Surgical management of genital prolapse : Is chain cystourethrography useful for evaluation of anatomical correction and urinary symptoms after surgery?

2000 ◽  
Vol 70 ◽  
pp. A144-A145
Author(s):  
T. Suzuki ◽  
M. Koizumi ◽  
T. Baba ◽  
R. Kudo
2000 ◽  
Vol 26 (4) ◽  
pp. 289-294
Author(s):  
Tsuyoshi Baba ◽  
Motoiki Koizumi ◽  
Ryoichi Tanaka ◽  
Satoko Yamashita ◽  
Masanari Noda ◽  
...  

2009 ◽  
Vol 11 (3) ◽  
pp. 304-309 ◽  
Author(s):  
Giannina L. Garcés-Ambrossi ◽  
Matthew J. McGirt ◽  
Roger Samuels ◽  
Daniel M. Sciubba ◽  
Ali Bydon ◽  
...  

Object Although postsurgical neurological outcomes in patients with tethered cord syndrome (TCS) are well known, the rate and development of neurological improvement after first-time tethered cord release is incompletely understood. The authors reviewed their institutional experience with the surgical management of adult TCS to assess the time course of symptomatic improvement, and to identify the patient subgroups most likely to experience improvement of motor symptoms. Methods The authors retrospectively reviewed 29 consecutive cases of first-time adult tethered cord release. Clinical symptoms of pain and motor and urinary dysfunction were evaluated at 1 and 3 months after surgery, and then every 6 months thereafter. Rates of improvement in pain and motor or urinary dysfunction over time were identified, and presenting factors associated with improvement of motor symptoms were assessed using a multivariate survival analysis (Cox model). Results The mean patient age was 38 ± 13 years. The causes of TCS included lipomyelomeningocele in 3 patients (10%), tight filum in 3 (10%), lumbosacral lipoma in 4 (14%), intradural tumor in 3 (10%), previous lumbosacral surgery in 2 (7%), and previous repair of myelomeningocele in 14 (48%). The mean ± SD duration of symptoms before presentation was 5 ± 7 months. Clinical presentation included diffuse pain/parasthesias in both lower extremities in 13 patients (45%), or perineal distribution in 18 (62%), lower extremity weakness in 17 (59%), gait difficulties in 17 (59%), and bladder dysfunction in 14 (48%). Laminectomy was performed in a mean of 2.5 ± 0.7 levels per patient, and 9 patients (30%) received duraplasty. At 18 months postoperatively, 47% of patients had improved urinary symptoms, 69% had improved lower extremity weakness and gait, and 79% had decreased painful dysesthesias. Median time to symptomatic improvement was least for pain (1 month), then motor (2.3 months), and then urinary symptoms (4.3 months; p = 0.04). In patients demonstrating improvement, 96% improved within 6 months of surgery. Only 4% improved beyond 1-year postoperatively. In a multivariate analysis, the authors found that patients who presented with asymmetrical lower extremity weakness (p = 0.0021, hazard ratio 5.7) or lower extremity hyperreflexia (p = 0.037, hazard ratio = 4.1) were most likely to experience improvement in motor symptoms. Conclusions In the authors' experience, pain and motor and urinary dysfunction improve postoperatively in the majority of patients. The rate of symptomatic improvement was greatest for pain resolution, followed by motor, and then urinary improvement. Patients who experienced improvement in any symptom had done so by 6 months after tethered cord release. Patients with asymmetrical motor symptoms or lower extremity hyperreflexia at presentation were most likely to experience improvements in motor symptoms. These findings may help guide patient education and surgical decision-making.


Author(s):  
Devasee Borakhatariya ◽  
Arvind Gadara ◽  
Arjun Kasundra

Pre and postpartum genital prolapse in cows is often a chronic and recurrent condition. Cervicovaginal prolapse is a very painful and serious condition due to which most of the animals undergo severe straining and may become recumbent. It is assumed that the occurrence of prolapse has a genetic predisposition in both cattle and sheep. It is regarded as an emergency condition and should be managed before excessive oedema, mucosal trauma, contamination and fatal haemorrhage lead to a grave prognosis.


2019 ◽  
Vol 4 (5) ◽  
pp. 857-869
Author(s):  
Oksana A. Jackson ◽  
Alison E. Kaye

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.


2001 ◽  
Vol 120 (5) ◽  
pp. A401-A401 ◽  
Author(s):  
D EFRON ◽  
K LILLEMOE ◽  
J CAMERON ◽  
S TIERNEY ◽  
S ABRAHAM ◽  
...  

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