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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.

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    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. Chronic Pelvic Pain

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

  5. 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.

  6. 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.

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    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

  7. 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 )

  8. Immune mediators of chronic pelvic pain syndrome.

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    Murphy, Stephen F; Schaeffer, Anthony J; Thumbikat, Praveen

    2014-05-01

    The cause of chronic pelvic pain syndrome (CPPS) has yet to be established. Since the late 1980s, cytokine, chemokine, and immunological classification studies using human samples have focused on identifying biomarkers for CPPS, but no diagnostically beneficial biomarkers have been identified, and these studies have done little to deepen our understanding of the mechanisms underlying chronic prostatic pain. Given the large number of men thought to be affected by this condition and the ineffective nature of current treatments, there is a pressing need to elucidate these mechanisms. Prostatitis types IIIa and IIIb are classified according to the presence of pain without concurrent presence of bacteria; however, it is becoming more evident that, although levels of bacteria are not directly associated with levels of pain, the presence of bacteria might act as the initiating factor that drives primary activation of mast-cell-mediated inflammation in the prostate. Mast cell activation is also known to suppress regulatory T cell (Treg) control of self-tolerance and also activate neural sensitization. This combination of established autoimmunity coupled with peripheral and central neural sensitization can result in the development of multiple symptoms, including pelvic pain and bladder irritation. Identifying these mechanisms as central mediators in CPPS offers new insight into the prospective treatment of the disease. PMID:24686526

  9. 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 b...

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

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    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.

  11. 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...

  12. 'Women get this': gendered meanings of chronic pelvic pain.

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    Grace, Victoria M; MacBride-Stewart, Sara

    2007-01-01

    Chronic pelvic pain in women is a key site through which explorations of the meanings of female gender and pain might further insights into the broader question of the embodied experience of women in relation to pain. A biocultural approach is used to present an analysis of interviews with 40 New Zealand women in which they reflect on 'how come' they have chronic pelvic pain. Women consistently employ a mechanistic rendition of medical discourse and understandings in their constructions of 'how come' they have pain, accompanied by a reiteration of 'not knowing' and a normalizing of their pelvic pain. We explore how this normalizing works within the narratives to establish women's pelvic pain as intrinsically gendered. Etiological meanings that are constructed in medical terms and yet are unable to be interpreted within a dualist frame of normality and pathology, we argue, permeate and shape gendered experience of chronic pain conditions. PMID:17158831

  13. 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.

  14. Role of laparoscopy in evaluation of chronic pelvic pain

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    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.

  15. Role of diagnostic laparoscopy in chronic pelvic pain

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    Pushpa Bhatia

    2016-04-01

    Conclusions: Laparoscopy is a gold standard tool in evaluation of women with chronic pelvic pain, because diagnosis and often treatment can be accomplished in one sitting, without subjecting them to exploratory laparotomy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1152-1157

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

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    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.

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

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    ANA CAROLINA FRANCO CARVALHO; OMERO BENEDITO POLI NETO; JOSÉ ALEXANDRE DE SOUZA CRIPPA; JAIME EDUARDO CECÍLIO HALLAK; FLÁVIA DE LIMA OSÓRIO

    2015-01-01

    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 th...

  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. Limbic associated pelvic pain: a hypothesis to explain the diagnostic relationships and features of patients with chronic pelvic pain.

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    Fenton, Bradford W

    2007-01-01

    Limbic associated pelvic pain is a proposed pathophysiology designed to explain features commonly encountered in patients with chronic pelvic pain, including the presence of multiple pain diagnoses, the frequency of previous abuse, the minimal or discordant pathologic changes of the involved organs, the paradoxical effectiveness of many treatments, and the recurrent nature of the condition. These conditions include endometriosis, interstitial cystitis, irritable bowel syndrome, levator ani syndrome, pelvic floor tension myalgia, vulvar vestibulitis, and vulvodynia. The hypothesis is based on recent improvements in the understanding of pain processing pathways in the central nervous system, and in particular the role of limbic structures, especially the anterior cingulate cortex, hippocampus and amygdala, in chronic and affective pain perception. Limbic associated pelvic pain is hypothesized to occur in patients with chronic pelvic pain out of proportion to any demonstrable pathology (hyperalgesia), and with more than one demonstrable pain generator (allodynia), and who are susceptible to development of the syndrome. This most likely occurs as a result of childhood sexual abuse but may include other painful pelvic events or stressors, which lead to limbic dysfunction. This limbic dysfunction is manifest both as an increased sensitivity to pain afferents from pelvic organs, and as an abnormal efferent innervation of pelvic musculature, both visceral and somatic. The pelvic musculature undergoes tonic contraction as a result of limbic efferent stimulation, which produces the minimal changes found on pathological examination, and generates a further sensation of pain. The pain afferents from these pelvic organs then follow the medial pain pathway back to the sensitized, hypervigilant limbic system. Chronic stimulation of the limbic system by pelvic pain afferents again produces an efferent contraction of the pelvic muscles, thus perpetuating the cycle. This cycle is

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

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    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

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    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. 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.

  3. 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)

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    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

  4. 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.

  5. 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.

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

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    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

  7. Sexual abuse evaluation in urological practice

    NARCIS (Netherlands)

    Beck, Jacobus Johannes Hendrikus

    2013-01-01

    The primary aim of this study is to investigate the prevalence of sexual abuse in a urological outpatient clinic. Can differences been made in urological population, i.e. general urological clinic, a university urological clinic and a tertiary university pelvic floor clinic? Do urologists inquire ab

  8. An Urologic Face of Chronic Lymphocytic Leukemia:Sequential Prostatic and Penis Localization

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    Giovanni D'Arena

    2013-01-01

    Full Text Available We report a patient with chronic lymphocytic leukemia (CLL in whom a leukemic involvement of prostate and penis occurred in the advanced phase of his disease. Obstructive urinary symptoms were indicative of prostatic CLL infiltration, followed by the occurrence of an ulcerative lesion on the glans. Histologic examination confirmed  the  neoplastic B-cell infiltration. Both localizations responded to conventional treatments. A review of the literature confirms that leukemic involvement of the genito-urinary system is   uncommon in CLL patients. However, such an involvement should be considered in CLL patients with urologic symptoms and a long history of the disease.

  9. Psycophisical predictor of outcome in pelvic chronic pain therapy

    Directory of Open Access Journals (Sweden)

    Paolo Poli

    2012-05-01

    Full Text Available 32 patients with chronic pelvic pain (CPP were compared with 24 patients with low back pain (LB for the entire course of treatment which lasted 1 year, with follow up at 1,6 and 12 months. At baseline, the group of subjects with CPP presented more hypochondriacal traits, major depression and affective inhibition if compared with LB group, but such psychological variables have not been able to predict the outcome to treatment. No significant difference has been found between LB and CPP subjects regarding the pain threshold of and/or the pain tolerance, when pain was induced by cold stimulation to the hand. High pain tolerance together with the high expectation of analgesia and the conviction of disease appear to be the most important predictors of treatment outcome.

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

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    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

  11. 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.

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

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    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.

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

    OpenAIRE

    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 In...

  14. 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

  15. Evolutionary considerations in the development of chronic pelvic pain.

    Science.gov (United States)

    Jarrell, John; Arendt-Nielsen, Lars

    2016-08-01

    Chronic pelvic pain is common among women of reproductive age and is associated with significant morbidity and comorbidities. In this Viewpoint, we explore the evolutionary cause of pelvic pain and summarize evidence that supports a menstruation-related evolutionary cause of chronic visceral pelvic pain: (1) lifetime menstruation has increased; (2) severe dysmenorrhea is common in the chronic pelvic pain population, particularly among those with pain sensitization; and (3) a potential biological mechanism can be identified. Thus, chronic pelvic pain may arise from the mismatch between the slow pace of biological evolution in our bodies and the relatively rapid pace of cultural changes that have resulted in increased menstrual frequency due to earlier menarche, later mortality, and lower fecundity. One possible mechanism that explains the development of persistent pain from repeated episodes of intermittent pain is hyperalgesic priming, a physiological process defined as a long-lasting latent hyperresponsiveness of nociceptors to inflammatory mediators after an inflammatory or neuropathic insult. The repetitive severely painful menstrual episodes may play such a role. From an evolutionary perspective the relatively rapid increase in lifetime menstruation experience in contemporary society may contribute to a mismatch between lifetime menstruation and the physiological pain processes, leading to a maladaptive state of chronic visceral pelvic pain. Our current physiology does not conform to current human needs. PMID:27269450

  16. Chronic Pelvic Pain in Women (Beyond the Basics)

    Science.gov (United States)

    ... their pelvic pain. There are several types of psychosocial support: ● Psychotherapy involves meeting with a psychologist, psychiatrist, ... mostly for endometriosis pain and has additional surgical risks, so it is not recommended for most women. ...

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

    OpenAIRE

    Sanyal Kumar; Bhawna Satija; Leena Wadhwa

    2012-01-01

    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...

  18. 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

  19. 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.

  20. Sexual abuse evaluation in urological practice

    OpenAIRE

    Beck, Jacobus Johannes Hendrikus

    2013-01-01

    The primary aim of this study is to investigate the prevalence of sexual abuse in a urological outpatient clinic. Can differences been made in urological population, i.e. general urological clinic, a university urological clinic and a tertiary university pelvic floor clinic? Do urologists inquire about female sexual dysfunction and sexual abuse history? And if so, what percentage of the Dutch urologist does so? What do sexual abuse patients think about screening for sexual abuse history? Can ...

  1. Evolutionary considerations in the development of chronic pelvic pain

    DEFF Research Database (Denmark)

    Jarrell, John; Arendt-Nielsen, Lars

    2016-01-01

    the relatively rapid increase in lifetime menstruation experience in contemporary society may contribute to a mismatch between lifetime menstruation and the physiological pain processes, leading to a maladaptive state of chronic visceral pelvic pain. Our current physiology does not conform to current human needs....

  2. 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.

  3. 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).

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

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    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.

  5. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    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 ifnd 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% conifdence 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 inlfammation in the prostate and producing the autoimmunizations causing CP/CPPS.

  7. 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.

  8. 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.

  9. Urologic Emergencies.

    Science.gov (United States)

    Ludvigson, Adam E; Beaule, Lisa T

    2016-06-01

    The diagnosis and management of urologic emergencies are incorporated into the basic training of all urology residents. In institutions without access to urologic services, it is usually left to the General Surgeon or Emergency Medicine physician to provide timely care. This article discusses diagnoses that are important to recognize and treatment that is practically meaningful for the non-Urologist to identify and treat. The non-Urology provider, after reading this article, will have a better understanding and a higher comfort level with treating patients with urologic emergencies. PMID:27261785

  10. 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.

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

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    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.

  12. 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.

  13. 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。

  14. 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.

  15. 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.

  16. 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.

  17. Is chronic pelvic pain a comfortable diagnosis for primary care practitioners: a qualitative study

    Directory of Open Access Journals (Sweden)

    Creed Francis

    2010-01-01

    Full Text Available Abstract Background Chronic pelvic pain (CPP has a prevalence similar to asthma and chronic back pain, but little is known about how general practitioners (GPs and practice nurses manage women with this problem. A clearer understanding of current management is necessary to develop appropriate strategies, in keeping with current health care policy, for the supported self-management of patients with long term conditions. The aim of this study was to explore GPs' and practice nurses' understanding and perspectives on the management of chronic pelvic pain. Methods Data were collected using semi-structured interviews with a purposive sample of 21 GPs and 20 practice nurses, in three primary care trusts in the North West of England. Data were analysed using the principles of Framework analysis. Results Analysis suggests that women who present with CPP pose a challenge to GPs and practice nurses. CPP is not necessarily recognized as a diagnostic label and making the diagnosis was achieved only by exclusion. This contrasts with the relative acceptability of labels such as irritable bowel syndrome (IBS. GPs expressed elements of therapeutic nihilism about the condition. Despite practice nurses taking on increasing responsibilities for the management of patients with long term conditions, respondents did not feel that CPP was an area that they were comfortable in managing. Conclusions The study demonstrates an educational/training need for both GPs and practice nurses. GPs described a number of skills and clinical competencies which could be harnessed to develop a more targeted management strategy. There is potential to develop facilitated self- management for use in this patient group, given that this approach has been successful in patients with similar conditions such as IBS.

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

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    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

  19. Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN in Patients with Chronic Pelvic Pain

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    Seyhan Sönmez

    2016-03-01

    Full Text Available Objective: To investigate the efficacy of laparoscopic uterine nerve ethanol neurolysis (LUNEN for pain man­agement in patients with chronic pelvic pain (CPP. Methods: LUNEN, as a chemical neurolysis procedure, was performed on 22 subjects, and these were com­pared with 20 controls that had a diagnostic laparoscopy alone. Pre-treatment and postoperative 6th month Visual Analogue Scale (VAS scores were estimated and a sub­jective pain evaluation questioning patients’ satisfaction about pain relief in the 6th month after surgery was also performed. Results: A total of 31 (73.8% out of 42 CPP patients had a laparoscopic pelvic pathology. Preoperative VAS scores were similar in the groups; however, the mean postop­erative VAS score was significantly lower in the LUNEN group than in the control group (3.18 ± 2.88 vs. 5.35 ± 3.09; p=0.02. In the LUNEN group, the number of pa­tients who stated that their pain was relieved partially or completely was also significantly higher than in the con­trol group (82% vs. 40%, p=0.019. Conclusion: LUNEN is a feasible, safe and effective sur­gical alternative to traditional surgical methods in patients suffering from CPP. J Clin Exp Invest 2016; 7 (1: 7-13

  20. Evidence for associations among somatoform dissociation, psychological dissociation, and reported trauma in patients with chronic pelvic pain

    NARCIS (Netherlands)

    Nijenhuis, ERS; van Dyck, R; ter Kuile, MM; Mourits, MJE; Spinhoven, P; van der Hart, O

    2003-01-01

    This study investigates somatoform as well as psychological dissociation, somatization and reported trauma among patients with chronic pelvic pain (CPP). Women with CPP (n = 52) who were newly referred to a gynecology department, or whose pain had resisted treatment, completed standardized self-repo

  1. 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.

  2. 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......, interventions, outcome measures and times of follow-up, prevented meta-analysis. Narrative synthesis of the results, based on effect estimates and clinically relevant pain improvement, disclosed some evidence to support an effect of multidisciplinary intervention and Mensendieck somatocognitive therapy...

  3. 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.

  4. Chronic Pelvic Inflammation Diminished Ovarian Reserve as Indicated by Serum Anti Mulerrian Hormone.

    Directory of Open Access Journals (Sweden)

    Linlin Cui

    Full Text Available To explore the potential damaging effect of chronic pelvic inflammation on ovarian reserve.Case-control study.A total of 122 women with bilateral tubal occlusion, diagnosed by hysterosalipingography (HSG and 217 women with normal fallopians were recruited.Serum anti-Mullerian hormone (AMH, basic follicle-stimulating hormone (FSH, luteining hormone (LH, estradiol (E2, and testosterone (T were measured; and antral follicle counts (AFCs were recorded.Significantly lower level of AMH was observed in women with bilateral tubal occlusion compared to control group [2.62 (2.95 ng/ml vs. 3.37 (3.11 ng/ml, P = 0.03], and the difference remained after adjustment of BMI (Padjust = 0.04. However, no statistical difference was found in the levels of FSH [7.00 (2.16 IU/L vs. 6.74 (2.30 IU/L], LH [4.18 (1.52 IU/L vs. 4.63 (2.52 IU/L], E2 [35.95 (20.40 pg/ml vs. 34.90 (17.85 pg/ml], T [25.07±11.46 ng/dl vs. 24.84±12.75 ng/dl], and AFC [6.00 (4.00 vs. 7.00 (4.00] between two groups (p>0.05.Women with bilateral tubal occlusion showed decreased AMH level, suggesting that chronic pelvic inflammation may diminish ovarian reserve. More caution should be paid when evaluating the detriment of PID on female fertility.

  5. 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.

  6. Retained intrauterine device, Lippes loop intrauterine device, for 40 years as unusual cause of chronic pelvic pain in 70 years old woman in Western Ethiopia

    Directory of Open Access Journals (Sweden)

    Temesgen Tilahun Bekabil

    2015-04-01

    Full Text Available Chronic Pelvic Pain (CPP is defined as chronic or persistent pain perceived in structures related to the pelvis for at least 6 months. This condition accounts for 10% of all outpatient gynecology visits and it significantly affects patients' health. Etiologies of chronic pelvic pain are multifactorial in nature and vary with patients' age. But retained intrauterine device in the uterus beyond its expiry date was not reported as the cause of chronic pelvic pain in postmenopausal age group. This case is presented to show that retained (expired intrauterine device left in situ in postmenopausal woman could cause chronic pelvic pain. In conclusion, intrauterine devices in situ should be remembered at menopause and removed per the guideline before it causes problems and unnecessary interventions. [Int J Res Med Sci 2015; 3(4.000: 1006-1008

  7. 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.

  8. 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.

  9. Robotics in paediatric urology.

    Science.gov (United States)

    Olsen, Lars Henning

    2006-02-01

    After the emergence of robotically assisted systems in laparoscopic surgery more than 15 years ago, several systems have been on the market. At the time being only one system, the da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA), has survived in clinical use with an increasing spread particularly among adult urologists used primarily for radical prostatectomies. However, the reconstructive nature of paediatric urology makes the system interesting for the paediatric urologists, since its strength is laparoscopic suturing and difficult dissection. So far only few reports have been published about its clinical use in paediatric urology. The main advantages are the 3D magnified view, the wrist-like movements of the instruments, and the scaling and precision of instrument movements. The system has been used for upper tract reconstruction like pyeloplasties and heminephrectomies, both for the transperitoneal and, more technical challenging, the retroperitoneal approach. In the pelvic region, anti-reflux surgery (both extra- and intravesically) and surgery for malformations of the internal genitalia like utriculus cysts and gonadal streaks are feasible. More simple procedures like nephrectomies and the management of the intra-abdominal testis are not justified due to the high costs. In addition, no advantage for the patients related to standard laparoscopic procedures has been proofed yet. For the surgeon the minimally challenging invasive procedures become feasible with certainly improved ergonomics. The use of the system is much easier than standard laparoscopic surgery and its widespread will give more patients to access minimal invasive surgery. PMID:18947593

  10. 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.

  11. 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

  12. Chronic Pelvic Ischemia: Contribution to the Pathogenesis of Lower Urinary Tract Symptoms (LUTS): A New Target for Pharmacological Treatment?

    Science.gov (United States)

    Andersson, Karl-Erik; Nomiya, Masanori; Yamaguchi, Osamu

    2015-01-01

    The incidence of lower urinary tract symptoms, including overactive bladder (OAB), is continuing to rise, and is associated with a negative impact on quality of life and a heavy economic burden. A major risk factor for OAB is advancing age. The etiology of OAB is multifactorial and appears to involve myogenic, neurogenic, and urotheliogenic factors. In this article, we review the strengthening preclinical evidence supporting the contribution of chronic pelvic ischemia to the pathogenesis of OAB. In animal models, chronic ischemia induced by arterial injury and a high-fat diet upregulates markers of oxidative stress and proinflammatory cytokines in the urothelium and lamina propria, and leads to increased expression of nerve growth factor. These processes result in increased afferent activity and an increased frequency of micturition, reflecting a state of bladder hyperactivity. In severe, prolonged cases, bladder overactivity may develop into underactivity. Antimuscarinic therapies are the mainstay of OAB treatment, but their usefulness is limited by modest efficacy and troublesome side-effects. Our increasing understanding of the contribution of chronic ischemia to OAB is leading toward novel therapeutic options targeting chronic pelvic ischemia and its morphological, functional, and oxidative consequences. Preclinical trials have demonstrated encouraging results with α1 -adrenoreceptor blockade, phosphodiesterase type 5 inhibition, β3 -adrenoreceptor agonism, free radical scavenging, and stem cell therapy, in preventing morphological, biochemical and functional changes induced by chronic bladder ischemia. PMID:26663644

  13. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  15. 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

  16. 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

  17. 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.

  18. The future of urology.

    Science.gov (United States)

    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

  19. 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

  20. Turn-amplitude analysis as a diagnostic test for myofascial syndrome in patients with chronic pelvic pain

    Science.gov (United States)

    Itza, Fernando; Zarza, Daniel; Salinas, Jesus; Teba, Fernando; Ximenez, Carmen

    2015-01-01

    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. OBJECTIVE: To validate the turns-amplitude analysis (TAA) as a diagnostic test for MPSPF in patients with CPP. METHODS: A case-control study was performed, and patients were consecutively sampled within a specified period of time. A total of 128 patients were included: 64 patients with CPP (32 men and 32 women) and 64 control patients (32 men and 32 women). The same operator conducted all tests. Electromyography of the TAA is based on the collection of motor unit potentials that measure the number of changes in the signal and the mean amplitude of the changes. The electromyogram transfers the data to a graphical point cloud, which enables the patient’s results to be compared with the results of the healthy subjects. RESULTS: In patients and control subjects, the sensitivity and specificity of the proposed diagnostic test showed a marked clinical significance: the sensitivity was 83%, and the specificity was 100%. A positive predictive value of 1 (95% CI 1 to 1) and a negative predictive value of 0.85 (95% CI 0.77 to 0.93) were observed. CONCLUSION: TAA is a reliable diagnostic test to detect MPSPF. Further studies are needed to reproduce these results. PMID:25848846

  1. Guideline of guidelines: thromboprophylaxis for urological surgery.

    Science.gov (United States)

    Violette, Philippe D; Cartwright, Rufus; Briel, Matthias; Tikkinen, Kari A O; Guyatt, Gordon H

    2016-09-01

    Decisions regarding thromboprophylaxis in urologic surgery involve a trade-off between decreased risk of venous thromboembolism (VTE) and increased risk of bleeding. Both patient- and procedure-specific factors are critical in making an informed decision on the use of thromboprophylaxis. Our systematic review of the literature revealed that existing guidelines in urology are limited. Recommendations from national and international guidelines often conflict and are largely based on indirect as opposed to procedure-specific evidence. These issues have likely contributed to large variation in the use of VTE prophylaxis within and between countries. The majority of existing guidelines typically suggest prolonged thromboprophylaxis for high-risk abdominal or pelvic surgery, without clear clarification of what these procedures are, for up to 4 weeks post-discharge. Existing guidance may result in the under-treatment of procedures with low risk of bleeding and the over-treatment of oncological procedures with low risk of VTE. Guidance for patients who are already anticoagulated are not specific to urological procedures but generally involve evaluating patient and surgical risks when deciding on bridging therapy. The European Association of Urology Guidelines Office has commissioned an ad hoc guideline panel that will present a formal thromboprophylaxis guideline for specific urological procedures and patient risk factors. PMID:27037846

  2. 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.

  3. Correlation of Chronic Pelvic Inflammatory Disease and Female Infertility%慢性盆腔炎与女性不孕不育的相关性探析

    Institute of Scientific and Technical Information of China (English)

    王家荣

    2015-01-01

    目的:探讨慢性盆腔炎与女性不孕不育的相关性。方法回顾性分析125例慢性盆腔炎患者的临床资料,包括患者的病程、受孕情况,并检测血清六项性激素水平。结果125例慢性盆腔炎患者中不孕发生率为26.4%。随着慢性盆腔炎病程的延长,不孕率逐渐升高(P<0.05)。与受孕组比较,卵泡期PRL和P升高,而FSH、E2、T降低,差异均有统计学意义(P<0.05)。结论慢性盆腔炎与女性不孕不育密切相关。%Objective To investigate the correlation between chronic pelvic inflammatory disease and female infertility. Methods To analysis the data of 125 cases of chronic pelvic inflammatory disease,including the course of disease,pregnancy,and detection of serum sex hormone levels of six. Results 125 cases of infertility and chronic pelvic inflammatory disease patients the incidence rate was 26.4%. Along with the extension of the course of chronic pelvic inflammatory disease,infertility rate increased gradual y(P<0.05).Compared with the control group,while PRL and P increased,while FSH,E2,T decreased,the differences were statistical y significant(P<0.05). Conclusion Chronic pelvic inflammatory disease is closely related with female infertility.

  4. 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

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

    Science.gov (United States)

    Whitaker, Lucy H. R.; Reid, Jen; Choa, Alex; McFee, Stuart; Seretny, Marta; Wilson, John; Elton, Rob A.; Vincent, Katy; Horne, Andrew W.

    2016-01-01

    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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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...

  11. Urinary symptoms and Micromotions of bladder wall in chronic pelvic pain (CPP)

    NARCIS (Netherlands)

    P. van Os-Bossagh (Pooran)

    1998-01-01

    textabstractChronic lower abdominal pain of unknown origin in women has intrigued many investigators. It is the gynecologist in particular to whom patients with this syndrome address for relief. AB a matter of fact not less than approximately 10% of patients visiting gynaecologists do so in cOlmecti

  12. 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

    2016-01-01

    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 MHD. PMID:27334333

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

    Science.gov (United States)

    Wang, Yan; Chen, Chen; Zhu, Changcai; Chen, Liang; Han, Qingrong; Ye, Huarong

    2016-01-01

    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. PMID:27579305

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

    Science.gov (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  16. 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. PMID:25233622

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. Functional anatomy of pelvic floor.

    Science.gov (United States)

    Rocca Rossetti, Salvatore

    2016-03-01

    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 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. PMID:27072173

  4. 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.

  5. 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. PMID:20085175

  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. Gerota's fascia over a pelvic ectopic kidney: Myth or reality?

    OpenAIRE

    Goel, Apul

    2012-01-01

    Objective: To prospectively evaluate for the presence or absence of Gerota's fascia in a pelvic ectopic kidney, as this is not well documented. Materials and Methods: Between January 2007 and July 2011, all patients with normal renal functions presenting to the Urology Clinic with pelvic ectopic kidney were evaluated for the presence of fascia similar to Gerota's fascia. Specific evaluation included a contrast-enhanced computed tomography (CT) scan and open surgery where indicated. A literatu...

  8. Training in laparoscopic urology

    NARCIS (Netherlands)

    M.P. Laguna; T.M. Reijke; H. Wijkstra; J.J.M.C.H. de la Rosette

    2006-01-01

    Purpose of review Training in laparoscopy has become an important issue in the current surgical scenario. In this overview we aim to update the current knowledge in the field of laparoscopic urological training and to highlight the potential dangers of using simulation for accreditation and selectio

  9. 莫西沙星治疗慢性盆腔炎临床探讨%Clinical Observation of Moxifloxacin Treatment of Chronic Pelvic Inflammatory Disease

    Institute of Scientific and Technical Information of China (English)

    程金阳

    2015-01-01

    Objective To Study of moxifloxacin in the treatmentof chronic pelvic inflammatory disease treatment effect. MethodWe selected 320 patients with chronic pelvic inflammatory disease in 2013 June --2014 yearinJune I treated patients in Department of gynecology and obstetrics, Were randomly divided into 2 groups with 160 cases in each, The control group was given penicillin combined with metronidazole in treatment, The observation group was given moxifloxacin treatment,Comparative analysis of therapeutic effect and adverse reaction oftwo groups.ResultThe observation group, the total efficiency is 96.3%, The control group the total effective rate was 81.8%, The observation group was significantly better than the control group(P< 0.05);The observation group the incidence of adverse reaction was 2.5%;the controlgroup, the incidence rate of adverse reaction was 10.6%, There was significant difference between two groups (P<0.05).Conclusion Moxifloxacin treatment using can obviously improve the clinical symptoms of patients with chronic pelvic inflammatory disease,And less adverse reaction, It is worth to popularize in the clinical application.%目的:探讨莫西沙星治疗慢性盆腔炎的治疗效果。方法选取2013年6月—2014年6月该妇产科收治的慢性盆腔炎患者320例,随机分为2组各160例,对照组给予青霉素联合甲硝唑治疗,观察组给予莫西沙星治疗,对比分析两组治疗效果和不良反应。结果观察组总有效率为96.3%,对照组总有效率为81.8%,观察组明显优于对照组(P<0.05);观察组不良反应发生率为2.5%;对照组不良反应发生率为10.6%,两组比较差异有统计学意义(P<0.05)。结论慢性盆腔炎患者采用莫西沙星治疗可明显改善患者临床症状,且不良反应少,值得在临床推广应用。

  10. 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.

  11. 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.

  12. Pelvic Organ Prolapse

    Science.gov (United States)

    ... Procedures Implants and Prosthetics Urogynecologic Surgical Mesh Implants Pelvic Organ Prolapse (POP) Share Tweet Linkedin Pin it More sharing ... Treatment Options for Pelvic Organ Prolapse? What is Pelvic Organ Prolapse? Pelvic organ prolapse (POP) occurs when the tissue ...

  13. 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.

  14. Interventional radiology in urology

    International Nuclear Information System (INIS)

    Full text: Ever since starting X-rays use in medical practice, the first interventional methods used in urological practice have been applied. In modern times, based on the use of different sources for image acquisition, the interventional procedures are generally conducted under three types of image control: X-ray, including the CT, non-X-ray, including ultrasound and MRI, and mixed. On the other hand, based on the access used for carrying out the interventional procedure on the urinary tract, the procedures are divided into the following types: the percutaneous, intravascular and intraluminal. Percutaneous manipulations, the most widely used ones, include puncture and drainage of renal cysts and collections in the kidney area, drainage studies of the upper urinary tract, bladder percutaneous drainage and percutaneous nephrostomy are now routinely used. In modern times, more practical interest is percutaneous renal lithotripsy, especially in combination with extracorporeal lithotripsy and percutaneous ablation of renal tumors. Intravascular manipulation, especially after the massive use of CT angiography, are limited to therapeutic use, as in this respect the mainly use is in transluminal angioplasty and renal artery stenting, and embolization. The modern devices entering into the urological practice, allow a high degree of overlap and less invasive therapeutic methods, such as uretero renoscopy, that gradually become major therapeutic approaches to many of the most common urological diseases. It should be noted the role of retrograde ureteric pyelography and ureteral endoprosthesis in the development of these methods. Key elements to achieve maximum efficiency, as diagnostic as therapeutic, from the application of interventional procedures, especially widely used in urological practice than technical mastery of the methodology, is the use of the most appropriate methods or a combination of an exact display and good collaboration with the urologist as in

  15. 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.

  16. 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.

  17. Pediatric robotic urologic surgery-2014.

    Science.gov (United States)

    Kearns, James T; Gundeti, Mohan S

    2014-07-01

    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. PMID:25197187

  18. Pelvic radiotherapy and sexual dysfunction in women

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine; Froeding, Ligita Paskeviciute

    2015-01-01

    BACKGROUND: During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing...... 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...

  19. 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 ...

  20. 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.

  1. 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

  2. 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

  3. URobotics—Urology Robotics at Johns Hopkins

    OpenAIRE

    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, t...

  4. PELVIC ORGAN PROLAPES

    OpenAIRE

    Ketut Yoga Mira Pratiwi; I Gede Mega Putra

    2013-01-01

    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 prolaps...

  5. UROLOGIC ROBOTS AND FUTURE DIRECTIONS

    OpenAIRE

    Mozer, Pierre; Troccaz, Jocelyne; Stoianovici, Dan

    2009-01-01

    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 rob...

  6. 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.

  7. 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

  8. Pelvic Radiation Disease Management by Hyperbaric Oxygen Therapy: Prospective Study of 44 Patients

    OpenAIRE

    Mehdi Ouaïssi; Stephanie Tran; Diane Mege; Vivien Latrasse; Alain Barthelemy; Nicolas Pirro; Philippe Grandval; James Lassey; Igor Sielezneff; Bernard Sastre; Mathieu Coulange

    2014-01-01

    Pelvic radiation disease (PRD) occurs in 2–11% of patients undergoing pelvic radiation for urologic and gynecologic malignancies. Hyperbaric oxygen therapy (HBOT) has previously been described as a noninvasive therapeutic option for the treatment of PRD. the purpose of study was to analyze prospectively the results of HBOT in 44 consecutive patients with PRD who were resistant to conventional oral or topical treatments. Material and Methods. The median age of the cohort was 65.7 years (39–85)...

  9. Diabetes and Sexual and Urologic Problems

    Science.gov (United States)

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

  10. Curative Effect of Abdominal Acupuncture and Moxibustion treatment on Chronic Pelvic Inflammation%腹针加透灸治疗慢性盆腔炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵燕; 赵义刚

    2015-01-01

    目的:观察腹针加透灸法治疗慢性盆腔炎的临床疗效及作用机制。方法:将40例慢性盆腔炎患者随机分为治疗组与对照组,各20例,对照组采用西药治疗,治疗组在对照组的基础上加腹针、透灸法治疗。结果:治疗组的临床疗效优于对照组(P<0.05),治疗组复发率也低于对照组(P<0.01)。结论:腹针加透灸治疗慢性盆腔炎有明显的临床疗效,并可降低复发率。%Objective:To observe the effect of abdominal acupuncture plus moxibustion treatment on chronic pelvic inflammation and mechanism of action.Methods:40 patients with chronic pelvic inflammation were ran-domly divided into a treatment group and a control group.20 cases in the control group received western medi-cine,and abdominal acupuncture and moxibustion were used in the treatment group on the basis of the therapy in the control group.Results:The clinical efficacy of the treatment group was better than that in the control group ( P<0.05) ,and in the treatment group the recurrence rate was also lower than that in the control group ( P<0.01 ) .Conclusion:Abdominal acupuncture and moxibustion treatment for chronic pelvic inflammation have a significantly clinical efficacy and can reduce the recurrence rate .

  11. 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.

  12. Adolescent Urology and Transitional Care.

    Science.gov (United States)

    Woodhouse, Christopher

    2015-11-01

    Babies with the major congenital anomalies of the genito-urinary tract have all-embracing holistic care during childhood. They require the same level of care in adult life. This is the role of transition and adolescent urology. PMID:26153563

  13. Urological diagnosis using clinical PACS

    Science.gov (United States)

    Mills, Stephen F.; Spetz, Kevin S.; Dwyer, Samuel J., III

    1995-05-01

    Urological diagnosis using fluoroscopy images has traditionally been performed using radiographic films. Images are generally acquired in conjunction with the application of a contrast agent, processed to create analog films, and inspected to ensure satisfactory image quality prior to being provided to a radiologist for reading. In the case of errors the entire process must be repeated. In addition, the radiologist must then often go to a particular reading room, possibly in a remote part of the healthcare facility, to read the images. The integration of digital fluoroscopy modalities with clinical PACS has the potential to significantly improve the urological diagnosis process by providing high-speed access to images at a variety of locations within a healthcare facility without costly film processing. The PACS additionally provides a cost-effective and reliable means of long-term storage and allows several medical users to simultaneously view the same images at different locations. The installation of a digital data interface between the existing clinically operational PACS at the University of Virginia Health Sciences Center and a digital urology fluoroscope is described. Preliminary user interviews that have been conducted to determine the clinical effectiveness of PACS workstations for urological diagnosis are discussed. The specific suitability of the workstation medium is discussed, as are overall advantages and disadvantages of the hardcopy and softcopy media in terms of efficiency, timeliness and cost. Throughput metrics and some specific parameters of gray-scale viewing stations and the expected system impacts resulting from the integration of a urology fluoroscope with PACS are also discussed.

  14. Pelvic Organ Prolapse

    Science.gov (United States)

    ... and layers of connective tissue, which are called fascia, become weakened, stretched, or are torn the pelvic ... delivery) can cause injury to the muscles or fascia of the pelvic floor. The increased pressure of ...

  15. Pelvic Support Problems

    Science.gov (United States)

    The pelvic floor is a group of muscles and other tissues that form a sling or hammock across the pelvis. ... place so that they can work properly. The pelvic floor can become weak or be injured. The main ...

  16. Optimising the management of gastrointestinal symptoms following pelvic radiotherapy.

    OpenAIRE

    Henson, Caroline Claire

    2014-01-01

    BackgroundPelvic radiotherapy is a well-established treatment for pelvic malignancies, with 30,000 patients per year in the UK receiving radical pelvic radiotherapy either alone or in combination with other oncological treatments. 80% develop acute gastrointestinal (GI) symptoms and 50% develop chronic GI symptoms and in parallel to improvements in survival, increasing numbers of patients are living to develop the long term consequences of treatment. Despite this, less than 20% of patients wh...

  17. [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.

  18. 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.

  19. Electrosurgery in urology: recent advances

    OpenAIRE

    Tremp, M; Hefermehl, L; Largo, R; Knönagel, H; Sulser, T; Eberli, D

    2011-01-01

    Inadequate hemostasis is one of the most important causes of morbidity and mortality following urological surgery. Despite the long-term usage of coagulation, there is an ongoing development of new devices, including bipolar transurethral resection of the prostate or new vessel-sealing devices. A thorough understanding of the advantages and disadvantages of these new instruments can improve the operative experience for both the urologist and patient. The optimal coagulation system should be s...

  20. Basic science research in urology training

    OpenAIRE

    Eberli, D.; Atala, A

    2009-01-01

    The role of basic science exposure during urology training is a timely topic that is relevant to urologic health and to the training of new physician scientists. Today, researchers are needed for the advancement of this specialty, and involvement in basic research will foster understanding of basic scientific concepts and the development of critical thinking skills, which will, in turn, improve clinical performance. If research education is not included in urology training, future urologists ...

  1. 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

  2. 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。

  3. 盐酸左氧氟沙星与替硝唑联用对慢性盆腔炎的治疗效果评价%Effect of Levofloxacin Combined With Tinidazole in Treatment of Chronic Pelvic Inflammatory

    Institute of Scientific and Technical Information of China (English)

    姜红

    2016-01-01

    目的:观察替硝唑联合盐酸左氧氟沙星治疗慢性盆腔炎的治疗效果。方法将天津河北区妇产科医院诊治的慢性盆腔炎患者随机分为研究组与对照组,对照组使用左氧氟沙星进行治疗,研究组替硝唑联合盐酸左氧氟沙星对患者进行治疗,对比两组的治疗效果与不良反应。结果经过治疗,研究组总有效率为93.3%,明显高于对照组83.3%( P<0.05);研究组不良反应率5.0%低于对照组13.3%( P<0.05)。结论替硝唑联合盐酸左氧氟沙星对于慢性盆腔炎患者来说,具有疗效好、安全性较高、不良反应较少等特点。%Objective To observe the joint tinidazole levofloxacin treatment of chronic pelvic inflammatory disease treatment.Methods Patients of chronic pelvic inflammatory in our hospital this study were randomly divided into study group and the control group, the control group were treated using levofloxacin, study group received levofloxacin combied with tinidazole.Compared the effect and adverse reaction of two groups s.Results After treatment, the study group, the total effective rate was 93.3%, significantly higher than 83.3%( P<0.05);adverse reaction rate of 5.0%in the study group than the control group 13.3%( P<0.05 ) .Conclusion Tinidazole joint levofloxacin chronic pelvic inflammatory disease, it has a good effect, high security, fewer adverse reactions and other characteristics.

  4. 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.

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

    International Nuclear Information System (INIS)

    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg 123I-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 123I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods. (orig.)

  6. 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.

  7. 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.

  8. 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. PMID:26757904

  9. 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。

  10. Relationship between proinflammatory cytokines and anti-inflammatory cytokines in patients with chronic pelvic inflammatory disease%慢性盆腔炎患者促炎因子与抗炎因子的关系

    Institute of Scientific and Technical Information of China (English)

    王莉; 吕耀凤; 姚丽娟

    2012-01-01

    目的:探讨慢性盆腔炎患者血清促炎因子与抗炎因子的表达与相关性.方法:选择87例慢性盆腔炎患者作为病例组,选择同期健康体检妇女69例作为对照组,ELISA法检测血清TNF-α、IL-1 β、IL-6和抗炎细胞因子IL-4、IL-10的表达.结果:病例组患者血清TNF-α、IL-1β和IL-6表达高于对照组(P<0.05),而血清IL-4和IL-10表达低于对照组(P<0.05);病例组患者血清促炎因子的表达与抗炎因子的表达呈负相关(P<0.05).结论:慢性盆腔炎患者促炎因子过度激活,而抗炎因子被抑制,并且二者表达具有一定的相关性,共同促进慢性盆腔炎的发生发展.%Objective: To explore the expressions of serum proinflammatory cytokines and anti — inflammatory cytokines in patients with chronic pelvic inflammatory disease and their correlation. Methods; A total of 87 patients with chronic pelvic inflammatory disease were selected as case group, and 69 women who received physical examination during the same period were selected as control group, ELISA was used to detect the expression levels of serum inflammatory cytokines ( TNF — α, IL - 1β, IL — 6 ) and anti — inflammatory cytokines (IL — 4, IL — 10) . Results; The expression levels of serum TNF — α, IL — 1 β, and IL - 6 in case group were statistically significantly higher than those in control group (P < 0. 05 ) . The expression levels of serum TL —4 and IL — 10 in case group were statistically significantly lower than those in control group (P<0. 05) . There was a negative correlation between expressions of serum proinflammatory cytokines and expressions of serum anti - inflammatory cytokines in case group (P <0. 05 ) . Conclusion; Among the patients with chronic pelvic inflammatory disease, proinflammatory cytokines were activated and anti — inflammatory cytokines were inhibited, and there was a certain correlation between them, both proinflammatory cytokines and anti — inflammatory

  11. 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...

  12. Predicting Late Effects of Pelvic Radiotherapy: Is There a Better Approach?

    International Nuclear Information System (INIS)

    Purpose: Significant chronic symptoms following pelvic radiotherapy occur more frequently than commonly realized. Predictive factors for the development of late symptoms are poorly defined. Moderate sustained acute (cumulative) toxicity might predict severe late effects better than peak reaction. Methods and Materials: To determine prospectively whether peak or cumulative gastrointestinal (GI) acute symptoms better predict late symptoms in patients receiving pelvic radiotherapy. Symptom scores were measured weekly from the start of radiotherapy, and at 1 year using the Modified Inflammatory Bowel Disease Questionnaire-Bowel subset. The possible prognostic impact of patient-related factors was explored. Results: Three hundred and eight patients were recruited. 100 were excluded due to lack of follow-up data at one year resulting from death, too ill, stoma, relapsed, non-response or withdrawal. A further 15 were excluded for incomplete data, leaving 193 patients with evaluable data. Of these, 28 had GI, 101 urological, and 64 gynecological cancers. Patients' median age was 65 years (range, 23-82), and they were treated with median 60 Gy dose for a median of 6 weeks. Univariate analysis revealed a significant association between cumulative acute symptom scores and scores at 1 year (p < 0.001), which was dose-independent (p < 0.001). Acute peak and 1-year scores were not associated (p = 0.431). The correlation coefficient between cumulative acute symptoms and symptoms at 1 year was 0.367 and for peak acute symptoms was weaker at 0.057. Patients with an abnormal body mass index and current smokers were more likely to experience worse symptoms at 1 year. Conclusion: Cumulative acute symptoms are more predictive of late symptoms than peak acute changes in score. This association is independent of the radiotherapy dose delivered and is suggestive of a consequential late effect.

  13. 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...

  14. 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...

  15. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  16. Telemedicine in Urology: State of the Art.

    Science.gov (United States)

    Ellimoottil, Chandy; Skolarus, Ted; Gettman, Matthew; Boxer, Richard; Kutikov, Alexander; Lee, Benjamin R; Shelton, Jeremy; Morgan, Todd

    2016-08-01

    Whereas telemedicine is recognized as one of the fastest-growing components of the healthcare system, the status of telemedicine use in urology is largely unknown. In this narrative review, we detail studies that investigate the use of televisits and teleconsultations for urologic conditions. Moreover, we discuss current regulatory and reimbursement policies. Finally, we discuss the significant barriers to widespread dissemination and implementation of telemedicine and reasons why the field of urology may be positioned to become a leader in the provision of telemedicine services. PMID:27109596

  17. Extracorporeal shock wave therapy (ESWT) in urology

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  18. Only a minority of patients in the urological emergency unit need urgent urology care

    Directory of Open Access Journals (Sweden)

    Žana Saratlija Novaković

    2014-11-01

    Full Text Available Objective. To present patients who were examined, monitored and admitted at the urological emergency unit (UEU at the University Hospital, Split during the summer and winter of 2010 and to establish who of them were really in need of immediate urological care. Methods. A retrospective study of patients and diagnoses of patients examined at the UEU was undertaken during two winter and two summer months 2010. We compared the total number of patients, the number of patients with urological issues, patients with urological emergencies, patients with non-urological issues, patients who were briefly monitored at the UEU, and patients admitted to the urology department, within these two periods. Descriptive statistic and chi squared tests were used. Results. During the winter period 465 patients were examined at the UEU and during the summer 733 patients. During the summer period there were statistically more urological issues (χ2=12.3; p=0.005 and urological emergencies (χ2=4.14; p=0.042 while in the winter period there were more non-urological issues and more patients were monitored at the UEU (χ2=33.9; p<0.001. The most common diagnoses are: renal colic and urine retention, in both periods. Only 8% of patients in both the winter and summer periods were admitted to hospital after examination at the UEU, which represents the actual number of patients who needed immediate urological care. Conclusion. Of all the patients examined at the UEU, only a fraction constituted real, life-threatening urological emergencies. Primary care physicians and general emergency departments should be more educated in urological emergencies so that they can resolve more nonemergency patients themselves.

  19. Sexual and Urologic Problems of Diabetes

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  20. Pelvic Inflammatory Disease

    Science.gov (United States)

    Pelvic inflammatory disease (PID) is an infection and inflammation of the uterus, ovaries, and other female reproductive organs. It causes scarring ... United States. Gonorrhea and chlamydia, two sexually transmitted diseases, are the most common causes of PID. Other ...

  1. Pelvic Support Problems

    Science.gov (United States)

    ... nonsurgical ways to obtain symptom relief? • What are Kegel exercises? • Can surgery correct pelvic support problems? • Glossary ... your overall health and possibly your prolapse symptoms. • Kegel exercises—These exercises strengthen the muscles that surround ...

  2. Pelvic Insufficiency Fractures

    OpenAIRE

    O’Connor, Timothy J.; Cole, Peter A.

    2014-01-01

    Pelvic insufficiency fractures may occur in the absence of trauma or as a result of low-energy trauma in osteoporotic bone. With a growing geriatric population, the incidence of pelvic insufficiency fracture has increased over the last 3 decades and will continue to do so. These fractures can cause considerable pain, loss of independence, and economic burden to both the patient and the health care system. While many of these injuries are identified and treated based on plain radiographs, some...

  3. 中药盆腔宁直肠给药治疗慢性盆腔炎的疗效评价%Treatment Evaluation of Treating Chronic Pelvic Inflammatory Disease by Rectal Administration of Penqiangning

    Institute of Scientific and Technical Information of China (English)

    温洁

    2012-01-01

    Objective; To evaluate the clinical effect of treating chronic pelvic inflammatory disease by rectal administration of Penqiangning and the improvement of the marital quality. Methods: To divide 61 patients into two groups randomly, 33cases in the treating group were given rectal administration of Penqiangning. They were given the treatment of 3 ~ Sdays after their menstruations, one dose a day, using 14days, and totally 3courses of treatment. 28 cases in the control group were given rectal administration of 16, 0000units Genlamicin plus 0.9% 100ml normal sodium, also totally 3courses of treatment. Results: Both two treatments could relieve pain obviously. The value of the pain scores by using Traditional Chinese Medicine declined 2. 71 after the treatment, and the value of the pain scores declined 3. 19of the control group. There was no difference between the two groups. Conclusion: Treating chronic pelvic inflammatory disease by rectal administration of Penqiangning is more safe on the premise of relieving pain, improving the quality of life and the marriage%目的:评价中药盆腔宁保留灌肠对缓解慢性盆腔炎疼痛的临床疗效以及婚姻质量的改善情况.方法:将61例慢性盆腔炎患者按随机化原则分成两组,治疗组33例给予中药盆腔宁保留灌肠,经净后3~5天每日1剂,连用14天,共3个疗程;对照组28例给予生理盐水100ml+庆大霉素16万单位灌肠治疗,共3个疗程.结果:中医或西医治疗疼痛均有明显缓解作用,中医治疗组治疗前后疼痛评分下降2.71,对照组下降3.19,两组比较,差异不具有统计学意义(P>0.05).结论:中药盆腔宁保留灌肠治疗慢性盆腔炎在具有缓解疼痛,改善生活质量及婚姻质量等明确疗效的前提下,安全性更优.

  4. Paediatric urological investigations - dose comparison between urology-related and CT irradiation

    International Nuclear Information System (INIS)

    Urological investigation in children frequently involves high radiation doses; however, the issue of radiation for these investigations receives little attention compared with CT. To compare the radiation dose from paediatric urological investigations with CT, which is commonly regarded as the more major source of radiation exposure. We conducted a retrospective audit in a tertiary paediatric centre of the number and radiation dose of CT scans, micturating cystourethrography exams and urological nuclear medicine scans from 2006 to 2011. This was compared with radiation doses in the literature and an audit of the frequency of these studies in Australia. The tertiary centre audit demonstrated that the ratio of the frequency of urological to CT examinations was 0.8:1 in children younger than 17 years. The ratio of the radiation dose of urological to CT examinations was 0.7:1. The ratio in children younger than 5 years was 1.9:1. In Australia the frequency of urological procedures compared with CT was 0.4:1 in children younger than 17 years and 3.1:1 in those younger than 5 years. The ratio of radiation-related publications was 1:9 favouring CT. The incidence and radiation dose of paediatric urological studies is comparable to those of CT. Nevertheless the radiation dose of urological procedures receives considerably less attention in the literature. (orig.)

  5. 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.

  6. 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

  7. 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...

  8. Pelvic Organ Prolapse--Surgery

    Science.gov (United States)

    ... About "It" Talking About PFD 3 Resources + More Pelvic Organ Prolapse POP Symptoms & Types Can I Prevent POP? POP ... Get Involved About the Campaign Supporters Contact Information Pelvic Organ Prolapse POP Symptoms & Types Can I Prevent POP? Kegel ...

  9. The impact of nuclear imaging on pediatric urology

    International Nuclear Information System (INIS)

    Nuclear imaging has a key role in diagnosis and therapy in modern pediatric urology. We discuss the value and limitations of radionuclide studies (diuresis renogramm, DMSA, VCUG, MIBG scintigraphy) with special regard to characteristic pathologic entities in pediatric urology. (orig.)

  10. Clinical Holistic Medicine: Holistic Sexology and Acupressure Through the Vagina (Hippocratic Pelvic Massage)

    OpenAIRE

    Søren Ventegodt; Birgitte Clausen; Hatim A. Omar; Joav Merrick

    2006-01-01

    Many gynecological and sexological problems (like urine incontinence, chronic pelvic pains, vulvodynia, and lack of lust, excitement, and orgasm) are resistant to standard medical treatment. In our work at the Research Clinic for Holistic Medicine in Copenhagen, we have found that vaginal acupressure, or Hippocratic pelvic massage, can help some of these problems. Technically, it is a very simple procedure as it corresponds to the explorative phase of the standard pelvic examination, suppleme...

  11. 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

  12. Iatrogenic urological triggers of autonomic dysreflexia

    DEFF Research Database (Denmark)

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

    2015-01-01

    STUDY DESIGN: This is a systematic review. OBJECTIVE: The objective of this study was to review the literature on iatrogenic urological triggers of autonomic dysreflexia (AD). SETTING: This study was conducted in an international setting. METHODS: A systematic review was conducted from Pub......Med search using AD/ autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood...... 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...

  13. 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。

  14. 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...

  15. 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...

  16. Asymptomatic Bacteriuria in Clinical Urological Practice

    DEFF Research Database (Denmark)

    Cai, Tommaso; Mazzoli, Sandra; Lanzafame, Paolo;

    2016-01-01

    issues in everyday urological practice that require special attention: the role of ABU in pre-operative prophylaxis and in women affected by recurrent urinary tract infections (rUTIs). Nowadays, this is the time to think over our practice and change our way of thinking. Here, we aimed to summarize...... the current literature knowledge in terms of ABU management in patients undergoing urological surgery and in patients with rUTIs. In the last years, the approach to patient with ABU has changed totally. Prior to all surgical procedures that do not enter the urinary tract, ABU is generally not considered...

  17. 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

  18. [Echo-color-Doppler in male pelvic congestion syndrome].

    Science.gov (United States)

    Sarteschi, Lelio Mario; Simi, Stefano; Turchi, Paolo; DeMaria, Maurizio; Morelli, Girolamo

    2002-12-01

    The pelvic congestion syndrome has been widely studied in the female sex, while there are not many publications on the male equivalent. Prostatitis represent the most frequent affections of the genito-urinary male tract that require the urologic consult, but in the majority of the cases the etiology of such affections remains unknown. Some forms of microscopic hematuria or macroscopic hematuria are also cryptogenetic. Varicocelectomy is widely given in the infertile patients, but not always the intervention achieves a recovery of the semen quality. In this work we revisit the anatomy of the pelvic male venous drain and we depict its objective findings with the echo-color-Doppler sonography (ECD). The purpose of the study is to encourage a polycentric uro-andrologic search on large numbers, with the goal of resolve if the ECD pictures of congestion pelvic syndrome could have relation with some "prostatitis syndromes", with some cryptogenetic hematuria and/or with the prognosis of the infertile patients undergone to varicocelectomy. PMID:12508723

  19. [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.

  20. 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.

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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.

  6. MANAGEMENT OF PELVIC FRACTURE URETHRAL DIS TRACTION DEFECT (PFUDD

    Directory of Open Access Journals (Sweden)

    Ramesh

    2015-01-01

    Full Text Available INTRODUCTION : Posterior pelvic fracture urethral distraction defect is a challenging urologic problem that may result in complications such as urinary incontinence and inability to void due to recurrent stricture leading to a lifelong disabling condition. AIMS AND OBJECTIVES : T o evaluate the outcome of primary realignment after pelvic fracture urethral injury a nd the outcome of urethroplasty after development of urethral stricture. T o study the outcome of simple trocar spc after pelvic fracture urethral injury and the results of stricture management. T o compare the results of primary realignment versus simple trocar spc after pelvic fracture urethral injury. MATERIALS AND METHODS : 50 patients with pelvic fracture urethral injury who attended emergency department were included in the study. All patients were subjected to RGU , USG and CECT Abdomen with delayed films in selected cases with high probability of rectal , bladder neck injury. In our study subjects undergoing primary catheter realignment are included in group A. and those undergoing simple emerge ncy SPC are included in group B. Both were followed up for the development of complications and managed accordingly. RESULTS : Out of 50 patients with pelvic fracture 26 (52% were in in 20 - 30 years age group. Trocar SPC was done in 40 patients (80% and ma naged conservatively. They are grouped as Group B. All of them underwent RGU after three weeks. When there was no demonstrable stricture , suprapubic catheter was clamped and voiding trial given. If the patient was not voiding well , SPC catheter continued f or 3 - 6 months until the healing of orthopedic injuries. If RGU shows stricture , SPC catheter is continued for 3 - 6 months. Patients with total block underwent combined RGU and VCUG ( up and downogram before planning for delayed urethroplasty. The remaining 10 patients (20% were included in Group A who underwent primary catheter realignment simultaneously when laparotomy is

  7. 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.

  8. 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.

  9. CT of pelvic fractures

    International Nuclear Information System (INIS)

    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

  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. 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.

  13. 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.

  14. 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.

  15. Emerging role of robotics in urology

    OpenAIRE

    Kumar Rajeev; Hemal Ashok

    2005-01-01

    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 degre...

  16. Phytotherapy: emerging therapeutic option in urologic disease

    OpenAIRE

    Kim, Sae Woong

    2012-01-01

    Phytotherapy belongs to the area of complementary and alternative medicine (CAM) and the definition of phytotherapy is the use of plants or plant extracts for medicinal uses. Interest in phytotherapy is growing in both Asian and western countries for its use in the prevention and management of disease, improvement of general health and anti-aging. And also, there are several studies about the efficacy of phytotherapy in urologic diseases like benign prostatic hyperplasia (BPH), erectile dysfu...

  17. 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.

  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. Robotic-Assisted Surgery for Benign Urological Conditions

    OpenAIRE

    Murphy, Declan G; Ben J. Challacombe; Lail-U-Mah Zaheer; M. Shamim Khan; Prokar Dasgupta

    2006-01-01

    Robotic technology for use in surgery has advanced considerably in the past 10 years. This has become particularly apparent in urology where robotic-assisted radical prostatectomy using the da VinciTM surgical system (Intuitive Surgical, CA) has become very popular. The use of robotic assistance for benign urological procedures is less well documented. This article considers the current robotic technology and reviews the situation with regard to robotic surgery for benign urological conditions.

  20. [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.

  1. Cytodiagnosis for pelvic tuberculosis.

    Directory of Open Access Journals (Sweden)

    Khilanani P

    1992-10-01

    Full Text Available A 25 yr old married woman with complaints of lower abdominal pain for 2 months, was found to have a irregular nontender mass in pelvis, adherent to uterus. Her Papanicolaou smear was inflammatory. To confirm the diagnosis of either ovarian malignancy or pelvic tuberculosis made on the basis of observations during exploratory laparotomy, ovarian biopsy was taken. The imprint cytodiagnosis was tuberculosis. The patient was then managed surgically and the previous diagnosis was reconfirmed by histopathology. Imprint cytodiagnosis appears to be a valuable technique whenever facilities for frozen section are not available.

  2. 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.

  3. 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.

  4. [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

  5. Therapeutic effect of chemical fractions of Smilax china on Chronic pelvic inflammation disease in rats%菝葜各化学部位对大鼠慢性盆腔炎模型的治疗作用

    Institute of Scientific and Technical Information of China (English)

    马云; 罗艳琴; 宋路瑶; 龚恬; 侯连兵

    2013-01-01

    Objective To study the effects of the total ethanol extract and separated chemical fractions of Smilax China on hematological and pathomorphological alterations in rats with chronic pelvic inflammation disease (CPID),and to identify the active sites of Smilax China for treating CPID.Methods One hundred and sixty female Sprague-Dawley rats were randomly divided into 16 groups.Rat CPID model were constructed by intrauterine injection of phenol mucilage.Each of the four chemical fractions of Smilax China was administered to the model rats by gavage with three different doses (32.4,16.2 and 8.1 g/kg) for 10 consecutive days,once per day.Jingangteng capsule was administered in a dose of 16.2 g/kg as a positive control group.The rats of model control group,control group and sham-operated group were administered with the same amount of distilled water.Twenty-four hours after the last drug administration,the rats were killed and blood was collected from the abdominal aorta for hematological analysis,while the two uteri were removed for pathomorphological analysis.Results Compared with the model control group,the ethyl acetate fraction of Smilax significantly ameliorated the inflammatory response in uterus at its high and middle dose (P < 0.01).Pathological analysis indicated that the uterus swelling extent decreased in Smilax China ethyl acetate fraction group.The anti-inflammation effect of Smilax China ethyl acetate fraction was equal to that of the total Smilax China ethanol extract,and was much better than that of Smilax China n-butanol fraction group and water fraction group.Conclusion The ethyl acetate fraction of Smilax China is the main active fraction against CPID.%目的 研究菝葜乙醇总提取物及各化学部位对慢性盆腔炎疾病(chronic pelvic inflammatory diease,CPID)模型大鼠的血液学及病理形态学改变的影响,筛选出菝葜抗慢性盆腔炎的主要活性部位.方法 160只SD雌性大鼠按随机数字表法分为16个组,除

  6. 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

  7. 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

  8. 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。

  9. 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. 

  10. 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.

  11. What is next in robotic urology?

    Science.gov (United States)

    Cathelineau, Xavier; Sanchez-Salas, Rafael; Sivaraman, Arjun

    2014-12-01

    The application of robotic technology in surgical practice was developed during the past three decades, but its clinical application has made a significant impact during the last 10 years. Urologists have embraced surgical robots throughout their evolution, and robot-assisted urologic surgeries have matured into everyday clinical practice in many parts of the world. Long-term data from robot-assisted radical prostatectomies (RARP), an early robotic urologic surgery, has shown that the results are comparable to contemporary open radical prostatectomy (ORP) cohorts. Robot-assisted partial nephrectomy (RAPN) is largely restricted to high-volume academic centers; comparative studies have demonstrated significant advantages in favor of RAPN over laparoscopic partial nephrectomy (LPN) to achieve adequate warm ischemia time, surgical margins free of cancer cells, and no peri-operative complications. Robot-assisted radical cystectomy shows results that are comparable to contemporary open radical cystectomy. Several authors have reported the feasibility of robotic intracorporeal urinary diversion. The available long-term outcomes of robot-assisted urological surgeries are comparable to conventional open surgical methods and are associated with fewer complications. Surgical robots continue to evolve, and robotic engineers alongside surgeons strive hard to synthesize and evaluate novel robotic platforms, downsize hardware, and develop flexible instruments and newer technologies. Robotic applications available at this point represent the infancy of this technology. Future developments in robotics are profoundly limited to human imagination and can potentially scale to unimaginable heights. We would expect robots coupled with imaging and energies, aiming to provide accurate and reliable treatments which will be finely targeted by biogenetic information. PMID:25341557

  12. 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.

  13. [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.

  14. Should we train urologists in female urology? A European view.

    NARCIS (Netherlands)

    Heesakkers, J.P.F.A.; Costantini, E.; Oelke, M.

    2009-01-01

    PURPOSE OF REVIEW: Training in female urology in Europe so far has been a national focus of individual European countries. Because of reasons like differentiation in pathology, activities of other specialisms like gynaecology and reimbursement issues, the way in which extra training in female urolog

  15. Prevalence of Sexual Abuse among Patients Seeking General Urological Care

    NARCIS (Netherlands)

    Beck, Jack J. H.; Bekker, Milou D.; van Driel, Mels F.; Roshani, Hossein; Putter, Hein; Pelger, Rob C. M.; Elzevier, Henk W.

    2011-01-01

    Introduction. Sexual abuse (SA) history can be found in the backgrounds of an important fraction of men (8-10%) and women (12-25%). Until now there are no data about this prevalence within a urological patient population. Aim. To establish the prevalence of SA among men and women visiting a urologic

  16. 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...

  17. The Global Prevalence of Infections in Urology Study

    DEFF Research Database (Denmark)

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

    2016-01-01

    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......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...... 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...

  18. 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.

