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Sample records for chronic urological pelvic

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

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    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. Chronic Pelvic Pain

    Science.gov (United States)

    ... 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 ...

  3. 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. PMID:26721470

  4. Rehabilitation of Patients with Urological Complications of Radical Surgery on Pelvic Organs

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    Sh. S. Allakhverdiev; A.O. Papoyan; A. R. Zagitov; A.A. Kazikhinurov; V. N. Pavlov

    2009-01-01

    One of the commonest urological complications of radical pelvic surgery is enuresis which effects patients quality of life and causes severe physical and moral sufferings. The operational methods of enuresis treatment are unproductive and often lead to recurring and more complicated surgical interventions. All this provides research and development of new non-invasive methods of treatment and rehabilitation of patients with enuresis. Treatment of enuresis after radical operations includes a s...

  5. 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

  6. '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

  7. A standard for terminology in chronic pelvic pain syndromes

    DEFF Research Database (Denmark)

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

    2016-01-01

    AIMS: Terms used in the field of chronic pelvic pain (CPP) are poorly defined and often confusing. An International Continence Society (ICS) Standard for Terminology in chronic pelvic pain syndromes (CPPS) has been developed with the aim of improving diagnosis and treatment of patients affected by...... domain from 1980 to 2014. Existing ICS Standards for terminology were utilized where appropriate to ensure transparency, accessibility, flexibility, and evolution. Consensus was based on majority agreement. RESULTS: The multidisciplinary CPPS Standard reports updated consensus terminology in nine domains...

  8. 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.

  9. Chronic pelvic pain: clinical dilemma or clinician's nightmare

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    Ghaly, A.; Chien, P

    2000-01-01

    Chronic pelvic pain is a common problem presenting a major challenge to healthcare professionals. This is partly due to the lack of understanding of the aetiology and natural history of the disease. This condition is best managed using a multidisciplinary approach. In recent years, the emphasis in the clinical management has tended towards psychosocial or psychosexual involvement after organic disease has been excluded.

  10. 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

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

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    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.

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

    OpenAIRE

    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...

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

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    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 with...... CPP and age-matched pain-free controls using multiple standardized intravaginal examination measures recommended by the International Continence Society. METHODS: This was a cross-sectional, population-based and controlled study with randomly selected participants among women in Denmark. We reported...... blinded findings from a set of standardized vaginal PFM examination manoeuvres in 50 female participants (24 with CPP, 26 pain free). A preliminary pilot study ensured the intra- and intertester reliability of the test procedure. PFM outcomes were resting tone, relaxation capacity, strength, surface...

  14. 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

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

    OpenAIRE

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

    2014-01-01

    Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) affects up to 15% of the male population and is characterized by pelvic pain. Mast cells are implicated in the murine experimental autoimmune prostatitis (EAP) model as key to chronic pelvic pain development. The mast cell mediator tryptase-β and its cognate receptor protease-activated receptor 2 (PAR2) are involved in mediating pain in other visceral disease models. Prostatic secretions and urines from CP/CPPS patients were examined ...

  16. 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…

  17. Sexual abuse evaluation in urological practice

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    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

  18. 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.

  19. 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

  20. 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.

  1. Psycophisical predictor of outcome in pelvic chronic pain therapy

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    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.

  2. Severity, affect, family and environment (safe) approach to evaluate chronic pelvic pain in adolescent girls

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    Wadhwa Leena; Sharma J; Arora R; Malhotra M; Sharma S

    2004-01-01

    BACKGROUND: Pelvic pain is common in adolescent girls in day-to-day practice. Severity, Affect, Family and Environment (SAFE) is a recent interview strategy to approach these patients and their families.. AIM: 1. To find the prevalence of pelvic pain in adolescent girls. 2. To find out the feasibility and acceptability of ′SAFE′ approach in evaluating chronic pelvic pain in adolescent girls. SETTINGS & DESIGN: 200 adolescent girls aged 13-23 years were selected at random ...

  3. 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

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

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    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.

  5. 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.

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

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    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...

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

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    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

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

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    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

  9. 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 ...

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

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    ... 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. ...

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

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    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...

  12. 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.

  13. Baropodometry on women suffering from chronic pelvic pain - a cross-sectional study

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    Kaercher Carolina W

    2011-11-01

    Full Text Available Abstract Background Previous studies have associated chronic pelvic pain with a stereotyped pattern of movement and posture, lack of normal body sensations, a characteristic pain distribution. We aimed at evaluating if these postural changes are detectable in baropodometry results in patients with chronic pelvic pain. Methods We performed a prospective study in a university hospital. We selected 32 patients suffering from chronic pelvic pain (study group and 30 women without this pathology (regular gynecological work out - control group. Pain scores and baropodometric analysis were performed. Results As expected, study group presented higher pain scores than control group. Study and control groups presented similar averages for the maximum pressures to the left and right soles as well as soles supports in the forefeet and hind feet. Women suffering from chronic pelvic pain did not present differences in baropodometric analysis when compared to healthy controls. Conclusions This data demonstrates that postural abnormalities resulting from CPP could not be demonstrated by baropodometric evaluation. Other postural measures should be addressed to evaluate pelvic pain patients.

  14. EVALUATION OF HYSTEROSCOPY AS A COMPLEMENTARY EXAM IN THE INVESTIGATION OF CHRONIC PELVIC PAIN.

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    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.

  15. Severity, affect, family and environment (safe approach to evaluate chronic pelvic pain in adolescent girls

    Directory of Open Access Journals (Sweden)

    Wadhwa Leena

    2004-07-01

    Full Text Available BACKGROUND: Pelvic pain is common in adolescent girls in day-to-day practice. Severity, Affect, Family and Environment (SAFE is a recent interview strategy to approach these patients and their families.. AIM: 1. To find the prevalence of pelvic pain in adolescent girls. 2. To find out the feasibility and acceptability of ′SAFE′ approach in evaluating chronic pelvic pain in adolescent girls. SETTINGS & DESIGN: 200 adolescent girls aged 13-23 years were selected at random from school and colleges nearby hospital campus. METHOD: A questionnaire method was adopted. Adolescent girls selected were divided into two groups, group I (with pain and group II (without pain. STATISTICAL ANALYSIS: It was performed using chi-square and Fischer tests with significance of p value being taken at 0.05. RESULTS: Out of 200 adolescent girls selected for interview, prevalence of pelvic pain was found to be 37.0%. Dysmenorrhoea was also found to have significant relationship with pelvic pain. Depression and anxiety, school absences and loss of weight were found to have significant association with pain. Pelvic pain was found to be more in adolescent girls with large family size (> 4 members, single parent, both parents working, ongoing marital problems at home and was less reported when there was good parent - child communication about sex and when the teenager was well prepared for menarche by the parents and the association with the above mentioned factors was found to be significant. CONCLUSION: ′SAFE′ approach contributes in identifying health problems in adolescent girls with chronic pelvic pain.

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

    Directory of Open Access Journals (Sweden)

    Jillian L. Capodice

    2005-01-01

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

  17. 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

  18. Acupuncture versus Sham Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain

    Science.gov (United States)

    Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay; Leong, Wing Seng; Chee, Christopher; Cheah, Phaik Yeong; Choong, Weng Pho; Wu, Yue; Khan, Nurzalina; Choong, Wooi Long; Yap, Hin Wai; Krieger, John N.

    2015-01-01

    Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) afflicts 2–10% of adult men. Available therapies offer little or no proven benefit. Because acupuncture represents an attractive “natural” therapy, we compared the efficacy of acupuncture to sham acupuncture for CP/CPPS Methods Participants met US National Institutes of Health (NIH) consensus criteria for CP/CPPS, aged ≥ 20 years old, with total score ≥ 15 on the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) and symptoms for at least 3 of the preceding 6 months were randomized 1:1 to acupuncture or sham acupuncture. Treatment consisted of twice weekly 30-minute sessions for 10 weeks (20 sessions total), without needle stimulation, herbs or adjuvants. The primary response criterion was a six-point decrease from baseline to week 10 in NIH-CPSI total score (range 0–43). Results Thirty-two (73%) of 44 participants responded in the acupuncture group compared to 21 (47%) of 45 sham group participants (relative risk [RR] 1.81, 95% confidence interval [CI], 1.3–3.1, p=0.02,). Long-term responses 24 weeks after completing therapy without additional treatment occurred in 14 (32%) of 44 acupuncture group participants and in 6 (13%) of 45 sham group participants (RR 2.39, 95% CI, 1.0–5.6, p=0.04). Conclusion After 10 weeks of treatment, acupuncture proved almost twice as likely as sham to improve CP/CPPS symptoms. Participants receiving acupuncture were 2.4 fold more likely to experience long-term benefit than participants receiving sham acupuncture. PMID:18187077

  19. Effects of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion. Preliminary results

    International Nuclear Information System (INIS)

    The present study was designed to reveal the usefulness of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion as evaluated by symptom scores, transrectal ultrasonography (TRUS) and magnetic resonance (MR) venography. Ten male patients suffering from non-inflammatory chronic pelvic pain syndrome (National Institutes of Health (NIH) category IIIB) with intrapelvic venous congestion were treated using acupuncture. Eight patients had previously received pharmacotherapy, which was unsuccessful. Acupuncture was performed using disposable stainless steel needles, which were inserted into the bilateral BL-33 points and rotated manually for 10 min. The treatment was repeated every week for 5 weeks without other therapeutic maneuvers. Results from TRUS and MR venography, as well as clinical symptoms based on the NIH chronic prostatitis symptom index (NIH-CPSI) and the international prostate symptom score (IPSS), were compared before and after the treatment. No side-effects were recognized throughout the treatment period. The average pain and quality of life (QOL) scores of the NIH-CPSI 1 week after the 5th acupuncture treatment decreased significantly (P<0.05 and P<0.01, respectively) compared with the baseline. The maximum width of the sonolucent zone 1 week after the 5th treatment also decreased significantly (P<0.01, compared with the baseline). Intrapelvic venous congestion demonstrated by MR venography was significantly improved in four patients. This study provided novel information concerning the therapeutic effects of acupuncture on non-inflammatory chronic pelvic pain syndrome. (author)

  20. The relationship between pelvic vein incompetence and chronic pelvic pain in women: systematic reviews of diagnosis and treatment effectiveness.

    Science.gov (United States)

    Champaneria, Rita; Shah, Laila; Moss, Jonathan; Gupta, Janesh K; Birch, Judy; Middleton, Lee J; Daniels, Jane P

    2016-01-01

    BACKGROUND Pelvic congestion syndrome (PCS) is described as chronic pelvic pain (CPP) arising from dilated and refluxing pelvic veins, although the causal relationship between pelvic vein incompetence (PVI) and CPP is not established. Non-invasive screening methods such as Doppler ultrasound and magnetic resonance venography are used before confirmation by venography. Percutaneous embolisation has become the principal treatment for PCS, with high success rates often cited. OBJECTIVES Our proposal aimed to systematically and critically review the definitions and diagnostic criteria of PCS, the association between PVI and CPP, the accuracy of various non-invasive imaging techniques and the effectiveness of embolisation for PVI; and to identify factors associated with successful outcome. We also wished to survey clinicians and patients to assess awareness and management of PCS and gauge the enthusiasm for further research. DATA SOURCES A comprehensive search strategy encompassing various terms for pelvic congestion, pain, imaging techniques and embolisation was deployed in 17 bibliographic databases, including MEDLINE, EMBASE and Web of Science. There was no restriction on study design. METHODS Methodological quality was assessed using appropriate tools. Online surveys were sent to clinicians and patients. The quality and heterogeneity generally precluded meta-analysis and so results were tabulated and described narratively. RESULTS We identified six association studies, 10 studies involving ultrasound, two studies involving magnetic resonance venography, 21 case series and one poor-quality randomised trial of embolisation. There were no consistent diagnostic criteria for PCS. We found that the associations between CPP and PVI were generally fairly similar, with three of five studies with sufficient data showing statistically significant associations (odds ratios of between 31 and 117). The prevalence of PVI ranged widely, although the majority of women with PVI had

  1. 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.

  2. 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.

  3. 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.

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

    OpenAIRE

    Bradford W. Fenton; Grey, Scott F.; Krystel Tossone; Michele McCarroll; von Gruenigen, Vivian E.

    2015-01-01

    Chronic pelvic pain affects multiple aspects of a patient’s physical, social, and emotional functioning. Latent class analysis (LCA) of Patient Reported Outcome Measures Information System (PROMIS) domains has the potential to improve clinical insight into these patients’ pain. Based on the 11 PROMIS domains applied to n=613 patients referred for evaluation in a chronic pelvic pain specialty center, exploratory factor analysis (EFA) was used to identify unidimensional superdomains. Latent pro...

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

    OpenAIRE

    Bruno Hállan Meneses Dias; Ana Carolina Rodrigues de Andrade; Angélica Maria Holanda Pascoal da Silva; Francisco Eugênio de Vasconcelos Filho; Jordana Parente Paiva; Francisco das Chagas Medeiros

    2013-01-01

    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 finding...

  6. Use of the Pain Assessment Scales in Complex Examination of Women with Chronic Pelvic Pain

    OpenAIRE

    Drogomyretska, N. V.

    2014-01-01

    The problem of improving the evaluation and treatment of women with chronic pelvic pain (CPP) syndrome is one of the biggest in modern gynecology. This is due to the high frequency of this pathology, numerous aspects of the pathogenesis, underlying psychological disorders and difficulties that arise in choosing an effective treatment. Treatment of patients with gynecological pathology is more effective in regard to assessment of pain intensity. The objective of our study was to establish the ...

  7. 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.

  8. Gynecological indications for the use of botulinum toxin in women with chronic pelvic pain.

    Science.gov (United States)

    Abbott, Jason

    2009-10-01

    Chronic pelvic pain in women is a common symptom with a wide variety of etiologies that demand accurate diagnosis and appropriate treatment if pain reduction is to be effected. Superficial conditions such as provoked vestibulodynia and problems affecting deeper structures such as pelvic floor muscle spasm are difficult to treat and can have significant impacts on quality of life for the sufferer. Apart from daily pain, symptoms such as painful intercourse (dyspareunia), painful bowel motions (dyschesia) and exacerbation of period pain (dysmenorrhea) are commonly reported by patients. For inflammatory conditions, and in areas where muscle spasm is thought to contribute to pain, botulinum toxins (BoNT) are used with considerable success. For gynecological indications, there are limited data, in the form of case reports and small series, to indicate that BoNT used in the vulva may have a benefit for 3-6 months after injection of 20-40U of BOTOX; for women with provoked vestibulodynia. Re-treatment is reported to be successful and side effects are limited. Controlled studies are essential to further explore this indication. For pelvic floor muscle spasm, a greater number of women have been studied and a double blind, randomized controlled study has reported a significant reduction in pelvic floor pressures with significant pain reduction for some types of pelvic pain compared to baseline. There were no differences in pain compared to the control group who had physical therapy as an intervention. Physical therapy could be used as a non-invasive first line treatment, with BoNT injections reserved for those who are refractory to treatment. In summary, BoNT treatment for a variety of gynecological indications seems successful with limited side effects, although there are minimal data, particularly in superficial vulval conditions. To allow recommendation for wider utilization of this treatment, it is essential that more research is performed to add further evidence to our

  9. 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.

  10. 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.

  11. 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。

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

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    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.

  13. Urological management.

    Science.gov (United States)

    Cuckow, Peter; Mishra, Pankaj

    2015-10-01

    The pediatric urologists role is confined to ischio-, para-, and pygopagus conjoined twins. The aim is to preserve renal function, to address problems with urinary continence, and to optimize genital issues with particular reference to sexual and reproductive function. Full urological imaging is essential prior to separation for planning and for the operation itself. PMID:26382264

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. [Sexuality and urological diseases].

    Science.gov (United States)

    Droupy, Stéphane

    2014-10-01

    Patients with lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) frequently suffer from sexual dysfunction (erectile dysfunction and ejaculatory dysfunction). Erectile dysfunction and premature ejaculation are two times more common in men with chronic pelvic pain/chronic prostatitis. All treatments of prostate cancer are responsible for sexual dysfunctions. Sexual disorders frequently appear during the management of infertile couples. Information and support should be offered to couples. Women with urinary incontinence also suffer frequently from coital incontinence. PMID:25201599

  19. 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

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

    Science.gov (United States)

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

    2016-04-01

    There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats. PMID:25990367

  1. 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.

  2. 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.

  3. Water Remedial Gymnastics as a Component of Preconception Training of Patients with Chronic Inflammatory Diseases of Pelvic Organs

    OpenAIRE

    K.V. Gordon; S.M. Avtomeenko

    2012-01-01

    The article considers medical and preventive efficiency of remedial gymnastics in fresh water swimming pool and thalassotherapy in the course of preconception training of 370 gynecological patients, suffering from chronic inflammatory diseases of pelvic organs and planning pregnancy. Combination of water remedial gymnastics, as well as natural and preformed physical therapeutic factors for complex preconception training enables to normalize women psycho-vegetative and immune status, increases...

  4. 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.

  5. 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

  6. 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

  7. 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

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

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    Jeffrey M Cohen

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

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

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    Małgorzata Malec-Milewska

    2015-05-01

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

  10. 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

  11. 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

  12. Quality of life associated to chronic pelvic pain is independent of endometriosis diagnosis-a cross-sectional survey

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    Chaves Marcia F

    2011-06-01

    Full Text Available Abstract Background Pain is strongly related to poor quality of life. We performed a cross-sectional study in a universitary hospital to investigate quality of life in women suffering from chronic pelvic pain (CPP due to endometriosis and others conditions. Methods Fifty-seven patients aged between 25 and 48 years-old submitted to laparoscopy because of CPP were evaluated for quality of life and depressive symptoms. Quality of life was accessed by a quality of life instrument [World Health Organization Quality of Life Assessment-Bref (WHOQOL-bref]. Causes of pelvic pain were determined and severity of CPP was measured with a visual analogue scale. According to the intensity of pelvic pain score, patients were classified in two groups (group Low CPP 25th percentile. Four dimensions on quality of life were measured (physical, psychological, social and environmental. We stratified the analysis of quality of life according CPP causes (presence or not of endometriosis in laparoscopy. Results Patients with higher pain scores presented lower quality of life status in psychological and environmental dimensions. We found a negative correlation between pain scores and psychological dimension of quality of life (r = -0.310, P = .02. Quality of life scores were similar between groups with and without endometriosis (physical 54.2 ± 12.8 and 51.1 ± 13.8, P = 0.504; psychological 56.2 ± 14.4 and 62.8 ± 12.4, P = 0.182; social 55.6 ± 18.2 and 62.1 ± 19.1, P = 0.325; environmental 59.2 ± 11.7 61.2 ± 10.8, P = 0.608; respectively Conclusions Higher pain scores are correlated to lower quality of life; however the fact of having endometriosis in addition to CPP does not have an additional impact upon the quality of life.

  13. 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

  14. 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.

  15. 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.

  16. 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...

  17. Pelvic Exam

    Science.gov (United States)

    ... My Pictures Browse Search Quick Search Image Details Exam, Pelvic View/Download: Small: 720x590 View Download Add to My Pictures Title: Exam, Pelvic Description: Pelvic exam; drawing shows a side ...

