sodium-ethylxanthate and Uterine-Prolapse

To define the prevalence of pelvic floor disorders in a non-institutionalised community and to determine the relationship to gender, age, parity and mode of delivery.. A representative population survey using the 1998 South Australian Health Omnibus Survey.. Random selection of 4400 households; 3010 interviews were conducted in the respondents' homes by trained female interviewers. This cross sectional survey included men and women aged 15-97 years.. The prevalence of all types of self-reported urinary incontinence in men was 4.4% and in women was 35.3% (P<0.001). Urinary incontinence was more commonly reported in nulliparous women than men and increased after pregnancy according to parity and age. The highest prevalence (51.9%) was reported in women aged 70-74 years. The prevalence of flatus and faecal incontinence was 6.8% and 2.3% in men and 10.9% and 3.5% in women, respectively. Pregnancy (> 20 weeks), regardless of the mode of delivery, greatly increased the prevalence of major pelvic floor dysfunction, defined as any type of incontinence, symptoms of prolapse or previous pelvic floor surgery. Multivariate logistic regression showed that, compared with nulliparity, pelvic floor dysfunction was significantly associated with caesarean section (OR 2.5, 95% CI 1.5-4.3), spontaneous vaginal delivery (OR 3.4, 95% CI 2.4-4.9) and at least one instrumental delivery (OR 4.3, 95% CI 2.8-6.6). The difference between caesarean and instrumental delivery was significant (P<0.03) but was not for caesarean and spontaneous delivery. Other associations with pelvic floor morbidity were age, body mass index, coughing, osteoporosis, arthritis and reduced quality of life scores. Symptoms of haemorrhoids also increased with age and parity and were reported in 19.9% of men and 30.2% of women.. Pelvic floor disorders are very common and are strongly associated with female gender, ageing, pregnancy, parity and instrumental delivery. Caesarean delivery is not associated with a significant reduction in long term pelvic floor morbidity compared with spontaneous vaginal delivery.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Cross-Sectional Studies; Delivery, Obstetric; Fecal Incontinence; Female; Humans; Male; Middle Aged; Obstetric Labor Complications; Parity; Pelvic Floor; Pregnancy; Sex; Urinary Incontinence; Uterine Prolapse

Mayer-Rokitansky-Kuster-Hauser syndrome is a rare entity. The creation of a sigmoid vagina was performed in some patients with this syndrome in the past, though it is not widely used now. We report on a patient who developed prolapse of a sigmoid vagina 33 years after the operation.. A 57-year-old woman presented with a "falling-out" sensation in the vagina, pain, leukorrhea and dyspareunia. She had undergone an operation for creation of a sigmoid vagina 33 years earlier in our hospital. She and her husband desired conservation of the ability for sexual intercourse. The transabdominal method of retroperitoneal sacropexy of the sigmoid vagina was performed. The patient has maintained a satisfactory sexual life with her husband since the operation.. There are a few cases of prolapse of a sigmoid vagina in the literature, while the repair methods are not described in detail. To our knowledge, this is the first report of reconstruction of a sigmoid vaginal prolapse. Although the reasons for the neovaginal prolapse were not understood, the retroperitoneal sacropexy was successful in this case.

Topics: Bioprosthesis; Colon, Sigmoid; Female; Humans; Middle Aged; Prosthesis Failure; Sex; Syndrome; Uterine Prolapse; Uterus; Vagina

A procedure of total vaginal hysterectomy without vaginectomy with a vaginal vault suspension to the anterior abdominal wall-- without laparotomy--is presented. The patient for whom this operation is indicated is the old sexually active women.

Topics: Aged; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Sex; Uterine Prolapse; Vagina

In a review of the effect of gynecological operations on sexual function, difficulties resulting from operative technique and from psychological side effects were discussed. In repair of prolapse of the vagina, operative technique has been considered of crucial importance in influencing the sexual life of the patient. Preoperative clinical assessment rarely gives an accurate picture but can prepare the operator for some unforeseen difficulties. Patients with recurrent prolapse may have to sacrifice a functional vagina in the interest of surgical cure. However, the patient's views on coitus must be sought before surgery. Vaginal hysterectomy as an alternative to abdominal surgery can result in a rapid return to normal sexual function. Anterior colporrhaphy, the most commonly performed prolapse repair, may narrow the vagina from a too wide excision of vaginal epithelium. Some degree of shortening was thought to be almost invariable. Posterior colpoperineorrhaphy has been the major cause of vaginal stenosis after prolapse repair. The operation should be avoided but a technique by Simmons avoids the useless skin bridge, the main cause of postoperative dyspareunia. In anticipation of continuing postmenopausal atrophy, undue tightening of the vagina should be avoided. Sexual difficulties resulting from episiotomy frequently result from inaccuracy of siting and repair in favor of speed and dispatch. However, some postpartum difficulties in return to sexual function can result from emotional factors. Relief from postoperative contracture after vaginal operations may be obtained by several means including William's operation for vaginal atresia. Other gynecological procedures were considered outside the scope of this article. Therapeutic abortion and sterilization represent a different kind of operation because of emotional impact. However, it is suggested that many sexual problems are the result of poor preoperative explanation and postoperative instructions.

Topics: Coitus; Female; Genital Diseases, Female; Humans; Hysterectomy, Vaginal; Perineum; Postoperative Complications; Sex; Uterine Prolapse; Vagina; Vaginal Diseases