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Sample records for renal pelvic diameter

  1. Association of left renal vein variations and pelvic varices in abdominal MDCT

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    Koc, Zafer [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Baskent Universitesi Adana Hastanesi, Adana (Turkey); Ulusan, Serife; Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)

    2007-05-15

    The aim of this study was to determine whether left renal vein (LRV) variation is associated with pelvic varices and left ovarian vein (LOV) reflux. Routine abdominal multidetector-row computed tomography scans of 324 women without symptoms of pelvic congestion syndrome were analyzed. Presence and type of LRV variants (circumaortic [CLRV] or retroaortic [RLRV]) were recorded. Diameters of the LRV, ovarian veins (OVs), and parauterine veins were measured and a specific LRV diameter ratio was calculated for each patient. Presence and severity of pelvic varices and LOV reflux were noted. Pelvic varices were detected in 59 (18%) of the total of 324 women, in 7 (37%) of the 19 women with RLRVs, in 7 (29%) of the 24 women with CLRVs, and in 45 (16%) of the 281 women with normal LRVs. The frequency of pelvic varices in the women with LRV variation was significantly higher than that in the group with normal LRV anatomy (33 vs. 16%; p=0.009). The frequency of pelvic varices in the women with RLRVs was also significantly higher than that in the group with normal LRV anatomy (p=0.02). LRV diameter ratio was correlated with presence of pelvic varices and presence of LOV reflux (p=0.0001 for both). This study revealed an association between pelvic varices and LRV variations in a population of predominantly multiparous women. (orig.)

  2. Antenatal renal pelvic dilatation; the long-term outlook

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    Duncan, K.A. [Royal Aberdeen Children' s Hospital and Aberdeen Maternity Hospital, Foresterhill, Aberdeen (United Kingdom)]. E-mail: k.duncan@nhs.net

    2007-02-15

    Aim: The purpose of this study was twofold: first to provide data for more accurate counselling of parents with regard to prognosis, and second, to ensure that by following a policy of selective micturating cystourethography (MCUG), significant pathology is not missed, in particular vesicoureteric reflux (VUR). (MCUG is only undertaken if the renal pelvic diameter (RPD) is {>=} 10 mm or if there is calyceal or ureteric dilatation.) Material and methods: Data were collected prospectively over a 6-year period. Pre and postnatal imaging findings were collected for all infants in whom a RPD of {>=} 5 mm was identified at any gestational age. The imaging records of all patients were reviewed in 2005 for evidence of pathology detected after re-presentation with symptoms. The age range at review varied from 2-8 years. Results: Complete data were available in 527 infants. The risk of significant pathology was related to the degree of antenatal renal pelvic dilatation varying from 6% for a RPD of 5 mm at 20 weeks gestation to 38% at 10mm. At 28-33 weeks gestation the risk varied from 5% at 5 mm to 15% at 10 mm. Subsequent imaging record review revealed only one patient with grade II VUR in the study population not picked up by our selective MCUG policy. Conclusion: The present study provides prognostic information that can be given to parents both antenatally and postnatally, and reassurance that a selective MCUG policy is appropriate.

  3. Pelvic Nephroureterectomy for Renal Cell Carcinoma in an Ectopic Kidney

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    Kevin G. Baldie

    2012-01-01

    Full Text Available We present a case of an ectopic renal tumor in a 61-year-old morbidly obese man with a pelvic kidney found after presenting with hematuria and irritative voiding symptoms. The mass, along with the ectopic kidney and ureter, was radically resected through an open operation that involved removing both them and the renal vessels from the underlying iliac vessels. Pathological analysis demonstrated an 8.3 cm papillary renal cell carcinoma (RCC with oncocytic features, Fuhrman nuclear grade 3, with angiolymphatic invasion and negative margins. The patient has been recurrence-free for over four years since tumor resection.

  4. Endoluminal isoproterenol reduces renal pelvic pressure during semirigid ureterorenoscopy

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    Jakobsen, Jørn S; Jung, Helene U; Gramsbergen, Jan B

    2009-01-01

    catheter was placed in the renal pelvis for pressure measurements, and a semirigid ureteroscope (7.8 F) was inserted retrogradely in the renal pelvis, through which the pelvis was perfused. The blood pressure and heart rate were recorded. The increase in renal pelvic pressure was examined with increasing....... The pressure-flow relation was linear; the maximum relaxation (27%) was obtained at 4 mL/min, from 52 to 38 mmHg during saline alone and ISO 0.1 microg/mL perfusion, respectively. The mean blood pressure did not change significantly (P = 0.330). The mean (sd) heart rate in the saline and ISO group were 109 (4...... ureterorenoscopy in this porcine model. ISO might be a potential additive to the irrigation fluid during upper urinary tract endoscopic procedures, minimizing pressure increases due to irrigation and manipulation....

  5. AB059. A novel technique of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure

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    Song, Le-Ming; Deng, Xiao-Lin

    2015-01-01

    Objective Flexible ureteroscopy is rapidly becoming a first line therapy for many patients with renal and ureteral calculi. Currently the medical infusion devices cannot monitor the renal pelvic pressure. We introduce a novel technique of flexible ureteroscopy with a suction system to treat upper urinary calculi and automatically control renal pelvic pressure. Methods We performed flexible URSs for patients with the help of a self-designed intelligent system including an irrigation and suctioning platform and a transparent ureteral access sheath (UAS) with a pressure-sensitive tip, which can precisely regulate the infusion flow and control the vacuum suctioning by computerized real-time recording and monitoring of RPP through pressure feedback, ensuring a stable RPP. The outer body diameter of the UAS was 15 F; the diameter of the working channel was 11.55 F; 
the length of the UAS was 20-45 cm. On the platform, RPP control value was set at −2 mmHg, RPP warning value was set at 20 mmHg, and RPP limit value was set at 30 mmHg. Intraoperatively, holmium laser was used to powderize the stone at 0.8 J/pulse with a frequency of 20 pulses/s (Lumenis, fiber diameter 200 um). In the process of powderizing lithotripsy using the laser, the scope body was moved back and forth slightly in an uninterrupted fashion in the sheath, with a distance of about 2-3 mm, to facilitate small gravel particles inside the sheath gap to be sucked out automatically. Gravel particles larger than sheath gap but less than UAS in diameter were sucked out by withdrawing the scope intermittently without a need of stone basketing. We retrospectively reviewed 37 patients with renal or ureteral calculus received the flexible URS from November 2014 to January 2015. Results The procedure was successfully performed in all patients with a clear operating field view. The mean stone size was 15.9±5.2 mm (rang: 8-35 mm). The mean operative time was 24.8±15.9 [13-49] min. The stone-free rates at

  6. Renal pelvic calculi and neoplasm. New indication for treatment of asymptomatic renal pelvic calculi?

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    Vibitis, H; Jørgensen, J B

    1990-01-01

    Metaplasia of the renal pelvis caused by chronic irritation, calculi, infection is a reversible pre-malignant condition. The application of ESWL on renal calculi as a safe treatment in relation to metaplasia is discussed and a case history is presented....

  7. Renal Pelviceal Keratinizing Squamous Metaplasia with Sparing of Pyramidal Zones

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    Richard H. Siderits

    2012-01-01

    Full Text Available Metaplastic changes in the urothelium of the upper urinary tract are relatively infrequent. Metaplasia may present as either squamous or less often glandular differentiation. The process may be associated with chronic inflammation or associated chronic infections. There may be malignant transformation to either squamous cell carcinoma or adenocarcinoma. The demarcation of the metaplastic process in the minor calyces has not been well documented to date. We report the case of a 74-year-old female patient who presented with a history of chronic renal disease and acute pyohydronephrosis. The patient underwent a nephroureterectomy which revealed keratinizing desquamative squamous metaplasia throughout the renal pelvis and upper urinary tract with abrupt termination of metaplasia at the junction of the renal pelvis and the minor calyx (pyramidal zone. Immunohistochemical evaluation documents metaplastic urothelium stained positive for CK5, before converting sharply to simple cuboidal epithelium in the minor calyx (pyramidal zones which stained positive CK7. At the junction of the metaplastic components and low cuboidal lined minor calyceal surfaces, the underlying stroma showed loss of ureteral muscularis mucosa with transition to renal parenchymal type stroma. We believe that this observation is unique and potentially relevant to the etiology and pathophysiology of pelviceal metaplasia.

  8. Utility of MRI features in differentiation of central renal cell carcinoma and renal pelvic urothelial carcinoma.

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    Wehrli, Natasha E; Kim, Min Ju; Matza, Brent W; Melamed, Jonathan; Taneja, Samir S; Rosenkrantz, Andrew B

    2013-12-01

    The purpose of this article is to evaluate the utility of various morphologic and quantitative MRI features in differentiating central renal cell carcinoma (RCC) from renal pelvic urothelial carcinoma. Sixty patients (39 men and 21 women; mean [± SD] age, 65 ± 14 years; 48 with central RCC and 12 with renal pelvic urothelial carcinoma) who underwent MRI, including diffusion-weighted imaging (b values, 0, 400, and 800 s/mm(2)) and dynamic contrast-enhanced imaging, before histopathologic confirmation were included. Tumor T2 signal intensity and apparent diffusion coefficients (ADCs) were measured and normalized to muscle and CSF (hereafter referred to as normalized T2 signal and normalized ADC, respectively) and then were compared using receiver operating characteristic analysis. Also, two blinded radiologists independently assessed all tumors for various qualitative features, which were compared with the Fisher exact test and unpaired Student t test. Urothelial carcinoma exhibited significantly lower normalized ADC than did RCC (p = 0.008), but no significant difference was seen in ADC or normalized T2 signal intensity (p = 0.247-0.773). Normalized ADC had the highest area under the curve (0.757); normalized ADC below an optimal threshold of 0.451 was associated with sensitivity of 83% and specificity of 71% for diagnosing urothelial carcinoma. Features that were significantly more prevalent in urothelial carcinoma included global impression of urothelial carcinoma, location centered within the collecting system, collecting system defect, extension to the ureteropelvic junction, preserved renal shape, absence of cystic or necrotic areas, absence of hemorrhage, homogeneous enhancement, and hypovascularity (all p features ranged from 61.7% to 98.3%. In addition to various qualitative MRI parameters, normalized ADC has utility in differentiating central RCC from renal pelvic urothelial carcinoma. Such differentiation may assist decisions regarding possible biopsy

  9. Ipsilateral synchronous renal pelvic transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma

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    韩平; 魏强; 石明; 杨宇如

    2004-01-01

    @@ Reports of multiple synchronous primary renal neoplasms in the literature are rare. Although primary renal tumors of 2 distinctively dissimilar origins have been sporadically described,1-6 to our knowledge there have been no reported cases of triple primary renal neoplasms in the same kidney. Here we report a very rare case of ipsilateral synchronous renal pelvic transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma with marked hydronephrosis and multiple stones in the same kidney.

  10. Incidence of renal carcinoma in non-functioning kidney due to renal pelvic stone disease

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    ZENGIN, KURSAD; TANIK, SERHAT; SENER, NEVZAT CAN; ALBAYRAK, SEBAHATTIN; EKICI, MUSA; BOZKURT, IBRAHIM HALIL; BAKIRTAS, HASAN; GURDAL, MESUT; IMAMOGLU, MUHAMMED ABDURRAHIM

    2015-01-01

    The objective of This study was to report our pathological findings in nephrectomy specimens from patients treated for non-functioning hydronephrotic kidney due to renal pelvic stone disease. A total of 97 patients who underwent nephrectomy for non-functioning hydronephrotic kidneys between January, 2011 and June, 2014 were retrospectively reviewed. A non-functioning kidney was defined as one having paper-thin parenchyma on urinary ultrasound or computed tomography, exhibiting no contrast visualization in the collecting duct system on intravenous urography and having a split renal function of <10% on nuclear renal function studies. Following pathological evaluation, 9 patients were diagnosed with xanthogranulomatous pyelonephritis, 9 with malignant tumors and 79 with chronic pyelonephritis. Of the patients with chronic pyelonephritis, 2 also had renal adenomas. The malignant tumors included 3 transitional cell carcinomas (TCC), 2 squamous cell carcinomas (SCC), 3 renal cell carcinomas (RCC) (1 sarcomatoid, 1 papillary and 1 clear cell RCC), whereas 1 patient had concurrent RCC and TCC. In conclusion, non-functioning kidneys, particularly those with kidney stones, should be managed as possible malignancies, due to the higher incidence of malignant tumors in such patients compared with the normal population. PMID:26171211

  11. Electrospun Matrices for Pelvic Floor Repair: Effect of Fiber Diameter on Mechanical Properties and Cell Behavior.

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    Vashaghian, Mahshid; Zandieh-Doulabi, Behrouz; Roovers, Jan-Paul; Smit, Theodoor Henri

    2016-12-01

    Electrospun matrices are proposed as an alternative for polypropylene meshes in reconstructive pelvic surgery. Here, we investigated the effect of fiber diameter on (1) the mechanical properties of electrospun poly (lactic-co-glycolic acid)-blended-poly(caprolactone) (PLGA/PCL) matrices; (2) cellular infiltration; and (3) the newly formed extracellular matrix (ECM) in vitro. We compared electrospun matrices with 1- and 8 μm fiber diameter and used nonporous PLGA/PCL films as controls. The 8-μm matrices were almost twice as stiff as the 1-μm matrices with 1.38 and 0.66 MPa, respectively. Matrices had the same ultimate tensile strength, but with 80% the 1-μm matrices were much more ductile than the 8-μm ones (18%). Cells infiltrated deeper into the matrices with larger pores, but cellular activity was comparable on both substrates. New ECM was deposited faster on the electrospun samples, but after 2 and 4 weeks the amount of collagen was comparable with that on nonporous films. The ECM deposited on the 1-μm matrices, and the nonporous film was about three times stiffer than the ECM found on the 8-μm matrices. Cell behavior in terms of myofibroblastic differentiation and remodeling was similar on the 1-μm matrices and nonporous films, in comparison to that on the 8-μm matrices. We conclude that electrospinning enhances the integration of host cells as compared with a nonporous film of the same material. The 1-μm matrices result in better mechanical behavior and qualitatively better matrix production than the 8-μm matrices, but with limited cellular infiltration. These data are useful for designing electrospun matrices for the pelvic floor.

  12. Renal cell carcinoma in an ectopic pelvic kidney in a patient presenting with acute urinary retention

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    Isabella Dash

    2010-12-01

    Full Text Available The incidence of renal cell carcinoma in a pelvic kidney is rare, and has only been described in a very small number of cases. We describe a case where an incidental ectopic kidney with invasive renal cell carcinoma was diagnosed during a separate emergency admission for acute urinary retention.

  13. Laparoscopic bilateral nephroureterectomy and bladder cuff excision for native renal pelvic and ureteral transitional cell carcinoma after renal transplantation.

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    Chen C

    2003-01-01

    Full Text Available A 37-years-old female who was suffering from end-stage renal disease for about 6 years received allograft renal transplantation 4 years ago. She has been receiving 50mg of Cyclosporin A orally daily for immuno-suppression since then. Gross haematuria was noted and computerised tomography showed native left renal pelvic and ureteral multi-focal transitional cell carcinoma with severe hydronephrosis. Laparoscopic bilateral nephroureterectomy and bladder cuff excision were performed. In the past, history of previous operation was considered a relative contraindication for laparoscopic surgery. To our knowledge, we present the first case of laparoscopic treatment for native renal pelvic and ureteral transitional cell carcinoma after renal allograft transplantation without a hand-assisted device. This case shows the feasibility of laparoscopic bilateral nephroureterectomy in patients with transplanted kidneys.

  14. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

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    Robert Marcovich

    2003-06-01

    Full Text Available Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial anatomy of the renal collecting system, presence of hydronephrosis, and other anatomic variables, such as the presence of calyceal diverticula and renal anomalies; and clinical or patient factors like morbid obesity, the presence of a solitary kidney, and renal insufficiency. The morbidity of each procedure in relation to its efficacy should be taken in to account. This article will review current knowledge and suggest an algorithm for the rational management of renal calculi with shock wave lithotripsy and percutaneous nephrolithotomy.

