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Sample records for chronic urological pelvic

  1. Antidepressant Drugs for Chronic Urological Pelvic Pain: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Christos Papandreou

    2009-01-01

    Full Text Available The use of antidepressant drugs for the management of chronic pelvic pain has been supported in the past. This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs were identified (two for amitriptyline and two for sertraline with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not adequately supported by methodologically sound RCTs. From the existing studies amitriptyline may be effective in interstitial cystitis but publication bias should be considered as an alternative explanation. All drugs were generally well tolerated with no serious events reported.

  2. Randomized Multicenter Feasibility Trial of Myofascial Physical Therapy for Treatment of Urologic Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    FitzGerald, Mary P; Anderson, Rodney U; Potts, Jeannette; Payne, Christopher K; Peters, Kenneth M; Clemens, J Quentin; Kotarinos, Rhonda; Fraser, Laura; Cosby, Annamarie; Fortman, Carole; Neville, Cynthia; Badillo, Suzanne; Odabachian, Lisa; Sanfield, Anna; O’Dougherty, Betsy; Halle-Podell, Rick; Cen, Liyi; Chuai, Shannon; Landis, J Richard; Kusek, John W; Nyberg, Leroy M

    2010-01-01

    Objectives To determine the feasibility of conducting a randomized clinical trial designed to compare two methods of manual therapy (myofascial physical therapy (MPT) and global therapeutic massage (GTM)) among patients with urologic chronic pelvic pain syndromes. Materials and Methods Our goal was to recruit 48 subjects with chronic prostatitis/chronic pelvic pain syndrome or interstitial cystitis/painful bladder syndrome at six clinical centers. Eligible patients were randomized to either MPT or GTM and were scheduled to receive up to 10 weekly treatments, each 1 hour in duration. Criteria to assess feasibility included adherence of therapists to prescribed therapeutic protocol as determined by records of treatment, adverse events which occurred during study treatment, and rate of response to therapy as assessed by the Patient Global Response Assessment (GRA). Primary outcome analysis compared response rates between treatment arms using Mantel-Haenszel methods. Results Twenty-three (49%) men and 24 (51%) women were randomized over a six month period. Twenty-four (51%) patients were randomized to GTM, 23 (49%) to MPT; 44 (94%) patients completed the study. Therapist adherence to the treatment protocols was excellent. The GRA response rate of 57% in the MPT group was significantly higher than the rate of 21% in the GTM treatment group (p=0.03). Conclusions The goals to judge feasibility of conducting a full-scale trial of physical therapy methods were met. The preliminary findings of a beneficial effect of MPT warrants further study. PMID:19535099

  3. Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP Research Network.

    Science.gov (United States)

    Alger, Jeffry R; Ellingson, Benjamin M; Ashe-McNalley, Cody; Woodworth, Davis C; Labus, Jennifer S; Farmer, Melissa; Huang, Lejian; Apkarian, A Vania; Johnson, Kevin A; Mackey, Sean C; Ness, Timothy J; Deutsch, Georg; Harris, Richard E; Clauw, Daniel J; Glover, Gary H; Parrish, Todd B; Hollander, Jan den; Kusek, John W; Mullins, Chris; Mayer, Emeran A

    2016-01-01

    The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network is an ongoing multi-center collaborative research group established to conduct integrated studies in participants with urologic chronic pelvic pain syndrome (UCPPS). The goal of these investigations is to provide new insights into the etiology, natural history, clinical, demographic and behavioral characteristics, search for new and evaluate candidate biomarkers, systematically test for contributions of infectious agents to symptoms, and conduct animal studies to understand underlying mechanisms for UCPPS. Study participants were enrolled in a one-year observational study and evaluated through a multisite, collaborative neuroimaging study to evaluate the association between UCPPS and brain structure and function. 3D T1-weighted structural images, resting-state fMRI, and high angular resolution diffusion MRI were acquired in five participating MAPP Network sites using 8 separate MRI hardware and software configurations. We describe the neuroimaging methods and procedures used to scan participants, the challenges encountered in obtaining data from multiple sites with different equipment/software, and our efforts to minimize site-to-site variation.

  4. Pelvic actinomycosis: urologic perspective

    Directory of Open Access Journals (Sweden)

    Venkata K. Marella

    2004-10-01

    Full Text Available PURPOSE: Actinomycosis is a chronic granulomatous infection caused by the gram-positive anaerobic bacteria, Actinomyces israelli. This paper reviews the etiology and clinical presentation associated with Actinomycosis that often presents as a pelvic mass that mimics a pelvic malignancy. MATERIALS AND METHODS: A combination of patients treated by the authors in the recent past and a literature review of patients with pelvic Actinomycosis were assessed for diographic, clinical and predisposing co-factors. An analysis is made of age distribution, gender, diagnostic methods and treatment concepts. RESULTS: Thirty-three patients were included in the study that included 2 current patients and 31 obtained from literature review. There were 27 fiales (age range 16 - 69 years, mean 38 years and 6 males (16 - 55 years, mean 36 years. Presenting signs and symptoms were lower abdominal mass in 28 (85%; lower abdominal pain in 21 (63%; vaginal discharge or hiaturia in 7 (22%. Two patients developed fistulae (entero-vesico 1; vesico-cutaneous 1. Nineteen (70% of the 27 fiale patients had intra-uterine contraceptive devices (IUD. Four patients (12.5% (3 males and 1 fiale had urachus or urachal rinants. Cystoscopy in 12 patients noted an extrinsic mass effect, bullous edia and in one patient vegetative proliferation proven to be a chronic inflammatory change. Exploratory laparotomy was performed in 32 of the 33 patients who had excision of mass and involved organs. Diagnosis was established by histologic examination of rioved tissue. Penicillin (6 weeks therapy was utilized to control infections. CONCLUSION: Pelvic actinomycosis mimics pelvic malignancy and may be associated with the long-term use of intra-uterine contraceptive devices, and persistent urachal rinants. Rioval of infected mass and antibiotic therapy will eradicate the inflammatory process.

  5. Chronic Pelvic Pain

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Pelvic Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  6. The posterior medial cortex in urologic chronic pelvic pain syndrome: detachment from default mode network-a resting-state study from the MAPP Research Network.

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    Martucci, Katherine T; Shirer, William R; Bagarinao, Epifanio; Johnson, Kevin A; Farmer, Melissa A; Labus, Jennifer S; Apkarian, A Vania; Deutsch, Georg; Harris, Richard E; Mayer, Emeran A; Clauw, Daniel J; Greicius, Michael D; Mackey, Sean C

    2015-09-01

    Altered resting-state (RS) brain activity, as a measure of functional connectivity (FC), is commonly observed in chronic pain. Identifying a reliable signature pattern of altered RS activity for chronic pain could provide strong mechanistic insights and serve as a highly beneficial neuroimaging-based diagnostic tool. We collected and analyzed RS functional magnetic resonance imaging data from female patients with urologic chronic pelvic pain syndrome (N = 45) and matched healthy participants (N = 45) as part of an NIDDK-funded multicenter project (www.mappnetwork.org). Using dual regression and seed-based analyses, we observed significantly decreased FC of the default mode network to 2 regions in the posterior medial cortex (PMC): the posterior cingulate cortex (PCC) and the left precuneus (threshold-free cluster enhancement, family-wise error corrected P pain, sensory, motor, and emotion regulation processes (eg, insular cortex, dorsolateral prefrontal cortex, thalamus, globus pallidus, putamen, amygdala, hippocampus). The left precuneus demonstrated decreased FC to several regions of pain processing, reward, and higher executive functioning within the prefrontal (orbitofrontal, anterior cingulate, ventromedial prefrontal) and parietal cortices (angular gyrus, superior and inferior parietal lobules). The altered PMC connectivity was associated with several phenotype measures, including pain and urologic symptom intensity, depression, anxiety, quality of relationships, and self-esteem levels in patients. Collectively, these findings indicate that in patients with urologic chronic pelvic pain syndrome, regions of the PMC are detached from the default mode network, whereas neurological processes of self-referential thought and introspection may be joined to pain and emotion regulatory processes.

  7. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.

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    Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J

    2016-06-01

    Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.

  8. Management of pelvic fractures with concomitant urologic injuries.

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    Taffet, R

    1997-07-01

    Controversy exists regarding the management of pelvic fractures with concomitant injuries to the lower urologic tract. This can be seen in both the urologic and orthopedic literature as it pertains to the ideal form of treatment for either problem and the timing of surgical intervention, if it is needed. This article reviews the anatomy, mechanism of injury, diagnostic approach, and treatment.

  9. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

    Fall, Magnus; Baranowski, Andrew P.; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J.; Oberpenning, Frank; Williams, Amanda C. de C.

    2010-01-01

    Context: These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. Objective: To revise guidelines for the diagnosis,

  10. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

  11. Unique Microstructural Changes in the Brain Associated with Urological Chronic Pelvic Pain Syndrome (UCPPS) Revealed by Diffusion Tensor MRI, Super-Resolution Track Density Imaging, and Statistical Parameter Mapping: A MAPP Network Neuroimaging Study.

    Science.gov (United States)

    Woodworth, Davis; Mayer, Emeran; Leu, Kevin; Ashe-McNalley, Cody; Naliboff, Bruce D; Labus, Jennifer S; Tillisch, Kirsten; Kutch, Jason J; Farmer, Melissa A; Apkarian, A Vania; Johnson, Kevin A; Mackey, Sean C; Ness, Timothy J; Landis, J Richard; Deutsch, Georg; Harris, Richard E; Clauw, Daniel J; Mullins, Chris; Ellingson, Benjamin M

    2015-01-01

    Studies have suggested chronic pain syndromes are associated with neural reorganization in specific regions associated with perception, processing, and integration of pain. Urological chronic pelvic pain syndrome (UCPPS) represents a collection of pain syndromes characterized by pelvic pain, namely Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS), that are both poorly understood in their pathophysiology, and treated ineffectively. We hypothesized patients with UCPPS may have microstructural differences in the brain compared with healthy control subjects (HCs), as well as patients with irritable bowel syndrome (IBS), a common gastrointestinal pain disorder. In the current study we performed population-based voxel-wise DTI and super-resolution track density imaging (TDI) in a large, two-center sample of phenotyped patients from the multicenter cohort with UCPPS (N = 45), IBS (N = 39), and HCs (N = 56) as part of the MAPP Research Network. Compared with HCs, UCPPS patients had lower fractional anisotropy (FA), lower generalized anisotropy (GA), lower track density, and higher mean diffusivity (MD) in brain regions commonly associated with perception and integration of pain information. Results also showed significant differences in specific anatomical regions in UCPPS patients when compared with IBS patients, consistent with microstructural alterations specific to UCPPS. While IBS patients showed clear sex related differences in FA, MD, GA, and track density consistent with previous reports, few such differences were observed in UCPPS patients. Heat maps illustrating the correlation between specific regions of interest and various pain and urinary symptom scores showed clustering of significant associations along the cortico-basal ganglia-thalamic-cortical loop associated with pain integration, modulation, and perception. Together, results suggest patients with UCPPS have extensive microstructural

  12. Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

    OpenAIRE

    2016-01-01

    Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report...

  13. Biofeedback therapy for chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhang-QunYE; DanCAI; Ru-ZhuLAN; Guang-HuiDU; Xiao-YiYUAN; ZhongCHEN; Yang-ZhiMA; You-MingHU; Gui-YunZENG

    2003-01-01

    Aim: To evaluate the efficacy of biofeedback therapy in patients with chronic pelvic pain syndrome(CPPS). Methods: From November 2001 to April 2002, patients visiting the Urological Outpatient Clinic of this Hospital were evaluated by means of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI)and classified by the NIH classification standard. Sixty-two patients of CPPS category Ⅲ were involved in this study. All patients had been treated by conventional approaches such as antibiotics and alpha-blockers for more than half a year without any improvement. The expressed prostatic secretion results were as follows: WBC 5 to 9/high power field, lipid +-+++ and bacterial culture negative. Their NIH-CPSI were 12-40. All the 62 cases complained of micturitional irritation (frequency, urgency, splitted stream and sense of residual urine), 32 cases, of pain or discomfort at the testicular, penile, scrotal, pelvic or rectal region and 13 cases, of white secretion-dripping. The patients were treated by the Urostym Biofeedback equipment (Laborie Co., Canada) 5 times a week for 2 weeks with a stimulus intensity of 15 mA-23 mA and duration of 20 minutes. Results: Sixty patients were significantly improved or cured, while no significant improvement in the remaining 2. No apparent side effect was observed. The NIH-CPSI dropped to 6 to 14 with an average reduction of 21 (P<0.01). In the 60 improved cases, pain was relieved after 2-3treatment courses and other symptoms disappeared after 4-5 courses. Conclusion: Biofeedback therapy is a safe and effective treatment for CPPS. Large randomized clinical trials are needed to confirm its efficacy and to explore the mechanism of action. ( Asian J Androl 2003 Jun; 5:155-158 )

  14. Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis.

    Science.gov (United States)

    Lee, Dae Wook; Lim, Chang Hun; Han, Jae Young; Kim, Woong Mo

    2016-10-01

    Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

  15. Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh.

    Science.gov (United States)

    Gyang, Anthony N; Feranec, Jessica B; Patel, Rakesh C; Lamvu, Georgine M

    2014-03-01

    In 2001, the US Food and Drug Administration (FDA) approved the first transvaginal mesh kit to treat pelvic organ prolapse (POP). Since the introduction of vaginal mesh kits, some vaginal meshes have been associated with chronic pelvic pain after reconstructive pelvic floor surgery. Pelvic pain results in between 0 % and 30 % of patients following transvaginal mesh placement. Common causes of chronic pelvic pain include pelvic floor muscle spasm, pudendal neuralgia, and infection. Paucity of data exists on the effective management of chronic pelvic pain after pelvic reconstructive surgery with mesh. We outline the management of chronic pelvic pain after transvaginal mesh placement for reconstructive pelvic floor repair based on our clinical experience and adaptation of data used in other aspects of managing chronic pelvic pain conditions.

  16. Physical Activity and Chronic Prostatitis/Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    Zhang, Ran; Chomistek, Andrea K.; Dimitrakoff, Jordan D.; Giovannucci, Edward L.; Willett, Walter C.; Rosner, Bernard A.; Wu, Kana

    2014-01-01

    Purpose Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urologic disorder among men, but its etiology is still poorly understood. Our objective was to examine the relationship between physical activity and incidence of CP/CPPS in a large cohort of male health professionals. Methods We conducted a prospective cohort study among men in the Health Professionals Follow-up Study followed from 1986 to 2008. The study population included 20,918 men who completed all CP/CPPS questions on the 2008 questionnaire. Leisure-time physical activity, including type and intensity of activity, was measured by questionnaire in 1986. A National Institute of Health Chronic Prostatitis Symptom Index pain score was calculated based on the responses on the 2008 questionnaire. Participants with pain scores ≥ 8 were considered CP/CPPS cases (n=689). Results Higher leisure-time physical activity was associated with lower risk of CP/CPPS. The multivariable-adjusted odds ratio (OR) comparing >35.0 to ≤3.5 MET-h/wk of physical activity was 0.72 (95% confidence interval (CI): 0.56, 0.92, p for trend <0.001). Observed inverse associations between physical activity and CP/CPPS were similar for both moderate- and vigorous-intensity activities. Sedentary behavior, measured as time spent watching television, was not associated with risk of CP/CPPS (p for trend 0.64). Conclusions Findings from this study, the first large scale and most comprehensive study to date on this association, suggest that higher levels of leisure-time physical activity may lower risk of CP/CPPS in middle-aged and older men. PMID:25116086

  17. Lifestyle and Risk of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in a Cohort of United States Male Health Professionals

    Science.gov (United States)

    Zhang, Ran; Sutcliffe, Siobhan; Giovannucci, Edward; Willett, Walter C.; Platz, Elizabeth A.; Rosner, Bernard A.; Dimitrakoff, Jordan D.; Wu, Kana

    2015-01-01

    Purpose Although chronic prostatitis/chronic pelvic pain syndrome is a prevalent urological disorder among men of all ages, its etiology remains unknown. Only a few previous studies have examined associations between lifestyle factors and chronic prostatitis/chronic pelvic pain syndrome, of which most were limited by the cross-sectional study design and lack of control for possible confounders. To address these limitations we performed a cohort study of major lifestyle factors (obesity, smoking and hypertension) and chronic prostatitis/chronic pelvic pain syndrome risk in the HPFS (Health Professionals Follow-up Study), a large ongoing cohort of United States based male health professionals. Materials and Methods The HPFS includes 51,529 men who were 40 to 75 years old at baseline in 1986. At enrollment and every 2 years thereafter participants have completed questionnaires on lifestyle and health conditions. In 2008 participants completed an additional set of questions on recent chronic prostatitis/chronic pelvic pain syndrome pain symptoms modified from the NIH (National Institutes of Health)-CPSI (Chronic Prostatitis Symptom Index) as well as questions on approximate date of symptom onset. The 653 participants with NIH-CPSI pain scores 8 or greater who first experienced symptoms after 1986 were considered incident chronic prostatitis/chronic pelvic pain syndrome cases and the 19,138 who completed chronic prostatitis/chronic pelvic pain syndrome questions but did not report chronic prostatitis/chronic pelvic pain syndrome related pain were considered noncases. Results No associations were observed for baseline body mass index, waist circumference, waist-to-hip ratio, cigarette smoking and hypertension with chronic prostatitis/chronic pelvic pain syndrome risk (each OR ≤1.34). Conclusions In this large cohort study none of the lifestyle factors examined was associated with chronic prostatitis/chronic pelvic pain syndrome risk. As the etiology of chronic

  18. Interstitial Cystitis: Chronic Pelvic Pain Syndrome

    OpenAIRE

    Fatih Atuğ; Naime Canoruç

    2005-01-01

    Interstitial cystitis, is a chronic inflammatory disease of the bladder of unknown etiology characterized by urinary frequency, urgency, nocturia and suprapubic pain. The syndrome presents differently in many patients, with the unifying factor being chronic pelvic pain and disruption of daily life activities.Although there are abundance of theories, the etiology of the condition remains unclear. This review focuses on recently published literature on the epidemiology, etiology, diagnosis and ...

  19. Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy.

    Science.gov (United States)

    Moldwin, Robert M; Fariello, Jennifer Yonaitis

    2013-10-01

    Myofascial trigger points (MTrP), or muscle "contraction knots," of the pelvic floor may be identified in as many as 85 % of patients suffering from urological, colorectal and gynecological pelvic pain syndromes; and can be responsible for some, if not all, symptoms related to these syndromes. Identification and conservative treatment of MTrPs in these populations has often been associated with impressive clinical improvements. In refractory cases, more "aggressive" therapy with varied trigger point needling techniques, including dry needling, anesthetic injections, or onabotulinumtoxinA injections, may be used, in combination with conservative therapies.

  20. Chronic pelvic ischemia: etiology, pathogenesis, clinical presentation and management.

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    Kapoor, H; Gupta, E; Sood, A

    2014-06-01

    Overactive bladder (OAB) and bladder pain syndrome (BPS) although common, are vaguely defined and difficult to diagnose and manage etiologies of storage-type lower urinary tract symptoms (LUTS). The lack of optimal management options is a direct consequence of deficient understanding of the pathophysiologic mechanisms underlying these conditions. These conditions are especially prevalent in females, and cumulative contemporary epidemiological, clinical and laboratory evidence implicates ischemia as one of the key players in the pathophysiologic foundation of both these disorders. Taken together they make up "the" diagnostic as well as therapeutic black-hole in urologic practice. Much akin to chronic ischemic heart disease, chronic ischemia-reperfusion has been shown to cause degenerative changes at cellular and subcellular level in the bladder mucosa, smooth muscle fibers, and vesical neural and microvascular structures leading to a hypersensitive, hyperactive bladder initially, which with time invariably progresses into a failed, fibrotic and pressurized bladder. Diagnosis and management of these diseases are currently symptom focused and remains a source of much frustration. Consideration of role of ischemia connotates hope and could lead to a paradigm shift in the management of these patients with a completely new therapeutic armamentarium attacking the pathology itself. The aim of the current review is to provide a clinical thought perspective on the etiology/pathophysiology of chronic pelvic ischemia and its role as a precursor to the aforementioned conditions, and shed some light upon the potential management strategies to consider.

  1. Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain.

    Science.gov (United States)

    Pastore, Elizabeth A; Katzman, Wendy B

    2012-01-01

    Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by health care providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, biofeedback, and electrical stimulation. An interdisciplinary team is essential for identifying and successfully treating MFPP.

  2. Chronic Prostatitis/Chronic Pelvic Pain Syndrome Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Cem Nedim Yuceturk

    2014-08-01

    Full Text Available Chronic prostatitis is a chronic syndrome that effects men with a wide range of age. The etiology, natural history and appropriate therapy models are still unclear. According to the classification of National Institutes of Health; 4 types of prostatitis were defined; acute bacterial prostatitis (category I, chronic bacterial prostatitis (category II, chronic nonbacterial prostatitis/chronic pelvic pain syndrome (category III and asymptomatic prostatitis (category IV.Since microorganisms can only be isolated from a small percent of patients, empiric treatment is given to the most of the men. Multidisciplinary approach to the patients with suspected chronic prostatitis will help clinicians to play an active role in the treatment and prevent unnecessary medical therapies. [Archives Medical Review Journal 2014; 23(4.000: 691-702

  3. Pelvic floor muscle dysfunctions are prevalent in female chronic pelvic pain

    DEFF Research Database (Denmark)

    Loving, S; Thomsen, Thordis; Jaszczak, Poul P.

    2014-01-01

    BACKGROUND: No current standardized set of pelvic floor muscle (PFM) outcome measures have been specifically tested for their applicability in a general female chronic pelvic pain (CPP) population. We aimed to compare PFM function between a randomly selected population-based sample of women...

  4. Category IIIB chronic prostatitis/chronic pelvic pain syndrome and sexual dysfunction

    Directory of Open Access Journals (Sweden)

    A. V. Sivkov

    2015-01-01

    Full Text Available The paper reviews the literature on the topical urological problem category IIIB chronic nonbacterial prostatitis (CNBP/chronic pelvic pain syndrome (CPPS and sexual dysfunction in this abnormality. As of now, there is no precise information on the etiology and pathogenesis of CNBP/CPPS and sexual dysfunction in this disease. Despite a considerable body of published work, the disease remains inadequately studied and untreatable.The diagnosis of CNBP/CPPS is most likely to mask a high range of different conditions, including those when the prostate is only indirectly or by no means involved in the pathological process. Some factors, such as pudendal neuropathy with the development of chronic prostatitis, CPPB, vesical obstruction, and neuroautonomic disorders, may be etiological and pathogenetic simultaneously.The problem of CNBP therapy remains unsolved so far in spite of a diversity of used treatments. Therapeutic approaches are generally aimed only at improving quality of life in a patient. All existing treatments for chronic prostatitis imply for reducing the level of sexual dysfunction too as a desirable result. Hopes for improving the results of treatment are associated with progress in the diagnosis and differential diagnosis of these conditions, with the improvement and detailed elaboration of clinical classification of the disease, and with the accumulation of the valid clinical results characterizing the efficacy and safety of drugs in well-defined patient groups.

  5. A standard for terminology in chronic pelvic pain syndromes

    DEFF Research Database (Denmark)

    Doggweiler, Regula; Whitmore, Kristene E; Meijlink, Jane M

    2016-01-01

    AIMS: Terms used in the field of chronic pelvic pain (CPP) are poorly defined and often confusing. An International Continence Society (ICS) Standard for Terminology in chronic pelvic pain syndromes (CPPS) has been developed with the aim of improving diagnosis and treatment of patients affected...... by chronic pelvic pain syndromes. The standard aims to facilitate research, enhance therapy development and support healthcare delivery, for healthcare providers, and patients. This document looks at the whole person and all the domains (organ systems) in a systematic way. METHODS: A dedicated working group...... for symptoms, signs, and evaluation (diagnostic work-up) of female and male patients with chronic pelvic pain syndromes, serving as a platform for ongoing development in this field. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc....

  6. Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome.

    Science.gov (United States)

    Lin, Guiting; Reed-Maldonado, Amanda B; Lin, Maofan; Xin, Zhongcheng; Lue, Tom F

    2016-07-01

    Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is one of the most common urologic diseases, and no curative treatments have been identified. Low-intensity pulsed ultrasound (LIPUS) has been successfully used in promoting tissue healing, inhibiting inflammation and pain, differentiating stem cells, and stimulating nerve regeneration/muscle regeneration, as well as enhancing angiogenesis. Very recently, LIPUS has been proven an effective approach for CP/CPPS. This review summarizes the possible mechanisms responsible for the therapeutic effect of LIPUS for CP/CPPS. To search publications relevant to the topics of this review, the search engine for life sciences of Entrez was used. We reviewed the available evidence from 1954 through 2015 concerning LIPUS for CP/CPPS. According to the literature, both transrectal and transperineal approaches of LIPUS are effective for CP/CPPS.

  7. Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Guiting Lin

    2016-07-01

    Full Text Available Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS is one of the most common urologic diseases, and no curative treatments have been identified. Low-intensity pulsed ultrasound (LIPUS has been successfully used in promoting tissue healing, inhibiting inflammation and pain, differentiating stem cells, and stimulating nerve regeneration/muscle regeneration, as well as enhancing angiogenesis. Very recently, LIPUS has been proven an effective approach for CP/CPPS. This review summarizes the possible mechanisms responsible for the therapeutic effect of LIPUS for CP/CPPS. To search publications relevant to the topics of this review, the search engine for life sciences of Entrez was used. We reviewed the available evidence from 1954 through 2015 concerning LIPUS for CP/CPPS. According to the literature, both transrectal and transperineal approaches of LIPUS are effective for CP/CPPS.

  8. Risk factors for chronic postsurgical abdominal and pelvic pain

    NARCIS (Netherlands)

    Rijckevorsel, D.C.M. van; Vries, M. de; Schreuder, L.T.W.; Wilder-Smith, O.H.G.; Goor, H. van

    2015-01-01

    SUMMARY Chronic postsurgical pain (CPSP) may develop after any surgical procedure, and is a common feature after abdominal and pelvic surgery with a prevalence varying between 10 and 40%. The pathological mechanisms leading to chronic CPSP are probably inflammation, tissue and nerve damage and alter

  9. High incidence of chronic pain following surgery for pelvic fracture

    DEFF Research Database (Denmark)

    Meyhoff, Christian Sylvest; Thomsen, Camilla Højland; Rasmussen, Lars Simon

    2006-01-01

    OBJECTIVES: To determine the incidence of chronic pain after surgery for pelvic fracture using a strict definition and measures of intensity and health-related quality of life. METHODS: In April 2004, a questionnaire was sent to 221 patients who underwent surgery for pelvic fracture in the period...... 1996 to 2000. Chronic pain was defined as pain at present that related back to the pelvic fracture and was not a consequence of other disease. Health-related quality of life was measured using the 15D questionnaire. RESULTS: The response rate was 72.9% after a median follow-up of 5.6 years. Chronic...... pain was seen in 48.4% (95% confidence interval, 40.7%-56.2%). These patients had a combination of somatic nociceptive, visceral nociceptive, and neuropathic pain and had significantly lower health-related quality of life. Also, the use of opioids (14.1% vs. 4.8%) and nonsteroidal anti...

  10. Role of laparoscopy in evaluation of chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Hebbar Shripad

    2005-01-01

    Full Text Available Introduction: Chronic pelvic pain (CPP is a common medical problem affecting women. Too often the physical signs are not specific. This study aims at determining the accuracy of diagnostic laparoscopy over clinical pelvic examination. Settings and Design: A retrospective study of patients who underwent diagnostic laparoscopy for CPP. Materials and Methods: The medical records of 86 women who underwent laparoscopic evaluation for CPP of at least 6-month duration were reviewed for presentation of symptoms, pelvic examination findings at the admission, operative findings and follow up when available. Statistical analysis used: McNemar Chi-square test for frequencies in a 2 x 2 table. Results: The most common presentation was acyclic lower abdominal pain (79.1%, followed by congestive dysmenorrhoea (26.7%. 61.6% of women did not reveal any significant signs on pelvic examination. Pelvic tenderness was elicited in 27.9%. Diagnostic laparoscopy revealed significant pelvic pathology in 58% of those who essentially had normal pervaginal findings. The most common pelvic pathology by laparoscopy was pelvic adhesions (20.9%, followed by pelvic congestion (18.6%. Laparoscopic adhesiolyis achieved pain relief only in one-third of the women. Conclusion: The study revealed very low incidence of endometriosis (4.7%. Overall clinical examination could detect abnormality in only 38% of women, where as laparoscopy could detect significant pathology in 66% of women with CPP. This shows superiority of diagnostic laparoscopy over clinical examination in detection of aetiology in women with CPP (P < 0.001. Adhesiolysis helps only small proportion of women in achieving pain control.

  11. Chronic pelvic pain: comorbidity between chronic musculoskeletal pain and vulvodynia

    Directory of Open Access Journals (Sweden)

    G. Biasi

    2014-06-01

    Full Text Available Chronic pelvic pain (CPP is a common condition that has a major impact on the quality of life of both men and women. Male CPP is usually attributable to well-defined urogenital conditions (most frequently infectious/non infectious prostatic diseases or musculoskeletal or bowel diseases, whereas the features of female CPP are much more complex and are of particular clinical and epidemiological importance. It is a multifactorial syndrome that can be due to diseases of the urogenital, gastrointestinal, or musculoskeletal systems, or to neurological or neuropsychiatric disorders. It is not always easy to identify its predominant pathogenesis, although it often occurs as a central sensitization syndrome triggered by an initial stimulus which is no longer detectable and only manifests itself clinically through pain. In this respect, there are some very interesting relationships between vulvodynia and fibromyalgic syndrome, as identified in a preliminary study of women with chronic musculoskeletal pain in which it was demonstrated that vulvar pain plays an important role, although it is often overlooked and undiagnosed.

  12. Gut microbiome and chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Arora, Hans C; Eng, Charis; Shoskes, Daniel A

    2017-01-01

    Analysis of the human microbiome continues to reveal new and previously unrealized associations between microbial dysbiosis and disease. Novel approaches to bacterial identification using culture-independent methods allow practitioners to discern the presence of alterations in the taxa and diversity of the microbiome and identify correlations with disease processes. While some of these diseases that have been extensively studied are well-defined in their etiology and treatment methods (colorectal cancer), others have provided much more significant challenges in both diagnosis and treatment. One such condition, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), has several etiological and potentiating contributions from infection, inflammation, central nervous system (CNS) changes, stress, and central sensitization-all factors that play important roles in the crosstalk between the human body and its microbiome. No singular cause of CP/CPPS has been identified and it is most likely a syndrome with multifactorial causes. This heterogeneity and ambiguity are sources of significant frustration for patients and providers alike. Despite multiple attempts, treatment of chronic prostatitis with monotherapy has seen limited success, which is thought to be due to its heterogeneous nature. Phenotypic approaches to both classify the disease and direct treatment for CP/CPPS have proven beneficial in these patients, but questions still remain regarding etiology. Newer microbiome research has found correlations between symptom scores and disease severity and the degree of dysbiosis in urine and gut (stool) microbiomes in these patients as compared to un-afflicted controls. These findings present potential new diagnostic and therapeutic targets in CP/CPPS patients.

  13. Sociopsychological factors in women with chronic pelvic pain with and without pelvic venous congestion.

    Science.gov (United States)

    Fry, R P; Beard, R W; Crisp, A H; McGuigan, S

    1997-01-01

    Social and psychological factors have long been proposed as being of importance in a sizeable subgroup of women complaining of unexplained chronic pelvic pain (CPP). The aim of this study was to examine this in two subgroups of CPP patients, thereby eliminating pain alone as the determining variable. Consecutive attenders at a clinic for CPP were assessed on a range of somatic, historical, social, and psychological variables using detailed interviews and questionnaires. They were subsequently allocated to one of two groups, based on the presence or absence of pelvic venous congestion (PVC). Significant associations emerged between some social arrangements, paternal parenting, and patterns of hostility in the group with pelvic venous congestion. The groups also differed in patterns of family illness, and the congested group tended to report more childhood sexual abuse (CSA). Clear case definition in CPP is important. In the subgroup with pelvic venous congestion early social experience may play an important role. Father-daughter relationships may be particularly relevant. Hostility patterns may influence the development of the condition. CSA does not appear to play a specific role in all unexplained CPP cases, but may have relevance for the subgroup with pelvic venous congestion.

  14. [Endovascular treatment of persistent dysuria and chronic pelvic pain in women with pelvic varicose veins].

    Science.gov (United States)

    Neĭmark, A I; Shelkovnikova, N V

    2012-01-01

    The results of the examination and treatment of 16 patients aged from 26 to 46 years with persistent urinary disorders and chronic pelvic pain due to severe pelvic varicose veins are presented. Using ultrasound with color Doppler mapping and venography of renal and ovarian vein for evaluation of condition of the venous system of the pelvis, the significant dilation of the internal iliac, ovarian and uterine veins with a pronounced decrease in blood flow in veins up to the stasis of blood, accompanied by flow turbulence and powerful backflow of renal blood through ovarian veins were found in all patients. According to uroflowmetry, there was a decrease in detrusor tone and a violation of evacuation capacity of the bladder. Evaluation of microcirculation using LDF allowed to diagnose congestive hemodynamic type of microcirculation. Scleroembolization for varicose ovarian vein with Gianturco coil and ethoxysclerol was performed in all patients. Positive therapeutic effect in the form of eliminating varicose pelvic veins, pain relieve, disappearance of persistent dysuria, and the remission of chronic cystitis was achieved in 86% of women. This intervention provided the normal outflow of blood from the pelvic veins, contributed to the normalization of uroflowmetry data and restoration of normal microcirculation in the urinary bladder.

  15. IL-17 is not essential for inflammation and chronic pelvic pain development in an experimental model of chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Motrich, Ruben D; Breser, María L; Sánchez, Leonardo R; Godoy, Gloria J; Prinz, Immo; Rivero, Virginia E

    2016-03-01

    Pain and inflammation in the absence of infection are hallmarks in chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) patients. The etiology of CP/CPPS is unclear, and autoimmunity has been proposed as a cause. Experimental autoimmune prostatitis (EAP) models have long been used for studying CP/CPPS. Herein, we studied prostate inflammation induction and chronic pelvic pain development in EAP using IL-12p40-KO, IL-4-KO, IL-17-KO, and wild-type (C57BL/6) mice. Prostate antigen (PAg) immunization in C57BL/6 mice induced specific Th1 and Th17 immune responses and severe prostate inflammation and cell infiltration, mainly composed of CD4 T cells and macrophages. Moreover, chronic pelvic pain was evidenced by increased allodynia responses. In immunized IL-17-KO mice, the presence of a prominent PAg-specific Th1 immune response caused similar prostate inflammation and chronic pelvic pain. Furthermore, markedly high PAg-specific Th1 immune responses, exacerbated prostate inflammation, and chronic pelvic pain were detected in immunized IL-4-KO mice. Conversely, immunized IL-12p40-KO mice developed PAg-specific Th2 immune responses, characterized by high IL-4 secretion and neither infiltration nor damage in the prostate. As observed in wild-type control animals, IL12p40-KO mice did not evidence tactile allodynia responses. Our results suggest that, as in patients, chronic pelvic pain is a consequence of prostate inflammation. After PAg immunization, a Th1-associated immune response develops and induces prostate inflammation and chronic pelvic pain. The absence of Th1 or Th2 cytokines, respectively, diminishes or enhances EAP susceptibility. In addition, IL-17 showed not to be essential for pathology induction and chronic pelvic pain development.

  16. Musculoskeletal Dysfunctions in Patients With Chronic Pelvic Pain

    DEFF Research Database (Denmark)

    Mieritz, Rune Mygind; Thorhauge, Kirsten; Forman, Axel;

    2016-01-01

    OBJECTIVE: The purpose of this study was to determine the prevalence of musculoskeletal dysfunctions based on a standardized clinical examination of patients with chronic pelvic pain (CPP) who were referred to a specialized tertiary care center for laparoscopic examination. In addition, we...... stratified levels of self-reported pelvic pain, self-rated health, education, and work status based on musculoskeletal dysfunction status. METHODS: This study used a cross-sectional design to determine the prevalence of musculoskeletal dysfunctions in women with CPP who were referred to a tertiary care......: Ninety-four patients returned the questionnaire, completed the clinical examination, and fulfilled the inclusion criteria. More than half of the referred patients with CPP (48 out of 94) had musculoskeletal dysfunctions in the lumbar/pelvic region. No statistically significant differences were found...

  17. From interstitial cystitis to chronic pelvic pain.

    Science.gov (United States)

    Persu, C; Cauni, V; Gutue, S; Blaj, Irina; Jinga, V; Geavlete, P

    2010-01-01

    There are still many things to be found out about interstitial cystitis/painful bladder syndrome (IC/PBS) because the pathological processes underlying the condition are not yet elucidated, biological markers of the condition are not yet available, and the type and severity of symptoms can vary, so, clearly defining the condition is not yet possible. For example, it is not clearly understood whether IC/PBS represents a systemic disease, if it is localized in the bladder, or if it was initially localized in the bladder and it later evolved into a systemic disease. This condition is best managed by using a multidisciplinary approach. Management requires a good integration and knowledge of all pelvic organ systems and other systems including musculoskeletal, neurologic, and psychiatric systems.

  18. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Chiarioni; Corrado Asteria; William E Whitehead

    2011-01-01

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: A recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.

  19. Providing holistic care for women with chronic pelvic pain.

    Science.gov (United States)

    Abercrombie, Priscilla D; Learman, Lee A

    2012-01-01

    Chronic pelvic pain (CPP) is one of the most common pain conditions affecting women and can have a significant impact on quality of life. Assessment of women with CPP is best approached in a comprehensive, systematic manner that includes exploration of physiological and psychological causes. A range of treatment options that draw from conventional medicine and complementary and alternative modalities should be offered. The women's health nurse plays a pivotal role in all aspects of care.

  20. Centering as a model for group visits among women with chronic pelvic pain.

    Science.gov (United States)

    Chao, Maria T; Abercrombie, Priscilla D; Duncan, Larissa G

    2012-01-01

    Providing comprehensive care for chronic pelvic pain is impeded by time and resource constraints of the standard health care visit. To provide patient education, psychosocial support, and health care assessment, we developed group visits for women with chronic pelvic pain using an evidence-based, holistic nursing approach. In this article, we describe the structure of group visits, the process of conducting Centering group visits focused on empowerment, and the content of a holistic curriculum for women with chronic pelvic pain.

  1. Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

    Science.gov (United States)

    Randolph, Mary E.; Reddy, Diane M.

    2006-01-01

    Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index…

  2. Extracorporeal shock wave therapy (ESWT) in urology

    DEFF Research Database (Denmark)

    Fojecki, Grzegorz Lukasz; Thiessen, Stefan; Osther, Palle Jörn Sloth

    2017-01-01

    PURPOSE: The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders. METHODS: We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline...... and PubMed was carried out. The systematic review was performed according to PRISMA guidelines. RESULTS: We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie's disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile......i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard...

  3. Progress on Clinical Study of Acupuncture Treatment for Chronic Pelvic Inflammation

    Institute of Scientific and Technical Information of China (English)

    ZHAO Wen-jie; HUANG Guo-qi

    2008-01-01

    @@ Chronic pelvic inflammation is mostly caused byincomplete treatment of acute pelvic inflammation orby transference from pathologic condition due to poorbody constitution, including chronic endometritis,chronic salpingo-oophoritis and chronic inflammationof connective tissue, and is a commonly andfrequently encountered disease in the gynecologydepartment. Due to long duration, intractablecondition and high recurrent rate, it is also acommonly encountered reason to induce heterotopicpregnancy, sterility, pelvic pain and pelvic adhesivediseases. In the investigative study on the domesticliterature about acupuncture treatment of chronicpelvic inflammation in the recent five years, theauthor hopes to summarize the information forreference in the clinical treatment and to point outsome issues existing in the current clinical study.

  4. MR aspect of the prostate in CPPS patients (chronic pelvic pain syndrome); MR-Befundmuster der Prostata bei Patienten mit CPP Syndrom (chronic pelvic pain syndrome)

    Energy Technology Data Exchange (ETDEWEB)

    Wiesinger, B.; Lichy, M.P.; Claussen, C.D.; Schlemmer, H.P. [Abt. fuer Radiologische Diagnostik, Universitaetsklinikum Tuebingen (Germany); Naegele, U.; Anastasiadis, A. [Abt. fuer Urologie, Universitaetsklinikum Tuebingen (Germany)

    2008-07-15

    Purpose: to describe typical morphological patterns of abacterial prostatitis using magnetic resonance imagine (MRI) in chronic pelvic pain syndrome patients including spectroscopy. Materials and methods: 18 patients (age range between 25 and 67 years, average 46.2 years) with recurrent chronic pelvic pain syndrome for at least 3 months were evaluated clinically in the urological department and included if there were no suspicious findings from endorectal digital palpation and if their PSA values were < 5 ng/ml. A retrospective analysis of these 18 patients with 30 contrast-enhanced MRI investigations with endorectal coils in 28 of 30 cases was performed with a 1.5T MRI. T2w signal intensity (SI) and spectroscopy data (9/18 patients) were acquired for the normal peripheral zone, the central zone, for the peripheral zone suspected of inflammation and for the muscle including SI ratios for the unaltered and the suspicious inflammatory peripheral zone. Results: typical MR patterns of signal alterations suspected of inflammation of CPPS patients were able to be detected as T2w hypointense triangular, stringy (n = 12, 66.6%) contrast-enhancing signal alterations without a nodular shape with well circumscribed margins of the capsula and without pericapsular signal alterations. In 6 patients changes also had a triangular but more homogeneous aspect (33.3%). Three patients had an additional periurethral uptake (16.6%). T2w SI measurements and T2w SI ratios showed much lower values for the peripheral zone suspected of inflammation as compared to the normal peripheral zone of the prostate (277.29 STD 77.5 to 432.9 STD 112.02 and 4.94 STD 1.47 to 7.58 STD 2.01 respectively). The spectroscopic analysis of the signal alterations suspected of inflammation showed normal Cholin+ Creatin/Citrate SI ratio values in 3 patients (SI < 0.5), ratios suspected of low grade cancer in 3 patients (SI 0.5 and < 0.7) and ratios suspected of intermediate grade prostate cancer in 3 patients (SI

  5. Complementary and alternative medications for chronic pelvic pain.

    Science.gov (United States)

    Leong, Fah Che

    2014-09-01

    Chronic pelvic pain is common, but rarely cured, thus patients seek both second opinions and alternative means of controlling their pain. Complementary and alternative medicine accounts for 11.2% of out-of-pocket medical expenditures for adults for all conditions in the United States. Although there are many treatments, rigorous testing and well-done randomized studies are lacking. Dietary changes and physical modalities such as physical therapy have often been included in the category of alternative medicine, but their use is now considered mainstream. This article concentrates on other sources of alternative and complementary medicine, such as dietary supplementation and acupuncture.

  6. Pelvic laparoscopy

    Science.gov (United States)

    ... nearby lymph nodes or tissue Chronic (long-term) pelvic pain, if no other cause has been found Ectopic ( ... pregnant or having a baby (infertility) Sudden, severe pelvic pain A pelvic laparoscopy may also be done to: ...

  7. Associations between chronic pelvic pain and psychiatric disorders and symptoms

    Directory of Open Access Journals (Sweden)

    ANA CAROLINA FRANCO CARVALHO

    2015-02-01

    Full Text Available Background Chronic pelvic pain (CPP is a complex condition wich is associated with emotional factors, specially depression and anxiety. Objectives To make a systematic review to provide a detailed summary of relevant literature on the association between CPP and different psychiatric disorders/symptoms. Methods A systematic review of articles in the international literature published between 2003 and 2014 was performed in the electronic databases PubMed, PsycINFO, LILACS, and SciELO using the terms (chronic pelvic pain AND (psychiatry OR psychiatric OR depression OR anxiety OR posttraumatic stress OR somatoform. The searches returned a total of 529 matches that were filtered according to predefined inclusion and exclusion criteria. A total of 18 articles were selected. Results The investigations focused mainly on the assessment of depression and anxiety disorders/symptoms, with rather high rates (17-38.6%. Depression and anxiety symptoms were more prevalent among women with CPP compared to healthy groups. Comparisons between groups with CPP and with specific pathologies that also have pain as a symptom showed that depression indicators are more frequent in CPP. Depressive symptoms tend to be more common in CPP and have no particular association with pain itself, the core feature of CPP. Discussion Other aspects of CPP seem to play a specific role in this association. Anxiety and other psychiatric disorders require further investigation so that their impact on CPP can be better understood.

  8. Psychosomatic group treatment helps women with chronic pelvic pain.

    Science.gov (United States)

    Albert, H

    1999-12-01

    This study evaluates group treatment for women suffering from chronic pelvic pain. The concept of group treatment was based on psychosomatic and physio-therapeutical principles and on cognitive and operant behavioral therapy. Each group was composed of up to six women suffering from chronic pelvic pain, and two physiotherapists. Each group treatment session lasted 2.5 h per week for a period of 10 weeks. The women completed questionnaires and pain drawings four times during the treatment period from the beginning of the period till 15 months later. During 13 group treatment periods 53 women accomplished the treatment. Before the treatment the women had experienced pain for an average period of 5 years and 9 months (ranging from 6 months to 22 years). The women's descriptions of the changes derived from group treatment were analyzed according to the Grounded Theory Method. A methodical triangulation of quantitative and qualitative data as well as analyzes of the drawings were applied. One year after the end of the treatment, 39% of the women were pain-free. The average level of pain measured according to the Visual Analog Scale was reduced from 2.8 to 0.9 (p Theory Analysis a model of the development process was elaborated. The process begins with the development of self-knowledge, followed by the woman assuming self responsibility for her own life and performing self-activeness. During the process the woman increases her feeling of self-control and personal mastery of her emotions. The women's pain drawings improved, resulting in more detailed drawings, the color intensity abating, the extent of pains declining, and the outlines blurring. In conclusion this kind of group treatment brings the women relief from their pain thus reducing the use of the National Health Service by women suffering from chronic pelvic pain. The women also experience a positive psychological development. This method of treatment, in which a synergetic combination of physical and

  9. Transcutaneous electrical nerve stimulation (TENS in the symptomatic management of chronic prostatitis/chronic pelvic pain syndrome: a placebo-control randomized trial

    Directory of Open Access Journals (Sweden)

    Sikiru Lamina

    2008-12-01

    Full Text Available OBJECTIVE: The aim of the study was to investigate the therapeutic efficacy of transcutaneous electrical nerve stimulation (TENS in the symptomatic management of chronic prostatitis pain/chronic pelvic pain syndrome. DESIGN: A pretest, posttest randomized double blind design was used in data collection. PARTICIPANT: Twenty-four patients diagnosed with chronic prostatitis- category IIIA and IIIB of the National Institute of Health Chronic Pain (NIH-CP were referred for physiotherapy from the Urology department. Intervention: Pre treatment pain level was assessed using the NIH-CP (pain domain index. The TENS group received TENS treatment, 5 times per week for a period of 4 weeks (mean treatment frequency, intensity, pulse width and duration of 60Hz, 100µS, 25mA and 20 minutes respectively. The Analgesic group received no TENS treatment but continued analgesics; the Control group received no TENS and Analgesic but placebo. All subjects were placed on antibiotics throughout the treatment period. Outcome measures: Post-treatment pain level was also assessed using NIH-CP pain index. RESULT: Findings of the study revealed significant effect of TENS on chronic prostatitis pain at p < 0.05. CONCLUSION: TENS is an effective means of non-invasive symptomatic management of chronic prostatitis pain.

  10. Physical therapy management of female chronic pelvic pain: Anatomic considerations.

    Science.gov (United States)

    George, Susan E; Clinton, Susan C; Borello-France, Diane F

    2013-01-01

    The multisystem nature of female chronic pelvic pain (CPP) makes this condition a challenge for physical therapists and other health care providers to manage. This article uses a case scenario to illustrate commonly reported somatic, visceral, and neurologic symptoms and their associated health and participation impact in a female with CPP. Differential diagnosis of pain generators requires an in-depth understanding of possible anatomic and physiologic contributors to this disorder. This article provides a detailed discussion of the relevant clinical anatomy with specific attention to complex interrelationships between anatomic structures potentially leading to the patient's pain. In addition, it describes the physical therapy management specific to this case, including examination, differential diagnosis, and progression of interventions.

  11. Tryptase - PAR2 axis in Experimental Autoimmune Prostatitis, a model for Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    Roman, Kenny; Done, Joseph D.; Schaeffer, Anthony J.; Murphy, Stephen F.; Thumbikat, Praveen

    2014-01-01

    Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) affects up to 15% of the male population and is characterized by pelvic pain. Mast cells are implicated in the murine experimental autoimmune prostatitis (EAP) model as key to chronic pelvic pain development. The mast cell mediator tryptase-β and its cognate receptor protease-activated receptor 2 (PAR2) are involved in mediating pain in other visceral disease models. Prostatic secretions and urines from CP/CPPS patients were examined for the presence of mast cell degranulation products. Tryptase-β and PAR2 expression were examined in murine experimental autoimmune prostatitis (EAP). Pelvic pain and inflammation were assessed in the presence or absence of PAR2 expression and upon PAR2 neutralization. Tryptase-β and carboxypeptidase A3 were elevated in CP/CPPS compared to healthy volunteers. Tryptase-β was capable of inducing pelvic pain and was increased in EAP along with its receptor PAR2. PAR2 was required for the development of chronic pelvic pain in EAP. PAR2 signaling in dorsal root ganglia lead to ERK1/2 phosphorylation and calcium influx. PAR2 neutralization using antibodies attenuated chronic pelvic pain in EAP. The tryptase-PAR2 axis is an important mediator of pelvic pain in EAP and may play a role in the pathogenesis of CP/CPPS. PMID:24726923

  12. Tryptase-PAR2 axis in experimental autoimmune prostatitis, a model for chronic pelvic pain syndrome.

    Science.gov (United States)

    Roman, Kenny; Done, Joseph D; Schaeffer, Anthony J; Murphy, Stephen F; Thumbikat, Praveen

    2014-07-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects up to 15% of the male population and is characterized by pelvic pain. Mast cells are implicated in the murine experimental autoimmune prostatitis (EAP) model as key to chronic pelvic pain development. The mast cell mediator tryptase-β and its cognate receptor protease-activated receptor 2 (PAR2) are involved in mediating pain in other visceral disease models. Prostatic secretions and urines from CP/CPPS patients were examined for the presence of mast cell degranulation products. Tryptase-β and PAR2 expression were examined in murine EAP. Pelvic pain and inflammation were assessed in the presence or absence of PAR2 expression and upon PAR2 neutralization. Tryptase-β and carboxypeptidase A3 were elevated in CP/CPPS compared to healthy volunteers. Tryptase-β was capable of inducing pelvic pain and was increased in EAP along with its receptor PAR2. PAR2 was required for the development of chronic pelvic pain in EAP. PAR2 signaling in dorsal root ganglia led to extracellular signal-regulated kinase (ERK)1/2 phosphorylation and calcium influx. PAR2 neutralization using antibodies attenuated chronic pelvic pain in EAP. The tryptase-PAR2 axis is an important mediator of pelvic pain in EAP and may play a role in the pathogenesis of CP/CPPS.

  13. Nongynecological factors leading to chronic pelvic pain%非妇科因素致慢性盆腔痛

    Institute of Scientific and Technical Information of China (English)

    杨欣

    2013-01-01

    慢性盆腔痛是影响女性健康的常见问题,疼痛的症状和病因常涉及妇科学、胃肠病学、泌尿和疼痛医学.非妇科因素导致的慢性盆腔痛的常见原因有肠易激综合征、膀胱疼痛综合征、腹部肌筋膜疼痛综合征等等.所以需要多学科共同参与诊治.%Chronic pelvic pain is a major public health problem for women. The symptoms and reasons of CPP include gynaecology, gastroenterology, urology and pain medicine. The common diseases of non-gynecological CPP are irritable bowel syndrome, painful bladder syndrome, intersitial cystitis, abdominal myo-fascial pain syndrome, ets. Pelvic pain should be approached by a multidisciplinary team in order to reach the best results in diagnosis and treatments.

  14. Women in pain : the course and diagnostics of chronic pelvic pain

    NARCIS (Netherlands)

    Weijenborg, Philomena Theodora Maria

    2009-01-01

    The main subject of this thesis is pelvic pain in women in secondary and/or tertiary medical care. Studies aim to examine: 1. The clinical course of acute abdominal pain and risks of pain persistence. 2. The clinical course of chronic pelvic pain (CPP) and predictors of recovery. 3. The moderat

  15. Urological injuries associated with pelvic fractures: A case report of a detached bone segment inside the bladder

    Directory of Open Access Journals (Sweden)

    Saud M. Alfayez, MBBS

    2016-01-01

    Conclusion: This unusual case illustrates the potential risk of bladder injury following stable pelvic fractures through a detached bone segment. It also emphasizes on having a high index of suspicion. The teamwork and multidisciplinary approach are essential for an optimal outcome.

  16. Referred pain patterns provoked on intra-pelvic structures among women with and without chronic pelvic pain: a descriptive study.

    Directory of Open Access Journals (Sweden)

    Thomas Torstensson

    Full Text Available To describe referred pain patterns provoked from intra-pelvic structures in women with chronic pelvic pain (CPP persisting after childbirth with the purpose to improve diagnostics and give implications for treatment.In this descriptive and comparative study 36 parous women with CPP were recruited from a physiotherapy department waiting list and by advertisements in newspapers. A control group of 29 parous women without CPP was consecutively assessed for eligibility from a midwifery surgery. Inclusion criterion for CPP was: moderate pain in the sacral region persisting at least six months after childbirth confirmed by pelvic pain provocation tests. Exclusion criteria in groups with and without CPP were: persistent back or pelvic pain with onset prior to pregnancy, previous back surgery and positive neurological signs. Pain was provoked by palpation of 13 predetermined intra-pelvic anatomical landmarks. The referred pain distribution was expressed in pain drawings and described in pain maps and calculated referred pain areas.Pain provoked by palpation of the posterior intra-pelvic landmarks was mostly referred to the sacral region and pain provoked by palpation of the ischial and pubic bones was mostly referred to the groin and pubic regions, with or without pain referred down the ipsilateral leg. The average pain distribution area provoked by palpation of all 13 anatomical landmarks was 30.3 mm² (19.2 to 53.7 in women with CPP as compared to 3.2 mm² (1.0 to 5.1 in women without CPP, p< 0.0001.Referred pain patterns provoked from intra-pelvic landmarks in women with CPP are consistent with sclerotomal sensory innervation. Magnification of referred pain patterns indicates allodynia and central sensitization. The results suggest that pain mapping can be used to evaluate and confirm the pain experience among women with CPP and contribute to diagnosis.

  17. Turn-Amplitude Analysis as a Diagnostic Test for Myofascial Syndrome in Patients with Chronic Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Fernando Itza

    2015-01-01

    Full Text Available BACKGROUND: Myofascial pain syndrome of the pelvic floor (MPSPF is a common disease in the context of chronic pelvic pain (CPP; however, there is currently no gold-standard test to diagnose it.

  18. Bedside Testing for Chronic Pelvic Pain: Discriminating Visceral from Somatic Pain

    OpenAIRE

    John Jarrell; Maria Adele Giamberardino; Magali Robert; Maryam Nasr-Esfahani

    2011-01-01

    Objectives. This study was done to evaluate three bedside tests in discriminating visceral pain from somatic pain among women with chronic pelvic pain. Study Design. The study was an exploratory cross-sectional evaluation of 81 women with chronic pelvic pain of 6 or more months' duration. Tests included abdominal cutaneous allodynia (aCA), perineal cutaneous allodynia (pCA), abdominal and perineal myofascial trigger points (aMFTP) and (pMFTP), and reduced pain thresholds (RPTs). Results. Eigh...

  19. Optimal management of chronic cyclical pelvic pain: an evidence-based and pragmatic approach

    Directory of Open Access Journals (Sweden)

    Ha Ryun Won

    2010-08-01

    Full Text Available Ha Ryun Won, Jason AbbottDepartment of Endo-Gynecology, Royal Hospital for Women, Sydney, New South Wales, AustraliaAbstract: This article reviews the literature on management of chronic cyclical pelvic pain (CCPP. Electronic resources including Medline, PubMed, CINAHL, The Cochrane Library, Current Contents, and EMBASE were searched using MeSH terms including all ­subheadings and keywords: “cyclical pelvic pain”, “chronic pain”, “dysmenorrheal”, “nonmenstrual ­pelvic pain”, and “endometriosis”. There is a dearth of high-quality evidence for this common ­problem. Chronic pelvic pain affects 4%–25% of women of reproductive age. Dysmenorrhea of varying degree affects 60% of women. Endometriosis is the commonest pathologic cause of CCPP. Other gynecological causes are adenomyosis, uterine fibroids, and pelvic floor myalgia, although other systems disease such as irritable bowel syndrome or interstitial cystitis may be responsible. ­Management options range from simple to invasive, where simple medical ­treatment such as the combined oral contraceptive pill may be used as a first-line treatment prior to invasive ­management. This review outlines an approach to patients with CCPP through history, physical examination, and investigation to identify the cause(s of the pain and its optimal management.Keywords: cyclical pelvic pain, chronic pain, dysmenorrhea, nonmenstrual pelvic pain, endometriosis

  20. A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome

    Science.gov (United States)

    Tripp, Dean A.; Nickel, J. Curtis; Katz, Laura; Krsmanovic, Adrijana; Ware, Mark A.; Santor, Darcy

    2014-01-01

    Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic pelvic pain condition largely refractory to treatment. Cannabis (marijuana) use has been reported for a wide variety of chronic pain conditions, but no study has examined prevalence of cannabis use, symptom benefit or side effects, or frequency in CP/CPPS. Methods: Participants were recruited from an outpatient CP/CPPS urology clinic (n = 98) and online through the Prostatitis Foundation website (n = 244). Participants completed questionnaires (demographics, CP/CPPS, depression, cannabis). Results: The clinic sample included Canadian patients and the online sample included primarily American patients. Due to differences, groups were examined separately. Almost 50% of respondents reported using cannabis (clinic n = 49; online n = 89). Of the cannabis users, 36.8% of clinic and 75% of online respondents reported that it improved their symptoms. Most of the respondents (from the clinic and online groups) reported that cannabis improved their mood, pain, muscle spasms, and sleep. However, they did not note any improvements for weakness, fatigue, numbness, ambulation, and urination. Overall, the effectiveness of cannabis for CP/CPPS was “somewhat/very effective” (57% clinic; 63% online). There were no differences between side effects or choice of consumption and most reported using cannabis rarely. Conclusions: These are the first estimates in men suffering from CP/CPPS and suggest that while cannabis use is prevalent, its medical use and benefit are unknown. This is an understudied area and the benefit or hazard for cannabis use awaits further study. PMID:25553163

  1. Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

    Science.gov (United States)

    Krsmanovic, Adrijana; Tripp, Dean A.; Nickel, J. Curtis; Shoskes, Daniel A.; Pontari, Michel; Litwin, Mark S.; McNaughton-Collins, Mary F.

    2014-01-01

    Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent, chronic pelvic pain condition largely unresponsive to medical interventions. Psychosocial risk factors are associated with poor outcomes in CP/CPPS, but have not been examined for their intervening roles between pain and reduced quality of life (QoL). This study aimed to determine if psychosocial risk factors (i.e., patient coping and catastrophizing) mediate the association between pain and QoL. Methods: Using a cross sectional design, 175 men with CP/CPPS (mean age 46.83; SD 10.86) were recruited from tertiary care urology clinics and completed questionnaires on demographics, pain, QoL, pain coping, depression, and catastrophizing. An exploratory factor analysis was conducted and aggregate factor scores were examined to improve the amount of meaningful measurement to be used in multiple mediations. The models specified multiple risk factors as mechanisms between pain and both physical and mental QoL as the primary outcome measurements. Results: Four aggregate psychosocial factor scores were produced from the psychosocial measures (i.e., illness and wellness-focused behavioural coping, depression and catastrophizing). Illness-focused coping partially mediated the relationship between pain and physical QoL. However, catastrophizing and illness-focused coping fully mediated the relation between pain and mental QoL, showing the association between pain and mental QoL was no longer significant when catastrophizing and illness-focused coping were in the model. Conclusion: Psychosocial factors function as mechanisms between higher pain and they are associated diminished mental QoL. These results introduce illness-focused coping as an important biopsychosocial target in CP/CPPS management. PMID:25553153

  2. Abordagem da dor pélvica crônica em mulheres Management of chronic pelvic pain in women

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    Antonio Alberto Nogueira

    2006-12-01

    Full Text Available Dor pélvica crônica é uma doença debilitante e de alta prevalência, com grande impacto na qualidade de vida e produtividade, além de custos significantes para os serviços de saúde. O dilema no manejo da dor pélvica crônica continua a frustrar médicos confrontados com o problema, em parte porque sua fisiopatologia é pobremente compreendida. Conseqüentemente, seu tratamento é muitas vezes insatisfatório e limitado ao alívio temporário dos sintomas. Nesta revisão, nós discutimos uma abordagem ampliada da dor pélvica crônica. Salientamos que uma história clínica e exame físico adequados deveriam incluir atenção especial aos sistemas gastrintestinal, urinário, ginecológico, músculo-esquelético, neurológico, psicológico e endócrino. Dessa forma, uma abordagem multidisciplinar é recomendada. Adicionalmente, enfatizamos que, embora úteis, procedimentos cirúrgicos específicos, tais como a laparoscopia, deveriam ser indicados somente para pacientes selecionadas, após excluir principalmente síndrome do intestino irritável e dor de origem miofascial.Chronic pelvic pain is a debilitating and highly prevalent disease with a major impact on quality of life and work productivity, beyond significant costs to health services. The dilemma of managing patients with chronic pelvic pain continues to frustrate physicians confronted with these complaints, in part because its pathophysiology is poorly understood. Consequently, its treatment is often unsatisfactory and limited to temporary symptom relief. In the present revision, we discuss the adequate management of chronic pelvic pain. We point out that a comprehensive medical history and physical examination should include special attention to gastrointestinal, urological, gynecological, muscle-skeletal, neurological, psychiatric, and endocrine systems. Thus, a multidisciplinary approach is recommended. Additionally, we emphasize that, although useful, specific surgical

  3. Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP

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    Jason J. Kutch

    2015-01-01

    Full Text Available Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the brain networks controlling pelvic floor muscles would also show altered resting state function in men with CP/CPPS. Here we describe the results of the first test of this hypothesis focusing on the motor cortical regions, termed pelvic-motor, that can directly activate pelvic floor muscles. A group of men with CP/CPPS (N = 28, as well as group of age-matched healthy male controls (N = 27, had resting state functional magnetic resonance imaging scans as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network study. Brain maps of the functional connectivity of pelvic-motor were compared between groups. A significant group difference was observed in the functional connectivity between pelvic-motor and the right posterior insula. The effect size of this group difference was among the largest effect sizes in functional connectivity between all pairs of 165 anatomically-defined subregions of the brain. Interestingly, many of the atlas region pairs with large effect sizes also involved other subregions of the insular cortices. We conclude that functional connectivity between motor cortex and the posterior insula may be among the most important markers of altered brain function in men with CP/CPPS, and may represent changes in the integration of viscerosensory and motor processing.

  4. Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP

    Science.gov (United States)

    Kutch, Jason J.; Yani, Moheb S.; Asavasopon, Skulpan; Kirages, Daniel J.; Rana, Manku; Cosand, Louise; Labus, Jennifer S.; Kilpatrick, Lisa A.; Ashe-McNalley, Cody; Farmer, Melissa A.; Johnson, Kevin A.; Ness, Timothy J.; Deutsch, Georg; Harris, Richard E.; Apkarian, A. Vania; Clauw, Daniel J.; Mackey, Sean C.; Mullins, Chris; Mayer, Emeran A.