  18. Common Questions About Chronic Prostatitis.

    Science.gov (United States)

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

    2016-02-15

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

  19. 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.

  20. 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.

  1. Bridging the urological divide

    OpenAIRE

    Roberts Robin

    2011-01-01

    Abstract The advanced disease clinical presentations, higher morbidity and mortality rates and lack of available treatment options in prostate cancer care, attest to disparities in the delivery and outcomes of urological services in Black men of African lineage in both the Developed and Developing countries. This gap in health care and services in the global management of prostate cancer denotes the urological divide. Through the experience of a Developing country urologist with a comparative...

  2. 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

  3. 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

  4. 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.

  5. 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. PMID:27051243

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Weihua Fu

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

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

    Science.gov (United States)

    Chen, Xin; Wang, Zhu; Chen, Shengfu; Yang, Qiyun; Wan, Zi; Han, Dayu; Xiao, Haipeng; Sun, Xiangzhou; Deng, Chunhua

    2016-01-01

    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 ofclinical 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 = 0.322)scores (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. PMID:27120096

  9. 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.

  10. Robotic technology in urology

    OpenAIRE

    Murphy, D.; Challacombe, B; Khan, M.S.; Dasgupta, P

    2006-01-01

    Urology has increasingly become a technology‐driven specialty. The advent of robotic surgical systems in the past 10 years has led to urologists becoming the world leaders in the use of such technology. In this paper, we review the history and current status of robotic technology in urology. From the earliest uses of robots for transurethral resection of the prostate, to robotic devices for manipulating laparoscopes and to the current crop of master–slave devices for robotic‐assisted laparosc...

  11. 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

  12. High prevalence of chronic pelvic pain in women in Ribeirão Preto, Brazil and direct association with abdominal surgery

    OpenAIRE

    Gabriela Pagano de Oliveira Goncalves da Silva; Anderson Luís do Nascimento; Daniela Michelazzo; Fernando Filardi Alves Junior; Marcelo Gondim Rocha; Júlio César Rosa e Silva; Francisco José Candido dos Reis; Antonio Alberto Nogueira; Omero Benedicto Poli Neto

    2011-01-01

    INTRODUCTION: Chronic pelvic pain is a disease that directly affects the social and professional lives of women. OBJECTIVE: To estimate the prevalence of this clinical condition and to identify independent factors associated with it in women living in Ribeirão Preto, Brazil. METHODS: A one-year cross-sectional study was conducted in a population sample of 1,278 women over the age of 1,278 women over the age of 14 years. The target population was predominantly composed of women who are treated...

  13. 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.

  14. High prevalence of chronic pelvic pain in women in Ribeirão Preto, Brazil and direct association with abdominal surgery

    Directory of Open Access Journals (Sweden)

    Gabriela Pagano de Oliveira Goncalves da Silva

    2011-01-01

    Full Text Available INTRODUCTION: Chronic pelvic pain is a disease that directly affects the social and professional lives of women. OBJECTIVE: To estimate the prevalence of this clinical condition and to identify independent factors associated with it in women living in Ribeirão Preto, Brazil. METHODS: A one-year cross-sectional study was conducted in a population sample of 1,278 women over the age of 1,278 women over the age of 14 years. The target population was predominantly composed of women who are treated by the public health system. The questionnaire was administered by interviewers who were not linked to the city health care programs. The prevalence of the morbidity was estimated. First, we identified the significant variables associated with pelvic pain (p<0.10 and then we attributed values of 0 or 1 to the absence or presence of these variables. Logistic regression analysis was used to identify and estimate the simultaneous impact of the independent variables. The results were expressed by odds ratio and their 95% confidence interval with p<0.05. RESULTS: The disease was found in 11.5% (147/1,278 of the sample. The independent predictors were dyspareunia, previous abdominal surgery, depression, dysmenorrhea, anxiety, current sexual activity, low back pain, constipation, urinary symptoms, and low educational level. CONCLUSION: The prevalence of chronic pelvic pain in Ribeirão Preto is high and is associated with conditions that can usually be prevented, controlled, or resolved by improvement of public health policies and public education.

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. EMERGENCY UROLOGIC IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Putu Surya Utami

    2013-12-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE A variety of anatomical and physiological changes occurring during pregnancy, which can affect any organ system. Urological problems in pregnancy represent a diagnostic and therapeutic challenge. Urinary tract symptoms in pregnant women comprise urinary tract infection, acute pyelonephritis, acute urinary retention, hematuria, placenta percreta, nefrolithiasis, uropathy obstructive, and malignancy urologic. A multidisciplinary approach is necessary, from the anesthetic and obstetric team. In this review, I will discuss the common urological problems that occur during pregnancy and outline an approach to their management. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";}

  1. Bridging the urological divide.

    Science.gov (United States)

    Roberts, Robin

    2011-09-23

    The advanced disease clinical presentations, higher morbidity and mortality rates and lack of available treatment options in prostate cancer care, attest to disparities in the delivery and outcomes of urological services in Black men of African lineage in both the Developed and Developing countries. This gap in health care and services in the global management of prostate cancer denotes the urological divide.Through the experience of a Developing country urologist with a comparative literature review, this presentation defines the determinants of the disparity through deficiencies in human, material and financial resources, as is most prevalent in Developing countries.Solutions to ending health care disparities must take into account the existing development phase of Third World countries and thus determine whether the Developed countries should export a total service delivery system or seek primarily to advance the competence and skills of the existing Developing country resources.Collaboration in prostate cancer research has the greatest promise and sustainability of bridging this urological divide and is of mutual benefit to both entities. PMID:21992183

  2. 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.

  3. 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...

  4. 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。

  5. Urological injuries following trauma

    Energy Technology Data Exchange (ETDEWEB)

    Bent, C. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)], E-mail: clare.bent@bartsandthelondon.nhs.uk; Iyngkaran, T.; Power, N.; Matson, M. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom); Hajdinjak, T.; Buchholz, N. [Department of Urology, Barts and The London NHS Trust, London (United Kingdom); Fotheringham, T. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)

    2008-12-15

    Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.

  6. 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.

  7. Predictive models in urology.

    Science.gov (United States)

    Cestari, Andrea

    2013-01-01

    Predictive modeling is emerging as an important knowledge-based technology in healthcare. The interest in the use of predictive modeling reflects advances on different fronts such as the availability of health information from increasingly complex databases and electronic health records, a better understanding of causal or statistical predictors of health, disease processes and multifactorial models of ill-health and developments in nonlinear computer models using artificial intelligence or neural networks. These new computer-based forms of modeling are increasingly able to establish technical credibility in clinical contexts. The current state of knowledge is still quite young in understanding the likely future direction of how this so-called 'machine intelligence' will evolve and therefore how current relatively sophisticated predictive models will evolve in response to improvements in technology, which is advancing along a wide front. Predictive models in urology are gaining progressive popularity not only for academic and scientific purposes but also into the clinical practice with the introduction of several nomograms dealing with the main fields of onco-urology. PMID:23423686

  8. News on pediatric urology

    Directory of Open Access Journals (Sweden)

    Giuseppe Masnata

    2015-10-01

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

  9. 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 ...

  10. 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...

  11. 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.

  12. 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 ...

  13. Extracorporeal shock wave therapy (ESWT) in urology

    DEFF Research Database (Denmark)

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

    2016-01-01

    inhibitor (PDE-5i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with...... treatment potentially may recover natural erection in PDE-5i responders. ESWT seems to be able to resolve pain in CPP patients in the short term. In all three disease entities, long-term outcome data are still warranted....

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

    Directory of Open Access Journals (Sweden)

    Renata Miranda

    2009-07-01

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

  15. Status of urological Kampo medicine: a narrative review and future vision.

    Science.gov (United States)

    Minagawa, Tomonori; Ishizuka, Osamu

    2015-03-01

    Clinical evidence for traditional Japanese Kampo medicine has been provided by modern scientific methodologies. Indeed, more than 150 Kampo formulations have been approved for use as prescription drugs by the Ministry of Health, Labor and Welfare of Japan, and are widely used in daily medical practice. More than 10 of these formulations can be used for urological problems, especially in cases of lower urinary tract dysfunction. However, there are few opportunities to introduce urological Kampo medicines for worldwide use, and the status of urological Kampo medicine has not been reviewed yet. Here, we present a narrative review to introduce the current status of urological Kampo medicine in Japan. First, we introduce the essence of general Kampo medicine, including its history and current status in Japan. We focused of Sou-Sei-Sou-Koku, "promotion and inhibition network among the Five Elements," which is the central dogma of Kampo medicine. To present Kampo medicine as scientific medicine, neural cross-talk among pelvic organs is presented in comparison with Sou-Sei-Sou-Koku. Second, we list representative urological Kampo formulations used for lower urinary tract symptoms. Furthermore, we also discuss their roles in the urological field, including their position in Japanese clinical guidelines. Third, we propose the multi-organ targeting strategy using Kampo formulations as a future vision. Dai-Ken-Chu-Tou (a common Kampo formulation for gastrointestinal problems and hypersensitivity to cold) is one candidate, and we present the results of a preliminary study using this Kampo medicine formulation. PMID:25597936

  16. 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 ...

  17. 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...

  18. 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

  19. 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.

  20. 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)...

  1. Urologic laser types and instrumentation.

    Science.gov (United States)

    Natalin, Ricardo A; Phillips, Courtney K; Clayman, Ralph V; Landman, Jaime

    2008-11-01

    Though the primary role of lasers in urology has always been in the treatment of urolithiasis, there are several other indications for their use. There are many different types of lasers currently available, each with unique properties conducive to treating certain disorders. As such, it is critical that today's urologist understands each laser's characteristics in order to optimize patient selection and treatment. The lasers which are primarily used in urologic applications include the carbon dioxide (CO2) laser; the Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG); the Potassium Titanyl Phosphate (KTP) laser and the Holmium:YAG (Ho:YAG) laser. This review focuses on the unique characteristics of each of these lasers as well as the instrumentation needed utilize and deploy these tools in the urinary tract. PMID:19140577

  2. 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 .

  3. 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 ...

  4. 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

  5. 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...

  6. 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 ...

  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. Encouraging scholastic publishing by urologic trainees

    OpenAIRE

    STEERS, W D

    2009-01-01

    There are many reasons why urologic trainees should publish scholarly work: Personal, professional, and institutional. Publishing by trainees creates an environment that improves the specialty of urology, maintains the quality of our literature, and promotes professionalism of our practitioners. Strategies to encourage scholastic publishing distil down to providing recognition, time, and support to the individual trainee.

  9. Encouraging scholastic publishing by urologic trainees.

    Science.gov (United States)

    Steers, W D

    2009-04-01

    THERE ARE MANY REASONS WHY UROLOGIC TRAINEES SHOULD PUBLISH SCHOLARLY WORK: Personal, professional, and institutional. Publishing by trainees creates an environment that improves the specialty of urology, maintains the quality of our literature, and promotes professionalism of our practitioners. Strategies to encourage scholastic publishing distil down to providing recognition, time, and support to the individual trainee. PMID:19672356

  10. 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.

  11. 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.)

  12. 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...

  13. 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.

  14. Chronic prostatitis

    OpenAIRE

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

    2008-01-01

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

  15. Basic science research in urology training.

    Science.gov (United States)

    Eberli, D; Atala, A

    2009-04-01

    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 may not be as likely to contribute to scientific discoveries.Currently, only a minority of urologists in training are currently exposed to significant research experience. In addition, the number of physician-scientists in urology has been decreasing over the last two decades, as fewer physicians are willing to undertake a career in academics and perform basic research. However, to ensure that the field of urology is driving forward and bringing novel techniques to patients, it is clear that more research-trained urologists are needed. In this article we will analyse the current status of basic research in urology training and discuss the importance of and obstacles to successful addition of research into the medical training curricula. Further, we will highlight different opportunities for trainees to obtain significant research exposure in urology. PMID:19672351

  16. 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...

  17. 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...

  18. 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.

  19. 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。

  20. Potential role for metformin in urologic oncology

    Science.gov (United States)

    Sayyid, Rashid Khalid

    2016-01-01

    Metformin is one of the most commonly used drugs worldwide. It is currently considered first-line pharmacological agent for management of diabetes mellitus type 2. Recent studies have suggested that metformin may have further benefits, especially in the field of urologic oncology. Use of metformin has been shown to be associated with decreased incidence and improved outcomes of prostate, bladder, and kidney cancer. These studies suggest that metformin does have a future role in the prevention and management of urologic malignancies. In this review, we will discuss the latest findings in this field and its implications on the management of urologic oncology patients. PMID:27195314

  1. 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

  2. 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.

  3. Pelvic radiotherapy and sexual dysfunction in women

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine; Froeding, Ligita Paskeviciute

    2015-01-01

    focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment. Following cure of cancer allow survivors focus on quality 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: The...

  4. 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, ...

  5. 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

  6. A snapshot of the adult spina bifida patient – high incidence of urologic procedures

    Science.gov (United States)

    Liu, Joceline S.; Greiman, Alyssa; Casey, Jessica T.; Mukherjee, Shubhra

    2016-01-01

    Introduction To describe the urologic outcomes of contemporary adult spina bifida patients managed in a multidisciplinary clinic. Material and methods A retrospective chart review of patients seen in our adult spina bifida clinic from January 2004 to November 2011 was performed to identify urologic management, urologic surgeries, and co-morbidities. Results 225 patients were identified (57.8% female, 42.2% male). Current median age was 30 years (IQR 27, 36) with a median age at first visit of 25 years (IQR 22, 30). The majority (70.7%) utilized clean intermittent catheterization, and 111 patients (49.3%) were prescribed anticholinergic medications. 65.8% had urodynamics performed at least once, and 56% obtained appropriate upper tract imaging at least every other year while under our care. 101 patients (44.9%) underwent at least one urologic surgical procedure during their lifetime, with a total of 191 procedures being performed, of which stone procedures (n = 51, 26.7%) were the most common. Other common procedures included continence procedures (n = 35, 18.3%) and augmentation cystoplasty (n = 29, 15.2%). Only 3.6% had a documented diagnosis of chronic kidney disease and 0.9% with end-stage renal disease. Conclusions Most adult spina bifida patient continue on anticholinergic medications and clean intermittent catheterization. A large percentage of patients required urologic procedures in adulthood. Patients should be encouraged to utilize conservative and effective bladder management strategies to reduce their risk of renal compromise. PMID:27123330

  7. [Ultrasonography in acute pelvic pain].

    Science.gov (United States)

    Kupesić, Sanja; Aksamija, Alenka; Vucić, Niksa; Tripalo, Ana; Kurjak, Asim

    2002-01-01

    accurate diagnosis of this entity since it enables differentiation between acute and chronic stages based on analysis of the vascular resistance. Hemorrhagic ovarian cysts may be presented by variety of ultrasound findings since intracystic echoes depend upon the quality and quantity of the blood clots. Color Doppler investigation demonstrates moderate to low vascular resistance typical of luteal flow. Leiomyomas undergoing degenerative changes are another cause of acute pelvic pain commonly present in patients of reproductive age. Color flow detects regularly separated vessels at the periphery of the leiomyoma, which exhibit moderate vascular resistance. Although the classic symptom of endometriosis is chronic pelvic pain, in some patients acute pelvic pain does occur. Most of these patients demonstrate an endometrioma or "chocolate" cyst containing diffuse carpet-like echoes. Sometimes, solid components may indicate even ovarian malignancy, but if color Doppler ultrasound is applied it is less likely to obtain false positive results. One should be aware that pericystic and/or hillar type of ovarian endometrioma vascularization facilitate correct recognition of this entity. Pelvic congestion syndrome is another condition that can cause an attack of acute pelvic pain. It is usually consequence of dilatation of venous plexuses, arteries or both systems. By switching color Doppler gynecologist can differentiate pelvic congestion syndrome from multilocular cysts, pelvic inflammatory disease or adenomyosis. Ovarian vein thrombosis is a potentially fatal disorder occurring most often in the early postpartal period. Hypercoagulability, infection and stasis are main etiologic factors, and transvaginal color Doppler ultrasound is an excellent diagnostic tool to diagnose it. Acute pelvic pain may occur even in normal intrauterine pregnancy. This may be explained by hormonal changes, rapid growth of the uterus and increased blood flow. Ultrasound is mandatory for distinguishing

  8. 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.

  9. 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.)

  10. 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.)

  11. 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...

  12. Our Urologic Laparoscopy Complications in Municipal Hospital

    Directory of Open Access Journals (Sweden)

    Deniz Abat

    2016-01-01

    Full Text Available Aim: The aim of the study is to assess the findings, complications and treatment methods of the laparoscopic urological procedures that are performed in a municipal hospital. Material and Method: 59 laparoscopic urology procedures performed on 57 patients in Kahramanmaras Afsin Municipal Hospital between November of 2011 and September of 2013 are evaluated retrospectively. Occurred complications are classified according to the Satava and Clavien classification system. Results: It is observed that intraoperative complications occurred in 13 of 57 patients who undergone a laparoscopic procedure (22.8%. Postoperative complications are observed in 7 of 57 patients (12.2%. All complications are presented in Table 3. Discussion: We believe that laparoscopic urology procedures should be used more extensively as most of the potential complications can be treated easily with the help of conservative methods in a municipal hospital.

  13. 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.

  14. 21 CFR 876.5090 - Suprapubic urological catheter and accessories.

    Science.gov (United States)

    2010-04-01

    .... This generic type of device includes the suprapubic catheter and tube, Malecot catheter, catheter punch... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suprapubic urological catheter and accessories... Suprapubic urological catheter and accessories. (a) Identification. A suprapubic urological catheter...

  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... Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is a... generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument,...

  16. 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...

  17. 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...

  18. 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 ...

  19. 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 ...

  20. 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...

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

    Science.gov (United States)

    Maldonado, Pedro A; Wai, Clifford Y

    2016-03-01

    As the field of reconstructive pelvic surgery continues to evolve, with descriptions of new procedures to repair pelvic organ prolapse, it remains imperative to maintain a functional understanding of pelvic floor anatomy and support. The goal of this review was to provide a focused, conceptual approach to differentiating anatomic defects contributing to prolapse in the various compartments of the vagina. Rather than provide exhaustive descriptions of pelvic floor anatomy, basic pelvic floor anatomy is reviewed, new and historical concepts of pelvic floor support are discussed, and relevance to the surgical management of specific anatomic defects is addressed. PMID:26880505

  2. Long-term urological outcomes in cloacal anomalies.

    Science.gov (United States)

    Caldwell, Brian T; Wilcox, Duncan T

    2016-04-01

    Cloacal anomalies are the most complex and severe form of congenital anorectal malformations (ARM) and urogenital malformations, and it has been well documented that increased severity of ARM leads to worse outcomes. While short-term data on persistent cloaca are available, a paucity of data on long-term outcomes exists, largely because of a lack of uniform terminology, inclusion with other ARM and evolution of the operative technique. On comprehensive review of the published literature on long-term urological outcomes in patients with cloacal anomalies, we found a significant risk of chronic kidney disease and incontinence, however, with improvements in surgical technique, outcomes have improved. Continence often requires intermittent catheterization and in some cases, bladder augmentation. The complexity of cloacal malformations and associated anomalies make long-term multidisciplinary follow-up imperative. PMID:26969235

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

    Institute of Scientific and Technical Information of China (English)

    宋玉娟; 张殿全; 苏丹萍

    2015-01-01

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

  4. 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...