  19. New trends in minimally invasive urological surgery

    Directory of Open Access Journals (Sweden)

    Prabhakar Rajan

    2009-10-01

    Full Text Available Purpose: The perceived benefits of minimally-invasive surgery include less postoperative pain, shorter hospitalization, reduced morbidity and better cosmesis while maintaining diagnostic accuracy and therapeutic outcome. We review the new trends in minimally-invasive urological surgery. Materials and method: We reviewed the English language literature using the National Library of Medicine database to identify the latest technological advances in minimally-invasive surgery with particular reference to urology. Results: Amongst other advances, studies incorporating needlescopic surgery, laparoendoscopic single-site surgery , magnetic anchoring and guidance systems, natural orifice transluminal endoscopic surgery and flexible robots were considered of interest. The results from initial animal and human studies are also outlined. Conclusion: Minimally-invasive surgery continues to evolve to meet the demands of the operators and patients. Many novel technologies are still in the testing phase, whilst others have entered clinical practice. Further evaluation is required to confirm the safety and efficacy of these techniques and validate the published reports.

  20. Update in systemic therapy of urologic malignancies.

    Science.gov (United States)

    Mooney, David; Paluri, Ravikumar; Mehta, Amitkumar; Goyal, Jatinder; Sonpavde, Guru

    2014-01-01

    Systemic therapy of advanced prostate and renal cancers has gained several recent additions to the therapeutic armamentarium. Treatment of patients with castration-resistant prostate cancer now includes additional immunotherapy (sipuleucel-T), chemotherapy (cabazitaxel), androgen-signaling inhibitors (abiraterone acetate, enzalutamide), and a radiopharmaceutical (alpharadin), based on extension of patient survival. Similarly, therapy for patients with renal cell carcinoma, a chemoresistant malignancy, has undergone dramatic changes based on an understanding of the role of angiogenesis. Multiple vascular endothelial growth factor inhibitors (sorafenib, sunitinib, pazopanib, axitinib, bevacizumab) and mammalian target of rapamycin inhibitors (temsirolimus, everolimus) have been added to the therapeutic arsenal. Additionally, immunotherapy retains an important treatment role, with a continuing application of high-dose interleukin-2 in select patients and the emergence of novel immunotherapeutic agents that may have significant benefit. Other major urologic malignancies, including urothelial, testicular, and penile cancers, have witnessed relatively few or no recent advances in therapy, although testicular germ cell tumors are one of the most curable malignancies. An agent for treatment of advanced urothelial cancer now has commercial approval, the chemotherapeutic agent, vinflunine, as second-line therapy in multiple countries-but not in the United States. Our review summarizes and updates the field of systemic therapy for advanced urologic malignancies, with a focus on castration-resistant prostate cancer and renal cell carcinoma. PMID:24393751

  1. 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.

  2. Laser tissue welding: a urological surgeon's perspective.

    Science.gov (United States)

    Poppas, D P; Scherr, D S

    1998-07-01

    Laser tissue welding has proven its efficacy in the laboratory setting when compared with more traditional modalities of tissue reapproximation. In the clinical environment, several areas including urethral reconstructive surgery have shown great promise. Several technological advancements including solder development, chromophore enhancement and temperature control have improved upon the welding process and have added more precision and reproducibility to the technique. The current potential applications for laser welding in urology are numerous. On a molecular level, growth factor supplementation has certain potential in improving upon weld site healing and wound strength. Laparoscopic surgery with its need for less cumbersome modes of tissue closure is a field that will greatly benefit from the technology of laser tissue welding. Surgical specialties outside of urology are also participating in developing the field of laser welding. In particular, cardiothoracic surgery, otolaryngology, plastic surgery, neurosurgery among others, have utilized the concept of laser tissue welding. There are many ares that have potential use for laser welding that have yet to be explored. Further investigation will likely reveal more applications for this valuable technology. PMID:9873775

  3. 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.

  4. 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.

  5. 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 ...

  6. Post partum pelvic floor changes.

    Science.gov (United States)

    Fonti, Ylenia; Giordano, Rosalba; Cacciatore, Alessandra; Romano, Mattea; La Rosa, Beatrice

    2009-10-01

    Pelvic-perineal dysfunctions, are the most common diseases in women after pregnancy. Urinary incontinence and genital prolapsy, often associated, are the most important consequences of childbirth and are determined by specific alterations in the structure of neurological and musculo-fascial pelvic support.Causation is difficult to prove because symptom occur remote from delivery.Furthermore it is unclear whether changes are secondary to the method of childbirth or to the pregnancy itself.This controversy fuels the debate about whether or not women should be offered the choice of elective caesarean delivery to avoid the development of subsequent pelvic floor disfunction.But it has been demonstrated that pregnancy itself, by means of mechanical changes of pelvic statics and changes in hormones, can be a significant risk factor for these diseases. Especially is the first child to be decisive for the stability of the pelvic floor.During pregnancy, the progressive increase in volume of the uterus subject perineal structures to a major overload. During delivery, the parties present and passes through the urogenital hiatus leading to growing pressure on the tissues causing the stretching of the pelvic floor with possible muscle damage, connective tissue and / or nervous.In this article we aim to describe genitourinary post partum changes with particular attention to the impact of pregnancy or childbirth on these changes. PMID:22439048

  7. Pelvic floor ultrasonography: an update.

    Science.gov (United States)

    Shek, K L; Dietz, H-P

    2013-02-01

    Female pelvic floor dysfunction encompasses a number of highly prevalent clinical conditions such as female pelvic organ prolapse, urinary and fecal incontinence, and sexual dysfunction. The etiology and pathophysiology of those conditions are, however, not well understood. Recent technological advances have seen a surge in the use of imaging, both in research and clinical practice. Among the techniques available such as sonography, X-ray, computed tomography and magnetic resonance imaging, ultrasound is superior for pelvic floor imaging, especially in the form of perineal or translabial imaging. The technique is safe with no radiation, simple, cheap, easily accessible and provides high spatial and temporal resolutions. Translabial or perineal ultrasound is useful in determining residual urinary volume, detrusor wall thickness, bladder neck mobility and in assessing pelvic organ prolapse as well as levator function and anatomy. It is at least equivalent to other imaging techniques in diagnosing, such diverse conditions as urethral diverticula, rectal intussusception and avulsion of the puborectalis muscle. Ultrasound is the only imaging method capable of visualizing modern slings and mesh implants and may help selecting patients for implant surgery. Delivery-related levator injury seems to be the most important etiological factor for pelvic organ prolapse and recurrence after prolapse surgery, and it is most conveniently diagnosed by pelvic floor ultrasound. This review gives an overview of the methodology. Its main current uses in clinical assessment and research will also be discussed. PMID:23412016

  8. 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.

  9. 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

  10. [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.

  11. [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.

  12. 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.

  13. 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.

  14. 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.

  15. 10 years of the Urology Chair of the Siberian State Medical University. History of urology in Tomsk

    Directory of Open Access Journals (Sweden)

    Gudkov A.V. Gudkov A.V. Gudkov

    2012-01-01

    Full Text Available The paper describes the history of development of urology in Tomskand the Tomsk Region. After the foundation of the ImperialTomskUniversity, the first university behind the Ural Mountains, in 1878, urology began to develop at the Chair of Hospital Surgery. University professors E.G. Salishchev, P.I. Tikhov, N.I. Berezganovskii, N.A. Bogoraz, V.M. Mysh, A.G. Savinykh, V.M. Voskresenskii and others contributed a tremendous contribution to the development of urology. Since the course of urology was opened in 1959 by Prof. I.S. Petrov, the Clinic of the MedicalUniversitybecame an organizational-methodical center of the urological service of the Tomsk Region. The Clinic trained urologists for the municipal and regional health services. In 1976, and the independent course of urology was organized, and in 2002 the Urology Chair headed by Prof. A.V. Gudkov was founded.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Pelvic Inflammatory Disease (PID) Treatment and Care

    Science.gov (United States)

    ... Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human Papillomavirus (HPV) Pelvic Inflammatory Disease ... is pelvic inflammatory disease treated? Several types of antibiotics can cure PID. Antibiotic treatment does not, however, reverse any ...

  3. How Are Pelvic Floor Disorders Commonly Treated?

    Science.gov (United States)

    ... stress incontinence at the time of surgery for pelvic organ prolapse in women who don't have symptoms of ... I., Majeroni, B. A., & Johnson, D. W. (2010). Pelvic organ prolapse. American Family Physician, 81 , 1111-1117. [top] Shamliyan, ...

  4. Can I prevent Pelvic Organ Prolapse

    Science.gov (United States)

    ... About "It" Talking About PFD 3 Resources + More Pelvic Organ Prolapse POP Symptoms & Types Can I Prevent POP? POP ... Get Involved About the Campaign Supporters Contact Information Pelvic Organ Prolapse POP Symptoms & Types Can I Prevent POP? Kegel ...

  5. '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 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...

  6. Fracture Detection in Traumatic Pelvic CT Images

    OpenAIRE

    Jie Wu; Pavani Davuluri; Kevin R. Ward; Charles Cockrell; Rosalyn Hobson; Kayvan Najarian

    2012-01-01

    Fracture detection in pelvic bones is vital for patient diagnostic decisions and treatment planning in traumatic pelvic injuries. Manual detection of bone fracture from computed tomography (CT) images is very challenging due to low resolution of the images and the complex pelvic structures. Automated fracture detection from segmented bones can significantly help physicians analyze pelvic CT images and detect the severity of injuries in a very short period. This paper presents an automated hie...

  7. 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

  8. [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.

  9. 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. PMID:26919913

  10. 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.

  11. [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.

  12. Immediate postoperative feeding in urological surgery.

    Science.gov (United States)

    Seidmon, E J; Pizzimenti, K V; Blumenstock, F A; Huben, R P; Wajsman, Z; Pontes, J E

    1984-06-01

    The value of immediate postoperative enteral hyperalimentation with an elemental diet (high nitrogen Vivonex, full strength) at 125 cc per hour for 4 days was assessed in patients after radical urological surgery. Of 32 patients studied 21 received an elemental diet using a Vivonex Moss tube, which is a 3-lumen tube with esophagogastric decompression and simultaneous duodenal feeding, and the remaining 11 had a nasogastric tube only without nutritional support. We have used a selected group of parameters, including serum albumin, serum transferrin, creatinine height index, weight loss, total lymphocyte count, nitrogen balance and plasma fibronectin. All patients in the Moss tube group approached or achieved positive nitrogen balance by 4 days postoperatively, whereas the nasogastric tube group remained in negative nitrogen balance. Postoperative paralytic ileus was prevented in the majority of patients in the Moss tube group while receiving full nutritional support. We have found that the use of the Moss tube is a reasonable approach for postoperative alimentation. The tube is relatively easy to insert and well tolerated, and its use is a less expensive alternative to parenteral hyperalimentation. PMID:6427479

  13. [Primary prevention of urologic tumors: prostate cancer].

    Science.gov (United States)

    Schmitz-Dräger, B J; Lümmen, G; Bismarck, E; Fischer, C

    2011-10-01

    Assessment of the role of vitamins and micronutrients in the primary prevention of prostate cancer has changed dramatically in the past 10 years. Efforts to confirm the efficacy of a single substance have not yet succeeded. Therefore, such recommendations should at present no longer be given. Consideration could even be given to discussing whether additional large-scale interventional studies are expedient in this regard. There is still solid evidence that a well-balanced moderate diet, reduced consumption of milk products, and an Asian or Mediterranean diet are not only beneficial for general good health but can also prevent the development of prostate cancer. This should be the focus of further epidemiological studies. Thus, one can certainly speak of a paradigm shift in the prevention of prostate cancer. In contrast, available data on chemoprevention with 5α-reductase inhibitors is unequivocal: intake of finasteride as well as dutasteride correlates with significantly decreased evidence for prostate cancer. Converting this result into urologic practice remains the topic of extensive controversy. PMID:21927877

  14. Urological complications of illicit drug use.

    Science.gov (United States)

    Skeldon, Sean C; Goldenberg, S Larry

    2014-03-01

    Illicit drug use is prevalent worldwide; over 24 million people are estimated to have used recreational drugs during the past month in the UK and USA alone. Illicit drug use can result in a wide spectrum of potential medical complications that include many urological manifestations. To ensure optimal care and treatment, urologists need to be cognizant of these complications in their patients, particularly among youths. Ketamine uropathy is thought to affect over one-quarter of ketamine users and can lead to severe lower urinary tract symptoms, as well as upper tract obstruction. Cannabis use has been associated with an increased risk of bladder cancer, prostate cancer and nonseminomatous germ cell tumours in case-control studies. Fournier's gangrene has been reported following injection of heroin and cocaine into the penis. Excessive use of cough medicines can lead to the development of radiolucent stones composed of ephedrine, pseudoephedrine and guaifenesin. As the current evidence is mostly limited to case reports and case series, future epidemiological studies are needed to fully address this issue. PMID:24535583

  15. 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.

  16. [Theophilus Protospatharius: Byzantine forerunner of urology].

    Science.gov (United States)

    Androutsos, Georges

    2007-01-01

    Theophilus Protospatharius was a physician in the court of the Byzantine Emperor Heraclius (610-641). His interesting medical manuscripts have been studied by many historians, although very little is known about his life. In Byzantium it was not unusual for prominent people to have many surnames according to their work, political status etc. For his piety two surnames were given to Theophilus : Philotheus (the person who loves god) and Philaretus (Virtuous). These last surnames gave rise to confusion and historians believed that two different medical men lived in Byzantium during the seventh century. Theophilus and Philaretus. This probably was the result of an error in the copies of ancient codes and erroneous translations to the old Latin manuscripts. These errors have been corrected after the studies of Corlieu who stated in 1885 that Theophilus and Philaretus were the same person. The written work left by Theophilus is very extensive. He continued the work of famous physicians of the Hellenistic period and contributed by his writings to the flourishing of the Medical School of Salerno which was founded on the 9th century D.C. Theophilus could be considered as one of the original forerunners of modern Urology. PMID:17992829

  17. [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.

  18. Benign mesothelioma of peritoneum presenting as a pelvic mass

    International Nuclear Information System (INIS)

    A large solitary multiloculated pelvic cyst in a 40-year-old woman with chronic pelvic pain was diagnosed to be a Multicystic Benign Mesothelioma (MBM) of peritoneum at laparotomy. Operative findings showed dense adhesions between uterus and bladder anteriorly, small intestines and pouch of Douglas posteriorly, a right ovarian cyst cm containing clear serous fluid and two nodular deposits were seen in the pouch of Douglas, small multiple deposits was found over the mesentery of small intestine and parietal peritoneum. Total abdominal hysterectomy with bilateral oophorectomy and infracolic omentectomy was done. During surgery, there was injury to the small intestine hence, resection of 10 inches of small intestine with re-anastomosis was carried out. Postoperative recovery was satisfactory. At 3 years follow-up, patient is symptom-free. (author)

  19. 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.

  20. 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.

  1. 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....

  2. [Immunooncology in Urologic Cancers: Current Status].

    Science.gov (United States)

    Grimm, M-O

    2016-09-01

    Immune checkpoint inhibitors are establishing itselves as a new systemic treatment option (in addition to chemotherapy and targeted therapy) for metastatic tumours. (Re)activating the immune system, these antibodies may lead to impressive remissions lasting for a long time in some patients. Regarding urological tumours, the anti-PD-1 antibody Nivolumab (Opdivo(®)) has been approved this year for advanced, previously treated renal cell carcinoma. In the United States, Atezolizumab (Tecentriq(®)) has been approved for metastatic urothelial carcinoma after platinum-based chemotherapy. In patients pre-treated with antiangiogenic drugs, Nivolumab has achieved a higher rate of remission (25 vs. 5%) and a 5.4-month increase in overall survival compared with Everolimus. An indirect comparison with chemotherapy demonstrates an increased remission rate (15%) and an increased 1-year survival rate (37%) for urothelial carcinoma after platinum-based chemotherapy with Atezolizumab. The frequency of side-effects resulting from these treatments is comparatively low. However, some patients experience what is called immune-mediated side-effects, which must be recognised and treated in a timely manner. Immune checkpoint inhibitors are being tested in numerous ongoing phase III clinical trials and have the potential to replace current first-line treatment options for metastatic tumours such as urothelial and renal cell carcinoma. These trials are also investigating anti-PD-1/anti-PD-L1 antibodies in combination with CTLA4 immune checkpoint inhibitors or antiangiogenic treatments. Approval trials are also investigating the role of immune checkpoint inhibitors in the adjuvant setting. PMID:27680188

  3. Our Initial Experiences with Laparoscopic Urologic Surgery

    Directory of Open Access Journals (Sweden)

    Selçuk Altın

    2016-03-01

    Full Text Available Objective: Retrospectively, to evaluate outcomes and complications of urological laparoscopic surgery cases performed in our clinic. Methods: A total of 115 patients who received laparo­scopic surgery between January 2012 and January 2015 were retrospectively evaluated. Included patients were assessed in terms of demographic characteristics, pre­operative diagnosis, type of laparoscopic approach, dura­tion of surgery and hospitalization, complications before and after surgery, and postoperative requirement for open surgery. Results: 61 of included patients were women, 54 were male, and the mean age was 52.4±11.7 years. Sixty-eight patients underwent transperitoneal and 47 patients re­ceived retroperitoneal procedures. While 29 patients re­ceived renal cyst excision, 25 had simple nephrectomy, 22 had ureterolithotomy, 19 had radical nephrectomy, 15 had pyelolithotomy and 5 had pyeloplasty. Four (3,4% of the 115 patients required converting to open surgery. Except these patients, no major complication or mortal­ity was encountered. The mean duration of surgery for the most commonly applied procedures were as follows: renal cyst excision 62 (50-110 min, simple nephrectomy 125 (95-140 min, ureterolithotomy 108 (90-130 min, rad­ical nephrectomy 141 (105-175 min, pyelolithotomy 116 (95-140 min, and pyeloplasty 166 (150-190 min. The mean hospital stay was 3.7±2.8 (2-11 days. Conclusion: The success and complication rates of the laparoscopic surgeries performed in our clinic were con­sistent with those reported in the literature. In the light of technological advances and increasing experience, as well as based on the higher tolerance exhibited by pa­tients, we believe that laparoscopic surgery is a minimally invasive method that is a safe alternative to open surgery.

  4. 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.

  5. 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...

  6. 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

  7. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... 3 resident at the University of Pennsylvania in urology. Hi, Shawn. Okay, one down. Yep. Very good. ... fellow for the year as well as the urology resident, Shawn White. Okay, nice. Stay right there, ...

  8. Computerized tomography of pelvic osteomyelitis in patients with spinal cord injuries

    International Nuclear Information System (INIS)

    Computerized tomography (CT) was performed in 19 patients with spinal cord injury (SCI) who had large pressure sores and in whom other complications were suspected. CT detected the depth, extent, and degree of undermining of the edges of the pressure sores in 19 of 27 lesions. Conventional radiography detected four cases of pelvic osteomyelitis. CT detected eight additional cases of pelvic osteomyelitis, as well as eight clinically unsuspected peripelvic and intrapelvic abscesses. Technetium-99m bone scanning was not very helpful because of localization in chronic proliferative changes of bone and widespread foci of myositis ossificans, as well as in osteomyelitis. Gallium-67 scanning detected only one of six abscesses. It was not very helpful because of confusion of abscess and osteomyelitis with intense soft tissue swelling and cellulitis, which are often associated with pressure sores in patients with chronic SCI. CT was found to be, by far, the modality of choice for detection of pelvic osteomyelitis and abscess in patients with SCI

  9. 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. PMID:25337040

  10. Diabetes Mellitus Type 2: A Driving Force for Urological Complications.

    Science.gov (United States)

    Sayyid, Rashid K; Fleshner, Neil E

    2016-05-01

    Type 2 diabetes mellitus (T2DM) is a growing epidemic associated with many adverse complications. Urological complications of diabetes mellitus in men are gaining recognition. Previously unknown associations between T2DM and risk for prostate cancer, bladder cancer, renal cell carcinomas, urinary tract infections, nephrolithiasis, penile lesions, androgen deficiency, and erectile dysfunction have been discovered. Significantly, metformin could play a role in the management of urological malignancies, and therapies used for management of these cancers could in return lead to increased risk for diabetes. In this review, we aim to bridge the gap between T2DM and urological complications by discussing the latest findings in these fields, with the ultimate goal being improved patient care on both fronts. PMID:26969242

  11. Pelvic sepsis after stapled hemorrhoidopexy

    Institute of Scientific and Technical Information of China (English)

    Remco JA van Wensen; Maarten H van Leuken; Koop Bosscha

    2008-01-01

    Stapled hemorrhoidopexy is a surgical procedure used worldwide for the treatment of grade Ⅲ and Ⅳ hemorrhoids in all age groups. However, life-threatening complications occur occasionally. The following case report describes the development of pelvic sepsis after stapled hemorrhoidopexy. A literature review of techniques used to manage major septic complications after stapled hemorrhoidopexy was performed. There is no standardized treatment currently available. Stapled hemorrhoidopexy is a safe, effective and time-efficient procedure in the hands of experienced colorectal surgeons.

  12. Pelvic morphology in ischiofemoral impingement

    International Nuclear Information System (INIS)

    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.)

  13. 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.)

  14. 中药联合次髎穴注射痰热清治疗慢性盆腔炎的临床研究%Clinical study of traditional Chinese drug united with Tanreqing Ciliao acupoint injection on chronic pelvic inflammatory disease

    Institute of Scientific and Technical Information of China (English)

    李涛; 张瑞红; 贾庆宇

    2011-01-01

    目的 观察中药联合次髎穴注射痰热清治疗慢性盆腔炎的疗效.方法 选择符合中医辨证分型属于湿热蕴结型的慢性盆腔炎患者200例.随机分为4组,A组50例单用次髎穴注射痰热清治疗,B组50例单口服中药治疗,C组50例予中药联合次髎穴注射痰热清治疗,D组50例予口服甲硝唑+头孢氨苄治疗.4组在治疗前和治疗后2周分别抽取外周静脉血测定C反应蛋白水平,治疗前后行盆腔B超检查了解炎性包块大小且进行对比,同时观察不良反应.结果 A组总有效率90%,B组92%,C组98%,D组76%,4组比较均有显著性差异(P均<0.01).结论 中药联合次髎穴注射痰热清治疗慢性盆腔炎疗效显著.%Objective It is to observe the curative effect of traditional Chinese drug united with Tanreqing Ciliao acupoint injection on chronic pelvic inflammatory disease. Methods 200 patients with chronic pelvic inflammatory disease whose Zheng differentiation - classification in traditional Chinese medicine belonged to dampness-heat heap note type were chosen and randomly divided into four groups in which there were 50 cases. Group A was treated with Tanreqing Ciliao acupoint injection only. Group B was treated with traditional Chinese drug taken orally only. Group C was treated with traditional Chinese drug united with Tanreqing Ciliao acupoint injection. Group D was treated with metronidazole and cephalexin taken orally. All the patients were taken blood from peripheral vein to determine C reactive protein level before treatment and after treatment for two weeks. All the patients were examined cavitas pelvis type B ultrasonic to get the message of the size of inflammatory mass and compare each other before and after treatment. At the same time the untoward reaction was observed. Results The total effective rate of group A was 90% , that of group B was 92% , that of group C was 98% and that of group D was 76% . There were all significant differences among the

  15. 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

  16. 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... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a)...

  17. [Current status of robotic urologic surgery in Italy].

    Science.gov (United States)

    Sacco, Emilio; Bientinesi, Riccardo; Bassi, Pier Francesco

    2015-10-01

    The introduction of robot-assisted surgery represents a milestone in the history of surgery. Today, many surgical disciplines make use of the DaVinci robotic system in performing surgery, even complex ones. Italy stands as one of the countries with a greater diffusion of robotics in surgery, particularly in urological surgery. In Italy, every year, numerous urological surgeries are performed with the DaVinci robot; however, costs of this technology are high and, although likely to decrease, constitute a limit to the spread of the same and restricting its use to shared areas. PMID:26429391

  18. 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.

  19. 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 ...

  20. Pelvic fixation for neuromuscular scoliosis deformity correction

    OpenAIRE

    Dayer, Romain; Ouellet, Jean Albert; Saran, Neil

    2012-01-01

    Pelvic fixation is most frequently indicated in the pediatric population for the treatment of neuromuscular scoliosis with significant pelvic obliquity. Neuromuscular scoliosis surgery is associated with a high risk of complications, and this is further increased by extension of fusion to the sacrum. Numerous techniques have been described for pelvic fixation associated with a long spine fusion each with its own set of specific benefits and risks. This article reviews the contemporary surgica...

  1. Urological applications of the holmium laser

    Science.gov (United States)

    Beaghler, Marc A.; Poon, Michael W.; Ruckle, Herbert C.; Stewart, Steven C.; Weil, Dane

    1998-07-01

    While the role of endoscopy was initially diagnostic, the advent of improved endoscopes and working instruments have increased its therapeutic applications. One of the most recent advances is the holmium laser. It has a broad range of urological applications due to its ability to fragment all urinary calculi and its soft tissue effects. This laser is based on laser energy delivered in a pulsatile fashion at 2100 nm. The purpose of this study is to report our experience with the holmium laser. A retrospective study of patients undergoing endourological procedures with the holmium laser was performed. One hundred and forty patients underwent 157 procedures. The holmium laser was used for the treatment of urinary calculi in 122 patients. Stone location included 61 renal, 64 ureteral, and 17 bladder stones. Renal stone burden was 17 mm (range 3-50), ureteral stone size averaged 10 mm (range 3 - 35), and mean bladder stone size was 31 mm (range 10 - 60). Other uses included treatment of transitional cell carcinoma of the renal pelvis, ureter, and bladder, incision of ureteral strictures, ureterocele, and prostate, and ablation of renal hemangiomas. Intraoperative and post operative complications were noted. Follow-up for calculi consisted of a plain film of the abdomen at one week and an ultrasound or intravenous pyelogram at six to eight weeks post procedure. No ureteral perforations or strictures occurred. The Holmium laser was capable of fragmenting all urinary calculi in this study. No complications were directly attributable to the Holmium laser. In our initial experience, the Holmium laser is safe and effective in the treatment of urinary pathology. It is the most effective lithotrite available and is able to incise and coagulate soft tissue as well. This combination allows the urologist to treat a variety of urinary pathology using a single modality. Its main limitation is the ability to access lower pole lesions in the upper urinary tract due to the fiber

  2. 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.

  3. [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.

  4. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... bulb here, the round ligaments, the pelvic cul-de-sac. We see some radiation fibrosis, the mottled ... And freeing up this pelvic peritoneum, pelvic cul-de-sac. De facto already free the ureter off ...

  5. 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.

  6. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... just to clarify. And freeing up this pelvic peritoneum, pelvic cul-de-sac. De facto already free the ureter off the pelvic peritoneum somewhat. Sara, this is going to be easier, ...

  7. Adolescent urology: developing lifelong care for congenital anomalies.

    Science.gov (United States)

    Wood, Dan

    2014-05-01

    Complex congenital urological anomalies often necessitate ongoing clinical and surgical management as patients reach adulthood and beyond. However, adolescent and lifelong care of such conditions is a relatively new urological specialty, and approaches to transitional health care require further development. Thus, although literature relating to the use of such approaches in urology are lacking, we are able to draw upon experience of models from other specialties. Urological anomalies might complicate an individual's development, particularly during adolescence, which represents a time of rapid and considerable change in most aspects of life. During this period, increased independence and responsibility, necessitating a shift from parent-driven to patient-driven care, and the desire to develop important and intimate social relationships can affect a patient's ability to cope with, and manage, disease. These factors also influence the ability of health-care providers to deliver adequate treatment. In particular, consideration of the effect of a condition or its treatment on the patient's capacity to live a normal life is important. A multidisciplinary approach is essential to overcoming these issues. Furthermore, diagnostic and treatment registries, as well as an increase in the number of adult-focused urologists willing to participate in the transition of patients from paediatric to adult care, are needed to enable provision of optimal patient care for the future. PMID:24709966

  8. 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.

  9. 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.

  10. '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...

  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

    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. 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.

  13. 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.

  14. 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

  15. Retroperitoneal and pelvic infections complications

    International Nuclear Information System (INIS)

    Retroperitoneal and pelvic infections complications are the major types of genito-urinary complications in Crohn's disease. CT has been shown to be a sensitive, non invasive method of documenting these infectious complications. On the other hand, conventional studies are more sensitive than CT to detect genitourinary fistulae. Some complications may manifest few or no symptom as urinary obstruction and nephrolithiasis, detected easily by sonography. For these reasons, it is important for radiologists to be aware of the genito-urinary complications of Crohn's disease. (authors). 42 refs., 20 figs

  16. The screening pelvic radiograph in pediatric trauma

    International Nuclear Information System (INIS)

    Background. Pelvic radiographs are routinely obtained in adult trauma to optimise early management. In adults, pelvic fractures are associated with high early transfusion requirement, high injury severity scores and an increased incidence of other abdominal and thoracic injuries. It is unclear whether this holds true in children. Objective. To determine whether the screening pelvic radiograph is necessary in paediatric trauma. Materials and methods. The notes of all patients who presented after trauma to the Starship Children's Hospital and were triaged to the resuscitation room during 1997 were reviewed. Results of initial radiography were obtained and correlated with later imaging. Results. Our review of 444 injured children seen over a period of 1 year revealed that of 347 children who had screening pelvic radiographs, only 1 had a pelvic fracture. The fracture in this child was clinically apparent and required no specific treatment. Conclusions. The presence of a pelvic fracture is rare in injured children. By omitting screening pelvic radiographs there are potential benefits, including reduced radiation exposure to children and cost savings. Uninterpretable or abnormal clinical examination or haematuria requires further investigation, but routine screening for pelvic fracture is unnecessary. (orig.)

  17. Pseudomonas pelvic osteomyelitis in a healthy child

    Directory of Open Access Journals (Sweden)

    Nour Akhras

    2011-12-01

    Full Text Available Pediatric pelvic osteomyelitis is a rare entity. The diagnosis is frequently delayed due to difficulty in confirming the diagnosis. To our knowledge, this is the first case report of Pseudomonas pelvic osteomyelitis in a previously healthy adolescent boy. The diagnosis was made radiographically and confirmed by culture. The patient was treated with Levofloxacin and Gentamicin resulting in a complete recovery.

  18. Pseudomonas pelvic osteomyelitis in a healthy child

    OpenAIRE

    Akhras, Nour; Blackwood, Alexander

    2011-01-01

    Pediatric pelvic osteomyelitis is a rare entity. The diagnosis is frequently delayed due to difficulty in confirming the diagnosis. To our knowledge, this is the first case report of Pseudomonas pelvic osteomyelitis in a previously healthy adolescent boy. The diagnosis was made radiographically and confirmed by culture. The patient was treated with Levofloxacin and Gentamicin resulting in a complete recovery.

  19. 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...

  20. [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.

  1. How Are Pelvic Floor Disorders Diagnosed?

    Science.gov (United States)

    ... I., Majeroni, B. A., & Johnson, D. W. (2010). Pelvic organ prolapse. American Family Physician, 81 , 1111-1117. [top] American Urogynecologic Society. (2008). Bladder tests. Retrieved May 18, 2012, from ... of the anorectal and pelvic floor area. Retrieved May 18, 2012, from http:// ...

  2. Imaging pelvic floor disorders. 2. rev. ed.

    International Nuclear Information System (INIS)

    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.)

