1/4. Vaginal evisceration long after vaginal hysterectomy.BACKGROUND: Vaginal evisceration can take place many years after vaginal surgery. CASE: An 87-year-old woman presented with evisceration of small bowel through the vagina, 15 years after she underwent a vaginal hysterectomy. On physical examination, her vital signs were normal. Forty centimeters of small bowel was visible emerging from the vagina, appearing viable and nonedematous. Because of the high surgical risk, the bowel was replaced and the defect in the vaginal wall was repaired transvaginally. CONCLUSION: Vaginal evisceration can be treated by a transvaginal surgical approach. Factors such as the medical condition of the patient and the viability of the herniated viscus should dictate the optimal approach in each case.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/4. Pelvic organ myiasis.BACKGROUND: myiasis is infestation with dipterous larvae, which feed on the host's dead or living tissue, liquid body substances, or ingested food. CASE: A 76-year-old, multiparous woman presented at a tertiary care hospital in india with vaginal discharge and itching for 3 weeks. The patient had a health care attendant who apparently failed to notice the problems she was experiencing. Pelvic examination revealed grade 2 uterine prolapse. vaginal discharge was purulent, foul smelling, and contained several 8-10-mm white maggots of Musca domestica (housefly). turpentine oil was instilled locally, and maggots were removed manually. The patient was treated with broad spectrum antibiotics. Maggot removal was repeated weekly for 3 weeks until no further maggots were present. hysteroscopy was normal. The prolapsed uterus was replaced in its anatomic position with vaginal pessary. CONCLUSION: Decreased physical and mental capabilities due to old age and poor care by health providers can lead to maggot infestation of prolapsed pelvic organs.- - - - - - - - - - ranking = 0.14704641337712keywords = physical (Clic here for more details about this article) |
3/4. uterine prolapse after laparoscopic uterosacral transection in nulliparous airborne trainees. A report of three cases.BACKGROUND: Laparoscopic uterine nerve ablation (LUNA) has become a common alternative therapy for refractory dysmenorrhea. Few long-term complications have been reported. CASES: Severe uterine prolapse was diagnosed in three young female soldiers during or after the rigors of airborne training. All three had previously undergone LUNA procedures. No other risk factors for uterine prolapse could be identified in these cases. CONCLUSION: The etiology of uterine prolapse is complex, and although no conclusions as to cause and effect can be made, these cases suggest that LUNA should be performed with caution on women whose occupation or life-style is associated with heavy physical labor or exercises producing marked increases in intraabdominal pressure.- - - - - - - - - - ranking = 0.14704641337712keywords = physical (Clic here for more details about this article) |
4/4. Use of a pessary for the management of pelvic organ prolapse.pessaries provide nonsurgical management of pelvic organ prolapse in women who are not viable candidates for or who do not choose to undergo surgical intervention. It is necessary to take into consideration that when pessary use is indicated, it is crucial that the clinician assess the physical and mental capabilities of the individual. A client with compromised eyesight or motor abilities may not be able to manage the insertion and subsequent care of the device.- - - - - - - - - - ranking = 0.14704641337712keywords = physical (Clic here for more details about this article) |