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Results for “Vaginal Approach”

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At least 451 records · Page 25Linked to original sources
PubMed1976

The effect of prophylactic ampicillin on pelvic infection following vaginal hysterectomy.

One hundred patients undergoing vaginal hysterectomy at the University of Kentucky Medical Center were given prophylactic ampicillin and compared to one hundred control patients. The use of prophylactic ampicillin caused significant reduction in both postoperative pelvic infection and hospital stay. However, two patients in the prophylactic antibiotic group later required readmission for infections resistant to ampicillin. Prophylactic antibiotics are beneficial in vaginal hysterectomy, but careful follow-up of all patients is mandatory.

Abscess↗
PubMed1989

Transcervical sterilization with use of methyl 2-cyanoacrylate and a newer delivery system (the FEMCEPT device).

The increasing use of sterilization as a means of permanent contraception prompts the search for simpler, safer methods. Methyl 2-cyanoacrylate 0.6 ml was administered to the uterocornual tubal junction with the use of the FEMCEPT transcervical delivery system in 35 healthy parous women aged 30 to 44 years. Hysterosalpingography 4 months after the procedure showed bilateral tubal occlusion in 88.2% of the study participants. There were no complications in the study group, and there were no pregnancies among those who demonstrated bilateral tubal occlusion. The technique, which is safe, effective, and simple, could consideraly reduce anesthetic and operative risk in sterilization.

Adult↗
PubMed1977

Surgical management of urogenital sinus abnormalities.

This report describes 12 cases of urogenital sinus malformations and their management in female infants, 10 with imperforate anus. Excluded were cases of urogenital sinus malformation secondary to the adrenogenital syndrome or primary sexual ambiguity. Immediate definition of the anatomy by appropritae endoscopy and radiography is essential to plan the correct operative approach. This can be a relatively simple flap vaginoplasty from below, together with perineal anoplasty in some cases. Others may require an extensive combined abdominal-perineal approach with vaginal pullthrough, ureteral reimplantation, creation of a urethra from the urogenital sinus, resection of vaginal septum, and creation of perineal skin flaps to join to the pulled through vagina which may be too short to reach the perineum.

Adolescent↗
PubMed1995

Management of breech presentation: the 1993 Israeli census.

OBJECTIVES: To investigate current attitudes to management of labor and delivery in pregnancies complicated by breech presentation. STUDY DESIGN: A questionnaire was sent to the directors of 23 units of maternal-fetal medicine, all members of the Israel Society of Perinatal Obstetricians. The survey included 69,072 deliveries in the year 1993. Current world literature on the topics included in the survey was also reviewed. RESULTS: The overall response rate was 83% (19/23). The overall breech presentation rate was 3.4%, and overall caesarean section rate was 11.2%. In breech presentation, the caesarean section rate was 63.6%. CONCLUSIONS: A rational approach allows vaginal breech delivery to be practiced in almost half of carefully selected cases. These results again emphasize the longstanding need for prospective randomized studies regarding the different aspects associated with the delivery of the fetus in breech presentation.

Breech Presentation↗
PubMedDate not supplied

The vagina as an ecologic system. Current understanding and clinical applications.

Recent advances in understanding the mechanisms of dominance of the healthful microecology by Lactobacillus acidophilus through microbicidal enzyme systems has led to renewed interest in ecologic approaches to vaginal health maintenance and treatment of vaginosis and vaginitis. Review of pertinent research suggests that due to inadequate adherence of lactobacilli from dairy sources, contaminants in commercial sources, and lack of evidence of effectiveness in sparse clinical trials, intravaginal applications of L. acidophilus cannot be recommended. Bacterial vaginosis is described in this article as a microecologic shift in the dominant organism of the microecology from L. acidophilus to Gardnerella vaginalis. This results in conditions favorable to vaginal establishment of many anaerobic organisms. The ability to identify and nurture healthful lactobacilli in the vaginal microflora is suggested as a future direction for health-enhancement-oriented research, practice, and screening.

Female↗
PubMed1980

Plasma estriol and its conjugates following oral and vaginal administration of estriol to postmenopausal women: correlations with gonadotropin levels.

A study was designed to compared the metabolic fate and the biologic effects of 4 mg of estriol (E3) administered either orally or vaginally to six postmenopausal women. Blood samples were collected every hour for 6 hours and five different estriol fractions as well as gonadotropins were measured. Vaginal E3 administration resulted in a decline of 45% in luteinizing hormone (LH) levels and 17% in follicle-stimulating hormone (FSH) levels at 6 hours after treatment (p < 0.05). In contrast, the administration of 4 mg of E3 orally did not produce a decline of LH and FSH, despite the fact that the serum levels of E3-3-sulfate, E3-3-sulfate-16-glucosiduronate, estriol-3-glucosiduronate, and estriol-16-glucosiduronate were all fourfold to 24-fold higher after oral administration than after vaginal estriol administration. However, since the levels of unconjugated E3 were higher after the vaginal than after the oral administration of estriol, we conclude that only unconjugated E3 suppresses gonadotropins.

Administration, Oral↗
PubMed1977

Transcervical tubal occlusion with a steerable hysteroscope: implantation of devices into extirpated human uteri.