  3. The relationship between pelvic alignment and dysmenorrhea

    Science.gov (United States)

    Kim, Moon-jeong; Baek, Il-hun; Goo, Bong-oh

    2016-01-01

    [Purpose] The purpose of this study was to investigate the relationship between pelvic alignment and dysmenorrhea in general women. [Subjects and Methods] One hundred two females participated in this study. They were divided into a dysmenorrhea group and a normal group based on the results of a Visual Analogue Scale (VAS) assessment of pain and the Menstrual Distress Questionnaire (MDQ). The survey data was collecting from 5th July to 20th September, 2014. Formetric 4D was used to measure the pelvic alignment, including the values of Trunk Imbalance, Pelvic Tilt, Surface Rotation, Lateral Deviation, Kyphosis Angle, Lordosis Angle. [Results] There was a difference in the spine alignments of each group. The value of pelvic torsion was 2.4 ± 1.8 degree in those with dysmenorrhea, while it was 1.7 ± 1.1 degree in those without. [Conclusion] In conclusion, the results suggest that there is a relationship between menstrual pain and pelvic torsion. PMID:27134354

  4. 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...

  5. 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.)

  6. 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.

  7. Thrombospondin-1 serum levels do not correlate with pelvic pain in patients with ovarian endometriosis

    Directory of Open Access Journals (Sweden)

    Manero Manuel

    2009-11-01

    Full Text Available Abstract Objetive Thrombospondin-1 serum levels is correlate with pelvic pain in patients with ovarian endometriosis. Patients Thrombospondin-1 serum levels were prospectively analysed in 51 patients (group A asymptomatic patients or patients presenting mild dysmenorrhea and women comprised group B severe dysmenorrhea and/or chronic pelvic pain and/or dyspareunia who underwent surgery for cystic ovarian endometriosis to asses whether a correlation exists among thrombospondin-1 serum levels and pelvic pain. Results From 56 patients, five cases were ultimateley excluded, because the histological diagnosis was other than cystic ovarian endometriosis (2 teratomas and 3 haemorragic cysts. The mean thrombospondin-1 serum levels in group A was 256,69 pg/ml_+37,07 and in group B was 291,41 pg/ml + 35,59. Conclusion Pain symptoms in ovarian endometriosis is not correlated with thrombospondin-1 serum levels.

  8. [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. PMID:26839117

  9. Middle calyx ureterocalicostomy in ectopic pelvic kidney with ureteropelvic junction obstruction: Only alternative for renal salvage

    Directory of Open Access Journals (Sweden)

    Jaisukh Kalathia

    2016-01-01

    Full Text Available Anomalous kidneys are mostly asymptomatic and are often found incidentally during physical or radiological investigations for urological or other medical complaints. The associated genital anomalies ranges from 15% to 45%. Females are associated with bicornuate or unicornuate uterus, rudimentary or absent uterus while males have undescended testes, duplication of the urethra, and hypospadias. A 21 year old married female presented with on and off lower abdomen pain for the past one year with history of primary amenorrhea. On examination an ill defined tender lump palpated in the lower abdomen. USG showed left ectopic pelvic kidney with gross hydronephrosis. The computed tomography confirmed hydronephrotic left ectopic pelvic kidney in front of the sacrum with anteriorly directed renal pelvis with ureter located posteriorly. There was delayed excretion from the ectopic kidney but right kidney was in normal position and function. The diethylene triamine pentaacetic acid (DTPA scan showed 33% function of the ectopic kidney. On diagnostic laparoscopy, the uterus was small hypoplastic with bilateral ovaries appearing normal. The patient was taken for open pyeloplasty where the ureter was transected below PUJ but for a dependent drainage, the middle calyx as was the most dependent calyx as seen on the CT-scan. So a middle calyx ureterocalicostomy was performed calyx with excellent outcome. The ectopic kidney always remains a challenge because of complex neurovascular anatomy, presence of viscera and associated UPJO, but for a dependent drainage, middle calyx ureterocalicostomy is a feasible option with excellent outcome as was in our case.

  10. ROLE OF URODYNAMICS IN MANAGEMENT OF PATIENTS WITH PELVIC ORGAN PROLAPSE

    Directory of Open Access Journals (Sweden)

    Karnika

    2015-06-01

    Full Text Available Utero - vaginal prolapse (UV is a common condition affecting millions of women worldwide, and a major cause of gynecological surgery. Although it is not life threatening but, it can have a severe impact on quality of life. Prolapse is a protrusion of a pel vic organs beyond its normal anatomical confines and it represents the failure of fibromuscular support to maintain normal position. Urodynamic Study (UDS is the dynamic study of the transport, storage and evacuation of urine . The ultimate goal of urodyna mics is to aid in the correct diagnosis of urinary incontinence based on pathophysiology. Urodynamic studies assess both the filling storage phase and the voiding phase of the bladder and urethral function. AIM : of this study is to assess the role of urody namic measures in pelvic organ prolapse (POP patients for identifying the urinary problems concomitant with prolapse for proper management. The use of urodynamic tests are for diagnosis, prognosis, guidance of clinical management and decision for type of surgery that results in improvement of patient outcomes with various urological conditions. KEYWORDS: With Pelvic Organ Prolapse (POP Urodynamic Study Urinary Incontinence.

  11. Can Transabdominal Sonography Predict Pelvic Relaxation?

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2009-01-01

    Full Text Available Introduction: Pelvic relaxation and cystocele is a common problem in middle to old age women. Transabdominal ultrasound (TAS is a noninvasive, available routine procedure in many situations. We evaluated whether TAS can predict pelvic relaxation or not. "nMaterials and Methods: In a cross sectional case- control study one hundred women 30 years or older were enrolled into the study. An expert female urologist examined the cases for the presence of signs and the grading of pelvic relaxation. A single radiologist blinded to pelvic exam results performed TAS. In the full bladder state the following criteria were recorded: 1. Bladder outlet funneling at rest and valsalva 2. Bladder base position in relation to the superior edge of the pubis symphysis 3. Bladder wall thickness 4. Pelvicaliceal system stasis 5.Post voiding residual urine ( PVR. "nResults: Bladder outlet funneling can predict pelvic relaxation (Se, 91.3%, both at rest and after valsalva. If the bladder base descent is seen below the superior edge of the pubis with the cut off point of 5 mm,it can predict pelvic relaxation. "nConclusion: TAS can be used as a safe and available modality to predict pelvic relaxation

  12. 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

  13. 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. PMID:24100517

  14. Using implementation science to improve urologic oncology care.

    Science.gov (United States)

    Skolarus, Ted A; Sales, Anne E

    2016-09-01

    There are many gaps between recommended urologic cancer care and real-world practice. Although we increasingly define these quality gaps because of our growing health services research capacity in urologic oncology, we often fall short in translating these findings into effective interventions and strategies to reduce gaps in care. In this article, we highlight implementation research as a logical next step for translating our health services research findings into effective individual and organizational behavior change strategies to improve quality of care. We explain how implementation research focuses on different, upstream outcomes from our clinical outcomes to get the right care to the right patient at the right time. Lastly, we share information about resources and training for those interested in learning more about this emerging, transdisciplinary field. PMID:27401405

  15. 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.

  16. Radiology of sport injuries of pelvic apophyses

    International Nuclear Information System (INIS)

    Pelvic apophyses are places of insertion of strong muscles and tendons and are therefore places of least resistance at the end of skeletal growth. Avulsions and disruptions of pelvic apophyses can be caused by overstrain during different kinds of sport activity. Typical radiological findings in 8 different cases of ruptures of apophyses, osteochondropathies, and resulting conditions of sport injuries are demonstrated. The difficulties of correct diagnosis and different diagnosis are pointed out. The significance of hormonal impairment of ossification for development and stress factor of pelvic apophyses is exposed. Questions of treatment and follow-up studies are discussed. (orig.)

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. [Practice marketing. Data analysis of a urological group practice].

    Science.gov (United States)

    Schneider, T; Schneider, B; Eisenhardt, A; Sperling, H

    2009-07-01

    The urological practice setting in Germany has changed tremendously over the last years. Group practices with two or more urologists working together are becoming more and more popular. At the same time, marketing has become essential even for urologists. To evaluate the patient flow to our group practice, we asked all new patients to fill out a questionnaire (n=2112). We also evaluated the efficacy of our recall system. The analysis showed that patients were 18-93 years old (mean 57 years), 68% being male and 32% female. The largest age group consisted of 41-50-year-olds. The most important reasons for choosing our practice were recommendations by general practitioners in 38%, recommendations by specialists in 11%, and recommendations by friends and relatives in 27%. Five percent of the patients chose the practice because of the Internet home page and 10% because of entries in various phone books. Three percent of the patients came because of newspaper articles about the practice owners, and advertising for a urological practice. Phone books are increasingly becoming less important, and the Internet is increasingly attractive to the younger population. Recall systems can also be useful for urological practices. PMID:19387608

  3. 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.

  4. 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.

  5. [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.

  6. Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse

    OpenAIRE

    Slieker-ten Hove, Marijke; Pool-Goudzwaard, Annelies; Eijkemans, René; Steegers-Theunissen, Régine; BURGER, Curt; Vierhout, Mark

    2010-01-01

    textabstractIntroduction and hypothesis: This study aims to examine the relationship between pelvic floor muscle function (PFMF) and pelvic organ prolapse (POP) in a general female population. Methods: Cross-sectional study on women aged 45-85 years. Validated questionnaires were used to assess pelvic floor muscle function. POP and PFMF were evaluated with vaginal examination. For statistical analysis chi-squared test for trend and analysis of variance were used. Results: Response rate to the...

  7. The differential roentgen diagnosis of the pelvic extraperitoneal effusion and the pelvic intraperitoneal effusion

    International Nuclear Information System (INIS)

    The plain film signs of a perivesical extraperitoneal effusion included displacement of the bladder, loss of normal pelvic soft tissure shadows, and upward-displacement of the peritoneum and pelvic ileal loops out of the pelvis. The roentgen appearances of the intraperitoneal pelvic effusion, were the radiographically discernible curvilinear lucent stripe representing the areolar tissure between the dome of the bladder and the pelvic peritoneum, the normally situated peritoneum, and the homogeneous density between the peritoneum and the displaced loops of bowel, referred to as the ''dog-ear'' sign by MeCort. (author)

  8. [Urological moulages: forgotten three-dimensional documents between university collections and panopticum -- a dying presentation form even in urological museology].

    Science.gov (United States)

    Moll, F H; Görgen, A; Fangerau, H

    2013-08-01

    The use of wax models traces its roots back to antiquity and appears to have reached the peak of perfection in the eighteenth century especially in Italy. From the beginning of the nineteenth century wax models and moulages were used in the new medical specialties, such as dermatology or urology depending on a new model of visualization in natural sciences. The moulage passed from local use into international acceptance with the institutionalization of the medical specialties and increase in scientific communication in the second half of the nineteenth century. By the 1970s moulages had all but lost their pre-eminent position as teaching and visual aids to depict dermatological and venereal diseases Unfortunately urology was not mentioned in the field of history of medicine or ethnic studies. PMID:23933709

  9. High acceptability of a newly developed urological practical skills training program.

    OpenAIRE

    de Vries, A.H.; Luijk, S.J. van; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E L; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills training program, including an assessment of the design characteristics that may increase its acceptability. Methods A questionnaire was sent to the urology residents (n = 87) and program directors (n = 45...

  10. Main nursing diagnoses in hospitalized elderly people who underwent urological surgery

    OpenAIRE

    Walisson Guimarães Lima; Simony Fabíola Lopes Nunes; Angela Maria Alvarez; Rafaela Vivian Valcarenghi; Maria Luiza Rêgo Bezerra

    2015-01-01

    Objective: to identify the main nursing diagnoses in the elderly during postoperative period of urologic surgeries. Methods: Cross-sectional and quantitative study conducted in a urological unit. Data collection was conducted through physical examinations and consultation to medical records. One hundred senior citizens who were hospitalized at the institution participated in the study. Results: The most frequent urological surgical procedures were: transurethral resection of the prostate (27 ...

  11. Emergence of Integrated Urology-Radiation Oncology Practices in the State of Texas

    International Nuclear Information System (INIS)

    Purpose: Integrated urology-radiation oncology (RO) practices have been advocated as a means to improve community-based prostate cancer care by joining urologic and radiation care in a single-practice environment. However, little is known regarding the scope and actual physical integration of such practices. We sought to characterize the emergence of such practices in Texas, their extent of physical integration, and their potential effect on patient travel times for radiation therapy. Methods and Materials: A telephone survey identified integrated urology-RO practices, defined as practices owned by urologists that offer RO services. Geographic information software was used to determine the proximity of integrated urology-RO clinic sites with respect to the state's population. We calculated patient travel time and distance from each integrated urology-RO clinic offering urologic services to the RO treatment facility owned by the integrated practice and to the nearest nonintegrated (independent) RO facility. We compared these times and distances using the Wilcoxon-Mann-Whitney test. Results: Of 229 urology practices identified, 12 (5%) offered integrated RO services, and 182 (28%) of 640 Texas urologists worked in such practices. Approximately 53% of the state population resides within 10 miles of an integrated urology-RO clinic site. Patients with a diagnosis of prostate cancer at an integrated urology-RO clinic site travel a mean of 19.7 miles (26.1 min) from the clinic to reach the RO facility owned by the integrated urology-RO practice vs 5.9 miles (9.2 min) to reach the nearest nonintegrated RO facility (P<.001). Conclusions: Integrated urology-RO practices are common in Texas and are generally clustered in urban areas. In most integrated practices, the urology clinics and the integrated RO facilities are not at the same location, and driving times and distances from the clinic to the integrated RO facility exceed those from the clinic to the nearest

  12. 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.

  13. [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.

  14. 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

  15. Effect of group education intervention on the quality of life and social function of patients with chronic pelvic inflammation diseases%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

    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

  16. Clinical Efficacy of Pulveres Fosfomycin Trometamolium plus Zhitong Huazheng Capsule in Treatment of Chronic Pelvic Inflammatory Disease%磷霉素氨丁三醇散联合止痛化症胶囊治疗慢性盆腔炎的临床疗效研究

    Institute of Scientific and Technical Information of China (English)

    崔媛; 翟建军; 冯碧波; 田秀兰; 蔡昱

    2013-01-01

    Objective To investigate the clinical effect of Pulveres Fosfomycin Trometamolium plus Zhitong Huazheng Capsule in the treatment of chronic pelvic inflammatory disease. Methods According to random number table, 84 patients with chronic pelvic inflammatory disease were divided into trial group and control group, with 42 in each. The patients in the control group were given 3 Capsules of Zhitong Huazheng, 3 times a day for 15 days; while those in the trial group were given additional Pulveres Fosfomycin Trometamolium, 3g daily for 7 days. The efficacies of patients between the two groups were compared after the end of treatment. Results ( 1 ) The symptom score in the trial group was ( 19. 05 ± 3. 04 ) before the treatment and ( 4. 29 ± 1. 21 ) after the treatment; while in the control group was ( 18. 96 ± 3. 87 ) and ( 8. 52 ±3. 47 ) respectively, with no statistically significant difference before the treatment ( P >0. 05 ), but with statistically significant difference after the treatment ( P <0. 05 ). ( 2 ) After the treatment, the cured, markedly effective, effective and non -effective cases were respectively 10 ( 23. 8% ), 16 ( 38. 1% ), 12 ( 28. 6% ), and 4 ( 9. 5% ) in the trial group; as compared with 6 ( 14. 3% ), 12 ( 28. 6% ), 14 ( 33. 3% ), and 10 ( 23. 8% ) in the control group the difference was statistically significant ( P <0. 05 ). Conclusion Pulveres Fosfomycin Trometamolium plus Zhitong Huazheng Capsule is more effective than single Zhitong Huazheng Capsule in treatment of chronic pelvic inflammatory disease. It is of definite and remarkable effect, with less side - effect.%目的 了解磷霉素氨丁三醇散联合止痛化症胶囊治疗慢性盆腔炎的临床疗效.方法 采用随机数字表法将我院收治的84例慢性盆腔炎患者分为治疗组与对照组各42例.对照组给予止痛化症胶囊口服,3粒/次,3次/d,连用15 d;治疗组在对照组的基础上给予磷霉素氨丁三醇散,3 g/d,连用7 d.治疗结束后对

  17. Resident behaviors during observed pelvic examinations.

    Science.gov (United States)

    Lang, F

    1990-01-01

    The pelvic exam is a procedure frequently complicated by difficult communication, sexual tension, and iatrogenic pain. Observations of family practice residents performing pelvic exams were done to identify ways in which they deal with these issues. Among the majority of residents, there was a failure to identify and deal with patients' discomfort. Several episodes of behavior felt to be dysfunctional to the doctor-patient relationship were observed. Implications of these findings for medical education are discussed. PMID:2323497

  18. Prevention and management of pelvic organ prolapse

    OpenAIRE

    Giarenis, Ilias; Robinson, Dudley

    2014-01-01

    Pelvic organ prolapse is a highly prevalent condition in the female population, which impairs the health-related quality of life of affected individuals. Despite the lack of robust evidence, selective modification of obstetric events or other risk factors could play a central role in the prevention of prolapse. While the value of pelvic floor muscle training as a preventive treatment remains uncertain, it has an essential role in the conservative management of prolapse. Surgical trends are cu...

  19. 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.

  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.

  1. IL17 Mediates Pelvic Pain in Experimental Autoimmune Prostatitis (EAP.

    Directory of Open Access Journals (Sweden)

    Stephen F Murphy

    Full Text Available Chronic pelvic pain syndrome (CPPS is the most common form of prostatitis, accounting for 90-95% of all diagnoses. It is a complex multi-symptom syndrome with unknown etiology and limited effective treatments. Previous investigations highlight roles for inflammatory mediators in disease progression by correlating levels of cytokines and chemokines with patient reported symptom scores. It is hypothesized that alteration of adaptive immune mechanisms results in autoimmunity and subsequent development of pain. Mouse models of CPPS have been developed to delineate these immune mechanisms driving pain in humans. Using the experimental autoimmune prostatitis (EAP in C57BL/6 mice model of CPPS we examined the role of CD4+T-cell subsets in the development and maintenance of prostate pain, by tactile allodynia behavioral testing and flow cytometry. In tandem with increased CD4+IL17A+ T-cells upon EAP induction, prophylactic treatment with an anti-IL17 antibody one-day prior to EAP induction prevented the onset of pelvic pain. Therapeutic blockade of IL17 did not reverse pain symptoms indicating that IL17 is essential for development but not maintenance of chronic pain in EAP. Furthermore we identified a cytokine, IL7, to be associated with increased symptom severity in CPPS patients and is increased in patient prostatic secretions and the prostates of EAP mice. IL7 is fundamental to development of IL17 producing cells and plays a role in maturation of auto-reactive T-cells, it is also associated with autoimmune disorders including multiple sclerosis and type-1 diabetes. More recently a growing body of research has pointed to IL17's role in development of neuropathic and chronic pain. This report presents novel data on the role of CD4+IL17+ T-cells in development and maintenance of pain in EAP and CPPS.

  2. Awareness and timing of pelvic floor muscle contraction, pelvic exercises and rehabilitation of pelvic floor in lifelong premature ejaculation: 5 years experience

    OpenAIRE

    Giuseppe La Pera

    2014-01-01

    Objectives: To assess the cure rate of patients with premature ejaculation who underwent a treatment involving: 1) awareness of the pelvic floor muscles 2) learning the timing of execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase 3) pelvic floor rehabilitation (bio feed back, pelvic exercises and electrostimulation). Materials and methods: We recruited 78 patients with lifelong premature ejaculation who completed the training. T...

  3. Triple pelvic ring fixation in patients with severe pregnancy-related low back and pelvic pain.

    NARCIS (Netherlands)

    Zwienen, C.M. van; Bosch, E.W. van den; Snijders, C.J.; Vugt, A.B. van

    2004-01-01

    STUDY DESIGN: Single-group prospective follow-up study. OBJECTIVES: To assess the functional outcome of internal fixation of the pelvic ring in patients with severe pregnancy-related low back and pelvic pain (PLBP) in whom all other treatments failed. BACKGROUND DATA: More than half of all pregnant

  4. Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction.

    NARCIS (Netherlands)

    Pool-Goudzwaard, A.; Slieker ten Hove, M.C.; Vierhout, M.E.; Mulder, P.H.M. de; Pool, J.; Snijders, C.J.; Stoeckart, R.

    2005-01-01

    To assess the occurrence of pelvic floor dysfunction (PFD) in pregnancy- related low back and pelvic pain (PLBP) patients, a cross-sectional study was performed, comprising 77 subjects. Each subject underwent physical assessment, and filled in the Urogenital Distress Inventory completed with gynaeco

  5. Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. METHODS: This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized...

  6. 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.

  7. Pelvic inflammatory disease: improving awareness, prevention, and treatment

    Science.gov (United States)

    Das, Breanne B; Ronda, Jocelyn; Trent, Maria

    2016-01-01

    Purpose Pelvic inflammatory disease (PID) is a common disorder of the reproductive tract that is frequently misdiagnosed and inadequately treated. PID and its complications, such as infertility, ectopic pregnancy, and chronic pelvic pain, are preventable by screening asymptomatic patients for sexually transmitted infections (STIs) and promptly treating individuals with STIs and PID. Recent findings The rates of adverse outcomes in women with PID are high and disproportionately affect young minority women. There are key opportunities for prevention including improving provider adherence with national screening guidelines for STIs and PID treatment recommendations and patient medication adherence. Nearly half of all eligible women are not screened for STIs according to national quality standards, which may increase the risk of both acute and subclinical PID. Moreover, in clinical practice, providers poorly adhere to the Centers for Disease Control and Prevention recommendations for treatment of PID. Additionally, patients with PID struggle to adhere to the current management strategies in the outpatient setting. Conclusion Novel evidence-based clinical and public health interventions to further reduce the rates of PID and to improve outcomes for affected women are warranted. We propose potential cost-effective approaches that could be employed in real-world settings. PMID:27578991

  8. Effects of pregnancy and childbirth on the pelvic floor

    Directory of Open Access Journals (Sweden)

    Michel Naser

    2012-04-01

    Full Text Available The pelvic floor dysfunctions include urinary incontinence, pelvic organ prolapsed and anal incontinence. One in ten women will be subjected to surgery for pelvic floor dysfunction during their lifetime. In addition, between 30% and 50% will have a recurrence of these interventions. Motherhood is a factor that contributes significantly to the submission of pelvic dysfunctions. There is still no proven evidence that vaginal delivery is an absolutely crucial factor for the presence of pelvic floor dysfunction. There is extensive research on pregnancy and child birth and their effects on the pelvic floor and if some of the obstetric action scan be modified in order to protect it from potential damage.

  9. Successful outpatient management of pelvic actinomycosis by ceftriaxone: a report of three cases

    Directory of Open Access Journals (Sweden)

    Eda Demir Onal

    2009-10-01

    Full Text Available Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by actinomyces israeli. Intravenous penicillin is the preferred antimicrobial but it requires hospitalization up to one month. An outpatient treatment strategy would be cost effective and a good choice for patients. Here we present three cases in which intramuscular ceftriaxone was successfully used in the outpatient settings following surgery and IV penicillin treatment in the hospital.

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. Adherence to European Association of Urology Guidelines on Prophylactic Antibiotics

    DEFF Research Database (Denmark)

    Cai, Tommaso; Verze, Paolo; Brugnolli, Anna;

    2016-01-01

    Escherichia coli to piperacillin/tazobactam (9.1% vs. 5.4%; p=0.03), gentamicin (18.3% vs. 11.2%; p=0.02), and ciprofloxacin (32.3% vs. 19.1%; p=0.03) decreased significantly after protocol introduction. The defined daily dose (DDD) use of ciprofloxacin fell from 4.2 to 0.2 DDD per 100 patient-days after....... We found that adherence to the guidelines reduced the rate of bacterial resistance, in particular against piperacillin/tazobactam, gentamicin, and ciprofloxacin, and reduced costs without increasing the risk of postoperative infection after urologic procedures. We recommend adherence to the...

  15. 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. PMID:26002798

  16. 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.

  17. 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.

  18. High acceptability of a newly developed urological practical skills training program.

    NARCIS (Netherlands)

    Vries, A.H. de; Luijk, S.J. van; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.; Koldewijn, E.L.; Wagner, C.; Schout, B.M.A.

    2015-01-01

    Background: Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills trainin

  19. 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

  20. 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.

  1. Specific stabilisation exercise for spinal and pelvic pain: a systematic review.

    Science.gov (United States)

    Ferreira, Paulo H; Ferreira, Manuela L; Maher, Christopher G; Herbert, Robert D; Refshauge, Kathryn

    2006-01-01

    The aim of this study was to conduct a systematic review of the efficacy of specific stabilisation exercise for spinal and pelvic pain. Randomised clinical trials evaluating specific stabilisation exercise were identified and retrieved. Outcomes were disability, pain, return to work, number of episodes, global perceived effect, or health-related quality of life. A single trial reported that specific stabilisation exercise was more effective than no treatment but not more effective than spinal manipulative therapy for the management of cervicogenic headache and associated neck pain. Single trials reported that specific stabilisation exercise was effective for pelvic pain and for prevention of recurrence after an acute episode of low back pain but not to reduce pain or disability associated with acute low back pain. Pooled analyses revealed that, for chronic low back pain, specific stabilisation exercise was superior to usual medical care and education but not to manipulative therapy, and no additional effect was found when specific stabilisation exercise was added to a conventional physiotherapy program. A single trial reported that specific stabilisation exercise and a surgical procedure to reduce pain and disability in chronic low back pain were equally effective. The available evidence suggests that specific stabilisation exercise is effective in reducing pain and disability in chronic but not acute low back pain. Single trials indicate that specific stabilisation exercise can be helpful in the treatment of cervicogenic headache and associated neck pain, pelvic pain, and in reducing recurrence after acute low back pain. PMID:16764545

  2. Survey on the perception of urology as a specialty by medical students

    Science.gov (United States)

    Kim, Soojin; Farrokhyar, Forough; Braga, Luis H.

    2016-01-01

    Introduction: Upon inquiring with medical students and urologists across Canada, it is evident that urology is perceived as a male-dominant specialty, among other stereotypes. These misperceptions may hamper the recruitment of the best and brightest trainees. With that in mind, we surveyed medical students at our institution to obtain an objective assessment of their perception of urology and to determine the cause for misperceptions. Methods: A 25-factor, validated, anonymous, cross-sectional, self-reported, electronic survey was sent to all medical students at McMaster University to assess their perception of urology. The survey was piloted among students and educational leaders to optimize face and content validity, and minimize measurement bias. Six variables (years in training, role model, a family member or friend in urology, gender, and exposure) were selected a priori and entered into a logistic regression model to determine factors associated with a positive impression of the specialty. Results: The overall response rate was 70%. Of the respondents, 66% had no exposure to urology and 61% found the amount of exposure to be inadequate. Urology staff and resident involvement in education was considered to be poor by over 30% of medical students. Over 70% perceived urology to be a specialty with a great gender imbalance. On multivariate analysis, exposure to urology was the most important factor (purology exposure and poor staff and resident involvement in undergraduate education were seen as potential causes for misperceptions of the specialty. Increasing exposure to urology, encouraging female students, constant effort to approach senior students, and providing mentorship are found to be important factors in establishing a positive perception of urology PMID:27800058

  3. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  4. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... anterior pelvic exenteration performed with the robotic surgical system on a woman with recurrent cervical cancer developing ... proceed with a pelvic exenteration using the robotic system both to minimize the risk of complications due ...

  5. Imaging of the posterior pelvic floor

    Energy Technology Data Exchange (ETDEWEB)

    Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Bartram, Clive I.; Halligan, Steve [Intestinal Imaging Centre, St. Mark' s Hospital, London (United Kingdom)

    2002-04-01

    Disorders of the posterior pelvic floor are relatively common. The role of imaging in this field is increasing, especially in constipation, prolapse and anal incontinence, and currently imaging is an integral part of the investigation of these pelvic floor disorders. Evacuation proctography provides both structural and functional information for rectal voiding and prolapse. Dynamic MRI may be a valuable alternative as the pelvic floor muscles are visualised, and it is currently under evaluation. Endoluminal imaging is important in the management of anal incontinence. Both endosonography and endoanal MRI can be used for detection of anal sphincter defects. Endoanal MRI has the advantage of simultaneously evaluating external sphincter atrophy, which is an important predictive factor for the outcome of sphincter repair. Many aspects of constipation and prolapse remain incompletely understood and treatment is partly empirical; however, imaging has a central role in management to place patients into treatment-defined groups. (orig.)

  6. Simulation-based training and assessment in urological surgery.

    Science.gov (United States)

    Aydin, Abdullatif; Raison, Nicholas; Khan, Muhammad Shamim; Dasgupta, Prokar; Ahmed, Kamran

    2016-09-01

    Simulation has become widely accepted as a supplementary method of training. Within urology, the greatest number of procedure-specific models and subsequent validation studies have been carried out in the field of endourology. Many generic-skills simulators have been created for laparoscopic and robot-assisted surgery, but only a limited number of procedure-specific models are available. By contrast, open urological simulation has only seen a handful of validated models. Of the available modalities, virtual reality (VR) simulators are most commonly used for endourology and robotic surgery training, the former also employing many high-fidelity bench models. Smaller dry-lab and ex vivo animal models have been used for laparoscopic and robotic training, whereas live animals and human cadavers are widely used for full procedural training. Newer concepts such as augmented-reality (AR) models and patient-specific simulators have also been introduced. Several curricula, including one recommended within, have been produced, incorporating various different training modalities and nontechnical skills training techniques. Such curricula and validated models should be used in a structured fashion to supplement operating room training. PMID:27549358

  7. Influence of pelvic suspension on beef meat quality

    OpenAIRE

    Lundesjö Ahnström, Maria

    2008-01-01

    The aim of this thesis was to investigate the effect of pelvic suspension on beef with different background and different genders. The response to pelvic suspension was studied in longissimus, semimembranosus, adductor, gluteus and psoas muscles from young bulls, bulls, heifers and cows. Prolonged ageing time until 14 days was evaluated for longissimus from heifers. It was concluded that pelvic suspension reduced shear force values for pelvic- compared to achilles-suspended sides in all muscl...

  8. Functional imaging of the pelvic floor

    Energy Technology Data Exchange (ETDEWEB)

    Lienemann, Andreas E-mail: andreaslienemann@web.de; Fischer, Tanja

    2003-08-01

    Introduction/Objective: Pelvic floor dysfunction and associated pelvic organ prolapse represent a major problem in our present-day society, mostly afflicting parous women. Magnetic resonance imaging (MRI) is assuming an increasingly important role in the more accurate delineation of the extent of the problem. This article briefly reviews one of the main radiological methods for the dynamic evaluation of the pelvic floor: functional cine MRI. Methods and Material: Out of the literature the smallest common denominator for functional cine MRI can be defined as follows: high field system; patient either in supine or sitting position; fast gradient echo sequence; midsagittal slice orientation; either a stack of slices or repeated measurements at the same slice position with the patient at rest or straining; image analysis using the pubococcygeal reference line. Results: All except two publications stress the usefulness of functional cine MRI in the evaluation of patients with organ descent and prolapse. This well accepted method allows for the visualization of all relevant structures in the anterior, middle and posterior compartment. It is especially useful in the detection of enteroceles, and provides a reliable postoperative follow-up tool. Isolated urinary or stool incontinence are not an indication for functional cine MRI, as is the case in patients with equivocal clinical findings. To date it does not allow for real 3D imaging of the pelvic floor or sufficient determination of fascial defects. Discussion: Functional cine MRI of the pelvic floor is a promising new imaging method for the detection of organ descent and prolapse in patients with equivocal clinical findings. The combination of function and morphology allows for an innovative view of the pelvic floor, and thus adds to our understanding of the various interactions of the structures.

  9. [Influence of the pelvic trauma registry of the DGU on treatment of pelvic ring fractures].