  5. 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...

  6. 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 ...

  7. Fluid dynamic modelling of renal pelvic pressure during endoscopic stone removal

    Science.gov (United States)

    Oratis, Alexandros; Subasic, John; Bird, James; Eisner, Brian

    2015-11-01

    Endoscopic kidney stone removal procedures are known to increase internal pressure in the renal pelvis, the kidney's urinary collecting system. High renal pelvic pressure incites systemic absorption of irrigation fluid, which can increase the risk of postoperative fever and sepsis or the unwanted absorption of electrolytes. Urologists choose the appropriate surgical procedure based on patient history and kidney stone size. However, no study has been conducted to compare the pressure profiles of each procedure, nor is there a precise sense of how the renal pelvic pressure scales with various operational parameters. Here we develop physical models for the flow rates and renal pelvic pressure for various procedures. We show that the results of our models are consistent with existing urological data on each procedure and that the models can predict pressure profiles where data is unavailable.

  8. 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

  9. [Urinary diversion in patients treated with pelvic irradiation: transverse colon conduit revisited].

    Science.gov (United States)

    Matsui, Yoshiyuki; Kanematsu, Akihiro; Negoro, Hiromitsu; Kobayashi, Takashi; Terada, Naoki; Sugino, Yoshio; Yamasaki, Toshinari; Inoue, Takahiro; Kamba, Tomomi; Yoshimura, Koji; Ogawa, Osamu

    2014-08-01

    In patients receiving pelvic irradiation for gynecological or genitourinary malignancies, urinary diversion is sometimes required for complete resection of malignancies or treatment of urological complications by irradiation. We report our attempts to promote healing and prevent complications by urinary diversion using a transverse colon conduit in cases in which urinary reconstruction was performed with irradiated lower abdominal organs such as small intestine or distal ureters. Between 2008 and 2012, 9 patients with pelvic irradiation received transverse colon conduit urinary diversion. Six patients received diversion for genitourinary complications, while 3 patients received complete resection of pelvic malignancies. Colostomy formation and lithotripsy of vesical stones were simultaneously performed in 4 cases. Wallace method was adopted for ureterointestinal anastomosis. There was no operative mortality. Although acute pyelonephritis, ileus, wound dehiscence and pelvic abscess formation were seen as postoperative complications, all but two improved without any additional procedure. Cases of pelvic abscess or wound dehiscence were treated by abscess drainage. In observation periods, no patients required urinary stent placement and none suffered from defecation problems. We think that transverse colon conduit can be a viable option for patients with pelvic irradiation history, affording them reasonable quality of life postoperatively. PMID:25179985

  10. Nuclear medicine in urology and nephrology

    Energy Technology Data Exchange (ETDEWEB)

    O' Reilly, P.H.; Shields, R.A.; Testa, H.J.

    1986-01-01

    This edition on radionuclide techniques in urology and nephrology reflects the many advances since 1979. Emphasis has been given to diuretic renography and studies of urinary reflux. A new chapter discusses the diagnosis of lower urinary tract problems. The editors have divided the book into three sections. The first part presents a description of the techniques and their interpretation. Renography, renal scanning, clearance studies, and bone scanning are covered. The second section gives an in-depth discussion of the application of these techniques to obstructive uropathy, urologic tumors, renal transplantation, trauma, and lower urinary tract, pediatric, and nephrologic problems. The last part of the book deals with basic principles. It expands on the relevant theoretical and technical aspects not covered in detail in part 1. In this last portion of the book the editors have grouped together the chapters on physics, instrumentation, radiopharmaceuticals, and radiation dosimetry.

  11. [Magnetic resonance urography in pediatric urology].

    Science.gov (United States)

    Schindele, D; Furth, C; Liehr, U B; Porsch, M; Baumunk, D; Janitzky, A; Wendler, J J; Genseke, P; Ricke, J; Schostak, M

    2012-12-01

    Magnetic resonance urography (MRU) provides high resolution imaging of the urogenital system and the use of paramagnetic contrast agents enables a functional depiction. This review summarizes existing data concerning this diagnostic procedure in pediatric urology. A systematic search and assessment of the literature was performed.A total of 12 studies were reviewed in detail. In mostly small study populations a great heterogeneity concerning methodology, use of comparative examinations and standards of reference was noted. Besides the quality of anatomical imaging, the functional study of renal excretory function and differential renal function was also assessed. Only a few studies performed statistical analyses.The authors' rating of MRU was mostly positive. Due to methodical weaknesses, lack of independent standards of reference and statistical analyses the overall level of evidence was low. Further high quality studies will be necessary to assess the value of MRU for the diagnostic workup in pediatric urology. PMID:23160606

  12. [PELVIC FLOOR RECONSTRUCTION AFTER PELVIC EVISCERATION USING GRACILIS MUSCULOCUTANEOUS FLAP].

    Science.gov (United States)

    Pavlov, V N; Bakirov, A A; Kabirov, I R; Izmajlov, A A; Kutlijarov, L M; Safiullin, R L; Urmancev, M F; Sultanov, I M; Abdrahimov, R V

    2015-01-01

    Evisceration of the pelvic organs (EPO) is a fairly uncommon surgical treatment that removes all organs from a patient's pelvic cavity. We use gracilis musculocutaneous flap to repair pelvic floor after EPO. Over the period from November 2013 to December 2014 we carried out EPO with reconstructive repair of the pelvic floor with gracilis musculocutaneous flap in 10 patients with locally advanced pelvic tumors. We describe the surgical procedure and surgical outcomes in these patients. Mean age of the patients was 55 years. Mean duration of EPO with the pelvic floor repair was 285 min., mean blood loss--595 mL and the average length of hospital stay--19 days. Gracilis musculocutaneous flap has a sufficient arterial supply and mobility for pelvic floor reconstruction. Necrosis of flap's distal edge occurred in one of the 10 clinical cases, while the remaining flaps were fully preserved. Complete healing of wounds with no signs of weakening of the pelvic floor muscles was observed in all cases. Pelvic floor reconstruction is an essential procedure in order to reduce complications associated with the evisceration of the pelvic organs. The Gracilis musculocutaneous flap is the logical alternative to repair pelvic floor defect. It does not contribute to complications like functional deficiency of the lower limbs, complications of stoma formation or weakening of the muscles of the anterior abdominal wall. PMID:26390558

  13. 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.

  14. 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.

  15. 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.

  16. Our Initial Experiences with Laparoscopic Urologic Surgery

    OpenAIRE

    Selçuk Altın; Ramazan Topaktaş2; Ali Akkoç; Cemil Aydın; Reha Girgin; Zeynep Banu Aydın; Kadir Yıldırım

    2016-01-01

    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 postoper...

  17. 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...

  18. 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...

  19. Unsuspected urological anomalies in asymptomatic cryptorchid boys

    International Nuclear Information System (INIS)

    In a period of 6 years 144 asymptomatic boys with cryptorchidism, of mean age 7 ± SD 3.5 years, underwent orchiopexy. None of these boys referred to a history of a known urological anomaly, urinary tract infection haematuria, palpable mass in the renal region, bladder extrophy, epispadias, hypospadias or anorectal malformation. On the third day after orchiopexy an intravenous pyelography was done in every boy following testicular protection against irradiation. Ultrasonic investigation was not available at that time. There were minor urological abnormalities in 36 (25%) boys and major ones in 8 (5.5%) boys. A major anomaly is defined as one resulting in significant loss of renal substance (one case of single kidney and three cases of unilateral renal hypoplasia), or requiring surgical correction for conservation of the renal substance (one case of ureterocele, two cases of pelviureteric stenosis and one case of vesicoureteric stenosis with ipsilateral hydronephrosis). The unsuspected major urological abnormalities are usually ipsilateral to the more undescended testis. They may be associated with a hernia and are more frequent in bilateral cryptorchidism. In conclusion we encourage the routine use of IVP, or ultrasonic investigation or dynamic renal scanning (99mTc-DTPA), if it is possible, in all patients undergoing orchiopexy for the detection of an unsuspected major renal anomaly. (orig.)

  20. 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

  1. Urological manifestations of Chikungunya fever: A single centre experience

    Directory of Open Access Journals (Sweden)

    Baishya Ramen

    2010-01-01

    Full Text Available Background: Chikungunya is a viral infection often associated with lower urinary tract dysfunction. This study evaluates the urological squeal of Chikungunya fever in a single centre after an epidemic in 2006-2007 in India. Materials and Methods: Retrospective analysis of medical records of 13 patients with lower urinary tract symptoms after Chikungunya fever was evaluated and outcome following intervention assessed. Results: A total of 13 patients (M:F=9:4, with age ranging from 30 to 72 years, were included in the study. They presented with chronic urinary retention (n=9, 69.23% of which two had paraparesis, voiding symptoms alone (n=7, 53.8%, storage symptoms alone (n=3, 23%, and acute urinary retention (n=1, 7.6%. Presentation with lower urinary tract symptoms after an episode of Chikungunya fever was after a mean period of 163 days (range 30-360 days. Mean serum creatinine on presentation was 1.8 mg/dl (0.6-6.5 mg/dl. Evaluation revealed dilated upper tract in four (30.7% patients. Cystometrography showed acontractile detrusor (n=3, 37.5%, hypocontractile detrusor (n=3, 37.5%, overactive detrusor (n=1, 12.5% and normal study (n=1, 12.5%. At the mean follow up of 11 months, 11 patients (84.6% had satisfactory functional outcome after intervention, namely supra pubic diversion and bladder training (n=5, 38.4%, alpha blocker (n=3, 23%, timed frequent voiding (n=2, 15.3%, clean intermittent catheterization (n=2, 15.3%, trial void with alpha blocker (n=1, 7.6% while two are on continuing supra pubic diversion due to persistent neurological deficit. Conclusions: Chikungunya fever is an uncommon entity in urological practice, often associated with urinary symptoms. An accurate assessment of the symptoms and timely intervention prevents upper tract deterioration and improves the quality of life.

  2. [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

  3. Pelvic inflammatory disease

    Directory of Open Access Journals (Sweden)

    Práxedes Rojas Quintana

    2007-12-01

    Full Text Available A bibliographical revision on the main topics referred to the acute pelvic inflammatory disease which includes definition, risk factors, diagnosis, and treatment with the objective to create a supporting educational aid to the teaching of students of 4th and 6th year of the medicine and nursing specialty in their rounds on the services of gynecology and obstetrics.

  4. 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

  5. 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.

  6. [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. PMID:25921509

  7. 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

  8. 10 years of the Urology Chair of the Siberian State Medical University. History of urology in Tomsk

    OpenAIRE

    Gudkov A.V. Gudkov A.V. Gudkov

    2016-01-01

    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 ...

  9. 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.

  10. [The role of the laser in urology].

    Science.gov (United States)

    Anidjar, M; Cussenot, O; Ravery, V; Teillac, P; Le Duc, A; Boccon-Gibod, L

    1995-04-01

    There is currently a renewed interest in laser in the field of urology, essentially for the treatment of benign prostatic hypertrophy, as a result of recent developments in the field of fibres. Laser is light coherent in time and space emitted continuously or in pulses. Only its thermal and photochemical properties are used in urology. Endoscopic coagulation of superficial bladder tumours by Nd YAG laser does not seem to be better than classical endoscopic resection, at the present time, as although it is less haemorrhagic, it does not decrease the recurrence rate. Photochemotherapy of bladder carcinoma in situ still constitutes a complex treatment protocol reserved for specialized centres. Lastly, upper urinary tract tumours can be treated by Nd YAG laser coagulation, in rare indications which are the same as those of ureteroscopic or percutaneous resection. The recent development of lateral firing laser fibres and contact tip fibres has led to a renewed interest in laser in benign prostatic hypertrophy. Two different techniques have been proposed: Nd YAG laser coagulation under direct visual or ultrasound control (TULIP), which gives delayed objective results (two or three months) and contact tissue vaporization (Nd YAG, diode), whose effects are more immediate. In both cases, intraoperative bleeding is minimal and the length of hospital stay is decreased, but the duration of urine drainage remains to be defined. Endoscopic pulsed laser urinary lithotripsy (dye, Ho YAG), although effective and atraumatic, is not justified at the present time because of its high cost compared to mechanical percussion lithotripters. Lastly, laser treatment for urethral stricture has not been found to be superior to classical scalpel urethrotomy and laser tissue welding is still in the experimental stages. In conclusion, laser technology, especially fibers, has currently reached an important phase of development with applications for urological disease, essentially in the treatment

  11. Significance of CT in urological imaging diagnosis

    International Nuclear Information System (INIS)

    There have been many reports about the usefulness of the CT imaging on the urological fields. Advance in CT equipment provides us some new diagnostic and therapeutic yields. There are the reconstruction, the dynamic scanning and the therapeutic application. Therefore, in addition to the ordinary characteristics of conventional CT equipment, the new CT scanner has several clinical advantages of the sagittal and coronal reformation, of the dynamic and quantitative evaluation, and of applying to radiation therapy planning. The CT scan should be performed reasonably after consideration of the potential advantages. (author)

  12. Common urological problems in children: prepuce, phimosis, and buried penis.

    Science.gov (United States)

    Chan, I Hy; Wong, K Ky

    2016-06-01

    Parents often bring their children to the family doctor because of urological problems. Many general practitioners have received little training in this specialty. In this review, we aimed to provide a concise and informative review of common urological problems in children. This review will focus on the prepuce. PMID:27149978

  13. 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

  14. 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

  15. 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...

  16. 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

  17. 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

  18. Pelvic radiation disease: Updates on treatment options.

    Science.gov (United States)

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

    2015-12-10

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

  19. The Global Prevalence of Infections in Urology Study

    DEFF Research Database (Denmark)

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

    2016-01-01

    The Global Prevalence of Infections in Urology (GPIU) study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological...... patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as...... urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions...

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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

  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. 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.

  8. [Use of the laser in urology].

    Science.gov (United States)

    Le Guillou, M; Ferrière, J M; Piéchaud, T; Gaston, R; Brucher, P

    1988-01-01

    The usage of laser therapy in urology is based upon thermal effects that lead to tissue destruction by coagulation necrosis and volatilization. The endoscopic treatment of bladder tumors has been its most important utilization. The authors report their experience with 681 bladder tumors in 198 patients and present the technical details of laser therapy, the indications and the results. The recurrence rate at the previously treated tumor area was found to be rather improved: 0.75/100 months/patient for stage pTa and 0.92/100 months/patient for stage pT1. Other utilizations for laser therapy exist: upper tract urothelial tumors mainly in selected cases as solitary kidney; urethral localizations of urothelial tumors and condylomata acuminata; urethral stenosis, as a complement of optical urethrotomy; hemorrhagic cystitis after radiotherapy and some forms of chemotherapy. The pulsed dye laser may become an important advance in endoscopic treatment of ureteral calculi. PMID:3289479

  9. [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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Florian Wagenlehner

    2016-01-01

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

  12. 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.

  13. [Expert opinion on surgical care pathway management of neurologic patients from Neuro-Urology Committee of the French National Association of Urology (AFU)].

    Science.gov (United States)

    Caremel, R; Phé, V; Bart, S; Castel-Lacanal, E; De Sèze, M; Duchene, F; Bertrandy-Loubat, M; Mazerolles, M; Scheiber-Nogueira, M C; Karsenty, G; Gamé, X

    2013-04-01

    The surgical care pathway of neurologic patients has two aims: preventing urinary morbidity and mortality and improving their quality of life. It requires taking into account the specificities of disabilities in domains of body functions: circulatory, ventilation and digestive physiology, motor functions, sensory functions, mental functions, and skin fragility which are responsible of dependencies in this heterogeneous group of patients. This management is necessarily multidisciplinary to be optimal and through specific clinical care pathway, providing guidance to the surgical procedure: preparation of the surgery, its realization, and post-operative rehabilitation. The indication for surgery must be coordinated and validated in neuro-urology multidisciplinary staff. Preoperative stay in a physical and rehabilitation medicine center may be useful to ensure a complete assessment and anticipate problems related to surgery. The patient will be hospitalized in the urology department in a single room suited to their disabilities and handicaps. The chronic treatments should be not modified if possible. The lack of sensitivity does not dispense anesthesia to prevent autonomic hyperreflexia, the most severe complication after high complete spinal cord injury. The laparoscopy and sub-peritoneal surgery, the early removal nasogastric tube and early refeeding make it possible to early resumption of intestinal transit. In many cases, the patients should be transferred to a physical and rehabilitation medicine during post-operative period where the nursing care will be most suitable. A quickly adapted rehabilitation must be able to reduce loss of function and physical dependence. PMID:23545005

  14. '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...... 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...

  15. '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...

  16. 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.

  17. 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.

  18. Prenatal diagnosis and telemedicine consultation of fetal urologic disorders.

    Science.gov (United States)

    Rabie, Nader Z; Canon, Stephen; Patel, Ashay; Zamilpa, Ismael; Magann, Everett F; Higley, Jared

    2016-06-01

    In Arkansas, telemedicine is used commonly in obstetrics through Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS), the existing statewide telemedicine network. This network is used primarily for tele-ultrasound and maternal-fetal medicine consultation. This study is a retrospective case series, describing all the patients who had a prenatally diagnosed urologic anomaly that required prenatal urologic consultation. From 2009-2013, approximately 1300 anomalies were recorded in the Arkansas Fetal Diagnosis and Management (AFDM) database, 14% of which were urologic anomalies. Twenty-six cases required prenatal urologic consultation, 25 of which were conducted via telemedicine. Teleconsultation allowed patients to combine maternal-fetal medicine and urologic consultations in one visit, saving time and effort and ultimately, for most patients, providing reassurance that delivery could be accomplished locally with postnatal follow-up already arranged. While there are several studies reporting the use of telemedicine for various subspecialty consultations, to our knowledge, this is the first to describe the use of telemedicine for prenatal urology consultation. Future research could randomize patients prospectively to allow comparison of both the outcomes as well as the patient experience. PMID:26199277

  19. ACR Appropriateness Criteria® Acute Pelvic Pain in the Reproductive Age Group.

    Science.gov (United States)

    Bhosale, Priyadarshani R; Javitt, Marcia C; Atri, Mostafa; Harris, Robert D; Kang, Stella K; Meyer, Benjamin J; Pandharipande, Pari V; Reinhold, Caroline; Salazar, Gloria M; Shipp, Thomas D; Simpson, Lynn; Sussman, Betsy L; Uyeda, Jennifer; Wall, Darci J; Zelop, Carolyn M; Glanc, Phyllis

    2016-06-01

    Acute pelvic pain in premenopausal women frequently poses a diagnostic dilemma. These patients may exhibit nonspecific signs and symptoms such as nausea, vomiting and leukocytosis. The cause of pelvic pain includes a myriad of diagnostic possibilities such as obstetric, gynecologic, urologic, gastrointestinal, and vascular etiologies. The choice of the imaging modality is usually determined by a suspected clinical differential diagnosis. Thus the patient should undergo careful evaluation and the suspected differential diagnosis should be narrowed before an optimal imaging modality is chosen. Transvaginal and transabdominal pelvic sonography is the modality of choice, to assess for pelvic pain, when an obstetric or gynecologic etiology is suspected and computed tomography is often more useful when gastrointestinal or genitourinary pathology is thought to be more likely. Magnetic resonance imaging, when available in the acute setting, is favored over computed tomography for assessing pregnant patients for nongynecologic etiologies owing to its lack of ionizing radiation.The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:26588104

  20. 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 ...