    2015-01-01

    Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the brain networks controlling pelvic floor muscles would also show altered resting state function in men with CP/CPPS. Here we describe the results of the first test of this hypothesis focusing on the motor cortical regions, termed pelvic-motor, that can directly activate pelvic floor muscles. A group of men with CP/CPPS (N = 28), as well as group of age-matched healthy male controls (N = 27), had resting state functional magnetic resonance imaging scans as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study. Brain maps of the functional connectivity of pelvic-motor were compared between groups. A significant group difference was observed in the functional connectivity between pelvic-motor and the right posterior insula. The effect size of this group difference was among the largest effect sizes in functional connectivity between all pairs of 165 anatomically-defined subregions of the brain. Interestingly, many of the atlas region pairs with large effect sizes also involved other subregions of the insular cortices. We conclude that functional connectivity between motor cortex and the posterior insula may be among the most important markers of altered brain function in men with CP/CPPS, and may represent changes in the integration of viscerosensory and motor processing. PMID:26106574

  5. [Combination of intersticial cystitis and adenomyosis in females suffering from chronic pelvic pain syndrome].

    Science.gov (United States)

    Neĭmark, A I; Shelkovnikova, N V

    2011-01-01

    General and endoscopic examinations of 25 patients aged 40-48 years with chronic pelvic pain syndrome (CPPS) revealed combination of two urogenital diseases: interstitial cystitis and adenomyosis of the second-third degree. The complex treatment including a course of lavomax immunocorrection relieved CPPS in 72% (18) patients, reduced the number of recurrences of chronic pelvic diseases in 16% (4) patients. The therapeutic complex proposed may serve an alternative to surgical treatment of adenomyosis of the second-third degree which is uncomplicated with posthemorrhagic iron-deficiency anemia, manifests with pain only and associated with interstitial cystitis.

  6. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

    ... the ectopic pregnancy is not diagnosed early. Chronic pelvic pain —PID may lead to long-lasting pelvic pain. Who is at risk of PID? PID can ... lead to pelvic inflammatory disease and infertility. Chronic Pelvic Pain: Persistent pain in the pelvic region that has ...

  7. Clinical Observation in 102 Cases of Chronic Pelvic Inflammation Treated with Qi Jie Granules

    Institute of Scientific and Technical Information of China (English)

    章勤; 何嘉琳; 何少山; 许萍

    2004-01-01

    Objective: To observe the therapeutic effects of Qi Jie Granule (芪竭颗粒) on chronic pelvic inflammation. Method: The therapeutic effect, T-lymphocytic subgroups and indexes of blood rheology were observed when 102 cases of chronic pelvic inflammation in the treatment group were treated with Qi Jie Granule, and another 70 cases were treated with Qian Jin Pian as the controls. Results: The total effective rate was 96.08% in the treatment group, but 84.29% in the control group with a significant difference between the two groups (P<0.01). Qi Jie Granule was also found effective in improving blood viscosity and regulating T-lymphocytic subgroups, and the difference before and after the treatment was also very significant (P<0.05 or P<0.01). Conclusion: The nature of chronic pelvic inflammation is qi deficiency and blood stasis in accordance with the theory of traditional Chinese medicine (TCM). As a drug that is indicated for chronic pelvic inflammation, its mechanism may be related to the improved blood circulation, accelerated inflammatory absorption and regulated immune function.

  8. Novel PI3Kγ Mutation in a 44-Year-Old Man with Chronic Infections and Chronic Pelvic Pain

    Science.gov (United States)

    Hoischen, Alexander; Veltman, Joris; Allsop, Stephen A.; Granadillo, Victor J. Anciano; William, Arsani; Netea, Mihai G.; Dimitrakoff, Jordan

    2013-01-01

    A 44-year-old man is presented here with 14 years of chronic purulent sinusitis, a chronic fungal rash of the scrotum, and chronic pelvic pain. Treatment with antifungal therapy resulted in symptom improvement, however he was unable to establish an effective long-term treatment regimen, resulting in debilitating symptoms. He had undergone extensive work-up without identifying a clear underlying etiology, although Candida species were cultured from the prostatic fluid. 100 genes involved in the cellular immune response were sequenced and a missense mutation was identified in the Ras-binding domain of PI3Kγ. PI3Kγ is a crucial signaling element in leukotaxis and other leukocyte functions. We hypothesize that his mutation led to his chronic infections and pelvic pain. PMID:23861857

  9. Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.

    Science.gov (United States)

    Anderson, Rodney U; Harvey, Richard H; Wise, David; Nevin Smith, J; Nathanson, Brian H; Sawyer, Tim

    2015-03-01

    This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).

  10. [A modern view on the problem of the chronic pelvic pain at the women].

    Science.gov (United States)

    Udovika, N A; Manishchenkov, S N

    2011-01-01

    The article contains the basic causes and consequences of chronic pelvic pain (HPP) at the women. Shown that HPP - serious medical and social problem, which changes the psyche and behavior of women, violates her social adaptation. Pathogenesis HPP associated with persistent violations intraorganic and regional hemodynamics and hypoxia and acidosis that occur at the same time, cause degeneration of receptors and conduction system of pelvic organs, malnutrition solar cells and aortic nerve plexuses. Briefly described stages of HPP and this characteristic psychogenic pain as a diagnosis of exclusion. These basic ways to eliminate pain and pharmacological methods, physio and psychological action at HPP.

  11. Acupuncture and Immune Function in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized, Controlled Study

    Science.gov (United States)

    Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay; Krieger, John N

    2014-01-01

    Objective The immune system has been implicated as one mechanism underlying the benefits of acupuncture therapy. Evidence suggests that acupuncture can ameliorate symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but the association between clinical response and the immune system has not been investigated. Design/Setting We investigated 12 CP/CPPS patients participating in a prospective randomized clinical trial comparing acupuncture versus sham acupuncture for effects on cellular immunity. Blood samples were taken before the first needling and after the last of 20 treatment sessions (week 10). Patients also completed questionnaires examining their CP/CPPS symptoms and mood status at the baseline and end of study visits. Results At the end of study 8 of 12 participants (67%) were classified as treatment responders, 4 participants each from the acupuncture and sham groups. The acupuncture group averaged a 5% increase in natural killer cell levels compared to corresponding sham (-13%; p=0.03). Similarly, patients randomized to acupuncture reported a reduction in other white blood cell parameters examined, supporting the possibility that immunity might be important in the pathophysiology of CP/CPPS. Conclusions The specific effect of acupuncture on CP/CPPS remains unclear. Further research is warranted to examine the mechanisms by which acupuncture therapy may improve clinical symptoms in patients with CP/CPPS. PMID:25453515

  12. Complementary and Alternative Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Jillian L. Capodice

    2005-01-01

    Full Text Available To discuss challenges concerning treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and review complementary and alternative medical (CAM therapies being evaluated for this condition, we performed a comprehensive search of articles published from 1990–2005 using the PubMed, Medline databases. Data from the articles were abstracted and pooled by subject. Keywords cross-searched with CP/CPPS included: complementary, alternative, integrative, therapies, interventions, nutrition, antioxidants, herbs, supplements, biofeedback and acupuncture. Listed articles with no abstracts were not included. Various CAM therapies for CP/CPPS exist including biofeedback, acupuncture, hyperthermia and electrostimulation. Additionally, a variety of in vitro and in vivo studies testing herbal and nutritional supplements were found. Saw palmetto, cernilton and quercetin were the most frequently tested supplements for CP/CPP Although many CAM therapies demonstrate positive preliminary observations as prospective treatments for CP/CPPS, further exploratory studies including more randomized, controlled trials are necessary for significant validation as treatment options for this complex disorder.

  13. Presence of Mental Imagery Associated with Chronic Pelvic Pain: A Pilot Study

    Science.gov (United States)

    Berna, Chantal; Vincent, Katy; Moore, Jane; Tracey, Irene; Goodwin, Guy M; Holmes, Emily A

    2011-01-01

    Objective To ascertain whether a small sample of patients with chronic pelvic pain experienced any pain-related cognitions in the form of mental images. Patients Ten women with chronic pelvic pain consecutively referred from a tertiary referral center by the physicians in charge of their treatment. Outcome measures An interview was used to determine the presence, emotional valence, content, and impact of cognitions about pain in the form of mental images and verbal thoughts. The Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), Spontaneous Use of Imagery Scale (SUIS), and Hospital Anxiety and Depression Scale (HADS) were completed. Results In a population of patients with a prolonged duration of pain and high distress, all patients reported experiencing cognitions about pain in the form of mental images. For each patient, the most significant image was both negative in valence and intrusive. The associated emotional-behavioral pattern could be described within a cognitive behavioral therapy framework. Eight patients also reported coping imagery. Conclusion Negative pain-related cognitions in the form of intrusive mental imagery were reported by women with chronic pelvic pain. Targeting such imagery has led to interesting treatment innovation in the emotional disorders. Thus, imagery, hitherto neglected in pain phenomenology, could provide a novel target for cognitive behavioral therapy in chronic pain. These exciting yet preliminary results require replication and extension in a broader population of patients with chronic pain. PMID:21668746

  14. New concepts on functional chronic pelvic and perineal pain: pathophysiology and multidisciplinary management.

    Science.gov (United States)

    Ploteau, Stéphane; Labat, Jean Jacques; Riant, Thibault; Levesque, Amélie; Robert, Roger; Nizard, Julien

    2015-03-01

    The management of chronic pelvic and perineal pain has been improved by a better understanding of the mechanisms of this pain and an optimized integrated multidisciplinary approach to the patient. The concept of organic lesions responsible for a persistent nociceptive factor has gradually been replaced by that of dysregulation of nociceptive messages derived from the pelvis and perineum. In this setting, painful diseases identified by organ specialists are usually also involved and share several common denominators (triggering factors, predisposing clinical context). These diseases include painful bladder syndrome, irritable bowel syndrome, vulvodynia, and chronic pelvic pain syndrome. The painful symptoms vary from one individual to another and according to his or her capacity to activate pain inhibition/control processes. Although the patient often attributes chronic pain to a particular organ (with the corollary that pain will persist until the organ has been treated), this pain is generally no longer derived from the organ but is expressed via this organ. Several types of clinical presentation of complex pelvic pain have therefore been pragmatically identified to facilitate the management of treatment failures resulting from a purely organ-based approach, which can also reinforce the patient's impression of incurability. These subtypes correspond to neuropathic pain, central sensitization (fibromyalgia), complex regional pain syndrome, and emotional components similar to those observed in post-traumatic stress disorder. These various components are also often associated and self-perpetuating. Consequently, when pelvic pain cannot be explained by an organ disease, this model, using each of these four components associated with their specific mechanisms, can be used to propose personalized treatment options and also to identify patients at high risk of postoperative pelvic pain (multi-operated patients, central sensitization, post-traumatic stress disorder, etc

  15. Evaluation of hysteroscopy as a complementary exam in the investigation of chronic pelvic pain.

    Directory of Open Access Journals (Sweden)

    Bruno Hállan Meneses Dias

    2013-09-01

    Full Text Available Introduction: Chronic pelvic pain (CPP is a difficult condition to identify and many disorders are correlated. This study investigates the role of hysteroscopy as a complementary exam in the diagnosis of CPP. Methods: One hundred ninety-one medical records of women with indication to perform a hysteroscopy and presented CPP were reviewed. Results: The analysis showed abnormalities in 99 patients. Of these, more than 70% presented conditions that could cause CPP. Cervical stenosis and findings suggestive of adenomyosis were the most frequent ocurrences. Conclusions: Hysteroscopy is useful to detect pathological conditions of the cervix and uterine cavity that may coexist with chronic pelvic pain.

  16. Redundant prepuce increases the odds of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

    Science.gov (United States)

    Zhao, Yu-Yang; Xu, Dong-Liang; Zhao, Fu-Jun; Han, Bang-Min; Shao, Yi; Zhao, Wei; Xia, Shu-Jie

    2014-01-01

    Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients (case group) and 341 nonCP/CPPS patients (control group). Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin (odds ratio (OR): 1.66, 95% confidence interval (CI): 1.04–2.66). In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 (95% CI, 1.2–2.88). The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS. PMID:24875824

  17. Redundant prepuce increases the odds of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS

    Directory of Open Access Journals (Sweden)

    Yu-Yang Zhao

    2014-10-01

    Full Text Available Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS. However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients (case group and 341 nonCP/CPPS patients (control group. Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin (odds ratio (OR: 1.66, 95% confidence interval (CI: 1.04-2.66. In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 (95% CI, 1.2-2.88. The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.

  18. Fluoxetine ameliorates symptoms of refractory chronic prostatitis/chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    XIA Dan; WANG Ping; CHEN Jun; WANG Shuo; JIANG Hai

    2011-01-01

    Background Category Ⅲ chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common syndrome of unclear etiology with significant impact on quality of life. Because the outcomes of multiple therapies for CP/CPPS have been far from approving, the possible psychological factors have been considered to play an important role in CP/CPPS.Based on this, we investigated the role of antidepressant drug (fluoxetine) in men with refractory CP/CPPS.Methods In this study, 42 men diagnosed with refractory CP/CPPS without response to standard therapy (include multiple antibiotic courses and a-blockers) were referred for fluoxetine therapy. All patients received fluoxetine (20 mg/d) for three months and were clinically evaluated before (baseline), and after 4, 8 and 12 weeks of therapy. The evaluation included a National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) and a Beck depression inventory (BDI) questionnaire. Moreover, the subjective global assessment (SGA) was assessed at the 4th, 8th and 12th week of therapy.Results Significant decreases were observed for total NIH-CPSI (28.55 to 9.29), NIH-CPSI pain (14.69 to 5.19),NIH-CPSI urinary (4.95 to 1.88 ), NIH-CPSI quality of life (8.83 to 2.20), and BDI (34.67 to 13.95) scores compared with baseline, all P values <0.05. Twenty-nine (69.05%) reported marked improvement on the subjective global assessment and 33 (78.57%) had a greater than 50% decrease in NIH-CPSI at the end of therapy (12th week). At the same time, the Pearson correlation coefficient analysis demonstrated a positive correlation between BDI score and each CPSI score. No adverse events were reported in this study.Conclusions Fluoxetine appears to be a safe and effective treatment in improving symptoms in, and the quality of life of, men with difficult CP/CPPS. Moreover, amelioration of difficult CP/CPPS-related symptoms could be related to a decrease in depressive symptoms.

  19. Multimodal therapy for category III chronic prostatitis/chronic pelvic pain syndrome in UPOINTS phenotyped patients

    Science.gov (United States)

    MAGRI, VITTORIO; MARRAS, EMANUELA; RESTELLI, ANTONELLA; WAGENLEHNER, FLORIAN M.E.; PERLETTI, GIANPAOLO

    2015-01-01

    The complex network of etiological factors, signals and tissue responses involved in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) cannot be successfully targeted by a single therapeutic agent. Multimodal approaches to the therapy of CP/CPPS have been and are currently being tested, as in the frame of complex diagnostic-therapeutic phenotypic approaches such as the urinary, psychosocial, organ-specific, infection, neurological and muscle tenderness (UPOINTS) system. In this study, the effect of combination therapy on 914 patients diagnosed, phenotyped and treated in a single specialized prostatitis clinic was analyzed. Patients received α-blockers, Serenoa repens (S. repens) extracts combined or not with supplements (lycopene and selenium) and, in the presence of documented or highly suspected infection, antibacterial agents. Combination treatment induced marked and significant improvements of National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) prostatitis symptom scores, International Index of Erectile Function (IIEF) sexual dysfunction scores, urinary peak flow rates and bladder voiding efficiency. These improvements, assessed after a 6-month course of therapy, were sustained throughout a follow-up period of 18 months. A clinically appreciable reduction of ≥6 points of the total NIH-CPSI score was achieved in 77.5% of patients subjected to combination therapy for a period of 6 months. When the patients were divided in two cohorts, depending on the diagnosis of CP/CPPS [inflammatory (IIIa) vs. non-inflammatory (IIIb) subtypes], significant improvements of all signs and symptoms of the syndrome were observed in both cohorts at the end of therapy. Intergroup comparison showed that patients affected by the IIIa sub-category of CP/CPPS showed more severe signs and symptoms (NIH-CPSI total, pain and quality of life impact scores, and Qmax) at baseline when compared with IIIb patients. However, the improvement of symptoms after

  20. Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

    Science.gov (United States)

    Qin, Zongshi; Wu, Jiani; Zhou, Jing; Liu, Zhishun

    2016-03-01

    Acupuncture is a promising therapy for relieving symptoms in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which affects >15% of adult men worldwide. The aim of the study was to assess the effects and safety of the use of acupuncture for CP/CPPS. MEDLINE, EMBASE, CENTRAL, Web of Science, CBM, CNKI, Wang-Fang Database, JCRM, and CiNii were searched from their inception through 30 November 2015. Grey literature databases and websites were also searched. No language limits were applied. Only randomized controlled trials (RCTs) with CP/CPPS treated by acupuncture were included. Two reviewers extracted data and assessed the risk of bias of RCTs using the Cochrane Risk of Bias Tools, respectively. Seven trials were included, involving 471 participants. The result of meta-analysis indicated that compared with sham acupuncture (MD: -6.09 [95%CI: -8.12 to -5.68]) and medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) (MD: -4.57 [95%CI: -7.58 to -1.56]), acupuncture was more effective at decreasing the total NIH-CPSI score. Real acupuncture was superior to sham acupuncture in improving symptoms (pain, voiding) and quality of life (Qof) domain subscores. Compared to sham acupuncture and medicine, acupuncture appears to be more effective at improving the global assessment. Two trials found that there is no significant difference between acupuncture and sham acupuncture in decreasing the IPSS score. Acupuncture failed to show more favorable effects in improving both symptoms and the Qof domain compared with medicine. Overall, current evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Based on the meta-analysis, acupuncture is superior to sham acupuncture in improving symptoms and Qof. Acupuncture might be similar to medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) in its long-term effects, but evidence was limited due to high ROB among included trials as well as potential heterogeneity

  1. Effects of “Danzhi Decoction” on Chronic Pelvic Pain, Hemodynamics, and Proinflammatory Factors in the Murine Model of Sequelae of Pelvic Inflammatory Disease

    Directory of Open Access Journals (Sweden)

    Xiaoling Bu

    2015-01-01

    Full Text Available Objective. To evaluate the effect of Danzhi decoction (DZD on chronic pelvic pain (CPP, hemodynamics, and proinflammatory factors of sequelae of pelvic inflammatory diseases (SPID in murine model. Methods. SPID mice were randomly treated with high-dose DZD, mid-dose DZD, low-dose DZD, aspirin, and vehicle for 3 estrous circles. The Mouse Grimace Scale (MGS was performed to evaluate CPP; blood flows of the upper genital tract, pelvic wall, and mesentery were used to assess hemodynamics in SPID mice; expressions of vascular endothelial growth factor (VEGF, angiopoietin-2 (Ang-2, and osteopontin (OPN were measured by Western blot and immunochemistry. Results. Treatment with dose-dependent DZD significantly decreased the MGS scores, accelerated blood flows of the pelvis, and reduced expressions of VEGF, Ang-2, and OPN in the upper genital tract. Conclusions and Discussions. DZD was effective in relieving CPP and improving hemodynamics of the pelvic blood-stasis microenvironment in SPID mice. There was a relationship between CPP and the pelvic blood-stasis microenvironment. Furthermore, DZD might play a positive role in the anti-inflammatory process.

  2. Complex mullerian duct anomaly in a young female with primary amenorrhoea, infertility, and chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Sanyal Kumar

    2012-01-01

    Full Text Available Mullerian duct anomalies, though rare, can be a treatable cause of pelvic pain and infertility. Various complex Mullerian duct anomalies may exist with combination of features of more than one class. Since there are no precise clinical or imaging criteria to enable specific categorisation, there is ambiguous classification of these anomalies by various radiologists and clinicians. A young female presented with complaints of chronic pelvic pain, primary amenorrhoea and infertility. The patient was evaluated by sonography and Magnetic Resonance Imaging and diagnosed as case of complex mullerian duct anomaly, a unicornuate uterus with cervical dysgenesis and cavitated, noncommunicating, rudimentary right horn. The findings were confirmed on laprohysteroscopy and the patient underwent hystertectomy. There should be an integrated clinico-radiological classification scheme and familiarity with rare and complex anomalies for appropriate diagnosis and management of complex Mullerian duct anomalies.

  3. Mast cells in chronic inflammation, pelvic pain and depression in women.

    Science.gov (United States)

    Graziottin, Alessandra; Skaper, Stephen D; Fusco, Mariella

    2014-07-01

    Inflammatory and neuroinflammatory processes are increasingly recognized as critical pathophysiologic steps in the development of multiple chronic diseases and in the etiology of persistent pain and depression. Mast cells are immune cells now viewed as cellular sensors in inflammation and immunity. When stimulated, mast cells release an array of mediators to orchestrate an inflammatory response. These mediators can directly initiate tissue responses on resident cells, and may also regulate the activity of other immune cells, including central microglia. New evidence supports the involvement of peripheral and central mast cells in the development of pain processes as well as in the transition from acute, to chronic and neuropathic pain. That behavioral and endocrine states can increase the number and activation of peripheral and brain mast cells suggests that mast cells represent the immune cells that peripherally and centrally coordinate inflammatory processes in neuropsychiatric diseases such as depression and anxiety which are associated with chronic pelvic pain. Given that increasing evidence supports the activated mast cell as a director of common inflammatory pathways/mechanisms contributing to chronic and neuropathic pelvic pain and comorbid neuropsychiatric diseases, mast cells may be considered a viable target for the multifactorial management of both pain and depression.

  4. Pollen extract in association with vitamins provides early pain relief in patients affected by chronic prostatitis/chronic pelvic pain syndrome

    Science.gov (United States)

    CAI, TOMMASO; WAGENLEHNER, FLORIAN M.E.; LUCIANI, LORENZO GIUSEPPE; TISCIONE, DANIELE; MALOSSINI, GIANNI; VERZE, PAOLO; MIRONE, VINCENZO; BARTOLETTI, RICCARDO

    2014-01-01

    The therapeutic efficacy for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is currently unsatisfactory. The aim of the present study was to assess the safety and efficacy of pollen extract in association with vitamins (DEPROX 500®) in males with CP/CPPS. All patients with a diagnosis of CP/CPPS attending the same urologic centre between March and October 2012 were enrolled in this randomised controlled phase III study. Participants were randomised to receive oral capsules of DEPROX 500® (two capsules every 24 h) or ibuprofen (600 mg, one tablet three times a day) for four weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score and Quality of Well-Being (QoL) questionnaires were used. In the intention-to-treat analysis, 87 males (25 class IIIa and 62 class IIIb) with a mean age of 33.6±5.9 years were randomly allocated to the DEPROX 500® (n=41) or ibuprofen (n=46) treatment groups. At the follow-up examination (following one month of treatment), in the DEPROX 500® group, 31/41 patients (75.6%) reported an improvement in quality of life, defined as a reduction of the NIH-CPSI total score by ≥25%, compared with 19/46 (41.3%) in the control group (P=0.002). The greater improvement in the DEPROX 500® group compared with the ibuprofen group was statistically significant (treatment difference in the NIH-CPSI pain domain, −2.14±0.51, P<0.001; QoL scores, P=0.002). All patients were negative at the Meares-Stamey test evaluation. Adverse events were less frequent in the DEPROX 500® group than in the ibuprofen group. The DEPROX 500® treatment significantly improved total symptoms, pain and quality of life compared with ibuprofen in patients with CP/CPPS, without severe side-effects. PMID:25187793

  5. Treatment effect of pelvic floor treating chronic pelvic inflammatory disease%盆底治疗在慢性盆腔炎中的治疗效果

    Institute of Scientific and Technical Information of China (English)

    蒋艳华

    2015-01-01

    Objective To explore the treatment effect of pelvic floor treating chronic pelvic inflammatory disease. Methods Selecting 100 cases of chronic pelvic inflammation patients admitted our hospital from November 2010 to November 2013,they were randomly divided into the 50 control group and 50 observation group.Simple drug treats control group patients,pelvic therapy instrument combined with pelvic floor muscle training treat observation group. Finally,observing the clinical condition of two groups of patients. Results The effective rate of observation group therapy was 96%,and recurrence rate was 8%,significantly higher than 80% of the control group and 48% (P < 0.05). At the same time,VSA score of after treatment was significantly lower than the control group (P < 0.05). Conclusion Pelvic floor treat patients with chronic pelvic inflammatory disease,the treatment effect is significant,and the recurrence rate is lower,it is high clinical value in using.%目的:探究盆底治疗在慢性盆腔炎中的治疗效果。方法选取我科在2010年11月~2013年11月收治的100例慢性盆腔炎患者,将其随机分为50例对照组和50例观察组。其中,单纯药物治疗对照组患者,盆底治疗仪联合盆底肌锻炼治疗观察组。最后观察两组患者的临床情况。结果观察组治疗有效率、复发率分别为96%、8%,明显优于对照组的80%、48%(P <0.05)。同时,治疗后,与对照组相比,观察组患者盆腔 VSA 评分明显较低(P <0.05)。结论盆底治疗慢性盆腔炎效果显著,复发率低,具有较高的临床利用价值。

  6. Novel Treatment of Chronic Bladder Pain Syndrome and Other Pelvic Pain Disorders by OnabotulinumtoxinA Injection

    Directory of Open Access Journals (Sweden)

    Jia-Fong Jhang

    2015-06-01

    Full Text Available Chronic pelvic pain (CPP is defined as pain in the pelvic organs and related structures of at least 6 months’ duration. The pathophysiology of CPP is uncertain, and its treatment presents challenges. Botulinum toxin A (BoNT-A, known for its antinociceptive, anti-inflammatory, and muscle relaxant activity, has been used recently to treat refractory CPP with promising results. In patients with interstitial cystitis/bladder pain syndrome, most studies suggest intravesical BoNT-A injection reduces bladder pain and increases bladder capacity. Repeated BoNT-A injection is also effective and reduces inflammation in the bladder. Intraprostatic BoNT-A injection could significantly improve prostate pain and urinary frequency in the patients with chronic prostatitis/chronic pelvic pain syndrome. Animal studies also suggest BoNT-A injection in the prostate decreases inflammation in the prostate. Patients with CPP due to pelvic muscle pain and spasm also benefit from localized BoNT-A injections. BoNT-A injection in the pelvic floor muscle improves dyspareunia and decreases pelvic floor pressure. Preliminary studies show intravesical BoNT-A injection is useful in inflammatory bladder diseases such as chemical cystitis, radiation cystitis, and ketamine related cystitis. Dysuria is the most common adverse effect after BoNT-A injection. Very few patients develop acute urinary retention after treatment.

  7. Phenotyping chronic pelvic pain based on latent class modeling of physical examination.

    Science.gov (United States)

    Fenton, B W; Grey, S F; Reichenbach, M; McCarroll, M; Von Gruenigen, V

    2013-01-01

    Introduction. Defining clinical phenotypes based on physical examination is required for clarifying heterogeneous disorders such as chronic pelvic pain (CPP). The objective of this study was to determine the number of classes within 4 examinable regions and then establish threshold and optimal exam criteria for the classes discovered. Methods. A total of 476 patients meeting the criteria for CPP were examined using pain pressure threshold (PPT) algometry and standardized numeric scale (NRS) pain ratings at 30 distinct sites over 4 pelvic regions. Exploratory factor analysis, latent profile analysis, and ROC curves were then used to identify classes, optimal examination points, and threshold scores. Results. Latent profile analysis produced two classes for each region: high and low pain groups. The optimal examination sites (and high pain minimum thresholds) were for the abdominal wall region: the pair at the midabdomen (PPT threshold depression of > 2); vulvar vestibule region: 10:00 position (NRS > 2); pelvic floor region: puborectalis (combined NRS > 6); vaginal apex region: uterosacral ligaments (combined NRS > 8). Conclusion. Physical examination scores of patients with CPP are best categorized into two classes: high pain and low pain. Standardization of the physical examination in CPP provides both researchers and general gynecologists with a validated technique.

  8. Detection of sexually transmitted pathogens in patients with chronic prostatitis/chronic pelvic pain: a prospective clinical study.

    Science.gov (United States)

    Papeš, Dino; Pasini, Miram; Jerončić, Ana; Vargović, Martina; Kotarski, Viktor; Markotić, Alemka; Škerk, Višnja

    2017-01-01

    In <10% of patients with prostatitis syndrome, a causative uropathogenic organism can be detected. It has been shown that certain organisms that cause sexually transmitted infections can also cause chronic bacterial prostatitis, which can be hard to diagnose and treat appropriately because prostatic samples obtained by prostatic massage are not routinely tested to detect them. We conducted a clinical study to determine the prevalence of Chlamydia, mycoplasma, and trichomonas infection in 254 patients that were previously diagnosed and treated for chronic prostatitis/chronic pelvic pain syndrome due to negative urethral swab, urine, and prostate samples. Urethral swabs and standard Meares-Stamey four-glass tests were done. Detailed microbiological analysis was conducted to detect the above organisms. Thirty-five (13.8%) patients had positive expressed prostatic secretions/VB3 samples, of which 22 (10.1%) were sexually transmitted organisms that were not detected on previous tests.

  9. Pelvic congestion syndrome and chronic pelvic pain%盆腔淤血综合征与慢性盆腔痛

    Institute of Scientific and Technical Information of China (English)

    肖喜荣; 李斌

    2013-01-01

    Pelvic congestion syndrome (PCS), caused by mechanical and/or hormonal factors, plays an important role in the disease of chronic pelvic pain. Patients commonly present with pelvic pain without positive physical examination finding. The imaging examination such as doppler ultrasound, contrast-enhanced magnetic resonance venography and pelvic venogra-phy is vital in the assessment of PCS and is often used to confirm the clinical suspicion of this condition. Besides traditional therapy, transcatheter embo-lotherapy gradually turns to be the optimal treatment option.%盆腔淤血综合征是慢性盆腔痛的重要原因,其发生与盆腔静脉解剖、体循环、内分泌等因素有关.盆腔淤血综合征患者的临床症状与体征不符,超声、增强磁共振静脉造影及盆腔静脉造影有助于诊断.在沿袭传统治疗的同时,经导管栓塞技术已逐步成为治疗盆腔淤血综合征的首选方案.

  10. Bedside Testing for Chronic Pelvic Pain: Discriminating Visceral from Somatic Pain

    Directory of Open Access Journals (Sweden)

    John Jarrell

    2011-01-01

    Full Text Available Objectives. This study was done to evaluate three bedside tests in discriminating visceral pain from somatic pain among women with chronic pelvic pain. Study Design. The study was an exploratory cross-sectional evaluation of 81 women with chronic pelvic pain of 6 or more months' duration. Tests included abdominal cutaneous allodynia (aCA, perineal cutaneous allodynia (pCA, abdominal and perineal myofascial trigger points (aMFTP and (pMFTP, and reduced pain thresholds (RPTs. Results. Eighty-one women were recruited, and all women provided informed consent. There were 62 women with apparent visceral pain and 19 with apparent somatic sources of pain. The positive predictive values for pelvic visceral disease were aCA-93%, pCA-91%, aMFTP-93%, pMFTP-81%, and RPT-79%. The likelihood ratio (+ and 95% C.I. for the detection of visceral sources of pain were aCA-4.19 (1.46, 12.0, pCA-2.91 (1.19, 7.11, aMTRP-4.19 (1.46, 12.0, pMFTP-1.35 (0.86, 2.13, and RPT-1.14 (0.85, 1.52, respectively. Conclusions. Tests of cutaneous allodynia, myofascial trigger points, and reduced pain thresholds are easily applied and well tolerated. The tests for cutaneous allodynia appear to have the greatest likelihood of identifying a visceral source of pain compared to somatic sources of pain.

  11. A Training Module for Laparoscopic Urology

    OpenAIRE

    2005-01-01

    Objectives: A fellowship training model in laparoscopic urological surgery has been established for interested urologists to help them proceed from the pelvic trainer/ animal laboratory environment to safe clinical practice. The objective of the model is to provide trainees with clinical experience under direct mentor supervision before embarking on independent laparoscopic urological surgery at their own base hospitals. Methods: The fellowship model incorporates 9 fluid phases: Phase 1 to co...

  12. Feasibility of robotic radical prostatectomy for medication refractory chronic prostatitis/chronic pelvic pain syndrome: Initial results

    Directory of Open Access Journals (Sweden)

    Sameer Chopra

    2016-01-01

    Full Text Available Four patients diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS, met criteria for National Institute of Health (NIH Category III prostatitis, failed multiple medicinal treatments and underwent robotic radical prostatectomy (RRP. Median operative time (range: 157 (127–259 min. Validated functional questionnaires responses and NIH CP symptom index (NIH-CPSI score were collected for each patient's status at different time points pre- and post-operatively. Median decreases (range were: International Prostate Symptom Score - 14 (1–19; Sexual Health Inventory for Men - 6 (−14–22; and NIH-CPSI total - 23.5 (13–33. Median length of follow-up (range was 34 (24–43 months. RRP appears to be an option for carefully selected patients with medication-refractory CP/CPPS who understand that baseline sexual function may not be restored postoperatively.

  13. Feasibility of robotic radical prostatectomy for medication refractory chronic prostatitis/chronic pelvic pain syndrome: Initial results.

    Science.gov (United States)

    Chopra, Sameer; Satkunasivam, Raj; Aron, Monish

    2016-01-01

    Four patients diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), met criteria for National Institute of Health (NIH) Category III prostatitis, failed multiple medicinal treatments and underwent robotic radical prostatectomy (RRP). Median operative time (range): 157 (127-259) min. Validated functional questionnaires responses and NIH CP symptom index (NIH-CPSI) score were collected for each patient's status at different time points pre- and post-operatively. Median decreases (range) were: International Prostate Symptom Score - 14 (1-19); Sexual Health Inventory for Men - 6 (-14-22); and NIH-CPSI total - 23.5 (13-33). Median length of follow-up (range) was 34 (24-43) months. RRP appears to be an option for carefully selected patients with medication-refractory CP/CPPS who understand that baseline sexual function may not be restored postoperatively.

  14. Pelvic actinomycosis.

    Science.gov (United States)

    Gorisek, B; Rebersek-Gorisek, H; Kavalar, R; Krajnc, I; Zavrsnik, S

    1999-08-20

    Pelvic actinomycosis is a rare chronic infection caused by bacteria of the family Actinomycetaceae. Prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor. We report six patients with pelvic actinomycosis, all of whom had an IUD inserted for over six years. Diagnostic problems necessitated a laparotomy in all patients. The pathohistological diagnosis was based on the characteristic microscopic image and specific staining. The patients were treated with penicillin and amoxycillin for several months.

  15. Effect of diosmin on chronic nonbacterial prostatitis caused by pelvic congestion in rats

    Directory of Open Access Journals (Sweden)

    Gong-ting CUI

    2014-08-01

    Full Text Available Objective To explore the effect of diosmin on chronic nonbacterial prostatitis (CNP in rats and its possible mechanisms. Methods Thirty-two healthy adult male SD rats were randomly divided into 4 groups: Sham-operated group (SO group, chronic prostatitis model group (CPM group, chronic prostatitis model + prostat treatment group (CPM-P group, and chronic prostatitis model + diosmin treatment group (CPM-D group. Rats in SO group underwent laparotomy only to expose the prostate, and those in other groups received prostatic vein ligation to reproduce pelvic congestion. HE staining was used for the examination of the prostate 35 days after the operation. 80mg/(kg.d of diosmin was given to the rats in CPM-D group, and 60mg/(kg.d of diosmin to the rats in CPM-P group twice a day by gavage for 7 days. Same volume of 5% acacia gum was given to rats in SO and CPM groups. All of the rats were sacrificed 1h after the last administration, and the serum levels of interleukin-10 (IL-10, IL-8, IL-1β, malondialdehyde (MDA, nitric oxide (NO were determined by ELISA, and the pathological changes in the prostate tissue were observed after HE staining and compared between the groups. Results The serum levels of IL-1β, IL-8 and NO were significantly lower in CPM-D group and CPM-P group than in CPM group (P<0.05, the serum level of IL-10 was significantly higher in CPM-D group and CPM-P group than in CPM group (P<0.05, and the serum MDA level was similar between the 3 groups. HE staining showed that chronic inflammatory changes in rats' prostate were reduced more significantly in CPM-P group and CPM-D group than in CPM group. Conclusion The therapeutic effect of diosmin on pelvic-congestion-induced chronic prostatitis is similar to that of prostat tablets, and its mechanism may be related to the alleviation of local inflammatory response by reducing the IL-1β, IL-8 and NO levels and increasing the IL-10 content in serum. DOI: 10.11855/j.issn.0577-7402.2014.06.04

  16. Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review

    DEFF Research Database (Denmark)

    Loving, Sys; Nordling, Jørgen; Jaszczak, Poul

    2012-01-01

    dysfunction is frequently cited as a possible aetiology. Physiotherapy is therefore recommended as one treatment modality. The aim of this systematic review was to source and critically evaluate the evidence for an effect of physiotherapy on pain, physical activity and quality of life in the treatment...... of female CPP. Methods Electronic databases, conference proceedings, text books and clinical guidelines were searched for quantitative, observational, and prospective clinical intervention studies of female chronic pelvic pain where physiotherapy was a sole or significant component of the intervention...... in the other study types. Physiotherapy treatments varied between studies and were provided in combination with psychotherapeutic modalities and medical management. This did not allow for the ‘stand-alone’ value of physiotherapy to be determined. Heterogeneity across the studies, with respect to participants...

  17. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction.

    Science.gov (United States)

    Aredo, Jacqueline V; Heyrana, Katrina J; Karp, Barbara I; Shah, Jay P; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections.

  18. Treatment of 15 Cases of Chronic Pelvic Inflammation by Acupuncture plus Herbal Enema

    Institute of Scientific and Technical Information of China (English)

    SHEN Jian

    2005-01-01

    Fifteen cases of chronic pelvic inflammation were treated by needling Guanyuan (CV 4), Qihai (CV 6), Sanyinjiao (SP 6), Zhongji (CV 3), Shidao (ST 28), Diji (SP 8), Zusanli (ST 36), Shenshu (BL 23), Dachangshu (BL 25) and Ciliao(BL 32) in combination with herbal enema effective to clear heat and relieve toxin, activate blood and resolve stagnant blood.After 2-course treatment, 13 cases were cured and 2 cases were improved.%针刺关元,气海,三阴交,中极,水道,地机,足三里,肾俞,大肠俞和次髎穴,同时用清热解毒和活血化瘀中药进行保留灌肠,治疗了15例慢性盆腔炎患者,经过2个疗程治疗,13例痊愈,2例有效.

  19. Irritable bowel syndrome and chronic pelvic pain: A singular or two different clinical syndrome?

    Institute of Scientific and Technical Information of China (English)

    Anna Matheis; Ute Martens; Johannes Kruse; Paul Enck

    2007-01-01

    Irritable bowel syndrome (IBS) and chronic pelvic pain (CPP) are both somatoform disorders with a high prevalence within the population in general. The objective was to compare both entities, to find the differences and the similarities related to epidemiology and psychosocial aspects like stressful life events, physical and sexual abuse, illness behaviour and comorbidity. The technical literature was reviewed systematically from 1971 to 2006 and compared. According to literature, IBS and CPP seem to be one rather than two different entities with the same localisation of pain. Both syndromes also are similar concerning prevalence, the coexistence of mental and somatoform disorders, the common history of sexual and physical abuse in the past and their health care utilization. It could be shown that there were many similarities between IBS and CPR Nevertheless both are traded as different clinical pictures as far. Therefore it seems to be reasonable and necessary to generate a common diagnosis algorithm and to bring gynaecologists and gastroenterologists into dialogue.

  20. Depression and Somatic Symptoms May Influence on Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Preliminary Study

    Science.gov (United States)

    Koh, Jun Sung; Ko, Hyo Jung; Wang, Sheng-Min; Cho, Kang Joon; Kim, Joon Chul; Lee, Soo-Jung

    2014-01-01

    The present study is the first one to investigate the impacts of depression and somatization on the disease severity and quality of life (QoL) in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The Korean version of National Institutes of Health (NIH)- Chronic Prostatitis Symptom Index (CPSI) for severity of CP/CPPS. Korean version of Patient Health Questionnaire-9 (PHQ-9) for depression, Korean version of Patient Health Questionnaire-15 (PHQ-15) for somatization, and Korean version of EuroQol Questionnaire-5 Dimensions (EQ-5D)- [(EQ-5D utility index and visual analog scale (EQ-5D VAS)] for QoL, were administered. Eighty patients were enrolled. The NIH-CPSI total scores were significantly higher in those with depression (25.3%, p=0.01) or somatization (23.2%, p=0.03) than in those without. These trends toward significantly negative influence of depression and somatic symptoms on QoL were also observed. Our preliminary results indicate that depression and somatization may have negative influence on the symptom severity and QoL in patients with CP/CPPS. However, adequately-powered and more well-designed studies are mandatory to prove our results. PMID:25395984

  1. A Combined Use of Acupuncture,Moxibustion and Long Dan Xie Gan Tang for Treatment of 36 Cases of Chronic Pelvic Inflammation

    Institute of Scientific and Technical Information of China (English)

    金亚蓓

    2004-01-01

    Objective: To observe the therapeutic effect of acupuncture and moxibustion on chronic pelvic inflammation. Method: Thirty-six cases of chronic pelvic inflammation were treated with acupuncture,the Pathogenic Fire of the Liver) and medicinal cake moxibustion. Result: The treatment resulted in cure in 9 cases, obvious effect in 16 cases, effect in 7 cases and no effect in 4 cases. Conclusion:Acupuncture, moxibustion and the ancient recipe Long Dan Xie Gan Tang used together can enhance the therapeutic effects on chronic pelvic inflammation.

  2. Pelvic Inflammatory Disease (For Parents)

    Science.gov (United States)

    ... ovaries, and uterus, which can lead to chronic pelvic pain and serious damage to the reproductive system . PID ... the inability to have a baby) and chronic pelvic pain. A teen girl or woman who has had ...

  3. Chronic Pelvic Pain frequency among a group of Iranian employed women

    Directory of Open Access Journals (Sweden)

    Dehghan FM

    2009-01-01

    Full Text Available "nBackground: Chronic Pelvic Pain (CPP, a common health problem in women, characterized by lower abdominal pain that has lasted at least for six months. Although, it's annual prevalence estimated 3.8 to 49%, there is no data in Iranian society. This study was aimed at gathering comprehensive and reliable data regarding the prevalence of CPP in female employees at two university hospitals in Tehran in 2006-2007. "nMethods: A cross-Sectional study was conducted to determine the CPP prevalence on 303 volunteer females aged 19-63(34.7±9.2 years, working in two university hospitals, Tehran. A designed questionnaire with four parts containing questions regarding demographic information, gynecological, urinary and gastrointestinal symptoms was used. The ethical committee of the Shaheed Beheshti Medical University approved the study. "nResults: The prevalence of present pelvic pain unrelated to menstrual cycle was 22.3% and totally 10.2% subjects suffered from CPP during the last 6-12 months. Our data showed a significant difference in prevalence of CPP between women with and without vaginal delivery (37% VS. 24 P=0.036%. There was a significant relationship between incomplete and hard defecation and occurrence of CPP (p<0.001. The prevalence of LBP & PPD in women with CPP was higher than women with no CPP (p<0.001. "nConclusions: Regarding to the prevalence of CPP and its relationship with gynecological, urinary, musculoskeletal and gastrointestinal factors, we emphasize on a multidisciplinary approach for management of CPP, also recommend performing further community-based epidemiological studies.

  4. Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Wang, X-J; Xia, L-L; Xu, T-Y; Zhang, X-H; Zhu, Z-W; Zhang, M-G; Liu, Y; Xu, C; Zhong, S; Shen, Z-J

    2016-04-01

    There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats.

  5. Association between chronic prostatitis/chronic pelvic pain syndrome and anxiety disorder: a population-based study.

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    Shiu-Dong Chung

    Full Text Available BACKGROUND: This case-control study utilized a population-based dataset to examine the association of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS with prior anxiety disorder (AD by comparing the risk of prior AD between subjects with CP/CPPS and matched controls in Taiwan. METHODS: We study used data sourced from the Taiwan Longitudinal Health Insurance Database. The cases comprised 8,088 subjects with CP/CPPS and 24,264 randomly matched subjects as controls. We used a conditional logistic regression to calculate the odds ratio (OR for having been previously diagnosed with AD between subjects with and without CP/CPPS. RESULTS: Of the 24,264 sampled subjects, 2309 (7.1% had received an AD diagnosis before the index date; AD was found in 930 (11.5% cases and 1379 (5.7% controls (p59 years. In particular, subjects aged 40∼59 years had the highest adjusted OR (of 2.53 for prior AD among cases compared to controls. CONCLUSIONS: We concluded that CP/CPPS is associated with previously diagnosed AD. Urologists should be alert for the association between CP/CPPS and AD in subjects suffering from AD.

  6. Chronic Prostatitis/Chronic Pelvic Pain Syndrome is associated with Irritable Bowel Syndrome: A Population-based Study.

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    Liao, Chun-Hou; Lin, Herng-Ching; Huang, Chao-Yuan

    2016-05-26

    This study aimed to examine this association by comparing the risk of prior irritable bowel syndrome (IBS) between patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and matched controls in Taiwan. Data were retrieved from the Longitudinal Health Insurance Database 2005. This study included 4870 cases with CP/CPPS and 4870 age-matched controls. Conditional logistic regressions were conducted to examine associations of CP/CPPS with previously diagnosed IBS. We found that a total of 753 (7.7%) of the 9740 sampled patients had IBS prior to the index date; IBS was found in 497 (10.2%) cases and in 256 (5.3%) controls. Conditional logistic regression revealed a higher odds ratio (OR) of prior IBS (OR 2.05, 95% CI = 1.75-2.40) for cases than controls. Furthermore, after adjusting for the patients' monthly income, geographical location, urbanization level, and hypertension and coronary heart disease, the conditional logistic regression analysis indicated that cases were more likely than controls to have prior IBS (OR = 1.96, 95% CI = 1.67-2.29). Furthermore, we found that CP/CPPS was consistently and significantly associated with prior IBS regardless of age group. We concluded that the diagnosis of CP/CPPS was associated with previously diagnosed IBS. Urologists should be aware of the association between CP/CPPS and IBS when treating patients.

  7. Clinical Significance of National Institutes of Health Classification in Patients With Chronic Prostatitis/Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    Sung, Yun Hsien; Jung, Jae Hung; Ryang, Seung Hoon; Kim, Sung Jin

    2014-01-01

    Purpose We determined the effects of alpha-blockers and quinolone in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) classified by National Institute of Health (NIH) consensus group. Materials and Methods Data from a total of 111 patients who were diagnosed with CP/CPPS between June 2010 and June 2012 were analyzed retrospectively. The patients were classified into group 1 (category IIIA, n=40) and group 2 (category IIIB, n=71). Treatment using alfuzosin and levofloxacin was given to both groups for 6 weeks. International Prostate Symptom Score (IPSS) and NIH Chronic Prostatitis Symptom Index were measured before and after therapy. Results Group 1 had a significant decrease in total IPSS score, CPSI pain score, CPSI quality of life (QoL) score, and total CPSI score (p=0.043, p=0.006, p=0.015, and p=0.006, respectively). Group 2 had a significant decrease in IPSS voiding symptom score, IPSS storage symptom score, total IPSS, CPSI pain score, CPSI voiding score, CPSI QoL score, and total CPSI score (p=0.002, p=0.004, p=0.001, p=0.001, p=0.006, p=0.001, and p=0.001, respectively). The CPSI score was reduced by 6 points or more in 50.0% of patients (n=18) in group 1 and in 51.6% of patients (n=32) in group 2. However, there was no statistically significant difference between the changes in IPSS and CPSI scores across the 2 groups. Conclusions Although combination treatment reduced the CPSI score in both groups, there was no significant difference between the groups after combination treatment. We suggest that factors other than inflammation also contribute to symptoms associated with CP/CPPS. PMID:24741418

  8. The Efficacy of Mirodenafil for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Middle-Aged Males

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    Kong, Do Hoon; Yun, Chang Jin; Park, Nam Cheol

    2014-01-01

    Purpose The aim of this study was to investigate the efficacy of mirodenafil in middle-aged male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Materials and Methods Eighty-eight males with CP/CPPS were randomized to receive either levofloxacin (500 mg/d) (group L, 40 patients) or levofloxacin (500 mg/d) and mirodenafil (50 mg/d) (group ML, 48 patients) for six weeks. The International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire were used to grade symptoms at baseline and 6 weeks after treatment. Results The mean change in total IPSS from baseline was higher in group ML than that in group L (group L, -1.1 vs. group ML, -4.3; p<0.05). Significant improvements were also seen in the IPSS voiding subscore (group L, -0.7 vs. group ML, -3.0; p<0.05). Changes observed in the NIH-CPSI of group ML at six weeks were greater than those at baseline (group L, -3.2 vs. group ML, -7.2; p<0.05). Significant improvements were seen in the NIH-CPSI voiding (group L, -0.5 vs. group ML, -1.7; p<0.05) and quality of life domains (group L, -1.0 vs. group ML, -1.8; p<0.05). Group ML showed a significantly greater increase in the IIEF-EF score than did group ML (group L, +0.2 vs. group ML, +7.8; p<0.05). Conclusions Mirodenafil (50 mg once daily) was well tolerated and resulted in significant symptomatic improvement in middle-aged males with CP/CPPS. PMID:25606563

  9. A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain

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    Stone Brian A

    2007-02-01

    Full Text Available Abstract Background The etiology and treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS remain poorly understood. Pain, lower urinary tract voiding symptoms and negative impact on quality of life (QOL are the most common complaints. Acupuncture, which has been widely used to treat painful and chronic conditions, may be a potential treatment to alleviate the constellation of symptoms experienced by men with CP/CPPS. The purpose of our study was to assess the impact of standardized full body and auricular acupuncture in men refractory to conventional therapies and collect pilot data to warrant further randomized trials. Methods Ten men diagnosed with category IIIA or IIIB CP/CPPS >6 months, refractory to at least 1 conventional therapy (antibiotics, anti-inflammatory agents, 5-α reductase inhibitors, α-1 blockers and scoring >4 on the pain subset of the NIH-CPSI were prospectively analyzed in an Institutional Review Board (IRB approved, single-center clinical trial (Columbia University Medical Center IRB#AAAA-7460. Standardized full body and auricular acupuncture treatment was given twice weekly for 6 weeks. The primary endpoints were total score of the NIH-CPSI and assessment of serious adverse events. The secondary endpoints were individual scores of the NIH-CPSI and QOL questionnaire scores of the short-form 36 (SF-36. Results The median age of the subjects was 36 years (range 29–63. Decreases in total NIH-CPSI scores (mean ± SD after 3 and 6 weeks from baseline (25.1 ± 6.6 were 17.6 ± 5.7 (P Conclusion The preliminary findings, although limited, suggest the potential therapeutic role of acupuncture in the treatment of CP/CPPS. Data from this and previous studies warrant randomized trials of acupuncture for CP/CPPS and particular attention towards acupuncture point selection, treatment intervention, and durability of acupuncture.

  10. Prevalence and conditions associated with chronic pelvic pain in women from São Luís, Brazil

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    L.S.C. Coelho

    2014-09-01

    Full Text Available The objective of the present study was to estimate the prevalence of chronic pelvic pain in the community of São Luís, capital of the State of Maranhão, Northeastern Brazil, and to identify independent conditions associated with it. A cross-sectional study was conducted, including a sample of 1470 women older than 14 years predominantly served by the public health system. The interviews were held in the subject's home by trained interviewers not affiliated with the public health services of the municipality. The homes were visited at random according to the city map and the prevalence of the condition was estimated. To identify the associated conditions, the significant variables (P=0.10 were selected and entered in a multivariate analysis model. Data are reported as odds ratio and 95% confidence interval, with the level of significance set at 0.05. The prevalence of chronic pelvic pain was 19.0%. The independent conditions associated with this diagnosis were: dyspareunia (OR=3.94, premenopausal status (OR=2.95, depressive symptoms (OR=2.33, dysmenorrhea (OR=1.77, smoking (OR=1.72, irregular menstrual flow (OR=1.62, and irritative bladder symptoms (OR=1.90. The prevalence of chronic pelvic pain in Sao Luís is high and is associated with the conditions cited above. Guidelines based on prevention and/or early identification of risk factors may reduce the prevalence of chronic pelvic pain in São Luís, Brazil.

  11. Classifying Patients with Chronic Pelvic Pain into Levels of Biopsychosocial Dysfunction Using Latent Class Modeling of Patient Reported Outcome Measures

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    Bradford W. Fenton

    2015-01-01

    Full Text Available Chronic pelvic pain affects multiple aspects of a patient’s physical, social, and emotional functioning. Latent class analysis (LCA of Patient Reported Outcome Measures Information System (PROMIS domains has the potential to improve clinical insight into these patients’ pain. Based on the 11 PROMIS domains applied to n=613 patients referred for evaluation in a chronic pelvic pain specialty center, exploratory factor analysis (EFA was used to identify unidimensional superdomains. Latent profile analysis (LPA was performed to identify the number of homogeneous classes present and to further define the pain classification system. The EFA combined the 11 PROMIS domains into four unidimensional superdomains of biopsychosocial dysfunction: Pain, Negative Affect, Fatigue, and Social Function. Based on multiple fit criteria, a latent class model revealed four distinct classes of CPP: No dysfunction (3.2%; Low Dysfunction (17.8%; Moderate Dysfunction (53.2%; and High Dysfunction (25.8%. This study is the first description of a novel approach to the complex disease process such as chronic pelvic pain and was validated by demographic, medical, and psychosocial variables. In addition to an essentially normal class, three classes of increasing biopsychosocial dysfunction were identified. The LCA approach has the potential for application to other complex multifactorial disease processes.

  12. A STUDY TO INVESTIGATE THE ROLE OF PELVIC FLOOR MUSCLE IN CHRONIC NONRESPONSIVE BACK ACHE IN FEMALES

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    Sadaf Subhi

    2016-02-01

    Full Text Available Background: Chronic low back pain remains a major health problem. Unfortunately, the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25–50% of patients respond to exercise. At present, however, there are no guidelines regarding the best treatment to help clinicians. As a result, time and money are wasted on treatment which ultimately fail to help the patient. A backache is described as annoying and gripping pain. It can be caused by poor posture, lack of manual handling skills, change in the center of gravity due to expanding abdomen, lack of exercise, or the weight of the baby and the stretching ligaments. Pelvic floor muscle weakness is one of the major cause of chronic backache. Weakness in the pelvic floor muscles is common in females which can lead to debilitating urinary symptoms, affect sexual function and cause chronic backache. Methods: In 3 months, 31 female subjects with mean age of 28 who had taken treatment for their chronic backache, were improvised with pelvic floor strength at our setup, with dramatically good results. 31 subjects with non-responsive chronic back pain who had taken conventional physiotherapy were included in the study. Both married and unmarried were included. Any sign of radiculopathy or inflammation were excluded. After assessing pain using Visual Analogue Scale, the Dr Glazer’s program and Kegel’s contractions were taught. Results: There was significant improvement by 50% on reassessment after 7 days. Then exercises for transverse abdominals were included to get a better response. On completion of the treatment sessions, reduction in pain was 92% on VAS and functional abilities increased by 89%. There was a significant improvement in the quality of life and in pelvic-floor muscle strength. Conclusion: Non-responsive chronic back pain in females when treated with pelvic floor muscle strengthening program showed 40

  13. Postural changes in women with chronic pelvic pain: a case control study

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    Nogueira Antonio A

    2009-07-01

    Full Text Available Abstract Background Chronic pelvic pain (CPP is a lower abdominal pain lasting at least 6 months, occurring continuously or intermittently and not associated exclusively with menstruation or intercourse. Although the musculoskeletal system has been found to be involved in CPP, few studies have assessed the contribution of posture in women with CPP. We aimed to determine if the frequency of postural changes was higher in women with CPP than healthy subjects. Methods A case-control study included 108 women with CPP of more than 6 months' duration (CPP group who consecutively attended at the Hospital of the University of São Paulo and 48 healthy female volunteers (control group. Postural assessment was noninvasive and performed in the standing position, with the reference points of Kendall used as normal parameters. Factors associated with CPP were assessed by logistic regression analysis. Results Logistic regression showed that the independent factors associated with CPP were postural changes in the cervical spine (OR 4.1; 95% CI 1.6–10.7; p Conclusion Musculoskeletal changes were associated with CPP in 34% of women. These findings suggest that a more detailed assessment of women with CPP is necessary for better diagnosis and for more effective treatment.

  14. Qualitative research as the basis for a biopsychosocial approach to women with chronic pelvic pain.

    Science.gov (United States)

    Souza, Paula Patricia; Romão, Adriana Salata; Rosa-e-Silva, Julio Cesar; Reis, Francisco Candido dos; Nogueira, Antonio Alberto; Poli-Neto, Omero Benedicto

    2011-12-01

    Chronic pelvic pain (CPP) is a highly prevalent clinical condition and is recognized as a public health problem. Although the number of qualitative studies related to the topic is increasing, it is essential that this knowledge be presented in a synthesized manner, grounded in the context of the care provided to patients with CPP, in order to increase the clinical and research applicability of the findings. Little attention is given to CPP in undergraduate courses and in meetings for the continuing education of health professionals, the approach to CPP typically being based on the biomedical model. We believe that qualitative research can provide insights into CPP and form the basis for a biopsychosocial approach to the condition, which can in turn lead to better results, including resolution of the pain and greater patient/health professional satisfaction. Therefore, we conducted a metasynthesis of seven qualitative studies of CPP, the principal themes of which were as follows: (a) coping with CPP versus secondary gain; (b) the great importance of determining the cause of the pain; (c) expectations regarding the doctor-patient relationship; and (d) gender issues. We hope that the present study can aid in restoring the humanistic aspects of CPP treatment.

  15. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity

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    Gülmezoglu Metin

    2006-07-01

    Full Text Available Abstract Background Health care planning for chronic pelvic pain (CPP, an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. Methods We identified data available from Medline (1966 to 2004, Embase (1980 to 2004, PsycINFO (1887 to 2003, LILACS (1982 to 2004, Science Citation index, CINAHL (January 1980 to 2004 and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate >80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies. Results There were 178 studies (459975 participants in 148 articles. Of these, 106 studies were (124259 participants on dysmenorrhoea, 54 (35973 participants on dyspareunia and 18 (301756 participants on noncyclical pain. There were only 19/95 (20% less developed and 1/45 (2.2% least developed countries with relevant data in contrast to 22/43 (51.2% developed countries. Meta-regression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5% high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%. Conclusion There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where

  16. [Urological emergencies].

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    Danuser, H; Ackermann, D K; Studer, U E

    1993-04-17

    Every general practitioner has to deal with urologic emergencies. The most frequent illnesses are urinary retention, acute scrotum, priapism, macrohematuria, nephritic colic, obstructive pyelonephritis and pyonephrosis. Whereas urinary retention, as well as acute ureteric stone colic must generally be treated by the practitioner, the urologist must often be consulted in case of an acute scrotum or for priapism. Testicular torsion is one situation, where surgical treatment needs to be performed within 6 hours. Of utmost importance is his timely assistance with the obstructive pyelonephritis and pyonephrosis. These are initially often not recognized, especially because the first ultrasound examination of the intrarenal pyelone may not show a dilatation of the collecting system despite obstruction. If the adequate treatment with drainage and antibiotics is applied too late, this can result in serious and potentially lethal consequences.

  17. Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy

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    Małgorzata Malec-Milewska

    2015-05-01

    Full Text Available Introduction. Chronic pelvic pain syndrome occurs in 4–14% of women. Pain pathomechanism in this syndrome is complex, as it is common to observe the features of nociceptive, inflammatory, neuropathic and psychogenic pain. The common findings in women with pelvic pain are endometriosis and pelvic adhesions. Objective. Aim of the study was to test the effectiveness of pharmacological treatment and regional anesthesia techniques for pain control as the next step of treatment after the lack of clinical results of surgical and pharmacological methods normally used in the management of endometriosis and pelvic adhesions. Materials and method. 18 women were treated between January 2010 – October 2013 in the Pain Clinic of the Department of Anaesthesiology and Intensive Care at the Centre for Postgraduate Education in Warsaw due to chronic pelvic pain syndrome related to either endometriosis or pelvic adhesions. During the previous step of management, both conservative and surgical treatments were completed without achieving satisfactory results. Initial constant pain severity was 3–9 points on the Numeric Rating Scale, while the reported paroxysmal pain level was 7–10. The pharmacological treatment implemented was based on oral gabapentinoids and antidepressants, aided by neurolytic block of ganglion of Walther, pudendal nerve blocks and topical treatment (5% lidocaine, 10% amitriptyline, 10% gabapentin. Results. In 17 women, a significant reduction of both constant and paroxysmal pain was achieved, of which complete and permanent cessation of pain occurred in 6 cases. One patient experienced no improvement in the severity of her symptoms. Conclusions. The combination of pain management with pharmacological treatment, pudendal nerve blocks, neurolysis of ganglion impar (Walther and topical preparations in cases of chronic pelvic pain syndrome seems to be adequate medical conduct after failed or otherwise ineffective causative therapy.

  18. Dyspareunia and chronic pelvic pain in patients with interstitial cystitis/bladder pain syndrome

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    Ming-Huei Lee

    2015-09-01

    Conclusion: IC/BPS women with dyspareunia have significantly more severe urological pain and a higher PUF scale score than women without dyspareunia. Physicians should consider sexual pain disorder in the management of patients with IC/BPS and use the PUF scale to evaluate not only IC-specific lower urinary tract symptoms, but also sexual pain disorder.

  19. Therapeutic intervention for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS: a systematic review and meta-analysis.