    Science.gov (United States)

    Holstein, J H; Stuby, F M; Herath, S C; Culemann, U; Aghayev, E; Pohlemann, T

    2016-06-01

    Fractures of the pelvic ring are comparatively rare with an incidence of 2-8 % of all fractures depending on the study in question. The severity of pelvic ring fractures can be very different ranging from simple and mostly "harmless" type A fractures up to life-threatening complex type C fractures. Although it was previously postulated that high-energy trauma was necessary to induce a pelvic ring fracture, over the past decades it became more and more evident, not least from data in the pelvic trauma registry of the German Society for Trauma Surgery (DGU), that low-energy minor trauma can also cause pelvic ring fractures of osteoporotic bone and in a rapidly increasing population of geriatric patients insufficiency fractures of the pelvic ring are nowadays observed with no preceding trauma.Even in large trauma centers the number of patients with pelvic ring fractures is mostly insufficient to perform valid and sufficiently powerful monocentric studies on epidemiological, diagnostic or therapeutic issues. For this reason, in 1991 the first and still the only registry worldwide for the documentation and evaluation of pelvic ring fractures was introduced by the Working Group Pelvis (AG Becken) of the DGU. Originally, the main objectives of the documentation were epidemiological and diagnostic issues; however, in the course of time it developed into an increasingly expanding dataset with comprehensive parameters on injury patterns, operative and conservative therapy regimens and short-term and long-term outcome of patients. Originally starting with 10 institutions, in the meantime more than 30 hospitals in Germany and other European countries participate in the documentation of data. In the third phase of the registry alone, which was started in 2004, data from approximately 15,000 patients with pelvic ring and acetabular fractures were documented. In addition to the scientific impact of the pelvic trauma registry, which is reflected in the numerous national and

  10. 腹针结合艾灸治疗慢性盆腔炎临床研究%Abdominal Acupuncture Combined with Moxibustion for Pelvic Inflammation

    Institute of Scientific and Technical Information of China (English)

    陈建华

    2011-01-01

    @@ Pelvic inflammation is a generic term for inflammation of the female upper reproductive tract and its surrounding tissues,which mainly includes endometritis, salpingitis, turbo-ovarian abscesses (TOA),and pelvioperitonitis.The inflammation can be limited in one site,or involves several sites.salpingitis and salpingo-oophoritis are most common,which might be acute or chronic.Chronic pelvic inflammation is more intractable,mainly manifesting as lower abdominal down-bearing sidtension or pain,lumbosacral pain,infertility,ectopic pregnancy and abnormal menstruation1l}21.From 2000 to 2007,the author treated 28 cases of chronic pelvic inflammation with abdominal acupuncture plus oxibustion and TDP,with 15 cases as control treated only with medicine.The outcome is here reported.

  11. Total Pelvic Exenteration for Gynecologic Malignancies

    Directory of Open Access Journals (Sweden)

    Elisabeth J. Diver

    2012-01-01

    Full Text Available Total pelvic exenteration (PE is a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In gynecologic oncology, it is most commonly indicated for the treatment of advanced primary or locally recurrent cancer. Careful patient selection and counseling are of paramount importance when considering someone for PE. Part of the evaluation process includes comprehensive assessment to exclude unresectable or metastatic disease. PE can be curative for carefully selected patients with gynecologic cancers. Major complications can be seen in as many as 50% of patients undergoing PE, underscoring the need to carefully discuss risks and benefits of this procedure with patients considering exenterative surgery.

  12. [Imaging of acute pelvic pain in women].

    Science.gov (United States)

    Genevois, A; Marouteau, N; Lemercier, E; Dacher, J N; Thiebot, J

    2008-01-01

    Acute pelvic pain in women is a routine situation in any emergency unit. The radiologist should know how to explore the patient with regards to the history and clinical findings. Ultrasonography is the primary and sometimes the only necessary imaging tool in the assessment of acute pelvic pain in women. MRI is the preferred technique in pregnant or young women. CT is more valuable for assessing nongynecologic disorders or post-partum and post-operative infections. This article reviews the contribution of each imaging technique in this clinical situation. Emphasis is put on the importance of age and clinical findings in the diagnostic strategy. PMID:18288036

  13. Diagnosis and Treatment of Disorders of the Posterior Pelvic Compartment

    NARCIS (Netherlands)

    D.M.J. Oom (Daniëlla)

    2009-01-01

    textabstractThe pelvic floor is an important structure, mandatory to maintain urinary and faecal continence and to prevent descent of pelvic viscera. Simultaneously it should also permit micturition, defaecation and sexual intercourse. Disorders associated with the pelvic floor are common, especiall

  14. OCT assisted identification of the grade of encrustation of urologic catheters

    Science.gov (United States)

    Sroka, Ronald; Püls, Michaela; Stepp, Herbert; Zilinberg, Katja; Bader, Markus; Weidlich, Patrick

    2013-06-01

    Introduction: Ureteric stenting is a commonly used endourologic procedure for temporary and long-term drainage of an obstructed upper urinary tract. The indication for ureteric stenting is obstruction due to intrinsic (intraureteral stones, strictures, or tumors) or extrinsic (for example compressing pelvic or retroperitoneal mass) causes. Despite the fact that stents do certainly have proven benefits in all fields of urology, there are potential morbidities. The most common problem of indwelling ureteral stents is infection. As foreign body in the urinary system, stents act as a nidus for bacteria colonization, crystallization and encrustation. Bacteria induced biofilm formation predisposes for the crystallization of lithogenic salts, such as calcium-phosphate, calcium-oxalate, magnesium-phosphate on the surface initiating stent encrustation. It was the objective of this study to evaluate whether optical coherence tomography (OCT) using both the surface and the endoluminal technique is feasible to investigate the locations and degree of encrustation process in clinically used ureteral stents. Patients and methods: After removal from patients, fourteen polyurethane JJ stents were investigated. A fresh JJ served as a control. The external surfaces were examined using an endoscopic surface OCT whereas the intraluminal surfaces were investigated by an endoluminal radial OCT device. The focus was on detection of encrustation or crystalline sedimentation. Results: In 12 female and 2 male patients, the median indwelling time of the ureteral catheter was 100 days (range 19- 217). Using the endoluminal OCT, the size and grade of intraluminal encrustation could be expressed as a percentage relating to the open lumen of the reference stent. The maximum encrustation observed resulted in a remaining unrestricted lumen of 15-35% compared to the reference. The luminal reduction caused by encrustation was significantly higher at the proximal end of the ureteral stent as compared

  15. Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?

    Science.gov (United States)

    Miklaszewska, Monika; Korohoda, Przemysław; Zachwieja, Katarzyna; Wolnicki, Michał; Mizerska-Wasiak, Małgorzata; Drożdż, Dorota; Pietrzyk, Jacek A

    2016-01-01

    Myelomeningocele (MMC) results from a failure of normal neural tube fusion in early fetal development. Retrospective, observational study of medical data of 54 children treated in Pediatric Nephrology and Urology Clinics for five years was performed. The following data were analyzed: serum creatinine, eGFR, urine analysis, renal scintigraphy (RS), renal ultrasound, and urodynamics. Mean age of studied population: 12.3 years, median of eGFR at the beginning and at the end of survey was 110.25 and 116.5 mL/min/1.73 m² accordingly. Median of frequency of urinary tract infections (fUTI): 1.2 episodes/year. In 24 children: low-pressure, in 30 children: high-pressure bladder was noted. Vesicouretral reflux (VUR) was noted in 23 children (42.6%). fUTI were more common in high-grade VUR group. High-grade VURs were more common in group of patients with severe renal damage. At the end of the survey 11.1% children were qualified to higher stages of chronic kidney disease. Renal parenchyma damage progression in RS was noted in 22.2% children. Positive VUR history, febrile recurrent UTIs, bladder wall trabeculation, and older age of the patients constitute risk factors of abnormal renal scans. More than 2.0 febrile, symptomatic UTIs annually increase by 5.6-fold the risk of severe renal parenchyma damage after five years. PMID:27598183

  16. Salicylic acid-releasing polyurethane acrylate polymers as anti-biofilm urological catheter coatings.

    Science.gov (United States)

    Nowatzki, Paul J; Koepsel, Richard R; Stoodley, Paul; Min, Ke; Harper, Alan; Murata, Hironobu; Donfack, Joseph; Hortelano, Edwin R; Ehrlich, Garth D; Russell, Alan J

    2012-05-01

    Biofilm-associated infections are a major complication of implanted and indwelling medical devices like urological and venous catheters. They commonly persist even in the presence of an oral or intravenous antibiotic regimen, often resulting in chronic illness. We have developed a new approach to inhibiting biofilm growth on synthetic materials through controlled release of salicylic acid from a polymeric coating. Herein we report the synthesis and testing of a ultraviolet-cured polyurethane acrylate polymer composed, in part, of salicyl acrylate, which hydrolyzes upon exposure to aqueous conditions, releasing salicylic acid while leaving the polymer backbone intact. The salicylic acid release rate was tuned by adjusting the polymer composition. Anti-biofilm performance of the coatings was assessed under several biofilm forming conditions using a novel combination of the MBEC Assay™ biofilm multi-peg growth system and bioluminescence monitoring for live cell quantification. Films of the salicylic acid-releasing polymers were found to inhibit biofilm formation, as shown by bioluminescent and GFP reporter strains of Pseudomonas aeruginosa and Escherichia coli. Urinary catheters coated on their inner lumens with the salicylic acid-releasing polymer significantly reduced biofilm formation by E. coli for up to 5 days under conditions that simulated physiological urine flow.

  17. PELVIC ACTINOMYCOSIS MIMICKING A LOCALLY ADVANCED PELVIC MALIGNANCY--CASE REPORT.

    Science.gov (United States)

    Velenciuc, Natalia; Velenciuc, I; Makkai Popa, S; Roată, C; Ferariu, D; Luncă, S

    2016-01-01

    We present the case of a former user of an intrauterine contraceptive device (IUD) for 10 years, diagnosed with a bulky, fixed pelvic tumor involving the internal genital organs and the recto sigmoid, causing luminal narrowing of the rectum, interpreted as locally advanced pelvic malignancy, probably of genital origin. Intraoperatively, a high index of suspicion made us collect a sample from the fibrous wall of the tumor mass, large Actinomyces colonies were thus identified. Surgery consisted in debridement, removal of a small amount of pus and appendectomy, thus avoiding a mutilating and useless surgery. Specific antibiotic therapy was administered for 3 months, with favorable postoperative and long-term outcomes. Pelvic actinomycosis should always be considered in the differential diagnosis of pelvic tumors in women using an IUD. The association of long-term antibiotic treatment is essential to eradicate the infection and prevent relapses. PMID:27483724

  18. Laparoscopic skill laboratory in urological surgery: tools and methods for resident training

    Directory of Open Access Journals (Sweden)

    Fabio C. M. Torricelli

    2011-02-01

    Full Text Available PURPOSE: Laparoscopy has certainly brought considerable benefits to patients, but laparoscopic surgery requires a set of skills different from open surgery, and learning in the operating room may increase surgical time, and even may be harmful to patients. Several training programs have been developed to decrease these potential prejudices. PURPOSES: to describe the laparoscopic training program for urological residents of the "Hospital das Clinicas" of the Sao Paulo Medical School, to report urological procedures that are feasible in dry and wet labs, and to perform a critical analysis of the cost-benefit relation of advanced laparoscopic skills laboratory. MATERIALS AND METHODS: The laparoscopic skill lab has two virtual simulators, three manual simulators, and four laparoscopic sets for study with a porcine model. The urology residents during their first year attend classes in the virtual and manual simulator and helps the senior urological resident in activities carried out with the laparoscopic sets. During the second year, the urological resident has six periods per week, each period lasting four hours, to perform laparoscopic procedures with a porcine model. Results: In a training program of ten weeks, one urological resident performs an average of 120 urological procedures. The most common procedures are total nephrectomy (30%, bladder suture (30%, partial nephrectomy (10%, pyeloplasty (10%, ureteral replacement or transuretero anastomosis (10%, and others like adrenalectomy, prostatectomy, and retroperitoneoscopy. These procedures are much quicker and caused less morbidity. CONCLUSION: Laparoscopic skills laboratory is a good method for achieving technical ability.

  19. AB271. Sexual dysfunction in chronic prostatitis

    OpenAIRE

    Cho, In-Rae

    2016-01-01

    Chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a clinical syndrome characterized by genital/ pelvic pain and lower urinary tract symptoms in the absence of urinary tract infection. CPPS is the most common prostatic disease in men younger than 50 years of age and the third most common in men older than 50 years of age. CP/CPPS is a complex entity with unclear etiology. Many articles reported that the high percentage of patients with CP/CPPS had...

  20. A rare case of chronic endometritis treated with hysteroscopy

    Directory of Open Access Journals (Sweden)

    Neena Gupta

    2013-08-01

    Full Text Available We present a case of 32 year old woman complaining of menometrorrhagia with chronic pelvic pain of following second trimester abortion. Her transabdominal ultrasound revealed chronic endometritis. She was treated with dilatation and curettage, on histopathological examination diagnosis of chronic endometritis was confirmed. Her menorrhagia was revealed but chronic pelvic pain persisted for which diagnostic hysteroscopy was planned. It revealed presence of tiny bony chips which were removed in the same setting. Intrauterine retained foetal bony chips due to previous medical termination of pregnancy were identified to be the cause of menometrorrhagia with chronic pelvic pain in the present case. Our case reiterates the importance of hysteroscopy in evaluation of such patients who are not responding to conventional medical management of abnormal uterine bleeding. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 726-727

  1. Pelvic Inflammatory Disease (PID) Fact Sheet

    Science.gov (United States)

    ... sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a serious condition, in women. 1 in 8 women with a history of PID experience difficulties getting pregnant. You can prevent PID if you ... sexually transmitted diseases. The content here can be syndicated (added to ...

  2. Pelvic fibromatoses--a rare gynecological entity.

    Science.gov (United States)

    Buckshee, K; Mittal, S; Agarwal, N; Chellani, M

    1988-06-01

    A rare case of pelvic fibromatoses is reported. This condition is rarely encountered in gynecological practice but when encountered, creates a diagnostic and therapeutic challenge. The reported patient highlights the difficulties encountered in surgical excision (done twice) and illustrates the local aggressive growth behavior of this entity.

  3. Sexual selection targets cetacean pelvic bones.

    Science.gov (United States)

    Dines, James P; Otárola-Castillo, Erik; Ralph, Peter; Alas, Jesse; Daley, Timothy; Smith, Andrew D; Dean, Matthew D

    2014-11-01

    Male genitalia evolve rapidly, probably as a result of sexual selection. Whether this pattern extends to the internal infrastructure that influences genital movements remains unknown. Cetaceans (whales and dolphins) offer a unique opportunity to test this hypothesis: since evolving from land-dwelling ancestors, they lost external hind limbs and evolved a highly reduced pelvis that seems to serve no other function except to anchor muscles that maneuver the penis. Here, we create a novel morphometric pipeline to analyze the size and shape evolution of pelvic bones from 130 individuals (29 species) in the context of inferred mating system. We present two main findings: (1) males from species with relatively intense sexual selection (inferred by relative testes size) tend to evolve larger penises and pelvic bones compared to their body length, and (2) pelvic bone shape has diverged more in species pairs that have diverged in inferred mating system. Neither pattern was observed in the anterior-most pair of vertebral ribs, which served as a negative control. This study provides evidence that sexual selection can affect internal anatomy that controls male genitalia. These important functions may explain why cetacean pelvic bones have not been lost through evolutionary time.

  4. A clinical study on the trocar-guided mesh repair system for pelvic organ prolapse surgery

    Science.gov (United States)

    Bak, Seul Gi; Moon, Jeong Beom; Kim, Kyoung Jin; Kim, Kyoung A; Lee, Ju Hyang

    2016-01-01

    Objective To evaluate the complication and recurrence rates in patients undergoing trocar-guided mesh implant for pelvic organ prolapse (POP) treatment. Methods A retrospective study was performed based on the medical records of patients who had undergone mesh implant by one surgeon from May 2006 to August 2013 at the Presbyterian Medical Center in Korea. We evaluated perioperative complications such as bladder injury, mesh exposure, urinary symptoms, infections, and chronic pelvic pain. Recurrence was defined as a POP-quantification system stage ≥II or any symptomatic prolapse. Results Sixty-seven patients were evaluated, and the mean age of patients was 65.4±7.2 years. Stage ≥III POP-quantification Ba was noted in 61 patients (91%). Intraoperative complications included three cases of bladder injury (4.5%). The mean follow-up period was 44.1±7.9 months. Postoperative complications occurred in seven women (10.5%): four cases of urinary symptoms (6%), two cases of infections (3%), and one case of chronic pelvic pain (1.5%). Mesh exposure did not occur (0%). Prolapse recurrence was reported in five patients (7.5%). Conclusion Based on our operational result, the trocar-guided mesh implant seems to provide safe and effective outcomes. PMID:27200311

  5. The economics of urologic practice in the twenty-first century.

    Science.gov (United States)

    Holtgrewe, H L

    1998-02-01

    Our nation's health care has been undergoing an economic revolution. The practice of urology has not escaped. Speculation regarding the economics of urologic practice in the twenty-first century must be based on the continuation of policy trends begun over the last decade by government and managed care coupled with the impact of changes in the science of urology, shifting population demographics, and changing social factors. The hallmarks of the years ahead include increased physician accountability, expanded use of clinical care guidelines, continued relentless penetration of managed care, and reduced reimbursement for surgical services.

  6. How 'male health' fits into the field of urology.

    Science.gov (United States)

    Elterman, Dean S; Kaplan, Steven A; Pelman, Richard S; Goldenberg, S Larry

    2013-10-01

    The shorter life span and poorer health of men compared with women is concerning, affecting spouses, families, and communities. Physicians and policy makers have identified a growing need for a gender-specific focus on the unique health needs of boys and men and accompanying services. Men's health has emerged as a new discipline that is responsible for a gender-specific approach to health-services delivery, government policy, research, and advocacy. The urologic community has taken a leadership role in this specialty by defining the issues that face men in the 21(st) century, bringing together disparate areas of clinical care and research, and collaborating with stakeholders (such as primary care physicians and specialists from other disciplines) to create and implement men's health initiatives. PMID:23897503

  7. The Perioperative Nursing of Patients with Pelvic Organ Prolapse undergoing Pelvic Floor Reconstruction%微创盆底重建术治疗盆腔器官脱垂患者的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    杨洋; 李晓玲

    2013-01-01

    目的 探讨加用网片盆底重建术(PROSIMA)治疗盆腔器官脱垂患者的围手术期护理方法.方法 对2010年6月-2011年6月收治的23例盆腔脏器脱垂患者施行的PROSIMA护理措施进行回顾性总结.结果 23例患者术后尿失禁症状明显好转,舒适感增加;仅1例发生尿潴留,予重置尿管后顺利排尿;治愈率达100%.术后6个月复查时均无阴道壁膨出或穹隆脱垂,未出现下尿路感染、网片侵蚀、下肢疼痛等并发症.结论 有效的护理措施可减少PROSIMA术后并发症,对提高手术成功率、促进患者康复有明显作用.%Objective To study the perioperative nursing for patients with pelvic organ prolapse undergoing Prosima devices pelvic floor reconstruction. Methods Twenty-three consecutive women with pelvic organ prolapse undergoing transvaginal placement of Prosima devices for pelvic floor reconstruction were enrolled retrospectively in this study from June 2010 to June 2011 in Urology Department of West China Hospital. All patients received distinctive nursing measures in support of the treatment. Results The cure rate of the surgical management was 100% with great symptoms relief and patients' well-being. Postoperative urinary retention occurred in one case which was cured by urinary catheterization in a few days. After six-month follow-up, there was no anterior vaginal or vault prolapse recurrence, no severe complication such as urinary tract infection, mesh erosion or groin pain. Conclusions Effective perioperative nursing measures can reduce the morbidity of postoperative complications after pelvic floor reconstruction. It is a significant way to assist surgical management and patients' recovery.

  8. Cirugía laparoscópica en urología Laparoscopic surgery in urology

    Directory of Open Access Journals (Sweden)

    J. I. Pascual

    2005-01-01

    Full Text Available La cirugía mínimamente invasiva está presente en el momento actual en todos los estándares de calidad de un servicio quirúrgico. La cirugía laparoscópica, base de esta cirugía de mínima invasión, está revolucionando la enseñanza y el manejo de muchas patologías quirúrgicas. En el ámbito urológico, aunque con un retraso de 5 años con respecto a los países de nuestro entorno, la laparoscopia se ha afianzado como una técnica prevalente en muchos procesos del aparato genito-urinario, siendo actualmente la técnica de elección para el tratamiento quirúrgico de la suprarrenal y afianzándose rápidamente en patologías diversas como tumores renales, prostáticos, estadiaje en enfermedades neoplásicas testiculares, patología quirúrgica benigna y en cirugía reconstructiva. El Servicio de Urología del Hospital de Navarra es pionero en el empleo de este tipo de técnicas desde 1995 y desde 1998 en la llamada cirugía laparoscópica avanzada, siendo referente nacional en alguno de los procedimientos como la adrenalectomía laparoscópica. Actualmente están incorporados en el servicio todos los procedimientos laparoscópicos avanzados en urología, con una curva de aprendizaje superada. Todo ello ha permitido mejorar la atención al paciente, consiguiendo una disminución del dolor postoperatorio, estancia hospitalaria y rápida reincorporación a la actividad laboral con unos resultados oncológicos superponibles a los de la cirugía abierta.At the present time minimally invasive surgery is present in all the standards of quality of a surgical service. Laparoscopic surgery, the basis of this minimally invasive surgery, is revolutionising the teaching and handling of many surgical pathologies. In the urological sphere, although with a delay of 5 years with respect to neighbouring countries, laparoscopy has become established as a prevalent technique in many processes of the urinary-genital apparatus. At present it is the chosen

  9. Pelvic actinomycosis presenting as a malignant pelvic mass: a case report

    Directory of Open Access Journals (Sweden)

    Perek Asiye

    2011-01-01

    Full Text Available Abstract Introduction Pelvic actinomycosis constitutes 3% of all human actinomycosis infections. It is usually insidious, and is often mistaken for other conditions such as diverticulitis, abscesses, inflammatory bowel disease and malignant tumors, presenting a diagnostic challenge pre-operatively; it is identified post-operatively in most cases. Here we present a case that presented as pelvic malignancy and was diagnosed as pelvic actinomycosis post-operatively. Case presentation A 48-year-old Caucasian Turkish woman presented to our clinic with a three-month history of abdominal pain, weight loss and difficulty in defecation. She had used an intra-uterine device for 16 years, however it had recently been removed. The rectosigmoidoscopy revealed narrowing of the lumen at 12 cm due to a mass lesion either in the wall or due to an extrinsic lesion that prevented the passage of the endoscope. On examination, there was no gynecological pathology. Magnetic resonance imaging showed a mass, measuring 5.5 × 4 cm attached to the rectum posterior to the uterus. The ureter on that side was dilated. Surgically there was a pelvic mass adhered to the rectum and uterine adnexes, measuring 10 × 12 cm. It originated from uterine adnexes, particularly ones from the left side and formed a conglomerated mass with the uterus and nearby organs; the left ureter was also dilated due to the pelvic mass. Because of concomitant tubal abscess formation and difficulty in dissection planes, total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed (our patient was 48 years old and had completed her childbearing period. The cytology revealed inflammatory cells with aggregates of Actinomyces. Penicillin therapy was given for six months without any complication. Conclusions Pelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intra-uterine devices, and who have a history of appendectomy, tonsillectomy

  10. Pelvic Insufficiency Fracture After Pelvic Radiotherapy for Cervical Cancer: Analysis of Risk Factors

    International Nuclear Information System (INIS)

    Purpose: To investigate the incidence, clinical characteristics, and risk factors of pelvic insufficiency fracture (PIF) after pelvic radiotherapy (RT) in cervical cancer. Methods and Materials: Medical records and imaging studies, including bone scintigraphy, CT, and MRI of 557 patients with cervical cancer who received whole-pelvic RT between January 1998 and August 2005 were reviewed. Results: Eighty-three patients were diagnosed as having PIF after pelvic RT. The 5-year cumulative incidence of PIF was 19.7%. The most commonly involved site was the sacroiliac joint. Pelvic pain developed in 48 patients (57.8%) at diagnosis. Eleven patients (13.3%) needed admission or narcotics because of severe pain, and others had good relief of symptoms with conservative management. In univariate analysis, age ≥55 years (p < 0.001), anteroposterior/posteroanterior parallel opposing technique (p = 0.001), curative treatment (p < 0.001), and radiation dose ≥50.4 Gy (p = 0.005) were the predisposing factors for development of PIF. Concurrent chemotherapy (p = 0.78) was not significant. Multivariate analysis showed that age ≥55 years (p < 0.001), body weight <55 kg (p = 0.02), curative treatment (p = 0.03), and radiation dose ≥50.4 Gy (p = 0.04) were significant predisposing factors for development of PIF. Conclusion: The development of PIF is not rare after pelvic RT. The use of multibeam arrangements to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture, especially in elderly women with low body weight

  11. Management of pelvic lymphoceles after radical prostatectomy: A multicentre community based study

    Directory of Open Access Journals (Sweden)

    Khoder WY

    2011-06-01

    Full Text Available Abstract Introduction Pelvic lymphoceles (LC following radical prostatectomy (LC-RP have an incidence up to 27%. LC-managements constitute 50% of surgical interventions performed in post-RP patients. Objectives To describe a therapeutic algorithm for LC-managements based on a community based representative retrospective study. Patients and methods: Multicentre data from 304 patients with LC-RP were retrospectively examined for LC-managements. RPs were performed by various surgeons from 67 urological departments. All patients had undergone 3 weeks rehabilitation in a specialized hospital where the data base was generated. Indications and results of therapeutic manoeuvres were used to develop a general concept for planning therapy decisions. Results Median age was 64 years. Complications occurred in 9% (28/304 of patients. Median LC-volume was 36 ml (range 20-1800 ml. There were more complications for LCs with ≥100 ml volume than those Conclusions This study based treatment algorithm provides a rationale approach with an accurate LC-classification as regard the indications and decision making for the available LC-RP-therapies. This could facilitate management decisions. Evaluation of this concept prospectively in large patient cohort is mandatory.

  12. Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

    Science.gov (United States)

    Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

    2014-08-01

    Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

  13. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... 5 percent is what we quote in the literature. Another viewer, Samir Sharma writes in, “What was ... The question with the mortality, in the urologic literature there is three recent series that were published, ...

  14. Are Patients at Nutritional Risk More Prone to Complications after Major Urological Surgery?

    OpenAIRE

    Cerantola, Yannick; Valerio, Massimo; Hubner, Martin; Iglesias, Katia; Vaucher, Laurent; Jichlinski, Patrice

    2016-01-01

    Purpose The nutritional risk score is a recommended screening tool for malnutrition. While a nutritional risk score of 3 or greater predicts adverse outcomes after digestive surgery, to our knowledge its predictive value for morbidity after urological interventions is unknown. We determined whether urological patients at nutritional risk are at higher risk for complications after major surgery than patients not at nutritional risk. Materials and methods We performed a prospective observation...

  15. Surgical simulators in urological training--views of UK Training Programme Directors.

    Science.gov (United States)

    Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

    2012-09-01

    What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. PMID:22233327

  16. [Development of the Stettin municipal hospital. The beginnings of urology in Stettin (1.)].

    Science.gov (United States)

    Zajaczkowski, T; Wojewski-Zajaczkowski, E M

    2005-01-01

    The growth of the city's population, rapid advances in medical science, the increasing understanding of the importance of hygiene and, finally, the demand for health care led to the erection of a modern 353-bed municipal hospital complex at Pommerensdorf, Apfelallee, which was officially opened in 1879. From the very beginning of its existence, the municipal hospital was constantly in the process of extension and rebuilding. A hospital base was set up and new departments and clinics were opened. In 1937, the number of the hospital beds had increased to 1,004. The official existence of an independent urology department with 30 beds, first headed by Dr. Felix Hagen (1880-1962), dates back to March 1919. The aim of this new department was to carry out examinations and differential diagnoses, together with the department of internal medicine, for those patients from the urological surgery sector including evaluation for surgery. Surgical urology was the responsibility of the surgery department. The remaining cases requiring urological experience, such as those involving transurethral intervention, diseases of the bladder and urinary tract infection, were treated in the new urology department. As an auxiliary department, de facto dependent on the departments of surgery and internal medicine, urology could not develop properly and survive. In October 1935, the position of the head of the urological department was terminated, and urology was incorporated into the department of surgery. During the Second World War, between 1939 and 1945, as during the World War 1, a field hospital was set up in the municipal hospital at Pommerensdorf in Stettin.

  17. Comparing the Efficacy of Intravenous Acetaminophen and Intravenous Meperidine in Pain Relief After Outpatient Urological Surgery

    OpenAIRE

    Kolahdouzan, Khosro; Eydi, Mahmood; Mohammadipour Anvari, Hassan; Golzari, Samad EJ; Abri, Reyhaneh; GHOJAZADEH, Morteza; Ojaghihaghighi, Seyed Hossein

    2014-01-01

    Background: Pain relief after surgery is an essential component of postoperative care. Objectives: The purpose of this study was to compare the efficacy of intravenous acetaminophen and intravenous meperidine in pain relief after outpatient urological surgery. Patients and Methods: In a prospective, randomized, double-blind clinical trial, 100 outpatients of urological surgery were studied in two groups of acetaminophen (A) and meperidine (M). Patients in group A received 1g of acetaminophen ...

  18. Conformal radiotherapy for prostate cancer - Longer duration of acute genitourinary toxicity in patients with prior history of invasive urological procedure

    Energy Technology Data Exchange (ETDEWEB)

    Odrazka, Karel; Vanasek, Jaroslav; Vaculikova, Miloslava; Petera, Jiri; Zouhar, Milan; Zoul, Zdenk; Stejskal, Jan; Skrabkova, Zuzana; Kadeka, David [Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic). Dept. of Radiotherapy and Oncology

    2001-11-01

    The incidence and predictors of acute toxicity were evaluated in patients treated with three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer. Between December 1997 and November 1999, 116 patients with T1-T3 prostatic carcinoma were enrolled in the study. Ninety patients were treated with 70 Gy and 26 patients with T3 tumors received 74 Gy. Of the 116 patients 42 (36.2%) had a prior history of invasive urological procedure (IUP) (transurethral resection of the prostate or transvesical prostatectomy for benign prostatic hyperplasia). Acute gastrointestinal (GI) and genitourinary (GU) symptoms were graded according to the EORTC/RTOG scoring system. Toxicity duration after the completion of 3D-CRT was recorded. The majority of patients experienced only mild or no (Grade 1) acute toxicities. Medications for GI and GU symptoms (Grade 2) were required by 28.4% and 12.9% of patients, respectively. Only one case of Grade 3 GI toxicity (0.9%) was observed. Seven patients (6.1%) experienced severe GU toxicity (Grade 3 or 4). No correlation was found between acute toxicity and age, stage, dose (70 Gy vs. 74 Gy), IUP and pelvic lymphadenectomy. A significant relationship was observed between the duration of acute GU toxicity and prior IUP. Symptoms persisted for more than 4 weeks in 51.9% and 26.0% of patients with and without a prior history of IUP, respectively (p = 0.02). The incidence of acute complications, associated with 3D-CRT for prostate cancer, was acceptable in our cohort of patients. A prior history of IUP resulted in a significantly longer duration of acute GU toxicity.

