1/40. pyometra as a lower abdominal doughnut sign on a Ga-67 scan.A 77-year-old woman was referred for Ga-67 scan to evaluate intermittent fever and chills that had lasted more than 20 days. The Ga-67 whole-body scan revealed a doughnut-shaped Ga-67 accumulation in the lower abdominal region. Combined Ga-67 and Tc-99m MDP bone scan confirmed that this activity was in the uterus, because the shape of the urinary bladder on bone scan was different from that of the Ga-67-avid lesion. pyometra was proved during operation, and pus culture was performed.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
2/40. Aggressive angiomyxoma presenting as polyp of uterine cavity.Aggressive angiomyxoma is a distinctive, locally aggressive tumor associated with a high risk of local recurrences that lacks metastatic potential. This tumor occurs mostly in the soft tissues of the pelvis and the perineum of adult women. It may rarely occur at less common sites, such as the vagina, urinary bladder, and soft tissue of the perineum and the perianal region in men, particularly the scrotum. We report a case of aggressive angiomyxoma presenting as an endometrial uterine polyp. To the best of our knowledge, the primary location of aggressive angiomyxoma within the uterine cavity has never been described. Immunohistochemical and ultrastructural findings support the conclusion that the progenitor cell displays myofibroblastic and fibroblastic features, with a capacity for smooth muscle differentiation.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
3/40. diagnosis and management of post-cesarean ureterouterine fistulae.Urinary leakage following obstetric or gynecologic surgery is a dreaded complication, most often caused by a urogenital fistula. Of these, uretero-uterine fistulae are relatively rare and pose a diagnostic and therapeutic dilemma. A 29-year-old woman presented with paradoxical incontinence of urine for 3 months. She had developed vaginal leakage of urine 2 weeks following an uneventful cesarean section. Conservative measures in the form of catheterization and bed rest did not relieve her symptoms. Subsequent examination and investigations revealed that she had a ureterouterine fistula. The case is discussed as well as the diagnostic modalities and treatment options.- - - - - - - - - - ranking = 15.973740475627keywords = incontinence (Clic here for more details about this article) |
4/40. A case report on vesico-uterine fistula: a very rare complication of the lower caesarean section.Vesico-uterine fistula is a very rare complication of lower caesarean section. There has only been two cases seen at the Department of urology in the past 2 decades. patients usually present in the early post operative period with the problem of continuous urinary incontinence. On the rare occasion, recurrent urinary tract infection, recurrent gross painless haematuria, or secondary infertility associated with secondary amenorrhoea would be the presenting complaint.- - - - - - - - - - ranking = 182.32383616293keywords = urinary incontinence, incontinence, urinary (Clic here for more details about this article) |
5/40. Endourologic management of obstetrical ureterouterine fistula: case report and review of literature.A 32-year-old woman presented to us with complaints of paradoxical incontinence for a period of 6 months following a cesarean section for obstructed labor performed elsewhere and subsequently treated elsewhere. Clinical and urographic assessment revealed an iatrogenic ureterouterine fistula, which was successfully treated endoscopically by dilatation of the ureteral stricture and ureteroscopic double-J stenting. It had been explained to the patient, and she had given consent for, ureteroneocystostomy in the event of failure. The literature regarding the management of this rare genitourinary fistula is reviewed and discussed.- - - - - - - - - - ranking = 16.973740475627keywords = incontinence, urinary (Clic here for more details about this article) |
6/40. urinary retention during the second trimester of pregnancy: a rare cause.Acute urinary retention during pregnancy is rare. Retention secondary to an impacted, gravid uterus is an emergency. Retroversion of the uterus, a history of pelvic inflammatory disease, and large fibroids are predisposing factors. The enlarging gravid uterus and uterine fibroids may trap the uterus inside the pelvic ring, preventing it from ascending into the abdominal cavity; furthermore, a history of inflammatory disease may trap the fundus of the uterus within scar tissue that also may prevent the enlarging, gravid uterus from ascending into the abdominal cavity. The impacted uterus should be manually replaced in the anterior position. Clean intermittent catheterization and placement of a vaginal pessary are temporizing measures. A knowledge of the causes of urinary retention during pregnancy can help prevent spontaneous abortion and other devastating consequences that can arise as a result of a delay in the diagnosis.- - - - - - - - - - ranking = 2keywords = urinary (Clic here for more details about this article) |
