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It is possible that for the physician, clinical evaluation alone of women with pelvic organ prolapse complicated with urinary and fecal incontinence or defecation disorders to be insufficient for an appropriate assessment. The role of ultrasonography is currently limited around the investigation of pelvic floor disorders. Besides that, the sonography presents the advantage of a low cost, noninvasively, accessible and very much represents a part of general practice in obstetrics and gynecology spread universally. Insensible urine loss, persistent dysuria, symptoms of prolapse, of obstructed defecation or fecal incontinence are just a few of indications for pelvic floor incontinence. Trough transrectal, transvaginal, transperineal/ translabial ultrasonography, functional and structural abnormalities like residual urine, detrusor wall thickness, bladder neck mobility, urethral integrity anterior, central, and posterior compartment prolapse can be evaluated. By means of 2-dimensional pelvic floor ultrasound or, if it's possible, 3-/4-dimensional, the delivery related levator trauma can be easily diagnosed, this being the most important known etiologic factor for pelvic organ prolapse. Definitely, diagnosis by imaging is more reproductible than a clinical based one. We review the feasibility of ultrasound assessment in pelvic floor disorders and complication after reconstructive surgery. [ABSTRACT FROM AUTHOR]

In a form of a flexible, transparent, plastic ring and releasing estrogen and progesterone, contraceptive vaginal ring is highly effective when used consistently and correctly. With a failure rate of 0.3%, equivalent with oral contraceptive, vaginal ring inhibits the ovulation completely when is left intravaginal for three weeks and secondary removed for one week. If systemic side effects are generally similar with those of oral contraceptive, local side effects are constituted particularly of vaginal symptoms. In this retrospective 10-year study our purpose was to determine the impact of the contraceptive ring on the tolerability and acceptability, the vaginal flora, changes on Pap exam, the incidence of thrombotic events and on bone mineral density. Our case-control study included 55 women, with the maximum age 50 years, diagnosed with premature ovarian failure. Our finding includes a good tolerability of the contraceptive vaginal ring; the vaginal flora was not influenced by the utilization of this method of contraception; the Pap exam results have not been changed also, no thrombotic events were recorded. The majority of patients who used contraceptive vaginal ring declared themselves satisfied. We intend to include the interpretation of our results in a literature review on the contraceptive efficacy and systemic and local side effects of the contraceptive vaginal ring. The effect of hormonal replacement therapy on pelvic structures is another subject that is worth to be debated. [ABSTRACT FROM AUTHOR]

Female pelvic organ prolapse refers to a loss of fibromuscular support of the pelvic viscera resulting the protrusion of the pelvic organs into the vaginal canal. These are worldwide problems that affect the quality of life of millions of women. The mortality due to this condition is rare, but symptomatic form is common, 11% of all women requiring at least one corrective surgical procedure. Thanks to standardized evaluation method, pelvic organ prolapse quantification system, the distribution of the severity of this condition among general population is highly studied. Through this article we intend to review the latest specialized literature discussing the clinical presentation, pathophysiology, evaluation and management of pelvic organ prolapse. Also, we proposed to summarize the risk factors leading to pelvic organ prolapse such as age, vaginal childbirth and obesity, diabetes, connective tissue disorders, neurological diseases and genetic predisposition to the development of pelvic organ prolapse. [ABSTRACT FROM AUTHOR]

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Introducere. Modificările statusului hormonal și ale imunității în sarcină predispun unele paciente la dezvoltarea infecțiilor vaginale micotice, bacteriene sau mixte. Vaginoza nespecifică, cu germeni anaerobi, este și ea des întâlnită la unele gravide. Majoritatea sunt mult timp asimptomatice, cel mai des întâlnite fiind infecțiile bacteriene. Apariția acestor infecții crește riscul unor complicații redutabile precum ruperea prematură a membranelor, nașteri premature sau avort. Screeningul pentru detectarea acestor infecții la pacientele asimptomatice nu este în general recomandat, însă odată diagnosticate, tratamentul este variabil și recidivele sunt frecvente. În cele ce urmează, prezentăm experiența noastră în abordarea gravidelor cu vaginoze. Material și metodă. Au fost incluse în studiu un număr total de 153 de gravide investigate și internate în decurs de 6 luni în Spitalul Universitar de Urgență București. Cu ocazia fiecărei consultații lunare uzuale s-au prelevat culturi din col și secreție vaginală, pacientele primind tratament în funcție de rezultate. Rezultate. Peste jumătate din gravidele luate în studiu au prezentat la un moment dat pe parcursul sarcinii simptomatologie sugestivă pentru vaginoza bacteriană, confirmată ulterior paraclinic. Simptomele au fost prezente mai frecvent după 20 de săptămâni de sarcină, pacientelor fiindu-le recomandată în cel puțin 2 momente o anumită soluție terapeutică (ovule intravaginale, creme intravaginale asociate sau nu cu terapie orală). Concluzii. Tratamentul vaginozei în sarcină prin administrare de comprimate vaginale de tip clorură de dequaliniu asociate cu unguente antimicotice vaginale, probiotice orale și metronidazol a dus la obținerea unor rezultate satisfăcătoare în cazul pacientelor noastre, în funcție de etiologie. [ABSTRACT FROM AUTHOR]