1/13. Primary non Hodgkin's lymphoma of the vagina.The genital tract as a primary site of malignant lymphoma in women is extremely rare. This report concerns a 64 year old patient with a primary vaginal non-Hodgkin lymphoma (large cell B lineage according to the REAL classification--centroblastic type according to the Kiel classification--"G" according Working Formulation) with an unusual clinical presentation--pelvic discomfort accompanied by frequent ureteral-like colic. Due to gynecological onset symptoms and the rarity of this extranodal primary site misinterpretation of a primary vaginal lymphoma as a benign inflammatory disease or endometriosis may occur. We emphasize the importance of their recognition and also the differential diagnosis of cervical lymphoma from other neoplastic and non-neoplastic lesions.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
2/13. diagnosis of ureteral obstruction during complex urogynecologic surgery.Intraoperative cystoscopy has been recommended to identify unsuspected bladder and ureteral injuries resulting from gynecologic surgery. We retrospectively reviewed 157 cases of complex urogynecologic procedures at our institution. Intraoperative cystoscopy revealed no bladder injuries. Five cases of unsuspected ureteral obstruction were identified (3.2%). One case of ureteral ligation was diagnosed and repaired intraoperatively. The remaining 4 cases were found to represent chronic ureteral obstruction resulting from pelvic organ prolapse (2 cases), ureteropelvic junction obstruction (1 case) and stenosis of the ureterovesical junction after transurethral resection (1 case). Intraoperative assessment required an average of 90 minutes. Our experience suggests that pre-existing ureteral obstruction may be more common than intraoperative injury. In selected populations, routine preoperative assessment of the ureters is indicated to simplify intraoperative evaluation.- - - - - - - - - - ranking = 6keywords = gynecologic (Clic here for more details about this article) |
3/13. Laparocopic ureteral reimplantation in ureteral stenosis after gynecologic laparoscopic surgery.Pelvic surgery is the most common cause of iatrogenic ureteral injury, and traditionally repair of such injuries requires laparotomy. We report the case of a 48-year-old woman with an iatrogenic ureteral injury after laparoscopic ophorectomy which was laparoscopically reimplanted using the Lich-Gregoire technique. Total operating time was 150 minutes and estimated blood loss was 100 mL. Two months after surgery she is asymptomatic with normal renal function.- - - - - - - - - - ranking = 4keywords = gynecologic (Clic here for more details about this article) |
4/13. Report of case: Partial ureteral obstruction masked by diuretics during intraoperative cystoscopy.Injury to the lower urinary tract is a potential complication in all major vaginal and urogynecologic surgical procedures. Several authors have recommended the routine use of intraoperative cystoscopy during urogynecologic procedures. To evaluate possible injury to the lower urinary tract during intraoperative cystoscopy, the concomitant use of diuretics with indigo carmine dye has been advocated; efflux of dye is hypothesized to indicate functional patency of the urinary tract. This report describes a case in which a partial ureteral obstruction was present at the time of intraoperative cystoscopy--despite the observation of diuresis caused by furosemide. This case indicates that the efflux of indigo carmine-stained urine from both ureteral orifices is not conclusive evidence of the absence of ureteral insult during intraoperative cystoscopy.- - - - - - - - - - ranking = 2keywords = gynecologic (Clic here for more details about this article) |
5/13. Management of the urinary tract involved by recurrent cancer.We present our experience from 1982 to the present in treating 33 patients with recurrent cancers (colorectal, 22; gynecologic, six; breast, two; melanoma, two; and lung, one) secondarily involving the genitourinary tract. All patients had severe symptoms that required palliation. Endoscopically placed stents relieved ureteral obstruction in 18 (75%) of 24 patients with widespread metastatic disease. Two patients required percutaneous nephrostomy tubes, and five required open operations. Good to excellent palliation was achieved in 23 of 24 patients. Mean survival in the group with diffuse metastases was 13 months (range, six to 29 months). Nine patients with localized recurrences underwent surgical procedures. For localized pelvic recurrences, total exenteration (with or without intraoperative radiotherapy) provided excellent palliation with low morbidity. At the time of this report, five of six such patients had no evidence of disease, and one had a small asymptomatic pelvic recurrence, with a mean follow-up of 13 months (range, five to 19 months).- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
6/13. leiomyoma of the bladder causing urethral and unilateral ureteral obstruction: a case report.We report a case of a vesical leiomyoma that obstructed not only the ureter but also the urethra. This entity is rare and to our knowledge it has not been described previously in the urological or gynecological literature.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
7/13. Retroperitoneal parasitic leiomyoma causing unilateral ureteral obstruction.A case is reported of obstruction of the pelvic ureter by a parasitic leiomyoma located in the retroperitoneal space. This condition is uncommon and has not been described in standard urological or gynecological textbooks.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
8/13. endometriosis causing ureteral obstruction.Although endometriosis accounts for 15 to 20% of all gynecologic laparotomies, ureteral obstruction secondary to this disease has received little attention. This may be partly the result of diagnostic difficulties secondary to the unusual symptoms and atypical age groups of the patients. Five cases of obstructive uropathy caused by endometriosis are reported. Each case was documented by urologic evaluation as well as excretory urograms, surgical exploration, and histologic confirmation. All patients had significant radiographic and laboratory renal compromise, including marked degrees of hydronephrosis. Follow-up included excretory urograms obtained in all cases, which showed cure of original symptoms with radiographic improvement in four of five patients, whereas one patient developed chronic renal failure and hypertension. The present report suggests that with thorough preoperative assessment of the urinary tract, including contrast radiography in select cases of pelvic pathology, curative gynecologic and urologic surgery can be performed.- - - - - - - - - - ranking = 2keywords = gynecologic (Clic here for more details about this article) |
9/13. Fractured ureteral catheters in gynecologic oncology.Two cases of fractured polyethylene double-pigtail ureteral catheters in pelvic cancer patients are reported. Current literature leaves a large void in guiding the management of these catheters. Surveillance techniques to help avoid complications in patients requiring these catheters are suggested.- - - - - - - - - - ranking = 4keywords = gynecologic (Clic here for more details about this article) |
10/13. endometriosis of the ureter.endometriosis of the ureter is an exceptional cause of ureteral obstruction. Pathogenesis and clinical picture are demonstrated on the basis of 2 cases, giving an example for the spread of endometrial tissue via the lymphatics. It is emphasized that young women should have a gynecological examination in case of pelvic ureteral obstruction. Final diagnosis of the isolate ureteral endometriosis can only be made by histological examination. Therapy is usually surgical followed by hormonal treatment. The routine use of excretory urograms in women suffering from endometriosis should prevent urological complications.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
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