Surgical Correction of the Sequelae of Obstetric Pubic Symphysis Ruptures



Cite item

Full Text

Abstract

Twenty eight patients with old postpartum ruptures of pubic symphysis complicated by functional bladder disorders were operated on during the period from 2000 to 2013. Time interval between vaginal delivery and pelvic ring stabilization made up from 1 month to 8 years. Clinical and roentgenologic examination enabled to detect predisposing factors for neurogenic, i.e. hyperactive bladder development that were treated surgically. In all cases plate osteosynthesis for pubic symphysis and fixation of sacroiliac joint with cannulated screws was performed. Subjective improvement of patients’ condition as well as the results of uroflowmetry and complex urodynamic investigation enabled to conclude that orthopaedic reconstruction of pelvic ring in old obstetric ruptures of pubic symphysis was an effective and reliable technique for the treatment of bladder dysfunction.

About the authors

Ya. G Gudushayri

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov

Email: gogich71@mail.ru

A. F Lazarev

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov

A. V Verzin

Scientific-Research Institute of Urology, Moscow, Russia

References

  1. Capiello G.A., Oliver B.C. Rupture of symphysis pubis by forceful and excessive abduction of the thighs with labor epidural anesthesia. J. Florida Med. Assoc. 1995; 82: 261-3.
  2. Kharrazi F.D., Rodgers W.B., Kennedy J.G., Lhowe D.W. Parturition-induced pelvic dislocation: a report of four cases J. Orthop. Trauma. 1997. 11 (4): 277-81.
  3. Snow R.E., Neubert A.G. Peripartum pubic symphysis separation: a case series and review of the literature. Gynecol. Surv. 1997; 52 (7): 438-43.
  4. Прокопьев Н.Я., Прокопьева P.C. Послеродовые растяжения и разрывы лонного сочленения. Фельдшер и акушерка. 1980; 11: 9-11.
  5. Демичев Н.П., Копишко В.М. Лекозимэлектрофорез в комплексном лечении симфизиолизиса: Методические рекомендации. Астрахань; 1990.
  6. Марусов А.П., Баландин А.Н., Минеев К.П. Хирургическая тактика при разрывах матки и тазового кольца в родах. Саранск: Издательство Мордовского университета; 1994.
  7. Shepherd J., Fry D. Symphysis pubis pain. Midwives. 1996; 109 (1302): 199-201.
  8. Минеев К.П., Стельмах К.К., Чаиркин И.Н. Рентгенографическое определение анатомических структур таза. Саранск: Издательство Мордовского университета; 1994.
  9. Чернуха Е.А. Родовой блок. М.: Триада-Х; 1999.
  10. Insulander В. Can oral contraceptives cause an unstable pelvic? Sjukgymnasten. 1978; 18: 27-8.
  11. MacLennan A.H., Nicolson R., Green R.C., Bath M. Serum relaxin and pelvic pain of pregnancy. Lancet. 1986; 2 (8501): 243-5.
  12. Lange R.H., Hansen S.T. Pelvic ring disruptions with symphysis pubis diastasis. Indication, technique, and limitations of anterior internal fixation. Clin. Orthop. Relat. Res. 1985; 201: 130-7.
  13. Chimura T., Banzai M., Yamakawa M., Sato S. Piogenic sacroiliitis in pregnancy. Jpn. J. Antibiot. 2001; 54 (9): 491-6.
  14. Анкин Л.Н. Остеосинтез металлическими пластинами. Киев: Здоровье; 1989.
  15. Kharrazi F.D., Rodgers W.B., Kennedy J.G., Lhowe D.W. Parturition-induced pelvic dislocation: a report of four cases J. Orthop. Trauma. 1997; 11 (4): 277-81.
  16. Hansell D.J., Bryant-Greenwood G.D., Greenwood F.C. Expression of the human relaxin HI gene in decidua, trophoblast and prostate. J. Clin. Endocrinol. Metab. 1991; 72: 899-904.
  17. Dhar S., Anderton J.M. Rupture of the symphysis pubis during labor. Clin. Orthop. Relat. Res. 1992; 283: 252-7.
  18. Spaeth D.G. Observatory clues to aid in the diagnosing of diastasis symphysis pubis: an underreported complication of parturition / D.G. Spaeth // J. Am. Osteopath. Assoc. - 1997. - Vol. 97. -N 3. - P.152-155.
  19. Глебова H.H., Конычева Е.А. Акушерские травмы сочленений таза. Акушерство и гинекология. 1983; 3: 46-7.
  20. Савельева Г.М., ред. Акушерство: Учебник. М.: Медицина; 2000: 612.
  21. Perkins J., Hammer R.L., Loubert P.V. Identification and management of pregnancy-related low back pain. J. Nurse-Midwifery. 1998; 43 (5): 331-40.
  22. Tee S.S., Hyzan Y., Razak M. Functional outcome of open reduction and internal fixation of pelvic ring injuriesэ. Med. J. Malaysia. 2000; 55 (1): 49-58.
  23. Stanton S.L., Cardozo L.D., Riddle P.R. Urological complications of traumatic diastasis of the symphysis pubis in the female. Br. J. Urol. 1981; 53: 453-4.
  24. Lovisetti G., Sala F., Battani A., Lovisetti L., Guicciardi E. Osteomyelitis of the pubic symphysis, abscess and late disjunction after delivery. A case report. Chir. Organi. Mov. 2000; 85 (1):85-8.
  25. Cass A.S., Behrens F., Comfort T., Matsuura J.K. Bladder problem in pelvic injuries treated with external fixation and direct urethral drainage. J. Trauma. 1983; 23 (1): 50-3.
  26. Козлов JI.A., Ключаров И.В., Нигматуллина H.A. Изменения лонного сочленения в акушерской практике: Методическое пособие для врачей, интернов и ординаторов. Казань: КГМУ; 2001.
  27. Айзенберг М.Ф. Возрастные и половые особенности лонного сочленения в рентгеновском изображении. Акушерство и гинекология. 1956; 3: 44-6.
  28. Glynn C.J., Carrie L.E. Cryoanalgesia to relieve pain in diastasis of the symphysis pubis during pregnancy. Br. Med. J. (Clin. Res. Ed). 1985; 290 (6486): 1946-7.
  29. Farbrot E. The relationship of the effect and pain of pregnancy to the anatomy of the pelvic. Acta. Radiol. 1952; 38: 403-19.
  30. Демидкин П.Н., Шнирельман А.И. Рентгенодиагностика в акушерстве и гинекологии. М.: Медицина; 1980.
  31. Czekanowski R., Chlabicz P. A case of pubic symphysis separation. Pol. Tyg. Lek. 1994; 49 (8-9): 203.
  32. Айзенберг М.Ф. Сочленения таза при беременности. Киев: Госмедиздат УССР; 1962.
  33. Bjiorklund K., Bergstrom S., Lindgren P.G., Ulmsten U. Ultrasonographic measurement of the symphysis pubis: a potential method of studying symphyseolysis in pregnancy. Gynecol. Obstet. Invest. 1996; 42 (3): 151-3.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2014 Eco-Vector



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-76249 от 19.07.2019.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies