组3个时期尿道膀胱连接部和宫颈外口的位置均低于对照组,后腔脱垂患者肛门直肠连接部的位置在张力期和缩肛期低于对照组.张力期POP组盆底器官向下的移动度明显大于对照组;而缩肛期的向上的移动度明显小于对照组.结论 经会阴二维超声可动态观察盆

  9. 保留子宫的全盆底重建术在治疗盆腔器官脱垂中的疗效分析%The uterus of the pelvic floor revascularization for the treatment of pelvic organ prolapse of curative effect analysis

    Institute of Scientific and Technical Information of China (English)

    罗汝琼

    2013-01-01

    objective:to observe the uterus total pelvic floor revascularization in application effect in the treatment of pelvic organ prolapse. Methods:in February 2012 to February 2013, our hospital of 50 patients with pelvic organ prolapse, giving the uterus total pelvic floor revascularization treatment, and the therapeutic effect was observed. Results:after treatment, there are 47 cases were cured, 3 cases of recurrence, the treatment effective rate was 94.0%;Postoperative urinary retention, vaginal infection, nerve injury, hernia of mesh, mesh erosion complications such as, after the late treatment were recovered. Conclusion:for patients with pelvic organ prolapse uterus total pelvic floor revascularization treatment, can improve the effect of clinical treatment, improve patient quality of life, is worth popularizing in clinical practice.%目的:观察保留子宫全盆底重建术在盆腔器官脱垂治疗中的应用效果。方法:选择2012年2月至2013年2月我院收治的50例盆腔器官脱垂患者,给予保留子宫全盆底重建术进行治疗,并观察其治疗效果。结果:经过临床治疗后,有47例治愈,3例复发,治疗有效率为94.0%;术后出现尿潴留、阴道感染、神经损伤、网片脱出、网片侵蚀等并发症,经过后期治疗均痊愈。结论:给予盆腔器官脱垂患者保留子宫全盆底重建术进行治疗,能够提高临床治疗效果,提高患者生活质量,值得在临床实践中推广使用。

  10. The value of CT three-dimensional reconstruction in the design of operation treatment of pelvic fracture and pelvic organ injury%CT三维重建在骨盆骨折及盆腔脏器损伤手术治疗方案设计中的价值

    Institute of Scientific and Technical Information of China (English)

    祝华强; 刘斯润; 邱剑; 罗东梅; 戴康贤; 彭昌贵; 邱其良; 张继民

    2014-01-01

    目的:探讨螺旋CT三维重建在骨盆骨折及盆腔脏器损伤手术治疗方案设计中的价值。方法分析2007年1月至2013年12月行手术治疗的骨盆骨折及盆腔脏器损伤的患者CT三维重建影像资料,比较术前与术后影像资料及疗效。采用SPSS 17.0统计软件和χ2检验分析轴位CT及三维CT对骨盆骨折诊断的差异。结果149例骨盆骨折患者通过CT三维重建确诊髂骨骨折19例、骶尾骨骨折43例、耻骨上下支骨折30例及髋臼骨折57例;关节脱位21例、耻骨联合分离5例。轴位CT组与三维CT组间比较在髋臼骨折及骶尾骨骨折上,差异有统计学意义(P<0.05)。髂骨骨折、耻骨上下支骨折、关节脱位及耻骨联合分离无统计学意义。合并盆腔脏器损伤有17例,其中膀胱破裂8例、后尿道损伤5例,盆腔血肿4例。149例患者术后复位效果中解剖复位64例,满意75例,不满意14例。获得随访20 d至83个月。按Matta疗效标准评定,临床标准:优97例,良45例,可7例,优良率95%;X线标准:优95例,良45例,可9例,优良率94%。结论螺旋CT三维成像多平面重建(MPR)、容积重建(VR)及表面遮盖重建(SSD)以最直观、全面的骨盆骨折及盆腔脏器损伤图像肯定并明确螺旋CT对骨盆骨折的分型;对治疗方案、手术入路、内固定物的选择和制定详细的手术计划可提供正确指导,在骨盆骨折及盆腔脏器损伤术前、术后影像检查中有较高的价值。%Objective To explore the value of spiral CT 3D reconstruction in the operation treatment of pelvic fracture and the injury of pelvic organs. Methods Retrospective review the image data of spiral CT 3D reconstruc-tion of pelvic fracture and pelvic organ injury in January 2007 to December 2013 operation treatment, compare preop-erative imaging and postoperative data and curative effect. The detection rate between axial CT and 3D CT

  11. Effect of individualized electrical stimulation in pelvic muscles via bio-feedback on the anatomy and function of pelvic prolapsed organs%个体化盆底生物反馈电刺激对盆腔脱垂器官解剖和功能的影响

    Institute of Scientific and Technical Information of China (English)

    何剑芬; 许红雁; 胡红波

    2015-01-01

    目的:探讨个体化盆底生物反馈电刺激治疗盆腔脱垂对器官解剖复位和功能恢复的影响。方法入选120例盆腔器官脱垂患者,随机分组接受为期6个月的Kegel锻炼联合个体化生物反馈电刺激方案(治疗组,60例)和单纯Kegel锻炼(对照组,60例),比较两组干预后患者的器官解剖复位和功能恢复指标的变化。结果(1)解剖位置方面:盆腔器官脱垂量化分期法比较,两组治疗后较治疗前明显改善(Z=6.790,P=0.000;Z=3.208,P=0.001),但治疗组患者的改善效果更佳(Z=3.530,P=0.000);(2)器官功能方面:两组治疗后的盆腔肌力均优于治疗前(Z=7.231,P=0.000;Z=1.995,P=0.037),但治疗组的疗效更好(Z=6.156,P=0.000);治疗后两组患者的最大尿流率较治疗前明显升高(P0.05)。结论个体化生物反馈电刺激治疗盆腔器官脱垂疗效良好、安全、无创伤性,值得在临床推广。%Objective To explore the effect of individualized electrical stimulation in pelvic muscles via bio-feedback on the anatomy and function of pelvic prolapsed organs. Methods A total of 120 patients with pelvic organ prolapse were randomized to two groups: treatment group (with individualized electrical stimulation in pelvic muscles via bio-feedback) and control group (with Kegel exercise only). Parameters were analyzed, including pelvic organs anatomic and functional assessment. Results In terms of anatomic restoration, both groups had improved de-grees and stages of prolapse according to the pelvic organ prolapse quantification (POP-Q). Both groups had signifi-cantly improved pelvic muscle strength and the average and maximum urine flow rates (P0.05). Conclusion In-dividualized electrical stimulation on pelvic muscles via bio-feedback associated with Kegel exercise is safe, atraumat-ic and worthy of application in POP treatment.

  12. Abdominoperineal Resection, Pelvic Exenteration, and Additional Organ Resection Increase the Risk of Surgical Site Infection after Elective Colorectal Surgery: An American College of Surgeons National Surgical Quality Improvement Program Analysis.

    Science.gov (United States)

    Kwaan, Mary R; Melton, Genevieve B; Madoff, Robert D; Chipman, Jeffrey G

    2015-12-01

    Determining predictors of surgical site infection (SSI) in a large cohort is important for the design of accurate SSI surveillance programs. We hypothesized that additional organ resection and pelvic exenterative procedures are associated independently with a higher risk of SSI. Patients in the American College of Surgeons National Surgical Quality Improvement Program® (ACS NSQIP®; American College of Surgeons, Chicago, IL) database (2005-2012) were identified (n=112,282). Surgical site infection (superficial or deep SSI) at 30 d was the primary outcome. Using primary and secondary CPT® codes (American Medical Association, Chicago, IL) pelvic exenteration was defined and additional organ resection was defined as: bladder resection/repair, hysterectomy, partial vaginectomy, additional segmental colectomy, small bowel, gastric, or diaphragm resection. Univariable analysis of patient and procedure factors identified significant (p40 (OR: 2.51), pulmonary comorbidities (OR: 1.22), smoking (OR: 1.24), bowel obstruction (OR: 1.40), wound classification 3 or 4 (OR: 1.18), and abdominoperineal resection (OR: 1.58). Laparoscopic or laparoscopically assisted procedures offered a protective effect against incision infection (OR: 0.55). Additional organ resection (OR: 1.08) was also associated independently with SSI, but the magnitude of the effect was decreased after accounting for operative duration. In the analysis that excludes operative duration, pelvic exenteration is associated with SSI (OR: 1.38), but incorporating operative duration into the model results in this variable becoming non-significant. In addition to other factors, obesity, surgery for bowel obstruction, abdominoperineal resection, and additional organ resection are independently associated with a higher risk of SSI. Surgical site infection risk in pelvic exenteration and multiple organ resection cases appears to be mediated by prolonged operative duration. In these established high-risk sub-groups of

  13. Research advances on the relationship of collagen metabolism and pelvic organ prolapse%胶原代谢与盆腔脏器脱垂的相关性研究进展

    Institute of Scientific and Technical Information of China (English)

    周慧娟

    2011-01-01

    Collagen, the skeleton structure of the extracellular matrix, is a glycoprotein widely distributed in various organs and tissues. The changes of ultrastructure and biochemisty of collagen have become a hot spot of research on the etiology of pelvic organ prolapse in recent years. Studies have shown that the incidence of pelvic organ prolapse is closely related to the collagen content,the proportion of collagen form, structure, genetic and metabolic changes. The study of the pathogenesis of pelvic organ prolapse can provide new approach for its treatment.%胶原蛋白是一种广泛分布在各器官、组织中的糖蛋白,是细胞外基质的骨架结构.胶原蛋白的超微结构和生化改变是近年来盆底器官脱垂病因学研究的热点.研究表明,盆底器官脱垂的发生与胶原蛋白含量、比例,胶原蛋白形态、结构、基因及其代谢密切相关,深入研究盆底器官脱垂的发病机制,可为其治疗提供新思路.

  14. Assessing conservation relevance of organism-environment relations using predicted changes in response variables

    Science.gov (United States)

    Gutzwiller, Kevin J.; Barrow, Wylie C.; White, Joseph D.; Johnson-Randall, Lori; Cade, Brian S.; Zygo, Lisa M.

    2010-01-01

    1. Organism–environment models are used widely in conservation. The degree to which they are useful for informing conservation decisions – the conservation relevance of these relations – is important because lack of relevance may lead to misapplication of scarce conservation resources or failure to resolve important conservation dilemmas. Even when models perform well based on model fit and predictive ability, conservation relevance of associations may not be clear without also knowing the magnitude and variability of predicted changes in response variables. 2. We introduce a method for evaluating the conservation relevance of organism–environment relations that employs confidence intervals for predicted changes in response variables. The confidence intervals are compared to a preselected magnitude of change that marks a threshold (trigger) for conservation action. To demonstrate the approach, we used a case study from the Chihuahuan Desert involving relations between avian richness and broad-scale patterns of shrubland. We considered relations for three winters and two spatial extents (1- and 2-km-radius areas) and compared predicted changes in richness to three thresholds (10%, 20% and 30% change). For each threshold, we examined 48 relations. 3. The method identified seven, four and zero conservation-relevant changes in mean richness for the 10%, 20% and 30% thresholds respectively. These changes were associated with major (20%) changes in shrubland cover, mean patch size, the coefficient of variation for patch size, or edge density but not with major changes in shrubland patch density. The relative rarity of conservation-relevant changes indicated that, overall, the relations had little practical value for informing conservation decisions about avian richness. 4. The approach we illustrate is appropriate for various response and predictor variables measured at any temporal or spatial scale. The method is broadly applicable across ecological

  15. Determining the organ of origin of large pelvic masses in females using multidetector CT angiography and three-dimensional volume rendering CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Li, YangKang; Chen, JunWei; Chen, XueYin; Lin, JianBang; Cai, AiQun; Zhou, XiuGuo [Cancer Hospital, Shantou University Medical College, Department of Radiology, Shantou, Guangdong Province (China); Zheng, Yu [Cancer Hospital, Shantou University Medical College, Department of Clinical Pharmacology, Shantou (China)

    2015-04-01

    To study the value of tumour feeding arteries and the ovarian vein in determining the organ of origin of large pelvic tumours in females using multidetector CT. One hundred and thirty patients with 131 pathologically proven tumours (>6.5 cm) were retrospectively reviewed. Conventional CT images and CT angiography were evaluated, with focus on assessing the value of tumour feeding arteries and the ovarian vein in differentiating ovarian from non-ovarian tumours. For 97 ovarian tumours, the feeding arteries included the ovarian artery (n = 51) and the ovarian branch of uterine artery (n = 64). For 34 non-ovarian tumours, the feeding arteries included the ovarian artery (n = 2), the uterine artery (n = 21), the mesenteric artery (n = 5), and the internal iliac artery (n = 1). The ovarian vein was identified in 86 ovarian tumours and 12 non-ovarian tumours. When the feeding arteries and the ovarian vein were combined to confirm ovarian origin, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.8 %, 84.2 %, 93.8 %, 94.1 %, and 93.9 %, respectively. The accuracy was significantly higher than that of independently using the ovarian vein or the ovarian feeding arteries. Combined application of tumour feeding arteries and the ovarian vein is valuable to differentiate large ovarian from non-ovarian tumours. (orig.)

  16. [Complex pelvic injury in childhood].

    Science.gov (United States)

    Schmal, H; Klemt, C; Haag, C; Bonnaire, F

    2002-08-01

    Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.

  17. 聚丙烯补片修复老年女性前盆腔器官功能障碍%Polypropylene patch repairs anterior pelvic organ dysfunction in older women patients

    Institute of Scientific and Technical Information of China (English)

    张小月

    2015-01-01

    BACKGROUND:The patch materials, originaly applied in the reconstruction and repair of abdominal hernia, have been successfuly applied in the vagina surgery; thus, it has been gradualy generalized in gynecological pelvic floor reconstruction. OBJECTIVE:To analyze the clinical effect of polypropylene patch in older female patients with anterior pelvic organ reconstruction. METHODS:Totaly 24 older female patients with stage III,IV anterior pelvic floor dysfunction were enroled. The individual treatment was formulated according to the wishes of patients, of which 12 patients underwent anterior pelvic organ reconstruction using polypropylene patch (test group), and 12 patients underwent the simply modified vaginal repair treatment (control group). Patients were folowed up for 12 months after repair. The clinical symptom remission, wound healing, pelvic organ prolapse staging and subjective disability index scores were observed. RESULTS AND CONCLUSIONS: After repair, the clinical symptoms in these two groups were significantly aleviated, and there was no infection, poor wound healing and other adverse reactions. At 12 months of folow-up, the subjective disability index scores in these two groups were al significantly lower than those before repair (P < 0.05); moreover, these scores were significantly lower in the test group than the control group (P < 0.05). There were eight cases of pelvic organ prolapse staging I, four cases of pelvic organ prolapse staging II in the test group;seven cases of pelvic organ prolapse staging I, two cases of pelvic organ prolapse staging II, two cases of pelvic organ prolapse staging III and one case of pelvic organ prolapse staging IV in the control group. The degree of organ prolapse in the test group was lower than that in the control group (P < 0.05). These results demonstrate that polypropylene patch repair used in older female anterior pelvic organ reconstruction is safe and effective, and leads to a low recurrence rate.%背景:

  18. Chronic Pelvic Pain in Women

    Science.gov (United States)

    Chronic pelvic pain in women Overview By Mayo Clinic Staff Chronic pelvic pain is pain in the area below your bellybutton ... your hips that lasts six months or longer. Chronic pelvic pain can have multiple causes. It can be a ...

  19. Imaging findings in idiopathic pelvic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Bongartz, G. [Inst. of Diagnostic Radiology University Hospital Basel (Switzerland); Stoffel, F. [Inst. of Urology, University Hospital Basel (Switzerland)

    2001-04-01

    Two patients presented with ureteric obstruction, and voiding symptoms and constipation, respectively, and were examined by means of intravenous urography and computed tomography. One patient was additionally examined by means of MR tomography. After CT (performed in both patients) and MRT (performed in one patient) had shown a diffuse, contrast-enhancing, infiltrating process in the small pelvis with infiltration of adjacent organs and vessels, surgical biopsy proved the diagnosis of idopathic pelvic fibrosis. Extension of retroperitoneal fibrosis below the pelvic rim is very rare. Clinical symptoms of pelvic fibrosis are variable and imaging findings may lead to a broad list of differential diagnoses. We present two patients with idiopathic pelvic fibrosis and discuss radiological findings and differential diagnoses of this rare disease. (orig.)

  20. Connecting Organic Aerosol Climate-Relevant Properties to Chemical Mechanisms of Sources and Processing

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Joel [Univ. of Washington, Seattle, WA (United States)

    2015-01-26

    The research conducted on this project aimed to improve our understanding of secondary organic aerosol (SOA) formation in the atmosphere, and how the properties of the SOA impact climate through its size, phase state, and optical properties. The goal of this project was to demonstrate that the use of molecular composition information to mechanistically connect source apportionment and climate properties can improve the physical basis for simulation of SOA formation and properties in climate models. The research involved developing and improving methods to provide online measurements of the molecular composition of SOA under atmospherically relevant conditions and to apply this technology to controlled simulation chamber experiments and field measurements. The science we have completed with the methodology will impact the simulation of aerosol particles in climate models.

  1. Isolated Pelvic Hyperthermochemotherapeutic Perfusion -An Experimental Study on Isolating Efficacy

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Hyperthermochemotherapeutic perfusion model through isolated pelvic vessels was developed to evaluate the leakage of hyperthermia and drugs (such as adriamycin) from the isolated pelvic circulation to systemic circulation and its associated side/toxic effects. The isolated pelvic circulation was perfused through a femoral artery catheter with hyperthermic (48 ℃ to 55 ℃) adriamycin solution (50 μg/ml) for 30 min. The efflux was drained through a femoral vein catheter. And the pelvic temperature was kept at the level of 43±0.5 ℃. The temperature of pelvic circulation was kept at 4 ℃ to 5 ℃ greater than the systemic/core temperature. The adriamycin concentration of pelvic efflux was 12 to 46 folds of that of systemic serum. The difference between them was very significant (P<0.001). As the perfusion pressure was increased, which kept lower than the mean systemic artery pressure, the leakage of the adriamycin from the isolated pelvic circulation to systemic circulation was increased, but there was no significant difference between them (P>0.05). During isolated perfusion, the systemic blood dynamics remained stable and there were no organic injuries on the important organs. It was suggested that the isolating efficacy of the modality of isolated pelvic hyperthermochemotherapeutic perfusion through vessels was rather high. The hyperthermia and drugs could be effectively limited in the isolated pelvic region with minor side effects on the systemic circulation and important organs.

  2. [Sexual dysfunction following pelvic surgery].

    Science.gov (United States)

    Hojo, K

    1997-11-01

    In male, sexual dysfunction was a common complication that occurred after radical pelvic surgery: radical protectomy, radical cysto-, prostatectomy. Upon the recent pelvic neuroanatomical findings and preservation of these nerves, it is now possible to perform successful cancer operation on the rectum, prostate or bladder with preservation of sexual function in the group of early cancer patients. Depending on the location and severity of these nerve injury, this could result in temporary or permanent erectile and ejaculation dysfunction. In female, the total hysterectomy for cervical cancer sacrifices or injuries the faculty of pregnancy or sexual intercourse. The oophorectomies causes a deficiency of female hormones. But recently the numbers of patients with a small or early stages cancer of uterine or ovary are increasing and we have become to be able to save the functions of these organs in many patients well with minimum local excision or partial resection of them.

  3. Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy.

    Science.gov (United States)

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent; Gimbel, Helga

    2015-04-01

    The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy and to estimate the risk of undergoing POP surgery after hysterectomy. The study was a population-based registry study. Patient data from 154,882 women hysterectomized for benign conditions in the period from 1977 to 2009 were extracted from the Danish National Patient Registry. Patients were followed up from hysterectomy to POP surgery, death/emigration, or end of study period. An estimate of the hazard of undergoing POP surgery following hysterectomy was calculated. Survival analysis was performed using the Kaplan-Meier product limit method. The frequency of POP surgery on hysterectomized women was high the first 2 years of the follow-up period with almost 800 women operated yearly. More than one third (n = 2,872) of all women operated for POP were operated less than 5 years after the hysterectomy with a median of 8.6 years. The cumulated incidence of POP surgery after hysterectomy with follow-up of up to 32 years was 12 %; 50 % (n = 5,451) of all POP surgeries were in the posterior compartment. The mean age of women undergoing a first POP surgery after hysterectomy was 60 years. POP after hysterectomy occurs as a long-term complication of hysterectomy; 12 % of hysterectomized women were operated for POP. They were operated at younger age than non-hysterectomized women and half the POP operations were performed in the posterior compartment.

  4. Preperitoneal pelvic packing: Technique and outcomes.

    Science.gov (United States)

    Filiberto, Dina M; Fox, Adam D

    2016-09-01

    Significant pelvic ring fractures are usually secondary to high-energy trauma, and when associated with other life-threatening injuries and hemodynamic instability, result in high mortality rates ranging from 40 to 60%. The major cause of death during the first 24 h after pelvic trauma is attributed to acute blood loss, with later mortality secondary to multisystem organ failure. In a majority of patients, the source of pelvic bleeding is from disruption of the presacral venous plexus and bony fracture sites, while arterial injury is present in only 10-15%. The optimal management algorithm for hemodynamically unstable patients with pelvic fractures remains controversial. The principles of care center on resuscitation, external stabilization of the pelvis, and hemorrhage control with angiography and embolization (AE) and/or preperitoneal pelvic packing (PPP). AE is effective in controlling arterial bleeding and its role in the management of hemodynamically unstable patients with pelvic fractures is supported by the EAST guidelines. However, since most patients suffer from venous bleeding, PPP can be an alternate life saving technique to control hemorrhage, especially if AE is not immediately available. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Pelvic floor and sexual male dysfunction

    Directory of Open Access Journals (Sweden)

    Antonella Pischedda

    2013-04-01

    Full Text Available The pelvic floor is a complex multifunctional structure that corresponds to the genito- urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.

  6. Different Coexpressions of Arthritis-Relevant Genes between Different Body Organs and Different Brain Regions in the Normal Mouse Population

    OpenAIRE

    Cao, Yanhong; Huang, Yue; Wang, Lishi; Zhu, JiaQian; Gu, Weikuan

    2012-01-01

    Structural changes in different parts of the brain in rheumatoid arthritis (RA) patients have been reported. RA is not regarded as a brain disease. Body organs such as spleen and lung produce RA-relevant genes. We hypothesized that the structural changes in the brain are caused by changes of gene expression in body organs. Changes in different parts of the brain may be affected by altered gene expressions in different body organs. This study explored whether an association between gene expres...

  7. 单侧骶棘韧带固定术治疗盆腔器官脱垂%Unilateral sacrospinous ligament fixation in treatment of pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    周宁; 赵恩峰; 张云

    2014-01-01

    目的:研究单侧骶棘韧带固定术(sacrospinous ligament fixation,SSLF))治疗盆腔脏器脱垂(pelvic organ prolapse,POP)的有效性及安全性。方法回顾性分析我院2005年12月-2012年12月妇产科就诊的80例严重盆腔脏器脱垂且接受单侧SSLF治疗的患者的临床资料,术后6周和6个月进行随访,效果评估包括标准化问卷以及特定部位的阴道检查,并进行POP-Q评分。结果完整随访70例,平均术后随访26.1个月,随访率为87.5%。平均手术时间52(46~110) min,平均失血量83(30~188) ml,平均住院日6.2 d,术后留置尿管平均2.5 d,术后病率17.5%(14/80)。3例(3.7%)盆腔右侧发生血肿,2例(2.8%)术后6个月时阴道穹窿复发。手术成功率85%(68/80)。11例(15.7%)有腰骶部、腹股沟或右侧腹部疼痛,6例(8.6%)伴有新发的压力性尿失禁,2例(2.8%)产生新发的急迫性尿失禁,5例(7.1%)发现缝合线阴道暴露。POP-Q的Aa、Ba、Ap、Bp和D项上,术前与术后差异有统计学意义(P<0.01)。结论单侧SSLF是治疗盆腔脏器脱垂一种安全、经济有效的方法,尤其适合严重的阴道顶端合并前壁膨出以及POPⅠ、Ⅱ或Ⅲ期的子宫脱垂者,其主要并发症是腰骶部、臀部和腹股沟疼痛以及新发的压力性尿失禁。%Objective To study the efficiency and safety of unilateral sacrospinous ligament fixation (SSLF) in treatment of pelvic organ prolapse (POP). Methods Clinical data about 80 patients with severe POP who underwent unilateral SSLF in our department from December 2005 to December 2012 were retrospectively analyzed. The patients were followed up from 6th week and 6th month after operation and their POP-Q was scored according to the standard questionnaire investigation and site-specific vaginal examination. Results Seventy (87.5%) out of the 80 patients were followed up with a mean follow-up time of 26.1 months. The average operation time was 52 min, the average

  8. Physical activity and the pelvic floor.

    Science.gov (United States)

    Nygaard, Ingrid E; Shaw, Janet M

    2016-02-01

    Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially modifiable risk factor; the large number of girls and women participating in sport and strenuous training regimens increases the need to understand associated risks and benefits of these exposures. The aim of this review was to summarize studies reporting the association between physical activity and pelvic floor disorders. Most studies are cross-sectional and most include small numbers of participants. The primary findings of this review include that urinary incontinence during exercise is common and is more prevalent in women during high-impact sports. Mild to moderate physical activity, such as brisk walking, decreases both the odds of having and the risk of developing urinary incontinence. In older women, mild to moderate activity also decreases the odds of having fecal incontinence; however, young women participating in high-intensity activity are more likely to report anal incontinence than less active women. Scant data suggest that in middle-aged women, lifetime physical activity increases the odds of stress urinary incontinence slightly and does not increase the odds of pelvic organ prolapse. Women undergoing surgery for pelvic organ prolapse are more likely to report a history of heavy work than controls; however, women recruited from the community with pelvic organ prolapse on examination report similar lifetime levels of strenuous activity as women without this examination finding. Data are insufficient to determine whether strenuous activity while young predisposes to pelvic floor disorders later in life. The existing literature suggests that most physical activity does not harm the pelvic floor and does provide numerous health benefits for

  9. Stability of Fe-oxide nanoparticles coated with natural organic matter under relevant environmental conditions.

    Science.gov (United States)

    Chekli, L; Phuntsho, S; Tijing, L D; Zhou, J L; Kim, J-H; Shon, H K

    2014-01-01

    Manufactured nanoparticles (MNPs) are increasingly released into the environment and thus research on their fate and behaviour in complex environmental samples is urgently needed. The fate of MNPs in the aquatic environment will mainly depend on the physico-chemical characteristics of the medium. The presence and concentration of natural organic matter (NOM) will play a significant role on the stability of MNPs by either decreasing or exacerbating the aggregation phenomenon. In this study, we firstly investigated the effect of NOM concentration on the aggregation behaviour of manufactured Fe-oxide nanoparticles. Then, the stability of the coated nanoparticles was assessed under relevant environmental conditions. Flow field-flow fractionation, an emerging method which is gaining popularity in the field of nanotechnology, has been employed and results have been compared to another size-measurement technique to provide increased confidence in the outcomes. Results showed enhanced stability when the nanoparticles are coated with NOM, which was due to electrosteric stabilisation. However, the presence of divalent cations, even at low concentration (i.e. less than 1 mM) was found to induce aggregation of NOM-coated nanoparticles via bridging mechanisms between NOM and Ca(2+).

  10. Aviation Technology Life Cycle Management: Importance for Aviation Companies, Aerospace Industry Organizations and Relevant Stakeholders

    Directory of Open Access Journals (Sweden)

    Stanislav Szabo

    2017-04-01

    Full Text Available The paper in the introductory part underlines some aspects concerning the importance of Aviation Technology Life Cycle Management and informs on basic international standards for the processes and stages of life cycle. The second part is focused on definition and main objectives of system life cycle management. The authors subsequently inform on system life cycle stages (in general and system life cycle processes according to ISO/IEC/IEEE 15288:2015 standard. Following the fact, that life cycle cost (LCC is inseparable part and has direct connection to the life cycle management, the paper contains brief information regarding to LCC (cost categories, cost breakdown structure, cost estimation a.o.. Recently was issued the first part of Aviation Technology Life Cycle Management monograph (in Slovak: ”Manažment životného cyklu leteckej techniky I”, written by I.Koblen and S.Szabo. Following this fact and direct relation to the topic of article it is a part of article briefly introduced the content of two parts of this monograph (the 2nd part of monograph it has been prepared for the print. The last part of article is focused on issue concerning main assumptions and conditions for successful application of aviation technology life cycle management in aviation companies, aerospace industry organizations as well as from the relevant stakeholders side.

  11. Pelvic Inflammatory Disease

    Science.gov (United States)

    ... and ambulatory settings. 17-20 While no single explanation exists for this declining trend, some have suggested ... Bacterial Vaginosis (BV) Chlamydia Genital Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human Papillomavirus (HPV) Pelvic Inflammatory Disease ( ...

