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At least 109 records · Page 6Linked to original sources
PubMed1976

Treatment of complete prolapse of the rectum by the vaginal approach.

Complete prolapse of the rectum is essentially an enterocele which emerges through the anus as a sliding hernia of the rectum. In women, this condition can be operated radically by a simple technique which causes only little stress to the patient, entirely in conformity with the principles of the hernia operation, as advocated by Graham (Ann. Surg., 1942, 115 (1007), by the abdominal approach.

Aged↗
PubMed1988

Current status of genitourinary fistula.

From 1970-1985, 303 women with genitourinary fistulas were seen at the Mayo Clinic. The fistula formed after treatment for benign conditions in 74% of the patients and malignant conditions in 14%; in 12%, we were unable to establish the nature of the condition. Gynecologic surgery was responsible for 82% of the fistulas, obstetric procedures for 8%, various forms of irradiation for 6%, and trauma or fulguration for 4%. In the nonirradiated patient, the ideal time for operative repair was eight to 12 weeks after fistula formation or failed repair. With ureterovaginal fistulas, the patient's general condition and the degree of obstruction of the ureter influenced the time and method of repair. We used a vaginal approach for urethral fistulas and an abdominal one for ureteral repairs. Because of difficulty with adequate exposure and the proximity of the ureter, an abdominal approach was used in 20% of the patients with vesicovaginal fistulas; the remaining 80% were approached vaginally, regardless of size, number, or history of previous repairs. Ninety-two percent of the urethrovaginal fistulas were corrected on the first attempt; the four failures were managed successfully at the second attempt. Ninety-eight percent of the vesicovaginal fistulas were corrected on the first attempt when approached vaginally, and all were managed successfully when approached abdominally, regardless of the number, size, or previous operative attempts.

Female↗
PubMed1981

Vaginal evisceration. A case report and brief review of the literature.

A 70-year-old woman was successfully treated for spontaneous vaginal evisceration, with extensive infarction of small intestine, by an abdominal and vaginal approach. Vaginal evisceration is a rare condition. It usually occurs in postmenopausal women after one or more vaginal operations and in the presence of an enterocele or other local abnormalities that contribute to tissue weakness. Prompt recognition and surgical treatment, combining abdominal and vaginal approaches as indicated, and use of ancillary antibiotics and anticoagulant regimens is associated with successful outcome in most instances.

Aged↗
PubMed1976

Prolapse of the vaginal vault. Improved techniques for management of the abdominal approach or vaginal approach.

A brief discussion of the history of techniques for the surgical management of prolapse of the vaginal vault is presented. The author's method for the abdominal procedure, sacral colpopexy, is presented together with a summary of twelve patients in whom it was used. The author's modification of the technique of the vaginal operation, "the anterior approach," is presented because it appears to make resection of the enterocele sac and identification of uterosacral ligaments easier and their utilization more effective.

Female↗
PubMed2006

[Radical trachelectomy: From the laparoscopic approach to the vaginal route].

OBJECTIVE: To report our experience of laparoscopic and vaginal radical trachelectomies. MATERIAL AND METHODS: Between February 2001 and May 2005, 10 patients met the requirements for a trachelectomy: 6 for a laparoscopic procedure, 4 for a vaginal procedure. In the laparoscopic procedure, coagulation of the uterine artery had to be performed in 2 patients whereas in the vaginal approach, it was always possible to conserve it. RESULTS: Mean age was 30 years. Median follow-up time was 25 months. Five patients were grade Ia2 and five were grade Ib1. One patient presented numerous lymphatic emboli and underwent radiation and chemotherapy. She died of a peritoneal progression of the disease. One had her baby with a scheduled C-section. One had a spontaneous miscarriage at 7 weeks. CONCLUSION: The radical trachelectomy technique as described by Professor Dargent relies on the selective ligature of the cervico vaginal arteries and the necessity to preserve the uterine arteries. In our experience and that of others reported in the literature, the laparoscopic approach does not always permit to conserve them. In our opinion, the vaginal approach constitutes the best option.

Adult↗
PubMed1996

Laparoscopic Removal of the Cervical Stump after Supracervical Hysterectomy for Persistent Pelvic Pain and Endometriosis

We evaluated the safety of laparoscopic removal of the cervical stump after supracervical hysterectomy. In six women the cervical stump was left due to the presence of severe endometriosis or adhesions in the posterior cul-de-sac between the rectum or uterosacral ligaments and cervix. One woman also expressed a desire to preserve her cervix. Cervical stump removal was secondary to the treatment of endometriosis or adhesions, both of which contraindicated a vaginal approach. A vaginal approach would not have allowed treatment of endometriosis involving the rectosigmoid colon, and it is unlikely that pain relief would be adequate. Five women had extensive pelvic endometriosis despite having had supracervical hysterectomy. Four of the five also had undergone bilateral salpingo-oophorectomy. Severe adhesions were present in all women, especially intestinal and omental attachments to the vaginal apex and adjacent structures. Mean blood loss was 100 ml (range 50-200 ml). There were no major intraoperative or postoperative complications. The only minor complication occurred in a woman who experienced minimal postoperative vaginal spotting from granulation tissue formation in the cuff. This was treated locally. Pathologic examination revealed endometriosis and fibrosis in all patients. Four women had complete pain relief and the other two had partial relief after follow-up of 2 to 24 months. If it is necessary to remove the cervical stump, it can be done safely by laparoscopy.

Journal Article↗