1/46. Protruding urethral leiomyoma obscuring vaginal introitus: case report. leiomyoma is quite rare in the female urethra. We report an additional case to 29 reported in the literature. A multiparous woman presented with a complaint of a gradually enlarging mass causing dyspareunia for the last seven months. The mass was originating from the upper part of the distal urethra with a relatively thin stalk covered by squamous epithelia, and immunohistopathological examination confirmed it as leiomyoma. ( info) |
2/46. Heterotopic ossification of the adductor longus muscle presenting as dyspareunia. dyspareunia after heterotopic ossification of the adductor longus is a rare complication. We describe a patient with symptomatic heterotopic ossification of the adductor muscle that developed years after sustaining a fracture of the inferior pubic ramus in association with an injury to the adductor longus muscle. The patient's pain was reduced and his dyspareunia resolved after excision of the adductor longus heterotopic ossification and subsequent physical therapy. ( info) |
3/46. dyspareunia and recurrent stress urinary incontinence after laparoscopic colposuspension with mesh and staples. A case report. BACKGROUND: A laparoscopic colposuspension technique using hernia staples and polypropylene mesh has been introduced for the treatment of stress urinary incontinence but is not without hazards. CASE: A 32-year-old woman developed recurrent stress urinary incontinence and dyspareunia approximately one year after undergoing laparoscopic colposuspension with hernia staples and polypropylene mesh. Metal staples palpated vaginally corresponded with the area of maximal tenderness, and the bladder neck was hypermobile. Upon surgical exploration of the space of Retzius, four staples were found in the bladder wall, and polypropylene mesh densely adherent to the bladder wall had eroded into the muscularis. CONCLUSION: Laparoscopic colposuspension with hernia staples and polypropylene mesh may be associated with early recurrence of incontinence and dyspareunia. ( info) |
4/46. Androgen-producing, atypically proliferating endometrioid tumor arising in endometriosis. A case of androgen-secreting borderline endometrioid tumor arising in endometriosis of the rectovaginal septum is presented. It occurred 10 years after total abdominal hysterectomy and bilateral salpingo-oophorectomy for extensive endometriosis of the fallopian tubes and ovaries, adenomyosis, and leiomyomas of the uterus. We believe 7 years of unopposed continuous oral estrogen replacement therapy contributed to the malignant transformation of the endometriosis. ( info) |
5/46. Sexual trauma--an unusual cause of a vesicovaginal fistula. A 20-year-old nullipara presented with a post-coital vesicovaginal fistula in the trigone of the bladder. She had normal genital development and no other cause was found. The fistula was repaired by vaginal route. ( info) |
6/46. Acquired pelvic anomaly preventing sexual intercourse in a female patient. This report describes a patient with dyspareunia related to an acquired pelvic anomaly that was treated surgically. ( info) |
| BACKGROUND:celiac disease may be subclinical and difficult to diagnose in adults. It has been associated with infertility and miscarriage but rarely with other gynecologic symptoms.CASE:A 43-year-old woman complaining of chronic abdominal and pelvic pain, deep dyspareunia, dysmenorrhea, diarrhea, and a 5-kg weight loss during the last 6 months was referred to our institution. Laboratory and clinical examinations were negative. At laparoscopy, numerous small leiomyomata were seen. A few filmy adhesions between the small bowel and the abdominal wall were lysed. With the exception of deep dyspareunia, all symptoms remitted after surgery, only to recur at 6 months of follow-up. A diagnostic work-up for celiac disease revealed the presence of antigliadin and antiendomysial antibodies. The diagnosis was confirmed at gastroduodenoscopy including biopsy. A gluten-free diet was prescribed, and the patient is now free of symptoms.CONCLUSION:celiac disease should be considered in women presenting with unexplained chronic pelvic pain, dysmenorrhea, and deep dyspareunia. ( info) |
8/46. Levatorplasty release and reconstruction of rectovaginal septum using allogenic dermal graft. The goal of reconstructive vaginal surgery include: restoration of normal anatomy, as well as maintaining visceral and sexual function. rectocele repair can be performed utilizing a number of techniques, however some of these techniques severely distort the posterior vaginal wall anatomy and subsequently may result in dyspareunia. We report two patients with postoperative dyspareunia following levatorplasty technique for the treatment of rectocele. The patients elected to have their levatorplasty released and their rectovaginal septum reconstructed utilizing allogenic dermal graft. Postoperatively both patients are sexually active without evidence of dyspareunia or rectocele. ( info) |
9/46. Brittle nails and dyspareunia as first clues to recurrences of malignant glucagonoma. glucagonoma syndrome is a paraneoplastic syndrome in which the occurrence and resolution of the characteristic necrolytic migratory erythema lesions parallel the course of the underlying glucagonoma. Nail abnormalities and dyspareunia are rarely reported in this syndrome. We describe a case of glucagonoma syndrome in which recurrent brittle nails and dyspareunia gave the patient the first clues of the recurrence of glucagonoma. It is possible that the significance of onychoschizia and dyspareunia has been overlooked in glucagonoma syndrome because patients might not report these problems to their doctors. Our case illustrates the importance of examining the nail and genital mucosa in patients with glucagonoma syndrome and including this syndrome in the differential diagnosis of onychoschizia and dyspareunia. ( info) |
10/46. Case report: labial fusion postpartum and clinical management of labial lacerations. lacerations of the external genitalia of various degrees are a common occurrence in the childbirth process. Evidence-based management of minor lacerations of the vulva has yet to emerge in the scientific literature. Spontaneous approximation of minor lacerations of the labia may uncommonly result in distorted anatomical healing, with resultant dyspareunia, among other distressing symptoms. Management of this occurrence, including pharmacologic and surgical strategies, is presented in this case study discussion. ( info) |