  15. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

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    Robert Marcovich; Smith, Arthur D.

    2003-01-01

    Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial...

  16. Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature

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    A. Altun

    2015-01-01

    Full Text Available A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF. He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature.

  17. Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature.

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    Altun, A; Kurna, S A; Sengor, T; Altun, G; Oflaz, A; Sonmez, H S

    2015-01-01

    A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature.

  18. Effects of efonidipine hydrochloride on renal arteriolar diameters in spontaneously hypertensive rats.

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    Nakamura, Masuhisa; Notoya, Mitsuru; Kohda, Yuka; Yamashita, Junji; Takashita, Yuko; Gemba, Munekazu

    2002-09-01

    Efonidipine, a calcium antagonist, has been reported to dilate not only afferent but also efferent arterioles, thereby reducing glomerular hydrostatic pressure. We investigated the effect of chronic treatment with efonidipine or lisinopril on the afferent and efferent arteriolar diameters by the vascular cast technique. Four-week-old spontaneously hypertensive rats (SHR) were divided into three groups: untreated, efonidipine (25 mg/kg/day)-treated, and lisinopril (3 mg/kg/day)-treated. At 22 weeks of age, the renal vasculatures were fixed at the maximally dilated condition. The morphometrical measurements showed that the treatments with efonidipine and lisinopril caused structural alteration of the vasculature, resulting in significantly greater efferent arteriolar diameters than in untreated SHR. In addition, lisinopril-treated rats had wider afferent lumina. The renoprotective effect of efonidipine and lisinopril might be partly due to the structurally larger efferent arteriolar lumen.

  19. Retroperitoneoscopic pyelolithotomy: a good alternative treatment for renal pelvic calculi in children

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    Bruno Nicolino Cezarino

    Full Text Available ABSTRACT Introduction: Nephrolitiasis, once considered an adult disease, has become increasingly prevalent in children, with an increase from 6% to 10 % annually in past 25 years. Kidney stones in pediatric population can result from metabolic diseases in up to 50% of children affected. Other factors associated with litiasis are infection, dietary factors, and anatomic malformations of urinary tract. Standard treatment procedures for pediatric population are similar to adult population. Extracorporeal shock wave lithotripsy (ESWL, ureterorenoscopy (URS, percutaneous nepfrolithotomy (PCNL, as well as laparoscopic and retroperitoneoscopic approaches can be indicated in selected cases. The advantages of laparoscopic or retroperitoneoscopic approaches are shorter mean operation time, no trauma of renal parenchyma, lower bleeding risk, and higher stone-free rates, especially in pelvic calculi with extrarenal pelvis, where the stone is removed intact. Patient and Methods: A 10 year-old girl presented with right abdominal flank pain, macroscopic hematuria, with previous history of urinary infections‥ Further investigation showed an 1,5 centimeter calculi in right kidney pelvis. A previous ureterorenoscopy was tried with no success, and a double J catheter was placed. After discussing options, a retroperitoneoscopic pielolithotomy was performed. Results: The procedure occurred with no complications, and the calculi was completely removed. The foley catheter was removed in first postoperative day and she was discharged 2 days after surgery. Double J stent was removed after 2 weeks. Conclusions: Retroperitoneoscopic pielolithotomy is a feasible and safe procedure in children, with same outcomes of the procedure for adult population.

  20. [Continent urinary reservoir using dilated renal pelvis of non-functioning pelvic kidney in a girl with cloacal exstrophy].

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    Matsumoto, F; Shimada, K; Hosokawa, S; Konya, E

    1997-01-01

    We performed construction of continent urinary reservoir in an 8-year-old girl with cloacal exstrophy who had double stoma of ileostomy and colon conduit. Preoperative evaluation revealed non-functioning right kidney with severely dilated renal pelvis and calyxes in her pelvis. Urinary reservoir was constructed using detubularized colon segment which had been used as the urinary conduit and dilated renal pelvis of non-functioning pelvic kidney. Using Mitrofanoff's principle, continent catheterizable channel was also made of the anterior wall of the renal pelvis. Postoperative course was uneventful. Reservoir capacity increased to 350 ml one and half year postoperatively and she is almost dry with clean intermittent catheterization 5 times a day. Dilated upper urinary tract is one of the ideal material for bladder enlargement that avoids the complication associated with the use of gastrointestinal tract.

  1. The comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy in the treatment of solitary large renal pelvic stones.

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    Tefekli, Ahmet; Tepeler, Abdulkadir; Akman, Tolga; Akçay, Muzaffer; Baykal, Murat; Karadağ, Mert Ali; Muslumanoglu, Ahmet Y; de la Rosette, Jean

    2012-10-01

    The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could find a place in the management of large renal pelvic stones which are generally considered as excellent indications for percutaneous nephrolithotomy (PNL). Between 2006 and 2009, 26 consecutive patients with large (>4 cm(2)) renal pelvic stones were treated by LPL and their charts were compared to 26 match-paired patients treated with PNL during the same period. The patients were matched for age, BMI, stone size and location as well as presence of congenital anomalies. Perioperative and postoperative findings were compared. The mean age, mean stone size, rate of congenital anomalies, history open renal surgery and shock wave lithotripsy were similar in both groups (p > 0.05). The mean operation time was 138.40 ± 51.19 (range 70-240) min in LPL group as compared to 57.92 ± 21.12 (range 40-110) min in PNL group (p PNL group (p = 0.024). Hospitalization was significantly shorter in PNL than LPL group (p = 0.0001). Stone-free rates were similar. Laparoscopic pyelolithotomy is associated with a longer operation time, is more invasive, and requires more skills when compared to PNL. However, LPL is associated with less blood loss. Laparoscopic pyelolithotomy is indicated for congenitally anomalous kidneys and especially in patients with concomitant UPJ.

  2. 超声造影和增强CT诊断肾盂癌的比较研究%Comparative study of renal pelvic carcinoma by contrast-enhanced ultrasonography and contrast-enhanced computed tomography

    Institute of Scientific and Technical Information of China (English)

    王晓; 黄备建; 李丛; 燕翠菊; 范培丽; 李超伦; 王文平

    2012-01-01

    目的 对比分析超声造影和增强CT显示肾盂癌血流灌注特点的异同点,探讨超声造影的临床应用价值.方法 对40例行超声造影和增强CT检查并经手术病理证实的肾盂癌病例进行回顾性分析,观察肿块的增强时相和增强方式,包括肿块的增强、消退时间和灌注表现.结果 超声造影显示皮质期40个肿块全部增强;同步增强14个,缓慢增强26个;达峰值呈低回声31个,高回声4个,等回声5个;实质期快速消退35个,同步消退2个,缓慢消退3个;显示最小病灶为1.5 cm.增强CT显示38个肿块增强,多呈轻、中度均匀强化,增强程度低于周围肾实质.超声造影诊断准确率为77.5%(31/40),增强CT诊断准确率为82.5%(33/40),两者比较差异无统计学意义(P>0.05).结论 超声造影和增强CT对肾盂癌均有较高的诊断准确率,联合检测可提高早期诊断的检出率.%Objective To compare and analyze the similarities and differences of the blood perfusion characteristics of the renal pelvic carcinoma displayed by contrast-enhanced ultrasonography(CEUS) and contrast-enhanced computed tomography(CECT).Methods The characteristics of CEUS and CECT were anzlyzed retrospectively in 40 confirmed renal pelvic carcinoma cases by operation and pathology.The modality and phases of enhancement,including wash-in and washout time,as well as the perfusion appearances,were observed by CEUS and CECT.Results CEUS detected the cortical phase enhancement in all renal pelvic tumors,including synchronously enhancement in 14 tumors and delayed enhancement in 26 tumors.At peak times,hypoechogenicity compared to the normal renal cortex was shown in 31 tumors,hyperechogenicity in 4 tumors and isoechogenicity in 5 tumors.Fast wash-out in medulla phase was displayed in 35 tumors,isochronously wash-out in 2 tumors and delayed wash-out in 3 tumors.The minimum diameter in 40 renal pelvic tumors was 1.5 cm.CECT showed the enhancement in 38 tumors

  3. Utility of anteroposterior diameter ratio of tumor and abdomen for laparoscopic approach for radical nephrectomy in large renal masses.

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    Yadav, Priyank; Srivastava, Devarshi; Arakere, Sachin; Gupta, Shashikant; Aga, Pallavi; Mandhani, Anil

    2017-08-07

    Laparoscopic radical nephrectomy (LRN) is now increasingly done for tumors larger than 10 cm. Despite selection of favorable cases, LRN may not be successful due to lack of adequate working space with large tumors. We describe a new feature on Contrast Enhanced Computed Tomography (CECT) abdomen to predict feasibility of LRN for large renal masses between 10 and 15 cm. From January 2005 to December 2015, renal tumors between 10 and 15 cm were selected retrospectively for LRN. Patients with retroperitoneal lymphadenopathy, Inferior vena cava (IVC) thrombus and involvement of adjacent organs were excluded. Anteroposterior (AP) diameter ratio of renal tumor and abdomen (APROTA) was calculated by dividing the maximum AP diameter of tumor along with normal renal parenchyma, by the AP diameter of abdomen on CECT. The patients were stratified into two groups: Group A (successful LRN) and Group B (conversion to open surgery) and outcomes were compared. The reasons for conversion were also noted. Of 29 patients, 16 (55.2%) had successful LRN (Group A), while 13 (44.8%) had conversion to open surgery (group B). The median tumor size in Group A was 11.3 ± 1.8 cm and in Group B was 13.6 ± 1.26 cm. Eleven of 13 patients had conversion due to large tumor size causing failure to progress. Two conversions were due to bleeding and injury to the colon each. There was a significant difference in the APROTA in group A and B [0.43 ± 0.09 in group A and 0.64 ± 0.14 in group B (p = 0.0001)]. Patients with APROTA of more than 0.65 are unlikely to have successful outcome with LRN.

  4. Sarcomatoid collecting duct carcinoma of kidney diagnosed with urine and renal pelvic lavage cytology.

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    Mimura, Akihiro; Sakuma, Takahiko; Furuta, Michiko; Tanigawa, Naoto; Takamizu, Ryuichi; Kawano, Kiyoshi

    2010-08-01

    A case of sarcomatoid collecting duct carcinoma (CDC) of kidney is presented, in which the diagnosis was made cytologically with voided urine and renal pelvis lavage. Cytology of hemorrhagic voided urine revealed highly atypical adenocarcinoma cells with reminiscent ductal structure, which suggested CDC as the most likely diagnosis. Computed tomography and magnetic resonance imaging demonstrated a left renal tumor, and selective lavage of left renal pelvis yielded spindle-shaped, highly atypical cells that indicated sarcomatoid carcinoma. The diagnosis of renal cancer with urine cytology is challenging because of small number of tumor cells in the urine, which are often associated with degeneration. As the urinary cytologic findings of sarcomatoid CDC have not been reported, the characteristic cytologic findings of sarcomatoid CDC are described in detail, and the differential diagnoses with diagnostic pitfalls were discussed.

  5. Antenatal Ultrasonographic Anteroposterior Renal Pelvis Diameter Measurement: Is It a Reliable Way of Defining Fetal Hydronephrosis?

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    Alamanda Kfoury Pereira

    2011-01-01

    Full Text Available Purpose. It was to quantify the intraobserver and interobserver variability of the sonographic measurements of renal pelvis and classify hydronephrosis severity. Methods. Two ultrasonographers evaluated 17 fetuses from 23 to 39 weeks of gestation. Renal pelvis APD were taken in 50 renal units. For intraobserver error, one of them performed three sequential measurements. The mean and standard deviation from the absolute and percentage differences between measurements were calculated. Bland-Altman plots were used to visually assess the relationship between the precision of repeated measurements. Hydronephrosis was classified as mild (5.0 to 9.9 mm, moderate (10.0 to 14.9 mm, or severe (≥15.0 mm. Interrater agreement were obtained using the Kappa index. Results. Absolute intraobserver variation in APD measurements was 5.2±3.5%. Interobserver variation of ultrasonographers was 9.3±9.7%. Neither intraobserver or interobserver error increased with increasing APD size. The overall percentage of agreement with the antenatal hydronephrosis diagnosis was 64%. Cohen's Kappa to hydronephrosis severity was 0.51 (95% CI, 0.33 to 0.69. Conclusion. Inter and intraobserver APD measurement errors were low in these group, but the agreement to hydronephrosis diagnosis and classification was fair. We suggest that standard and serial APD measurement can better define and evaluate fetal hydronephrosis.

  6. Kidney volume correlates with tumor diameter in renal cell carcinoma and is associated with histological poor prognostic features.

    Science.gov (United States)

    Hayes, Brian D; Finn, Stephen P

    2014-02-01

    We aimed to correlate kidney volume (KV) in renal cell carcinoma nephrectomy specimens with tumor diameter (TD), macroscopic growth pattern, and histological features associated with poor prognosis. Histopathology reports, macroscopic specimen photographs, and selected glass slides were retrospectively reviewed. KV was approximated to the volume of an ellipsoid. A total of 273 specimens were identified with median KV 245 cm(3). Kidneys larger than this contained larger tumors (7.5 vs 4.5 cm). KV was significantly greater in tumors of high grade, involving perinephric fat, exhibiting venous invasion, and involving renal sinus. There was a robust linear correlation between KV and TD (r = 0.602) and a weaker correlation between kidney diameter (KD) and TD (r = 0.53). In pT1 tumors, KV (r = 0.40) also correlated better with TD than did KD (r = 0.27). By multiple regression analysis, both TD and venous invasion independently predicted both KD (R (2) = 38.27%) and KV (R (2) = 51.97%). KV and KD correlate well with TD and histopathological features of aggressiveness, although KD correlates better overall and in the pT1 subset.

  7. Spontaneous Pelvic Rupture as a Result of Renal Colic in a Patient with Klinefelter Syndrome

    Directory of Open Access Journals (Sweden)

    Sergey Reva

    2013-01-01

    Full Text Available We present the case of a young man with Klinefelter syndrome, who was admitted to our clinic with renal colic. Shortly after admittance, spontaneous decrease in pain has occurred. Ultrasound and intravenous contrast computed tomography were performed, which showed the evidence of urine extravasation at the level of left renal pelvis and a 4 mm stone in the lower third of the left ureter. The management with a double-J ureteric stent for three weeks was successful. Then, the stent was removed and computed tomography confirmed the absence of urine extravasation. We also analyze the literature related to this case and discuss the main mechanisms of collecting system rupture.