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    Jeffrey M Cohen

    Full Text Available BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS has been treated with several different interventions with limited success. This meta-analysis aims to review all trials reporting on therapeutic intervention for CP/CPPS using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI. METHODS: We searched Medline, PubMed, the Cochrane Pain, Palliative & Supportive Care Trials, the Cochrane Register of Controlled Trials, CINAHL, ClinicalTrials.gov, and the NIDDK website between 1947 and December 31, 2011 without language or study type restrictions. All RCTs for CP/CPPS lasting at least 6 weeks, with a minimum of 10 participants per arm, and using the NIH-CPSI score, the criterion standard for CP/CPPS, as an outcome measure were included. Data was extracted from each study by two independent reviewers. Gillbraith and I-squared plots were used for heterogeneity testing and Eggers and Peters methods for publication bias. Quality was assessed using a component approach and meta-regression was used to analyze sources of heterogeneity. RESULTS: Mepartricin, percutaneous tibial nerve stimulation (PTNS, and triple therapy comprised of doxazosin + ibuprofen + thiocolchicoside (DIT resulted in clinically and statistically significant reduction in NIH-CPSI total score. The same agents and aerobic exercise resulted in clinically and statistically significant NIH-CPSI pain domain score reduction. Acupuncture, DIT, and PTNS were found to produce statistically and clinically significant reductions in the NIH-CPSI voiding domain. A statistically significant placebo effect was found for all outcomes and time analysis showed that efficacy of all treatments increased over time. Alpha-blockers, antibiotics, and combinations of the two failed to show statistically or clinically significant NIH-CPSI reductions. CONCLUSION: Results from this meta-analysis reflect our current inability to effectively manage CP/CPPS. Clinicians and

  20. A preliminary evaluation of the psychometric profiles in Chinese men with chronic prostatitis/chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    ZHANG Guo-xi; BAI Wen-jun; XU Tao; WANG Xiao-feng

    2011-01-01

    Background As one of the most commonly diagnosed diseases, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by a variety of complex symptoms. Anxiety and depression are two of the most prevalent clinical manifestations of patients with CP/CPPS, and have adverse effects on the health of the subjects and prognosis of comorbidities. Such psychological disorders, however, have not been deeply and thoroughly studied in China. The aim of this study was to investigate the prevalence and severity of psychological disorders in Chinese adults with CP/CPPS.Methods From April 2008 to June 2009, 80 patients and 40 age-matched healthy men participating in a voluntary health examination were recruited. The majority of the subjects completed the questionnaires on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) as well as the hospital anxiety and depression scale (HADS).Results Of all the participants, 77 (96.3%) patients and 37 (92.5%) healthy controls completed the questionnaires. The average NIH-CPSI total score was 21.0±9.5 for the patients and 2.2±1.5 for the controls (P=0.03). Of the 77 patients with CP/CPPS, 48 (62.3%), 5 (6.5%), and 1 (1.2%) had anxiety symptoms, depression symptoms, or both anxiety and depression symptoms, respectively. For the controls, the average HADS anxiety and depression scores in patients were 14.5±6.8 and 5.2±4.5, which were both significantly higher than in controls. Moreover, the prevalence and the symptom scores of both the HADS anxiety and depression were higher for the younger age group (<35 years) than for the older age group (<35 years).Conclusions This preliminary study revealed that male patients with CP/CPPS had a higher prevalence of psychological disorders than in the control subjects. Moreover, the differences of the prevalence and severity of the psychological symptoms between the two different age groups may imply that psychological disorders related to CP/CPPS may be

  1. Pelvic floor muscle rehabilitation using biofeedback.

    Science.gov (United States)

    Newman, Diane K

    2014-01-01

    Pelvic floor muscle exercises have been recommended for urinary incontinence since first described by obstetrician gynecologist Dr. Arnold Kegel more than six decades ago. These exercises are performed to strengthen pelvic floor muscles, provide urethral support to prevent urine leakage, and suppress urgency. In clinical urology practice, expert clinicians also teach patients how to relax the muscle to improve bladder emptying and relieve pelvic pain caused by muscle spasm. When treating lower urinary tract symptoms, an exercise training program combined with biofeedback therapy has been recommended as first-line treatment. This article provides clinical application of pelvic floor muscle rehabilitation using biofeedback as a technique to enhance pelvic floor muscle training.

  2. Pelvic Inflammatory Disease (For Teens)

    Science.gov (United States)

    ... lead to internal scarring that might cause ongoing pelvic pain, infertility, or an ectopic pregnancy. What Are the ... the inability to have a baby) and chronic pelvic pain. A teen girl or woman who has had ...

  3. Management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): an evidence-based approach

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods: The randomized controlled trials (RCTs) about the treatment for CP/CPPS all over the world were searched. MEDLINE (January 1966 to June 2007), EMBASE (January 1988 to June 2007), and 4 Chinese databases were electronically searched. The studies included in the references of eligible studies were additionally searched. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by crosschecking. Divergences of opinion were settled by discussion or consulted by the experts. Meta-analysis was performed by using RevMan 4.2 software. Results: Twelve original studies involving 1 003 participants met inclusion criteria. Compared with placebo, alpha-blockers could improve the symptoms of CP/CPPS obviously with WMD of NIH-CPSI, total score and pain score were -4.10 (95%CI: -6.92 to -1.28) and -1.68 (95%CI: -2.54 to -0.82). Antibiotics could not improve the symptoms obviously with WMD of NIH-CPSI; total score and pain score were -2.71 (95%CI: -4.78 to -0.64) and -0.86 (95%CI: -2.07 to 0.36). Flavoxate could not improve the NIH-CPSI total score obviously, but could relieve the pain, with WMD of NIH-CPSI total score and pain score being -2.96 (95%CI: -5.17 to -0.74) and -2.31 (95% CI: -4.05 to 0.03). Prostat could improve the NIH CPSI total score obviously, but could not relieve the pain, with WMD of NIH-CPSI total score and pain score being -7.60 (95%CI: -9.97 to -5.23) and -2.02 (95%CI: -4.07 to 0.04). Conclusion: Drug intervention could improve total symptoms of CP/CPPS in some degree, but no universally effective treatment is available that can prove significant lasting benefit for all the symptoms of CP/CPPS. Future RCT must use an appropriate sample size and optimal duration and follow-up of participants. It is important to improve the quality

  4. Correlation between altered central pain processing and concentration of peritoneal fluid inflammatory cytokines in endometriosis patients with chronic pelvic pain.

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    Neziri, Alban Y; Bersinger, Nick A; Andersen, Ole K; Arendt-Nielsen, Lars; Mueller, Michael D; Curatolo, Michele

    2014-01-01

    Translational research has not yet elucidated whether alterations in central pain processes are related to peripheral inflammatory processes in chronic pain patients. We tested the hypothesis that the concentration of cytokines in the peritoneal fluid of endometriosis patients with chronic pain correlate with parameters of hyperexcitability of the nociceptive system. The concentrations of 15 peritoneal fluid cytokines were measured in 11 patients with chronic pelvic pain and a diagnosis of endometriosis. Six parameters assessing central pain processes were recorded. Positive correlations between concentration of some cytokines in the peritoneal fluid and amplification of central pain processing were found. The results suggest that inflammatory mechanisms may be important in the pathophysiology of altered central pain processes and that cytokines produced in the environment of endometriosis could act as mediators between the peripheral lesion and changes in central nociceptive processes.

  5. Effects of yogic intervention on pain scores and quality of life in females with chronic pelvic pain

    Science.gov (United States)

    Saxena, Rahul; Gupta, Manish; Shankar, Nilima; Jain, Sandhya; Saxena, Arushi

    2017-01-01

    Context: Chronic pelvic pain (CPP) is a common condition of women of the reproductive age group. It has a negative impact on a woman's personal health and quality of life (QOL). Practicing yoga has shown numerous benefits in various chronic painful conditions. Aim: To study the effects of yogic intervention on pain scores and quality of life in females of reproductive age group with CPP, on conventional therapy. Settings and Design: It is a follow-up, randomized case-control study done in a tertiary care hospital. Subjects and Methods: Sixty female patients of CPP in the age group of 18–45 years were randomly divided into Group I (n = 30) and Group II (n = 30). Group I received only conventional therapy in the form of NSAIDS and Group II received yoga therapy in the form of asanas, pranayama, and relaxation along with the conventional therapy for 8 weeks. They were assessed twice (pre- and post-treatment) for pain scores through visual analog scale (VAS) score and QOL by the World Health Organization quality of life-BREF (WHOQOL-BREF) questionnaire. Statistical Analysis Used: Repeated measure ANOVA followed by Tukey's test. P yoga causes a reduction in the pain intensity and improves the quality of life in patients with chronic pelvic pain. PMID:28149062

  6. The future of urology.

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    Abrams, Paul; Brausi, Maurizio; Buntrock, Stefan; Ebert, Thomas; Hashim, Hashim; Tiselius, Hans-Göran; Wyndaele, Jean-Jacques

    2012-03-01

    The Future of Urology has been written in times of economic downturn, with the inevitable effects on health sector spending. Nevertheless, this document aims to define a path whereby the EAU can play a pivotal role in ensuring the highest standard of care throughout Europe, and by setting standards, throughout the rest of the world. The future of urology will be dependent on improved education and training leading to high quality urological care, and to developing a service that is patient focused. The patient focus is becoming increasingly important in urology. This means providing full information about disease processes and urological procedures to patients and allowing them to judge the quality of the urological service that they may choose. Education must start in medical school and as 5% of community medical practice is urology then every medical student must receive urological training. This also applies to nurses and the other professions allied to medicine (PAMS). The EAU should provide a urological curriculum for training of medical students, nurses and PAMS, as well as the more conventional curriculum for postgraduate training and continued medical education for urological specialists. An integrated EAU Knowledge and Learning Centre would provide an invaluable resource to patients and to those who deliver urologic care alike. With high quality training must come a vigorous assessment of knowledge and competence. In the future, the competence of all those delivering urological care will need to be assessed. For urologists in training and specialist urologists this will include not only an assessment of knowledge but an assessment of surgical competence. Improving quality will be supported by the continued subspecialisation of urology, ensuring that all urologists have a surgical portfolio which ensures their competency in the procedures they deliver. This will inevitably result in a concentration of urological services and indeed to the development of

  7. Chronic pain in the pelvic area or lower extremities after rectal cancer treatment and its impact on quality of life: a population-based cross-sectional study.

    Science.gov (United States)

    Feddern, Marie-Louise; Jensen, Troels Staehelin; Laurberg, Søren

    2015-09-01

    The aim of this investigation was to examine the prevalence of and factors associated with chronic pain in the pelvic area or lower extremities after rectal cancer treatment and its impact on quality of life (QoL). This is a population-based cross-sectional study of chronic pain and QoL in patients treated for rectal cancer from 2001 to 2007. A modified version of the Brief Descriptive Danish Pain Questionnaire and the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire were mailed to 1713 Danish patients. Informative answers were obtained from 1369 patients (80%). A total of 426 patients (31%) reported chronic pain in the pelvic area or lower extremities, 173 (41%) of whom had daily pain. Pain in other parts of the body was associated with the presence of pain in the pelvic region (odds ratio [OR] 4.81 [3.63-6.38], P pain in female patients (OR 1.91 [1.51-2.43], P pelvic pain. Chronic pain in the pelvic region or lower extremities after rectal cancer treatment is a common but largely neglected problem that is associated with female gender, type of surgery, radio(chemo)therapy, and young age, all of which impact the patient's QoL.

  8. Reduction of blood nitric oxide levels is associated with clinical improvement of the chronic pelvic pain related to endometriosis

    Directory of Open Access Journals (Sweden)

    M.G. Rocha

    2015-04-01

    Full Text Available The objective of this prospective study was to determine the plasma levels of nitric oxide (NO in women with chronic pelvic pain secondary to endometriosis (n=24 and abdominal myofascial pain syndrome (n=16. NO levels were measured in plasma collected before and 1 month after treatment. Pretreatment NO levels (μM were lower in healthy volunteers (47.0±12.7 than in women with myofascial pain (64.2±5.0, P=0.01 or endometriosis (99.5±12.9, P<0.0001. After treatment, plasma NO levels were reduced only in the endometriosis group (99.5±12.9 vs 61.6±5.9, P=0.002. A correlation between reduction of pain intensity and reduction of NO level was observed in the endometriosis group [correlation = 0.67 (95%CI = 0.35 to 0.85, P<0.0001]. Reduction of NO levels was associated with an increase of pain threshold in this group [correlation = -0.53 (-0.78 to -0.14, P<0.0001]. NO levels appeared elevated in women with chronic pelvic pain diagnosed as secondary to endometriosis, and were directly associated with reduction in pain intensity and increase in pain threshold after treatment. Further studies are needed to investigate the role of NO in the pathophysiology of pain in women with endometriosis and its eventual association with central sensitization.

  9. 慢性盆腔痛的研究进展%Progress in research on chronic pelvic pain

    Institute of Scientific and Technical Information of China (English)

    李晓宏; 高崇荣; 杨承祥; 李光仪

    2008-01-01

    慢性盆腔痛(chronic pelvic pain,CPP)是疼痛科和妇科门诊的常见疾病,因其病因复杂,其中有妇科方面的因素,也有非妇科方面的原因,所以诊断异常棘手,目前诊断的金标准是腹腔镜检查;CPP的保守治疗效果欠佳,临床治疗主要是以手术为主,如腹腔镜下骶前神经的切除,但现提倡多学科的治疗,如介入治疗的上腹下丛神经毁损,也能取得很好的效果.%Chronic pelvic pain (CCP) is a common pain syndrome which has complex causes including gynecologic and nongynecologic factors. A exact diagnosis is difficult to be delivered. The current gold standard of diagnostic examination is abdominoscopy. Lacking ideal effect with conventional therapy, the main therapeutic method adopted is surgical intervention, such as laparoscopic presacral neureetomy. Muhidisciplinary managements, for example, superior hypogastric plexus neurolysis using interventional therapy,are expected to be effective.

  10. 慢性盆腔痛病因及发病率分析%Analysis of causes and incidence of chronic pelvic pain

    Institute of Scientific and Technical Information of China (English)

    李伟娟; 王亚男; 马艳宏; 张燕宏; 梁丽华; 孙聪欣; 姜彩霞

    2012-01-01

    目的 探讨女性慢性盆腔痛的病因及其发病率.方法 对2010年5月~2011年5月到我院妇科就诊的1 017例慢性盆腔痛患者进行回顾性分析.结果 5 219例普通妇科疾病患者中,慢性盆腔痛就诊者1 017例,占19.5%.5 219例中20~40岁就诊者2 012例,慢性盆腔痛发病率为27.1%;41~55岁就诊者3 207例,慢性盆腔痛发病率为14.7%,两组比较,差异有统计学意义(P 0.05).慢性盆腔痛就诊者中既往有剖宫产手术史者占慢性盆腔痛患者53.0%,顺产者占19.5%,两组比较,差异有统计学意义(P 0.05). For patients with cesarean section group, the incidence rate of chronic pelvic pain was 53.0%. Patients with nature birth group, the incidence rate was 19.5%, with significant difference (P < 0.05). Conclusion Chronic pelvic pain often occurs in reproductive-aged female. The common etiologies are chronic pelvic inflammatory, endometriosis, pelvic mass and pelvic venous congestion syndrome, etc. Cesarean section may cause chronic pelvic pain. It should master the cesarean section indications on clinical treatments, and reduce the rate of cesarean sections.

  11. Pelvic Inflammatory Disease

    Science.gov (United States)

    ... a sexually active woman with lower abdominal pain. Pregnancy (including ectopic pregnancy) must also be excluded, as PID can occur ... include Tubo-ovarian abscess (TOA) Tubal factor infertility Ectopic pregnancy Chronic pelvic pain Recurrent episodes of PID and ...

  12. Osteopathy for Endometriosis and Chronic Pelvic Pain – a Pilot Study

    Science.gov (United States)

    Sillem, M.; Juhasz-Böss, I.; Klausmeier, I.; Mechsner, S.; Siedentopf, F.; Solomayer, E.

    2016-01-01

    Introduction: Pelvic pain is a common problem in gynaecological practice. It is often unclear whether definite causality exists between reported symptoms and objective clinical findings of the female genital tract, and medical or operative treatments do not always achieve long-term resolution of symptoms. Methods: This pilot study investigated 28 patients (age 20–65, median 36.5 years) from a gynaecology practice whose only clinical finding was painful pelvic floor muscle tightness. Following standardised gynaecological and physiotherapist examination, all patients received osteopathic treatment. Pain had been present for a median of 3 years (range 1 month to 20 years). 14 patients had previously confirmed endometriosis. Treatment success was evaluated on consultation with patients in person or in writing. Results: 22 of the 28 participants completed the treatment according to plan. Overall, 17 reported symptom improvement, while 10 of the 14 patients with endometriosis did. Conclusion: Osteopathy is well received by women with painful pelvic floor muscle tightness and appears to be an effective treatment option. PMID:27681520

  13. Advanced urology nursing practice.

    Science.gov (United States)

    Crowe, Helen

    2014-03-01

    Urology nursing has developed as a specialty over the past few decades in response to several factors, workload demands being a prime reason. Nurses are taking on additional roles and activities including procedures such as cystoscopy and prostate biopsy, and running nurse-led clinics for a variety of urological conditions. Audits of advanced urological nursing practice have shown this care to be of a high standard and investigative procedures performed by these nurses match the diagnostic quality of existing services. Professional urological nursing organizations support the professional needs of these nurses, but the provision of education and training for advanced practice activities remains an unaddressed need. A range of confusing advanced urology nursing titles exists, and uncertainty regarding the roles and scope of practice for these nurses remains a concern. Acceptance and support from medical colleagues is required for the success of advanced urological nursing practice, but opinions on these roles remain divided.

  14. 慢性盆腔疼痛病因分析及临床诊治%Etiological Analysis, Diagnosis and Treatment of Chronic Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    吴文珍; 陈武

    2013-01-01

      目的:探讨引起慢性盆腔疼痛的病因、诊断标准及治疗原则.方法:回顾性分析2009年2月~2012年2月在我院收治的120例慢性盆腔疼痛病例的临床资料,总结分析病因、症状、体征及治疗方式.结果:引起慢性盆腔疼痛的前2位病因为慢性盆腔炎65例,占54.17%;子宫内膜异位症30例,占25.00%;其它疾病也占一定比例.结论:明确慢性盆腔疼痛病因,正确处理,运用多种方法综合治疗,可以提高治疗效果.%Objective:To investigate the cause of chronic pelvic pain, diagnostic criteria and ther-apeutic principle. Methods: Retrospective analyzed the information of 120 cases of chronic pelvic pain patients in our hospital from Feb 2009 to Feb 2012, then summarized and analyzed the cause, symptoms, signs and treatment. Results:The first two causes of chronic pelvic pain are:65 cases for chronic pelvic inflammatory disease accounting for 54.17%, 30 cases for endometriosis accounting for 25.00%; other diseases also account for a certain proportion. Conclusion: Clear the cause of chronic pelvic pain, treat it properly, use comprehensive treatment with variety of methods, can im-prove the therapeutic effect.

  15. Endometriosis and chronic pelvic pain%子宫内膜异位症与慢性盆腔痛

    Institute of Scientific and Technical Information of China (English)

    陈正云; 林俊

    2013-01-01

    Chronic pelvic pain is the manifestation of endometriosis The pathophysiology and causes of endometriosis-associated pain are complex. Management can be medical (first-line treatment is oral contraceptive pills combined with along with NSAIDs), surgical, or and the two combined (surgery combined with suppression of ovarian function). It is recommended that long-term treatment combined with multiple modes of therapies for the pain associated with endometriosis individually.%慢性盆腔痛是子宫内膜异位症(内异症)的常见症状.内异症相关疼痛的机制复杂,可采取药物(首选口服避孕药联合非甾体类抗炎药)、手术以及手术联合药物抑制卵巢功能的治疗,现多主张采取长期综合个体化治疗.

  16. 慢性盆腔痛的非手术治疗%Non-surgical management of chronic pelvic pain

    Institute of Scientific and Technical Information of China (English)

    武昕; 钟艳芬

    2013-01-01

    The etiology of chronic pelvic pain (CPP) is complicated. The aim of treatment is improved function and alleviated pain. We summarized the methods of non-surgical treatments for CPP. First, Chinese and Western medical therapies, Second, ladder analgesics. Third, ultrasound and interventional as well as Physiotherapy. Fourth, psychotherapy including medicine and psychological persuasion.%慢性盆腔痛的病因复杂,治疗的目标在于改善功能,并尽可能缓解疼痛.文章就非手术治疗的中西药物治疗,阶梯性镇痛,超声、介入、理疗等物理治疗,药物及心理疏导的心理治疗进行归纳与概括.

  17. Career development resource: urology.

    Science.gov (United States)

    Gormley, E Ann

    2012-07-01

    Urology has always been seen as being on the cutting edge of technology and this has been especially prevalent in the past 10 to 15 years with a move to robotic surgery, increased use of laser technology, and stem cell research leading to organ regeneration. Urology has a number of subspecialties including pediatrics, urologic oncology, renal transplantation, male infertility and andrology, calculi, female urology, neurourology, and trauma and reconstruction. Urologists have a wide array of practice options ranging from performing major oncologic procedures with extensive reconstruction to having an office-based practice and performing endoscopic cases with everything else in between. Subspecialization is becoming increasingly more organized and regulated.

  18. 78 FR 63997 - Kidney, Urologic, and Hematologic Diseases Interagency Coordinating Committee; Urology...

    Science.gov (United States)

    2013-10-25

    ... Coordinating Committee; Urology Subcommittee Workshop SUMMARY: The Urology Subcommittee of the Kidney, Urologic...--Urology Subcommittee, National Institute of Diabetes and Digestive and Kidney Diseases, 6707 Democracy..., workshop held by the KUHICC Urology Subcommittee, also called the ``Urology Interagency...

  19. The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain.

    Science.gov (United States)

    Mohseni-Bandpei, Mohammad A; Rahmani, Nahid; Behtash, Hamid; Karimloo, Masoud

    2011-01-01

    Dysfunction of spinal stability seems to be one of the causes of low back pain (LBP). It is thought that a large number of muscles have a role in spinal stability including the pelvic floor muscle (PFM). The purpose of this study was to investigate the effect of PFM exercise in the treatment of chronic LBP. After ethical approval, a randomized controlled clinical trial was carried out on 20 women with chronic LBP. Patients were randomly allocated into two groups: an experimental and a control group. The control group was given routine treatment including electrotherapy and general exercises; and the experimental group received routine treatment and additional PFM exercise. Pain intensity, functional disability and PFM strength and endurance were measured before, immediately after intervention and at 3 months follow-up. In both groups pain and functional disability were significantly reduced following treatment (p0.05). All measurements were improved in both groups (p<0.01) although patients in the experimental group showed greater improvement in PFM strength and endurance (p<0.01). It seems that the PFM exercise combined with routine treatment was not superior to routine treatment alone in patients with chronic LBP.

  20. Pelvic ultrasonography.

    Science.gov (United States)

    Phelan, M B; Valley, V T; Mateer, J R

    1997-11-01

    Pelvic ultrasonography is a valuable tool for the emergency physician in the evaluation of the wide spectrum of pelvic complaints presenting to the emergency department. The goal of this article is to outline pelvic problems that can be readily identified by the emergency physician using pelvic sonography early in the patient's evaluation. A special emphasis is placed on the sonographic diagnosis of ectopic pregnancy.

  1. Common Questions About Chronic Prostatitis.

    Science.gov (United States)

    Holt, James D; Garrett, W Allan; McCurry, Tyler K; Teichman, Joel M H

    2016-02-15

    Chronic prostatitis is relatively common, with a lifetime prevalence of 1.8% to 8.2%. Risk factors include conditions that facilitate introduction of bacteria into the urethra and prostate (which also predispose the patient to urinary tract infections) and conditions that can lead to chronic neuropathic pain. Chronic prostatitis must be differentiated from other causes of chronic pelvic pain, such as interstitial cystitis/bladder pain syndrome and pelvic floor dysfunction; prostate and bladder cancers; benign prostatic hyperplasia; urolithiasis; and other causes of dysuria, urinary frequency, and nocturia. The National Institutes of Health divides prostatitis into four syndromes: acute bacterial prostatitis, chronic bacterial prostatitis (CBP), chronic nonbacterial prostatitis (CNP)/chronic pelvic pain syndrome (CPPS), and asymptomatic inflammatory prostatitis. CBP and CNP/CPPS both lead to pelvic pain and lower urinary tract symptoms. CBP presents as recurrent urinary tract infections with the same organism identified on repeated cultures; it responds to a prolonged course of an antibiotic that adequately penetrates the prostate, if the urine culture suggests sensitivity. If four to six weeks of antibiotic therapy is effective but symptoms recur, another course may be prescribed, perhaps in combination with alpha blockers or nonopioid analgesics. CNP/CPPS, accounting for more than 90% of chronic prostatitis cases, presents as prostatic pain lasting at least three months without consistent culture results. Weak evidence supports the use of alpha blockers, pain medications, and a four- to six-week course of antibiotics for the treatment of CNP/CPPS. Patients may also be referred to a psychologist experienced in managing chronic pain. Experts on this condition recommend a combination of treatments tailored to the patient's phenotypic presentation. Urology referral should be considered when appropriate treatment is ineffective. Additional treatments include pelvic

  2. An Exploratory Study into Objective and Reported Characteristics of Neuropathic Pain in Women with Chronic Pelvic Pain.

    Directory of Open Access Journals (Sweden)

    Lucy H R Whitaker

    Full Text Available Chronic pelvic pain (CPP affects 5.7-26.6% women worldwide. 55% have no obvious pathology and 40% have associated endometriosis. Neuropathic pain (NeP is pain arising as a consequence of a lesion/disease affecting the somatosensory system. The prevalence of NeP in women with CPP is not known. The diagnosis of NeP is challenging because there is no gold-standard assessment. Questionnaires have been used in the clinical setting to diagnose NeP in other chronic pain conditions and quantitative sensory testing (QST has been used in a research setting to identify abnormal sensory function. We aimed to determine if women with chronic pelvic pain (CPP have a neuropathic pain (NeP component to their painful symptoms and how this is best assessed. We performed an exploratory prospective cohort study of 72 pre-menopausal women with a diagnosis of CPP. They underwent a clinician completed questionnaire (DN4 and completed the S-LANSS and PainDETECT™ questionnaires. Additionally QST testing was performed by a clinician. They also completed a patient acceptability questionnaire. Clinical features of NeP were identified by both questionnaires and QST. Of the women who were NeP positive, 56%, 35% and 26% were identified by the S-LANSS, DN4 and PainDETECT™ respectively. When NeP was identified by questionnaire, the associated laparoscopy findings were similar irrespective of which questionnaire was used. No subject had entirely unchanged QST parameters. There were distinct loss and gain subgroups, as well as mixed alteration in function, but this was not necessarily clinically significant in all patients. 80% of patients were confident that questionnaires could diagnose NeP, and 90% found them easy to complete. Early identification of NeP in women with CPP with a simple questionnaire could facilitate targeted therapy with neuromodulators, which are cheap, readily available, and have good safety profiles. This approach could prevent unnecessary or fertility

  3. Gabapentin for the Management of Chronic Pelvic Pain in Women (GaPP1: A Pilot Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Steff C Lewis

    Full Text Available Chronic pelvic pain (CPP affects 2.1-24% of women. Frequently, no underlying pathology is identified, and the pain is difficult to manage. Gabapentin is prescribed for CPP despite no robust evidence of efficacy. We performed a pilot trial in two UK centres to inform the planning of a future multicentre RCT to evaluate gabapentin in CPP management. Our primary objective was to determine levels of participant recruitment and retention. Secondary objectives included estimating potential effectiveness, acceptability to participants of trial methodology, and cost-effectiveness of gabapentin. Women with CPP and no obvious pelvic pathology were assigned to an increasing regimen of gabapentin (300-2700mg daily or placebo. We calculated the proportion of eligible women randomised, and of randomised participants who were followed up to six months. The analyses by treatment group were by intention-to-treat. Interviews were conducted to evaluate women's experiences of the trial. A probabilistic decision analytical model was used to estimate cost-effectiveness. Between September 2012-2013, 47 women (34% of those eligible were randomised (22 to gabapentin, 25 to placebo, and 25 (53% completed six-month follow-up. Participants on gabapentin had less pain (BPI difference 1.72 points, 95% CI:0.07-3.36, and an improvement in mood (HADS difference 4.35 points, 95% CI:1.97-6.73 at six months than those allocated placebo. The majority of participants described their trial experience favorably. At the UK threshold for willingness-to-pay, the probabilities of gabapentin or no treatment being cost-effective are similar. A pilot trial assessing gabapentin for CPP was feasible, but uncertainty remains, highlighting the need for a large definitive trial.

  4. Gabapentin for the Management of Chronic Pelvic Pain in Women (GaPP1): A Pilot Randomised Controlled Trial.

    Science.gov (United States)

    Lewis, Steff C; Bhattacharya, Siladitya; Wu, Olivia; Vincent, Katy; Jack, Stuart A; Critchley, Hilary O D; Porter, Maureen A; Cranley, Denise; Wilson, John A; Horne, Andrew W

    2016-01-01

    Chronic pelvic pain (CPP) affects 2.1-24% of women. Frequently, no underlying pathology is identified, and the pain is difficult to manage. Gabapentin is prescribed for CPP despite no robust evidence of efficacy. We performed a pilot trial in two UK centres to inform the planning of a future multicentre RCT to evaluate gabapentin in CPP management. Our primary objective was to determine levels of participant recruitment and retention. Secondary objectives included estimating potential effectiveness, acceptability to participants of trial methodology, and cost-effectiveness of gabapentin. Women with CPP and no obvious pelvic pathology were assigned to an increasing regimen of gabapentin (300-2700 mg daily) or placebo. We calculated the proportion of eligible women randomised, and of randomised participants who were followed up to six months. The analyses by treatment group were by intention-to-treat. Interviews were conducted to evaluate women's experiences of the trial. A probabilistic decision analytical model was used to estimate cost-effectiveness. Between September 2012-2013, 47 women (34% of those eligible) were randomised (22 to gabapentin, 25 to placebo), and 25 (53%) completed six-month follow-up. Participants on gabapentin had less pain (BPI difference 1.72 points, 95% CI:0.07-3.36), and an improvement in mood (HADS difference 4.35 points, 95% CI:1.97-6.73) at six months than those allocated placebo. The majority of participants described their trial experience favorably. At the UK threshold for willingness-to-pay, the probabilities of gabapentin or no treatment being cost-effective are similar. A pilot trial assessing gabapentin for CPP was feasible, but uncertainty remains, highlighting the need for a large definitive trial.

  5. Treatment of intractable chronic pelvic pain syndrome by injecting a compound of Bupivacaine and Fentanyl into sacral spinal space

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zhan-song; SONG Bo; NIE Fa-chuan; CHEN Jin-mei

    2006-01-01

    Objective:To investigate the effect of injecting a compound of Bupivacaine and Fentanyl into sacral spinal space to treat chronic pelvic pain syndrome (CPPS). Methods: A total of 36 men with recalcitrant CPPS refractory to multiple prior therapies were treated with the injection of a compound of Bupivacaine and Fentanyl (10 ml of 0. 125% upivacaine, .05 mg Fentanyl, 5 mg Dexamethasone, 100 mg Vitamin B1 and 1 mg Vitamin B12) into sacral space once a week for 4 weeks. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), maximum and average flow rate were performed at the start and the end of 4 weeks' therapy. Results :Mean NIH-CPSI total score was decreased from 26.5±.6 to 13.4±2.0 (P<0. 001). Significant improvement was seen in each subscore domain. A total of 32 patients (89%) had at least 25% improvement on NIH-CPSI and 22 (61%) had at least 50% improvement. Maximal and average flow rate were increased from 19. 5±3.8 to 23. 6±4. 2 and 10. 9±2.6 to 14.3± 2.4 respectively. Conclusion: Injection of this compound of Bupivacaine, Fentanyl and Dexamethasone into sacral spinal space is an effective and safe approach for recalcitrant CPPS. Further study of the mechanisms and prospective placebo controlled trials are warranted.

  6. Hatha Yoga therapy management of urologic disorders.

    Science.gov (United States)

    Ripoll, Emmey; Mahowald, Dawn

    2002-11-01

    Hatha Yoga (often referred to as "yoga") is an ancient type of physical and mental exercise that has been used as a therapeutic modality in traditional Indian medicine for centuries. Yoga as a complementary modality in western medicine is more recent and continues to grow. Chronic urologic disorders are often difficult to diagnose because their presentation mimic other medical conditions and are often a diagnosis of exclusion. Treatment is also frustrating because the more traditional treatments are often unsuccessful in managing chronic disorders. Health care practitioners are often forced to look elsewhere for other modalities to provide pain relief and improve quality of life. Hatha Yoga is one of these modalities which has been extremely useful to many patients in reducing the suffering seen with chronic urologic conditions such as: prostatodynia, chronic orchitis, chronic epididymitis, vulvodynia, interstitial cystitis, etc.

  7. Evolution of urological imaging.

    Science.gov (United States)

    Bueschen, Anton J; Lockhart, Mark E

    2011-02-01

    The evolution of urological imaging has had a major impact on the diagnosis and treatment of urological diseases since the discovery of the X-ray by Roentgen in 1895. Early developments included plain films of the abdomen, retrograde urographic techniques, development of contrast media, excretory urography, renal mass puncture, renal angiography, cystography and nuclear medicine procedures. These procedures led to the maturation of the specialties of diagnostic radiology and urology, and the development of the subspecialties of pediatric urology and urological radiology during the first seven decades of the 20th century. Subsequently, many imaging advances have occurred leading to changes in diagnosis and management of urological patients. Ultrasound and cross-sectional imaging technologies (computed tomography and magnetic resonance imaging) are increasingly applied in urological evaluation, treatment and surveillance. Current developments include dual energy computed tomography, positron emission tomography computed tomography, renal donor and renal transplant imaging, prostate magnetic resonance imaging, and microbubble contrast enhanced ultrasound. Imaging advances will continue. It is the responsibility of all physicians to assess the advantages of new developments while weighing those advantages against the additional radiation exposure and the costs associated with new procedures.

  8. 慢性盆腔炎患者血液流变学指标的变化%Hemorheological Changes in Patients with Chronic Pelvic Infection

    Institute of Scientific and Technical Information of China (English)

    赵俊娟; 裴颖

    2001-01-01

    Objective:The change of hemorheology was studied in patients with chronic pelvic infection.Methods:Hemorheological parameters were determined in 70 cases of chronic pelvic infection, 40 cases of normal control.Results:Whole blood vicosity in high,middle and low shear rate,ESR,Hct,reductive viscosity in high and low shaer rate,plasma viscosity,ESR with K value,erythrocyte aggregation index,erythrocyte rigidity index and red biood cell deformation in patients with chronic pelvic infection compared with the normal controls all have sighificant difference (P<0.01).Conclusion:The patients with chronic pelvic infetion having hemorheological changes may cause metabolism and function disorder.%目的观察慢性盆腔炎患者血液流变学指标的改变。方法对70例慢性盆腔炎患者及40例正常对照组进行血液流变学指标检测。结果慢性盆腔炎患者的全血粘度、血浆粘度、血沉、全血还原粘度、血沉方程K值、红细胞聚集指数及刚性指数与正常对照组比较,均有显著性差异(P<0.01)。结论慢性盆腔炎患者血液流变学指标的改变,可引起机体代谢和功能失调。

  9. Effect of Kangfu antiphlogistic suppository combined with pelvic inflammatory therapeutic equip-ment on chronic pelvic pain caused by pelvic inflammation%康妇消炎栓联合盆腔炎治疗仪治疗盆腔炎所致慢性疼痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    孙鲁芳; 杜仕秀; 贺秀华

    2015-01-01

    Objective To investigate the effect of Kangfu antiphlogistic suppository combined with pelvic inflammatory therapeutic equipment on chronic pelvic pain caused by pelvic inflammation. Methods The control group received Kangfu antiphlogistic suppository treatment, and the study group received Kangfu antiphlogistic suppository combined with pelvic inflammatory therapeutic apparatus.The clinical effects on chronic pain caused by pelvic inflammatory disease and incidences of adverse reactions were recorded.Results The clinical total efficiency of study group was 91.11%, which was signifi-cantly higher than that of the control group ( 71.11%) , there was significant difference ( P0.05 ) .Conclusions Kangfu antiphlogistic suppository com-bined with pelvic inflammatory therapeutic apparatus for chronic pain caused by pelvic inflammatory can significantly improve its clinical efficacy, and help protect the quality of life of patients.%目的:探讨康妇消炎栓联合盆腔炎治疗仪在盆腔炎所致慢性疼痛中的治疗效果。方法对照组给予康妇消炎栓治疗;研究组给予康妇消炎栓联合盆腔炎治疗仪治疗,记录两组盆腔炎所致慢性疼痛患者临床疗效及不良反应发生率。结果研究组临床治疗总有效率高达91.11%,显著高于对照组临床治疗总有效率(71.11%),差异有统计学意义(P <0.05)。研究组不良反应发生率为17.78%,对照组不良反应发生率为15.56%,差异未见统计学意义( P>0.05)。结论对盆腔炎所致慢性疼痛患者给予康妇消炎栓联合盆腔炎治疗仪治疗后可显著提高其临床疗效,有利于保障患者生活质量。

  10. Review on Chronic Pelvic Inflammatory Disease Treated by Traditional Chinese Medicine%慢性盆腔炎中医药治疗概述

    Institute of Scientific and Technical Information of China (English)

    姬丽丽

    2012-01-01

    Chronic pelvic inflammatory disease is a common gynecological disease, frequently-occurring. The main clinical manifestations include lower abdominal pain, lumbosacral pain, leucorrhea increase, many accompanied by menstrual disorders, dysmenorrhea, sexual intercourse or defecation before and after pain and infertility. Many TCM therapy of chronic pelvic inflammatory disease are obviously effective, and have advantages. TCM treatment for chronic pelvic inflammatory disease has a broad developing prospect.%慢性盆腔炎是妇科常见病、多发病.临床主要表现为下腹部疼痛,腰骶部酸痛,带下增多,多伴有月经失调、痛经、性交或排便前后疼痛及不孕等症.慢性盆腔炎的中医药治疗方法较多,疗效明显,优势凸现,中医药治疗慢性盆腔炎具有广阔的发展前景.

  11. Social Determinants of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Related Lifestyle and Behaviors among Urban Men in China: A Case-Control Study

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    Yan Wang

    2016-01-01

    Full Text Available Purpose. In order to find key risk factors of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS among urban men in China, an age-matched case-control study was performed from September 2012 to May 2013 in Yichang, Hubei Province, China. Methodology. A total of 279 patients and 558 controls were recruited in this study. Data were collected by a self-administered questionnaire, including demographics, diet and lifestyle, psychological status, and a physical exam. Conditional logistic regression model was used to analyze collected data. Results. Chemical factors exposure, night shift, severity of mood, and poor self-health cognition were entered into the regression model, and result displayed that these four factors had odds ratios of 1.929 (95% CI, 1.321–2.819, 1.456 (95% CI, 1.087–1.949, 1.619 (95% CI, 1.280–2.046, and 1.304 (95% CI, 1.094–1.555, respectively, which suggested that these four factors could significantly affect CP/CPPS. Conclusion. These results suggest that many factors affect CP/CPPS, including biological, social, and psychological factors.

  12. Effects of Omega-3 Fatty Acids on Erectile Dysfunction in a Rat Model of Atherosclerosis-induced Chronic Pelvic Ischemia.

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    Shim, Ji Sung; Kim, Dae Hee; Bae, Jae Hyun; Moon, Du Geon

    2016-04-01

    The aim of this study was to investigate whether the omega-3 fatty acids help to improve erectile function in an atherosclerosis-induced erectile dysfunction rat model. A total of 20 male Sprague-Dawley rats at age 8 weeks were divided into three groups: Control group (n = 6, untreated sham operated rats), Pathologic group (n = 7, untreated rats with chronic pelvic ischemia [CPI]), and Treatment group (n = 7, CPI rats treated with omega-3 fatty acids). For the in vivo study, electrical stimulation of the cavernosal nerve was performed and erectile function was measured in all groups. Immunohistochemical antibody staining was performed for transforming growth factor beta-1 (TGF-β1), endothelial nitric oxide synthase (eNOS), and hypoxia inducible factor 1-alpha (HIF-1α). In vivo measurement of erectile function in the Pathologic group showed significantly lower values than those in the Control group, whereas the Treatment group showed significantly improved values in comparison with those in the Pathologic group. The results of western blot analysis revealed that systemically administered omega-3 fatty acids ameliorated the cavernosal molecular environment. Our study suggests that omega-3 fatty acids improve intracavernosal pressure and have a beneficial role against pathophysiological consequences such as fibrosis or hypoxic damage on a CPI rat model, which represents a structural erectile dysfunction model.

  13. Characteristics of pathological findings in women with chronic pelvic pain using conscious mini-laparoscopic pain mapping

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    XU Hong-mei; ZHANG Na-wei; ZHANG Zhen-yu; LI Shu-hong; SHI Xiu-ting; LIU Chong-dong

    2010-01-01

    @@ Chronic pelvic pain (CPP) is a common and disabling disorder of women that may have a significant impact on a woman's personal health and quality of life.Data have shown an annual prevalence of 3.8% in women 15 to 73 years of age, making its prevalence comparable to that of asthma (3.7%), back pain (4.1%), and migraines (2.1%). CPP in women is described as "intermittent or constant pain in the lower abdomen or pelvis of at least six months duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy". In addition, the condition is considered as a symptom, not a diagnosis. CPP is estimated to account for 10% of all referrals to gynecologists, 12% of all hysterectomies, and more than 40% of gynecologic diagnostic laparoscopies. The etiology is complex and may involve disorders of the reproductive tract,gastrointestinal tract, urinary tract, musculoskeletal system, and psychoneurological system. The diagnosis is often difficult, especially when nothing positive is found on physical examimation and imaging studies. The optimal management is usually difficult due to the unknown etiology.

  14. Effects of a self-assessment device for pelvic position on chronic back pain and range of motion of the trunk.

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    Yoo, Won-Gyu

    2015-12-01

    [Purpose] The purpose of the present study was to investigate the effects of a self-assessment device for pelvic position in a computer user with back pain. [Subjects] A 37-year-old man who complained of low back pain at L3-5 levels was the participant. [Methods] In this study, a self-assessment device for the pelvic position was developed. The patient was instructed in self-assessment of the pelvic position and an exercise program for two months. Prior to this instruction, the visual analog scale score and range of motion of the trunk were assessed. [Results] After the instruction in self-assessment of the pelvic position and exercise program, the visual analog scale score decreased from 7 to 3, and trunk flexion, extension, and bilateral lateral flexion range of motion were increased compared to the initial assessment. [Conclusion] Therefore, use of self-anthropometers and measuring methods in patients with chronic back pain is considered an important area of study.

  15. The Influence of Dual Pressure Biofeedback Units on Pelvic Rotation and Abdominal Muscle Activity during the Active Straight Leg Raise in Women with Chronic Lower Back Pain.

    Science.gov (United States)

    Noh, Kyung-Hee; Kim, Ji-Won; Kim, Gyoung-Mo; Ha, Sung-Min; Oh, Jae-Seop

    2014-05-01

    [Purpose] This study was performed to assess the influence of applying dual pressure biofeedback units (DPBUs) on the angle of pelvic rotation and abdominal muscle activity during the active straight leg raise (ASLR). [Subjects] Seventeen patients with low-back pain (LBP) participated in this study. [Methods] The subjects were asked to perform an active straight leg raise (ASLR) without a PBU, with a single PBU, and with DPBUs. The angles of pelvic rotation were measured using a three-dimensional motion-analysis system, and the muscle activity of the bilateral internal oblique abdominis (IO), external oblique abdominis (EO), and rectus abdominis (RA) was recorded using surface electromyography (EMG). One-way repeated-measures ANOVA was performed to determine the rotation angles and muscle activity under the three conditions. [Results] The EMG activity of the ipsilateral IO, contralateral EO, and bilateral RA was greater and pelvic rotation was lower with the DPBUs than with no PBU or a single PBU. [Conclusion] The results of this study suggest that applying DPBUs during ASLR is effective in decreasing unwanted pelvic rotation and increasing abdominal muscle activity in women with chronic low back pain.

  16. The Comparison of The Efficacy of Three Different Treatment Protocols on The Type 3 Chronic Prostatitis (Chronic Pelvic Pain Syndrome

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    Fikret Erdemir

    2010-05-01

    Full Text Available  Aim: In this study, the effect of three different treatment protocols on the type 3 chronic prostatitis was evaluated. In addition to our knowledge, the comparative studies which related CPPS are limited in Turkish literature. Material and Methods: Between January 2004 and December 2008 a total of 87 male patients with diagnosed of type 3 chronic prostatitis, were evaluated in our clinic. According to treatment protocols patients with type 3 chronic prostatitis, were randomized into three groups as fallows group 1; antibiotic+antiinflammatory+ α-blocker, group 2; α-blocker and group 3; antibiotic+antiinflammatory. Pretreatment and post treatment results were compared. Results: The mean age of all patients was 34.14±7.68 years. The mean age of the patients was 34.13±7.39 years, 34.76±7.99 years, and 33.72±8.25 years in group 1, group 2 and group 3, respectively (p>0.05. While the improvement rates after treatment was detected 68% in group 1, these rates were found as 35.3% and 52% in group 2 and group 3, respectively.This difference was statitistically significant in combined group when  compared to other groups (p=0.047. Conclusion:Although alternative treatment researches have still been continue in type 3 chronic prostatitis which consist of 90-95% of all prostatitis. It is seen that combined treatment is beneficial. However, studies in larger, randomized and controlled series are needed to prove the effect of treatment on type 3 chronic prostatitis.

  17. Network Meta-Analysis of the Efficacy of Acupuncture, Alpha-blockers and Antibiotics on Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

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    Qin, Zongshi; Wu, Jiani; Tian, Jinhui; Zhou, Jing; Liu, Yali; Liu, Zhishun

    2016-10-19

    Alpha-blockers and antibiotics are most commonly used to treat chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in clinical practice. Currently, increasing evidence also suggests acupuncture as an effective strategy. This network meta-analysis intended to assess the comparative efficacy and safety of acupuncture, alpha-blockers and antibiotics for CP/CPPS. Twelve trials involving 1203 participants were included. Based on decreases in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, a network meta-analysis indicated that electro-acupuncture (standard mean difference [SMD]: 4.29; 95% credible interval [CrI], 1.96-6.65), acupuncture (SMD: 3.69; 95% CrI, 0.27-7.17), alpha-blockers (SMD: 1.85; 95% CrI, 1.07-2.64), antibiotics (SMD: 2.66; 95% CrI, 1.57-3.76), and dual therapy (SMD: 3.20; 95% CrI, 1.95-4.42) are superior to placebo in decreasing this score. Additionally, electro-acupuncture (SMD: 2.44; 95% CrI, 0.08-4.83) and dual therapy (SMD: 1.35; 95% CrI, 0.07-2.62) were more effective than alpha-blockers in decreasing the total NIH-CPSI total score. Other network meta-analyses did not show significant differences between interventions other placebo. The incidence of adverse events of acupuncture was relatively rare (5.4%) compared with placebo (17.1%), alpha-blockers (24.9%), antibiotics (31%) and dual therapy (48.6%). Overall, rank tests and safety analyses indicate that electro-acupuncture/acupuncture may be recommended for the treatment of CP/CPPS.

  18. Observation on Different TCM Methods in Treating Pelvic Effusions Complicated with Chronic Pelvic Inflammation%不同中医方法治疗盆腔积液合并慢性盆腔炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵福玲

    2013-01-01

    目的:观察不同中医方法治疗盆腔积液合并慢性盆腔炎的临床疗效。方法:将盆腔积液合并慢性盆腔炎患者112例分为观察组和对照组各56例,2组均采用中药灌肠法治疗,观察组同时结合体外电场热疗治疗,对照组结合中药治疗,1周后比较2组患者临床疗效。结果:观察组显效45例,有效10例,总有效率为98.21%;对照组显效30例,有效20例,总有效率89.29%,观察组疗效优于对照组,差异有统计学意义(P<0.05)。结论:中药灌肠结合体外电场热疗,可促进药物快速吸收,迅速缓解临床症状,是治疗盆腔积液合并慢性盆腔炎的有效方法之一。%Objective:To verify curative effects of different TCM methods in treating pelvic effusions compli-cated with chronic pelvic inflammation. Method:All 112 patients were separated into the observation group and the control group, 56 cases each group. Both groups received retention enema with herbs, the observation group were given with electric field hyperthermia in vitro and the control group herbs, curative effects of the patients in both groups were compared in one week. Result:There were 45 cases improved remarkably, ten cases effective, total ef-fective rate of the observation group was 98.21%;30 cases were improved significantly, 20 cases effective, total ef-fective rate of the control group was 89.29%, the observation group was superior to the control group in clinical ef-fects, the difference had statistical meaning (P<0.05). Conclusion:Retention enema with herb and electric field hy-perthermia in vitro could promote the rapid absorption of the drugs and relieve clinical symptoms swiftly, which is one of the effective methods for pelvic effusions complicated with chronic pelvic inflammation.

  19. Extracorporeal shock wave treatment for non-inflammatory chronic pelvic pain syndrome: a prospective, randomized and sham-controlled study

    Institute of Scientific and Technical Information of China (English)

    ZENG Xiao-yong; LIANG Chen; YE Zhang-qun

    2012-01-01

    Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum,pelvis,suprapubic area,or external genitalia and variable degrees of voiding and ejaculatory disturbance.The analgesic effect of extracorporeal shock wave treatment (ESWT) was an interesting phenomenon with an unclear mechanism discovered by chance in the applications for urolithiasis,on which ESWT has become an increasingly popular therapeutic approach as an alternative option for the treatment of a number of soft tissue complaints.In this study,we aimed to evaluate the feasibility and efficacy of ESWT in non-inflammatory (ⅢB) CP/CPPS.Methods Men diagnosed with ⅢB CP/CPPS were randomized to either ESWT (group 1,n=40) or the control (group 2,n=40).Group 1 received 20 000 shock wave impulses in 10 sessions over a two-week period,whereas group 2 received only a sham procedure.The total scores and sub-domain scores of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) for both groups were assessed at baseline,mid-treatment,end-point,and 4-week and 12-week follow-up visits.Results The mean total NIH-CPSI score of group 1 was significantly decreased from baseline at all post-treatment time points (P <0.01 for all).Decreases in pain domain and quality of life (QOL) scores were also significant.In group 2,no significant decreases of total NIH-CPSI score and pain domain score were found at all post-treatment time points.At the end-point of treatment,71.1% of group 1 exhibited perceptible improvement in total NIH-CPSI compared with 27.0% of group 2 (P <0.001); additionally,28.9% of group 1 exhibited clinically significant improvement compared with 10.8% of group 2 (P <0.01).Moreover,a greater number of patients in group 1 at 4-week and 12-week follow-up were rated as responders (perceptible and clinically significant response) compared with group 2.Conclusion ESWT exhibits a potentially therapeutic

  20. [Aging-related changes of the female pelvic floor].

    Science.gov (United States)

    Scheiner, David; Betschart, Cornelia; Perucchini, Daniele

    2010-01-01

    The pelvic floor as lower closure of the abdominal cavity has to withstand the abdominal pressure. Meanwhile, the pelvic floor has to allow physiologic functions like micturition, defecation, sexual function and reproduction. But while pregnancy and vaginal delivery damage the pelvic floor directly, chronic stress like caugh, heavy lifting, or obesity lead to a chronic overstraining of the pelvic floor. Aging, structural changes, and possibly estrogen deficiency have a negative impact on the pelvic floor.

  1. Development and validation of an animal model of prostate inflammation-induced chronic pelvic pain: evaluating from inflammation of the prostate to pain behavioral modifications.

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    Feng Zeng

    Full Text Available BACKGROUND: Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS is the most common type of prostatitis. Due to the lack of a suitable animal model partly, the pathogenesis for this condition is obscure. In the current study we developed and validated an animal model for nonbacterial prostatitis and prostate inflammation-induced chronic pelvic pain in rats with the use of intraprostatic injection of λ-carrageenan. METHODS: Male Sprague-Dawley rats weighing 250-350 g were used for the experiments. After intraprostatic injection of 3% λ-carrageenan, at different time points(after 24 h, 7 d, 14 d and 30 d of injection, radiant heat and von Frey filaments were applied to the scrotum of rats to measure the heat and mechanical thresholds respectively. Then the prostate was removed for histology, and cyclooxygenase (COX 2 protein expression was determined by Western-blot. Evans blue(50 mg/kg was also injected intravenously to assess for plasma protein extravasation at different time points after injection of λ-carrageenan. RESULTS: Compared to control group, inflamed animals showed a significant reduction in mechanical threshold (mechanical allodynia at 24 h and 7d(p = 0.022,0.046, respectively, and a significant reduction in heat threshold (thermal hyperalgesia at 24 h, 7d and 14 d(p = 0.014, 0.018, 0.002, respectively in the scrotal skin. Significant increase of inflammatory cell accumulation, COX2 expression and Evans blue extravasation were observed at 24 h, 7d and 14 d after injection. CONCLUSIONS: Intraprostatic λ-carrageenan injection induced neurogenic prostatitis and prostate inflammation pain, which lasted at least 2 weeks. The current model is expected to be a valuable preclinical tool to study the neurobiological mechanisms of male chronic pelvic pain.

  2. Applying the RE-AIM Framework to Evaluate Integrative Medicine Group Visits Among Diverse Women with Chronic Pelvic Pain.

    Science.gov (United States)

    Chao, Maria T; Abercrombie, Priscilla D; Santana, Trilce; Duncan, Larissa G

    2015-12-01

    The purpose of this study was to evaluate group medical visits using an integrative health approach for underserved women with chronic pelvic pain (CPP). We implemented an integrative medicine program to improve quality of life among women with CPP using Centering, a group-based model that combines healthcare assessment, education, and social support. Patients were from university-affiliated and public hospital-affiliated clinics. We evaluated the program with qualitative and quantitative data to address components of the RE-AIM framework: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Participants of the Centering CPP Program participants (n = 26) were demographically similar to a sample of women with CPP who sought care at Bay Area hospitals (n = 701). Participants were on average 40 years of age, a majority of whom were racial/ethnic minorities with low household income (76%). Women who attended four or more sessions (n = 16) had improved health-related quality of life, including decreases in average number of unhealthy days in the past month (from 24 to 18, p < .05), depressive symptoms (from 11.7 to 9.0, p < .05), and symptom severity (from 4.2 to 3.1, p < .01). Sexual health outcomes also improved (30.5 to 50.3, p = .02). No improvements were observed for pain catastrophizing. Our pilot program provides preliminary data that an integrative health approach using a group-based model can be adapted and implemented to reach diverse women with CPP to improve physical and psychological well-being. Given these promising findings, rigorous evaluation of implementation and effectiveness of this approach compared with usual care is warranted.

  3. The Effect of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) on Semen Parameters in Human Males: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Fu, Weihua; Zhou, Zhansong; Liu, Shijian; Li, Qianwei; Yao, Jiwei; Li, Weibing; Yan, Junan

    2014-01-01

    Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the risk factors of impaired male fertility potential. Studies have investigated the effect of CP/CPPS on several semen parameters but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the association between CP/CPPS and basic semen parameters in adult men. Methods Systematic literature searches were conducted with PubMed, EMBASE and the Cochrane Library up to August 2013 for case-control studies that involved the impact of CP/CPSS on semen parameters. Meta-analysis was performed with Review Manager and Stata software. Standard mean differences (SMD) of semen parameters were identified with 95% confidence intervals (95% CI) in a random effects model. Results Twelve studies were identified, including 999 cases of CP/CPPS and 455 controls. Our results illustrated that the sperm concentration and the percentage of progressively motile sperm and morphologically normal sperm from patients with CP/CPPS were significantly lower than controls (SMD (95% CI) −14.12 (−21.69, −6.63), −5.94 (−8.63, −3.25) and −8.26 (−11.83, −4.66), respectively). However, semen volume in the CP/CPPS group was higher than in the control group (SMD (95% CI) 0.50 (0.11, 0.89)). There was no significant effect of CP/CPPS on the total sperm count, sperm total motility, and sperm vitality. Conclusions The present study illustrates that there was a significant negative effect of CP/CPPS on sperm concentration, sperm progressive motility, and normal sperm morphology. Further studies with larger sample sizes are needed to better illuminate the negative impact of CP/CPPS on semen parameters. PMID:24743301

  4. The Effect of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) on Erectile Function: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Chen, Xiang; Zhou, ZhiRui; Qiu, XiaoChun; Wang, Bin; Dai, JiCan

    2015-01-01

    Background High prevalence of erectile dysfunction (ED) has been observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, whether or not CP/CPPS is a risk factor of ED remains unknown and controversial. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between CP/CPPS and ED. Methods PubMed, Embase, Web of Science, and The Cochrane Library were searched up to November 11, 2014 to identify studies reporting the association between CP/CPPS and ED. Case–control, cohort and cross-sectional studies were included. Quality of the included studies was assessed. The odds ratio of ED and the mean difference of five-item International Index of Erectile Function (IIEF-5) score were pooled using a random effects model. Subgroup analysis and sensitivity analyses were performed. Results Three cross-sectional studies, two case–control studies, and four retrospective studies with 31,956 participants were included to calculate the pooled odds ratio of ED, and two studies with 1499 participants were included to calculate the pooled mean difference of IIEF-5 scores. A strong correlation was found between CP/CPPS and ED (pooled odds ratio: 3.02, 95% CI: 2.18–4.17, P < 0.01), with heterogeneity across studies (I2 = 65%; P < 0.01). A significant decrease in the IIFE-5 score was observed in the CP/CPPS group (pooled mean difference: −4.54, 95% CI: −5.11–−3.98; P < 0.01). Conclusion Our study indicates that patients with CP/CPPS have an increased risk of suffering from ED. Assessment of erectile function is necessary for the therapy of patients with CP/CPPS. Further evidence is necessary to confirm the relationship between CP/CPPS and ED. PMID:26509575

  5. The Effect of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS on Erectile Function: A Systematic Review and Meta-Analysis.

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    Xiang Chen

    Full Text Available High prevalence of erectile dysfunction (ED has been observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS. However, whether or not CP/CPPS is a risk factor of ED remains unknown and controversial. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between CP/CPPS and ED.PubMed, Embase, Web of Science, and The Cochrane Library were searched up to November 11, 2014 to identify studies reporting the association between CP/CPPS and ED. Case-control, cohort and cross-sectional studies were included. Quality of the included studies was assessed. The odds ratio of ED and the mean difference of five-item International Index of Erectile Function (IIEF-5 score were pooled using a random effects model. Subgroup analysis and sensitivity analyses were performed.Three cross-sectional studies, two case-control studies, and four retrospective studies with 31,956 participants were included to calculate the pooled odds ratio of ED, and two studies with 1499 participants were included to calculate the pooled mean difference of IIEF-5 scores. A strong correlation was found between CP/CPPS and ED (pooled odds ratio: 3.02, 95% CI: 2.18-4.17, P < 0.01, with heterogeneity across studies (I2 = 65%; P < 0.01. A significant decrease in the IIFE-5 score was observed in the CP/CPPS group (pooled mean difference: -4.54, 95% CI: -5.11--3.98; P < 0.01.Our study indicates that patients with CP/CPPS have an increased risk of suffering from ED. Assessment of erectile function is necessary for the therapy of patients with CP/CPPS. Further evidence is necessary to confirm the relationship between CP/CPPS and ED.

  6. The effect of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS on semen parameters in human males: a systematic review and meta-analysis.

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    Weihua Fu

    Full Text Available BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS is one of the risk factors of impaired male fertility potential. Studies have investigated the effect of CP/CPPS on several semen parameters but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the association between CP/CPPS and basic semen parameters in adult men. METHODS: Systematic literature searches were conducted with PubMed, EMBASE and the Cochrane Library up to August 2013 for case-control studies that involved the impact of CP/CPSS on semen parameters. Meta-analysis was performed with Review Manager and Stata software. Standard mean differences (SMD of semen parameters were identified with 95% confidence intervals (95% CI in a random effects model. RESULTS: Twelve studies were identified, including 999 cases of CP/CPPS and 455 controls. Our results illustrated that the sperm concentration and the percentage of progressively motile sperm and morphologically normal sperm from patients with CP/CPPS were significantly lower than controls (SMD (95% CI -14.12 (-21.69, -6.63, -5.94 (-8.63, -3.25 and -8.26 (-11.83, -4.66, respectively. However, semen volume in the CP/CPPS group was higher than in the control group (SMD (95% CI 0.50 (0.11, 0.89. There was no significant effect of CP/CPPS on the total sperm count, sperm total motility, and sperm vitality. CONCLUSIONS: The present study illustrates that there was a significant negative effect of CP/CPPS on sperm concentration, sperm progressive motility, and normal sperm morphology. Further studies with larger sample sizes are needed to better illuminate the negative impact of CP/CPPS on semen parameters.

  7. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center.

    Directory of Open Access Journals (Sweden)

    Yadong Zhang

    Full Text Available The aim of this study was to investigate the prevalence of erectile dysfunction (ED in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and explore the influence of UPOINT domains, National Institutes of Health-CP symptom index (NIH-CPSI and other factors on ED prevalence. This was a prospective study of consecutive patients with CP/CPPS seen at 11 tertiary hospitals during January-July 2014. ED was diagnosed as a score of<21 on the International Index of Erectile Function (IIEF-5. Patients from one center were evaluated by the UPOINT system and NIH-CPSI. Each patient was assessed using clinical examination, asocio-demographic questionnaire, the Patient Health Questionnaire (PHQ, the Pain Catastrophizing Scale (PCS, NIH-CPSI and IIEF-5.1406 patients from 11 centers (mean age, 32.18 years; range 18-60 years were enrolled. ED was found in 638/1406 patients (45.4%, and was categorized as mild in 291(45.6%, moderate in 297(46.6% and severe in50(7.7%. 192 patients from one center(mean age,31.3 years; range 18-57 years were further studied.IIEF-5 score correlated negatively with NIH-CPSI(r = 0.251, PHQ (r = 0.355 and PCS (r = 0.322scores (P<0.001.PHQ score correlated positively with NIH-CPSI (r = 0.586 and PCS(r = 0.662 scores (P<0.001.NIH-CPSI, PHQ, PCS and IIEF-5 scores did not differ significantly between class IIIA and IIIB CP/CPPS. Multivariate logistic regression showed that UPOINT psychological (P domain and NIH-CPSI symptom severity were independent risk factors for ED in CP/CPPS. It is concluded that psychological factors and symptom severity are independent risk factors for ED in CP/CPPS.

  8. The role of inflammatory cytokines and ERK1/2 signaling in chronic prostatitis/chronic pelvic pain syndrome with related mental health disorders.

    Science.gov (United States)

    Hu, Chao; Yang, Hualan; Zhao, Yanfang; Chen, Xiang; Dong, Yinying; Li, Long; Dong, Yehao; Cui, Jiefeng; Zhu, Tongyu; Zheng, Ping; Lin, Ching-Shwun; Dai, Jican

    2016-06-23

    Mental health disorders(MHD) in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been widely studied. However, the underlying role of inflammatory cytokines and their associated signaling pathways have not been investigated. Here, we report the potential role of cytokines and associated signaling pathways in CP/CPPS patients with MHD and in a CP/CPPS animal model. CP/CPPS patients (n = 810) and control subjects (n = 992) were enrolled in this case-control multicenter study, and serum cytokine levels were measured. Male Sprague-Dawley rats received multiple intracutaneous injections of an immuno-agent along with a pertussis-diphtheria-tetanus triple vaccine for autoimmune CP/CPPS development. The results revealed that, in CP/CPPS patients with significant MHD, elevated IL-1α, IL-1β, IL-4, IL-13, and TNF-α serum levels were observed. The above five cytokines in CP/CPPS rats were significantly elevated in prostate tissue (p < 0.05), and IL-1β levels were elevated in serum and cerebrospinal fluid. In behavioral tests, CP/CPPS rats showed anxiety- and depression-like symptoms, and impaired spatial and associative memory performance (p < 0.05). In the CP/CPPS group, ERK1/2 phosphorylation levels were increased in the amygdala and nucleus accumbens, and decreased in the hippocampus, but not caudate nucleus. Thus, prostate-derived cytokines, especially IL-1β, cross the blood brain barrier and may lead to enhanced ERK1/2 signaling in several brain areas, possibly underlying induction of CP/CPPS-related MHD.

  9. Characterisation of the bacterial community in expressed prostatic secretions from patients with chronic prostatitis/chronic pelvic pain syndrome and infertile men: a preliminary investigation

    Institute of Scientific and Technical Information of China (English)

    Dong-Sheng Hou; Wen-Min Long; Jian Shen; Li-Ping Zhao; Xiao-Yan Pang; Chen XU

    2012-01-01

    The expressed prostatic secretions (EPSs) of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS),infertile men and normal men were subjected to microbiological study.EPSs were collected from the subjects,which included 26 normal men,11 infertile patients and 51 CP/CPPS patients.DNA was extracted from each specimen,and the V3 regions of the 16S rRNA genes were amplified using universal bacterial primers.The results showed that the EPS 16S rRNA gene-positive rate in the CP/CPPS and infertile patients was much higher than in the normal men,but without any difference among the three patient groups.The denaturing gradient gel electrophoresis (DGGE) method was used to characterize the EPS bacterial community structure of the prostate fluid from patients with CP/CPPS or infertility issues.Principal component analysis (PCA) and partial least squares (PLS) analyses of PCR-DGGE profiles revealed that the EPS bacterial community structure differed among the three groups.Three bands were identified as the key factors responsible for the discrepancy between CP/CPPS patients and infertile patients (P<0.05).Two bands were identified as priority factors in the discrepancy of category ⅢA and category ⅢB prostatitis patients (P<0.05).According to this research,the ecological balance of the prostate and low urethra tract,when considered as a microenvironment,might play an important role in the maintenance of a healthy male reproductive tract.