  12. Pelvic inflammatory disease (PID)

    Science.gov (United States)

    ... for cancer) Getting an intrauterine device (IUD) Miscarriage Abortion In the United States, nearly 1 million women ... gonorrhea, chlamydia, or other causes of PID. Pelvic ultrasound or CT scan to see what else may ...

  13. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

  14. Chronic pelvic pain

    African Journals Online (AJOL)

    It affects all spheres of life, from physical and psychological health to relationship intimacy .... pelvic and sexual pain, in the absence of obvious pathology, has a strong .... Uterine orientation, size, mobility and sensitivity can point to a chronic ...

  15. Chronic pelvic pain

    National Research Council Canada - National Science Library

    Slawomir Wozniak

    2016-01-01

    [b][/b][b]Introduction. [/b]Chronic pelvic pain (CPP) affects about 10–40% of women presenting to a physician, and is characterised by pain within the minor pelvis persisting for over 6 months. [b...

  16. Clinical Analysis of Cervical Vaginal Abdominal Fascia Suspension for the Treatment of Pelvic Organ Prolapse%宫颈阴道腹壁筋膜悬吊术治疗盆腔脏器脱垂的临床分析

    Institute of Scientific and Technical Information of China (English)

    闫士琳

    2015-01-01

    Objective To analyze curative effect of cervical vaginal abdominal fascia suspension surgery for pelvic organ prolapse. Methods In our hospital from 38 patients with pelvic organ prolapse in January 2013 to December 2013 who were treated as the research object. All patients were given cervical fascia suspension in the treatment of abdominal wall. Observe and record the perioperative clinical indicators and treatment effect, complications. Results All the patients after treatment, the success rate of operation was 100%, no complications occurred after the operation, operation cost is low. Conclusion The application of cervical vaginal abdominal fascia suspension surgery for pelvic organ prolapse patients, a signiifcant clinical effect, low cost, wide clinical application.%目的:探讨宫颈阴道腹壁筋膜悬吊术对盆腔脏器脱垂的疗效分析。方法选取我院从2013年1月至2013年12月门诊收治的38例盆腔脏器脱垂患者作为研究对象。所有患者均给予宫颈阴道腹壁筋膜悬吊术治疗。观察记录患者的围手术期各项临床指标及治疗效果,并发症发生情况。结果所有患者经过治疗,手术成功率为100%,术后无并发症发生,手术费用较低。结论应用宫颈阴道腹壁筋膜悬吊术对盆腔脏器脱垂患者治疗,临床效果显著,费用较低,临床值得广泛推广应用。

  17. Robotic pelvic organ prolapse surgery.

    Science.gov (United States)

    Sajadi, Kamran P; Goldman, Howard B

    2015-04-01

    Robotic sacrocolpopexy (RSC) has rapidly gained popularity over the past 10 years, owing to claims that it is associated with a reduced learning curve compared with standard laparoscopic sacrocolpopexy (LSC) and that it has equal efficacy to the gold-standard treatment, abdominal sacrocolpopexy (ASC). The specifics of the surgical technique used for RSC vary widely, but the basic steps and principles are largely the same. Although complication rates are low, specific complications can be minimized by meticulous attention to surgical technique at several important points in the procedure. Multiple levels of evidence support the efficacy of RSC, and show that it is associated with a shorter hospital stay and convalescence than ASC. The learning curve for RSC usually comprises 10-20 procedures but for those with extensive experience of laparoscopy it is likely to be even shorter. RSC is more expensive than LSC but cheaper than ASC. As RSC has only been used for about a decade, we await long-term outcomes of more than a few years.

  18. PELVIC ACTINOMYCOSIS MIMICKING A LOCALLY ADVANCED PELVIC MALIGNANCY--CASE REPORT.

    Science.gov (United States)

    Velenciuc, Natalia; Velenciuc, I; Makkai Popa, S; Roată, C; Ferariu, D; Luncă, S

    2016-01-01

    We present the case of a former user of an intrauterine contraceptive device (IUD) for 10 years, diagnosed with a bulky, fixed pelvic tumor involving the internal genital organs and the recto sigmoid, causing luminal narrowing of the rectum, interpreted as locally advanced pelvic malignancy, probably of genital origin. Intraoperatively, a high index of suspicion made us collect a sample from the fibrous wall of the tumor mass, large Actinomyces colonies were thus identified. Surgery consisted in debridement, removal of a small amount of pus and appendectomy, thus avoiding a mutilating and useless surgery. Specific antibiotic therapy was administered for 3 months, with favorable postoperative and long-term outcomes. Pelvic actinomycosis should always be considered in the differential diagnosis of pelvic tumors in women using an IUD. The association of long-term antibiotic treatment is essential to eradicate the infection and prevent relapses.

  19. Case report: pelvic actinomycosis.

    Science.gov (United States)

    Maxová, K; Menzlová, E; Kolařík, D; Dundr, P; Halaška, M

    2012-01-01

    A case of pelvic actinomycosis is presented. The patient is 42-year-old female with a 5 weeks history of pelvic pain. An intrauterine device (IUD) was taken out 3 weeks ago. There is a lump length 9 cm between rectus muscles. Ultrasound, magnetic resonance imaging (MRI) and histology are used to make the diagnosis. Actinomycosis can mimic the tumour disease. The definitive diagnosis requires positive anaerobic culture or histological identification of actinomyces granulas. A long lasting antibiotic therapy is performed.

  20. 中老年女性盆腔器官脱垂患者尿动力学检查106例临床分析%Analysis of urodynamics in women with pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    程大丽

    2011-01-01

    Objective To study the characteristics of pelvic organ prolapse( POP) and its relationship with stress urinary incontinence(SUI) in women with POP by the urodynamic method. Methods From January 2006 to December 2009,106 peri-menopausal and post-menopausal women who were diagnosed as POP in Shengjing Hospital, China Medical University were included in this study. The urodynamics test which was based on the pelvic organ prolapse quantitative examination (POP-Q)was examined in those 106 women. The urodynamics parameters of the patients were measured according to the principle made by the International Continence Society (ICS). Informed consent was obtained from all participants. Results Among 106 patients ,76 of them had stress urinary incontinence (36 with type I stress urinary incontinence,24 with type II stress urinary incontinence, 16 with type HI stress urinary incontinence) (71. 7% ,76/106) , 10 of them had mixed urinary incontinence (9. 4% , 10/106). Conclusions Women with POP may often associate with various degrees of stress urinary incontinence. Urodynamics may play an important role in the treatment of POP.%目的 探讨女性盆腔脏器脱垂(pelvic organ prolapse,POP)的尿动力学特点,了解盆腔脏器脱垂与压力性尿失禁(stress urinary incontinence,SUI)的关系. 方法 对2006年1月至2009年12月在本院就诊的106例女性盆腔脏器脱垂患者,采用盆腔脏器脱垂评估分类法(pelvic organ prolapse quantitative examination,POP-Q)评估,并进行尿动力学检查,测定尿动力学参数,对结果进行统计学分析. 结果 106例盆腔脏器脱垂患者中,合并SUI76例(Ⅰ型SUI 36例,Ⅱ型24例,Ⅲ型16例)(71.7%,76/106),混合性尿失禁10例(9.4%,10/106).结论 盆腔脏器脱垂与SUI密切相关.尿动力学检查在女性盆腔脏器脱垂的诊断治疗方面具有重要指导意义.

  1. Dynamic MR colpocystorectography assessing pelvic-floor descent

    Energy Technology Data Exchange (ETDEWEB)

    Lienemann, A.; Kohz, P.; Reiser, M. [Department of Radiology, Klinikum Grosshadern, Ludwig-Maximilians-University, Marchioninistrasse 15, D-81 377 Munich (Germany); Anthuber, C.; Baron, A. [Department of Obstetrics and Gynecology, Klinikum Grosshadern, Ludwig-Maximilians-University, Marchioninistrasse 15, D-81 377 Munich (Germany)

    1997-10-01

    Magnetic resonance colpocystorectography (MR-CCRG) is presented in the evaluation of patients with pelvic-floor disorders. Five healthy volunteers and 44 female patients with isolated or combined visceral descent underwent dynamic MRI and dynamic fluoroscopy (DF). MR-CCRG was performed with the patient in a supine position using a True FISP sequence (1 image/1.2 s; in-plane resolution 1.02 mm) during pelvic floor contraction, relaxation, and straining maneuvers. Relevant organs, such as urethra, bladder, vagina, and rectum, were opacified by using a saline solution, Magnevist (Schering AG, Berlin, Germany), and sonography gel, respectively. The clinical evaluation and the intraoperative results (30 cases) were used as reference. MR-CCRG and DF were non-diagnostic in 3 cases each. Most patients had a combined type of visceral prolapse, the most frequent combination being a vaginal vault prolapse and a cystocele. The points of reference were sufficiently outlined by DF and MR-CCRG. In comparison with the clinical and intraoperative results, MR-CCRG proved to be especially beneficial in the diagnosis of different types of enteroceles including a uterovaginal prolapse. MR-CCRG showed an equal or higher sensitivity and specificity for all individual sites when compared with DF. Also, predominant herniation obscuring other concomitant prolapse could be verified in 8 cases. MR-CCRG is superior to DF and accurately depicts pelvic-floor descent and prolapse in women. The possibility of dynamic presentation (see enclosed CD-ROM) allows for a better understanding of the organ movements within a given topographic reference setting. (orig.). With 5 figs., 3 tabs.

  2. Factors predisposing women to chronic pelvic pain: systematic review

    Science.gov (United States)

    Latthe, Pallavi; Mignini, Luciano; Gray, Richard; Hills, Robert; Khan, Khalid

    2006-01-01

    Objective To evaluate factors predisposing women to chronic and recurrent pelvic pain. Design, data sources, and methods Systematic review of relevant studies without language restrictions identified through Medline, Embase, PsycINFO, Cochrane Library. SCISEARCH, conference papers, and bibliographies of retrieved primary and review articles. Two reviewers independently extracted data on study characteristics, quality, and results. Exposure to risk factors was compared between women with and without pelvic pain. Results were pooled within subgroups defined by type of pain and risk factors. Results There were 122 studies (in 111 articles) of which 63 (in 64 286 women) evaluated 54 risk factors for dysmenorrhoea, 19 (in 18 601 women) evaluated 14 risk factors for dyspareunia, and 40 (in 12 040 women) evaluated 48 factors for non-cyclical pelvic pain. Age < 30 years, low body mass index, smoking, earlier menarche (< 12 years), longer cycles, heavy menstrual flow, nulliparity, premenstrual syndrome, sterilisation, clinically suspected pelvic inflammatory disease, sexual abuse, and psychological symptoms were associated with dysmenorrhoea. Younger age at first childbirth, exercise, and oral contraceptives were negatively associated with dysmenorrhoea. Menopause, pelvic inflammatory disease, sexual abuse, anxiety, and depression were associated with dyspareunia. Drug or alcohol abuse, miscarriage, heavy menstrual flow, pelvic inflammatory disease, previous caesarean section, pelvic pathology, abuse, and psychological comorbidity were associated with an increased risk of non-cyclical pelvic pain. Conclusion Several gynaecological and psychosocial factors are strongly associated with chronic pelvic pain. Randomised controlled trials of interventions targeting these potentially modifiable factors are needed to assess their clinical relevance in chronic pelvic pain. PMID:16484239

  3. Sociopsychological factors in women with chronic pelvic pain with and without pelvic venous congestion.

    Science.gov (United States)

    Fry, R P; Beard, R W; Crisp, A H; McGuigan, S

    1997-01-01

    Social and psychological factors have long been proposed as being of importance in a sizeable subgroup of women complaining of unexplained chronic pelvic pain (CPP). The aim of this study was to examine this in two subgroups of CPP patients, thereby eliminating pain alone as the determining variable. Consecutive attenders at a clinic for CPP were assessed on a range of somatic, historical, social, and psychological variables using detailed interviews and questionnaires. They were subsequently allocated to one of two groups, based on the presence or absence of pelvic venous congestion (PVC). Significant associations emerged between some social arrangements, paternal parenting, and patterns of hostility in the group with pelvic venous congestion. The groups also differed in patterns of family illness, and the congested group tended to report more childhood sexual abuse (CSA). Clear case definition in CPP is important. In the subgroup with pelvic venous congestion early social experience may play an important role. Father-daughter relationships may be particularly relevant. Hostility patterns may influence the development of the condition. CSA does not appear to play a specific role in all unexplained CPP cases, but may have relevance for the subgroup with pelvic venous congestion.

  4. Comparative histology of mouse, rat, and human pelvic ligaments.

    Science.gov (United States)

    Iwanaga, Ritsuko; Orlicky, David J; Arnett, Jameson; Guess, Marsha K; Hurt, K Joseph; Connell, Kathleen A

    2016-11-01

    The uterosacral (USL) and cardinal ligaments (CL) provide support to the uterus and pelvic organs, and the round ligaments (RL) maintain their position in the pelvis. In women with pelvic organ prolapse (POP), the connective tissue, smooth muscle, vasculature, and innervation of the pelvic support structures are altered. Rodents are commonly used animal models for POP research. However, the pelvic ligaments have not been defined in these animals. In this study, we hypothesized that the gross anatomy and histological composition of pelvic ligaments in rodents and humans are similar. We performed an extensive literature search for anatomical and histological descriptions of the pelvic support ligaments in rodents. We also performed anatomical dissections of the pelvis to define anatomical landmarks in relation to the ligaments. In addition, we identified the histological components of the pelvic ligaments and performed quantitative analysis of the smooth muscle bundles and connective tissue of the USL and RL. The anatomy of the USL, CL, and RL and their anatomical landmarks are similar in mice, rats, and humans. All species contain the same cellular components and have similar histological architecture. However, the cervical portion of the mouse USL and RL contain more smooth muscle and less connective tissue compared with rat and human ligaments. The pelvic support structures of rats and mice are anatomically and histologically similar to those of humans. We propose that both mice and rats are appropriate, cost-effective models for directed studies in POP research.

  5. Total Pelvic Exenteration for Gynecologic Malignancies

    Directory of Open Access Journals (Sweden)

    Elisabeth J. Diver

    2012-01-01

    Full Text Available Total pelvic exenteration (PE is a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In gynecologic oncology, it is most commonly indicated for the treatment of advanced primary or locally recurrent cancer. Careful patient selection and counseling are of paramount importance when considering someone for PE. Part of the evaluation process includes comprehensive assessment to exclude unresectable or metastatic disease. PE can be curative for carefully selected patients with gynecologic cancers. Major complications can be seen in as many as 50% of patients undergoing PE, underscoring the need to carefully discuss risks and benefits of this procedure with patients considering exenterative surgery.

  6. Pelvic floor muscle function in women with pelvic floor dysfunction

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Dehlendorff, Christian

    2014-01-01

    The objectives of this study were to investigate the level of pelvic floor muscle (PFM) function in women with pelvic floor dysfunction (PFD) referred by gynaecologists and urologists for in-hospital pelvic floor muscle training (PFMT), and to identity associated factors for a low level of PFM fu...

  7. How Is Pelvic Pain Treated?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How is pelvic pain treated? Skip sharing on social media links Share ... Page Content Treatment depends on the cause of pelvic pain, how intense the pain is, and how often ...

  8. How Is Pelvic Pain Diagnosed?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How is pelvic pain diagnosed? Skip sharing on social media links Share ... needed to help diagnose the cause of the pelvic pain. These tests or procedures may include 1 , 2 : ...

  9. Pelvic floor muscle training exercises

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003975.htm Pelvic floor muscle training exercises To use the sharing features on this page, please enable JavaScript. Pelvic floor muscle training exercises are a series of exercises ...

  10. Pelvic Inflammatory Disease (For Teens)

    Science.gov (United States)

    ... lead to internal scarring that might cause ongoing pelvic pain, infertility, or an ectopic pregnancy. What Are the ... the inability to have a baby) and chronic pelvic pain. A teen girl or woman who has had ...

  11. Pelvic Inflammatory Disease (For Parents)

    Science.gov (United States)

    ... ovaries, and uterus, which can lead to chronic pelvic pain and serious damage to the reproductive system . PID ... the inability to have a baby) and chronic pelvic pain. A teen girl or woman who has had ...

  12. Pelvic Inflammatory Disease (PID) Statistics

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Pelvic Inflammatory Disease (PID) Note: Javascript is disabled or is not ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Pelvic Inflammatory Disease (PID) Statistics Recommend on Facebook Tweet Share Compartir ...

  13. Pelvic inflammatory disease (PID) -- aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000710.htm Pelvic inflammatory disease (PID) - aftercare To use the sharing features on ... have just seen your health care provider for pelvic inflammatory disease (PID). PID refers to an infection of the ...

  14. Survival trends and predictors of mortality in severe pelvic trauma

    DEFF Research Database (Denmark)

    Pohlemann, Tim; Stengel, Dirk; Tosounidis, Georgios

    2011-01-01

    STUDY OBJECTIVE: To determine longitudinal trends in mortality, and the contribution of specific injury characteristics and treatment modalities to the risk of a fatal outcome after severe and complex pelvic trauma. METHODS: We studied 5048 patients with pelvic ring fractures enrolled in the German...... Pelvic Trauma Registry Initiative between 1991 and 1993, 1998 and 2000, and 2004 and 2006. Complete datasets were available for 5014 cases, including 508 complex injuries, defined as unstable fractures with severe peri-pelvic soft tissue and organ laceration. Multivariable mixed-effects logistic...... with this type of injury was 18% (95% CI 9-32%) in 2006. CONCLUSION: In contrast to an overall decline in trauma mortality, complex pelvic ring injuries remain associated with a significant risk of death. Awareness of this potentially life-threatening condition should be increased amongst trauma care...

  15. Angioembolization for pelvic hemorrhage control

    DEFF Research Database (Denmark)

    Hauschild, Oliver; Aghayev, Emin; von Heyden, Johanna

    2012-01-01

    with pelvic fractures and computed tomography scan-proven vascular injuries. METHODS: The data from the prospective multicenter German pelvic injury registry were analyzed. Of 5,040 patients with pelvic fractures, 152 patients with associated vascular injuries were identified. Patients undergoing...... pelvic fracture-related vascular lesions. It might prove even more effective when performed early enough to avoid prolonged blood transfusion requirement. Further studies without the mentioned limitations of the study are desired. LEVEL OF EVIDENCE: Therapeutic study, level IV....

  16. Relevance of mycotoxins to product quality and animal health in organic farming

    OpenAIRE

    Paulsen, Hans Marten; Weißmann, Friedrich

    2002-01-01

    Organic farming is not generally more endangered by the risk of contamination of the products with mycotoxins than other farming systems. Knowledge about the influence of litter beddings on mycotoxin exposure of livestock is rare. Due to restrictions on silage additives and fungicides, organic farms are limited in their possibilities to prevent and to cure fungal diseases. But the organic production system offers several important factors for lowering infections with mycotoxin producing fungi.

  17. Different coexpressions of arthritis-relevant genes between different body organs and different brain regions in the normal mouse population.

    Science.gov (United States)

    Cao, Yanhong; Huang, Yue; Wang, Lishi; Zhu, Jiaqian; Gu, Weikuan

    2013-02-25

    Structural changes in different parts of the brain in rheumatoid arthritis (RA) patients have been reported. RA is not regarded as a brain disease. Body organs such as spleen and lung produce RA-relevant genes. We hypothesized that the structural changes in the brain are caused by changes of gene expression in body organs. Changes in different parts of the brain may be affected by altered gene expressions in different body organs. This study explored whether an association between gene expressions of an organ or a body part varies in different brain structures. By examining the association of the 10 most altered genes from a mouse model of spontaneous arthritis in a normal mouse population, we found two groups of gene expression patterns between five brain structures and spleen. The correlation patterns between the prefrontal cortex, nucleus accumbens, and spleen were similar, while the associations between the other three parts of the brain and spleen showed a different pattern. Among overall patterns of the associations between body organs and brain structures, spleen and lung had a similar pattern, and patterns for kidney and liver were similar. Analysis of the five additional known arthritis-relevant genes produced similar results. Analysis of 10 nonrelevant-arthritis genes did not result in a strong association of gene expression or clearly segregated patterns. Our data suggest that abnormal gene expressions in different diseased body organs may influence structural changes in different brain parts.

  18. Separation of Industrially-Relevant Gas Mixtures With Metal-Organic Frameworks

    Science.gov (United States)

    Herm, Zoey Rose

    The work herein describes the investigation of metal-organic frameworks for industrial applications, specifically gas phase separations of mixtures. Metal-organic frameworks are crystalline molecular scaffolds built from cationic metal vertices and organic bridging ligands. They are porous on a molecular scale and can separate gas mixtures when one component interacts more strongly with the pore walls than others. The near-infinite combination of metals and ligands allows for optimization of metal-organic framework structures for specific separations. (Abstract shortened by UMI.)

  19. An investigation of the impact of transvaginal reconstructive pelvic surgery with polypropylene mesh on quality of life in elderly patients with severe pelvic organ prolapse%经阴道聚丙烯网片盆底重建术治疗重度盆腔器官脱垂的主观疗效观察

    Institute of Scientific and Technical Information of China (English)

    张迎辉; 鲁永鲜; 刘昕; 沈文洁; 刘静霞

    2012-01-01

    Objective:To study the impact of transvaginal reconstructive pelvic surgery with polypropylene mesh on quality of life in elderly patients with severe pelvic organ prolapse (POP). Methods:From May 2004 to March 2011 , 114 severe POP patients with stage DI and IV by POP-Q system underwent transvaginal reconstructive pelvic surgery with polypropylene mesh. All the patients completed pelvic floor distress inventory short form(PFDI-20) and pelvic floor impact questionnaire brief form(PFIQ-7) before operation, and it was repeated 2 months ,6 months and 1 year after operation. Results:There were 96 (84%), 85 (75%) and 77 (68%) patients respectively completed the questionnaire at 2 months ,6 months and 1 year after operation. All patients had POP-Q stage≤I 1 year after operation. Nineteen (19. 8% ,19/96 cases)patients had mesh exposure at 2 months and 6(7. 8% ,6/77 cases) at 1 year follow-up. Most bothersome vaginal and pelvic symptoms, including urinary and obstructive defecation symptoms were improved significantly at 2 months after operation , and this improvement was maintained at the 1 year follow-up. Mean score of PFDI-20 and PFIQ-7 decreased significantly after operation at the 2-month, 6-month and 1 year follow-up (P<0. 01). Conclusions : Transvaginal reconstructive pelvic surgery with polypropylene mesh can effectively resolve bothersome symptoms associated with pelvic floor dysfunction and improve quality of life of patients' with severe POP.%目的:调查经阴道聚丙烯网片盆底重建术治疗重度盆腔器官脱垂(POP)的主观疗效.方法:对2004年5月-2011年3月因重度POP在解放军总医院第一附属医院行经阴道聚丙烯网片盆底重建术治疗的114例患者,分别于术前及术后2个月、6个月、1年时进行盆底功能障碍症状及其对生活质量影响的问卷调查,调查采用盆底功能障碍(PFD)症状问卷——盆底困扰量表简表(PFDI-20)以及生活质量问卷——盆底影响问卷简表(PFIQ-7).

  20. [Anatomy of the pelvic lymphatic system].

    Science.gov (United States)

    Wolfram-Gabel, R

    2013-10-01

    The lymphatic system of the pelvis collects the lymph of the genital and urinary organs and of the digestive tract. It is formed by lymphatic nodes and vessels situated inside the conjunctive tissue, near the organs (visceral lymphatic nodes) but especially along the external, internal and common iliac vessels (iliac lymphatic nodes). These nodes receive afferent vessels issued from the different pelvic organs. From the iliac lymphnodes arise efferent vessels running towards lymphatic collectors, situated above them, and which end in the lymphatic lombar duct. The lymphatic pathways represent the preferential way of scattering of cancerous cells. Therefore, the knowledge of the anatomy, of the situation and of the draining of the nodes is of the utmost importance in the evaluation of a cancer of a pelvic organ.

  1. Chronic pelvic pain due to pelvic lymphangioleiomyomatosis: A case report

    Directory of Open Access Journals (Sweden)

    Tetsu Wakimoto

    2016-05-01

    Full Text Available Lymphangioleiomyomatosis (LAM, a rare multisystem disease affecting mainly young women, is characterized by an abnormal proliferation of smooth muscle-like cells in the lungs. We report a case of endometriosis with chronic pelvic pain due to pelvic LAM. A 41-year-old gravida 1, para 1 woman had been experiencing intermittent left pelvic pain for several years. She also complained of dyspnea on effort 2 years previously, and was diagnosed with pulmonary LAM. Abdominal magnetic resonance imaging showed a right ovarian endometriotic cyst and a left pelvic mass. She was referred to our hospital for the treatment of pelvic pain; she underwent laparoscopic cystectomy of the right ovarian endometriotic cyst. Her left pelvic cyst was found in the retroperitoneal space, and biopsy confirmed the diagnosis of LAM. Therefore, we suggest that LAM localized in the pelvis should be considered when a patient with pulmonary LAM presents with pelvic pain or abdominal distention.

  2. Why public moralities matter--the relevance of socioempirical premises for the ethical debate on organ markets.

    Science.gov (United States)

    Schweda, Mark; Schicktanz, Silke

    2014-06-01

    The ongoing bioethical debate about organ markets rests not only on theoretical premises, but also on assumptions regarding public views of and attitudes toward organ donation that need closer socioempirical examination. Summarizing results from our previous qualitative social research in this field, this paper illustrates the ethical significance of such public moralities in two respects: On one hand, it analyzes the implicit bias of the common rhetoric of "organ scarcity" which motivates much of the commercialization debate. On the other hand, it explores the blind spots of the paradigm of "altruistic donation" which informs many arguments against commercialization. We conclude that the ethical discourse has to appreciate the social nature of organ donation as a reciprocal interaction between different parties with irreducibly different but equally relevant viewpoints. We criticize the neglect of such well-founded public considerations in certain philosophical-ethical approaches and stress the need for further systematic and comparative socioempirical studies about peoples' actual perspectives in bioethics.

  3. Relevant Factors for Implementation of Operational-level IS/ICT Processes in Small IT Organizations

    Directory of Open Access Journals (Sweden)

    Jaroslav Kalina

    2010-10-01

    Full Text Available Having IS/ICT processes compliant according to well known standards like COBIT or ITIL is relatively popular especially among larger organizations (to which these standard are primarily aimed. This paper discusses how standardization of processes affects or is affected by a selected set of process characteristics and tries to provide general guidelines which should be considered prior to their implementation (standards. Special attention is paid to the specifics of small IS/ICT organizations since implementation of these frameworks (intended for rather larger organizations represents in this context more demanding endeavor.

  4. Intermolecular THz Vibrations Relevant to Optically and Thermally Induced Magnetic Phase Transitions in the Strongly Correlated Organic Radical TTTA

    OpenAIRE

    Kawano, Taro; Katayama, Ikufumi; Ohara, Jun; Ashida, Masaaki; Takeda, Jun

    2014-01-01

    Intermolecular vibrations relevant to optically and thermally induced magnetic phase transitions between low temperature (LT) diamagnetic and high temperature (HT) paramagnetic phases in a strongly correlated organic radical 1,3,5-trithia-2,4,6-triazapentalenyl (TTTA) crystal have been investigated using broadband terahertz (THz) time-domain spectroscopy. Two absorption bands with different polarizations were clearly observed at 1.3 and 4.0 THz in the LT phase, whilst absent in the HT phase. ...

  5. X-ray CT imaging of normal abdominal and pelvic organs of adult rhesus monkeys%猕猴腹部及盆腔结构的CT影像学观察

    Institute of Scientific and Technical Information of China (English)

    周建华; 范春梅; 李志雄; 俞春英; 王训立

    2012-01-01

    Objective To obtain X-ray computed tomography (CT) imaging of abdominal and pelvic organs of healthy adult rhesus monkeys. Methods Six conventional laboratory rhesus monkeys, 3 male and 3 female, in the age of 5-8 yean were included in this study. The monkeys were placed on the CT table-board in supine position and were scanned to get CT images of the abdominal and pelvic organs by enhanced scan techniques. Volumetric data were collected and reconstruction of the original data was conducted. Meaningful anatomical scanning images were observed, identified and selected; 7 images of the abdominal structures and 10 pelvic organs (5 of males and 5 of females), and each layer of the major visceral organs were labeled. Result On the CT images, the subtle changes of most organs and tissues could be distinguished, and the interface of relatively large organs and blood vessels was clear. But the interface of smaller organs, blood vessels, nerves and muscles, etc. Was not distinct. Conclusions CT images of normal abdominal and pelvic structures of healthy adult rhesus monkeys has been obtained in this study. It provides valuable imaging basis for further studies on disease diagnosis and scientific experiments.%目的 应用CT技术对成年猕猴进行断层扫描,建立猕猴腹部及盆腔CT断层扫描图谱.方法 选择普通级实验猕猴6只,雌雄各半,年龄5~8岁,取头前尾后仰卧位,采用增强扫描CT技术,对其腹部及盆腔进行断层扫描,采集容积数据及对原始数据重建.通过观察、确认,精选具有解剖意义的扫描图像:腹部7张、盆腔10张(雌雄各5张),对其每个层面的主要脏器进行标注.结果 CT影像能分辨出大部分组织器官的细微变化,较大器官、大血管界面清晰,但较小器官和细小血管、神经、肌肉组织等界面尚不清晰.结论 获得了健康成年猕猴腹部及盆腔的影像学图谱,为CT技术在猕猴影像学研究、疾病的临床诊断及科学实验方面

  6. Relevant uses of surface proteins – display on self‐organized biological structures

    OpenAIRE

    Jahns, Anika C.; Rehm, Bernd H. A.