  8. Retroperitoneoscopic pyelolithotomy: A minimally invasive alternative for the management of large renal pelvic stone

    Directory of Open Access Journals (Sweden)

    Saurabh Sudhir Chipde

    2014-01-01

    Full Text Available Introduction: Large stones in renal pelvis can be treated with percutaneous nephrolithotomy (PCNL or pyelolithotomy (either by open or laparoscopic techniques. PCNL is difficult in undilated system. For pyelolithotomy, laparoscopy is more preferable over the open surgery. Surgeons are more familiar with the tansperitoneoscopic anatomy than retroperitoneoscopic one, but retroperitoneoscopic approach can be attempted if we anticipate the problems in the transperitoneal route. Case: A fifty years old gentleman presented to us with the complaint of dull aching right flank pain. On ultrasonographic examination, he was found to have a large stone in renal pelvis with minimal hydronephrosis and thickened omentum on right side. Xray KUB showed a large radio-opaque shadow in renal area. We did the CECT-Urogram of the patient to know the detailed anatomy, which showed a stone of 5.3 x 3.7 cm in right extra-rena pelvis without hydronephrosis and a large focal area of marked fat stranding in omentum on the right side in mid and lower abdomen with swirling of fat stranding on the superior aspect suggestive of omental infarction and torsion. Due to undilated caliceal system, we preferred laparoscopic surgery over the PCNL in this patient. As whole of the omental tissue was stuck on right side we decided to proceed with transperitoneoscopic route instead of retroperitoneoscopic one. The DJ stent was inserted preoperatively.The surgery was performed in the flank position with three ports, one 10mm port just antero-inferior to tip of 12th rib for camera and two 5mm working ports, one at anterior axillary line and other at renal angle. We created the retroperitoneal space with the customized balloon, made with the glove-fingure. Results: The operative time was 1 hour 40 minutes, and there were no intra or post-operative complications. The stone was removed in toto. Patient was orally allowed on first postoperative day and foleys was removed on second day. patient

  9. Clinical Significance of Renal Pelvic Dilatation less than 10 mm in Neonates: Correlation with Urinary Tract Infection and Vesicoureteral Reflux

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woong Hee; Kim, Young Tong; Jo, Sung Sik; Kim, Sang Won; Shin, Hyung Cheol; Kim, Il Young [Cheonan Hospital, Soonchunhyang University, Cheonan (Korea, Republic of)

    2009-12-15

    We wanted to evaluate the correlation of mild renal pelvic dilatation (RPD) that is observed to be less than 10 mm on ultrasound (US) with urinary tract infection (UTI) and vesicoureteral reflux (VUR) in neonates. We reviewed 137 kidneys of 107 neonates who had RPD less than 10 mm on US. All the kidneys were divided into two groups: Group I (RPD <= 5.0 mm) and Group II (RPD > 5.0 mm), and we statistically analyzed the RPD change according to UTI and VUR. Seven neonates had VUR (5.1%), and there was no statistical significance between Group I (6 neonates, 5.6%) and Group II (1 neonate, 3.3%). Thirty seven cases (27%) had UTI and there was no statistical significance between Group I (30 cases, 28.0%) and Group II (7 cases, 23.3%). The RPD did not change in 81.8% of the cases, it increased in 4.4% of the cases and it decreased in 13.9% of the cases on follow up US. The incidence of VUR and UTI were not different according to the change of RPD. There were no statistical differences between the changes of RPD and the incidences of UTI and VUR in neonates with mild RPD less than 10 mm. Most of RPD did not change on the follow up US

  10. Possible linkages between lignite aquifers, pathogenic microbes, and renal pelvic cancer in northwestern Louisiana, USA

    Energy Technology Data Exchange (ETDEWEB)

    Bunnell, J.E.; Tatu, C.A.; Bushon, R.N.; Stoeckel, D.M.; Brady, A.M.G.; Beck, M.; Lerch, H.E.; McGee, B.; Hanson, B.C.; Shi, R.H.; Orem, W.H. [USGS, Reston, VA (United States)

    2006-12-15

    In May and September, 2002, 14 private residential drinking water wells, one dewatering well at a lignite mine, eight surface water sites, and lignite from an active coal mine were sampled in five Parishes of northwestern Louisiana, USA. Using a geographic information system (GIS), wells were selected that were likely to draw water that had been in contact with lignite; control wells were located in areas devoid of lignite deposits. Well water samples were analyzed for pH, conductivity, organic compounds, and nutrient and anion concentrations. All samples were further tested for presence of fungi (cultures maintained for up to 28 days and colonies counted and identified microscopically) and for metal and trace element concentration by inductively-coupled plasma mass spectrometry and atomic emission spectrometry. Surface water samples were tested for dissolved oxygen and presence of pathogenic leptospiral bacteria. The Spearman correlation method was used to assess the association between the endpoints for these field/laboratory analyses and incidence of cancer of the renal pelvis (RPC) based on data obtained from the Louisiana Tumor Registry for the five Parishes included in the study. Significant associations were revealed between the cancer rate and the presence in drinking water of organic compounds, the fungi Zygomycetes, the nutrients PO{sub 4} and NH{sub 3}, and 13 chemical elements. Presence of human pathogenic leptospires was detected in four out of eight (50%) of the surface water sites sampled.

  11. Possible linkages between lignite aquifers, pathogenic microbes, and renal pelvic cancer in northwestern Louisiana, USA

    Science.gov (United States)

    Bunnell, J.E.; Tatu, C.A.; Bushon, R.N.; Stoeckel, D.M.; Brady, A.M.G.; Beck, M.; Lerch, H.E.; McGee, B.; Hanson, B.C.; Shi, R.; Orem, W.H.

    2006-01-01

    In May and September, 2002, 14 private residential drinking water wells, one dewatering well at a lignite mine, eight surface water sites, and lignite from an active coal mine were sampled in five Parishes of northwestern Louisiana, USA. Using a geographic information system (GIS), wells were selected that were likely to draw water that had been in contact with lignite; control wells were located in areas devoid of lignite deposits. Well water samples were analyzed for pH, conductivity, organic compounds, and nutrient and anion concentrations. All samples were further tested for presence of fungi (cultures maintained for up to 28 days and colonies counted and identified microscopically) and for metal and trace element concentration by inductively-coupled plasma mass spectrometry and atomic emission spectrometry. Surface water samples were tested for dissolved oxygen and presence of pathogenic leptospiral bacteria. The Spearman correlation method was used to assess the association between the endpoints for these field/laboratory analyses and incidence of cancer of the renal pelvis (RPC) based on data obtained from the Louisiana Tumor Registry for the five Parishes included in the study. Significant associations were revealed between the cancer rate and the presence in drinking water of organic compounds, the fungi Zygomycetes, the nutrients PO4 and NH3, and 13 chemical elements. Presence of human pathogenic leptospires was detected in four out of eight (50%) of the surface water sites sampled. The present study of a stable rural population examined possible linkages between aquifers containing chemically reactive lignite deposits, hydrologic conditions favorable to the leaching and transport of toxic organic compounds from the lignite into the groundwater, possible microbial contamination, and RPC risk. ?? Springer Science+Business Media B.V. 2006.

  12. Possible linkages between lignite aquifers, pathogenic microbes, and renal pelvic cancer in northwestern Louisiana, USA.

    Science.gov (United States)

    Bunnell, Joseph E; Tatu, Calin A; Bushon, Rebecca N; Stoeckel, Donald M; Brady, Amie M G; Beck, Marisa; Lerch, Harry E; McGee, Benton; Hanson, Bradford C; Shi, Runhua; Orem, William H

    2006-12-01

    In May and September, 2002, 14 private residential drinking water wells, one dewatering well at a lignite mine, eight surface water sites, and lignite from an active coal mine were sampled in five Parishes of northwestern Louisiana, USA. Using a geographic information system (GIS), wells were selected that were likely to draw water that had been in contact with lignite; control wells were located in areas devoid of lignite deposits. Well water samples were analyzed for pH, conductivity, organic compounds, and nutrient and anion concentrations. All samples were further tested for presence of fungi (cultures maintained for up to 28 days and colonies counted and identified microscopically) and for metal and trace element concentration by inductively-coupled plasma mass spectrometry and atomic emission spectrometry. Surface water samples were tested for dissolved oxygen and presence of pathogenic leptospiral bacteria. The Spearman correlation method was used to assess the association between the endpoints for these field/laboratory analyses and incidence of cancer of the renal pelvis (RPC) based on data obtained from the Louisiana Tumor Registry for the five Parishes included in the study. Significant associations were revealed between the cancer rate and the presence in drinking water of organic compounds, the fungi Zygomycetes, the nutrients PO(4) and NH(3), and 13 chemical elements. Presence of human pathogenic leptospires was detected in four out of eight (50%) of the surface water sites sampled. The present study of a stable rural population examined possible linkages between aquifers containing chemically reactive lignite deposits, hydrologic conditions favorable to the leaching and transport of toxic organic compounds from the lignite into the groundwater, possible microbial contamination, and RPC risk.

  13. Retrograde Intrarenal Surgery versus Percutaneous Lithotripsy to Treat Renal Stones 2-3 cm in Diameter

    Directory of Open Access Journals (Sweden)

    Kursad Zengin

    2015-01-01

    Full Text Available Objective. Retrograde intrarenal surgery (RIRS performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL. However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter. Materials and Methods. The medical records of 154 patients (74 PNL, 80 RIRS were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2. Results. The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P=0.061. The respective complication rates (evaluated using the Clavien system were 13.5% and 8.8% (P=0.520. Conclusions. RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings.

  14. Retrograde Intrarenal Surgery versus Percutaneous Lithotripsy to Treat Renal Stones 2-3 cm in Diameter

    Science.gov (United States)

    Zengin, Kursad; Tanik, Serhat; Sener, Nevzat Can; Albayrak, Sebahattin; Tuygun, Can; Bakirtas, Hasan; Imamoglu, M. Abdurrahim; Gurdal, Mesut

    2015-01-01

    Objective. Retrograde intrarenal surgery (RIRS) performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL). However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter. Materials and Methods. The medical records of 154 patients (74 PNL, 80 RIRS) were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2. Results. The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P = 0.061). The respective complication rates (evaluated using the Clavien system) were 13.5% and 8.8% (P = 0.520). Conclusions. RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings. PMID:25821828

  15. Pelvic laparoscopy

    Science.gov (United States)

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

  16. Fever with intradialytic pelvic pain: a case of iliopsoas abscess complicated with Methicillin-sensitive Staphylococcus Aureus bacteraemia in an end stage renal failure patient.

    Science.gov (United States)

    Alif Adlan, M T; Wan Mohd Rasis, W A K; Mohd Ramadhan, M D

    2016-04-01

    Staphylococcus Aureus is a Gram-positive cocci bacteria which had been found to be the causative organism in over 88% of patients with primary iliopsoas abscess. We report the case of a 53-year-old diabetic woman with end-stage renal failure diagnosed with left iliopsoas abscess with a catheter-related infection. Computed tomogram (CT) of abdomen and pelvis revealed hypodense lesions of left psoas, iliacus and quadratus lumborum suggestive of psoas abscesses. In addition, osteomyelitis changes at left sacroiliac and hip joint were seen. At surgery, she was found to have abscess at the posterior psoas muscle where she underwent open surgery drainage and percutaneous drain was inserted. A high index of suspicion of iliopsoas abscess should be maintained among haemodialysis patients presenting with intradialytic pelvic and hip pain and treated with optimal antibiotics therapy with appropriate surgical intervention.

  17. Pelvic ultrasonography.

    Science.gov (United States)

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

    1997-11-01

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

  18. Clinical Analysis of 1 Cases of Atypical Renal Pelvic Carcinoma%不典型肾盂癌1例分析

    Institute of Scientific and Technical Information of China (English)

    尹淑荣

    2014-01-01

    At present, the renal pelvis cancer incidence in China to rise, and its cause is not clear, most of the patients at the age of 41~63 years old in the elderly population, and in males. The most common clinical symptoms of renal pelvic carcinoma is the whole process of indirect visible to the naked eye hematuria, and with low back pain, decreased appetite, dif iculty in urination and other symptoms. Research and analysis to continuously in recent years, the incidence of carcinoma of renal pelvis and the environment, food chemical factors have correlation, some research shows that smoking is more concrete, and also has a direct relationship. At the same time of renal pelvis carcinoma is a common evil tumor in urinary system, at the same time as the disease position is special, in the ureter, bladder and urethra, confirmed the need for detailed examination, by examining the early diagnosis of comprehensive system, prevent to delay the disease, which is crucial for carcinoma of renal pelvis examination.%目前肾盂癌在我国的发病率以呈上升趋势,其发生的原因还不清楚,多数患者年龄在41~63岁的中老年人群,并且以男性居多。临床肾盂癌最常见症状是间接性肉眼可见血尿全过程,并且伴随腰痛、食欲下降、排尿困难等症状。通过近年来不断的研究和分析,提出肾盂癌的发病与环境、饮食化学物质等因素都有关联,有些研究显示更具体,表明与吸烟也有直接的关系。同时肾盂癌作为泌尿系统中常见恶的肿瘤,同时由于病症位置比较特殊,在输尿管、膀胱乃至尿道地,确诊需要进行详细的检查,通过全面系统的检查早期确诊,防止耽误病情,由此对于肾盂癌的检查至关重要。

  19. [Thrombotic occlusion of the terminal aorta associated to a renal fusion and pelvic location ("pancake" kidney). First case report].

    Science.gov (United States)

    Martins, Carlos; Moura, Carlos; Almeida, Paulo; Dinis da Gama, A

    2006-01-01

    Coexistence of thrombotic occlusion of the terminal aorta with a "pancake" kidney is reported in 63-year old man, diagnosed by CT-scans and selective angiography, to assess the renal circulation and for surgical planning. Surgical exposure was transperitoneal and revascularization was accomplished through a bifurcation Dacron graft from the supraceliac aorta to both femorals, associated to the renal revascularization, by means of PTFE graft from the prosthesis to the renal artery. The success of procedure was later demonstrated by angio-RM, showing both grafts working in excellent condition. According to an extensive bibliographic review, this seems to be the first case reporting the association of a thrombotic occlusion of the terminal aorta to a "pancake" kidney, thus justifying its presentation and divulgation.

  20. Pelvic radiation - discharge

    Science.gov (United States)

    Radiation of the pelvis - discharge; Cancer treatment - pelvic radiation; Prostate cancer - pelvic radiation; Ovarian cancer - pelvic radiation; Cervical cancer - pelvic radiation; Uterine cancer - pelvic radiation; Rectal cancer - pelvic radiation

  1. Evaluation of left renal vein entrapment using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Poyraz, Ahmet K.; Onur, Mehmet R. [Dept. of Radiology, Firat Univ. School of Medicine, Elazig (Turkey)], e-mail: akursadpoyraz@yahoo.com.tr; Firdolas, Fatih [Dept. of Urology, Firat Univ. School of Medicine, Elazig (Turkey); Kocakoc, Ercan [Dept. of Radiology, Bezmialem Vakif Univ., School of Medicine, Istanbul (Turkey)

    2013-03-15

    Background: Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. Purpose: To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. Material and Methods: The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. Results: Left renal vein entrapment was observed in 10.9% (109), retroaortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% (3) of patients. Mean diameters of right (8.8 {+-} 1.9 mm) and unentrapped left (8.9 {+-} 1.8 mm) renal veins were not significantly different (P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3 {+-} 2 mm) was significantly greater (P = 0.04) than contralateral renal veins (8.6 {+-} 2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. Conclusion: Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

  2. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris

    2008-01-01

    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  3. Right ovarian vein drainage variant: Is there a relationship with pelvic varices?

    Energy Technology Data Exchange (ETDEWEB)

    Koc, Zafer [Baskent Universitesi, Adana Hastanesi, Radyoloji Boeluemue, Serin Evler 39, Sok. No. 6 Yueregir, Adana (Turkey)]. E-mail: koczafer@gmail.com; Ulusan, Serife [Baskent Universitesi, Adana Hastanesi, Radyoloji Boeluemue, Serin Evler 39, Sok. No. 6 Yueregir, Adana (Turkey); Oguzkurt, Levent [Baskent Universitesi, Adana Hastanesi, Radyoloji Boeluemue, Serin Evler 39, Sok. No. 6 Yueregir, Adana (Turkey)

    2006-09-15

    Objective: To correlate right ovarian vein (ROV) variations that drain into the right renal vein (RRV) with the presence of pelvic varices. Materials and methods: Routine abdominal multidetector-row computed tomography scans of 324 women were analyzed for the presence and type of ROV variations in this retrospective study. The subjects were divided into 2 groups: those with ROV variations and those without such variations. The diameters of the subjects' ROV, left ovarian vein (LOV), and parauterine veins were measured. Pelvic varices and the presence and degree of ovarian vein reflux were noted and compared between the 2 groups. The {chi}{sup 2}-test and the Pearson correlation test were used for statistical analysis. Results: Thirty-two (9.9%) of 324 women studied exhibited ROV variant that drained into the right renal vein, and the remaining subjects (90.1%) exhibited a normal pattern of ROV drainage that flowed directly into the inferior vena cava. Pelvic varices were identified in 59 (18%) of the subjects. Reflux was not observed in any patient without pelvic varices. Fifty-seven of 59 women exhibited ovarian vein reflux. In 56 of those 57 individuals, reflux occurred only in the LOV, and in 1 subject, reflux was noted predominantly in the ROV. No significant relationship between the presence of an ROV that drained into the right renal vein and pelvic varices was noted. Conclusion: Although right-sided pelvic varices associated with right ovarian vein drainage variations are rare, anatomic variations of the right ovarian vein are not. This study did not find an association between the presence of right ovarian vein and pelvic varices.