  10. A randomised controlled trial to assess the efficacy of Laparoscopic Uterosacral Nerve Ablation (LUNA in the treatment of chronic pelvic pain: The trial protocol [ISRCTN41196151

    Directory of Open Access Journals (Sweden)

    2003-12-01

    Full Text Available Abstract Background Chronic pelvic pain is a common condition with a major impact on health-related quality of life, work productivity and health care utilisation. The cause of the pain is not always obvious as no pathology is seen in 40–60% of the cases. In the absence of pathology there is no established treatment. The Lee-Frankenhauser sensory nerve plexuses and parasympathetic ganglia in the uterosacral ligaments carry pain from the uterus, cervix and other pelvic structures. Interruption of these nerve trunks by laparoscopic uterosacral nerve ablation (LUNA may alleviate pain. However, the balance of benefits and risks of this intervention have not been reliably assessed. LUNA has, nevertheless, been introduced into practice, although there remains controversy regarding indications for LUNA. Hence, there is an urgent need for a randomised controlled trial to confirm, or refute, any worthwhile effectiveness. The principal hypothesis is that, in women with chronic pelvic pain in whom diagnostic laparoscopy reveals either no pathology or mild endometriosis (AFS score ≤ 5 LUNA alleviates pain and improves life quality at 12 months. Methods/Design The principal objective is to test the hypothesis that in women with chronic pelvic pain in whom diagnostic laparoscopy reveals either no pathology or mild endometriosis (AFS score ≤ 5 LUNA alleviates pain and improves life quality at 12 months. A multi-centre, prospective, randomised-controlled-trial will be carried out with blind assessment of outcomes in eligible consenting patients randomised at diagnostic laparoscopy to LUNA (experimental group or to no pelvic denervation (control group. Postal questionnaires including visual analogue scale for pain (primary outcome, an index of sexual satisfaction and the EuroQoL 5D-EQ instrument (secondary outcomes will be administered at 3, 6 and 12 months. The primary assessment of the effectiveness of LUNA will be from comparison of outcomes at the one

  11. Nanotechnology in Urology

    Science.gov (United States)

    Jayasimha, Sudhindra

    2017-01-01

    Introduction: Nanotechnology has revolutionized our approach to medical diagnostics as well as therapeutics and has spanned an entirely new branch of research. This review addresses the potential applications of Nanotechnology in Urology. This article is based on the Dr. Sitharaman Best Essay award of the Urological Society of India for 2016. Methods: A PubMed search was performed for all relevant articles using the terms, “nanotechnology, nanoparticles, nanoshells, nanoscaffolds, and nanofibers.” Results: The developments in diagnostics include novel techniques of imaging of genitourinary malignancies, prostate-specific antigen measurement, early detection of mutations that are diagnostic for polycystic kidney disease. The potential applications of nanotechnology are in the targeted therapy of genitourinary malignancies, erectile dysfunction, overactive bladder, bladder reconstruction, construction of artificial kidneys and biodegradable stents as well as in robotic surgery. Conclusions: Nanotechnology is a rapidly emerging branch of research in urology with diverse and clinically significant applications in diagnostics as well as therapeutics. PMID:28197024

  12. Prevention of urological cancer

    Directory of Open Access Journals (Sweden)

    M S Ansari

    2003-01-01

    Full Text Available Objectives: Many urological cancers like prostate and bladder have protracted course and maybe ideal for chemoprevention strategies. This article reviews the biol-ogy, epidemiology and possible preventive strategies for the various urological cancers. Methods: The author reviewed the relevant articles published in the last 20 years and studied the biology of the various urological cancers. An attempt is made to identify the various dietary, nutritional and occupation-related factors implicated in the onset and progression of various urological cancers. The various interventions and clinical trial results are described to prove the relevance of these factors. Results: Epidemiological reports provide the strongest evidence of protective role for dietary agents in cancer of prostate, bladder and kidney. Cancers of prostate and blad-der are uniquely suitable for chemopreventive strategies. For prostate cancer strong evidence exists for a preven-tive effect of reduced fat intake, vitamin E, selenium, lycopene and soya proteins. Vitamin A administration shows a strong inverse relation to bladder cancer. Better prevention is seen with combination of high doses of vita-mins A, C, E and B6. High-energy intake is related to the higher incidence of renal cell carcinoma (RCC. While vitamins D and E supplementation has resulted in lower incidence of RCC. Conclusions: Numerous studies implicate dietary and nutritional factors in the onset and progression of various urological cancers. Hence, it is possible that bioactive compounds (anti-oxidants like vits. A, D, C, and E, min-erals like selenium and carotenoids like lycopene along with reduction of animal fat in diet can be a part of pre-ventive strategies for various urological cancers.

  13. Functional anatomy of pelvic floor.

    Science.gov (United States)

    Rocca Rossetti, Salvatore

    2016-03-31

    Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

  14. Functional anatomy of pelvic floor

    Directory of Open Access Journals (Sweden)

    Salvatore Rocca Rossetti

    2016-03-01

    Full Text Available Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

  15. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study

    Science.gov (United States)

    Guan, Xiao; Zhao, Cheng; Ou, Zhen-Yu; Wang, Long; Zeng, Feng; Qi, Lin; Tang, Zheng-Yan; Dun, Jin-Geng; Liu, Long-Fei

    2015-01-01

    The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness (UPOINT) phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CP/CPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index (NIH-CPSI) was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores (r = 0.796, P < 0.001). Symptom duration was associated with a greater number of positive domains (r = 0.589, P < 0.001). With 6 months follow-up at least, 75.0% (105/140) had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones: pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ± 5.70 (all P < 0.0001). Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy. PMID:25248659

  16. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study

    Directory of Open Access Journals (Sweden)

    Xiao Guan

    2015-02-01

    Full Text Available The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness (UPOINT phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CP/CPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index (NIH-CPSI was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores (r = 0.796, P< 0.001. Symptom duration was associated with a greater number of positive domains (r = 0.589, P< 0.001. With 6 months follow-up at least, 75.0% (105/140 had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones: pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ± 5.70 (all P< 0.0001. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.

  17. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome:a prospective study

    Institute of Scientific and Technical Information of China (English)

    Xiao Guan; Cheng Zhao; Zhen-Yu Ou; Long Wang; Feng Zeng; Lin Qi; Zheng-Yan Tang; Jin-Geng Dun; Long-Fei Liu

    2015-01-01

    The urinary, psychosocial, organ‑specific, infection, neurological/systemic and tenderness (UPOINT) phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CP/CPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re‑examined after 6 months. A minimum 6‑point drop in National Institutes of Health‑Chronic Prostatitis Symptoms Index (NIH‑CPSI) was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH‑CPSI scores (r = 0.796, P < 0.001). Symptom duration was associated with a greater number of positive domains (r = 0.589, P < 0.001). With 6 months follow‑up at least, 75.0% (105/140) had at least a 6‑point improvement in NIH‑CPSI after taking the therapy. All NIH‑CPSI scores were significantly improved from original ones: pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ± 5.70 (all P < 0.0001). Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.

  18. Clinical countermeasure of management for chronic pelvic pain%慢性盆腔疼痛临床处理对策

    Institute of Scientific and Technical Information of China (English)

    朱兰; 娄文佳

    2012-01-01

    慢性盆腔疼痛(chronic pelvic pain,CPP)由各种功能性或(和)器质性原因引起的以骨盆及其周围组织疼痛为主要症状,时间超过6个月的一组疾病或综合征.文章阐述了与CPP有关的妇科疾病,以及目前对CPP诊断方法的评价和治疗的有效方法.

  19. FDG in Urologic Malignancies

    DEFF Research Database (Denmark)

    Høilund-Carlsen, Poul Flemming; Poulsen, Mads Hvid; Petersen, Henrik;

    2014-01-01

    F-fluoro-deoxy-glucose (FDG). PET imaging has been applied more often in prostate cancer. FDG-PET/CT is claimed to have a high frequency of false-negative results in urologic cancers; however, this finding may instead reflect correctly the state of disease being due to slow-growing cancers...

  20. The Effect of Chronic Pelvic Inflammatory Disease by Ultrashort Wave Therapy Apparatus and Nursing%慢性盆腔炎经超短波治疗仪治疗的效果与护理

    Institute of Scientific and Technical Information of China (English)

    吴建丽

    2015-01-01

    Objective To investigate the effect of ultrashort wave treatment of chronic pelvic inflammatory disease and care. Methods Through the 52 cases of chronic pelvic inflammatory disease treatment using ultrashort. Results 47 cases of patients with effective,efficient and 90%. Conclusion Ultrashort wave therapy for the treatment of chronic pelvic inflammatory disease,Effect, no pain, easy to accept, it is worth promoting.%目的:探讨超短波治疗慢性盆腔炎的效果与护理。方法通过对52例慢性盆腔炎患者采用超短波治疗。结果47例患者有效,有效率90%。结论超短波治疗仪治疗慢性盆腔炎,效果好,无痛苦,易接受。

  1. [Chronic prostatitis: a new paradigm of treatment].

    Science.gov (United States)

    Bozhedomov, V A

    2016-08-01

    This paper proposes health care recommendations for men with chronic prostatitis (CP) taking into account etiopathogenesis and the clinical presentation of the disease. The proposal is based on the experience of federal and regional clinics of urology and gynecology, respective departments for postgraduate education and on the analysis of scientific literature. It is shown that managing patients with CP requires consideration of factors beyond the traditional practice of urology. The author validates the need to use the modern prostatitis classification UPOINT instead of the traditional NIH NIDDK (1995) to increase the effectiveness of treatment. It is demonstrated that the concurrent use of medications and non-pharmacological treatments aimed at different aspects of the state improve the treatment effectiveness. Indications are refined for medical and non-pharmacological treatments: antibiotics, alpha-blockers, anticholinergic agents, analgesics, antidepressants, herbal remedies, pelvic floor physiotherapy, psychotherapy. The shortcomings and mistakes of existing guidelines/standards are analyzed.

  2. 妇炎宁汤对慢性盆腔炎大鼠模型体内TNF-α影响%Influence of Fuyanning Decoction on TNF-α in Rats with Chronic Pelvic Inflammation

    Institute of Scientific and Technical Information of China (English)

    凌娜; 陈莹

    2013-01-01

    Objective: To study the influence of Fuyaning Decoction on expression of TNF- α in rats with chronic pelvic inflammation and those who were Yang deficiency. Methods: The rat models of chronic pelvic inflammation and Yang deficiency syndrome of chronic pelvic inflammation were established. 120 rats which were chronic pelvic inflammation and Yang deficiency syndrome of chronic pelvic inflammation, were randomly divided into normal group, model group, Kangfuyan group, Levofloxacin group and Fuyaning Decoction low, middle and high dose groups.There were 12 in each group.The expression change of TNF- α was detected by semiquantitative RT-PCR and HE staining methods. Results : TNF- α expression was obviously decreased. Conclusion : Fuyaning Decoction can reduce the expression of TNF- α in rats with chronic pelvic inflammation.%目的:了解妇炎宁汤对慢性盆腔炎及阳虚型慢性盆腔炎大鼠模型体内TNF-α表达的影响.方法:复制大鼠慢性盆腔炎及阳虚型慢性盆腔炎模型,将120只大鼠随机在慢性盆腔炎组和阳虚型慢性盆腔炎组分别分为正常组、模型组、康妇炎胶囊组、左氧氟沙星组和妇炎宁高中低剂量组,每组12只,采用HE染色和半定量RT-PCR法检测各组TNF-α表达的变化.结果:大鼠TNF-α量明显降低.结论:妇炎宁汤可以降低慢性盆腔炎大鼠模型中TNF-α表达.

  3. Laparoscope Diagnosis and Treatment to Chronic Pelvic Cavity Pain (CPP)%慢性盆腔痛腹腔镜诊治探讨

    Institute of Scientific and Technical Information of China (English)

    王芳

    2012-01-01

    [Objective] To explore the cure effect of laparoscope on CPP. [Method] Trace back and analyse the pathological change, treatment and clinical effect of 80 cases of CPP treated with laparoscope. [Result] 85.00% had definite pathological changes; endometriosis (37.5%) .chronic pelvic inflammation(27.5%) .pelvic adhesion(12.5%) were the main pathological changes of CPP, occupying 77.5%(62/80)of total cases. [Conclusion] Laparoscope is a quick, effective and optimized method for defining the causa morbi of chronic pelvic cavity pain. and can improve diagnosis rate and effective rate of CPP.%[目的]探讨腹腔镜在慢性盆腔痛(CPP)中的诊断治疗作用.[方法]回顾性分析使用腹腔镜进行诊治的80例慢性盆腔痛患者的病理改变、治疗方法及临床疗效.[结果]85.00%( 68/80)的CPP患者在腹腔镜使用下明确了其病理改变,子宫内膜异位症(37.5%)、慢性盆腔炎(27.5%)、盆腔粘连(125%)是 CPP的主要病理改变,占总病例的77.50%( 62/80).[结论]腹腔镜是明确慢性盆腔痛病理病因的一种快速、有效、优选的方法,能提高慢性盆腔痛诊治的确诊率和有效率.

  4. Chronic prostatitis/chronic pelvic pain syndrome impairs erectile function through increased endothelial dysfunction, oxidative stress, apoptosis, and corporal fibrosis in a rat model.

    Science.gov (United States)

    Hu, Y; Niu, X; Wang, G; Huang, J; Liu, M; Peng, B

    2016-11-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is an independent risk factor for the development of erectile dysfunction (ED). But the molecular mechanisms underlying the relationship between CP/CPPS and ED are still unclear. The aim of this study was to investigate the effect of CP/CPPS on erectile function in a rat model and the possible mechanisms. A rat model of experimental autoimmune prostatitis (EAP) was established to mimic human CP⁄CPPS. Then twenty 2-month-old male Sprague-Dawley rats were divided into EAP group and control group. Intracavernosal pressure (ICP) and mean arterial pressure (MAP) were measured during cavernous nerve electrostimulation, the ratio of max ICP/MAP was calculated. Blood was collected to measure the levels of serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and testosterone, respectively. The expression of endothelial nitric oxide synthase (eNOS), cyclic guanosine monophosphate (cGMP) levels, superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels in corpus cavernosum were detected. We also evaluated the smooth muscle/collagen ratio and apoptotic index (AI). The ratio of max ICP/MAP in EAP group were significantly lower than that in control group. The levels of serum CRP, TNF-α, IL-1β, and IL-6 in EAP group were all significantly higher than these in control group. The expression of eNOS and cGMP levels in corpus cavernosum of EAP rats were significantly downregulated. Furthermore, decreased SOD activity and smooth muscle/collagen ratio, increased MDA levels and AI were found in corpus cavernosum of EAP rats. In conclusion, CP/CPPS impaired penile erectile function in a rat model. The declines of eNOS expression and cGMP levels in corpus cavernosum may be an important mechanism of CP/CPPS-induced ED. CP/CPPS also increased oxidative stress, cell apoptosis and decreased smooth muscle/collagen ratio in corpus cavernosum of rats, which were

  5. AB129. The effect of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) on erectile function: a systematic review and meta-analysis

    Science.gov (United States)

    Dai, Jican

    2015-01-01

    Objective High prevalence of erectile dysfunction (ED) was observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, it is still unknown whether CP/CPPS is a risk factor of ED. This systematic review and meta-analysis was conducted to evaluate the relationship between CP/CPPS and ED. Methods PubMed, EMBASE, Web of Science and the Cochrane library were searched up to November 2014 to identify literatures that reported the association between CP/CPPS and ED. Case-control, cohort or cross-sectional studies were included. Newcastle-Ottawa Quality Assessment scale was used in assessing qualities of included case-control and cohort studies and an eleven item quality assessment table was used in cross-sectional studies. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Odds ratio of ED and mean difference of 5-item International Index of Erectile Function scores were pooled across studies and analyzed using random effect model. Results A total of 3 cross-sectional studies, 2 case-control studies and 4 retrospective studies with 31,956 participants were included to calculate pooled OR of ED, and 2 studies for pooled mean difference of IIEF-5 score. A strong correlation between CP/CPPS and ED (pooled OR: 3.02, 95% CI: 2.18-4.17, P<0.01) was found, with significant heterogeneity across studies (I2=65%, P<0.01). Also a significant decrease of IIFE-5 score in CP/CPPS group (pooled MD: –4.54, 95% CI: –5.11-–3.98, P<0.01) was observed. Conclusions Patients with CP/CPPS have a more increased risk of suffering from ED, but the mechanisms were unclear. Evidence of higher level is needed to further confirm this relationship. Physicians should pay more attention on erectile function of patients with CP/CPPS.

  6. Emphasis on the diagnosis and treatment of chronic pelvic pain%重视慢性盆腔痛的诊治

    Institute of Scientific and Technical Information of China (English)

    冷金花

    2013-01-01

    Chronic pelvic pain (CPP) is a ubiquitous, yet enigmatic condition that mainly affects women of reproductive age. Pain symptoms and the associated infertility may significantly affect their physical, mental and social wellbeing, resulting in a considerable burden in terms of health care costs. Thus, there is a pressing need to update the current knowledge of CPP, and to evaluate the effect of treatment. Further, the need for a comprehensive treatment guideline is considered timely.%慢性盆腔痛(chronic pelvic pain,CPP)多见于育龄女性,自然病史复杂,病因不明确,治疗反应差,严重威胁患者的健康和生育能力、社会心理状况及家庭关系,其危害及防治消耗了大量的社会和卫生经济资源.重视CPP的诊治有利于深入了解疾病机制,提高疾病综合治疗水平,并形成全面的诊治指南和流程.

  7. Chronic pelvic pain.

    Science.gov (United States)

    Herbert, Bettina

    2010-01-01

    Though there are myriad etiologies of CPP, common therapeutic targets include inflammation, somatic dysfunction, and psychological disturbances. Inflammation may be addressed not only with dietary changes including nutritional and botanical supplements but also with mind-body therapies. Somatic dysfunction may respond to manipulative therapies provided by osteopaths, naturopaths, chiropractors, and some physical therapists. Therapists may also offer visceral, craniosacral, myofascial, and other whole-body therapies, as can highly trained massage therapists and bodyworkers. Mental health care may be key in many cases. Integrative medicine heralds the return to a sense of the human being's intrinsic capacity for healing, incorporating the vitalism of many of the therapies' origins (traditional Chinese medicine, indigenous medicine, ayurveda, osteopathy, chiropractic, etc) with the gains made by a more reductionistic tradition. Given the complexity and wide variation of etiologies and symptoms of CPP, using an integrative approach may offer expanded therapeutic solutions. We must expand our capacity to listen to each patient-with ears, eyes, mind, heart, and hands. Each treatment plan may then be tailored to the unique history and perspective that lie within the individual. Doing so requires the essential elements of time, skill, and love.

  8. Clinical nursing effect of pelvic exercise combined with abdominal massage on the chronic pelvic pain%盆腔操锻炼联合腹部推拿在慢性盆腔痛的护理效果分析

    Institute of Scientific and Technical Information of China (English)

    黄其会

    2015-01-01

    目的:观察盆腔操锻炼联合腹部推拿对治疗慢性盆腔痛的临床效果。方法选择2013年3月~2014年6月收治的98例慢性盆腔痛患者,按数字表随机法分成对照组和观察组,其中对照组给予常规治疗,观察组在常规治疗的基础上同时进行盆腔操锻炼联合腹部推拿治疗,观察记录两组患者在入院时、治疗7 d 后以及治疗14 d 后的疼痛指数,并在治疗14 d 后对其临床疗效进行评定。结果两组患者在入院时的疼痛指数差异无统计学意义(P >0.05);与入院前比较,两组患者治疗7 d 后疼痛有明显缓解(P <0.05),与对照组比较,差异无统计学意义(P >0.05);治疗14 d 后观察组疼痛明显减轻,与对照组比较,差异有统计学意义(P <0.05)。治疗14 d 后,观察组总有效率为87.76%(43/49),高于对照组总有效率为69.39%(34/49),差异有统计学意义(χ2=4.91,P <0.05)。结论盆腔操锻炼联合腹部推拿能有效改善慢性盆腔痛患者的疼痛程度,疗效满意。%Objective To observe the clinical nursing effect of pelvic exercise combined with abdominal massage on the chronic pelvic pain. Methods 98 patients with chronic pelvic pain in our hospital from March 2013 to June 2014 were analyzed,and divided into control group and observation group randomly. The patients of control group were given conventional treatment and nursing care,while the patients of observation group were on pelvic exercise combined with abdominal massage on the basis of routine treatment and nursing care. Then the pain indexes and clinical efficacy rates were observed and recorded in the two groups at the time of admission/7 days later and 14 days later to evaluate the nursing effects. Results The pain index NRS score of the observation group was not significantly different from that of the control group at the time of admission/ 7 d later(P > 0.05),but was significantly

  9. Urologic Issues During Pregnancy

    Directory of Open Access Journals (Sweden)

    Jeffrey P. Weiss

    2004-01-01

    Full Text Available Pregnancy induces a variety of physiologic changes in the urinary tract. When such changes become accentuated the physiologic becomes the pathologic and symptoms arise, at times of significance enough to threaten the well being of mother and/or fetus. This article intends to describe the basis for urinary physiology and its pathologic counterparts during pregnancy. Such a background may then facilitate a rational management protocol for various urologic problems in the gravid state.

  10. The laser in urology

    Science.gov (United States)

    Hofstetter, Alfons G.

    2002-10-01

    Laser is an acronym for a physical principle and means: Light Amplification by stimulated Emission of Radiation. This principle offers a lot of tissue/light effects caused by the parameters: power density/time and the special qualities of the laser light. Nowadays for diagnosis and therapy following lasers are used in urology: Krypton- and Dye-lasers as well as the Neodymium-YAG- (nd:YAG-), Holmium-YAG (Ho:YAG-), Diode-, Argon- and the CO2-lasers.

  11. Wound healing in urology.

    Science.gov (United States)

    Ninan, Neethu; Thomas, Sabu; Grohens, Yves

    2015-03-01

    Wound healing is a dynamic and complex phenomenon of replacing devitalized tissues in the body. Urethral healing takes place in four phases namely inflammation, proliferation, maturation and remodelling, similar to dermal healing. However, the duration of each phase of wound healing in urology is extended for a longer period when compared to that of dermatology. An ideal wound dressing material removes exudate, creates a moist environment, offers protection from foreign substances and promotes tissue regeneration. A single wound dressing material shall not be sufficient to treat all kinds of wounds as each wound is distinct. This review includes the recent attempts to explore the hidden potential of growth factors, stem cells, siRNA, miRNA and drugs for promoting wound healing in urology. The review also discusses the different technologies used in hospitals to treat wounds in urology, which make use of innovative biomaterials synthesised in regenerative medicines like hydrogels, hydrocolloids, foams, films etc., incorporated with growth factors, drug molecules or nanoparticles. These include surgical zippers, laser tissue welding, negative pressure wound therapy, and hyperbaric oxygen treatment.

  12. Met in Urological Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Miyata, Yasuyoshi, E-mail: int.doc.miya@m3.dion.ne.jp; Asai, Akihiro; Mitsunari, Kensuke; Matsuo, Tomohiro; Ohba, Kojiro; Mochizuki, Yasushi; Sakai, Hideki [Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501 (Japan)

    2014-12-16

    Met is a tyrosine kinase receptor that is considered to be a proto-oncogene. The hepatocyte growth factor (HGF)-Met signaling system plays an important role in tumor growth, invasion, and metastasis in many types of malignancies. Furthermore, Met expression has been reported to be a useful predictive biomarker for disease progression and patient survival in these malignancies. Many studies have focused on the clinical significance and prognostic role of Met in urological cancers, including prostate cancer (PCa), renal cell carcinoma (RCC), and urothelial cancer. Several preclinical studies and clinical trials are in progress. In this review, the current understanding of the pathological role of Met in cancer cell lines, its clinical significance in cancer tissues, and its predictive value in patients with urological cancers are summarized. In particular, Met-related malignant behavior in castration-resistant PCa and the different pathological roles Met plays in papillary RCC and other histological types of RCC are the subjects of focus. In addition, the pathological significance of phosphorylated Met in these cancers is shown. In recent years, Met has been recognized as a potential therapeutic target in various types of cancer; therapeutic strategies used by Met-targeted agents in urological cancers are summarized in this review.

  13. Diabetes and Sexual and Urologic Problems

    Science.gov (United States)

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes & Sexual & Urologic Problems Troublesome bladder symptoms and changes ... early onset of these sexual and urologic problems. Diabetes and Sexual Problems Both men and women with ...

  14. Renal and urologic emergencies in the HIV-infected patient.

    Science.gov (United States)

    Liang, Stephen Y; Overton, E Turner

    2010-05-01

    Antiretroviral therapy has revolutionized the care of individuals infected with the human immunodeficiency virus (HIV) and has fundamentally altered the scope of the disease. Acute renal failure and chronic kidney disease from medication toxicity and comorbid noninfectious illnesses are just as likely today as end-organ injury from the virus itself. Chronic immunosuppression renders HIV-infected patients vulnerable to any of several unique urological infections not frequently seen in immunocompetent patients. A deeper understanding of renal and urological emergencies in the context of the HIV-infected patient will better prepare the emergency physician to render optimal care to this rapidly expanding and aging patient population.

  15. 慢性盆腔疼痛症的中医治疗体会%The Experience of Traditional Chinese Medicine in Treatment of Chronic Pelvic Pain Syndrome

    Institute of Scientific and Technical Information of China (English)

    林丽波

    2015-01-01

    目的:对中医疗法治疗慢性盆腔疼痛症的临床治疗效果进行探究。方法选取我院于2014年1月~2014年9月收治的44例慢性盆腔疼痛症患者,随机分为对照组和治疗组各22例患者,对照组患者采用西医治疗,治疗组患者采用中医治疗,对两组患者的治疗效果进行对比分析。结果经过3个疗程的治疗,对照组和治疗组的治疗总有效率分别为77.3%和90.9%,两组治疗效果对比差异显著,治疗有统计学意义(P<0.05)。结论采用中医疗法治疗慢性盆腔疼痛症能够取得满意的效果,是治疗慢性盆腔疼痛症的一种极其有效的方法。%Objective The traditional Chinese medicine treatment efficacy in treatment of chronic pelvic pain syndrome is to be analyzed.Methods Choose 44 patients with chronic pelvic pain syndrome who are received and treated in hospital from January 2013 to September 2014 and separate them into control group and study group at random with 22 patients in each group. Patients in control group are given western medicine treatment,while patients in study group are given traditional chinese medicine treatment,and then observe and compare the treatment efficacy of the two groups.ResultsThe treatment efficiency in control group and study group is 77.3% and 90.9% respectively after three courses of treatment,there is a treatment differential between the two groups,and such a differential has statistic value(P<0.05).Conclusion The traditional chinese medicine is of efficiency to cure chronic pelvic pain syndrome with favorable result. Thus,such an effective treatment approach is quite worthwhile to be promoted and applied.

  16. An Overiew of Treatment of Chronic Pelvic Ache with Integrated Traditional Chinese and Western Medicine%中西医结合治疗慢性盆腔疼痛概述

    Institute of Scientific and Technical Information of China (English)

    卢永霞

    2008-01-01

    慢性盆腔疼痛是妇科常见症状之一,指持续六个月或以上,且不完全与月经周期及性交有关的盆腔疼痛.在育龄妯女的发病率为3.8%.慢性盆腔疼痛在临床上常见,难处理且易复发,严重影响妇女的工作及性生活质量.目前,越来越多的证据表明中西医结合治疗女性慢性盆腔疼痛有着很好的效果.%Chronic pelvic pain is a common disease in women,manifested by more than six months pain in the lower abdominal area,which is not entirely associated with the menstrual cycle or sexual intercourse.Chronic pelvic pain has a prevalence of 3.8% among women of reproductive age.It is commonly seen in clinic,but difficult to be treated and easily relapses.Chronic pelvic pain may have profound effects on women's work and quality of sexual life.In recent years,more and more evidence suggest that integrated traditional Chinese and western medicine has a great efficancy in treating patients with Chronic pelvic pain.

  17. A Clinical Study on the Treatment of Chronic Pelvic Inflammation of Qi-stagnation with Blood Stasis Syndrome by Penyanqing Capsule (盆炎清胶囊)

    Institute of Scientific and Technical Information of China (English)

    SHEN Bi-qiong; SITU Yi; HUANG Jian-ling; SU Xiao-mei; HE Wei-tang; ZHANG Mao-wei; CHEN Qu-bo

    2005-01-01

    Objective: To observe the clinical efficacy of Penyanqing Capsule (盆炎清胶囊, PYQC) in treating pelvic inflammation of Qi-stagnation with blood stasis syndrome. Methods: The randomized, single blinded, parallel positive drug controlled method was adopted, with 82 patients assigned into two groups by envelop method. The 42 patients in the treated group received PYQC 3 times a day, 4 capsules each time taken orally; the 40 patients in the control group were given orally Fuyankang tablets (妇炎康片, FYKT) 3 times a day, 6 tablets each time. The therapeutic course for both groups was 2 months, and 2 courses of treatment were given successively to observe the comprehensive effect, changes of symptoms and signs before and after treatment. The effects of PYQC on hemorrheological character in part of the patients and on the pathogenetic chlamydia and mycoplasma were also observed. Results: The total effective rate in the treated group was 83.3 %, which was insignificantly different from that in the control group ( 77.5 %, P > 0.05 ).However, PYQC could significantly lower the hemorrheologic indexes in patients and showed definite influence on the pathogenetic chlamydia and mycoplasma. Conclusion: PYQC has good therapeutic effect in treating chronic pelvic inflammation of Qi-stagnation with blood stasis syndrome, and showed definite effect on chlamydia and mycoplasma.

  18. Urinary Metabolomics Identifies a Molecular Correlate of Interstitial Cystitis/Bladder Pain Syndrome in a Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network Cohort

    Directory of Open Access Journals (Sweden)

    Kaveri S. Parker

    2016-05-01

    Full Text Available Interstitial cystitis/bladder pain syndrome (IC/BPS is a poorly understood syndrome affecting up to 6.5% of adult women in the U.S. The lack of broadly accepted objective laboratory markers for this condition hampers efforts to diagnose and treat this condition. To identify biochemical markers for IC/BPS, we applied mass spectrometry-based global metabolite profiling to urine specimens from a cohort of female IC/BPS subjects from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network. These analyses identified multiple metabolites capable of discriminating IC/BPS and control subjects. Of these candidate markers, etiocholan-3α-ol-17-one sulfate (Etio-S, a sulfoconjugated 5-β reduced isomer of testosterone, distinguished female IC/BPS and control subjects with a sensitivity and specificity >90%. Among IC/BPS subjects, urinary Etio-S levels are correlated with elevated symptom scores (symptoms, pelvic pain, and number of painful body sites and could resolve high- from low-symptom IC/BPS subgroups. Etio-S-associated biochemical changes persisted through 3–6 months of longitudinal follow up. These results raise the possibility that an underlying biochemical abnormality contributes to symptoms in patients with severe IC/BPS.

  19. 丹莪妇康煎膏治疗不同病因慢性盆腔痛122例分析%122 Cases Effect Analysis of Dan'e Fukang Decocted Extract on the Women Chronic Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    林松; 李云霞; 赵子菡

    2013-01-01

    目的 比较丹莪妇康煎膏对不同病因慢性盆腔痛的疗效.方法 收集我院门诊2007年10月-2011年6月就诊的慢性盆腔炎、子宫内膜异位症及其它原因所致的慢性盆腔痛患者122例,用丹莪妇康煎膏进行治疗,10~15g/次,每日2次,每月连续服用20d,3个月为1疗程,比较丹莪妇康煎膏对不同病因慢性盆腔痛的临床疗效.结果 丹莪妇康煎膏对慢性盆腔炎、子宫内膜异位症及其它原因所致的慢性盆腔痛总有效率分别为88.7%,95.8%、和80.9%,各组相比差异无统计学意义.结论 丹莪妇康煎膏对多种不同病因引起的女性慢性盆腔痛均有治疗作用.%Objective To investigate the therapeutic effect of Dan' e Fukang decocted extract on the women chronic pelvic pain caused by different reasons. Methods 122 cases with chronic pelvic pain caused by chronic pelvic inflammatory, endometrio-sis and other reasons were employed. All of the patients were treated with the Dan'e Fukang decocted extract and took orally, 10-15 grams each time,2 times a day,consecutively 20 days per month and the course of treatment is 3 months. Then comparative the clinical effect of Dan' e Fukang decocted extract in treating the chronic pelvic pain caused by different reasons. Results Total effective rate of the decoction on chronic pelvic pain caused by chronic pelvic inflammatory was 88. 7%,caused by endometriosis was 95. 8%, and caused by other reasons was 80. 9% separately. There were no statistical difference among each treated group. Conclusion Dan'e Fukang decocted extract has therapeutic effect on the chronic pelvic pain caused by different reasons.

  20. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)

    2005-04-01

    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  1. Magnetic resonance neurography-guided nerve blocks for the diagnosis and treatment of chronic pelvic pain syndrome.

    Science.gov (United States)

    Fritz, Jan; Chhabra, Avneesh; Wang, Kenneth C; Carrino, John A

    2014-02-01

    Magnetic resonance (MR) neurography - guided nerve blocks and injections describe a techniques for selective percutaneous drug delivery, in which limited MR neurography and interventional MR imaging are used jointly to map and target specific pelvic nerves or muscles, navigate needles to the target, visualize the injected drug and detect spread to confounding structures. The procedures described, specifically include nerve blocks of the obturator nerve, lateral femoral cutaneous nerve, pudendal nerve, posterior femoral cutaneous nerve, sciatic nerve, ganglion impar, sacral spinal nerve, and injection into the piriformis muscle.

  2. Predictive models in urology.

    Science.gov (United States)

    Cestari, Andrea

    2013-01-01

    Predictive modeling is emerging as an important knowledge-based technology in healthcare. The interest in the use of predictive modeling reflects advances on different fronts such as the availability of health information from increasingly complex databases and electronic health records, a better understanding of causal or statistical predictors of health, disease processes and multifactorial models of ill-health and developments in nonlinear computer models using artificial intelligence or neural networks. These new computer-based forms of modeling are increasingly able to establish technical credibility in clinical contexts. The current state of knowledge is still quite young in understanding the likely future direction of how this so-called 'machine intelligence' will evolve and therefore how current relatively sophisticated predictive models will evolve in response to improvements in technology, which is advancing along a wide front. Predictive models in urology are gaining progressive popularity not only for academic and scientific purposes but also into the clinical practice with the introduction of several nomograms dealing with the main fields of onco-urology.

  3. Stem cells in urology.

    Science.gov (United States)

    Aboushwareb, Tamer; Atala, Anthony

    2008-11-01

    The shortage of donors for organ transplantation has stimulated research on stem cells as a potential resource for cell-based therapy in all human tissues. Stem cells have been used for regenerative medicine applications in many organ systems, including the genitourinary system. The potential applications for stem cell therapy have, however, been restricted by the ethical issues associated with embryonic stem cell research. Instead, scientists have explored other cell sources, including progenitor and stem cells derived from adult tissues and stem cells derived from the amniotic fluid and placenta. In addition, novel techniques for generating stem cells in the laboratory are being developed. These techniques include somatic cell nuclear transfer, in which the nucleus of an adult somatic cell is placed into an oocyte, and reprogramming of adult cells to induce stem-cell-like behavior. Such techniques are now being used in tissue engineering applications, and some of the most successful experiments have been in the field of urology. Techniques to regenerate bladder tissue have reached the clinic, and exciting progress is being made in other areas, such as regeneration of the kidney and urethra. Cell therapy as a treatment for incontinence and infertility might soon become a reality. Physicians should be optimistic that regenerative medicine and tissue engineering will one day provide mainstream treatment options for urologic disorders.

  4. Laparoendoscopic single site in pelvic surgery.

    Science.gov (United States)

    Sanchez-Salas, Rafael; Clavijo, Rafael; Barret, Eric; Sotelo, Rene

    2012-01-01

    Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena..

  5. Clinical study of duloxetine hydrochloride combined with doxazosin for the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome: An observational study.

    Science.gov (United States)

    Zhang, Mingxin; Li, Hanzhong; Ji, Zhigang; Dong, Dexin; Yan, Su

    2017-03-01

    To explore the safety and efficacy of the selective 5-serotonin and norepinephrine reuptake inhibitor duloxetine hydrochloride and alpha-adrenergic receptor blocker (alpha-blocker) doxazosin mesylate-controlled tablets in the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).In all, 150 patients were enrolled and 126 patients completed the study (41 patients in the doxazosin group, 41 patients in the sertraline group, and 44 patients in the duloxetine group). This was an open randomized 6-month study. CP/CPPS patients who met the diagnostic criteria were randomized into 3 groups. The patients in the duloxetine group received doxazosin 4 mg + duloxetine 30 mg once a day, and the dosage of duloxetine was increased to 60 mg after a week. The patients in the doxazosin group received doxazosin 4 mg once a day. The patients in the sertraline group received doxazosin 4 mg + sertraline 50 mg once a day. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, the short-form McGill Pain questionnaire (SF-MPQ), and the hospital anxiety and depression scale (HAD) were applied for evaluations during follow-up of 1, 3, and 6 months after treatment.There were slight positive significant correlations between NIH-CPSI scores and HAD scores, moderate positive significant correlations between the quality of life (QOL) and SF-MPQ, and slight positive significant correlations between HAD and QOL. The effective rate in the doxazosin group was 4.88%, 19.51%, and 56.10% after 1, 3, and 6 months, respectively (P < 0.05). The SF-MPQ score in the doxazosin group decreased to 1.80 ± 1.29, 2.66 ± 1.57, and 3.24 ± 1.67 after 1, 3, and 6 months, respectively (P < 0.05). The HAD score in the doxazosin group decreased to 2.24 ± 2.17, 4 ± 2.11, and 4.90 ± 2.62 after 1, 3, and 6 months, respectively (P < 0.05). The effective rate in the sertraline group was 9.76%, 36.59%, and 63

  6. Clinical study of duloxetine hydrochloride combined with doxazosin for the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome

    Science.gov (United States)

    Zhang, Mingxin; Li, Hanzhong; Ji, Zhigang; Dong, Dexin; Yan, Su

    2017-01-01

    Abstract To explore the safety and efficacy of the selective 5-serotonin and norepinephrine reuptake inhibitor duloxetine hydrochloride and alpha-adrenergic receptor blocker (alpha-blocker) doxazosin mesylate-controlled tablets in the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In all, 150 patients were enrolled and 126 patients completed the study (41 patients in the doxazosin group, 41 patients in the sertraline group, and 44 patients in the duloxetine group). This was an open randomized 6-month study. CP/CPPS patients who met the diagnostic criteria were randomized into 3 groups. The patients in the duloxetine group received doxazosin 4 mg + duloxetine 30 mg once a day, and the dosage of duloxetine was increased to 60 mg after a week. The patients in the doxazosin group received doxazosin 4 mg once a day. The patients in the sertraline group received doxazosin 4 mg + sertraline 50 mg once a day. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, the short-form McGill Pain questionnaire (SF-MPQ), and the hospital anxiety and depression scale (HAD) were applied for evaluations during follow-up of 1, 3, and 6 months after treatment.There were slight positive significant correlations between NIH-CPSI scores and HAD scores, moderate positive significant correlations between the quality of life (QOL) and SF-MPQ, and slight positive significant correlations between HAD and QOL. The effective rate in the doxazosin group was 4.88%, 19.51%, and 56.10% after 1, 3, and 6 months, respectively (P < 0.05). The SF-MPQ score in the doxazosin group decreased to 1.80 ± 1.29, 2.66 ± 1.57, and 3.24 ± 1.67 after 1, 3, and 6 months, respectively (P < 0.05). The HAD score in the doxazosin group decreased to 2.24 ± 2.17, 4 ± 2.11, and 4.90 ± 2.62 after 1, 3, and 6 months, respectively (P < 0.05). The effective rate in the sertraline group was 9.76%, 36

  7. 腹腔镜诊治慢性盆腔痛72例临床分析%Clinical Analysis of 72 Cases of Laparoscopic Diagnosis and Treatment of Chronic Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    许苏华; 蒯国林; 虞丽相

    2012-01-01

      Objective We sought to evaluate the effects of laparoscopy for women who suffered from chronic pelvic pain. Methods We retrospectively analysed 72 patients who underwent laparoscopy for chronic pelvic pain, and compare the clinical manifestation, the presentation during the surgery, the detailed surgery, the detailed surgery procedure and the follow-up. Results It turns out that 70 patients, taking up 97.22%, had pathologic or anatomic changed which is identified by laparoscopy. Among them, 35 patents (48.61%) suffered from endometriosis, 23 patients(31.94%) suffered from pelvic adhesion,9 patients(12.5%) suffered from sequelae of chronic pelvic inflammation, 3 patients(4.17%) suffered pelvic hyperemia syndrome, 2 patients(2.78%) had no obvious changed. 37 patients(51.39%) were completely alleviated, 29 patients (40.28%) were partially alleviated, 6 patients (8.33%)got no alleviation. Conclusion The diagnosis and treatment of chronic pelvic pain with laparoscopy manifests much advantage, thus we advocate the wider use of laparoscopy for chronic pelvic pain.%  目的评价腹腔镜诊治慢性盆腔痛的效果.方法对腹腔镜诊治的72例慢性盆腔痛的患者进行回顾分析,比较其临床表现、术中所见、腹腔镜下实施的手术及术后随访资料.结果72例患者中,腹腔镜证实有病理改变和解剖改变的70例,占97.22%;其中,子宫内膜异位症有35例(48.61%),盆腔粘连23例(31.94%),慢性盆腔炎后遗症9例(12.50%),盆腔静脉淤血症3例(4.17%),盆腔未发现病变2例(2.78%).术后疼痛症状完全缓解37例(51.39%),部分缓解29例(40.28%),未缓解6例(8.33%).结论腹腔镜诊断慢性盆腔痛是一种较优越的方法,在寻找病因的同时可给予适当的治疗,值得推广使用.

  8. News on pediatric urology

    Directory of Open Access Journals (Sweden)

    Giuseppe Masnata

    2015-10-01

    Full Text Available Pediatric urology is a pediatric speciality dedicated to the diagnosis and treatment of congenital and acquired genitourinary tract diseases. It is a speciality that is rapidly changing, thanks to the technological development that has been emerging in recent years. There have been important diagnostic and therapeutic news.Congenital anomalies of the kidneys and urinary tract (CAKUT include various entities of structural malformations that result from defects in their morphogenesis. Clinical research and genetic studies on the origins of CAKUT are quickly evolving, with significant growth of high-quality research.Management goals of CAKUT include prevention of febrile urinary tract infections (UTIs in newborns and toddles and renal injury, while minimizing the morbidity of treatment and follow-up. Treatment options include observation with or without continuous antibiotic prophylaxis (CAP and surgical correction. Now, randomized controlled studies show that children with normal urinary tracts or low-grade vesicoureteral reflux (VUR do not benefit from prophylaxis.All children with known mechanical or functional obstructions of the urinary tract are considered to have UTI. Functional obstruction often results from lower urinary tract dysfunction (LUTD of either neurogenic or non-neurogenic origin and dilating VUR.The role of bladder and bowel dysfunction (BBD in children with UTI and the long-term risk of renal scarring have shed new light on treatment strategies. Often it is BBD, rather than reflux, that causes UTI in children older than 2 years.Pediatric urology has evolved in recent years, with a greater focus on bladder and renal function, minimally invasive treatment, evidence-based interventions, and guideline adherence. Other topics in pediatric urology include urinary incontinence in children with special needs and the use of robot-assisted laparoscopic surgery (RALS in children, with advantages over conventional laparoscopic surgery

  9. Chronic pelvic pain (pelvic congestion syndrome)

    Science.gov (United States)

    ... RESIDENCY IR TRAINING PATHWAYS FELLOWSHIP ESIR INDEPENDENT RESIDENCY INTEGRATED RESIDENCY Advocacy and Outreach ADVOCACY AND OUTREACH SIRPAC CORPORATE RELATIONS AMBASSADORS MEETINGS AND EXHIBITS ADVERTISING GLOBAL OUTREACH INTERNATIONAL MEMBERSHIP RECOGNITION AND NETWORKING INTERNATIONAL ...

  10. Pelvic Pain

    Science.gov (United States)

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  11. The psychological profile of women presenting to a multidisciplinary clinic for chronic pelvic pain: high levels of psychological dysfunction and implications for practice

    Directory of Open Access Journals (Sweden)

    Bryant C

    2016-11-01

    Full Text Available Christina Bryant,1,2 Rebecca Cockburn,1 Anne-Florence Plante,3 Angela Chia4 1Centre for Women’s Mental Health, Royal Women’s Hospital, Parkville, 2Melbourne School of Psychological Sciences, University of Melbourne, 3Department of Physiotherapy, 4Department of Anaesthesia, Royal Women’s Hospital, Parkville, VIC, Australia Objective: Chronic pelvic pain (CPP is widely acknowledged as a common problem with significant consequences for those diagnosed with this condition. There is a lack of studies with good sample size that provide a comprehensive psychological profile of women presenting to specialist chronic pain clinics. Therefore, the objective of this study was to describe the psychological profile of a representative sample of women presenting with CPP at a tertiary referral center. Design: This was a cross-sectional study. Women were asked to complete a questionnaire assessing symptoms of anxiety and depression, pain severity and interference, pain self-efficacy and catastrophizing beliefs, and sexual functioning. Methods: One-hundred and seventy-five women with CPP were recruited when they attended their initial assessment at a specialist CPP clinic of the Royal Women’s Hospital, a public ­hospital in Melbourne, Australia. Results: Over 75% of the participants had experienced pain for longer than 2 years. Fifty-three percent of women experienced either moderate or severe anxiety, and 26.7% experienced moderate-to-severe depression. There were strong correlations between depressive symptoms and pain interference, pain catastrophizing and self-efficacy beliefs. Conclusion: Our findings confirm previous evidence for high levels of psychological distress and functional impairment associated with this condition, and extend these findings by including measures that are highly relevant to treatment planning, such as thinking styles and pain self-efficacy. Therefore, treatment of this complex condition needs to be holistic, and a multi

  12. Urologic robots and future directions

    OpenAIRE

    Mozer, Pierre; Troccaz, Jocelyne; Stoianovici, Dan

    2008-01-01

    International audience; PURPOSE OF REVIEW: Robot-assisted laparoscopic surgery in urology has gained immense popularity with the daVinci system, but a lot of research teams are working on new robots. The purpose of this study is to review current urologic robots and present future development directions. RECENT FINDINGS: Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots. SUMMARY: The final goal of robot...

  13. Pediatric robotic urologic surgery-2014

    Directory of Open Access Journals (Sweden)

    James T Kearns

    2014-01-01

    Full Text Available We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide.

  14. Avaliação postural em mulheres com dor pélvica crônica Postural evaluation in women with chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Renata Miranda

    2009-07-01

    Full Text Available OBJETIVO: avaliar por meio da fotogrametria as alterações posturais de mulheres com dor pélvica crônica. MÉTODOS: foram avaliadas 30 mulheres com queixa de dor pélvica crônica e 37 sem essa queixa, totalizando 67 mulheres. A avaliação constituiu de anamnese, colocação de marcadores fixos em pontos anatômicos definidos e obtenção de fotografias em vista frontal, posterior, lateral esquerda e direita. A análise das fotos foi realizada com o software CorelDraw®, versão 11.0. Foram identificados valores para as variáveis de análise postural de tornozelo, joelho no plano sagital, pelve, lordose lombar, cifose torácica, escápula aduzida/abduzida, ombros, cabeça e teste do terceiro dedo ao chão. As variáveis qualitativas estudadas foram joelho (varo, valgo ou normal, presença ou não de escápula alada e de nivelamento de ombros. Para as análises estatísticas utilizamos o Statistical Package for Social Sciences, versão 16.0. Para a comparação entre as variáveis qualitativas foi utilizado o teste exato de Fisher e método de Monte-Carlo e, para a comparação de dados quantitativos foi utilizado o teste t ou o de Mann-Whitney. As comparações entre os dados contínuos corrigidos para possíveis variáveis de confusão foram feitas pela análise de covariância univariada. O nível de significância foi estabelecido como 0,05 ou 5%. RESULTADOS: foi observada diferença significante entre casos e controles para cabeça protusa (47,5 e 52,0º, respectivamente; pOBJECTIVE: to evaluate by photogrammetry, postural changes in women with chronic pelvic pain. METHODS: thirty women with complaint of chronic pelvic pain and 37 without it, in a total of 67 women, were evaluated. The evaluation was realized through anamnesis, fixed markers in defined anatomical sites, and frontal, posterior, left and right lateral photographies. Photo analysis has been done by the software CorelDraw®, version 11.0. Quantitative values for postural

  15. More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study.

    Science.gov (United States)

    Paick, J-S; Lee, S C; Ku, J H

    2006-01-01

    The objective of this study was to evaluate whether extracorporeal magnetic innervation (ExMI) combined with alpha-blocker therapy is more effective than alpha-blocker monotherapy for patients with non-inflammatory chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS), category IIIB. Patients were randomized to either terazosin monotherapy (group 1, n=21) or terazosin combined with ExMI therapy (group 2, n=19). Patients in group 2 had 12 treatment sessions of ExMI twice a week during 6 weeks. None of the patients experienced any side effects from treatment. The changes in each domain of the National Institutes of Health (NIH)-Chronic Prostatitis Symptom Index (CPSI) measured on week 6 were not significantly different between the groups. However, the difference (median, 25-75th percentiles) between the two groups in total NIH-CPSI scores was -4 (-11.5, -2) for group 1 and -12 (-17.3, -2.3) for group 2, respectively (P=0.047). At 6 weeks, 47.6% (10 of 21) of group 1 had a >25% decrease in total NIH-CPSI compared with 78.9% (15 of 19) of group 2 (P=0.041). Also, more patients in group 2 (78.9%) were rated as responders with a 6-point decrease in NIH-CPSI compared with group 1 (47.6%) (P=0.041). The early results suggest that ExMI combined with alpha-blocker therapy has better effect than alpha-blocker monotherapy for the treatment of CP/CPPS.

  16. Pelvic Floor Disorders

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Pelvic Floor Disorders: Condition Information Skip sharing on social media links Share this: Page Content What is the pelvic floor? The term "pelvic floor" refers to the group ...

  17. Long-term effect of extracorporeal shock wave therapy on the treatment of chronic pelvic pain syndrome due to non bacterial prostatitis

    Directory of Open Access Journals (Sweden)

    Amir Moayednia

    2014-01-01

    Full Text Available Background: There is limited evidence about the chronic pelvic pain syndrome (CPPS treatment by shockwave therapy, and the aim of this study was to evaluate the effect of extracorporeal shockwave therapy on CPPS due to non bacterial prostatitis in a long-term period. Materials and Methods: In a follow-up survey, 40 patients with CPPS (that were randomly distributed into the treatment or sham groups were evaluated at 16, 20, and 24 weeks. In the treatment group, patients were treated by extracorporeal shock wave therapy (ESWT once a week for 4 weeks by a protocol of 3000 impulses, 0.25 mJ/m 2 and 3 Hz of frequency. 0.05 mJ/m 2 were added in each week. In the sham group, the same protocol was applied, but with the probe being turned off. The follow-up assessments were done by visual analog scale for pain and National Institutes of Health-developed Chronic Prostatitis Symptom Index (NIH-CPSI. Data were compared using independent t-test or analysis of variences. Results: Three patients did not complete the study protocol, 37 patients were evlauated (19 patients in treatment and 18 patients in the sham group. At week 24, the mean of pain score, urinary score, quality-of-life and NIH-CPSI score between two groups were not statistically different. Conclusion: Although, ESWT therapy as a safe and effective therapy in CPPS in short-term follow-up has been established, its long-term efficacy was not supported by this study.

  18. The psychological profile of women presenting to a multidisciplinary clinic for chronic pelvic pain: high levels of psychological dysfunction and implications for practice

    Science.gov (United States)

    Bryant, Christina; Cockburn, Rebecca; Plante, Anne-Florence; Chia, Angela

    2016-01-01

    Objective Chronic pelvic pain (CPP) is widely acknowledged as a common problem with significant consequences for those diagnosed with this condition. There is a lack of studies with good sample size that provide a comprehensive psychological profile of women presenting to specialist chronic pain clinics. Therefore, the objective of this study was to describe the psychological profile of a representative sample of women presenting with CPP at a tertiary referral center. Design This was a cross-sectional study. Women were asked to complete a questionnaire assessing symptoms of anxiety and depression, pain severity and interference, pain self-efficacy and catastrophizing beliefs, and sexual functioning. Methods One-hundred and seventy-five women with CPP were recruited when they attended their initial assessment at a specialist CPP clinic of the Royal Women’s Hospital, a public hospital in Melbourne, Australia. Results Over 75% of the participants had experienced pain for longer than 2 years. Fifty-three percent of women experienced either moderate or severe anxiety, and 26.7% experienced moderate-to-severe depression. There were strong correlations between depressive symptoms and pain interference, pain catastrophizing and self-efficacy beliefs. Conclusion Our findings confirm previous evidence for high levels of psychological distress and functional impairment associated with this condition, and extend these findings by including measures that are highly relevant to treatment planning, such as thinking styles and pain self-efficacy. Therefore, treatment of this complex condition needs to be holistic, and a multidisciplinary approach is likely to be the best way to achieve this. PMID:27895510

  19. Medical Treatments for Endometriosis-Associated Pelvic Pain

    OpenAIRE

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endome...

  20. [Doping and urologic tumors].

    Science.gov (United States)

    Pinto, F; Sacco, E; Volpe, A; Gardi, M; Totaro, A; Calarco, A; Racioppi, M; Gulino, G; D'Addessi, A; Bassi, P F

    2010-01-01

    Several substances such as growth hormone (GH), erythropoietin (Epo), and anabolic steroids (AS) are improperly utilized to increase the performance of athletes. Evaluating the potential cancer risk associated with doping agents is difficult since these drugs are often used at very high doses and in combination with other licit or illicit drugs. The GH, via its mediator, the insulin-like growth factor 1 (IGF-1), is involved in the development and progression of cancer. Animal studies suggested that high levels of GH/IGF-1 increase progression of androgen-independent prostate cancer. Clinical data regarding prostate cancer are mostly based on epidemiological studies or indirect data such as IGF-1 high levels in patients with prostate cancer. Even if experimental studies showed a correlation between Epo and cancer, no clinical data are currently available on cancer development related to Epo as a doping agent. Androgens are involved in prostate carcinogenesis modulating genes that regulate cell proliferation, apoptosis and angiogenesis. Most information on AS is anecdotal (case reports on prostate, kidney and testicular cancers). Prospective epidemiologic studies failed to support the hypothesis that circulating androgens are positively associated with prostate cancer risk. Currently, clinical and epidemiological studies supporting association between doping and urological neoplasias are not available. Nowadays, exposure to doping agents starts more prematurely with a consequent longer exposition period; drugs are often used at very high doses and in combination with other licit or illicit drugs. Due to all these elements it is impossible to predict all the side effects, including cancer; more detailed studies are therefore necessary.

  1. 坦索罗辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征的疗效观察%Observing the effectiveness of tamsulosin for treating chronic prostatitis/chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    杨肖波; 潘铁军; 谢旭敏

    2014-01-01

    Objectives To observe the validity and the safety of tamsulosin treating chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS).Methods One hundred patients who were confirmed as CPPS and treated in the department of urology of Wuhan general hospital of Guangzhou Command were enrolled from January 2011 to June 2013.ALL patients were accessed the NIH-Chronic prostatitis symptom index (NIH-CPSI) before the treatment,and they were divided into 3 groups by NIH-CPSI.Group A,group Band group C were classified as the scores of 1 ~ 14,15 ~ 29 and 30 ~ 43 respectively.ALL patients took 200mg tamsulosin every night,and re-evaluated the NIH-CPSI after 8 weeks.All side-effects were recorded.And all data was collected and the variables were compared.Results All average NIH-CPSI scores of three groups had declined from 24.3 to 13.4 (P < 0.01).The pain score and the life quality score had significantly declined,while the urination score hadnt.Moreover,with the symptom increased,the rate of validity of tamsulosin decreased.Conclusions Tarnsulosin can modify pain and evaluate the life quality,and it is safe with little side effect.We recommend using tamsulosin as the main therapy for CP/CPPS.%目的 观察评价坦索罗辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征的有效性及安全性.方法 收集2011年1月至2013年6月广州军区武汉总医院泌尿外科确诊为Ⅲ型前列腺炎患者100例,治疗前进行症状指数(NIH-CPSI)评分,按轻度(1~14)、中度(15 ~29)、重度(30 ~43)分成A、B、C三组.所有患者均给予坦索罗辛0.2mg,每晚睡前口服,连服8周,用药后第8周再次评估NIH-CPSI,记录不良反应,并进行统计学分析.结果 A、B、C三组平均NIH-CPSI评分由原来的24.3降至13.4(P<0.01).治疗后疼痛不适评分与生活质量评分明显下降(P<0.01),而排尿症状评分则下降不明显.三组患者随着症状严重程度的增加,坦索罗辛治疗的有效率逐渐递减,C组有

  2. An Evaluation Model for a Multidisciplinary Chronic Pelvic Pain Clinic: Application of the RE-AIM Framework.

    Science.gov (United States)

    Chen, Innie; Money, Deborah; Yong, Paul; Williams, Christina; Allaire, Catherine

    2015-09-01

    Objectif : La douleur pelvienne chronique (DPC) est un trouble prévalent, débilitant et coûteux. Bien que des lignes directrices nationales et des données empiriques soutiennent l’utilisation d’un modèle de soins multidisciplinaires pour les patientes qui présentent des DPC, les cliniques canadiennes offrant un tel modèle sont peu nombreuses. Le BC Women’s Centre for Pelvic Pain and Endometriosis a été créé pour répondre à ce besoin et un intérêt a été manifesté à l’endroit des effets de ce modèle de soins sur le fardeau de la maladie en Colombie-Britannique. Nous avons cherché à créer une approche envers son évaluation en utilisant le cadre de référence RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) pour déterminer les effets de ce modèle de soins et pour orienter le processus décisionnel clinique et la formulation de politiques en la matière. Méthodes : Le cadre d’évaluation RE-AIM a été appliqué pour nous permettre d’envisager les diverses dimensions des effets du BC Centre. Les mesures proposées, les sources de données et les stratégies de gestion des données pour cette approche à méthodes mixtes ont été identifiées. Résultats : Les cinq dimensions des effets ont été prises en considération aux niveaux personnel et organisationnel, et des indicateurs correspondants ont été proposés pour en permettre l’intégration dans l’infrastructure de données existante, en vue de faciliter la collecte des données et l’évaluation précoce du programme. Conclusion : Le cadre RE-AIM peut être appliqué à l’évaluation d’une clinique multidisciplinaire visant la douleur pelvienne chronique. Cela permettra la tenue d’une meilleure évaluation des effets de modèles novateurs de soins chez les femmes qui connaissent des douleurs pelviennes chroniques.

  3. Pelvic radiotherapy and sexual dysfunction in women

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine; Froeding, Ligita Paskeviciute

    2015-01-01

    of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. METHODS: An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological...... and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. RESULTS...... during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. CONCLUSIONS: Pelvic radiotherapy has a persistent deteriorating effect on the vaginal mucosa impacting negatively on the sexual...

  4. Nanotechnology applications in urology: a review.

    Science.gov (United States)

    Maddox, Michael; Liu, James; Mandava, Sree Harsha; Callaghan, Cameron; John, Vijay; Lee, Benjamin R

    2014-11-01

    The objectives of this review are to discuss the current literature and summarise some of the promising areas with which nanotechnology may improve urological care. A Medline literature search was performed to elucidate all relevant studies of nanotechnology with specific attention to its application in urology. Urological applications of nanotechnology include its use in medical imaging, gene therapy, drug delivery, and photothermal ablation of tumours. In vitro and animal studies have shown initial encouraging results. Further study of nanotechnology for urological applications is warranted to bridge the gap between preclinical studies and translation into clinical practice, but nanomedicine has shown significant potential to improve urological patient care.

  5. Treating 52 cases of gynecological chronic pelvic pain (qi stagnation and blood stasis type) by herbal penetration therapy%中药外治法治疗妇科慢性盆腔痛(气滞血瘀型)52例

    Institute of Scientific and Technical Information of China (English)

    陈琰; 王赛莉; 赵燕宁

    2012-01-01

      Objective: To observe the clinical curative effects of herbal enema and herbal penetration therapy in treating gynecological chronic pelvic pains and investigate the mechanism of relieving pains. Methods: 52 cases of patients with gynecological chronic pelvic pains were selected and treated with herbal enema and herbal penetration therapy. The variation of pain scores before and after treatment was observed to evaluate the improvement of chronic pelvic pains by herbal enema and herbal penetration therapy, while the TCM syndromes scores and Hamilton depression scores (24 items) were observed to evaluate the improvement of TCM syndromes of chronic pelvic pain and the affection of depressed emotion by herbal enema and herbal penetration therapy. Results: Syndromes of chronic pelvic pain improved obviously after treatment. The total effective rate was 88.46%. There was a significant difference between the pain scores before and after treatment (P<0.01). The depressed emotion of patients improved a lot along with the relieving of pains. There was a significant difference between the Hamilton depressed scores before and after treatment (P<0.01). Conclusion: The herbal enema and herbal penetration therapy had an obvious effect in dispersing the depressed liver-energy, promoting Qi, warming meridians, activating blood circulation, removing blood stasis and pains. It was worthy of wide application because it could relieve the syndromes of chronic pelvic pain and improve the depressed emotion of patients, and in addition it was convenient, effective and with little side effects.%  目的:观察中药灌肠、中药外敷治疗气滞血瘀型妇科慢性盆腔痛的临床疗效,探讨其缓解疼痛的作用机理.方法:选择妇科慢性盆腔痛(气滞血瘀型)患者52例,予中药保留灌肠、中药外敷治疗两个疗程,通过观察治疗前后数字疼痛评分(NRS)的变化,评价中药灌肠、外敷对妇科慢性盆腔疼痛的改善情

  6. 中药热奄包治疗慢性盆腔炎的护理体会%The Chinese medicine hot package of ursing experience for the treatment of chronic pelvic inflammatory disease

    Institute of Scientific and Technical Information of China (English)

    乔增凤; 龚干珍

    2016-01-01

    目的:总结中药热奄包治疗慢性盆腔炎的护理体会。方法:将加有跌打酊蒸热后的中药热奄包对慢性盆腔炎患者进行治疗,每次30分钟,每天一次,一个疗程10次,连续2个疗程后,观察疗效。结果:治疗组总有效率达83.4%,与对照组总有效率比较,P<0.05。结论:中药热奄包治疗慢性盆腔炎,疗效确切,简单方便,患者无痛苦。%Objective: To summarize the traditional Chinese medicine hot package nursing experience for the treatment of chronic pelvic inflammatory disease. Methods: With entitled tincture of traditional Chinese medicine after steaming hot package treatment in patients with chronic pelvic inflammatory disease, 30 minutes each time, once a day, a course of 10 times, observation curative effect after a period of treatment. Results: Treatment group total effective rate was 83.4%, compared with the control group total effective rate, P < 0.05.Conclusion: Chinese medicine hot pack for the treatment of chronic pelvic inflammatory disease, curative effect is exact, simple and convenient, with no pain.

