ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objectives: To evaluate the effectiveness of a bilateral cervical uterosacral suspension and cardinal cervical fixation as a method of resuspending the uterus in patients with uterovaginal prolapse wishing to preserve their uteri.Methods and Materials: Five patients with uterovaginal prolapse who wished to retain their uteri underwent multifaceted pelvic reconstructive surgical procedures, which included a suspension of posterior paracervical fascial tissues to both sacrospinous ligaments and anterior cardinal cervical fixation of the uterus. Mean age of the patients was 33.8 years old.Results: No significant intra-operative complications were encountered. Mean follow-up for 4 patients was 3.2 years. There was one failure. One patient, who achieved pregnancy, had Cesarean section with hysterectomy, and another patient had a vaginal delivery.Conclusions: This operation may play a role in cases of uterovaginal prolapse that necessitate repair if the patient wishes to preserve her uterus.

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Objective: The purpose of the study was to determine the incidence and type of bladder dysfunction after radical hysterectomy and to preoperatively identify factors that may predict patients at high risk for urinary dysfunction.Study Design: The effect of radical hysterectomy on bladder function was addressed prospectively in 12 patients at The Medical College of Georgia. Multichannel urodynamic evaluations with microtip transducers were performed perioperatively and at 6 and 12 months postoperatively.Results: The results of all preoperative evaluations were normal. At the 6-month postoperative visit, a significant difference was found in the mean volume at the first desire to void and at maximal cystometric capacity; both became insignificant at the 12-month visit. Stress incontinence developed in two patients, and detrusor instability developed in one.Conclusions: An 8.3% incidence of detrusor instability and a 16.7% incidence of genuine stress incontinence was found in this study population.

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background: Obesity poses a significant challenge to the pelvic surgeon and increases perioperative morbidity. Although the combination of plastic surgery with gynecology has not been the traditional standard, improved exposure, wound hygiene, and cosmesis may make panniculectomy a useful addition to pelvic procedures in the obese patient.Methods: Eighteen women, mean age 46 (range 36 to 72), underwent various benign gynecologic (total abdominal and vaginal hysterectomies, posterior repair, and sacrospinous ligament fixation) and gynecologic oncology procedures (total abdominal hysterectomy for endometrial cancer). The majority of the patients had some degree of maceration of the dependent aspect of their pannus, and each patient expressed a desire for the reduction of her abdominal panniculus. Patient weight ranged from 52 kg to 175 kg (mean 106 kg) with a mean body mass index of 40.5 (range 21 to 62.3). Panniculectomies were performed in addition to vaginal or abdominal procedures; the average pannus weighed 4049 g (813 g to 12,000 g). The morbidity encountered was limited to five patients whose problems included a midline wound separation, a focal wound seroma, febrile morbidity (2 patients), and a nonfatal pulmonary embolus.Results: Patient satisfaction was assessed 4–12 months postoperatively by telephone interview. Ninety-two percent of the patients surveyed were very satisfied with the outcome and would still opt for the elective procedure retrospectively. We present the evaluation, surgical technique, postoperative management, and literature review of combining panniculectomy with gynecologic surgical procedures.

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Long-tube decompression first was applied in the 1920s during laparotomy through jejunotomy in patients with small bowel obstruction. Decompressing the bowel relieved the obstruction in 80% of these patients.The second advance came with the use of the duodenal drainage tube that decompressed the distended small bowel without operation. The third advance was the use of the Miller Abbott tube that could proceed through the entire small bowel and decompress all segments leading to the point of obstruction. This nonoperative method was 80% successful in relieving the obstruction. By decompressing the fluid-filled loop just proximal to the obstruction, a 95% obstruction caused by the weight of the fluid returned to a 50% obstruction, allowing the return of normal flow.Endoscopic placement of the tube into the jejunum, the fourth advance, allowed the tube to become functional immediately and avoided the frustrating delay of passage from the stomach into the small bowel. The modification of the Miller Abbott tube was the fifth advance and provided a better flow rate, a sump, a guide wire, a suture at the tip, and control of the balloon; there was no need for mercury or fluoroscopy. The guide wire allows fluoroscopic placement beyond the pylorus, and further studies are planned to compare endoscopic and fluoroscopic methods. In properly selected patients, immediate endoscopic placement of the improved tube has achieved successful decompression in 15 of 17 patients (88%).

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background: The penile skin inversion procedure for vaginoplasty in male-to-female transsexuals has proven to be safe, leading to satisfying results without major morbidity. So far, osteitis has not been reported as a possible postoperative complication.Case: A case of pelvic osteitis, thought to be caused by using sutures to fix the penile skin to the pubic arch during inversion vaginoplasty, is presented.Conclusions: Although serious, this complication does not contraindicate the use of these fixing sutures because it occurred only once in more than 300 primary penile skin inversion vaginoplasties.

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Claudius Galen (circa 130–200), a Greek physician who gained fame while practicing in Rome, influenced the medical world for more than 14 centuries. His writings and works were accepted as authority in Greek, Roman, and Arabic medical practices.

ISSN:1077-2847    

出版商:OVID    

年代:1997

数据来源: OVID