RESUMO
BACKGROUND AND AIMS: Evacuation disorders associated with a rectocele can be improved by rectocele repair. This study investigated whether anorectal function tests results change after rectocele repair. PATIENTS AND METHODS: Fourteen patients with 2nd or 3rd degree rectocele and evacuation disorder were treated by posterior colporrhaphy and evaluated pre- and postoperatively (after 8 months, range 3-14) using questionnaires, anal manometry and endosonography, rectal barostat testing, and colonic transit time measurement with radio-opaque markers. Results from female controls were used for comparison. RESULTS: Preoperatively, rectocele patients had high maximal basal sphincter pressures, large sphincter lengths, and low maximal squeeze pressures, with an anal sphincter defect in seven and lower visceral sensitivity scores than in controls. Postprandial rectal responses (more than 10% decrease in postprandial volume after 1 h) were found in 3 of 14 patients compared to 2 of 11 parous and 9 of 11 nulliparous controls. After repair, a rectocele of 2nd degree was found in four patients. Questionnaire scores were significantly decreased for straining, evacuation disorder, manual support, and protrusion. Overall patient satisfaction with the operation scored 8.25 (range 3-10). Defecation frequencies and stool consistencies were unaltered. Anal pressures, rectal compliance-curves, visceral sensitivity, and colonic transit times were unaltered after the rectocele repair. CONCLUSION: Rectocele repair improved complaints of evacuation disorder and protrusion, but defecation frequency and stool consistency were not affected. Anorectal function was unaltered after rectocele repair. Selection of patients for rectocele repair should be performed based on evacuation and protrusion complaints, anorectal function, or colonic transit time measurements have a limited role.
Assuntos
Canal Anal/patologia , Canal Anal/fisiologia , Colo/fisiologia , Constipação Intestinal/etiologia , Constipação Intestinal/terapia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Retocele/cirurgia , Adulto , Idoso , Defecação/fisiologia , Feminino , Trânsito Gastrointestinal , Humanos , Pessoa de Meia-Idade , Pressão , Prognóstico , Retocele/complicações , Retocele/patologia , Resultado do Tratamento , VíscerasRESUMO
The aims of this study were to assess the incidence of LBW in the Gogo Chatinkha Banda Maternity wing of Queen Elizabeth Central Hospital(Chatinkha Martenity Wing) in Blantyre; to subdivide the LBW infants into preterm and TSGA groups; and to use the results to make suggestions for optimal management of LBW at Chatinkha Maternity Wing
Assuntos
Saúde Materno-Infantil , Ciências da Nutrição , PediatriaRESUMO
A case of three successive ruptured tubal pregnancies in the same patient is described. This is a rare occurrence. A review of the literature on the conservative approach in the surgical management of tubal pregnancy, is given.
Assuntos
Tubas Uterinas/cirurgia , Complicações na Gravidez , Gravidez Tubária/cirurgia , Adulto , Feminino , Humanos , Doença Inflamatória Pélvica , Gravidez , Gravidez Tubária/complicações , Gravidez Tubária/etiologia , Recidiva , Ruptura Espontânea , ZâmbiaRESUMO
Sixty-three cases of obstructed labour encountered at the University Teaching Hospital, Lusaka, Zambia, are analysed for the period April 1972 - December 1973. For the same period there were 27 348 deliveries and 1 432 Caesarean sections. The management of choice was Caesarean section, because of a lack of experienced medical staff and the poor results obtained, together with the serious complications which follow destructive operations before vaginal deliveries. Eighty-five per cent of the babies were delivered alive. There was no maternal death. Twenty-six mothers remained in hospital for longer than 10 days. There was 1 case of a burst abdomen.
