Nitrosamines are carcinogenic substances found in cigarette smoke, and it is known that female smokers have an increased risk of cervical carcinoma and premalignant change. Nitrosamines may also be formed due to the combination of amines and nitrites in an acidic medium. This study has shown a statistically significant association between anaerobic vaginosis which produce amines and cervical intraepithelial neoplasia 2 and 3. In addition nitrate reducing organisms are found in the acidic lower genital tract in a significant number of cases. It is therefore theoretically possible that nitrosamines may be an important agent in the development of premalignant disease of the cervix.
Objective: To evaluate the success of Le Forte's colpocleisis. Design: Retrospective review. Setting: Southmead Hospital, Bristol, UK. Methods: All women who had undergone a colpocleisis procedure from 1995-2002 at Southmead Hospital, Bristol were retrospectively reviewed. Main outcome measures: Satisfaction with operation, recurrence of prolapse, development of urinary incontinence. Results: Twenty-seven women underwent Le Forte's colpocleisis during the 7 years. The median length of time of the operation was 35 min; in two of the cohort the operation was performed under local anaesthesia. The procedure was successful in 89% of the women. There was 100% satisfaction in this remaining group. There were no new cases of urinary incontinence. Conclusion: Le Forte's colpocleisis is a useful procedure in the management of genital tract prolapse in elderly or medically unfit women. Patient selection is of crucial importance, but this caveat applies to all therapeutic interventions.
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