  4. Reference Renal Artery Diameter Is a Stronger Predictor of Contrast-Induced Nephropathy than Chronic Kidney Disease in Patients with High Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Luca Zanoli

    2011-08-01

    Full Text Available Introduction: The incidence of contrast-induced nephropathy (CIN increases in high cardiovascular risk patients. Chronic kidney disease (CKD is a known risk factor for CIN development. In a previous report, we demonstrated that the mean reference renal artery diameter (RVD is an important determinant of CKD in patients undergoing coronary angiography for ischemic heart disease. However, RVD was never tested as a predictor of CIN. Aim: To look at the predictors of CIN. Methods: A total of 218 consecutive patients undergoing coronary and renal angiography were enrolled from the cohort of the RAS-CAD study (NCT 01173666. CIN was defined as a relative increase in baseline serum creatinine ≧25% within 1 week of contrast administration. Results: The incidence of CIN was 22%. In a fully adjusted model, contrast medium dose (20 ml increase, OR 1.12, 95% CI 1.06–1.19, p 2 increase, OR 0.59, 95% CI 0.41–0.86, p Conclusions: In patients undergoing coronary angiography for ischemic heart disease, RVD is a stronger predictor of CIN than CKD.

  5. Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy in management of lower-pole renal stones with a diameter of smaller than 15 mm.

    Science.gov (United States)

    Kirac, Mustafa; Bozkurt, Ömer Faruk; Tunc, Lutfi; Guneri, Cagri; Unsal, Ali; Biri, Hasan

    2013-06-01

    The aim of this study was to compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PNL) in management of lower-pole renal stones with a diameter smaller than 15 mm. Between December 2009 and July 2012, the patients with the diagnosis of lower-pole stones were evaluated by ultrasonography, intravenous pyelography and computed tomography. The records of 73 evaluable patients who underwent mini-PNL (n = 37) or RIRS (n = 36) for lower-pole (LP) stones with diameter smaller than 15 mm were reviewed retrospectively. Of the 73 patients, 37 underwent mini-PNL and 36 underwent RIRS. The stone-free rates were 89.1 and 88.8 % for mini-PNL and RIRS groups, respectively. The mean operation time was 53.7 ± 14.5 in the mini-PNL group but 66.4 ± 15.8 in the RIRS group (P = 0.01). The mean fluoroscopy times and hospitalization times were significantly higher in the mini-PNL group. There was no major complication in any patient. RIRS and mini-PNL are safe and effective methods for treatment of LP calculi with a diameter smaller than 15 mm. RIRS is a non-invasive and feasible treatment option, and has also short hospitalization time, low morbidity and complication rate. It may be an alternative of mini-PNL in the treatment LP calculi with smaller than 15 mm.

  6. Chronic Pelvic Pain

    Science.gov (United States)

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

  7. Chronic Pelvic Pain

    Science.gov (United States)

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

  8. 荧光原位杂交技术在肾盂肿瘤诊断中的应用%Detection of renal pelvic tumor using fluorescence in situ hybridization technique

    Institute of Scientific and Technical Information of China (English)

    陈文轩; 林毅; 郭洪波; 李黎明

    2010-01-01

    目的 评价荧光原位杂交(FISH)技术在肾盂肿瘤诊断中的应用价值.方法 20例健康人通过FISH技术检测3、7、17号染色体及9号染色体p16位点的变异情况,建立阚值.15例影像学提示肾脏占位的血尿患者留取晨尿,分别进行尿脱落细胞学检查和FISH技术检测.以至少两种探针检测结果超过阈值或一种探针检测结果存在至少两种异常为诊断阳性.结果 15例血尿患者经手术及病理证实肾盂尿路上皮癌8例,肾透明细胞癌5例,肾嫌色细胞癌1例,黄色肉芽肿性肾盂肾炎1例.8例肾盂尿路上皮癌FISH技术检测均为阳性,3、7、17号染色体畸变阳性率均为100%(8/8),9号染色体p16位点畸变阳性率为75%(6/8).尿脱落细胞学检查仅1例阳性.7例非肾盂尿路上皮癌6例FISH技术检测阴性,而尿脱落细胞学检查则均为阴性.结论 FISH技术是一种无创快速诊断方法,在肾盂肿瘤诊断中优于尿脱落细胞学检查.%Objective To investigate the feasibihty and effectiveness of the fluorescence in situ hybridization(FISH)technique in the diagnosis of renal pelvic tumor.Methods FISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9 p16 from 20 people without malignancy.The morning's first urine were availahled from 15 patients with hematuria and suspected of renal mass by imaging,then were studied by FISH technique and urine cytology respectively.The sample was considered positive if two or more probes results were higher than the criteria,or one probe had two or more abnormal results.Results Eight of 15 patients with hematuria were renal pelvic urothehal carcinoma,5 were renal clear cell carcinoma,1 was renal chromophobe cell carcinoma,1 was xanthogranulomatous pyelonephritis,confirmed by pathology.All of the 8 renal pelvic carcinoma were considered positive by FISH technique,while only 1 was considered positive by urine cytology.The variation rate of chromosome 3,7,17 were 100%(8/8)and

  9. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases.

    Science.gov (United States)

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC.

  10. Pelvic actinomycosis.

    Science.gov (United States)

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

    1999-08-20

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

  11. COMPARATIVE STUDY OF CULTURE AND SENSITIVITY PATTERNS OF PRE OPERATIVE MID STREAM URINE WITH RENAL PELVIC URINE AND STONE TO PREDICT UROSEPSIS FOLLOWING PERCUTANEOUS NEPHROLITHOTOMY: A PROSPECTIVE CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Bhargava Vardhana Reddy

    2015-11-01

    Full Text Available INTRODUCTION : Percutaneous nephrolithotomy (PCNL is the most frequently performed surgery for stone disease at our institution. Nearly 100 PCNL procedures are being performed in a year at our institution. Septicemia following PCNL can be catastrophic despite sterile preoperative urine and prophylactic antibiotics. Infected stones, obstructed kidneys , and comorbidit y have been held responsible. In this study we analyzed various culture specimens, namely Mid - stream urine (MSU, renal pelvic urine and crushed stones. MATERIALS AND METHODS : We performed a prospective clinical study in all our patients undergoing PCNL b etween January 2013 and December 2014. MSU was sent for culture and sensitivity testing (C&S one day prior to surgery. Percutaneous access into the ipsilateral pelvicaliceal system is achieved under image intensification using a fine, 14 gauge Kellet need le. Urine from the pelvicaliceal system is first aspirated and sent as pelvic urine C&S. Stone fragments are collected to be proces0sed for C&S. The data collected were divided into 3 main groups, that is MSU C&S, pelvic urine C&S and stone C&S. RESULTS : A total of 83 patients were included in the study, of this MSU C&S was positive in 9/83 (10.8% patients, Pelvic C&S in 10 /73 (13.7% patients and Stone C&S in 25/83 (30.1% patients. Out of 25 cases of stone culture positive patients 17 patients develope d Systemic Inflammatory Response Syndrome (SIRS but only 2 patients developed SIRS in MSU C & S positive patients. CONCLUSIONS: The results of our study suggest that positive stone C&S is the better predictor of potential urosepsis than MSU. Stone cultur e is available only after surgery but appears to be the best guide for antibiotic therapy in case of sepsis. So the routine collection of stone for C&S will be beneficial

  12. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Pelvic Inflammatory Disease (PID) Home For Patients Search FAQs Pelvic Inflammatory ... Inflammatory Disease (PID) FAQ077, September 2015 PDF Format Pelvic Inflammatory Disease (PID) Gynecologic Problems What is pelvic inflammatory disease ( ...

  13. Pelvic Actinomycosis

    Directory of Open Access Journals (Sweden)

    Alejandra García-García

    2017-01-01

    Full Text Available Introduction. Actinomycosis is a chronic bacterial infection caused by Actinomyces, Gram-positive anaerobic bacteria. Its symptomatology imitates some malignant pelvic tumours, tuberculosis, or nocardiosis, causing abscesses and fistulas. Actinomycoses are opportunistic infections and require normal mucous barriers to be altered. No epidemiological studies have been conducted to determine prevalence or incidence of such infections. Objective. To analyse the clinical cases of pelvic actinomycosis reported worldwide, to update the information about the disease. Methods. A systematic review of worldwide pelvic actinomycosis cases between 1980 and 2014 was performed, utilising the PubMed, Scopus, and Google Scholar databases. The following information was analysed: year, country, type of study, number of cases, use of intrauterine device (IUD, final and initial diagnosis, and method of diagnosis. Results. 63 articles met the search criteria, of which 55 reported clinical cases and 8 reported cross-sectional studies. Conclusions. Pelvic actinomycosis is confusing to diagnose and should be considered in the differential diagnosis of pelvic chronic inflammatory lesions. It is commonly diagnosed through a histological report, obtained after a surgery subsequent to an erroneous initial diagnosis. A bacterial culture in anaerobic medium could be useful for the diagnosis but requires a controlled technique and should be performed using specialised equipment.

  14. 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 ...

  15. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

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

  16. Pelvic Floor Disorders

    Science.gov (United States)

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

  17. [Scintigraphic assessment of function in renal dystopia].

    Science.gov (United States)

    Pilgrim, S

    1998-06-01

    In patients with renal dystopia radionuclide urography in commonly used technique may yield inaccurate results concerning split renal function. In a case of unilateral pelvic kidney a simple strategy to avoid this methodical error is demonstrated.

  18. CT differentiation of periappendiceal inflammation with appendicitis and pelvic inflammatory disease in woman with right lower quadrant pain

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Hyun Hye; Kim, Mi Young; Kim, Jung Eun; Kim, Youn Jeong; Suh, Chang Hae [Inha University College of Medicine, Incheon (Korea, Republic of)

    2006-07-15

    We wanted to determine the usefulness of the computed tomography (CT) findings for making the diagnosis between periappendiceal inflammation (PAI) with appendicitis and pelvic inflammatory disease (PID) for the women presenting with right lower quadrant pain. We retrospectively analyzed the CT findings of 83 women with right lower quadrant pain: PAI in 36 and PID in 47 patients. We reviewed the CT images, including the appendiceal diameter and the enhancing wall thickening, the cecal thickening, the location of the appendix, thickening of the right anterior renal fascia, abscess, mesenteric fatty infiltration, ascites, heterogeneous uterine enhancement and paralytic ileus. Statistical analysis was performed by using the t-test for the diameter of appendix, and the x{sup 2} test or Fisher's exact test for the CT findings. The mean diameter of the appendix was 11.0 {+-} 3.4 mm for the PAI subjects and it was 6.7 {+-} 2.0 mm for the PID subjects ({rho} < 0.0001). Wall thickening of the appendix was more commonly detected in PAI (25 subjects, 69%) than in PID (15 subjects, 32%) ({rho} = 0.0007). Thickening of the right anterior renal fascia was more commonly detected in PAI (18 subjects, 50%) than in PID (7 subjects, 15%). Cecal thickening, ascitis, heterogeneous uterine enhancement and paralytic ileus were not significantly different between PAI and PID. Abscess and mesenteric fatty infiltration were more frequently detected in the RLQ and in the abdomen or pelvic cavity in PAI and PID, respectively ({rho} < 0.05). There was no significant difference in the distribution of ascites between the diseases. The CT findings of the appendiceal diameter, enhancing wall thickening and thickening of the right anterior renal fascia are useful for making the diagnosis of PAI. The abdominal and pelvic distributions of abscess and mesenteric fatty infiltration are highly suggestive findings of PID.

  19. Congenital ureteropelvic junction obstruction: physiopathology, decoupling of tout court pelvic dilatation-obstruction semantic connection, biomarkers to predict renal damage evolution.

    Science.gov (United States)

    Alberti, C

    2012-02-01

    The widespread use of fetal ultrasonography results in a frequent antenatally observation of hydronephrosis, ureteropelvic junction obstruction (UPJO) accounting for the greatest fraction of congenital obstructive nephropathy. UPJO may be considered, in most cases, as a functional obstructive condition, depending on defective fetal smooth muscle/nerve development at this level, with lack of peristaltic wave propagation--aperistaltic segment--and, therefore, poor urine ejection from the renal pelvis into the ureter. The UPJO-related physiopathologic events are, at first, the compliant dilatation of renal pelvis that, acting as hydraulic buffer, protects the renal parenchyma from the rising intrapelvic pressure-related potential damages, and, subsequently, beyond such phase of dynamic balance, the tubular cell stretch-stress induced by increased intratubular pressure and following parenchymal inflammatory lesions: inflammatory infiltrates, fibroblast proliferation, activation of myofibroblasts, tubulo-interstitial fibrosis. Reactive oxygen species (ROS), nitric oxide (NO), several chemo- and cytokines, growth factors, prostaglandins and eicosanoids, angiotensin-II are the main pathogenetic mediators of the obstructive nephropathy. Apoptosis of tubular cells is the major cause of the tubular atrophy, together with epithelial-mesenchymal transdifferentiation. Some criticisms on tout court semantic renal pelvis dilatation-obstruction connection have been raised considering that the renal pelvis expansion isn't, in any case, linked to an ostructive condition, as it may be verified by diuretic (furosemide) renogram together with scintiscan-based evaluation of differential renal function. In this regard, rather than repetitive invasive nuclear procedures that expose the children to ionizing radiations, an intriguing noninvasive strategy, based on the evaluation of urinary biomarkers and urinary proteome, can define the UPJO-related possible progress of parenchymal lesions

  20. p53 and H-ras mutations and microsatellite instability in renal pelvic carcinomas of NON / Shi mice treated with N-butyl-N-(4-hydroxybutyl)-nitrosamine: different genetic alteration from urinary bladder carcinoma.

    Science.gov (United States)

    Gen, H; Yamamoto, S; Morimura, K; Min, W; Mitsuhashi, M; Murai, T; Mori, S; Hosono, M; Oohara, T; Makino, S; Wanibuchi, H; Fukushima, S

    2001-12-01

    We previously reported p53 mutations to be frequent (greater than 70%), whereas both H-ras mutations and microsatellite instability (MSI) were infrequent (about 10%), in urinary bladder carcinomas (UBCs) and their metastatic foci in the N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN)-induced mouse urothelial carcinogenesis model. In the present study, an analysis of p53 and H-ras mutations as well as MSI was performed on 12 renal pelvic carcinomas (RPCs) and 8 metastatic or invading foci produced by the same experimental procedure. Histologically, 10 of the RPCs were transitional cell carcinomas and the remaining 2 were squamous cell carcinomas. p53 mutations were infrequent and only found in one primary RPC (8%), its metastatic foci and an invading lesion in another animal (in a total 2 of 12; 17%). H-ras mutations were slightly more frequent (found in 3 of 12 animals; 25%), 4 of 5 involving codon 44, GTG to GCG, not a hot-spot reported for human cancers. In two cases, H-ras mutations were confined to lung metastasis and not detectable in their primary RPCs. MSI analysis was available for 6 pairs of primary RPCs and their metastatic foci, and 4 animals (67%) had MSI at one or more microsatellite loci. Overall, the distribution of genetic alterations differed from that in UBCs produced by the same experimental protocol. The results thus suggest that different genetic pathways may participate in carcinogenesis of the upper and lower urinary tract due to BBN.

