[Geriatric surgery in gynecology].
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Biomedical subjects
Publications and source records attributed to C Anthuber.
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OBJECTIVE: To investigate the manometrical and clinical long-term results following a tear III. PATIENTS: 27 Primiparae with a tear III following a spontaneous vaginal delivery were retrospectively compared with 22 Primiparae without sphincter injury (follow-up: 27 months). METHODS: Water-Perfusion-Manometry and clinical assessment (modified Kelly-Score). Manometric parameter (at rest and during contraction): sphinctertone and - length, vectorvolume, radial asymmetry. Wilcoxon-Text (p < 0.05). RESULTS: Tear III patients showed a significant decrease in sphincter length and vector volume both at rest and during contraction. On clinical assessment there was no difference. CONCLUSION: A tear III weakens the anal sphincter by decreasing sphincter length and vector volume. This weakness can be demonstrated only manometrically but not clinically.
This is a report of a 22-year-old woman who suffered from a loss of urine via the vagina of unknown origin since childhood. The diagnosis of a left ureteral and renal duplication with an opening of an ectopic ureter into the cervix was established. Due to the result of the retrograde pyelogram we came to the conclusion that the opening into the cervix must have been via a segment of a Gartner duct. The ectopic system and the Gartner duct were completely removed by a combined abdomino-vaginal operation. Genesis, diagnostics, differential diagnostics and therapy of ectopic ureters are described.
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Pulmonary embolism is the most common cause of maternal death during pregnancy. CASE REPORT. We report a 28-year-old obstetric patient (35th gestational week) who was admitted to the hospital because of intermittent vaginal bleeding caused by placenta totalis et accreta. Eleven days after admission she suffered a cardiac arrest. After cardiopulmonary resuscitation, an emergency caesarian section was performed and a healthy child was delivered. Abdominal sonography (B-mode) showed a floating thrombus in the inferior vena cava. Perfusion scintigraphy and cavography were normal; a computed tomography i.v. contrast medium study confirmed the presence of the thrombus. An open thrombectomy was performed to protect the patient from further pulmonary emboli. After 8 days she left the intensive care unit without residual complications. CONCLUSION. This case emphasises the importance of bedside sonography as a diagnostic method of identifying the source of a thrombus in patients with suspected pulmonary embolism.
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