  19. Pelvic Organ Prolapse-Associated Cystitis.

    Science.gov (United States)

    Hamid, Rizwan; Losco, Giovanni

    2014-01-01

    Pelvic organ prolapse (POP) and urinary tract infection (UTI) are important problems, estimated to affect around 14 and 40 % of women, respectively, at some point in their lives. Positive urine culture in the presence of symptoms is the cornerstone of diagnosis of UTI and should be performed along with ultrasound assessment of postvoid residual (PVR) in all women presenting with POP and UTI. PVR over 30 mL is an independent risk factor for UTI, although no specific association with POP and UTI has been demonstrated. The use of prophylactic antibiotics remains controversial. The major risk factors for postoperative UTI are postoperative catheterisation, prolonged catheterisation, previous recurrent UTI and an increased urethro-anal distance-suggesting that global pelvic floor dysfunction may play a role. PMID:25170365

  20. Pelvic schwannoma in the right parametrium

    Directory of Open Access Journals (Sweden)

    Machairiotis N

    2013-03-01

    Full Text Available Nikolaos Machairiotis,4 Paul Zarogoulidis,3 Aikaterini Stylianaki,1 Eleni Karatrasoglou,4 Georgia Sotiropoulou,4 Alvin Floreskou,4 Eleana Chatzi,4 Athanasia Karamani,4 Georgia Liapi,5 Eleni Papakonstantinou,5 Nikolaos Katsikogiannis,1 Nikolaos Courcoutsakis,2 Christodoulos Machairiotis4 1Surgery Department, 2Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece; 3Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 4Obstetric Gynecology Department, 5Pathology Department, Thriasio General Hospital, Athens, Greece Abstract: Neurilemomas are benign usually encapsulated nerve sheath tumors derived from the Schwann cells. These tumors commonly arise from the cranial nerves as acoustic neurinomas but they are extremely rare in the pelvis and the retroperitoneal area (less than 0.5% of reported cases, unless they are combined with von Recklinghausen disease (type 1 neurofibromatosis. We report the case of a 58-year-old female with pelvic schwannoma, 6.5 × 5.5 cm in size, in the right parametrium. This is the first case reported in the literature. Based on the rarity of this tumor and in order to ensure optimum treatment and survival for our patient, we performed laparotomy with total abdominal hysterectomy and en-block tumor excision. A frozen section was taken during the surgery before complete resection of the mass, which was ambiguous. Because of the possibility of malignancy, complete excision of the mass was performed, with pelvic blunt dissection. Histological examination showed a benign neoplasm, originating from the cells of peripheral nerve sheaths; diagnosis was a schwannoma. There were degenerative areas, including cystic degeneration, hemorrhagic infiltrations, ischemic foci with pycnotic cells, and collagen replacement. Pelvic schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe

  1. Mechanical devices in pelvic organ prolapsed

    OpenAIRE

    Raja AM, Seema SR

    2013-01-01

    Pelvic organ prolapse (POP) is a common condition, up to 50% of women will have some degree of prolapse and many are asymptomatic. The pessaries are intended to decrease the symptoms of prolapse and are valid options for patients with stress incontinence. Generally pessaries are safe to use. There are two types of pessaries, support type and space occupying type. Ring pessary is very commonly used, as it is easy to insert and remove. Pessaries can make a significant difference in the quality ...

  2. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

    Directory of Open Access Journals (Sweden)

    Teresa Pusiol

    2011-01-01

    Full Text Available Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device.

  3. Fourth joint meeting of the American Urological Association and the Japanese Urological Association Specialty Society program at the 104th annual meeting of the American Urological Association at Chicago 2009.

    Science.gov (United States)

    Cooperberg, Matthew R; Hinotsu, Shiro; Chancellor, Michael B; Homma, Yukio; Nelson, Peter S; Matsuyama, Hideyasu; Menon, Mani; Kucuk, Omer; Hara, Isao; Egawa, Shin; Uzzo, Robert G; Kanayama, Hiro-Omi; Okuyama, Akihiko; Akaza, Hideyuki

    2009-08-01

    We are heartily grateful for the warm support of all of the people concerned, including the moderators and panelists of both societies for giving us the opportunity to hold the 4th American Urological Association/Japanese Urological Association (AUA/JUA) Joint Meeting, held once again at the 104th Annual Meeting of the American Urological Association (25-30 April 2009, Chicago, Illinois, USA). 2009 is a memorable year, being the start of new collaborations between AUA and JUA. The JUA in collaboration with AUA is promoting an academic exchange program whereby outstanding and promising Japanese and American junior faculty members will be given the opportunity to work in the USA and Japan for one month. The program not only allows the sharing of knowledge and experience, but is designed to foster a closer alliance between the AUA and JUA, and assists in identifying future leaders within both organizations. The JUA will have an exhibit booth at the AUA annual meeting, promoting our new joint activities. The Journal of Urology and International Journal of Urology will share reviewers. The JUA will participate in developing AUA guidelines. With all of these activities, the JUA hopes it will provide greater opportunities to young Japanese urologists to participate in educational projects in the US. We would like to thank Professor Robert C. Flanigan, the Secretary General of AUA, Professor Glenn M. Preminger, the Chairman of the AUA Office of Education and the staff of AUA and JUA for supporting our program. We hope to keep holding the joint meeting and have plenty of ideas on themes and forums. We believe that this international program helps to establish a closer relationship between JUA and AUA in the scientific field. PMID:19682110

  4. Physical exercise and pelvic girdle pain in pregnancy

    DEFF Research Database (Denmark)

    Andersen, Linda Kahr; Backhausen, Mette; Hegaard, Hanne Kristine;

    2015-01-01

    OBJECTIVE: Pelvic girdle pain is a frequent cause of sick leave among pregnant women in Denmark. Studies regarding prevention of pelvic girdle pain are sparse. The aim of this study was to examine the association between physical exercise and pelvic girdle pain in pregnancy. STUDY DESIGN: A nested...... case-control study within the Danish National Birth Cohort (n = 5304). METHODS: This study used self-reported data on pelvic girdle pain obtained from an interview six months after childbirth. Information on physical exercise was obtained from the pregnancy interview around gestational week 16....... The association was estimated using logistic regression analysis. RESULTS: Physical exercise in pregnancy was associated with decreased risk of overall pelvic girdle pain (OR = 0.87; 95% CI: 0.77-0.99, p = 0.028). Tests for trend indicated decreasing odds for pelvic girdle pain with increasing number of hours per...

  5. Animal models of female pelvic organ prolapse: lessons learned

    OpenAIRE

    Couri, Bruna M.; Lenis, Andrew T.; Borazjani, Ali; Paraiso, Marie Fidela R; Damaser, Margot S.

    2012-01-01

    Pelvic organ prolapse is a vaginal protrusion of female pelvic organs. It has high prevalence worldwide and represents a great burden to the economy. The pathophysiology of pelvic organ prolapse is multifactorial and includes genetic predisposition, aberrant connective tissue, obesity, advancing age, vaginal delivery and other risk factors. Owing to the long course prior to patients becoming symptomatic and ethical questions surrounding human studies, animal models are necessary and useful. T...

  6. Pelvic pain after childbirth: a longitudinal population study.

    Science.gov (United States)

    Bjelland, Elisabeth Krefting; Owe, Katrine Mari; Pingel, Ronnie; Kristiansson, Per; Vangen, Siri; Eberhard-Gran, Malin

    2016-03-01

    In this longitudinal population study, the aims were to study associations of mode of delivery with new onset of pelvic pain and changes in pelvic pain scores up to 7 to 18 months after childbirth. We included 20,248 participants enrolled in the Norwegian Mother and Child Cohort Study (1999-2008) without preexisting pelvic pain in pregnancy. Data were obtained by 4 self-administered questionnaires and linked to the Medical Birth Registry of Norway. A total of 4.5% of the women reported new onset of pelvic pain 0 to 3 months postpartum. Compared to unassisted vaginal delivery, operative vaginal delivery was associated with increased odds of pelvic pain (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.06-1.59). Planned and emergency cesarean deliveries were associated with reduced odds of pelvic pain (adjusted OR: 0.48; 95% CI: 0.31-0.74 and adjusted OR: 0.65; 95% CI: 0.49-0.87, respectively). Planned cesarean delivery, young maternal age, and low Symptom Checklist-8 scores were associated with low pelvic pain scores after childbirth. A history of pain was the only factor associated with increased pelvic pain scores over time (P = 0.047). We conclude that new onset of pelvic pain after childbirth was not commonly reported, particularly following cesarean delivery. Overall, pelvic pain scores were rather low at all time points and women with a history of pain reported increased pelvic pain scores over time. Hence, clinicians should follow up women with pelvic pain after a difficult childbirth experience, particularly if they have a history of pain. PMID:26588694

  7. Pelvic pain after childbirth: a longitudinal population study.

    Science.gov (United States)

    Bjelland, Elisabeth Krefting; Owe, Katrine Mari; Pingel, Ronnie; Kristiansson, Per; Vangen, Siri; Eberhard-Gran, Malin

    2016-03-01

    In this longitudinal population study, the aims were to study associations of mode of delivery with new onset of pelvic pain and changes in pelvic pain scores up to 7 to 18 months after childbirth. We included 20,248 participants enrolled in the Norwegian Mother and Child Cohort Study (1999-2008) without preexisting pelvic pain in pregnancy. Data were obtained by 4 self-administered questionnaires and linked to the Medical Birth Registry of Norway. A total of 4.5% of the women reported new onset of pelvic pain 0 to 3 months postpartum. Compared to unassisted vaginal delivery, operative vaginal delivery was associated with increased odds of pelvic pain (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.06-1.59). Planned and emergency cesarean deliveries were associated with reduced odds of pelvic pain (adjusted OR: 0.48; 95% CI: 0.31-0.74 and adjusted OR: 0.65; 95% CI: 0.49-0.87, respectively). Planned cesarean delivery, young maternal age, and low Symptom Checklist-8 scores were associated with low pelvic pain scores after childbirth. A history of pain was the only factor associated with increased pelvic pain scores over time (P = 0.047). We conclude that new onset of pelvic pain after childbirth was not commonly reported, particularly following cesarean delivery. Overall, pelvic pain scores were rather low at all time points and women with a history of pain reported increased pelvic pain scores over time. Hence, clinicians should follow up women with pelvic pain after a difficult childbirth experience, particularly if they have a history of pain.

  8. Attitude and perception of urology by medical students at the end of their medical school: An appraisal from Saudi Arabia

    OpenAIRE

    Saleh Binsaleh; Abdulrahman Al-Jasser; Raed Almannie; Khaled Madbouly

    2015-01-01

    Objectives: To evaluate the attitude and perception of the graduates of King Saud University (KSU) College of Medicine regarding the quality of their urology rotation, urology exposure during this rotation, confidence about managing common conditions, and career prospects. Materials and Methods: In 2013, a questionnaire regarding the students′ perceptions of urology rotation was developed and E-mailed to all final (5 th ) year medical students and interns of KSU College of Medicine, Riyad...

  9. Pelvic Organ Prolapse Quantification System (POP–Q) – a new era in pelvic prolapse staging

    OpenAIRE

    Persu, C; Chapple, CR; Cauni, V; Gutue, S; Geavlete, P

    2011-01-01

    The prolapse of one or several pelvic organs is a condition that has been known by medicine since its early days, and different therapeutic approaches have been proposed and accepted. But one of the main problems concerning the prolapse of pelvic organs is the need for a universal, clear and reliable staging method. Because the prolapse has been known and recognized as a disease for more than one hundred years, so are different systems proposed for its staging. But none has proved itself to r...

  10. The diagnostic value of CT of pelvic masses in children

    International Nuclear Information System (INIS)

    Objective: To retrospectively analyze CT appearances and diagnostic value of pelvic masses in 50 children proved by operation and pathology. Methods: 50 cases of pelvic masses were performed with axial plain CT scan. 32 cases of them underwent contrast-enhanced CT scan. These were 31 girls and 19 boys. The age ranged from 2 hours to 14 years, mean 5.8 years. 47 cases were proved by surgical pathology, 2 cases by biopsy pathology, and 1 case by voiding cystourethrography. Results: The pelvic masses were : 27 germ cell tumors, 7 rhabdomyosarcomas (RMS), 4 tumors of neural origin, 2 hydrometrocolpos, 1 pelvic lipomatosis, 1 ureterocele in bladder, 1 non-Hodgkin's lymphoma(NHL), 1 ectopic hyperplasia of prostate in pelvic, 1 appendiceal abscess, 1 prostatic abscess,1 megabladder, 1 mesenteric cyst, 1 duplication of the small intestine, 1 leiomyosarcoma. 46 of 50 cases were correctly diagnosed by CT scan before surgery (92 %), 4 cases were mistaken by CT scan (8 %). 31 cases were benign masses (62%), and 19 cases were malignant masses (38% ), 17 of 19 malignant masses were solid (89.5%). 29 of 31 benign masses were mixed density masses and cystic masses(93. 5%) . Conclusion: CT scan was the best method of choices in showing the size, density, shape, and location of pelvic masses and its relationship to pelvic organs, musculature, and bones. Pelvic CT is the most recent technique utilized in the diagnosis of patients with pelvic masses

  11. Isolated Pelvic Hyperthermochemotherapeutic Perfusion -An Experimental Study on Isolating Efficacy

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Hyperthermochemotherapeutic perfusion model through isolated pelvic vessels was developed to evaluate the leakage of hyperthermia and drugs (such as adriamycin) from the isolated pelvic circulation to systemic circulation and its associated side/toxic effects. The isolated pelvic circulation was perfused through a femoral artery catheter with hyperthermic (48 ℃ to 55 ℃) adriamycin solution (50 μg/ml) for 30 min. The efflux was drained through a femoral vein catheter. And the pelvic temperature was kept at the level of 43±0.5 ℃. The temperature of pelvic circulation was kept at 4 ℃ to 5 ℃ greater than the systemic/core temperature. The adriamycin concentration of pelvic efflux was 12 to 46 folds of that of systemic serum. The difference between them was very significant (P<0.001). As the perfusion pressure was increased, which kept lower than the mean systemic artery pressure, the leakage of the adriamycin from the isolated pelvic circulation to systemic circulation was increased, but there was no significant difference between them (P>0.05). During isolated perfusion, the systemic blood dynamics remained stable and there were no organic injuries on the important organs. It was suggested that the isolating efficacy of the modality of isolated pelvic hyperthermochemotherapeutic perfusion through vessels was rather high. The hyperthermia and drugs could be effectively limited in the isolated pelvic region with minor side effects on the systemic circulation and important organs.

  12. [Oswald Schwarz: a pioneer in psychosomatic urology and sexual medicine].

    Science.gov (United States)

    Berberich, H J; Schultheiss, D; Kieser, B

    2015-01-01

    Oswald Schwarz, a urologist from Vienna, was a scholar of Anton Ritter von Frisch and Hans Rubritius. As a physician during World War I, he was confronted with numerous bullet wounds to the spinal cord. In 1919, he completed his professorial thesis"Bladder dysfunction as a result of bullet wounds to the spinal cord". Oswald Schwarz was known as a committed surgeon. As an urologist he also treated patients with sexual dysfunction. Besides his practical and scientific urology-related work, he was also interested in psychology and philosophy. He held lectures on both subjects earning himself the nickname, the Urosoph. In the 1920s, Oswald Schwarz belonged to the inner circle of Alfred Adler, the founder of Individual Psychology, and was editor of the first psychosomatic textbook published in German, "Psychological origin and psychotherapy of physical symptoms" (1925). In addition, Schwarz wrote numerous articles and several books on sexual medicine. He also made many valuable contributions to the development of medical anthropology. Altogether, his work includes over 130 publications. Faced with the rise of fascism and National Socialism in Europe, Oswald Schwarz, who was of Jewish origin, emigrated to England in 1934. There he died in 1949. Unfortunately his scientific work has largely been forgotten. The aim of the following article is to remind us of his important contributions to the field. PMID:25537746

  13. Physicochemical properties investigations of metallic urological stent after implantation

    Directory of Open Access Journals (Sweden)

    J. Tyrlik-Held

    2008-04-01

    Full Text Available Purpose: : The aim of the work was to determine the surfaces as well as physicochemical properties changes of the metallic urological stent. The tested stent was made of Co-Cr-Ni-Fe-Mo-Mn alloy and was implanted during four years.Design/methodology/approach: Electrochemical tests have been used for corrosion resistance investigations. They were carried out in the artificial urine solution at the temperature 37±1°C with the use of the VoltaLab® PGP 201 system. The evaluation of pitting corrosion was realized by recording of anodic polarization curves with the use of the potentiodynamic method. Chemical composition investigations of the surface have been carried out with the use of X-ray Photoelectron Spectroscopy (XPS. The topography of surfaces changes was observed in scanning electron microscope (SEM.Findings: Surface observations haven’t showed the signs of pitting corrosion. No decrease of corrosion resistance for metallic material was stated. Furthermore in surface layer the presence of the organic compounds was observed.Practical implications: The time of four years of implantation didn’t induce the significant changes in electrochemical properties of metallic material of the tested stent which was in contact with the natural environment of physiological fluids.Originality/value: The results obtained concern to investigations of the metallic material of the stent, which was implanted during the period of four years in human body that mean in natural environment of human tissues and physiological fluids.

  14. [Oswald Schwarz: a pioneer in psychosomatic urology and sexual medicine].

    Science.gov (United States)

    Berberich, H J; Schultheiss, D; Kieser, B

    2015-01-01

    Oswald Schwarz, a urologist from Vienna, was a scholar of Anton Ritter von Frisch and Hans Rubritius. As a physician during World War I, he was confronted with numerous bullet wounds to the spinal cord. In 1919, he completed his professorial thesis"Bladder dysfunction as a result of bullet wounds to the spinal cord". Oswald Schwarz was known as a committed surgeon. As an urologist he also treated patients with sexual dysfunction. Besides his practical and scientific urology-related work, he was also interested in psychology and philosophy. He held lectures on both subjects earning himself the nickname, the Urosoph. In the 1920s, Oswald Schwarz belonged to the inner circle of Alfred Adler, the founder of Individual Psychology, and was editor of the first psychosomatic textbook published in German, "Psychological origin and psychotherapy of physical symptoms" (1925). In addition, Schwarz wrote numerous articles and several books on sexual medicine. He also made many valuable contributions to the development of medical anthropology. Altogether, his work includes over 130 publications. Faced with the rise of fascism and National Socialism in Europe, Oswald Schwarz, who was of Jewish origin, emigrated to England in 1934. There he died in 1949. Unfortunately his scientific work has largely been forgotten. The aim of the following article is to remind us of his important contributions to the field.

  15. Laparoscopy in Urology Practice at a Tertiary Care Centre

    International Nuclear Information System (INIS)

    Objective: To describe the results of laparoscopic procedures at a Urology - Nephrology tertiary care centre. Study Design: Case series / observational study. Place and Duration of Study: The Kidney Centre Postgraduate Training Institute, Karachi, from August 2007 to March 2012. Methodology: Medical records of all planned laparoscopic surgery conducted during the study period were reviewed. Those cases which to open surgery were excluded. All were performed by a single surgeon, initially as supervised and later independently. Data was maintained for demographic data, procedure details, length of hospital stay, and complications including conversion to open surgeries. Data was analyzed through SPSS 17.0. Results: There were 36 planned laparoscopic surgeries in the specified period. Out of 36 cases, 8 were converted to open surgery. Those who underwent laparoscopic surgery include two diagnostic procedures and renal cyst deroofing each, four ureterolithotomy, nineteen simple nephrectomy and one radical nephrectomy. So in total 28 cases were performed on 15 females and 13 males with mean age of 33.01 A +- 10.9 years. The mean operative time was 216 A +- 100 minutes and mean length of hospital stay was as 2.7 A +- 1.04 days. There were 10 complications in 28 cases, majority being Clavien Grade II including 7% (2/28) blood transfusion. Conclusion: There are technical challenges in learning laparoscopy for practicing urologists. Following some learning model in a systematic manner will help surmounting the technical challenges in learning laparoscopy. (author)

  16. Clinical aspects of antimicrobial prophylaxis for invasive urological procedures.

    Science.gov (United States)

    Mirone, Vincenzo; Franco, Marco

    2014-10-01

    The essential value of antimicrobial prophylaxis is to defend the patient undergoing invasive diagnostic procedures or surgery against infectious complications by reducing the bacterial load. Escherichia coli remains the predominant uropathogen (70-80%) isolated in acute community-acquired uncomplicated infections, followed by Staphylococcus saprophyticus (10 to 15%). Klebsiella, Enterobacter, Proteus species, and enterococci infrequently cause uncomplicated cystitis and pyelonephritis. The pathogens traditionally associated with UTI are altering many of their features, particularly because of antimicrobial resistance. Currently, only transurethral resection of prostate and prostate biopsy has been well studied and has high and moderately high levels of evidence in favor of using antibiotic prophylaxis. Other urological interventions have not been well studied. The moderate to low evidence suggests that there is no need for antibiotic prophylaxis in cystoscopy, urodynamic investigations, and extracorporeal shock-wave lithotripsy, whereas the low evidence favors the use of antibiotic prophylaxis for therapeutic ureterorenoscopy and percutaneous nephrolithotomy. The scarce data from studies on transurethral resection of bladder tumors cannot provide a definitive indication for antibiotic prophylaxis for this intervention. PMID:25245706

  17. [Pathological pelvic kidney. Apropos of 11 cases].

    Science.gov (United States)

    Benchekroun, A; Kasmaoui, E H; Jira, H; Iken, A; Nouini, Y; Benslimane, L; Faik, M

    2002-07-01

    The diseases ectopic kidney is a rare malformation. It can be associated with other urological or nonurological malformation. We report 11 cases observed between 1980 and 1998. They were five females and six males with a mean age of 28 years. The clinical symptomatology was dominated by pain and urinary symptoms. Diagnosis was based on the IVP data and ultrasonography. Renal stone and hynronephrosis were each associated in five cases and one patient had renal stone associated with hydronephrosis. The treatment consisted on a iliopelvic approach and extraction of the stone and or pyeloplasty. In three cases a nephrectomy was realised for muet kidney or pyonephrosis. The outcome was good in ten cases and one patient had a pyelo-ureteral secondary stenosis managed by endoscopy.

  18. FEMORAL MONONEUROPATHY: COMPLICATING A DIFFICULT PELVIC URETEROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    D. Mehraban

    1996-07-01

    Full Text Available Femoral mononeuropathy is a complication of gynecological and urological operations. Tlte objective of this citse report is to bring to the attention of fellow urologists the very existence of this complication and offer measures to prevent it. A 48 year old obese worman with a 2 year history of frequent left renal colics, anil a nonfunction left kidney on IVP underwent a retrograde ureterogram study anil a transvaginal ureterolithotomy, in an exaggerated lithotomy position. Postoperatively, a left leg paralysis required 3 weeks of care and encouragement to heal. To prevent this complication, avoid putting too long and too much pressure by retractors on the psoas muscles. During the abdomino-perineal procedures, frequent change of retractor site and monitoring of distal arterial pulses would he helpful. Also, do not use the exaggerated lithotomy position for an extended period of time.

  19. [Our experience in the use of prostatilen in urology].

    Science.gov (United States)

    Al'-Shukri, S Kh; Bobkov, Iu A; Gorbachev, A G; Kuz'min, I V; Tkachuk, V N

    2003-01-01

    Prostatilen was used in 1115 patients with chronic pyelonephritis and prostatitis. It is shown that prostatilen has a corrective effect on hemocoagulation and immunity disorders, restores microcirculation, suppresses inflammation in the kidney and prostate. Thus, prostatilen is a pathogenetically sound drug for treatment in urogenital inflammation while in chronic prostatitis it can be used as a basic therapy.

  20. Pelvic bone and hip joint hydatid disease revealing a retroperitoneal location

    Directory of Open Access Journals (Sweden)

    Abdelhalim El Ibrahimi

    2009-07-01

    Full Text Available Echinococcosis is a parasitic disease produced by the larval stage of Echinococcus granulosus. Hydatid disease of bone is rarely seen in humans and it has been reported in only 1-2% of cases of echinococcosis. We present a patient who developed hydatid disease of the left pelvic and femoral bones with cartilage destruction of the ipsilateral hip joint revealing a retroperitoneal location of hydatid cyst. Hydatid bone must be present in the differential diagnosis of chronic monoarthritis; the risk is to perform a total hip replacement in a septic environment.

  1. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.

    Science.gov (United States)

    Barry, M J; Fowler, F J; O'Leary, M P; Bruskewitz, R C; Holtgrewe, H L; Mebust, W K; Cockett, A T

    1992-11-01

    A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach's alpha = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects' global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p < 0.001). The AUA symptom index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols.

  2. Clinical Holistic Medicine: Holistic Sexology and Acupressure Through the Vagina (Hippocratic Pelvic Massage

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2006-01-01

    Full Text Available Many gynecological and sexological problems (like urine incontinence, chronic pelvic pains, vulvodynia, and lack of lust, excitement, and orgasm are resistant to standard medical treatment. In our work at the Research Clinic for Holistic Medicine in Copenhagen, we have found that vaginal acupressure, or Hippocratic pelvic massage, can help some of these problems. Technically, it is a very simple procedure as it corresponds to the explorative phase of the standard pelvic examination, supplemented with the patient's report on the feelings it provokes and the processing and integration of these feelings. Sometimes it can be very difficult to control the emotions released by the technique, i.e., regression to earlier traumas from childhood sexual abuse. This review discusses the theory behind vaginal acupressure, ethical aspects, and presentation of a case story. This procedure helped the patient to become present in her pelvis and to integrate old traumas with painful emotions. Holistic gynecology and sexology can help the patient to identify and let go of negative feelings, beliefs, and attitudes related to sex, gender, sexual organs, body, and soul at large. Shame, guilt, helplessness, fear, disgust, anxiety, anger, hatred, and other strong feelings are almost always an important part of a sexual or functional problem as these feelings are “held” by the tissue of the pelvis and sexual organs. Acupressure through the vagina/pelvic massage must be done with great care by an experienced physician, with a third person present, after obtaining consent and the necessary trust of the patient. It must be followed by conversational therapy and further holistic existential processing.

  3. Laparoscopic pelvic sling placement facilitates optimum therapeutic radiotherapy delivery in the management of pelvic malignancy.

    LENUS (Irish Health Repository)

    Joyce, M

    2012-02-01

    BACKGROUND: Radiotherapy has a significant role in the management of pelvic malignancies. However, the small intestine represents the main dose limiting organ. Invasive and non-invasive mechanical methods have been described to displace bowel out of the radiation field. We herein report a case series of laparoscopic placement of an absorbable pelvic sling in patients requiring pelvic radiotherapy. METHODS: Six patients were referred to our minimally invasive unit. Four patients required radical radiotherapy for localised prostate cancer, one was scheduled for salvage localised radiotherapy for post-prostatectomy PSA progression and one patient required adjuvant radiotherapy post-cystoprostatectomy for bladder carcinoma. All patients had excessive small intestine within the radiation fields despite the use of non-invasive displacement methods. RESULTS: All patients underwent laparoscopic mesh placement, allowing for an elevation of small bowel from the pelvis. The presence of an ileal conduit or previous surgery did not prevent mesh placement. Post-operative planning radiotherapy CT scans confirmed displacement of the small intestine allowing all patients to receive safely the planned radiotherapy in terms of both volume and radiation schedule. CONCLUSION: Laparoscopic mesh placement represents a safe and efficient procedure in patients requiring high-dose pelvic radiation, presenting with unacceptable small intestine volume in the radiation field. This procedure is also feasible in those that have undergone previous major abdominal surgery.

  4. Trans-vaginal total pelvic floor repair using customized prolene mesh: A safe and cost-effective approach for high-grade pelvic organ prolapse

    OpenAIRE

    Chaturvedi, Samit; Bansal, Rajesh; Ranjan, Priyadarshi; Ansari, M. S.; Kapoor, Deepa; Kapoor, Rakesh

    2012-01-01

    Aims: To assess safety, efficacy, and cost-effectiveness of trans-vaginal total pelvic floor repair with customized prolene mesh in patients with high-grade pelvic organ prolapse. Materials and Methods: A total of 32 patients, who underwent trans-vaginal total pelvic floor repair using a customized prolene mesh from January 2007 to June 2010 for grade III and IV pelvic organ prolapse, were analyzed retrospectively. Prolapse was graded using Pelvic Organ Prolapse Quantification system of Inter...

  5. Current status of robot-assisted laparoscopic surgery in pediatric urology.

    Science.gov (United States)

    Song, Sang Hoon; Kim, Kun Suk

    2014-08-01

    Laparoscopic procedures for urological diseases in children have been proven to be safe and effective. However, the availability of laparoscopic procedures is still partly limited to experienced, high-volume centers because the procedures are technically demanding. The da Vinci robot system is being used for an increasing variety of reconstructive procedures because of the advantages of this approach, such as motion scaling, greater optical magnification, stereoscopic vision, increased instrument tip dexterity, and tremor filtration. Particularly in pediatric urologic surgery, where the operational field is limited owing to the small abdominal cavity of children, robotic surgical technology has its own strengths. Currently, robots are used to perform most surgeries in children that can be performed laparoscopically. In this review, we aimed to provide a comprehensive overview of the current role of robot-assisted laparoscopic surgery in Pediatric Urology by analyzing the published data in this field. A growing body of evidence supports the view that robotic technology is technically feasible and safe in pediatric urological surgery. Robotic technology provides additional benefits for performing reconstructive urologic surgery, such as in pyeloplasty, ureteral reimplantation, and enterocystoplasty procedures. The main limitations to robotic surgery are its high purchase and maintenance costs and that the cost-effectiveness of this technology remains to be validated. PMID:25132942

  6. Robot-assisted urologic surgery in 2010 - Advancements and future outlook

    Directory of Open Access Journals (Sweden)

    Paurush Babbar

    2011-01-01

    Full Text Available Robotic surgery is a cutting edge and minimally invasive procedure, which has generated a great deal of excitement in the urologic community. While there has been much advancement in this emerging technology, it is safe to say that robotic urologic surgery holds tremendous potential for progress in the near future. Hence, it is paramount that urologists stay up-to-date regarding new developments in the realm of robotics with respect to novel applications, limitations and opportunities for incorporation into their practice. Robot-assisted surgery provides an enhanced 3D view, increased magnification of the surgical field, better manual dexterity, relatively bloodless field, elimination of surgeon′s tremor, reduction in a surgeon′s fatigue and mitigation of scattered light. All these factors translate into greater precision of surgical dissection, which is imperative in providing better intraoperative and postoperative outcomes. Pioneering work assessing the feasibility of robotic surgery in urology began in the early 2000′s with robot-assisted radical prostatectomy and has since expanded to procedures such as robot-assisted radical cystectomy, robot-assisted partial nephrectomy, robot-assisted nephroureterectomy and robot-assisted pyeloplasty. A MEDLINE search was used to identify recent articles (within the last two years and publications of specific importance, which highlighted the recent developments and future direction of robotics. This review will use the aforementioned urologic surgeries as vehicles to evaluate the current status and future role of robotics in the advancement of the field of urology.

