PMID- 22288316 OWN - NLM STAT- MEDLINE DA - 20120131 DCOM- 20120209 IS - 1115-2613 (Print) IS - 1115-2613 (Linking) VI - 20 IP - 4 DP - 2011 Oct-Dec

TI - An audit of vaginal hysterectomies at the University College Hospital, Iba dan. PG - 426-31 AB - BACKGROUND: Cost reduction, less postoperative morbidity and absence of ab dominal scars are advantages of vaginal hysterectomy. The study aimed to examine t he rate, indications, and complications of vaginal hysterectomies performed a t University College Hospital Ibadan to derive lessons for the immediate fut ure. METHODS: An analysis of the records of all vaginal hysterectomies performe d from 1995-2004. Information on the patients' epidemiological characteristics, indications and details of surgery performed, length of duration of surger y and postoperative course was retrieved. Data was analyzed with Stata-11 softwa re. RESULTS: Vaginal: abdominal hysterectomy ratio was 1:9, the former constit uting 2.3% of major gynaecological operations done. The mean age of patients was 56.6 +/- 12.9 years and most were grandmultiparous. Twenty-two cases (81.8%) we re due to genital prolapse. No uteri were larger than 12 weeks' size. Most (78.1% ) were performed by consultants. Complication rate was 63.0%; the most frequent w as intra-operative haemorrhage. Mean hospital stay was 7.4 +/- 3.5 days. Post-operation anaemia was associated with longer hospital stay (p = 0.02) . CONCLUSION: With increasing detection rate of CIN, lesser parities and the availability of the operating laparoscope at our centre, there is need to widen case selection beyond genital prolapse (in view of known benefits of vagin al hysterectomy) for renewed skill acquisition to reduce the high complicatio n rates and for better training of resident doctors. AD - Department of Obstetrics and Gynaccology, University of Ibadan, Ibadan, Ni geria. dr.nikebello@yahoo.com FAU - Bello, F A AU - Bello FA FAU - Olayemi, O AU - Olayemi O FAU - Odukogbe, A A AU - Odukogbe AA LA - eng

PT PL TA JT dent JID SB MH MH MH MH MH MH MH MH MH MH MH MH MH MH MH MH MH EDATMHDACRDTPST SO -

Journal Article Nigeria Niger J Med Nigerian journal of medicine : journal of the National Association of Resi Doctors of Nigeria 100888321 IM Adult Aged Comorbidity Female Hemorrhage/epidemiology Hospitals, University/statistics & numerical data Humans Hysterectomy, Vaginal/adverse effects/*statistics & numerical data Intraoperative Complications/epidemiology Length of Stay Medical Audit Middle Aged Nigeria Ovariectomy/statistics & numerical data Retrospective Studies Urinary Tract Infections/epidemiology Uterine Prolapse/epidemiology/surgery 2012/02/01 06:00 2012/02/10 06:00 2012/02/01 06:00 ppublish Niger J Med. 2011 Oct-Dec;20(4):426-31.

PMID- 22129812 OWN - NLM STAT- MEDLINE DA - 20120131 DCOM- 20120621 IS - 1872-7654 (Electronic) IS - 0301-2115 (Linking) VI - 160 IP - 2 DP - 2012 Feb TI - Traction on the cervix in theatre before anterior repair: Does it tell us when to perform a concomitant hysterectomy? PG - 205-9 LID - 10.1016/j.ejogrb.2011.11.002 [doi] AB - OBJECTIVE: To evaluate the surgical outcome of uterine preservation during anterior colporrhaphy, in women with apparent uterine descent, after the application of validated cervical traction under anaesthesia. STUDY DESIGN : This study was conducted at a tertiary referral hospital in the United Kingdom. Thirty five patients with symptomatic anterior compartment prolapse (stage 2 or m ore) with the cervix, pelvic organ prolapse quantification (POPQ) point C, at o r higher than -3 cm (stage 1), who had requested surgical repair, were recru ited. In all patients there was no evidence of apical descent, with point D at 8 cm or