    2012-01-01

    Summary Proteins are often found attached to surfaces of self‐assembling biological units such as whole microbial cells or subcellular structures, e.g. intracellular inclusions. In the last two decades surface proteins were identified that could serve as anchors for the display of foreign protein functions. Extensive protein engineering based on structure–function data enabled efficient display of technically and/or medically relevant protein functions. Small size, diversity of the anchor pro...

  7. Defecatory dysfunction and fecal incontinence in women with or without posterior vaginal wall prolapse as measured by pelvic organ prolapse quantification (POP-Q).

    Science.gov (United States)

    Augusto, Kathiane Lustosa; Bezerra, Leonardo Robson Pinheiro Sobreira; Murad-Regadas, Sthela Maria; Vasconcelos Neto, José Ananias; Vasconcelos, Camila Teixeira Moreira; Karbage, Sara Arcanjo Lino; Bilhar, Andreisa Paiva Monteiro; Regadas, Francisco Sérgio Pinheiro

    2017-07-01

    Pelvic Floor Dysfunction is a complex condition that may be asymptomatic or may involve a loto f symptoms. This study evaluates defecatory dysfunction, fecal incontinence, and quality of life in relation to presence of posterior vaginal prolapse. 265 patients were divided into two groups according to posterior POP-Q stage: posterior POP-Q stage ≥2 and posterior POP-Q stage POP-Q stage, percentage of patients with defecatory dysfunction, percentage of patients with fecal incontinence, pelvic floor muscle strength, and quality of life scores. The correlation between severity of the prolapse and severity of constipation was calculated using ρ de Spearman (rho). Women with Bp stage ≥2 were significantly older and had significantly higher BMI, numbers of pregnancies and births, and overall POP-Q stage than women with stage POP-Q stage did not correlate with severity of constipation and incontinence. General quality of life perception on the SF-36 was significantly worse in patients with POP-Q stage ≥2 than in those with POP-Q stage <2. The lack of a clinically important association between the presence of posterior vaginal prolapse and symptoms of constipation or anal incontinence leads us to agree with the conclusion that posterior vaginal prolapse probably is not an independent cause defecatory dysfunction or fecal incontinence. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. [Establishement for regional pelvic trauma database in Hunan Province].

    Science.gov (United States)

    Cheng, Liang; Zhu, Yong; Long, Haitao; Yang, Junxiao; Sun, Buhua; Li, Kanghua

    2017-04-28

    To establish a database for pelvic trauma in Hunan Province, and to start the work of multicenter pelvic trauma registry.
 Methods: To establish the database, literatures relevant to pelvic trauma were screened, the experiences from the established trauma database in China and abroad were learned, and the actual situations for pelvic trauma rescue in Hunan Province were considered. The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.
 Results: The complex procedure for pelvic trauma rescue was described structurally. The contents for the database included general patient information, injurious condition, prehospital rescue, conditions in admission, treatment in hospital, status on discharge, diagnosis, classification, complication, trauma scoring and therapeutic effect. The database can be accessed through the internet by browser/servicer. The functions for the database include patient information management, data export, history query, progress report, video-image management and personal information management.
 Conclusion: The database with whole life cycle pelvic trauma is successfully established for the first time in China. It is scientific, functional, practical, and user-friendly.

  9. [Small pelvic MRI on "Ellipse" low-adz tomograph made in Russia].

    Science.gov (United States)

    Shotemor, Sh Sh; Churaiants, V V; Bozhko, O V; Ol'kina, O V

    2000-01-01

    The paper presents the authors' experience in using small pelvic MRI on an Ellipse low-field apparatus made in Russia. A total of 74 patients were examined. Abnormal formations in the small pelvic organs were visualized in 72 patients. The potentialities and limitations of MRI in visualizing small pelvic organs and their pathology are shown. The technique is compared with CT and ultrasound study.

  10. Relevance of a perchloric acid extraction scheme to determine mineral and organic phosphorus in swine slurry.

    Science.gov (United States)

    Daumer, Marie-Line; Béline, Fabrice; Spérandio, Mathieu; Morel, Christian

    2008-03-01

    To increase the phosphorus recycling potential from swine slurry, mineral phosphorus products which could be used as fertilizers should be obtained and new processes need to be investigated. A routine method is needed to better evaluate the dissolved and solid mineral phosphorus in swine slurry. Cold perchloric acid extraction method previously developed for wastewater or sludge analysis was adapted. Ionic chromatography was used to measure orthophosphate in extracts. Only one extraction step was needed to distinguish between mineral and organic phosphorus in slurry. Reproducibility of the method was high (less than 5% of variation on the measured fractions). Selectivity was assessed by adding several organic and mineral phosphorus sources in the slurry. Cold perchloric extraction followed by ionic chromatography was very selective in quantifying both the mineral and organic forms of phosphorus in swine slurry.

  11. Pelvic actinomycosis presenting as a malignant pelvic mass: a case report

    Directory of Open Access Journals (Sweden)

    Perek Asiye

    2011-01-01

    Full Text Available Abstract Introduction Pelvic actinomycosis constitutes 3% of all human actinomycosis infections. It is usually insidious, and is often mistaken for other conditions such as diverticulitis, abscesses, inflammatory bowel disease and malignant tumors, presenting a diagnostic challenge pre-operatively; it is identified post-operatively in most cases. Here we present a case that presented as pelvic malignancy and was diagnosed as pelvic actinomycosis post-operatively. Case presentation A 48-year-old Caucasian Turkish woman presented to our clinic with a three-month history of abdominal pain, weight loss and difficulty in defecation. She had used an intra-uterine device for 16 years, however it had recently been removed. The rectosigmoidoscopy revealed narrowing of the lumen at 12 cm due to a mass lesion either in the wall or due to an extrinsic lesion that prevented the passage of the endoscope. On examination, there was no gynecological pathology. Magnetic resonance imaging showed a mass, measuring 5.5 × 4 cm attached to the rectum posterior to the uterus. The ureter on that side was dilated. Surgically there was a pelvic mass adhered to the rectum and uterine adnexes, measuring 10 × 12 cm. It originated from uterine adnexes, particularly ones from the left side and formed a conglomerated mass with the uterus and nearby organs; the left ureter was also dilated due to the pelvic mass. Because of concomitant tubal abscess formation and difficulty in dissection planes, total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed (our patient was 48 years old and had completed her childbearing period. The cytology revealed inflammatory cells with aggregates of Actinomyces. Penicillin therapy was given for six months without any complication. Conclusions Pelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intra-uterine devices, and who have a history of appendectomy, tonsillectomy

  12. The relevance of metal organic frameworks (MOFs) in inorganic materials chemistry

    Indian Academy of Sciences (India)

    Srinivasan Natarajan; Partha Mahata; Debajit Sarma

    2012-03-01

    The metal organic frameworks (MOFs) have evolved to be an important family and a corner stone for research in the area of inorganic chemistry. The progress made since 2000 has attracted researchers from other disciplines to actively engage themselves in this area. This cooperative synergy of different scientific believes have provided important edge and spread to the chemistry of metal-organic frameworks. The ease of synthesis coupled with the observation of properties in the areas of catalysis, sorption, separation, luminescence, bioactivity, magnetism, etc., are a proof of this synergism. In this article, we present the recent developments in this area.

  13. Risk of pelvic injury from femoral neck guidewires.

    Science.gov (United States)

    Feeney, M; Masterson, E; Keogh, P; Quinlan, W

    1997-01-01

    Many of the devices used in the internal fixation of femoral neck fractures are cannulated and require the initial placement of one or more guidewires for accurate positioning. These wires are occasionally advanced inadvertently through the hip joint and the acetabulum. Pelvic visceral damage may follow. To assess this risk, we inserted three guidewires to a depth of 16 cm into each femoral neck of ten cadavers and explored the pelvis during autopsy. Thirty-two of the 60 guidewires had penetrated a pelvic organ. The literature on intrapelvic injuries associated with hip surgery is reviewed, and suggestions are offered on the avoidance of pelvic penetration during hip fracture fixation.

  14. Treatment of volatile organic contaminants in a vertical flow filter: Relevance of different removal processes

    NARCIS (Netherlands)

    De Biase, C.; Reger, D.; Schmidt, A.; Jechalke, S.; Reiche, N.; Martínez-Lavanchy, P.M.; Rosell, M.; Van Afferden, M.; Maier, U.; Oswald, S.E.; Thullner, M.

    2011-01-01

    Vertical flow filters and vertical flow constructed wetlands are established wastewater treatment systems and have also been proposed for the treatment of contaminated groundwater. This study investigates the removal processes of volatile organic compounds in a pilot-scale vertical flow filter. The

  15. Predicting soil N mineralization: Relevance of organic matter fractions and soil properties.

    NARCIS (Netherlands)

    Ros, G.H.; Hanegraaf, M.C.; Hoffland, E.; Riemsdijk, van W.H.

    2011-01-01

    Distinct extractable organic matter (EOM) fractions have been used to assess the capacity of soils to supply nitrogen (N). However, substantial uncertainty exists on their role in the N cycle and their functional dependency on soil properties. We therefore examined the variation in mineralizable N

  16. Treatment of volatile organic contaminants in a vertical flow filter: Relevance of different removal processes

    NARCIS (Netherlands)

    De Biase, C.; Reger, D.; Schmidt, A.; Jechalke, S.; Reiche, N.; Martínez-Lavanchy, P.M.; Rosell, M.; Van Afferden, M.; Maier, U.; Oswald, S.E.; Thullner, M.

    2011-01-01

    Vertical flow filters and vertical flow constructed wetlands are established wastewater treatment systems and have also been proposed for the treatment of contaminated groundwater. This study investigates the removal processes of volatile organic compounds in a pilot-scale vertical flow filter.

  17. Effects of dissolved organic matter (DOM) at environmentally relevant carbon concentrations on atrazine degradation by Chelatobacter heintzii SalB.

    Science.gov (United States)

    Cheyns, Karlien; Calcoen, Jasper; Martin-Laurent, Fabrice; Bru, David; Smolders, Erik; Springael, Dirk

    2012-09-01

    The dissolved organic matter (DOM) is the term used for organic components of natural origin present in the soil solution and is probably the most available C-source that primes microbial activity in subsoils. Contrasting effects of organic C components on pesticide degradation have been reported; however, most studies have used model organic compounds with compositions and concentrations which differ substantially from those found in the environment. Degradation of atrazine (AT) by Chelatobacter heintzii SalB was monitored in liquid batch assays in the absence or presence of well-defined model C compounds (glucose, gluconate and citrate) as model DOM (mDOM) or complex, less-defined, environmental DOM solutions (eDOM: isolated humic substances, soil and plant residue extracts) at environmentally relevant concentrations. Glucose significantly increased AT degradation rate by more than a factor of 8 at and above 2.5 mg C L( - 1). Optical density measurements showed that this stimulation is related to microbial growth. Gluconate and citrate had no effects unless at non-relevant concentrations (1,000 mg DOC L( - 1)) at which stimulations (gluconate) or inhibitions (citrate) were found. The effects of eDOM added at 10 mg DOC L( - 1) on AT degradation were generally small. The AT degradation time was reduced by factors 1.4-1.9 in the presence of humic acids and eDOM from soils amended with plant residues; however, no effects were found for fulvic acids or eDOM from a soil leachate solution or extracted from unamended peat or forest soil. In conclusion, DOM supplied as both mDOM and eDOM did not inhibit AT degradation at environmentally relevant concentrations, and stimulation can be found for selected DOM samples and this is partly related to its effect on growth.

  18. Demonstration of high current carbon nanotube enabled vertical organic field effect transistors at industrially relevant voltages

    Science.gov (United States)

    McCarthy, Mitchell

    The display market is presently dominated by the active matrix liquid crystal display (LCD). However, the active matrix organic light emitting diode (AMOLED) display is argued to become the successor to the LCD, and is already beginning its way into the market, mainly in small size displays. But, for AMOLED technology to become comparable in market share to LCD, larger size displays must become available at a competitive price with their LCD counterparts. A major issue preventing low-cost large AMOLED displays is the thin-film transistor (TFT) technology. Unlike the voltage driven LCD, the OLEDs in the AMOLED display are current driven. Because of this, the mature amorphous silicon TFT backplane technology used in the LCD must be upgraded to a material possessing a higher mobility. Polycrystalline silicon and transparent oxide TFT technologies are being considered to fill this need. But these technologies bring with them significant manufacturing complexity and cost concerns. Carbon nanotube enabled vertical organic field effect transistors (CN-VFETs) offer a unique solution to this problem (now known as the AMOLED backplane problem). The CN-VFET allows the use of organic semiconductors to be used for the semiconductor layer. Organics are known for their low-cost large area processing compatibility. Although the mobility of the best organics is only comparable to that of amorphous silicon, the CN-VFET makes up for this by orienting the channel vertically, as opposed to horizontally (like in conventional TFTs). This allows the CN-VFET to achieve sub-micron channel lengths without expensive high resolution patterning. Additionally, because the CN-VFET can be easily converted into a light emitting transistor (called the carbon nanotube enabled vertical organic light emitting transistor---CN-VOLET) by essentially stacking an OLED on top of the CN-VFET, more potential benefits can be realized. These potential benefits include, increased aperture ratio, increased OLED

  19. Avaliação dos glicosaminoglicanos do tecido periuretral de pacientes com e sem prolapso genital Evaluation of glycosaminoglycans of periurethral tissue in patients with and without pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Paulo Cezar Feldner Jr

    2008-04-01

    Full Text Available OBJETIVOS: Caracterizar e quantificar os subtipos de glicosaminoglicanos sulfatados (GAGs existentes no tecido peri-uretral de pacientes com e sem prolapso genital. METODOS: Foram incluídas 35 pacientes que se submeteram a cirurgia vaginal para correção de distopias genitais e/ou incontinência urinária de esforço ou por outra condição benigna. As pacientes foram avaliadas por anamnese padronizada, exame físico e urodinâmico e agrupadas segundo a existência do prolapso genital. Durante o procedimento cirúrgico, amostras de aproximadamente 1,0 x 1,0 cm do tecido periuretral foram retiradas para avaliação. Os GAGs foram extraídos do tecido por proteólise e precipitação por ácido tricloroacético e caracterizados por eletroforese em gel de agarose. A quantificação foi feita por meio de densitometria a 525 nm do gel corado com azul de toluidina. Compararam-se os dados pela análise de variância (ANOVA. RESULTADOS: Nos grupos estudados, houve maior predomínio de dermatam sulfato (DS, em torno de 85% do total de GAGs, seguido do condroitim sulfato (CS e do heparam sulfato (HS. Observou-se aumento significativo dos GAGs totais, do DS e do HS em mulheres com prolapso genital. Não se observou diferença significante com relação ao CS. CONCLUSÃO: Este estudo demonstrou diferenças na matriz extracelular do tecido periuretral com aumento de GAGs totais, DS e HS nas mulheres com prolapso genital.OBJECTIVE: To characterize and quantify periurethral tissue sulphated glycosaminoglycans (GAGs in women with and without pelvic organ prolapse. STUDY DESIGN: Periurethral tissue was obtained from 35 women who underwent surgery for pelvic organ prolapse, for stress urinary incontinence, or for other gynecological benign conditions. Patients were submitted to a clinical history, physical and urodynamic examination and were divided in two groups according to genital prolapse. The standard biopsy with 1.0 x 1.0 cm was taken from periurethral

  20. The Relevance of the Organic Tradition in Architecture in the Digital Age

    DEFF Research Database (Denmark)

    Jaeger, Thomas Arvid; Carter, Adrian Stanley

    2017-01-01

    production and was in fact able to develop a prefabricated system for double curved form. This paper shows how Utzon’s major work collects the threads from the past and actually fulfils the goals in the architectural scale for new organic form – as Noyes defined it in 1941. This article will present some...... of industrialization and mass production must be seen in the perspective of today’s digitalization of nearly every aspect of the modern architecture and society.......Abstract The paper will propose that as the digital technology evolves, enabling us to increasingly emulate the forms of nature within our built environment, as we see in the parametric design, it will be ever more important to understand the origins of nature and organic growth in form and concept...

  1. Pelvic floor dysfunction in inflammatory bowel disease.

    Science.gov (United States)

    Bondurri, A; Maffioli, A; Danelli, P

    2015-12-01

    Advances in tailored medical therapy and introduction of biologic agents for inflammatory bowel disease (IBD) treatment have ensured long-term disease remission. Some patients, however, still report defecatory symptoms. Patients present with a wide spectrum of conditions - anal incontinence, obstructed defecation and pelvic pain among the most frequent - that have a great impact on their quality of life. Due to IBD diagnosis, little relevance is attributed to this type of symptoms and their epidemiologic distribution is unknown. Pathogenetic hypotheses are currently under investigation. Routine diagnostic workflow and therapeutic options in pelvic floor service are often underused. The evaluation of these disorders starts with an endoscopy to rule out ongoing disease; the following diagnostic workflow is the same as in patients without IBD. For fecal incontinence and obstructed defecation, simple conservative therapy with dietary modifications and appropriate fluid intake is effective in most cases. In non-responding patients, anorectal physiology tests and imaging are required to select patients for pelvic floor muscle training and biofeedback. These treatments have been proven effective in IBD patients. Some new minimally invasive alternative strategies are available for IBD patients, as sacral nerve and posterior tibial nerve stimulation; for other ones (e.g., bulking agent implantation) IBD still remains an exclusion criterion. In order to preserve anatomical areas that could be useful for future reconstructive techniques, surgical options to cure pelvic floor dysfunction are indicated only in a small group of IBD patients, due to the high risk of failure in wound healing and to the possible side effects of surgery, which can lead to anal incontinence or to a possible proctectomy. A particular issue among defecatory symptoms in patients with IBD is paradoxical puborectalis contraction after restorative proctocolectomy: if this disorder is properly diagnosed, a

  2. Relevance of mission statements in Flemish not-for-profit healthcare organizations.

    Science.gov (United States)

    Vandijck, Dominique; Desmidt, Sebastian; Buelens, Marc

    2007-03-01

    The aims of the study were to determine: (1) which components managers of Flemish not-for-profit healthcare organizations chose to incorporate in their mission statement, (2) how satisfied managers of Flemish not-for-profit healthcare organizations are with the formulation of various mission statement components and (3) if the managers of Flemish not-for-profit healthcare organizations subscribe the presumed positive relationship between mission statements and organizational performance. To address these research questions, a questionnaire was send to a convenience sample of Flemish not-for-profit healthcare managers and to a control group. The results indicate that Flemish not-for-profit healthcare managers do discriminate and differentiate between mission statement components and that they are not equally satisfied with the articulation of every component. Furthermore, Flemish not-for-profit healthcare managers do support the assumption that a well-written mission statement can produce a host of benefits. The mission statement is considered as an energy source, a guide in decision-making and to influence the managers' behaviour.

  3. The relevance of different trust models for representation in patient organizations: conceptual considerations.

    Science.gov (United States)

    Gerhards, Helene; Jongsma, Karin; Schicktanz, Silke

    2017-07-11

    Trust within organizations is important for ensuring members' acceptance of the organization's activities and to expand their scope of action. Remarkably, Patient Organizations (POs) that often both function as a forum for self-help and represent patients on the health-political level, have been understudied in this respect. This paper analyzes the relation between trust and representation in POs. We distinguish between two models of representation originating from political theory: the trustee and delegate model and between two types of trust: horizontal and vertical trust. Our theoretical approach is illustrated with an analysis of 13 interviews with representatives of German POs. We have found that the delegate model requires horizontal trust and the trustee model vertical trust. Both models: horizontal/delegate and vertical/trustee exist within single POs. The representation process within POs demands a balancing act between inclusion of affected persons and strategically aggregating a clear-cut political claim. Trust plays in that process of coming from individual wishes to collective and political standpoints a major role both in terms of horizontal as well as vertical trust. Horizontal trust serves the communication between affected members, and vertical trust allows representatives to be decisive.

  4. Magnetic resonance imaging of pelvic endometriosis.

    Science.gov (United States)

    Méndez Fernández, R; Barrera Ortega, J

    Endometriosis is common in women of reproductive age; it can cause pelvic pain and infertility. It is important to diagnose endometriosis and to thoroughly evaluate its extension, especially when surgical treatment is being considered. Magnetic resonance imaging (MRI) with careful examination technique and interpretation enables more accurate and complete diagnosis and staging than ultrasonography, especially in cases of deep pelvic endometriosis. Furthermore, MRI can identify implants in sites that can be difficult to access in endoscopic or laparoscopic explorations. In this article, we describe the appropriate MRI protocol for the study of pelvic endometriosis and the MRI signs of pelvic organ involvement. It is necessary to know the subtle findings and to look for them so we can ensure that they are not overlooked. We describe clinical grading systems for endometriosis and review the diagnostic efficacy of MRI in comparison with other imaging techniques and surgery. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Pediatric Crohn's disease presenting with a large calcified pelvic mass

    OpenAIRE

    Grimberg, Dominic C.; Lau, Lung W.; Dahoud, Wissam; Couturier, Spencer; Redline, Raymond W.; Anne C. Kim

    2017-01-01

    Small bowel Crohn's disease classically presents with symptoms of abdominal pain, diarrhea, and weight loss in the pediatric population. However, there is no published literature on its presentation associated with a dystrophically calcified pelvic mass. We present a case of a 15-year-old female presenting with four weeks of inflammatory bowel disease (IBD) symptoms as well as a large calcified pelvic mass suggestive of chronic, organized inflammatory process versus a calcifying fibrous tumor.

  6. [Pelvic inflammatory disease].

    Science.gov (United States)

    Hoof, Kathrin

    2007-07-01

    Pelvic inflammatory disease and upper genital tract infection describe inflammatory changes in the upper female genital tract of any combination: endometritis, salpingitis, tubo-ovarian abscess and peritonitis in the small pelvis. In most cases the infection is ascending, Chlamydia trachomatis and Neisseria gonorrhoeae are common with increasing incidence. The spectrum ranges from subclinical, asymptomatic infection to severe, life-threatening illness. Antibiotic treatment should be initiated promptly and must cover a broad spectrum of germs. Surgical treatment is necessary in cases of failure of antibiotic treatment and in cases with persisting symptoms after antibiotic treatment. Pelvic inflammatory diseases are one of the main causes of tubal sterility, ectopic pregnancies and chronic abdominal pain.

  7. Relevance of dissolved organic nutrients for the Arctic Ocean nutrient budget

    Science.gov (United States)

    Torres-Valdés, Sinhué; Tsubouchi, Takamasa; Davey, Emily; Yashayaev, Igor; Bacon, Sheldon

    2016-06-01

    We ask whether dissolved organic nitrogen (DON) and phosphorus (DOP) could account for previously identified Arctic Ocean (AO) inorganic nutrient budget imbalances. We assess transports to/from the AO by calculating indicative budgets. Marked DON:DOP ratio differences between the Amerasian and Eurasian AO reflect different physical and biogeochemical pathways. DON and DOP are exported to the North Atlantic via Davis Strait potentially being enhanced in transit from Bering Strait. Fram Strait transports are balanced. Barents Sea Opening transports may provide an additional nutrient source to the Barents Sea or may be locked within the wider AO Atlantic Water circulation. Gaps in our knowledge are identified and discussed.

  8. Machines as organisms: an exploration of the relevance of recent results.

    Science.gov (United States)

    Laing, R

    1979-08-01

    The capacity of machines to exhibit organism-like behavior is examined. Some known results on machine description, self-description, construction and self-construction, are reviewed. The basic mechanism of machines and the ways in which they can be combined to form more complex biological-like systems are put forth as a source of explanatory mechanisms in biology. The proven properties can be employed in the design of machines which can repair themselves, and can exhibit a behavior distinguishing between machines which are or are not structurally similar to themselves. It is then argued that in an appropriate setting of variation and competition, such behavior would arise without explicit design.

  9. [The place of pelvic adhesions in gynecology. Possibilities of prevention].

    Science.gov (United States)

    Inovay, J; Szendei, G

    1997-10-05

    The authors review the recent international literature dealing with the role of pelvic adhesions in gynaecologic surgery. They point out that pelvic adhesions can be detected via laparatomy or laparoscopy in every third patient suffering from chronic pelvic pain, whereas abdominal adhesions revealed rarely correlate with anamnestic chronic pelvic pain. Correlation of pelvic pain and adhesions is neither consequent nor mutual. Lacking more detailed information on the pathomechanism of pain, the role of the vegetative innervation of the visceral and parietal peritoneum and of the excitation of the nerve fibers in the neoformed-and vascularized adhesions can only be postulated. According to the attractive but not well established theory extensive adhesions can directly provoke pain through fixing the pelvic organs hampering their motility and mobility. It is generally accepted, that lysis of adhesions in symptomatic patients can resolve or reduce the complaints. However the duration of the beneficial effect and its transitoric or definitive nature cannot be predicted in advance. Subsequently the authors review the adjuvant methods complementary to microsurgical techniques possibly preventing the formation and neoformation of pelvic adhesions. Despite of general acceptance and widespread usage, the effectiveness of crystalloids, macromolecular solutions, intraperitoneal heparin and steroids in the prevention of adhesions cannot be scientifically supported. The encouraging results already achieved by mechanical barriers (intercede, Gore-Tex) can hopefully be surpassed by biodegradable barriers actually studied in animal models.

  10. Spanish language translation of pelvic floor disorders instruments.

    Science.gov (United States)

    Young, Amy E; Fine, Paul M; McCrery, Rebecca; Wren, Patricia A; Richter, Holly E; Brubaker, Linda; Brown, Morton B; Weber, Anne M

    2007-10-01

    The purpose of the study is to translate existing measures of pelvic symptoms and quality of life from English into Spanish, facilitating research participation of Hispanic/Latina women. The forward-backward translation protocol was applied then adjudicated by a concordance committee. The measures included the Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ), Medical, Epidemiological, and Social Aspects of Aging (MESA) Questionnaire, Hunskaar Severity Measure, Fecal Incontinence Severity Index and modified Manchester Questionnaire, Pelvic Organ Prolapse/Urinary Incontinence Sexual Functioning Questionnaire (PISQ), and the Life Orientation Test (LOT). English and Spanish versions were administered to 50 Hispanic/Latina women with pelvic symptoms. Kappa correlations of items and correlation coefficients for scales were computed. Psychometric testing for translations demonstrated good (0.80-0.89), very good (0.90-0.95), or excellent (>0.95) correlations for primary scales of the PFDI, PFIQ, MESA, Hunskaar, PISQ, and LOT. Strict translation techniques and testing yielded valid Spanish translations of instruments assessing pelvic symptoms/functional life impact in women with pelvic floor disorders.

  11. Relevant uses of surface proteins--display on self-organized biological structures.

    Science.gov (United States)

    Jahns, Anika C; Rehm, Bernd H A

    2012-03-01

    Proteins are often found attached to surfaces of self-assembling biological units such as whole microbial cells or subcellular structures, e.g. intracellular inclusions. In the last two decades surface proteins were identified that could serve as anchors for the display of foreign protein functions. Extensive protein engineering based on structure-function data enabled efficient display of technically and/or medically relevant protein functions. Small size, diversity of the anchor protein as well as support structure, genetic manipulability and controlled cultivation of phages, bacterial cells and yeasts contributed to the establishment of designed and specifically functionalized tools for applications as sensors, catalysis, biomedicine, vaccine development and library-based screening technologies. Traditionally, phage display is employed for library screening but applications in biomedicine and vaccine development are also perceived. For some diagnostic purposes phages are even too small in size so other carrier materials where needed and gave way for cell and yeast display. Only recently, intracellular inclusions such as magnetosomes, polyhydroxyalkanoate granules and lipid bodies were conceived as stable subcellular structures enabling the display of foreign protein functions and showing potential as specific and tailor-made devices for medical and biotechnological applications.

