Correction of vaginal vault prolapse using Capio™ suture capturing device: our experience.

AIM: Aim of the present study was to evaluate advantages and disadvantages of the sacrospinous ligament fixation (SSF) technique using the Capio™ suture capturing device (Boston Scientific, Natick, MA, USA) in a group of menopausal women affected by vaginal vault prolapse. METHODS: This was an observational, retrospective, cross-sectional study. Menopausal women with vaginal vault prolapse (grade >2) who had never before been treated to correct the vaginal prolapse received the SSF technique using the Capio™ suture capturing device. RESULTS: Forty-seven patients underwent unilateral (38.2%) or bilateral (61.8%) fixation, through the paravescical (65.9%) or pararectal (34.1%) route. Median follow-up was 18.5 months (range 3-34); follow-up visits were performed 30 days after the intervention, at 3, 6 and 12 months in the first postoperative year and every 6 months from then on. Other concomitant procedures such as cystopexy, rectopexy, correction of enterocele or vaginal paravaginal repair were performed as necessary. The procedure was successful in 89.3% of patients, with a resulting mean vaginal length of 7.1±2.4 cm, regardless of the approach used. Only 5 patients suffered from prolapse recurrence. Main long-term complications were de novo and recurrent cystocele, observed mainly in patients who presented risk factors and with no significant differences related to the surgical procedure. CONCLUSION: The use of the Capio™ suture capturing device can simplify the SSF procedure compared with the traditional technique. The use of small devices requires less surgical dissection, reducing surgery time. Future studies are required to solve open issues.

[Spiral x-ray computed tomography in the diagnosis of central venous catheterization complications]. / Contribution de la tomodensitométrie spiralée dans le diagnostic des complications du cathétérisme veineux central.

In this work we report our initial experience on the utilisation of the spiral tomodensitometry in the study of the vascular complications due to the catheterization of the internal jugular vein. We present the results of a systematic search of vascular lesions after removal of an indwelling catheter in a group of 18 patients and describe a few cases of acute complications where the use of TDMS has been very useful in the diagnostic workout. The results confirm the risks associated with the catheterization of the internal jugular vein, showing a frequency of lesions of various degree in about 50% of the cases. Moreover, we discuss some aspects of the thrombotic complications in the patients carrying a central venous catheter and the advantages of the diagnostic application of the spiral tomodensitometry.

[Computerized tomography of cerebrovascular disorders in old age]. / La tomografia computerizzata (TC) nelle vasculopatie cerebrali dell'anziano.

The authors present and demonstrate the more typical CT patterns of cerebrovascular diseases in old age, on the basis of literature and of personal experience of more than 1000 CT examinations of old patients in 1991-1992. They stress the basic role of CT in differential diagnosis between hemorrhagic and ischemic lesions. Finally, they propose a protocol for the better use of CT in the early diagnosis and the outcome of cerebrovascular diseases.

[Possibility of radiology in the study of defection disorders]. / Possibilità della radiologia nello studio dei disturbi della defecazione.

Chronic constipation and defecation disorders are a very common disease, but the diagnosis is often unsatisfactory and therefore therapy is mostly inadequate. The purpose of this paper is to demonstrate the contribution of radiological procedures and mainly of the defecography, in improving and determining the diagnosis itself. Many normal and pathological cases are reviewed, described and demonstrated by radiological patterns. Finally, a correct protocol of different procedures, radiological and not, for morphological and functional study of large bowel and pelvis floor is stressed.