  7. Analysis of the TCM Syndrome, Physical Distribution and Other Relative Factors of Chronic Pelvic Inflammatory Disease%慢性盆腔炎中医证候、体质分布及其相关因素分析

    Institute of Scientific and Technical Information of China (English)

    段小青

    2014-01-01

    Objective To analyze the TCM syndrome, physical distribution and other relative factors of chronic pelvic inflammatory disease. Methods 60 cases diagnosed with chronic pelvic inflammatory disease and treated in our hospital from April 2012 to April 2014 were selected as the study group, and 60 cases healthy females with the similar age were randomly selected as the con-trol group. The TCM syndromes, physical distribution and other relevant factors of the two groups of females were studied. Results 33.3%of the 60 patients with chronic pelvic inflammation disease in the study group had kidney deficiency blood stasis, approxi-mate 21.7% had damp heat and blood stasis syndrome, 18.3% had liver depression and kidney deficiency with qi stagnation and blood stasis, in addition, patients with qi deficiency and blood stasis accounted for 15.0%, patients with cold damp stagnation syn-drome accounted for 11.7%. Most of the healthy women in the control group had moderate constitution (73.3%), while in the pa-tients with chronic pelvic inflammatory disease in the study group, the number of patients with blood stasis constitution (40.0%) and that with damp heat constitution (43.3%) was much more than that in the control group(3.3% and 1.7%), respectively, and the difference between the two groups had statistical significance (P0.05). The difference in the menstrual sex, vaginal irrigation times, the way of contraception, the uterine cavity operation times and the number of abortion between the two groups were statistically significant(P0.05)﹔两组女性在经期进行性生活、阴道冲洗次数、避孕方式、宫腔操作次数和流产次数差异有统计学意义(P<0.05)。结论慢性盆腔炎患者多为肾虚血瘀证,湿热体质和瘀血体质更容易发病,经期进行性生活、阴道冲洗次数、避孕方式、宫腔操作次数和流产次数也与慢性盆腔炎的发病密切相关。

  8. 子宫内膜异位症慢性盆腔痛中西医治疗研究进展%Research Advance in the Treatment of Endometriosis Chronic Pelvic Pain Treated with Integrated Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    李萍; 孙建萍

    2011-01-01

    @@ 慢性盆腔痛(chronic pelvic pain,CPP)是指非月经期的盆腔疼痛持续6个月以上,产生功能性障碍或需要药物或手术治疗[1]的病症.它是妇科常见病之一,其病因复杂,涉及多个系统,其中子宫内膜异位症是其因为之一.

  9. Clinical study on the treatment of chronic pelvic inflammatory disease byabdominal extracorporeal shock%体外冲击波经腹治疗慢性盆腔炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    贾桂英; 吕艺; 唐海涛; 胡欣姝

    2014-01-01

    目的:体外冲击波治疗慢性盆腔炎的临床疗效观察。方法对200例慢性盆腔炎患者随机分成2组;治疗组采用体外冲击波定位于盆腔炎B超可见病理改变部位,以下腹部为冲击波路径的治疗方法,发挥最大的生物效应,每周治疗一次,连续治疗4次为一疗程(避开月经期和排卵期),每次治疗电压选择8~10kv,冲击波次数为1000次。对照组采用微波理疗,频率30hz,每次时间20分钟。评估慢性盆腔炎治疗前后两组临床指标的变化。结果治疗3个月后,发现治疗组慢性盆腔炎的临床症状较治疗前有较好的改变,病理改变恢复程度明显优于对照组。结论体外冲击波是治疗慢性盆腔炎行之有效的新方法,无辐射,无毒副作用,近远期疗效显著,恰当选择能量,无明显不良并发症,临床疗效显著。%to observe the clinical curative effect of objectiveextracorporeal shock wave therapy on chronic pelvic inlfammatory disease. Methods 200 cases of chronic pelvic inlfammatory disease were randomly divided into 2 groups;treatment group were treated withextracorporeal shock wave in pelvic inflammatory disease B ultrasoundvisible pathological ch anges position, treatment following abdominalshock wave path, play the biological effects of the largest, weekly treatment, continuous treatment of 4 times for a course of treatment (to avoid the menstrual period and ovulation period each treatment), voltage8 ~ 10kV, the shock wave 1000 times. the control group usingmicrowave therapy, the frequency of 30Hz, every time 20 minutes. To assess the changes before and after treatment of chronic pelvic inlfammation in two groups of clinical indicators. Results 3 months after treatment than before treatment, found that clinical symptoms of chronic pelvic inflammatory disease treatment group had better change,pathological change degree of recovery was better than the control group. Conclusion

  10. Pelvic ultrasound - abdominal

    Science.gov (United States)

    ... tubes Abnormal vaginal bleeding Menstrual problems Problems becoming pregnant (infertility) Normal pregnancy Ectopic pregnancy , a pregnancy that occurs outside the uterus Pelvic pain Pelvic ultrasound is also used during ...

  11. Pelvic Pain: Other FAQs

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Pelvic Pain: Other FAQs Skip sharing on social media links ... more than one reason for my pain? Can pelvic pain affect my ability to become pregnant? Can alternative ...

  12. Pelvic fractures and mortality.

    OpenAIRE

    K.H. Chong; DeCoster, T.; Osler, T.; Robinson, B.

    1997-01-01

    A retrospective study of all patients (N = 343) with pelvic fractures admitted to our trauma service was conducted to evaluate the impact of pelvic fractures on mortality. All patients sustained additional injuries with an average Injury Severity Score (ISS) of twenty. Thirty-six patients died. This group had more severe pelvic fractures as graded by the Tile classification as well as a greater number and severity of associated injuries. Six patients died as a direct result of pelvic hemorrha...

  13. Current status of nanotechnology in urology

    Directory of Open Access Journals (Sweden)

    Suresh K. Goyal

    2016-08-01

    Full Text Available Nanotechnology has been investigated for its applications in medicine. The objective of this review was to summarize the current applications of nanotechnology in Urology. A systematic search of literature was performed and relevant articles were analyzed with specific reference to applications in Urology. Nanotechnology has applications in diagnostic urology like in uroimaging using nanoparticles and nanosensors. It has therapeutic applications in infections, malignancies, genetic disease using targeted drug delivery, gene transfers, nano device-based manipulations etc. Nanotechnology has many applications in Urology. More efforts are required to make these applications practically feasible and affordable. [Int J Res Med Sci 2016; 4(8.000: 3114-3120

  14. [Primary Pelvic Cystic Echinococcosis].

    Science.gov (United States)

    Yaman, İsmail; İnceboz, Ümit; İnceboz, Tonay; Keyik, Bahar; Uzgören, Engin

    2015-06-01

    Cystic echinococcosis caused by Echinococcus granulosus is still an important health problem in endemic areas. Cystic echinococcosis may involve different organs or areas with the most common sites being the liver and the lungs. Pelvic involvement has previously been reported and was mainly accepted as secondary to cystic echinococcosis in other organs, isolated pelvic involvement is very rare. In this case report, we aimed to present the case with pelvic cystic mass that was finally diagnosed with isolated pelvic cystic echinococcosis in and after the operation, and we would like to draw attention to include "cystic echinococcosis" in the differential diagnosis of pelvic masses.

  15. PELVIC ORGAN PROLAPES

    Directory of Open Access Journals (Sweden)

    Ketut Yoga Mira Pratiwi

    2013-04-01

    Full Text Available Pelvic organ prolapse (POP is defined as a decrease in abnormal or herniation of the pelvic organs out of place attached to its normal position or in the pelvic cavity. As for the anatomy of the pelvic organs consists of bones, muscles, and nerves. The presence of damage to the pelvic connective tissue and visceral attachment pelvic organs the cause occurs. The symptoms that appear in patients POP not specific to distinguish prolapse of some compartments but can reflect the degree of prolapse as a whole. Physical examination focused on pelvic examination, beginning with inspection on the vulva and vagina to identify the presence of erosion, ulceration, or other lesions. As for the existing therapy options include observation, non-operative management, and operative management.

  16. Indications and results of the unilateral /sup 123/I-hippurate-clearance in an ambulant urological-nephrological patients collective

    Energy Technology Data Exchange (ETDEWEB)

    Mariss, P.; Haubold, E.

    1988-02-01

    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg /sup 123/I-hippurate using a large field scintillation camera, external scintillation probe over the right shoulder and a computer system. The indications were patients with hypertension, chronic pyelonephritis, unilateral nephrocirrhosis, exclusion or approval of renal failure, furthermore diverse malformations of the urovesical system, nephrolithiasis and follow-up after urological operations. The unilateral renal clearance by /sup 123/I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods.

  17. Changes in urological surgical techniques

    Directory of Open Access Journals (Sweden)

    Oktay Üçer

    2010-06-01

    Full Text Available Recently, laparoscopic and afterwards robotic techniques have constituted most of urologic surgery procedures. Open surgery may give place to robotic surgery due to possible widespread use of robots in the future. Studies, that compare these two techniques are usually designed about radical prostatectomy, since it is the most common operation performed by using these techniques. In literature,robotic surgery seems more advantageous than other techniques but the most important disadvantage of this technique is cost-effective problems. In present review,history of open, laparoscopic and robotic surgery, and comparison of advantages, disadvantages and cost of these techniques have been discussed with literature.

  18. [Traditional Chinese medicine in urology].

    Science.gov (United States)

    Hüsch, T; Tsaur, I; Reiter, M; Mager, R; Haferkamp, A

    2014-11-01

    Traditional Chinese medicine (TCM) is an ancient holistic medicine based on the doctrine of Tao and Qi. Tao represents an alteration from which the polarity of Yin and Yang arises and Qi is the vitality which circulates through the body. Therapeutic concepts of TCM include acupuncture, herbal therapy, nutrition and Tuina, a form of manual therapy. TCM is now gaining increased acceptance in the Western society as a complementary therapy. Acupuncture and herbal therapy are the main forms of implementation of TCM in urology.

  19. Hollow waveguide for urology treatment

    Science.gov (United States)

    Jelínková, H.; Němec, M.; Koranda, P.; Pokorný, J.; Kőhler, O.; Drlík, P.; Miyagi, M.; Iwai, K.; Matsuura, Y.

    2010-02-01

    The aim of our work was the application of the special sealed hollow waveguide system for the urology treatment - In our experimental study we have compared the effects of Ho:YAG (wavelength 2100 nm) and Er:YAG (wavelength 2940 nm) laser radiation both on human urinary stones (or compressed plaster samples which serve as a model) fragmentation and soft ureter tissue incision in vitro. Cyclic Olefin Polymer - coated silver (COP/Ag) hollow glass waveguides with inner and outer diameters 700 and 850 μm, respectively, were used for the experiment. To prevent any liquid to diminish and stop the transmission, the waveguide termination was utilized.

  20. URobotics--Urology Robotics at Johns Hopkins.

    Science.gov (United States)

    Stoianovici, D

    2001-01-01

    URobotics (Urology Robotics) is a program of the Urology Department at the Johns Hopkins Medical Institutions dedicated to the development of new technology for urologic surgery (http://urology.jhu.edu/ urobotics). The program is unique in that it is the only academic engineering program exclusively applied to urology. The program combines efforts and expertise from the medical and engineering fields through a close partnership of clinical and technical personnel. Since its creation in 1996, the URobotics lab has created several devices, instruments, and robotic systems, several of which have been successfully used in the operating room. This article reviews the technology developed in our laboratory and its surgical applications, and highlights our future directions.

  1. Urologic robots and future directions

    CERN Document Server

    Mozer, Pierre; Stoianovici, Dan; 10.1097/MOU.0b013e32831cc1ba

    2008-01-01

    PURPOSE OF REVIEW: Robot-assisted laparoscopic surgery in urology has gained immense popularity with the daVinci system, but a lot of research teams are working on new robots. The purpose of this study is to review current urologic robots and present future development directions. RECENT FINDINGS: Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots. SUMMARY: The final goal of robots is to allow safer and more homogeneous outcomes with less variability of surgeon performance, as well as new tools to perform tasks on the basis of medical transcutaneous imaging, in a less invasive way, at lower costs. It is expected that improvements for a remote system could be augmented in reality, with haptic feedback, size reduction, and development of new tools for natural orifice translumenal endoscopic surgery. The paradigm of image-guided robots is close to clinical availability and the most advanced robots are presented with end-use...

  2. Comparison of National Institutes of Health-Chronic Prostatitis Symptom Index with International Index of Erectile Function 5 in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Large Cross-Sectional Study in China

    Directory of Open Access Journals (Sweden)

    Jingjing Gao

    2015-01-01

    Full Text Available The purpose of the study is to evaluate the relationship between NIH-CPSI and IIEF-5 in Chinese men with CP/CPPS. A large cross-sectional and multicenter survey was conducted from July 2012 to January 2014. Men were recruited from urology clinics which were located at the five cities in China. All men participated in the survey by completing a verbal questionnaire (consisted of sociodemographics, past medical history, sexual history, and self-estimated scales. The results showed that 1,280 men completed the survey. Based on the CP/CPPS definition, a total of 801 men were diagnosed as having CP/CPPS. Men with CP/CPPS reported higher scores of NIH-CPSI and lower scores of IIEF-5 than men without CP/CPPS. NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. The total scores of NIH-CPSI were significantly more strongly correlated with question 5 than other questions of IIEF-5. The total scores of IIEF-5 were significantly more strongly correlated with pain symptoms scores of NIH-CPSI. Strongest correlation was found between QoL impact and question 5 of IIEF-5. The findings suggested that NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. Strongest correlation was found between QoL impact and question 5 of IIEF-5.

  3. Comparison of National Institutes of Health-Chronic Prostatitis Symptom Index with International Index of Erectile Function 5 in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Large Cross-Sectional Study in China

    Science.gov (United States)

    Gao, Jingjing; Gao, Pan; Hao, Zongyao; Zhou, Zengrong; Liu, Jihong; Li, Hongjun; Xing, Junping; Zhou, Zhansong; Deng, Chunhua; Deng, Liwen; Wei, Qiang; Zhang, Xiansheng; Zhou, Jun; Fan, Song; Tai, Sheng; Yang, Chen; Shi, Kai; Huang, Yuanyuan; Ye, Zhangqun; Liang, Chaozhao

    2015-01-01

    The purpose of the study is to evaluate the relationship between NIH-CPSI and IIEF-5 in Chinese men with CP/CPPS. A large cross-sectional and multicenter survey was conducted from July 2012 to January 2014. Men were recruited from urology clinics which were located at the five cities in China. All men participated in the survey by completing a verbal questionnaire (consisted of sociodemographics, past medical history, sexual history, and self-estimated scales). The results showed that 1,280 men completed the survey. Based on the CP/CPPS definition, a total of 801 men were diagnosed as having CP/CPPS. Men with CP/CPPS reported higher scores of NIH-CPSI and lower scores of IIEF-5 than men without CP/CPPS. NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. The total scores of NIH-CPSI were significantly more strongly correlated with question 5 than other questions of IIEF-5. The total scores of IIEF-5 were significantly more strongly correlated with pain symptoms scores of NIH-CPSI. Strongest correlation was found between QoL impact and question 5 of IIEF-5. The findings suggested that NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. Strongest correlation was found between QoL impact and question 5 of IIEF-5. PMID:26273630

  4. Curative effect observation of ozone therapy combined with western medicine in the treatment of chronic pelvic inflammatory%臭氧疗法联合西药治疗慢性盆腔炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    潘禹

    2014-01-01

    Objective:To observe the curative effect of ozone therapy combined with western medicine in the treatment of chronic pelvic inflammatory.Methods:226 patients with chronic pelvic inflammation were randomly divided into the control group in 106 cases and the observation group in 120 cases.The control group was given the western medicine therapy,such as ampicillin sodium,tinidazole.The observation group was given ozone therapy on the basis of the control group.Results:In the observation group,the total efficiency was 98.3%,the cure rate was 54.16%.In the control group,the total efficiency was 83%,the cure rate was 33.96%.there was significant difference between two groups(P<0.05).Conclusion:The curative effect of ozone therapy combined with western medicine in the treatment of chronic pelvic inflammatory disease is better than pure western medicine treatment,and it is safe and reliable.%目的:观察臭氧疗法联合西药治疗慢性盆腔炎的临床疗效。方法:将226例慢性盆腔炎患者随机分为对照组106例和观察组120例,对照组给予氨苄西林钠、替硝唑等西药治疗,观察组在对照组的基础上配合臭氧治疗。结果:观察组总有效率98.30%,治愈率54.16%;对照组总有效率83.00%,治愈率33.96%。两组比较差异有统计学意义(P<0.05)。结论:臭氧疗法联合西药治疗慢性盆腔炎疗效优于单纯西药治疗,而且安全可靠。

  5. Analysis of the Traditional Chinese Medicine Treatment Effect of the Gynecologic Chronic Pelvic Pain Syndrome%浅析中医治疗妇科慢性盆腔疼痛症临床效果

    Institute of Scientific and Technical Information of China (English)

    信长华

    2015-01-01

    Objective To analyze the traditional Chinese medicine treatment experience of the gynecologic chronic pelvic pain syndrome. Methods Selected 80 cases of patients with chronic pelvic pain syndrome in our hospital from January 2014 to December 2014,randomly divided into western medicine group and Chinese medicine group. 40 cases in western medicine group with conventional western medicine treatment,the others in treatment group by traditional Chinese medicine formula,compared the clinical efficacies of two groups of patients after a period of treatment. Results The effectiveness of Chinese medicine treatment group was 90%. The effectiveness of western medicine treatment group was 80%. There was efficient difference obvious between the two groups. It was statistical y significant,P<0.05. Conclusion The traditional Chinese medicine treatment of the gynecologic chronic pelvic pain syndrome has the very high clinical value,with remarkable effct.%目的:分析总结中医治疗妇科慢性盆腔疼痛症的临床经验。方法选取我院2014年1~12月收治的80例慢性盆腔疼痛症患者,将其随机分为西医组和中医组,每组患者各40例。西医组患者采取常规西医方法治疗,中医组患者采用中药方剂治疗,一个疗程后,对比分析两组患者的临床疗效。结果中医组治疗有效率是90%,西医组治疗有效率是80%。两组患者的治疗有效率差异有统计学意义,P<0.05。结论中医治疗妇科慢性盆腔疼痛效果显著。

  6. Pelvic Floor Muscle Training: Underutilization in the USA.

    Science.gov (United States)

    Lamin, Eliza; Parrillo, Lisa M; Newman, Diane K; Smith, Ariana L

    2016-02-01

    Pelvic floor disorders are highly prevalent in women of all ages and can greatly impair quality of life. Pelvic floor muscle training (PFMT) is a viable treatment option for several pelvic floor conditions including urinary incontinence and pelvic organ prolapse. PFMT is a program of therapy initiated by an experienced clinician (e.g., women's health or urology nurse practitioner (NP), physical therapist (PT)) that involves exercises for women with stress urinary incontinence (UI) and exercises combined with behavioral or conservative treatments (lifestyle changes, bladder training with urge suppression) for women with urgency or mixed UI. These exercise programs are more comprehensive than simple Kegel exercises. Despite evidence-based research indicating the efficacy and cost-effectiveness for treatment of urinary incontinence, PFMT is not commonly used as a first-line treatment in clinical practice in the USA (Abrams et al., 2012). This article will review PFMT for the treatment of UI and pelvic organ prolapse (POP) and theorize how this conservative therapy can be utilized more effectively in the USA.

  7. 21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology fiberoptic retractor. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4530 Gastroenterology-urology fiberoptic retractor. (a) Identification. A gastroenterology-urology fiberoptic...

  8. 21 CFR 876.4370 - Gastroenterology-urology evacuator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to...

  9. Chronic prostatitis

    OpenAIRE

    Le, Brian; Schaeffer, Anthony J.

    2011-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome [CP/CPPS]). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  10. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  11. 不同方法治疗慢性盆腔炎的临床效果观察%Clinical effect of different methods on chronic pelvic inflammatory disease

    Institute of Scientific and Technical Information of China (English)

    刘康燕; 王彬

    2016-01-01

    Objective To investigate the clinical effect of different methods on chronic pelvic inflammatory disease. Methods One hundred and ninety two patients with chronic pelvic inflammatory disease from December 2009 to December 2012 were selected. The patients were randomly divided into treatment group and control group. They were respectively taken with En-ema therapy and antibiotic therapy. The incidence of treatment time,the overall treatment effect and adverse reaction were ob-served and compared. Results The treatment time of the treatment group was shorter than that in the control group. The total ef-ficiency of the treatment group was higher than that in the control group. The incidence of adverse reaction of the treatment group was lower than that in the control group,there was significant differences. Conclusion In clinical practice for patients with chronic pelvic inflammation treated in the practice process,compared with the antibiotic treatment,the Chinese medicine reten-tion enema has significant clinical therapeutic effect,the adverse reactions can be effectively controlled,so it is the ideal clinical treatment of chronic pelvic inflammatory disease.%目的:探讨不同方法治疗慢性盆腔炎的临床效果。方法选取2009年12月至2012年12月期间罗湖区妇幼保健院收治的慢性盆腔炎患者192例。随机将患者分成治疗组和对照组,分别采用中药灌肠治疗和抗生素治疗。对两组入选对象的治疗时间、整体治疗效果和不良反应发生情况进行观察和比较。结果治疗组治疗时间显著低于对照组;治疗组总有效率显著高于对照组;治疗组的不良反应发生率显著低于对照组,且差异有统计学意义。结论在临床针对慢性盆腔炎患者实施治疗的实践过程中,与抗生素治疗方法相比较,采用中药保留灌肠治疗方法的临床治疗效果显著,不良反应可以得到有效控制,是临床治疗慢性盆腔炎的理想选择。

  12. Observation on Chronic Pelvic Pain Syndrome (186 cases) Treated by Capsule for Relieving Blood Stasis%前列通淤胶囊治疗慢性盆腔疼痛综合征186例观察

    Institute of Scientific and Technical Information of China (English)

    孙中明; 鲍严钟

    2003-01-01

    @@ 慢性前列腺炎是影响成年男性生活质量的常见病,估计全球男性的发病率为9%~14%[1].据美国国家卫生研究院(NIH)分类标准(1995年),慢性前列腺炎分为慢性细菌性前列腺炎(Ⅱ类),慢性非细菌性前列腺炎/慢性盆腔疼痛综合征(chronic pelvic pain syndrome,CPPS)(Ⅲ类)以及无症状炎症性前列腺炎(Ⅳ类)三类[2].

  13. Advances in Pediatric Urologic Laparoscopy

    Directory of Open Access Journals (Sweden)

    M. C. Smaldone

    2007-01-01

    Full Text Available The spectrum of laparoscopic surgery in children has undergone a dramatic evolution. Initially used as a diagnostic modality for many pediatric urologists, complex as well as reconstructive procedures are now being performed laparoscopically. Laparoscopic orchiopexy and nephrectomy are well established and are being performed at many centers. Laparoscopic partial nephrectomy, adrenalectomy, and dismembered pyeloplasty series have reported shortened hospital stays and operative times that are comparable to that of open techniques or are decreasing with experience. The initial experiences with laparoscopic ureteral reimplantation and laparoscopic-assisted bladder reconstructive surgery have been described, reporting encouraging results with regards to feasibility, hospital stay, and cosmetic outcome. This report will provide a directed review of the literature to establish the current indications for laparoscopy in pediatric urologic surgery.

  14. Extracorporeal Shock-Wave Therapy in Treating Chronic Pelvic Pain Syndrome in Males%体外冲击波治疗在男性慢性骨盆疼痛综合征中的应用进展

    Institute of Scientific and Technical Information of China (English)

    童亮; 吕军

    2012-01-01

    Category Ⅲ prostatitis is also called chronic pelvic pain syndrome ( CPPS ), accounting for about 90% of chronic prostatitis, and studies have suggested that its age range was from 20 to 83 years, and its incidence is between 4% to 16%. The clinical manifestations of CPPS include long - term and reduplicated pelvic region pain or discomfort, and it can last for more than 3 months. Furthermore, it may be associated with some degrees of micturition symptoms and sexual dysfunction, which seriously reduced the quality of life of the patients. At present, the etiology and pathogenesis of CPPS are unclear, and there has been no standard treatments. Extracorporeal shock - wave therapy has been used clinically in treating CPPS in males and has received good clinical effects.%Ⅲ型前列腺炎又称为慢性骨盆疼痛综合征(CPPS),约占慢性前列腺炎的90%,20~83岁男性均可发病,发病率为4%~16%.临床表现为长期、反复的骨盆区域疼痛或不适,持续时间超过3个月,可伴有不同程度的排尿症状和性功能障碍,严重影响患者的生活质量.目前,CPPS的发病机制和病因尚不明确,尚没有标准的治疗方法.临床运用体外冲击波治疗男性CPPS,收到良好的临床效果.

  15. Iatrogenic urological triggers of autonomic dysreflexia

    DEFF Research Database (Denmark)

    Liu, N; Zhou, M; Biering-Sørensen, F

    2015-01-01

    pressure (BP) assessments during urological procedures were excluded. RESULTS: Forty studies were included for analysis and categorized into four groups: (1) urodynamics and cystometry; (2) cystoscopy and transurethral litholapaxy; (3) extracorporeal shock-wave lithotripsy (ESWL); and (4) other procedures...

  16. 腹腔镜诊治子宫内膜异位症相关性慢性盆腔痛的临床研究%Combined Treatment of Endometriosis-Related Chronic Pelvic Pain with Laparoscopy

    Institute of Scientific and Technical Information of China (English)

    胡碧洪; 李莉芳; 王帅; 黄浩

    2011-01-01

    Objective: To evaluate the diagnosis and treatment of endometriosis-related chronic pelvic pain (EMT-related CPP) by laparoscope. Methods:The relationship between site, stage of endometriosis (EMT) and the effect of laparoscope, as well as the pain degree in 86 cases of endometriosis-related chronic pelvic pain patients were retrospectively analyzed. Results;The remission rate of EMT-related CPP by laparoscopic surgery was 90. 7%. Ⅰ degree of pain in n stage by rAFS was 71.4%, more than II degree of pain in 1 and IV stage was 95. 5%. I and U degree of pain in simple ovarian chocolate cysts and (or) pelvic peritoneum EMT pain was 88.4%. II to 1 degree of pain in EMT patients with ectopic lesions invasion of uterosacral ligaments, Douglas pouch, posterior wall of uterus and deep infiltrating was 93. 0%. Conclusions;The main causes of EMT-related CPP are invasion of uetrosacral ligament, Douglas pouch, posterior wall of uterus and deep infiltrating in pelvic endometriosis. Laparoscopy can confirm the diagnosis and treat EMT-related CPP, the therapy is satisfactory.%目的:评价腹腔镜在子宫内膜异位症(EMT)相关性慢性盆腔痛诊断及治疗中的应用价值.方法:回顾性分析86例EMT相关性慢性盆腔痛患者行腹腔镜手术治疗的效果及疼痛程度与EMT分期及部位的关系.结果:腹腔镜手术治疗EMT相关性慢性盆腔痛疼痛缓解率90.7%.rAFS分期Ⅱ期患者Ⅰ度疼痛占71.4%,Ⅲ期和Ⅳ期患者Ⅱ度以上疼痛占95.5%.单纯卵巢巧克力囊肿和(或)盆腔腹膜EMT患者Ⅰ、Ⅱ度疼痛占88.4%,病灶侵犯宫骶韧带、直肠子宫陷凹和子宫后壁以及深部浸润的EMT患者Ⅱ、Ⅲ度疼痛占93.0%.结论:盆腔子宫内膜异位病灶侵犯宫骶韧带、直肠子宫陷凹、子宫后壁和深部浸润是引起EMT相关性慢性盆腔痛的主要原因,腹腔镜能明确诊断及治疗EMT相关性慢性盆腔痛,治疗效果满意.

  17. Occupational exposure and urological cancer.

    Science.gov (United States)

    Golka, Klaus; Wiese, Andreas; Assennato, Giorgio; Bolt, Hermann M

    2004-02-01

    Occupational exposure is definitely a major cause of cancer. In the field of urology, the urinary bladder is the most important target. A classical cause of bladder cancer is exposure to carcinogenic aromatic amines, especially benzidine and beta-naphthylamine. Such exposures were related to work places in the chemical industry, implying production and processing of classical aromatic amines, and in the rubber industry. Occupational bladder cancer has also been observed in dyers, painters and hairdressers. Even some occupations with much lower exposures to carcinogenic aromatic amines, like coke oven workers or workers in the rubber industry after the ban on beta-naphthylamine, are at risk. In these occupations, exposure to complex mixtures of substances containing combustion products (e.g. polycyclic aromatic hydrocarbons) or nitrosamines is common. Renal cell cancer has been observed as an occupational disease in cases of very high exposure to trichloroethylene having led to narcotic or prenarcotic symptoms. Occupationally related cancers of the prostate or the testes appear currently not relevant.

  18. Myofascial pelvic pain.

    Science.gov (United States)

    Kotarinos, Rhonda

    2012-10-01

    Myofascial pelvic pain is fraught with many unknowns. Is it the organs of the pelvis, is it the muscles of the pelvis, or is the origin of the pelvic pain from an extrapelvic muscle? Is there a single source or multiple? In this state of confusion what is the best way to manage the many symptoms that can be associated with myofascial pelvic pain. This article reviews current studies that attempt to answer some of these questions. More questions seem to develop as each study presents its findings.

  19. [The place of pelvic adhesions in gynecology. Possibilities of prevention].

    Science.gov (United States)

    Inovay, J; Szendei, G

    1997-10-05

    The authors review the recent international literature dealing with the role of pelvic adhesions in gynaecologic surgery. They point out that pelvic adhesions can be detected via laparatomy or laparoscopy in every third patient suffering from chronic pelvic pain, whereas abdominal adhesions revealed rarely correlate with anamnestic chronic pelvic pain. Correlation of pelvic pain and adhesions is neither consequent nor mutual. Lacking more detailed information on the pathomechanism of pain, the role of the vegetative innervation of the visceral and parietal peritoneum and of the excitation of the nerve fibers in the neoformed-and vascularized adhesions can only be postulated. According to the attractive but not well established theory extensive adhesions can directly provoke pain through fixing the pelvic organs hampering their motility and mobility. It is generally accepted, that lysis of adhesions in symptomatic patients can resolve or reduce the complaints. However the duration of the beneficial effect and its transitoric or definitive nature cannot be predicted in advance. Subsequently the authors review the adjuvant methods complementary to microsurgical techniques possibly preventing the formation and neoformation of pelvic adhesions. Despite of general acceptance and widespread usage, the effectiveness of crystalloids, macromolecular solutions, intraperitoneal heparin and steroids in the prevention of adhesions cannot be scientifically supported. The encouraging results already achieved by mechanical barriers (intercede, Gore-Tex) can hopefully be surpassed by biodegradable barriers actually studied in animal models.

  20. Differentiating pelvic actinomycosis from advanced ovarian cancer: a report of two cases, management reflections and literature review

    OpenAIRE

    2014-01-01

    Pelvic actinomycosis comprises a rare, subacute to chronic bacterial infection characterised by suppurative and granulomatous inflammation. Diagnosis is difficult as it may simulate pelvic malignancies. Laboratory and radiological findings are non-specific. We reported on 2 cases of pelvic actinomycosis mimicking ovarian malignancy with different management approaches that lead to opposite outcomes. We reviewed the literature on pelvic actinomycosis imitating ovarian cancer with a focus on it...

  1. Case report: pelvic actinomycosis.

    Science.gov (United States)

    Maxová, K; Menzlová, E; Kolařík, D; Dundr, P; Halaška, M

    2012-01-01

    A case of pelvic actinomycosis is presented. The patient is 42-year-old female with a 5 weeks history of pelvic pain. An intrauterine device (IUD) was taken out 3 weeks ago. There is a lump length 9 cm between rectus muscles. Ultrasound, magnetic resonance imaging (MRI) and histology are used to make the diagnosis. Actinomycosis can mimic the tumour disease. The definitive diagnosis requires positive anaerobic culture or histological identification of actinomyces granulas. A long lasting antibiotic therapy is performed.

  2. [Pelvic actinomycosis in Tunisia: five cases].

    Science.gov (United States)

    Chelli, Dalenda; Hassini, Abdelwahed; Aloui, Fadhel; Sfar, Ezzeddine; Zouaoui, Béchir; Chelli, Héla; Chanoufi, Badis

    2008-01-01

    Actinomycosis is a rare suppurative disease due to Actinomyces species. These Gram-positive, non-acid fast anaerobic filamentous bacteria are normal inhabitants of the human body, tending to reside in the oropharynx and bowel but are occasionally found in the vagina. Pelvic actinomycosis is a rare bacterial disease in women. Clinical manifestations are various and non specific and may be acute or chronic. No consensus exists for treatment. We reviewed files and identified all five cases of pelvic actinomycosis managed at Obstetrics and Gynaecology department "A" at the Maternity Center of Tunis over an eight-year period (1998-2005). The women's average age was 39.2 years. One patient was menopausal and consulted for bleeding. The other four patients were younger and had all been using an intrauterine device (IUD) for contraception. They presented with acute clinical manifestations. Their main symptom was pelvic pain. Three women had fever, and two presented with urinary tract obstruction. All patients had surgery. A pelvic abscess was found in four cases. Laparoscopic management was possible in only one case. Laparotomy was necessary in the other four. Four women had adnexectomies, two with hysterectomy. Digestive complications occurred in three cases. Actinomycosis was diagnosed only after surgery, by the histological examination. This series confirms the difficulties encountered in the management of pelvic actinomycosis. We review the recent literature and describe the diagnostic and therapeutic procedures currently recommended. The relationship between pelvic actinomycosis and IUDs, the most common method of contraception in Tunisia, is clearly established. Clinical diagnosis of pelvic actinomycosis is difficult because the symptoms are non-specific. Laboratory tests can help by showing serious inflammation, however. Imaging findings are also non-specific and may suggest an abscess or an inflammatory or neoplastic process. Interventional radiology, specifically

  3. [Pelvic floor and pregnancy].

    Science.gov (United States)

    Fritel, X

    2010-05-01

    Congenital factor, obesity, aging, pregnancy and childbirth are the main risk factors for female pelvic floor disorders (urinary incontinence, anal incontinence, pelvic organ prolapse, dyspareunia). Vaginal delivery may cause injury to the pudendal nerve, the anal sphincter, or the anal sphincter. However the link between these injuries and pelvic floor symptoms is not always determined and we still ignore what might be the ways of prevention. Of the many obstetrical methods proposed to prevent postpartum symptoms, episiotomy, delivery in vertical position, delayed pushing, perineal massage, warm pack, pelvic floor rehabilitation, results are disappointing or limited. Caesarean section is followed by less postnatal urinary incontinence than vaginal childbirth. However this difference tends to disappear with time and following childbirth. Limit the number of instrumental extractions and prefer the vacuum to forceps could reduce pelvic floor disorders after childbirth. Ultrasound examination of the anal sphincter after a second-degree perineal tear is useful to detect and repair infra-clinic anal sphincter lesions. Scientific data is insufficient to justify an elective cesarean section in order to avoid pelvic floor symptoms in a woman without previous disorders.

  4. The Efficacy Evaluation of Traditional Rehabilitation Therapy for Chronic Pelvic Inflammatory Disease%传统康复疗法治疗慢性盆腔炎的疗效评价

    Institute of Scientific and Technical Information of China (English)

    柯楚真; 凌岚; 何倩; 苏景玫; 彭凌云

    2012-01-01

    目的:评价传统康复疗法对慢性盆腔炎的治疗价值.方法:选取2010年2月~2011年3月我院收治的85例慢性盆腔炎患者,将其随机分为传统康复疗法治疗组(研究组n=46)和常规西药抗炎治疗组(对照组n=39),研究组采用传统针刺、艾灸联合物理疗法治疗,穴位取子宫(右)、足三里(双)、太冲(双)、三阴交(双)、关元等,1次/d.理疗采用储能式波谱治疗仪对下腹部疼痛区垂直照射,2次/d,10d(每月经期干净时开始)为1疗程,连续使用3 个月;对照组则采用常规抗炎西药静脉滴注,1次/d,7d(每月经期来潮时开始)为1疗程,连续使用3 个月,观察两组的临床疗效.结果:研究组治疗有效率为91.3%,而对照组治疗有效率仅为74.3%,两组比较差异具有统计学意义P<0.05.结论:传统康复疗法治疗慢性盆腔炎疗效显著.%Objective:To evaluate the treatment value of traditional rehabilitation therapy for chronic pelvic inflammatory disease. Methods:Selected 85 cases of patients with chronic pelvic inflammatory disease admitted to our hospital from Feb 2010 to Mar 2011, divided them into traditional rehabilitation therapy group(study group n=46) and conventional western anti-inflammatory treatment group(control group n=39), study group were given traditional acupuncture, moxibustion combined physical therapy, acupuncture points were taking the uterus (right), Zusanli (double), Tai Chong (double), Sanyinjiao (double), Guan Yuan and others, 1 time/d. Physiotherapy treatment were using vertical radiation of energy storage spectrum therapeutic apparatus for area of lower abdominal pain, 2 times/d, 10 days (monthly period a clean start) were a course of treatment, for 3 months continuous use; Control group were given intravenous infusion of conventional anti-inflammatory medicine,l time/d, 7 days (monthly menstrual cramps start) were a course of treatment, for 3 months continuous use, observed the clinical effect of two groups

  5. Pelvic Organ Prolapse: New Concepts in Pelvic Floor Anatomy.

    Science.gov (United States)

    Maldonado, Pedro A; Wai, Clifford Y

    2016-03-01

    As the field of reconstructive pelvic surgery continues to evolve, with descriptions of new procedures to repair pelvic organ prolapse, it remains imperative to maintain a functional understanding of pelvic floor anatomy and support. The goal of this review was to provide a focused, conceptual approach to differentiating anatomic defects contributing to prolapse in the various compartments of the vagina. Rather than provide exhaustive descriptions of pelvic floor anatomy, basic pelvic floor anatomy is reviewed, new and historical concepts of pelvic floor support are discussed, and relevance to the surgical management of specific anatomic defects is addressed.

  6. Robot-assisted surgery: applications in urology

    Directory of Open Access Journals (Sweden)

    Mathew C Raynor

    2010-05-01

    Full Text Available Mathew C Raynor, Raj S PruthiDivision of Urologic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAAbstract: The past decade has seen a dramatic shift in the surgical management of certain urologic conditions with the advent of a robotic surgical platform. In fact, the surgical management of prostate cancer has seen the most dramatic shift, with the majority of cases now being performed robotically. Technical refinements over the years have led to improved outcomes regarding oncologic and functional results. Recently, robotic surgery has also been utilized for the surgical management of bladder cancer, renal cancer, and other benign conditions. As further experience is gained and longer-term outcomes are realized, robotic surgery will likely play an increasing role in the surgical management of many urologic conditions.Keywords: robot-assisted surgery, robotic surgery, cystectomy, prostatectomy, partial nephrectomy

  7. Resorbable extracellular matrix grafts in urologic reconstruction

    Directory of Open Access Journals (Sweden)

    Richard A. Santucci

    2005-06-01

    Full Text Available PURPOSE: There is an increasingly large body of literature concerning tissue-engineering products that may be used in urology. Some of these are quite complex (such as multilayer patient-specific cell-seeded implants yet the most simple and successful products to date are also the most uncomplicated: resorbable acellular extra-cellular matrices (ECMs harvested from animals. ECMs have been used in a variety of difficult urologic reconstruction problems, and this review is intended to summarize this complex literature for the practicing urologist. METHODS: Medline search of related terms such as "SIS, small intestinal submucosa, ECM, extracellular matrix, acellular matrix and urologic reconstruction". Manuscripts missed in the initial search were taken from the bibliographies of the primary references. RESULTS: Full review of potential clinical uses of resorbable extra-cellular matrices in urologic reconstruction. CONCLUSIONS: Currently, the "state of the art" in tissue engineering solutions for urologic reconstruction means resorbable acellular xenograft matrices. They show promise when used as a pubovaginal sling or extra bolstering layers in ureteral or urethral repairs, although recent problems with inflammation following 8-ply pubovaginal sling use and failures after 1- and 4-ply SIS repair of Peyronie's disease underscore the need for research before wide adoption. Preliminary data is mixed concerning the potential for ECM urethral patch graft, and more data is needed before extended uses such as bladder augmentation and ureteral replacement are contemplated. The distant future of ECMs in urology likely will include cell-seeded grafts with the eventual hope of producing "off the shelf" replacement materials. Until that day arrives, ECMs only fulfill some of the requirements for the reconstructive urologist.

  8. The effect of steroids for the treatment of delayed urological involvement arising from radiation therapy; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Shinichi; Tasaki, Yoshihisa; Fukunaga, Yoshikazu (Oita National Hospital (Japan))

    1992-07-01

    A 55-year-old woman visited our hospital with the chief complaint of high fever. She had received whole pelvic radiation therapy following radical hysterectomy 22 years earlier. Excretory urography revealed bilateral severe hydrone phrosis. Urological examinations were carried out. Urethral stricture and marked small bladder were found. This case was diagnosed as delayed urological involvement arising from radiation therapy complicated with neurogenic bladder. Prednisolone at a total dose of 1,060 mg was administered over 51 days under indwelling catheters to the urethra and to both ureters. The function of the urinary bladder has been maintained at an improved level over a period of 2 months following the removal of the ureteral and urethral catheters. (author).

  9. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Science.gov (United States)

    2010-04-01

    ... generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument, suction... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  10. 21 CFR 876.4890 - Urological table and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological table and accessories. 876.4890 Section 876.4890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4890 Urological table...

  11. 21 CFR 876.5160 - Urological clamp for males.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological clamp for males. 876.5160 Section 876.5160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5160 Urological clamp for...

  12. 中药熏药联合辨证施膳治疗慢性盆腔炎病人效果观察%Effect observation on herbal medicine smoked combined with dialectical dietary therapy for patients with chronic pelvic inflammation

    Institute of Scientific and Technical Information of China (English)

    夏令琼; 梁云花; 王鑫; 廖色青

    2016-01-01

    Objective:To investigate the clinical effect of herbal medicine smoked combined with dialectical dieta-ry therapy for patients with chronic pelvic inflammation.Methods:A total of 93 patients were randomly divided into control group with 46 cases and observation group with 47 cases.Two groups of patients were treated with conventional antibiotics,the patients in observation group received routine antibiotic therapy based on the use of herbal medicine smoked combined with dialectical dietary,7 days for a course,a total of 2 treatment courses. Then observed the clinical effect before and after treatment,symptom score,quality of life of patients in order to evaluate the improvement of symptoms.Results:Pelvic inflammatory disease symptoms in observation group was significantly reduced compared with the control group,the difference was significant (P <0.05).The syn-drome score in observation group was lower than that in control group (P <0.05).After treatment,quality of life score in observation group was higher than that in control group (P <0.05 ).Conclusion:Herbal medicine smoked combined with dialectical dietary therapy for patients with chronic pelvic inflammatory disease could re-duce inflammation,improve clinical symptoms and quality of life for patients.%[目的]探讨中药熏药联合辨证施膳对慢性盆腔炎病人临床疗效。[方法]将93例病人按随机数字表法分为对照组46例和观察组47例。两组病人均采用常规抗生素治疗,观察组在常规抗生素治疗的基础上加用中药熏药联合辨证施膳,7 d 为1疗程,总共治疗2疗程。观察治疗前后疗效、症候评分、生活质量以评估病人症状改善情况。[结果]观察组的盆腔炎症状明显减轻,与对照组比较差异有统计学意义(P <0.05);观察组证候评分低于对照组(P <0.05);治疗后观察组生存质量评分高于对照组(P <0.05)。[结论]中药熏药联合辨证施膳治疗慢性盆腔炎能减轻病人炎症反应,改

  13. [Intrauterine device and pelvic tumor: two case reports of pelvic actinomycosis with pseudotumor from tropical zones].

    Science.gov (United States)

    Abid, M; Ben Amar, M; Damak, Z; Feriani, N; Guirat, A; Khebir, A; Mzali, R; Frikha, M F; Beyrouti, M I

    2010-06-01

    Pelvic actinomycosis is a rare chronic disease caused by actinomycete species. The pseudotumorous form is the most common and often leads to misdiagnosis. The purpose of this report is to describe two cases of pelvic actinomycosis involving women with a history of intrauterine contraceptive device (IUD) use. Diagnosis was based on pelvic mass and the findings of surgery undertaken for suspicion of an advanced ovarian tumor with hepatic metastasis in one case and for a tumor of the right ovary in the other case. Diagnosis was confirmed by histological examination of a biopsy specimen in the first case and of the surgical specimen (right ovariectomy) in the second case. Long-term antibiotic therapy was effective in both patients. Based on these two cases and review of the literature, discussion focuses on diagnostic pitfalls, natural course, and therapeutic options for this particular infection.

  14. Pelvic floor muscle function in women with pelvic floor dysfunction

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Dehlendorff, Christian

    2014-01-01

    The objectives of this study were to investigate the level of pelvic floor muscle (PFM) function in women with pelvic floor dysfunction (PFD) referred by gynaecologists and urologists for in-hospital pelvic floor muscle training (PFMT), and to identity associated factors for a low level of PFM...

  15. Conscious pain mapping by laparoscopy in women with chronic pelvic pain%腹腔镜清醒疼痛定位在慢性盆腔痛诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    许洪梅; 张震宇

    2013-01-01

    慢性盆腔痛在女性各个年龄阶段均可发病,严重影响患者身心健康.清醒疼痛定位指在局部麻醉下患者清醒,在患者的配合下了解疼痛位置和范围.腹腔镜清醒疼痛定位可以明确慢性盆腔痛疼痛部位和病因,避免不必要的手术,应用清醒疼痛定位指导腹腔镜保守性手术可以有效缓解慢性盆腔痛.%Chronic pelvic pain is a common and significant disorder of women. Conscious laparoscopic pain mapping (CLPM) is a diagnostic laparoscopy under local anesthesia directed at the identification of sources of pain. Diagnosis of an etiological lesion or organ is based on CLPM. CLPM can decrease unnecessary surgical interventions and improve pain relief.

  16. Pelvic floor muscle training exercises

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003975.htm Pelvic floor muscle training exercises To use the sharing features on this page, please enable JavaScript. Pelvic floor muscle training exercises are a series of exercises ...

  17. How Is Pelvic Pain Treated?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How is pelvic pain treated? Skip sharing on social media links Share ... Page Content Treatment depends on the cause of pelvic pain, how intense the pain is, and how often ...

  18. How Is Pelvic Pain Diagnosed?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How is pelvic pain diagnosed? Skip sharing on social media links Share ... needed to help diagnose the cause of the pelvic pain. These tests or procedures may include 1 , 2 : ...

  19. 3D Printing and Its Urologic Applications.

    Science.gov (United States)

    Soliman, Youssef; Feibus, Allison H; Baum, Neil

    2015-01-01

    3D printing is the development of 3D objects via an additive process in which successive layers of material are applied under computer control. This article discusses 3D printing, with an emphasis on its historical context and its potential use in the field of urology.

  20. Raman spectroscopy and its urological applications

    Directory of Open Access Journals (Sweden)

    Vishwanath S Hanchanale

    2008-01-01

    Conclusion: Raman spectroscopy is an exciting tool for real-time diagnosis and in vivo evaluation of living tissue. The potential applications of Raman spectroscopy may herald a new future in the management of various malignant, premalignant, and other benign conditions in urology.

  1. 3D Printing and Its Urologic Applications

    Science.gov (United States)

    Soliman, Youssef; Feibus, Allison H; Baum, Neil

    2015-01-01

    3D printing is the development of 3D objects via an additive process in which successive layers of material are applied under computer control. This article discusses 3D printing, with an emphasis on its historical context and its potential use in the field of urology. PMID:26028997

  2. Anorectal and pelvic floor anatomy

    NARCIS (Netherlands)

    J. Stoker

    2009-01-01

    The anorectum and pelvic floor are crucial in maintaining continence, facilitating evacuation, providing pelvic organ support while in females the pelvic floor is part of the birth canal. The anal sphincter is a multilayered cylindrical structure, including the smooth muscle internal sphincter and t

  3. Clinical Study on Abdominal Acupuncture plus Herbal Medicine for Chronic Pelvic Pain Due to Qi Stagnation and Blood Stasis%腹针配合中药治疗气滞血瘀型慢性盆腔痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋玉娟; 张殿全; 苏丹萍

    2015-01-01

    Objective To observe the clinical efficacy of abdominal acupuncture plus herbal medicine in treating chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.Method Sixty patients with chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by abdominal acupuncture plus herbal medicine, while the control group was by herbal medicine alone. After 3 menstrual cycles, the Visual Analogue Scale (VAS) for abdominal pain and McCormack scale were observed.Result After intervention, the abdominal VAS score and McCormack score were changed significantly in both groups (P<0.01,P<0.05). After intervention, there were significant differences in comparing the VAS score and McCormack score between the two groups (P<0.01).Conclusion Abdominal acupuncture plus herbal medicine can reduce chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.%目的:观察腹针配合中药治疗盆腔炎性疾病后气滞血瘀型慢性盆腔痛的临床疗效。方法将60例盆腔炎性疾病后气滞血瘀型慢性盆腔痛患者随机分为治疗组和对照组,每组30例。治疗组采用腹针配合中药治疗,对照组采用单纯中药治疗。治疗3个月经周期后,观察两组治疗前后腹痛VAS评分及McCormack量表评分变化。结果两组治疗后腹痛VAS评分及McCormack量表评分与同组治疗前比较,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗后腹痛VAS评分及McCormack量表评分与对照组比较,差异均具有统计学意义(P<0.01)。结论腹针配合中药能够减轻盆腔炎性疾病后气滞血瘀型慢性盆腔痛。

  4. Urology in Stettin (Szczecin). The impact of political changes on progress in urology and medicine.

    Science.gov (United States)

    Zajaczkowski, Tadeusz; Wojewska-Zajaczkowska, Elzbieta

    2012-01-01

    The history of modern hospitals in Stettin is about 280 years long. The history of urology in Stettin (Szczecin), like in Europe, is closely associated with the construction of the useful cystoscope, discovery of X-rays, and progress in radiology and endoscopy. In Stettin, like in many other cities, patients with urological diseases were treated at departments of surgery or departments of internal medicine. On March 1It, 1919, a specialized urology ward with 27 beds was opened in the Municipal Hospital in Stettin. Dr. Felix Hagen from Berlin was the first head of this ward. The main duty of the urology ward at that time was to conduct differential diagnosis and to offer conservative treatment to patients not needing surgery. Cystoscopy, chromocystoscopy, and radiographs were done in the beginning. Later on, retroperitoneal pneumography, pneumopyelography, and retrograde pyelography were added. Urography in the final period enabled a more precise assessment of the kidney prior to surgery. The preparation of patients with benign prostate hyperplasia for surgery was an important element. Therapeutic activities of the urology ward included transurethral procedures such as lithotripsy of bladder stones and treatment of bladder cancer. Urological surgery was done at the surgery ward. Patients with tuberculosis were usually referred to the Tuberculosis Hospital in Hohenkrug (Zdunowo). In 1935, the urology ward in Stettin was closed and incorporated into the surgery ward. During the World War II, just as during the World War I, the Municipal Hospital in Stettin was transformed into a field hospital. The end of the World War II created a new political situation in Europe. Stettin (Szczecin) and West Pomerania became part of Poland. In 1948, the Polish government established the Pomeranian Medical Academy (PAM) in Stettin. During the first 10 years of its existence all urological operations were performed at surgery wards. In August 1955, a 30-bed urology ward affiliated

  5. Understanding the pelvic pain mechanism is key to find an adequate therapeutic approach.

    Science.gov (United States)

    Van Kerrebroeck, Philip

    2016-06-25

    Pain is a natural mechanism to actual or potential tissue damage and involves both a sensory and an emotional experience. In chronic pelvic pain, localisation of pain can be widespread and can cause considerable distress. A multidisciplinary approach is needed in order to fully understand the pelvic pain mechanism and to identify an adequate therapeutic approach.

  6. Hormonal treatment for endometriosis associated pelvic pain

    Directory of Open Access Journals (Sweden)

    Wu Shun Felix Wong

    2011-01-01

    Full Text Available AbstractBackground: Endometriosis is a common gynecological problem associated with chronic pelvic pain. Objective: To evaluate the effectiveness of current hormonal treatments of endometriosis associated pain.Materials and Methods: Randomized Controlled studies identified from databases of Medline and Cochrane Systemic Review groups were pooled. 7 RCTs were recruited for evaluation in this review. Data from these studies were pooled and meta-analysis was performed in three comparison groups: 1 Progestogen versus GnRHa; 2 Implanon versus Progestogen (injection; 3 Combined oral contraceptive pills versus placebo and progestogen. Response to treatment was measured as a reduction in pain score. Pain improvement was defined as improvement ≥1 at the end of treatment. Results: There was no significant difference between treatment groups of progestogen and GnRHa (RR: 0.036; CI:-0.030-0.102 for relieving endometriosis associated pelvic pain. Long acting progestogen (Implanon and Mirena are not inferior to GnRHa and depot medroxy progesterone acetate (DMPA (RR: 0.006; CI:-0.142-0.162. Combined oral contraceptive pills demonstrated effective treatment of relieving endometriosis associated pelvic pain when compared with placebo groups (RR:0.321CI-0.066-0.707. Progestogen was more effective than combined oral contraceptive pills in controlling dysmenorrhea (RR:-0.160; CI:-0.386-0.066, however, progestogen is associated with more side effects like spotting and bloating than the combined contraceptive pills. Conclusion: Combined oral contraceptive pills (COCP, GnRHa and progestogens are equally effective in relieving endometriosis associated pelvic pain. COCP and progestogens are relatively cheap and more suitable for long-term use as compared to GnRHa. Long-term RCT of medicated contraceptive devices like Mirena and Implanon are required to evaluate their long-term effects on relieving the endometriosis associated pelvic pain

  7. [The history of urologic journalism in Spain (II). Chronology of Spanish publications specialized in urologic topics].

    Science.gov (United States)

    Maganto Pavón, E

    1996-11-01

    The history of Spanish urological periodicals, like that of the surgical specialties, encompasses several periods as the specialties emerge, are then defined and finally established. It is difficult to determine precisely when the urological specialty began in Spain, since there were surgeons with some dedication to Urology early in the 19th century. Perhaps it began in 1884, when the first service dedicated to the diseases of the urinary tract was created at the Instituto de Terapéutica Operatoria (Institute of Surgical Therapeutics) of the Hospital de la Princesa in Madrid. Although some periodicals with urological descriptions that date back to an earlier period (1800-1850) can be found, it is widely recognized that regular publication of literature and periodicals on the urinary tract started in the mid-19th century, when 'El Especialista' (The Specialist) first appeared in Madrid in 1859. This was the first non monographic specialized periodical where the section 'Genitourinary Disorders' appeared for the first time together with three other specialties. During this second period, journal names were nonspecific or too comprehensive to the point that other medical fields became indiscernible, but they became more explicit as the specialties became more defined. In 1887, the first issue of 'Gaceta de Enfermedades de los Organos Génito-Urinarios' (Gazette of Diseases of the Genitourinary Organs) was published in Madrid. It was the first Spanish journal dedicated exclusively to urological topics. It ushered in a third period, which can be defined as the period of specialized monographic publications, that concluded in 1911 with the founding of the Asociación Española de Urología (Spanish Urological Society). The present article reviews the historical and bibliographical data concerning the six periodicals that were established during these two latter periods.

  8. Differentiating pelvic actinomycosis from advanced ovarian cancer: a report of two cases, management reflections and literature review.

    Science.gov (United States)

    Laios, Alex; Terekh, Iryna; Majd, Hooman Soleymani; Pathiraja, Pubudu; Manek, Sanjiv; Haldar, Krishnayan

    2014-01-01

    Pelvic actinomycosis comprises a rare, subacute to chronic bacterial infection characterised by suppurative and granulomatous inflammation. Diagnosis is difficult as it may simulate pelvic malignancies. Laboratory and radiological findings are non-specific. We reported on 2 cases of pelvic actinomycosis mimicking ovarian malignancy with different management approaches that lead to opposite outcomes. We reviewed the literature on pelvic actinomycosis imitating ovarian cancer with a focus on its surgical management. Despite agreement on the duration of antibiotic therapy following surgical management, consensus regarding surgical approach was rather equivocal. We concluded that pelvic actinomycosis should be strongly suspected in women with presumed ovarian cancer of atypical presentation and a history of intrauterine devices (IUD).

  9. [Pelvic floor muscle training and pelvic floor disorders in women].

    Science.gov (United States)

    Thubert, T; Bakker, E; Fritel, X

    2015-05-01

    Our goal is to provide an update on the results of pelvic floor rehabilitation in the treatment of urinary incontinence and genital prolapse symptoms. Pelvic floor muscle training allows a reduction of urinary incontinence symptoms. Pelvic floor muscle contractions supervised by a healthcare professional allow cure in half cases of stress urinary incontinence. Viewing this contraction through biofeedback improves outcomes, but this effect could also be due by a more intensive and prolonged program with the physiotherapist. The place of electrostimulation remains unclear. The results obtained with vaginal cones are similar to pelvic floor muscle training with or without biofeedback or electrostimulation. It is not known whether pelvic floor muscle training has an effect after one year. In case of stress urinary incontinence, supervised pelvic floor muscle training avoids surgery in half of the cases at 1-year follow-up. Pelvic floor muscle training is the first-line treatment of post-partum urinary incontinence. Its preventive effect is uncertain. Pelvic floor muscle training may reduce the symptoms associated with genital prolapse. In conclusion, pelvic floor rehabilitation supervised by a physiotherapist is an effective short-term treatment to reduce the symptoms of urinary incontinence or pelvic organ prolapse.

  10. Tratamiento farmacológico en el dolor pélvico urogenital crónico: revisión de la evidencia disponible Drug therapy for chronic pelvic urogenital pain: a review of available evidence

    Directory of Open Access Journals (Sweden)

    S. Fernández

    2011-02-01

    Full Text Available La falta de consenso en las definiciones y de conocimiento de la fisiopatología del dolor crónico del aparato genitourinario son algunos de los factores que explican la multitud de fármacos ensayados para su tratamiento y la carencia de terapias definitivas. Existen muchas patologías orgánicas y funcionales de la vejiga urinaria, el tracto reproductor y la musculatura del suelo pélvico capaces de generar dolor. En esta revisión nos centraremos en los desórdenes funcionales en los que el dolor no puede ser explicado por una patología estructural demostrable. Las estrategias terapéuticas actuales van desde la acupuntura y la terapia física pasando por la terapia psicológica, los fármacos sistémicos y locales, los bloqueos nerviosos y la neuromodulación de raíces sacras. Centrándonos en la terapia farmacológica es llamativa la multitud de fármacos ensayados en el tratamiento de estas entidades. Muchos estudios clínicos fracasan en su intento de demostrar la eficacia de los tratamientos actualmente en uso quizás porque muchas terapias son efectivas en subgrupos de pacientes. El esfuerzo debería centrarse pues en identificar a esos subgrupos de pacientes respondedores a determinadas terapias y orientar el tratamiento en este sentido. Por otro lado, teniendo en cuenta que en el dolor pélvico y urogenital crónico pueden coexistir diferentes mecanismos patogénicos del dolor, va a ser necesaria la combinación de agentes farmacológicos con diferentes dianas terapéuticas y la asociación de diferentes modalidades terapéuticas para obtener un resultado óptimo.Lack of consensus in definitions and scarce knowledge about urogenital system chronic pain physiopathology are some factors that explain the use of dozens of drugs, tested for its treatment and the lack of definitive therapy. There are many urinary bladder, reproductive tract and pelvic floor organic and functional pathologies that may be origin of pain. In this review we

  11. 针灸治疗慢性盆腔炎随机对照试验质量报告%On Quality of Randomized Controlled Trial of Chronic Pelvic Inflammation Treated with Acupuncture and Moxibustion

    Institute of Scientific and Technical Information of China (English)

    王丽芬; 黄丽萍; 熊俊; 杨峥; 屈箫箫

    2014-01-01

    目的:采用CONSORT声明和STRICTA标准评价国内针灸治疗慢性盆腔炎临床随机对照试验质量。方法:利用计算机检索与手工检索。检索CNKI、CBM、VIP和万方4个数据库,结合手工检索相关期刊,筛选出符合研究标准的文献,采用CON-SORT声明和STRICTA标准进行质量评价。结果:共纳入合格文献85篇。大部分文献存在随机方法描述不清和无随机隐藏、盲法使用率低、无样本量计算、无意向治疗分析、针刺细节报道不充分、无针刺治疗医生的资历等问题。结论:针灸治疗慢性盆腔炎的临床随机对照试验质量普遍较低,影响报道的可靠性和同质可比性。为提高针灸临床随机试验可靠性和质量,应该将CON-SORT声明和STRICTA标准引入针灸临床随机试验设计并严格执行。%Objective:To assess the quality of randomized controlled clinical trials of chronic pelvic inflammation treated acupuncture and moxibustion , using consolidated standards for reporting of trials ( CONSORT ) and standards for reporting interventions in controlled trials of acupuncture ( STRICTA ) as the criteria. Methods:Computer and human retrievals were applied. Databases including China National Knowledge Infrastructure (CNKI),China Biomedicine Literature Database(CBM),VIP Journal Integration Platform(VJIP) and WANFANG Data were searched in combination with human retrieval for relevant journals ,to find out the literature meeting with the inclusion criteria. CONSORT and STRICTA were used to assess the quality of the included literature. Results:A total of 85 papers were included. In most of those ,there were no clear description of methods for randomization and allocation concealment ,low percentage of using blind methods ,no calculation of sample size,no intention-to-treat analysis,clinical report without detailed description,and no mention of practitioners’ background. Conclusions:The quality of randomized controlled

  12. 慢性盆腔炎疼痛与焦虑状况相关性分析及护理%Correlation Analysis and Nursing of the Pain and Anxiety of Chronic Pelvic Inflammatory Disease

    Institute of Scientific and Technical Information of China (English)

    何锋云; 刘瑶; 陈少英

    2014-01-01

    Objective To investigate the correlation analysis and nursing of the pain and anxiety of chronic pelvic inflammatory disease. Methods The pain level of 87 cases of patients with chronic pelvic inflammatory disease treated in our hospital from Jan-uary, 2011 to October, 2013 was evaluated by visual analogue scale, the anxiety of the patients was evaluated by Hamilton Anxiety Scale, and the correlation of these two groups of scores was compared. Results The pain level of the patients was evaluated by vi-sual analogue scale, patients with the score below 4 points accounted for 54.02%, those with the score between 4 points to 6 points accounted for 35.63%, and those with the score over 6 points accounted for 10.35%. The anxiety state of the patients was evaluat-ed by Hamilton Anxiety Scale, patients whose score more than 30 points accounted for 8.05%,those whose score between 29 points to 14 points accounted for 28.73%,and those whose score between 13 points to 7 points accounted for 35.63%, those whose score below 7 points accounted for 27.59%. The correlation between pain and anxiety conditions was analyzed. The average anxi-ety score of patients whose pain score below 4 points was (8.51±1.92)points, and that of the patients whose pain score between 4 points to 6 points was (14.27±1.83) points, that of the patients whose pain score more than 6 points was (20.62±2.57) points, which showed that there was a positive correlation between pain and anxiety conditions (P6分患者占总患者数的10.35%。根据汉密尔顿焦虑量表对患者的焦虑状况进行评分,得分>30分患者占总患者数的8.05%,得分29分~14分患者占总患者数的28.73%,得分为13分~7分患者占总患者数的35.63%,得分6分患者的焦虑平均得分(20.62±2.57)分。疼痛与焦虑状况呈现正相关(P<0.05)。结论慢性盆腔炎患者的疼痛和焦虑状况呈现相关性,疼痛强患者的焦虑状况也随之升高,在临床护理过程中应加

  13. 34例慢性盆底功能障碍骶神经调节治疗的测试结果观察%Test results of sacral neuromodulation in 34 patients with chronic pelvic floor dysfunction

    Institute of Scientific and Technical Information of China (English)

    卫中庆; 沈百欣; 丁留成; 易超然; 丁曙晴; 于洪波; 文伟; 孙则禹; PhilipVanKerrebroeck

    2012-01-01

    Objective To investigate the therapeutic effect and safety of temporary electrode and Tined Lead electrode in Bacral neuromodulation evaluation. Methods Thirty-four patients with chronic pelvic floor dysfunction were divided into temporary electrode group (n = 16) and Tined Lead electrode group (n = 18), and temporary stimulation tests were performed after electrode placement. The conditions of voiding and defecation were recorded every day, and related urodynamic parameters were measured. Results The symptoms improved in 43% patients with urgent incontinence and 35% patients with urinary frequency and urgency, and 10% patients with urgent incontinence or urinary frequency and urgency were cured. There were significant differences in the rates of self-perceived improvement of voiding and defecation between temporary electrode group and Tined Lead electrode group (32.2% vs 38. 2% , P 0.0S) . Electrode shift took place in 4 patients in temporary electrode group and in 1 patient in Tined Lead electrode group. Conclusion Sacral neuromodulation is a safe, minimally invasive and effective method for treatment of chronic pelvic floor dysfunction, and Tined Lead electrode may prevent the electrode shift, increase the rate of success, and improve the therapeutic effect.%目的 探讨骶神经调节测试评估阶段临时电极及自固定例齿状( Tined Lead)电极的疗效及安全性.方法 将34例慢性盆底功能障碍患者按电极置入方法不同分为临时电极组(n=16)和自固定Tined Lead电极组(n=18),并进行术后两种电极临时刺激测试.在测试期记录排尿排便日记,进行相关尿动力学参数测定.结果 急迫性尿失禁患者中,有43%症状改善;尿频尿急患者中有35%症状改善;10%的急迫性尿失禁/尿频尿急患者治愈.临时电极组患者排尿排便自我感觉的改善率为32.2%,自固定Tined Lead电极组为38.2%,两组差异有统计学意义(P<0.05).盆底疼痛综合征/间质性膀胱

  14. Pelvic inflammatory disease and pelvic pain%盆腔炎性疾病与盆腔痛

    Institute of Scientific and Technical Information of China (English)

    秦君璞; 张帝开

    2013-01-01

    Pelvic inflammatory disease (PID) has remarkably influenced female reproductive health. There is significant relationship between the incidence of PID outbreaking and its further sequela, such as chronic pelvic pain. Diagnostic Laparoscopy is a gold standard in evaluation of chronic pelvic pain. The patients who underwent a laparoscopic operation would have a decrease in the amount of pelvic pain. Besides, application of oral drugs and physical therapy are also infective ways in treatment of chronic pelvic pain.%盆腔炎性疾病严重影响广大女性的生殖健康,若不能及时治疗,易引起后遗病变.慢性盆腔痛是盆腔炎性疾病所引起的后遗病变之一.诊断性腹腔镜是目前评价慢性盆腔痛原因的有效方法,可在进行诊断同时对盆腔病变进行手术治疗.此外,口服药物、理疗等方法也可有效缓解盆腔疼痛.