A new steerable fiberoptic hysteroscope particularly useful in visualizing the tubal ostia has been evaluated in 61 extirpated uteri. The efficacy and safety of this hysteroscope were shown. The feasibility of deploying occlusive devices into the intramural portion of the tubes with the steerable hysteroscope was demonstrated. Whether these devices or modifications thereof will prove to be superior to other currently tested methods of occlusion, e.g., caustics, plastics, or cautery under in vivo conditions, remains to be established. The steerability of the hysteroscope has advantage irrespective of the method to achieve transcervical tubal occlusion as it allows coaxial alignment of the delivery.

Adult↗
PubMed2001

A method for the repair of vesicovaginal fistulas.

OBJECTIVE: To determine the efficacy of the sliding layers method for repairing vesicovaginal fistulas caused by surgical trauma. METHOD: Twenty one women suffering from vesicovaginal fistulas after surgical trauma, operated on between 1990 and 1995 using the sliding layers method, were included in an uncontrolled prospective study and followed 24 months after the procedure. Patient outcome was assessed according to subjective estimation, gynecological examination and objectively by instillation of diluted methylene blue to the urinary bladder. RESULTS: Sixteen out of 21 patients suffered vesicovaginal fistulas after being subjected to abdominal hysterectomy and five patients after vaginal surgery. Fourteen fistulas were located 5 to 10 mm over the interureteric edge, five fistulas were in the trigone and two fistulas were in the bladder neck region. Fistula size ranged from 5 to 35 mm in diameter but 72.1% of patient fistulas were less than 10 mm in diameter. Only one patient had a large bladder defect of 35 mm in diameter. According to subjective estimation and objective assessment the overall success rate of the procedure after 2 years was 95.2%. Only one patient had to be subjected to a second successful attempt for fistula closure. CONCLUSION: The sliding layers method is a safe and reliable vaginal surgical approach for the repair of vesicovaginal fistulas after surgical trauma.

Adult↗
PubMed1997

Reliability of preoperative evaluation of prognostic factors in endometrial carcinoma.

OBJECTIVE: To define the accuracy of preoperative evaluation of prognostic factors in detecting patients with low risk of node metastasis in which different surgical approaches can be proposed. SUBJECTS: Seventy-five patients with a histologically proven endometrial carcinoma were considered in this study. METHODS: All the patients underwent a preoperative evaluation of grading (G), and myometrial invasion (M) by endometrial biopsy and transvaginal ultrasound (TVS). In 41 patients preoperative ploidy of carcinoma cells (P) was determined by flow cytometry. Pre-surgical G, M and P were then compared with surgical specimens. We considered 'low risk', patients with no or moderate myometrial invasion, well-differentiated histological grading and diploid DNA. RESULTS: We were able to identify 19/23 (82.6%) low risk cases. Correct identification of high risk patients was obtained in 49/52 (94%) patients. In three low risk patients, correctly diagnosed preoperatively, the final FIGO stage was IIIA (two for adnexal involvement and one for positive peritoneal washing). CONCLUSIONS: Our findings suggest that it is possible to detect preoperatively patients with a low risk of node metastasis. Alternative surgical approaches, i.e. vaginal surgery, can be taken into account in such patients.

Adult↗
PubMed1986

Vesicouterine fistula--a review.

Ninety-two cases of vesicouterine fistula reported in the world literature since 1908 are reviewed. The lesion was rarely seen before 1947. It usually followed a vaginal operative delivery and the usual complaint was total urinary incontinence. Diagnosis was most often made indirectly by seeing urine or dye pass through an intact external cervical os. Management usually involved a vaginal, surgical approach to repair. Since 1947, vesicouterine fistula, while not common, is no longer rare. It occurs most often after low segment cesarean section. While urinary incontinence may occur, the major symptom is cyclic hematuria (menouria). The diagnosis is best made by hysterogram performed with a short-tipped cannula. Management consists of an abdominal, surgical approach, the technique of which varies with the patient's need for future reproductive capacity.

Cesarean Section↗
PubMed1978

The influence of pre-induction vaginal prostaglandin E2 gel upon subsequent labour.

Eight hundred and three patients with singleton viable pregnancies and fetal cephalic presentation were given prostaglandin E2 in viscous gel by intravaginal instillation the evening before planned surgical induction. When the cervix was 'ripe', surgical induction was avoided in 65.9 per cent of primigravidae and 87.5 per cent of multigravidae; the administration of epidural analgesia was less frequent, the rate of spontaneous vaginal delivery greater, the Caesarean section rate lower, and the state of the newborn at delivery better than in those patients who required surgical induction. Side effects attributable to the prostaglandin gel were rare as were complications.

Administration, Topical↗
PubMed1979

Induction of labour using prostaglandin E2 pessaries.

The routine method of induction at Queen Charlotte's Maternity Hospital is now by the use of prostaglandin E2 pessaries. The first 502 consecutive patients thus induced are presented: the caesarean section rate for a failed induction with an unfavourable cervix has fallen to 2%. The prostaglandin E2 pessary is highly efficient and acceptable for all cases in which a simple amniotomy will not suffice.

Adolescent↗
PubMed1975

Cervicectomy with uterovaginal anastomosis in the rhesus monkey: a new surgical model for reproductive studies.

Cervicectomy with uterovaginal anastomosis in the rhesus monkey allows easy and non-traumatic access to the uterine cavity through the vagina for such purposes as biopsy, flushing, aspiration of fluid, and placement of IUDs. Endometrial and tissue samples cannot be contaminated by cervical mucus. The surgical procedure and results on eleven animals are described. Neither uterine nor ovarian function appeared to be significantly altered. The surgical model seems well suited to long-term studies on IUDs.

Animals↗