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Results for “DOUGLAS' POUCH”

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At least 127 records · Page 7Linked to original sources
PubMed1996

Anaerobic and aerobic microflora of pouch of Douglas aspirate v/s high vaginal swab in cases of pelvic inflammatory disease.

The anaerobic and aerobic bacterial flora in pouch of Douglas (POD) aspirate and high vaginal swabs (HVS) was studied in 43 cases of pelvic inflammatory disease (PID) using standard techniques. High vaginal swabs from 20 healthy women were included as controls. Anaerobic and aerobic bacteria were isolated from 37 (86%) HVS and 31 (72%) POD aspirates from these 43 women. A total of 100 aerobic and 10 anaerobic bacterial strains were recovered from both the sites. Coagulase negative staphylococci (28), Escherichia coli (23) and Streptococcus faecalis (14) were predominant aerobic bacteria. Of the anaerobes, peptostreptococci species and Bacteroides species were more common, polymicrobial flora (more than one type of organism) was present in a total of 27 specimens. However mixture of anaerobic and aerobic bacteria were seen in only 5 specimens. Of the 20 control specimens, ten were positive for organisms. Ten aerobic and 3 anaerobic bacterial strains were recovered.

Adult↗
PubMed1998

[Chlamydia trachomatis in cervical canal and in the pouch of Douglas in infertile women].

The results of microbiological examination of samples from cervical canal of the uterus and from pouch of Douglas in 71 women who underwent diagnostic and operative laparoscopy is presented. In 33 cases diagnosed because of infertility Chlamydia trachomatis was present in 2 (6.1%) women and in one woman both in cervical canal and pouch of Douglas. In second woman only in cervical canal Chlamydia trachomatis was present. There was not statistically significant correlation between control and study groups.

Adult↗
PubMed2001

Impact of surgical resection of rectovaginal pouch of douglas endometriotic nodules on pelvic pain and some elements of patients' sex life.

STUDY OBJECTIVE: To assess the impact of laparoscopic resection of endometriotic nodules in the rectovaginal pouch of Douglas on women's pain symptoms, analgesic intake, work absenteeism, work difficulties, and some elements of sex life. DESIGN: Observational study (Canadian Task Force classification II-2). SETTING: Gynecology department at a university hospital. PATIENTS: Twenty-six women with rectovaginal pouch of Douglas endometriotic nodules and no evidence of other potential cause of pain at physical examination, laparoscopy, and transvaginal ultrasonography. INTERVENTION: Laparoscopic resection of endometriotic nodules with the CO2 laser until no residual induration was felt in surrounding tissues. MEASUREMENTS AND MAIN RESULTS: Significant statistical differences were found between preoperative and postoperative pain scores, percentages of women absent from work, percentages taking analgesics or nonsteroidal antiinflammatory drugs, and percentages having work difficulties due to pain. A significant difference also was found in frequencies of sexual desire and coitus. CONCLUSION: Endometriotic nodules in the rectovaginal pouch of Douglas may be responsible for major pelvic pain and also for sexual dysfunction (lack of sexual desire, dyspareunia). Laparoscopic resection of the nodules significantly improves these conditions. (J Am Assoc Gynecol Laparosc 8(1):55-60, 2001)

Adult↗
PubMed1998

[Mycoplasma hominis and Ureaplasma urealyticum of cervical canal and in the pouch of Douglas in infertile women: a preliminary report].

Detection of Mycoplasma hominis and Ureaplasma urealyticum in the samples obtained from the cervical canal of the uterus and from the pouch of Douglas in 71 women in whom underwent diagnostic and operative laparoscopy is presented. Ureaplasma urealyticum in 33 cases diagnosed for infertility was present in 6 (18.2%) patients. In cervical canal and the pouch of Douglas in 5 and 2 women respectively. In 1 (3.0%) woman Ureaplasma urealyticum was present in both places. In the women from the control group U. urealyticum was detected in 6 (15.5%) cases only in cervical canal. Mycoplasma hominis was present only in cervical canal more frequently in the control group 4 (cases) than among infertile women 1 (3.0%).

