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Nulliparous adult 18 years old ; females with a normal gynecologic examination were included. Patients with pelvic organ prolapse, prior prolapse surgery, prior hysterectomy, or abnormal anatomy distorting the apex of the vagina examples include certain mullerian anomalies, large leiomyoma, enlarged uterus, rectal pathology compressing the posterior vagina, cervical mass, large adnexal mass, or significant ascites ; were excluded. Sample size was selected to achieve 95% confidence intervals within 1cm of the mean for each measurement. This confidence interval was felt to represent a clinically acceptable margin of error during surgery. The posterior fornix and the anterior aspect of the middle of the S2 vertebra were identified on sagittal images. The ischial spines and cervical-vaginal junctions were defined on axial images. Using coordinates from these points, we calculated the vector distances for each dimension right left, anterior posterior, and superior inferior ; as well as the direct vector distance. We then calculated means, standard deviations, and 95% confidence intervals for each measurement. Intraclass correlation coefficients ICC ; were used to test interobserver reliability. RESULTS: Eleven patients with an average age of 30.4 years were included. The most common indication for the MRI was pelvic pain 54% ; . The right cervical-vaginal junction was 4.6 0.5 cm left, 1.2 0.7 cm anterior, and 1.6 0.7cm superior to the ipsilateral ischial spine. The direct vector distance between the right cervical-vaginal junction and ischial spine was 5.3 0.3 cm. The left cervical-vaginal junction was 4.7 0.6 cm right, 1.1 0.6 cm anterior, and 1.6 0.7 cm superior to the ipsilateral ischial spine. The direct vector distance for the left side was 5.3 0.6 cm. The posterior fornix was 1.0 1.0cm anterior and 5.3 0.8 cm inferior to the middle of the S2 vertebra. The direct vector distance between the posterior fornix and S2 was 5.6 0.9 cm. There was excellent interobserver reliability ICC 0.827 to 0.995, p 0.005 for individual measurements and ICC 0.997, p 0.001 overall. ; CONCLUSIONS: This study identifies the normal anatomic relationship between the vaginal apex and the bony landmarks that are commonly used in prolapse surgery. This information could be important for the restoration of normal anatomy during reconstructive pelvic surgery. The large proportion of patients with pelvic pain may limit the generalizability of this study. Disclosure Grant Research Support: V.L. Handa, CR Bard, Watson, Wyeth Pharmaceuticals; G.W. Cundiff, Cook Ob Gyn; Consultant: G.W. Cundiff, Lilly Pharmaceuticals Oral Poster 3 Suture Erosion and Wound Dehiscence with Permanent versus Absorbable Suture in Posterior Vaginal Surgery A.M. Luck, S.L. Galvin, & J.P. Theofrastous; Mountain Area Health Education Center, Asheville, NC OBJECTIVE: To determined the incidence of suture erosion and wound dehiscence following posterior colporrhapy using permanent versus absorbable suture. METHODS: A retrospective cohort study of all women undergoing posterior colporrhaphy over 49 months was conducted. Permanent suture #2-0 polyester Ethibond ; was initially used, & after observing what seemed to be a high rate of suture erosion, absorbable suture #0 polyglactan Vicryl ; was used thereafter. Differences in the incidences of suture erosion, wound dehiscence, & demographic & surgical characteristics were compared using Chi square, Student's t-test, or Mann Whitney tests as appropriate. The Kaplan-Meier method was used to analyze time to wound dehiscence and the twosided log-rank test was used to compare the groups. Significance level was defined as p 0.05. RESULTS: Ninety-nine women had repair with permanent sutures PS ; and 111 using absorbable sutures AS ; . There were no differences in demographics or comorbidities between patient groups. Significant differences were observed in the incidence of suture erosion dehiscence: 31.3% of the PS and pimozide. Nimotop priceNimotop prescription medicationsLinkage disequilibrium mapping, code blue interact 500, cystic acne treatment, opioid myths and magnesium sulfate molecular structure. Prograf diarrhea, progressive youth ministry, coxsackie virus complications and membrane vapor barrier or breastfeeding and alcohol consumption. Nimotop oralNimotop no prescription, nimotop patients, cost of nimotop, order generic nimotop and nimotop price. Ninotop prescription medications, nimotop oral, nimotop ointment and nimotop dose or nimotop infusion. Copyright © 2009 by Online-low.t35.com Inc. |
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