Vaginal hysterectomy and sacrospinous colpopexy for uterovaginal prolapse: anatomical and functional outcomes

The surgical management of pelvic organ prolapse requires a combination of techniques. This study evaluated the anatomical outcomes, functional outcomes and complications of vaginal hysterectomy and sacrospinous colpopexy in women with uterovaginal prolapse. We retrospectively evaluated 85 women who underwent vaginal hysterectomy and sacrospinous colpopexy over a period of 3 years. The primary outcome measures included anatomical outcome success rates [as assessed by pelvic organ prolapse quantification, POP-Q], pelvic floor function outcomes and complication rates. At a mean follow-up duration of 35 months [range: 12-60], the overall objective success [for all compartments] was 81% [69/85], while the objective success rates for the anterior, posterior and apical compartments were 82% [70/85], 89% [76/85] and 92% [78/85]. Respectively, there were no stage 3 or 4 recurrences at any site. Overactive bladder [OAB] symptoms improved significantly following the surgery, while new-onset stress urinary incontinence occurred in 5 patients. There was no significant change in sexual activity or dyspareunia. Surgical complications were minor. The combination of vaginal hysterectomy and sacrospinous colpopexy for the treatment of uterovaginal prolapse is reasonably effective in restoring pelvic anatomy and results in favourable pelvic function with an acceptable complication rate

Perceptions and expectations among pregnant women receiving second-trimester ultrasound scans at Jordan University Hospita

To evaluate women's information about the purpose of the second-trimester ultrasound scan, their expectations before the scan, the extent to which these expectations are fulfilled after the scan, and their perceptions of the foetus. A sample of pregnant women [540] attending a second-trimester ultrasound scan at Jordan University Hospital were asked to complete two parts of a questionnaire during a 3-month period in 2011. The first part included patients' characteristics, the purpose of the scan, and expectations before the scan. The second part included patients' perceptions of the foetus and how the expectations of the scan were fulfilled. Both parts of the questionnaires were completed by 503 [93%] of the women. Three fourths of the participants were accompanied by their husband or a family member. Sixty [12%] women were referred specifically to rule out congenital anomalies. Comparison between patients' expectations before and after the scan using the chi-square test showed significant improvement in all expectations variables [P-value< 0.001]. A routine second-trimester ultrasound scan is an important event for most participating women. Improvements are required in the provision of pre-ultrasound information

Spontaneous uterine rupture at 16-week gestation after abdominal myomectomy

Uterine rupture during pregnancy after abdominal myomectomy is an uncommon complication. Most of these cases occur during the third trimester of pregnancy or during labor. We report a 16-week pregnant lady with previous history of abdominal myomectomy presenting with acute abdomen. Emergency laparotomy revealed a spontaneous uterine rupture. The fetus within the amniotic sac and the placenta were expelled in the abdominal cavity. Although it is rare, uterine rupture may occur early in pregnancy