  1. 小儿肾积水肾盂压力变化对肾结构的影响%The Effects of Intra-pelvic Pressure on the Renal Structure in Congenital Hydronephrosis

    Institute of Scientific and Technical Information of China (English)

    文建国; 童尔昌; 袁继炎; 夏慧敏

    1991-01-01

    Pyelomanometry and histological study of renal cortex with light and electron microscope were carried out in 36 patients (39 kidneys)with congenital hydronephrosis.The basic intrapelvic pressure (BPP) ranged from 0.049kPa to 3.72kPa(50-380mmH2O).The renal parenchyma became thinner as the BPP increased.When the BPP was greater than 1.47kPa,the average thickness of renal parenchyma would be about 3.24 ± 0.45mm with glomaruli fibrosis,tubules atrophy and connective tissue proliferation.All the glomeruli were damaged if excretory urography showed nonfunctioning and BPP revealed less than 0.49kPa.The Whitaker test may prove an obstructed ureter in children if the maximum intra-pelvic pressure is over 2.156kPa.%作者对36例(39侧肾)先天性肾积水进行肾盂压力测定和肾脏组织学检查.结果显示肾盂压力变化范围0.049kPa~3.724kPa.压力越高肾实质破坏越重.肾盂压力>1.470kPa时,肾实质厚度平均为3.2mm,大部分肾小球纤维化,肾小管萎缩,但肾脏仍有一定功能.当静脉肾盂造影不显影,肾盂压力<0.490kPa时,肾小球全部破坏.肾盂压力容积测定能准确地判断儿童输尿管梗阻.Whitaker试验肾盂最大压力>2.156kPa时提示输尿管有梗阻存在.

  2. Pelvic ultrasound - abdominal

    Science.gov (United States)

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

  3. Pelvic Pain: Other FAQs

    Science.gov (United States)

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

  4. Pelvic fractures and mortality.

    OpenAIRE

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

    1997-01-01

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

  5. [Primary Pelvic Cystic Echinococcosis].

    Science.gov (United States)

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

    2015-06-01

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

  6. 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.

  7. Idiopathic retroperitoneal fibrosis involving a unilateral renal sinus: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seul Bi; Yoon, Jung Hee; Kim, Seung Ho; Lee, Ye Daum; Kim, Suk Jung; Lim, Yun Jung; Jung, Hyun Kyung; Lee, Jin Soo [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2016-06-15

    Idiopathic retroperitoneal fibrosis (RPF) is a rare disease entity and its etiology is uncertain. We report two similar cases which showed an uncommon presentation of idiopathic RPF. A 66-year-old woman and an 80-year-old man presented with incidental findings of left renal pelvic mass-like lesions. Computed tomography revealed a soft tissue density mass replacing the left renal pelvis, which was suspicious for renal pelvic cancer, and the diagnosis of idiopathic RPF was surgically confirmed. To the best of our knowledge, a few cases of idiopathic RPF presenting with features of a localized unilateral renal pelvic mass mimicking renal pelvic cancer have been reported.

  8. Chronic Pelvic Pain in Women

    Science.gov (United States)

    Chronic pelvic pain in women Overview By Mayo Clinic Staff Chronic pelvic pain is pain in the area below your bellybutton ... your hips that lasts six months or longer. Chronic pelvic pain can have multiple causes. It can be a ...

  9. A reformed ureteral stripping technique and its application in the treatment of post renal transplant patients with renal pelvic tumor of the graft homonymy primitive kidney%改良输尿管剥脱在移植肾同侧原肾肾盂癌手术中的应用

    Institute of Scientific and Technical Information of China (English)

    田野; 张峰波; 杜林栋

    2008-01-01

    Objective To evaluate the clinical outcomes of a reformed endoscope assisted ureteral stripping technique in post renal transplant patients with renal pelvic tumor of the graft homonymy primitive kidney.Methods Seven post renal transplant patients with renal pelvic tumor of the graft homonymy primitive kidneys(2 males and 5 females)with average age of 54 years old were recruited.Standard retroperitoneal laparoscopic nephrectomies were performed for all patients after placement of a 5 F ureteral stent as the ureteral stripper. After the closure of the ureter at the lower kidney pole level with metal clips, the distal ureter was separated and the ureteral muscle layer and serous membrane layer were split. The ureter muscle layer was then tied tightly to the ureteral stent tip. The ureter and the stent were pulled out through urethra. Transurethral resection around the everted ureteral orifice was performed and the ureter was removed afterwards. The graft function, operation time,complication and estimated blood loss were recorded.Results All the 7 patients successfully underwent the operations and no major complication such as ureteral disruption, stripping embarrassment and converting to open operation happened. The mean operation time was 126 min (ranging from 105 to 160 min) and the mean blood loss was 124 ml (ranging from 80 to 160 ml). Introvesical chemotherapy with farmorubine hydrochloride was performed 3 weeks after surgery. The mean preoperation and 6 months post-operation creatinine and urea nitrogen levels were 136.5μmol/L, 138. 6μmol/L and 7.42 mmol/L, 7.80 mmol/L respectively and there was no statistical difference. There was no tumor recurrence during 6 month follow-up except one case having simultaneous bladder cancer had bladder cancer relapse 3 months after operation and required another TURBt.Conclusion The reformed endoscope assisted ureteral stripping technique is minimally invasive and convenient in the treatment of post renal transplant

  10. Pelvic organ prolapse - a review

    National Research Council Canada - National Science Library

    Dietz, Hans Peter

    2015-01-01

    Background: Female pelvic floor dysfunction encompasses a number of prevalent clinical conditions including urinary and faecal incontinence, obstructed defaecation, sexual dysfunction and female pelvic organ prolapse (FPOP...

  11. Pelvic reconstruction improves pelvic floor strength in pelvic organ prolapse patients

    Directory of Open Access Journals (Sweden)

    Zhong Guan

    2015-10-01

    Conclusion: The modified pelvic reconstruction procedure could improve pelvic floor muscle strength in POP patients, which remains lower when compared with the normal population. Pelvic floor muscle strength should be included in the assessment of surgical outcomes in POP.

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

    Science.gov (United States)

    Neĭmark, A I; Shelkovnikova, N V

    2012-01-01

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

  13. Sonographic Renal Parenchymal Measurements for the Evaluation and Management of Ureteropelvic Junction Obstruction in Children

    Directory of Open Access Journals (Sweden)

    Jeremy C Kelley

    2016-05-01

    Full Text Available Purpose: To correlate sonographic renal parenchymal measurements among patients with ureteropelvic junction obstruction (UPJO labeled Society of Fetal Urology (SFU hydronephrosis grades 1 to 4 and to examine whether sonographic renal parenchymal measurements could be used to differentiate conservative versus surgical management.Materials and Methods: Retrospective chart review and sonographic renal parenchymal measurements (renal length, medullary pyramid thickness, and renal parenchymal thickness were performed in patients with SFU grades 1 to 4 hydronephrosis secondary to UPJO managed between 2009 and 2014. Exclusion criteria included other concomitant genitourinary pathology or incomplete follow-up. Anterior-posterior renal pelvic diameter (APRPD and radionuclide renography were also evaluated when available. Results: 104 patient with ureteropelvic junction obstruction underwent 244 RBUS (1,464 sonographic renal parenchymal measurements in 488 kidneys. Medullary pyramid thickness and renal parenchymal thickness progressively decreased from SFU grades 1 to 4 (p<0.05. A similar trend was appreciated when comparing SFU grades 1 and 2 vs. 3 and 4, as well as SFU grades 3 vs. 4 (p<0.05. SFU grade 3 and 4 patients who underwent pyeloplasty had longer renal length in comparison to those who were managed conservatively (p<0.02.Conclusions: This is the first study that evaluates these objective, quantifiable sonographic renal parenchymal measurements in children with unilateral UPJO. These sonographic renal parenchymal measurements correlate closely with worsening of hydronephrosis graded by the SFU and APRPD classification systems. Prospective studies are needed to elucidate the role of sonographic renal parenchymal measurements in the management of children with UPJO.□

  14. Myofascial pelvic pain.

    Science.gov (United States)

    Kotarinos, Rhonda

    2012-10-01

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

  15. [Nephrolithiasis in "disk-variant" cross-over renal dystopia. Report of a case].

    Science.gov (United States)

    Gebauer, B; Meyer, D R; Friedrich, M

    1998-01-01

    Renal dystopia is a frequent urogenital anomality. Renal dystopia encloses pelvic kidney or malascending kidney, but also rare anomalities like renal duplication or crossed renal dystopia. These allotopias are often diagnosed on routine examination of the urogenital system. We report a case with fused crossed renal dystopia on the left with atypical symptoms of nephrolithiasis and give a summery of the embryological origin.

  16. Pelvic Inflammatory Disease

    Science.gov (United States)

    ... and ambulatory settings. 17-20 While no single explanation exists for this declining trend, some have suggested ... Bacterial Vaginosis (BV) Chlamydia Genital Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human Papillomavirus (HPV) Pelvic Inflammatory Disease ( ...

  17. Pelvic inflammatory disease (PID)

    Science.gov (United States)

    ... for cancer) Getting an intrauterine device (IUD) Miscarriage Abortion In the United States, nearly 1 million women ... gonorrhea, chlamydia, or other causes of PID. Pelvic ultrasound or CT scan to see what else may ...

  18. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

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

  19. Chronic pelvic pain

    African Journals Online (AJOL)

    It affects all spheres of life, from physical and psychological health to relationship intimacy .... pelvic and sexual pain, in the absence of obvious pathology, has a strong .... Uterine orientation, size, mobility and sensitivity can point to a chronic ...

  20. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...

  1. Chronic pelvic pain

    National Research Council Canada - National Science Library

    Slawomir Wozniak

    2016-01-01

    [b][/b][b]Introduction. [/b]Chronic pelvic pain (CPP) affects about 10–40% of women presenting to a physician, and is characterised by pain within the minor pelvis persisting for over 6 months. [b...

  2. Case report: pelvic actinomycosis.

    Science.gov (United States)

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

    2012-01-01

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

  3. [Pelvic floor and pregnancy].

    Science.gov (United States)

    Fritel, X

    2010-05-01

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

  4. 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.

  5. A Three-Dimensional Reconstructive Study of Pelvic Cavity in the New Zealand Rabbit (Oryctolagus cuniculus

    Directory of Open Access Journals (Sweden)

    Sema Özkadif

    2014-01-01

    Full Text Available The present study has been performed to reveal biometrical aspects and diameter-related differences in terms of sexes regarding pelvic cavity via three-dimensional (3D reconstruction by using multidetector computed tomography (MDCT images of pelvic cavity of the New Zealand rabbit. A total of 16 adult New Zealand rabbits, including 8 males and 8 females, were used in this study. Under anesthesia, the images obtained from MDCT were stacked and overlaid to reconstruct the 3D model of the pelvic cavity using 3D modeling software (Mimics 13.1. Measurements, such as the conjugate, transverse, and vertical diameters of the pelvic cavity, and the pelvic inclination were calculated and analyzed statistically. Biometrical differences of the pelvic diameters in New Zealand rabbits of both sexes were shown clearly. It was concluded that the pelvic diameters revealed by 3D modeling techniques can shed light on medical students who take both anatomy training and gynecological applications. The authors hope that the synchronization of medical approaches may give rise to novel diagnostic and therapeutic developments related to pelvic cavity.

  6. Chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Slawomir Wozniak

    2016-06-01

    Full Text Available [b][/b][b]Introduction. [/b]Chronic pelvic pain (CPP affects about 10–40% of women presenting to a physician, and is characterised by pain within the minor pelvis persisting for over 6 months. [b]Materials and method. [/b]The Medline database was searched using the key words ‘chronic pelvic pain’ and ‘pelvic congestion syndrome’, published in English during the past 15 years. The condition markedly deteriorates the quality of life of the affected. Its aetiology has not been fully described and elucidated, although organic, functional and psychosomatic factors are implicated. Pain associated with parametrial varices was defined as pelvis congestion syndrome (PCS. Since the aetiology of CPP is complex, multi-directional diagnostic procedures are required. [b]Results. [/b]The main diagnostic methods employed are imaging examinations (ultrasound, computer tomography, magnetic resonance. Advances in interventional radiology considerably contributed to the CPP treatment. Currently, embolization of parametrial vessels is one of the most effective methods to relieve pain associated with pelvic congestion syndrome. [b]Conclusions. [/b]Due to the complex aetiology of chronic pelvic pain, the most beneficial effects are obtained when the therapy is based on cooperation of the gynaecologist, physiotherapist, psychologist and interventional radiologist.

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

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Dehlendorff, Christian

    2014-01-01

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

  8. How Is Pelvic Pain Treated?

    Science.gov (United States)

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

  9. How Is Pelvic Pain Diagnosed?

    Science.gov (United States)

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

  10. Pelvic floor muscle training exercises

    Science.gov (United States)

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

  11. Pelvic Inflammatory Disease (For Teens)

    Science.gov (United States)

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

  12. Pelvic Inflammatory Disease (For Parents)

    Science.gov (United States)

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

  13. Pelvic Inflammatory Disease (PID) Statistics

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Pelvic Inflammatory Disease (PID) Note: Javascript is disabled or is not ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Pelvic Inflammatory Disease (PID) Statistics Recommend on Facebook Tweet Share Compartir ...

  14. Pelvic inflammatory disease (PID) -- aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000710.htm Pelvic inflammatory disease (PID) - aftercare To use the sharing features on ... have just seen your health care provider for pelvic inflammatory disease (PID). PID refers to an infection of the ...

  15. Angioembolization for pelvic hemorrhage control

    DEFF Research Database (Denmark)

    Hauschild, Oliver; Aghayev, Emin; von Heyden, Johanna

    2012-01-01

    with pelvic fractures and computed tomography scan-proven vascular injuries. METHODS: The data from the prospective multicenter German pelvic injury registry were analyzed. Of 5,040 patients with pelvic fractures, 152 patients with associated vascular injuries were identified. Patients undergoing...... pelvic fracture-related vascular lesions. It might prove even more effective when performed early enough to avoid prolonged blood transfusion requirement. Further studies without the mentioned limitations of the study are desired. LEVEL OF EVIDENCE: Therapeutic study, level IV....

  16. 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

  17. Current Concepts of Pelvic Congestion and Chronic Pelvic Pain

    Science.gov (United States)

    2001-01-01

    Chronic pelvic pain in women is a common and disabling illness caused by numerous organic pathologies usually accompanied by varying psychological dysfunctions. Many patients may receive misdiagnosis, misdirected therapies, or do not seek help at all. Pelvic congestion may be responsible for pain in patients without more common diseases, such as endometriosis and pelvic adhesions, among others. Our view of this condition is evolving. In the United States, this medical condition remains controversial. More recent research from the United Kingdom has caused a fresh look at the diagnosis and treatment of chronic pelvic pain produced by pelvic congestion. Potentially, many patients may benefit from a reconsideration of this approach. PMID:11394421

  18. Ultrasound-guided drainage of deep pelvic abscesses

    DEFF Research Database (Denmark)

    Lorentzen, Torben; Nolsøe, Christian; Skjoldbye, Bjørn

    2011-01-01

    The aim of this study was to demonstrate and evaluate the ultrasound-guided drainage of deep pelvic abscesses in which transabdominal percutaneous access could not be performed because of overlying structures. A retrospective analysis of 32 consecutive patients with 33 deep pelvic abscesses...... (median diameter 7 cm), 19 were treated with catheter drainage and 18 of these cases resulted in favorable clinical outcomes. Of the smaller abscesses (median diameter 4 cm), 14 were treated with needle drainage. In two of these cases, follow-up US showed that a repeat puncture and drainage was necessary...... and the subsequent in-dwelling catheter period, there were no serious complications related to the drainage procedures. We conclude that ultrasound-guided transrectal, transvaginal, transperineal and transgluteal drainage of deep pelvic abscesses are safe and effective treatment approaches. Based on our findings...

