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PubMed1984

Uterine prolapse in the neonate.

The rare condition of neonatal uterine prolapse is usually associated with congenital spinal defects and is often resistant to simple reduction. Previously, treatment has been primarily surgical and often deforming. In this case report a silastic-ensheathed pessary fashioned from a rubber Penrose drain allowed a nonoperative, simple and permanent correction, permitting the more important, yet less obvious, associated defects to take therapeutic precedence.

Female↗
PubMed1989

Surgical management of uterine prolapse in young women.

A new procedure was developed for the management of uterine prolapse in young women. Transvaginal sacrospinous uterine fixation was employed successfully in five patients. The advantages of the procedure are that it avoids surgical trauma to the cervix, can be accomplished entirely vaginally, maintains the normal vaginal axis and obliterates the space for potential enterocele.

Adult↗
PubMed1992

Survival and fertility of dairy cows following uterine prolapse.

During the springs of the 1990-91 and 1991-92 dairying seasons, 103 cases of uterine prolapse in dairy cows were treated and then followed to determine the survival rate and the pregnancy rate of the remaining cows. It was found that 19 (18.4%) cows died within 24 hours of treatment and a further 16 (15.5%) died or were lost to the study during the course of the season. The 68 cows that remained were mated, and of these 53 (77.9%) were found to be pregnant and six (8.8%) aborted later. No cows suffered a repeat prolapse during the season. Cases were seen in all age groups, with the highest incidence in this study occurring in the 4 year-olds. All cases that survived went on to milk satisfactorily until the end of the season, indicating that prompt attention to uterine prolapse gives a reasonable survival rate and an acceptable conception rate.

Journal Article↗
PubMed1989

Primary carcinoma of vagina with uterine prolapse.

Eleven cases of primary carcinoma of vagina were admitted in Kasturba Medical College Hospital during the last 10 years, of which 6 cases aged 44-72 years, were associated with 3rd degree uterine prolapse. All the patients attended the hospital in late stage in spite of having 3rd degree uterine prolapse. Blood stained discharge and ulceration on the prolapsed part, irreducible prolapse with urinary retention and marked oedema of local and surrounding tissues were the presenting symptoms. Lesion on the vagina varied in size from 5 cm to 15 cm. IVP in both the cases of irreducible prolapse and retention of urine revealed hydroureter and hydronephrosis bilaterally. X-ray chest revealed secondaries in one patient only. Histopathology of vaginal biopsy revealed well differentiated squamous cell carcinoma in 5 cases and undifferentiated squamous cell carcinoma in one. Since the patients were in late stage of malignancy and were inoperable, treatment with external telecobalt therapy was undertaken. One patient developed vesicovaginal fistula during the treatment period and another patient developed it at the end of telecobalt therapy.

Adult↗
PubMed1980

Uterine prolapse and renal dysfunction.

We report 2 cases of complete uterine prolapse and bilateral severe hydronephrosis. Although vaginal hysterectomy corrected the obstruction the development of post-obstruction atrophy was associated with hypertension and moderate renal failure. Early diagnosis and correction are required to prevent these sequelae.

Aged↗
PubMed1996

Laparoscopic Treatment of Uterine Prolapse and Relaxation

A new technique was developed for treating patients with uterine prolapse and relaxation by means of laparoscopy with special tools. The assistant transposes the uterus with a special vaginal probe to remove the descensus. This position is fixed with the help of laparoscope, brought to the new position of the uterus. With laparoscopic lighting, this point is seen at the front abdominal wall. A cutaneous section (2-3 cm) up to the aponeurosis is made under this point. A puncture with a special needle with a hole for suture is made through the section and uterine fundus under laparoscopic control. The suture is taken from the needle by a forceps introduced through the operating laparoscope cannula. The needle then is removed from the abdomen and another puncture is made 1 to 1.5 cm from the first puncture under laparoscopic control (the laparoscope remains in the abdomen until the procedure is completed). The uterus is punctured with the empty needle 1 to 1.5 cm from the puncture and the suture is taken out. The suture left after the first puncture is pulled by the forceps, loaded into the empty needle, and led through the uterine fundus. Then the needle with the suture is placed in the incision in the abdomen wall. The uterus is pulled up to the required position with the two sutures under laparoscopic control and the suture is tied. The uterus is now fixed to the aponeurosis. The incision in the abdomen is sewed with one or two sutures or subcutaneously. The operation lasts 7 to 10 minutes. Since January 1994, 34 procedures were performed. Prolapse recurred in one woman. Patients with evident uterine prolapse and relaxation first underwent anterior and posterior colporrhaphy and then laparoscopic fixation of the uterus.