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

    Directory of Open Access Journals (Sweden)

    Schaeffer Anthony J

    2009-11-01

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

  2. 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

  3. 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

  4. 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

  5. Impact of Bioelectronic Medicine on the Neural Regulation of Pelvic Visceral Function

    OpenAIRE

    de Groat, William C.; Tai, Changfeng

    2015-01-01

    Neuromodulation elicited by electrical stimulation of peripheral or spinal nerves is a U.S. Food and Drug Administered (FDA)-approved therapy for treating disorders of the pelvic viscera, including urinary urgency, urgency-frequency, nonobstructive urinary retention and fecal incontinence. The technique is also being tested experimentally for its efficacy in treating interstitial cystitis, chronic constipation and pelvic pain. The goal of neuromodulation is to suppress abnormal visceral sensa...

  6. [The future of biomaterials in urology].

    Science.gov (United States)

    Grise, Philippe

    2002-12-01

    The fields of application of implanted biomaterials will continue to grow, ranging from the use of catheters and slings for the genitourinary tract, to the production of tissues and organs. The scale of research has changed over recent years, passing from a macroscopic view to a microscopic view, resulting in a change from mechanical devices, such as prostheses, catheters and slings to the cellular unit and more particularly in vitro cell cultures. New techniques, such as gene therapy and cell reconstruction have been recently introduced into the field of urology. Prospective biocompatibility studies must be conducted to establish appropriate biocompatibility standards adapted to new materials. The development of these new materials required a multidisciplinary approach involving engineers, biologists and physicists. It must be conducted in specialized centres skilled in biocompatibility research and in close collaboration with a basic bioscience and clinical practice. In the future, synthetic biomaterials will have an almost unlimited range of mechanical properties allowing much more specific applications. Another improvement of materials will concern a reduction of the risk of infection, erosion, mineral deposits, migration of particles, secondary reactions, and finally improved durability. However, the long-term properties of synthetic materials will probably not be as good as those of natural or almost natural biomaterials derived from biotechnology by tissue engineering. PMID:12545647

  7. 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

  8. 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

  9. [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

  10. [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

  11. 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.

  12. Implications of Biofilm Formation on Urological Devices

    Science.gov (United States)

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

    2008-09-01

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

  13. 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.

  14. 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...

  15. Differential diagnosis and staging of urological tumors by magnetic resonance imaging compared with computed tomography

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) was performed on 49 urological tumors (11 renal cell carcinomas, 3 renal pelvic cancers, 2 renal angiomyolipomas, 1 renal leiomyosarcoma, 1 large renal cvst, 4 adrenal tumors, 11 bladder cancers, 2 bone metastasis from bladder cancer, 10 prostatic cancers, 1 prostatic sarcoma, 1 urethral cancer, 1 penile cancer and 1 perivesical granuloma) since October 1985 to September 1986. MRI was performed using a Signa (G.E.) with a 1.5 T superconductive magnet and 3 images, including T1 weighted image, T2 weighted image, and proton density image, were obtained. In conclusion MRI is a noninvasive examination and gives more information than computed tomography despite its high cost. In renal cell carcinoma, the chemical shift in MRI and clear visualization of tumor thrombus enable accurate staging. Differential diagnosis from other renal mass lesions may be possible by the T2 weighted image. In adrenal disease, most of the adrenal masses can be differentiated, but in some cases it is impossible. In bladder cancer, wall invasion of tumor may be evaluated in T2 weighted image, and MRI is suitable for staging of locally advanced tumor. In prostatic cancer, visualization of periprostatic plexus and differentiation between internal and external gland may enable local staging and identification of low stage tumors. (author)

  16. 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, ...

  17. 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 ...

  18. 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 ...

  19. Screening Pelvic Examination in Nonpregnant Adult Women

    Science.gov (United States)

    ... the cervix to look for cervical cancer (Papanicolaou [Pap] smear) during the pelvic examination. However, the value of ... have no symptoms and do not need a Pap smear is unclear. The potential benefits of pelvic examination ...

  20. 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

  1. 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

  2. The standard of urological consultation of patients qualified for renal transplant – a review

    OpenAIRE

    Antoniewicz, Artur Andrzej; ZAPAŁA, ŁUKASZ; Bogucki, Arkadiusz; Małecki, Robert

    2015-01-01

    Urological consultation is an important step in the procedure of a patient's preparation before placing him/her on a waiting list for a renal transplant. Urological work-up aims to diagnose, treat, and optimize any preexisting urological disease. In the present paper we present the review of the literature together with the authors’ conclusions based on literature and their experience. There is not enough data in current literature and urology manuals on the adequate sequence of the urologica...

  3. 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...

  4. THE STATE OF UROLOGIC CANCER CARE IN MOSCOW

    Directory of Open Access Journals (Sweden)

    V. I. Shirokorad

    2014-07-01

    Full Text Available In 2003 malignant neoplasms (MN of the urinary system and male genital organs affected more than 43,000 people in Russia, amounting to 9.4% in the structure of total cancer morbidity. In 2012, the incidence of urologic cancers at only three sites (prostate, kidney, and bladder was 12.1%. In the same year, Moscow showed the proportion of patients with new-onset urologic cancer, which accounted for one sixth (16.5% of the total MN morbidity and almost one fifth (18.5% of the total number of registered cancer patients.

  5. Surgical Management of Urologic Trauma and Iatrogenic Injuries.

    Science.gov (United States)

    Zinman, Leonard N; Vanni, Alex J

    2016-06-01

    Genitourinary trauma usually occurs in the setting of multisystem trauma, accounting for approximately 10% of all emergency department admissions. Timely evaluation and management of the trauma patient have the potential to minimize urologic morbidity and mortality. New imaging modalities and a growing emphasis on nonoperative expectant management of both upper and lower urinary tract injuries have changed the field of urologic trauma. Concomitant injury to both the upper and the lower urinary tract is rare, but careful evaluation is critical to identify these devastating injuries. PMID:27261786

  6. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual gastroenterology-urology surgical... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a)...

  7. Absence of bile acid malabsorption as a late effect of pelvic irradiation

    International Nuclear Information System (INIS)

    The pathophysiology of chronic radiation-induced diarrhea was evaluated in 28 patients who had undergone pelvic irradiation for gynecologic neoplasms 2 to 7 years previously. Twenty-seven patients undergoing radiotherapy with techniques that did not require abdominal or pelvic irradiation served as controls. The glycine conjugates of cholic acid (GC) were measured in serum by radioimmunoassay. Fasting and 2 hr. pp GC levels for the pelvic irradiated patients were 11.0 +/- 11.1 (mean +/- SD) and 24.8 +/- 17.3 micrograms/dl. Fasting and 2 hr. pp GC levels for controls were 12.6 +/- 7.4 and 28.0 +/- 14.7. There were no significant differences in the post-prandial increases in serum GC between pelvic irradiated patients and controls (p = .23, Type II error probability = .13). There was also no significant difference in the 2 hr. pp and fasting GC ratio (p = .39). There was significant difference between the stool frequency (p less than .01) and the prevalence of diarrhea (p less than .02) between pelvic irradiated patients and controls. The data suggest that bile acid malabsorption due to ileal dysfunction is not an inevitable late complication of pelvic irradiation and is not the major determinant in the pathophysiology of chronic radiation-induced diarrhea

  8. 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

  9. Pelvic spleen with uterovaginal prolapse

    International Nuclear Information System (INIS)

    A case of wandering (pelvic) spleen associated with third degree uterovaginal prolapse and ascaris in the biliary and intestinal tract is being presented here. On laparotomy; congested splenomegaly was found in the pelvis. Splenectomy, total abdominal hysterectomy and bilateral salpingo-ophrectomy was performed. (author)

  10. 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

  11. 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.

  12. [Artificial neural networks for decision making in urologic oncology].

    Science.gov (United States)

    Remzi, M; Djavan, B

    2007-06-01

    This chapter presents a detailed introduction regarding Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. It includes a description of ANNs methodology and points out the differences between Artifical Intelligence and traditional statistic models in terms of usefulness for patients and clinicians, and its advantages over current statistical analysis. PMID:18260271

  13. 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.

  14. 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

  15. 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)

  16. Concomitant laparoscopic urological procedures: Does it contribute to morbidity?

    Directory of Open Access Journals (Sweden)

    Maurya Kamlesh

    2009-01-01

    Full Text Available Aim: With advancement in minimal access surgery two laparoscopic procedures can be combined together shortening the total hospital stay, decreasing morbidity and overall reduced cost. Combining two laparoscopic procedures in a single session has been reported in general surgery. Very few articles are available in literature with regard to combined urological laparoscopic surgeries. This article retrospectively analyses the outcomes of multiple laparoscopic procedures performed in a single stage at our centre. Materials and Methods: Patients undergoing simultaneous procedures from May 2003 to Jan 2009 were included in the study. Patients were categorised into three groups according to the primary urological organ involved, for better comparison with the control group. Diseases involving the adrenals gland were grouped in (group 1, kidney (group 2 and renal collecting system/ureter (group 3. All patients had one urological procedure for either of the above-mentioned organs combined with another surgical procedure. Similarly three control groups were chosen according to the primary urological organ involved (group 1c- unilateral laparoscopic adrenalectomy, group 2c- unilateral laparoscopic radical nephrectomy and group 3c- unilateral laparoscopic ureterolithotomy for comparative study. The operative details, hospital stay and complications were analysed. Results: Thirty-two patients underwent 64 laparoscopic procedures under single anaesthesia. The most common procedure in this series was laparoscopic adrenalectomy (n=34 followed by laparoscopic nephrectomy (n=13. Group 1 patients had a prolonged operative time ( P=0.012 and hospital stay ( P=0.025 when compared with group 1c. However, blood loss was comparable in both the groups. Patients in groups 2 and 3 had comparable operative times, blood loss and recovery period with respect to their controls. Intraoperatively, the end tidal carbon dioxide levels were within permissible limits. All

  17. 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, ...

  18. 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

  19. 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....

  20. 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.

  1. 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.

  2. Pelvic morphology in ischiofemoral impingement

    Energy Technology Data Exchange (ETDEWEB)

    Bredella, Miriam A.; Azevedo, Debora C.; Oliveira, Adriana L.; Simeone, Frank J.; Chang, Connie Y.; Torriani, Martin [Massachusetts General Hospital, Department of Radiology, Musculoskeletal Imaging and Intervention, Boston, MA (United States); Stubbs, Allston J. [Wake Forest University School of Medicine, Department of Orthopedic Surgery, Division of Sports Medicine, Winston-Salem, NC (United States)

    2014-11-06

    To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls. The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender. The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15 %) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender. Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI. (orig.)

  3. 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.)

  4. Pelvic floor rehabilitation in multiple sclerosis.

    Science.gov (United States)

    De Ridder, D; Vermeulen, C; Ketelaer, P; Van Poppel, H; Baert, L

    1999-03-01

    Although primarily used for treatment of stress incontinence, pelvic floor rehabilitation has been reported to have some value in the treatment of detrusor instability and urgency. In neurogenic bladder dysfunction due to Multiple Sclerosis, many authors have suggested the possible use of pelvic floor rehabilitation as a treatment modality. Therefore, we designed an open prospective trial to look at the possible role of pelvic floor rehabilitation in voiding dysfunction due to MS, concentrating upon the clinical and neurological parameters in relation to the outcome. A new scoring system for pelvic floor dysfunction is introduced. Thirty female patients were evaluated. In 25, the strength of the pelvic floor was significantly improved after one month (p rehabiltation has a place in the treatment of MS patients with a low Kurtzke score and without pelvic floor spasticity. PMID:10218095

  5. [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

  6. Diagnostic trials using CT scanning in urology

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, T. (Fujita Gakuen Univ., Toyoake, Aichi (Japan). School of Medicine)

    1981-07-01

    We attempted various new diagnostic trials using CT scanning. The results obtained were: 1) Twelve transplanted kidneys were scanned after bolus contrast administration. Enhancing indices (EI) calculated from the formula: EI = (CT numbers 10 minutes after injection) / (CT numbers before injection) were inversely proportional to serum creatinine. 2) CT guided puncture was successful in percutaneous nephrostomy in 3 of 5 cases of obstructive uropathy and in 5 cases of renal cystic disease. 3) Emergent CT scans were diagnostically useful in 9 cases of urinary tract injury to indicate surgery. 4) CT scans after perivesical pneumography in 5 cases of vesical tumor diclosed perivesical invasion. 5) Cervical CT scans were performed as a localization study of parathyroid gland in 3 cases of secondary hyperparathyroidism in chronic renal insufficiency. More than 1400 mg of parathyroid gland in the neck was clearly visualized on cervical CT scans.

  7. Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Pelvic Organ Prolapse Women

    OpenAIRE

    Ying, Tao; Li, Qin; Xu, Lian; LIU, FEIFEI; Hu, Bing

    2012-01-01

    The present study investigated the morphology and structure of pelvic floor in 50 nulliparous and 50 pelvic organ prolapse (POP) women using translabial three-dimensional (3D) ultrasound. The levator hiatus in POP women was significantly different from that in nullipara women. In POP women, the size of pelvic floor increased, with a circular shape, and the axis of levator hiatus departed from the normal position in 36 (72%) cases. The puborectalis was avulsed in 18 (36%) cases and the pelvic ...

  8. Intraoperative radioguidance with a portable gamma camera: a novel technique for laparoscopic sentinel node localisation in urological malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Vermeeren, L.; Valdes Olmos, R.A.; Vogel, W.V.; Sivro, F.; Hoefnagel, C.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Meinhardt, W.; Bex, A.; Poel, H.G. van der; Horenblas, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands)

    2009-07-15

    Our aim was to assess the feasibility of intraoperative radioguidance with a portable gamma camera during laparoscopic sentinel node (SN) procedures in urological malignancies. We evaluated the use of the intraoperative portable gamma camera in 20 patients: 16 patients with prostate carcinoma (PCC), 2 patients with renal cell carcinoma (RC) and 2 patients with testicular cancer (TC). Intra/peritumoural injection of {sup 99m}Tc-nanocolloid ({sup 99m}Tc) was followed by planar lymphoscintigraphy, SPECT/CT and marking of SN levels. Before laparoscopy a {sup 125}I seed was fixed on the laparoscopic gamma probe as a pointer of SN seeking. The portable gamma camera was set to display the {sup 99m}Tc signal for SN localisation and the {sup 125}I signal for SN seeking. Matching of these signals on screen indicated exact SN localisation, and consequently this SN was removed. The mean injected dose was 218 MBq in PCC, 228 MBq in RC and 88 MBq in TC. Pelvic SN were visualised in all PCC patients, with uncommonly located SN in seven patients. SN metastases were found in seven patients (one in a uncommonly located SN). Both RC patients and TC patients had para-aortic SN, which were all tumour free. A total of 59 SN were removed. The portable gamma camera enabled real-time SN display/identification in 18 patients (90%). The use of a portable gamma camera in combination with a laparoscopic gamma probe incorporates intraoperative real-time imaging with improved SN identification in urological malignancies. This procedure might also be useful for SN identification of other deep draining malignancies. (orig.)

  9. 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...

  10. 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

  11. 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

  12. 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.

  13. 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 ...

  14. Assessment of pelvic floor dysfunctions using dynamic magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Hoda Salah Darwish

    2014-03-01

    Conclusion: Dynamic MRI is an ideal, non invasive technique which does not require patient preparation for evaluation of pelvic floor. It acts as one stop shop for diagnosing single or multiple pelvic compartment involvement in patients with pelvic floor dysfunction.

  15. 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, ...

  16. [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. PMID:22914883

  17. 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.

  18. Retrospective review of pelvic malignancies undergoing total pelvic exenteration

    Directory of Open Access Journals (Sweden)

    Kuhrt Maureen P

    2012-06-01

    Full Text Available Abstract Background In patients with locally advanced or recurrent pelvic malignancies, total pelvic exenteration (TPE may be necessary for curative treatment. Despite improvements in mortality rates since TPE was first described, morbidity rates remain high due to the extensive resection and the aggressiveness of these tumors. We have studied the outcomes of TPE surgery performed at our institution. Methods Fifty-three patients with various pelvic pathologies underwent TPE between 2004 and 2010. Patients were divided into two groups based on pathology: colorectal (n = 36 versus non-colorectal (n = 17 malignancies. Demographics, operative reports, pathology reports, periprocedural events, and outcomes were analyzed. Comparison of the two groups was performed using student’s t-test and Fisher’s exact test. Survival curves were constructed using the Kaplan–Meier method and compared using the log rank test. Results The colorectal and non-colorectal groups were similar in demographics, operative times, length of stay, estimated blood loss, and rates of preoperative and intraoperative radiation use. Chemotherapy use was increased in the colorectal group compared with the non-colorectal group (55.6% vs. 23.5%, P = 0.04. Complication rates were similar: 86% in the colorectal group and 76% in the non-colorectal group. In the colorectal group, 27.8% of patients developed perineal abscesses, whereas no patients developed these complications in the non-colorectal group (P = 0.02. No survival difference was seen in primary versus recurrent colorectal tumors; however, within the colorectal group there was a survival advantage when comparing R0 resection to R1 and R2 resection combined. Median survival rates were 27.3 months for R0 resection and 10.7 months for R1 and R2 resection combined. The median survival was 21.4 months for the colorectal group and 6.9 months for the non-colorectal group (P = 0.002. Conclusions

  19. Embolization of Incompetent Pelvic Veins for the Treatment of Recurrent Varicose Veins in Lower Limbs and Pelvic Congestion Syndrome

    International Nuclear Information System (INIS)

    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.

  20. 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.

  1. [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

  2. 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 ...

  3. 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

  4. Task completion time: Objective tool for assessment of technical skills in laparoscopic simulator for urology trainees

    OpenAIRE

    Mishra, Shashi K.; Ganpule, A.; Kurien, A; Muthu, V.; Desai, Mahesh R.

    2008-01-01

    Context: Laparoscopic surgical simulation is a valuable training tool for urology trainees. Aims: We assessed the validity of task completion time (TCT) as an objective tool for practicing and acquiring technical skills in a simulated laparoscopy environment. Materials and Methods: Fifteen participants comprising postgraduate urology trainees from first to third year (n = 12), urology fellow (n = 1) and consultants (n = 2) underwent basic laparoscopic training on the “Beetle Universal” endotr...

  5. 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...

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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:// ...

  11. 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...

  12. 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.)

  13. 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.)