  7. Perineal elevator for postoperative pelvic irradiation

    International Nuclear Information System (INIS)

    A styrofoam block has been used to push or elevate the posterior perineal tissues in a cephalad direction in 5 male patients receiving radiation therapy following abdomino-perineal resection for rectal adenocarcinoma. Following abdomino-perineal resection for rectal adenocarcinoma, the posterior perineum is frequently pendulous, particularly in male patients. In order to include the perineal scar and adjacent tissues in the irradiated volume, the caudal edge of the radiation fields is extended caudally. The external genitalia are frequently within the extended radiation field. A technique has been developed that pushes or elevates the perineum 3-5 cm cephalad during pelvic irradiation

  8. Magnetic Resonance of Pelvic and Gastrointestinal Emergencies.

    Science.gov (United States)

    Wongwaisayawan, Sirote; Kaewlai, Rathachai; Dattwyler, Matthew; Abujudeh, Hani H; Singh, Ajay K

    2016-05-01

    Magnetic resonance (MR) imaging is gaining increased acceptance in the emergency setting despite the continued dominance of computed tomography. MR has the advantages of more precise tissue characterization, superior soft tissue contrast, and a lack of ionizing radiation. Traditional barriers to emergent MR are being overcome by streamlined imaging protocols and newer rapid-acquisition sequences. As the utilization of MR imaging in the emergency department increases, a strong working knowledge of the MR appearance of the most commonly encountered abdominopelvic pathologies is essential. In this article, MR imaging protocols and findings of acute pelvic, scrotal, and gastrointestinal pathologies are discussed. PMID:27150327

  9. [Posttraumatic adhesive ileus following pelvic ring fracture].

    Science.gov (United States)

    Kusmenkov, T; Kasparek, M S; Brumann, M; Bogner, V; Mutschler, W

    2015-09-01

    We report on two cases of posttraumatic ileus after pelvic ring fracture in two patients aged 73 and 74 years, respectively. Although all conservative measures were exhausted, in both cases the ileus resulted in additional operative procedures and a significant extension of the hospital stay. Intraoperatively both patients presented with a mechanical ileus caused by adhesions which were unapparent for decades. Only the trauma-related motility disorder led to a clinical manifestation. Pathophysiological mechanisms and their implications on prophylaxis and therapy are discussed. PMID:25432671

  10. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  11. [Ancient urology in the Kingdom of Valencia. Height and declivity].

    Science.gov (United States)

    López Alcina, E; Pérez Albacete, M; Canovas Ivorra, J A

    2007-03-01

    During the second half of the XVIth century the interest of the clinicians moves towards the venereal ailments and the urethral carnosities (narrowness) to the detriment of the litiasic processes. They are of special relevancy for us, in the period summit of the medical sciences in Valencian lands, Miguel Juan Pascual who in his work "Morborum internorum" (1555) there synthesizes everything known on the syphilis in this epoch, its origin, diagnosis and treatment, Juan Calvo considered one of the best surgeons of the XVIth century and Miguel de Leriza author of the "Tractatus of the way of treating the carnosities and corns of the route of the urine". The baroque was an epoch of general crisis in Spain and in the ancient Kingdom of Valencia, specially clear in fields as the anatomy and the surgery. The serious decadence that suffered during these years the scientific Valencian production turns out to be evident. Not even an alone anatomical text was published in the first half of the XVIIth century, whereas in the surgical area the "Summary of everything about the theoretical and practice of Surgery", of Alonso Romano can be considered deigns of mention. The illustration brought new reformists airs and around the flourishing scientific academies, there congregated the most select of the Valencian intellectuality. Andres Piquer Arrufat is considered to be the maximum figure of the Valencian medicine of this period. Not even after the war of independence and the reign of Fernando VII who died in 1833 when there sit down the bases of the modern urology and the consolidation as speciality at the end of the XIXth. The Valencian principal figures of this period are Miguel Más y Soler, Alejandro Settler and especially Rafael Mollá y Rodrigo. PMID:17658148

  12. Managed care and its impact on American urology.

    Science.gov (United States)

    Holtgrewe, H L

    1998-05-01

    America's health care is undergoing a revolution. A previous private, fee-for-service, delivery system chiefly centered around hospital specialty care is rapidly being replaced by a commercialized system of managed care, controlled by businessmen whose prime motive is profit. Increasing emphasis of these managed care organizations is upon primary physicians who function as gatekeepers. While this new commercialized method of health care has been attended with reductions in the previous omnipresent health care inflation our country has experienced for the past several decades, its impact on quality of care and patient choice of physician remain a great concern. Especially vulnerable in this new system are our nation's academic centers, which, burdened with responsibility for education and research, are at a disadvantage in the competitive cost-based bidding for managed care contracts. Urology work force issues and the number of urologists in our nation remain another concern for urologists as they compete for access to patients in this new highly competitive environment. In a 1995 survey of a cohort of urologists in seven states, the respondents reported 35.8% of gross income came from managed care contracts, 86% reported the need for preservice approval for many diagnostic and therapeutic undertakings, 87% reported an inability to refer complex cases outside the Managed Care Organization (MCO) network, and 23% reported they were required to retain patients for treatment who they would have otherwise referred to a more qualified urologist. The majority of American urologists are reporting dropping gross revenues and increasing overhead in their dealings with managed care contracts. The advent of managed care is being attended with dropping gross revenues, increasing overhead costs and interference with the practice patterns of American urologists.

  13. Subpubic Cartilaginous Pseudocyst: Orthopedic Feature with Urological Consequences

    Directory of Open Access Journals (Sweden)

    Fawzy Farag

    2014-01-01

    Full Text Available Introduction. Masses arising from structures adjacent to the female urethra can cause obstructive urinary symptoms. Subpubic cartilaginous pseudocyst is a rare degenerative lesion of pubic symphysis that may cause these symptoms. Materials and Methods. A 61-year- and 57-year-old women presented with symptoms of difficult micturition and dyspareunia. Physical examination revealed a painless smooth, rounded, firm, and cystic mass, at the anterior vaginal wall of about 4 cm width. The mass caused inward deviation of the external urethral meatus. Cystoscopy and MRI were done. Results. Cystoscopy of case 1 (61 y demonstrated anterior external urethral compression with normal urethral mucosa. Cystoscopy was not possible in case 2 (57 y because the urethra could not be entered under local anesthesia. MRI showed almost the same findings in both cases: midline, rounded, and cystic mass ~3×3×4 cm, anterosuperior to the urethra, and posteroinferior to the pubic symphysis, with normal features of the urinary bladder. Open surgical excision of theses lesions was performed in both patients. Histopathologic assessment of the specimen obtained from both patients showed degenerated hyaline with areas of fibrinous and mucoid degeneration, a picture suggestive of cartilaginous subpubic pseudocyst. After 11-month and 4-month followup of patients numbers 1 and 2, respectively, there is no evidence of local recurrence of the lesion, either clinically or radiologically and both patients void empty. Conclusions. Subpubic cartilaginous pseudocysts are rare benign lesions with only 13 cases were reported in the literature. Patients present with a spectrum of gynecological and/or urological manifestations. Sizable lesions severely compressing the urethra need surgical excision to restore the voiding function.

  14. Pregnancy Related Low Back and Pelvic Pain: a surgical approach

    NARCIS (Netherlands)

    C.M.A. Zwienen

    2005-01-01

    textabstractMore than half of all pregnant women experience low back and/or pelvic pain of whom one-third has severe complaints. In most cases the pelvic pain disap­pears within a few months after delivery, either spontaneously or after con­servative treatment. In a minority of patients the pain per

  15. Objective Measures for Pregnancy Related Low Back and Pelvic Pain

    NARCIS (Netherlands)

    M. de Groot (Mirthe)

    2005-01-01

    textabstractPain in the lumbar spine and pelvic region is a frequent complication of pregnancy and delivery. The prevalence of pregnancy related low back and pelvic pain (PLBP) varies between 14.2 and 56%. In 6 to 15% the pain is so severe that it impedes daily life activities. The symptoms of PL

  16. Ultrasound-guided drainage of deep pelvic abscesses

    DEFF Research Database (Denmark)

    Lorentzen, Torben; Nolsøe, Christian; Skjoldbye, Bjørn

    2011-01-01

    The aim of this study was to demonstrate and evaluate the ultrasound-guided drainage of deep pelvic abscesses in which transabdominal percutaneous access could not be performed because of overlying structures. A retrospective analysis of 32 consecutive patients with 33 deep pelvic abscesses was p...

  17. Aggressive angiomyxoma in female pelvic cavity : a case report

    International Nuclear Information System (INIS)

    Aggressive angiomyxoma is a rare neoplasm occuring in the female pelvic cavity or perineum, and tends to recur. The radiographic findings of angiomyxoma have not been previously reported in Korea; we describe a case of aggressive angiomyxoma in the female pelvic cavity, with emphasis on the pathologic and radiologic findings, and review the literature. (author). 10 refs., 4 figs

  18. Aggressive angiomyxoma in female pelvic cavity : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Eo, Geun; Hwang, Ho Kyung; Kim, Jang Min; Kim, Young Sun; Lee, Jung Hee; Lee, Don Young [Kwangmyung Sungae Hospital, Kwangmyung (Korea, Republic of)

    1998-04-01

    Aggressive angiomyxoma is a rare neoplasm occuring in the female pelvic cavity or perineum, and tends to recur. The radiographic findings of angiomyxoma have not been previously reported in Korea; we describe a case of aggressive angiomyxoma in the female pelvic cavity, with emphasis on the pathologic and radiologic findings, and review the literature. (author). 10 refs., 4 figs.

  19. Pelvic actinomycosis associated with intrauterine device use: case report

    Energy Technology Data Exchange (ETDEWEB)

    Alfuhaid, T. [Dept. of Medical Imaging, Univ. Health Centre and Mount Sinai Hospital, Toronto General Hospital, Toronto, Ontario (Canada); Reinhold, C. [Radiology, Gastroenterology and Gynecology, McGill Univ. Health Centre, Montreal General Hospital, Montreal, Quebec (Canada)

    2003-06-01

    Pelvic actinomycosis is a rare disease that may complicate longstanding intrauterine device (IUD) use. Its timely recognition is crucial to minimize morbidity and avoid the erroneous diagnosis of malignancy with subsequent, unnecessary surgery. We describe a case of pelvic actinomycosis. The role of magnetic resonance imaging (MRI) in recognizing this infectious disease process is stressed. (author)

  20. Diagnosis and treatment of rare complications of pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    Zhao-Wen Zong; Quan-wei Bao; Hua-Yu Liu; Yue Shen; Yu-Feng Zhao; Xiang Hua; Qing-Shan Guo

    2016-01-01

    Purpose:To enhance the awareness of rare complications of pelvic fracture and describe the correct diagnosis and effective treatment.Methods:A total of 188 cases of pelvic fractures were retrospectively reviewed,and four patients who suffered from four types of rare pelvic fracture complications were described,namely ureteral obstruction caused by retroperitoneal hematoma-induced abdominal compartment syndrome (ACS),bowel entrapment,external iliac artery injury,and open scrotal sac injury.Results:We demonstrated that combined measures should be employed to prevent the occurrence of ACS following major pelvic fractures.Ureteral catheter support may be a good option at an early stage when ACS occurred.Contrasted computed tomography examination and sufficient awareness are keys to a correct diagnosis of bowel entrapment following pelvic fractures.Recognition of risk factors,early diagnosis,and prompt treatment of suspected injury of the external iliac artery are keys to patient survival and to avoid limb loss.Scrotal and/or testicular injury complicated by pelvic fractures should be carefully treated to maintain normal gonad function.Additionally, establishment of a sophisticated trauma care system and multi-disdplinary coordination are important for correct diagnosis and treatment of rare complications in pelvic fractures.Conclusions:Rare complications of pelvic fractures are difficult to diagnose and negatively impact outcome.Recognition of risk factors and sufficient awareness are essential for correct diagnosis and prompt treatment.

  1. Does pelvic injury trigger erectile dysfunction in men?

    Institute of Scientific and Technical Information of China (English)

    H.Hüseyin Ceylan; Ersin Kuyucu; Remzi Erdem; G(o)khan Polat; Ferit Y(i)lmaz; Bilal Gümü(s); Mehmet Erdil

    2015-01-01

    Purpose:Pelvic ring fractures constitute 3%-8% of all fractures of the skeletal system and are generally related with high energy trauma.Sexual dysfunction following pelvic fracture has a high incidence,and affects the male patients both physically and psychologically.In this study,we aimed to investigate the impact and frequencies of comorbidities such as erectile dysfunction (ED) with adverse sociocultural and psychological consequences for the patient who had a pelvic ring fracture.Methods:This study included 26 men who corresponded to the inclusion criteria and agreed to participate our study.Results:According to fracture types,most of our cases were Tile type A1 and type A2.Severe and moderate ED were detected in 46.1% (12/26) of these patients via the International Index of Erectile Function-5 questionnaire.Conclusion:ED develops following pelvic fractures,especially in Tile type B and C pelvic fractures.

  2. Effect of pelvic floor muscle exercises on pulmonary function.

    Science.gov (United States)

    Han, DongWook; Ha, Misook

    2015-10-01

    [Purpose] This study aimed to determine the correlation between pelvic floor muscle strength and pulmonary function. In particular, we examined whether pelvic floor muscle exercises can improve pulmonary function. [Subjects] Thirty female college students aged 19-21 with no history of nervous or musculoskeletal system injury were randomly divided into experimental and control groups. [Methods] For the pulmonary function test, spirometry items included forced vital capacity and maximal voluntary ventilation. Pelvic floor muscle exercises consisted of Kegel exercises performed three times daily for 4 weeks. [Results] Kegel exercises performed in the experimental group significantly improved forced vital capacity, forced expiratory volume in 1 second, PER, FEF 25-75%, IC, and maximum voluntary ventilation compared to no improvement in the control group. [Conclusion] Kegel exercises significantly improved pulmonary function. When abdominal pressure increased, pelvic floor muscles performed contraction at the same time. Therefore, we recommend that the use of pelvic floor muscle exercises be considered for improving pulmonary function. PMID:26644681

  3. 当归芍药散对慢性盆腔炎大鼠外周血Th、 Tc细胞和NO、 IL-4、 IL-10的影响%Effect of Danggui Shaoyao San on Th, Tc Cells and Nitric Oxide, Interleukin-4, Interleukin-10 Levels in Peripheral Blood of Rats with Chronic Pelvic Inflammatory Disease

    Institute of Scientific and Technical Information of China (English)

    高升; 高飞; 闫亚楠; 任存霞

    2016-01-01

    目的:从T细胞亚群及细胞因子的角度探究当归芍药散对慢性盆腔炎大鼠模型的作用机制。方法采用混合菌感染合并机械损伤法制备慢性盆腔炎大鼠模型。60只雌性大鼠随机分为正常组,模型组,金刚藤胶囊组,当归芍药散高、中、低剂量组。用药14 d后,观察子宫病理组织改变;流式细胞术测定外周血CD3、CD4、 CD8细胞,辅助性淋巴细胞(Th细胞),细胞毒性淋巴细胞(Tc细胞)数量百分比;测定血清中一氧化氮(NO)、白细胞介素(IL)-4、 IL-10的含量。结果光学显微镜观察显示,当归芍药散高、中剂量组可以降低大鼠子宫内膜的炎症细胞浸润,促进病变上皮细胞增生修复;当归芍药散高、中剂量组可以显著升高Th细胞、CD3细胞、 CD4细胞以及Th/Tc、 CD4/CD8比值(P<0.01, P<0.05),降低Tc细胞、 CD8细胞(P<0.01, P<0.05);当归芍药散高、中剂量组可以显著升高IL-4、 IL-10含量,降低NO含量(P<0.05);与金刚藤胶囊组比较,高剂量组显著升高IL-4含量(P<0.01),降低NO含量(P<0.05)。结论当归芍药散可能通过改善免疫状态,降低炎症反应以发挥治疗慢性盆腔炎的作用。%ObjectiveTo explore the therapeutic mechanism ofDangguiShaoyaoSan(DSS)in treating chronic pelvic inflammatory disease(CPID)through observation of T-cell subsets and cytokines.MethodsRat model of CPID was established by mixed bacterial infection and mechanical damage. Sixty female rats were randomized into normal group,model group,Jingangtengcapsule group,and high-,medium-,and low-dose DSS groups. After treatment for 14 days,pathological features of the uterus were observed,the percentage of CD3,CD4,CD8 cells as well as helper T lymphocytes(Th),cytotoxic T lymphocytes(Tc)in peripheral blood was measured by flow cytometry,and the levels of nitric oxide(NO),interleukin-4(IL-4)and IL-10 in the blood

  4. Irritable bowel syndrome in women with chronic pelvic pain in a Northeast Brazilian city Síndrome do intestino irritável em mulheres com dor pélvica crônica em uma cidade do Nordeste Brasileiro

    Directory of Open Access Journals (Sweden)

    Lígia Maria Montenegro Lessa

    2013-02-01

    Full Text Available PURPOSES: To determine the prevalence of irritable bowel syndrome (IBS in women with chronic pelvic pain (CPP and its associated features; to determine whether IBS and CPP constitute the same syndrome. METHODS: Cross-sectional population survey with systematic sequential sampling according to census districts in which 1470 women were interviewed with respect to the sample calculation. The participants resided in their own homes, were at least 14 years of age, experienced menarche and presented CPP according to the American College of Obstetrics and Gynaecology. The dependent variable was IBS based on Rome III criteria in women with CPP, and the following independent variables were possibly associated with IBS: age, schooling, duration of pain, sedentary lifestyle, migraine, depression, insomnia, back pain, dysmenorrhea, dyspareunia, depression, history of violence, and intestinal symptoms. The sample was subdivided into groups with and without IBS. After the descriptive analysis of the variables was performed, the respective frequencies were evaluated using GraphPad Prism 5 software. To evaluate the association between the dependent variable and the independent variables, the χ² test was used with a significance level of 5%. RESULTS: The prevalence of IBS in women with CPP was 19,5%. Pain duration (p=0.03, back pain (p=0.002, history of physical or sexual abuse (p=0.002, and intestinal complaints were more prevalent in the group with IBS and CPP. There was no difference between the groups regarding other criteria. CONCLUSION: The data confirmed the literature, identified several aspects that were shared between the pathologies and supported the hypothesis that both pathologies can constitute the same syndrome.OBJETIVOS: Verificar a prevalência da síndrome do intestino irritável (SII em mulheres com dor pélvica crônica (DPC e as características associadas; analisar se SII e DPC constituem a mesma síndrome. MÉTODOS: Estudo transversal do

  5. Detection and Isolation of Circulating Tumor Cells in Urologic Cancers: A Review

    Directory of Open Access Journals (Sweden)

    Robert D. Loberg

    2004-07-01

    Full Text Available The American Cancer Society has estimated that in 2003, there will be approximately 239,600 new cases of urologic cancer diagnosed and 54,600 urologic cancer-related deaths in the United States. To date, the majority of research and therapy design have focused on the microenvironment of the primary tumor site, as well as the microenvironment of the metastatic or secondary (target tumor site. Little attention has been placed on the interactions of the circulating tumor cells and the microenvironment of the circulation (i.e., the third microenvironment. The purpose of this review is to present the methods for the detection and isolation of circulating tumor cells and to discuss the importance of circulating tumor cells in the biology and treatment of urologic cancers.

  6. Penile Rehabilitation after Pelvic Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Erectile dysfunction is the most common complication after pelvic radical surgery. Rehabilitation programs are increasingly being used in clinical practice but there is no high level of evidence supporting its efficacy. The principle of early penile rehabilitation stems from animal studies showing early histological and molecular changes associated with penile corporal hypoxia after cavernous nerve injury. The concept of early penile rehabilitation was developed in late nineties with a subsequent number of clinical studies supporting early pharmacologic penile rehabilitation. These studies included all available phosphodiesterase type 5 inhibitors, intracavernosal injection and intraurethral use of prostaglandin E1 and to lesser extent vacuum erectile devices. However, these studies are of small number, difficult to interpret, and often with no control group. Furthermore, no studies have proven an in vivo derangement of endothelial or smooth muscle cell metabolism secondary to a prolonged flaccid state. The purpose of the present report is a synthetic overview of the literature in order to analyze the concept and the rationale of rehabilitation program of erectile dysfunction following radical pelvic surgery and the evidence of such programs in clinical practice. Emphasis will be placed on penile rehabilitation programs after radical cystoprostatectomy, radical prostatectomy, and rectal cancer treatment. Future perspectives are also analyzed.

  7. [From "Karzinos" to modern urologic oncology : A long way from the first surgical procedures to targeted therapy].

    Science.gov (United States)

    Konert, J

    2016-08-01

    Cancer can be traced back to the Iron Age. Both the ancient Egyptians and Hippocrates dealt with the disease. Urological tumor treatment is an integral part of urology and has undergone interesting developments. Today, it comprises all possible forms of treatment-from radical surgery to the most modern radiological therapies, including antihormal therapy, chemotherapy, and modern targeted therapy. PMID:27422312

  8. 78 FR 41937 - Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the...

    Science.gov (United States)

    2013-07-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Joint Meeting of the Gastroenterology-Urology Panel and the... the public. Name of Committee: Gastroenterology-Urology Panel and Radiological Devices Panel of...

  9. Evaluation of urologic morbidity after radiotherapy for cervical carcinoma by urodynamic examinations and patient voiding schemes: a prospective study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranov, Ingrid R; Bagi, Per;

    2002-01-01

    To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma.......To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma....

  10. Effectiveness and complications of pelvic circumferential compression devices in patients with unstable pelvic fractures: A systematic review of literature

    NARCIS (Netherlands)

    W.R. Spanjersberg (Willem); S.P. Knops (Simon); N.W.L. Schep (Niels); E.M.M. van Lieshout (Esther); P. Patka (Peter); I.B. Schipper (Inger)

    2009-01-01

    textabstractBackground: Pelvic fractures can cause massive haemorrhage. Early stabilisation and compression of unstable fractures is thought to limit blood loss. Reposition of fracture parts and reduction of pelvic volume may provide haemorrhage control. Several non-invasive techniques for early sta

  11. Effectiveness and complications of pelvic circumferential compression devices in patients with unstable pelvic fractures: a systematic review of literature.

    NARCIS (Netherlands)

    Spanjersberg, W.R.; Knops, S.P.; Schep, N.W.; Lieshout, E.M. van; Patka, P.; Schipper, I.B.

    2009-01-01

    BACKGROUND: Pelvic fractures can cause massive haemorrhage. Early stabilisation and compression of unstable fractures is thought to limit blood loss. Reposition of fracture parts and reduction of pelvic volume may provide haemorrhage control. Several non-invasive techniques for early stabilisation h

  12. Do women with pelvic floor dysfunction referred by gynaecologists and urologists at hospitals complete a pelvic floor muscle training programme?

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Dehlendorff, Christian

    2013-01-01

    For decades women with pelvic floor dysfunction (PFD) have been referred to pelvic floor muscle training (PFMT), but there is only little information on whether the women complete the programmes and why. The objectives of this study were to investigate to which extent women completed a PFMT...

  13. Pelvic floor muscle training as a persistent nursing intervention: Effect on delivery outcome and pelvic floor myodynamia

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2014-03-01

    Conclusion: Persistent nursing intervention for pregnant/postpartum women helped to shorten the second stage of labour and contributed to the recovery of postpartum pelvic floor myodynamia. The influence of this intervention on the delivery mode, and rates of episiotomy and perineal laceration remains unknown. Medical staff should strengthen health education programmes that involve pelvic floor functional rehabilitation.

  14. [Use of Intramag devices with Intraterm and LAST-02 attachments in complex therapy of chronic prostatitis].

    Science.gov (United States)

    Shaplygin, L V; Begaev, A I; V'iushina, V V

    2006-01-01

    The examination of the patients exposed to physical factors (magnetotherapy, laser therapy and thermotherapy) has demonstrated that Intramag unit with attachments Intraterm and LAST-02 for local physiotherapy is effective in patients with chronic prostatitis and can be used in urological hospitals and outpatient clinics. PMID:17058682

  15. From Leonardo to da Vinci: the history of robot-assisted surgery in urology.

    Science.gov (United States)

    Yates, David R; Vaessen, Christophe; Roupret, Morgan

    2011-12-01

    What's known on the subject? and What does the study add? Numerous urological procedures can now be performed with robotic assistance. Though not definitely proven to be superior to conventional laparoscopy or traditional open surgery in the setting of a randomised trial, in experienced centres robot-assisted surgery allows for excellent surgical outcomes and is a valuable tool to augment modern surgical practice. Our review highlights the depth of history that underpins the robotic surgical platform we utilise today, whilst also detailing the current place of robot-assisted surgery in urology in 2011. The evolution of robots in general and as platforms to augment surgical practice is an intriguing story that spans cultures, continents and centuries. A timeline from Yan Shi (1023-957 bc), Archytas of Tarentum (400 bc), Aristotle (322 bc), Heron of Alexandria (10-70 ad), Leonardo da Vinci (1495), the Industrial Revolution (1790), 'telepresence' (1950) and to the da Vinci(®) Surgical System (1999), shows the incredible depth of history and development that underpins the modern surgical robot we use to treat our patients. Robot-assisted surgery is now well-established in Urology and although not currently regarded as a 'gold standard' approach for any urological procedure, it is being increasingly used for index operations of the prostate, kidney and bladder. We perceive that robotic evolution will continue infinitely, securing the place of robots in the history of Urological surgery. Herein, we detail the history of robots in general, in surgery and in Urology, highlighting the current place of robot-assisted surgery in radical prostatectomy, partial nephrectomy, pyeloplasty and radical cystectomy.

  16. Food and Drug Administration process for development and approval of drugs and radiopharmaceuticals: treatments in urologic oncology.

    Science.gov (United States)

    Ning, Yang-Min; Maher, V Ellen

    2015-03-01

    Regulatory advice and assessment play an important role in the successful development of new drugs and radiopharmaceuticals for the treatment of urologic malignancies. Cooperation between the US Food and Drug Administration (FDA) and the pharmaceutical industry has led to the approval of more than 20 new urologic oncology products in the last 2 decades. Despite these advances, more effective treatments need to be developed and approved for the treatment of urologic malignancies. This review provides general information about the FDA's role in the development of investigational new drugs, with an emphasis on the regulatory process and the requirements for marketing approval. In addition, this review summarizes the products for the treatment of urologic malignancies that were approved by the FDA in the last 30 years and the key issues concerning urologic oncology products that were discussed publicly at Oncologic Drug Advisory Committee meetings in the past 10 years.

  17. [Comparative study of two protocols of antibiotic prophylaxis in endoscopic urologic surgery].

    Science.gov (United States)

    Lepage, J Y; Malinowsky, J M; Cozian, A; Viers, M F; Rolland, M T; Péron, M; Souron, R; Baron, D

    1990-06-01

    We report an open, prospective, randomized and double-blind study which compared two groups of patients without preoperative bacteriuria, undergoing transurethral urologic surgery. A first group received cefazoline 3 g perioperatively and a second group a single preoperative dose of cefotiam 1 g. A hundred patients were included in each group which were well matched on all essential characteristics, risk factors, surgery, anesthesia and postoperative temperature. The incidence of postoperative infection (bacteriemia and bacteriuria) was the same in both groups (16%). It is concluded that in transurethral urologic surgery performed in patients without preoperative bacteriuria, 1 preoperative dose cefotiam is as efficacious as 3 perioperative doses cefazoline.

  18. Infrequent Reservoir‐Related Complications of Urologic Prosthetics: A Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Tao Cui, MD

    2015-12-01

    Conclusion: Complications involving urologic prosthesis reservoirs, although rare, can have serious implications for patients. A high index of suspicion and familiarity with treatment options is required in order to allow timely diagnosis and appropriate treatment. Patients with prior major abdominal surgeries seem to be more prone to intestinal complications of reservoirs and warrant special concern. Cui T, Terlecki R, and Mirzazadeh M. Infrequent reservoir‐related complications of urologic prosthetics: A case series and literature review. Sex Med 2015;3:334–338.

  19. Prospective investigation of change in the prostate-specific antigens after various urologic procedures

    Directory of Open Access Journals (Sweden)

    Park SC

    2015-07-01

    Full Text Available Seung Chol Park,1 Yu Seob Shin,2 Li Tao Zhang,2 Dal Sik Kim,3 Sung Zoo Kim,4 Nam Cheol Park,5 Tai Young Ahn,6 Je Jong Kim,7 Sung Won Lee,8 Insuk So,9 Jong Kwan Park2,10,11 1Department of Urology, Wonkwang University School of Medicine and Hospital, Iksan, South Korea; 2Department of Urology, 3Department of Laboratory Medicine, 4Department of Physiology, Medical School, Institute for Medical Sciences, Chonbuk National University, Jeonju, 5Department of Urology, College of Medicine, Pusan National University Hospital, Busan, 6Department of Urology, College of Medicine, Ulsan University, Seoul, 7Department of Urology, College of Medicine, Korea University, Seoul, 8Department of Urology, Samsung Medical Center, College of Medicine, SungKyunkwan University, Seoul, 9Department of Physiology, College of Medicine, Seoul National University, Seoul, 10Research Institute of Clinical Medicine, Chonbuk National University, 11Biomedical Research Institute and Clinical Trial Center, Chonbuk National University Hospital, Jeonju, South KoreaPurpose: Prostate-specific antigen (PSA is the most important marker in the diagnosis and follow-up of patients with prostate cancer. The primary objective of this study was to evaluate the effect of various urologic procedures in prostatic area on serum free and total PSA levels.Subjects and methods: A series of 62 patients (8 after digital rectal examination [DRE], 12 after transrectal ultrasonography [TRUS], 11 after rigid cystoscopy, 13 after prostatic massage, 8 after TRUS-guided prostate biopsy, and 10 after transurethral resection of prostate [TURP] were enrolled in the study. Blood samples were taken from each patient before procedure and at 10, 30, 60, and 120 minutes after procedures.Results: Prostate massage, rigid cystoscopy, TURP, and TRUS-guided prostate biopsy caused statistically significant rise in total and free PSA levels in the serum. There was no significant increase in total and free PSA levels in the

  20. Classics of urology: a half century history of the most frequently cited articles (1955-2009).

    Science.gov (United States)

    Heldwein, Flavio Lobo; Rhoden, Ernani Luis; Morgentaler, Abraham

    2010-06-01

    To identify and characterize the most frequently cited articles published in Journals dedicated to Urology over the last 50 years. A Pubmed search was performed of all articles published in the 13 most cited urological journals between 1955 and 2009. Articles with more than 100 citations were identified as "classic", and were analyzed further. Of 97,554 articles published during this time, 1239 articles were cited more than 100 times. The most common topic among classic articles was prostate cancer and prostate-specific antigen (33.5%), followed by bladder cancer and benign prostatic hyperplasia. A further analysis was performed for the 50 most frequently cited articles ("top-50").

  1. AB271. Sexual dysfunction in chronic prostatitis

    Science.gov (United States)

    Cho, In-Rae

    2016-01-01

    Chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a clinical syndrome characterized by genital/ pelvic pain and lower urinary tract symptoms in the absence of urinary tract infection. CPPS is the most common prostatic disease in men younger than 50 years of age and the third most common in men older than 50 years of age. CP/CPPS is a complex entity with unclear etiology. Many articles reported that the high percentage of patients with CP/CPPS had sexual dysfunction. The most common symptoms of sexual dysfunction in chronic prostatitis patients are erectile dysfunction (ED), painful ejaculation and premature ejaculation. So we will discuss about ED and ejaculation problems in CP/CPPS patients.

