笔记详情
标题
Patients and Methods
内容
Between December 2006 and July 2007, twenty patients affected with anterior prolapse were included in this prospective survey. All the patients were referred to our Urology Unit because of their voiding problems. Mean age was 52 years (36–76). Mean parity, 3 vaginal childbirths. Sixteen patients with anterior vaginal wall prolapse reported socially annoying type II or III urinary stress incontinence, 4 patients reported voiding difficulty and related a history of urinary incontinence that has resolved with worsening of their prolapse. These patients were considered at risk for development of de novo stress incontinence after the prolapse is repaired. Twelve patients reported symptoms related to prolapse including the sensation of a vaginal mass or bulge, pelvic pressure, low back pain, and sexual difficulty. Twelve patients were sexually active, 8 had sexual difficulty (Table 1). The examination was first performed with the patient supine in lithotomy position. A retractor or Sims speculum was used to depress the posterior vagina to aid in visualizing the anterior vagina. After the resting examination, the patient was instructed to strain down forcefully or to cough vigorously. During this maneuver, the order of descent of the pelvic organs and their relationship at the peak of straining were noted. If physical findings did not correspond to symptoms or if the maximum extent of the prolapse could not be confirmed, the woman was reexamined in the standing position.
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来源
Adv Urol. 2009; 2009: 341268.
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