Neurogenic vesical dysfunction.

Hemorrhage continues to be a serious complication of both obstetrical and gynecologic surgeries. Physicians have used packing in cases of uncontrollable hemorrhage for many years, and this article reports on a modification of standard packing techniques that prevents some of the limitations of traditional packing. This technique was used in 1 patient after cesarean hysterectomy and 3 patients after debulking surgery for advanced gynecologic cancer. The pack consists of a wide piece of ribbon gauze and a Penrose drain. One end of the ribbon gauze is draped over a layer of surgicel (oxidized regenerated cellulose), while the rest is threaded through a 1-inch Penrose drain tightly folded several times to maintain pressure over the bleeding area. The other end of the Penrose drain, with the ribbon gauze visible within it, is inserted through a stab incision in the ipsilateral side of the lower abdomen. This technique allows for continuous bleeding assessment and easy removal of the gauze at bedside.

Abdominal Cavity↗

PubMed2006

Acute alterations in biochemistry, morphology and contractility of rat isolated urinary bladder via increased intra-abdominal pressure.

OBJECTIVE: To determine the acute effects of increased intra-abdominal pressure (IAP) on the biochemistry, morphology and contractility of the rat isolated urinary bladder using an experimental laparoscopy model. METHODS: We divided 24 adult female Sprague-Dawley rats into three groups. The control group (group I) was not subjected to increased IAP. In groups II and III, IAPs of 10 and 20 mm Hg, respectively, were established by carbon dioxide pneumoperitoneum for 60 min. Thirty minutes after desufflation, the rat urinary bladder dome was removed for in vitro pharmacological investigation, measurement of malondialdehyde (MDA) levels and histopathological examination. Statistical comparisons between groups were performed. RESULTS: Tissue MDA levels in groups II and III were significantly higher than in the control group. In group II, only the lamina propria was significantly damaged. However, the epithelium, lamina propria, and serosa were significantly damaged in group III. Acetylcholine potentiated contractions in both IAP groups. Increased responses to electrical field stimulation in the IAP groups were significant only in group II. CONCLUSIONS: In this experimental model, 10 and 20 mm Hg of IAP induced by pneumoperitoneum increased MDA levels and caused important changes in the morphology and contractile response of the urinary bladder.

Abdominal Cavity↗