  12. Haemodynamically Unstable Pelvic Fractures

    Science.gov (United States)

    2009-01-01

    through the pubic symphysis, and posteriorlywith the sacrum forming the sacroiliac (SI) joints (Fig. 1). The SI joints are the strongest in the body...Gardner MJ, Kendoff D, Ostermeier S, et al. Sacroiliac joint compression using an anterior pelvic compressor: a mechanical study in synthetic bone. J...commonly identified at arteriography.35 Posterior fracture along the SI joints may cause disruption of a main iliac trunk, but is rare, occurring less

  13. Normal Vulvovaginal, Perineal, and Pelvic Anatomy with Reconstructive Considerations

    Science.gov (United States)

    Yavagal, Sujata; de Farias, Thais F.; Medina, Carlos A.; Takacs, Peter

    2011-01-01

    A thorough insight into the female genital anatomy is crucial for understanding and performing pelvic reconstructive procedures. The intimate relationship between the genitalia and the muscles, ligaments, and fascia that provide support is complex, but critical to restore during surgery for correction of prolapse or aesthetic reasons. The external female genitalia include the mons pubis, labia majora and minora, clitoris, vestibule with glands, perineal body, and the muscles and fascia surrounding these structures. Through the perineal membrane and the perineal body, these superficial vulvar structures are structurally related to the deep pelvic muscle levator ani with its fascia. The levator ani forms the pelvic floor with the coccygeus muscle and provides vital support to all the pelvic organs and stability to the perineum. The internal female genital organs include the vagina, cervix, uterus, tubes, and ovaries with their visceral fascia. The visceral fascia also called the endopelvic fascia, surrounds the pelvic organs and connects them to the pelvic walls. It is continuous with the paraurethral and paravaginal fascia, which is attached to the perineal membrane. Thus, the internal and external genitalia are closely related to the muscles and fascia, and work as one functioning unit. PMID:22547969

  14. Apical vault repair, the cornerstone or pelvic vault reconstruction.

    Science.gov (United States)

    Ross, J W

    1997-01-01

    Pelvic organ prolapse remains a difficult problem for pelvic reconstructive surgery. Before new surgical procedures can be developed a good understanding of pelvic anatomy is necessary. It is widely held that the etiology of pelvic organ prolapse is secondary to stretch neuropathy following childbirth and chronic cough or constipation. Several transvaginal and transabdominal procedures have been developed over the years. With the increasing use of laparoscopy, a new variation on existing culdeplasty techniques has been developed. Following anatomical principles, the apical vault repair reestablishes the pericervical ring at the vaginal apex. The incorporation of pubocervical fascia, uterosacral-cardinal ligament and the rectovaginal fascia provides a strong anchor for the vaginal apex. In addition, the repair should help prevent future transverse cystocele, rectocele, enterocele and apical vault prolapse. Early outcome studies suggest that the apical vault repair should be used routinely with laparoscopic urethropexy, laparoscopic hysterectomy and the repair of pelvic organ prolapse. Good apical vault support is considered the cornerstone of pelvic reconstruction.

  15. Pelvic Fasciae in Urology

    Science.gov (United States)

    Raychaudhuri, B; Cahill, D

    2008-01-01

    INTRODUCTION Despite the vast literature on pelvic fascia, there is confusion over the periprostatic structures and their nomenclature, including their orientation, the neurovascular bundles and the existence of the prostatic ‘capsule’. In this review, we seek to clarify some of these issues. MATERIALS AND METHODS Review of published medical literature relating to the anatomy of the pelvic fascia including a Pubmed search using the terms – pelvic fascia, Denonvilliers' fascia, prostate capsule, neurovascular bundle of Walsh, pubo-prostatic ligament and the detrusor apron. CONCLUSIONS The findings of the study were as follows: The ‘capsule’ of the prostate does not exist. Rather, the fibromuscular band surrounding the prostate forms an integral part of the gland.The prostate is surrounded by fascial structures – anteriorly/anterolaterally by the prostatic fascia and posteriorly by the Denonvilliers' fascia. Laterally, the prostatic fascia merges with the endopelvic fascia.The posterior longitudinal fascia of the detrusor comprises a ‘posterior layer’ of the detrusor apron, extending from the bladder neck to the prostate base.The neurovascular structures tend to be located posterolaterally, but may not always form a bundle. A significant proportion of fibres may lie away from the main nerve structures, along the lateral/posterior aspects of the prostate. PMID:18828961

  16. Organic compounds in hydrothermal systems on the Russian Far East: relevance to the origin of life

    Science.gov (United States)

    Kompanichenko, Vladimir

    In 70th of the last century L. Mukhin with co-authors (1) explored amino acids in the hot springs and water-steam mixture from the boreholes in Kamchatka peninsula of eastern Rus-sia. According to their results, 12 amino acids of biological origination were detected in hot springs inhabited by thermophiles and hyperthermophiles. Only a single amino acid -glycine -was found in the lifeless condensate of water-steam mixture. These authors proposed its abiotic genesis. Our research is devoted to exploration of moderately volatile organic com-pounds in the hot springs and water-steam mixture in Kamchatka peninsula, Kuriles and intracontinental part of eastern Russia. Samples were taken from hot springs far from poten-tial sources of contamination by human populations, and from boreholes 60 to 1200 meters in depth. The temperature ranged from 175C (sterile water-steam mixture) to 55C (hot water with thermophile populations). The samples were analyzed by the gas chromatomass-spectrometer Shimatsu (GCMS-QP20105). Lifeless condensate of water-steam mixture (t = 108-175C) con-tains aromatic hydrocarbons (naphthalene, 1,2-methylnaphtaline biphenyl, phenathrene, fluo-rene,squalene, 1,3-diethylbenzene, and trichlorobenzene)., n-alkanes (decane, dodecane, tride-cane, tetradecane, pentadecane, hexadecane, and geptadecane), aldehyde (oktadekanal), ketone (2-geptadekanon), and alcohol (2-undetsenol-1). 10 homologous series have been found in hot solutions (t = 55-99C) inhabited by thermophilic and hyperthermophilic microorganisms hav-ing low concentrations: aromatic hydrocarbons, n-alkanes, alkenes, aldehydes, dietoxyalkanes, naphthenes, fatty acids, methyl ethers of fatty acids, monoglycerides, and steroids. Especially diverse organic substance is detected in alkaline lower-temperature solutions (pH 9-9.5, t up to 72C). The source of these compounds is not yet established. They may represent pre-existing organic material that has been chemically degraded by pyrolysis. For

  17. Major Histocompatibility Complex Class I Chain-Related A (MICA) Molecules: Relevance in Solid Organ Transplantation

    Science.gov (United States)

    Baranwal, Ajay Kumar; Mehra, Narinder K.

    2017-01-01

    An ever growing number of reports on graft rejection and/or failure even with good HLA matches have highlighted an important role of non-HLA antigens in influencing allograft immunity. The list of non-HLA antigens that have been implicated in graft rejection in different types of organ transplantation has already grown long. Of these, the Major Histocompatibility Complex class I chain-related molecule A (MICA) is one of the most polymorphic and extensively studied non-HLA antigenic targets especially in the kidney transplantation. Humoral response to MICA antigens has repeatedly been associated with lower graft survival and an increased risk of acute and chronic rejection following kidney and liver transplantation with few studies showing conflicting results. Although there are clear indications of MICA antibodies being associated with adverse graft outcome, a definitive consensus on this relationship has not been arrived yet. Furthermore, only a few studies have dealt with the impact of MICA donor-specific antibodies as compared to those that are not donor specific on graft outcome. In addition to the membrane bound form, a soluble isoform of MICA (sMICA), which has the potential to engage the natural killer cell-activating receptor NKG2D resulting in endocytosis and degradation of receptor–ligand interaction complex leading to suppression of NKG2D-mediated host innate immunity, has been a subject of intense discussion. Most studies on sMICA have been directed toward understanding their influence on tumor growth, with limited literature focusing its role in transplant biology. Furthermore, a unique dimorphism (methionine to valine) at position 129 in the α2 domain categorizes MICA alleles into strong (MICA-129 met) and weak (MICA-129 val) binders of NKG2D receptor depending on whether they have methionine or valine at this position. Although the implications of MICA 129 dimorphism have been highlighted in hematopoietic stem cell transplantation, its role in

  18. CT of pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Falchi, Marco E-mail: marcofalchi@yahoo.it; Rollandi, Gian Andrea

    2004-04-01

    Although magnetic resonance imaging has become the dominant modality for cross-sectional musculo-skeletal imaging, the widespread availability, speed, and versatility of computed tomography (CT) continue to make it a mainstay of emergency room (ER) diagnostic imaging. Pelvic ring and acetabular fractures occur as the result of significant trauma secondary to either a motor vehicle accident or a high-velocity fall. These injuries are correlated with significant morbidity and mortality, both from the complications of pelvic ring fractures and from commonly associated injuries. The most commonly used classification of pelvic and acetabular fractures has been based on conventional radiographs that are, in the majority of cases, sufficient to determine the type of injury. However, because of the complexity of pelvic and acetabular fractures, precise pathological anatomy is not easily demonstrated by routine radiographs and in many cases details of fractures are not visible. Moreover, the insufficient co-operation of the patient or the difficulty of maintaining special positions can be overcome by using computed tomography. Spiral computed tomography provides information regarding the extent of the fractures and is complementary to radiography for ascertaining the spatial arrangement of fracture fragments. Spiral computed tomography is an effective tool for understanding complex fracture patterns, particularly when combined with multi-planar reconstruction two-dimensional (MPR 2D) reformatted images or three-dimensional images (3D) images. Including these techniques of reconstruction in routine pelvic imaging protocols can change management in a significant number of cases. Subtle fractures, particularly those oriented in the axial plane, are better seen on MPR images or 3D volume-rendered images. Complex injuries can be better demonstrated with 3D volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily

  19. Musculoskeletal etiologies of pelvic pain.

    Science.gov (United States)

    Prather, Heidi; Camacho-Soto, Alejandra

    2014-09-01

    Several musculoskeletal diagnoses are frequently concomitant with pelvic floor pathology and pain. The definition of pelvic pain itself often depends on the medical specialist evaluating the patient. Because there is variability among disorders associated with pelvic pain, patients may seek treatment for extended periods as various treatment options are attempted. Further, health care providers should recognize that there may not be a single source of dysfunction. This article discusses the musculoskeletal disorders of the pelvic girdle (structures within the bony pelvis) and their association with lumbar spine and hip disorders.

  20. The clinical application and the effect of PROSIMA repair system in treating pelvic organ prolapse%PROSIMA修复系统在盆腔器官脱垂患者中的应用及疗效分析

    Institute of Scientific and Technical Information of China (English)

    纪妹; 史惠蓉; 苏玥辉; 赵曌; 王琳; 张孝艳

    2012-01-01

    目的 通过PROSIMA盆底重建手术治疗症状性Ⅱ~Ⅲ期盆腔器官脱垂(pelvic organ prolapse,POP),旨在寻找一种治疗POP的理想手术方式.方法 对2010年9月至2011年12月郑州大学第一附属医院32例症状性POP-QⅡ~Ⅲ期盆腔器官脱垂患者施行PROSIMA修复系统盆底重建手术,采用盆底功能障碍影响问卷简要版(PFIQ-7)和盆腔器官脱垂/尿失禁性功能问卷(PISQ-12)评价其效果,并分析手术并发症情况.结果 32例患者症状均缓解,手术成功率为100%,术中平均出血量为(40.4±13.7)ml,平均手术时间为(65.1±33.5)min,无血管、神经、膀胱及肠道损伤.平均随访时间为(10.1±9.2)个月(3~18个月),无不适、感染及排异情况.2例补片暴露,对症治疗.无新发急迫性及压力性尿失禁.术后3个月PFIQ-7评分(21.4±21.2)分较术前[(69.1±21.6)分]明显降低(P<0.05).20例患者术后有性生活,术后3个月PISQ-12评分[(26.7±11.7)分]较术前[(81.3±12.6)分]明显降低(P<0.05).结论 PROSIMA修复系统盆底重建手术创伤小、出血少、安全可行,近期疗效好,但其远期疗效及患者性生活质量有待进一步随访.%Objective To evaluate the effect of PROSIMA repair system in treating symptomatic moderate to severe pelvic organ prolapse (POP). Methods 32 patients with POP (stageⅡ- Ⅲ ) who underwent PROSIMA pelvic floor reconstruction form Sep. 2010 to Dec, 2011 were followed up. The clinical outcome and complications were anylazed. Reaults The average blood loss was (40.4±13. 7) ml (20~50ml), the average operation time was (65.1±33. 5) min (5~090 min) . No blood vessels and nerves damage, no bladder and bowel injury occurred during operation. After 3 to 18 months follow-up, the anatomic success was 100%. There was one mesh erosion and was cured after outpatient treatment. No postoperative complications ourred such as infection and rejection, physical pain and feeling motor dysfunction. Ten patients who

  1. Clinical study on concomitant surgery for stress urinary incontinence and pelvic organ prolapse%同期手术治疗女性压力性尿失禁与盆腔脏器脱垂的临床研究

    Institute of Scientific and Technical Information of China (English)

    袁正勇; 戴轶; 陈燕; 魏强; 沈宏

    2008-01-01

    目的 探讨同期手术治疗女性压力性尿失禁(SUI)与盆腔脏器脱垂(POP)的适应证及治疗效果.方法 回顾性总结16例同期手术治疗SUI与POP患者的病例资料,其中有SUI症状并伴有中度以上阴道前壁膨出的患者12例,主诉阴道脱出物,检查发现子宫中度以上脱垂伴排尿困难4例,术前经查体、尿动力及膀胱造影检查确诊均存在Ⅱ型SUI.盆底修补手术包括Gynemesh网片、Prolift前片及全片植入,抗尿失禁手术采用TVT或TVT-O术,术中先行盆底修补术.结果 随访6~30个月,全部患者获满意效果,达到完全控尿,同时无排尿困难发生,未发现盆底膨出复发.结论 对合并有症状或中度以上POP的SUI患者,应积极同期处理相应的POP,以免加重POP的程度或排尿困难的发生;对单独发生的POP患者,应警惕隐性SUI的可能,同期行相应的控尿手术可避免术后SUI的发生.%Objective To discuss indications and therapeutic effects of concomitant surgery for stress urinary incontinence(SUI)and pelvic organ prolapse(POP)through a retrospective clinical review.Method A retrospective review ofthe data of 16 women undergoing concomitant surgery for SUI and POP WaS available for analysis.In these cases.12 patients presented with SUI symptoms associated with medemte or Severe anterior vaginal wall prolapse;4 patients had moderate or severe uterine prolapse associated with dySUXia.All cases were confirmed to have type II stress urinary incontinence by preoperative physical examination,uredynamic study and cystography.The surgical procedures for pelvic floor repair included the placement of Gynemesh mesh impant.anterior or total Prolift mesh implant.The tension-free vaginal tape (TVT)or transvaginal tension free vaginal tape-obturator(TVT-O)was used for the anti-incontinence procedure.During the concurrent surgical procedures,pelvic floor repair was performed first.Results Followel up from 6 to 30 months.all cases got

  2. Avaliação do impacto da correção cirúrgica de distopias genitais sobre a função sexual feminina Impact of surgery for pelvic organ prolapse on female sexual function

    Directory of Open Access Journals (Sweden)

    Daniela Siqueira Prado

    2007-10-01

    Full Text Available OBJETIVO: avaliar as repercussões das cirurgias de correção de distopia genital sobre a função sexual feminina, bem como os resultados anatômicos pós-operatórios, e detectar possíveis correlações entre eles. MÉTODOS: estudo prospectivo realizado entre outubro de 2004 e setembro de 2006. Foram incluídas 43 mulheres sexualmente ativas com distopia genital com indicação de cirurgia de reconstrução do assoalho pélvico. No pré-operatório e três e seis meses após a cirurgia, as pacientes responderam ao questionário de avaliação do comportamento sexual e escalas analógicas para quantificação do grau de desejo, excitação e satisfação, além de se submeterem a exame físico para graduação da distopia genital. Para análise dos resultados, utilizaram-se os testes de simetria de Bowker, Wilcoxon, t de Student, chi2 e análise de variância (ANOVA, quando indicados, com limite de significância estatística de 5% (pPURPOSE: to identify the impact of pelvic reconstructive surgery on female sexual function, as well as the changes in vaginal anatomy, and to detect possible correlations between them. METHODS: a prospective, descriptive study, including 43 sexually active women with genital dystopy, undergoing surgery for pelvic organ prolapse, conducted between October 2004 and September 2006. The women completed the same multiple-choice questionnaire regarding sexual function, and analogic scales to quantify the degree of desire, arousal and satisfaction, and were clinically assessed using the pelvic organ prolapse quantification (POP-Q staging system, before the surgery and three and six months after it. Statistical analysis was performed through the Bowker test for symmetry, Wilcoxon test, Student t test, chi2 and analysis of variance (ANOVA as appropriate, with statistical significance set at 5% (p<0.05. RESULTS: all 43 women completed the follow-up at three and six months after the surgery, but two of them lost their

  3. What Are the Symptoms of Pelvic Pain?

    Science.gov (United States)

    ... Resources and Publications What are the symptoms of pelvic pain? Skip sharing on social media links Share this: Page Content The symptoms of pelvic pain vary from woman to woman. Pelvic pain can ...

  4. Cefotaxime Treatment of Pelvic Inflammatory Disease

    OpenAIRE

    Monson, Thomas P; Miller, Timothy T.; Nolan, Charles M.

    1981-01-01

    We studied cefotaxime in the treatment of gonococcal and nongonococcal pelvic inflammatory disease. Cefotaxime was uniformly effective against gonococcal pelvic inflammatory disease. However, 4 of 11 patients with nongonococcal pelvic inflammatory disease had a suboptimal response.

  5. Particulate organic acids in the atmosphere of Italian cities: Are they environmentally relevant?

    Science.gov (United States)

    Balducci, Catia; Cecinato, Angelo

    2010-02-01

    Mono- and dicarboxylic n-alkyl acids were extensively investigated in downtown Rome, Italy, and in Montelibretti, ˜30 km NE of the city, during 2005-2007. Congeners ranging from lauric to mellisic, and from succinic to α,ω-docosanedioic acids were evaluated as well as phthalic, palmitoleic and oleic acids, by solvent extraction of airborne particulates followed by derivatization with propanol in the presence of boron trifluoride, and gas chromatographic-mass spectrometric analysis. Shorter measurements were made in Milan, in Taranto, at suburban and rural sites of Italy, and in the polar regions, from 1996 to 2005. The predominance of palmitic and stearic acids observed elsewhere was confirmed, and the behaviour of azelaic and phthalic acids resulted strongly dependent upon the year season. In the urban sites, among the long-chain compounds, the lignoceric acid was usually the most abundant, while the cerotic, montanic and mellisic homologues cumulatively never exceeded 8% of the total. Unlike other contaminants, the concentrations of organic acids remained fairly invariant over the last decade, suggesting that more attention must be paid to them in the future.

  6. Raman spectroscopic analysis of minerals and organic molecules of relevance to astrobiology.

    Science.gov (United States)

    Alajtal, A I; Edwards, H G M; Scowen, I J

    2010-05-01

    Characteristic geological features and hydrated minerals recently found on the surface of Mars by the NASA planetary rovers Spirit and Opportunity suggest that a possible biosphere could have once existed there. Analytical instrumentation protocols for the unequivocal detection of biomarkers in suitable geological matrices are critical for future unmanned explorations, including the forthcoming ESA-ExoMars mission scheduled for 2018. Raman spectroscopy is currently a part of the Pasteur instrumentation suite of the ExoMars mission scheduled for 2018 for the remote detection of extant or extinct life signatures in the Martian surface and subsurface. Terrestrial analogues of Martian sites have been identified, and the biogeological modifications incurred as a result of extremophilic survival activity have been studied. Polyaromatic hydrocarbons (PAHs) are recognised as a class of degradation product that occur from biological processes terrestrially. In this work, various concentrations of polyaromatic hydrocarbons in matrices of gypsum, calcite and quartz have been investigated by Raman microspectrometry to determine the lowest detectable organic levels. The studies are conceived in simulation of their potential PAHs identification in geobiological conditions in Martian scenarios. Two laser source wavelengths, namely, 785 and 633 nm, were adopted to excite Raman spectra from the PAHs, which represent degraded carbons and therefore potentially provide a key bimolecular marker of ancient life.

  7. The clinical relevance of Organ Procurement and Transplantation Network screening criteria for program performance review in the United States.

    Science.gov (United States)

    Salkowski, Nicholas; Wey, Andrew; Snyder, Jon J; Orlowski, Jeffrey P; Israni, Ajay K; Kasiske, Bertram L

    2016-09-01

    The Organ Procurement and Transplantation Network is charged with overseeing the quality of transplant programs in the United States. However, there has been controversy over whether too many programs are being identified as underperforming. It has also been suggested that dramatic improvements in outcomes throughout the United States have made the thresholds for determining which deceased donor transplant programs are underperforming no longer clinically relevant. The Scientific Registry of Transplant Recipients compared actual and expected 1-y graft survival for transplant programs identified as underperforming in the most recent cohort (transplants from July 1, 2012 to December 31, 2014). For most organs, actual 1-y graft survival was substantially lower for programs identified as underperforming than for programs identified as performing as expected. Differences were smallest for kidney programs: median 1-y graft survival 89.2% vs 95.4% in large-volume programs identified and not identified for Membership and Professional Standards Committee review, respectively. Median expected graft survival was only slightly lower (94.8% vs 95.1%, respectively), suggesting that identified and not identified programs tend to have similar risk tolerances. An excess of 143 grafts were lost from kidney programs identified as underperforming. Transplant programs identified as underperforming generally have reduced 1-y graft survival that stakeholders may consider clinically relevant.

  8. Treatment effects and genotoxicity relevance of the toxic organic pollutants in semi-coking wastewater by combined treatment process.

    Science.gov (United States)

    Liu, Yongjun; Liu, Jing; Zhang, Aining; Liu, Zhe

    2017-01-01

    The removal effects of main toxic organic pollutants in semi-coking wastewater by combined treatment process were investigated, while the genotoxicity relevance of wastewater from different treatment units were monitored by using Vicia faba bioassays. Results showed that 37 kinds of toxic organic pollutants were detected in the crude sewage, most of them were removed by physicochemical pretreatment, and the total concentration of organic pollutants decreased from 4826 mg L(-1) to 546 mg L(-1). After pretreatment, benzenes, phenols, quinolines and indoles in the wastewater were mainly removed by anaerobic/aerobic biodegradation, but the polycyclic aromatic hydrocarbons (PAHs) were removed mainly by advanced treatment, total concentration of toxic organic pollutants was lower than 0.5 mg L(-1) in the effluent. Genotoxicity evaluation results showed that the wastewater from coagulating sedimentation unit or foregoing had significant mutagenic properties. However, the micronuclei (MN) frequency (‰, which was calculated by observing 1000 cells) induced by wastewater after adsorption with modified coke was only 8.06‰, it was no significant difference compared with negative control (7.43‰). It could be concluded that the adsorption treatment was required for the safety of effluent, and the physicochemical-biochemical combined process in this study was suitable for high concentration semi-coking wastewater treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Relevance of Target-Organ Lesions as Predictors of Mortality in Patients with Diabetes Mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Bianco, Henrique Tria, E-mail: henriquetria@uol.com.br; Izar, Maria Cristina; Fonseca, Henrique Andrade; Póvoa, Rui Manuel [Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Saraiva, José Francisco [Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP (Brazil); Forti, Adriana [Centro de Diabetes e Hipertensão de Fortaleza, Fortaleza, CE (Brazil); Jardim, Paulo Cesar B. V. [Universidade Federal de Goiânia, Goiânia, GO (Brazil); Introcaso, Luis [Centro de Investigação Clínica de Brasília, Brasília, DF (Brazil); Yugar-Toledo, Juan [Escola de Medicina de São José do Rio Preto, São José do Rio Preto, SP (Brazil); Xavier, Hermes Tóros [Centro de Investigação Clínica de Santos, Santos, SP (Brazil); Universidade de São Paulo (USP), São Paulo, SP (Brazil); Faludi, André Arpad [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil); Fonseca, Francisco A. H. [Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

    2014-10-15

    Patients with diabetes are in extract higher risk for fatal cardiovascular events. To evaluate major predictors of mortality in subjects with type 2 diabetes. A cohort of 323 individuals with type 2 diabetes from several regions of Brazil was followed for a long period. Baseline electrocardiograms, clinical and laboratory data obtained were used to determine hazard ratios (HR) and confidence interval (CI) related to cardiovascular and total mortality. After 9.2 years of follow-up (median), 33 subjects died (17 from cardiovascular causes). Cardiovascular mortality was associated with male gender; smoking; prior myocardial infarction; long QTc interval; left ventricular hypertrophy; and eGFR <60 mL/min. These factors, in addition to obesity, were predictors of total mortality. Cardiovascular mortality was adjusted for age and gender, but remained associated with: smoking (HR = 3.8; 95% CI 1.3-11.8; p = 0.019); prior myocardial infarction (HR = 8.5; 95% CI 1.8-39.9; p = 0.007); eGFR < 60 mL/min (HR = 9.5; 95% CI 2.7-33.7; p = 0.001); long QTc interval (HR = 5.1; 95% CI 1.7-15.2; p = 0.004); and left ventricular hypertrophy (HR = 3.5; 95% CI 1.3-9.7; p = 0.002). Total mortality was associated with obesity (HR = 2.3; 95% CI 1.1-5.1; p = 0.030); smoking (HR = 2.5; 95% CI 1.0-6.1; p = 0.046); prior myocardial infarction (HR = 3.1; 95% CI 1.4-6.1; p = 0.005), and long QTc interval (HR = 3.1; 95% CI 1.4-6.1; p = 0.017). Biomarkers of simple measurement, particularly those related to target-organ lesions, were predictors of mortality in subjects with type 2 diabetes.

  10. Relevance of Target-Organ Lesions as Predictors of Mortality in Patients with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Henrique Tria Bianco

    2014-10-01

    Full Text Available Background: Patients with diabetes are in extract higher risk for fatal cardiovascular events. Objective: To evaluate major predictors of mortality in subjects with type 2 diabetes. Methods: A cohort of 323 individuals with type 2 diabetes from several regions of Brazil was followed for a long period. Baseline electrocardiograms, clinical and laboratory data obtained were used to determine hazard ratios (HR and confidence interval (CI related to cardiovascular and total mortality. Results: After 9.2 years of follow-up (median, 33 subjects died (17 from cardiovascular causes. Cardiovascular mortality was associated with male gender; smoking; prior myocardial infarction; long QTc interval; left ventricular hypertrophy; and eGFR <60 mL/min. These factors, in addition to obesity, were predictors of total mortality. Cardiovascular mortality was adjusted for age and gender, but remained associated with: smoking (HR = 3.8; 95% CI 1.3-11.8; p = 0.019; prior myocardial infarction (HR = 8.5; 95% CI 1.8-39.9; p = 0.007; eGFR < 60 mL/min (HR = 9.5; 95% CI 2.7-33.7; p = 0.001; long QTc interval (HR = 5.1; 95% CI 1.7-15.2; p = 0.004; and left ventricular hypertrophy (HR = 3.5; 95% CI 1.3-9.7; p = 0.002. Total mortality was associated with obesity (HR = 2.3; 95% CI 1.1-5.1; p = 0.030; smoking (HR = 2.5; 95% CI 1.0-6.1; p = 0.046; prior myocardial infarction (HR = 3.1; 95% CI 1.4-6.1; p = 0.005, and long QTc interval (HR = 3.1; 95% CI 1.4-6.1; p = 0.017. Conclusions: Biomarkers of simple measurement, particularly those related to target-organ lesions, were predictors of mortality in subjects with type 2 diabetes.

  11. A standard for terminology in chronic pelvic pain syndromes

    DEFF Research Database (Denmark)

    Doggweiler, Regula; Whitmore, Kristene E; Meijlink, Jane M

    2016-01-01

    AIMS: Terms used in the field of chronic pelvic pain (CPP) are poorly defined and often confusing. An International Continence Society (ICS) Standard for Terminology in chronic pelvic pain syndromes (CPPS) has been developed with the aim of improving diagnosis and treatment of patients affected...... by chronic pelvic pain syndromes. The standard aims to facilitate research, enhance therapy development and support healthcare delivery, for healthcare providers, and patients. This document looks at the whole person and all the domains (organ systems) in a systematic way. METHODS: A dedicated working group...... for symptoms, signs, and evaluation (diagnostic work-up) of female and male patients with chronic pelvic pain syndromes, serving as a platform for ongoing development in this field. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc....

  12. Treatment of Pelvic Ring Fractures with Pelvic Circumferential Compression Divices

    NARCIS (Netherlands)

    S.P. Knops (Simon)

    2014-01-01

    markdownabstract__Abstract__ High energy pelvic fractures are life-threatening injuries and are among the most challenging injuries to treat. Complete evaluation of the patient with a high energy pelvic fracture is essential because this is rarely an isolated injury. Most deaths in patients with pe

  13. Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

    Directory of Open Access Journals (Sweden)

    Murat Bozkurt

    2014-12-01

    Full Text Available Pelvic floor dysfunction (PFD, although seems to be simple, is a complex process that develops secondary to multifactorial factors. The incidence of PFD is increasing with increasing life expectancy. PFD is a term that refers to a broad range of clinical scenarios, including lower urinary tract excretory and defecation disorders, such as urinary and anal incontinence, overactive bladder, and pelvic organ prolapse, as well as sexual disorders. It is a financial burden on the health care system and disrupts women's quality of life. Strategies applied to decrease PFD are focused on the course of pregnancy, mode and management of delivery, and pelvic exercise methods. Many studies in the literature define traumatic birth, usage of forceps, length of the second stage of delivery, and sphincter damage as modifiable risk factors for PFD. Maternal age, fetal position, and fetal head circumference are nonmodifiable risk factors. Although numerous studies show that vaginal delivery affects pelvic floor structures and their functions in a negative way, there is not enough scientific evidence to recommend elective cesarean delivery in order to prevent development of PFD. PFD is a heterogeneous pathological condition, and the effects of pregnancy, vaginal delivery, cesarean delivery, and possible risk factors of PFD may be different from each other. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist; therefore, the isolated effects of these variables on the pelvic floor are difficult to study. The routine use of episiotomy for many years in order to prevent PFD is not recommended anymore; episiotomy should be used in selected cases, and the mediolateral procedures should be used if needed.