above. All patients had a validated 'cervical traction' force applied intra-operatively to the cervix, and if the cervix, point C, did not come down further than 'stage 2' (+1cm) the uterus was conserved. These patients had an anterior repair, without a vaginal hysterectomy or apical support procedur e, and were reviewed 3 months postoperatively. International Consultation on Incontinence Questionnaire-vaginal symptoms (ICIQ-VS) and POP-Q scores wer e completed pre- and post-operatively, with another POPQ performed intraoper atively during validated cervical traction. The Wilcoxon test was used to look at differences in vaginal descent and also to compare specific items of the I CIQ. RESULTS: In all 35 women, there was cervical descent below -1cm (stage 2) when a validated amount of cervical traction was applied. When examined at follow up, however, the cervix (point C) had returned to its preoperative, asymptomat ic level (stage 1) in all except one patient. There was no significant change in the position of point C pre- and 3 months post- operatively. Only one of the 3 5 women required a subsequent vaginal hysterectomy for prolapse (2.86%, 95% CI 0.07-14.91%). Significant improvements in ICIQ-VS scores were observed fol lowing anterior repair with uterine conservation. CONCLUSION: The degree of uteri ne descent with cervical traction under anaesthesia has not been shown to be helpful in assessing the need for vaginal hysterectomy at the time of vaginal repa ir. The 'cervical traction' test is therefore unnecessary, and the decision as to whether to perform a concomitant vaginal hysterectomy should be based on the clini cal findings on examination in the clinic. CI - Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved. AD - Derriford Hospital, Plymouth, UK. r.p.foon@talk21.com FAU - Foon, Richard AU - Foon R FAU - Agur, Wael AU - Agur W FAU - Kingsly, Alianu AU - Kingsly A FAU - White, Paul AU - White P FAU - Smith, Phillip AU - Smith P LA - eng PT - Journal Article DEP - 20111129 PL - Ireland TA - Eur J Obstet Gynecol Reprod Biol JT - European journal of obstetrics, gynecology, and reproductive biology JID - 0375672 SB - IM MH - Cervix Uteri/*surgery

MH MH MH MH MH MH MH MH MH MH MH MH MH EDATMHDACRDTPHSTPHSTPHSTPHSTAID AID PST SO PMIDOWN STATDA DCOMIS IS VI IP DP TI prior

Female Great Britain Humans Hysterectomy, Vaginal Middle Aged Pelvic Organ Prolapse/physiopathology/*surgery Postoperative Complications/prevention & control Prospective Studies Questionnaires Severity of Illness Index *Traction Uterine Prolapse/physiopathology/*surgery Vagina/*surgery 2011/12/02 06:00 2012/06/22 06:00 2011/12/02 06:00 2011/06/23 [received] 2011/10/11 [revised] 2011/11/06 [accepted] 2011/11/29 [aheadofprint] S0301-2115(11)00622-1 [pii] 10.1016/j.ejogrb.2011.11.002 [doi] ppublish Eur J Obstet Gynecol Reprod Biol. 2012 Feb;160(2):205-9. doi: 10.1016/j.ejogrb.2011.11.002. Epub 2011 Nov 29. 21692758 NLM MEDLINE 20110919 20111109 1600-0412 (Electronic) 0001-6349 (Linking) 90 10 2011 Oct Vaginal prolapse--perceptions and healthcare-seeking behavior among women

to gynecological surgery. PG - 1115-20 LID - 10.1111/j.1600-0412.2011.01225.x [doi] AB - OBJECTIVE: To investigate perceptions of vaginal prolapse and healthcare-s eeking behavior in women prior to gynecological surgery. DESIGN: Prospective, cross-sectional study using a web-based questionnaire. SETTING: Clinics in cluding patients in the Swedish National Register for Gynecological Surgery (Gynop-register). POPULATION: 214 women with vaginal prolapse and 347 wome n without prolapse as reference patients. METHODS: A questionnaire was devel oped for assessment of women's perception of prolapse and their healthcare-seek ing behavior. Data were collected through the Gynop-register. For comparisons between the study groups, Student's t-test and the chi-squared test were used. MAI N OUTCOME MEASURES: Perceptions of prolapse, healthcare-seeking behavior, an d source of information. RESULTS: The most common definition of prolapse rep

orted by the women was presence of a vaginal bulge. Reasons for seeking healthca re were interference with physical activity and increasing symptoms. One in five w omen with prolapse could not relate the symptoms to prolapse. Participants in t he prolapse group gained less information on their own condition from brochur es and public media compared to participants in the reference group (p<0.001). CONCLUSION: There appeared to be a lack of information on pelvic organ pro lapse in the public domain. Healthcare professionals have a significant role to play in informing women about symptoms related to the condition and the available treatment options. CI - (c) 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica(c) 2011 Nordic Federation of Societies of Obstetrics and Gynecology. AD - Department of Clinical Sciences, Obstetrics and Gynecology Department of A pplied Educational Science, Umea University, Umea, Sweden. Mojgan.Pakbaz@obgyn.um u.se FAU - Pakbaz, Mojgan AU - Pakbaz M FAU - Rolfsman, Ewa AU - Rolfsman E FAU - Mogren, Ingrid AU - Mogren I FAU - Lofgren, Mats AU - Lofgren M LA - eng PT - Comparative Study PT - Journal Article DEP - 20110727 PL - England TA - Acta Obstet Gynecol Scand JT - Acta obstetricia et gynecologica Scandinavica JID - 0370343 SB - IM MH - Aged MH - Chi-Square Distribution MH - Cross-Sectional Studies MH - Female MH - Gynecologic Surgical Procedures/methods/psychology/*statistics & numerical data MH - *Health Behavior MH - Humans MH - Hysterectomy, Vaginal/adverse effects/methods MH - Incidence MH - Internet MH - Middle Aged MH - Patient Acceptance of Health Care/psychology/*statistics & numerical data MH - Patient Satisfaction/statistics & numerical data MH - Perception MH - Prospective Studies MH - *Quality of Life MH - Questionnaires MH - Risk Assessment MH - Sickness Impact Profile