Journal Article↗
PubMed1993

Incarcerated uterine prolapse associated with a cul-de-sac abscess.

BACKGROUND: Incarceration is a rare complication of uterine prolapse and is usually associated with bladder calculi. We report a case of uterine incarceration associated with an abscess in the cul-de-sac. CASE: A 64-year-old woman presented with complaints of vaginal prolapse. Pelvic examination on admission revealed an edematous, prolapsed uterus and eversion of the vagina. The bladder was catheterized, and subsequent attempts to reduce the prolapse were unsuccessful. Conservative treatments were initiated including Trendelenburg positioning, estrogen cream, and moist soaks. Failure to reduce the prolapse under general anesthesia necessitated a vaginal hysterectomy and anteroposterior repair. When the cul-de-sac was entered, there was purulent material draining from an abscess behind the uterus. Postoperatively, the patient received antibiotics for 3 days and was sent home on day 4. CONCLUSIONS: Irreducible uterine prolapse is a rare condition and may be attributed to a narrowed introitus, bladder calculi, or pelvic abscesses. Historically, conservative management has attempted to alleviate the edema and restore the prolapse, to allow definitive surgery at a later date. We believe that the pelvic abscess in our case exemplifies a danger of delaying surgery. We recommended that when the patient is in stable condition, a hysterectomy and plastic repair be performed promptly.

Abscess↗
PubMed2006

End-stage renal failure due to total uterine prolapse.

A 64-year-old woman had been diagnosed with uterine prolapse (UP), with a postvoid residual urine volume 4 years previously. In addition, she had had moderate renal dysfunction diagnosed 2 years before presentation. Her serum creatinine was 10.1 mg/dL, and she underwent right double-J stenting and insertion of an intravaginal ring. Pelvic examination revealed third degree UP, and computed tomography showed bilateral hydroureteronephrosis due to the UP. Stenting and the ring did not resolve the bilateral hydroureteronephrosis, and her renal function did not improve. The hydroureteronephrosis resulting from UP was the major cause of end-stage renal failure, and she was maintained on hemodialysis. Reduction of UP is needed before irreversible renal failure occurs.

Female↗
PubMed1986

[Sacrospinous ligament fixation of vaginal apex for repair operation of uterine prolapse--operative procedure and postoperative outcome evaluated with score system and X-ray subtraction colpography].

To preserve a snug vagina with complete repair, sacrospinous ligament fixation (SLF) to the vaginal apex was applied in operations for uterine prolapse from the April of 1983 to the April of 1984. SLF was added to 11 vaginal hysterectomies with anterior and posterior (A-P) colporrhaphy, 1 Manchester operation and 1 A-P colporrhaphy. SLF was performed at the stage of posterior colporrhaphy in each operation. The postoperative outcome was evaluated with a score system and an X-ray subtraction colpography. The score system describes the grade of vaginal relaxation in each part of the vagina before and after the operation. It showed that the vagina was repaired quite well by the SLF especially in the area of the vaginal apex and posterior wall. The subtraction colpography revealed the side view of the vagina and its movement on straining. It suggested that the SLF was a reasonable procedure for the prevention of recurrence. SLF also proved to have wide application to the repair of uterine prolapse including patients desiring the preservation of childbearing capability and elderly or poor-risk patients.

Adult↗
PubMed1992

Uterine prolapse after laparoscopic uterosacral transection. A case report.

Two cases of severe uterine prolapse are reported following laser uterosacral nerve ablation (LUNA). Both patients had a history of vaginal childbirth and subsequent development of secondary infertility and severe dysmenorrhea. It is suggested that this procedure be performed with caution on vaginally parous patients, and that it be reserved for use in patients who have adequate uterine support. Future studies are needed to determine the long-term incidence of uterine procidentia following this procedure.

Adult↗
PubMed1990

Survival and fertility after uterine prolapse in dairy cows.