  19. Scintigraphic assessment of renal function in a case of renal dystopia; Szintigraphische Funktionsberechnung bei renaler Lageanomalie

    Energy Technology Data Exchange (ETDEWEB)

    Pilgrim, S. [Gemeinschaftspraxis fuer Nuklearmedizin, Luebeck (Germany)

    1998-06-01

    In patients with renal dystopia radionuclide urography in commonly used technique may yield inaccurate results concerning split renal function. In a case of unilateral pelvic kidney a simple strategy to avoid this methodical error is demonstrated. (orig.) [Deutsch] Am Fallbeispiel eines Patienten mit einseitiger Beckenniere wird dargestellt, dass bei einer Lageanomalie und Anwendung der renalen Funktionsszintigraphie in ueblicher Technik eine deutliche Fehleinschaetzung der seitengetrennten Funktionsanteile resultieren kann. Ein einfaches Verfahren zur Vermeidung dieses Bestimmungsfehlers wird aufgezeigt. (orig.)

  20. The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage IA-IIB Cervical Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Yu Liu

    2015-01-01

    Full Text Available Background: Pelvic lymph node metastasis (LNM is an important prognostic factor in cervical cancer. Cervical squamous cell carcinoma accounts for approximately 75-80% of all cervical cancers. Analyses of the effects of the number of positive lymph nodes (LNs, unilateral versus bilateral pelvic LNM and a single group versus multiple groups of pelvic LNM on survival and recurrence of cervical squamous cell carcinoma are still lacking. The study aimed to analyze the effects of the number of positive pelvic LNs and a single group versus multiple groups of pelvic LNM on survival and recurrence. Methods: We performed a retrospective review of 296 patients diagnosed with Stage IA-IIB cervical squamous cell carcinoma who received extensive/sub-extensive hysterectomy with pelvic lymphadenectomy/pelvic LN sampling at Peking University People′s Hospital from November 2004 to July 2013. Ten clinicopathological variables were evaluated as risk factors for pelvic LNM: Age at diagnosis, gravidity, clinical stage, histological grade, tumor diameter, lymph-vascular space involvement (LVSI, depth of cervical stromal invasion, uterine invasion, parametrial invasion, and neoadjuvant chemotherapy. Results: The incidence of pelvic LNM was 20.27% (60/296 cases. Pelvic LNM (P = 0.00 was significantly correlated with recurrence. Pelvic LNM (P = 0.00, the number of positive pelvic LNs (P = 0.04 and a single group versus multiple groups of pelvic LNM (P = 0.03 had a significant influence on survival. Multivariate analysis revealed that LVSI (P = 0.00, depth of cervical stromal invasion (P = 0.00 and parametrial invasion (P = 0.03 were independently associated with pelvic LNM. Conclusions: Patients with pelvic LNM had a higher recurrence rate and poor survival outcomes. Furthermore, more than 2 positive pelvic LNs and multiple groups of pelvic LNM appeared to identify patients with worse survival outcomes in node-positive IA-IIB cervical squamous cell carcinoma. LVSI

  1. [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.

  2. Chronic pelvic pain due to pelvic lymphangioleiomyomatosis: A case report

    Directory of Open Access Journals (Sweden)

    Tetsu Wakimoto

    2016-05-01

    Full Text Available Lymphangioleiomyomatosis (LAM, a rare multisystem disease affecting mainly young women, is characterized by an abnormal proliferation of smooth muscle-like cells in the lungs. We report a case of endometriosis with chronic pelvic pain due to pelvic LAM. A 41-year-old gravida 1, para 1 woman had been experiencing intermittent left pelvic pain for several years. She also complained of dyspnea on effort 2 years previously, and was diagnosed with pulmonary LAM. Abdominal magnetic resonance imaging showed a right ovarian endometriotic cyst and a left pelvic mass. She was referred to our hospital for the treatment of pelvic pain; she underwent laparoscopic cystectomy of the right ovarian endometriotic cyst. Her left pelvic cyst was found in the retroperitoneal space, and biopsy confirmed the diagnosis of LAM. Therefore, we suggest that LAM localized in the pelvis should be considered when a patient with pulmonary LAM presents with pelvic pain or abdominal distention.

  3. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... to help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel and colon, such as: infections such as appendicitis , pyelonephritis or infected fluid collections, also known as abscesses. inflammatory bowel disease such as ulcerative colitis or Crohn's ...

  4. Pelvic actinomycosis: urologic perspective

    Directory of Open Access Journals (Sweden)

    Venkata K. Marella

    2004-10-01

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

  5. Laparoscopic nephroureterectomy with bladder cuff resection through a lower midline abdomen incision for treatment of native renal pelvic or ureteral tumor in renal transplant recipients A feasibility investigation%肾移植后原肾盂或输尿管肿瘤患者腹腔镜肾输尿管全长切除中下腹部入路的可行性

    Institute of Scientific and Technical Information of China (English)

    张树栋; 马潞林; 肖春雷; 黄毅; 侯小飞; 王国良; 罗康平; 赵磊

    2009-01-01

    BACKGROUND: Following renal transplantation, native renal pelvic or ureteral tumor occurs not only on one side, but also on both sides simultaneously or continuously.OBJECTIVE: To describe a new procedure in managing native renal pelvic or ureteral tumor, in which, retroperitoneal laparoscopic nephroureterectomy was first done followed by transurethral resection of ureteral orifice, and finally the kidney and the complete ureter with a bladder cuff were taken out through a midline abdomen incision, and to validate its feasibility.DESIGN, TIME AND SETTING: A technique modification experiment was performed at the Department of Urinary Surgery, Third Hospital, Peking University between July 2004 and March 2006.PARTICIPANTS: Eight patients (7 males and 1 female) with native renal pelvic or ureteral tumor who received laparoscopic nephroureterectomy with bladder cuff resection were included into this study. Of them, 4 cases had bilateral lesions. Laparoscopic nephroureterectomy with bladder cuff resection was conducted 12 times totally.METHODS: Retroperitoneal laparoscopic nephroureterectomy was first done in the lateral decubitus, followed by transurethral resection of the ureteral orifice with resectoscope in the lithotomy position, and finally, an incision was created in the lower midline abdomen to allow dissection of the distal ureter and bladder cuff and intact specimen extraction. Postoperatively, intravesical chemotherapy was routinely performed to prevent tumor recurrence. The patients were followed up at 3, 6, and 12 months after surgery, and once a year thereafter.MAIN OUTCOME MEASURES: Surgery time, blood loss volume, pathological report, tumor recurrence time, tumor-free survival time, and complications.RESULTS: The mean surgery time was 3.8 hours (range: 2.5-7 hours). The mean hemorrhage volume was 240 mL (range: 50-1 200 mL). Two cases needed blood transfusion, 600 and 1 000 mL, respectively. Transitional cell carcinoma grade Ⅲ was found in 3 cases

  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.

  7. Assessment of Differential Renal Function in Children with Hydronephrosis: Comparison of DMSA and MAG-3

    Directory of Open Access Journals (Sweden)

    Cem Akbal

    2015-09-01

    Full Text Available Objective Nuclear imaging techniques such as 99mTc-dimercaptosuccinic acid (DMSA and 99mTc-mercaptoacetyltriglycine (MAG-3 are widely used for the diagnosis and follow-up of urinary tract obstructions. Both imaging techniques provide the differential renal function (DRF in slightly different ways. The aim of this study was to assess the MAG-3 scan as an adjunct or alternative to DMSA for evaluating DRF in children with hydronephrosis. Materials and Methods Eighty-one patients with hydronephrosis were enrolled in this study. Patient age, sex, anteroposterior renal pelvis diameter (RPD at the time of diagnosis, parenchymal thickness and the DRF percentage found by both DMSA and MAG-3 were recorded. DMSA scintigraphy was used for detecting renal scars and estimating DRF. MAG-3 scintigraphy was used for evaluation of renal clearance, the collecting system’s outflow pattern and estimating DRF. Results A total of 102 renal units (38 left, 22 right and 21 bilateral were evaluated. High correlation rates were found when we compared both tests’ DRF values according to antero-posterior renal pelvic diameter and patient age (p>0.05. In all groups compared in the present study, both tests demonstrated very similar results and DRF values. Statistical analysis of cut-offs (45%, 40%, 10% were also similar in both methods (p>0.05, kappa >0.7, r=0.926 Pearson. Conclusion DMSA and MAG-3 are tests that are of assistance in the evaluation of hydronephrosis. Compared to DMSA, MAG-3 also provides valuable information to evaluate DRF values in hydronephrotic renal unit (RU. Avoiding unnecessary DMSA imaging will save time and cost and prevent over-radiation of the pediatric population.

  8. Diagnosis and treatment of renal artery stenosis.

    NARCIS (Netherlands)

    Plouin, P.F.; Bax, L.

    2010-01-01

    A reduction in the diameter of the renal arteries can lead to hypertension, renal dysfunction and/or pulmonary edema. About 90% of patients with renal artery stenosis have atherosclerosis, and 10% have fibromuscular dysplasia. Atherosclerotic renal artery stenosis is a common condition that typicall

  9. [Pelvic inflammatory disease].

    Science.gov (United States)

    Hoof, Kathrin

    2007-07-01

    Pelvic inflammatory disease and upper genital tract infection describe inflammatory changes in the upper female genital tract of any combination: endometritis, salpingitis, tubo-ovarian abscess and peritonitis in the small pelvis. In most cases the infection is ascending, Chlamydia trachomatis and Neisseria gonorrhoeae are common with increasing incidence. The spectrum ranges from subclinical, asymptomatic infection to severe, life-threatening illness. Antibiotic treatment should be initiated promptly and must cover a broad spectrum of germs. Surgical treatment is necessary in cases of failure of antibiotic treatment and in cases with persisting symptoms after antibiotic treatment. Pelvic inflammatory diseases are one of the main causes of tubal sterility, ectopic pregnancies and chronic abdominal pain.

  10. Interpreting stem diameter changes

    Science.gov (United States)

    Hölttä, T.; Sevanto, S.; Nikinmaa, E.

    2009-12-01

    Detecting phloem transport in stem diameter changes Teemu Hölttä1, Sanna Sevanto2, Eero Nikinmaa1 1Department of Forest Ecology, P.O. Box 27, FIN-00014 University of Helsinki, Finland 2Department of Physics, P.O. Box 48, FIN-00014 University of Helsinki, Finland Introduction The volume of living cells and xylem conduits vary according to pressures they are subjected to. Our proposition is that the behavior of the inner bark diameter variation which cannot be explained by changes in xylem water status arise from changes in the osmotic concentration of the phloem and cambial growth. Materials and methods Simultaneous xylem and stem diameter measurements were conducted between June 28th to October 4th 2006 in Southern Finland on a 47-year old, 15 meter tall, Scots pine tree (DBH 15 cm) at heights of 1.5 and 10 meters. The difference between the measured inner bark diameter and the inner bark diameter predicted from xylem diameter change with a simple model (assuming there was no change in the osmotic concentration of the phloem) is hypothesized to give the changes in the osmotic concentration of the inner bark. The simple model calculates the radial water exchange between the xylem and phloem driven by the water potential changes in the xylem. Results and Discussion The major signal in the inner bark diameter was the transpiration rate as assumed, but also a signal arising from the change in the osmotic concentration (Fig 1a). The predicted osmotic concentration of the phloem typically increased during the afternoon due to the loading of photosynthesized sugars to the phloem. Inner bark osmotic concentration followed the photosynthesis rate with a 3 and 4 hour time-lag at the top and base, respectively (Fig 1b). The connection between photosynthesis and the predicted change in phloem osmotic concentration was stronger in the upper part of the tree compared to lower part. The changes in the predicted osmotic concentration were not similar every day, indicating that

  11. Haemodynamically Unstable Pelvic Fractures

    Science.gov (United States)

    2009-01-01

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

  12. Pelvic Fasciae in Urology

    Science.gov (United States)

    Raychaudhuri, B; Cahill, D

    2008-01-01

    INTRODUCTION Despite the vast literature on pelvic fascia, there is confusion over the periprostatic structures and their nomenclature, including their orientation, the neurovascular bundles and the existence of the prostatic ‘capsule’. In this review, we seek to clarify some of these issues. MATERIALS AND METHODS Review of published medical literature relating to the anatomy of the pelvic fascia including a Pubmed search using the terms – pelvic fascia, Denonvilliers' fascia, prostate capsule, neurovascular bundle of Walsh, pubo-prostatic ligament and the detrusor apron. CONCLUSIONS The findings of the study were as follows: The ‘capsule’ of the prostate does not exist. Rather, the fibromuscular band surrounding the prostate forms an integral part of the gland.The prostate is surrounded by fascial structures – anteriorly/anterolaterally by the prostatic fascia and posteriorly by the Denonvilliers' fascia. Laterally, the prostatic fascia merges with the endopelvic fascia.The posterior longitudinal fascia of the detrusor comprises a ‘posterior layer’ of the detrusor apron, extending from the bladder neck to the prostate base.The neurovascular structures tend to be located posterolaterally, but may not always form a bundle. A significant proportion of fibres may lie away from the main nerve structures, along the lateral/posterior aspects of the prostate. PMID:18828961

  13. Radiologic imaging and percutaneous treatment of pelvic lymphocele

    Energy Technology Data Exchange (ETDEWEB)

    Karcaaltincaba, Musturay [Department of Radiology, Division of Abdominal and Interventional Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara 06100 (Turkey); Akhan, Okan [Department of Radiology, Division of Abdominal and Interventional Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara 06100 (Turkey)]. E-mail: oakhan@hacettepe.edu.tr

    2005-09-01

    Pelvic lymphocele, also known as lymphocyst, is a cystic structure caused by lymphatic injury usually secondary to pelvic lymphadenectomy and renal transplantation. Lymphoceles can cause morbidity and rarely mortality by compression of adjacent structures and infectious complications. This review discusses etiology and treatment options for pelvic lymphoceles including surgical and percutaneous methods with emphasis on percutaneous techniques particularly in conjunction with sclerotherapy. Percutaneous catheter drainage with sclerotherapy procedure with various sclerosing agents is described in detail. Ethanol, povidone-iodine, tetracycline, doxycycline, bleomycin, talc and fibrin glue can be used as sclerosing agents. Combination of sclerosing agents to percutaneous catheter drainage significantly improves success rate in the treatment of pelvic lymphoceles. Infected lymphoceles are usually treated solely with percutaneous catheter drainage. Percutaneous treatment can be tailored according to volume of lymphoceles. We generally prefer single session sclerotherapy and 1 day catheter drainage in lymphoceles less than 150 mL, and larger ones are treated by multi-session sclerotherapy until daily drainage decreases below 10 mL. Percutaneous treatment preferably with sclerotherapy should be considered as the first-line treatment modality for pelvic lymphoceles due to its effectiveness, widespread applicability on an outpatient basis, ease of procedure and low complication rate.

  14. 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

  15. Musculoskeletal etiologies of pelvic pain.

    Science.gov (United States)

    Prather, Heidi; Camacho-Soto, Alejandra

    2014-09-01

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

  16. What Are the Symptoms of Pelvic Pain?

    Science.gov (United States)

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

  17. Cefotaxime Treatment of Pelvic Inflammatory Disease

    OpenAIRE

    Monson, Thomas P; Miller, Timothy T.; Nolan, Charles M.

    1981-01-01

    We studied cefotaxime in the treatment of gonococcal and nongonococcal pelvic inflammatory disease. Cefotaxime was uniformly effective against gonococcal pelvic inflammatory disease. However, 4 of 11 patients with nongonococcal pelvic inflammatory disease had a suboptimal response.