7/40. Sonographic diagnosis of vesicouterine fistula.Vesicouterine fistula is one of the least common types of urogenital fistula, accounting for only 1-4% of all cases. We report a case of vesicouterine fistula after vacuum delivery in a woman with a history of a previous cesarean section. The 29-year-old woman was hospitalized due to continuous serosanguinous vaginal leakage and hematuria. Transvaginal sonography demonstrated the presence of a fistulous tract between the uterus and the bladder. cystoscopy demonstrated a small opening in the posterior bladder wall and a cystogram revealed a fistulous tract between the posterior portion of the bladder and the uterine cavity. Since the patient could not tolerate her symptoms, we decided to close the fistulous tract surgically. The fistulous tract was excised and the bladder and uterus were closed primarily. The bladder was drained with a Foley catheter for 12 days and subsequent follow-up of the patient has demonstrated urinary continence.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
8/40. Vesicouterine fistulas following cesarean section: report on a case, review and update of the literature.Herein we report on 1 more case of vesicouterine fistula following cesarean section with review and update of the literature concerning this unusual topic. The disease presented with vaginal urinary leakage, cyclic hematuria and amenorrhea. The fistula was successfully repaired by delayed surgery. Actually, all over the world the prevalence of the disease is increasing for the frequent use of the cesarean section. Fistulas may develop immediately after a cesarean section, manifest in the late puerperium or occur after repeated procedures. Spontaneous healing is reported in 5% of cases. Vesicouterine fistulas present with vaginal urinary leakage, cyclic hematuira (menouria), amenorrhea, infertility, and first trimester abortions. The diagnosis is ruled out by showing the fistulous track between bladder and uterus as well as by excluding other more frequent urogenital fistulas. The disease treatment options include conservative treatment as well as surgical repair. Rarely, patients refuse any kind of treatment because of the benignity of symptoms and prognosis of the disease. Conservative management by bladder catheterization for at least 4-8 weeks is indicated when the fistula is discoveredjust after delivery since there is good chance for spontaneous closure of the fistulous track. Hormonal management should be tried in women presenting with Youssef's syndrome. Surgery is the maninstay and definitive treatment of vesicouterine fistulas after cesarean section. patients scheduled for surgery should undergo pretreatment of urinary tract infections. Surgical repair of vesico-uterine fistulas are performed by different approaches which include the vaginal, transvesical-retroperitoneal and transperitoneal access which is considered the most effective with the lowest relapse rate. Recently, laparoscopy has been proposed as a valid option for repairing vesicouterine fistulas. The endoscopic treatment may be effective in treating small vesicouterine fistulas. The pregnancy rate after repair is 31.25% with a rate of term deliveries of 25%. The disease may be prevented by emptying the bladder as well as by carefully dissecting the lower uterine segment. It is advisable that after vesicouterine fistula repair delivery should be performed by repeating a cesarean section since the risk of fistula recurrence. Usually, vesicouterine fistulas are diagnosed postoperatively. As a result, at least 95% of patients will undergo another operation for repairing the fistula. In the meantime they are bothered by related symptoms which impair their quality of life. As far as we are concerned intraoperative diagnosis is the gold standard in detecting vesicouterine fistulas for allowing immediate repair. We propose intraoperative sonography by the transvaginal (or transrectal) route for the Foley transurethral catheter producing bloody urine, for suspecting bladder injury while dissecting the uterine lower segment and for monitoring patients who already had had vesicouterine fistula repair. As a result patients will avoid the familial and social problems related to the disease as well another operation. Moreover, ultrasound Doppler examination may help in better investigating and understanding the pathophysiology of vesicouterine fistulas.- - - - - - - - - - ranking = 3keywords = urinary (Clic here for more details about this article) |
9/40. Conservative management of a traumatic uterovesical fistula ('Youssef's syndrome').'Youssef's syndrome' is characterised by cyclical haematuria, the absence of vaginal bleeding and complete urinary continence. It is a rare complication of caesarean section when bladder injury occurs and a fistula develops. While operative repair may be required, we describe a case that was managed conservatively and resolved without surgical intervention.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
10/40. Uterine incarceration in a 9-week multifetal pregnancy resulting from in vitro fertilization. A case report.BACKGROUND: Although retroversion of the uterus is a common finding, incarceration of the gravid uterus is a rare complication. It occurs usually between the 12th and 16th weeks of gestation and can lead to severe complications. No case of incarceration has been reported before in a multifetal gestation resulting from in vitro fertilization. CASE: A 35-year-old woman with a triplet pregnancy presented at 9 weeks' gestation with acute urinary retention and was diagnosed with uterine incarceration. This diagnosis was confirmed by ultrasound and was resolved using transvaginal pressure under epidural anesthesia. CONCLUSION: This is the first reported case of uterine incarceration in a triplet pregnancy that resulted from in vitro fertilization. There is no universal protocol for treatment of incarceration, but several techniques have been described.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
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