  14. [Occurrence and relevance to health of persistent organic substances and phthalates in breast milk].

    Science.gov (United States)

    Fromme, H; Raab, U; Fürst, P; Vieth, B; Völkel, W; Albrecht, M; Schwegler, U

    2011-01-01

    The aim of this study is to give an overview of the concentrations of persistent organic pollutants like the polychlorinated dibenzo- P-dioxins (PCDD), polychlorinated dibenzofurans (PCDF), polychlorinated biphenyls (PCB), polybrominated diphenyl ether (PBDE), perfluorinated compounds (PFC) and of phthalates in breast milk. On the basis of median and 95 (th) percentile values an "average" and a "high" intake were calculated for a 3-month-old infant exclusively breast-fed. Moreover, the actual daily intake was compared with tolerable daily intakes (TDI) recommended by scientific institutions. On this basis, we found an "average" ("high") daily intake of 70 (140) pg TEQ/kg body weight (b. w.) for PCDD/F and dioxin-like PCB (dl-PCB), 10 (20) ng/kg b. w. for PFOS (perfluorooctanesulfonate), 20 (50) ng/kg b. w. for PFOA (perfluorooctanoate), 1.7 (7.5) ng/kg b. w. for BDE 47, and 0.6 (2.1) ng/kg b. w. for BDE 99. For di-2-ethylhexyl phthalate (DEHP) and di- N-butyl phthalate (DnBP) an "average" and "high" intake of 400 ng/kg b. w. and 2,000 ng/kg b. w. and of 100 and 500 ng/kg b.w. were assumed, respectively. For all of these substances we found a daily intake via breast milk below the TDI, established on a livelong basis. On contrary, the daily intake for the sum of the PCDD/F and dl-PCB considerably exceeded the recommended TDI value. Even with regard to the "high" daily intake values the share of PBDE, PFC, and phthalates on the TDI was only in the lower percentage. Scientific organisations assume that an exceeding of the PCDD/F and dl-PCB intake in relation to the TDI value is acceptable only on the basis of the still declining levels in breast milk and the fact that this high exposure only occurs during some months of the entire life when breast milk is consumed. On the basis of the recent exposure situation mothers can exclusively breast-feed their infants for 6 months without any hesitation. The well established health benefits for mothers and infants when

  15. Clinical analysis on severe pelvic organ prolapse treated by total pelvic floor reconstruction surgery and routine transvaginal surgery%全盆底重建术与传统阴式修补术治疗重度盆腔器官脱垂的疗效比较

    Institute of Scientific and Technical Information of China (English)

    仲丹; 翟永宁; 张蕾; 沈宇飞; 钱宇佳; 刘娟

    2013-01-01

    Objective To explore the clinical effects and quality - of - life outcomes between total pelvic floor reconstruction surgery and traditional vaginal hysterectomy with vaginal anterior and posterior wall repair in treatment of severe pelvic floor prolapse (POP). Methods From January 2008 to December 2009, 70 POP patients (stage Ⅲ to Ⅳ according to POP - Q staging) were treated in our department, the clinical data was, analyzed retrospectively. Patients were divided into reconstruction group (35 cases) and routine group (35 cases). In reconstruction group, 35 patients received total pelvic floor reconstruction, 14 of them underuent transvaginal hysterectomy at the same time because of old age, cervical lesion or no reserve uterine aspiration; in routine group, the patients received vaginal hysterectomy with colporrhaphia anterior and posterior. All patients were tracked and visited in 1 month, 6 months, 12 months and 24 months after surgery, the therapeutic effect and impact on quality- of- life were analyzed through scores of pelvic floor impact questionnaire - short form 7 (PFIQ- 7) , pelvic floor distress inventory- short form 20 (PFDI- 20) and pelvic organ prolapse- urinary incontinence sexual questionnaire (PISQ). In routine group, 11 patients had sexual activity before surgery, but 9 of them refused intercourse after treatment, so PISQ could not be obtained. Results ①The average operation times, the amounts of blood loss during operation, the times of indwelling urethral catheter and hospitalization time were (108.3 ± 29.4) minutes, (192.3 ± 72. 9) ml, (3. 8±1.1) days and (7.1 ± 1. 5) days in reconstruction group and (127. 0 ± 18. 5) minutes, (251. 4± 56.2) ml, (5.8±0.7) days, (9.0 ± 2.4) days in routine group, differences were statistically significant (P0. 05). In routine group, 11 patients had sexual activity before surgery, but 9 of them refused intercourse after surgery because of operations. Conclusion Compared with routine transvaginal

  16. Périnée et Grossesse [Pelvic floor and pregnancy

    OpenAIRE

    Fritel, Xavier

    2010-01-01

    International audience; Congenital factor, obesity, aging, pregnancy and childbirth are the main risk factors for female pelvic floor disorders (urinary incontinence, anal incontinence, pelvic organ prolapse, dyspareunia). Vaginal delivery may cause injury to the pudendal nerve, the anal sphincter, or the anal sphincter. However the link between these injuries and pelvic floor symptoms is not always determined and we still ignore what might be the ways of prevention. Of the many obstetrical m...

  17. Pelvic Floor Disorders in Female Veterans: What a Difference an X Makes

    Science.gov (United States)

    2011-07-22

    PELVIC FLOOR DISORDERS IN FEMALE VETERANS What a difference an X Makes July 22, 2011 Christine L. G. Sears MD CDR MC USN Report Documentation Page...DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Pelvic Floor Disorders in Female Veterans 5a. CONTRACT NUMBER 5b. GRANT NUMBER...Urinary Tract Infection and related symptoms  Pelvic Organ Prolapse  Urinary Incontinence  Bladder Pain Syndrome  Graphics non intrusive  Discuss

  18. Microlaparoscopic Conscious Pain Mapping in the Evaluation of Chronic Pelvic Pain: A Case Report

    Science.gov (United States)

    2002-01-01

    Chronic pelvic pain is a debilitating, life-altering syndrome that negatively affects a woman's quality of life and personal relationships. Many women continue to suffer with pelvic pain despite having undergone multiple medical and surgical treatments. Unfortunately, some women are incorrectly labeled as having psychological illness when organic disease may be present. I report a case of a woman who underwent multiple pelvic and abdominal surgeries before the cause of her pain was identified through microlaparoscopic conscious pain mapping. PMID:12004805

  19. Prolift系统盆底重建术与常规阴式手术治疗盆腔器官脱垂的临床分析%Clinical analysis on pelvic organ prolapse treated by pelvic floor reconstruction surgery with Prolift system and routine transvaginal surgery

    Institute of Scientific and Technical Information of China (English)

    曹杰; 赵纯全

    2014-01-01

    目的:比较Prolift系统盆底重建术与常规阴式手术治疗盆腔器官脱垂的临床疗效。方法回顾性分析2009年6月至2011年3月重庆医科大学附属第一医院收治入院的盆腔器官脱垂患者64例,将其分为Prolift系统盆底重建组(重建组)32例和阴式子宫切除加阴道前后壁修补术组(常规组)32例,比较两组患者一般情况、围术期及随访资料,并进行统计学处理,分析其手术效果。结果两组患者的年龄、体质量指数、绝经年龄、孕产次及子宫脱垂程度差异均无统计学意义(P>0.05),所有患者手术均获成功,均未出现严重的术后并发症。重建组患者在术中出血量、平均手术时间、肛门排气时间、术后最高体温、留置尿管天数以及术后住院天数等指标上均明显优于常规组( P<0.05)。重建组随访率93.8%(30/32),术后1例(3.1%)复发,1例(3.1%)补片侵蚀,1例(3.1%)新发下尿路症状,19例恢复性生活者,1例性交痛,2例性交不适感;常规组随访率90.6%(29/32),术后8例(25%)复发,4例(12.5%)新发下尿路症状,16例恢复性生活者,3例性交痛,5例性交不适感。术后3个月及6个月两组间客观治愈率比较差异无统计学意义(P>0.05);术后12个月两组间客观治愈率比较差异有统计学意义(P<0.05),重建组客观治愈率高于常规组。结论 Prolift系统盆底重建术较常规阴式手术在治疗盆腔脏器脱垂中能更好地恢复盆底解剖结构和功能,手术创伤小,短期安全有效,但远期疗效仍需进一步研究。%Objective To investigate the clinical effectiveness of pelvic floor reconstruction surgery with Prolift system and rou‐tine transvaginal surgery in treating pelvic organ prolapse (POP) .Methods We analyzed an retrospective study of 64 patients with POP patients from June 2009 to

  20. 盆底脏器脱垂患者与下尿路功能障碍关系的探讨%Exploration of the relationship between pelvic organ prolapse and lower urinary tract dysfunction

    Institute of Scientific and Technical Information of China (English)

    陈日笑; 张晓薇

    2012-01-01

    目的 探讨盆底脏器脱垂患者与下尿路功能障碍之间的关系.方法 于2009年7月-2010年11月对54例诊断为盆腔脏器脱垂的住院患者进行病史采集、妇科检查、POP-Q评分及尿动力学检查,探讨盆腔脏器脱垂与下尿路功能障碍的关系.结果 54例POP患者中,出现下尿路主观症状44例,其中尿失禁症状27例(压力性24例,急迫性1例,混合性2例),尿急和/或尿频27例,排尿功能障碍16例.尿动力学检查结果显示:压力性尿失禁28例,急迫性尿失禁2例,混合性尿失禁2例,伴膀胱顺应性降低1例,腹压排尿3例.腹部漏尿点压力( ALPP)< 60 cmH2O有10例,60 ~ 90 cmH2O 13例,>90 cmH2O 7例.与尿失禁主观症状的符合率为70%( 19/27);隐匿性尿失禁的发生率为41%( 11/27),均为重度阴道前壁脱垂的患者.结论 POP患者术前在减轻脱垂程度情况下行尿动力学检查可更客观地评价下尿路功能障碍,POP患者术前应了解膀胱及尿道括约肌功能,注意排除隐匿性尿失禁.%Objective To explore the relationship between pelvic organ prolapse and lower urinary tract dysfunction.Methods From July,2009 to November,2010,collected the medical history of 54 patients diagnosed with pelvic organ prolapse,and conducted gynecological examination and pelvic organ prolapse quantitative examination ( POP-Q )on them,then explored the relationship between pelvic organ prolapse and lower urinary tract dysfunction.Results Among all the patients with POP,44 cases developed subjective symptoms of lower urinary tract,among which,27 cases had urinary incontinence ( 24 with stress,1 with urgency,2 with mixed incontinence ); 27 cases got bladder irritation; 16 cases underwent with voiding dysfunction.The urodynamic tests revealed that:28 cases had stress urinary incontinence,2 cases had urgent incontinence,2 cases got mixed incontinence,1 case had reduced bladder compliance,and 3 cases had abdominal voiding.There were 10 cases with

  1. [Hemophilic pelvic pseudotumor].

    Science.gov (United States)

    Castro-Boix, Sandra; Pradell-Teigell, Jordi; Boqué-Genovard, Ramón; Zanón-Navarro, Vicente; Nadal-Guinard, Antoni; Altisent-Roca, Carme; Armengol-Carrasco, Manel

    2007-02-01

    Surgery in hemophilic patients is a challenge for the general surgeon. Hemophilic pseudotumor is a rare complication occurring in 1-2% of hemophiliacs and affecting mainly patients with severe disease or those who have developed antibodies to factor VIII or IX. A number of alternatives are available for the management of these tumors, including conservative treatment, surgical removal, percutaneous drainage, embolization, and external radiation. The only definitive treatment is surgical excision. We report a case of hemophilic pseudotumor of the pelvic bone. Treatment consisted of surgical resection after arterial embolization using factor replacement to achieve hemostasis.

  2. [Pelvic actinomycosis abscess and intrauterine device].

    Science.gov (United States)

    Ko-Kivok-Yun, P; Charasson, T; Halasz, A; Fournié, A

    1997-03-01

    A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.

  3. Investigation of coatings of natural organic matter on silver nanoparticles under environmentally relevant conditions by surface-enhanced Raman scattering.

    Science.gov (United States)

    Kühn, Melanie; Ivleva, Natalia P; Klitzke, Sondra; Niessner, Reinhard; Baumann, Thomas

    2015-12-01

    The widespread use of engineered inorganic nanoparticles (EINP) leads to a growing risk for an unintended release into the environment. Despite the good characterization of EINP in regard to their function scale and the application areas, there is still a gap of knowledge concerning their behaviour in the different environmental compartments. Due to their high surface to volume ratio, surface properties and existence or development of a coating are of high importance for their stability and transport behaviour. However, analytical methods to investigate organic coatings on nanoparticles in aqueous media are scarce. We used Raman microspectroscopy in combination with surface-enhanced Raman scattering (SERS) to investigate humic acid coatings on silver nanoparticles under environmentally relevant conditions and in real world samples. This setup is more challenging than previous mechanistic studies using SERS to characterize the humic acids in tailored settings where only one type of organic matter is present and the concentrations of the nanoparticles can be easily adjusted to the experimental needs. SERS offers the unique opportunity to work with little sample preparation directly with liquid samples, thus significantly reducing artefacts. SERS spectra of different natural organic matter brought into contact with silver nanoparticles indicate humic acid in close proximity to the nanoparticles. This coating was also present after several washing steps by centrifugation and resuspension in deionized water and after an increase in ionic strength.

  4. Quality of life in women with pelvic floor dysfunction

    Directory of Open Access Journals (Sweden)

    Mladenović-Segedi Ljiljana

    2011-01-01

    Full Text Available Background/Aim. Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfaction in adult women with pelvic organ prolapse presenting to tertiary care clinic for surgical treatment. Methods. This prospective case-control study included 50 patients who presented to tertiary care gynecology clinic for surgical treatment and 50 controls with normal pelvic floor support and without urinary incontinence who presented tertiary care gynecology clinic for other reasons. Both, patients and controls, completed two quastionnaires recommended for the evaluation of symptoms (Pelvic floor distress inventory - short forms and quality of life impact (Pelvic floor impact questionnaire - short form of pelvic organ prolapse, and Body Image Scale. Results. The patients scored significantly worse on the prolapse, urinary, colorectal scales and overall score of Pelvic floor distress inventory - 20 than controls subjects (134.91 vs 78.08; p < 0.01. The patients also measured significant decrease in condition- specific quality of life (89.23 vs 3.1; p < 0.01. They were more likely to feel self-conscious (78% vs 42%; p < 0.01, less likely to feel physically attractive (78% vs 22%; p < 0.01, more likely to have difficulty looking at themselves naked (70% vs 42%; p < 0.01, less likely to feel sexually attractive (64% vs 32%; p < 0.01, and less likely to feel feminine (56% vs 16%; p < 0.05, than controls. There were no differencies in their feeling of dissatisfaction with appearance when dressed, avoiding people because of appereance and overall dissatisfaction with

  5. Laparoscopy for pelvic floor disorders.

    Science.gov (United States)

    Van Geluwe, B; Wolthuis, A; D'Hoore, A

    2014-02-01

    Surgical treatment of pelvic floor disorders has significantly evolved during the last decade, with increasing understanding of anatomy, pathophysiology and the minimally-invasive 'revolution' of laparoscopic surgery. Laparoscopic pelvic floor repair requires a thorough knowledge of pelvic floor anatomy and its supportive components before repair of defective anatomy is possible. Several surgical procedures have been introduced and applied to treat rectal prolapse syndromes. Transabdominal procedures include a variety of rectopexies with the use of sutures or prosthesis and with or without resection of redundant sigmoid colon. Unfortunately there is lack of one generally accepted standard treatment technique. This article will focus on recent advances in the management of pelvic floor disorders affecting defecation, with a brief overview of contemporary concepts in pelvic floor anatomy and different laparoscopic treatment options.

  6. On pelvic reference lines and the MR evaluation of genital prolapse: a proposal for standardization using the Pelvic Inclination Correction System.

    Science.gov (United States)

    Betschart, C; Chen, L; Ashton-Miller, J A; Delancey, J O L

    2013-09-01

    Five midsagittal pelvic reference lines have been employed to quantify prolapse using MRI. However, the lack of standardization makes study results difficult to compare. Using MRI scans from 149 women, we demonstrate how use of existing reference lines can systematically affect measurements in three distinct ways: in oblique line systems, distances measured to the reference line vary with antero-posterior location; soft issue-based reference lines can underestimate organ movement relative to the pelvic bones; and systems defined relative to the MR scanner are affected by intra- and interindividual differences in the pelvic inclination angle at rest and strain. Thus, we propose a standardized approach called the Pelvic Inclination Correction System (PICS). Based on bony structures and the body axis, the PICS system corrects for variation in pelvic inclination, at rest of straining, and allows for the standardized measurement of organ displacement in the direction of prolapse.

  7. Theoretical molecular descriptors relevant to the uptake of persistent organic pollutants from soil by zucchini. A QSAR study.

    Science.gov (United States)

    Bordás, Barna; Bélai, Iván; Koomíves, Tamás

    2011-04-13

    The uptake of persistent organic pollutants (POPs) from soil by plants allows the development of phytoremediation protocols to rehabilitate contaminated areas. The use of diverse theoretical descriptors has been reported in the literature for developing quantitative structure-activity relationship (QSAR) models for predicting the bioconcentration factors (BCFs) of POPs in different plants. In this paper an evaluation is given on the molecular properties of POPs in terms of theoretical molecular descriptors that are relevant to the uptake and accumulation of these persistent pollutants from soil by two zucchini varieties. Statistically significant and predictive linear regression models have been developed for the BCF values of 20 polychlorinated dibenzo-p-dioxins/dibenzofurans and 14 polyhalogenated biphenyls in two zucchini varieties based on retrospective data. The relevant parameters have been selected from a set of 1660 DRAGON, 150 VolSurf, and 11 quantum chemical descriptors. The two most significant regression models, containing VolSurf, DRAGON GETAWAY, and quantum chemical descriptors, displayed the following statistical parameters: (eq 3) n = 27, R(2) = 0.940, q(2) = 0.922, SE = 0.155, F = 392.1; (eq 4) n = 27, R(2) = 0.921, q(2) = 0.898, SE = 0.161, F = 140.4. Predictive capabilities of the equations have been validated by using external validation sets. The QSAR models proposed might contribute to the development of viable soil remediation strategies.

  8. Pelvic hydatid cyst with uncommon sciatalgia manifestation: a case report

    Directory of Open Access Journals (Sweden)

    Ghodratolah Maddah

    2013-11-01

    Full Text Available Background: Hydatid disease or echinococcosis is a common parasitic disease of human and bovine, caused by infection with larva of the cestode echinococcus. Liver is the most common organ that is involved in this disease. Pelvic involvement and neurological symptoms, due to mass effect of pelvic involvement, in lower extremities are very uncommon manifestations of the disease.Case presentation: A forty six year old man was referred to clinic of surgery at Ghaem Hospital, Medical University of Mashhad, Iran. The patient complained about weakness and motor impairment in right lower extremity accompanied by numbness and radicular pain over past two months. Physical examination demonstrated muscular atrophy and reduced muscular strength in right lower extremity. Computed tomography and ultrasonographic studies showed a cystic mass in right side of the pelvic cavity with extention to the sciatic notch and another cystic mass in right gluteal region. Surgical operation revealed a cystic mass deep in pelvic cavity with the extention to the right sciatic notch with compression of nerve roots. The cystic mass was contained of daughter cysts which confirmed the diagnosis of hydatid cyst disease. This diagnosis was confirmed by pathologic assessment.Conclusion: Although uncommon, but hydatid disease can involve the pelvic cavity and make a pelvic, usually cystic, mass; that can make compression on nerve roots and so making neurologic symptoms in lower extremities. So in endemic areas for hydatid disease, such as Iran, pelvic hydatid cysts should be considered as a possible differential diagnosis in patients presenting with the sciatic pain and neurological manifestations in whom a pelvic mass has been found too.

  9. Laparoscopic pelvic sling placement facilitates optimum therapeutic radiotherapy delivery in the management of pelvic malignancy.

    LENUS (Irish Health Repository)

    Joyce, M

    2012-02-01

    BACKGROUND: Radiotherapy has a significant role in the management of pelvic malignancies. However, the small intestine represents the main dose limiting organ. Invasive and non-invasive mechanical methods have been described to displace bowel out of the radiation field. We herein report a case series of laparoscopic placement of an absorbable pelvic sling in patients requiring pelvic radiotherapy. METHODS: Six patients were referred to our minimally invasive unit. Four patients required radical radiotherapy for localised prostate cancer, one was scheduled for salvage localised radiotherapy for post-prostatectomy PSA progression and one patient required adjuvant radiotherapy post-cystoprostatectomy for bladder carcinoma. All patients had excessive small intestine within the radiation fields despite the use of non-invasive displacement methods. RESULTS: All patients underwent laparoscopic mesh placement, allowing for an elevation of small bowel from the pelvis. The presence of an ileal conduit or previous surgery did not prevent mesh placement. Post-operative planning radiotherapy CT scans confirmed displacement of the small intestine allowing all patients to receive safely the planned radiotherapy in terms of both volume and radiation schedule. CONCLUSION: Laparoscopic mesh placement represents a safe and efficient procedure in patients requiring high-dose pelvic radiation, presenting with unacceptable small intestine volume in the radiation field. This procedure is also feasible in those that have undergone previous major abdominal surgery.

  10. Pelvic fistulas complicating pelvic surgery or diseases: spectrum of imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Gyu; Kim, Seung Hyup; Lee, Hak Jong; Moon, Min Hoan; Myung, Jae Sung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2001-06-01

    Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.

  11. Pelvic floor function before and after robotic sacrocolpopexy: one-year outcomes.

    Science.gov (United States)

    Geller, Elizabeth J; Parnell, Brent A; Dunivan, Gena C

    2011-01-01

    Estimate pelvic floor function and support 1 year after robotic sacrocolpopexy. Prospective cohort analysis of women undergoing robotic sacrocolpopexy for correction of advanced pelvic organ prolapse (Canadian Task Force Classification III). Primary outcome was pelvic floor function. Secondary outcomes included anatomic support and long-term surgical failures and complications. One university hospital in the southeastern United States. Primarily postmenopausal women (mean age 60) with advanced pelvic organ prolapse. All subjects underwent robotic sacrocolpopexy during the study period. Subjects then underwent 1-year postoperative assessment of pelvic floor function via validated condition-specific quality of life questionnaires and assessment of pelvic floor support, long-term surgical failures, and complications via physical examination. From November 2007 to April 2009, there were 28 subjects, 25 of whom (89.3%) were evaluated. Mean time since surgery was 14.8 months. Pelvic floor function remained significantly improved over preoperative baseline: PFDI-20 (117 vs 38, p function: PISQ-12 (34 vs. 36, p = .17), and improved pelvic support on POP-Q: Ba (+3 vs -2, p = .001), Bp (+0.5 vs -1, p = .092), C (+2.25 vs -8, p = .001). Anatomic cure for vault prolapse was 100% at 1 year. There were two mesh exposures and two subsequent prolapse surgeries. Robotic sacrocolpopexy demonstrates durable improvement in pelvic floor function and support, with high sexual function and reasonable failure and complication rates 1 year after surgery. Copyright © 2011 AAGL. Published by Elsevier Inc. All rights reserved.

  12. Post Pelvic Radiotherapy Bony Changes

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Seung Jae [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-03-15

    There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as 8.2{approx}20% after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

  13. Prevention of pelvic floor disorders: international urogynecological association research and development committee opinion

    NARCIS (Netherlands)

    Bazi, T.; Takahashi, S.; Ismail, S.; Bo, K.; Ruiz Zapata, A.M.; Duckett, J.; Kammerer-Doak, D.

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: Pelvic floor disorders (PFD), including urinary incontinence, anal incontinence, and pelvic organ prolapse, are common and have a negative effect on the quality of life of women. Treatment is associated with morbidity and may not be totally satisfactory. Prevention of PF

  14. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

    Directory of Open Access Journals (Sweden)

    Teresa Pusiol

    2011-01-01

    Full Text Available Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device.

  15. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

    Science.gov (United States)

    Pusiol, Teresa; Morichetti, Doriana; Pedrazzani, Corrado; Ricci, Francesco

    2011-01-01

    Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device. PMID:21904441

  16. Radioterapia: lesões inflamatórias e funcionais de órgãos pélvicos Radiotherapy: inflammatory and functional lesions of pelvic organs

    Directory of Open Access Journals (Sweden)

    Júlio César Monteiro dos Santos Jr.

    2006-09-01

    fiquem livres da radioterapia e, por outro lado, buscar o aperfeiçoamento da técnica de radiação para os casos cujas necessidades excedam a abrangência do tratamento cirúrgico, exclusivo.Radiotherapy reducing local failure rates and improving overall survival has a favorable impact on the primary treatment of rectal cancer. However, radiation as an adjuvant therapy for that purpose and other pelvic malignances has been shown to increase long-term morbidity causing severe rectal or vesical mucositis, sometimes stenosis, undistensibler rectum with reduced capacity and/or anorectal dysfunction due lombosacralneuropathy with physiologic changes whose interaction remains poorly understood 60,63. Those iatrogenic outcomes stress the need for finding predictive factors for local recurrence to exclude patients with very high probability for cure with surgery alone and to use optimized radiation techniques22,64.

  17. 盆底器官脱垂患者肛提肌的动态MRI研究%Dynamic MR imaging of levator ani muscle for patients with pelvic organs prolapse

    Institute of Scientific and Technical Information of China (English)

    柯桂珠; 宋岩峰; 陈自谦; 马明

    2009-01-01

    Objective To study the dynamic MR imaging characteristic of levator ani muscle in pelvic organs prolapse (POP) patients, and to establish a set of evaluation system with dynamic MR imaging for the diagnosis and evaluation of POP. Methods Thirty-two POP patients and 15 contrasts were enrolled in this study. The differences of the thickness of puborectal muscle and ihococcygeal musde, the angle of iliococcygeal muscle and levator plate, the size of the levator hiatus were compared. Results (1) The size of levator hiatus in POP group was larger than that of control group(P = 0.008) ; (2) The thickness of puborectal muscle and iliococcygeal muscle of POP group were thinner than those of the control group, both at rest and on maximal abdominal pressure(P 0.05);(3)最大腹压时,POP组髂尾肌角度和肛提肌板角度较对照组明显增大(P=0.001和0.007);比较腹压作用前后的角度变化,POP组有显著差异(P=0.003和0.044).结论 MRI检查可以很好地观察肛提肌的形态,动态检查还可以评价肛提肌的功能状态.

  18. Tomographical anatomy of the pelvis, pelvic floor, and related structures.

    Science.gov (United States)

    Fröhlich, B; Hötzinger, H; Fritsch, H

    1997-01-01

    The sectional anatomy of the pelvic floor was studied in plastinated sections of adult pelves by computed tomography and by magnetic resonance imaging. In sectional anatomy, the levator ani is composed of three portions that can be clearly distinguished by their planes of cleavage and by the course of their fiber bundles. No muscular connections are found between the levator ani portions and the pelvic organs. The fascia of the levator ani in always interposed between the muscle and the pelvic organs. The sectional anatomy of the sphincter ani externus reveals a subdivision into a subcutaneous and a deep portion. Although the puborectalis portion of the levator ani and the deep portion of the sphincter ani externus are more or less continuous, in sectional anatomy they can be distinguished due to their different origins and attachments.

  19. A review of pelvic fractures in adult pedestrians: experimental studies involving PMHS used to determine injury criteria for pedestrian dummies and component test procedures.

    Science.gov (United States)

    Arregui-Dalmases, Carlos; Kerrigan, Jason R; Sanchez-Molina, David; Velazquez-Ameijide, Juan; Crandall, Jeff R

    2015-01-01

    Perform a systematic review for the most relevant pelvic injury research involving PMHS. The review begins with an explanation of the pelvic anatomy and a general description of pelvic fracture patterns followed by the particular case of pelvic fractures sustained in pedestrian-vehicle collisions. Field data documenting the vehicle, crash, and human risk factors for pedestrian pelvic injuries are assessed. A summary of full-scale PMHS tests and subsystem lateral pelvic tests is provided with an interpretation of the most significant findings for the most relevant studies. Based on the mechanisms of pedestrian pelvic injury, force, acceleration, and velocity and compression have been assessed as predictive variables by researchers although no consensus criterion exists.