  15. Post-transplant urological and vascular complications

    Directory of Open Access Journals (Sweden)

    Safa Javid

    2009-01-01

    Full Text Available To determine the prevalence of urological and vascular complications in renal trans-plant recipients (RTx at Tabriz Renal Transplant Center, we studied 55 recipients of renal allo-grafts (25 male and 29 female patients with a mean age of 38.3 ± 13.4 years from October 2005 to November 2006. The surgical complications in our study included hematomas: 20.4%, renal artery stenosis: 20.4%, calculi: 7.4%, hydronephrosis or ureteral stricture: 5.6%, urinary leakage: 5.6%, lymphoceles: 1.9%, and renal vein thrombosis: 1.9%. We conclude that the most common urologic complications in our center were ureteric strictures and urine leaks, and the most common vascular complication was renal artery stenosis.

  16. Current status of robotics in urologic laparoscopy.

    Science.gov (United States)

    Gettman, Matthew T; Blute, Michael L; Peschel, Reinhard; Bartsch, Georg

    2003-02-01

    Urology has continuously embraced novel technologies like laparoscopy that reduce patient morbidity yet maintain an excellent standard of care. Because of limitations on maneuverability, operative vision, manual dexterity, and tactile sense, laparoscopy can be more difficult to perform than corresponding tasks in open surgery. To potentially increase clinical applicability of laparoscopy, robots that enhance operative performance have recently been introduced for a variety of laparoscopic procedures such as laparoscopic radical prostatectomy, pyeloplasty, and even laparoscopic cystectomy and neobladder construction. While these robots have generated excitement and many robotic applications have been described, the benefit of the advanced technology in expanded series of patients remains largely unknown. In addition, the ability of telerobotics to be used by surgeons inexperienced in conventional laparoscopy is also poorly understood. This review compares current features of available robots, advantages and limitations of robots, the emerging clinical applications, and the future potential of robotics in urology.

  17. Efficacy of biofeedback and electrical stimulation combined with drugs for chronic prostatitis/chronic pelvic pain syndrome%生物反馈电刺激联合药物治疗慢性前列腺炎/慢性骨盆疼痛综合征的临床研究

    Institute of Scientific and Technical Information of China (English)

    唐荣; 安瑞华

    2012-01-01

    目的 探讨生物反馈电刺激联合药物治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的效果.方法 符合入选标准的患者随机分为药物组(A组)、药物+生物反馈电刺激组(B组),每组25例,另单设一单纯药物治疗无效组(C组)25例.B、C两组均采用生物反馈电刺激治疗仪治疗,B组加常规药物治疗,A组应用常规药物治疗.结果 A组和B组治疗后患者的临床症状较治疗前均有显著改善(P<0.05);且B组优于A组.C组治疗后的临床症状亦较治疗前有显著改善(P<0.05).结论 生物反馈电刺激治疗能明显改善慢性前列腺炎/慢性盆底疼痛综合征患者的临床症状及性功能,且能改善药物治疗无效的顽固性前列腺炎症状.%Objective To investigate the effect of biofeedback and electrical stimulation combined with drugs on chronic prostatitis/chronic pelvic pain syndrome ( CP/CPPS). Methods Seventy five eligible patients were randomly divided into 3 groups (each 25 patients) ; group A received routine drugs, group B received biofeedback and electrical stimulation combined with ' routine drugs. Patients in group C were treated ineffectively with routine drugs,and received biofeedback and electrical stimulation therapy only. Results The clinical symptoms of patients in group A and group B after treatment were both significantly improved than before treatment (P <0.05), clinical symptoms of patients in group B were better than in group A. The clinical symptoms of patients in group C after treatment compared with that before treatment were significantly improved (P < 0. 05). Conclusion Biofeedback electrical stimulation therapy may significantly improve the clinical symptoms and sexual function of patients with chronic prostatitis/chronic pelvic pain syndrome. It also can improve the clinical symptoms of patients with refractory prostatitis who were treated ineffectively with routine drugs.

  18. Computer- and robot-assisted urological surgery

    CERN Document Server

    Troccaz, Jocelyne

    2006-01-01

    The author reviews the computer and robotic tools available to urologists to help in diagnosis and technical procedures. The first part concerns the contribution of robotics and presents several systems at various stages of development (laboratory prototypes, systems under validation or marketed systems). The second part describes image fusion tools and navigation systems currently under development or evaluation. Several studies on computerized simulation of urological procedures are also presented.

  19. Urologic manifestations of the iliacus hematoma syndrome.

    Science.gov (United States)

    Colapinto, V; Comisarow, R H

    1979-08-01

    Anticoagulated patients may have a characteristic syndrome of femoral neuropathy from an iliacus muscle hematoma. They may present with urologic signs and symptoms, including groin, flank and thigh pain, groin tenderness, an iliac fossa mass and hematuria. Urography may reveal an enlarged psoas shadow and hydronephrosis from ureteral obstruction. Prompt diagnosis is essential so that early operative decompression of the femoral nerve can be done. The urologist has an important role in the diagnosis and treatment of this syndrome.

  20. Urology on the internet - introduction and update

    OpenAIRE

    Inumpudi Anand; Srinivas, M.; A K Hemal

    2000-01-01

    The Internet, which has truly united the developed and developing nations, is an extensive network of inter-linked computers storing immense bytes of information, which can be accessed by anyone transcending all geographi-cal barriers and this has become the ultimate frontier to access information. The Urology and Andrology informa-tion on Internet is exponentially growing. The urologist need not know the intricacies of the hardware and soft-ware but can start right away navigating through th...

  1. Minimal Invasive Urologic Surgery and Postoperative Ileus

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-07-01

    Full Text Available Postoperative ileus (POI is the most common cause of prolonged length of hospital stays (LOS and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress in the future. In the field of gastrointestinal surgery, several studies had reported lower incidence rates for POI following minimal invasive surgery compared to conventional open procedures. In contrast, little is known about the effect of minimal invasive approach on the recovery of bowel motility after urologic surgery. We performed an overview of the potential benefit of minimal invasive approach on POI for urologic procedures. The mechanisms and risk factors responsible for the onset of POI are discussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radical cystectomy but it is rarely of clinical significance for other minimal invasive interventions. Laparoscopy or robotic assisted laparoscopic techniques when studied individually may reduce to their own the duration and prevent the onset of POI in a subset of procedures. The potential influence of age and urinary diversion type on postoperative ileus is contradictory in the literature. There is some evidence suggesting that BMI, blood loss, urinary extravasation, existence of a major complication, bowel resection, operative time and transperitoneal approach are independent risk factors for POI. Treatment of POI remains elusive. One of the most important and effective management strategies for patients undergoing radical cystectomy has been the development and use of enhanced recovery programs. An optimal rational strategy to shorten the duration of POI should incorporate minimal invasive approach when appropriate into multimodal fast track programs designed to reduce POI and shorten LOS.

  2. Holmium laser for multifunctional use in urology

    Science.gov (United States)

    Watson, Graham M.; Shroff, Sunil; Thomas, Robert; Kellett, Michael

    1994-05-01

    The holmium laser pulsed at 350 microsecond cuts tissue and fragments calculi. It has been assessed for minimally invasive urological intervention. It is useful for partly excising and partly coagulating tumors, incising strictures and the obstructed PUJ. It partly drill and partly fragments urinary calculi however hard. Other lasers are more effective at any one particular application, but this laser is a useful compromise as a multifunctional device.

  3. Clinical Study of Vitamin K3 Acupoint Injection In Treating Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    ZHAO Wen-jie (赵文洁); WANG Li (王莉); WENG Jian'er (翁健儿); YU Jin (俞瑾)

    2003-01-01

    @@ Pelvic pain is one of the most common symptoms in gynecologic outpatients. Primary dysmenorrhea, acute or chronic pelvic inflammatory disease, endometriosis, post-operational pelvic adhesion, blood stagnation of pelvic vein, etc., are mentioned as the often encountered causes of pelvic pain. It has been reported in the recent ten or more years that intramuscular injection of vitamin K3 (Vit K3) could relieve pain induced by smooth muscle spasm(1,2). In order to evaluate the effect of Vit K3 administered by acupoint injection in relieving pelvic pain, 180 patients were treated and observed from April 1997 to April 1999 in our hospital, and good therapeutic effect was obtained. It was reported as follows.

  4. Organising a clinical service for patients with pelvic floor disorders.

    Science.gov (United States)

    Chatoor, Dave; Soligo, Marco; Emmanuel, Anton

    2009-01-01

    The evolution of the multidisciplinary approach to the management of chronic conditions is a reflection of how medicine has evolved from a singular to a plural effort recognising the complex causations and consequences of such disorders. This thinking should not be confined to tertiary centres alone and should be adapted where local expertise is available. Such an approach is especially important in pelvic floor disorders, where the correlation between structure and function is not always straightforward. There is a need to avoid over-investigation by accurate clinical assessment allied to tailored investigation, leading to a step-wise approach to treatment (which may include behavioural, physiotherapy, medical or surgical management). The algorithms here on faecal incontinence, obstetric trauma, pelvic floor prolapse and chronic pelvic pain attempt to provide such a logical approach to patients.

  5. Haemodynamically Unstable Pelvic Fractures

    Science.gov (United States)

    2009-01-01

    through the pubic symphysis, and posteriorlywith the sacrum forming the sacroiliac (SI) joints (Fig. 1). The SI joints are the strongest in the body...Gardner MJ, Kendoff D, Ostermeier S, et al. Sacroiliac joint compression using an anterior pelvic compressor: a mechanical study in synthetic bone. J...commonly identified at arteriography.35 Posterior fracture along the SI joints may cause disruption of a main iliac trunk, but is rare, occurring less

  6. Apical vault repair, the cornerstone or pelvic vault reconstruction.

    Science.gov (United States)

    Ross, J W

    1997-01-01

    Pelvic organ prolapse remains a difficult problem for pelvic reconstructive surgery. Before new surgical procedures can be developed a good understanding of pelvic anatomy is necessary. It is widely held that the etiology of pelvic organ prolapse is secondary to stretch neuropathy following childbirth and chronic cough or constipation. Several transvaginal and transabdominal procedures have been developed over the years. With the increasing use of laparoscopy, a new variation on existing culdeplasty techniques has been developed. Following anatomical principles, the apical vault repair reestablishes the pericervical ring at the vaginal apex. The incorporation of pubocervical fascia, uterosacral-cardinal ligament and the rectovaginal fascia provides a strong anchor for the vaginal apex. In addition, the repair should help prevent future transverse cystocele, rectocele, enterocele and apical vault prolapse. Early outcome studies suggest that the apical vault repair should be used routinely with laparoscopic urethropexy, laparoscopic hysterectomy and the repair of pelvic organ prolapse. Good apical vault support is considered the cornerstone of pelvic reconstruction.

  7. Prostate and Urologic Cancer | Division of Cancer Prevention

    Science.gov (United States)

    [[{"fid":"183","view_mode":"default","fields":{"format":"default","field_file_image_alt_text[und][0][value]":"Prostate and Urologic Cancer Research Group Homepage Logo","field_file_image_title_text[und][0][value]":"Prostate and Urologic Cancer Research Group Homepage Logo","field_folder[und]":"15"},"type":"media","attributes":{"alt":"Prostate and Urologic Cancer Research Group Homepage Logo","title":"Prostate and Urologic Cancer Research Group Homepage Logo","height":"266","width":"400","clas | Conducts and supports research on the prevention and early detection of prostate, bladder, and skin cancers.

  8. Looking forward, looking back-10 years in urology.

    Science.gov (United States)

    Albersen, Maarten; Cartwright, Rufus; Choyke, Peter; Goldenberg, S Larry; Goldman, Howard; Lawrentschuk, Nathan; Linehan, W Marston; Murphy, Declan; Nagler, Harris; Scardino, Peter; Shortliffe, Linda; Stenzl, Arnulf; Theodorescu, Dan

    2014-11-01

    When Nature Reviews Urology launched in 2004, the field of urology was vastly different to that which we work in today, and the past 10 years have seen the field change immensely. As a specialty on the forefront of cutting-edge innovation, urologists are often the first to embrace new technologies and ideas. In this Viewpoint, members of the Nature Reviews Urology advisory board were asked what they thought was the most important change, issue or innovation in urology in the past 10 years, and what they expected to be the most important in the next decade. Here are their opinions.

  9. The Current State of Medical Malpractice in Urology.

    Science.gov (United States)

    Sherer, Benjamin A; Coogan, Christopher L

    2015-07-01

    Medical malpractice can present an unwelcome professional, emotional, and economic burden to the practicing urologist. To date, there is a paucity of data specific to urologic malpractice in the literature. We performed a comprehensive literature search to identify and evaluate recent studies related to urologic malpractice. We also analyzed 6249 closed urologic claims from the largest available specialty-specific data set gathered by Physician Insurers Association of America from 1985 to 2012. The resulting comprehensive review seeks to raise awareness of current trends in the malpractice environment specific to urologic surgery while also helping urologists identify opportunities for risk management and improved patient care.

  10. CT of pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Falchi, Marco E-mail: marcofalchi@yahoo.it; Rollandi, Gian Andrea

    2004-04-01

    Although magnetic resonance imaging has become the dominant modality for cross-sectional musculo-skeletal imaging, the widespread availability, speed, and versatility of computed tomography (CT) continue to make it a mainstay of emergency room (ER) diagnostic imaging. Pelvic ring and acetabular fractures occur as the result of significant trauma secondary to either a motor vehicle accident or a high-velocity fall. These injuries are correlated with significant morbidity and mortality, both from the complications of pelvic ring fractures and from commonly associated injuries. The most commonly used classification of pelvic and acetabular fractures has been based on conventional radiographs that are, in the majority of cases, sufficient to determine the type of injury. However, because of the complexity of pelvic and acetabular fractures, precise pathological anatomy is not easily demonstrated by routine radiographs and in many cases details of fractures are not visible. Moreover, the insufficient co-operation of the patient or the difficulty of maintaining special positions can be overcome by using computed tomography. Spiral computed tomography provides information regarding the extent of the fractures and is complementary to radiography for ascertaining the spatial arrangement of fracture fragments. Spiral computed tomography is an effective tool for understanding complex fracture patterns, particularly when combined with multi-planar reconstruction two-dimensional (MPR 2D) reformatted images or three-dimensional images (3D) images. Including these techniques of reconstruction in routine pelvic imaging protocols can change management in a significant number of cases. Subtle fractures, particularly those oriented in the axial plane, are better seen on MPR images or 3D volume-rendered images. Complex injuries can be better demonstrated with 3D volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily

  11. Analysis of Clinical Curative Effct of kangfuxiaoyan Suppository and Microwave Physiotherapy Combined with Antibiotics in the Treatment of Chronic Pelvic Inflam-matory Disease%康妇消炎栓及微波配合抗菌素治疗慢性盆腔炎临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    熊洪光

    2015-01-01

    Objective To study the effect and application value of kangfuxiaoyan Suppository and Microwave Physiotherapy Combined with Antibiotics on Chronic Pelvic Inflammatory Disease.Methods Selecting 120 patients with chronic pelvic inflammatory disease were divided into the observation group and control group randomly,two groups were treated with antibiotics, the observation group was treated with kangfuxiaoyan Suppository and Microwave Physiotherapy based on antibiotics treatment,observed compared and reseached the effect.Results The total effective rate of the observation group was 95%,the control group was 86.67%,the difference was statistically significant(P<0.05).Conclusions Kangfuxiaoyan Suppository and Microwave Physiotherapy combined with antibiotics is effective in treating chronic pelvic inflammatory disease and is worthy of wide application.%目的:探讨康妇消炎栓、微波、抗菌素相结合治疗慢性盆腔炎的临床效果及应用价值。方法选择该院收治的慢性盆腔炎患者120例作为研究对象,随机分为观察组和对照组,两组均使用抗菌素治疗,观察组加用康妇消炎栓和微波进行治疗,观察两组患者的临床治疗效果。结果观察组总有效率为95%,对照组总有效率为86.67%,两组比较差异有统计学意义(P<0.05)。结论应用康妇消炎栓和微波理疗协同抗菌素治疗慢性盆腔炎的疗效肯定,值得推广。

  12. Musculoskeletal etiologies of pelvic pain.

    Science.gov (United States)

    Prather, Heidi; Camacho-Soto, Alejandra

    2014-09-01

    Several musculoskeletal diagnoses are frequently concomitant with pelvic floor pathology and pain. The definition of pelvic pain itself often depends on the medical specialist evaluating the patient. Because there is variability among disorders associated with pelvic pain, patients may seek treatment for extended periods as various treatment options are attempted. Further, health care providers should recognize that there may not be a single source of dysfunction. This article discusses the musculoskeletal disorders of the pelvic girdle (structures within the bony pelvis) and their association with lumbar spine and hip disorders.

  13. What Are the Symptoms of Pelvic Pain?

    Science.gov (United States)

    ... Resources and Publications What are the symptoms of pelvic pain? Skip sharing on social media links Share this: Page Content The symptoms of pelvic pain vary from woman to woman. Pelvic pain can ...

  14. Pelvic radiation disease: Updates on treatment options

    Science.gov (United States)

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

    2015-01-01

    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  15. Preliminary Study on in Vitro Antibacterial Effect of Chronic Pelvic Inflammatory Disease Enema on 7 Kinds of Pathogenic Bacteria%慢性盆腔炎灌肠液对7种致病菌体外抗菌作用的初步研究

    Institute of Scientific and Technical Information of China (English)

    黄涛阳; 陈龙浩; 王晖; 欧小龙; 翁燕君; 谢新民

    2014-01-01

    目的:观察慢性盆腔炎灌肠液的体外抗菌作用。方法用平皿二倍稀释法测定慢性盆腔炎灌肠液对大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、化脓性链球菌、凝固酶阴性葡萄球菌、伤寒沙门杆菌、福氏志贺杆菌7种细菌的最小抑菌浓度( MIC)及最低杀菌浓度( MBC)。结果慢性盆腔炎灌肠液对大肠埃希菌、金黄色葡萄球菌有较明显的抑菌活性,对化脓性链球菌、伤寒沙门杆菌、福氏志贺杆菌有一定的抑菌活性,对铜绿假单胞菌、凝固酶阴性葡萄球菌的体外抑菌活性不明显。结论慢性盆腔炎灌肠液具有一定的体外抑菌活性,现时的药物浓度为最适合的药物浓度。%Objective To observe the in vitro antibacterial effect of chronic pelvic inflammatory disease enema. Methods The minimal inhibitory concentration( MIC) and the minimum bactericidal concentration( MBC) of chronic pelvic inflammatory disease enema on 7 kinds of bacteria Escherichia coli,Pseudomonas aeruginosa,Staphylococcus aureus,Streptococcus pyogenes,coagulase negative staphylococ-ci,typhoid Salmonella and Shigella flexneri bacilli were detected by using the two - fold agar dilution method. Results Chronic pelvic inflammatory disease enema had obvious antibacterial activity against Escherichia coli and Staphylococcus aureus,certain antibacterial ac-tivity against Streptococcus pyogenes,typhoid Salmonella and Shigella flexneri bacilli and unobvious antibacterial activity against Pseu-domonas aeruginosa and coagulase negative staphylococci. Conclusion Chronic pelvic inflammatory disease enema has certain antibacte-rial activity in vitro,the current drug concentration is the most suitable drug concentration.

  16. Treatment of Pelvic Ring Fractures with Pelvic Circumferential Compression Divices

    NARCIS (Netherlands)

    S.P. Knops (Simon)

    2014-01-01

    markdownabstract__Abstract__ High energy pelvic fractures are life-threatening injuries and are among the most challenging injuries to treat. Complete evaluation of the patient with a high energy pelvic fracture is essential because this is rarely an isolated injury. Most deaths in patients with pe

  17. [The William P. Didusch Center for Urologic History of the American Urological Association: new exciting approaches in presenting urologic history, not only in the USA - a personal guided tour].

    Science.gov (United States)

    Engel, R M

    2011-04-01

    The Didusch Center for Urologic History encompasses a rich and varied collection of drawings, photographs, and instruments of historical importance to urology, many displayed in the urological exhibits during the American Urological Association (AUA) conventions. The Center also houses a library devoted to urological and early medical texts and the AUA archives and is the institution of research in all fields of urologic history in the USA. The museum collection features most of Didusch's original drawings, as well as an impressive instrument collection acquired primarily through donations by urologists. The original William P. Didusch Museum (now known as the William P. Didusch Center for Urologic History) was originally housed in the AUA's Baltimore City headquarters building. Upon the association's move to Linthicum, MD in 2003, the museum has evolved into the William P. Didusch Center for Urologic History and taken on new tasks and responsibilities that include the topic of research in urologic history.

  18. Urological disorders and pregnancy: An overall experience

    Directory of Open Access Journals (Sweden)

    Debasmita Mandal

    2017-01-01

    Full Text Available Aim: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems. Materials and Methods: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. All pregnant women with urological problems were included as subjects. Results: A total of 33 subjects were followed up throughout their antenatal period. Among them majority (72.72% presented with hydro nephrosis followed by hydroureter (60.6%, PUJ obstruction and pyelonephritis each with incidence of 15.15%, then urolithiasis (12.12%, nephrolithiasis (6.06% and renal abscess (12.12%. Interventions required were DJ stenting (72.72%, pyeloplasty (15.15% and others were RURSL, abscess drainage and ATT. The pregnancy outcome was complicated with preterm labor in majority of patients (45.45%, oligohydramnious (18.18%, PIH (9.09% and still birth (6.06%. Twenty four live birth were there. Majority required NICU admissions as predominantly prematurity was an important concern. Majority women with hydronephrosis underwent DJ stenting. Conclusion: Preterm labor is an important obstetric concern. Vaginal delivery is the choicest mode of termination and LSCS can be reserved for obstetric reason. DJ stenting is safe and practical approach for continuation of pregnancy with hydronephrosis. Regular follow up, vigilant antenatal care and multidisciplinary approach from urologist, obstetrician and neonatologist will bring out successful pregnancy outcome.

  19. Urological disorders and pregnancy: An overall experience

    Science.gov (United States)

    Mandal, Debasmita; Saha, Mriganka Mouli; Pal, Dillip Kumar

    2017-01-01

    Aim: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems. Materials and Methods: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. All pregnant women with urological problems were included as subjects. Results: A total of 33 subjects were followed up throughout their antenatal period. Among them majority (72.72%) presented with hydro nephrosis followed by hydroureter (60.6%), PUJ obstruction and pyelonephritis each with incidence of 15.15%, then urolithiasis (12.12%), nephrolithiasis (6.06%) and renal abscess (12.12%). Interventions required were DJ stenting (72.72%), pyeloplasty (15.15%) and others were RURSL, abscess drainage and ATT. The pregnancy outcome was complicated with preterm labor in majority of patients (45.45%), oligohydramnious (18.18%), PIH (9.09%) and still birth (6.06%). Twenty four live birth were there. Majority required NICU admissions as predominantly prematurity was an important concern. Majority women with hydronephrosis underwent DJ stenting. Conclusion: Preterm labor is an important obstetric concern. Vaginal delivery is the choicest mode of termination and LSCS can be reserved for obstetric reason. DJ stenting is safe and practical approach for continuation of pregnancy with hydronephrosis. Regular follow up, vigilant antenatal care and multidisciplinary approach from urologist, obstetrician and neonatologist will bring out successful pregnancy outcome. PMID:28216926

  20. Efficacy of transvaginal biofeedback and electrical stimulation in women with urinary urgency and frequency and associated pelvic floor muscle spasm.

    Science.gov (United States)

    Bendaña, Emma E; Belarmino, James M; Dinh, Jenny H; Cook, Cynthia L; Murray, Brian P; Feustel, Paul J; De, Elise J B

    2009-01-01

    Women with urinary urgency and frequency may also have pelvic floor muscle spasm. Transvaginal biofeedback (TVBF) and electrical stimulation (EStim) is a treatment modality that has been used to treat vaginismus and chronic pelvic pain. In this study, TVBF/EStim was evaluated in women with pelvic floor muscle spasm associated with urinary symptoms. Fifty-two women underwent therapy with TVBF/EStim and reported a mean symptom improvement of 64.5%.

  1. [Management of brain metastases from urological malignancies].

    Science.gov (United States)

    Gaillard, S; Lebret, T; Scarone, P; Lepeintre, J-F; Méjean, A; Aldea, S

    2008-11-01

    Brain metastases account for 30 to 40% of all brain tumors in adults. Even if urological carcinomas are not very common, anti-angiogenic drugs have transformed their prognosis, leading physicians to consider their specific treatment. For the majority of cases, surgery is quite simple with low associated morbidity. Depending on the size and the location, surgery or stereotaxic radiotherapy should be discussed. As soon as the metastasis is suspected a neurosurgerical opinion must be sought before beginning any treatment to coordinate the global management.

  2. [German Urological Associations under National Socialism].

    Science.gov (United States)

    Krischel, M; Moll, F; Fangerau, H

    2011-09-01

    The Deutsche Gesellschaft für Urologie (German Urological Association), established in 1907, was a German-Austrian medical society in which Jewish physicians held important positions. When the Nazis seized power in 1933, the Austrian Hans Rubritius was president of the society. The non-German presidency and the exclusion of Jewish colleagues from the professional society and medical practice led to a halt of the society's activities. At the same time in the mid 1930s, German urologists founded the Gesellschaft Reichsdeutscher Urologen (Association of Reichs-German Urologists) whose members aligned themselves with Nazi health policies and in turn received professional and personal benefits.

  3. 21 CFR 876.5130 - Urological catheter and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological catheter and accessories. 876.5130 Section 876.5130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5130...

  4. Feasibility and acceptability of couple counselling and pelvic floor muscle training after operation for prostate cancer

    DEFF Research Database (Denmark)

    Karlsen, Randi V; E Bidstrup, Pernille; Hvarness, Helle

    2017-01-01

    BACKGROUND: Radical prostatectomy is often followed by long-lasting erectile dysfunction and urinary incontinence, with adverse effects on the quality of life and intimate relationship of patients and partners. We developed the ProCan intervention to ameliorate sexual and urological dysfunction......Can intervention, which consists of up to six couple counselling sessions, group instruction in pelvic floor muscle training (PFMT), up to three individual PFMT sessions and a DVD home training program. We examined its feasibility on the basis of the recruitment rate, adherence to and acceptability...

  5. [Hemophilic pelvic pseudotumor].

    Science.gov (United States)

    Castro-Boix, Sandra; Pradell-Teigell, Jordi; Boqué-Genovard, Ramón; Zanón-Navarro, Vicente; Nadal-Guinard, Antoni; Altisent-Roca, Carme; Armengol-Carrasco, Manel

    2007-02-01

    Surgery in hemophilic patients is a challenge for the general surgeon. Hemophilic pseudotumor is a rare complication occurring in 1-2% of hemophiliacs and affecting mainly patients with severe disease or those who have developed antibodies to factor VIII or IX. A number of alternatives are available for the management of these tumors, including conservative treatment, surgical removal, percutaneous drainage, embolization, and external radiation. The only definitive treatment is surgical excision. We report a case of hemophilic pseudotumor of the pelvic bone. Treatment consisted of surgical resection after arterial embolization using factor replacement to achieve hemostasis.

  6. Laparoscopy for pelvic floor disorders.

    Science.gov (United States)

    Van Geluwe, B; Wolthuis, A; D'Hoore, A

    2014-02-01

    Surgical treatment of pelvic floor disorders has significantly evolved during the last decade, with increasing understanding of anatomy, pathophysiology and the minimally-invasive 'revolution' of laparoscopic surgery. Laparoscopic pelvic floor repair requires a thorough knowledge of pelvic floor anatomy and its supportive components before repair of defective anatomy is possible. Several surgical procedures have been introduced and applied to treat rectal prolapse syndromes. Transabdominal procedures include a variety of rectopexies with the use of sutures or prosthesis and with or without resection of redundant sigmoid colon. Unfortunately there is lack of one generally accepted standard treatment technique. This article will focus on recent advances in the management of pelvic floor disorders affecting defecation, with a brief overview of contemporary concepts in pelvic floor anatomy and different laparoscopic treatment options.

  7. Management of pelvic organ prolapse.

    Science.gov (United States)

    Ahmed, Faisal; Sotelo, Tiffany

    2011-12-01

    Symptomatic pelvic organ prolapse can afflict up to 10% of women. Urinary incontinence, voiding dysfunction or difficulty possibly related to bladder outlet obstruction are common symptoms. Infrequently hydronephrosis or defecatory dysfunction can be seen. The management of pelvic organ prolapse (POP) should start with adequate assessment of all pelvic floor complaints. If a patient is not symptomatic, surgical intervention is usually not indicated. While the use of a variety of graft materials are available today including porcine, dermal and synthetic grafts, that are used in some surgical approaches to pelvic organ prolapse, other more conservative approaches may prove beneficial to many patients. This article describes our approach to the patient with pelvic organ prolapse.

  8. Clinial study on external electric heat theropy with shortwave plus the theropy of enema with Chinese herbs on chronic pelvic inflammation%体外短波电场热疗配合中药灌肠治疗慢性盆腔炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    潘小清; 何燕芳; 王坚; 周大庆; 李文刚

    2011-01-01

    Objective To discuss clinical effects of external electric heat theropy with shortwave plus the theropy of enema with Chinese herbs on patients with chronic pelvic inflammation. Methods Ninety cases with chronic pelvic inflammation were divided into 3 groups : control group 1 with Chinese herbs , control group 2 treated by external electric heat treatment with shortwave and treatment group by external electric heat theropy with shortwave plus the theropy of enema with Chinese herbs (30 cases in each). The clinical effects in each g roup were evaluated by clinical examination and results of B ultrasound. Results The effective rate in treatment group was higher than that in control group 1 and group 2, the extinctive rate of pelvic inflammatory mass in treatment group was significantly higher than that in control groups (P< 0.05). There was no obvious toxic and side effects. Conclusions Effects of external electric heat theropy with shortwave plus the theropy of enema with Chinese herbs on chronic pelvic inflammation is significant and this theropy is worthy of doing futher reseaches.%目的:探讨体外短波电场热疗配合中药灌肠治疗慢性盆腔炎的临床疗效.方法:观察慢性盆腔炎的患者90例,随机分为3组,每组30例,即中药组,短波热疗组,体外电场热疗配合中药灌肠治疗组(中药组+短波热疗组).给予体外短波电场热疗、中药灌肠治疗,采用临床查体及B超检查评定临床疗效.结果:中药组+短波热疗组总有效率显著高于中药组、短波热疗组,盆腔炎性肿块消退率显著高于对照组(P<0.05);各组均无明显的毒副作用.结论:采用体外短波电场热疗配合中药灌肠治疗慢性盆腔炎,临床疗效显著,值得进一步研究探讨.

  9. Post-traumatic pelvic deformity with old injuries of rectum and urogenital tract: 18-year follow-up

    Directory of Open Access Journals (Sweden)

    A. V. Runkov

    2015-01-01

    Full Text Available The authors described a case of management the severe combined pelvis trauma in female patient with 18 years follow-up. At the age of seven, the patient was injured: the open vertical unstable pelvis injury with severe damage of urogenital tract and rectum. Numerous operations on the pelvic organs without surgical treatment of pelvic ring fractures were accompanied by complications. At the age of 21 (14 years later the patient was subjected to the surgery according to the techniques designed in the Chaklin Ural Scientific Research Institute of Traumatology and Orthopaedics: percutaneous osteotomy of posterior and anterior pelvis, external pelvis fixation using circular device with a further gradual (within 1.5 months correction of the deformity with apparatus and subsequent internal fixation with screws. There were achieved partially elimination of shortening of the right lower limb, correction of the pelvic ring form, increasing the pelvic cavity volume, elimination of vaginal impingement, that allowed to correct urological problems with the possibility of further recovery of the vagina and hip replacement surgery. This case showed that the management of patients with complicated pelvis injuries required a multidisciplinary approach: emergency fixation of the unstable injuries and application of techniques to correct long-standing pelvis deformities to restore stability and shape of the pelvic ring, which created the more favorable conditions for reconstructive surgery of the pelvic organs.

  10. Emerging role of robotics in urology

    Directory of Open Access Journals (Sweden)

    Kumar Rajeev

    2005-01-01

    Full Text Available Robotic assistance is one of the latest additions to the field of laparoscopic surgery. The most commonly used robotic device in Urology is the da Vinci ® system of which over 200 devices are installed worldwide including 3 in India. This robot consists of three or four arms, one of which is used to hold and manipulate the laparoscopic camera while the others are used to manipulate specialized laparoscopic instruments with endowrist ® technology that allows 7 degrees of freedom. The robot is currently used primarily for radical prostatectomies where complex dissection and reconstruction can be performed in less than 2 hours with excellent outcomes. There is a progressive increase in the number of surgeries being performed by this device which allows laparoscopy naοve surgeons to offer the benefits of minimally invasive surgery to their patients. The other surgeries where this device has been used to benefit are pyeloplasty, cystectomy with urinary diversion, nephrectomy and ureteric re-implant. The principal drawbacks of the device are the steep cost of machine and disposables. However, the benefits achieved in terms of improved surgical precision, magnified 3 dimensional vision, scaling of movements, remote surgery and as a teaching tools will help the robot establish a definitive place in the urologic armamentarium.

  11. Integrated visualization of problemcentric urologic patient records.

    Science.gov (United States)

    Bui, Aleex A T; Taira, Ricky K; Churchill, Bernard; Kangarloo, Hooshang

    2002-12-01

    The collision of computer-based technologies and the medical environment is resulting in an increasingly electronic multimedia patient record, consisting of not only the traditional types of data (e.g., clinic notes and laboratory reports), but also digital images (e.g., computed tomography and magnetic resonance imaging) and other visual representations of patient data (e.g., pulmonary function graphs and urodynamic charts). Given the increasing amount of data made available to physicians, it is not only critical that the totality of a patient's medical record be accessible to a clinician, but that the diverse data be integrated and presented in a manner conducive to patient management: key information should be easily discovered. This paper describes a problemcentric time-based visualization of urologic conditions, whereby a patient's medical history is automatically organized around a medical problem and presented as a graphic chronology. Urology-related data in the patient medical record is organized in accord with an expert constructed knowledge-base, and plotted on a timeline using iconic representations. The user interface permits the physician to quickly view multimedia data and to visualize relationships between events in the patient's history.

  12. Current status of laser applications in urology

    Science.gov (United States)

    Knipper, Ansgar; Thomas, Stephen; Durek, C.; Jocham, Dieter

    1993-05-01

    The overall development of laser use in urology is recessing. The reasons are the refinement of methods of radical surgery and the continuing development of alternative technologies involving electric current. Taking the cost factor into account, are lasers still opportune in medicine? The answer is definitely yes. Cost reduction in medical practice without quality loss is only possible with effective methods of minimally invasive surgery. Continuing investigation of cutting, welding, coagulating and ablating instruments is justified. Competition of lasers to other technologies can only be beneficial to the cause. But where are the highlights of laser applications? The unsurpassed utilization of optical properties of lasers lie in the concept of photodynamic therapies and in optical feedback mechanisms for laser applications. The combination of lasers with three dimensional visualization of the treatment area by ultrasound (TULIP-procedure for benign prostatic hyperplasia) is a novel approach in laser application. The further development of these treatment modalities will reveal the true benefit of laser technology in urological applications.

  13. Application of CUA Guidelines on Prostatitis in the management of chronic pelvic pain syndrome: A nationwide survey%泌尿男科医师应用《CUA前列腺炎诊断治疗指南》诊疗CPPS的调查

    Institute of Scientific and Technical Information of China (English)

    张凯; 白文俊; 商学军; 肖云翔; 刘继红; 李铮; 邓春华; 王怀鹏

    2013-01-01

    目的:了解中华医学会泌尿外科学分会(CUA)《前列腺炎诊断治疗指南》(以下简称《指南》)的推广和应用效果,及其对我国泌尿男科医师诊断、治疗CPPS的观念和实践的影响. 方法:在全国21个城市173家医院泌尿男科发放问卷,回收问卷后,对有效问卷进行统计分析. 结果:发放问卷1056份,回收有效问卷851份(80.6%).答卷者中,71.6%来自三级医院,高级和中级职称的医师占80.7%,97.5%的医师学习过《指南》.绝大多数医师认同Ⅲ型前列腺炎是一种临床综合征,诊断需要排除其他引起类似症状的疾病,治疗目标是缓解疼痛、改善排尿症状、提高生活质量.在学过或没学过指南的医师中,对部分观点的认同也有差异.在临床实际工作中,泌尿男科医师给CPPS患者最常选用的治疗方法(多选)是心理治疗(80.7%)、药物治疗(80.4%)、调整生活方式(79.6%);最常用的前3类药物是植物药(80.0%)、α受体阻滞剂(68.9%)和抗生素(61.0%). 结论:CUA《前列腺炎诊断治疗指南》得到了广泛的推广,其主要内容得到了深入的领会和应用,推动了我国泌尿男科医师规范化诊治CPPS的进程.%Objective: To investigate the application of the Chinese Urological Association (CUA) Guidelines on Prostatitis and its effects on the clinical practice patterns of diagnosing and treating chronic pelvic pain syndrome (CPPS) among Chinese urologists and andrologists. Methods; We conducted a questionnaire investigation on the application of the CUA Guidelines on Prostatitis among the urologists and andrologists of 173 hospitals in 21 cities of China, and performed statistical analyses on all the eligible questionnaires collected. Results: Of the 1 056 questionnaires distributed, 851 (80. 6% ) were eligible, of which 71. 6% were from the urologists or andrologists in grade 3 hospitals, 80. 7% of them with senior or intermediate professional titles and 97

  14. Results of pelvic exenteration in a woman for cancers and radiotherapy complications

    Directory of Open Access Journals (Sweden)

    V. R. Latypov

    2015-03-01

    Full Text Available This investigation was conducted in women with small pelvic involvements. Thirty-five case reports were analyzed; treatment results were known in 33 (94.3 % patients. The patients» age was 55.9 (34-82 years. According to the source of the pathological process, there were 3 patient groups: gynecological, urological, and colorectal. The basic surgical procedure was anterior or total pelvic exenteration. The specific features of all cases were locally advanced tumors, recurrences, and complications due to performed treatment (radiotherapy for cancer of the cervix uteri. Surgical treatment was feasible in all cases; in this case bleeding was arrested, pain syndrome was relieved, and urination and defecation control was restored. 

  15. [Contraception and pelvic infection in women].

    Science.gov (United States)

    Keith, L; Berger, G S; Brown, E R

    1986-01-01

    Although sexually transmitted diseases are a major public health problem at the international level, the relationship between contraception and pelvic infection is seldom examined. Numerous STDs are more difficult to diagnose, more frequent, and more serious in women than in men. Differential diagnosis between pelvic infection and other intraabdominal syndromes has been a concern for practitioners for years, and many pelvic infections are probably never diagnosed. Lower abdominal pain and sensitivity as well as fever, leucocytosis, accelerated sedimentation rate, inflammatory annexial mass evident on sonography, and microorganisms in the pouch of Douglass and presence of leucocytes in the peritoneal fluid are diagnostic criteria. Apart from errors in treatment resulting from errors in diagnosis, pelvic infections are often inadequately treated, especially in the initial phase before symptoms are confirmed. The exact incidence of pelvic infections in the US is unknown, but pelvic inflammatory disease (PID) accounted for over 200,000 hospitalizations per year between 1970-75. PID carries grave risks of subsequent ectopic pregnancy, chronic pelvic pain, and infertility which is more likely as the number of acute episodes increases. The female genital tract has diverse microenvironments propitious for growth of microorganisms of different types, aerobic and anaerobic. Each anatomic site has specific features conditioning bacterial growth. Histological modifications during the menstrual cycle and pregnancy affect the microbial flora. Except in the case of gonorrhea, it is not known how many female lower genital tract infections spread to the upper tract. Since 1970, several studies have domonstrated a growing diversity of cervical and vaginal flora in asymptomatic subjects. The principal risk factors for PID have been well described in the literature. All contraceptive methods except the IUD provide some degree of protection against PID. Even among IUD users the risk of

  16. Clinical observation on treating 80 cases of chronic pelvic inflammatory disease in TCM enteroclyster plus deep-part thermotherapy%中药配合深部热疗治疗慢性盆腔炎80例临床观察

    Institute of Scientific and Technical Information of China (English)

    申素峰; 冯秋霞

    2013-01-01

    Objective:To investigate the clinical effect of TCM enteroclyster combined with deep-part thermotherapy in treating chronic pelvic inflammatory disease. Methods: 156 patients were randomly divided into the TCM enteroclyster group and TCM enteroclyster plus deep-part thermotherapy group. Results: The clinical efficacy in the TCM enteroclyster plus deep-part thermotherapy group was significantly better than that in the TCM enteroclyster group. Conclusion:TCM enteroclyster plus deep-part thermotherapy was significantly effective on chronic pelvic inflammatory disease, worthy of a wide clinical application.%  目的:探讨中药灌肠加深部热疗对慢性盆腔炎的治疗效果。方法:对我院收治的156例慢性盆腔炎患者随机分为中药灌肠组和中药灌肠加深部热疗组。结果:中药灌肠加深部热疗组临床疗效明显高于单纯中药灌肠组,P<0.05差异有显著性。结论:中药灌肠加深部热疗对慢性盆腔炎治疗效果良好,值得临床推广。

  17. Post Pelvic Radiotherapy Bony Changes

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Seung Jae [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-03-15

    There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as 8.2{approx}20% after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

  18. Study on treatment of chronic prostatitis/chronic pelvic pain syndrome using stepwise therapy(report of 147 cases)%阶梯式治疗慢性前列腺炎/慢性盆底疼痛综合征的疗效观察(附147例报告)

    Institute of Scientific and Technical Information of China (English)

    李青; 刘俊敏; 李明川

    2011-01-01

    Objective To evaluate the treatment of chronic prostatitis/chronic pelvic pain syndrome using stepwise therapy.Methods A total of 271 patients were assessed by the NIH-CPSI and SGA.The sequence modality therapy was as follow: antibiotics, anti-inflammatory phytotherapy, α -blockers and antianxiety &antidepressant.Results Mean age of patients was 42 years old and median symptom history was 1.6 years.Based on results of bacterial culture and routine examination of urine and prostatic fluid, 11.8% of the cases were type Ⅱ prostatitis, other 88.2% were type Ⅲ prostatitis including 42.4% type Ⅲa and 45.8% Ⅲb.The score on the NIH-CPSI were changed from (23.2±5.6) to (12.5±8.7) (P<0.001).Based on SGA score, 82% of the cases were better,12% were the same and 6% were worse.Conclusion Stepwise modality therapy with antibiotics, anti-inflammatory phytotherapy, α -blockers and antianxiety & antidepressant was effective for treatment of most patients with chronic prostatitis/chronic pelvic pain syndrome.%目的 探索慢性前列腺炎/慢性盆底疼痛综合征的阶梯式治疗手段的结果.方法 全部147例病人使用慢性前列腺炎症状积分指数(NIH-CPSI)评分和SGA(全球主观症状评估)评分进行评估,治疗方法依次为:抗生素、抗炎药、α受体阻滞剂和抗焦虑抑郁药.结果 患者平均年龄42岁,病程平均1.6年.根据尿与前列腺液的培养和常规检查,11.8%为Ⅱ型前列腺炎;另外88.2%是Ⅲ型前列腺炎,这其中42.4%属于Ⅲa,其余45.8%属于Ⅲb.这些病人(147例)的NIH-CPSI评分从最初的(23.2±5.6)下降到(12.5±8.7)(P<0.001),根据SGA评分,其中82%为好转,12%无变化,6%恶化.结论 阶梯式应用抗生素、抗炎药、α受体阻滞剂和抗焦虑抑郁药可以成功地治愈绝大多数的慢性前列腺炎/慢性盆底疼痛综合症的病人.

  19. [The demographic development in Germany : challenge and chances for urology].

    Science.gov (United States)

    Schneider, A W; Fichtner, J

    2014-08-01

    Urology is affected by the demographic development in Germany more than any other medical discipline. Despite a relatively stable total population, by the year 2040 there will be an absolute and relevant increase in urological diseases caused only by the demographic development in the population. This is particularly true for the increase in oncological treatment just in the field of the discipline of urology. Even now the current numbers for tumor development in Germany (RKI 2014) in the urological oncology segment of all tumor diseases show an increasing trend with more than 23 %. This significant increase in performance is in contrast to the age development of the specialists in this discipline. In total but especially due to the significantly over-aged specialist medical profession in urology, this leads to a substantial bottleneck of specialists in the discipline of urology. This deficiency of personnel resources in urology is aggravated by the requirements of Generation Y for a well-adjusted work-life balance and the associated feminization of the medical profession. This requires intelligent strategies for.

  20. How to develop a simulation programme in urology.

    Science.gov (United States)

    Ahmed, Kamran; Amer, Tarik; Challacombe, Ben; Jaye, Peter; Dasgupta, Prokar; Khan, Mohammad Shamim

    2011-12-01

    What's known on the subject? and What does the study add? Inanimate trainers and simulators have been shown to facilitate the skill acquisition of urologists. However, there are significant challenges to integrating standalone simulation programmes into mainstream urology curricula. This study provides a framework to overcome these challenges and discusses the advantages of centralised urology simulation centres and their potential to serve as key adjuncts in the certification and validation process of urologists. Fixed performance-based outcomes of inanimate trainers and simulators have been praised as useful adjuncts in urology for reducing the learning curve associated with the acquisition of new technical and non-technical skills without compromising patient safety. Simulators are becoming an integral part of the urology training curriculum and their effectiveness is totally dependent on the structure of the programme implemented. The present paper discusses the fundamental concepts of centralized urology centres and their potential to serve as key adjuncts in the certification and validation process of urologists. In summary, proficiency-based curricula with well structured endpoints and objective tools for validating proficiency are critical in developing a simulation programme in urology. We concludes that more educational research into the outcomes of integrated urology curricula followed by trainee/trainer opinion surveys will help address some of these criteria.

  1. Use of Botulinum Toxin in Urologic Diseases.

    Science.gov (United States)

    Chermansky, Christopher J; Chancellor, Michael B

    2016-05-01

    OnabotulinumtoxinA (onaBoNTA) is approved by the US Food and Drug Administration for the treatment of urinary incontinence due to neurogenic detrusor overactivity and for the treatment of refractory overactive bladder. As a treatment for benign prostatic hyperplasia, onaBoNTA showed no difference over placebo in recently published studies. In contrast, treating interstitial cystitis/bladder pain syndrome with onaBoNTA has shown efficacy, and the current American Urological Association guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome lists onaBoNTA as fourth-line treatment. This comprehensive review will present all studied applications of onaBoNTA within the lower urinary tract.

  2. Medical treatments for endometriosis-associated pelvic pain.

    Science.gov (United States)

    Zito, Gabriella; Luppi, Stefania; Giolo, Elena; Martinelli, Monica; Venturin, Irene; Di Lorenzo, Giovanni; Ricci, Giuseppe

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  3. Medical Treatments for Endometriosis-Associated Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Gabriella Zito

    2014-01-01

    Full Text Available The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  4. Pelvic actinomycosis and usage of intrauterine contraceptive devices.

    Science.gov (United States)

    Kelly, J; Aaron, J

    1982-01-01

    Pelvic inflammatory disease (PID) is one of the most commonly encountered serious infectious disease entities in gynecology. The past decade has witnessed many advances in our understanding of the pathogenesis of PID. It is now evident that such pelvic infections are largely polymicrobial in origin, with major involvement by anaerobic organisms. Salpingo-oophoritis is a part of the spectrum of PID. Included among this group of infections are tubo-ovarian abscesses, traditionally referred to as either gonococcal or non-gonococcal in origin. Within the latter group of infections the importance of anaerobic organisms has also been elucidated. Of particular interest is the reported observation of an increased frequency of salpingo-oophoritis among users of intrauterine devices (IUDs). These reports have noted the specific occurrence of serious pelvic infections due to Actinomyces species, and this will be the topic of the infectious disease conference. Our patient presented with a chronic illness characterized by lethargy, back pain, fever, and anemia; subsequently evaluation disclosed the presence of a large pelvic mass which was confirmed as a tubo-ovarian abscess at surgery. Histological evaluation demonstrated involvement by Actinomyces species. This patient's illness is discussed as a complication of chronic IUD usage with reference to specific management for this emerging problem.

  5. The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

    Science.gov (United States)

    Wagenlehner, Florian; Tandogdu, Zafer; Bartoletti, Riccardo; Cai, Tommaso; Cek, Mete; Kulchavenya, Ekaterina; Köves, Béla; Naber, Kurt; Perepanova, Tamara; Tenke, Peter; Wullt, Björn; Bogenhard, Florian; Johansen, Truls Erik Bjerklund

    2016-01-01

    The Global Prevalence of Infections in Urology (GPIU) study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI). Investigators registered data through a web-based application (http://gpiu.esiu.org/). Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years. PMID:26797640

  6. The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

    Directory of Open Access Journals (Sweden)

    Florian Wagenlehner

    2016-01-01

    Full Text Available The Global Prevalence of Infections in Urology (GPIU study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI. Investigators registered data through a web-based application (http://gpiu.esiu.org/. Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years.

  7. [William P. Didusch. Pioneer of modern scientific illustrations for visualization in urology].

    Science.gov (United States)

    Görgen, A; Moll, F H; Engel, R; Fangerau, H

    2010-06-01

    Bill Didusch was one of the most influential illustrators in American urology. His biography is of great importance not only because of his artistic achievements, but also the work he has accomplished in the service of the American Urological Association. He founded a museum of urological artifacts that bears his name. The article reflects Didusch's biography and emphasizes his impact on American urology and urological illustration as an integral part of visualisation in medicine.

  8. Urological aspects of HIV and AIDS.

    Science.gov (United States)

    Heyns, Chris F; Smit, Shaun G; van der Merwe, André; Zarrabi, Amir D

    2013-12-01

    The use of highly active antiretroviral therapy (HAART) in HIV-infected people has led to a dramatic decrease in the incidence of opportunistic infections and virus-related malignancies such as non-Hodgkin lymphoma and Kaposi sarcoma, but not cervical or anal cancer. Advanced-stage cervical cancer is associated with a high incidence of urological complications such as hydronephrosis, renal failure, and vesicovaginal fistula. Adult male circumcison can significantly reduce the risk of male HIV acquisition. Although HAART does not completely eradicate HIV, compliance with medication increases life expectancy. HIV infection or treatment can result in renal failure, which can be managed with dialysis and transplantation (as for HIV-negative patients). Although treatment for erectile dysfunction--including phosphodiesterase 5 inhibitors, intracavernosal injection therapy, and penile prosthesis--can increase the risk of HIV transmission, treatment decisions for men with erectile dysfunction should not be determined by HIV status. The challenges faced when administering chemotherapy to HIV-infected patients with cancer include late presentation, immunodeficiency, drug interactions, and adverse effects associated with compounded medications. Nonetheless, HIV-infected patients should receive the same cancer treatment as HIV-negative patients. The urologist is increasingly likely to encounter HIV-positive patients who present with the same urological problems as the general population, because HAART confers a prolonged life expectancy. Performing surgery in an HIV-infected individual raises safety issues for both the patient (if severely immunocompromised) and the surgeon, but the risk of HIV transmission from patients on fully suppressive HAART is small.

  9. Surgery for Pelvic Organ Prolapse

    Science.gov (United States)

    ... organs. Targeting specific symptoms may be another option. Kegel exercises may be recommended in addition to symptom- ... Inability to control bodily functions such as urination. Kegel Exercises: Pelvic muscle exercises that assist in bladder ...

  10. Pharmacologic attenuation of pelvic pain in a murine model of interstitial cystitis

    Directory of Open Access Journals (Sweden)

    Schaeffer Anthony J

    2009-11-01

    Full Text Available Abstract Background Interstitial cystitis/painful bladder syndrome (IC/PBS is a bladder disease that causes debilitating pelvic pain of unknown origin, and IC/PBS symptoms correlate with elevated bladder lamina propria mast cell counts. Similar to IC/PBS patients, pseudorabies virus (PRV infection in mice induces a neurogenic cystitis associated with bladder lamina propria mast cell accumulation and pelvic pain. We evaluated several drugs to determine the effectiveness of reducing PRV-induced pelvic pain. Methods Neurogenic cystitis was induced by the injection of Bartha's strain of PRV into the abductor caudalis dorsalis tail base muscle of female C57BL/6 mice. Therapeutic modulation of pelvic pain was assessed daily for five days using von Frey filament stimulation to the pelvic region to quantify tactile allodynia. Results Significant reduction of PRV-induced pelvic pain was observed for animals treated with antagonists of neurokinin receptor 1 (NK1R and histamine receptors. In contrast, the H1R antagonist hydroxyzine, proton pump inhibitors, a histamine receptor 3 agonist, and gabapentin had little or no effect on PRV-induced pelvic pain. Conclusion These data demonstrate that bladder-associated pelvic pain is attenuated by antagonists of NK1R and H2R. Therefore, NK1R and H2Rrepresent direct therapeutic targets for pain in IC/PBS and potentially other chronic pain conditions.

  11. Functional anatomy of pelvic floor

    OpenAIRE

    Salvatore Rocca Rossetti

    2016-01-01

    Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its mul...

  12. Salpingitis and pelvic inflammatory disease.

    Science.gov (United States)

    Swinker, M L

    1985-01-01

    Chlamydia trachomatis is becoming an increasingly important etiologic agent. The physician must also be aware of other nongonococcal causes of pelvic inflammatory disease, such as Mycoplasma, Ureaplasma, coliforms and anaerobes. Epidemiologic characteristics of the various microorganisms differ, with the frequency of nongonococcal disease higher in older women. Intrauterine devices increase the potential for pelvic inflammatory disease. The rising incidence of nongonococcal and dual infections has led to therapeutic and preventive techniques aimed at multiple etiologies.

  13. Pharmaceutical screening of the effective fraction from Smilax for treatment of chronic pelvic inflammatory disease%菝葜治疗慢性盆腔炎有效部位的药效学筛选研究

    Institute of Scientific and Technical Information of China (English)

    马云; 罗艳琴; 宋路遥; 秦飞; 侯连兵

    2013-01-01

    Objective To determine the effective fraction of Smilax for treatment of chronic pelvic inflammatory disease (CPID) by pharmacodynamic screening as the basis for further development of sarsaparilla preparations. Methods The chemical fractions of Smilax were administered intragastrically in rat models of CPID induced by injecting phenol mucilage into the uterus to observe the therapeutic effects. The anti-inflammatory effects of different extract fractions from Smilax were tested in mice with xylene-induced ear edema and in rats with cotton-ball-induced granuloma. Results High-dose ethyl acetate extract of Smilax could obviously inhibit uterus inflammation in rats with CPID, showing also strong anti-inflammatory effects against ear edema in mice and granuloma in rats (P<0.01). The moderate dose of ethyl acetate extract also obviously ameliorated the inflammation. Both the ethyl acetate extract fraction and the total extract fraction of Smilax showed anti-inflammatory effects, while the former produced strong effects while the latter has only weak actions. Conclusion The ethyl acetate extract fraction of Smilax is the effective fraction to produce anti-inflammatory and anti-CPID effects.%目的 通过对菝葜各化学部位的药效学筛选,确定其治疗慢性盆腔炎疾病(CPID)的有效部位,为菝葜制剂的二次开发提供科学依据.方法 采用苯酚胶浆注入大鼠子宫造成大鼠CPID模型,观察菝葜各化学部位对CPID模型大鼠的治疗作用;采用二甲苯致小鼠耳肿胀法和大鼠棉球肉芽肿法,探讨菝葜各化学部位的抗炎作用.结果 菝葜乙酸乙酯部位的高剂量组能显著降低CPID模型大鼠的子宫炎症反应,对小鼠耳肿胀和大鼠棉球肉芽肿的抗炎作用与模型对照组比较均有显著性差异(P<0.01);中剂量组也能明显改善炎症程度.总体抗炎作用优于总提液组.正丁醇部位作用不明显.结论 菝葜的乙酸乙酯部位为菝葜抗炎及抗慢性盆腔炎的有效部位.

  14. 腹腔镜检查慢性盆腔疼痛与社会心理因素的相关分析%Analysis on correlation between chronic pelvic pain checked by laparoscope and social-psychological factor

    Institute of Scientific and Technical Information of China (English)

    温坚; 张震; 殷新明

    2012-01-01

    目的:探讨慢性盆腔疼痛(CPP)与社会心理因素的相关性;方法:以212例CPP患者和295例子宫肌瘤患者为实验对象,对CPP患者142例行腹腔镜检查,自编社会心理变量调查表,人组时完成精神卫生自评量表(SCL-90)的测评,以各社会心理变量及简明精神病评定量表(SCL-90)的抑郁和焦虑因子标准分作为观察数据,采用美国SPSS 11.0版进行独立样本的t检验、x2检验和逐步回归分析.结果:腹腔镜检查结果阴性的CPP患者的婚姻状况、性伤害史、诊治次数、诱因及SCL-90抑郁因子标准分、焦虑因子标准分与对照组比较差异有统计学意义(P<0.05);而与文化程度、总病程无相关性,差异无统计学意义(P>0.05).腹腔镜检查结果阴性的CPP患者经心理咨询或抗抑郁治疗后疼痛症状有所减轻.结论:对于腹腔镜检查结果阴性的CPP患者而言,社会心理因素可能是导致其发病的成因之一,提示在诊疗CPP无效时,结合腹腔镜检查对患者实施充分的心理评估、恰当的心理治疗及抗抑郁、抗焦虑治疗是非常有必要的.%Objective: To explore the correlation between chronic pelvic pain (CPP) and social -psychological factor. Methods; A total of 212 CPP patients and 295 patients with uterine myoma were selected as experimental objects, 142 CPP patients received laparosco-py, a self - designed social - psychological variable questionnaire was used in the study, SCL - 90 was finished when the objects entered into group, various social - psychological variables and standard scores of depression and anxiety from SCL - 90 were obtained as observation data, SPSS 11. 0 software was used to conduct t test, χ2 test and stepwise regression analysis of independent sample. Results; There were statistically significant differences in marital status, sexual damage history, times of diagnosis and treatment, inducing factors, standard scores of depression and anxiety between CPP patients

  15. Qualidade de vida de mulheres com dor pélvica crônica: um estudo de corte transversal analítico Quality of life of women with chronic pelvic pain: a cross-sectional analytical study

    Directory of Open Access Journals (Sweden)

    Priscilla Rodrigues Barcelos

    2010-05-01

    Full Text Available OBJETIVOS: comparar a qualidade de vida (QV de mulheres com e sem dor pélvica crônica (DPC e investigar os fatores associados à QV de mulheres com DPC. MÉTODOS: conduziu-se estudo de corte transversal, incluindo 30 mulheres com DPC e 20 sem DPC. Foram avaliadas características sociodemográficas e clínicas. A QV foi investigada pelo questionário SF-36, que apresenta oito domínios: capacidade funcional, aspectos físicos, dor, estado geral de saúde, vitalidade, aspectos sociais, aspectos emocionais e saúde mental. Esses domínios podem ser resumidos em dois sumários: sumário do componente físico (SCF e sumário do componente mental (SCM. A intensidade da dor foi pesquisada, aplicando-se a escala visual analógica. Utilizou-se análise de regressão linear para comparação dos escores de QV entre mulheres com e sem DPC e para identificação dos fatores associados à QV de mulheres com DPC. RESULTADOS: a média de idade das mulheres com e sem DPC foi de 35,2±7,5 e de 36±9,3 anos (p=0,77, respectivamente. Mulheres com DPC apresentaram menor renda familiar mensal (p=0,04 e maior prevalência de dismenorreia (87 versus 40%; pPURPOSE: to compare the quality of life (QL of women with and without chronic pelvic pain (CPP and to investigate the factors associated with QL in women with CPP. METHODS: a cross-sectional study was conducted on 30 women with CPP and 20 women without CPP. Sociodemographic and clinical characteristics were evaluated. QL was investigated by applying the SF-36 questionnaire, which contains eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health. These domains can be summarized into two groups: physical component summary (PCS and mental component summary (MCS. Pain intensity was investigated by applying the visual analogue scale. Linear regression analysis was used to compare QL scores between women with and without CPP and to

  16. Pelvic actynomyces infection: report of two cases occurred in the Hospital of San José.

    Science.gov (United States)

    Urbina, Sergio; Ruiz, Hernando; Parejas, Sofia

    2006-01-01

    The actynomyces infection is a rare cause of chronic pelvic inflammation, which can be manifested in multiple ways. It is caused by the actynomyces bacteria, usually by the israelii type, which can be a part of the normal flora of the genital tract in patients who use intrauterine device (IUD). There is a discussion about the importance of considering this infection disease as part of the differential diagnosis in patients using the IUD, with atypical manifestations and bizarre presentation of infections of the genital tract, severe pelvic adherent syndromes, tubo-ovarian complexes (abscesses) barely symptomatic, and in the case of intraoperatory suspicion of pelvic carcinomatosis among others.

