Laparoscopic cervicopexy in uterine prolapse, a prospective study

Background: Pelvic organ prolapse is a common condition and a major cause of gynecological surgery. The lifetime risk of having an operation for prolapse may be 11%. Uterine conserving surgeries using synthetic mesh, especially in younger age group can restore normal anatomy relieving their pelvic symptoms. To evaluate the safety, intra operative and postoperative complications and efficacy of the laparoscopic cervicopexy.Methods: This Prospective observational study was carried out on women aged below 45 years attending gynaecology outpatient department with uterine prolapse at MES Medical College, Perinthalmanna between January 1st and December 31st, 2015. 39 women underwent laparoscopic cervicopexy and follow up assessments was done among them at 2 weeks, 3 months and 6 months. Results: The mean operative time was 27.6 minutes and blood loss was 0.4 gm/dl. No intraoperative and postoperative complications occurred. Short duration of hospital stay with mean of 1.4 days. 7.7% patients and 5.5% had mersilene tape reaction at 3 months and 6 months. The POP Q score C was significantly away from hymen at 2 weeks,3 months and 6 months (+4.4 - -4.3). 7.7% and 2.6% had recurrence at 3 month and 6 months. 5.1% underwent vaginal hysterectomy to get relieved from symptom.Conclusion: Laparoscopic cervicopexy is an effective option for women with pelvic organ prolapse who desire uterine preservation.

Health Problems among Women Building Construction Workers.

Back ground: Construction industry is one of the stable growing industries world over, including Bangladesh. In Dhaka city there are many construction sites, where workers are exposed to hazardous condition, specially the female workers. Throughout the world, over 90% of construction workers are male. In some developing countries, the proportion of women is higher. In Bangladesh their number is increasing day by day. Objective: To explore the health problems among the women building construction workers Methods: This cross-sectional study was carried out among 134 female construction workers. Data was collected through face to face interview by using prefixed questionnaire. The study was conducted from September 2011 to December 2012 in the Department of Community medicine, Dhaka National Medical College, Dhaka. The subjects were selected from different building construction sites of old Dhaka city. Results: It was observed that among 134 respondents, majority 96(71.6%) of the women construction worker were brick breaker and 38(28.3%) were weight carrier. Their mean age was 38.29±6.9 years. Most workers 110 (82.1%) had different types of skin problem. The proportion of skin problems was found to be high among the weight carrier and the difference was statistically highly significant (pOE .001). 89(66.5%) respondents had urinary tract infection, 66(49.3%) had constipation and 24(17.9%) complaint uterine prolapse. Among the total respondents 68(58.2%) complain of backache. The workers who complain of backache, 52(54.1%) were brick breaker and 16(42.1%) were weight carrier. 79 (58.9%) respondents used personal protective equipments, among them 61(77.2%) used self made hand gloves and 38(48.1%) used folded towel to carry weight. Besides of the total respondents 117(87.3%) complain of different types of respiratory problem. Conclusion: The study concludes that different types of skin diseases are present among female construction workers that might be attributable to exposure to hot humid working environment. Besides pain full micturation, uterine prolapse, low backache and respiratory problem were found among them which might need special attention.

A Case Report of Ectopic Fibroid: Vaginal Leiomyoma

We hereby report a rare case of a woman who presented with symptoms of urogenital prolapse and menorrhagia. She was erroneously diagnosed to have cervical mass and underwent examination under anesthesia and was found to have only a vaginal leiomyoma. The fibroid was enucleated successfully through a vaginal incision. We discuss the rare case.

Fatores de risco para o prolapso genital em uma população brasileira / Risk factors for genital prolapse in a Brazilian population

OBJETIVO: avaliar os fatores de risco para o desenvolvimento de prolapso genital na população brasileira. MÉTODOS: estudo caso-controle envolvendo 316 pacientes que foram submetidas a estadiamento de prolapso, utilizando-se o sistema de quantificação de prolapso dos órgãos pélvicos. As pacientes foram divididas em dois grupos. No Grupo Caso, foram incluídas 107 pacientes com prolapso nos estádios III ou IV, e no Controle, 209 mulheres com estádios 0 ou I. As mulheres selecionadas respondiam à anamnese na qual eram questionadas sobre a presença de possíveis fatores de risco para prolapso genital, tais como: idade, idade da menopausa, paridade, tipos de parto (vaginal, cesariana ou fórcipe), ocorrência de macrossomia fetal, história familiar em parentes de primeiro grau de distopia genital, tosse crônica e constipação intestinal. RESULTADOS: as variáveis que se mostraram diferentes entre os grupos foram: idade, índice de massa corpórea, paridade, número de partos vaginais, de cesarianas, de partos fórcipe, peso do recém-nascido e história familiar positiva para prolapso. Raça, idade da menopausa, tosse crônica e constipação intestinal não se mostraram diferentes entre os grupos. Após a regressão logística, somente três variáveis se apresentaram como fatores de risco independentes: presença de pelo menos um parto vaginal, macrossomia fetal e história familiar positiva. A cesariana se mostrou como fator protetor. CONCLUSÕES: na população brasileira, os fatores de risco independentes para prolapso foram a presença de pelo menos um parto normal, macrossomia fetal e história familiar positiva para distopia.

PURPOSE: to evaluate risk factors for the development of genital prolapse in the Brazilian population. METHODS: case-control study involving 316 patients submitted to prolapse staging, according to the pelvic organ prolapse quantification system. The patients were divided into two groups: in the Case Group there were 107 patients with prolapse at stage III or IV, and in the Control Group, 209 women at stage 0 or I. In the anamnesis, the selected women have been questioned about the presence of possible risk factors for genital prolapse, such as: age, menopause age, parturition, delivery type (vaginal, caesarean section or forceps), occurrence of fetal macrosomia, family history of genital dystopia in first degree relatives, chronic cough and intestinal constipation. RESULTS: The variables that were different between the groups were: age, body mass index, parturition, number of vaginal, caesarean section or forceps deliveries, newborn weight and positive family history for prolapse. Race, menopause age, chronic cough and intestinal constipation did not present differences between the groups. After logistic regression, only three variables have been shown to be independent risk factors: presence of at least one vaginal delivery, fetal macrosomia and positive family history for dystopia. Cesarean section was shown to be a protective factor. CONCLUSION: in the Brazilian population, the independent risk factor for genital prolapse were: personal antecedent of at least one vaginal delivery, fetal macrosomia and family history of dystopia.