Adult↗
PubMedDate not supplied

The cytology of the pouch of Douglas in polycystic ovarian disease.

Cul-de-sac aspiration was performed for cytologic sampling in 137 cases of polycystic ovaries treated by wedge resection. Fifty patients undergoing abdominal tubal ligations also underwent aspiration of the pouch of Douglas as a control group. The cytodifferential count in polycystic ovarian disease showed 30% to 40% mesothelial cells, 15% to 20% polymorphonuclear leukocytes, 15% to 20% lymphocytes, 10% to 15% squamous cells and 1% to 5% histiocytes. The corresponding count in the control group showed 15% to 20% mesothelial cells, 20% to 25% polymorphonuclear leukocytes, 15% to 20% lymphocytes, 10% to 15% squamous cells and 1% to 3% histiocytes. Cells exfoliated from the fimbrial end of the tube were encountered in most smears. Abnormal cells were diagnosed in seven cases of polycystic ovarian disease due to a coexistent neoplasm, i.e., two dermoid cysts, a carcinoid tumor, a hilus cell tumor, a simple serous cyst, a pseudomucinous cystadenoma and endometriosis of the ovary. All tumors were histologically diagnosed in the resected wedges of the ovaries.

Ascitic Fluid↗
PubMed1998

Pouch of Douglas block for laparoscopic sterilisation.

The use of local anaesthetic has been shown to reduce the incidence of pain after laparoscopic sterilisation and the need for opioid analgesia from day surgery. We investigated a technique in which a catheter is placed in the pouch of Douglas allowing repeated administration of local anaesthetic in the postoperative period. Forty patients were randomly allocated pre-operatively into one of two groups to receive in a double-blind manner either lignocaine 1% or normal saline. Pain was assessed using visual analogue and subjective scoring systems. Postoperative pain scores were significantly reduced (p < 0.05) after injection of lignocaine through the catheter. There were no complications related to the technique and no evidence of local anaesthetic toxicity. Lignocaine instilled into the Pouch of Douglas is an effective method for postoperative pain relief after laparoscopic sterilisation.

Adult↗
PubMedDate not supplied

Extragenital mullerian adenosarcoma with sarcomatous overgrowth arising in an endometriotic cyst in the pouch of Douglas.

Mullerian adenosarcoma is a neoplasm composed of benign mullerian epithelium and a sarcomatous stroma. This tumor classically occurs in the endometrium of postmenopausal women and less frequently in the extrauterine genital tract. Rare cases of extragenital adenosarcoma have been reported. We present the case of a 23-year-old female who presented with an extragenital adenosarcoma arising in an endometriotic cyst in the pouch of Douglas. The patient was treated with local excision, chemotherapy and radiotherapy. At 2 years follow-up she was disease-free. The literature on extragenital adenosarcoma is reviewed. These tumors are clinically more aggressive than their uterine counterparts. Surgical excision is the initial treatment modality for these patients. Little information is available regarding the efficacy of adjuvant chemotherapy or radiotherapy. This is an area that requires further study.

Adenosarcoma↗
PubMed2000

[An effective case of intraperitoneal and intra-arterial combined chemotherapy for unresectably advanced Borrmann type IV gastric carcinoma].

We report an effective case of intraperitoneal and intra-arterial combined chemotherapy for unresectably advanced Borrmann type IV gastric carcinoma. A 59-year-old man was admitted with advanced Borrmann type IV gastric carcinoma in June 1999. With informed consent, the patient underwent laparotomy, which revealed far advanced Stage IV gastric carcinoma of T4, N3, P1, H0, M1, CY1 for resection. Three ports to both subphrenic pouches and Douglas' pouch were placed for intraperitoneal infusion chemotherapy. Pathological findings of omental lesions were metastatic gastric carcinomas of por 2-histological type. Intraperitoneal and intravenous infusion combined chemotherapy with a modified low-dose CDDP and 5-FU regimen were started. The artery-side port was placed in the aorta at the Th. 9/10 levels for arterial infusion chemotherapy in September 1999. The patient was followed-up as an outpatient and continued to receive the intraperitoneal and intra-arterial combined chemotherapy. We report an effective case of intraperitoneal and intra-arterial combined chemotherapy for unresectably advanced Borrmann type IV gastric carcinoma, who could be followed-up as an outpatient while maintaining his quality of life.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1978

[Late results of surgical development of the artificial vagina from the Douglas's pouch (author's transl)].