  17. [Functional disorders of the rectum and pelvic floor. Ambulatory/conservative therapy].

    Science.gov (United States)

    Bock, J U; Jongen, J

    1997-01-01

    Early diagnosed functional disorders of the ano-rectum or pelvic floor can be treated in the office by conservative treatment or out-patient surgery. The normal anatomy of the anal canal must be restituted by reducing enlarged haemorrhoids, removing a prolapse of the anterior rectal wall with rubber-band ligation, excision of chronic fissures and prolapsing tumours. The basic therapy then consists of normalisation of bowel habits and stool consistency. An anal stenosis must be dilated. Training of the sphincter, gymnastics of the pelvic floor, electrostimulation and biofeedback are the therapy for the sphincter and pelvic floor insufficiency.

  18. 王忠民辨治甲状腺功能减退症合并慢性盆腔炎经验%Experience of Wang Zhongmin in Treating Hypothyroidism Combined with Chronic Pelvic Inflammatory Disease

    Institute of Scientific and Technical Information of China (English)

    王明闯; 张菲菲

    2015-01-01

    Hypothyroidism has significant kidney deficiency syndrome,and many developed in the fetal period with close relations with kidney empty. Decline of kidney­Yang is outstanding. Kidney is the foundation of the innate. Hypothyroidism combined with chronic pel­ vic inflammatory disease( CPID)will hurt Yin. Although one positive syndrome,it should also pay attention to Yin and Yang,and not hurt Yin repair sun be the spirit. In addition,the spleen and the main operation and the blood metaplasia,belong to the day after tomor­ row,to improve the disease resistance is particularly important. Temper weak,less food intake or inappropriate,nutritional deficiencies, the day after tomorrow is easy Qi,kidney Yang deficiency,the spleen Yang,and temper weak can worsen kidney empty again. Patients with spleen main limbs,muscle and hypothyroidism accounted for most of the patients with muscle weakness,accompanied by sensory disorder,such as hand,foot and numbness,muscle pain,stiffness or cramps are particularly common,at the same time,about 32% -82% in patients with combined anemia. The emergence of this situation,make hypothyroidism merger CPID patients more will not more lingering,appear the symptom such as disorder of Qi and blood,menstrual disorders,pelvic cavity accumulates fluid,hypothyroidism pa­ tients often have bradycardia,pulse heavy card such as late,belongs to the weak heart Yang,accord with 〝kidney life canˊt evaporate, heart Yang encouraged incompetent〝,clinical common hypothyroidism of long course of disease,often happen after kidney Yang from heart Yang,to compound the cold. Therefore,when treatment it still needs to pay attention to the change. Hypothyroidism Yang deficien­ cy and CPID with the origin as the combined them often delay duration. For a long time,not more is phlegm,dampness can appear in myxedema,abdominal cystic mass,this〝is completely blood stasis and turbidity Qi,phlegm stagnation and become〝. Therefore,we must give full consideration

  19. Traumatic Testicular Dislocation Associated with Lateral Compression Pelvic Ring Injury and T-Shaped Acetabulum Fracture

    Directory of Open Access Journals (Sweden)

    Daniel Howard Wiznia

    2016-01-01

    Full Text Available We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3 and left T-shaped acetabulum fracture (OTA classification 62-B2 in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum. In follow-up, the patient did not suffer urologic or sexual dysfunction. All motorcycle collision patients presenting with pelvic ring injuries or acetabulum fractures should be worked up for possible testicular dislocation with a scrotal exam. Advanced imaging and a urologic consult may be necessary to detect and treat these injuries.

  20. Prevention of pelvic radiation disease

    Institute of Scientific and Technical Information of China (English)

    Lorenzo; Fuccio; Leonardo; Frazzoni; Alessandra; Guido

    2015-01-01

    Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal(GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. The incidence of pelvic radiation disease changes according to the radiation technique, the length of follow up, the assessmentmethod, the type and stage of cancer and several other variables. Notably, even with the most recent radiation techniques, i.e., intensity-modulated radiotherapy, the incidence of radiation-induced GI side effects is overall reduced but still not negligible. In addition, radiation-induced GI side effects can develop even after several decades; therefore, the improvement of patient life expectancy will unavoidably increase the risk of developing radiation-induced complications. Once developed, the management of pelvic radiation disease may be challenging. Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease.

  1. The etiology of pelvic inflammatory disease.

    Science.gov (United States)

    Keith, L; Berger, G S

    1984-05-01

    The etiology of pelvic inflammatory disease (PID) is speculated upon based on reported incidence and epidemiological studies. In Western society, the incidence of PID (annual) is 1% among women aged 15-34 years and 2% in the high risk group of women aged 15-24 years. The annual incidence in the US is higher, at least 2% among fecund sexually active women aged 13-44 years. The medical consequences of PID are infertility, ectopic pregnancy, and chronic pelvic pain. Causative agents include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis and various other aerobic and anaerobic microorganisms; however, the natural genital flora of females is so varied that determining actual causative agents is difficult. some case-control studies have determined risk factors for PID; these include particularly current or prior use of IUD, prior pelvic surgery, sexual activity (including number of partners), race, and prior PID acute infection. PID is not a sexually transmitted disease, but rather is classified as sexually derived. Use of barrier methods and oral contraceptives protects against PID. IUD use greatly increases the risk of PID, probably because of the avenue the device provides for organisms to ascend from the lower to the upper genital tract. The role of males in PID etiology is currently the subject of much discussion. It is theorized that the mechanical action of penis insertion in intercourse helps to move causative agents to the upper genital region; also, semen may carry vaginal flora through the cervical opening into the uterus and tubes. Menstruation and PID are closely associated, perhaps because the cervix dilates during bleedings. Research areas include: determination of role of sexual activity (and number of partners) in PID etiology; evaluation of events of menstruation that are predisposing; evaluation of relationship between bacteriosperma and lower and upper genital infections; relationship of particular contraceptive methods to PID

  2. Aesthetic, urological, orthopaedic and functional outcomes in complex bladder exstrophy-epispadias′s management

    Directory of Open Access Journals (Sweden)

    Bertin Dibi Kouame

    2015-01-01

    Full Text Available Background: Postoperative complications are related to the surgical procedures, of failures of initial bladder closure and influence the urological, aesthetical and orthopaedic outcomes. Materials and Methods: We reviewed four patients who underwent complex bladder exstrophy-epispadias repair over a period of 14 years. The outcomes of treatment were assessed using, aesthetic, urological and orthopaedic examination data. Orthopaedic complications were explored by a radiography of the pelvis. Results: Out of four patients who underwent bladder exstrophy surgical management, aesthetic, functional outcomes and complications in the short and long follow-up were achieved in three patients. The first patient is a male and had a good penis aspect. He has a normal erection during micturition with a good jet miction. He has a moderate urinary incontinence, which requires diaper. In the erection, his penis-measures 4 cm long and 3 cm as circumference. The second patient was a female. She had an unsightly appearance of the female external genitalia with bipartite clitoris. Urinary continence could not be assessed; she did not have the age of cleanness yet. The third patient had a significant urinary leakage due to the failure of the epispadias repair. He has a limp, a pelvic obliquity, varus and internal rotation of the femoral head. He has an inequality of limbs length. Pelvis radiograph shows the right osteotomy through the ilium bone, the left osteotomy through the hip joint at the acetabular roof. Conclusion: When, the epispadias repair is performed contemporary to initial bladder closure, its success is decisive for urinary continence. In the female, surgical revision is required after the initial bladder closure for an aesthetic appearance to the external genitalia. Innominate osteotomy must be performed with brilliancy amplifier to avoid osteotomy through to the hip joint to prevent inequality in leg length.

  3. Image guided robotic surgery: Current evidence for effectiveness in urology

    Directory of Open Access Journals (Sweden)

    Anum Pervez

    2014-12-01

    Full Text Available Objectives: Discussion of the evolution of image guided surgery (IGS and its fundamental components and current evidence for effectiveness of IGS in clinical urology. Methods: Literature search for image-guided robotic urology. Results: Current literature in image-guided robotic urology with its use in robot assisted radical prostatectomy and robot assisted partial nephrectomy are shown. Conclusions: Image guided surgery can be a useful aid to improve visualisation of anatomy and subsurface structures during minimally invasive surgery. Soft-tissue deformation makes it difficult to implement IGS in urology but current studies have shown an attempt to address this issue. The feasibility of IGS requires randomised control trials assessing in particular its accuracy and affect on clinical outcome.

  4. Applications of three-dimensional printing technology in urological practice.

    Science.gov (United States)

    Youssef, Ramy F; Spradling, Kyle; Yoon, Renai; Dolan, Benjamin; Chamberlin, Joshua; Okhunov, Zhamshid; Clayman, Ralph; Landman, Jaime

    2015-11-01

    A rapid expansion in the medical applications of three-dimensional (3D)-printing technology has been seen in recent years. This technology is capable of manufacturing low-cost and customisable surgical devices, 3D models for use in preoperative planning and surgical education, and fabricated biomaterials. While several studies have suggested 3D printers may be a useful and cost-effective tool in urological practice, few studies are available that clearly demonstrate the clinical benefit of 3D-printed materials. Nevertheless, 3D-printing technology continues to advance rapidly and promises to play an increasingly larger role in the field of urology. Herein, we review the current urological applications of 3D printing and discuss the potential impact of 3D-printing technology on the future of urological practice.

  5. Optimizing urology group partnerships: collaboration strategies and compensation best practices.

    Science.gov (United States)

    Jacoby, Dana L; Maller, Bruce S; Peltier, Lisa R

    2014-10-01

    Market forces in health care have created substantial regulatory, legislative, and reimbursement changes that have had a significant impact on urology group practices. To maintain viability, many urology groups have merged into larger integrated entities. Although group operations vary considerably, the majority of groups have struggled with the development of a strong culture, effective decision-making, and consensus-building around shared resources, income, and expense. Creating a sustainable business model requires urology group leaders to allocate appropriate time and resources to address these issues in a proactive manner. This article outlines collaboration strategies for creating an effective culture, governance, and leadership, and provides practical suggestions for optimizing the performance of the urology group practice.

  6. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... have a hard time staying still, are very nervous or anxious or have chronic pain, you may ... speak with you through a built-in intercom system. With pediatric patients, a parent may be allowed ...

  7. Efficacy of the Technique of Ganglion Impar Modulation for Treating Chronic Abacterial Prostatitis/Chronic Pelvic Pain Syndrome%奇神经节调制技术在治疗慢性非细菌性前列腺炎/慢性盆腔疼痛综合征中的临床应用与疗效观察

    Institute of Scientific and Technical Information of China (English)

    吕小平; 徐群; 张杭杭; 徐新建; 陈磊; 周智恒

    2016-01-01

    Objective To evaluate the efficacy of the technique of ganglion impar modulation for treating Chronic abacterial prostatitis/ chronic pelvic pain syndrome(CNP/ CPPS). Methods A total of 46 cases who were treated in Department of Andrology in Shaoxing Xinchang County Hospital of Traditional Chinese Medicine during Febrary 2013 to March 2015,met CNP/ CPPS inclusion and exclusion criteria,they were divided into group Ⅰ(treated with terazosin)and group Ⅱ(treated with ganglion Impar modulation technique )equally by the sequence of seeing a doctor,all cases were treated for a treatment course. The score of the national institute health - chronic prostatits symptom index( NIH-CPSI),score of VAS,and score of leukocyte count in the expressed prostate secretion(EPS)were recorded before and after treatment. The adverse reactions were also observed. Results There was no significant difference in score of NIH-CPSI,score of VAS,and score of leukocyte count in the EPS between the two groups before treatment(P > 0. 05). The score of NIH-CPSI,score of VAS,and score of leukocyte count in the EPS in group Ⅱ was significantly lower than that in group Ⅰ after treatment,respectively(P 0.05)。治疗后Ⅱ组NIH-CPSI评分、VAS 评分、EPS 常规镜检白细胞变化情况评分均低于Ⅰ组(P <0.05)。两组临床疗效比较,差异有统计学意义(P <0.05)。治疗期间,Ⅰ组患者均无体位性低血压及心悸情况发生,仅有1例出现轻度腹泻,另有1例出现一过性轻微头晕,未经特殊处理,3 d 内自行缓解;Ⅱ组无一例发生运动/感觉功能障碍、会阴部感觉异常、排尿和/或排便功能障碍、穿刺部位感染/出血等。结论奇神经节调制技术治疗 CNP/ CPPS 疗效显著、安全,值得临床推广应用。

  8. 热敏灸结合中药离子透入治疗慢性盆腔炎临床研究%The Clinical Comparison of Chronic Pelvic Inflammatory Disease Treated by Traditional Chinese Medicine Iontophoresis and Heat Sensitive Moxibustion

    Institute of Scientific and Technical Information of China (English)

    李勇

    2016-01-01

    Objective To investigate the thermal moxibustion combined with traditional Chinese medicine iontophoresis in the treatment of chronic pelvic inflammatory disease clinical curative effect.Methods 120 patients with chronic pelvic inflammation treated from October 2014 to March 2016 in our hospital were randomly. The patients were divided into observation group and control group, 60 cases in each group, the control group were treated with thermal moxibustion treatment, while the observation group received traditional Chinese medicine iontophoresis on the basis of the control group, the clinical comparative analysis the curative effect, two groups of TCM syndrome score and pelvic effusion volume before and after treatment.Results: the observation group was 100%, control group total effective rate was 86.6%, with significant differences between the two groups (P<0.05); compared with before treatment, the two groups after treatment of TCM syndrome integral were improved, but the observation group than the control group, the difference was statistically significant (P<0.05); the observation group after treatment the amount of pelvic fluid less than the control group, the difference was statistically significant (P<0.05).Conclusion moxibustion combined with traditional Chinese medicine iontophoresis in the treatment of chronic pelvic inflammatory disease clinical curative effect, worthy of clinical reference.%目的:探讨热敏灸结合中药离子透入治疗慢性盆腔炎临床疗效。方法选取我院2014年10月至2016年3月门诊治疗的慢性盆腔炎患者120例,按照随机对照原则,将患者分为观察组和对照组,每组各60例,对照组患者单纯给予热敏灸治疗,而观察组在对照组的基础上给予中药离子透入治疗,对比分析两组的临床疗效、治疗前后中医证候积分及盆腔积液量情况。结果:观察组有效率为100%,对照组总有效率为86.6%,两组比较差

  9. 'Image and treat': an individualized approach to urological tumors

    DEFF Research Database (Denmark)

    Bouchelouche, Kirsten; Capala, Jacek

    2010-01-01

    The current treatment options for advanced urologic cancers demonstrate limited efficacy. To obtain optimal clinical results, there is a need for new, individualized, therapeutic strategies, which have only recently been applied to these malignancies. Nuclear medicine plays an important role in e...... in establishing imaging biomarkers necessary for personalized medicine. This review focuses on the current status of the 'image and treat' approach combining molecular imaging with targeted radionuclide therapy of urological malignancies...

  10. The Global Prevalence of Infections in Urology Study

    DEFF Research Database (Denmark)

    Wagenlehner, Florian; Tandogdu, Zafer; Bartoletti, Riccardo;

    2016-01-01

    as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions....... Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years....

  11. Treatment of Acute Pelvic Inflammatory Disease

    Directory of Open Access Journals (Sweden)

    Richard L. Sweet

    2011-01-01

    Full Text Available Pelvic inflammatory disease (PID, one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is associated with major long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its complications incurs substantial health care costs. Prevention of these long-term sequelae is dependent upon development of treatment strategies based on knowledge of the microbiologic etiology of acute PID. It is well accepted that acute PID is a polymicrobic infection. The sexually transmitted organisms, Neisseria gonorrhoeae and Chlamydia trachomatis, are present in many cases, and microorganisms comprising the endogenous vaginal and cervical flora are frequently associated with PID. This includes anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Genital tract mycoplasmas, most importantly Mycoplasma genitalium, have recently also been implicated as a cause of acute PID. As a consequence, treatment regimens for acute PID should provide broad spectrum coverage that is effective against these microorganisms.

  12. AB39. Cryotherapy in urologic neolplasms

    Science.gov (United States)

    He, Leye

    2014-01-01

    Cryosurgery has a long history dating back to the mid-1800s when James Arnott, an English physician, used a salt and ice mixture to treat cervical and breast carcinoma. Modern cryosurgery began in 1961 with the development of automated equipment by Cooper and Lee. Since then, tumors in various organs have been treated with cryoablation, and probes of various shapes and sizes have been designed to improve tumor accessibility and ablation. During the last decade there has been a resurgence of cryotherapy in the field of urology, particularly in the treatment of malignant lesions of the kidney and prostate. As a minimally invasive treatment, the cryotherapy appears to be the most durable. Currently, select kidney and prostatic lesions are treated using cryotherapy and clinical series have provided compelling results, promoting interest in renal and prostatic cryoablation. By the advancement of radiographic technology and surgical instrumentation, much of the interest has been promoted along with the movement toward to provide minimally invasive therapeutic options for patients. The optimal indication for renal cryotherapy is a peripheral, enhancing, well circumscribed lesion less than 4 cm. Along with tumor characteristics, certain patient populations may benefit from kidney cryotherapy. They include elderly patients with comorbidities, particularly hypertension, diabetes, kidney stones, renal insufficiency, cerebrovascular accidents, and congestive heart failure. Other considerations include unique situations such as lesions less than 4 cm in a solitary or transplant kidney, along with certain hereditary conditions such as von Hippel-Lindau disease, tuberous sclerosis, and hereditary papillary renal cell carcinoma. Contraindications to kidney cryoablation include locally advanced and/or metastatic disease and uncontrolled bleeding disorders. Other relative contraindications include lesions contiguous with bowel, great vessels, and/or tumor size of at least 5 cm

  13. The curative effect analysis of intractable chronic pelvic pain syndrome by ureteroscopy dredging the seminal duct and lavaging seminal vesicle%小儿输尿管镜下精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎的治疗分析

    Institute of Scientific and Technical Information of China (English)

    高本敏; 黎勇林; 唐正严; 王桂林; 曾铭强; 薛睿智

    2015-01-01

    目的 评价小儿输尿管镜下行精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎的治疗效果.方法 收集45例难治性Ⅲ型前列腺炎患者,随机分为两组,手术组行小儿输尿管镜下精道疏通加精囊灌洗手术,对照组服用前列腺相关药物治疗4周以上,治疗后随访1年并评价其临床疗效.结果 难治性Ⅲ型前列腺炎患者45例,手术组20例,其中伴有血精2例,精囊结石1例,术后20例患者临床症状均有改善,其中显著改善者13例(65%).对照组药物治疗后25例患者临床症状中18例(72%)有改善,显著改善者6例(24%),随访1年,18例改善者中有7例(39%)临床症状反复.结论 手术治疗与药物治疗对难治性前列腺炎临床症状都有一定效果,但是小儿输尿管镜下精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎疗效将更加显著.%Objectives To evaluate the efficacy of intractable chronic pelvic pain syndrome by ureteroscopy dredging the seminal duct and lavaging seminal vesicle.Methods 45 cases of intractable chronic pelvic pain syndrome were collected,which were divided into two groups randomly,Operation group executed operation by ureteroscopy dredging the seminal duct and lavaging seminal vesicle,Control group continued to receive the medication more than 4 weeks.Followed up 1 year and evaluated the curative effect.Results 45 cases of intractable chronic pelvic pain syndrome,In Operation group 20 cases clinlcal symptom was improved and significant improvement was found in 13 cases (65 %) of them.In Control group,18 cases (72%) clinlcal symptom were improved and significant improvement was found in 6 cases(24%).Followed up 1 year,7 cases (39%) recurrent attacks.Conclusions Both operation and medication are effective to intractable chronic pelvic pain syndrome.But the operation by ureteroscopy dredging the seminal duct and lavaging seminal vesicle is more effective.

  14. Pelvic manikins as learning aids.

    Science.gov (United States)

    Macintosh, M C; Chard, T

    1997-05-01

    The use of pelvic trainers in undergraduate teaching was evaluated, using a questionnaire based on examination findings of a series of four pelvic trainers by 20 medical students and 34 gynaecologists. The main outcome measures were the ability to correctly identify pelvic findings in the trainers, and the numbers of false positive findings. There were two adnexal masses in two of the trainers. One was correctly identified by 33 (14 (70%) medical students and 19 (56%) doctors) in one trainer, whereas the other was missed by 52 of 54 examiners. Prolapse was missed by 41 of 54. The normal pelvis was correctly identified by 30 (16 (80%) medical students and 20 (59%) doctors. There were 15 false positive identifications of adnexal masses (6 by medical students and 9 by doctors) and 22 false positive identification of uterine enlargements (5 by medical students and 17 by doctors). The pelvic trainers were of value in demonstrating the process of pelvic and speculum examination. Some of the clinical conditions emulated were missed by most of the gynaecologists, suggesting that they were not suitable for training students in abnormal findings. Although the figures were not statistically significant, there was a trend for qualified doctors rather than medical students to make false positive findings.

  15. [Pelvic actinomycosis in menopausal patient, case review].

    Science.gov (United States)

    Treviño Salinas, Emilio Modesto; Martínez Palones, José María; Pérez Benavente, Ma Asunción; Xercavins Montosa, Jordi

    2003-10-01

    Pelvic actinomycosis is a granulomatous chronic illness due to anaerobic, gram-positive, branching filamentous bacteria (Actinomyces israelii), this and other species of actinomyces occur in the normal flora of the gastrointestinal and genital tract in humans. Infection is associated in women using an IUD (Intrauterine device) for long periods and it has the characteristic of simulate malignant diseases causing most of the times wrong preoperative diagnosis. We analyzed a postmenopausal patient who was treated surgically without specific diagnosis, then by anatomo-pathologic study of the specimen the result was actinomycosis. The main purpose to obtain the correct preoperative diagnosis is because we have to use antibiotics in the treatment and it may reduce the frequency of radical surgeries.

  16. [The clinic Heilanstalt Weidenplan in Halle (Saale), origin of the German urology. Otto Kneise's founding of the first independent urology department in Germany].

    Science.gov (United States)

    Zacher, W; Stolze, K-J

    2014-07-01

    The routine use of cystoscope initiated the development of the modern urology. Otto Kneise (1875-1953) extended the targets of cystoscopy by including examinations of the male bladder and prostate. He achieved the goal that "cystoscopy is part of general work in urology and not a pure gynecological act". He, thus, founded the specialty gynecological urology in the field urology, which prevented it from becoming an independent field. Under the leadership of Otto Kneise, the first independent urology department in Germany was created in the hospital Heilanstalt Weidenplan.

  17. Urology on the internet - introduction and update

    Directory of Open Access Journals (Sweden)

    Inumpudi Anand

    2000-01-01

    Full Text Available The Internet, which has truly united the developed and developing nations, is an extensive network of inter-linked computers storing immense bytes of information, which can be accessed by anyone transcending all geographi-cal barriers and this has become the ultimate frontier to access information. The Urology and Andrology informa-tion on Internet is exponentially growing. The urologist need not know the intricacies of the hardware and soft-ware but can start right away navigating through this web. We reviewed methods available to take advantage of this network to provide a glimpse to busy urologists to accrue the benefits easily and efficiently rather than to be lost in the information-ocean by surfing individually. By getting connected to Internet, an urologist of any part of the world gains enormous information by interacting with other urologists of the rest of the world. This could be of use to gain knowledge and to offer the best and the most modern treatment to the patient. Internet has revolutionised the scientific publication by virtue of its faster and accurate transmission of manuscripts. We can send manuscripts by this channel and also access journals obviating the lag period inherent in snail mail. The on-line journals have virtually brought the library to the desktop.

  18. Obesity and urologic complications after renal transplantation

    Directory of Open Access Journals (Sweden)

    Ashkan Heshmatzadeh Behzadi

    2014-01-01

    Full Text Available Although obesity has been associated with improved survival on dialysis, its short-and long-term effects on renal transplantation outcomes remain unclear. Herein, we evaluate the short-term and intermediate long-term effects of obesity on first-time renal transplant patients. A retrospective analysis was performed on 180 consecutive renal transplant recipients from living unrelated donors during 2006-2008 in a major transplantation center in Tehran, Iran. Among these, 34 (18% patients were found to be obese (body mass index ≥30 kg/m 2 . Obese patients were more likely to develop post-transplant renal artery stenosis (RAS (17.6% vs. 2.8%, P <0.001, hematoma (47.9% vs. 17.6, P = 0.009, surgical wound complications (64.7% vs. 9.6%, P <0.001 and renal vein thrombosis (2% vs. 0%, P <0.001. However, the incidence of delayed graft function, lymphocele, urologic complications of ureterovesical junction stenosis or urinary leakage, surgical complications of excessive bleeding or renal artery thrombosis and duration of hospitalization were similar between the two groups. The two-year patient and graft survival were also statistically not different. Renal transplantation in obese recipients is associated with a higher incidence of post-transplant RAS, hematoma, surgical wound complications and renal vein thrombosis, but similar two-year patient and graft survival.

  19. Lymphocele – urological complication after renal transplantation

    Directory of Open Access Journals (Sweden)

    Wojciech Krajewski

    2013-04-01

    Full Text Available Renal transplantation is the best renal replacement treatment. It provides longer survival and a better quality of life. The outcome of renal transplantation is influenced by the occurrence of various complications, including urological. One of the most frequently occurring complicationsis lymphocele. Most cases of lymphocele develop during a period of several weeks after the procedure of transplantation. However, there are some literature reports concerning lymphocele diagnosis in the later period, even after several years. Most cases of lymphocele are asymptomatic and are diagnosed accidentally. Nevertheless, a large lymphocele may press the kidney, ureter, urinary bladder or neighbouring blood vessels, causing deterioration of renal function, leg oedema and thrombosis of iliac vessels. Among other complications there are infections. The cause of lymphocele is collection of the lymph drained from damaged lymph vessels surrounding iliac blood vessels and/or lymph vessels of the graft. Important factors predisposing to lymphocele are immunosuppressive treatment, including mTOR inhibitors, mycophenolic acid derivatives and high doses of glucosteroids. Factors favouring occurrence of lymphocele comprise obesity, diabetes, elderly age of recipient, long time of warm ischaemia, acute rejection episodes and delayed graft function. The authors describe presently available treatment methods including aspiration and percutaneous drainage, with or without sclerotisation, drainage using the Tenckhoff catheter and laparoscopic or open fenestration. At present, laparoscopic fenestration is considered to be the most efficient and the safest method. However, there are clinical cases where open surgical treatment is necessary.

  20. Preliminary study of saw palmetto extract in treatment of chronic prostatitis/chronic pelvic pain syndrome%锯叶棕果实提取物治疗慢性前列腺炎/慢性骨盆疼痛综合征的初步研究

    Institute of Scientific and Technical Information of China (English)

    吴小军; 周占松; 张恒; 沈文浩; 何鹏; 李为兵; 陈志文; 卢根生

    2014-01-01

    目的 探讨锯叶棕果实提取物治疗慢性前列腺炎/慢性骨盆疼痛综合征(chronic prostatitis/chronic pelvic pain syndrome,CP/CPPS)的疗效.方法 选择我科门诊2011年3月至2013年5月收治的Ⅲ型前列腺炎患者118例,包括ⅢA型46例,ⅢB型72例.口服锯叶棕果实提取物,160 mg/次,2次/d,8周一疗程.以美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)、前列腺液常规白细胞计数和国际勃起功能评分问卷(international conventional erectile function score questionnaire,IIEF-5)评分为疗效评价指标,进行治疗前后比较.结果 115例患者完成治疗和随访,包括ⅢA型CP45例,ⅢB型CP 70例.患者口服锯叶棕果实提取物后,NIH-CPSI评分及前列腺液白细胞计数均显著降低(P<0.05).治愈23例(20.0%),显效32例(27.8%),有效42例(36.5%),无效18例(15.7%),总有效率84.3%.IIEF-5评分有所升高(P>0.05).未发生明显不良反应.结论 锯叶棕果实提取物单独用于治疗前列腺炎(尤CP/CPPS),对减轻患者疼痛、改善排尿症状及提高生活质量有较好疗效,且没有明显不良反应.

  1. How Are Pelvic Floor Disorders Commonly Treated?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How are pelvic floor disorders commonly treated? Skip sharing on social media ... Treatment Nonsurgical treatments commonly used for PFDs include: Pelvic floor muscle training (PFMT). Also called Kegel (pronounced KEY- ...

  2. How Are Pelvic Floor Disorders Diagnosed?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How are pelvic floor disorders diagnosed? Skip sharing on social media links ... fee ). This test is used to evaluate the pelvic floor and rectum while the patient is having a ...

  3. Can I prevent Pelvic Organ Prolapse

    Science.gov (United States)

    ... Prolapse POP Symptoms & Types Can I Prevent POP? Kegel Exercises POP Diagnosis Find a Provider Talking with ... developing POP. Pelvic Muscle Exercises Pelvic muscle exercises (Kegel) strengthen or retrain the nerves and muscles of ...

  4. SPARING CYSTECTOMY IN THE TREATMENT OF BLADDER CANCER WITH UROLOGICAL COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    A. N. Abizgildin

    2014-08-01

    Full Text Available Bladder cancer (BC accounts for 5 to 10% of all cancers and ranks fourth in the prevalence of male cancers. In Russia, its morbidity increases with age and amounts to 8.1—9.6 per 100,000 with the annual increase being 3.34%.Objective: to assess the results of sparing cystectomy (CE for BC in the presence of urological complications.Subjects and methods. From February 1999 to December 2007, the study consequently included 196 patients receiving surgical treatment for the aggressive form of BC, of whom 101 patients received surgical treatment for CE with intestinal plastic repair. There were 33 (84.6% males and 6 (15.4% females. The patients' mean age was 69.4 (range 35-81 years; the duration of the disease averaged 1.4 years (range 6 months to 5 years. The proportion of the males who has undergone sparing CE was 48.5% of the total number of patients. There were no women who had been operated on.Results. Examination of 101 patients with invasive CE revealed that 69 patients had the following types of complications: intractable bleeding, hydronephrosis, acute pyelonephritis, chronic renal failure, progressive cancer intoxication, and acute urinary retention. These patients were determined as having undergone sparing CE. Group 2 comprised 127 patients who had received organ-preserving therapy.Conclusion. Physical examination, instrumental, and X-ray studies established a correlation of the tumor aggression with the severity of urological complications; sparing CE for urological involvement in patients with invasive UBC has an advantage over organ-preserving treatment (33.3% versus 4.7% in providing 5-year survival. However, the early postoperative mortality from occurring complications was higher in Group 1 than that in Group 2 without radical treatment.

  5. SPARING CYSTECTOMY IN THE TREATMENT OF BLADDER CANCER WITH UROLOGICAL COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    A. N. Abizgildin

    2009-01-01

    Full Text Available Bladder cancer (BC accounts for 5 to 10% of all cancers and ranks fourth in the prevalence of male cancers. In Russia, its morbidity increases with age and amounts to 8.1—9.6 per 100,000 with the annual increase being 3.34%.Objective: to assess the results of sparing cystectomy (CE for BC in the presence of urological complications.Subjects and methods. From February 1999 to December 2007, the study consequently included 196 patients receiving surgical treatment for the aggressive form of BC, of whom 101 patients received surgical treatment for CE with intestinal plastic repair. There were 33 (84.6% males and 6 (15.4% females. The patients' mean age was 69.4 (range 35-81 years; the duration of the disease averaged 1.4 years (range 6 months to 5 years. The proportion of the males who has undergone sparing CE was 48.5% of the total number of patients. There were no women who had been operated on.Results. Examination of 101 patients with invasive CE revealed that 69 patients had the following types of complications: intractable bleeding, hydronephrosis, acute pyelonephritis, chronic renal failure, progressive cancer intoxication, and acute urinary retention. These patients were determined as having undergone sparing CE. Group 2 comprised 127 patients who had received organ-preserving therapy.Conclusion. Physical examination, instrumental, and X-ray studies established a correlation of the tumor aggression with the severity of urological complications; sparing CE for urological involvement in patients with invasive UBC has an advantage over organ-preserving treatment (33.3% versus 4.7% in providing 5-year survival. However, the early postoperative mortality from occurring complications was higher in Group 1 than that in Group 2 without radical treatment.

  6. [Lesion of pelvic organs in secondary varicose veins of the small pelvis].

    Science.gov (United States)

    Tsukanov, Yu T; Tsukanov, A Yu; Levdansky, E G

    2015-01-01

    The authors studied peculiarities of pelvic organs lesions in patients presenting with secondary small pelvic varicose veins (SPVV) induced by endured thrombosis of iliac veins. The study included a total of 70 patients after endured thrombosis of iliac veins verified by radiodiagnostic methods. The average duration of thrombosis amounted to 3.8 years. The patients were subdivided into two groups. The Study Group comprised 48 patients presenting with small pelvic varicose veins revealed by duplex scanning; the Control Group was composed of 22 patients with no varicose pelvic veins. It was determined that characteristic features of patients with secondary SPVV having developed after iliac veins thrombosis included chronic pelvic pain, dilatation of cavernous veins of the rectum, inguinal vein varicosity and varicose veins of the groin and anterior abdominal wall. Formation of secondary SPVV after endured iliac vein thrombosis leads to disorders of pelvic organs, similar to those in primary varicosity, but more often being functional. Endured iliac veins thrombosis in formation of secondary SPVV leads to urination impairments with prevalence of moderately pronounced symptomatology. Small pelvic organs dysfunction in women with secondary SPVV due to endured iliac veins thrombosis manifests itself in dyspareunia, leukorrhea, and dysmenorrhea.

  7. Biomechanics of the pelvic floor musculature

    NARCIS (Netherlands)

    Janda, S.

    2006-01-01

    The present thesis was motivated by two main goals. The first research goal of the thesis was to understand the complex biomechanical behaviour of the pelvic floor muscles. The second goal was to study the mechanism of the pelvic organ prolapse (genital prolapse). The pelvic floor in humans is a ve

  8. Early development of the human pelvic diaphragm

    NARCIS (Netherlands)

    Koch, Wijnandus Franciscus Robertus Maria

    2006-01-01

    The last decade an increasing interest in the pelvic floor can be observed in medical sciences. The lack of data on the development of the human pelvic floor is striking. The early development of the human pelvic diaphragm was studied. Materials and methods Use was made of 38 human embryos and fetus

  9. Yoga on chronic non-bacterial prostatitis/chronic pelvic pain rehabilitation assistance syndrome%瑜伽锻炼对慢性非细菌性前列腺炎/慢性骨盆疼痛综合征的辅助康复治疗效果

    Institute of Scientific and Technical Information of China (English)

    唐锋; 刘花云; 孙洪涛; 连天; 李源湘

    2011-01-01

    目的:探讨瑜伽锻炼对慢性非细菌性前列腺炎/慢性骨盆疼痛综合征(CAP/CPPS)的辅助康复治疗效果.方法:将2008年4月~2010年4月期间符合CAP/CPPS诊断标准的200名患者,随机分为对照组和实验组.对照组采用常规治疗方法,实验组采用在常规治疗的基础上辅以瑜伽锻炼,每周5次,每次40 min左右,以患者不感疲劳为限.采用问卷调查方式,二组患者在治疗前、治疗1个月、治疗3个月予前列腺炎症状指数评分;测定二组患者在治疗前、治疗1个月、治疗3个月的最大尿流率及精浆IL-1、TNF-α水平;统计治愈率、总有效率.结果:实验组患者治疗1个月、治疗3个月前列腺炎症状指数评分、最大尿流率及精浆IL-1、TNF-α水平,与对照组比较具有统计学意义(P<0.05).实验组治愈率(67%)和总有效率(82%)均明显高于对照组治愈率(67%)、总有效率(68呦,P<0.05.结论:CAP/CPPS患者在常规治疗的基础上辅以瑜伽体育锻炼,效果显著.%Objective To explore Yoga in assisted rehabilitation therapy on chronic non-bacterial prostatitis / chronic pelvic pain syndrome. Methods 200 patients were randomly divided into control and experimental groups from April 2008 to April 2010. Experimental group, on the basis of routine treatment, were supplemented by Yoga exercise, every 40 minutes and 5 times a week. The patients do not feel the fatigue limit. A questionnaire survey method, the control group and experimental group of patients before treatment, 1 month, 3 months for treatment of chronic prostatitis symptom index score;determination of the control group and experimental group patients before treatment, 1 month, treatment 3. Results In the control group and experimental group patients 1 month,3 months treatment of chronic prostatitis symptom index score, maximum flow rate and the seminal plasma IL-1, TNF-α levels, statistical test between two groups P <0.05, there statistically

  10. Antibiotic prophylaxis for transurethral urological surgeries: Systematic review.

    Science.gov (United States)

    Alsaywid, Basim S; Smith, Grahame H H

    2013-04-01

    The use of antibiotic prophylaxis to prevent urinary tract infection and bacteremia (sepsis) following endoscopic urologic procedures is a controversial topic. Evidence in the literature revealed that urological instrumentation is associated with increased incidence of urinary tract infection and bacteremia. The aim of this review is to evaluate the effectiveness of antibiotic prophylaxis in reducing the risk of urinary tract infection in patients who had transurethral urological surgeries. We have selected all RCTs of adult population who underwent all different types of transurethral urological surgery, including cystoscopy, transurethral resection of prostate and transurethral resection of bladder tumor, and received prophylactic antibiotics or placebo/no treatment. At first, more than 3000 references were identified and reviewed; of which 42 studies with a total of 7496 patients were included in the final analysis. All those trials were analyzing antibiotic prophylaxis versus placebo/no treatment, and they were significantly favoring antibiotic use in reducing all outcomes, including bacteriuria (RR 0.36, 95% CI 0.29 to 0.46, P urinary tract infections and its sequels following transurethral urological surgeries in patients with preoperative sterile urine.

  11. Recent trends in the urology workforce in the United States.

    Science.gov (United States)

    Pruthi, Raj S; Neuwahl, Simon; Nielsen, Matthew E; Fraher, Erin

    2013-11-01

    The present study examines the current status of urology physician manpower in the United States, in the context of trends in the demographics, geographic distribution, and practice make-up of urologists. Physicians were identified as surgeons and classified into surgical groups using a combination of American Medical Association primary and secondary self-reported specialties and American Board of Medical Specialties certifications. From these groups, urologic surgeons were isolated for analysis. The supply of urologists per capita has declined since 1981 - most dramatically since 1991. With an average age of 52.5 years, urology is one of the oldest surgical specialties. Over 7% of urologists are older than 70 years and 44% are older than 55 years, suggesting an aging urology workforce. The number of female urologists has grown almost a 1000-fold and represents a growing and younger cohort of the workforce. The number of rural urologists and the number of international medical graduates have continued to decline since 1981. Over the past 10 years, an increasing number of urologists are now in group practices (over 60%), and these tended to be younger and in urban settings. In contrast to most other surgical specialties, there has been a decrease in the supply of urologists relative to population growth, which is expected to be exacerbated by an aging and relatively older urology physician workforce, particularly in rural areas, a slight increase in female urologists, and the gravitation of younger urologists toward group practice in urban areas.

  12. Implications of Biofilm Formation on Urological Devices

    Science.gov (United States)

    Cadieux, Peter A.; Wignall, Geoffrey R.; Carriveau, Rupp; Denstedt, John D.

    2008-09-01

    Despite millions of dollars and several decades of research targeted at their prevention and eradication, biofilm-associated infections remain the major cause of urological device failure. Numerous strategies have been aimed at improving device design, biomaterial composition, surface properties and drug delivery, but have been largely circumvented by microbes and their plethora of attachment, host evasion, antimicrobial resistance, and dissemination strategies. This is not entirely surprising since natural biofilm formation has been going on for millions of years and remains a major part of microorganism survival and evolution. Thus, the fact that biofilms develop on and in the biomaterials and tissues of humans is really an extension of this natural tendency and greatly explains why they are so difficult for us to combat. Firstly, biofilm structure and composition inherently provide a protective environment for microorganisms, shielding them from the shear stress of urine flow, immune cell attack and some antimicrobials. Secondly, many biofilm organisms enter a metabolically dormant state that renders them tolerant to those antibiotics and host factors able to penetrate the biofilm matrix. Lastly, the majority of organisms that cause biofilm-associated urinary tract infections originate from our own oral cavity, skin, gastrointestinal and urogenital tracts and therefore have already adapted to many of our host defenses. Ultimately, while biofilms continue to hold an advantage with respect to recurrent infections and biomaterial usage within the urinary tract, significant progress has been made in understanding these dynamic microbial communities and novel approaches offer promise for their prevention and eradication. These include novel device designs, antimicrobials, anti-adhesive coatings, biodegradable polymers and biofilm-disrupting compounds and therapies.

  13. Urologic surgery laparoscopic access: vascular complications

    Science.gov (United States)

    Branco, Anibal Wood

    2017-01-01

    ABSTRACT Vascular injury in accidental punctures may occur in large abdominal vessels, it is known that 76% of injuries occur during the development of pneumoperitoneum. The aim of this video is to demonstrate two cases of vascular injury occurring during access in laparoscopic urologic surgery. The first case presents a 60-year old female patient with a 3cm tumor in the superior pole of the right kidney who underwent a laparoscopic partial nephrectomy. After the Verres needle insertion, output of blood was verified. During the evaluation of the cavity, a significant hematoma in the inferior vena cava was noticed. After the dissection, a lesion in the inferior vena cava was identified and controlled with a prolene suture, the estimated bloos loss was 300ml. The second case presents a 42-year old female live donor patient who had her right kidney selected to laparoscopic live donor nephrectomy. After the insertion of the first trocar, during the introduction of the 10mm scope, an active bleeding from the mesentery was noticed. The right colon was dissected and an inferior vena cava perforation was identified; a prolene suture was used to control the bleeding, the estimated blood loss was 200mL, in both cases the patients had no previous abdominal surgery. Urologists must be aware of this uncommon, serious, and potentially lethal complication. Once recognized and in the hands of experienced surgeons, some lesions may be repaired laparoscopically. Whenever in doubt, the best alternative is the immediate conversion to open surgery to minimize morbidity and mortality. PMID:28124541

  14. Successful treatment of pelvic actinomycosis using transgluteal drainage: A case report.

    Science.gov (United States)

    Inatomi, Ayako; Tsuji, Shunichiro; Amano, Tsukuru; Kobayashi, Masashi

    2016-08-01

    Actinomycosis is a rare chronic suppurative granulomatous infection, associated with long-term IUD placement. Standard treatment is long-term antibiotic administration. Here, we report a more radical pelvic abscess drainage treatment, because conservative therapy failed to provide relief. A 52-year-old woman (gravida 4 para 3) with an 18-year IUD history was referred to our hospital with a pelvic abscess, indicated clinically to be pelvic actinomycosis. Standard conservative penicillin therapy provided no relief. We performed transgluteal drainage, confirmed actinomycosis pathologically, administered clindamycin, and observed no relapse. Transgluteal percutaneous drainage combined with antibiotics may be useful for refractory deep pelvic abscess caused by actinomycosis and may even curtail the antibiotic administration period.

  15. Late urologic morbidity in 177 consecutive patients after radiotherapy for cervical carcinoma: a longitudinal study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranow, Ingrid R.; Skovgaard, Lene Theil;

    2002-01-01

    Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate......Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate...

  16. Coalition for the advancement of prosthetic urology: history, accomplishments, and continuing mission.

    Science.gov (United States)

    Daubert, Gail

    2006-11-01

    The Coalition for the Advancement of Prosthetic Urology (CAPU) is the leading policy advocacy group representing the prosthetic urology community and has been very effective in educating federal health care policy-makers.

  17. Ultrasound Imaging of the Pelvic Floor.

    Science.gov (United States)

    Stone, Daniel E; Quiroz, Lieschen H

    2016-03-01

    This article discusses the background and appraisal of endoluminal ultrasound of the pelvic floor. It provides a detailed anatomic assessment of the muscles and surrounding organs of the pelvic floor. Different anatomic variability and pathology, such as prolapse, fecal incontinence, urinary incontinence, vaginal wall cysts, synthetic implanted material, and pelvic pain, are easily assessed with endoluminal vaginal ultrasound. With pelvic organ prolapse in particular, not only is the prolapse itself seen but the underlying cause related to the anatomic and functional abnormalities of the pelvic floor muscle structures are also visualized.

  18. The emerging role of social media in urology.

    Science.gov (United States)

    Leveridge, Michael J

    2014-01-01

    Social media have become so integrated into modern communications as to be universal in our personal and, increasingly, professional lives. Recent examples of social media uptake in urology, and the emergence of data to quantify it, reveal the expansion of conventional communication routes beyond the in-person forum. In every domain of urologic practice, from patient interaction through research to continuing professional development, the move online has unlocked another layer of conversation, dissemination, and, indeed, caveats. Social media have a democratizing effect, placing patients, trainees, practitioners, and thought leaders in the same arena and on equal footing. If uptake of social media in medicine even remotely parallels its rise to ubiquity in other areas, it will only expand and evolve in the coming years. For these reasons, this article presents an overview of the most recent data on the impact and potential complications of social media usage in the urologic community.

  19. Urological conditions in pregnancy: a diagnostic and therapeutic challenge.

    Science.gov (United States)

    Shrotri, K N; Morrison, I D; Shrotri, N C

    2007-10-01

    Urological conditions in pregnancy represent a major diagnostic and therapeutic challenge. The potential adverse effects of anaesthesia, radiation and drugs on the fetus often complicate traditional diagnostic and treatment measures. As frontline clinicians, obstetricians need an awareness of symptoms, associated obstetric complications and an appreciation of available current diagnostic and therapeutic modalities and their associated risks. This article describes common urinary problems encountered in pregnancy: infection, hydronephrosis and urolithiasis specifically. The aim of this paper is to review the safety, efficacy and role of different imaging studies available for the diagnosis of urolithiasis in pregnancy. Conservative management as first line treatment and a variety of interventional urological procedures with postoperative management are also discussed. Such a background may facilitate a rational management protocol for urological problems in a pregnant woman.

  20. The role of human papilloma virus in urological malignancies.

    Science.gov (United States)

    Heidegger, Isabel; Borena, Wegene; Pichler, Renate

    2015-05-01

    Human papillomavirus (HPV) is associated with cancer of the cervix uteri, penis, vulva, vagina, anus and oropharynx. However, the role of HPV infection in urological tumors is not yet clarified. HPV appears not to play a major causative role in renal and testicular carcinogenesis. However, HPV infection should be kept in mind regarding cases of prostate cancer, as well as in a sub-group of patients with bladder cancer with squamous differentiation. Concerning the role of HPV in penile cancer incidence, it is a recognized risk factor proven in a large number of studies. This short review provides an update regarding recent literature on HPV in urological malignancies, thereby, also discussing possible limitations on HPV detection in urological cancer.

  1. Image-guided urological interventions: What the urologists must know

    Directory of Open Access Journals (Sweden)

    Chandan J Das

    2015-01-01

    Full Text Available Advances in imaging technology, especially in the last two decades, have led to a paradigm shift in the field of image-guided interventions in urology. While the traditional biopsy and drainage techniques are firmly established, image-based stone management and endovascular management of hematuria have evolved further. Ablative techniques for renal and prostate cancer and prostate artery embolization for benign prostatic hypertrophy have evolved into viable alternative treatments. Many urologic diseases that were earlier treated surgically are now effectively managed using minimally invasive image-guided techniques, often on a day care basis using only local anesthesia or conscious sedation. This article presents an overview of the technique and status of various image-guided urological procedures, including recent emerging techniques.

  2. 慢性盆腔炎患者治疗前后生活质量调查%Quality of life suvery of patients with chronic pelvic inflammatory disease before and after treatment

    Institute of Scientific and Technical Information of China (English)

    汪文娟

    2015-01-01

    目的:比较慢性盆腔炎患者治疗前后生活质量情况。方法选择在我科治疗的慢性盆腔炎患者160例为研究对象。对治疗前后的患者生活质量进行调查并比较,并分析年龄对患者生活质量的影响。结果治疗后患者腹痛、腹胀、异常分泌物、尿频、尿痛、发热、性生活频率、睡眠质量方面均有显著改善(P<0.05)。20~40岁的患者治疗后生活质量改善显著(P<0.01),而>40岁的患者治疗前后生活质量并没有显著的改善。结论慢性盆腔炎给女性患者的生活质量造成严重的影响,治疗后患者生活质量得到显著的改善。%Objective To compare quality of life of patients with pelvic inflammatory disease before and after treatment. Methods 160 cases with pelvic inflammatory disease were selected as subjects. Quality of life before and after treatment were surveyed and compared, and effect of age on quality of life was analyzed. Results Abdominal pain, abdominal distention, abnormal secretions, frequent urination, urinary pain, fever, frequency of sexual life, sleep quality improved apparently after treatment(P 40 years old showed no significant improvement after treatment. Conclusion Pelvic inflammation cause serious influence on quality of life of patients, and after treatment quality of life improves.

  3. [Functional aspects of pelvic floor surgery].

    Science.gov (United States)

    Wagenlehner, F M E; Gunnemann, A; Liedl, B; Weidner, W

    2009-11-01

    Pelvic floor dysfunctions are frequently seen in females. The human pelvic floor is a complex structure and heavily stressed throughout female life. Recent findings in the functional anatomy of the pelvic floor have led to a much better understand-ing, on the basis of which enormous improvements in the therapeutic options have arisen. The pelvic floor activity is regulated by three main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor -organs, bladder and rectum. For different reasons laxity in the vagina or its supporting ligaments as a result of altered connective tissue can distort this functional anatomy. A variety of symptoms can derive from these pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, faecal incontinence, obstructive bowel disease syndrome and pelvic pain. Pelvic floor reconstruction is nowadays driven by the concept that in the case of pelvic floor symptoms restoration of the anatomy will translate into restoration of the physiology and ultimately improve the patients' symptoms. The exact surgical reconstruction of the anatomy is there-fore almost exclusively focused on the restoration of the lax pelvic floor ligaments. An exact identification of the anatomic lesions preoperatively is eminently necessary, to allow for an exact anatomic reconstruction with respect to the muscular forces of the pelvic floor.

  4. Synthetic biomaterials for pelvic floor reconstruction.

    Science.gov (United States)

    Karlovsky, Matthew E; Kushner, Leslie; Badlani, Gopal H

    2005-09-01

    Pelvic organ prolapse and stress urinary incontinence increase with age. The increasing proportion of the aging female population is likely to result in a demand for care of pelvic floor prolapse and incontinence. Experimental evidence of altered connective tissue metabolism may predispose to pelvic floor dysfunction, supporting the use of biomaterials, such as synthetic mesh, to correct pelvic fascial defects. Re-establishing pelvic support and continence calls for a biomaterial to be inert, flexible, and durable and to simultaneously minimize infection and erosion risk. Mesh as a biomaterial has evolved considerably throughout the past half century to the current line that combines ease of use, achieves good outcomes, and minimizes risk. This article explores the biochemical basis for pelvic floor attenuation and reviews various pelvic reconstructive mesh materials, their successes, failures, complications, and management.

  5. [Complex pelvic injury in childhood].

    Science.gov (United States)

    Schmal, H; Klemt, C; Haag, C; Bonnaire, F

    2002-08-01

    Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.

  6. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual gastroenterology-urology surgical... Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification. A manual gastroenterology-urology surgical instrument and accessories is a device designed to...

  7. Urological Surveillance and Medical Complications after Spinal Cord Injury in the United States

    NARCIS (Netherlands)

    Cameron, Anne P.; Lai, Julie; Saigal, Christopher S.; Clemens, J. Quentin; Wijmenga, T. J.

    2015-01-01

    OBJECTIVE To evaluate the national patterns of urologic follow up after spinal cord injury (SCI) and the occurrence and predictors of urological complications. MATERIALS AND METHODS This retrospective cohort study used a 5% sample of Medicare data 2007-2010. The minimum adequate urologic surveillanc

  8. Genitourinary Prosthetics: A Primer for the Non-urologic Surgeon.

    Science.gov (United States)

    Lavien, Garjae; Zaid, Uwais; Peterson, Andrew C

    2016-06-01

    Genitourinary prosthetics are used for correction of functional deficits and to improve the quality of lives of affected patients. General surgeons must evaluate patients scheduled for nonurologic surgery with urologic devices that can impact their perioperative management. Lack of recognition of these prosthetics preoperatively can lead to unnecessary morbidity for the patient and have legal implications for the surgeon. Close consultation with a urologist may avoid common complications associated with these devices and allows for surgical assistance when operative misadventures do occur. This article reviews 3 common urologic prosthetics: testicular prosthesis, artificial urinary sphincter, and penile prosthesis.

  9. Surgical Management of Urologic Trauma and Iatrogenic Injuries.

    Science.gov (United States)

    Zinman, Leonard N; Vanni, Alex J

    2016-06-01

    Genitourinary trauma usually occurs in the setting of multisystem trauma, accounting for approximately 10% of all emergency department admissions. Timely evaluation and management of the trauma patient have the potential to minimize urologic morbidity and mortality. New imaging modalities and a growing emphasis on nonoperative expectant management of both upper and lower urinary tract injuries have changed the field of urologic trauma. Concomitant injury to both the upper and the lower urinary tract is rare, but careful evaluation is critical to identify these devastating injuries.

  10. A rare presentation of appendiceal diverticulitis associated with pelvic pseudocyst

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    We report a case of a 32-year-old woman with episodic right lower quadrant abdominal pain. With the diagnosis of either acute appendicitis or tuba-ovarian abscess, she was treated with antibiotics, which successfully relieved the pain and the inflammatory findings. She repeated the clinical condition a few times and antibiotics worked each time. In a year, her subjective symptoms became milder, however, a giant pelvic cyst appeared. She had an exploratory laparotomy to confirm this diagnosis. Histopathological studies revealed herniated appendiceal mucosa through the muscular layer associated with chronic inflammation and marked fibrosis. Gynecological disorders such as endometriosis or lutein cyst rupture was denied. These findings represent appendiceal diverticulitis. We discuss the clinical features of the disease and its relation with the pelvic pseudocyst.

  11. Validation of the Pelvic Floor Distress Inventory-20 and the Pelvic Floor Impact Questionnaire-7 in Danish women with pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2013-01-01

    To translate the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) and to evaluate their psychometric properties in Danish women with symptomatic pelvic organ prolapse.......To translate the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) and to evaluate their psychometric properties in Danish women with symptomatic pelvic organ prolapse....

  12. Pelvic compartment syndrome caused by retroperitoneal hematoma of pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Feng-qi; ZHANG Ying-ze; PAN Jin-she; PENG A-qin; WANG Hui-juan

    2005-01-01

    @@ Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis.

  13. 慢性前列腺炎/慢性骨盆疼痛综合征的发病相关危险因素分析%Analysis on related dangerous factors of morbidity of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

    Institute of Scientific and Technical Information of China (English)

    李春弟; 崔崑; 蒋聿瑛

    2015-01-01

    Objective To discuss the related dangerous factors of morbidity of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods A total of 200 cases of clinical information of patients with CP/CPPS were analyzed, re-ceived and cured, who were selected as observation group, and 200 cases of male urinary systerm infection patients, who given the medical treatment at the same time were selected as control group. The circumstances of urethritis, unre-strained sexual life, frequent masturbation, urinary injury, anxious psychology, infection of sexual partner, long-time withholding urine, frequent stay up and long-term fixed position of patients in two groups were observed. The multi-variate Logistic regression analysis on patients with CP/CPPS were observed. Results The circumstances of unrestrained sexual life, frequent masturbation, anxious psychology, long-time withholding urine, frequent stay up and long-term fixed position of patients in two groups, statistical differences were appeared (P<0.05), which were the dangerous fac-tors to induce CP/CPPS by multivariate Logistic regression analysis on patients with CP/CPPS (P<0.05). Conclusion Healthy living habit, regular and moderate sexual life, positive psychology and suitable self healthy care are the basis to decrease occurrences of CP/CPPS.%目的:探讨慢性前列腺炎/慢性骨盆疼痛综合征的发病相关危险因素情况。方法分析收治的200例慢性前列腺炎/慢性骨盆疼痛综合征患者的临床资料,选取慢性前列腺炎/慢性骨盆疼痛综合征患者作为观察组,同时选取同期收治的男性泌尿系感染患者200例作为对照组。观察两组患者尿道炎、无节制性生活、频繁手淫、泌尿损伤、焦虑心理、性伴侣感染、长时间憋尿、经常熬夜、长期固定体位情况。观察慢性前列腺炎/慢性骨盆疼痛综合征患者多因素Logistic回归分析情况。结果两组患者无节制性生活、频繁手淫、焦虑

  14. Laser therapy in the treatment of urological diseases

    Science.gov (United States)

    Nelius, T.; de Riese, W. T.; Reiher, F.; Filleur, S.; Allhoff, E. P.

    2006-02-01

    Applications of lasers (light amplification by stimulated emission of radiation) in various disciplines of medicine including Urology are well developed. Urology is among the medical specialties that apply many different types of laser systems to treat a broad spectrum of clinical conditions ranging from genital, bladder and urethral tumors to the treatment of benign prostate hyperplasia (BPH), urethral strictures, and stones. The specific application of various laser systems depends on the characteristics of the laser itself, delivery media for the beams, laser-tissue interaction and the desired effect. These complex conditions require an intensive and continuous exchange of information between non-medical researchers and physicians to verify "what is currently technically possible and what is medically needed". Only this exchange can lead to the development of new laser systems. While lasers have become the treatment of choice in some conditions, they could not, despite excellent clinical results, replace conventional therapy options in others. Nonetheless, the use and the introduction of lasers of different wavelengths forces urologists to keep step with the fast developing laser technology. This paper reviews current indications for clinical laser applications relevant to urology and the advantages and disadvantages of using lasers for the management of various urological lesions.

  15. Tumor banks: the cornerstone of basic research in urology

    Directory of Open Access Journals (Sweden)

    Sabrina T. Reis

    2010-06-01

    Full Text Available PURPOSE: Tumor banks have the primary responsibility for collecting, cataloging, storing and disseminating samples of tissues, cells and fluids, which are used by researchers to identify diagnostic molecular markers, prognostic indicators and therapeutic targets. The objective of this review was to describe a simple, reliable and reproducible protocol for obtaining and storing samples of urological tumors. MATERIALS AND METHODS: Urogenital tumor tissues were collected by the surgeons from the Urology Division of University of Sao Paulo Medical School. The obtained surgical specimens were immediately placed in liquid nitrogen, dry ice or in a tube containing RNAlater ®, and then stored by cryopreservation (-80°C. A mirror fragment was fixed in 10% formalin processed routinely and embedded in Paraplast®. RESULTS: We developed a protocol for the collection, cataloging, storage, conservation and use of tumor samples. During a period of one year the Urological Tumor Bank of the Urology Division stored 274 samples of prostate, bladder, kidney, penis and testicle tumors of different histological types, 74 urine and 271 serum samples. CONCLUSIONS: Having biological materials characterized and available along with the clinical patient information provides an integrated portrait of the patients and their diseases facilitating advances in molecular biology. It also promotes the development of translational research improving methods of diagnosis and cancer treatment.

  16. 'Image and treat': an individualized approach to urological tumors

    DEFF Research Database (Denmark)

    Bouchelouche, Kirsten; Capala, Jacek

    2010-01-01

    The current treatment options for advanced urologic cancers demonstrate limited efficacy. To obtain optimal clinical results, there is a need for new, individualized, therapeutic strategies, which have only recently been applied to these malignancies. Nuclear medicine plays an important role in e...

  17. [Artificial neural networks for decision making in urologic oncology].

    Science.gov (United States)

    Remzi, M; Djavan, B

    2007-06-01

    This chapter presents a detailed introduction regarding Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. It includes a description of ANNs methodology and points out the differences between Artifical Intelligence and traditional statistic models in terms of usefulness for patients and clinicians, and its advantages over current statistical analysis.

  18. The spectrum of urological disease in patients with spina bifida.

    LENUS (Irish Health Repository)

    Cahill, R A

    2012-02-03

    BACKGROUND: [corrected] Urological complications are the major cause of ill health during childhood and adult life of patients with spina bifida but the significance of urinary tract disease on the individual and the healthcare services is underemphasised. AIM: To assess the effects of spina bifida on the individual and the healthcare services. METHODS: A retrospective review was performed to assess the frequency and significance of urological conditions requiring hospital attendance in patients with spina bifida currently attending a specialised multidisciplinary clinic over a period of six months. RESULTS: Urinary sepsis accounted for the majority of admissions (62%), while 38 of 62 patients required 60 surgical procedures. Targeting the primary urological abnormality (the dysfunctional and usually poorly compliant bladder) allows implementation of effective treatments, including regular intermittent bladder catherisation (52%) in order to preserve upper renal tract function. Associated postural abnormalities complicated both conservative and interventional therapies. CONCLUSION: This study highlights the surgical commitment for units caring for patients with spina bifida, the important considerations for the future healthcare services, and the range and severity of urological diseases encountered by these patients.

  19. [Sexual dysfunction following pelvic surgery].

    Science.gov (United States)

    Hojo, K

    1997-11-01

    In male, sexual dysfunction was a common complication that occurred after radical pelvic surgery: radical protectomy, radical cysto-, prostatectomy. Upon the recent pelvic neuroanatomical findings and preservation of these nerves, it is now possible to perform successful cancer operation on the rectum, prostate or bladder with preservation of sexual function in the group of early cancer patients. Depending on the location and severity of these nerve injury, this could result in temporary or permanent erectile and ejaculation dysfunction. In female, the total hysterectomy for cervical cancer sacrifices or injuries the faculty of pregnancy or sexual intercourse. The oophorectomies causes a deficiency of female hormones. But recently the numbers of patients with a small or early stages cancer of uterine or ovary are increasing and we have become to be able to save the functions of these organs in many patients well with minimum local excision or partial resection of them.

  20. Obesity and pelvic floor dysfunction.

    Science.gov (United States)

    Ramalingam, Kalaivani; Monga, Ash

    2015-05-01

    Obesity is associated with a high prevalence of pelvic floor disorders. Patients with obesity present with a range of urinary, bowel and sexual dysfunction problems as well as uterovaginal prolapse. Urinary incontinence, faecal incontinence and sexual dysfunction are more prevalent in patients with obesity. Uterovaginal prolapse is also more common than in the non-obese population. Weight loss by surgical and non-surgical methods plays a major role in the improvement of these symptoms in such patients. The treatment of symptoms leads to an improvement in their quality of life. However, surgical treatment of these symptoms may be accompanied by an increased risk of complications in obese patients. A better understanding of the mechanism of obesity-associated pelvic floor dysfunction is essential.

  1. 14A. Pelvic Pain and Headache in an Adolescent Female: A Case of Self-determination and Healthful Recovery

    OpenAIRE

    Daut, Alexys

    2013-01-01

    Focus Areas: Integrative Approaches to Care, Pediatrics, Alleviating Pain A 16-year-old previously healthy white female presented to our office with complaints of a 1-year history of chronic severe pelvic pain, leg pain, and severe daily headaches that were adversely affecting her school performance. Her leg and pelvic pain caused weakness and discomfort to the point that she used a walker or a wheelchair when she had to ambulate distances longer than 20 feet. She had been disenrolled from sc...

  2. Pelvic morphology in ischiofemoral impingement

    Energy Technology Data Exchange (ETDEWEB)

    Bredella, Miriam A.; Azevedo, Debora C.; Oliveira, Adriana L.; Simeone, Frank J.; Chang, Connie Y.; Torriani, Martin [Massachusetts General Hospital, Department of Radiology, Musculoskeletal Imaging and Intervention, Boston, MA (United States); Stubbs, Allston J. [Wake Forest University School of Medicine, Department of Orthopedic Surgery, Division of Sports Medicine, Winston-Salem, NC (United States)

    2014-11-06

    To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls. The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender. The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15 %) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender. Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI. (orig.)

