General radiography leaves enough clues for the ongoing diagnostic evaluation of the patient. The important clues can save a lot of time lost and other unnecessary investigations in the management of the patient illne...General radiography leaves enough clues for the ongoing diagnostic evaluation of the patient. The important clues can save a lot of time lost and other unnecessary investigations in the management of the patient illness. Sacrospinous ligament connects the sacrum with the pelvis. This in fact stabilizes the pelvis as it provides the support. This is important as this is helpful in supporting the vaginal vault in cases of prolapsed uterus in females. We report a 50-year-old male who had come for his intravenous pyelography for left ureteric calculus and was found to be having multiple other associated findings like osteophytosis, bilateral ilial horns and bilateral sacrospinous ligament calcifications. The clue was that of calcification and hardening of left sacrospinous ligament which has led to the formation of left side ureteric calculus. This ureteric calculus has caused great progressive damage to the left kidney by causing gross hydrouretero-nephrosis due to complete obstruction.展开更多
Objective: To determine whether endovaginal ultrasound is a reliable measure in visualization of the sacrospinous ligament among women with prolapse versus women without prolapse, and thus might be clinically applicab...Objective: To determine whether endovaginal ultrasound is a reliable measure in visualization of the sacrospinous ligament among women with prolapse versus women without prolapse, and thus might be clinically applicable in the design of an ultrasound-guided device for performing sacrospinous ligament anchor placement as a treatment for pelvic organ prolapse. Methods: In the first phase of this study we performed a sacrospinous anchor placement in four normal fresh-frozen female pelves. Afterwards, an endovaginal ultrasound was performed to visualize the anchor localization which was validated by dissection of the cadaveric pelves. In the second phase of the study: two groups of volunteer females with and without pelvic organ prolapsed (POP-group, vs NON-POP group) were evaluated by endovaginal ultrasound to localize the sacrospinous ligament. Results: Cadaveric dissection demonstrated accurate anchor placement into the 8/8 sacrospinous ligament. We performed endovaginal ultrasound in a total of 17 N-POP and 10 (POP) patients. Among the N-POP group, the right and left ischial spines were visible in 6/17 (35%) and (6/17) 35% vs 0/10 (0%) for both right and left sides in POP group (p = 0.008). The right sacrospinous ligament was visualized in 4/17 (23%) N-POP subjects and 0/10 POP subjects (p = 0.27) and the left sacrospinous ligament was visualized in 7/17 (41%) N-POP subjects and 2/10 POP subjects (p = 0.48). Conclusions: Sacrospinous ligament and the ischial spines couldn’t be reliably visualized among women with or without pelvic organ prolapse using endovaginal ultrasound, although the structures are visualized more in some of the non-prolapsed women. The sacrospinous anchoring device demonstrated accurate placement by cadaveric dissections.展开更多
