Biomedical subjects

S Poilpot

Publications and source records attributed to S Poilpot.

5 recordsLinked to original sources

PubMed2003

[Imaging pelvic floor prolapse].

OBJECTIVES: Dynamic MR imaging (MRI) may be used as an alternative to dynamic cystoproctography for the evaluation of pelvic floor prolapse. Our study aimed to define the range of dynamic pelvic MRI aspects observed during the exploration of pelvic prolapse. MATERIAL: Fascial and anatomic defects can include a combinaison of cystocele, rectocele, uterine prolapse, enterocele and vault prolapse. Acute diagnosis of the coexisting abnormalities is essential in planning reconstructive procedures so that the risks of recurrence and reoperation can be minimized. At this time colpocystography is the study of choice to evaluate pelvic floor dysfunction. Dynamic magnetic resonance imaging for exploration of pelvic floor dysfunction is under evaluation. RESULTS: Pubococcygeal line and puborectalis muscle were the references points. The grading system is based on degree of organ prolapse through the hiatus and the degree of pubo-rectalis descent and hiatal enlargement. Unfortunately, there is a real discordance between the reality of the prolapse and its imaging. However, a new reference line, the mid pubic line, was drawn on the magnetic resonance image to correspond to the hymeneal ring marker used in clinical staging. Intra-operative findings were considered the gold standard against which physical examination, dynamic colpocystodefecography and MRI were compared. Using these criteria the sensitivity, specificity and positive predictive value of MRI were 70%, 100%, 100% for cystocele; 42%, 81%, 60% for vaginal vault or uterine prolapse; 100%, 83%, 75% for enterocele; 87%, 72% and 66% for rectocele. CONCLUSION: MRI appears to be an important adjunct in the comprehensive evaluation of the female pelvis. Except for vaginal vault, pelvic prolapse is accurately staged and pelvic organ prolapse reliably detected. The technique is rapid, non invasive and cost effective, it allows the clinician to visualize the whole pelvis using a single dynamic study that provides anatomical details.

Adult↗

PubMed2002

[New physiological, diagnostic and therapeutic concepts in the management of rectoceles in women].

Anterior rectocele is not only a herniation of the anterior rectal wall into the vagina, but rather a complex anatomical and functional abnormality which may be isolated or associated with other pelvic floor disorders. It could result in rectal obstruction with dyschezia, manual extraction of feces, and fecal or gas incontinence. The purpose of this review is to describe and to assess the most useful methods for the diagnosis and for the treatment of the rectocele. Data from physical examination may be improved by defecography. Surgery remains the main treatment: several surgical ways (perineal, anal, abdominal, laparoscopic) are described. Analysis of the anatomical and functional results allows to assess these techniques and to determine the best therapeutic option.

Defecation↗

PubMed2002

[Home birth: opinion of French women and perinatal risk. Results of the French overseas departments 2000 survey].

OBJECTIVES: This study has two objectives: firstly, to find out what are the women's views about home birth, and secondly to perform a review of the perinatal risk associated with home birth. PATIENTS AND METHODS: A questionnaire was sent to 121 women in three maternity hospitals and a Medline search was performed using the following keywords: home delivery, hospital delivery, risk factor, perinatal transfer. RESULTS: Fifty two percent of these women think that home delivery "should or could be offered" (group I), 22% think that it "should never be offered" (group II); finally 26% "do not know" whether it should or not be offered (group III). The level of maternity care, educational standards, nationality, parity, annual income, age, location of the place of residence, do not modify the rate of women belonging to group I. Thirty four percent of women who have heard about complications happening during delivery think that home delivery "should never be offered" while 13% of women who have never heard of complications during delivery stated that it should never be offered (p = 0.024). Even if it is not significant the number of women belonging to group II increases with educational standards and maternal age. Most women believed that hospital delivery is safer, more restful, that pain relief is better, but also stated that it is more impersonal than home delivery. CONCLUSION: In this study more than one out of two women believed that home delivery "should or could be offered". Nevertheless, 22% stated that home delivery "should never be offered". The level of opposition to home delivery seems to increase with the level of information about potential obstetrical complications. A study should be designed to confirm this statement. The analysis of perinatal risks related to home delivery shows that two conditions should be fulfilled in order to allow home delivery: a careful selection, with validated risk factor, to eliminate high risk pregnancies, and clear and complete information on the small but real risk of perinatal transfer.

Demography↗

PubMed2002

[Prolapse in the young woman: study of risk factors].

OBJECTIVE: To determine the risk factors for genital prolapse in a group of 37 young women less than 45 years old. PATIENTS AND METHODS: We studied 37 young women who had been operated for genital prolapse, whereas the control group consisted of women operated for benign gynaecologic disorders. RESULTS: In the study group the number of pregnancies and deliveries, the babies' weight, the positive family history of prolapse were heavier than in the control group. The women with prolapse had more often chronic pulmonary diseases, asthma, as well as operations for abdominal hernias. The mode of delivery, be it a cesarean section or the use of forceps, and the active second stage of labor had no effect whatever on the occurring of genital prolapse in young women. CONCLUSION: Our data support the suggestion that multiparity, babies' weight and congenital factors are responsible for a higher rate of genital prolapse in young women.

Adult↗

PubMed2000

[Stereotactic excisional nonpalpable breast lesions using the advanced breast biopsy instrumentation].

UNLABELLED: Today, the widespead use of mammography has increased the detection of suspected nonpalpable lesions. Accordingly, the number of surgical biopsies is higher. PURPOSE: Evaluation of Advanced Breast Biopsy Instrumentation (ABBI) system as a promising alternative to conventional surgical biopsy in stereotactic excisional breast biopsies less than 20 mm. METHODS: From October 1998 and May 1999, 33 women have had: stereotactic excisional breast biopsies less than 20mm using ABBI. Epidemiologic, mammographic and histologic datas were collected. RESULTS: Mammographic finding were 23 microcalcifications and 10 nonpalpable solid nodular densities. In 25 cases, pathology were benign (79%), 7 cases (21%) were cancer. In these cases, the cancer could be treated later, with a single surgical procedure. No complication occurred and tolerance was excellent in most cases. CONCLUSION: Stereotactic excisional breast biopsies less than 20 mm using ABBI is a very good alternative (reliable, reproducible, ambulatory, very weak morbidity) to surgical biopsy.

Anesthesia, Local↗