Sixty-eight cases of uterine prolapase in pastured dairy cows were treated in 2 consecutive spring calving seasons in East Gippsland, Victoria. Fifty cows survived (73.5%). Of 43 cows available for followup, 36 (84%) conceived in the mating period following the prolapse, taking 10 d longer to conceive than herd mates that calved on the same day. Three of the 36 cows (8%) that conceived, aborted, this occurring in the middle trimester of pregnancy. No prolapses occurred at the following calving but one case had suffered uterine prolapse 2 years previously. The conclusions drawn from these observations are that cows with uterine prolapse have a good chance of surviving if treated, that treatment is cost-effective, that uterine prolapse is unlikely to reoccur and treated cows have a good chance of conceiving. The veterinarians involved in this investigation were reasonably accurate in their ability to predict long term survival but not as good in predicting ability to conceive again.

Age Factors↗
PubMed1995

Manchester procedure vs. vaginal hysterectomy for uterine prolapse. A comparison.

The Manchester procedure (MP) was compared with vaginal hysterectomy (VH) to determine whether any differences regarding patient demographics or operative or postoperative outcome could be found between the two techniques. A retrospective chart analysis was done comparing data from 88 consecutive MP to 105 randomly selected VH patients. All the operations were performed for uterine prolapse at Mount Sinai Hospital between 1984 and 1988. MP patients, when compared to VH patients, were more likely to be older and postmenopausal at the time of surgery and to have a private physician. MP patients were less likely to have significant medical illnesses than were VH patients. Statistically significant differences between MP and VH were found for operative time (100 vs 130 minutes, respectively) and blood loss (200 vs. 300 mL, respectively) (P < .001). This difference was not dependent on the performance of anterior or posterior repair. MP was associated with shorter operative time and less blood loss when compared to VH. This, coupled with apparently similar operative outcomes, suggests the use of MP as an alternative to VH in the absence of uterine pathology in appropriate candidates with uterine prolapse. Prospective, controlled, long-term studies comparing the operative results of these two procedures are needed.

Adult↗
PubMed1995

The use of combined xylazine and lignocaine epidural injection in ewes with vaginal or uterine prolapses.

Two millilitres of solution calculated to contain 0.07 mg/kg xylazine and 0.5 mg/kg lignocaine injected at the sacrococcygeal epidural site provided caudal analgesia within 2 min in 61 sheep. This analgesic protocol eliminated forceful abdominal straining behavior following replacement of vaginal prolapse for at least 24 h in 48 of 52 ewes (92%) and in all 9 ewes with uterine prolapse. Moderate pelvic limb ataxia was observed in 25 sheep (41%) for up to 24 h after epidural injection. Sedation was noted in one ewe but no other systemic effects of xylazine injection, such as excessive salivation or ruminal distension, were observed. No long-term adverse reactions to xylazine injection were noted. The combined epidural injection regimen of xylazine and lignocaine is recommended as an adjunct for pain relief and control of abdominal straining following replacement of vaginal and uterine prolapse in ewes.

Journal Article↗
PubMed2005

Incarceration of a retroflexed, gravid uterus from severe uterine prolapse: a case report.

BACKGROUND: Acute urinary retention as a result of incarceration of a retroflexed, gravid uterus is a known phenomenon. However, prolapse as a risk factor has not been previously described. CASE: A 40-year-old woman, gravida 4, para 2, with an intrauterine gestation of 19 weeks presented to the emergency room complaining of inability to void for the previous 12 hours and difficulty voiding and constipation for the previous 6 weeks. She had a history significant for stage III uterine prolapse in early pregnancy. Foley catheterization yielded 800 mL of urine, and an examination revealed a retroflexed uterus. The cervix was displaced anteriorly behind the pubic symphysis. Ultrasound confirmed these findings and the presence of a viable gestation. The uterus was successfully manually displaced under epidural anesthesia. The patient was able to void without difficulty after uterine displacement. CONCLUSION: Incarceration of a retroflexed uterus should be considered in the differential diagnosis in any woman who presents with voiding difficulty in the late first or second trimester. Uterine prolapse is a risk factor for incarceration of a retroflexed uterus. Epidural anesthesia should be considered for a patient if manual uterine displacement cannot be performed successfully without anesthesia.

Adult↗
PubMed1967

Modified Williams-Richardson operation for uterine prolapse.

A preliminary report is made of 11 patients of childbearing age treated for symptomatic uterine prolapse by a suspension technic employing straps of external oblique aponeurosis according to the method of Williams and Richardson. In a relatively short period of follow-up, the operative results have been excellent in all patients. The procedure does not interfere with childbearing function; 2 of the 11 patients have subsequently had a term pregnancy without recurrence of prolapse.

Adult↗