Late results of surgical development of artificial vagina in 18 patients by the Glowiński method are discussed. The Rokitansky-Küster syndrome was found in 16 women, and pseudomale hermaphrodism in two. In 12 cases the results of operation were positive, satisfactory in 3, and negative in the remaining 3 cases. The surgical method is simple and safe, and from the functional point of view prognosis is favourable.

Adult↗
PubMed1991

[Clinical evaluation of intra-arterial infusion of hyperthermo-chemotherapy in gastric cancer].

We performed intra-arterial infusion hyperthermochemotherapy by retaining an intra-arterial reservoir in 17 lesions of 12 patients with non-resectable, metastatic or recurrent gastric cancers. The 12 patients consisted of one with a primary gastric cancer lesion, 6 with a solitary gastric cancer lesion metastasizing to the liver, 4 with gastric cancer accompanied by hepatic metastasis, lymph node metastasis or local recurrence, and one with a gastric cancer lesion metastasizing to Douglas' pouch. A catheter was retained in the hepatic artery of all 6 patients with a solitary gastric cancer lesion metastasizing to the liver, and a catheter was retained in the aorta of the patient with a primary lesion, 3 of the 4 patients with two or more metastatic lesions, and the patient with a lesion metastasizing to Douglas' pouch. The duration of each hyperthermia session was 50 minutes, and one or two sessions were performed within a week. One course consisting of 5 or 6 sessions was repeated. Antineoplastic drugs such as MMC, 5-FU, ADR, epi-ADR, CDDP and VP-16 were injected in bolus form or administered serially through the reservoir. Nine of the 12 patients had polypharmacy. One to 3 courses or 4 to 20 sessions at maximum (average 9.8 sessions) were given. The rate of efficacy of intra-arterial infusion hyperthermochemotherapy was 44% for hepatic metastasis and 25% for lymph node metastasis. The local recurrent lesions, the lesion metastasizing to Douglas' pouch and the primary lesion did not respond to therapy.

Adenocarcinoma, Mucinous↗
PubMed1983

[X-ray anatomy of the recto-genital pouch in the child].

Peritoneography is a simple radio-anatomic method to get informations about the depth and the orientation of the Douglas pouch in children in relation to fixed bony landmarks in the pelvis (upper part of the pubic bone-lowest sacral segment). Measurements were recorded on patients ranging from 15 days-old to 15 years-old. The older the patient, the deeper and the more posterior seemed to be the Douglas pouch.

Adolescent↗
PubMedDate not supplied

[Infusion pre-hydration and a humid room in the prevention of postoperative adhesions].

The Authors after an overview on the most important causes of postsurgical adhesions, drove their attention to the tissue injury determined, during abdominal surgery, by exposure of pelvic serosa to the humidity of operating area. The AA tested body temperature in the Douglas pouch and under the liver on 30 patients who were operated by conservative surgery (myomectomy) and on 8 patient who underwent laparoscopy. A decrease of one degree in the Douglas pouch after one hour on the patient who had a Pfannestiel incision has been detected. While on the patients with longitudinal laparotomy no difference was evidenced. Serosal biopsies done at the beginning of surgery after pelvis exposure to the external conditions (temperature, humidity) showed a marked phlogosis in the tissue of the patients not treated at all. These tissue injuries were almost absent in the group treated with saline tissue irrigation and absent in the group that had parenteral prehydration, too. The AA suggested the use of the two techniques in conservative surgery in order to obtain in the open abdomen surgery results similar to those of the endoscopic one.