  3. The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes.

    Science.gov (United States)

    Everaert, K; Devulder, J; De Muynck, M; Stockman, S; Depaepe, H; De Looze, D; Van Buyten, J; Oosterlinck, W

    2001-01-01

    The aim of the study was to report our results of sacral nerve stimulation in patients with pelvic pain after failed conservative treatment. From 1992 to August 1998 we treated 111 patients (40 males, 71 females, ages 46 +/- 16 years) with chronic pelvic pain. All patients with causal treatment were excluded from this study. Pelvic floor training, transcutaneous electrical nerve stimulation (TENS) and intrarectal or intravaginal electrostimulation were applied and sacral nerve stimulation was used for therapy-resistant pain. The outcome of conservative treatment and sacral nerve stimulation (VAS 50% pain relief) was related to symptoms of voiding dysfunction and dyschezia, and urodynamic proof of dysfunctional voiding, not to the pain localization or treatment modality. Outcome was inversely related to neuropathic pain. When conservative treatment failed, a test stimulation of the S3 root was effective in 16/26 patients, and 11 patients were implanted successfully with a follow-up of 36 +/- 8 months. So far no late failures have been seen. A longer test stimulation is needed in patients with pelvic pain because of a higher incidence of initial false positive tests. Our conclusion is that sacral nerve stimulation is effective in the treatment of therapy-resistant pelvic pain syndromes linked to pelvic floor dysfunction.

  4. Patient Understanding of Pelvic Floor Disorders: What Women Want to Know

    Science.gov (United States)

    Kiyosaki, Krista; Ackerman, A. Lenore; Histed, Stephanie; Sevilla, Claudia; Eilber, Karyn; Maliski, Sally; Anger, Jennifer

    2013-01-01

    Objective To assess the effect of initial visit with a specialist on disease understanding in women with pelvic floor disorders. Methods Women with referrals or chief complaints suggestive of urinary incontinence (UI) or pelvic organ prolapse (POP) were recruited from an academic urology clinic. Patients completed a Test of Functional Health Literacy in Adults (TOFHLA) and scripted interview sessions before and after the physician encounter. Physician treatment plans were standardized based on diagnosis and were explained using models. Interview transcripts were analyzed using qualitative grounded theory methodology. Results Twenty women with pelvic floor disorders (UI or POP) were recruited and enrolled in this pilot study. The mean age was 60.5 years (range 31–87 years) and the majority of women were Caucasian with a college degree or beyond. TOFHLA scores indicated adequate to high levels of health literacy. Preliminary themes before and after the physician encounter were extracted from interviews, and two main concepts emerged: 1) After the initial physician visit, knowledge of their diagnosis and the ability to treat their symptoms relieved patient concerns related to misunderstandings of the severity of their disease 2) Patients tended to focus on treatment and had difficulty grasping certain diagnostic terms. This resulted in good understanding of treatment plans despite an inconsistent understanding of diagnosis. Conclusion Our findings demonstrated a significant effect of the initial physician visit on patient understanding of her pelvic floor disorder. Despite the variation in diagnostic recall after the physician encounter, patients had good understanding of treatment plans. This served to increase perceived control and adequately relieve patient fears. PMID:22543763

  5. 关于盆腔疼痛与妇科疾病的探讨%Discussion on pelvic pain and gynecological diseases

    Institute of Scientific and Technical Information of China (English)

    黄阳玲

    2015-01-01

    Chronic pelvic pain (Chronic Pelvie Pain, CPP) occurred in the pelvic cavity within the scope of the chronic non periodic, recurrent attacks of over six for 6 months, causing pain symptoms of dysfunction or drug oroperation treatment, is a common gynecological disorder. In order tofind the way to relieve women pelvic pain, this paper discusses the causes of chronic pelvic pain, pelvic pain and analyzes the relationship between thedisease of Department of gynaecology, thus draws the conclusion:chronic pelvic pain is very common, but the cause of chronic pelvic pain in women is very complex, involving many gynecological diseases, should be targeted to patients with chronic the specific causes of pelvic pain fortargeted prevention and control.%慢性盆腔疼痛(Chronic Pelvie Pain,CPP)是发生在盆腔范围内的慢性无周期性的、反复发作超六6个月,产生功能障碍或需要药物或手术治疗的疼痛症状,是一种常见的妇科症状。为了找到缓解女性朋友盆腔疼痛的方法,本文探讨了慢性盆腔疼痛的病因,分析了盆腔疼痛与妇科疾病的关系,从而得出结论:慢性盆腔疼痛十分常见,而引起女性慢性盆腔疼痛的原因也十分复杂,涉及妇科中的诸多疾病,应针对具体病因对慢性盆腔疼痛患者进行有针对性的防治。

  6. Vaginal shape at resting pelvic MRI: Predictor of pelvic floor weakness?

    OpenAIRE

    Tillack, AA; Joe, B; Yeh, B; Jun, SL; Kornak, J; Zhao, S; Deng, D

    2014-01-01

    © 2014 Elsevier Inc. Objective: The objective was to determine if alteration in vaginal shape seen on nonstraining pelvic magnetic resonance (MR) scans is associated with pelvic floor weakness. Methods: Two readers classified the shape of the middle third of the vagina on resting T2-weighted axial images as normal or abnormal for 76 women with and without pelvic floor weakness. Results: The sensitivity and specificity for diagnosing pelvic floor dysfunction were 84% and 68% for reader A and 4...

  7. Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Pelvic Organ Prolapse Women

    OpenAIRE

    Ying, Tao; Li, Qin; Xu, Lian; Liu, Feifei; Hu, Bing

    2012-01-01

    The present study investigated the morphology and structure of pelvic floor in 50 nulliparous and 50 pelvic organ prolapse (POP) women using translabial three-dimensional (3D) ultrasound. The levator hiatus in POP women was significantly different from that in nullipara women. In POP women, the size of pelvic floor increased, with a circular shape, and the axis of levator hiatus departed from the normal position in 36 (72%) cases. The puborectalis was avulsed in 18 (36%) cases and the pelvic ...

  8. Primary Clear Cell Adenocarcinoma of a Urethral Diverticulum Treated with Multidisciplinary Robotic Anterior Pelvic Exenteration

    Directory of Open Access Journals (Sweden)

    Dane Scantling

    2013-01-01

    Full Text Available Primary urethral carcinoma is extremely rare and is marked by a variety of clinical symptoms. Primary carcinoma of a urethral diverticulum is still rarer and clear cell adenocarcinoma of the urethra is particularly uncommon (Swartz et al., 2006. Such infrequency has led to inadequate management guidance in the literature for a disease that is often late in presentation and carries substantial morbidity and mortality. This treatable but grave disease deserves definitive curative treatment. We present the first published instance in which it was treated with robotic anterior exenteration. In our case, a 47-year-old female was referred to the urology service for investigation of recurring urinary tract infections. During the workup, the patient was found to have an advanced clear cell urethral adenocarcinoma originating in a urethral diverticulum. We discuss the natural history of this condition, its consequences, and the first instance of its treatment using robotic anterior pelvic exenteration.

  9. The pelvic floor in health and disease.

    OpenAIRE

    Shelton, A A; Welton, M L

    1997-01-01

    Normal pelvic floor function involves a set of learned and reflex responses that are essential for the normal control and evacuation of stool. A variety of functional disturbances of the pelvic floor, including incontinence and constipation, are not life threatening, but can cause significant distress to affected patients. Understanding the normal anatomy and physiology of the pelvic floor is essential to understanding and treating these disorders of defecation. This article describes the nor...

  10. Vaginal childbirth and pelvic floor disorders

    OpenAIRE

    Memon, Hafsa U.; Handa, Victoria L.

    2013-01-01

    Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal deli...

  11. Attitude and perception of urology by medical students at the end of their medical school: An appraisal from Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Saleh Binsaleh

    2015-01-01

    Conclusions: Knowledge of medical school graduates is insufficient in many urologic subjects, and there is a need for more urology exposure. Social reasons and lack of knowledge about urology hinder the choice of urology specialty as a future career. Clearance of learning objectives, immediate and prompt feedback on performance and adequate emphasis of common problems and ambulatory care are some aspects that should be taken into account by curriculum planners as they consider improvements to urology rotation program.

  12. [Functional anatomy of the pelvic floor].

    Science.gov (United States)

    Yiou, René; Delmas, Vincent

    2013-01-01

    The pelvic floor is the support of the pelvic viscera. The levator ani muscle (LA) with its two bundles (pubo- and iliococcygeus) is the major component of this pelvic floor. LA is formed essentially by type I fibers (slow twitch, with high oxidative capability and presence of slow myosin) as in postural muscles. The aerobic metabolism makes LA fragile to excentric contraction and to mitochondrial dysfunction. The innervation of the pelvic floor comes from the 2nd, 3rd, 4th anterior sacral roots; denervation affects pelvic dynamism. Perineum includes the musculofascial structures under the LA: ventrally the striated sphincter of urethra and the ischiocavernosus and bulbospongiosus, caudally the fatty tissue filling the ischioanal fossa. Pelvic fascia covers the muscles ; it presents reinforcements : the uterosacral and cardinal ligaments, the arcus tendineus fascia pelvis (ATFP) and the arcus tendineus levator ani (ATLA). The pelvis statics is supported by the combined action of all this anatomical structures anteriorly forming the perineal "hammock," medially the uterosacral and cardinal ligaments, posteriorly the rectovaginal fascia and the perineal body. The angles formed by the pelvic viscera with their evacuation ducts participate to the pelvic statics. During the pelvic dynamics the modification of these angles expresses the action of the musculofascial structures.

  13. Emergency management of hemodynamically unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-gang

    2011-01-01

    Pelvic fractures are serious injuries.Death within 24 hours is most often a result of acute blood loss.The emergency management of these patients is challenging and controversial.The key issues in its management are identifying the site(s) of hemorrhage and then controlling the bleeding.Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team.The issues addressed in this management algorithm are diagnostic evaluation,damage control resuscitation,indications for noninvasive pelvic stabilization,preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography.This review article focuses on the recent body of knowledge on those determinations.

  14. Assessment of pelvic floor dysfunctions using dynamic magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Hoda Salah Darwish

    2014-03-01

    Conclusion: Dynamic MRI is an ideal, non invasive technique which does not require patient preparation for evaluation of pelvic floor. It acts as one stop shop for diagnosing single or multiple pelvic compartment involvement in patients with pelvic floor dysfunction.

  15. Testing of the Anorectal and Pelvic Floor Area

    Science.gov (United States)

    ... Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Personal Stories Contact About GI Motility ... Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Personal Stories Contact Anorectal and Pelvic ...

  16. Shared genetic factors underlie chronic pain syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Zavos, Helena M. S.; Lachance, Genevieve; Hammond, Christopher J.; Williams, Frances M. K.

    2014-01-01

    Chronic pain syndromes (CPS) are highly prevalent in the general population, and increasingly the evidence points to a common etiological pathway. Using a large cohort of twins (n = 8564) characterized for chronic widespread musculoskeletal pain (CWP), chronic pelvic pain (PP), migraine (MIG), dry e

  17. Embolization of Incompetent Pelvic Veins for the Treatment of Recurrent Varicose Veins in Lower Limbs and Pelvic Congestion Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Meneses, Luis, E-mail: lmeneseq@gmail.com; Fava, Mario; Diaz, Pia; Andia, Marcelo [Pontificia Universidad Catolica de Chile, Radiology Department and Biomedical Imaging Center (Chile); Tejos, Cristian; Irarrazabal, Pablo [Pontificia Universidad Catolica de Chile, Biomedical Imaging Center (Chile); Uribe, Sergio, E-mail: suribe@med.puc.cl [Pontificia Universidad Catolica de Chile, Radiology Department and Biomedical Imaging Center (Chile)

    2013-02-15

    We present our experience with embolization of incompetent pelvic veins (IPV) in women with recurrence of varicose veins (VV) in lower limbs, as well as symptoms of pelvic congestion syndrome (PCS), after first surgery. In addition, we evaluated the effects of embolization in decreasing the symptoms of VV before surgery as well as its effects on PCS symptoms. We included 10 women who had consulted a vascular surgeon because of recurrent VV in lower limbs after surgery. All of these patients were included in the study because they also had symptoms of PCS, probably due to IPV. In patients who had confirmed IPV, we performed embolization before a second surgery. VV and PCS were assessed before and at 3 months after embolization (before the second surgery) using a venous clinical severity score (VCSS) and a visual analog pain scale (VAS), respectively. Patients were controlled between 3 and 6 months after embolization. Paired Student t test analysis was used for comparing data before and after embolization. Fifteen vein segments in 10 women were suitable for embolization. There was a significant (p < 0.001) decrease of VCSS after embolization, and recurrence of VV was not detected within a period of 6 months. There was also significant (p < 0.01) relief of chronic pelvic pain related to PCS evaluated using VAS at 3 months after embolization. Embolization decreases the risk of VV recurrence after surgery and also improves PCS symptoms in women with VV in lower limbs and IPV.

  18. Intraoperative radioguidance with a portable gamma camera: a novel technique for laparoscopic sentinel node localisation in urological malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Vermeeren, L.; Valdes Olmos, R.A.; Vogel, W.V.; Sivro, F.; Hoefnagel, C.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Meinhardt, W.; Bex, A.; Poel, H.G. van der; Horenblas, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands)

    2009-07-15

    Our aim was to assess the feasibility of intraoperative radioguidance with a portable gamma camera during laparoscopic sentinel node (SN) procedures in urological malignancies. We evaluated the use of the intraoperative portable gamma camera in 20 patients: 16 patients with prostate carcinoma (PCC), 2 patients with renal cell carcinoma (RC) and 2 patients with testicular cancer (TC). Intra/peritumoural injection of {sup 99m}Tc-nanocolloid ({sup 99m}Tc) was followed by planar lymphoscintigraphy, SPECT/CT and marking of SN levels. Before laparoscopy a {sup 125}I seed was fixed on the laparoscopic gamma probe as a pointer of SN seeking. The portable gamma camera was set to display the {sup 99m}Tc signal for SN localisation and the {sup 125}I signal for SN seeking. Matching of these signals on screen indicated exact SN localisation, and consequently this SN was removed. The mean injected dose was 218 MBq in PCC, 228 MBq in RC and 88 MBq in TC. Pelvic SN were visualised in all PCC patients, with uncommonly located SN in seven patients. SN metastases were found in seven patients (one in a uncommonly located SN). Both RC patients and TC patients had para-aortic SN, which were all tumour free. A total of 59 SN were removed. The portable gamma camera enabled real-time SN display/identification in 18 patients (90%). The use of a portable gamma camera in combination with a laparoscopic gamma probe incorporates intraoperative real-time imaging with improved SN identification in urological malignancies. This procedure might also be useful for SN identification of other deep draining malignancies. (orig.)

  19. [Urology and Sexology in Berlin 1880-1933: Original citations for the establishment of this frontier of urology - protagonists as reflected in their publications].

    Science.gov (United States)

    Moll, Friedrich H; Fangerau, Heiner

    2016-02-01

    The connections between urology and sexology are often not obvious today. At the end of the 19th century both specialties developed in parallel especially in Berlin and had a fruitful relationship. Urologic journals and books were an ideal forum for publication especially for sexologists.

  20. Combination therapy of non-intrusive ultrasound with integrated Chinese-western medcine for chronic prostatitis/chronic pelvic pain syndrome%非介入式前列腺超声联合中西药治疗慢性前列腺炎/慢性骨盆疼痛综合征

    Institute of Scientific and Technical Information of China (English)

    迟凯凯; 王瑞; 崔勇; 陈铸; 何伟; 王锁刚; 张卫星; 王光策

    2014-01-01

    目的:探讨非介入式前列腺超声联合中西药治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的临床效果。方法收集临床诊断为CP/CPPS且符合研究标准的患者105例,随机分为3组,每组35例。A组采用非介入式前列腺超声联合中西药治疗方法;B组为中西药物治疗组;C组单用非介入式前列腺超声治疗。观察各组治疗前后前列腺炎症状指数(NIH-CPSI)疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分及各组治疗总有效率。结果3组治疗前后NIH-CPSI疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分差异比较有统计学意义(P<0.05)。治疗后,A组分别与B组、C组比较,NIH-CPSI疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分差异均具有统计学意义(P<0.05);B组与C组比较差异无统计学意义(P>0.05)。治疗总有效率,A组为88.6%,B组为68.6%,C组为74.3%,A组总有效率最高,A组与B组C组比较差异均具统计学意义(P<0.05)。结论非介入式前列腺超声与中西药在临床治疗CP/CPPS中具有协同作用,非介入式前列腺超声联合中西药治疗方法能明显改善CP/CPPS患者的NIH-CPSI疼痛或不适症状、排尿症状,提高生活质量。%Objective To investigate the clinical effects of combination therapy of non-intrusive ultrasound with integrated Chinese-western medcine for patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods A total of 105 cases withCP/CPPS were randomly divided into a combined non-intrusive ultrasound with integrated Chinese-western medcine group (group A, n=35), a Chinese-western medcine group (group B, n=35) and a non-intrusive ultrasound group (group C, n=35). The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores were obtained before and after treatment

  1. Reconstructive options in pelvic tumours

    Directory of Open Access Journals (Sweden)

    Mayilvahanan N

    2005-01-01

    Full Text Available Background: Pelvic tumours present a complex problem. It is difficult to choose between limb salvage and hemipelvectomy. Method: Forty three patients of tumours of pelvis underwent limb salvage resection with reconstruction in 32 patients. The majority were chondrosarcomas (20 cases followed by Ewing sarcoma. Stage II B was the most common stage in malignant lesions and all the seven benign lesions were aggressive (B3. Surgical margins achieved were wide in 31 and marginal in 12 cases. Ilium was involved in 51% of cases and periacetabular involvement was seen in 12 patients. The resections done were mostly of types I &II of Enneking′s classification of pelvic resection. Arthrodesis was attempted in 24 patients. Customized Saddle prosthesis was used in seven patients and no reconstruction in 12 patients. Adjuvant chemotherapy was given to all high-grade malignant tumours, combined with radiotherapy in 7 patients. Results: With a mean follow up of 48.5 months and one patient lost to follow up, the recurrence rate among the evaluated cases was 16.6%. Oncologically, 30 patients were continuously disease free with 7 local recurrences and 4 deaths due to disseminated disease and 2 patients died of other causes. During the initial years, satisfactory functional results were achieved with prosthetic replacement. Long-term functional result of 36 patients who were alive at the time of latest follow up was satisfactory in 75% who underwent arthrodesis and in those where no reconstruction was used. We also describe a method of new classification of pelvic resections that clarifies certain shortcomings of the previous systems of classification. Conclusion: Selection of a procedure depends largely on the patient factors, the tumour grade, the resultant defect and the tissue factors. Resection with proper margins gives better functional and oncological results

  2. Imaging of male pelvic trauma.

    Science.gov (United States)

    Avery, Laura L; Scheinfeld, Meir H

    2012-11-01

    Prompt imaging plays an important role in the evaluation of male pelvic soft tissue trauma. Using appropriate imaging modalities, with optimization of contrast administration when appropriate, is essential for accurate diagnosis. Traumatic bladder rupture, either extraperitoneal or intraperitoneal, is diagnosed with high accuracy using computed tomography cystography. Suspicion of urethral injury warrants evaluation with retrograde urethrography to evaluate for the presence of injury and injury location. Early identification of laceration of the testicular tunica albuginea is essential. Understanding both normal penile anatomy and the imaging appearance of corpus rupture (as opposed to a hematoma) is imperative for proper diagnosis and management.

  3. [Functional rehabilitation of the pelvic floor].

    Science.gov (United States)

    Minschaert, M

    2003-09-01

    Pelvic floor revalidation is devoted to conserve perineal functions as statics, urinary continence and sexual harmony. The therapeutics includes preventive and curative actions, and is based upon muscular and neuromuscular properties of pelvic floor. The different steps are: information, local muscular work, behavioral education, biofeedback, functional electrostimulation, intraabdominal pressure control. The therapeutics is only continued if clinical improvement is demonstrated after 10 sessions.

  4. 38 CFR 4.67 - Pelvic bones.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of...

  5. Application of Virtual, Augmented, and Mixed Reality to Urology.

    Science.gov (United States)

    Hamacher, Alaric; Kim, Su Jin; Cho, Sung Tae; Pardeshi, Sunil; Lee, Seung Hyun; Eun, Sung-Jong; Whangbo, Taeg Keun

    2016-09-01

    Recent developments in virtual, augmented, and mixed reality have introduced a considerable number of new devices into the consumer market. This momentum is also affecting the medical and health care sector. Although many of the theoretical and practical foundations of virtual reality (VR) were already researched and experienced in the 1980s, the vastly improved features of displays, sensors, interactivity, and computing power currently available in devices offer a new field of applications to the medical sector and also to urology in particular. The purpose of this review article is to review the extent to which VR technology has already influenced certain aspects of medicine, the applications that are currently in use in urology, and the future development trends that could be expected.

  6. Antibiotic resistant urinary tract infections in an urology ward

    Directory of Open Access Journals (Sweden)

    A. Rădulescu

    2015-12-01

    Full Text Available Introduction: UTI (urinary tract infections represent a central pathology for a urological service. Antibiotic resistance is growing at a steady and alarming rate worldwide and especially in Romania. Method and materials: We have analyzed all the patients that were admitted to our clinic for continuous hospitalization between January 2015 and October 2015. All patients undergone urine culture and all cultures positive had an antibiogram worked up. We have selected all patients that had antibiotic resistance to at least an antibiotic. Results: From 1745 patients admitted for continuous hospitalization, we had 180 positive urine cultures at admission from which 125 had at least an antibiotic resistance. Conclusions: Antibiotic resistance is a serious phenomenon, with potential lethal complications, which we encounter daily in urological practice.

  7. Robot-assisted laparoscopic urological surgery in children.

    Science.gov (United States)

    Sávio, Luís F; Nguyen, Hiep T

    2013-11-01

    Robot-assisted laparoscopic surgery (RALS) has been proven to be safe and effective for various urological procedures in children, including pyeloplasty, orchiopexy, nephrectomy, and bladder augmentation. The robot system enables delicate and precise movements, which are ideal for the types of reconstructive surgeries that children with urological issues often require, overcoming many of the impediments associated with the conventional laparoscopic approach. RALS helps the relative novice to perform fine surgical techniques and is thought to reduce the learning curve associated with some surgical techniques, such as intracorporeal suturing, owing to the improved freedom of movement of the surgical instruments, the ergonomic positioning of the surgeon, and the 3D vision provided by the robotic system. Given the favourable safety profile and associated benefits of the robot system, including reductions in mean postoperative hospital stay compared with conventional procedures, RALS is becoming more widely adopted by paediatric urologists.

  8. Application of Virtual, Augmented, and Mixed Reality to Urology

    Science.gov (United States)

    2016-01-01

    Recent developments in virtual, augmented, and mixed reality have introduced a considerable number of new devices into the consumer market. This momentum is also affecting the medical and health care sector. Although many of the theoretical and practical foundations of virtual reality (VR) were already researched and experienced in the 1980s, the vastly improved features of displays, sensors, interactivity, and computing power currently available in devices offer a new field of applications to the medical sector and also to urology in particular. The purpose of this review article is to review the extent to which VR technology has already influenced certain aspects of medicine, the applications that are currently in use in urology, and the future development trends that could be expected. PMID:27706017

  9. Design and construction of translational medicine platform for urologic oncology.

    Science.gov (United States)

    Xu, Yong; Yang, Kuo

    2012-03-01

    Translational medicine is a new medical model which focus on overcoming the serious imbalance among the basic research, its clinical and public health application. Its core is to establish effective ties among basic medical researchers, public health workers and doctors who know the needs of patients, particularly translating the molecular medical research results to suitable disease prevention, diagnosis, treatment and prevention methods effectively. This paper discusses the design and construction of the translational medicine platform for urologic system tumors. However, there is no draw on the precedent, it is a challenging project to create such a complicated platform and make it running smoothly and effectively. Based on the Tianjin Translational Medicine Platform for Urologic Oncology (TTMPUO) which had been established in support of Tianjin Science and Technology Commission, this paper will focus on describing the design ideas and the essential parts of the platform.

  10. Optimal management of urosepsis from the urological perspective.

    Science.gov (United States)

    Wagenlehner, Florian M E; Weidner, Wolfgang; Naber, Kurt G

    2007-11-01

    Urosepsis in adults comprises approximately 25% of all sepsis cases and in most cases is due to complicated urinary tract infections (UTIs). In this paper we review the optimal management of urosepsis from the urological point of view. Urosepsis is often due to obstructed uropathy of the upper or lower urinary tract. The treatment of urosepsis comprises four major aspects: 1. Early goal-directed therapy; 2. Optimal pharmacodynamic exposure to antimicrobials both in blood and in the urinary tract; 3. Control of complicating factors in the urinary tract; 4. Specific sepsis therapy. Early tissue oxygenation, appropriate initial antibiotic therapy and rapid identification and control of the septic focus in the urinary tract are critical steps in the successful management of a patient with severe urosepsis. To achieve this goal an optimal interdisciplinary approach encompassing the emergency unit, urological specialties and intensive-care medicine is necessary.

  11. Nuclear medicine in urological cancers: what is new?

    Science.gov (United States)

    Nanni, Cristina; Zanoni, Lucia; Fanti, Stefano

    2014-10-01

    The diffusion of PET/computed tomography has opened up a new role for nuclear imaging in urological oncology. Prostate cancer is evaluated with choline ((11)C or (18)F) PET due to a lack of sensitivity of (18)F-fluorodeoxyglucose (FDG). However, many new tracers, such as (18)F-fluorocyclobutane-1-carboxylic acid and (68)Ga-prostate-specific membrane antigen, are under investigation, offering promising results in the particular setting of radically treated patients with biochemical relapse. The performance of (18)F-FDG depends on the histological type; indeed, renal cell cancer may present variable metabolic uptake. In this field, mainly antibodies labeled with positron emitters are under clinical evaluation. Finally, (18)F-FDG PET/computed tomography has been proven to show good accuracy in detecting metastatic testicular and bladder cancers, despite not having valid results in detecting local disease. The urological cancer diagnostic process is currently under continuous development.

  12. Urologic robotic surgery in Korea: Past and present

    OpenAIRE

    Seo, Ill Young

    2015-01-01

    Since 2005 when the da Vinci surgical system was approved as a medical device by the Korean Ministry of Health and Welfare, 51 systems have been installed in 40 institutions as of May 2015. Although robotic surgery is not covered by the national health insurance service in Korea, it has been used in several urologic fields as a less invasive surgery. Since the first robotic-assisted laparoscopic radical prostatectomy in 2005, partial nephrectomy, radical cystectomy, pyeloplasty, and other uro...

  13. [Cyclooxygenase 2 inhibitors and urologic and gynaecologic cancers].

    Science.gov (United States)

    Eschwege, Pascal

    2004-05-01

    PGE2 is one of the most important prostaglandin involved in the oncogenesis. PGE2 is found at high concentration level in the most of epithelial cancer. Urologic and gynaecologic cancer express the enzyme which are at the origin of PGE2: cyclooxygenase 2. Cox2 inhibitors present anticancer properties demonstrated in wide varieties of cellular and animal models. Human applications are currently tested in many clinical trials for bladder, prostate and uterine carcinomas.

  14. Use of a semiconductor-diode laser in urology

    Science.gov (United States)

    Watson, Graham M.

    1994-05-01

    The gallium arsenide semiconductor laser can emit in the near infrared where the depth of penetration into tissue is great although scattering is less than with the Nd:YAG laser. The laser is highly compact. It runs off a normal electrical outlet with no cooling requirement. It is therefore quiet and convenient. The laser has been assessed in a wide variety of applications in our urological department.

  15. Imaging pelvic floor disorders. 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Stoker, Jaap [Amsterdam Univ. (Netherlands). Dept. of Radiology; Taylor, Stuart A. [University College Hospital, London (United Kingdom). Dept. of Specialist X-Ray; DeLancey, John O.L. (eds.) [Michigan Univ., Ann Arbor, MI (United States). L4000 Women' s Hospital

    2008-07-01

    This volume builds on the success of the first edition of imaging pelvic floor disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. (orig.)

  16. Occupational lifting and pelvic pain during pregnancy:

    DEFF Research Database (Denmark)

    Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Juhl, Mette;

    2013-01-01

    OBJECTIVES: Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim...... of this study was to examine the association between occupational lifting and pelvic pain during pregnancy. METHODS: The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996-2002. During pregnancy, the women provided information on occupational lifting...... (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression. RESULTS: Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg...

  17. Role of CD4+ CDhigh25 regulatory T cells and relative cytokines on the pathogenesis of chronic abacterial pros-tatitis/chronic pelvic pain syndrome%慢性非细菌性前列腺炎/慢性骨盆疼痛综合征患者外周血T调节细胞检测及与临床症状的相关性分析

    Institute of Scientific and Technical Information of China (English)

    王少刚; 白剑; 席启林; 胡东亮; 苏世强; 刘继红; 叶章群

    2008-01-01

    Objective To explore the role of CD4+ CDhigh25 regulatory T cells in the pathogenesis of chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS).Methods The percentage of CD4+ CD+25 and CD4+ CDhigh25 regulatory T cells was detected by flow cytometry from 45 CAP/CPPS pa-tients and 18 normal controls.The levels of interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α) and transforming growth factor-β1 (TGF-β1) in serum and seminal plasma were measured by ELISA in the same cohort.Results There was no significant difference in the percentage of peripheral blood CD4+CD+25 and CD4+Cdhigh+ cells between CAP/CPPS patients and normal control (P>0.05).The ser-CD4+CD+25 and CD4+Cdhigh+ cells between CAP/CPPS patients and normal control (P>0.05>.The ser-um levels of TGF-β1 in patients with CAP/CPPS were markedly lower than those in controls (P0.05);与正常对照组比较,CAP/CPPS患者血清中TNF-α水平增加[(0.34±0.01)ng/ml与(0.11±0.01)ng/ml,P0.05;r-=0.506,P>0.05;r=-0.112,P>0.05).结论 外周血CD4+ CDhigh25 T调节细胞数量与CAP/CPPS的发病无明显关联,其功能缺陷可能导致CAP/CPPS发病,细胞因子在CAP/CPPS的发病过程中起重要作用,并且与临床症状密切相关.

  18. Manipulating the epigenome for the treatment of urological malignancies.

    LENUS (Irish Health Repository)

    O'Rourke, Colm J

    2013-05-01

    Urological malignancies (cancers of the prostate, bladder, kidney and testes) account for 15% of all human cancers and more than 500,000 deaths worldwide each year. This group of malignancies is spread across multiple generations, affecting the young (testicular) through middle and old-age (kidney, prostate and bladder). Like most human cancers, urological cancers are characterized by widespread epigenetic insult, causing changes in DNA hypermethylation and histone modifications leading to silencing of tumor suppressor genes and genomic instability. The inherent stability yet dynamic plasticity of the epigenome lends itself well to therapeutic manipulation. Epigenetic changes are amongst the earliest lesions to occur during carcinogenesis and are essentially reversible (unlike mutations). For this reason, much attention has been placed over the past two decades on deriving pharmacological compounds that can specifically target and reverse such epi-mutations, either halting cancer on its developmental trajectory or reverting fully formed cancers to a more clinically manageable state. This review discusses DNA methyltransferase and histone deacetylase inhibitors that have been extensively studied in preclinical models and clinical trials for advanced and metastatic urological cancers.

  19. [Transparency regime: semiotics of radiographical images in urological diagnostics].

    Science.gov (United States)

    Martin, M; Fangerau, H

    2012-10-01

    Shortly after Röntgen discovered x-rays urology became one of the main test fields for the application of this new technology. Initial scepticism among physicians, who were inclined to cling to traditional manual methods of diagnosing, was replaced by enthusiasm for radiographic technologies and the new method soon became the standard in, for example the diagnosis of concrements. Patients favoring radiographic procedures over the use of probes and a convincing documentation of stones in radiograms were factors that impacted the relatively rapid integration of radiology into urology. The radiographic representation of soft tissues and body cavities was more difficult and the development of contrast agents in particular posed a serious problem. Several patients died during this research. A new diagnostic dimension was revealed when radiography and cystography were combined to form the method of retrograde pyelography. However, the problem of how urologists could learn how to read the new images remained. In order to allow trainee physicians to practice interpreting radiograms atlases were produced which offered explanatory texts and drawings for radiographic images of the kidneys, the bladder etc. Thus, urologists developed a self-contained semiotics which facilitated the appropriation of a unique urological radiographical gaze.

  20. Non-Traumatic Urologic Emergencies in Men: A Clinical Review

    Directory of Open Access Journals (Sweden)

    Kessler, Chad S

    2009-11-01

    Full Text Available Although true urologic emergencies are extremely rare, they are a vital part of any emergency physician’s (EP knowledge base, as delays in treatment lead to permanent damage. The four urologic emergencies discussed are priapism, paraphimosis, testicular torsion, and Fournier’s gangrene. An overview is given for each, including causes, pathophysiology, diagnosis, treatment, and new developments. The focus for priapism is on diagnosis and distinguishing high-flow from low-flow forms, as the latter requires emergent treatment. For paraphimosis, we describe various methods of relieving the stricture, from manual reduction to surgery in extreme cases. For testicular torsion, the most important factor in salvaging the testicle is decreasing time to treatment. This is accomplished through experience and understanding which signs and symptoms strongly suggest it, so that time-consuming tests are avoided. Lastly, Fournier’s gangrene is potentially fatal. While aggressive medical and surgical therapy will improve chances of survival and outcome, it is vital for the emergency department (ED physician to diagnose Fournier’s. It often presents in the elderly, immunocompromised, or those with depressed mental status. The goal of this paper is to arm EPs with information to recognize urological emergencies and intervene quickly to preserve tissue, fertility, and life.[West J Emerg Med. 2009;10(4:281-287.

  1. [Urologic surgery and risks of complaints in medical responsibility].

    Science.gov (United States)

    Haillot, O; Haertig, A; Vannier, J; Janin, P; Lanson, Y

    1989-01-01

    The card-index study of specialized insurance companies allowed the analysis of 82 cases concerning urological surgical procedures. Forty-two cases went to the Civil Court, 10 to the Penal Court and 5 to the Administrative Tribunal, while 5 cases were simply declared to insurance companies without judiciary consequences. Sixty-two cases concerned private plaintiffs surgeons and 34 cases concerned non specialist urologic surgeons. Sixteen plaintiffs were compensated, 9 after a conciliatory agreement and 7 after trial. There were no penal condemnations (one case on the waiting list). Impotence was the most frequent cause for complaint which was compensated. Next, came incontinence generally secondary to endoscopic resection. Retrospectively, 19 cases seemed to be unwarranted due to the dishonesty of patients (3 patients were prosecuted for unwarranted procedures). On the other hand, 32 cases seemed to be due to a lack of information given to the patients themselves or to their families, either before of after the incriminated act. The risk of prosecution is relatively low in urology. It could be decreased by careful management of the medical chart, by rapid analysis of complications and by a constant effort to inform the patient and his family.

  2. Use of the 2-μm cw laser as addition and/or alternative for the Nd:YAG in urology

    Science.gov (United States)

    de Boorder, Tjeerd; Verdaasdonk, Rudolf; Lock, Tycho; Grimbergen, Matthijs; Klaessens, John

    2007-02-01

    Recently, 2 μm cw laser systems have been introduced for surgery. The 2 μm wavelength is predominantly absorbed by water and enables effective cutting and ablation of tissue similar to the cw CO II laser. In contrast to the CO II laser, the 2 μm wavelength is delivered through fiber optics and available for endoscopic procedures. After many years of experience with the 1.06 μm Nd:YAG laser, we started to use the 2 μm cw laser as alternative for various urological treatments. The treatments strategies and optimal settings were examined in the lab comparing the two 1.06 and 2 μm wavelengths performing thermal measurements. Consequently, the laser was applied for various urological cases. Penile tumors were resected with haemostatic effects and good aesthetic healing comparable with the Nd:YAG laser. Although the Nd:YAG has initially a deeper penetration, the blackening of the fiber during tissue cutting, provides a more superficial effect like the 2 μm laser. Bladder (pre)malignancies were ablated after biopsy. Only with higher stage tumors, coagulation depth of the Nd:YAG might be preferable for adequate treatment. Strictures in the urethra were incised and stents were effectively desobstructed: one patient with a stent implanted after a pelvic trauma, and one patient with catheterizable apedico stoma stenoses. The thermal damage during incision to deeper layers is minimal so recurrence due to scarring is not expected. Also hair grow in patients who underwent urethroplasty was effectively treated and scrotal atheromata cysts were effectively resected without recurrence. Laparoscopic nefrectomies are being considered using the 2 μm cw laser. The 2 μm cw laser has shown to be a versatile instrument for effective treatment of various urological indications. More patients and long term results are needed to prove the clinical significance compared to other treatment modalities

  3. Total pelvic floor ultrasound for pelvic floor defaecatory dysfunction: a pictorial review.

    Science.gov (United States)

    Hainsworth, Alison J; Solanki, Deepa; Schizas, Alexis M P; Williams, Andrew B

    2015-01-01

    Total pelvic floor ultrasound is used for the dynamic assessment of pelvic floor dysfunction and allows multicompartmental anatomical and functional assessment. Pelvic floor dysfunction includes defaecatory, urinary and sexual dysfunction, pelvic organ prolapse and pain. It is common, increasingly recognized and associated with increasing age and multiparity. Other options for assessment include defaecation proctography and defaecation MRI. Total pelvic floor ultrasound is a cheap, safe, imaging tool, which may be performed as a first-line investigation in outpatients. It allows dynamic assessment of the entire pelvic floor, essential for treatment planning for females who often have multiple diagnoses where treatment should address all aspects of dysfunction to yield optimal results. Transvaginal scanning using a rotating single crystal probe provides sagittal views of bladder neck support anteriorly. Posterior transvaginal ultrasound may reveal rectocoele, enterocoele or intussusception whilst bearing down. The vaginal probe is also used to acquire a 360° cross-sectional image to allow anatomical visualization of the pelvic floor and provides information regarding levator plate integrity and pelvic organ alignment. Dynamic transperineal ultrasound using a conventional curved array probe provides a global view of the anterior, middle and posterior compartments and may show cystocoele, enterocoele, sigmoidocoele or rectocoele. This pictorial review provides an atlas of normal and pathological images required for global pelvic floor assessment in females presenting with defaecatory dysfunction. Total pelvic floor ultrasound may be used with complementary endoanal ultrasound to assess the sphincter complex, but this is beyond the scope of this review.

  4. [Wolfgang Amadeus Mozart. A urological pathography].

    Science.gov (United States)

    Hatzinger, M; Häcker, A; Langbein, S; Bross, S; Honeck, P; Alken, P

    2006-04-01

    The death of Wolfgang Amadeus Mozart was mysterious from the very first day, and cause of wildest speculation and adventurous assertions. Over the last 100 years, medical science has investigated the physical sufferings and the mysterious death of Mozart with increasing intensity. By means of letters from his father Leopold, his sister "Nannerl", himself and reports from his physicians and contemporaries, we would like to create a medical pathography. The rumour that Mozart was poisoned appeared soon after his early death at the age of 35 on December 5th 1791, and was kept up persistently. Accused were the physician van Swieten, Mozart's freemason's loge and the royal band master Salieri. Mozart, however, died due to chronic kidney disease and ultimately due to uraemia. Once the renal damage has reached a certain point, a minimum of additional stress leads to decompensation. This catastrophe occurs typically within the fourth decade of life. When listening to Mozart's music, we should remember that this apparently happy person was actually a premature adult robbed of his childhood, whose short life was an endless chain of indisposition, over fatigue, misery, concern and illness.

  5. History of urology in Iwów (Lemberg, Lviv). the impact of political changes on progress in urology and medicine.

    Science.gov (United States)

    Zajaczkowski, Tadeusz

    2013-01-01

    Innovations in diagnostic techniques due to the introduction of endoscopy, and the development in X-ray technology were fundamental in lessening dependence on surgery, and for urology to be recognised as a new discipline. Afterwards, endoscopic surgery came to the fore. Urology in Lemberg, The aim of the study is to present the development of urology in Lemberg as an independent speciality, and its separation from surgery. Well-known Lemberg surgeons who were interested in surgery of the genitourinary system are discussed. The beginning of urology and its development within the framework of surgical departments, and as an independent facility in the interwar period is described. The fate of the Polish department of urology during the interwar period and the World War II is also presented. The development of Ukrainian urology after the World War II is also described. Extensive research was undertaken to collect the literature and documents in Polish and German archives and libraries in order to prepare this study. The author also presents the leading Ukrainian urologists who contributed from the post war period to the last 22 years of free Ukraine (from December 1991), and discusses the development of modern urology in Lviv today.

  6. Outcome analysis of pelvic ring fractures

    Directory of Open Access Journals (Sweden)

    Sen Ramesh

    2010-01-01

    Full Text Available Background: The behavior of pelvic ring fractures in the long run has been very sparsely studied. The purpose of this study is to assess the long-term outcome of pelvic ring fractures. Materials and Methods: A total of 24 patients with pelvic ring fractures, not involving the acetabulum, were followed up for an average duration of 33 months (range 24-49 months. The clinicoradiological assessment was done using the pelvic scoring system adapted from Cole et al. Parameters assessed included sacroiliac (SI joint involvement and, among SI joint injuries, the presence of a fracture disruption and the degree of displacement. Results: Pain and limp were present in 13 patients (54.2% each and residual working disability in 9 patients (37.5%. The overall Cole′s pelvic score was 31.3 ± 7.02 of a total score of 40. The average pelvic score in patients with SI disruption was 29.2 ± 6.75; much lower than patients without SI disruption with an average score of 34.9 ± 6.25 reaching statistical significance. The pelvic score among patients with a displacement ≤10 mm was 33.0 ± 3.92 and with a displacement> 10 mm 25.88 ± 7.14. The difference was statistically significant. Conclusions: Pelvic ring injuries can lead to long term problems significantly. The involvement of the SI joint affects the long-term outcome adversely, more so if the residual displacement is> 10 mm. The pelvic scoring system is comprehensive and depicts subtle differences in the outcome, which the individual parameters of the assessment fail to show.

  7. Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Pelvic Organ Prolapse Women

    Directory of Open Access Journals (Sweden)

    Tao Ying, Qin Li, Lian Xu, Feifei Liu, Bing Hu

    2012-01-01

    Full Text Available The present study investigated the morphology and structure of pelvic floor in 50 nulliparous and 50 pelvic organ prolapse (POP women using translabial three-dimensional (3D ultrasound. The levator hiatus in POP women was significantly different from that in nullipara women. In POP women, the size of pelvic floor increased, with a circular shape, and the axis of levator hiatus departed from the normal position in 36 (72% cases. The puborectalis was avulsed in 18 (36% cases and the pelvic organs arranged abnormally in 23 (46% cases. In summary, 3D ultrasound is an effective tool to detect the pelvic floor in POP women who presented with abnormalities in the morphology and structure of pelvic floor.

  8. [Patients with hemodynamic unstable pelvic fractures in extremis: pelvic packing or angiography?].

    Science.gov (United States)

    Liñán-Padilla, A; Giráldez-Sánchez, M Á; Serrano-Toledano, D; Lázaro-Gonzálvez, A; Cano-Luís, P

    2013-01-01

    The multidisciplinary management of patients with pelvic trauma has improved prognosis, but mortality is still very high. The appropriate treatment strategy remains controversial, especially regarding the control of bleeding in patients whose clinical situation is extreme by using angiography or pelvic packing. We propose using a tool of evidence-based medicine (CAT) the benefit of the completion of pelvic packing in relation to a specific clinical question from a specific situation. What is best for the management of bleeding, extraperitoneal pelvic packing or angiography, in patients with hemodynamically unstable pelvic fracture in extremis? From this study we can conclude that angiography may improve control of bleeding in patients with arterial bleeding and hemodynamically stable but the packing has priority in patients with pelvic fractures and hemodynamic instability.

  9. Pelvic Mass Due to Transmigrated IUD

    Directory of Open Access Journals (Sweden)

    Nadereh Behtash

    2010-03-01

    Full Text Available Intrauterine device (IUD, a conventional method of contraception is rarely associated with uterine perforation and extra uterine dislocation. A 29 years old woman complaining of vaginal bleeding was referred for pelvic mass identified in ultrasound. The mass was confirmed with CT scan. In laparatomy we found an IUD in cul-de-sac and pelvic mass was apparently an organized hematoma. Transmigrated IUD can induce organized hematomas presenting as a pelvic mass."n© 2010 Tehran University of Medical Sciences. All rights reserved.

  10. Informed Consent for Reconstructive Pelvic Surgery.

    Science.gov (United States)

    Alam, Pakeeza; Iglesia, Cheryl B

    2016-03-01

    Informed consent is the process in which a patient makes a decision about a surgical procedure or medical intervention after adequate information is relayed by the physician and understood by the patient. This process is critical for reconstructive pelvic surgeries, particularly with the advent of vaginal mesh procedures. In this article, we review the principles of informed consent, the pros and cons of different approaches in reconstructive pelvic surgery, the current legal issues surrounding mesh use for vaginal surgery, and tips on how to incorporate this information when consenting patients for pelvic floor surgery.

  11. Locally vascularized pelvic accessory spleen.

    Science.gov (United States)

    Iorio, F; Frantellizzi, V; Drudi, Francesco M; Maghella, F; Liberatore, M

    2016-01-01

    Polysplenism and accessory spleen are congenital, usually asymptomatic anomalies. A rare case of polysplenism with ectopic spleen in pelvis of a 67-year-old, Caucasian female is reported here. A transvaginal ultrasound found a soft well-defined homogeneous and vascularized mass in the left pelvis. Patient underwent MRI evaluation and contrast-CT abdominal scan: images with parenchymal aspect, similar to spleen were obtained. Abdominal scintigraphy with 99mTc-albumin nanocolloid was performed and pelvic region was studied with planar scans and SPECT. The results showed the presence of an uptake area of the radiopharmaceutical in the pelvis, while the spleen was normally visualized. These findings confirmed the presence of an accessory spleen with an artery originated from the aorta and a vein that joined with the superior mesenteric vein. To our knowledge, in the literature, there is just only one case of a true ectopic, locally vascularized spleen in the pelvis.

  12. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    OpenAIRE

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and ...

  13. The “Pelvic Harness”: a skeletonized mesh implant for safe pelvic floor reconstruction

    OpenAIRE

    Sumerova Natalia; Neuman Menahem; Krissi Haim; Pushkar Dmitri

    2016-01-01

    ABSTRACT Objectives To evaluate the feasibility, safety and surgical results of skeletonized mesh implants to form a pelvic harness for pelvic floor reconstruction surgery. Study design Patients with advanced pelvic floor prolapse were enrolled to this study. Study model was a kit mesh, reduced to 75% of the original surface area by cutting out mesh material from the central mesh body. Patients were evaluated at the end of the 1st and 6th post-operative months and interviewed at the study...

  14. mHealth in Urology: A Review of Experts’ Involvement in App Development

    Science.gov (United States)

    Pereira-Azevedo, Nuno; Carrasquinho, Eduardo; Cardoso de Oliveira, Eduardo; Cavadas, Vitor; Osório, Luís; Fraga, Avelino; Castelo-Branco, Miguel; Roobol, Monique J.

    2015-01-01

    Introduction Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP) and scientific Urology associations in their development. Material and Methods A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app’s platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development. Results The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7%) and only a third had been developed with a scientific Urology association (34.7%). The lowest percentage of HCP (13.4%) and urological association (1.9%) involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed. Conclusions Despite the increasing Mobile Health (mHealth) market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation. PMID:25984916

  15. mHealth in Urology: A Review of Experts' Involvement in App Development.

    Directory of Open Access Journals (Sweden)

    Nuno Pereira-Azevedo

    Full Text Available Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP and scientific Urology associations in their development.A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app's platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development.The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7% and only a third had been developed with a scientific Urology association (34.7%. The lowest percentage of HCP (13.4% and urological association (1.9% involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed.Despite the increasing Mobile Health (mHealth market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation.

  16. Long-term urological outcomes in spinal dysraphism

    NARCIS (Netherlands)

    Veenboer, P.W.

    2014-01-01

    Spinal dysraphism (SD) is a common name for a group of heterogeneous congenital conditions of the central nervous system, of which myelomeningocele is the most well-known form. SD has a wide spectrum of symptoms, mainly caused by neurological deficits. The bladder and pelvic floor are also affected

  17. Augmented reality assisted surgery: a urologic training tool.

    Science.gov (United States)

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  18. Urological surgery in elderly patients: results and complications

    Directory of Open Access Journals (Sweden)

    Brodak M

    2015-02-01

    Full Text Available Milos Brodak, Jan Tomasek, Jaroslav Pacovsky, Lukas Holub, Petr Husek Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic Purpose: Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients.Methods: The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012. The average age of patients was 78. The results and complications were categorized based on the type of surgery performed, and the Dindo–Clavien scale.Results: The median follow-up was 18 months. All surgeries for malignant tumors were performed successfully with no residual disease. Totally, 48 (22% complications were recorded. The most serious were as follows: one patient (<0.5% died; and four (<2% patients underwent reoperation. The most common complications involved infection, mainly sepsis and surgical site infections. Other complications included mild respiratory insufficiency, delirium, bleeding, etc.Conclusion: Surgeries in elderly patients were effective and safe. The cornerstone of safety is careful preparation and treatment of comorbidities. Complications occurred mainly as a result of emergency procedures during emergency procedures and in major surgeries such as cystectomy and nephrectomy. The standard use of low molecular-weight heparin caused no incidence of thromboembolic disease. Keywords: urinary tract, aged, postoperative complications, Dindo–Clavien classification

  19. Augmented reality assisted surgery: a urologic training tool

    Directory of Open Access Journals (Sweden)

    Ryan M Dickey

    2016-01-01

    Full Text Available Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  20. Augmented reality assisted surgery: a urologic training tool

    Science.gov (United States)

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training. PMID:26620455

  1. Pelvic Gliomatosis within Foci of Endometriosis

    OpenAIRE

    Killeen, Vincent B.; Reich, Harry; McGlynn, Fran; Virgilio, Lawrence A.; Krawitz, Michael A.; Sekel, Lisa

    1997-01-01

    The third reported case of pelvic gliomatosis found within foci of endometriosis is documented 16 years after the removal of a benign cystic teratoma. Grossly at laparoscopy the lesions appear as typical deep fibrotic endometriotic implants.

  2. Pelvic Surgical Site Infections in Gynecologic Surgery

    Directory of Open Access Journals (Sweden)

    Mark P. Lachiewicz

    2015-01-01

    Full Text Available The development of surgical site infection (SSI remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  3. Mortality in patients with pelvic fractures

    DEFF Research Database (Denmark)

    Hauschild, Oliver; Strohm, Peter C; Culemann, Ulf

    2008-01-01

    and adult pelvic trauma and evaluate the influence of changes in medical treatment by comparison of two treatment periods. METHODS: In this multicenter register study, data of 4,291 patients treated from 1991 to 1993 (n = 1,723) or 1998 to 2000 (n = 2,568) for pelvic fractures in one of the 23 participating......BACKGROUND: Pelvic and acetabular fractures are rare injuries and account for approximately 3% to 8% of all fractures. Often the result of high energy blunt trauma, most of the patients sustaining pelvic injuries are at high risk of associated injuries strongly influencing outcome and survival...... and treatment in the latter treatment period were associated with an increased survival rate. We found no difference between the adult and the pediatric group in terms of ISS and concomitant peripelvic soft tissue injuries. Children were less likely to receive surgical treatment (19.4% vs. 34.5%, p

  4. Postoperative pelvic pain: An imaging approach.

    Science.gov (United States)

    Farah, H; Laurent, N; Phalippou, J; Bazot, M; Giraudet, G; Serb, T; Poncelet, E

    2015-10-01

    Postoperative pelvic pain after gynecological surgery is a readily detected but unspecific sign of complication. Imaging as a complement to physical examination helps establish the etiological diagnosis. In the context of emergency surgery, vascular, urinary and digestive injuries constitute the most frequent intraoperative complications. During the follow-up of patients who had undergone pelvic surgery, imaging should be performed to detect recurrent disease, postoperative fibrosis, adhesions and more specific complications related to prosthetic material. Current guidelines recommend using pelvic ultrasonography as the first line imaging modality whereas the use of pelvic computed tomography and/or magnetic resonance imaging should be restricted to specific situations, depending on local availability of equipment and suspected disease.

  5. Imaging findings in idiopathic pelvic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Bongartz, G. [Inst. of Diagnostic Radiology University Hospital Basel (Switzerland); Stoffel, F. [Inst. of Urology, University Hospital Basel (Switzerland)

    2001-04-01

    Two patients presented with ureteric obstruction, and voiding symptoms and constipation, respectively, and were examined by means of intravenous urography and computed tomography. One patient was additionally examined by means of MR tomography. After CT (performed in both patients) and MRT (performed in one patient) had shown a diffuse, contrast-enhancing, infiltrating process in the small pelvis with infiltration of adjacent organs and vessels, surgical biopsy proved the diagnosis of idopathic pelvic fibrosis. Extension of retroperitoneal fibrosis below the pelvic rim is very rare. Clinical symptoms of pelvic fibrosis are variable and imaging findings may lead to a broad list of differential diagnoses. We present two patients with idiopathic pelvic fibrosis and discuss radiological findings and differential diagnoses of this rare disease. (orig.)

  6. [Pelvic actinomycosis and sub-acute abdomen].

    Science.gov (United States)

    Messalli, E M; Cobellis, L; Festa, B; Pecori, E; Stradella, L; Cobellis, G

    2002-12-01

    An interesting case of pelvic actinomycosis with paculiar clinical manifestation is presented. A 42 years-old patient came to our emergency service for an abdominal pelvic pain and fever. Past history showed IUD in situ for over 15 years. The patient was submitted to a ultrasonographic scan and a complete hematological screening was performed. The diagnosis was of subacute abdomen, and an exploratory laparotomy was carried out. During laparotomy an atypical reactive tissue and a suppurative cavity were found. The histological finding of tissue biopsy showed pelvic actinomycosis. On the basis of these findings the conclusion is drawn that a better prevention of pelvic actinomycosis is necessary of its diffusion in the last years due to sexual habit changes.

  7. 团体教育干预对慢性盆腔炎患者生存质量和社会功能的影响%Effect of group education intervention on the quality of life and social function of patients with chronic pelvic inflammation diseases

    Institute of Scientific and Technical Information of China (English)

    康秀花

    2014-01-01

    目的:探讨团体教育干预对慢性盆腔炎患者生存质量和社会功能的影响。方法:将160例慢性盆腔炎患者根据护理方式不同分为观察组和对照组各80例,观察组给予常规护理联合团体教育干预,对照组给予常规护理。比较两组整体疗效、生存质量和社会功能。结果:观察组治疗总有效率优于对照组( P﹤0.05);护理后,两组患者的整体质量评分均高于治疗前( P﹤0.05),且观察组自我实现、健康责任、运动、营养、人际关系、应对压力评分均高于对照组( P﹤0.05);护理后,两组社会职能缺陷评分均低于护理前( P﹤0.05),且观察组职业和工作、婚姻职能、父母职能、社会退缩性、家庭外社会活动、家庭内活动、家庭职能、个人生活理解、对外界的兴趣和关心、责任心和计划性评分均低于对照组(P﹤0.05)。结论:团体教育干预有助于改善整体治疗效果、提高生存质量和社会功能,在慢性盆腔炎的治疗中具有积极应用价值。%Objective:To investigate the effect of group education intervention on the quality of life and social function of patients with chronic pelvic inflammation diseases. Methods:160 patients with chronic pelvic inflammation diseases were divided into the observation group and the control group(80 cases in each group)according to the different nursing methods. The patients in the observation group were given routine nursing care combined with group education intervention and the patients in the control group were only given routine nursing care. The overall effect,quality of life and social function of the patients were compared between the two groups. Results:The total effective rate was higher in the observation group than the control group(P﹤0. 05);the scores of overall quality were higher after nursing care than those before nursing care in the two groups(P﹤0. 05);the scores of self

  8. Urologic applications of multiplanar and three-dimensional computed tomography.

    Science.gov (United States)

    Olson, M C; Posniak, H V

    1995-01-01

    The introduction of helical computed tomography (CT) has resulted in improved quality of multiplanar reformations and three-dimensional reconstructions in the chest and abdomen and has made CT angiography a clinical reality. These imaging techniques are useful for evaluating the urinary tract, adding a new dimension to its display, resulting in improved diagnosis of renal and perirenal disease. This article reviews the indications and techniques utilized for multiplanar and three-dimensional CT for urology. The advantages and limitations are discussed, and normal and pathologic findings in the urinary tract illustrated.

  9. Interventional urology: endourology in small animal veterinary medicine.

    Science.gov (United States)

    Berent, Allyson C

    2015-07-01

    The use of novel image-guided techniques in veterinary medicine has become more widespread, especially in urologic diseases. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of minimally invasive alternatives using interventional radiology and interventional endoscopy techniques has become incredibly appealing to owners and clinicians. This article provides a brief overview of some of the most common procedures done in endourology in veterinary medicine to date, providing as much evidence-based medicine as possible when comparing with traditional surgical alternatives.

  10. Ethics and contemporary urology practice: Setting out principles

    Directory of Open Access Journals (Sweden)

    A Mohan

    2009-01-01

    Full Text Available Several situations of great ethical implications are encountered by physicians in daily urological practice. Informed consent for interventions, selection of patients for operative demonstrations and educational workshops, enrollment of patients in clinical trials, and the use of technology are some issues that call for stringent application of ethical principles in decision making. The issues of autonomy, privacy, rights, duties, and privileges that arise have to pass the tests prescribed by contemporary social mores and regulations. Some of the issues encountered, principles applicable, and covenants and documents that guide decision making are discussed.

  11. Urological outcome after myelomeningocele: 20 years of follow-up

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Biering-Sorensen, Fin; Cortes, Dina

    2011-01-01

    %) compared to those with normal function of both kidneys (24%). In total, 48% of the 52 myelomeningocele individuals were continent at follow-up. Continence surgery was performed in eight patients, nine used anticholinergica, three had regular botulinum toxin detrusor injections, and 27 used clean......Study Type - Therapy (case series)¿Level of Evidence 4 OBJECTIVES: To evaluate the urological outcome in a long-term follow-up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood. MATERIAL AND METHODS: Individuals with myelomeningocele born...

  12. Cyanoacrylic tissue glues: Biochemical properties and their usage in urology

    Science.gov (United States)

    Ayyıldız, Sema Nur; Ayyıldız, Ali

    2017-01-01

    Tissue adhesives are being used in medical and cosmetic industries and first aid for a long time. But their everyday usage has not been widespread. Only case report information is available about their usage. Despite good and meaningful results after they were used, there is lack of standard information that gives idea of about in which cases they could be helpful. Nowadays, cyanoacrylates are used in the surgery more frequently. In this review, we wanted to oversee the biochemical properties and the urological utilisation areas of cyanoacrylates. PMID:28270946

  13. Multimedia search system for a textbook of urology in Japanese.

    Science.gov (United States)

    Okada, Y; Yamashita, Y; Takahashi, T

    1995-01-01

    A search system for the textbook of urology has been developed and evaluated. The textbook is written in Japanese with 1.4 megabytes of text and has about 1000 pictures. The contents of the textbook can be seen with English or Japanese medical terms. The system contains a dictionary of Japanese medical terms. The dictionary has a network structure based on Japanese ideographic characters. Such a search system is useful for physicians because of its speed and the widely spread medical knowledge of many authors of the textbook.

  14. Robotic Urological Surgery%机器人泌尿外科手术

    Institute of Scientific and Technical Information of China (English)

    吴志辉; 莱锦洪

    2008-01-01

    @@ 1 Introduction In past few decades, better understandings of anatomy and advance in techniques and technology have revolutionized urological surgery. Laparoscopic surgery has now become one of the basic instruments of urologists. Laparoscopic radical nephrectomy is currently the standard of care in most urological centers.

  15. Program for laparoscopic urological skills assessment: setting certification standards for residents

    NARCIS (Netherlands)

    Tjiam, I.M.; Schout, B.M.; Hendrikx, A.J.M.; Muijtjens, A.M.M.; Scherpbier, A.J.J.A.; Witjes, J.A.; Vleuten, C.P.M. van der

    2013-01-01

    AIM: There is growing pressure from the government and the public to define proficiency standards for surgical skills. Aim of this study was to estimate the reliability of the Program for Laparoscopic Urological Skills (PLUS) assessment and to set a certification standard for second-year urological

  16. A prospective audit of emergency urology activity in a university teaching hospital

    LENUS (Irish Health Repository)

    2014-06-01

    Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period.

  17. mHealth in urology : A review of experts' involvement in app development

    NARCIS (Netherlands)

    Pereira-Azevedo, N. (Nuno); Carrasquinho, E. (Eduardo); De Oliveira, E.C. (Eduardo Cardoso); Cavadas, V. (Vitor); Osório, L. (Luís); Fraga, A. (Avelino); Castelo-Branco, M. (Miguel); Roobol, M.J. (Monique J.)

    2015-01-01

    textabstractIntroduction: Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with

  18. Prevalence of Trichomonas vaginalis by PCR in men attending a primary care urology clinic in South Korea.

    Science.gov (United States)

    Seo, Jun-Hyeok; Yang, Hye-Won; Joo, So-Young; Song, Su-Min; Lee, Yu-Ran; Ryu, Jae-Sook; Yoo, Eun Sang; Lee, Won Kee; Kong, Hyun-Hee; Lee, Sang-Eun; Lee, Won-Ja; Goo, Youn-Kyoung; Chung, Dong-Il; Hong, Yeonchul

    2014-10-01

    Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.

  19. Pelvic floor and sexual male dysfunction

    Directory of Open Access Journals (Sweden)

    Antonella Pischedda

    2013-04-01

    Full Text Available The pelvic floor is a complex multifunctional structure that corresponds to the genito- urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.

  20. Pelvic inflammatory disease: Contemporary diagnostic and therapeutic approach

    Directory of Open Access Journals (Sweden)

    Terzić Milan

    2010-01-01

    Full Text Available Pelvic inflammatory disease (PID is polymicrobial infection in women characterized by inflammation of the upper genital tract, including endometritis, salpingitis, pelvic peritonitis, occasionally leading to the formation of tubo-ovarian abscess (TOA. PID primarily affects young, sexually active women, and it is highly correlated with having several sexual partners, intrauterine contraceptive device and sexually transmited diseases. The spectrum of disease is caused most commonly by Chlamydia trachomatis and Neisseria gonorrhoeae in 30-50% of cases. PID is responsible for severe acute morbidity and significant long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. The following clinical features are suggestive of a diagnosis of PID: bilateral lower abdominal tenderness, abnormal vaginal or cervical discharge, fever (higher than 38°C, abnormal vaginal bleeding, dyspareunia, cervical motion tenderness and adnexal tenderness, with or without a palpable mass. In laboratory findings, there is presence of excess leucocytes, elevated erythrocyte sedimentation rate or C-reactive protein. Transvaginal ultrasound scanning may be helpful, and its sensitivity is up to 85%. It can identify inflamed and dilated tubes and tubo-ovarian masses. Magnetic resonance imaging can be helpful in a final diagnosis in 95% of cases. In 15-30% of suspected cases, there is no laparoscopic evidence of disease. Treatment regimens for PID include broadspectrum antibiotics, including coverage for Neisseria gonorrhoeae and Chlamydia trachomatis. The usage of parenteral or oral therapy, inpatient or outpatient regimens, depends on the patient’s clinical condition. Considering the potential complications of disease, there is a need for good health educational programmes in reproductive period.