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

    NARCIS (Netherlands)

    S.P. Knops (Simon)

    2014-01-01

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

  19. Congenital seminal vesicle cyst accompanying with ipsilateral renal agenesis in an adolescent patient: A pediatric radiologist approach to Zinner’s syndrome

    Directory of Open Access Journals (Sweden)

    Mehmet Burak Özkan

    2015-12-01

    Full Text Available A fifteen-year-old boy who had complaints of left sided pelvic pain with known ipsilateral left renal agenesia was referred to pediatric radiology department. Incidentally, his sonography examination revealed a dilated tubular structure located in the retro-vesicular region from cephalic to prostate. Contrast enhanced pelvic MRI showed a huge seminal vesicle cyst which is over 6 cm without a mass effect near the aspect border of the prostate and bladder. The patient was diagnosed with Zinner syndrome. The patient doesn’t have new complaint with no definite increase in the diameter of the cyst. In this case presentation we are discussing the Zinner syndrome’s imaging findings from a pediatric radiologist approach with a brief review of the literature.

  20. [Hemophilic pelvic pseudotumor].

    Science.gov (United States)

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

    2007-02-01

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

  1. Laparoscopy for pelvic floor disorders.

    Science.gov (United States)

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

    2014-02-01

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

  2. Management of pelvic organ prolapse.

    Science.gov (United States)

    Ahmed, Faisal; Sotelo, Tiffany

    2011-12-01

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

  3. Pelvic fistulas complicating pelvic surgery or diseases: spectrum of imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Gyu; Kim, Seung Hyup; Lee, Hak Jong; Moon, Min Hoan; Myung, Jae Sung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2001-06-01

    Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.

  4. Complication Nursing of Renal Eight Light Puncture Needle through Posterior Vaginal Fornix in Treatment of Patient with Pelvic Encapsulated Fluid%经阴道后穹窿肾八光穿刺治疗盆腔包裹性积液患者的并发症护理

    Institute of Scientific and Technical Information of China (English)

    费敏

    2014-01-01

    目的:探讨在B超定位下用肾八光穿刺针经阴道后穹窿穿刺治疗盆腔包裹性积液(pelvic encapsulated fluid ,PEF)患者的并发症护理干预方法及效果。方法2012年1月至2014年1月,湖州市中心医院妇科收治的PEF患者150例,按入院先后将其分为观察组及对照组各75例,两组均经阴道后穹窿肾八光穿刺治疗PEF ,对照组实施常规护理,观察组在对照组的基础上实施并发症护理干预,比较两组患者的治疗效果。结果两组患者均于1个月后进行门诊随访及B超复查,结果显示,观察组患者的疗效明显优于对照组,并发症发生率明显低于对照组,差异均有统计学意义(均 P<00.5)。结论经阴道后穹窿肾八光穿刺治疗PEF联合并发症护理干预,近期疗效肯定,并发症发生率明显降低,值得在临床推广应用。%Objective To discuss the effect and complication nursing intervention method of renal eight light puncture needle under ultrasound B localization through posterior vaginal fornix in the treatment of patient with pelvic encapsulated fluid (PEF) .Methods Totally 150 patients with PEF were selected and e‐qually divided into control group and treatment group according to the admission time .Patients in control group had conventional nursing of renal eight light puncture needle through posterior vaginal fornix in the treatment of PEF ;the treatment group had complications nursing intervention based on the treatment of the control group ,and the treatment outcome was compared between the 2 groups .Results Two groups of patients were all had clinical follow‐up and ultrasound B test 1 month after surgery .The outcome in treat‐ment group was better than which in control group ,and the incidence of complication was also lower than control group (all P<0 .05) .Conclusion Renal eight light puncture needle combined with complications nursing intervention for the treatment of PEF has

  5. 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.

  6. Management of lithiasis in pelvic kidney through laparoscopy-guided percutaneous transperitoneal nephrolithotripsy

    Directory of Open Access Journals (Sweden)

    Santos Alesse R. dos

    2004-01-01

    Full Text Available We report the case of a patient with pain and an abdominal palpable mass whose tests showed a left pelvic kidney with a 1.5-cm stone in the renal pelvis. We describe the successful management through videolaparoscopy-guided percutaneous transperitoneal nephrolithotripsy, stressing that this method is a therapeutic option in such cases.

  7. Management of lithiasis in pelvic kidney through laparoscopy-guided percutaneous transperitoneal nephrolithotripsy

    OpenAIRE

    Santos Alesse R. dos; Rocha Filho Delson C. B.; Tajra Luis C. F.

    2004-01-01

    We report the case of a patient with pain and an abdominal palpable mass whose tests showed a left pelvic kidney with a 1.5-cm stone in the renal pelvis. We describe the successful management through videolaparoscopy-guided percutaneous transperitoneal nephrolithotripsy, stressing that this method is a therapeutic option in such cases.

  8. 盆腔异位肾肾动态显像前后位像GFR测定值的差异比较%Comparing the difference of measured GFR of ectopic pelvic kidney between anterior and posterior imaging processing in renal dynamic imaging

    Institute of Scientific and Technical Information of China (English)

    李保军; 赵德善

    2014-01-01

    目的 比较分析盆腔异位肾肾动态显像前、后位像肾小球滤过率(GFR)测定值的差异.方法 回顾性分析10例盆腔异位肾患者的肾动态显像GFR测定结果,分别进行前位异位单肾处理和后位双肾处理,将后位像处理所获正常肾脏GFR与前位像处理所获异位肾GFR相加,获得总肾GFR,并与后位像处理所获双肾GFR和双血浆法GFR测定结果进行比较和相关性分析,并进行了相应随访.采用配对t检验法和双变量相关分析检验法对数据进行统计学分析.结果 10例盆腔异位肾患者前位像处理所获异位肾GFR[(27.48± 12.24) ml/(min· 1.73 m2)]较后位像处理所获异位肾GFR [(10.71±4.74) ml/(min· 1.73 m2)]高出46%,二者间差异有统计学意义(t=5.481,P<0.01).前位像处理所获总GFR与双血浆法GFR差异无统计学意义(t=-2.238,P>0.05),二者的相关性较好(r=0.704,P<0.05);后位像处理所获总GFR与双血浆法GFR差异有统计学意义(t=4.629,P<0.01),二者的相关性较差(r=0.576,P>0.05).结论 在肾动态显像中,前位像处理所获GFR较后位像更能真实地反映盆腔异位肾的功能状况.%Objective To compare and analyze the difference of measured glomerular filtration rate (GFR) of ectopic pelvic kidney between anterior and posterior imaging processing in renal dynamic imaging.Methods There were 10 patients collected retrospectively,with ectopic kidneys in pelvic cavity confirmed by ultrasound,CT,renal dynamic imaging and other imaging modalities.All images of ectopic kidneys in renal dynamic imaging were processed by anterior and posterior methods respectively.The ectopic kidney was only processed in anterior imaging,ectopic kidney and contralateral normal kidney were processed in posterior imaging.Total GFR equalled the sum of GFR of normal kidney in posterior imaging and GFR of ectopic kidney in anterior imaging,was compared with total GFR of two kidneys in posterior imaging and GFR in two

  9. Surgery for Pelvic Organ Prolapse

    Science.gov (United States)

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

  10. Salpingitis and pelvic inflammatory disease.

    Science.gov (United States)

    Swinker, M L

    1985-01-01

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

  11. Functional anatomy of pelvic floor

    OpenAIRE

    Salvatore Rocca Rossetti

    2016-01-01

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

  12. Giant Ectopic Ureter Mimicking Pelvic Organ Prolapse: A Case Report

    Directory of Open Access Journals (Sweden)

    Adnan Simsir

    2011-01-01

    Full Text Available Ectopic ureter is one of the most common urinary tract anomalies. We, herein, present a case of a giant ureter with ectopic orifice, mimicking pelvic organ prolapse, which is the first in the literature. A 59-year-old female patient presenting with frequently recurrent urinary tract infection had grade 3 pelvic organ prolapse. On examination, the organ producing the appearance of prolapse was found to be a right ureter of giant size and was obstructed by a large stone at the distal segment. The proximal end of the ureter ended blindly. After exploration, the stone was removed, the ureter was detached from the urethra, and the lumen was tied off and cut 5 cm proximally. At 6 months postoperatively, the patient is being followed up without any clinical problems. In such cases with nonfunctioning renal segment draining proximally, the chance of cure can be obtained without a need for a comprehensive intervention such as total abdominal ureterectomy.

  13. Prevention of pelvic radiation disease

    Institute of Scientific and Technical Information of China (English)

    Lorenzo; Fuccio; Leonardo; Frazzoni; Alessandra; Guido

    2015-01-01

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

  14. Double diameter boring tool

    Science.gov (United States)

    Ashbaugh, Fred N.; Murry, Kenneth R.

    1988-12-27

    A boring tool and a method of operation are provided for boring two concentric holes of precision diameters and depths in a single operation. The boring tool includes an elongated tool body, a shank for attachment to a standard adjustable boring head which is used on a manual or numerical control milling machine and first and second diametrically opposed cutting edges formed for cutting in opposite directions. The diameter of the elongated tool body is substantially equal to the distance from the first cutting edge tip to the axis of rotation plus the distance from the second cutting edge tip to the axis of rotation. The axis of rotation of the tool is spaced from the tool centerline a distance substantially equal to one-half the distance from the second cutting edge tip to the axis of rotation minus one-half the distance from the first cutting edge tip to the axis of rotation. The method includes the step of inserting the boring tool into the boring head, adjusting the distance between the tool centerline and the tool axis of rotation as described above and boring the two concentric holes.

  15. Risk Factors and Pain Characteristics Assessment in Women with Urologic Disease related Chronic Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Oana MĂGUREAN

    2012-03-01

    Full Text Available Purpose: The aim of our study was to evaluate factors predisposing or related to chronic pelvic pain in women, and whether those factors allows classification using generalized cluster analysis, consistent with the presence of chronic pelvic pain. Material and method: A survey was done on 2469 women referred to Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania, between January 2006 - December 2010. Patients were stratify in regard with presence of chronic pelvic pain (GrA and assessed in regard with demographic and habitual risk factors, medical and reproductive history, lifestyle, and pain characteristics. Identified factors were used for classification using generalized cluster analysis by k-mean technique. The results were assessed in terms of correlation with the presence of chronic pelvic pain. Results: On univariate analysis, marital status and higher education were protective while complications at delivery and physical work were risk factors for chronic pelvic pain. Age at presentation and age at menarche were lower in GrA, while caffeine and alcohol consumption, number of cigarettes smoked per day, pain intensity, coexistence of pain related to periods, deep intercourse, bladder filling, and voiding have been increased in GrA. Classification of patients correlates with the presence of chronic pelvic pain (p<0.001. Conclusions: Age, marital status, level of education, type of activity, complications at delivery, caffeine and alcohol consumption are risk factors related to chronic pelvic pain in women referred for urologic conditions. Pain intensity is related to chronic pelvic pain, regardless of type and localization. Classification of patients using k-mean technique cluster analysis correlates significantly statistic with chronic pelvic pain.

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

    Science.gov (United States)

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

    2014-03-01

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

  17. Myofascial Pelvic Pain and Related Disorders.

    Science.gov (United States)

    Bonder, Jaclyn H; Chi, Michelle; Rispoli, Leia

    2017-08-01

    Myofascial pelvic pain refers to pain in the pelvic floor muscles, the pelvic floor connective tissue, and the surrounding fascia. The cause is often multifactorial and requires treatment that encompasses multiple modalities. This type of pain is often associated with other abdominopelvic disorders, so providers in these specialties need to be aware of these connections. A comprehensive musculoskeletal examination, including evaluation of the pelvic floor muscles, and history are key to diagnosing myofascial pelvic pain. Treatments include physical therapy, muscle relaxers, oral neuromodulators, cognitive-behavioral therapy, and pelvic floor muscle injections. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  19. Pelvic retroversion: a compensatory mechanism for lumbar stenosis.

    Science.gov (United States)

    Pourtaheri, Sina; Sharma, Akshay; Savage, Jason; Kalfas, Iain; Mroz, Thomas E; Benzel, Edward; Steinmetz, Michael P

    2017-08-01

    OBJECTIVE The flexed posture of the proximal (L1-3) or distal (L4-S1) lumbar spine increases the diameter of the spinal canal and neuroforamina and can relieve symptoms of neurogenic claudication. Distal lumbar flexion can result in pelvic retroversion; therefore, in cases of flexible sagittal imbalance, pelvic retroversion may be compensatory for lumbar stenosis and not solely compensatory for the sagittal imbalance as previously thought. The authors investigate underlying causes for pelvic retroversion in patients with flexible sagittal imbalance. METHODS One hundred thirty-eight patients with sagittal imbalance who underwent a total of 148 fusion procedures of the thoracolumbar spine were identified from a prospective clinical database. Radiographic parameters were obtained from images preoperatively, intraoperatively, and at 6-month and 2-year follow-up. A cohort of 24 patients with flexible sagittal imbalance was identified and individually matched with a control cohort of 23 patients with fixed deformities. Flexible deformities were defined as a 10° change in lumbar lordosis between weight-bearing and non-weight-bearing images. Pelvic retroversion was quantified as the ratio of pelvic tilt (PT) to pelvic incidence (PI). RESULTS The average difference between lumbar lordosis on supine MR images and standing radiographs was 15° in the flexible cohort. Sixty-eight percent of the patients in the flexible cohort were diagnosed preoperatively with lumbar stenosis compared with only 22% in the fixed sagittal imbalance cohort (p = 0.0032). There was no difference between the flexible and fixed cohorts with regard to C-2 sagittal vertical axis (SVA) (p = 0.95) or C-7 SVA (p = 0.43). When assessing for postural compensation by pelvic retroversion in the stenotic patients and nonstenotic patients, the PT/PI ratio was found to be significantly greater in the patients with stenosis (p = 0.019). CONCLUSIONS For flexible sagittal imbalance, preoperative attention should

  20. Renal arteriography

    Science.gov (United States)

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Review Date 1/5/2016 Updated by: Jason Levy, ...

  1. 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.

  2. Functional anatomy of pelvic floor.

    Science.gov (United States)

    Rocca Rossetti, Salvatore

    2016-03-31

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

  3. Pelvic manikins as learning aids.

    Science.gov (United States)

    Macintosh, M C; Chard, T

    1997-05-01

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

  4. How Are Pelvic Floor Disorders Commonly Treated?

    Science.gov (United States)

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

  5. How Are Pelvic Floor Disorders Diagnosed?

    Science.gov (United States)

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

  6. Pelvic Inflammatory Disease (PID) Treatment and Care

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Pelvic Inflammatory Disease (PID) Note: Javascript is disabled or is not ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Pelvic Inflammatory Disease (PID) Treatment and Care Recommend on Facebook Tweet ...

  7. Can I prevent Pelvic Organ Prolapse

    Science.gov (United States)

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

  8. Small diameter carbon nanopipettes

    Science.gov (United States)

    Singhal, Riju; Bhattacharyya, Sayan; Orynbayeva, Zulfiya; Vitol, Elina; Friedman, Gary; Gogotsi, Yury

    2010-01-01

    Nanoscale multifunctional carbon probes facilitate cellular studies due to their small size, which makes it possible to interrogate organelles within living cells in a minimally invasive fashion. However, connecting nanotubes to macroscopic devices and constructing an integrated system for the purpose of fluid and electrical signal transfer is challenging, as is often the case with nanoscale components. We describe a non-catalytic chemical vapor deposition based method for batch fabrication of integrated multifunctional carbon nanopipettes (CNPs) with tip diameters much smaller (10-30 nm) than previously reported (200 nm and above) and approaching those observed for multiwalled carbon nanotubes. This eliminates the need for complicated attachment/assembly of nanotubes into nanofluidic devices. Variable tip geometries and structures were obtained by controlled deposition of carbon inside and outside quartz pipettes. We have shown that the capillary length and gas flow rate have a marked effect on the carbon deposition. This gives us a flexible protocol, useful for growing carbon layers of different thicknesses at selective locations on a glass pipette to yield a large variety of cellular probes in bulk quantities. The CNPs possess an open channel for fluid transfer with the carbon deposited inside at 875 °C behaving like an amorphous semiconductor. Vacuum annealing of the CNP tips at temperatures up to 2000 °C yields graphitic carbon structures with an increase in conductivity of two orders of magnitude. Penetration of the integrated carbon nanoprobes into cells was shown to produce minimal Ca2+ signals, fast recovery of basal Ca2+ levels and no adverse activation of the cellular metabolism during interrogation times as long as 0.5-1 h.

