-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Twins case part I From: Griffiths Malcolm (Malcolm.Griffiths@ldh-tr.anglox.nhs.uk) Tue Apr 30 09:03:45 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Griffiths Malcolm: "Re: Twins case part I" Previous message: Griffiths Malcolm: "Re: Twins case part I" Maybe in reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Twins case part I" Next in thread: Griffiths Malcolm: "Re: Twins case part I" >From Malcolm.Griffiths@ldh-tr.anglox.nhs.uk Tue Apr 30 09:03:40 2002 Received: from exchange-2.ldh-tr.anglox.nhs.uk (hide228.nhs.uk [195.107.47.228]) by mail.medispecialty.com (8.11.6/8.11.6/dsb-1.1) with ESMTP id g3UE2xL08211 for <ob-gyn-l@obgyn.net>; Tue, 30 Apr 2002 09:03:39 -0500 Message-ID: <488899a8b696f9534afc40e563e604d83ccea415@> From: "Griffiths Malcolm (RC9) Luton & Dunstable Hospital TR" <Malcolm.Griffiths@ldh-tr.anglox.nhs.uk> To: "'ob-gyn-l@obgyn.net'" <ob-gyn-l@obgyn.net> Subject: Re: I've never seen a prolapse this bad. Date: Tue, 30 Apr 2002 15:02:07 +0100 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Would a shelf pessary not work? I would treat any ulcerated area with dressings or packs and topical oestrogens and then insert shelf pessary. I have only ever encountered one lady who a shelf didn't work in and she was a younger woman who had a very deficient perineum who declined surgery. Biggest shelf I could get simply popped out. Malcolm Griffiths Clinical director & consultant - obstetrics & gynaecology Luton & Dunstable Hospital NHS Trust, Luton, LU4 0DZ, UK Tel:+(44) 1582 497533 Fax: +(44) 1582 497376 -----Original Message----- From: Douglas Krell [mailto:officekrell@ix.netcom.com] Sent: 30 April 2002 12:49 To: Multiple recipients of list OB-GYN-L Subject: I've never seen a prolapse this bad. OB/GYN.net colleagues, 87 year old Caucasian female with massive vaginal protrusion. S/P hysterectomy 40 years ago. Recently widowed and moved from the hills of Arkansas where she was told nothing could be done. Pessaries failed years ago. She was seen in the ER for sudden hematuria and inability to void. Ulcerated, bleeding vaginal protrusion obviously containing bladder and small intestine. Catheterizaion revealed gross hematuria, clots in the bladder. Serum creatinine 8.8 All other labs WNL including EKG/CXR. Overnight with foley irrigation and drainage, serum creatinine back to 1.8. Urine grossly clear, but microscopically mixed cellularity. Renal U/S showed mild hydronephrosis. Urine culture pending, but antibiotics begun. -------------------------- What would be your treatment approach and surgical recommendations? -------------------------- How long would you wait before surgery? What procedure would be most -------------------------- likely to leave the patient continent of urine? What procedure would result in the least morbidity? -- Douglas Krell MD FACOG ********************************************************************** This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This footnote also confirms that this email message has been swept by MIMEsweeper for the presence of computer viruses. http://www.mimesweeper.com ********************************************************************** Next message: Griffiths Malcolm: "Re: Twins case part I" Previous message: Griffiths Malcolm: "Re: Twins case part I" Maybe in reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Twins case part I" Next in thread: Griffiths Malcolm: "Re: Twins case part I"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 04:51:24 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.