ABSTRACT
Background: Uterovaginal prolapse is a common gynaecological condition in low resource countries because of high prevalence of grand multiparity, low skilled attendant at delivery and low contraceptive usage. Objective of this study was to determine the prevalence, sociodemographic profiles, utilization of reproductive health services and delay in seeking medical care of patient with uterovaginal prolapse in Calabar, Nigeria.Methods: This was a retrospective study of women who presented with uterovaginal prolapse at University of Calabar Teaching Hospital, Calabar, Nigeria between 1st May 2009 and 1st June 2019. Patients case records were retrieved and analyzed. Statistical analysis was done using SPSS version 22.Results: The prevalence of genital prolapse was 0.3%. The mean age and parity were 60.19±8.71 years and 6.31±2.80, respectively. The mean duration of symptoms before presentation was 3.19±2.16 years. Genital prolapse was commonest among age group 60-79 years (52.8%), parity 5-9 (66.7%), post-menopausal (97.2%), primary education (55.6%) and farmers (47.2%). Grade 3 uterovaginal prolapse was the commonest grade (58.3%). Most patients (86.1%) had symptoms of genital prolapse for less than 5 years before seeking medical treatment. The majority of patients had no antenatal care during their pregnancies (80.6%), no skilled attendant at deliveries (86.1%) and no contraceptive use during their reproductive years (77.8%). Participants with lower parity (1-4) (p=0.03), higher educational level (p˂0.001) and teachers/civil servants (p=0.043) presented earlier (less than 1 year) to the hospital.Conclusions: There is poor utilization of reproductive health services among women who develop uterovaginal prolapse in study environment. Women with higher social status sought for help earlier. Increasing awareness of this condition and providing antenatal care, skilled birth attendants and contraceptive services will reduce the burden of this condition.
ABSTRACT
Background: Pelvic organ prolapse is common in women and 7-9% undergo surgical repair. Abdominal sacrocolpopexy and sacrohysteropexy is the most durable operation for vault prolapse and Nulliparous prolapse respectively. The objectives of this study were to describe Anatomic and symptomatic outcomes up to 5 years after abdominal sacrocolpopexy or sacrohysteropexy.Methods: This study was conducted in ASCOMS hospital for a cohort of patients who underwent abdominal sacrocolpopexy (ASC) or sacrohysteropexy (ASH) in 2 years (2013-2015) and follow up done for a period of 5 years from 2015-2019. These patients were evaluated for subjective and objective outcomes following ASC and ASH. women completed questionnaires and were examined in gynaecology clinic. Prospective follow up study using standarised examination with pelvic organ prolapse quantification system (POP-Q) and questionnairesResults: In the present study, there was low incidence of intraoperative and postoperative complications as well as long term complications were significantly low. The anatomical cure rate and patient satisfaction rate was both 100%.Conclusions: Abdominal sacrocolpopexy for vault prolapse and sacrohysteropexy for Nulliparous prolapse is safe and effective method and is considered gold standard for treatment of Apical compartment prolapse.
ABSTRACT
Pelvic organ prolapse is a common problem worldwide affecting parous women over 50 years of age withsignificant influence on quality of life. Sacrospinous fixation is a novel technique to treat patients ofuterovaginal prolapse and vault prolapse. This study was conducted on the patients operated withsacrospinous fixation surgery for a period of 5 years from 2012 to 2017. Their intraoperative and postoperativefindings were noted. These cases were followed up for 2-5 years after surgery to note the anatomicalcure rate and patient satisfaction rate. There was low incidence of intraoperative and postoperativecomplications. The anatomical cure rate and patient satisfaction rate was both 92% with 8% incidence offailure of procedure. Thus, Sacrospinous surgery is a safe, simple and effective method especially forcases with uterovaginal prolapse along with posterior compartment defects and vault prolapse.
ABSTRACT
Massive or giant vesical calculus is a rare entity in urological practice. Females are less affected than males. Vesical calculi are usually due to long-standing uterovaginal prolapse and bladder outlet obstruction coupled with chronic infection. These patients present with recurrent urinary tract infection (UTI), hematuria or with retention of urine. We report a case of 50-yearold female, who presented with history of mass per vagina and recurrent UTI. Her renal function tests were normal and urine examination showed infection. Plain X-ray showed a large radio-opaque calculus in pelvic region. Ultrasound pelvis reported a large freely mobile vesical calculus 9 x 11 cm with bilateral hydroureteronephrosis, which was more pronounced on left side than right. After controlling UTI, she underwent an open suprapubic cystolithotomy and total abdominal hysterectomy and bilateral salpingo-oophorectomy. Postoperative stay was uneventful and she was discharged on 10th postoperative day. Patient is still on follow-up with good urinary function and no recurrent UTI.
ABSTRACT
A two-month-old female infant born of a consanguineous marriage, presented with loose, wrinkled and inelastic skin over the neck, axillae, trunk, inguinal region and thighs with slow elastic recoil. Patient also had systemic manifestations in the form of bilateral apical lobe consolidation of lung, bilateral inguinal hernia, rectal and uterovaginal prolapse. Histopathological examination of skin biopsy with special stain for elastic tissue revealed absence of dermal elastic tissue. Genital abnormalities in patients with congenital cutis laxa have been reported rarely. But rectal and uterovaginal prolapse have not been reported at an early age of two months. In the absence of mutational screening, with history and clinical findings our case is likely to be Type I autosomal recessive form of congenital cutis laxa.