  14. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Stoker, Jaap [Amsterdam Univ. (Netherlands). Dept. of Radiology; Taylor, Stuart A. [University College Hospital, London (United Kingdom). Dept. of Specialist X-Ray; DeLancey, John O.L. (eds.) [Michigan Univ., Ann Arbor, MI (United States). L4000 Women' s Hospital

    2008-07-01

    This volume builds on the success of the first edition of imaging pelvic floor disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. (orig.)

  16. Occupational lifting and pelvic pain during pregnancy

    DEFF Research Database (Denmark)

    Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Juhl, Mette;

    2013-01-01

    OBJECTIVES: Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim...... of this study was to examine the association between occupational lifting and pelvic pain during pregnancy. METHODS: The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996-2002. During pregnancy, the women provided information on occupational...... lifting (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression. RESULTS: Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg) was...

  17. Urinary-bladder toxicity following pelvic irradiation and simultaneous cyclophosphamide therapy

    International Nuclear Information System (INIS)

    The frequency and severity of urinary-bladder toxicity were determined retrospectively in a large series of childhood cancer patients treated with either pelvic irradiation and simultaneous cyclophosphamide or cyclophosphamide with extrapelvic irradiation. Of 50 patients who received the first combination, 17 (34 percent) developed urinary-bladder toxicity. Eight of the 17 had transient hematuria and dysuria with complete clearing clinically after cessation of treatment; nine had chronic or intermittent hematuria which persisted after treatment was stopped and often resulted in demonstrable fibrosis and telangiectasia of the bladder. By contrast, of 60 children who received cyclophosphamide with radiotherapy outside the pelvic region, only five (8 percent) developed hematuria and in all instances it was transient. This comparative study demonstrates a significantly increased frequency and severity of urinary-bladder toxicity in cancer patients receiving pelvic irradiation with simultaneous cyclophosphamide

  18. 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.

  19. Progressive paralyzing sciatica revealing a pelvic pseudoaneurysm a year after hip surgery in a 12yo boy.

    Science.gov (United States)

    Boulouis, Grégoire; Shotar, Eimad; Dangouloff-Ros, Volodia; Janklevicz, Pierre-Henri; Boddaert, Nathalie; Naggara, Olivier; Brunelle, Francis

    2016-01-01

    Identifying extra spinal causes of a lumbar radiculopathy or polyneuropathy can be a tricky diagnosis challenge, especially in children. Among them, traumatic or iatrogenic pseudoaneurysms of iliac arteries have been seldom reported, in adults' series. The authors report an unusual case of progressive paralyzing left sciatica and lumbar plexopathy in a 12 years old boy, 12 months after a pelvic osteotomy for bilateral hip luxation secondary to osteochondritis dissecans. Spine MRI and pelvic CT angiography revealed a giant internal iliac artery pseudoaneurysm, enclosed in a chronic hematoma. The patient was successfully treated with endovascular coil embolization, and subsequent surgical hematoma evacuation. However, three months after treatment, neurological recovery was incomplete. This case highlights the importance of a rapid and extensive diagnosis work up of all causes of lower limb radiculopathies in children, including pelvic arteries lesions especially after pelvic surgery to avoid therapeutic delays that may jeopardize the chances of neurological recovery. PMID:26545958

  20. 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.

  1. 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.

  2. 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.

  3. Relative Mortality in U.S. Medicare Beneficiaries with Parkinson Disease and Hip and Pelvic Fractures

    Science.gov (United States)

    Harris-Hayes, Marcie; Willis, Allison W.; Klein, Sandra E.; Czuppon, Sylvia; Crowner, Beth; Racette, Brad A.

    2014-01-01

    diagnosis of dementia (HR = 2.73, 95% CI = 2.68 to 2.79), kidney disease (HR = 2.66, 95% CI = 2.60 to 2.72), and chronic obstructive pulmonary disease (HR = 2.48, 95% CI = 2.43 to 2.53). Conclusions: Mortality after hip/pelvic fracture in Parkinson disease varies according to demographic factors. Mortality after hip/pelvic fracture is substantially increased among those with Parkinson disease. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. PMID:24553896

  4. Urological surgery in elderly patients: results and complications

    Directory of Open Access Journals (Sweden)

    Brodak M

    2015-02-01

    Full Text Available Milos Brodak, Jan Tomasek, Jaroslav Pacovsky, Lukas Holub, Petr Husek Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic Purpose: Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients.Methods: The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012. The average age of patients was 78. The results and complications were categorized based on the type of surgery performed, and the Dindo–Clavien scale.Results: The median follow-up was 18 months. All surgeries for malignant tumors were performed successfully with no residual disease. Totally, 48 (22% complications were recorded. The most serious were as follows: one patient (<0.5% died; and four (<2% patients underwent reoperation. The most common complications involved infection, mainly sepsis and surgical site infections. Other complications included mild respiratory insufficiency, delirium, bleeding, etc.Conclusion: Surgeries in elderly patients were effective and safe. The cornerstone of safety is careful preparation and treatment of comorbidities. Complications occurred mainly as a result of emergency procedures during emergency procedures and in major surgeries such as cystectomy and nephrectomy. The standard use of low molecular-weight heparin caused no incidence of thromboembolic disease. Keywords: urinary tract, aged, postoperative complications, Dindo–Clavien classification

  5. 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

  6. 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.

  7. 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

  8. Urological anomalies in the Northern Region Fetal Abnormality Survey.

    OpenAIRE

    Scott, J. E.; Renwick, M

    1993-01-01

    From 1 January 1985 to 31 December 1990, the Northern Region Fetal Abnormality Survey received 736 notifications of fetuses with suspected urological abnormalities; a prevalence of three per 1000 births. There was a male:female ratio of 2:1, the ratio was higher in obstructive than in intrinsic renal parenchymal lesions. Overall diagnostic sensitivity was 68.9% and positive predictive value 50.8%. Hydronephrosis was the most frequent antenatal diagnosis (421 cases, 57.2%): 233 (55.3%) of thes...

  9. Surgery therapy of lung metastasis by urological malignity

    International Nuclear Information System (INIS)

    The authors analyse the group of 49 patients operated for pulmonary metastases due to a primary urological tumor. The patients were randomized into two groups. The first group were the patient suffering from from pulmonary metastases of testicular tumors treated by primary chemotherapy and subsequent surgery. The other group were the patients with pulmonary metastases of renal and urinal bladder cancer treated by primary surgery. On longitudinal fallow up, pulmonary recurrence was detected in 10 patients. Six patients underwent a repeat operation Based on their own experience, the authors consider indicated. Primary removal or their recurrence of pulmonary metastases (authors). 3 tabs., 2 figs., 16 refs

  10. 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...

  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. European Association of Urology--31st Annual Congress (March 11-15, 2016--Munich, Germany).

    Science.gov (United States)

    Dulsat, C

    2016-04-01

    The 31st Annual European Association of Urology (EAU) Congress held in Munich, Germany, was a platform for expert urological specialists from all over the world to find a unique space to share their evidence-based knowledge during state-of-the art lectures, presentations and courses. This report covers selected presentations covering cancer-related presentations. PMID:27252990

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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.)

  19. 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. PMID:26880513

  20. 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.

  1. 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.

  2. 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...

  3. Current status of sentinel node biopsy in urological malignancies

    Directory of Open Access Journals (Sweden)

    Friedhelm Wawroschek

    2010-08-01

    Full Text Available Like in most other malignancies the lymph node status is of outstanding prognostic relevance and an important tool for the determination of adjuvant strategies for urological tumor entities, too. Even in the era of PET/CT and MRI with iron oxid nano-particles the radiological imaging technology is strongly limited in cases of metastases smaller than 5 mm. Therefore only the operative lymph node exploration is suitable for an exact lymph node staging. The dilemma, however, is that the extended lymphadenectomy techniques feature a high morbidity and that any limitation of the dissection area results in a reduced detection rate of metastases in penile and prostate cancer. In contrast the sentinel- guided lymphadenectomy (SLND offers a short operation time and a low morbidity without the risk of a significantly reduced detection of lymph node positive patients. As a consequence of many published papers dealing with a few thousands of patients the European Association of Urology (EAU guidelines recommend the SLND in penile cancer (tumor stages ≥ T1G2 and as an option in prostate cancer. The latest studies of bladder, renal cell and testicular cancer promise the feasibility for these tumor entities, too. Up to which extend these thera- peutic concepts are able to replace or at least complement the default therapeutic procedures has to be shown in further studies.

  4. Usefulness of fetal MR imaging for congenital urological anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Akasaka, Yoshinobu; Sugimura, Kazuro [Kobe Univ. (Japan). Graduate School of Medicine; Kanegawa, Kimio [Kobe Children' s Hospital (Japan)

    2002-04-01

    Despite the fact that congenital urological anomalies are not rare, the role of fetal MRI in these disorders has not been well defined. We evaluated the usefulness of MRI in the prenatal diagnosis of patients with such anomalies. A total of 23 cases were included in this study. The 23 cases were divided as follows: 7 cases of bilateral renal agenesis or severe hypogenesis (Potter sequence: PS), 8 cases of multicystic dysplastic kidney (2 cases were bilateral: MCDK), 5 cases of hydronephrosis (HN), one case of hydroureteronephrosis (HUN) and 2 cases of HN or HUN with duplication (DUP). In this study the scan time for fetal MRI was approximately 30 seconds for one sequence. Overall, the diagnostic accuracy was 65.2%; 85.2% for PS, 87.5% for MCDK, 60.0% for HN, 50.0% for HUN and 0% for DUP. Even though imaging quality was relatively poor for motion artifact in this series, we were able to diagnose PS and MCDK because of associated lung hypoplasia and its characteristic shape. The diagnosis of HN, HUN and DUP was difficult. HN was sometimes misdiagnosed as a retroperitoneal cystic mass because the dilation of calices was obscured in severe cases. In HUN and DUP cases dilation of the ureter was unclear. However, using HASTE or true FISP sequence may solve this problem. Based on this data, we conclude that fetal MRI is useful for prenatal diagnosis of urological anomalies. (author)

  5. Investigation about the usefulness of strontium 89 for urological cancer

    International Nuclear Information System (INIS)

    We investigate the efficacy and the safety of Strontium89 (Sr89) for urological cancer. A total of 18 patients with urological cancers (6 patients with renal cell carcinoma and 12 patients with prostatic carcinoma) were administered intravenously at a dose of 2.0 MBq/kg, maximum 141 MBq/body Sr89 for pain palliation. The evaluation method of the efficacy is that effective' is for the case Sr89 could reduced the amount of pain killers, no change', and 'ineffective' is for the case increasing the amount of pain killers. We also investigated when the effect appeared and how long it continued in the effective cases. The safety of Sr89 was evaluated by Common Terminology Criteria for Adverse Events version3.0 (CTCAEv3.0). Sr89 was effective in 16 patients of the 18, no change in 1 patient, and ineffective in 1 patient. The pain level improved within 1 to 4 weeks and the effect continued for about 2 months. Bone marrow suppression was observed in 4 cases of the 18, but they were not critical. 18 patients with renal cell carcinoma or prostatic carcinoma were administered Sr89 for pain palliation. Pain was substantially improved after Sr89 therapy in 16 patients. Most of the improved patients experienced pain relief from 1 or 2 weeks following Sr89 therapy and the effect continued for 2 months. The minor adverse effects were observed, but they were not seemed to be in trouble through the clinical use. (author)

  6. 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)

  7. Imaging findings in idiopathic pelvic fibrosis

    International Nuclear Information System (INIS)

    Two patients presented with ureteric obstruction, and voiding symptoms and constipation, respectively, and were examined by means of intravenous urography and computed tomography. One patient was additionally examined by means of MR tomography. After CT (performed in both patients) and MRT (performed in one patient) had shown a diffuse, contrast-enhancing, infiltrating process in the small pelvis with infiltration of adjacent organs and vessels, surgical biopsy proved the diagnosis of idopathic pelvic fibrosis. Extension of retroperitoneal fibrosis below the pelvic rim is very rare. Clinical symptoms of pelvic fibrosis are variable and imaging findings may lead to a broad list of differential diagnoses. We present two patients with idiopathic pelvic fibrosis and discuss radiological findings and differential diagnoses of this rare disease. (orig.)

  8. 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.

  9. PERCUTANEOUS ENDOSCOPIC ELECTRORESECTION OF RENAL PELVIC TUMORS

    Directory of Open Access Journals (Sweden)

    B. K. Komyakov

    2014-07-01

    Full Text Available The paper gives the results of percutaneous electroresection of the renal pelvic wall with a tumor in 4 patients. The operation has been made for absolute indications: 3 patients had a single kidney and the fourth patient had a single functioning left kidney (the right pelvic dystopic kidney failed to function. In all the patients, the primary symptom of the disease was macrohematuria, the examination for which revealed a renal pelvic tumor measuring 1.2 to 2.5 cm in size. There were no complications after percutaneous electroresection of the renal pelvic wall with a tumor. Intrarenal BCG therapy was performed in the postoperative period. Percutaneous electroresection is indicated for tumors of the renal pelvis and the upper third of the ureter of the single kidney.

  10. 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...

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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...

  16. 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

  17. 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.

  18. 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

  19. 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 to a...

  20. 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.

  1. [Experience with argon laser in urological diseases (author's transl)].

    Science.gov (United States)

    Rothauge, C F; Nöske, H D; Kraushaar, J

    1981-09-01

    The application of the Argon laser in urology has proved to be effective in resecting recurrent, exophytic urothelial tumors of the bladder up to the size of a raspberry. In cases of wide spread bladder tumors we only perform a radiation of the resected area as local recurrence prophylaxis following transurethral resection. The urethroscopic Argon laser irradiation makes laser urethrotomy and evaporisation of urethral strictures possible. Furthermore, a curative and conservative treatment of urethral tumors is possible in combination with chemotherapy. The same applies for the penis carcinoma. Urethral ruptures are also successfully treated by urethroscopic laser recanalization. A determination of the ureteral submucosal course, which may allow a prognosis about the probable maturation, is possible in cases of cystoureteral reflux with the help of laser diaphanoscopy. PMID:7197839

  2. Novel Technologies in Urologic Surgery: a Rapidly Changing Scenario.

    Science.gov (United States)

    Gandaglia, Giorgio; Schatteman, Peter; De Naeyer, Geert; D'Hondt, Frederiek; Mottrie, Alexandre

    2016-03-01

    The introduction of laparoscopy and robotic surgery revolutionized the surgical management of urologic patients. Nonetheless, we live in an era of rapid changes, and we are probably still in the infancy of technology applied to surgery. When considering currently available technologies, there are several unmet needs to be addressed. These include the application of augmented reality, haptic feedback, tissue recognition, distant remote control, miniaturization of surgical instruments, the learning curve typical of the introduction of novel techniques, and excessive costs. In the next few years, evolution in imaging modalities in pre- and intraoperative surgical planning, as well as the introduction of novel minimally invasive platforms, would in part address these issues, substantially improving surgical outcomes. In addition, validated training programs would allow for the safe implementation of novel techniques in the clinical practice. Finally, a reduction in costs would be necessary to make technology affordable and to optimize healthcare resources. PMID:26874531

  3. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves.

    Science.gov (United States)

    Legaye, J; Duval-Beaupère, G; Hecquet, J; Marty, C

    1998-01-01

    This paper proposes an anatomical parameter, the pelvic incidence, as the key factor for managing the spinal balance. Pelvic and spinal sagittal parameters were investigated for normal and scoliotic adult subjects. The relation between pelvic orientation, and spinal sagittal balance was examined by statistical analysis. A close relationship was observed, for both normal and scoliotic subjects, between the anatomical parameter of pelvic incidence and the sacral slope, which strongly determines lumbar lordosis. Taking into account the Cobb angle and the apical vertebral rotation confers a three-dimensional aspect to this chain of relations between pelvis and spine. A predictive equation of lordosis is postulated. The pelvic incidence appears to be the main axis of the sagittal balance of the spine. It controls spinal curves in accordance with the adaptability of the other parameters. PMID:9629932

  4. Laparoscopy for urologic diseases (report of 286 cases)

    International Nuclear Information System (INIS)

    Objective: To report the experience in laparoscopy for urologic diseases. Methods: Two hundred and eighty-six patients were performed laparoscopy via the transperitoneal or retroperitoneal or extroperitoneal approach, including 160 cases of unroofing of renal cysts, 2 cases of radical nephrectomy, 15 cases of simple nephrectomy, 2 cases of nephroureterectomy of renal duplication, 7 cases of radical nephroureterectomy, 1 case of pyeloureteroplasty, 1 case of renal pedicle lymphatic disconnection, 57 cases of tumorectomy or adrenalectomy, 25 cases of ureterolithotomy, 4 cases of radical prostatecomy, 11 cases of ligations of spermatics vessels and 1 case of orchiopexy. Results: The procedures were successful in 156 cases of renal cyst. The average operative time was 82 min (ranging from 30 to 185 min). Four cases were converted to open surgery, and they were all performed retroperitoneal approach. Two radical nephrectomy were successful, the operation time were 145 to 160 min. Seventeen nephrectomy were also successful, the operation time were 85 to 220 min. Seven radical nephroureterectomy were successful, the operation time were 210 to 310 min. All adrenal procedure was successful except that in the first case. The average operation time was 132 min (ranging from 45 to 225 min). Twenty-five cases of ureterolithotomy, 4 radical prostatecomy, 11 ligations of spermatics vessels, 1 case of pyeloureteroplasty, l orchiopexy and 1 renal pedicle lymphatic disconnection were also successful. All patients recovered rightly. The average hospital stay was 5.3 days (ranging from 2 to 23 days). Conclusion: Laparoscopy is a safe, effective and minimally invasive procedure for the treatment of urologic diseases. Patients suffer pain little, and recover quickly from illness. (authors)

  5. 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.

  6. 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...

  7. 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.

  8. 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.

  9. 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 ...

  10. Symptomatic Urinary Lithiasis: Epidemiology and Management at Urology Department of University Hospital of Cotonou

    OpenAIRE

    Prince Pascal Hounnasso; Josué Dejinnin Georges Avakoudjo; Abdoul Karim Paré; Kirakoya Brahima; Adama Ouattara; Michel Michael Agounkpé; Gilles Natchagandé; Sanni Rafiou Toré; Abubakar Babagana Mustapha; Alexandre Vodounou

    2015-01-01

    Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years period ranging from January 1st, 2004 to December 31st, 2013. One hundred and two patients who were hospitalized for symptomatic urolithiasis at the Urology Department of University Hospital of Cotonou were enrolled. Results: Hospital incidence of urolithiasis w...

  11. Assessing urology and nephrology research activity in Arab countries using ISI web of science bibliometric database

    OpenAIRE

    Waleed M. Sweileh; Zyoud, Sa’ed H.; Al-Jabi, Samah W.; Sawalha, Ansam F

    2014-01-01

    Background Bibliometric analysis is increasingly being used for research assessment. The main objective of this study was to assess research output in Urology and Nephrology subject from the Arab countries. Original scientific articles or reviews published from the 21 Arab countries in “Urology and Nephrology” subject were screened using the ISI Web of Science database. Research productivity was evaluated based on a methodology developed and used in other bibliometric studies by analyzing the...

  12. 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 ...

  13. 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

  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. 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.)