  20. Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study

    OpenAIRE

    Nygaard, Ingrid E; Clark, Erin; Clark, Lauren; Egger, Marlene J.; Hitchcock, Robert; Hsu, Yvonne; Norton, Peggy; Sanchez-Birkhead, Ana; Shaw, Janet; Sheng, Xiaoming; Varner, Michael

    2017-01-01

    Introduction Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-fu...

  1. Treatment of pelvic inflammatory disease.

    Science.gov (United States)

    Cunha, B A

    1990-04-01

    The pathogenesis, risk factors, microbiology, sequelae, diagnosis, and treatment of pelvic inflammatory disease (PID) are reviewed, and factors associated with the selection of effective, safe, and economical drug therapy are discussed. PID is an acute clinical syndrome not related to surgery or pregnancy that is caused by the spread of microorganisms from the vagina and cervix to the endometrium, fallopian tubes, and other adnexal structures. Primary PID, the most common form of the disease, is the result of the ascent of sexually acquired or endogenous lower genital tract microorganisms to the upper genital tract. Presence of a sexually transmitted disease is the most common risk factor for PID, but a previous episode of PID, multiple sexual partners, intrauterine device use, and young age are also risk factors. PID is classified as gonococcal or nongonococcal (i.e., caused by anaerobic and aerobic pelvic organisms). The long-term consequences of PID are the most devastating aspects of the disease; infertility remains the most common sequela. Therapy of PID is aimed at preserving fertility, preventing long-term consequences, and relieving acute clinical symptoms. In areas in which penicillinase-producing Neisseria gonorrhoeae is endemic, therapy that is effective against penicillinase-producing N. gonorrhoeae is necessary. Gonococcal PID that is not penicillin resistant may be treated with a single intramuscular or oral dose of a penicillin; penicillin-resistant infection may be treated with a cephalosporin or ciprofloxacin. If chlamydia is a diagnostic consideration, a one- to two-week course of oral tetracycline or doxycycline (injectable-drug therapy is an alternative) should be added to the regimen. Single-agent therapy is a cost-effective alternative to combination regimens. Ampicillin-sulbactam is a cost-effective alternative to the more costly injectable cephalosporins or the combination regimens of an aminoglycoside plus clindamycin or metronidazole. With

  2. Pelvic Floor Muscle Training: Underutilization in the USA.

    Science.gov (United States)

    Lamin, Eliza; Parrillo, Lisa M; Newman, Diane K; Smith, Ariana L

    2016-02-01

    Pelvic floor disorders are highly prevalent in women of all ages and can greatly impair quality of life. Pelvic floor muscle training (PFMT) is a viable treatment option for several pelvic floor conditions including urinary incontinence and pelvic organ prolapse. PFMT is a program of therapy initiated by an experienced clinician (e.g., women's health or urology nurse practitioner (NP), physical therapist (PT)) that involves exercises for women with stress urinary incontinence (UI) and exercises combined with behavioral or conservative treatments (lifestyle changes, bladder training with urge suppression) for women with urgency or mixed UI. These exercise programs are more comprehensive than simple Kegel exercises. Despite evidence-based research indicating the efficacy and cost-effectiveness for treatment of urinary incontinence, PFMT is not commonly used as a first-line treatment in clinical practice in the USA (Abrams et al., 2012). This article will review PFMT for the treatment of UI and pelvic organ prolapse (POP) and theorize how this conservative therapy can be utilized more effectively in the USA.

  3. Responsiveness of the Spanish Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaires Short Forms (PFDI-20 and PFIQ-7) in women with pelvic floor disorders.

    Science.gov (United States)

    Sánchez Sánchez, Beatriz; Torres Lacomba, Maria; Navarro Brazález, Beatriz; Cerezo Téllez, Ester; Pacheco Da Costa, Soraya; Gutiérrez Ortega, Carlos

    2015-07-01

    To evaluate the responsiveness of the Spanish versions of Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire Short Forms (PFDI-20 and PFIQ-7), in order to assess symptoms and quality of life in Spanish women with pelvic floor disorders. Prospective observational study to assess the responsiveness in 85 women with pelvic floor disorders. PFDI-20 and PFIQ-7 were completed before and after Physiotherapy intervention. The responsiveness was assessed with the p values using the Wilcoxon signed-rank test, the standardized response means of the change (SRM) and the effect size (ES). The Spanish PFDI-20 and PFIQ-7 and the subscales demonstrated small to good responsiveness. The responsiveness was higher for PFDI-20 than for PFIQ-7. The statistic for PFDI-20 was moderate to good (ES 0.68 and SRM 0.84; presponsiveness was better for Pelvic Organ Prolapse Distress Inventory (POPDI) than Pelvic Organ Prolapse Impact Questionnaire (POPIQ) (ES 0.70 and SRM 0.78; ES 0.42 and SRM 0.47 respectively; presponsiveness was found for Urinary Distress Inventory (UDI) and Urinary Impact Questionnaire (UIQ) (ES 0.54 and SRM 0.67; ES 0.52 and SRM 0.61 respectively; presponsiveness, small in both (ES 0.42, SRM 0.50 and presponsiveness was significant. PFDI-20 and PFIQ-7 Spanish versions showed good responsiveness to evaluate the symptoms and the quality of life in Spanish women with PFD undergoing Physiotherapy treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Relevance of Vṛkṣāyurveda and other traditional methods for organic production of nursery seedlings of useful plants.

    Science.gov (United States)

    Suresh, Geetha; Haridasan, K; Krishnamurthy, Kulithala Viswanathan

    2013-07-01

    Plant propagation is critical to augment the resource and has been the main concern for farmers and planters through history. India has evolved the science of Vṛkṣāyurveda to address the above issue. An effort is made here to review Vṛkṣāyurveda literature related to nursery techniques. Different libraries were visited and relevant review material obtained by hand search and from databases. Interaction with Sanskrit scholars and eminent scientists working in the field of Vṛkṣāyurveda, as well as the efforts of the authors of this paper, helped in the selection of pertinent literature. In the absence of original texts, authentic translations of the publications were referred. A conscious decision was made to limit the search to the fields of seed storage, pretreatment and nutrition of seedlings. To have a comparative account recent trends and literature on nursery technology were also examined. This was supplemented by interviews with traditional organic farmers. Our survey revealed that the time period of the literature pertaining to Vṛkṣāyurveda ranges from BCE 1200 to the present times. The subject has evolved from morphological descriptions and uses of plants, in texts such as Ṛgveda and Atharvaveda, to treatises dedicated solely to the art of growing plants like Kṛṣi-Parāśara and Vṛkṣāyurveda. It is also evident that there were important periods when more works appeared across subjects such as water divining, soil types, seed collection and storage, propagation, germination and sprouting, watering regimen, pest, and disease control. The review revealed that valuable information pertaining to nursery techniques is available in Vṛkṣāyurveda, which can be used in the development of nursery protocol. This will not only help in effective organic nursery management, but also ensure the health and livelihood security of the communities involved and effective waste management.

  5. Relevance of Vṛkṣāyurveda and other traditional methods for organic production of nursery seedlings of useful plants

    Directory of Open Access Journals (Sweden)

    Geetha Suresh

    2013-01-01

    Full Text Available Plant propagation is critical to augment the resource and has been the main concern for farmers and planters through history. India has evolved the science of Vṛkṣāyurveda to address the above issue. An effort is made here to review Vṛkṣāyurveda literature related to nursery techniques. Different libraries were visited and relevant review material obtained by hand search and from databases. Interaction with Sanskrit scholars and eminent scientists working in the field of Vṛkṣāyurveda, as well as the efforts of the authors of this paper, helped in the selection of pertinent literature. In the absence of original texts, authentic translations of the publications were referred. A conscious decision was made to limit the search to the fields of seed storage, pretreatment and nutrition of seedlings. To have a comparative account recent trends and literature on nursery technology were also examined. This was supplemented by interviews with traditional organic farmers. Our survey revealed that the time period of the literature pertaining to Vṛkṣāyurveda ranges from BCE 1200 to the present times. The subject has evolved from morphological descriptions and uses of plants, in texts such as R.gveda and Atharvaveda, to treatises dedicated solely to the art of growing plants like Kṛṣi-Parāśara and Vṛkṣāyurveda. It is also evident that there were important periods when more works appeared across subjects such as water divining, soil types, seed collection and storage, propagation, germination and sprouting, watering regimen, pest, and disease control. The review revealed that valuable information pertaining to nursery techniques is available in Vṛkṣāyurveda, which can be used in the development of nursery protocol. This will not only help in effective organic nursery management, but also ensure the health and livelihood security of the communities involved and effective waste management.

  6. Salpingitis and pelvic inflammatory disease.

    Science.gov (United States)

    Swinker, M L

    1985-01-01

    Chlamydia trachomatis is becoming an increasingly important etiologic agent. The physician must also be aware of other nongonococcal causes of pelvic inflammatory disease, such as Mycoplasma, Ureaplasma, coliforms and anaerobes. Epidemiologic characteristics of the various microorganisms differ, with the frequency of nongonococcal disease higher in older women. Intrauterine devices increase the potential for pelvic inflammatory disease. The rising incidence of nongonococcal and dual infections has led to therapeutic and preventive techniques aimed at multiple etiologies.

  7. Functional anatomy of pelvic floor

    OpenAIRE

    Salvatore Rocca Rossetti

    2016-01-01

    Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its mul...

  8. Prevention of pelvic radiation disease

    Institute of Scientific and Technical Information of China (English)

    Lorenzo; Fuccio; Leonardo; Frazzoni; Alessandra; Guido

    2015-01-01

    Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal(GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. The incidence of pelvic radiation disease changes according to the radiation technique, the length of follow up, the assessmentmethod, the type and stage of cancer and several other variables. Notably, even with the most recent radiation techniques, i.e., intensity-modulated radiotherapy, the incidence of radiation-induced GI side effects is overall reduced but still not negligible. In addition, radiation-induced GI side effects can develop even after several decades; therefore, the improvement of patient life expectancy will unavoidably increase the risk of developing radiation-induced complications. Once developed, the management of pelvic radiation disease may be challenging. Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease.

  9. Myofascial Pelvic Pain and Related Disorders.

    Science.gov (United States)

    Bonder, Jaclyn H; Chi, Michelle; Rispoli, Leia

    2017-08-01

    Myofascial pelvic pain refers to pain in the pelvic floor muscles, the pelvic floor connective tissue, and the surrounding fascia. The cause is often multifactorial and requires treatment that encompasses multiple modalities. This type of pain is often associated with other abdominopelvic disorders, so providers in these specialties need to be aware of these connections. A comprehensive musculoskeletal examination, including evaluation of the pelvic floor muscles, and history are key to diagnosing myofascial pelvic pain. Treatments include physical therapy, muscle relaxers, oral neuromodulators, cognitive-behavioral therapy, and pelvic floor muscle injections. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Tissue-engineering as an adjunct to pelvic reconstructive surgery

    DEFF Research Database (Denmark)

    Jangö, Hanna

    of pelvic organ prolapse (POP) are warranted. Traditional native tissue repair may be associated with poor long-term outcome and augmentation with permanent polypropylene meshes is associated with frequent and severe adverse effects. Tissue-engineering is a regenerative strategy that aims at creating...... functional tissue using stem cells, scaffolds and trophic factors. The aim of this thesis was to investigate the potential adjunctive use of a tissue-engineering technique for pelvic reconstructive surgery using two synthetic biodegradable materials; methoxypolyethyleneglycol-poly(lactic-co-glycolic acid...

  11. Relevance of Simpson grading system and recurrence-free survival after surgery for World Health Organization Grade I meningioma.

    Science.gov (United States)

    Nanda, Anil; Bir, Shyamal C; Maiti, Tanmoy K; Konar, Subhas K; Missios, Symeon; Guthikonda, Bharat

    2017-01-01

    OBJECTIVE The clinical significance of the Simpson system for grading the extent of meningioma resection and its role as a predictor of the recurrence of World Health Organization (WHO) Grade I meningiomas have been questioned in the past, echoing changes in meningioma surgery over the years. The authors reviewed their experience in resecting WHO Grade I meningiomas and assessed the association between extent of resection, as evaluated using the Simpson classification, and recurrence-free survival (RFS) of patients after meningioma surgery. METHODS Clinical and radiological information for patients with WHO Grade I meningiomas who had undergone resective surgery over the past 20 years was retrospectively reviewed. Simpson and Shinshu grading scales were used to evaluate the extent of resection. Statistical analysis was conducted using Kaplan-Meier curves and Cox proportional-hazards regression. RESULTS Four hundred fifty-eight patients were eligible for analysis. Overall tumor recurrence rates for Simpson resection Grades I, II, III, and IV were 5%, 22%, 31%, and 35%, respectively. After Cox regression analysis, Simpson Grade I (extensive resection) was revealed as a significant predictor of RFS (p = 0.003). Patients undergoing Simpson Grade I and II resections showed significant improvement in RFS compared with patients undergoing Grade III and IV resections (p = 0.005). Extent of resection had a significant effect on recurrence rates for both skull base (p = 0.047) and convexity (p = 0.012) meningiomas. Female sex and a Karnofsky Performance Scale score > 70 were also identified as independent predictors of RFS after resection of WHO Grade I meningioma. CONCLUSIONS In this patient cohort, a significant association was noted between extent of resection and rates of tumor recurrence. In the authors' experience the Simpson grading system maintains its relevance and prognostic value and can serve an important role for patient education. Even though complete tumor

  12. Pathways of extrapelvic spread of pelvic disease: imaging findings.

    Science.gov (United States)

    Tan, Cher Heng; Vikram, Raghunandan; Boonsirikamchai, Piyaporn; Faria, Silvana C; Charnsangavej, Chusilp; Bhosale, Priya R

    2011-01-01

    The complex extraperitoneal anatomy of the pelvis includes various outlets for the transit of organs and neurovascular structures to the rest of the body. These outlets include the greater sciatic foramen, lesser sciatic foramen, inguinal canal, femoral triangle, obturator canal, anal and genitourinary hiatuses of the pelvic floor, prevesical space, and iliopsoas compartment. All of these structures serve as conduits for the dissemination of malignant and benign inflammatory diseases from the pelvic cavity and into the soft-tissue structures of the abdominal wall, buttocks, and upper thigh. Knowledge of the pelvic anatomy is crucial to understand these patterns of disease spread. Cross-sectional imaging provides important anatomic information and depicts the extent of disease and its involvement of surrounding extrapelvic structures, information that is important for planning surgery and radiation therapy. RSNA, 2011

  13. Age effects on pelvic floor symptoms in a cohort of nulliparous patients.

    Science.gov (United States)

    Quiroz, Lieschen H; White, Dena E; Juarez, Dianna; Shobeiri, Seyed Abbas

    2012-01-01

    This study aimed to investigate the effects of age on pelvic floor symptoms (PFSs) in nulliparous women. Eighty community-dwelling nulliparous women, aged 21 to 70 years, were recruited. Pelvic floor support was assessed with pelvic organ prolapse quantification system. Participants completed the Pelvic Floor Distress Inventory 20 and Pelvic Floor Impact Questionnaire 7. Sexual function was assessed with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 and health status with the Short-Form Health Survey. The correlation between age and questionnaire scores was evaluated using Pearson coefficient. Logistic regression assessed predictors associated with PFS. Participants had a median age of 47 years, average body mass index of 28.3 kg/m, and most were white; 52.5% were healthy and 30% were postmenopausal. The most common stage of prolapse was stage I.Age was associated with slightly higher Pelvic Floor Distress Inventory-20 scores (r = 0.41, P = 0.002), corresponding to more bothersome PFS, and lower Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 scores, corresponding to worsening sexual function with advancing age (r = -0.41, P = 0.0012). There was no association between age and overall Pelvic Floor Impact Questionnaire scores (P = 0.12). For symptomatic patients, logistic regression showed age to be associated with increased odds of having PFS [odds ratio (OR), 1.881; 95% confidence interval (CI), 1.216-2.91]. Menopausal status was not associated with increased odds of reporting symptoms (OR, 3.05; 95% CI, 0.80-11.62). When age and age by menopause were incorporated in the model, age remained a significant predictor of having PFS (OR, 1.78; 95% CI, 1.13-2.78). In this population of community-dwelling nulliparous women, age was associated with worsening sexual function and slightly increased odds of reporting symptoms of pelvic floor disorders.

  14. [Diagnosis of pelvic inflammatory disease. Which clinical and paraclinical criteria? Role of imaging and laparoscopy?].

    Science.gov (United States)

    Bouquier, J; Fauconnier, A; Fraser, W; Dumont, A; Huchon, C

    2012-12-01

    Diagnosis of pelvic inflammatory disease is difficult. We focus on a systematic literature review to study diagnostic values of history-taking, clinical examination, laboratory tests and imagery. After this literature review, we build a diagnostic model for pelvic inflammatory disease. This diagnostic model is built on two major criteria: presence of adnexal tenderness or cervical motion tenderness. Additional minor criteria, increasing the likelihood of the diagnosis of pelvic inflammatory disease were added based on their specificity and their positive likelihood ratio. These minor criteria are supported by history-taking, clinical examination, laboratory tests and also on relevant ultrasonographic criteria. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Functional anatomy of pelvic floor

    Directory of Open Access Journals (Sweden)

    Salvatore Rocca Rossetti

    2016-03-01

    Full Text Available Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

  16. Functional anatomy of pelvic floor.

    Science.gov (United States)

    Rocca Rossetti, Salvatore

    2016-03-31

    Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

  17. Pelvic manikins as learning aids.

    Science.gov (United States)

    Macintosh, M C; Chard, T

    1997-05-01

    The use of pelvic trainers in undergraduate teaching was evaluated, using a questionnaire based on examination findings of a series of four pelvic trainers by 20 medical students and 34 gynaecologists. The main outcome measures were the ability to correctly identify pelvic findings in the trainers, and the numbers of false positive findings. There were two adnexal masses in two of the trainers. One was correctly identified by 33 (14 (70%) medical students and 19 (56%) doctors) in one trainer, whereas the other was missed by 52 of 54 examiners. Prolapse was missed by 41 of 54. The normal pelvis was correctly identified by 30 (16 (80%) medical students and 20 (59%) doctors. There were 15 false positive identifications of adnexal masses (6 by medical students and 9 by doctors) and 22 false positive identification of uterine enlargements (5 by medical students and 17 by doctors). The pelvic trainers were of value in demonstrating the process of pelvic and speculum examination. Some of the clinical conditions emulated were missed by most of the gynaecologists, suggesting that they were not suitable for training students in abnormal findings. Although the figures were not statistically significant, there was a trend for qualified doctors rather than medical students to make false positive findings.

  18. Toward a new generation of pelvic floor implants with electrospun nanofibrous matrices: A feasibility study

    NARCIS (Netherlands)

    Vashaghian, M.; Ruiz-Zapata, A.M.; Kerkhof, M.H.; Zandieh-Doulabi, B.; Werner, A.; Roovers, J.P.; Smit, T.H.

    2017-01-01

    OBJECTIVE: The use of knitted, polypropylene meshes for the surgical treatment of pelvic organ prolapse (POP) is frequently accompanied by severe complications. Looking for alternatives, we studied the potential of three different electrospun matrices in supporting the adhesion, proliferation, and

  19. Orem自理理论在盆腔脏器脱垂患者围手术期的应用%Application of Orem self-care theory in patients with pelvic organ prolapse during peri-operative period

    Institute of Scientific and Technical Information of China (English)

    忻莉莉; 杨婷; 黄竹; 徐静

    2013-01-01

    Objective To discuss the effect of Orem self-care theory for patients with pelvic organ prolapse during peri-operative period.Methods Forty cases of patients with pelvic organ prolapse were chosen and randomly divided into the intervention and control group,each with 20 cases.The intervention group received nursing according to Orem self-care theory,while the control group received conventional rehabilitation guidance without self-care theory.Patients' rehabilitation situation was compared during peri-operative period to evaluate the effect of Orem self-care theory.Results The number of patients who could turn over by themselves without external force in 6 hours after surgery,who could bend and stretch their ankle joint in 24 hours,who could get off bed for exercise in 72 hours,who had good mental states and who were satisfied was respectively 19,18,19,18,18 in the intervention group,and 11,9,12,9,11 in the control group,and the differences were statistically significant (x2 =8.533,9.231,7.025,9.231,6.144,respectively; P < 0.05).And the differences of number of patients who could expel intestinal gas through anus in 48 hours after surgery,who could urinate by themselves 2 hours after pulling out the catheter,and who could defecate by themselves in 3 days without difficulty between two groups were also statistically significant (x2 =8.533,7.025,7.025,9.231,respectively;P < 0.05).Conclusions Orem self-care theory for patients with pelvic organ prolapse during peri-operative period can improve their self-care ability and nursing efficiency,which is practical and worthy of promoting.%目的 探讨Orem自理理论在盆腔脏器脱垂患者围手术期中的应用效果.方法 选取40例手术治疗盆腔脏器脱垂患者,按随机数字表法随机分为干预组与对照组各20例,干预组按照Orem自理理论进行护理,对照组按照常规康复指导(不加用自理理论),通过对其围手术期恢复状况进行对比,评

  20. Limited evidence of the effect of prophylactic pelvic floor training on genital prolapse

    DEFF Research Database (Denmark)

    Boie, Sidsel; Jeppesen, Ulla; Bor, Isil Pinar

    2012-01-01

    Abstract A growing number of women are bothered by genital prolapse. The treatment of genital prolapse includes pelvic floor exercise in variable extent, but only few data are published. Variations in interventions, follow-up time, outcome etc. complicates a comparison. Because of the very limited...... material it is difficult to conclude if pelvic floor exercises have any effect on genital prolapse. There is need for studies concerning the clinical relevance and a cost-benefit analysis....

  1. How Are Pelvic Floor Disorders Commonly Treated?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How are pelvic floor disorders commonly treated? Skip sharing on social media ... Treatment Nonsurgical treatments commonly used for PFDs include: Pelvic floor muscle training (PFMT). Also called Kegel (pronounced KEY- ...

  2. How Are Pelvic Floor Disorders Diagnosed?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How are pelvic floor disorders diagnosed? Skip sharing on social media links ... fee ). This test is used to evaluate the pelvic floor and rectum while the patient is having a ...

  3. Pelvic Inflammatory Disease (PID) Treatment and Care

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Pelvic Inflammatory Disease (PID) Note: Javascript is disabled or is not ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Pelvic Inflammatory Disease (PID) Treatment and Care Recommend on Facebook Tweet ...

  4. The role of local estrogen therapy in the management of pelvic floor disorders.

    Science.gov (United States)

    Tzur, T; Yohai, D; Weintraub, A Y

    2016-04-01

    Pelvic floor disorders are common and bothersome problems that include a variety of conditions. These conditions greatly affect the performance of daily activities and social function such as work, traveling, physical exercise, sleep and sexual function. Aging is a well-known factor affecting the pelvic floor and lower urinary tract anatomy and function. It is clear that the pelvic organs and their surrounding muscular and connective tissue support are estrogen-responsive. Treatment of pelvic floor disorders requires significant health-care resources and their impact is likely to increase in the near future. This literature review aims to provide an overview of both research and clinical aspects of the pathophysiology of urogenital estrogen deficiency and the role of local estrogen therapy as part of the management strategy of different pelvic floor disorders. The safety and risk concerns regarding the use of local estrogen therapy are addressed as well.

  5. Design, Development, and Psychometric Analysis of a General, Organic, and Biological Chemistry Topic Inventory Based on the Identified Main Chemistry Topics Relevant to Nursing Clinical Practice

    Science.gov (United States)

    Brown, Corina E.

    2013-01-01

    This two-stage study focused on the undergraduate nursing course that covers topics in general, organic, and biological (GOB) chemistry. In the first stage, the central objective was to identify the main concepts of GOB chemistry relevant to the clinical practice of nursing. The collection of data was based on open-ended interviews of both nursing…

  6. The etiology of pelvic inflammatory disease.

    Science.gov (United States)

    Keith, L; Berger, G S

    1984-05-01

    The etiology of pelvic inflammatory disease (PID) is speculated upon based on reported incidence and epidemiological studies. In Western society, the incidence of PID (annual) is 1% among women aged 15-34 years and 2% in the high risk group of women aged 15-24 years. The annual incidence in the US is higher, at least 2% among fecund sexually active women aged 13-44 years. The medical consequences of PID are infertility, ectopic pregnancy, and chronic pelvic pain. Causative agents include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis and various other aerobic and anaerobic microorganisms; however, the natural genital flora of females is so varied that determining actual causative agents is difficult. some case-control studies have determined risk factors for PID; these include particularly current or prior use of IUD, prior pelvic surgery, sexual activity (including number of partners), race, and prior PID acute infection. PID is not a sexually transmitted disease, but rather is classified as sexually derived. Use of barrier methods and oral contraceptives protects against PID. IUD use greatly increases the risk of PID, probably because of the avenue the device provides for organisms to ascend from the lower to the upper genital tract. The role of males in PID etiology is currently the subject of much discussion. It is theorized that the mechanical action of penis insertion in intercourse helps to move causative agents to the upper genital region; also, semen may carry vaginal flora through the cervical opening into the uterus and tubes. Menstruation and PID are closely associated, perhaps because the cervix dilates during bleedings. Research areas include: determination of role of sexual activity (and number of partners) in PID etiology; evaluation of events of menstruation that are predisposing; evaluation of relationship between bacteriosperma and lower and upper genital infections; relationship of particular contraceptive methods to PID

  7. Early development of the human pelvic diaphragm

    NARCIS (Netherlands)

    Koch, Wijnandus Franciscus Robertus Maria

    2006-01-01

    The last decade an increasing interest in the pelvic floor can be observed in medical sciences. The lack of data on the development of the human pelvic floor is striking. The early development of the human pelvic diaphragm was studied. Materials and methods Use was made of 38 human embryos and fetus

  8. Early development of the human pelvic diaphragm

    NARCIS (Netherlands)

    Koch, Wijnandus Franciscus Robertus Maria

    2006-01-01

    The last decade an increasing interest in the pelvic floor can be observed in medical sciences. The lack of data on the development of the human pelvic floor is striking. The early development of the human pelvic diaphragm was studied. Materials and methodsUse was made of 38 human embryos and

  9. Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment

    Directory of Open Access Journals (Sweden)

    Lucente V

    2017-08-01

    Full Text Available Vincent Lucente,1 Heather van Raalte,2 Miles Murphy,1 Vladimir Egorov3 1The Institute for Female Pelvic Medicine and Reconstructive Surgery, Allentown, PA, USA; 2Princeton Urogynecology, Princeton, NJ, USA; 3Artann Laboratories, Trenton, NJ, USA Background: Further progress in restoring a woman’s health may be possible if a patient with a damaged pelvic floor could undergo medical imaging and biomechanical diagnostic tests. The results of such tests could contribute to the analysis of multiple treatment options and suggest the optimal one for that patient.Aim: To develop a new approach for the biomechanical characterization of vaginal conditions, muscles, and connective tissues in the female pelvic floor.Methods: Vaginal tactile imaging (VTI allows biomechanical assessment of the soft tissue along the entire length of the anterior, posterior, and lateral vaginal walls at rest, with manually applied deflection pressures and with muscle contraction, muscle relaxation, and Valsalva maneuver. VTI allows a large body of measurements to evaluate individual variations in tissue elasticity, support defects, as well as pelvic muscle function. Presuming that 1 the female pelvic floor organs are suspended by ligaments against which muscles contract to open or close the outlets and 2 damaged ligaments weaken the support and may reduce the force of muscle contraction, we made an attempt to characterize multiple pelvic floor structures from VTI data.Results: All of the 138 women enrolled in the study were successfully examined with the VTI. The study subjects have had normal pelvic support or pelvic organ prolapse (stages I–IV. The average age of this group of subjects was 60±15 years. We transposed a set of 31 VTI parameters into a quantitative characterization of pelvic muscles and ligamentous structures. Interpretation of the acquired VTI data for normal pelvic floor support and prolapse conditions is proposed based on biomechanical assessment of the

  10. A three-dimensional pelvic model made with a three-dimensional printer: applications for laparoscopic surgery to treat rectal cancer.

    Science.gov (United States)

    Hamabe, A; Ito, M

    2017-05-01

    To help understand the three-dimensional (3D) spatial relationships among the highly complex structures of the pelvis, we made a novel 3D pelvic model with a 3D printing system. We created two pelvic models including the muscles, vessels, nerves, and urogenital organs; the first based on the pelvic anatomy of a healthy male volunteer and the second on the pelvic anatomy of a female volunteer with rectal cancer. The models clearly demonstrated the complicated spatial relationships between anatomical structures in the pelvis. Surgeons could use these models to improve their spatial understanding of pelvic anatomy, which could consequently improve the safety and efficiency of laparoscopic rectal cancer surgery.

