Utero-vaginal Prolapse during Pregnancy

Summary
Twenty-three patients with severe degrees of utero-vaginal prolapse complicating pregnancy and labour have been studied.
The underlying pathology, symptomatology and methods of treatment are considered.
It is emphasized that the symptoms of utero-vaginal prolapse are aggravated in the latter half of pregnancy and the traditional remission of symptoms in the middle and third trimesters occurs exceptionally.
Labour is usually uninfluenced by severe degrees of utero-vaginal prolapse, and is usually of shorter duration than normal.     

Quality Measures for Prolapse Management

Quality measure development has become increasingly important over the past few years, and there have been many attempts to increase the scientific literature on the subject. Measurement of quality is now an integral part of the healthcare system. This review considers recently recommended quality metrics for prolapse management, subdividing these into structural, process, and outcome metrics. The Quality in Prolapse Surgery (QuIPS) project, Choosing Wisely® campaign by the American Board of Internal Medicine (ABIM), quality measures proposed by AUGS, and the 2012 joint report from IUGA and International Continence Society (ICS) are included this review. Evaluation of adherence to quality metrics is also discussed.     

阴道穹隆吊带悬吊术治疗子宫及阴道穹隆脱垂35例临床分析

目的:探讨阴道穹隆吊带悬吊术(P-IVS)治疗子宫脱垂及阴道穹隆脱垂的临床有效性、围手术期并发症以及近期随访效果.方法:采用POP-Q分期法对35例盆腔器官脱垂患者进行分期,行阴道穹隆吊带悬吊术,术后定期随访了解盆腔器官脱垂复发情况.结果:P-IVS手术时间平均24.5分钟,术中平均出血量30 ml;6例患者发生围手术期并发症,包括术中阴道后壁修补致直肠穿孔1例,术后阴道断端血肿2例,阴道断端活动性出血、泌尿系感染及尿潴留各1例;术后随访6～35月,平均20.3月,至今无一例子宫脱垂或阴道穹隆脱垂复发.结论:阴道穹隆吊带悬吊术是一种治疗子宫脱垂及阴道穹窿脱垂的简单、微创、有效、容易掌握的手术方式.