PakMediNet Discussion Forum : Obstetrics and Gynecology : dilemma ! a pt. with a vaginal lump.& .....
A 50 yr , postmenopausal woman came to the GYNAE OPD few days ago with complaints of a vaginal lump (4years)which she felt hampered her from sitting down, No other accompanied problem in her medical history.Surgically she had had a Manchester repair with an anterior & posterior repair. On examination there was a 2nd degree uterine descent. The past repair & subsiquent post menopausal vaginal shrinkage Had narrowed the vagina so much that the tightness of the interiotus had prevented the descent from being a procidentia. The cervix is fibrosed & almost flush with the vagina.
She refused a vaginal pessary in favour of surgery!
She has been offered A TAH & BSO. I would be grateful for anyones opinion. In particular What measures you would consider to prevent uretral/bladder injury especilly considering that her past injury risks damage to both these structures.The Patient is particularly annoyed since the last operation as it did not deliver what she wanted & wants to know of the potential risks involved this time !!!
Posted by: rzaskhan Posts: 8 :: 02-11-2003 :: | Reply to this Message
quote:
rzaskhan wrote:
A 50 yr , postmenopausal woman came to the GYNAE OPD few days ago with complaints of a vaginal lump (4years)which she felt hampered her from sitting down, No other accompanied problem in her medical history.Surgically she had had a Manchester repair with an anterior & posterior repair. On examination there was a 2nd degree uterine descent. The past repair & subsiquent post menopausal vaginal shrinkage Had narrowed the vagina so much that the tightness of the interiotus had prevented the descent from being a procidentia. The cervix is fibrosed & almost flush with the vagina.
She refused a vaginal pessary in favour of surgery!
She has been offered A TAH & BSO. I would be grateful for anyones opinion. In particular What measures you would consider to prevent uretral/bladder injury especilly considering that her past injury risks damage to both these structures.The Patient is particularly annoyed since the last operation as it did not deliver what she wanted & wants to know of the potential risks involved this time !!!
Posted by: chameed Posts: 173 :: 21-11-2003 :: | Reply to this Message
Thanks !
Posted by: rzaskhan Posts: 8 :: 11-01-2004 :: | Reply to this Message