  16. Pelvic arteriovenous malformation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Min; Huh, Jin Do; Joh, Young Duk [Kosin Meidcal College, Busan (Korea, Republic of)

    1995-10-15

    Arteriovenous malformation (AVM) of female pelvic organ is a rare disease of unknown cause. The authors report a case of pelvic AVM which was incidentally found during US examination of the patient with choriocarcinoma after chemotherapy. The real-time sonography revealed several cystic lesions around the uterus with adjacent dilated tortuous vessels. The color Doppler sonography depicted abundant blood flow mixed with red and blue colors within the cystic lesions and rapid turbulent systolic and diastolic flows. CT showed well-enhancing round vascular lesions with elongated vessels in the pelvis, and MRI depicted signal-void cystic lesions on both T1 and T2 weighted images with small portions of high intensity with the lesions on T2 weighted image. The angiography revealed pelvic AVM fed by tortuous uterine and vaginal arteries with a dilated draining vein.

  17. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    International Nuclear Information System (INIS)

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  18. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Lagisetty, Jyothi [Memorial Hermann Medical Center, Emergency Medicine Department, Houston, TX (United States); Slovis, Thomas [Wayne State University School of Medicine, Department of Radiology, Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Thomas, Ronald [Children' s Hospital of Michigan, Wayne State University of Medicine, Department of Pediatrics, Detroit, MI (United States); Knazik, Stephen; Stankovic, Curt [Wayne State University of Medicine, Division of Emergency Medicine, Children' s Hospital of Michigan, Detroit, MI (United States)

    2012-07-15

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  19. 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...

  20. Soft-tissue CT changes in pelvic venous thrombosis

    International Nuclear Information System (INIS)

    The computed tomographic (CT) changes in the soft tissues of the pelvis are presented in three patients with pelvic venous thrombosis. Pelvic venous thrombosis may lead to swelling of surrounding muscles and may present as a pelvic mass. This mass can simulate a tumor clinically, radiographically, and sonographically, but its origin and cause can be demonstrated by CT. Proper understanding of such changes may prevent an erroneous diagnosis of enlarged pelvic lymph nodes or an inflammatory or neoplastic mass

  1. 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.

  2. [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

  3. Robotic Female Pelvic Floor Reconstruction: A Review.

    Science.gov (United States)

    Clifton, Marisa M; Pizarro-Berdichevsky, Javier; Goldman, Howard B

    2016-05-01

    As the surgical correction of pelvic organ prolapse has continued to evolve, robotic-assisted abdominal sacrocolpopexy (RASC) has gained increasing popularity. Studies have shown equivalent subjective and objective outcomes compared with the "gold standard" abdominal sacrocolpopexy. Additionally, this approach is associated with a shorter hospital stay and less cost than the traditional open procedure. Although there is a learning curve associated with RASC, the basic principles of the procedure are the same. Herein, we discuss the robotic techniques for repair of pelvic organ prolapse as well as discuss the currently available literature regarding RASC. PMID:26723179

  4. [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

  5. 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

  6. Pelvic congestion syndrome: demonstration and diagnosis by helical CT.

    Science.gov (United States)

    Desimpelaere, J H; Seynaeve, P C; Hagers, Y M; Appel, B J; Mortelmans, L L

    1999-01-01

    Pelvic pain is a common gynaecological complaint, sometimes without any obvious etiology. We report a case of pelvic congestion syndrome, an often overlooked cause of pelvic pain, diagnosed by helical computed tomography. This seems to be an effective and noninvasive imaging modality. PMID:9933685

  7. 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

  8. 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

  9. [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

  10. 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.

  11. Clinical application of positron emission tomography imaging in urologic tumors

    International Nuclear Information System (INIS)

    Positron emission tomography (PET) is an advanced noninvasive molecular imaging modality that is being investigated for use in the differentiation, diagnosis, and guiding therapy ora variety of cancer types. FDG PET has the unique clinical value in the differentiation, diagnosis, and monitoring therapy of prostate, such as bladder, renal, and testicle cancer. However, high false-positive and false-negative findings are observed in the detection of these tumors with FDG PET. 11C-Choline (CH) and 11C-acetate (AC) can overcome the pitfall of FDG, and appear to be more successful than FGD in imaging prostate cancer and bladder cancer. The short half-life of 11C prevents the widespread use of CH and AC and 18F-fluorocholine (FCH) and 18F-fluoroacetate (FAC) seem to be potential tracers. Potential clinical value of the new PET tracers, such as 3'-deoxy-3'-18F-fluorothymidine (FLT), 18F-fluorodihydrotestosterone (FDHT), and 9-(4-18F-3-hydroxymethylbutyl)-guanine(18F-FHBG) in the detection of urologic tumors, can deserve further study. (authors)

  12. Extracellular MicroRNAs in Urologic Malignancies: Chances and Challenges

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2013-07-01

    Full Text Available Small noncoding RNAs that are 19-23 nucleotides long, known as microRNAs (miRNAs, are involved in almost all biological mechanisms during carcinogenesis. Recent studies show that miRNAs released from live cells are detectable in body fluids and may be taken up by other cells to confer cell-cell communication. These released miRNAs (here referred to as extracellular miRNAs are often protected by RNA-binding proteins or embedded inside circulating microvesicles. Due to their relative stability, extracellular miRNAs are believed to be promising candidates as biomarkers for diagnosis and prognosis of disease, or even as therapeutic agents for targeted treatment. In this review, we first describe biogenesis and characteristics of these miRNAs. We then summarize recent publications involving extracellular miRNA profiling studies in three representative urologic cancers, including: prostate cancer, bladder cancer, and renal cell carcinoma. We focus on the diagnostic, prognostic, and therapeutic potential of these miRNAs in biological fluids, such as serum, plasma, and urine. Finally, we discuss advantages and challenges of these miRNAs in clinical applications.

  13. 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)

  14. 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

  15. 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

  16. 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...

  17. 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. PMID:25186496

  18. 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 ...

  19. 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.

  20. Ultrasonography findings of the pelvic masses

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    Yim, Neung Jae; Lee, Hak Seo; Youn, Eun Kyung [Korea General Hospital, Seoul (Korea, Republic of)

    1984-12-15

    Ultrasonography is most common utilized diagnostic tool in obstetric and gynecology for the evaluation of patient with a pelvic mass or pregnancy. For it is characterized by no radiation hazard, noninvasive examination and high diagnostic accuracy. Also it affords an accurate assessment of the presence, size, location and internal consistency of a pelvic mass. The recent availability and improved resolution of realtime scanning have afforded a more flexible and complete approach to evaluation of normal and abnormal structures in the pelvis. We analyzed ultrasonographic findings in 154 pathologically proven cases of pelvic mass examined at Korea General Hospital from January 1983 to April 1984. The results were as follows: 1. The age distribution was from 12 years to 66 years and the majority of patients were between the ages of 21 and 51 years (91.4%). 2. The incidence of pelvic mass was 27.9% in uterine leiomyoma, 22.7% in ovarian cyst, 13.0% in adenomyosis and 8.4% in serous cystadenoma. 3. Mild to moderately echogenic nodular uterine enlargement with some cystic change (81.4%) of leiomyoma and multiple small vesicular pattern of intrauterine contents with uterine enlargement of H-mole were the most common ultrasonographic findings. The location and type of leiomyoma were most common in the fundus and body (95.3%), and intramural myoma (53.5%). The most frequent findings of ovarian teratoma was cystic mass with echogenic focus (41.7%) but the echogenic appearance of the lesions was extremely variable.The ultrasonographic findings of ectopic pregnancy were cystic or complex adnexal mass (80.0%), with or without fluid in cul-de-sac and deviation of uterus by adnexal mass. 4. Accuracy of ultrasonography i determining the overall correct diagnosis of the pelvic masses compared with proven diagnosis was approximately 61.7%. The diagnostic accuracy was 90.7% in uterine leiomyoma, 100% in H-mole and 80.0% in ectopic pregnancy.

  1. Ultrasonography findings of the pelvic masses

    International Nuclear Information System (INIS)

    Ultrasonography is most common utilized diagnostic tool in obstetric and gynecology for the evaluation of patient with a pelvic mass or pregnancy. For it is characterized by no radiation hazard, noninvasive examination and high diagnostic accuracy. Also it affords an accurate assessment of the presence, size, location and internal consistency of a pelvic mass. The recent availability and improved resolution of realtime scanning have afforded a more flexible and complete approach to evaluation of normal and abnormal structures in the pelvis. We analyzed ultrasonographic findings in 154 pathologically proven cases of pelvic mass examined at Korea General Hospital from January 1983 to April 1984. The results were as follows: 1. The age distribution was from 12 years to 66 years and the majority of patients were between the ages of 21 and 51 years (91.4%). 2. The incidence of pelvic mass was 27.9% in uterine leiomyoma, 22.7% in ovarian cyst, 13.0% in adenomyosis and 8.4% in serous cystadenoma. 3. Mild to moderately echogenic nodular uterine enlargement with some cystic change (81.4%) of leiomyoma and multiple small vesicular pattern of intrauterine contents with uterine enlargement of H-mole were the most common ultrasonographic findings. The location and type of leiomyoma were most common in the fundus and body (95.3%), and intramural myoma (53.5%). The most frequent findings of ovarian teratoma was cystic mass with echogenic focus (41.7%) but the echogenic appearance of the lesions was extremely variable.The ultrasonographic findings of ectopic pregnancy were cystic or complex adnexal mass (80.0%), with or without fluid in cul-de-sac and deviation of uterus by adnexal mass. 4. Accuracy of ultrasonography i determining the overall correct diagnosis of the pelvic masses compared with proven diagnosis was approximately 61.7%. The diagnostic accuracy was 90.7% in uterine leiomyoma, 100% in H-mole and 80.0% in ectopic pregnancy.

  2. Peroperative transperineal brachytherapy for recurrent pelvic malignancies

    International Nuclear Information System (INIS)

    Recurrent pelvic malignancies represent often a challenge to the therapist due to the limited efficacy of most classical treatment especially in case of prior radiation or lateral extension. Moreover, a surgical resection such as a total pelvic exenteration is only recommended for central recurrence due to the severe mutilation. An innovative approach combining transperineal brachytherapy (BT) with rigid templates and peroperative BT with plastic tubes was developed for the treatment of pelvic recurrence. Plastic tubes were placed during surgery using hollow perineal needles. The laparotomy offers the possibility of a perfect visualisation of the target area to be implanted. Furthermore, a debulking of the tumor mass is possible, limiting the residual volume to be treated. One week after surgery, the loading with 192iridium wires is performed after simulation and dosimetry CTscan. Computed dosimetry is obtained by means of orthogonal radiographs and isodoses are superimposed on the CTslices. Since december 1994, 3 patients were treated for a pelvic relapse of a cervix cancer (2pts) and a sigmoidal cancer (1ppt) to test the feasibility of this approach. Two patients had an history of pelvic irradiation. The third patient was treated with an implant after 40 Gy external beam radiotherapy. A total dose of 60 to 80 Gy was delivered with this technique to a volume ranging from 15 to 24 cm3. One patient had an acute urethritis and another developed a vesicovaginal fistula after a biopsy performed for a slight irregularity of the vaginal mucosa in the highly irradiated area. One relapse in the implanted area is reported within this period of observation. Additional follow up and experience is required to assess the real efficacy of this method. Nevertheless, this approach offers a good alternative for patients relapsing in the pelvis especially in already irradiated area with a good acute and late tolerance and a satisfactory implantation technique

  3. 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, ...

  4. 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.

  5. Effects of pelvic adjustment on pelvic posture and angles of the lower limb joints during walking in female university students

    Science.gov (United States)

    Cho, Misuk

    2016-01-01

    [Purpose] This study investigated the effects of pelvic adjustment on pelvic posture and lower limb joint angles during walking in female university students. [Subjects] Thirty healthy female university students were randomly assigned to an experimental group (pelvic adjustment group, n = 15) and a control group (stretching group, n = 15). [Methods] Pelvic adjustment was performed three times on the experimental group. The control group performed three sets of pelvic muscle stretching for 15 minutes. A back mapper and motion analysis equipment were used to measure pelvic posture and angles of lower limb joints for the experimental and control group. [Results] The values obtained before and after the intervention were compared. For the experimental group, the results were significantly different in terms of reduced differences in hip flexion between the left and right hips and in knee abduction between the left and right knees. Differences in pelvic position and pelvic torsion were also found in the experimental group. No significant differences in the control group were identified. [Conclusion] Pelvic adjustment affects pelvic position and torsion and this enhancement to pelvic stability decreases hip flexion and knee abduction during walking.

  6. A guide to the management of urologic dilemmas for the primary care physician (PCP).

    Science.gov (United States)

    Barkin, Jack; Rosenberg, Matt T; Miner, Martin

    2014-06-01

    Patients with urologic conditions may present to a primary care physician (PCP) in the emergency department or in the PCP's office. Some conditions are true emergencies that require immediate surgical intervention. Others may require medical treatment or possibly simply reassuring the patient that there is no serious medical problem. Sometimes the diagnosis can be easily made, whereas other times the PCP needs to be able to rule out serious causes for a presenting problem and execute a guideline-recommended patient work up, to make a final diagnosis. Sometimes recommended diagnostic tests may not be readily available. When a PCP believes that a patient may have a serious urologic condition and is unsure of the appropriate patient management strategy, then he or she must quickly refer the patient to a urologist. This article describes common urology-related issues-hematuria, prostate-specific antigen (PSA) test interpretation, phimosis and paraphimosis, acute scrotal pain and masses in the child and adult, urinary tract infection, renal colic, and castration-treatment-induced bone loss. It provides insights into decision-making processes for patient management of some urologic conditions, and information about managing sequelae and side effects of long term treatment. It includes practical diagnostic suggestions and patient management strategies based on the authors' years of urologic clinical practice experience. PMID:24978632

  7. 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

  8. Stem cells, biomarkers and genetic profiling: approaching future challenges in Urology.

    Science.gov (United States)

    Mancini, Mariangela; Zazzara, Michele; Zattoni, Filiberto

    2016-03-01

    Urological research is facing future challenges, the most difficult one is the fast and meaningful transfer of the massive amount of data from research basic to clinical practice. Between the most important issues that research should focus in the next years are targeting of tumor stem cells, clinical application of biomarkers, and wide application of genetic profiling of urological neoplasms. Several clinical implications are expected, from diagnosis to selection of candidates for different treatment modalities, to modulation of sequential treatment plans, to prognosis. A number of clinical trials based on research data from the hottest issues are in the pipeline. In this review, we will focus on new insights from recent work worlwide in urological research, with particular attention to high-risk nonmuscle-invasive and muscle-invasive bladder cancer, prostate cancer, and kidney cancer. Cancer care is moving towards a personalized approach in patient management. The most important issues in urological research point strongly in this direction and show an enormous potential for the rapid landing of Urology in the era of personalized medicine. PMID:26940971

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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 ...

  17. 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

  18. Primary Pelvic Hydatid Cyst Obstructing the Labour

    OpenAIRE

    Sandhya S. Ware; Suwarna B Patil; Dilip S Sarate; Vinod K Sawaitul

    2015-01-01

    Hydatid disease, caused by Echinococcus granulosus, is a common parasitic infection of the liver. Primary pelvic hydatid cyst is an extremely rare condition and occurs in approximately 0.7% of patients. Hydatid disease in pregnancy is a very rare condition with incidence of 1/20000 pregnancies. We report here an unusual case of hydatid cyst of the pelvis in a 30 years old multigravida presenting with obstructed labour. Ultrasonography showed well defined mixechoic c...

  19. 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....

  20. 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...

  1. Publication rates of full-text journal articles converted from abstracts presented during the 22nd Turkish National Urology Congress

    Science.gov (United States)

    Kocaaslan, Ramazan; Kayalı, Yunus; Tok, Adem; Tepeler, Abdulkadir

    2016-01-01

    Objective To analyze the publication rates of full-text journal articles converted from the abstracts presented in the 22nd Turkish National Urology Congress in 2012. Material and Methods A total of 576 abstracts accepted for presentation at the 22nd Turkish National Urology Association Meeting were identified from the published abstract book. The abstracts were categorized into subsections such as endourology and pediatric urology. The subsequent publication rate for the studies was evaluated by scanning PubMed Medline. Abstracts published before the proceedings were excluded from the study. Results The abstracts were categorized as being presented orally (n=155), by poster (n=421), or by video (n=78). Of the 28 (18.3%) of 155 oral and 34 (8.15%) of 421 poster presentations, were subsequently published in several journals until March 2015. The publication rates of the abstracts based on urology subsections were as follows: neurology (25%), andrology (18.6%), endourology (17.2%), urolithiasis (15.3%), general urology (12.5%), infectious diseases (7.14%), pediatric urology (6.25%), uro-gynecology (6.06%), reconstructive urology (5.8%), and urooncology (3.8%). The average time to publication was 11.77 (0–33) months. Conclusion This is the first study assessing the publication rates of abstracts presented at a Turkish National Urology Congress. It reveals that more qualified randomized studies need to be done to improve the rate of publication. PMID:27011876

  2. [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

  3. Prophylactic ibuprofed administration during pelvic irradiation

    International Nuclear Information System (INIS)

    Thirty-five patients who were to begin pelvic irradiation for malignant disease were randomized to receive ibuprofen 400 mg P.O. q.i.d. during their radiotherapy or standard therapy for radiation-induced gastrointestinal symptoms. Seventeen of 19 patients in the ibuprofen group completed the protocol. There was no significant difference in the daily stool frequency between the ibuprofen and control patients during the 5 to 6 week course of pelvic irradiation; the incidence and severity of diarrhea was the same. There was no significant difference in the incidence of nausea reported by the patients but the severity of nausea was less in the ibuprofen group; none of the 17 patients in the ibuprofen group reported vomiting at any time, whereas, 27% of the patients in the control group reported vomiting. The difference was statistically significant (p < 0.05). The data suggest that prophylactic ibuprofen administration may be beneficial in reducing the severity of nausea and preventing radiation-induced vomiting in patients who receive pelvic irradiation

  4. Tachykinin receptors in the equine pelvic flexure

    International Nuclear Information System (INIS)

    Tachykinins, of which substance P (SP) is the prototype, are neuropeptides which are widely distributed in the nervous systems. In the equine gut, SP is present in enteric nerves and is a powerful constrictor of enteric muscle; in other species, SP is also known to have potent vasodilatory and pro-inflammatory effects. The specific effects of SP are determined by the subtype of receptor present in the target tissue. There are 3 known subtypes of tachykinin receptors, distinguished by their relative affinities for SP and other tachykinins. The distribution of SP binding sites in the equine pelvic flexure was determined using 125I-Bolton Hunter SP (I-BHSP) autoradiography. Most I-BHSP binding sites were determined to be saturable and specific, therefore presumably representing tachykinin receptors. The greatest degree of I-BHSP binding occurred over very small vessels, and over the muscularis mucosae; I-BHSP binding was also intense over the circular muscle of the muscularis externa and mucosa, and present, although less intense, over the longitudinal muscle of the muscularis externa. Competition of I-BHSP with specific receptor agonists for binding sites in the equine pelvic flexure were used to determine the subtypes of tachykinin receptors present. The neurokinin-1 receptor subtype predominated in the equine pelvic flexure, followed by the neurokinin-3 receptor subtype

  5. 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.