  2. Urological complications after radical hysterectomy: Incidence rates and predisposing factors

    Directory of Open Access Journals (Sweden)

    Likić-Lađević Ivana

    2007-01-01

    Full Text Available Bacground/Aim. Radical hysterectomy is a surgical approach for stage Ib and IIa of cervical cancer. The incidence of intraoperative injuries of the bladder during radical hysterectomy ranges from 0.4-3.7%. The ureter can be crushed, caught in sutures, transsected, obstructed by angulation, or ischemic by the stippling or periureteric fascia. Vesicovaginal and ureterovaginal fistuls are reported to develop in 0.9-2% of patients after radical abdominal hysterectomy. Fistulas usually become manifested or visible at speculum examination within 14 days following the surgery. The aim of this study was to establish the incidence and predisposing factor of urological complications after radical hysterectomy. Methods. The study included a total of 536 patients with invasive stage Ib to IIb cancer of the cervix uteri who had underwent radical hysterectomy. The special elements considered were: the patient’s age; the International Federation of Ginecology and Obstetrics (FIGO stage after pathohistology; duration of operation; the result of preoperative laboratory tests for diabetes, anemia, hypoproteinemia, or disorders of liver or kidney function; ASA status; postoperative surgical infection. Results. The average age of the patients with complications was 48.68 years. All patients with intraoperative ureteric and bladder injuries had statisticaly significant higher stage of disease and operation lasted more than in others without injury. We noticed 1.3% ureteral injuries and 1.49% bladder injuries, more than 50% of the patients with a previously mentioned injuries were operated on more than 3 hours. We found 2.61% vesicovaginal and 2.43% ureterovaginal fistuls. A total of 50% of the patients with bladder injury and vesicovaginal fistuls and 70% of the patients with ureterovaginal fistuls had diabetes mellitus. Postoperative infection of surgical site is a very important factor for the development of fistule. Half of the patients with vesicovaginal

  3. Ex vivo applications of multiphoton microscopy in urology

    Science.gov (United States)

    Jain, Manu; Mukherjee, Sushmita

    2016-03-01

    Background: Routine urological surgery frequently requires rapid on-site histopathological tissue evaluation either during biopsy or intra-operative procedure. However, resected tissue needs to undergo processing, which is not only time consuming but may also create artifacts hindering real-time tissue assessment. Likewise, pathologist often relies on several ancillary methods, in addition to H&E to arrive at a definitive diagnosis. Although, helpful these techniques are tedious and time consuming and often show overlapping results. Therefore, there is a need for an imaging tool that can rapidly assess tissue in real-time at cellular level. Multiphoton microscopy (MPM) is one such technique that can generate histology-quality images from fresh and fixed tissue solely based on their intrinsic autofluorescence emission, without the need for tissue processing or staining. Design: Fresh tissue sections (neoplastic and non-neoplastic) from biopsy and surgical specimens of bladder and kidney were obtained. Unstained deparaffinized slides from biopsy of medical kidney disease and oncocytic renal neoplasms were also obtained. MPM images were acquired using with an Olympus FluoView FV1000MPE system. After imaging, fresh tissues were submitted for routine histopathology. Results: Based on the architectural and cellular details of the tissue, MPM could characterize normal components of bladder and kidney. Neoplastic tissue could be differentiated from non-neoplastic tissue and could be further classified as per histopathological convention. Some of the tumors had unique MPM signatures not otherwise seen on H&E sections. Various subtypes of glomerular lesions were identified as well as renal oncocytic neoplasms were differentiated on unstained deparaffinized slides. Conclusions: We envision MPM to become an integral part of regular diagnostic workflow for rapid assessment of tissue. MPM can be used to evaluate the adequacy of biopsies and triage tissues for ancillary studies

  4. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  5. A new tilt on pelvic radiographs: a pilot study

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate pelvic tilt on commonly performed measurements on radiography in primary protrusio acetabuli and developmental dysplasia of the hip. A dry assembled pelvis and spine skeleton was positioned in an isocentric skull unit and films exposed with increasing degrees of angulation of pelvic tilt. The films were then read by two independent readers for seven different measurements used to evaluate the hips and acetabular: acetabular line to ilioischial line, teardrop appearance, intercristal/intertuberous ratio, co-ordinates of femoral head, centre edge angle, acetabular depth/width ratio and acetabular angle. There was so much variation in the protrusio results that no formal recommendation of any standard radiographic test can be given. Only the inter tuberous distance is not effected by pelvic tilt. The acetabular angles for developmental dysplasia of the hip showed the most potential with pelvic tilt below 15 . As pelvic tilt increases, measurements used in protusio become unreliable, and computed tomography/magnetic resonance imaging are probably going to be more accurate as one can directly visualise pelvic intrusion. We recommend a lateral view to assess the degree of pelvic tilt in patients with protrusion to ensure these measurements are valid. (orig.)

  6. A new tilt on pelvic radiographs: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Richards, P.J. [North Staffordshire Royal Infirmary, Department of Radiology, Stoke-on-Trent, Staffordshire (United Kingdom); Pattison, J.M. [University Hospital of North Staffordshire, Department of Radiology, Stoke on Trent (United Kingdom); Belcher, J. [Keele University, Department of Mathematics, Keele, Staffordshire (United Kingdom); DeCann, R.W. [IMECS, Department of Radiology, Market Drayton, Shropshire (United Kingdom); Anderson, Suzanne [University of Melbourne, Department of Radiology, Melbourne (Australia); Wynn-Jones, C. [University Hospital of North Staffordshire, Department of Orthopaedic Surgery, Stoke on Trent (United Kingdom)

    2009-02-15

    The aim of this study was to evaluate pelvic tilt on commonly performed measurements on radiography in primary protrusio acetabuli and developmental dysplasia of the hip. A dry assembled pelvis and spine skeleton was positioned in an isocentric skull unit and films exposed with increasing degrees of angulation of pelvic tilt. The films were then read by two independent readers for seven different measurements used to evaluate the hips and acetabular: acetabular line to ilioischial line, teardrop appearance, intercristal/intertuberous ratio, co-ordinates of femoral head, centre edge angle, acetabular depth/width ratio and acetabular angle. There was so much variation in the protrusio results that no formal recommendation of any standard radiographic test can be given. Only the inter tuberous distance is not effected by pelvic tilt. The acetabular angles for developmental dysplasia of the hip showed the most potential with pelvic tilt below 15 . As pelvic tilt increases, measurements used in protusio become unreliable, and computed tomography/magnetic resonance imaging are probably going to be more accurate as one can directly visualise pelvic intrusion. We recommend a lateral view to assess the degree of pelvic tilt in patients with protrusion to ensure these measurements are valid. (orig.)

  7. Effect of promoting blood circulation by removing blood stasis on serum transforming growth factor - β1, interleukin -4 and interleukin - 10 levels in female rats with chronic pelvic inflammatory disease%活血化瘀法对慢性盆腔炎雌性大鼠血清TGF-β1和IL-4、IL-10水平的影响

    Institute of Scientific and Technical Information of China (English)

    师伟; 刘瑞芬; 杨晓娜; 徐丽

    2011-01-01

    rat model of chronic pelvic inflammatory disease, 60 rats were divided into model group, high dose cassia tuckahoe capsule group, middle dose cassia tuckahoe capsule group, low dose cassia tuckahoe capsule group and control group randomly, 12 rats in each group; 12 rats in sham operation group and 12 rats in normal group were also selected. ELISA was used to detect the serum levels of TGF - β1, IL-4 and IL - 10 in the seven groups. Results; ①The serum level of TCF - β1 in model group was significantly higher than those in normal group and sham operation group ( P 0. 05) ; the serum level of TGF - β1 in low dose cassia tuckahoe capsule group was significantly higher than that in control group (P 0.05 ) ; the serum levels of IL - 4 and IL-10 in middle dose cassia tuckahoe capsule group and high dose cassia tuckahoe capsule group were higher than those in control group, and there was significant difference in the serum level of IL - 4 ( P 0.05); the serum levels of IL-4 and IL -10 in low dose cassia tuckahoe capsule group were lower than those in control group, and there was no significant difference in the serum level of IL - 4 ( P > 0. 05 ) , while there was significant difference in the serum level of IL-10 ( P < 0.01); the serum levels of IL-4 and IL - 10 in middle dose cassia tuckahoe capsule group were significantly higher than those in high dose cassia tuckahoe capsule group and low dose cassia tuckahoe capsule group. ③There was a significant negative correlation between serum TGF - β1 level and serum IL-4,IL -10 levels ( P < 0. 01) , there was a significant positive correlation between serum IL - 4 level and serum IL - 10 level (P < 0.01) . Conclusion; Promoting blood circulation by removing blood stasis can affect the serum levels of TGF - β1, IL-4 and IL -10 in female rats with chrome pelvic inflammatory disease, and the effect is correlated with the dose of drug, which may be one of the mechanisms of effect of promoting blood circulation by removing

  8. [Collaterals after flow alternation in pelvic arteries: precondition for pelvic reservoir therapy].

    Science.gov (United States)

    Nasu, K; Fujimoto, H; Yamamoto, S; Naitou, H; Maekawa, I; Yasuda, S; Itou, H

    1998-04-01

    To determine the best flow alternation in the internal iliac arteries for regional chemotherapy using a reservoir to treat pelvic malignancies, collateral arteries that arose after arterial flow alternation were evaluated on follow-up pelvic angiographies. Follow-up angiographies were obtained in 11 patients with 21 embolized arteries; six male and five female patients including three with urinary bladder cancer, two with prostate cancer, four with uterine cervical cancer and two with bone metastasis. The interval until follow-up angiography ranged from one to-28 months (mean 8.9 months). Three radiologists interpreted the angiographic results and evaluated collateral vessels. Among 21 embolized arteries, 19 were well occluded, while two were not blocked completely. The two arteries with incomplete embolization did not induce collaterals. Eight internal iliac arteries occluded at the proximal portion enhanced retrogradely via collaterals from the ipsilateral external iliac arteries. Collaterals between the bilateral internal iliac arteries were noted only in four of them. In conclusion, embolization at the proximal point of the internal iliac arteries usually induced collaterals from the ipsilateral external iliac arteries and did not always from collaterals between the bilateral internal iliac arteries, which were necessary for regional chemotherapy. This should be considered when pelvic malignancies are treated with reservoirs.

  9. Extensive colonic stricture due to pelvic actinomycosis.

    Science.gov (United States)

    Kim, J C; Cho, M K; Yook, J W; Choe, G Y; Lee, I C

    1995-04-01

    A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively. PMID:7576294

  10. Laparoscopic radical prostatectomy: omitting a pelvic drain

    Directory of Open Access Journals (Sweden)

    David Canes

    2008-03-01

    Full Text Available PURPOSE: Our goal was to assess outcomes of a selective drain placement strategy during laparoscopic radical prostatectomy (LRP with a running urethrovesical anastomosis (RUVA using cystographic imaging in all patients. Materials and Methods: A retrospective chart review was performed for all patients undergoing LRP between January 2003 and December 2004. The anastomosis was performed using a modified van Velthoven technique. A drain was placed at the discretion of the senior surgeon when a urinary leak was demonstrated with bladder irrigation, clinical suspicion for a urinary leak was high, or a complex bladder neck reconstruction was performed. Routine postoperative cystograms were obtained. RESULTS: 208 patients underwent LRP with a RUVA. Data including cystogram was available for 206 patients. The overall rate of cystographic urine leak was 5.8%. A drain was placed in 51 patients. Of these, 8 (15.6% had a postoperative leak on cystogram. Of the 157 undrained patients, urine leak was radiographically visible in 4 (2.5%. The higher leak rate in the drained vs. undrained cohort was statistically significant (p = 0.002. Twenty-four patients underwent pelvic lymph node dissection (8 drained, 16 undrained. Three undrained patients developed lymphoceles, which presented clinically on average 3 weeks postoperatively. There were no urinomas or hematomas in either group. CONCLUSIONS: Routine placement of a pelvic drain after LRP with a RUVA is not necessary, unless the anastomotic integrity is suboptimal intraoperatively. Experienced clinical judgment is essential and accurate in identifying patients at risk for postoperative leakage. When suspicion is low, omitting a drain does not increase morbidity.

  11. Ischemia in pelvic organs as an independent pathogenic factor in the development of benign prostatic hyperplasia and urinary bladder dysfunction.

    Science.gov (United States)

    Kirpatovskii, V I; Mudraya, I S; Mkrtchyan, K G; Revenko, S V; Efremov, G D; Nadtochii, O N; Kabanova, I V

    2015-04-01

    Blood supply to the pelvic organs of outbred male rats was diminished by graduated constriction of the distal part of the inferior vena cava. Deficiency of intramural blood supply in prostate and urinary bladder was revealed by bioimpedance harmonic analysis according to the magnitude of first cardiac peak in the bioimpedance spectrogram. In 1-1.5 months, the histological examination revealed the glandular-stromal form of progressive benign prostatic hyperplasia in all ischemic rats. The development of hyperplasia was not accompanied by the changes in testosterone, dihydrotestosterone, or estradiol in blood and prostatic tissue. Assessment of vesical functional status by recording the intravesical pressure during infusion cystometry revealed an increase in the amplitude of spontaneous fluctuations of detrusor tone and intravesical pressure during bladder filling, which can be considered as indicator of detrusor hyperactivity. The data conclude that chronic ischemia of pelvic organs is an individual pathogenic factor in the development of benign prostatic hyperplasia and associated urinary disorders. PMID:25896589

  12. Female Sexual Abuse Evaluation in the Urological Practice : Results of a Dutch Survey

    NARCIS (Netherlands)

    Beck, Jack; Bekker, Milou; Van Driel, Mels; Putter, Hein; Pelger, Rob; Nijeholt, A. A. B. Lycklama A.; Elzevier, Henk Willem

    2010-01-01

    Introduction. There is a strong association between urological complaints and a history of sexual abuse, especially in females. It is not known whether urologists integrate these facts in their daily practice. Aim. To evaluate whether Dutch urologists address the issues of sexual abuse in their fema

  13. Variability of the urological clinical practice in prostate cancer in Spain

    OpenAIRE

    Núñez-Mora, Carlos; Angulo Cuesta, Javier; Sánchez-Chapado, Manuel; Alonso, S.; Portillo, José A.; Villavicencio, Humberto

    2012-01-01

    Our purpose was to study the opinion of the Spanish urologists regarding the main points in the diagnosis, prevention, quality of life and treatment of prostate cancer. An anonymous questionnaire was administered to 290 specialists who represented the uro 1.144 JCR (2012) Q4, 57/73 Urology & nephrology

  14. Economies of scale, physician volume for urology patients, and DRG prospective hospital payment system.

    Science.gov (United States)

    Munoz, E; Boiardo, R; Mulloy, K; Goldstein, J; Brewster, J G; Wise, L

    1990-11-01

    Diagnosis Related Group (DRG) hospital payment has begun to squeeze hospitals financially and is likely to do so in the future. This study analyzed the relationship between the volume of urologic procedures by an individual urologist, hospital costs per patient, and outcome. We used a three-year DRG database of urology patients (N = 2,980) at an academic medical center to analyze these. Low-volume urologists (arbitrarily defined by us) had higher hospital costs per patient, financial losses versus profits under DRGs, and a poorer outcome when compared with high-volume urologists. Pearson correlation showed a positive relationship between cost per patient and physician volume for nonemergency patients (-0.129, p less than 0.0001) and emergency patients (-0.368, p less than 0.0001). This may have been explained (in part) by a greater severity of illness for patients of low-volume urologists. These findings suggest, however, that the volume of urologic procedures per urologist may be related to hospital resource consumption. The health care financing environment of the future should provide substantial interest in this finding for those involved in the consumption of urologic services.

  15. Integrating Social Media into Urologic Health care: What Can We Learn from Other Disciplines?

    Science.gov (United States)

    Salem, Johannes; Borgmann, Hendrik; Murphy, Declan G

    2016-02-01

    Social media (SoMe) have become an integral part in many aspects of personal and professional life. With current uptake rates of 50-70% among urologists, SoMe platforms merit huge potential for dissemination of information and professional exchange among stakeholders in urology. Application of SoMe includes conference conversations via tweet chats, health education via YouTube videos, and Twitter online journal clubs. In addition, a number of urology journals have embraced SoMe to allow rapid dissemination of their content and engagement with their readers. Guidance for the appropriate use of SoMe is provided to urologists by several organizations. Besides urology, other disciplines have adopted SoMe for a variety of areas: continuing professional development, awareness of rare diseases, recruitment of study participants, patient education and support, and publicizing research. Openness to new approaches is the basic prerequisite for a transfer of successful concepts embraced by other specialties, to the field of urology. PMID:26757907

  16. The place of female sexual dysfunction in the urological practice : Results of a Dutch Survey

    NARCIS (Netherlands)

    Bekker, Milou; Beck, Jacky; Putter, Hein; van Driel, Mels; Pelger, Rob; Nijeholt, August Lycklama A.; Elzevier, Henk

    2009-01-01

    Introduction. Female sexual dysfunction (FSD) is a highly prevalent and often underestimated problem. There is a strong association between urological complaints and FSD. Aims. The purpose of this survey was to evaluate how Dutch urologists address FSD in their daily practice. Methods. We performed

  17. Possible benefits of robot-assisted rectal cancer surgery regarding urological and sexual dysfunction

    DEFF Research Database (Denmark)

    Broholm Andersen, Malene; Pommergaard, H-C; Gögenür, I

    2015-01-01

    Library were systematically searched in February 2014. All studies investigating urogenital function after robot-assisted rectal cancer surgery were identified. The inclusion criteria for meta-analysis studies required comparison of robot-assisted with laparoscopic surgery and the evaluation of urological...

  18. About the Prostate and Urologic Cancer Research Group | Division of Cancer Prevention

    Science.gov (United States)

    The Prostate and Urologic Cancer Research Group conducts and supports research on prostate and bladder cancers, and new approaches to clinical prevention studies including cancer immunoprevention. The group develops, implements and monitors research efforts in chemoprevention, nutrition, genetic, and immunologic interventions, screening, early detection and other prevention strategies. |

  19. The impact of the 2005 International Society of Urological Pathology consensus guidelines on Gleason grading

    DEFF Research Database (Denmark)

    Berg, Kasper D; Thomsen, Frederik B; Nerstrøm, Camilla;

    2016-01-01

    OBJECTIVES: To investigate whether the International Society of Urological Pathology (ISUP) 2005 revision of the Gleason grading system has influenced the risk of biochemical recurrence (BCR) after radical prostatectomy (RP), as the new guideline implies that some prostate cancers previously graded...

  20. 76 FR 71983 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2011-11-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: Gastroenterology and...

  1. 75 FR 57968 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2010-09-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: Gastroenterology and...

  2. 77 FR 18829 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2012-03-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: Gastroenterology and...

  3. 78 FR 38867 - Gastroenterology-Urology Devices; Reclassification of Implanted Blood Access Devices

    Science.gov (United States)

    2013-06-28

    ... discussed in the preamble to the proposed rule (46 FR 7616; January 23, 1981), the Gastroenterology-Urology... section 513(e) proposing the reclassification of implanted blood access devices for hemodialysis (77 FR... reclassification for June 27, 2013 (78 FR 25747; May 2, 2013). The three comments submitted in response to...

  4. Staff lens doses in interventional urology. A comparison with interventional radiology, cardiology and vascular surgery values.

    Science.gov (United States)

    Vano, E; Fernandez, J M; Resel, L E; Moreno, J; Sanchez, R M

    2016-03-01

    The purpose of this work is to evaluate radiation doses to the lens of urologists during interventional procedures and to compare them with values measured during interventional radiology, cardiology and vascular surgery. The measurements were carried out in a surgical theatre using a mobile C-arm system and electronic occupational dosimeters (worn over the lead apron). Patient and staff dose measurements were collected in a sample of 34 urology interventions (nephrolithotomies). The same dosimetry system was used in other medical specialties for comparison purposes. Median and 3rd quartile values for urology procedures were: patient doses 30 and 40 Gy cm(2); personal dose equivalent Hp(10) over the apron (μSv/procedure): 393 and 848 (for urologists); 21 and 39 (for nurses). Median values of over apron dose per procedure for urologists resulted 18.7 times higher than those measured for radiologists and cardiologists working with proper protection (using ceiling suspended screens) in catheterisation laboratories, and 4.2 times higher than the values measured for vascular surgeons at the same hospital. Comparison with passive dosimeters worn near the eyes suggests that dosimeters worn over the apron could be a reasonable conservative estimate for ocular doses for interventional urology. Authors recommend that at least the main surgeon uses protective eyewear during interventional urology procedures. PMID:26583458

  5. Bladder management methods and urological complications in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Roop Singh

    2011-01-01

    Full Text Available Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI and other urological complications in spinal cord injury patients (SCI, and to compare the incidence of these complications with different bladder management subgroups. Materials and Methods: 545 patients (386 males and 159 females of traumatic spinal cord injury with the mean age of 35.4±16.2 years (range, 18 - 73 years were included in the study. The data regarding demography, bladder type, method of bladder management, and urological complications, were recorded. Bladder management methods included indwelling catheterization in 224 cases, clean intermittent catheterization (CIC in 180 cases, condom drainage in 45 cases, suprapubic cystostomy in 24 cases, reflex voiding in 32 cases, and normal voiding in 40 cases. We assessed the incidence of UTI and bacteriuria as the number of episodes per hundred person-days, and other urological complications as percentages. Results: The overall incidence of bacteriuria was 1.70 / hundred person-days. The overall incidenceof urinary tract infection was 0.64 / hundered person-days. The incidence of UTI per 100 person-days was 2.68 for indwelling catheterization, 0.34 for CIC, 0.34 for condom drainage, 0.56 for suprapubic cystostomy, 0.34 for reflex voiding, and 0.32 for normal voiding. Other urological complications recorded were urethral stricture (n=66, 12.1%, urethritis (n=78, 14.3%, periurethral abscess (n=45, 8.2%, epididymorchitis (n=44, 8.07%, urethral false passage (n=22, 4.03%, urethral fistula (n=11, 2%, lithiasis (n=23, 4.2%, hematuria (n=44, 8.07%, stress incontinence (n=60, 11%, and pyelonephritis (n=6, 1.1%. Clean intermittent catheterization was associated with lower incidence of urological complications, in comparison to indwelling catheterization. Conclusions

  6. Awareness and timing of pelvic floor muscle contraction, pelvic exercises and rehabilitation of pelvic floor in lifelong premature ejaculation: 5 years experience

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    Giuseppe La Pera

    2014-06-01

    Full Text Available Objectives: To assess the cure rate of patients with premature ejaculation who underwent a treatment involving: 1 awareness of the pelvic floor muscles 2 learning the timing of execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase 3 pelvic floor rehabilitation (bio feed back, pelvic exercises and electrostimulation. Materials and methods: We recruited 78 patients with lifelong premature ejaculation who completed the training. The patients were informed of the role of the pelvic floor. They were taught to carry out the execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase to control the ejaculatory reflex. In order to improve the awareness, the tone and the endurance of the pelvic floor muscles, patients were treated with the rehabilitation of pelvic floor (RPF consisting mainly in biofeedback, pelvic exercises and in some cases also in electro-stimulation (ES. The training was carried out for a period of about 2-6 months with an average of 2-5 visits per cycle. Results: 54% of patients who completed the training were cured of premature ejaculation and learned over time to be able to postpone the ejaculation reflex. In a subgroup of 26 patients was also measured the IELT which on the average increased from < 2 minutes to >10 minutes. The best results occurred mainly in patients aged less than 35 where the cure rate was 65%. There were no side effects. Conclusions: In this study, approximately half of patients with premature ejaculation were cured after applying the above treatment.This therapy, necessitates a fairly long period of time (2-6 months and a great commitment on the part of the patient, nevertheless it can be a valid and effective treatment for patients with premature ejaculation. This treatment makes the patient independent in that he is not bound to specific times for taking medication. Furthermore there are no

  7. Survey on lower urinary tract symptoms and sleep disorders in patients treated at urology departments

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    Shimizu N

    2013-01-01

    Full Text Available Nobutaka Shimizu,1 Yasuharu Nagai,1 Yutaka Yamamoto,1 Takafumi Minami,1 Taiji Hayashi,1 Hidenori Tsuji,1 Masahiro Nozawa,1 Kazuhiro Yoshimura,1 Tokumi Ishii,1 Hirotsugu Uemura,1 Takashi Oki,2 Koichi Sugimoto,2 Kazuhiro Nose,2 Tsukasa Nishioka21Department of Urology, Kinki University Faculty of Medicine, Osaka, Japan; 2Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Osaka, JapanObjectives: This study examined the association between sleep disorders and lower urinary tract symptoms in patients who had visited urology departments.Methods: This was an independent cross-sectional, observational study. Outpatients who had visited the urology departments at the Kinki University School of Medicine or the Sakai Hospital, Kinki University School of Medicine, between August 2011 and January 2012 were assessed using the Athens Insomnia Scale and the International Prostate Symptom Score.Results: In total, 1174 patients (mean age, 65.7 ± 13.7 years, with 895 men (67.1 ± 13.2 years old and 279 women (61.4 ± 14.6 years old, were included in the study. Approximately half of these patients were suspected of having a sleep disorder. With regard to the International Prostate Symptom Score subscores, a significant increase in the risk for suspected sleep disorders was observed among patients with a post-micturition symptom (the feeling of incomplete emptying subscore of ≥1 (a 2.3-fold increase, a storage symptom (daytime frequency + urgency + nocturia subscore of ≥5 (a 2.7-fold increase, a voiding symptom (intermittency + slow stream + hesitancy subscore of ≥2 (a 2.6-fold increase, and a nocturia subscore of ≥2 (a 1.9-fold increase.Conclusion: The results demonstrated that the risk factors for sleep disorders could also include voiding, post-micturition, and storage symptoms, in addition to nocturia.Keywords: lower urinary tract symptoms, sleep disturbance, urological disease

  8. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale (VAS) Long-Term Follow-up Clinical Evaluation in 202 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Laborda, Alicia, E-mail: alaborda@unizar.es; Medrano, Joaquin, E-mail: oauieao@gmail.com [University of Zaragoza, Group of Research in Minimally Invasive Techniques Research (GITMI) (Spain); Blas, Ignacio de, E-mail: deblas@unizar.es [University of Zaragoza, Edificio Hospital Veterinario, Department of Animal Pathology (Unit of Infectious Diseases and Epidemiology) (Spain); Urtiaga, Ignacio, E-mail: info@doctorurtiaga.com [Hospital Clinico Universitario ' Lozano Blesa' , Department of Vascular Surgery (Spain); Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br [University of Sao Paulo, Medical School, Interventional Radiology (Brazil); Gregorio, Miguel A. de, E-mail: mgregori@unizar.es [University of Zaragoza, Group of Research in Minimally Invasive Techniques Research (GITMI) (Spain)

    2013-08-01

    PurposeThis study was designed to evaluate the clinical outcome and patients' satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency.MethodsA total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27-57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Both ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years.ResultsTechnical success was 100 %. Clinical success was achieved in 168 patients (93.85 %), with complete disappearance of symptoms in 60 patients (33.52 %). Pain score (VAS) was 7.34 {+-} 0.7 preprocedural versus 0.78 {+-} 1.2 at the end of follow-up (P < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5 %), there was recurrence of their leg varices within the follow-up. The mean degree of patients' satisfaction was 7.4/9.ConclusionsCoil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction.

  9. Whole pelvic osteomyelitis: Unusual finding in staphylococcal sepsis

    International Nuclear Information System (INIS)

    We describe an infrequent case of combined infection of bone, articulation and lung by staphylococcus aureus, with affectation of all pelvic bones. Studies with 99m Tc pyrophosphate were repeatedly negative, becoming positive following the appearance of radiological signs. (orig.)

  10. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... Anterior Pelvic Exenteration January 22, 2009 From Pennsylvania Hospital Welcome to this "OR Live" Webcast presentation brought ... And I'm a gynecologic oncologist at Pennsylvania Hospital in Philadelphia. My colleague, Dr. Daniel Eun and ...

  11. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... to me, I felt that with her given history of prior pelvic radiation and being a Jehovah’s ... due to our limitations and a prior radiation history. We hope that you guys enjoy our case ...

  12. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

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    Full Text Available ... and uterine arteries and opened the recto-vaginal space posteriorly, taken down much of those pelvic side ... anterior extent, coming down in the pre-vesicle space and doing the cystectomy and connecting that cystectomy ...

  13. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... without any transfusions. Typically, what’s performed in this clinical situation is a procedure called a pelvic exenteration. In this case, since the rectum is not involved, we would ...

  14. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... aortic lymph node dissection, allowing him not only access to the lower pelvic lymph node dissections but ... few more questions in from viewers over the Internet, one from Kristin Connelly, “What is the mortality ...

  15. Whole pelvic osteomyelitis: Unusual finding in staphylococcal sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Mata, J.M.; Donoso, L.; Olazabal, A.; Blanch, L.; Ris, J.

    1987-07-01

    We describe an infrequent case of combined infection of bone, articulation and lung by staphylococcus aureus, with affectation of all pelvic bones. Studies with 99m Tc pyrophosphate were repeatedly negative, becoming positive following the appearance of radiological signs.

  16. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Science.gov (United States)

    ... to proceed with a pelvic exenteration using the robotic system both to minimize the risk of complications due to the precision of the instrumentation and of our vision as well last our ability to minimize bleeding ...

  17. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... to proceed with a pelvic exenteration using the robotic system both to minimize the risk of complications due to the precision of the instrumentation and of our vision as well last our ability to minimize bleeding ...

  18. Quality of life in women with pelvic floor dysfunction

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    Mladenović-Segedi Ljiljana

    2011-01-01

    Full Text Available Background/Aim. Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfaction in adult women with pelvic organ prolapse presenting to tertiary care clinic for surgical treatment. Methods. This prospective case-control study included 50 patients who presented to tertiary care gynecology clinic for surgical treatment and 50 controls with normal pelvic floor support and without urinary incontinence who presented tertiary care gynecology clinic for other reasons. Both, patients and controls, completed two quastionnaires recommended for the evaluation of symptoms (Pelvic floor distress inventory - short forms and quality of life impact (Pelvic floor impact questionnaire - short form of pelvic organ prolapse, and Body Image Scale. Results. The patients scored significantly worse on the prolapse, urinary, colorectal scales and overall score of Pelvic floor distress inventory - 20 than controls subjects (134.91 vs 78.08; p < 0.01. The patients also measured significant decrease in condition- specific quality of life (89.23 vs 3.1; p < 0.01. They were more likely to feel self-conscious (78% vs 42%; p < 0.01, less likely to feel physically attractive (78% vs 22%; p < 0.01, more likely to have difficulty looking at themselves naked (70% vs 42%; p < 0.01, less likely to feel sexually attractive (64% vs 32%; p < 0.01, and less likely to feel feminine (56% vs 16%; p < 0.05, than controls. There were no differencies in their feeling of dissatisfaction with appearance when dressed, avoiding people because of appereance and overall dissatisfaction with

  19. Can pelvic tilting be ignored in total hip arthroplasty?

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    Won Yong Shon

    2014-01-01

    CONCLUSION: The sagittal position of pelvis is a key factor in impingement and dislocation after total hip arthroplasty. Pelvic tilting affects the position of acetabular component in the sagittal plane of the body as compared with its anatomic position in the pelvis. We suggest a preoperative lateral view of spine-pelvis, in upright and supine position for evaluation of a corrective adaptation of the acetabular cup accordingly with pelvic balance.

  20. Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes

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    Lopez, Anthony James, E-mail: consultant@radiologist.co.uk [The Imaging Clinic (United Kingdom)

    2015-08-15

    Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory ‘proof’ of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world’s population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure.