Multiple urinary bladder calculi: a rare cause of irreducible uterovaginal prolapse

A case of irreducible prolapse with multiple bladder calculi in a 65-years-old multiparous, postmenopausal woman is reported. Inability to walk, constipation and urinary incontinence were her primary complaints. Routine ultrasound of the abdomen and pelvis failed to reveal multiple vesical calculi as the prolapse was lying outside the pelvis. However, targeted plain X-ray of the prolapsed mass showed multiple vesical calculi. The patient was managed with single-stage vaginal hysterectomy and laparotomy. First vaginal hysterectomy was done then prolapsed cystocele was reduced and extraperitoneal vesicolithotomy done. Currently, the patient is relieved of all symptoms. Management of an irreducible procidentia and a hard mass in the anterior compartment, as in this case, can be challenging and requires a diligent effort to confirm the diagnosis and to execute the appropriate surgical protocol to achieve optimal outcome with minimal intra- and post-operative complications.

Uterine Perforation in Postmenopausal Woman – Case Report

Rupture of uterus occurring spontaneously is a rare occurrence. Here we are presenting a case of spontaneous postmenopausal rupture of uterus caused by pyometra. This can be associated with high morbidity if generalized peritonitis and sepsis occurs. The symptoms will be like acute abdomen similar to that caused by ruptured bowel or gastric perforation. In case of postmenopausal rupture like ours, gynaecological symptoms are very less. Hence the diagnosis becomes difficult and challenging. Here we report a rare case of uterine rupture that occurred in a postmenopausal woman because of pyometra. The patient landed up in the surgical department as case of acute abdomen. Definitive diagnosis was made at the time of laparotomy only when exploration was done and gynaecologist called.

Perception attitude and exercise compliance among menopausal females

Background: Menopause is perhaps the most striking event occurring during the middle age in women and represents the end of woman's reproductive life. With the general increase in life expectancy, many women are likely to live for more than 20 years after menopause, spending about one quarter of their lives or more in a state of oestrogen deficiency. Owing to lack of oestrogen woman may experience decrease physical and mental wellbeing that’s why postmenopausal woman can be considered a risk population. There is a lack of data to find the compliance and attitude towards exercise among menopausal females in India.Methods: A questionnaire-based survey was conducted among sample size of 150 menopausal females. Self-made questionnaire was the outcome measure.Results: 21% consider menopause is associated with changes in the body.1 % perceived all the symptoms to be associated with menopause.30% perceived that none are associated with menopause. Perception was seen to be positive overall.36% of uneducated females do not consider exercise at all important.51% of educated females consider it important. Only 61% exercise on regular basis.Conclusions: Most females perceive menopause as a positive life event. Exercise was considered somewhat important by menopausal females; however exercise compliance was poor.