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R F Porges

Publications and source records attributed to R F Porges.

At least 19 recordsLinked to original sources
PubMed1997

Estrogen and progesterone receptors in the uterosacral ligament.

OBJECTIVE: To evaluate steroid hormone receptor status in the uterosacral ligament, a structure that contributes to pelvic support. METHODS: A descriptive study was conducted by sampling the uterosacral ligaments from 25 consecutive women undergoing hysterectomy by the primary author for nonmalignant conditions. Using immunohistochemical staining techniques, uterosacral ligaments were assessed for the presence and location of estrogen and progesterone receptors. Positive and negative controls were used. Confirmation of the uterosacral ligament was performed histologically. RESULTS: Using commercially available monoclonal antibodies, estrogen and progesterone receptors were detected in the nuclei of smooth muscle cells of the uterosacral ligament in all patients, regardless of variations in age, race, menopausal status, parity, body mass index, and medications affecting serum steroid hormone levels. Hormone receptors were not found in the collagen, vascular, or neuronal components. CONCLUSION: The presence of estrogen and progesterone receptors in the uterosacral ligaments means that this structure may be a target for estrogen and progesterone. This finding might suggest a possible role for steroid hormones in pelvic support.

Adnexa Uteri↗
PubMed1994

Long-term analysis of the surgical management of pelvic support defects.

OBJECTIVE: The aim of this study was to determine the success of various procedures to correct defects of pelvic support and to elucidate the role of sacrospinous ligament fixation in primary versus nonprimary vaginal operations. STUDY DESIGN: This study was a retrospective analysis, covering 23 years, of 486 patients treated for pelvic support defects, grouped according to the location and severity of the defect, type of repair, and outcome. RESULTS: For primary repairs the recurrences were more frequent the more severe the defect, but this relationship did not hold for repeat surgery. Sacrospinous ligament fixation, when performed concurrently with vaginal hysterectomy for patients with third-degree prolapse in primary cases reduced the rate of recurrence from 15.8% to 6.7%. CONCLUSION: The original degree and type of pelvic support defect is important in selecting the appropriate operative procedure for the highest likelihood of cure. There may be a wider role for sacrospinous ligament fixation in primary operations for patients with severe defects.

Female↗
PubMed1993

Incarcerated uterine prolapse associated with a cul-de-sac abscess.

BACKGROUND: Incarceration is a rare complication of uterine prolapse and is usually associated with bladder calculi. We report a case of uterine incarceration associated with an abscess in the cul-de-sac. CASE: A 64-year-old woman presented with complaints of vaginal prolapse. Pelvic examination on admission revealed an edematous, prolapsed uterus and eversion of the vagina. The bladder was catheterized, and subsequent attempts to reduce the prolapse were unsuccessful. Conservative treatments were initiated including Trendelenburg positioning, estrogen cream, and moist soaks. Failure to reduce the prolapse under general anesthesia necessitated a vaginal hysterectomy and anteroposterior repair. When the cul-de-sac was entered, there was purulent material draining from an abscess behind the uterus. Postoperatively, the patient received antibiotics for 3 days and was sent home on day 4. CONCLUSIONS: Irreducible uterine prolapse is a rare condition and may be attributed to a narrowed introitus, bladder calculi, or pelvic abscesses. Historically, conservative management has attempted to alleviate the edema and restore the prolapse, to allow definitive surgery at a later date. We believe that the pelvic abscess in our case exemplifies a danger of delaying surgery. We recommended that when the patient is in stable condition, a hysterectomy and plastic repair be performed promptly.

Abscess↗
PubMed1986

An epidemic of maternal thrombocytopenia associated with elevated antiplatelet antibody. Platelet count and antiplatelet antibody in 116 consecutive pregnancies: relationship to neonatal platelet count.

Twenty-eight (24%) of 116 pregnant women studied prospectively during an 8-month period in 1983 had platelet counts of less than 150,000/mm3 at least once during pregnancy. Thirteen of these were thrombocytopenic in both the prenatal and the peripartum period. Eighteen were restudied 3 to 12 months after delivery. One woman, who was pregnant again, had a platelet count of 140,000/mm3. In the others, platelet counts were in the normal range. Platelet-associated immunoglobulin G and serum antiplatelet antibody levels were elevated in 79% and 61%, respectively, of these 28 women on at least one occasion. However, 59% of 73 pregnant nonthrombocytopenic women had increased platelet-associated immunoglobulin G levels and 59% had positive serum antiplatelet antibody test results. Twenty women who had increased platelet-associated immunoglobulin G levels and positive serum antiplatelet antibody test results were normal 6 to 10 months after delivery. Of 105 infants studied, 10 were thrombocytopenic. Neonatal thrombocytopenia was not predicted by maternal platelet count, platelet-associated immunoglobulin G, or serum antiplatelet antibody. By the fall of 1984, the incidence of thrombocytopenia had dropped to two in 280 consecutive pregnancies. We conclude that (1) epidemics of thrombocytopenia can occur in pregnant women and (2) if a women is found to be thrombocytopenic for the first time during pregnancy, she should not be subjected to the measures advocated for the management of pregnancy in women with autoimmune thrombocytopenic purpura.

Adult↗
PubMed1980

Changing indications for vaginal hysterectomy.

The recent history of vaginal hysterectomy in America is summarized to bring current trends into focus. A series of 252 vaginal hysterectomies is analyzed. The discussion deals with factors contributing to morbidity, the relative advantages of various techniques, and the recognition and management of complications.

Adult↗
PubMed1978

Pregnancy in familial dysautonomia.

This report describes the first two known instances of viable pregnancies in two patients with familial dysautonomia (Riley-Day syndrome). The offspring were apparently normal. Several conditions, specifically related to autonomic and sensory dysfunction in pregnancy, are discussed.

Adult↗