ABSTRACT
Although surgical correction of vesico-uterine fistulae gives good results, endoscopic fulguration is a new trend for treatment of these cases. These two modalities were compared. Six cases of vesico- uterine fistula caused by bladder injury at cesarean section [4 cases] and by rupture uterus and bladder after obstructed labor [2 cases]. Three cases were treated by endoscopic fulguration, after 6 months follow up, 2 cases have been small and just admitting the 6 ch. fulguration electrode, but the third case showed vaginal leakage immediately after removal of the urethral catheter 6 weeks after fulguration, this case had a giant fistula. Three cases were treated abdominally via transabdominal transperitoneal route and omental flap. All these cases were completely cured. Treatment of small vesico- uterine fistula by endoscopic fulguration is recommended, because of its simplicity and low morbidity. However, large fistulae are preferably treated surgically
Subject(s)
Humans , Female , Hysteroscopy/methods , Fistula/surgery , Endoscopy/methodsABSTRACT
The anatomical closeness of internal female genital organs to the pelvic urinary system makes it clear that dislocation of the uterus and upper vagina, as happens with prolapse, may affect the bladder and/or urethra. The aim of the present study was to delineate the urodynamic changes in urethrovesical function in relation to different degrees of uterine prolapse. Thirty patients with different degrees of uterine prolapse were evaluated urodynamically cystometry and uroflowmetry revealed insignificant changes with different degrees of prolapse except for a significant reduction of the voiding and flow times secondary to significant acceleration of the flow rate in women with III degree uterine prolapse compared to those with I degree uterine prolapse. Profilometry revealed insignificant reduction of the maximum urethral pressure, maximum closure pressure and the functional urethral length in patients with Ill degree uterine prolapse although the incidence of urinary stress incontinence was insignificant higher in patients with I degree uterine prolapse. It is therefore enigmatic that women with the worst support defect, those with severe degrees of uterovaginal prolapse seldom have genuine stress incontinence
Subject(s)
Humans , Female , Genitalia, Female/anatomy & histologyABSTRACT
Sixty preeclamptic together with one hundred and fifty normal Egyptian pregnant women were invtstigated as regards the human leucocyuc antigen [HLA] system. Out of the sixty women with pree-clampsia, 7 [11.66%] had only one identical detectable antigen [i.e. homozygous] at B locus while 42 [28%] out of the one hundred and fifty normal control had one identical antigen detected. This tendency of preeclamptic, than normal control, to be heterozygous at the B locus did not apply to the A or D related loci. No specific HLA, A, B, or DR antigen occurred more commonly in the preeclamptic patitnts
Subject(s)
Humans , Female , HLA Antigens/classification , Pregnancy , HLA-DR Antigens/analysisABSTRACT
Sixty two female patients with genuine stress urinary incontinence associated with genital prolapse were included in this study. Patients underwent single stage procedure for treatment of both incontinence and prolapse. Two types of operations were done anterior colporrhaphy with Kelly plication sutures [32 cases], and modified Burch colposuspension [30 cases]. Clinical and urodynamic evaluation were done preoperatively and repeated 1 year after surgery. The modified Burch operation produced significantly higher cure rate from stress incontinence [83.3%] compared to Kelly plication sutures [59.3%], P <0.05. Both procedures resulted in significant increase in the urethral pressure when treatment was successful. Suprapubic operation was not associated with increased postoperative voiding problems. It was concluded that modified Burch operation is more effective in treatment of stress incontinence and should be the primary operation of choice unless the patient's poor general condition necessitates less time consuming procedure
Subject(s)
Female , FemaleABSTRACT
Sixty two female patients with genuine stress urinary incontinence associated with genital prolapse were included in this study. Patients underwent single stage procedure for treatment of both incontinence and prolapse. Two types of operations were done anterior colporrhaphy with Kelly plication sutures [32 cases], and modified Burch colposuspension [30 cases]. Clinical and urodynamic evaluation were done preoperatively and repeated 1 year after surgery. The modified Burch operation produced significantly higher cure rate from stress incontinence [83.3%] compared to Kelly plication sutures [59.3%], P <0.05. Both procedures resulted in significant increase in the urethral pressure when treatment was successful. Suprapubic operation was not associated with increased postoperative voiding problems. It was concluded that modified Burch operation is more effective in treatment of stress incontinence and should be the primary operation of choice unless the patient's poor general condition necessitates less time consuming procedure