MH MH MH EDATMHDACRDTPHSTAID PST SO -

Treatment Outcome Urinary Incontinence, Stress/complications/diagnosis Uterine Prolapse/etiology/psychology/*surgery 2011/06/23 06:00 2011/11/10 06:00 2011/06/23 06:00 2011/07/27 [aheadofprint] 10.1111/j.1600-0412.2011.01225.x [doi] ppublish Acta Obstet Gynecol Scand. 2011 Oct;90(10):1115-20. doi: 10.1111/j.1600-0412.2011.01225.x. Epub 2011 Jul 27.

PMID- 21631443 OWN - NLM STAT- MEDLINE DA - 20110602 DCOM- 20110926 IS - 1479-828X (Electronic) IS - 0004-8666 (Linking) VI - 51 IP - 3 DP - 2011 Jun TI - A review of the technique and complications from 2,012 cases of laparoscop ically assisted vaginal hysterectomy at a single institution. PG - 239-43 LID - 10.1111/j.1479-828X.2011.01296.x [doi] AB - AIMS: To present our experience of modified laparoscopically assisted vagi nal hysterectomy (LAVH) and to evaluate the surgical outcomes and complication s. METHODS: Women with benign gynaecologic tumours that underwent a modified LAVH at the Samsung Medical Centre were analysed retrospectively. The technique is primarily a vaginal hysterectomy with a minor component of the laparoscopi c procedures (stage 2 laparoscopic hysterectomy (LH)) and had two modificati ons (vaginal anterior colpotomy and McCall culdoplasty) from the standard tech nique. RESULTS: A total of 2012 LAVH procedures were performed from January 2000 to May 2008. The mean duration of the operations and the uterine weight were 102+ /-32 min and 305+/-168 g, respectively. In 196 (9.7%) cases, the uterine weight was more than 500 g. Conversion to laparotomy was needed in 97 cases. Major intraoperative complications occurred in 45 cases (2.2%): bladder injury, 26 (1.29%); bowel injury, nine (0.45%); haemorrhage of major vessels, nine (0 .45%); and ureteral injury, one (0.05%). Major long-term complications occurred i n three cases: one fistula and two trocar site herniations. CONCLUSIONS: Stage 2 L H combined with modified vaginal anterior colpotomy and modified McCall culd oplasty is safe and effective for benign gynaecologic tumours and the prevention o f post-LAVH vaginal prolapse.

CI - (c) 2011 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology (c) 2011 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. AD - Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunk wan University School of Medicine, 50 Irwon-Dong, Gangnam-gu, Seoul, Korea. FAU - Song, Taejong AU - Song T FAU - Kim, Tae-Joong AU - Kim TJ FAU - Kang, Heeseok AU - Kang H FAU - Lee, Yoo-Young AU - Lee YY FAU - Choi, Chel Hun AU - Choi CH FAU - Lee, Jeong-Won AU - Lee JW FAU - Kim, Byoung-Gie AU - Kim BG FAU - Bae, Duk-Soo AU - Bae DS LA - eng PT - Journal Article PL - Australia TA - Aust N Z J Obstet Gynaecol JT - The Australian & New Zealand journal of obstetrics & gynaecology JID - 0001027 SB - IM MH - Adult MH - Colon/injuries MH - Female MH - Hemorrhage/etiology MH - Humans MH - Hysterectomy, Vaginal/*adverse effects/*methods/statistics & numerical dat a MH - Intraoperative Complications/*epidemiology MH - Laparoscopy/*adverse effects/*methods/statistics & numerical data MH - Laparotomy/adverse effects/statistics & numerical data MH - Middle Aged MH - Postoperative Complications/*epidemiology MH - Retrospective Studies MH - Surgical Instruments/adverse effects MH - Urethra/injuries MH - Urinary Bladder/injuries MH - Uterine Prolapse/prevention & control MH - Vesicovaginal Fistula/etiology EDAT- 2011/06/03 06:00 MHDA- 2011/09/29 06:00 CRDT- 2011/06/03 06:00 AID - 10.1111/j.1479-828X.2011.01296.x [doi] PST - ppublish SO - Aust N Z J Obstet Gynaecol. 2011 Jun;51(3):239-43. doi: 10.1111/j.1479-828X.2011.01296.x.