  11. Sciatica due to pelvic hematoma: case report

    Directory of Open Access Journals (Sweden)

    Kocaman Umit

    2016-12-01

    Full Text Available Sciatica is defined as pain in the sciatic nerve distribution. The most common reason of sciatica is radiculopathy due to lumbar disc hernia. Other causes can be congenital, acquired, infectious, neoplastic, or inflammatory. The piriformis syndrome is another cause. The pain starts in an insidious manner when the cause of sciatica is an extraspinal tumor. It is intermittent at first but a constant and progressive pain that does not decrease with position or rest gradually develops in all patients. The possibility of an intraabdominal or pelvic mass should always be considered and the relevant tests requested when the cause of the sciatica cannot be explained. We present an 83-year-old male who presented with non-traumatic and non-vascular lumbosacral plexopathy due to a large hematoma in the left adductor muscle following the use of warfarin sodium.

  12. Membrane Dialysis Extraction (MDE): a novel approach for extracting toxicologically relevant hydrophobic organic compounds from soils and sediments for assessment in biotests

    Energy Technology Data Exchange (ETDEWEB)

    Seiler, T.B.; Leist, E.; Braunbeck, T.; Hollert, H. [Dept. of Zoology, Aquatic Ecology and Toxicology, Univ. of Heidelberg (Germany); Rastall, A.C.; Erdinger, L. [Inst. of Hygiene and Medical Microbiology, Univ. of Heidelberg (Germany)

    2006-02-15

    Goal, scope and background. Organic solvents are routinely used to extract toxicants from polluted soils and sediments prior to chemical analysis or bioassay. Conventional extraction methods often require the use of heated organic solvents, in some cases under high pressure. These conditions can result in loss of volatile compounds from the sample and the degradation of thermally labile target analytes. Moreover, extracts of soils and sediments also frequently contain substantial quantities of organic macromolecules which can act as sorbing phases for target analytes and in doing so interfere with both chemical analysis and bioassays. Membrane dialysis extraction (MDE) is described as a simple, passive extraction method for selectively extracting toxicologically relevant hydrophobic organic compounds (HOCs) from polluted soils and sediments and analyzed for its applicability in ecotoxicological investigations. Methods. Toxicologically relevant hydrophobic organic compounds were extracted from wet and dry sediments by sealing replicate samples in individual lengths of pre-cleaned low-density polyethylene (LD-PE) tubing and then dialysing in n-hexane. Results. The membrane dialysis extraction was found to be at least as efficient as Soxhlet methodology to extract toxicologically relevant HOCs from sediment samples. In most cases, MDE-derived extracts showed a higher toxicological potential than the Soxhlet extracts. Lack of any significant effects in any MDE controls indicated these differences were not caused by contamination of the LD-PE membrane used. The elevated toxicological potential of MDE extracts is most likely the result of enhanced bioavailability of toxic compounds in consequence of lower amounts of organic macromolecules (i.e. sorbing phases) in the MDE extracts. This effect is probably the result of a size-selective restriction by the LD-PE membrane. Conclusion. Membrane dialysis extraction was found to be a simple, efficient and cost-effective method

  13. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...

  14. MRI in pelvic inflammatory disease: a pictorial review.

    Science.gov (United States)

    Czeyda-Pommersheim, Ferenc; Kalb, Bobby; Costello, James; Liau, Joy; Meshksar, Arash; Arif Tiwari, Hina; Martin, Diego

    2017-03-01

    Pelvic inflammatory disease (PID) is an ascending infection of the female genital tract caused by the spread of bacteria from the vagina to the pelvic reproductive organs and occasionally the peritoneum. The most common causative organisms are sexually transmitted. PID is a significant source of morbidity among reproductive age women both as a cause of abdominal pain and as a common cause of infertility. Its clinical presentation is often nonspecific, and the correct diagnosis may first come to light based on the results of imaging studies. MRI is well suited for the evaluation of PID and its complications due to its superior soft tissue contrast and high sensitivity for inflammation. MRI findings in acute PID include cervicitis, endometritis, salpingitis/oophoritis, and inflammation in the pelvic soft tissues. Acute complications include pyosalpinx, tuboovarian abscess, peritonitis, and perihepatitis. Hydrosalpinx, pelvic inclusion cysts and ureteral obstruction may develop as chronic sequela of PID. The pathophysiology, classification, treatment, and prognosis of PID are reviewed, followed by case examples of the appearance of acute and subclinical PID on MR images.

  15. Pelvic actinomycosis and usage of intrauterine contraceptive devices.

    Science.gov (United States)

    Kelly, J; Aaron, J

    1982-01-01

    Pelvic inflammatory disease (PID) is one of the most commonly encountered serious infectious disease entities in gynecology. The past decade has witnessed many advances in our understanding of the pathogenesis of PID. It is now evident that such pelvic infections are largely polymicrobial in origin, with major involvement by anaerobic organisms. Salpingo-oophoritis is a part of the spectrum of PID. Included among this group of infections are tubo-ovarian abscesses, traditionally referred to as either gonococcal or non-gonococcal in origin. Within the latter group of infections the importance of anaerobic organisms has also been elucidated. Of particular interest is the reported observation of an increased frequency of salpingo-oophoritis among users of intrauterine devices (IUDs). These reports have noted the specific occurrence of serious pelvic infections due to Actinomyces species, and this will be the topic of the infectious disease conference. Our patient presented with a chronic illness characterized by lethargy, back pain, fever, and anemia; subsequently evaluation disclosed the presence of a large pelvic mass which was confirmed as a tubo-ovarian abscess at surgery. Histological evaluation demonstrated involvement by Actinomyces species. This patient's illness is discussed as a complication of chronic IUD usage with reference to specific management for this emerging problem.

  16. Pelvic floor muscle rehabilitation using biofeedback.

    Science.gov (United States)

    Newman, Diane K

    2014-01-01

    Pelvic floor muscle exercises have been recommended for urinary incontinence since first described by obstetrician gynecologist Dr. Arnold Kegel more than six decades ago. These exercises are performed to strengthen pelvic floor muscles, provide urethral support to prevent urine leakage, and suppress urgency. In clinical urology practice, expert clinicians also teach patients how to relax the muscle to improve bladder emptying and relieve pelvic pain caused by muscle spasm. When treating lower urinary tract symptoms, an exercise training program combined with biofeedback therapy has been recommended as first-line treatment. This article provides clinical application of pelvic floor muscle rehabilitation using biofeedback as a technique to enhance pelvic floor muscle training.

  17. Treatment of Acute Pelvic Inflammatory Disease

    Directory of Open Access Journals (Sweden)

    Richard L. Sweet

    2011-01-01

    Full Text Available Pelvic inflammatory disease (PID, one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is associated with major long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its complications incurs substantial health care costs. Prevention of these long-term sequelae is dependent upon development of treatment strategies based on knowledge of the microbiologic etiology of acute PID. It is well accepted that acute PID is a polymicrobic infection. The sexually transmitted organisms, Neisseria gonorrhoeae and Chlamydia trachomatis, are present in many cases, and microorganisms comprising the endogenous vaginal and cervical flora are frequently associated with PID. This includes anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Genital tract mycoplasmas, most importantly Mycoplasma genitalium, have recently also been implicated as a cause of acute PID. As a consequence, treatment regimens for acute PID should provide broad spectrum coverage that is effective against these microorganisms.

  18. Dynamic Magnetic Resonance Imaging Used in Evaluation of Female Pelvic Prolapse: Experience from Nine Cases

    Directory of Open Access Journals (Sweden)

    Tony Wing-Cheong Chi

    2007-06-01

    Full Text Available Prolapse of pelvic organs in a female can be simple or complex. To make a definite diagnosis of pelvic prolapse preoperatively, dynamic magnetic resonance (MR is an alternative to conventional fluoroscopic or sonographic examination, with the advantage of providing greater details, and thus helping the surgeon to have a good preoperative plan. Nine women suffering from pelvic prolapse with or without urinary stress incontinence underwent dynamic MR imaging examination (1.0T Magnex100/HP, Shimadzu, Kyoto, Japan before surgery. All patients were examined in the supine position. A single-shot ultra-high speed scan (FE/8/3.02–20°, 128, 100%- 100% 1 NEX 1 slice 10 mm L 1.0 second was used to obtain midline sagittal images, with the patients at rest and during pelvic strain. MR images were then obtained every 4 seconds. Each examination was analyzed, based on specific measurements, to determine the presence and extent of prolapse of pelvic organs. The pubococcygeal, levator hiatus width and muscular pelvic floor relaxation lines, and the angle of the levator plate were identified. Based on these measurements, multicompartment involvement in the pelvic prolapse was confirmed in five patients (5/9. Four patients (4/9 had single compartment involvement. Seven patients underwent surgery. All patients reported significant improvement in their symptoms and signs after surgical intervention. Two patients had an almost complete recovery. MR demonstrated simple or complex organ descent in all pelvic compartments, and may become a standard preoperative examination for pelvic floor abnormalities. The MR images facilitated comprehensive planning by the surgeon; thus, they can increase the success rate and help to accurately predict the outcome of the surgical intervention. The surgeons also expressed high postsurgical satisfaction with the information provided by dynamic MR.

  19. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... liver, shows up in shades of gray, and air appears black. With CT scanning, numerous x-ray ... injected into a vein) to help evaluate blood vessels and organs such as the liver, kidneys and ...

  20. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... as organ transplants. stage, plan and properly administer radiation treatments for tumors as well as monitor response ... conventional x-ray exam, a small amount of radiation is aimed at and passes through the part ...

  1. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney ... and organs such as the liver, kidneys and pancreas. When you enter the CT scanner, special light ...

  2. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...

  3. Pelvic Support Problems

    Science.gov (United States)

    ... A device inserted into the vagina to support sagging organs. Rectocele: Bulging of the rectum into the ... the urethra into the vaginal wall. Uterine Prolapse: Sagging of the uterus into the vagina. Uterus: A ...

  4. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... diseases of the small bowel, colon and other internal organs and is often used to determine the ... and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save ...

  5. Abdominal and Pelvic CT

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    Full Text Available ... the results of surgery, such as organ transplants. stage, plan and properly administer radiation treatments for tumors ... You may also be asked to remove hearing aids and removable dental work. Women will be asked ...

  6. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... as abscess drainages and minimally invasive tumor treatments. plan for and assess the results of surgery, such as organ transplants. stage, plan and properly administer radiation treatments for tumors as ...

  7. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... internal organs, small bowel and colon, such as: infections such as appendicitis , pyelonephritis or infected fluid collections, ... invasive diagnostic procedures. When pain is caused by infection and inflammation, the speed, ease and accuracy of ...

  8. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. ... ray; soft tissue, such as organs like the heart or liver, shows up in shades of gray, ...

  9. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels. top of page What are some common uses ...

  10. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... treatments. plan for and assess the results of surgery, such as organ transplants. stage, plan and properly ... CT scanning may eliminate the need for exploratory surgery and surgical biopsy. No radiation remains in a ...

  11. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...

  12. Magnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group

    Energy Technology Data Exchange (ETDEWEB)

    El Sayed, Rania Farouk [Cairo University Hospitals, Genitourinary and Pelvic Floor MR Imaging Unit, Department of Radiology, Faculty of Medicine, Cairo (Egypt); Alt, Celine D. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany); Maccioni, Francesca [Sapienza University Rome, Department of Radiological Sciences, Oncology and Pathology Policlinico Umberto I Hospital, Rome (Italy); Meissnitzer, Matthias [University Hospital Salzburg, Paracelsus Medical University, Department of Radiology, Salzburg (Austria); Masselli, Gabriele [Sapienza University of Rome, Department of Radiology Dea, Umberto I Hospital, Rome (Italy); Manganaro, Lucia; Vinci, Valeria [Sapienza University of Rome, Department of Radiological Sciences, Policlinico Umberto I Hospital, Rome (Italy); Weishaupt, Dominik [Triemli Hospital Zurich, Institute of Radiology and Nuclear Medicine, Zurich (Switzerland); Collaboration: On behalf of the ESUR and ESGAR Pelvic Floor Working Group

    2017-05-15

    To develop recommendations that can be used as guidance for standardized approach regarding indications, patient preparation, sequences acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for diagnosis and grading of pelvic floor dysfunction (PFD). The technique included critical literature between 1993 and 2013 and expert consensus about MRI protocols by the pelvic floor-imaging working group of the European Society of Urogenital Radiology (ESUR) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) from one Egyptian and seven European institutions. Data collection and analysis were achieved in 5 consecutive steps. Eighty-two items were scored to be eligible for further analysis and scaling. Agreement of at least 80 % was defined as consensus finding. Consensus was reached for 88 % of 82 items. Recommended reporting template should include two main sections for measurements and grading. The pubococcygeal line (PCL) is recommended as the reference line to measure pelvic organ prolapse. The recommended grading scheme is the ''Rule of three'' for Pelvic Organ Prolapse (POP), while a rectocele and ARJ descent each has its specific grading system. This literature review and expert consensus recommendations can be used as guidance for MR imaging and reporting of PFD. (orig.)

  13. Functional MRI of the pelvic floor: postpartum changes of primiparous women after spontaneous vaginal delivery; Funktionelle Magnetresonanztomographie (MRT) des Beckenbodens: Postpartale Veraenderungen bei Erstgebaerenden nach vaginaler Spontangeburt

    Energy Technology Data Exchange (ETDEWEB)

    Lienemann, A.; Fischer, T.; Reiser, M. [Inst. fuer Klinische Radiologie, Klinikum der Univ. Muenchen (Germany); Anthuber, C. [Klinik und Poliklinik fuer Geburtshilfe und Frauenheilkunde, Klinikum der Univ. Muenchen/Grosshadern (Germany)

    2003-08-01

    Purpose: Detection of morphological and functional changes of the pelvic floor with functional MRI in primiparous women after spontaneous vaginal delivery. Methods and Materials: The study comprises 26 primiparous women after vaginal delivery and a control group of 41 healthy asymptomatic nulliparous volunteers. MRI was performed on a 1.5 T system in supine position with vagina and rectum opacified with Sonogel. The static images consisted of sagittal and axial T{sub 2}-weighted SE sequences and functional images of true FISP sequences in midsagittal and axial planes acquired with the patient at rest, straining and during defecation. Evaluation of morphometric parameters included pelvimetry, thickness of the puborectal muscle and width of the urogenital hiatus as well as position and movement of the pelvic organs relative to the pubococcygeal reference line. Results: The configuration of the bony pelvis did not differ for both groups. The puborectal muscle was significantly thinner in the study group (0.8 cm vs 0.6 cm). The functional images showed no significant differences between both groups at rest but a significantly increased incidence in the descent of the bladder neck, vaginal fornix and anorectal junction in the study group during straining. In addition, the primiparous women had more prominent rectoceles (0.6 cm vs 1.5 cm). Conclusion: Static imaging alone fails to demonstrate relevant pelvic floor changes and a functional method is necessary to evaluate the interactions of the pelvic organs regarding organ descent. Functional MRI of the pelvic floor is an excellent method to reveal the significant changes of the pelvic floor after vaginal birth without exposing the uterus to radiation. (orig.) [German] Ziel: Darstellung von morphologischen und funktionellen Veraenderungen am Beckenboden bei Erstgebaerenden nach spontanvaginaler Entbindung mittels funktioneller MRT. Methodik: Funktionelle MRT des Beckenbodens von 26 Erstgebaerenden nach vaginaler

  14. A Pelvic Health Curriculum in School Settings: The Effect on Adolescent Females' Knowledge.

    Science.gov (United States)

    Hebert-Beirne, Jennifer M; O'Conor, Rachel; Ihm, Jeni Donatelli; Parlier, Molly Kirk; Lavender, Missy D; Brubaker, Linda

    2017-04-01

    In this pilot study we ascertained baseline knowledge of pelvic anatomy and function among female adolescents and tested the educational effectiveness of a pelvic health curriculum among female adolescent students with the hypothesis that teaching pelvic anatomy, muscle, and organ function, and pelvic hygiene increases pelvic health knowledge. Intervention-control group, community-based effectiveness study. Three Chicago area schools with racial minority and low-income student populations were selected as study sites. One hundred sixty-eight students with a mean age of 14.1 (±0.1) years. Most (69%) self-reported race as black or African American; 23.8% reported Hispanic ethnicity. Pelvic health teachers delivered 6 weekly, 1-hour classes (intervention group, n = 103; control group, n = 65). A comparison control group received standard curricula (physical education or science). Knowledge change was measured using the Adolescent Bladder and Pelvic Health Questionnaire. We used χ(2) tests to compared bivariate differences between study arms and generalized equation estimate to test for before and after change across groups. Baseline pelvic anatomy and function knowledge was minimal. The level of anatomical knowledge was very low with few in either group correctly able to identify where urine exits the body or the number of openings in the vulva. After intervention, significant increases in knowledge included pelvic floor muscle awareness in the control and intervention group (20% vs 89%; P knowledge that urine loss was abnormal (25.4% vs 60%; P knowledge deficits among female adolescents and suggest that short-term pelvic health educational intervention results in significant knowledge acquisition. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  15. Ultrasound-guided Transvaginal Aspiration in the Management of Actinomyces Pelvic Abscess

    Science.gov (United States)

    Rahav, Galiya; Hanoch, Josef; Shimonovitz, Shlomo; Yagel, Simcha; Laufer, Neri

    1996-01-01

    Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified. Case: A 38-year-old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound-guided needle aspiration. It resulted in marked improvement and avoided surgical treatment. Conclusion: Transvaginal needle aspiration of Actinomyces pelvic abscess may be an alternative to surgical therapy, thereby allowing the preservation of pelvic organs. PMID:18476111

  16. Efficient radiologic diagnosis of pelvic and acetabular trauma; Rationelle bildgebende Diagnostik von Becken- und Azetabulumverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Rommens, P.M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Unfallchirurgie

    2000-01-01

    In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.) [German] Bei der Klaerung einer Verletzung des Beckens oder des Azetabulums stellen konventionelle Uebersichtsaufnahmen weiterhin die Basis der bildgebenden Diagnostik dar. Art und Umfang werden bestimmt von lokalen Gegebenheiten (z.B. Verfuegbarkeit von CT-Geraeten) sowie vom klinischen Zustand des Patienten. Aufgrund der diagnostischen Ungenauigkeit der konventionellen Roentgendiagnostik gerade im Bereich des stabilitaetsbedeutsamen dorsalen Beckenringes und des Azetabulums schliesst sich beim klinisch stabilen

  17. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may increase the risk of an unusual adverse ... tissue, such as organs like the heart or liver, shows up in shades of gray, ...

  18. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may increase the risk of an unusual adverse ... tissue, such as organs like the heart or liver, shows up in shades of gray, ...

  19. Pelvic compartment syndrome caused by retroperitoneal hematoma of pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Feng-qi; ZHANG Ying-ze; PAN Jin-she; PENG A-qin; WANG Hui-juan

    2005-01-01

    @@ Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis.

  20. Carboxylic acid functionalization prevents the translocation of multi-walled carbon nanotubes at predicted environmentally relevant concentrations into targeted organs of nematode Caenorhabditis elegans

    Science.gov (United States)

    Nouara, Abdelli; Wu, Qiuli; Li, Yinxia; Tang, Meng; Wang, Haifang; Zhao, Yuliang; Wang, Dayong

    2013-06-01

    Carboxyl (-COOH) surface modified multi-walled carbon nanotubes (MWCNTs-COOH) can be used for targeted delivery of drugs and imaging. However, whether MWCNTs-COOH at environmentally relevant concentrations exert certain toxic effects on multicellular organisms and the underlying mechanisms are still largely unclear. In the present study, we applied the nematode Caenorhabditis elegans to evaluate the properties of MWCNTs-COOH at environmentally relevant concentrations by comparing the effects of MWCNTs and MWCNTs-COOH exposure on C. elegans from L1-larvae to adult at concentrations of 0.001-1000 μg L-1. Exposure to MWCNTs could potentially damage the intestine (primary targeted organ) at concentrations greater than 0.1 μg L-1 and functions of neurons and reproductive organ (secondary targeted organs) at concentrations greater than 0.001 μg L-1. Carboxyl modification prevented the toxicity of MWCNTs on the primary and the secondary targeted organs at concentrations less than 100 μg L-1, suggesting that carboxyl modification can effectively prevent the adverse effects of MWCNTs at environmentally relevant concentrations. After exposure, MWCNTs-COOH (1 mg L-1) were translocated into the spermatheca and embryos in the body through the primary targeted organs. However, MWCNTs-COOH (10 μg L-1) were not observed in spermatheca and embryos in the body of nematodes. Moreover, relatively high concentrations of MWCNTs-COOH exposed nematodes might have a hyper-permeable intestinal barrier, whereas MWCNTs-COOH at environmentally relevant concentrations effectively sustained the normally permeable state for the intestinal barrier. Therefore, we elucidated the cellular basis of carboxyl modification to prevent toxicity of MWCNTs at environmentally relevant concentrations. Our data highlights the key role of biological barriers in the primary targeted organs to block toxicity formation from MWCNTs, which will be useful for the design of effective prevention strategies against

  1. Diabetes and Obesity-Related Risks for Pelvic Reconstructive Surgery in a Cohort of Swedish Twins

    OpenAIRE

    Forsman, Mats; Iliadou, Anastasia; Magnusson, Patrik; Falconer, Christian; Altman, Daniel

    2008-01-01

    OBJECTIVE—To determine the diabetes- and obesity-related risks for surgically managed stress urinary incontinence and pelvic organ prolapse. RESEARCH DESIGN AND METHODS—This twin cohort study used the Swedish Twin Register to identify 8,443 female twin pairs born from 1926 through 1958. The association between diabetes and pelvic floor surgery was estimated while taking into account the correlated (twin) structure of the data. RESULTS—For type 1 and type 2 diabetes, no significant association...

  2. Robot-assisted laparoscopic resection of a huge pelvic tumor: A case report.

    Science.gov (United States)

    Jia, Zhuomin; Lyu, Xiangjun; Xu, Yong; Leonardi, Rosario; Zhang, Xu

    2016-07-04

    The traditional open surgery, for the treatment of huge tumor in the narrow space of pelvic cavity and in close proximity to pelvic organs and neurovascular structures, is very difficult and challenging. We report a case of huge neurilemmoma operated using the robot-assisted laparoscopy. We used interventional pre-operation embolization to control blood supply of tumor because MRI showed the tumor had a sufficient blood supply.

  3. From interstitial cystitis to chronic pelvic pain.

    Science.gov (United States)

    Persu, C; Cauni, V; Gutue, S; Blaj, Irina; Jinga, V; Geavlete, P

    2010-01-01

    There are still many things to be found out about interstitial cystitis/painful bladder syndrome (IC/PBS) because the pathological processes underlying the condition are not yet elucidated, biological markers of the condition are not yet available, and the type and severity of symptoms can vary, so, clearly defining the condition is not yet possible. For example, it is not clearly understood whether IC/PBS represents a systemic disease, if it is localized in the bladder, or if it was initially localized in the bladder and it later evolved into a systemic disease. This condition is best managed by using a multidisciplinary approach. Management requires a good integration and knowledge of all pelvic organ systems and other systems including musculoskeletal, neurologic, and psychiatric systems.

  4. Energy absorption buildup factors of human organs and tissues at energies and penetration depths relevant for radiotherapy and diagnostics.

    Science.gov (United States)

    Manohara, S R; Hanagodimath, S M; Gerward, L

    2011-11-15

    Energy absorption geometric progression (GP) fitting parameters and the corresponding buildup factors have been computed for human organs and tissues, such as adipose tissue, blood (whole), cortical bone, brain (grey/white matter), breast tissue, eye lens, lung tissue, skeletal muscle, ovary, testis, soft tissue, and soft tissue (4-component), for the photon energy range 0.015-15 MeV and for penetration depths up to 40 mfp (mean free path). The chemical composition of human organs and tissues is seen to influence the energy absorption buildup factors. It is also found that the buildup factor of human organs and tissues changes significantly with the change of incident photon energy and effective atomic number, Z(eff). These changes are due to the dominance of different photon interaction processes in different energy regions and different chemical compositions of human organs and tissues. With the proper knowledge of buildup factors of human organs and tissues, energy absorption in the human body can be carefully controlled. The present results will help in estimating safe dose levels for radiotherapy patients and also useful in diagnostics and dosimetry. The tissue-equivalent materials for skeletal muscle, adipose tissue, cortical bone, and lung tissue are also discussed. It is observed that water and MS20 are good tissue equivalent materials for skeletal muscle in the extended energy range.

  5. Obesity and pelvic floor dysfunction.

    Science.gov (United States)

    Ramalingam, Kalaivani; Monga, Ash

    2015-05-01

    Obesity is associated with a high prevalence of pelvic floor disorders. Patients with obesity present with a range of urinary, bowel and sexual dysfunction problems as well as uterovaginal prolapse. Urinary incontinence, faecal incontinence and sexual dysfunction are more prevalent in patients with obesity. Uterovaginal prolapse is also more common than in the non-obese population. Weight loss by surgical and non-surgical methods plays a major role in the improvement of these symptoms in such patients. The treatment of symptoms leads to an improvement in their quality of life. However, surgical treatment of these symptoms may be accompanied by an increased risk of complications in obese patients. A better understanding of the mechanism of obesity-associated pelvic floor dysfunction is essential.

  6. The Relevance of IT Service Management Maturity for IT Alignment and Its Strategy and Organization Size Contingencies

    DEFF Research Database (Denmark)

    Winkler, Till J.; Wulf, Jochen; Brenner, Walter

    2014-01-01

    The paradigm to manage information technology (IT) services in accordance with widely accepted ‘good practices’ has led to the widespread adoption of IT Service Management (ITSM) frameworks such as the IT Infrastructure Library (ITIL). Little academic research, however, has been conducted....... Our findings strengthen the view that ITSM frameworks like ITIL incorporate governance mechanisms that can enhance the effect of the established relational antecedents of IT alignment. In addition, our data particularly provide evidence for the relevance of execution-level ITSM processes and suggest...

  7. Numerical simulation of the damage evolution in the pelvic floor muscles during childbirth.

    Science.gov (United States)

    Oliveira, Dulce A; Parente, Marco P L; Calvo, Begoña; Mascarenhas, Teresa; Natal Jorge, Renato M

    2016-02-29

    Several studies have shown that pelvic floor injuries during a vaginal delivery can be considered a significant factor in the development of pelvic floor dysfunction. Such disorders include a group of conditions affecting women like urinary incontinence, pelvic organ prolapse and fecal incontinence. Numerical simulations are valuable tools that are contributing to the clarification of the mechanisms behind pelvic floor disorders. The aim of this work is to propose a mechanical model implemented in the finite element method context to estimate the damage in the pelvic floor muscles by mechanical effects during a vaginal delivery of a fetus in vertex presentation and occipitoanterior position. The constitutive model adopted has already been successfully used in the simulation of childbirth and the structural damage model added has previously been applied to characterize the damage process in biological soft tissues undergoing finite deformations. The constitutive parameters were fit to experimental data available in the literature and the final proposed material model is suitable to estimate the mechanical damage in the pelvic floor muscle during a vaginal delivery. The computational model predicts that even an apparently uneventful vaginal delivery inflicts injuries to the pelvic floor muscles, particularly during the extension of the fetus head, having been obtained more than 10% of damaged fibers. As a clinical evidence, the present work allows to conclude that the puborectalis component of the levator ani muscle is the most prone to damage.

  8. Air monitoring of volatile organic compounds at relevant receptors during hydraulic fracturing operations in Washington County, Pennsylvania.

    Science.gov (United States)

    Maskrey, Joshua R; Insley, Allison L; Hynds, Erin S; Panko, Julie M

    2016-07-01

    A 3-month air monitoring study was conducted in Washington County, Pennsylvania, at the request of local community members regarding the potential risks resulting from air emissions of pollutants related to hydraulic fracturing operations. Continuous air monitoring for total volatile organic compounds was performed at two sampling sites, including a school and a residence, located within 900 m of a hydraulic fracturing well pad that had been drilled prior to the study. Intermittent 24-hour air samples for 62 individual volatile organic compounds were also collected. The ambient air at both sites was monitored during four distinct periods of unconventional natural gas extraction activity: an inactive period prior to fracturing operations, during fracturing operations, during flaring operations, and during another inactive period after operations. The results of the continuous monitoring during fracturing and flaring sampling periods for total volatile organic compounds were similar to the results obtained during inactive periods. Total volatile organic compound 24-hour average concentrations ranged between 0.16 and 80 ppb during all sampling periods. Several individual volatile compounds were detected in the 24-hour samples, but they were consistent with background atmospheric levels measured previously at nearby sampling sites and in other areas in Washington County. Furthermore, a basic yet conservative screening level evaluation demonstrated that the detected volatile organic compounds were well below health-protective levels. The primary finding of this study was that the operation of a hydraulic fracturing well pad in Washington County did not substantially affect local air concentrations of total and individual volatile organic compounds.