  6. 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

  7. Advances in laparoscopic urologic surgery techniques [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Haidar M. Abdul-Muhsin

    2016-04-01

    Full Text Available The last two decades witnessed the inception and exponential implementation of key technological advancements in laparoscopic urology. While some of these technologies thrived and became part of daily practice, others are still hindered by major challenges. This review was conducted through a comprehensive literature search in order to highlight some of the most promising technologies in laparoscopic visualization, augmented reality, and insufflation. Additionally, this review will provide an update regarding the current status of single-site and natural orifice surgery in urology.

  8. 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...

  9. 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

  10. 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

  11. 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...

  12. Quality of life in women with pelvic floor dysfunction

    OpenAIRE

    Mladenović-Segedi Ljiljana; Parezanović-Ilić Katarina; Ćurčić Aleksandar; Višnjevac Nemanja

    2011-01-01

    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 satisfac...

  13. Archosaurian respiration and the pelvic girdle aspiration breathing of crocodyliforms

    OpenAIRE

    Claessens, Leon P.A.M.

    2009-01-01

    Birds and crocodylians, the only living archosaurs, are generally believed to employ pelvic girdle movements as a component of their respiratory mechanism. This in turn provides a phylogenetic basis for inferring that extinct archosaurs, including dinosaurs, also used pelvic girdle breathing. I examined lung ventilation through cineradiography (high-speed X-ray filming) and observed that alligators indeed rotate the pubis to increase tidal volume, but did not observe pelvic girdle movement co...

  14. Hydatidosis of the Pelvic Cavity: A Big Masquerade

    Directory of Open Access Journals (Sweden)

    Peyman Varedi

    2008-01-01

    Full Text Available We report and discuss a case of primary hydatidosis of the pelvic cavity in a woman who presented with severe weight loss and abdominal pain. This unusual presentation was initially considered as a tumor process until surgical exploration and microscopic studies confirmed the diagnosis. The gynecologists should be aware of possibility of primary hydatid cyst of the pelvic cavity and should be considered in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic.

  15. Radiodiagnosis of pelvic birth injuries and their consequences

    Energy Technology Data Exchange (ETDEWEB)

    Konycheva, E.A.; Loskutova, L.A. (Bashkirskij Meditsinskij Inst. (USSR))

    A study was made of the changes in the pelvic articulations in women with birth injuries 2-5 years following birth on the basis of the clinicoroentgenological findings. Pathological adhesion of birth injuries of the pelvic bones, that manifested itself in the formation of callus and arthrosis of the public and sacroiliac articulations, was noted. The study confirmed incomplete rehabilitation in this group of women. For prognosis of subsequent parturition roentgenopelvimetry is recommended for women with birth injuries of the pelvic girdle.

  16. 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

  17. A pelvic retroperitoneal Schwannoma presenting as an adnexal mass.

    Science.gov (United States)

    Khatib, R A; Khalil, A M; Saba, M I; Aswad, N K; Mroueh, A M

    1994-05-01

    Solitary nerve sheath tumors such as benign schwannomas arising in the pelvic retroperitoneum are infrequently reported. We report a case of a benign retroperitoneal pelvic schwannoma that presented with pelvic pain and an adnexal mass. Complete surgical excision was achieved only after transection of the S1 nerve root on the left side. The adjacent vascular and urinary channels sustained no injuries and the patient had minimal neurologic deficit. PMID:8188087

  18. 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...

  19. [Avoidance of complications in oncological surgery of the pelvic region : combined oncosurgical and plastic reconstruction measures].

    Science.gov (United States)

    Beier, J P; Croner, R S; Lang, W; Arkudas, A; Schmitz, M; Göhl, J; Hohenberger, W; Horch, R E

    2015-03-01

    Prevention of perioperative and postoperative complications resulting from surgical oncology in the pelvic region remains a major interdisciplinary challenge. With modern interdisciplinary concepts joining forces of various surgical specialties, tumor resection can be sufficiently carried out with wide margins and the patients benefit from reduced morbidity even in complex situations. As an example chronic fistulation and secretion from the presacral cavity and sinus may result as potential sequelae from intra-abdominal and intrapelvic tumor resection, especially when neoadjuvant multimodal therapies have been applied. This can be prevented by simultaneous transplantation of for example transpelvic vertical rectus abdominis myocutaneous (VRAM) flap transfer, while extensive perineal skin and soft tissue defects may also be simultaneously reconstructed. In cases of malignant soft tissue tumors in the pelvic region a staged surgical procedure can be performed with a period of time between tumor resection and reconstruction. Thus, a histological R0 status can be secured prior to plastic reconstruction surgery in order to increase oncological safety. In cases of postresectional exposition of e. g. pelvic or femoral vessels or intrapelvic and intra-abdominal organs simultaneous flap procedure is mandatory.The reconstructive armamentarium of the plastic surgeon should contain not only pedicled but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. At the same time perioperative and postoperative complications may be avoided and the patient quality of life can be preserved even in more complex cases. PMID:25620285

  20. 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.

  1. 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

  2. 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 ...

  3. Metastatic squamous cell carcinoma urinary bladder coexisting with tuberculosis in pelvic lymph nodes.

    Science.gov (United States)

    Karthikeyan, Vilvapathy Senguttuvan; Manikandan, Ramanitharan; Jacob, Sajini Elizabeth; Murugan, P Puvai

    2013-01-01

    Squamous cell carcinoma (SCC) of the urinary bladder is usually associated with Schistosoma haematobium and chronic bladder irritation. We report a case of coexistent metastatic SCC and tuberculosis in obturator lymph nodes in radical cystoprostatectomy and pelvic lymphadenectomy specimens. Though tubercular iliac lymphadenitis and metastatic transitional carcinoma following intravesical BCG has been reported, the concurrent presence of non-transitional cell cancer and primary lymph nodal tuberculosis in regional lymph nodes is rare. This case is reported to highlight the paucity of management guidelines available presently in the treatment of such patients who require systemic chemotherapy and antitubercular therapy. PMID:24296773

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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

  10. 77 FR 9610 - Gastroenterology-Urology Devices; Reclassification of Sorbent Hemoperfusion Devices for the...

    Science.gov (United States)

    2012-02-17

    ... electrical shocks in patients using them. Electromagnetic interference, which may lead to adverse... HUMAN SERVICES Food and Drug Administration 21 CFR Part 876 Gastroenterology-Urology Devices...) establish a comprehensive system for the regulation of medical devices intended for human use. Section...

  11. 76 FR 71983 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2011-11-21

    ... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide... HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION:...

  12. Epididymitis in Patients with Anorectal Malformations: A Cause for Urologic Concern

    Directory of Open Access Journals (Sweden)

    Brian A. VanderBrink

    2014-10-01

    Full Text Available Introduction Epididymitis in patients with anorectal malformation (ARM represents a unique problem because unlike the general population, an underlying urinary tract problem is frequently identified. We review our experience with epididymitis in ARM population with an emphasis on examining urologic outcomes. Materials and Methods We performed a retrospective review of male patients with ARM cared for from 1980 to 2010. Clinical and pathologic variables recorded included age at presentation, recurrence, associated urologic anomalies, incidence of ureteral fusion with mesonephric ductal structures, glomerular filtration rate and urodynamic parameters. Results Twenty-six patients were identified with documented episodes of epididymitis. Renal injury was noted in five patients (19%, all of whom were diagnosed with neurogenic bladder (NGB several years after anorectoplasty. NGB was found in ten patients (38% in our series. Ectopic insertion of ureter into a mesonephric ductal structure was discovered in five patients (19%. Twelve patients (46% had recurrent episodes of epididymitis, with seven of these patients (58% being diagnosed with NGB. Two patients in the pubertal group presented with a history of epididymitis and complained of ejaculatory pain. Conclusion Epididymitis in a patient with ARM warrants a comprehensive urologic investigation, particularly in recurrent episodes. Attempts at surgical intervention (e.g. vasectomy should be avoided until functional assessment of the urinary tract has occurred. Failure to recognize this association may lead to potentially avoidable complications and morbidity. Long term urological follow up of these patients is warranted to identify at risk patients and minimize renal deterioration

  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. 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. |

  15. Clinical applications of low-intensity pulsed ultrasound and its potential role in urology

    Science.gov (United States)

    Lin, Guiting; Lei, Hongen; Lue, Tom F.; Guo, Yinglu

    2016-01-01

    Low-intensity pulsed ultrasound (LIPUS) is a form of ultrasound that delivered at a much lower intensity (erectile dysfunction (ED), and stress urinary incontinence (SUI) in the field of urology. It still needs an intense effort for basic-science and clinical investigators to explore the biomedical applications of ultrasound.

  16. 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

  17. 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...

  18. 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...

  19. 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...

  20. 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

  1. Readability of American Online Patient Education Materials in Urologic Oncology: a Need for Simple Communication

    Science.gov (United States)

    Pruthi, Amanda; Nielsen, Matthew E.; Raynor, Mathew C.; Woods, Michael E.; Wallen, Eric M.; Smith, Angela B.

    2014-01-01

    Objectives To determine readability levels of reputable cancer and urologic websites addressing bladder, prostate, kidney and testicular cancers. Methods Online patient education materials (PEMs) for bladder, prostate, kidney and testicular malignancies were evaluated from the American Cancer Society, American Society of Clinical Oncology (ASCO), National Cancer Institute (NCI), Urology Care Foundation (AUA-UCF), Bladder Cancer Advocacy Network (BCAN), Prostate Cancer Foundation (PCF), Kidney Cancer Association (KCA), and Testicular Cancer Resource Center (TCRC). Grade level was determined using several readability indices, and analyses were performed based on cancer type, website, and content area (general, causes, risk factors and prevention, diagnosis and staging, treatment, and post-treatment). Results Estimated grade level of online PEMs ranged from 9.2 to 14.2 with an overall mean of 11.7. Websites for kidney cancer had the least difficult readability (11.3) and prostate cancer had the most difficult readability (12.1). Among specific websites, the most difficult readability levels were noted for the AUA-UCF website for bladder and prostate cancer and the KCA and TCRC for kidney and testes cancer. Readability levels within content areas varied based on disease and website. Conclusion Online PEMs in urologic oncology are written at a level above the average American reader. Simplification of these resources are necessary to improve patient understanding of urologic malignancy. PMID:25623686

  2. 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.

  3. 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...

  4. 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

  5. Effect of pelvic irradiation of lactose absorption

    International Nuclear Information System (INIS)

    Twenty-four patients undergoing pelvic irradiation for gynecologic malignancies had 14C-lactose breath tests performed in the first and fifth weeks of their treatment. The 14C-lactose breath test was performed by administering 2 μCi of 14C-lactose by mouth along with 50 g of lactose. Breath samples were collected in ethanolic hyamine 1, 2, and 3 hr later; the radioactivity of the trapped 14CO2 was determined by liquid scintillation spectroscopy. In the first week of treatment the percentage of administered 14C excreted as 14CO2 at 1, 2, and 3 hr was 1.7 +- 0.8% (mean +- SD), 4.5 +- 1.6%, and 5.8 +- 1.4%, respectively. In the fifth week of treatment the 1-hr, 2-hr, and 3-hr values were 1.2 +- 0.9%, 3.6 +- 2.0%, and 4.7 +- 1.9%, respectively. The difference between the first week and fifth week test results at 1, 2, and 3 hr was statistically significant (t = 2.64, p 14C-lactose breath test results in the fifth week and the stool frequency at that time (r = -0.44, p 14C-lactose breath test results in the fifth week were below normal (<1.2%) had nausea at that time. The data suggest that in some patients, lactose malabsorption as a result of the effect of radiation on small intestinal function may be etiologically related to the symptoms of nausea and diarrhea which occur commonly in patients who are undergoing pelvic irradiation. In addition, the results suggest that lactose-containing foods should be restricted in some patients who are undergoing pelvic irradiation to prevent symptoms resulting from radiation-induced lactose intolerance

  6. [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

  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. Symptomatic pelvic paraganglioma in an adult

    Directory of Open Access Journals (Sweden)

    Zubair Syed

    2016-01-01

    Full Text Available Paragangliomas are relatively rare in an adults, with most arising from para-aortic sympathetic chain. Paraganglioma localized at the extravesical pelvic cavity is extremely rare, only few case reports are published. We report a case of paravesical paraganglioma in a 45-year-old man who initially presented with irritable bladder and palpitations after voiding for 6 years and was being treated symptomatically for urinary tract infection and anxiety. Cross-sectional imaging showed a paravesical mass and was treated by robotic excision of the mass.

  9. [Comprehensive treatment with ofloxacin in pyo-inflammatory urologic diseases].

    Science.gov (United States)

    Pytel', Iu A; Volkova, V S

    1996-01-01

    Fifteen patients with various forms of pyelonephritis and chronic cystitis were treated with ofloxacin. The drug was used in the complex antiinflammatory and detoxification therapy and in cases with indicated hemotransfusion. Ofloxacin was administered intravenously during the first days of the treatment with its later oral use. High efficacy of ofloxacin was observed in the patients with acute purulent renal affections accompanied by pyo-intoxication when the treatment was started with the drug parenteral administration. PMID:9005796

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

    Directory of Open Access Journals (Sweden)

    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

  11. 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

  12. 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.

  13. Navicular bone fracture in the pelvic limb in two horses

    International Nuclear Information System (INIS)

    The case history, radiographic and scintigraphic findings of two horses with pelvic limb navicular bone fractures are presented. In both cases the fractures were of traumatic origin. One horse had a bilateral fracture of the navicular bone, distal border, the other horse had a fracture of the proximal articular border in one pelvic limb navicular bone

  14. 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)

  15. Computed tomography in the urological field by means of scanner of fan beam x-ray rotationary

    International Nuclear Information System (INIS)

    Twelve cases of urological patients were observed by computed tomography (Ohio-nuclear's Delta-scan 2020). 5 cases of them were as follows: 1) A 25-year-old female of chronic renal failure, in which both kidneys showed multiple cystic structure, what is called ''acquired cyst of the kidney''. 2) A 28-year-old male of chronic renal failure, in which round calcificated shadow was revealed at the left kidney. It was very difficult to demonstrate the round shadow on KUB. Renal carcinoma was suspected by selective renal arteriography, and the nephrectomy specimen revealed renal cell carcinoma. 3) A 39-year-old male of left renal carcinoma, in which CT of lung showed manifest metastatis, and abdominal slice showed large tumor embolus of left renal vein. 4) A 67-year-old male of bladder tumor at the left lateral wall, in which stalk was not clearly confirmed by a cystoscopic examination. By CT of supine or prone position, the tumor mass inclined downward. This suggested the existence of stalk. Extravesical outline seemed smooth, and so the tumor was suspected to be of low stage. 5) A 71-year-old male of prostatic cancer, in which by RI bone scanning and x-ray examination, the left scapula, ribs, 2nd lumbar vertebra were shown to have metastases. CT of 2nd vertebra revealed patchy high density area. By this scanner, only two seconds per one slice are required. So the artifacts, such as so-called streaking by respiration, movement of intestinal gas, are almost dissoluted. And this fact is very important and useful for many clinical fields, such as alimentary organs and urogenital organs. (author)

  16. 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.

  17. 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

  18. Pelvic orientation and assessment of hip dysplasia in adults

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Lund, B;

    2004-01-01

    on the measurements of radiographic indices of hip dysplasia. MATERIAL AND METHODS: We investigated the effect of varying pelvic orientation on radiographic measurements of acetabular dysplasia using a cadaver model. Results from the cadaver study were used to validate the radiographic assessments of...... pelvic radiograph was recorded at each 3 degrees increment. The most widely used radiographic parameters of hip dysplasia were assessed. 2) Critical limits of acceptable rotation and inclination/reclination of pelvises were determined on 4151 standing, standardised pelvic radiographs of the CCHS cohort......BACKGROUND: The study was performed to qualify the source material of 4151 pelvic radiographs for the research into the relationship between unrecognised childhood hip disorders and the development of hip osteoarthrosis, and to investigate the effect of varying degrees of pelvic tilt and rotation...

  19. The role of spiral CT in pelvic trauma management

    International Nuclear Information System (INIS)

    Rapid and accurate assessment of pelvic injury is critical for good patient management. Plain X-ray is often used as a preliminary evaluation of the injury but this may not give adequate diagnosis of the acetabulum fracture, subtle fracture of the pelvic bone and the associated soft tissue injuries. Nowadays, spiral CT has taken an increasing role in the evaluation of pelvic trauma. It gives a rapid assessment of the bone and soft tissue injuries as compared to conventional CT. Besides, 2-D (multiplanar imaging) and 3-D image reconstruction with multiple angle views, provide the maximum information which facilitates detailed pelvic trauma evaluation. Three cases were used to illustrate the role of spiral CT in pelvic trauma management. Copyright (1999) Blackwell Science Pty Ltd

  20. 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.

  1. Penile rehabilitation after pelvic cancer surgery.

    Science.gov (United States)

    Aoun, Fouad; Peltier, Alexandre; van Velthoven, Roland

    2015-01-01

    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. PMID:25785286

  2. 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...

  3. 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.

  4. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  5. Nuclear nephro-urology in the paediatric patient

    International Nuclear Information System (INIS)

    Full text: Static renal scan using Tc 99m DMSA, is indicated either to detect a focal parenchymal defect or to hunt for the missing kidney. The commonest specific indication includes the squeal of a urinary tract infection (UTI) either in the acute phase or in the late phase to detect a renal scar. Renal defects in the acute phase are not scars since the defect may regress spontaneously. Animal experiments have shown a very high sensitivity of DMSA in the detection of renal defects. When hunting for the missing kidney, anterior views including the pelvis are essential. Processing of the data must include viewing the images with a low window. High quality images are essential and these can only be obtained by ensuring minimal movement of the child, a high resolution collimator and the chid lying as close as possible to the camera if not on top of the collimator. (See guidelines on DMSA at www.eanm.org). Dynamic renography using either Tc 99m MAG3 or DTPA is Indicated in the presence of dilatation of the collecting systems, to establish differential renal function (DRF), following renal transplantation and in the follow-up of older children with vesico-ureteric reflux (VUR) or bladder dysfunction. In the presence of hydronephrosis data acquisition should include the use of a diuretic as well as acquiring dynamic images following a change in posture and micturition. Processing of the renogram should include estimation of DRF during the period 50 - 130 seconds from background subtracted renal curves. The response to the diuretic challenge must take into account the function of the kidney as well as the effect of the change in posture and micturition. Interpretation of impaired drainage in prenatally diagnosed unilateral renal pelvic dilatation must be interpreted with caution as poor drainage does not imply obstruction in this group of young children. (See guidelines for diuretic renography in children on www.eanm.org). In children with bladder dysfunction, recurrent

  6. 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.)

