PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Vaginal Approach”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMed1988

[Are operations for urinary incontinence using colposuspension contraindicated in low urethral closing pressure?].

In a retrospective study the influence of maximum resting urethral closure pressure (CP) and body weight on the results of 33 fascial colposuspension operations were analyzed. The success rate of incontinence surgery was most inferior in cases in which the preoperative CP was lower than 50% of the age-related normal value. Incomplete success or even failure were also attributable mostly to patients with overweight. On the other side, also patients with considerable overweight and/or very low CP were treated successfully. It was unimportant whether fascial colposuspension was performed as primary or secondary operation or in combination with or after hysterectomy. The need to bladder neck elevation and the presence of optimal vaginal condition proved to be the decisive prerequisites for this approach.

Fasciotomy↗
PubMedDate not supplied

Indications and results of total hysterectomy.

During a 16 year period, 3,410 total hysterectomies were performed. The abdominal approach was preferred in 2,910 cases (85.33%) and the vaginal in 500 (14.67%). About 3/4 (74.77%) of the patients subjected to abdominal hysterectomy (AH) were aged 36 to 55, and 70.6% of the women subjected to vaginal hysterectomy (VH) were aged 56 to 75. The indications were 85.75% for benign and 14.25% for malignant diseases. Among benign diseases, the main indications were 54.6% for uterine myomas, 13.51% for uterine prolapse and 5.46% for benign ovarian tumors. Indications due to malignant diseases rated 5.01% for malignant ovarian tumors, 4.94%, for Ca of corpus uteri and 3.02% for in situ cervical Ca. In almost one out of every three patients the condition was aggravated by a chronic disease or pathological situation. More than 1 in 4 patients had one postoperative complication. In hysterectomies due to benign diseases the complication rate was 24.21%, while those with malignant disease presented a two-fold complication rate. The complication rate for both routes of operation was similar, with fever complications in middle aged patients (25.98%), while patients of young or advanced age presented higher complication rates (29.71% and 31.28% respectively). The overall mortality rate up to the fourth postoperative day was 0.652%, 0.645% for AH and 0.60% for VH. Operations due to benign disease had a 0.20% mortality rate while those with malignant etiology rated 2.966%.

Adult↗
PubMed1994

An intervention to reduce the risk of mother-to-infant HIV transmission: results of a pilot toxicity study.

Although unproven, vaginal cleansing with antiseptics during labour could be a practical approach to reducing the rate of transmission of HIV infection from mother to infant. Before initiating a large scale clinical trial of the antiseptic chlorhexidine, we conducted a study to assess possible toxic effects as well as beneficial outcomes in 160 women volunteers: 40 non-pregnant chlorhexidine washed, 40 pregnant not washed, 40 pregnant saline washed, and 40 pregnant chlorhexidine washed. The wash was easily administered by the nurse-midwives. The participants generally felt better after the procedure, and had no complaints or adverse reactions in the subsequent 24 hours. Bacteriologically, the procedures lowered the carriage of Group B streptococcus and Staphylococcus aureus, but did not affect the frequency of T. vaginalis detection. No clinical problems were seen, and therefore the larger clinical trial of efficacy will proceed. Results of this trial are expected in late 1995.

Administration, Intravaginal↗
PubMed1996

[A new modification of the neovagina reconstruction with peritoneum technique].

There are several surgical methods designed to construct a vagina when it is congenitally absent. Davidov has described a technique for correcting this condition, using the pelvic peritoneum to line the vaginal space. We performed new modifications to prevent disadvantages of this technique. An operative vagina was constructed in eight patients with vaginal agenesis, the vaginal surface were covered, using parietal peritoneum flaps with abdominovaginal approach. One year later, we found that four of them had an anatomically and functionally sufficient vagina. The remaining four patients can't be controlled yet, because not enough time has passed after the operation.

Adolescent↗
PubMed1998

The women with dysuria.

Bacterial cystitis is the most common bacterial infection occurring in women. Thirty percent of women will experience at least one episode of cystitis during their lifetime. About one third of patients presenting with symptoms of cystitis have upper urinary tract infection. A careful history to identify risk factors for subclinical pyelonephritis is important. Symptoms of chronic cystitis accompanied by sterile urine without pyuria may represent interstitial cystitis. Dysuria may also be the principal complaint of women with vaginitis (infectious, atrophic or chemical) or urethritis. A stepwise diagnostic approach, accompanied by inexpensive office laboratory testing, is usually sufficient to determine the cause of dysuria.

Bacterial Infections↗
PubMed1998

Cervical balloon for dysfunctional labor following amniotomy.

The conventional treatment for arrest of protracted active phase dilatation is amniotomy and oxitocin. This kind of labor dystocia is associated with an increased incidence in Cesarean delivery. We describe the use of cervical balloon after amniotomy for protracted active phase dilatation. We have used this approach in five parturients. All five patients had a spontaneous vaginal delivery. Intrapartum cervical balloon in patients with dysfunctional labor may reduce the need for Cesarean delivery.

Catheterization↗
PubMed1999

Cervical pregnancy--a conservative stepwise approach.

A case of cervical pregnancy resistant to intramuscular methotrexate therapy is presented, which was successfully treated by intra-arterial methotrexate followed by selective prophylactic hypogastric artery embolization to avoid aggravating the vaginal bleeding. It is suggested that, in cervical pregnancies in which fertility preservation is desired, a stepwise conservative approach should be applied before resorting to surgical intervention.

Adult↗
PubMed2003

Laparoscopic-assisted radical parametrectomy including pelvic and/or paraaortic lymphadenectomy in women after prior hysterectomy-three cases.

BACKGROUND: Radical abdominal surgery in patients who have previously undergone a hysterectomy is a surgical challenge. This type of surgery for invasive cervical cancer after a hysterectomy or vaginal stump metastasis traditionally requires a major laparotomy; however, a minimal-access approach is now being applied to this type of procedure. CASE: A laparoscopic-assisted radical parametrectomy including a pelvic and/or paraaortic lymphadenectomy was performed on two patients presenting invasive cervical cancer diagnosed after a simple hysterectomy and one patient with recurred endometrial cancer in the vaginal stump. All three patients had an excellent clinical outcome and made a rapid recovery with no major complications, even though two cases involved a bladder laceration. CONCLUSION: A laparoscopic radical parametrectomy including a pelvic and/or paraaortic lymphadenectomy is a viable technique for women with invasive cervical cancer or recurrent endometrial vaginal cancer after a prior hysterectomy.

Adenocarcinoma↗
PubMed1991

Evaluation of patients with atypical results of a Papanicolaou smear.

One hundred women with atypical Papanicolaou smear results were examined in a protocol of colposcopy, cervicography, cervical cultures, and wet preparations of vaginal secretions. Infections of the vagina and cervix were rare and often found in patients with coexistent cervical dysplasia. Cervicography identified many of the patients who ultimately were found to have cervical dysplasia but had high false positive and false negative rates. Forty-seven percent of the patients had cervical dysplasia or cervical condyloma. Based on this high rate of dysplasia, treatment of vaginitis and repeated cervical cytology cannot be recommended. Colposcopy represents the most appropriate approach to the patient with atypical cytology.

Colposcopy↗
PubMed2004

Successful obstetrical management of 110-day intertwin delivery interval without cerclage: counseling and conservative management approach to extreme asynchronous twin birth.

BACKGROUND: This report describes a patient counseling approach and non-surgical management of a dichorionic-diamniotic twin pregnancy where delivery of the second twin followed the delivery of the first by 110 days. CASE PRESENTATION: An early transvaginal sonogram at 19 1/2 weeks suggested cervical dilation with protruding amniotic membranes. Tocolytic and antibiotic therapy was initiated; no cerclage was placed. Spontaneous rupture of membranes and cord prolapse occurred 48 h later, resulting in delivery of a stillborn female infant. Conservative management was offered after counseling for possible risks associated with maternal sepsis, need for extended hospitalization, potential for hysterectomy and death. The cervix appeared closed after delivery and the umbilical cord was ligated, with subsequent spontaneous cord retraction in utero. Reassuring fetal status was observed for twin B without evidence of contractions or chorioamnionitis. A viable male infant (2894 g) was delivered vaginally at 35 1/2 weeks. CONCLUSIONS: This report outlines a counseling approach useful for patients with premature delivery of one twin, and presents application of conservative obstetrical management principles for the aftercoming twin even when delivery interval is extreme.

Journal Article↗
PubMed2004

A daily diary analysis of vaginal bleeding and coitus among adolescent women.

OBJECTIVE: To evaluate the effect of vaginal bleeding on the likelihood of coitus among adolescent women. METHODS: Participants were 191 sexually active women aged 14 to 21 years enrolled from a sexually transmitted disease clinic and three primary care adolescent clinics. Data were collected from diaries maintained for up to 7 months. Subjects recorded each occurrence of coitus, partner initials, condom use, and vaginal bleeding. Multivariable logistic regression was used for the analyses. Generalized estimating equations approach was used to adjust the estimated parameters for within-subject correlation. RESULTS: Subjects reported a total 21334 diary days, with 2684 days with coitus (12.6% of diary days) and 1433 days with bleeding (6.7% of diary days). Only 65/2684 (2.4%) coital events were associated with vaginal bleeding. Multivariable analysis showed that absence of bleeding was associated with increased likelihood (odds ratio = 4.2) of coitus, independent of age, race, and usual coital frequency. Younger age and higher coital frequency were associated with increased likelihood of any coitus during vaginal bleeding. CONCLUSIONS: For most sexually active adolescent women, bleeding is associated with avoidance of coitus.

Adolescent↗
PubMed2005

[Treatment of vaginismus with the Paula Garburg sphincter muscle exercises].