目的:探讨经阴道骶棘韧带固定术(SSLF)与盆底重建术(PFR)对子宫脱垂患者的临床疗效及术后生活质量的影响。方法:选择子宫脱垂患者25例行SSLF作为研究组,35例患者行PFR作为对照组,收集两组患者住院期间的手术相关指标(手术时间、术中出...目的:探讨经阴道骶棘韧带固定术(SSLF)与盆底重建术(PFR)对子宫脱垂患者的临床疗效及术后生活质量的影响。方法:选择子宫脱垂患者25例行SSLF作为研究组,35例患者行PFR作为对照组,收集两组患者住院期间的手术相关指标(手术时间、术中出血量、术后发热、解剖恢复、术后自主排尿时间、住院时间、手术费用等)及术后随访调查资料(复发病例数、术后大腿及臀部疼痛、新发尿失禁、便秘、阴道长度、性交疼痛及性生活满意度),采用盆底功能障碍问卷(PFDI-20)评价两组患者手术前后的生活质量。结果:研究组患者手术时间、术后自主排尿时间、平均住院日和手术费用均明显少于对照组,差异均有高度统计学意义( P <0.001);术后两组患者PFDI-20各分量表得分和总分均较术前降低( P <0.05),术后两组患者PEDI-20分量表UDI-6评分和PFDI-20总分差异有统计学意义( P <0.05);手术后随访资料结果显示,两组患者的复发率、会阴及臀部疼痛率、新发尿失禁发生率、便秘发生率、性交疼痛率及性生活满意度比例比较,差异均无统计学意义( P >0.05)。结论: SSLF相对于PFR治疗子宫脱垂患者的优点是手术时间较短、术后自主排尿时间较早、平均住院日较少和手术费用较低,能提高患者术后的生活质量,且可以达到同样的远期效果,值得临床推广。展开更多
Background Genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a ...Background Genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a low recurrence and complication rate. This study aimed to investigate the efficacy and safety of unilateral sacrospinous ligament fixation （SSLF） for the management of pelvic organ prolapse （POP）.Methods Forty patients with severe prolapse of pelvic organ undergoing unilateral SSLF were retrospectively studied.In this study, all patients were staged by the value of POP-Q. All procedures were performed by a senior physician. The characteristics of these patients and their immediate and short-term post-operative outcome were recorded. All patients were seen six weeks and six months after the surgery. The evaluation included standardized questionnaire and site-specific vaginal examination by one physician.Results The average operation time was 65-92 minutes. The average blood loss was 83-188 ml. The average hospitalization time was 6.1 days. The average cost was 5885 yuan. The average day of urethral catheter removal after the operation was 2.1 days. The incidence of postoperative morbidity was 17.1%. One （2.4%） patient had hematoma in the right pelvic. The mean length of postoperative follow-up for 35 patients was 13.1 months. The rate of follow-up was 87.5%. One （2.9%） patient showed recurrent vaginal vault prolapse six months after the surgery. The objective success rate of pelvic organ prolapse was 85% （34/40）. There was significant difference between the POP-Q of Aa, Ba, Ap, Bp,and D before and after operation （P 〈0.001 ）. Five （14.3%） patients complained lower back pain, gluteal pain or right groin pain. Three （8.6%） patients developed de novo stress incontinence. Vaginal disabsorbable sutures were found in three （8.6%） patients. One （2.9%） patient had de novo urge incontinence.Conclusions Unilateral SSLF was both cost and treatment effective management fo展开更多
文摘General radiography leaves enough clues for the ongoing diagnostic evaluation of the patient. The important clues can save a lot of time lost and other unnecessary investigations in the management of the patient illness. Sacrospinous ligament connects the sacrum with the pelvis. This in fact stabilizes the pelvis as it provides the support. This is important as this is helpful in supporting the vaginal vault in cases of prolapsed uterus in females. We report a 50-year-old male who had come for his intravenous pyelography for left ureteric calculus and was found to be having multiple other associated findings like osteophytosis, bilateral ilial horns and bilateral sacrospinous ligament calcifications. The clue was that of calcification and hardening of left sacrospinous ligament which has led to the formation of left side ureteric calculus. This ureteric calculus has caused great progressive damage to the left kidney by causing gross hydrouretero-nephrosis due to complete obstruction.
