Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele

The treatment of cervical intraepithelial neoplasia aims at removing the squamocolumnar junction area, including abnormal tissues, up to the healthy tissue. Old postpartum perineal tears associated with cystorectocele, hypertrophic cervical elongation, and first and second degree uterine prolapse ar...

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Main Authors: Bogdan Marian Puca, Anca Daniela Braila, Cosmin Vasile Obleaga, Mihai Braila, Hany Saad, Cristian Lungulescu, Mihai Deca
Format: Article
Language:English
Published: MDPI AG 2019-10-01
Series:Journal of Mind and Medical Sciences
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Online Access:https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1208&context=jmms
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author Bogdan Marian Puca
Anca Daniela Braila
Cosmin Vasile Obleaga
Mihai Braila
Hany Saad
Cristian Lungulescu
Mihai Deca
author_facet Bogdan Marian Puca
Anca Daniela Braila
Cosmin Vasile Obleaga
Mihai Braila
Hany Saad
Cristian Lungulescu
Mihai Deca
author_sort Bogdan Marian Puca
collection DOAJ
description The treatment of cervical intraepithelial neoplasia aims at removing the squamocolumnar junction area, including abnormal tissues, up to the healthy tissue. Old postpartum perineal tears associated with cystorectocele, hypertrophic cervical elongation, and first and second degree uterine prolapse are pelvic static disorders. Particular aspects of pelvic-genital static disorder are related to the vulnerability of the pelvic-perineal floor during birth. On the occasion of birth, especially when there are different forms of dystocia during labor, the degradation of soft pelvic, genital, and vaginal-perineal tissues can occur. The objective of this study was to re-evaluate the conservative treatment of cervical dysplasia, depending on the degree of cervical lesions, the surface extension, the age of the patients, and the pathology associated with cervical lesions – colpocele, cystorectocele, and urinary incontinence in the old postpartum perineal tears. In order to solve the three types of concomitant lesions, we used the Manchester operation: the anterior colporrhaphy with the recalibration of the urethra and the suspension of the cystocele, the minimal colpectomy, the lesional cervical amputation with the anterior fixation of the parameters, and the posterior colpoperineorrhaphy with high myorrhaphy of the levator ani muscles. The decision on the management of cervical dysplasia has taken into account the degree of cervical lesions, the extension on the surface, the patients’ age and the pregnancy planning, and the pathology associated with cervical lesions. The Manchester operation is a conservative surgical procedure, effective in women under 45 years old, multiparous, with present genital activity, with dysplastic cervical lesions and cystorectocele. It also solves cystorectocele, cervical dysplasia, hypertrophic cervical elongation, and first and second degree uterine prolapse.
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spelling doaj-art-3cbcf1e039a54cf190778e00d8d1dcba2025-08-20T01:51:00ZengMDPI AGJournal of Mind and Medical Sciences2392-76742392-76742019-10-016234034510.22543/7674.62.P340345Conservative surgical treatment in cervical dysplastic lesions associated with cystorectoceleBogdan Marian Puca0Anca Daniela Braila1Cosmin Vasile Obleaga2Mihai Braila3Hany Saad4Cristian Lungulescu5Mihai Deca6Craiova University of Medicine and Pharmacy, Department of General SurgeryCraiova University of Medicine and Pharmacy, Obstetrics and GynecologyCraiova University of Medicine and Pharmacy, Department of General SurgeryCraiova University of Medicine and Pharmacy, Obstetrics and GynecologyCraiova University of Medicine and PharmacyCraiova University of Medicine and Pharmacy, Department of OncologyCraiova University of Medicine and Pharmacy, Department of UrologyThe treatment of cervical intraepithelial neoplasia aims at removing the squamocolumnar junction area, including abnormal tissues, up to the healthy tissue. Old postpartum perineal tears associated with cystorectocele, hypertrophic cervical elongation, and first and second degree uterine prolapse are pelvic static disorders. Particular aspects of pelvic-genital static disorder are related to the vulnerability of the pelvic-perineal floor during birth. On the occasion of birth, especially when there are different forms of dystocia during labor, the degradation of soft pelvic, genital, and vaginal-perineal tissues can occur. The objective of this study was to re-evaluate the conservative treatment of cervical dysplasia, depending on the degree of cervical lesions, the surface extension, the age of the patients, and the pathology associated with cervical lesions – colpocele, cystorectocele, and urinary incontinence in the old postpartum perineal tears. In order to solve the three types of concomitant lesions, we used the Manchester operation: the anterior colporrhaphy with the recalibration of the urethra and the suspension of the cystocele, the minimal colpectomy, the lesional cervical amputation with the anterior fixation of the parameters, and the posterior colpoperineorrhaphy with high myorrhaphy of the levator ani muscles. The decision on the management of cervical dysplasia has taken into account the degree of cervical lesions, the extension on the surface, the patients’ age and the pregnancy planning, and the pathology associated with cervical lesions. The Manchester operation is a conservative surgical procedure, effective in women under 45 years old, multiparous, with present genital activity, with dysplastic cervical lesions and cystorectocele. It also solves cystorectocele, cervical dysplasia, hypertrophic cervical elongation, and first and second degree uterine prolapse.https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1208&context=jmmscervical dysplasiacystocelerectoceleconservative surgical treatment
spellingShingle Bogdan Marian Puca
Anca Daniela Braila
Cosmin Vasile Obleaga
Mihai Braila
Hany Saad
Cristian Lungulescu
Mihai Deca
Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele
Journal of Mind and Medical Sciences
cervical dysplasia
cystocele
rectocele
conservative surgical treatment
title Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele
title_full Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele
title_fullStr Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele
title_full_unstemmed Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele
title_short Conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele
title_sort conservative surgical treatment in cervical dysplastic lesions associated with cystorectocele
topic cervical dysplasia
cystocele
rectocele
conservative surgical treatment
url https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1208&context=jmms
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