Structural support of the urethra as it relates to stress urinary incontinence: The hammock hypothesis

https://www.hormonebalance.org/images/documents/Vaginal%20Drug%20administation%20Alexander%20F&S%2004.pdf

Why consider vaginal drug administration

Restorative proctocolectomy with an ileal pouch-anal anastomosis preserves anal sphincters, the normal route of defaecation and the normal body image and it has been suggested that the procedure might be associated with less gynaecological and sexual problems than conventional proctocolectomy. To shed further light on this subject 60 female patients were invited to participate in a study comprising a detailed interview, examination by a gynaecologist and investigation with hysterosalpingography and vaginography. Twenty-one women with a mean follow-up of 38 months after surgery agreed to participate. Their gynaecological state was considered normal although one woman complained of vaginal discharge. Five women experienced occasional dyspareunia and 2 patients had to take special precautions to avoid bowel leaks at intercourse. While the position of the vagina and uterus in the pelvis appeared normal, hysterosalpingography disclosed bilateral occlusion of the fallopian tubes in 2 and unilateral occlusion in another 9 patients with tubes adhering to the bottom of the lesser pelvis in 10 of the patients. Only one out of 14 patients succeeded in trying to conceive during the follow-up period. Among the remaining 39 women not specially studied 5 out of 14 had conceived after the operation.

Gynaecological and sexual function related to anatomical changes in the female pelvis after restorative proctocolectomy.

Management of vaginal vault prolapse

Paravaginal repair of lateral vaginal wall defects by fixation to the ischial periosteum and obturator membrane.

Vaginograms were done on 20 normal women to determine the exact axis, length, and direction of the normal vagina. The vagina was found to be a curved organ with a distinct upper portion that has an axis between the third and fourth sacral vetebrae. The importance of restoring this axis in pelvic surgery, especially for vault prolapse, is discussed.

M I Funt

Papers

Normal vaginal axis.