  7. Knowledge of the pelvic floor in nulliparous women

    Science.gov (United States)

    Neels, Hedwig; Wyndaele, Jean-Jacques; Tjalma, Wiebren A. A.; De Wachter, Stefan; Wyndaele, Michel; Vermandel, Alexandra

    2016-01-01

    [Purpose] Proper pelvic floor function is important to avoid serious dysfunctions including incontinence, prolapse, and sexual problems. The current study evaluated the knowledge of young nulliparous women about their pelvic floor and identified what additional information they wanted. [Subjects and Methods] In this cross-sectional survey, a validated, 36 item questionnaire was distributed to 212 nulliparous women. The questionnaire addressed demography, pelvic floor muscles, pelvic floor dysfunction, and possible information sources. Descriptive statistics were generated for all variables. Stability and validity testing were performed using Kappa statistics and intra class correlation coefficients to define agreement for each question. The study was approved by the ethics Committee (B300201318334). [Results] Using a VAS scale (0 to 10), the women rated their knowledge about the pelvic floor as a mean of 2.4 (SD 2.01). A total of 93% of the women were insufficiently informed and requested more information; 25% had concerns about developing urinary incontinence, and 14% about fecal incontinence. Many of the women were unaware what pelvic floor training meant. [Conclusion] There was a significant lack of knowledge about pelvic floor function among nulliparous women. The majority of nulliparous women expressed a need for education, which might offer a way to reduce dysfunction. PMID:27313364

  8. 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.)

  9. Toward a Common Therapeutic Framework in Castration Resistant Prostate Cancer: A Model for Urologic Oncology and Medical Oncology Interaction

    OpenAIRE

    de Vere White, Ralph; Lara, Primo N.

    2014-01-01

    The rapid evolution of palliative therapeutic choices in the last few years for patients with advanced castration resistant prostate cancer (CRPC) has resulted in a dilemma currently troubling a few other epithelial malignancies: which systemic agent to choose and at what time? In addition, which specialty specifically directs the delivery of such care – Urology or Medical Oncology – has not been clearly established. Recognizing the lack of consensus, we propose a framework for Urology and Me...

  10. Successful reduction of hospital-acquired methicillin-resistant Staphylococcus aureus in a urology ward: a 10-year study

    OpenAIRE

    Tatokoro, Manabu; Kihara, Kazunori; Masuda, Hitoshi; Ito, Masaya; Yoshida, Soichiro; Kijima, Toshiki; Yokoyama, Minato; Saito, Kazutaka; Koga, Fumitaka; Kawakami, Satoru; Fujii, Yasuhisa

    2013-01-01

    Background To eradicate hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) using a stepwise infection control strategy that includes an avoidance of antimicrobial prophylaxis (AMP) based on surgical wound classification and an improvement in operative procedures in gasless single-port urologic surgery. Methods The study was conducted at an 801-bed university hospital. Since 2001, in the urology ward, we have introduced the stepwise infection control strategy. In 2007, survei...

  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. Pelvic-peritoneal tuberculosis mimicking ovarian cancer

    International Nuclear Information System (INIS)

    Pelvic-peritoneal tuberculosis is a common extrapulmonary site in young females mimicking an advanced ovarian malignancy. We present 2 cases with the classical triad of advanced-stage ovarian carcinoma-ascites, abdominopelvic masses and elevated serum CA-125 levels. Laparoscopic examination revealed peritoneal nodules which on biopsy showed granulomatous inflammation and no malignant cells. Patients were started on anti-tuberculous therapy and on follow-up their symptoms as well as CA-125 levels normalized. Medical awareness of peritoneal tuberculosis is lacking and many young women with this disease undergo unnecessary extended surgery. Diagnostic laparoscopy combined with peritoneal biopsy seems to be a sufficient and safe method to provide a definitive diagnosis for this curable infection. If left untreated, the disease may disseminate and result in significant organ dysfunctions particularly infertility. (author)

  13. 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

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

    Medline Plus

    Full Text Available ... invasively, you always have to compare to the standard, which is open surgery, and to show that it is at least as efficacious and as oncologicaly safe. And the literature in urology that is being driven by the International Laudi -- cystectomy Consortium, headed by Guru Krishi Guru ...

  15. Applications of neuromodulation of the lower urinary tract in female urology

    Directory of Open Access Journals (Sweden)

    Firouz Daneshgari

    2006-06-01

    Full Text Available Neuromodulation is becoming part of clinical armamentarium for treatment of a variety of lower urinary tract conditions in female urology. Its increased usage stems from need of patients who have exhausted all other therapeutic options for their complex and poorly understood lower urinary tract disorders. Currently neuromodulation may consist of the use of sacral nerve stimulation (SNS and injectable therapies. Herein, we will discuss the background and development of SNS, its current indications, methods of patient selection and will review the results of the recent published literature on SNS. In addition, we will discuss some of the newer developments in SNS such as Bion device and the future direction in integration of SNS in female urology.

  16. 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.

  17. Urological surgery in epidermolysis bullosa: tactical planning for surgery and anesthesia

    Directory of Open Access Journals (Sweden)

    Lisieux Eyer de Jesus

    2014-10-01

    Full Text Available Epidermolysis bullosa (EB is characterized by extreme fragility of the skin and mucosae. Anesthetic and surgical techniques have to be adapted to those children and routine practice may not be adequate. Urological problems are relatively common, but surgical techniques adapted to those children have not been well debated and only low evidence is available to this moment. Herein we discuss the specifics of anesthetic and surgical techniques chosen to treat a six year old EB male presenting with symptomatic phimosis.

  18. Urological surgery in epidermolysis bullosa: tactical planning for surgery and anesthesia

    OpenAIRE

    Lisieux Eyer de Jesus; Maira Rangel; Ronaldo S. Moura Filho; Glória Novaes; Ada Quattrino; Angelica F. Aguas

    2014-01-01

    Epidermolysis bullosa (EB) is characterized by extreme fragility of the skin and mucosae. Anesthetic and surgical techniques have to be adapted to those children and routine practice may not be adequate. Urological problems are relatively common, but surgical techniques adapted to those children have not been well debated and only low evidence is available to this moment. Herein we discuss the specifics of anesthetic and surgical techniques chosen to treat a six year old EB male presenting wi...

  19. Urological surgery in epidermolysis bullosa: tactical planning for surgery and anesthesia.

    Science.gov (United States)

    Jesus, Lisieux Eyer de; Rangel, Maira; Moura-Filho, Ronaldo S; Novaes, Glória; Quattrino, Ada; Aguas, Angelica F

    2014-01-01

    Epidermolysis bullosa (EB) is characterized by extreme fragility of the skin and mucosae. Anesthetic and surgical techniques have to be adapted to those children and routine practice may not be adequate. Urological problems are relatively common, but surgical techniques adapted to those children have not been well debated and only low evidence is available to this moment. Herein we discuss the specifics of anesthetic and surgical techniques chosen to treat a six year old EB male presenting with symptomatic phimosis. PMID:25498283

  20. Xenogenic extracellular matrices as potential biomaterials for interposition grafting in urological surgery.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-01-31

    PURPOSE: The field of tissue engineering focuses on developing strategies for reconstructing injured, diseased, and congenitally absent tissues and organs. During the last decade urologists have benefited from remodeling and regenerative properties of bioscaffolds derived from xenogenic extracellular matrices. We comprehensively reviewed the current literature on structural and functional characteristics of xenogenic extracellular matrix grafting since it was first described in urological surgery. We also reviewed the clinical limitations, and assessed the potential for safe and effective urological application of extracellular matrix grafting in place of autogenous tissue. MATERIALS AND METHODS: We performed literature searches for English language publications using the PubMed(R) and MEDLINE(R) databases. Keywords included "xenogenic," "extracellular matrix" and "genitourinary tract applications." A total of 112 articles were scrutinized, of which 50 were suitable for review based on clinical relevance and importance of content. RESULTS: Since the mid 1990s xenogenic extracellular matrices have been used to successfully treat a number of pathological conditions that affect the upper and lower genitourinary tract. They are typically prepared from porcine organs such as small intestine and bladder. These organs are harvested and subjected to decellularization and sterilization techniques before surgical implantation. Bioinductive growth factors that are retained during the preparation process induce constructive tissue remodeling as the extracellular matrix is simultaneously degraded and excreted. However, recent documented concerns over durability, decreased mechanical strength and residual porcine DNA after preparation techniques have temporarily hampered the potential of extracellular matrices as a reliable replacement for genitourinary tract structures. CONCLUSIONS: Extracellular matrices are a useful alternative for successfully treating a number of urological

  1. First Report of the Stapled Mesh Stoma Reinforcement Technique in a Urologic Context

    OpenAIRE

    Dwayne Tun Soong Chang; Isaac Andrew Thyer; John Oliver Larkin; Marina Helen Wallace; Dickon Hayne

    2014-01-01

    Parastomal hernia is a common complication of ileal conduit formation. Mesh repair of parastomal hernia has lower rate of recurrence than nonmesh techniques but can be time-consuming to perform. The stapled mesh stoma reinforcement technique (SMART) is a novel method of rapidly constructing a reinforced stapled stoma. We report the first case utilising this technique in a urologic context. The procedure was performed on a middle-aged female with recurrent parastomal hernia of her ileal condui...

  2. The Role of Religion and Spirituality in Psychological Distress Prior to Surgery for Urologic Cancer

    OpenAIRE

    Biegler, Kelly; Cohen, Lorenzo; Scott, Shellie; Hitzhusen, Katherine; Parker, Patricia; Gilts, Chelsea D.; Canada, Andrea; Pisters, Louis

    2011-01-01

    The present study examined the associations between religion and spirituality (R/S), presurgical distress, and other psychosocial factors such as engagement coping, avoidant coping, and social support. Participants were 115 men scheduled for surgery for urologic cancer. Before surgery, participants completed scales measuring intrinsic religiosity, organized religious activity, and nonorganized religious activity (IR, ORA, NORA); social support (Medical Outcomes Study Social Support Survey); a...

  3. MR urography (MRU) for urologic diseases of the infants and children

    International Nuclear Information System (INIS)

    MR urography (MRU) was performed for urologic diseases of 12 cases. The conditions are hydronephrosis, hydroureters, double renal pelvis, ureteral duplication, ectopic ureter, etc.. It has become clear that MRU can catch the whole image of urinary tract, and it is useful for the delineation of the urinary tract of infants and children with deteriorated renal function. MRU will become the primary urinary tract imaging which would replace DIP in the infants in the future. (author)

  4. Comparison of the reliability of two hydronephrosis grading systems: The Society for Foetal Urology grading system vs. the Onen grading system

    International Nuclear Information System (INIS)

    Aim: To compare the reliability of the conventional ultrasonography grading system for hydronephrosis as suggested by the Society for Fetal Urology (SFU) in 1993 and that developed by Onen in 2007. Materials and methods: One hundred and eighty kidneys in 90 paediatric patients were assessed by four radiologists using each of the two grading systems twice. The SFU system was graded 0–4 (0 = no hydronephrosis; 1 = visualized only renal pelvis; 2 = plus a few caliceal dilatation; 3 = all calyceal dilatation; 4 = plus parenchymal thinning). The Onen system was graded 0–4 (0 = no hydronephrosis; 1 = only renal pelvic dilatation; 2 = plus caliceal dilatation; 3 = plus 50% renal parenchymal loss). Cohen's kappa statistic was used to estimate intra- and interobserver agreement. The weighted least-squares approach was used to compare the intra-observer agreement, and bootstrapping was used to compare the interobserver agreement between the two systems. Results: Intra-observer agreement was substantial to almost perfect in both the SFU (κ 0.79–0.95) and the Onen (κ 0.66–0.97) grading system without difference. The overall interobserver agreement was substantial in both the SFU (κ 0.61–0.68) and the Onen (κ 0.66–0.76) grading system. However, interobserver agreement was fair to moderate for SFU grades 1 and 2 and Onen grades 2 and 3. Conclusion: Both the SFU and Onen grading system are reliable with good intra- and interobserver agreement. However, decreased interobserver agreement was demonstrated for SFU grades 1 and 2 and Onen grades 2 and 3

  5. The human immunodeficiency virus protease inhibitor ritonavir is potentially active against urological malignancies

    Directory of Open Access Journals (Sweden)

    Sato A

    2015-04-01

    Full Text Available Akinori Sato Department of Urology, National Defense Medical College, Tokorozawa, Japan Abstract: The human immunodeficiency virus protease inhibitor ritonavir has recently been shown to have antineoplastic activity, and its use in urological malignancies is under investigation with an eye toward drug repositioning. Ritonavir is thought to exert its antineoplastic activity by inhibiting multiple signaling pathways, including the Akt and nuclear factor-kappaB pathways. It can increase the amount of unfolded proteins in the cell by inhibiting both the proteasome and heat shock protein 90. Combinations of ritonavir with agents that increase the amount of unfolded proteins, such as proteasome inhibitors, histone deacetylase inhibitors, or heat shock protein 90 inhibitors, therefore, induce endoplasmic reticulum stress cooperatively and thereby kill cancer cells effectively. Ritonavir is also a potent cytochrome P450 3A4 and P-glycoprotein inhibitor, increasing the intracellular concentration of combined drugs by inhibiting their degradation and efflux from cancer cells and thereby enhancing their antineoplastic activity. Furthermore, riotnavir’s antineoplastic activity includes modulation of immune system activity. Therapies using ritonavir are thus an attractive new approach to cancer treatment and, due to their novel mechanisms of action, are expected to be effective against malignancies that are refractory to current treatment strategies. Further investigations using ritonavir are expected to find new uses for clinically available drugs in the treatment of urological malignancies as well as many other types of cancer. Keywords: drug repositioning, novel treatment

  6. Soft-tissue applications of the holmium:YAG laser in urology

    Science.gov (United States)

    Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.

    1995-05-01

    The ideal surgical laser for the treatment of soft tissue pathology should possess both ablative and hemostatic abilities. As well, for use in urologic conditions the laser must also be suitable for endoscopic use. The Holmium:YAG laser possesses these qualities and in preliminary clinical use has demonstrated a variety of potential urologic applications. In this study we review our initial experience with the Holmium:YAG laser over a 18 month period. A total of 51 patients underwent 53 procedures for a variety of soft tissue conditions including: bladder tumor ablation (25), incision of ureteral stricture (15), incision of urethral stricture (6), treatment of ureteropelvic junction obstruction (3), incision of bladder neck contracture (2), and ablation of a ureteral tumor (2). Satisfactory hemostasis was achieved in all cases. Procedures were considered successful (no further intervention being required to treat the condition) in 81% of the cases. Two patients with dense bladder neck contractures required electroincision under the same anesthetic for completion of the procedure. A single complication, that of urinary extravasation following incision of a urethral stricture resolved with conservative management. In summary, the Holmium:YAG laser has demonstrated safety and proficiency in the treatment of a variety of urologic soft tissue conditions.

  7. Multi-institute survey on actual conditions of urologic management for severe bladder dysfunction after hysterectomy

    International Nuclear Information System (INIS)

    We conducted a multi-institute survey on the conditions related to urologic management of severe voiding dysfunction after hysterectomy for uterine cancer with or without postoperative irradiation. Our first study population was a group of adult female patients currently managed by urologists, using clean intermittent catheterization (CIC). Of the 287 patients in this group, 99 (34%) had suffered from uterine cancer. Of these patients, 94 underwent hysterectomy for this disease; 44 and 30 were treated with or without postoperative radiation, respectively, while postoperative irradiation status was unknown for 20. Median follow-up after surgery was 21 (0.2-52) years and median interval from operation to the introduction of CIC was 4.0 (0-49) years. CIC tended to be introduced later for patients with postoperative radiation than those without it. Seventy-four patients, who required invasive urologic interventions other than CIC for voiding dysfunction after hysterectomy, are the second study population. Most of these (82%) had received postoperative irradiation. Continuous Foley catheter placement was the most frequent procedure. Long-term follow-up and urologic management for voiding dysfunction is required for patients undergoing hysterectomy. (author)

  8. Avicenna's Canon of Medicine and Modern Urology: part I: bladder and its diseases.

    Science.gov (United States)

    Madineh, Seyed Mohammad Ali

    2008-01-01

    Studying the Avicenna's Canon of Medicine, provides noteworthy information on the subjects related to urology. Some examples of these amazing items have been confirmed by the modern urology: explaining the 2-stage function of the bladder (filling and emptying stages); indirect pointing to a scientific law, named later as the Laplace's law, which is applicable to bladder physiology and explains intravesical pressure stability; describing the bladder layers and strength of the urothelial layer, which was later proved to be due to the tight junctions; describing the intramural ureter and its antireflux mechanism; scientific classifying the urethral and bladder diseases; and describing meticulously the semiology and epidemiology of bladder calculi. Avicenna has also pointed to inversion therapy in the treatment of urinary calculi, grating sign in bladder calculi, manipulation methods for treatment of bladder calculi, and finally, the Crede maneuver. His methodology is completely scientific, based on experiments and truly a basis of the modern medicine. This article is a review of Avicenna's views in medicine and their comparison with the modern urology. PMID:19101908

  9. Skeletal-related events in urological cancer patients with bone metastasis. A multicenter study in Japan

    International Nuclear Information System (INIS)

    The objective of this study was to investigate the incidence of skeletal-related events (SRE) in urological cancer patients with bone metastases in Japan. Five hundred eleven patients with urological cancer and documented bone metastases treated from January 2003 to April 2008 in ten Japanese institutions were included in a retrospective analysis. Type and incidence of SRE (fracture, radiotherapy, spinal cord compression, surgery, hypercalcemia, and bone pain) were determined from patient medical records. The overall incidence of SRE, including 'pain', was 61%. The most common event was radiotherapy for bone metastases, with an incidence of 31%. The overall incidence of events seemed to be similar among Japanese and Western patients with prostate cancer and renal cell carcinoma when comparing data with previously published reports. Nevertheless, a much lower incidence of fracture (19.1%) was observed in Japanese renal cell carcinoma patients. The overall incidence of SRE in Japanese urological cancer patients with bone metastasis was similar to that in Western patients, but the incidence of fracture was lower in Japanese renal cancer patients. (author)

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

    International Nuclear Information System (INIS)

    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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. 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 ... robot, he’s having a real hard time getting access into this plane and yet you can still ...

  14. 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.)

  15. 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 ...

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

    Medline Plus

    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 ...

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

    Medline Plus

    Full Text Available ... going to do a little bit of a water ballast there to keep that in the pelvis ... and uterine arteries and opened the recto-vaginal space posteriorly, taken down much of those pelvic side ...

  18. 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 ...

  19. 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 ...

  20. Pelvic orientation and assessment of hip dysplasia in adults

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Lund, Bjarne;

    2004-01-01

    on the measurements of radiographic indices of hip dysplasia. MATERIAL AND METHODS: We investigated the effect of varying pelvic orientation on radiographic measurements of acetabular dysplasia using a cadaver model. Results from the cadaver study were used to validate the radiographic assessments of acetabular...... radiograph was recorded at each 3 degrees increment. The most widely used radiographic parameters of hip dysplasia were assessed. 2) Critical limits of acceptable rotation and inclination/reclination of pelvises were determined on 4151 standing, standardised pelvic radiographs of the CCHS cohort. RESULTS......BACKGROUND: The study was performed to qualify the source material of 4151 pelvic radiographs for the research into the relationship between unrecognised childhood hip disorders and the development of hip osteoarthrosis, and to investigate the effect of varying degrees of pelvic tilt and rotation...