ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesTo evaluate the use of suprapubic versus transurethral catheterization for bladder drainage after open Burch retropubic urethropexy.MethodsFifty-seven women with genuine stress incontinence were randomized to receive either a Bonanno suprapubic (N = 30) or Foley transurethral (N = 27) catheter at the time of Burch retropubic urethropexy. Outcome measures consisted of the return of voiding function, patient comfort, length of hospitalization, and the development of lower urinary tract infection. Women rated their discomfort related to the catheter each day using a linear scale.ResultsUsing a standardized voiding trial, the catheter was discontinued on postoperative day (POD) 1 in 26%, POD 2 in 46%, POD 3 in 7%, and by POD 7 in 14% of patients. The remaining women (7%) had their catheters removed by POD 13. There were no significant differences between the two groups in the mean duration of catheterization, hospital stay, or cystitis. Women with a transurethral catheter had more discomfort on POD 1 (P= 0.03), but there were no differences in subsequent catheter discomfort scores. Women with more initial postoperative discomfort were more likely to be discharged home with a catheter (P≤ 0.009). Paravaginal repair increased the duration of catheterization (P= 0.04).ConclusionThere is no difference in the return of bladder function, hospital duration, or rate of cystitis between transurethral and suprapubic catheterization after retropubic urethropexy. Voiding trials with transurethral catheterization are associated with more discomfort on POD 1. Increased postoperative discomfort and paravaginal repairs are associated with prolonged catheterization.

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThis paper will describe one general obstetric and gynecologic group’s experience and complications using polyester slings for the treatment of urinary incontinence.MethodsA retrospective chart review involving 48 patients who underwent a suburethral sling procedure using polyester slings from February 1997 through November of 1999. Data collected included patient age, parity, body mass index, postoperative complaints, postoperative continence status, history of previous gynecologic or urologic surgeries, method of closure of the vaginal mucosa, presence of concomitant medical problems, and date of last follow-up. The number of slings removed was recorded. Comparison was made between those whose slings were removed and those whose were not using chi-squared analysis.ResultsSuburethral sling procedures were performed in 48 patients. Symptoms such as mild pain, bleeding, and malodorous discharge occurred in 16 patients (33%). Office treatment, such as estrogen cream, silver nitrate, antibiotic cream, and removal of a protruding suture was performed on 6 (12.5%) of these patients. Removal occurred in 10 (20.8%) patients. Time from placement to removal ranged from 3 to 24 months. Incontinence was reported in 2 (20%) of the 10 patients who had undergone sling removal. Among the 38 patients whose slings were not removed, 5 (13%) reported postoperative incontinence. No association was found between sling removal and the following patient characteristics: age, parity, body mass index, history of previous gynecologic or urologic surgery, or concomitant medical conditions. An association was found between the type of closure of the vaginal mucosa (running locking vs. interrupted) and sling removal [&khgr;2(1) = 5.256;P= 0.022)]ConclusionSignificant postoperative morbidity involving polyester suburethral slings was found, resulting in a high number of removals.

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo evaluate the patient for bladder, rectum, and sexual function after laparoscopic vaginal resection and colorectal anastomosis for endometriosis of the rectovaginal septum with rectum stenosis.MethodsA total of 83 patients underwent this surgical procedure, but only 65 patients had a follow-up examination in the past 6 months. All these patients completed a questionnaire retrospectively.ResultsWithin 6 months to 1 year, 80% of the patients recovered normal bladder function, and the rate of obstipation was significantly reduced. The surgical procedure did not adversely affect the sexual health of the patients.ConclusionThis surgical procedure is radical in terms of excision of the endometriosis, but the nerve-sparing aspect of the procedure should preserve the function of the pelvic organs.

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTo report on results and anatomic observations with and development of a technique for removal of the non-prolapsed vagina.Materials and MethodsA data profile has been kept on a population of patients undergoing woman-to-man transgender surgery (including vaginectomy) since the first case (1/6/95). During surgeries careful anatomic observations were made and recorded.ResultsDuring the 5-year study, 17 patients were accrued. Extirpative surgery was as follows: 9 underwent TAHBSO and vaginectomy; 6 underwent vaginectomy; 2 underwent TVHBSO, and vaginectomy (the parous patients). The median time for the extirpative procedures was 150 minutes and the median EBL was 400 mL. During the extirpative surgery, 5 patients had an EBL > 1000 mL and 2 received transfusions. Intraoperative complications included rectal injury (1) and massive hemorrhage (1). The median day of discharge was 4 (range, 2–13). Anatomic observations and the technique developed for vaginectomy are described.ConclusionAn anatomically based surgical approach allows for total removal of the non-prolapsed vagina with a low overall complication rate but occasional serious morbidity.

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BackgroundAlthough rare, leiomyoma is the most common mesenchymal neoplasm of the vagina. Unlike uterine leiomyoma, the tumor is more common in white than nonwhite patients.ClinicalThese tumors may be symptomatic or an incidental finding and are commonly found at middle age. Often the nature of the tumor is only known for certain on histologic examination, at which time 9% to 12% will be seen to be actually leiomyosarcomas.TreatmentLocal excision is ordinarily curative for the benign tumor whereas recurrence is common for the malignant tumor.

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:2002

数据来源: OVID