ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The following article is the first in a series that theJournal of Pelvic Surgerywill publish concerning contemporary issues in pelvic surgery. The information is transcribed from a panel discussion for which I was moderator, and participants were James W. Fleshman, MD, Associate Professor, Division of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri; Robert D. Madoff, MD, Clinical Associate Professor of Surgery, Division of Colon and Rectal Surgery, University of Minnesota Medical School, Saint Paul, Minnesota; and John H. Pemberton, MD, Surgeon and Consultant, Department of Colon and Rectal Surgery, Mayo Clinic and Foundation, Rochester, Minnesota.This presentation does not follow the usual format for theJournal of Pelvic Surgery.You will not find citations and references throughout the article, nor will you find an extensive bibliography at its conclusion. Rather, a synopsis will be presented by experts with a combined experience of more than 50 years of practice in the field. They outline a current understanding of fecal continence, together with clinical assessment of and therapy for fecal incontinence.To facilitate reading, if you have specific questions or comments for the panelists, you may send them to my attention, as Editor-in-Chief of theJournal of Pelvic Surgery.The panelists will be asked to respond, and the questions with their answers will be included in the next issue of theJournal(space and time constraints taken into consideration).

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveThe aim of this study was to compare the amount of collagen type III in the pelvic supportive tissues in patients with and without stress urinary incontinence (SUI).Study DesignSixty women participated in the study; 30 had SUI and pelvic relaxation (group 1); 15 had pelvic relaxation without SUI (group 2); and 15 had no pelvic relaxation or SUI (group 3). All women underwent a complete preoperative urodynamic workup. Biopsies were obtained during surgery for benign disease from perianal skin, uterosacral ligaments, and paravaginal fascia. The presence of collagen types III and I was determined by immunohistochemical procedure. The chi-square test was used for statistical analysis.ResultsAmount of collagen type III was significantly reduced (P< 0.05) in patients with SUI (group 1) compared with patients with pelvic relaxation only (group 2) and patients with no signs or symptoms of SUI (group 3). Specimens from women without SUI (groups 2 and 3) had a similar density of type III collagen.ConclusionThe present study confirms that density in type III collagen of the pelvic supportive tissues is reduced in women with SUI. Altered biochemical composition of the connective tissue may contribute to the mechanism of urinary incontinence.

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Eversion of the vaginal vault after hysterectomy remains a challenging problem in gynecology. The authors describe a transabdominal surgical technique that restores support to the prolapsed vaginal apex by suspending it from the sacrum using an interposed polyester mesh. When combined with a meticulous culdoplasty to prevent recurrent enterocele formation, this technique provides durable and long-lasting vaginal support while maintaining vaginal length and mobility.

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo report the surgical management of advanced pelvic organ prolapse in two patients with exstrophy of the urinary bladder and to review the available literature concerning surgical approaches to prolapse in patients with bladder exstrophy.Materials and MethodsData concerning the presented case reports was abstracted from review of the medical records. A search of the MEDLINE database from 1966 was undertaken for articles published in English that addressed the surgical management of pelvic prolapse in patients with bladder exstrophy. References antecedent to 1966 were obtained by review of the bibliographies from articles obtained.ResultsLiterature review produced seven publications that addressed surgical correction of prolapse in 26 patients with bladder exstrophy in addition to the two patients in this report. A review of exstrophy of the bladder and associated pelvic defects is presented. Pelvic organ prolapse appears to be associated with pregnancy and introitus revision surgery, although neither is a prerequisite. The majority of surgical approaches was abdominal, but no clear consensus exists because of the paucity of case material.ConclusionThe principle of site-specific defect repair should guide any attempt at reconstructive pelvic surgery in these patients. Consideration of factors such as previous lower urinary tract and prolapse surgery must be an integral part of choosing an operation. The vaginal approach may offer advantages in patients with extensive urologic reconstruction.

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Cesarean section probably was first performed in a live mother during the 16th century. The procedure did not become acceptable until the 19th century, when mortality rates and morbidity decreased. With improvements in surgical technique, antibiotics, blood transfusions, and antiseptic procedures, cesarean section now is an option for normal childbirth.

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1998

数据来源: OVID