OBJECTIVE: To prospectively assess and compare a novel approach to the treatment of vaginismus based on Paula Garburg's sphincter muscle exercises to the traditional approach based on Masters & Johnson. PATIENTS AND METHODS: The study population included 60 consecutive patients with vaginismus who were referred to our sex therapy clinic. The patients were randomly assigned into two groups. The study group (30 patients) underwent a step-by-step program consisting of the performance of the Paula Garburg sphincter muscle exercises to achieve pelvic muscle relaxation combined with the active introduction of Young vaginal dilators of graduated size. A control group (30 patients) underwent a behavioral treatment based on Masters and Johnson's desensitization approach that was combined with the active introduction of Young vaginal dilators of graduated size. RESULTS: All patients completed the program, all with a successful outcome, as defined by the achievement of full intercourse or the introduction of a number 6 Young vaginal dilator. The mean number of treatment sessions required for successful outcome was shorter in the study as compared to the control group (4.9 +/- 1.4 vs. 7.4 +/- 3.5, respectively. P < 0.001). Furthermore, while the percentage of patients undergoing up to 5 sessions until successful outcome was significantly higher in the study as compared to the control group (p < 0.05), the percentage of patients undergoing > 10 sessions was significantly lower. CONCLUSION: Paula Garburg's sphincter muscle exercises together with the use of Young vaginal dilators is a simple, easy and very effective treatment for vaginismus. The outcome matched or even surpassed that of the traditional behavioral approaches.

Exercise↗
PubMed1996

Anatomic goals in the correction of female stress urinary incontinence.

The goal of stress incontinence surgery is to prevent opening of the urethra during increases in intra-abdominal pressure. Greater refinements in the understanding of the pathophysiology of incontinence and experience with newer treatments have extended surgical thinking beyond the familiar paradigm "to place the urethra in a high retropubic position." When incontinence is associated with vaginal hypermobility, vaginal support may be sufficient to restore continence if the suburethral vaginal wall is sufficiently strong, an evaluation which must often be made by physical examination alone. However, when the vaginal wall is weak, the urethra will require an alternative form of support, usually a sling. If the urethra is intrinsically deficient, vaginal support may not be sufficient to prevent opening during increased intra-abdominal pressure, and coaptation by sling obstruction or periurethral bulking injection may be required. Most laparoscopic approaches to stress incontinence use Burch's method, which offers excellent urethral stability provided the suburethral vaginal wall is strong. Newer insights into the relation between vaginal mobility and urethral closure are discussed, as well as anatomic aspects of the Burch suspension relevant to laparoscopic repair.

Female↗
PubMed1996

[Vaginal bleeding patterns and the regularity in use of Norplant].

OBJECTIVES: To understand vaginal bleeding patterns and the regularity in use of Norplant, and find out the main cause of termination that Norplant users can not bear. METHODS: A total of 306 menstrual diaries of Norplant users for 5 years were analyzed. The analysis of bleeding patterns was carried out by using the reference period approach and followed the guidelings published by WHO. RESULTS: The total number of vaginal bleeding days and the number of spotting days in the first reference periods were 36.6 days and 21.5 days, respectively. They were decreased obviously in the third reference period. The number of bleeding days was not obviously changed. The percentage of irregular bleeding was predominent in all of the bleeding patterns, 43.1%-57.6% usually. The percentage of prolonged bleeding was 13.4%-31.0%, secondly. The percentage of "normal" was only 33%. The number of bleeding days and the percentage of prolonged bleeding were more in bleeding termination group than in continuation group. The percentage of irregular bleeding was lower. CONCLUSIONS: During the initial stage of use of Norplant the total number of vaginal bleeding days was increased, but decreased obviously after 6 months. This change was influenced by the number of spotting days. Irregular bleeding and prolonged bleeding were main types of the disturbance of menstrual cycles after use of Norplant, The main cause of termination was prolonged bleeding.

Adult↗
PubMed2000

Management of vaginal bleeding irregularities induced by progestin-only contraceptives.

As the use of progestin-only methods of contraception continues to increase worldwide, the problem of the vaginal bleeding disturbances these methods induce is becoming of increasing public health relevance. A number of approaches are used by clinicians to control these bleeding irregularities but few treatments have been adequately tested and, to date, none appears sufficiently effective. Better understanding of the mechanisms underlying vaginal bleeding as well as of the attitudes of women towards menstrual disturbances is needed, so that effective and acceptable therapies can be devised.

Contraceptive Agents, Female↗
PubMed1985

Ceftriaxone and cefazolin prophylaxis for hysterectomy.

Two hundred and twenty-five women scheduled for elective hysterectomy were entered into a prospective, comparative, randomized, double-blind clinical trial of antibiotic prophylaxis; 117 had vaginal hysterectomy and 108 had abdominal hysterectomy. They were given a 1 gram preoperative dose of ceftriaxone, an investigational cephalosporin or three 1 gram parenteral doses of cefazolin over a 16 hour period. Antibiotic concentrations were measured in serum and vagina, myometrium, fallopian tube or ovary and mean ceftriaxone concentrations were consistently higher than those of cefazolin. Both regimens were safe, well tolerated and equally effective at preventing major postoperative infection. Diabetes increased the risk for infection regardless of regimen and surgical approach (p = 0.009) and specific risk factors were identified for women undergoing vaginal hysterectomy. The incidence of infection was 1.7 per cent after vaginal hysterectomy, significantly lower than the 7.4 per cent observed after abdominal hysterectomy (p = 0.039). Several of the clinical and surgical variables were identified that could explain this difference.

Adult↗