Body Temperature↗
PubMed1993

Colpocystodefecography.

PURPOSE: To assess, in one single procedure, a complete study of the female pelvis, including the Douglas pouch. METHODS: Colpocystodefecography (CCD) combines vaginal opacification, voiding cystography, and defecography. Three hundred examinations are reviewed. RESULTS: Thanks to the simultaneous visualization of the pelvic structures, CCD proved to be more useful than clinical evaluation to diagnose prolapses and particularly Douglas pouch hernias (enteroceles), the clinical diagnosis of which was missed in 93 of 111 cases. Moreover, in addition to morphologic and functional information, CCD brings about a new insight in the study of pelvic organs reciprocal influences, should they be positive (supporting function) or negative (external compression). Finally, significative pelvic surgery and particularly hysterectomy enhances greatly the risk of enteroceles. CONCLUSION: CCD is helpful in the preoperative staging, especially in the selection of the surgical procedure that will least likely predispose to possible late postoperative complications such as vaginal prolapses or enteroceles.

Adult↗
PubMed1987

[Sigmoiditis with lower rectal and perirectal development].

Lesions of sigmoiditis do not extend beyond the recto-sigmoid junction and Douglas' pouch. However, in 9 out of 271 patients operated upon for sigmoiditis the lesions invaded the rectum either anteriorly by perforating Douglas' pouch, or around it and posteriorly through the meso-rectum. These cases of "lower" sigmoiditis have several features in common: a long history of infection, frequent haemorrhages and fistulae, pseudo-tumoral lesions, sometimes very large, detectable by rectal palpation. Surgery is indicated only in cases with serious complications, since many technical problems may be encountered. Wide resection of the rectum followed by low-sited anastomosis ensure stable results.

Aged↗
PubMed1989

[A case of advanced paratesticular rhabdomyosarcoma].

A case of paratesticular rhabdomyosarcoma is presented. An 18-year-old male was admitted with the complaint of giant scrotal swelling and abdominal fullness on September 5, 1986. Left radical orchiectomy was performed with the pathologic diagnosis of alveolar rhabdomyosarcoma. The tumor was paratesticular in location and had invaded a spermatic cord. Radiological examination showed a gross metastatic mass in retroperitoneal lymph nodes, supraclavicular lymph nodes and Douglas pouch. The patient received induction chemotherapy containing vincristine, actinomycin-D, cyclophosphamide, bleomycin, CDDP and VP-16. After 3 courses, he had no mass in Douglas pouch and supraclavicular lesion. He received retroperitoneal lymph node dissection for residual retroperitoneal mass, and postoperative radiotherapy was given. However, recurrent disease was developed in the paraaortic region with malignant ascites. He was treated with salvage chemotherapy, had without any significant effect. He died of liver dysfunction due to progressive mass in hepatic hilum. A review of the current approach of paratesticular rhabdomyosarcoma with the usefulness of combination chemotherapy is given.

Adolescent↗
PubMed1989

[Cytologic study in assessing the effectiveness of chemotherapy in patients with ovarian cancer].

Chemotherapeutic pathomorphosis has been studied in 179 patients, aged 29 to 70, with mainly disseminated stages of ovarian carcinoma. Fluids from serous cavities, tumor puncture specimens, scrapings off and smears-impressions of removed tumors, puncture specimens and washings from Douglas' pouch have been examined using native smears and smears stained according to Pappenheim. Before therapy fluids from serous cavities (in cases with the ascitic forms) and washings from Douglas' pouch (in non-ascitic forms) have been examined to diagnose the condition. Altogether 114 patients have been examined over the course of therapy and after it. Microscopic changes of the tumor cells due to chemotherapy have been detected in 87% of the patients. Cytograms of 24 patients have shown changes in the nuclei of few tumor cells: pyknosis, karyorrhexis, intensification of the degenerative changes in the cytoplasm, the appearance of bare nuclei, all this indicating a poorly manifest chemotherapeutic pathomorphosis. In 40 cases similar changes have been detected in the majority of tumor cells, sometimes just few intact cells could be found, this being considered as necrosis; 17 patients of this group had a stable remission. Cytograms of 35 patients have shown a still more manifest destruction of the tumor cells and a reduction of their number, which fact is considered as a marked cytolytic effect. In 15 patients no clinical effect of chemotherapy has been observed, this being confirmed by cytologic findings.