  9. Pelvic morphology in ischiofemoral impingement

    Energy Technology Data Exchange (ETDEWEB)

    Bredella, Miriam A.; Azevedo, Debora C.; Oliveira, Adriana L.; Simeone, Frank J.; Chang, Connie Y.; Torriani, Martin [Massachusetts General Hospital, Department of Radiology, Musculoskeletal Imaging and Intervention, Boston, MA (United States); Stubbs, Allston J. [Wake Forest University School of Medicine, Department of Orthopedic Surgery, Division of Sports Medicine, Winston-Salem, NC (United States)

    2014-11-06

    To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls. The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender. The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15 %) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender. Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI. (orig.)

  10. Animal models of gastrointestinal and liver diseases. Animal models of visceral pain: pathophysiology, translational relevance, and challenges.

    Science.gov (United States)

    Greenwood-Van Meerveld, Beverley; Prusator, Dawn K; Johnson, Anthony C

    2015-06-01

    Visceral pain describes pain emanating from the thoracic, pelvic, or abdominal organs. In contrast to somatic pain, visceral pain is generally vague, poorly localized, and characterized by hypersensitivity to a stimulus such as organ distension. Animal models have played a pivotal role in our understanding of the mechanisms underlying the pathophysiology of visceral pain. This review focuses on animal models of visceral pain and their translational relevance. In addition, the challenges of using animal models to develop novel therapeutic approaches to treat visceral pain will be discussed. Copyright © 2015 the American Physiological Society.

  11. The effect of particle acidity on secondary organic aerosol formation from α-pinene photooxidation under atmospherically relevant conditions

    Science.gov (United States)

    Han, Yuemei; Stroud, Craig A.; Liggio, John; Li, Shao-Meng

    2016-11-01

    Secondary organic aerosol (SOA) formation from photooxidation of α-pinene has been investigated in a photochemical reaction chamber under varied inorganic seed particle acidity levels at moderate relative humidity. The effect of particle acidity on SOA yield and chemical composition was examined under high- and low-NOx conditions. The SOA yield (4.2-7.6 %) increased nearly linearly with the increase in particle acidity under high-NOx conditions. In contrast, the SOA yield (28.6-36.3 %) was substantially higher under low-NOx conditions, but its dependency on particle acidity was insignificant. A relatively strong increase in SOA yield (up to 220 %) was observed in the first hour of α-pinene photooxidation under high-NOx conditions, suggesting that SOA formation was more effective for early α-pinene oxidation products in the presence of fresh acidic particles. The SOA yield decreased gradually with the increase in organic mass in the initial stage (approximately 0-1 h) under high-NOx conditions, which is likely due to the inaccessibility to the acidity over time with the coating of α-pinene SOA, assuming a slow particle-phase diffusion of organic molecules into the inorganic seeds. The formation of later-generation SOA was enhanced by particle acidity even under low-NOx conditions when introducing acidic seed particles after α-pinene photooxidation, suggesting a different acidity effect exists for α-pinene SOA derived from later oxidation stages. This effect could be important in the atmosphere under conditions where α-pinene oxidation products in the gas-phase originating in forested areas (with low NOx and SOx) are transported to regions abundant in acidic aerosols such as power plant plumes or urban regions. The fraction of oxygen-containing organic fragments (CxHyO1+ 33-35 % and CxHyO2+ 16-17 %) in the total organics and the O / C ratio (0.52-0.56) of α-pinene SOA were lower under high-NOx conditions than those under low-NOx conditions (39-40, 17-19, and

  12. Energy absorption buildup factors of human organs and tissues at energies and penetration depths relevant for radiotherapy and diagnostics

    DEFF Research Database (Denmark)

    Manohara, S. R.; Hanagodimath, S. M.; Gerward, Leif

    2011-01-01

    Energy absorption geometric progression (GP) fitting parameters and the corresponding buildup factors have been computed for human organs and tissues, such as adipose tissue, blood (whole), cortical bone, brain (grey/white matter), breast tissue, eye lens, lung tissue, skeletal muscle, ovary...

  13. 盆腔器官脱垂手术对下尿路症状影响的前瞻性研究%Prospective study of the impact on lower urinary tract symptoms after pelvic organ prolapse surgery

    Institute of Scientific and Technical Information of China (English)

    于海洋; 杨欣; 李桂花

    2011-01-01

    Objective To investigate effect of urinary conditions and lower urinary tract symptoms (LUTS) in patients before and after the reconstructive pelvic surgery (RPS) for pelvic organ prolapse (POP) as well as effect of urinary conditions and LUTS by tension-free vaginal tape-obturator (TVT-O).Methods From Jan. 2007 to Dec. 2009, 213 patients with POP underwent RPS, the factors on preoperative, postoperative urinary conditions and qualities of life and postoperative urinary incontinence were studied prospectively. Results Totally 193 patients who was followed up for more than 3 months after surgery attend questionnaires, and 165 preoperative patients of 193 (85.5%) had LUTS, 105 postoperative patients of 193 (54.4%) had LUTS, which reached statistical difference (P <0. 01 ). The rate of LUTS before and after operation: urinary frequency ( 57.0% and 25.9% ), urinary urgency ( 51.8% and 28.0% ), urinary leakage due to cough ( 50. 3% and 15.0% ), dropping urinary leakage ( 44. 6% and 14. 5% ), dysuria (34. 7% and 23.3% ), vesicaltenesmus (49.2% and 19. 7% ) and hand assist urination (31.1% and 2.6% ). The incidence of LUTS after surgery is much lower than that of pre-operation ( P <0. 05 ). POP patients with stress urinary incontinence ( SUI ) before the operation, surgery without TVT-O simultaneously are the risk factors of unimproved symptom ( OR = 4. 933, 95% CI: 1. 353 - 17. 990, P=0. 016). Conclusions RPS have alleviated LUTS in patients with POP. RPS with TVT-O are more effective than traditional RPS in treatment of the urinary incontinence if the POP patient with SUI or occult SUI.%目的 探讨盆腔器官脱垂患者盆底修复手术后下尿路症状的变化情况,以及术中加行经闭孔尿道中段无张力悬吊带术(TVT-O)对漏尿及下尿路症状的影响.方法 2007年1月至2009年12月期间,共193例盆腔器官脱垂患者在北京大学第一医院行盆底修复手术(其中131例加行TVT-O)且术后随访达3个月以上,前瞻性研

  14. Vaginal shape at resting pelvic MRI: Predictor of pelvic floor weakness?

    OpenAIRE

    Tillack, AA; Joe, B; Yeh, B; Jun, SL; Kornak, J; Zhao, S; Deng, D

    2014-01-01

    © 2014 Elsevier Inc. Objective: The objective was to determine if alteration in vaginal shape seen on nonstraining pelvic magnetic resonance (MR) scans is associated with pelvic floor weakness. Methods: Two readers classified the shape of the middle third of the vagina on resting T2-weighted axial images as normal or abnormal for 76 women with and without pelvic floor weakness. Results: The sensitivity and specificity for diagnosing pelvic floor dysfunction were 84% and 68% for reader A and 4...

  15. Gynecological pelvic pain as emergency pathology.

    Science.gov (United States)

    Rivera Domínguez, A; Mora Jurado, A; García de la Oliva, A; de Araujo Martins-Romeo, D; Cueto Álvarez, L

    Acute pelvic pain is a common condition in emergency. The sources of acute pelvic pain are multifactorial, so it is important to be familiar with this type of pathologies. The purpose of this article is review the main causes of gynecological acute pelvic pain and their radiologic appearances to be able to make an accurate diagnosis and provide objective criteria for patient management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. The pelvic floor in health and disease.

    OpenAIRE

    Shelton, A A; Welton, M L

    1997-01-01

    Normal pelvic floor function involves a set of learned and reflex responses that are essential for the normal control and evacuation of stool. A variety of functional disturbances of the pelvic floor, including incontinence and constipation, are not life threatening, but can cause significant distress to affected patients. Understanding the normal anatomy and physiology of the pelvic floor is essential to understanding and treating these disorders of defecation. This article describes the nor...

  17. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)

    2005-04-01

    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  18. The first pelvic examination for an adolescent: is this rite of passage used to its full potential?

    Science.gov (United States)

    Siwe, Karin; Wijma, Barbro

    2013-10-01

    Adolescents' experiences of their first pelvic examination (external inspection, speculum examination and bimanual palpation) may have a marked influence on future experiences; why examination techniques and strategies for creating a positive experience of this situation need to be developed. This review addresses to what extent that ambition is reflected in recent literature. The majority of articles on 'pelvic examination during adolescence' come from the United States, which skews the review's perspective. Several researchers recommend using investigations based on new technology rather than a pelvic examination when medical indications for a full examination are present. The profession's attitudes toward annual check-ups and pelvic examinations (in the United States) are currently debated, for teens as well as for adults.How to perform a first pelvic examination on an adolescent is not often discussed, nor are strategies for creating a positive experience of this event.The contexts in which a first pelvic examination is performed probably differ among societies. The Swedish and the US contexts are compared as an illustration; for example preventive healthcare and sex education is in Sweden the responsibility of schools, open for anybody and without admission fees. Recent literature does not mirror a need for developing examination techniques and strategies for creating a positive experience of the first pelvic examination, nor for exploiting its maximal potential as a positive rite of passage.The ongoing US debate on indications for pelvic examinations and annual check-ups is even more relevant for adolescents, in whom contraindications need to be considered.

  19. Osteosarcoma of pelvic bones: imaging features.

    Science.gov (United States)

    Park, Se Kyoung; Lee, In Sook; Cho, Kil Ho; Lee, Young Hwan; Yi, Jae Hyuck; Choi, Kyung Un

    The metaphyseal locations of tubular bones with osteoid mineralization in young patients are important diagnostic radiologic features of osteosarcoma. The pelvic bones are an unusual location of osteosarcoma. Although osteosarcoma occurring in pelvic bones is not common, the osteoid matrix may be a critical finding for differentiating osteosarcoma from other common pelvic bone tumors. Therefore, the possibility of osteosarcoma in pelvic bones may be considered in the presence of osteoid matrix even in the old age group. Copyright © 2016. Published by Elsevier Inc.

  20. [Functional anatomy of the pelvic floor].

    Science.gov (United States)

    Yiou, René; Delmas, Vincent

    2013-01-01

    The pelvic floor is the support of the pelvic viscera. The levator ani muscle (LA) with its two bundles (pubo- and iliococcygeus) is the major component of this pelvic floor. LA is formed essentially by type I fibers (slow twitch, with high oxidative capability and presence of slow myosin) as in postural muscles. The aerobic metabolism makes LA fragile to excentric contraction and to mitochondrial dysfunction. The innervation of the pelvic floor comes from the 2nd, 3rd, 4th anterior sacral roots; denervation affects pelvic dynamism. Perineum includes the musculofascial structures under the LA: ventrally the striated sphincter of urethra and the ischiocavernosus and bulbospongiosus, caudally the fatty tissue filling the ischioanal fossa. Pelvic fascia covers the muscles ; it presents reinforcements : the uterosacral and cardinal ligaments, the arcus tendineus fascia pelvis (ATFP) and the arcus tendineus levator ani (ATLA). The pelvis statics is supported by the combined action of all this anatomical structures anteriorly forming the perineal "hammock," medially the uterosacral and cardinal ligaments, posteriorly the rectovaginal fascia and the perineal body. The angles formed by the pelvic viscera with their evacuation ducts participate to the pelvic statics. During the pelvic dynamics the modification of these angles expresses the action of the musculofascial structures.

  1. Emergency management of hemodynamically unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-gang

    2011-01-01

    Pelvic fractures are serious injuries.Death within 24 hours is most often a result of acute blood loss.The emergency management of these patients is challenging and controversial.The key issues in its management are identifying the site(s) of hemorrhage and then controlling the bleeding.Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team.The issues addressed in this management algorithm are diagnostic evaluation,damage control resuscitation,indications for noninvasive pelvic stabilization,preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography.This review article focuses on the recent body of knowledge on those determinations.

  2. Hygroscopic properties of potassium chloride and its internal mixtures with organic compounds relevant to biomass burning aerosol particles

    Science.gov (United States)

    Jing, Bo; Peng, Chao; Wang, Yidan; Liu, Qifan; Tong, Shengrui; Zhang, Yunhong; Ge, Maofa

    2017-02-01

    While water uptake of aerosols exerts considerable impacts on climate, the effects of aerosol composition and potential interactions between species on hygroscopicity of atmospheric particles have not been fully characterized. The water uptake behaviors of potassium chloride and its internal mixtures with water soluble organic compounds (WSOCs) related to biomass burning aerosols including oxalic acid, levoglucosan and humic acid at different mass ratios were investigated using a hygroscopicity tandem differential mobility analyzer (HTDMA). Deliquescence points of KCl/organic mixtures were observed to occur at lower RH values and over a broader RH range eventually disappearing at high organic mass fractions. This leads to substantial under-prediction of water uptake at intermediate RH. Large discrepancies for water content between model predictions and measurements were observed for KCl aerosols with 75 wt% oxalic acid content, which is likely due to the formation of less hygroscopic potassium oxalate from interactions between KCl and oxalic acid without taken into account in the model methods. Our results also indicate strong influence of levoglucosan on hygroscopic behaviors of multicomponent mixed particles. These findings are important in further understanding the role of interactions between WSOCs and inorganic salt on hygroscopic behaviors and environmental effects of atmospheric particles.

  3. Hygroscopic properties of potassium chloride and its internal mixtures with organic compounds relevant to biomass burning aerosol particles

    Science.gov (United States)

    Jing, Bo; Peng, Chao; Wang, Yidan; Liu, Qifan; Tong, Shengrui; Zhang, Yunhong; Ge, Maofa

    2017-01-01

    While water uptake of aerosols exerts considerable impacts on climate, the effects of aerosol composition and potential interactions between species on hygroscopicity of atmospheric particles have not been fully characterized. The water uptake behaviors of potassium chloride and its internal mixtures with water soluble organic compounds (WSOCs) related to biomass burning aerosols including oxalic acid, levoglucosan and humic acid at different mass ratios were investigated using a hygroscopicity tandem differential mobility analyzer (HTDMA). Deliquescence points of KCl/organic mixtures were observed to occur at lower RH values and over a broader RH range eventually disappearing at high organic mass fractions. This leads to substantial under-prediction of water uptake at intermediate RH. Large discrepancies for water content between model predictions and measurements were observed for KCl aerosols with 75 wt% oxalic acid content, which is likely due to the formation of less hygroscopic potassium oxalate from interactions between KCl and oxalic acid without taken into account in the model methods. Our results also indicate strong influence of levoglucosan on hygroscopic behaviors of multicomponent mixed particles. These findings are important in further understanding the role of interactions between WSOCs and inorganic salt on hygroscopic behaviors and environmental effects of atmospheric particles. PMID:28240258

  4. Assessment of pelvic floor dysfunctions using dynamic magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Hoda Salah Darwish

    2014-03-01

    Conclusion: Dynamic MRI is an ideal, non invasive technique which does not require patient preparation for evaluation of pelvic floor. It acts as one stop shop for diagnosing single or multiple pelvic compartment involvement in patients with pelvic floor dysfunction.

  5. Testing of the Anorectal and Pelvic Floor Area

    Science.gov (United States)

    ... Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Personal Stories Contact About GI Motility ... Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Personal Stories Contact Anorectal and Pelvic ...

  6. Pelvic inflammatory disease in virginal adolescent females without tubo-ovarian abscess.

    Science.gov (United States)

    Kielly, Maria; Jamieson, Mary Anne

    2014-02-01

    Pelvic inflammatory disease (PID) is an infection of the upper genital tract that is often caused by an ascending sexually transmitted infection. The complications of PID include pyosalpinx and tubo-ovarian abscess, infertility or ectopic pregnancy, and chronic pelvic pain of varying degrees. These sequelae underscore the importance of prompt diagnosis. We present 2 cases of PID in young women who denied any history of sexual activity or sexual abuse. Both cases were brought to the operating room with suspected appendicitis; however, laparoscopic evaluation revealed purulent fluid surrounding the pelvic organs. The literature is scant with respect to PID in the virginal patient. It is important to keep pelvic infection in the differential diagnosis of virginal patients who present with clinical symptoms of an acute abdomen. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  7. Biological Effects of Clinically Relevant CoCr Nanoparticles in the Dura Mater: An Organ Culture Study

    Directory of Open Access Journals (Sweden)

    Iraklis Papageorgiou

    2014-06-01

    Full Text Available Medical interventions for the treatment of spinal disc degeneration include total disc replacement and fusion devices. There are, however, concerns regarding the generation of wear particles by these devices, the majority of which are in the nanometre sized range with the potential to cause adverse biological effects in the surrounding tissues. The aims of this study were to develop an organ culture model of the porcine dura mater and to investigate the biological effects of CoCr nanoparticles in this model. A range of histological techniques were used to analyse the structure of the tissue in the organ culture. The biological effects of the CoCr wear particles and the subsequent structural changes were assessed using tissue viability assays, cytokine assays, histology, immunohistochemistry, and TEM imaging. The physiological structure of the dura mater remained unchanged during the seven days of in vitro culture. There was no significant loss of cell viability. After exposure of the organ culture to CoCr nanoparticles, there was significant loosening of the epithelial layer, as well as the underlying collagen matrix. TEM imaging confirmed these structural alterations. These structural alterations were attributed to the production of MMP-1, -3, -9, -13, and TIMP-1. ELISA analysis revealed that there was significant release of cytokines including IL-8, IL-6, TNF-α, ECP and also the matrix protein, tenascin-C. This study suggested that CoCr nanoparticles did not cause cytotoxicity in the dura mater but they caused significant alterations to its structural integrity that could lead to significant secondary effects due to nanoparticle penetration, such as inflammation to the local neural tissue.

  8. National and International Standardization (International Organization for Standardization and European Committee for Standardization Relevant for Sustainability in Construction

    Directory of Open Access Journals (Sweden)

    Renata Morbiducci

    2010-12-01

    Full Text Available Sustainability in construction has a short history in terms of principles, standardizations and applications. From the Brundtland Report “Our Common Future”, a new vision of the resource deficits, climate impacts and the social responsibility gave growth to the idea of sustainability also in design and construction. Consequently, in around 2000, the international and national organizations for standardization started to develop standards for the application of sustainable principles. This paper gives an overview of existing and planned standards, and examples on how to use them as a framework for the development of methods and tools for assessment.

  9. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Chiarioni; Corrado Asteria; William E Whitehead

    2011-01-01

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: A recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.

  10. Relevance of P-glycoprotein on CXCR4(+) B cells to organ manifestation in highly active rheumatoid arthritis.

    Science.gov (United States)

    Tsujimura, Shizuyo; Adachi, Tomoko; Saito, Kazuyoshi; Kawabe, Akio; Tanaka, Yoshiya

    2017-07-11

    In rheumatoid arthritis (RA), P-glycoprotein (P-gp) expression on activated B cells is associated with active efflux of intracellular drugs, resulting in drug resistance. CXCR4 is associated with migration of B cells. This study was designed to elucidate the relevance of P-gp expression on CXCR4(+) B cells to clinical manifestations in refractory RA. CD19(+) B cells were analyzed using flow cytometry and immunohistochemistry. P-gp was highly expressed especially on CXCR4(+)CD19(+) B cells in RA. The proportion of P-gp-expressing CXCR4(+) B cells correlated with disease activity, estimated by Simplified Disease Activity Index (SDAI), and showed marked expansion in RA patients with high SDAI and extra-articular involvement. In highly active RA, massive infiltration of P-gp(+)CXCR4(+)CD19(+) B cells was noted in CXCL12-expressing inflammatory lesions of RA synovitis and RA-associated interstitial pneumonitis. In RA patient with active extra-articular involvement, intracellular dexamethasone level (IDL) in lymphocytes diminished with expansion of P-gp(+)CXCR4(+) CD19(+) B cells. Adalimumab reduced P-gp(+)CXCR4(+) CD19(+) B cells, increased IDL in lymphocytes, and improved the clinical manifestation and allowed tapering of concomitant medications. Expansion of P-gp(+)CXCR4(+) B cells seems to be associated with drug resistance, disease activity and progressive destructive arthritis with extra-articular involvement in RA.

  11. Organic carbon movement through two SWRO facilities from source water to pretreatment to product with relevance to membrane biofouling

    KAUST Repository

    Alshahri, Abdullah H.

    2016-12-29

    The presence of algae, bacteria, various fractions of natural organic matter (NOM), and transparent exopolymer particles (TEP) in the raw water, after each pretreatment process and in the permeate and concentrate streams, were measured at two SWRO plants to assess biofouling potential. It was found that the most significant process controlling the concentration of algae, bacteria, and the biopolymer and humic substances was the intake type with the subsurface intake discharge showing significant reductions. The mixed media filtration process was marginally useful in removing some TOC and NOM, but had little effect on TEP removal. Some bacterial regrowth may be occurring in the cartridge filters, but the evidence is inconsistent. Significant quantities of the biopolymer and humic substance concentrations were found to be retained in the membranes, but the concentrations were significantly greater in the facility using an open-ocean intake. Bacteria and TEP were found in the permeate stream, which may document bacterial regrowth and TEP production downstream of the membrane process. Measurements of the organic carbon passage through SWRO facilities can be successfully used to evaluate pretreatment process effectiveness and to make SWRO plant operational improvements.

  12. Clinical relevance of the small intestine as an organ of drug elimination: drug-fruit juice interactions.

    Science.gov (United States)

    Paine, Mary F; Oberlies, Nicholas H

    2007-02-01

    Most drugs are taken orally. For those intended to act systemically, a significant fraction of the dose can be eliminated during its first passage through a sequence of organs before entry into the general circulation. For some drugs, the degree of first-pass elimination can be large enough such that oral bioavailability is significantly reduced, with the consequent potential for a reduced clinical response. Of these first-pass eliminating organs, the small intestine and liver are the most commonly implicated, in part because they express the highest levels of drug-metabolizing enzymes. For several drugs whose major route of elimination occurs via CYP3A-mediated metabolism, the extent of first-pass metabolism in the small intestine can rival that in the liver. As such, alterations in enteric CYP3A activity alone can significantly influence oral bioavailability. The most extensively studied xenobiotic shown to inhibit only enteric CYP3A is grapefruit juice, the consequences of which can be clinically significant. Although much information has been gained regarding the grapefruit juice effect, progress in the relatively understudied area of drug-diet interactions continues to be sluggish and reactive. In stark contrast, the potential for drug-drug interactions involving any new therapeutic agent must be evaluated, prospectively, before market introduction. To prospectively elucidate mechanisms underlying drug-diet interactions, a multidisciplinary, translational research approach is required, which capitalizes on the collective expertise of drug metabolism scientists and natural products chemists. Such an approach would allow proper between-study comparisons, and ultimately provide conclusive information as to whether specific dietary substances can be taken safely with certain medications.

  13. Reconstructive options in pelvic tumours

    Directory of Open Access Journals (Sweden)

    Mayilvahanan N

    2005-01-01

    Full Text Available Background: Pelvic tumours present a complex problem. It is difficult to choose between limb salvage and hemipelvectomy. Method: Forty three patients of tumours of pelvis underwent limb salvage resection with reconstruction in 32 patients. The majority were chondrosarcomas (20 cases followed by Ewing sarcoma. Stage II B was the most common stage in malignant lesions and all the seven benign lesions were aggressive (B3. Surgical margins achieved were wide in 31 and marginal in 12 cases. Ilium was involved in 51% of cases and periacetabular involvement was seen in 12 patients. The resections done were mostly of types I &II of Enneking′s classification of pelvic resection. Arthrodesis was attempted in 24 patients. Customized Saddle prosthesis was used in seven patients and no reconstruction in 12 patients. Adjuvant chemotherapy was given to all high-grade malignant tumours, combined with radiotherapy in 7 patients. Results: With a mean follow up of 48.5 months and one patient lost to follow up, the recurrence rate among the evaluated cases was 16.6%. Oncologically, 30 patients were continuously disease free with 7 local recurrences and 4 deaths due to disseminated disease and 2 patients died of other causes. During the initial years, satisfactory functional results were achieved with prosthetic replacement. Long-term functional result of 36 patients who were alive at the time of latest follow up was satisfactory in 75% who underwent arthrodesis and in those where no reconstruction was used. We also describe a method of new classification of pelvic resections that clarifies certain shortcomings of the previous systems of classification. Conclusion: Selection of a procedure depends largely on the patient factors, the tumour grade, the resultant defect and the tissue factors. Resection with proper margins gives better functional and oncological results

  14. Ice nucleation activity of diesel soot particles at Cirrus relevant conditions: Effects of hydration, secondary organics coating, hydration, soot morphology, and coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Kulkarni, Gourihar R.; China, Swarup; Liu, Shang; Nandasiri, Manjula I.; Sharma, Noopur; Wilson, Jacqueline M.; Aiken, A. C.; Chand, Duli; Laskin, Alexander; Mazzoleni, Claudio; Pekour, Mikhail S.; Shilling, John E.; Shutthanandan, V.; Zelenyuk, Alla; Zaveri, Rahul A.

    2016-04-16

    The role of atmospheric relevant soot particles that are processed in the atmosphere toward ice nucleation at cirrus cloud condition is poorly understood. In this study, the ice nucleating properties of diesel soot particles subjected to various physical and chemical aging treatments were investigated at temperatures ranging from -40 to -50 °C. We show that bare soot particles nucleate ice in deposition mode, but coating with secondary organics suppresses the heterogeneous ice nucleation potential of soot particles requiring homogeneous freezing threshold conditions. However, the ice nucleation efficiency of soot particles coated with an aqueous organic layer was similar to bare soot particles. Hydration of bare soot particles slightly enhanced the ice nucleation efficiency, and the IN abilities of compact soot particles (roundness = ~ 0.6) were similar to bare lacey soot particles (roundness = ~ 0.4). These results indicate that ice nucleation properties are sensitive to the various aging treatments.

  15. 盆底超声评价女性盆底组织结构的研究进展%Reseach progress of pelvic floor ultrasonography on evaluation of female pelvic floor structure

    Institute of Scientific and Technical Information of China (English)

    叶艳娜; 张馥绯; 张清学

    2014-01-01

    女性盆底解剖和功能异常是盆腔脏器脱垂主要原因。近几年,研究人员利用各种手段对盆底组织结构进行研究,其中盆底超声技术发展迅速,已经成为研究盆底组织结构不可或缺的手段。该文围绕女性盆底组织结构解剖、盆底超声技术(经阴道超声、经直肠超声和经会阴超声)、盆底超声临床应用的研究现状进行综述,旨在为临床诊断提供新思路。%Anatomical and functional abnormalities of female pelvic floor is the major cause of pelvic organ prolapse. In recent years,researchers have used various means to study the pelvic floor structure. With its rapid development,pelvic ultrasonography has become an important means in the study of the pelvic floor structure. This article summarizes recent progress in anatomy of pelvic floor,different ultrasound techniques (transvaginal sonography,endoanal ultrasound and transperineal ultrasound)for pelvic floor imaging,and clin-ical applications of the pelvic floor ultrasound,which may provide some new ideas for clinical diagnosis.

  16. Imaging of male pelvic trauma.

    Science.gov (United States)

    Avery, Laura L; Scheinfeld, Meir H

    2012-11-01

    Prompt imaging plays an important role in the evaluation of male pelvic soft tissue trauma. Using appropriate imaging modalities, with optimization of contrast administration when appropriate, is essential for accurate diagnosis. Traumatic bladder rupture, either extraperitoneal or intraperitoneal, is diagnosed with high accuracy using computed tomography cystography. Suspicion of urethral injury warrants evaluation with retrograde urethrography to evaluate for the presence of injury and injury location. Early identification of laceration of the testicular tunica albuginea is essential. Understanding both normal penile anatomy and the imaging appearance of corpus rupture (as opposed to a hematoma) is imperative for proper diagnosis and management.

  17. 38 CFR 4.67 - Pelvic bones.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of...

  18. [Functional rehabilitation of the pelvic floor].

    Science.gov (United States)

    Minschaert, M

    2003-09-01

    Pelvic floor revalidation is devoted to conserve perineal functions as statics, urinary continence and sexual harmony. The therapeutics includes preventive and curative actions, and is based upon muscular and neuromuscular properties of pelvic floor. The different steps are: information, local muscular work, behavioral education, biofeedback, functional electrostimulation, intraabdominal pressure control. The therapeutics is only continued if clinical improvement is demonstrated after 10 sessions.

  19. Pelvic Inflammatory Disease (PID) Fact Sheet

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Pelvic Inflammatory Disease (PID) Note: Javascript is disabled or is not ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Pelvic Inflammatory Disease (PID) - CDC Fact Sheet Language: English (US) Españ ...

  20. Laparoscopic Pelvic Floor Repair Using Polypropylene Mesh

    Directory of Open Access Journals (Sweden)

    Shih-Shien Weng

    2008-09-01

    Conclusion: Laparoscopic pelvic floor repair using a single piece of polypropylene mesh combined with uterosacral ligament suspension appears to be a feasible procedure for the treatment of advanced vaginal vault prolapse and enterocele. Fewer mesh erosions and postoperative pain syndromes were seen in patients who had no previous pelvic floor reconstructive surgery.