ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectivesThis study evaluated the symptoms, results of pelvic examination, and laboratory and radiologic findings of patients with endometriosis of the urinary tract over a 25-year period.Materials and MethodsThe records of 40 patients with urinary tract involvement by endometriosis were reviewed. Overall extrinsic and intrinsic involvement of the urinary tract occurred in 40 (16%) of 249 patients with advanced pelvic endometriosis. Pelvic pain was the most common presenting symptom, experienced by 25 (63%) patients.ResultsA pelvic mass was the most common finding on pelvic examination (80%). Pelvic computed tomography or ultrasonography revealed a pelvic mass in 18 (78%) of 23 patients who underwent such evaluation. Intravenous pyelography revealed ureteral obstruction in 15 (55%) of 27 patients with ureteral involvement. Microscopic hematuria existed in 4 (11%) patients. The association of cyclic pain with gross hematuria was not noted.ConclusionsThe clinical symptoms, results of pelvic examination, and computed tomography or ultrasonography findings were not different from those seen in patients who had endometriosis without urinary tract involvement as reported in the literature. Negative results of intravenous pyelography do not eliminate the possibility of nonobstructive ureteral involvement by endometriosis.

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectivesThis study evaluated the complications and results of surgical therapy for endometriosis of the urinary tract over a 25-year period.Materials and MethodsThe records of 40 patients with urinary tract involvement by endometriosis were reviewed. Long-term follow-up data were obtained from the medical records, from the patient, or from other physicians. The bladder was involved in 4 patients, the ureter(s) in 33, and both in 3. Surgical therapy included partial bladder resection in 4 patients, ureterol-ysis in 21, and segmental ureteral resection in 15.ResultsThe cure rate at a mean follow-up of 74 months (range, 14–240) was 97.3%. Ure-terolysis and ureteral resection were equally effective in relieving ureteral obstruction. No patients experienced recurrence that involved the urinary tract. One patient had a recurrence that consisted of an endometrioma involving the rectovaginal septum.ConclusionsSurgical therapy for endometriosis of the urinary tract provided an excellent long-term cure rate, and most patients had resolution of symptoms.

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

BackgroundThe problem of obstetric, genital tract fistulas is a major one in West Africa. One of the main obstacles to overcome is the limited number of doctors available to repair these devastating childbirth injuries. Training programs were established after holding planning conferences to provide more physicians capable of performing corrective surgery, and to integrate these services with improved perinatal care programs to reduce the incidence of obstetric fistulas. Previous long-term training efforts of several years' duration had been only minimally productive.MethodsTraining sites, where large numbers of patients with obstetric fistulas could be found, were staffed by experienced surgeons and teachers in Nigeria and Ghana. Brief, intensive didactic and surgical programs were conducted for senior level residents in obstetrics and gynecology from the medical schools of these countries, which are usually far away from the sites where the majority of patients with fistulas are found.ResultsEight sessions resulted in the training of over 12 physicians who now specialize in OB/GYN, and who have remained involved in providing care for patients with fistulas. Repair rates for those trained show an 85% successful surgery rate.ConclusionBrief, intensive didacticandsurgical training programs can result in well-trained surgeons who are able to repair the majority of obstetric fistulas and who can take leadership roles in developing obstetric care programs that will lead to fistula prevention in the future.

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The Hungarian physician Ignaz Semmelweis (1818–1865), a pioneer in antisepsis in obstetrics, is credited with proving that puerperal fever is contagious. He suggested the means needed to control it.

ISSN:1077-2847    

出版商:OVID    

年代:1996

数据来源: OVID