Adult↗
PubMedDate not supplied

Abdominal and pelvic CT for detection and volume assessment of peritoneal sarcomatosis.

OBJECTIVE: Peritoneal sarcomatosis is a common finding in patients with recurrent abdominal or pelvic sarcoma. CT of the abdomen and pelvis is the standard radiological examination for evaluation of tumor volume and location in the peritoneal cavity; however data regarding the reliability of recurrent sarcoma detection has not been available. The purpose of this study was to evaluate the sensitivity of CT in detecting recurrent peritoneal sarcomatosis. METHODS: Abdominal and pelvic CT scans of 33 patients with abdominal or pelvic sarcoma recurrence were retrospectively reviewed. Subsequently all patients underwent surgery at which time complete exploration of the abdomen and pelvis was performed. Twenty-five CT parameters were evaluated and statistically analyzed using the findings at surgery as a standard. RESULTS: Among the anatomic sites, the lesser omentum and the Douglas pouch showed a sensitivity of 100%. In the nine abdominopelvic regions sensitivity was greater than 85% in the central region, the left lower quadrant and the pelvis. In all regions and sites, the pelvis and Douglas pouch showed the highest accuracy (91%). The volume of tumor present within an abdominopelvic region influenced the sensitivity. A sensitivity of 72.5% was recorded when tumor nodules were less than 0.5 cm in diameter. This increased to 90% when tumor diameter was greater than 5 cm. CONCLUSIONS: Abdominal and pelvic CT is a reliable test to evaluate recurrent sarcoma. The nodules in the pelvis were most accurately detected. Even small nodules of 0.5 cm were detected; the sensitivity increased as the nodules became greater than 5 cm.

Adult↗
PubMed2000

Does hyperthermia induce peritoneal damage in continuous hyperthermic peritoneal perfusion?

To investigate the mechanisms of the peritoneal damage induced by continuous hyperthermic peritoneal perfusion (CHPP), protein and fluid loss during and after CHPP and continuous normothermic peritoneal perfusion (CNPP) was studied. Sixteen patients with advanced gastric cancer underwent peritoneal perfusion therapy with saline solution containing 150 to 300 mg cisplatin and 30 to 60 mg mitomycin C for 60 minutes. The temperature in Douglas' pouch was maintained at 42.0 degrees C in the CHPP group (n = 9) and 37.0 degrees C in the CNPP group (n = 7) during perfusion. No statistical differences were found in patients' characteristics between the groups except the maximum temperature in Douglas' pouch during perfusion (41.6 degrees +/- 0.4 degrees C and 37.6 degrees +/- 0.4 degrees C in CHPP and CNPP groups, respectively, p < 0.05). The amount of protein lost into the perfusate was 0.35 +/- 0.22 g/kg body weight in the CHPP group and 0.37 +/- 0.19 g/kg in the CNPP group, showing no significant difference. On the day of surgery, there was no significant difference in the amount of protein and fluid lost through the abdominal drains between the CHPP group (27.9 +/- 24.6 mg/kg/hr and 0.94 +/- 0.63 ml/kg/hr, respectively) and the CNPP group (25.9 +/- 8.6 mg/kg/hr and 1.03 +/- 0.31 ml/kg/hr, respectively). We could not find any significant differences in postoperative protein and fluid loss between the groups on the following 3 days either. We conclude that the peritoneal damage by CHPP is not caused by the hyperthermia but by the peritoneal perfusion with saline solution containing anticancer drugs.

Chemotherapy, Cancer, Regional Perfusion↗