Browsing by Author "Gunasekara, P.C."

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    Altered pelvic floor physiology in women with uterovaginal prolapse (UVP)
    (Sri Lanka Medical Association, 1997) Deen, K.I.; Gunasekara, P.C.
    INTRODUCTION: Although an association between Uterovaginal prolapse (UVP) and urinary incontinence is known, the prevalence of anoreetal dysfunction in UVP remains largely unexplored. AIM: To evaluate the prevalence of u re ih roves Seal and anorectal dysfunction in UVP. METHODS: 27 women (median age - 52 years, range 31 - 68 years) with UVP were evaluated by functional and anoreetal physiologic assessment. Data were compared with 20 age matched controls without UVP. Urethrovesical fimcfion was assessed by a 5 point functional score (micturitition frequency, nociuria, urgency, stress incontinence and residual sensation of urine), where 0- no dysfunction, 1,2-minimal, 3,4 - moderate and 5 implied severe dysfunction. Anoredal function was evaluated by clinical assessment and anoreetal physiology. Anal canal pressures were measured by microballoon manomelry. RESULTS : Moderate to severe urethrovesical dysfunction was seen in 33% of patients compared with none of (lie control group (P = 0.052, test of proportions). Anorectal mucosal prolapse was seen in 63% of patients compared with 13% of controls (p = 0.045, test of proportions). Maximum resting (MRP) and squeeze anal pressures (MSP) did not differ significantly between patients and controls. MRP [median, (range)] - Patients; 51 mm Hg (20 - 87) vs. Controls; 60mm 1 Ig (25 - 80), P>0.05; MSP [median, (range)] - Patients; 82 mm Hg (39 - 165) vs. Controls; 100mm Ilg (60 - 185, p>0.05, Wiieoxon test. However, the length of Hie high pressure zone (I IPZ) was significantly less in patients compared with controls (111*2 I cm - Patients = 56% vs. IIPZ 1cm - Controls = 10%, P=0.038, test of proportions). Abnormal anal electroscnsilivity (> 14 inAmps) was seen in 52% of patients compared with none in the control group (P=0.024) and abnormal vaginal electrosensation (> 12mAmps) in 55% of patients vs. 10% Of controls (P = 0.031), test of proportions. CONCLUSION: A greater proportion of women with UVP exhibited either urethrovcssical or anoreetal dysfunction or both compared with controls indicating a pan-pelvic floor weakness. Theses abnormalities should be considered in overall management of women with UVP
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    Should Sri Lanka reconsider its rubella immunisation strategy?
    (Ceylon Medical Association, 1997) Gunasekara, P.C.; Gunasekara, D.P.
    No abstract available