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Introduction and hypothesis
Avulsion of the puborectalis muscle from its bony insertion is common in women presenting with prolapse. We present a simple vaginal technique for levator reconstruction.Methods
This is a prospective surgical pilot study comprising 17 patients enrolled to undergo levator repair in the context of prolapse surgery. This was performed through a lateral colpotomy at the level of the hymen using a mesh patch for reinforcement.Results
We performed 20 levator repairs in 17 women (three bilateral). There were no intraoperative complications. Recovery was unremarkable in all cases. Results are given for a mean follow-up of 1.3 years. Most (13/17, 76 %) women were satisfied with the outcome. Six patients complained of symptoms of recurrent prolapse, three of de novo dyspareunia, and four of pain related to the repair site on palpation. There were two mesh erosions, one of which healed with oestrogen treatment. Prolapse recurrence beyond the hymen was observed in five patients. The mean hiatal area on Valsalva was reduced from 36.84 cm2 to 30.71 cm2 (P?=?0.001).Conclusions
Direct surgical repair of a levator avulsion is feasible at the time of prolapse surgery. However, its effect on prolapse recurrence and hiatal dimensions is relatively disappointing, suggesting that there often is microscopic trauma and functional muscle impairment in addition to the avulsion. 相似文献4.
Korda Athanasia Zamaro Ewa Wagner Franca Morrison Miranda Caversaccio Marco Domenico Sauter Thomas C Schneider Erich Mantokoudis Georgios 《Journal of neurology》2022,269(3):1396-1403
Journal of Neurology - Skew deviation results from a dysfunction of the graviceptive pathways in patients with an acute vestibular syndrome (AVS) leading to vertical diplopia due to vertical ocular... 相似文献
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Der Freie Zahnarzt - 相似文献
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Mihaela Humar M. Kordaš Živa Melik 《Pflügers Archiv : European journal of physiology》1980,386(1):67-70
Papaine is known to detach cholinesterases from the synaptic cleft. It could be expected that this would result in an increase of the amplitude and half-time of the end-plate current. Thus, the effect of papaine on the end-plate current should be similar to the effect of anticholinesterase methanesulfonyl-fluoride.The end-plate current was recorded in frog skeletal muscle at various levels of membrane potential, before and after papaine was added to the bath.The effect of papaine was an increase of the half-time of the end-plate current, similarly as after treatment of the muscle by methanesulfonylfluoride.It seems that both papaine and methanesulfonyl-fluoride have a similar mechanism of action. In either experimental condition hydrolysis of transmitter is decreased or abolished, which results in an increase of the half-time of the end-plate current.This work was supported by the Research Community of Slovenia 相似文献
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Andrew Korda FRCOG FRACOG Mark Krieger MRCOG FRACOG Peter Hunter MRCOG FRACOG FRCR 《The Australian & New Zealand journal of obstetrics & gynaecology》1987,27(2):155-157
Fifty patients suffering from detrusor instability who failed to respond to anticholinergic treatment were treated with prolonged bladder distension. Twelve months after treatment 9 were symptom free, 15 improved and 26 remained symptomatically unchanged. Extraperitoneal bladder rupture occurred in 2 patients. 相似文献
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David M.B. Rosen MRACOG rew R. Korda MA FRCOG FRACOG CU Richard C. Waugh FRACR 《The Australian & New Zealand journal of obstetrics & gynaecology》1996,36(3):354-358
Summary: The Burch colposuspension operation is an accepted and effective technique for the correction of genuine stress incontinence. It is, however, associated with a number of well-recognized complications. Ureteric injury at the time of colposuspension is a potentially severe, if uncommon, complication of this procedure with legal ramifications for the surgeon as well as health risks for the patient. To date, only 19 cases have been described in the literature. This paper highlights 4 cases of this injury occurring amongst the patients of 1 urogynaecologist (2) and gives an incidence for its occurrence as well as discussing the aetiology and management of this complication. 相似文献
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