文摘Objective: To determine whether endovaginal ultrasound is a reliable measure in visualization of the sacrospinous ligament among women with prolapse versus women without prolapse, and thus might be clinically applicable in the design of an ultrasound-guided device for performing sacrospinous ligament anchor placement as a treatment for pelvic organ prolapse. Methods: In the first phase of this study we performed a sacrospinous anchor placement in four normal fresh-frozen female pelves. Afterwards, an endovaginal ultrasound was performed to visualize the anchor localization which was validated by dissection of the cadaveric pelves. In the second phase of the study: two groups of volunteer females with and without pelvic organ prolapsed (POP-group, vs NON-POP group) were evaluated by endovaginal ultrasound to localize the sacrospinous ligament. Results: Cadaveric dissection demonstrated accurate anchor placement into the 8/8 sacrospinous ligament. We performed endovaginal ultrasound in a total of 17 N-POP and 10 (POP) patients. Among the N-POP group, the right and left ischial spines were visible in 6/17 (35%) and (6/17) 35% vs 0/10 (0%) for both right and left sides in POP group (p = 0.008). The right sacrospinous ligament was visualized in 4/17 (23%) N-POP subjects and 0/10 POP subjects (p = 0.27) and the left sacrospinous ligament was visualized in 7/17 (41%) N-POP subjects and 2/10 POP subjects (p = 0.48). Conclusions: Sacrospinous ligament and the ischial spines couldn’t be reliably visualized among women with or without pelvic organ prolapse using endovaginal ultrasound, although the structures are visualized more in some of the non-prolapsed women. The sacrospinous anchoring device demonstrated accurate placement by cadaveric dissections.
文摘目的:探讨经阴道骶棘韧带固定术(SSLF)与盆底重建术(PFR)对子宫脱垂患者的临床疗效及术后生活质量的影响。方法:选择子宫脱垂患者25例行SSLF作为研究组,35例患者行PFR作为对照组,收集两组患者住院期间的手术相关指标(手术时间、术中出血量、术后发热、解剖恢复、术后自主排尿时间、住院时间、手术费用等)及术后随访调查资料(复发病例数、术后大腿及臀部疼痛、新发尿失禁、便秘、阴道长度、性交疼痛及性生活满意度),采用盆底功能障碍问卷(PFDI-20)评价两组患者手术前后的生活质量。结果:研究组患者手术时间、术后自主排尿时间、平均住院日和手术费用均明显少于对照组,差异均有高度统计学意义( P <0.001);术后两组患者PFDI-20各分量表得分和总分均较术前降低( P <0.05),术后两组患者PEDI-20分量表UDI-6评分和PFDI-20总分差异有统计学意义( P <0.05);手术后随访资料结果显示,两组患者的复发率、会阴及臀部疼痛率、新发尿失禁发生率、便秘发生率、性交疼痛率及性生活满意度比例比较,差异均无统计学意义( P >0.05)。结论: SSLF相对于PFR治疗子宫脱垂患者的优点是手术时间较短、术后自主排尿时间较早、平均住院日较少和手术费用较低,能提高患者术后的生活质量,且可以达到同样的远期效果,值得临床推广。
文摘Background Genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a low recurrence and complication rate. This study aimed to investigate the efficacy and safety of unilateral sacrospinous ligament fixation （SSLF） for the management of pelvic organ prolapse （POP）.Methods Forty patients with severe prolapse of pelvic organ undergoing unilateral SSLF were retrospectively studied.In this study, all patients were staged by the value of POP-Q. All procedures were performed by a senior physician. The characteristics of these patients and their immediate and short-term post-operative outcome were recorded. All patients were seen six weeks and six months after the surgery. The evaluation included standardized questionnaire and site-specific vaginal examination by one physician.Results The average operation time was 65-92 minutes. The average blood loss was 83-188 ml. The average hospitalization time was 6.1 days. The average cost was 5885 yuan. The average day of urethral catheter removal after the operation was 2.1 days. The incidence of postoperative morbidity was 17.1%. One （2.4%） patient had hematoma in the right pelvic. The mean length of postoperative follow-up for 35 patients was 13.1 months. The rate of follow-up was 87.5%. One （2.9%） patient showed recurrent vaginal vault prolapse six months after the surgery. The objective success rate of pelvic organ prolapse was 85% （34/40）. There was significant difference between the POP-Q of Aa, Ba, Ap, Bp,and D before and after operation （P 〈0.001 ）. Five （14.3%） patients complained lower back pain, gluteal pain or right groin pain. Three （8.6%） patients developed de novo stress incontinence. Vaginal disabsorbable sutures were found in three （8.6%） patients. One （2.9%） patient had de novo urge incontinence.Conclusions Unilateral SSLF was both cost and treatment effective management fo