  9. Endourological Evaluation and Management of Leukoplakia of the Renal Pelvis

    Directory of Open Access Journals (Sweden)

    Hidehiro Kakizaki

    1996-01-01

    Full Text Available Since August 1989, we have seen 4 patients with leukoplakia of the renal pelvis associated with a longstanding renal stone. In 2 of them, excretory or retrograde pyelography revealed multiple filling defects in the left renal pelvis as well as a renal stone, although urine cytological examination was negative. One of the other 2 patients underwent extracorporeal shock wave lithotripsy (ESWL for the renal stone, but this was not followed by the passage of stone fragments. The renal stone in the remaining patient was associated with staghorn calculi. For stone extraction as well as endoscopic evaluation of the intrapelvic lesion, percutaneous nephroscopy was performed. A small to large amount of tissue-like white debris in sheets characteristic of leukoplakia was found in the renal pelvis with stones embedded in it and was removed directly by forceps or suction and then by irrigating with saline. We propose that 1 the endourological approach should be recommended for patients with renal pelvic lesions associated with longstanding renal stones or for patients who show difficulty in passing stone fragments after ESWL and 2 this entity of leukoplakia should be kept in mind for the differential diagnosis of renal pelvic lesions associated with renal stones.

  10. Biomechanics of the pelvic floor musculature

    NARCIS (Netherlands)

    Janda, S.

    2006-01-01

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

  11. Early development of the human pelvic diaphragm

    NARCIS (Netherlands)

    Koch, Wijnandus Franciscus Robertus Maria

    2006-01-01

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

  12. Early development of the human pelvic diaphragm

    NARCIS (Netherlands)

    Koch, Wijnandus Franciscus Robertus Maria

    2006-01-01

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

  13. Emphysematous prostatitis in renal transplant

    Directory of Open Access Journals (Sweden)

    Krishnaswamy Sampathkumar

    2007-01-01

    Full Text Available Urinary tract infections are common following renal transplant. The spectrum varies from asymptomatic bacteriuria to septicemia. Gas-producing infections of the urinary tract are rare but tend to have a grave prognosis when they do occur. We report a 57-year-old gentleman who underwent a renal transplant 20 months earlier. He presented to us with fever and dysuria. Clinical examination revealed a febrile and ill-looking patient with severe graft tenderness. An emergency pelvic CT scan revealed presence of emphysematous prostatitis, cystitis and pyelitis. Urine and blood cultures grew E. coli . Endoscopic abscess drainage was done and antibiotics given but he succumbed to his illness due to multiorgan failure within 48h. This is the first reported case of emphysematous prostatitis in a renal allograft recipient.

  14. 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.

  15. Ultrasound Imaging of the Pelvic Floor.

    Science.gov (United States)

    Stone, Daniel E; Quiroz, Lieschen H

    2016-03-01

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

  16. Transarterial embolization for serious renal hemorrhage following renal biopsy.

    Science.gov (United States)

    Zeng, Dan; Liu, Guihua; Sun, Xiangzhou; Zhuang, Wenquan; Zhang, Yuanyuan; Guo, Wenbo; Yang, Jianyong; Chen, Wei

    2013-01-01

    The goal of this study is to evaluate the feasibility and efficacy of percutaneous transarterial embolization for the treatment of serious renal hemorrhage after renal biopsy. Nine patients with renal hemorrhage had frank pain and gross hematuria as main symptoms after renal biopsy. Intrarenal arterial injuries and perinephric hematoma were confirmed by angiography in all cases. The arterial injuries led to two types of renal hemorrhage, Type I: severe renal injure or intrarenal renal artery rupture (n=5), with contrast medium spilling out of the artery and spreading into renal pelvis or kidney capsule in angiography; Type II, pseudo aneurysm or potential risk of intrarenal artery injure (n=4), where contrast medium that spilled out of intraartery was retained in the parenchyma as little spots less than 5 mm in diameter in angiography. Transcatheter superselective intrarenal artery embolization was performed with coils or microcoils (Type I intrarenal artery injure) and polyvinyl alcohol particles (Type II injure). The intrarenal arterial injuries were occluded successfully in all patients. Light or mild back or abdominal pain in the side of the embolized kidney was found in three patients following embolization procedures and disappeared 3 days later. Serum creatinine and perinephric hematoma were stable, and gross hematuresis stopped immediately (n=4) or 3-5 days (n=3) after embolization. In conclusions, transcatheter superselective intrarenal artery embolization as a minimally invasive therapy is safe and effective for treatment of serious renal hemorrhage following percutaneous renal biopsy.

  17. [Functional aspects of pelvic floor surgery].

    Science.gov (United States)

    Wagenlehner, F M E; Gunnemann, A; Liedl, B; Weidner, W

    2009-11-01

    Pelvic floor dysfunctions are frequently seen in females. The human pelvic floor is a complex structure and heavily stressed throughout female life. Recent findings in the functional anatomy of the pelvic floor have led to a much better understand-ing, on the basis of which enormous improvements in the therapeutic options have arisen. The pelvic floor activity is regulated by three main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor -organs, bladder and rectum. For different reasons laxity in the vagina or its supporting ligaments as a result of altered connective tissue can distort this functional anatomy. A variety of symptoms can derive from these pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, faecal incontinence, obstructive bowel disease syndrome and pelvic pain. Pelvic floor reconstruction is nowadays driven by the concept that in the case of pelvic floor symptoms restoration of the anatomy will translate into restoration of the physiology and ultimately improve the patients' symptoms. The exact surgical reconstruction of the anatomy is there-fore almost exclusively focused on the restoration of the lax pelvic floor ligaments. An exact identification of the anatomic lesions preoperatively is eminently necessary, to allow for an exact anatomic reconstruction with respect to the muscular forces of the pelvic floor.

  18. Synthetic biomaterials for pelvic floor reconstruction.

    Science.gov (United States)

    Karlovsky, Matthew E; Kushner, Leslie; Badlani, Gopal H

    2005-09-01

    Pelvic organ prolapse and stress urinary incontinence increase with age. The increasing proportion of the aging female population is likely to result in a demand for care of pelvic floor prolapse and incontinence. Experimental evidence of altered connective tissue metabolism may predispose to pelvic floor dysfunction, supporting the use of biomaterials, such as synthetic mesh, to correct pelvic fascial defects. Re-establishing pelvic support and continence calls for a biomaterial to be inert, flexible, and durable and to simultaneously minimize infection and erosion risk. Mesh as a biomaterial has evolved considerably throughout the past half century to the current line that combines ease of use, achieves good outcomes, and minimizes risk. This article explores the biochemical basis for pelvic floor attenuation and reviews various pelvic reconstructive mesh materials, their successes, failures, complications, and management.

  19. [Complex pelvic injury in childhood].

    Science.gov (United States)

    Schmal, H; Klemt, C; Haag, C; Bonnaire, F

    2002-08-01

    Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.

  20. Renal trauma in occult ureteropelvic junction obstruction: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Sebastia, M.C.; Rodriguez-Dobao, M.; Quiroga, S.; Pallisa, E.; Martinez-Rodriguez, M.; Alvarez-Castells, A. [Dept. of Radiology, Hospital General Universitari Vall d`Hebron, Barcelona (Spain)

    1999-05-01

    The aim of this study was to present CT findings of occult ureteropelvic junction obstruction in patients with renal trauma and to describe the clinical signs and singular CT features that are characteristically observed with trauma and are relevant to management of these patients. We retrospectively reviewed 82 helical CT studies in patients with renal trauma referred to our institution. We found 13 cases of occult preexisting renal pathology, six of which were occult ureteropelvic junction obstructions. The clinical presentation, radiologic findings of trauma according to the Federle classification, and CT findings of obstructed ureteropelvic junction are presented. We found three category-I lesions (one in a horseshoe kidney), two of them treated with nephrostomy because of increased ureteropelvic junction obstruction due to pelvic clots; two category-II lesions (parenchymal and renal pelvis lacerations) that had presented only with microhematuria; and one category-IV lesion (pelvic laceration alone). Pelvic extension was demonstrated in all the cases with perirenal collections. The CT studies in all the cases with suspected ureteropelvic junction obstruction showed decreased parenchymal thickness and enhancement, and dilatation of the renal pelvis and calyx, with a normal ureter. Computed tomography can provide information to confidently diagnose underlying ureteropelvic junction obstruction in renal trauma, categorize the traumatic injury (at times clinically silent) and facilitate proper management according to the singularities observed, such us rupture of the renal pelvis alone (Federle category IV) and increasing ureteropelvic obstruction due to clots which can be decompressed by nephrostomy. (orig.) With 6 figs., 3 tabs., 13 refs.

  1. Transvaginal ultrasound examination of women with and without pelvic venous congestion

    Energy Technology Data Exchange (ETDEWEB)

    Halligan, Steve; Campbell, Deidre; Bartram, Clive I.; Rogers, Vera; El-Haddad, Cadria; Patel, Sujata; Beard, Richard W

    2000-12-01

    AIM: To determine if transvaginal ultrasound, including power Doppler examination, can distinguish between women with and without pelvic congestion. MATERIALS AND METHODS: Thirty-six women with pelvic congestion were prospectively examined using transvaginal ultrasonography and standard uterine and ovarian measurements made. Additionally, planimetric measurements of each ovary were taken using an image analysis program to determine the cross-sectional area of ovarian stroma and follicles, if any. Power Doppler images of adnexal vessels were obtained and planimetric estimates of surface area calculated. A congestion score was assigned to each patient, based on vein number, diameter and morphology on grey-scale scanning. Identical measurements were obtained from 19 asymptomatic women and results compared. RESULTS: There was no significant difference between women with pelvic congestion and controls with respect to power Doppler or grey-scale images of adnexal vessels, or congestion score. However, women with pelvic congestion had significantly larger and multicystic ovaries when compared to controls. CONCLUSIONS: Transvaginal ultrasound measurements of adnexal vasculature, including power Doppler measurements, cannot reliably distinguish women with pelvic congestion from controls. However, ultrasound may remain useful for diagnosis of pelvic congestion, predominantly because it is able to visualize multi-cystic ovaries in these patients. Halligan, S. (2000).Clinical Radiology 55 , 954-958.

  2. 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....

  3. Renal Osteodystrophy

    Directory of Open Access Journals (Sweden)

    Aynur Metin Terzibaşoğlu

    2004-12-01

    Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

  4. Pelvic compartment syndrome caused by retroperitoneal hematoma of pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Feng-qi; ZHANG Ying-ze; PAN Jin-she; PENG A-qin; WANG Hui-juan

    2005-01-01

    @@ Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture.1 In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis.

  5. Obesity and pelvic floor dysfunction.

    Science.gov (United States)

    Ramalingam, Kalaivani; Monga, Ash

    2015-05-01

    Obesity is associated with a high prevalence of pelvic floor disorders. Patients with obesity present with a range of urinary, bowel and sexual dysfunction problems as well as uterovaginal prolapse. Urinary incontinence, faecal incontinence and sexual dysfunction are more prevalent in patients with obesity. Uterovaginal prolapse is also more common than in the non-obese population. Weight loss by surgical and non-surgical methods plays a major role in the improvement of these symptoms in such patients. The treatment of symptoms leads to an improvement in their quality of life. However, surgical treatment of these symptoms may be accompanied by an increased risk of complications in obese patients. A better understanding of the mechanism of obesity-associated pelvic floor dysfunction is essential.

  6. [Sexual dysfunction following pelvic surgery].

    Science.gov (United States)

    Hojo, K

    1997-11-01

    In male, sexual dysfunction was a common complication that occurred after radical pelvic surgery: radical protectomy, radical cysto-, prostatectomy. Upon the recent pelvic neuroanatomical findings and preservation of these nerves, it is now possible to perform successful cancer operation on the rectum, prostate or bladder with preservation of sexual function in the group of early cancer patients. Depending on the location and severity of these nerve injury, this could result in temporary or permanent erectile and ejaculation dysfunction. In female, the total hysterectomy for cervical cancer sacrifices or injuries the faculty of pregnancy or sexual intercourse. The oophorectomies causes a deficiency of female hormones. But recently the numbers of patients with a small or early stages cancer of uterine or ovary are increasing and we have become to be able to save the functions of these organs in many patients well with minimum local excision or partial resection of them.

  7. 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.)

  8. Evaluation of magnetization transfer ratio in ascites and pelvic cystic masses

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Susumu [Nippon Medical School, Inba, Chiba (Japan). Chiba-Hokuso Hospital; Kato, Tomoyasu; Yamashita, Takashi [and others

    1997-12-01

    To investigate the feasibility of magnetization transfer contrast (MTC) in characterization of pelvic cystic masses and ascites, in vitro studies were performed. Cystic fluids were taken from operative specimens of ten ovarian cystic masses (five mucinous cystadenomas, one cystadenocarcinoma, two serous cystadenocarcinomas, two clear cell carcinomas) and three non-ovarian pelvic cysts (one paraovarian cyst, one pseudomyxoma peritonei, one pelvic abscess). Samples of ascitic flied were drawn by peritoneal puncture in twenty patients (thirteen with peritonitis carcinomatosa, five with liver dysfunction, two with renal dysfunction). Total protein content in ascitic fluids was measured. Magnetization transfer ratio (MTR) was calculated by the signal intensities under the gradient echo sequence with and without the application of off-resonance pulses. The relative signal intensities (RSI) relative to water in T{sub 1} and T{sub 2} weighted images were obtained using spin echo sequence. There was no correlation between histological type of pelvic mass and MTR and RSI. Good correlation (R{sup 2}=0.761) was obtained between MTR and protein content in ascitic fluids, whereas no correlation was noted between RSI and protein content in ascitic fluids. These results suggest that MTC is not useful in the characterization of pelvic masses but is applicable in the differentiation between exudative ascites and transudative ascites. (author)

  9. Vaginal shape at resting pelvic MRI: Predictor of pelvic floor weakness?

    OpenAIRE

    Tillack, AA; Joe, B; Yeh, B; Jun, SL; Kornak, J; Zhao, S; Deng, D

    2014-01-01

    © 2014 Elsevier Inc. Objective: The objective was to determine if alteration in vaginal shape seen on nonstraining pelvic magnetic resonance (MR) scans is associated with pelvic floor weakness. Methods: Two readers classified the shape of the middle third of the vagina on resting T2-weighted axial images as normal or abnormal for 76 women with and without pelvic floor weakness. Results: The sensitivity and specificity for diagnosing pelvic floor dysfunction were 84% and 68% for reader A and 4...

  10. 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 ...

  11. Gynecological pelvic pain as emergency pathology.

    Science.gov (United States)

    Rivera Domínguez, A; Mora Jurado, A; García de la Oliva, A; de Araujo Martins-Romeo, D; Cueto Álvarez, L

    Acute pelvic pain is a common condition in emergency. The sources of acute pelvic pain are multifactorial, so it is important to be familiar with this type of pathologies. The purpose of this article is review the main causes of gynecological acute pelvic pain and their radiologic appearances to be able to make an accurate diagnosis and provide objective criteria for patient management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Vaginal childbirth and pelvic floor disorders

    OpenAIRE

    Memon, Hafsa U.; Handa, Victoria L.

    2013-01-01

    Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal deli...

  13. The pelvic floor in health and disease.

    OpenAIRE

    Shelton, A A; Welton, M L

    1997-01-01

    Normal pelvic floor function involves a set of learned and reflex responses that are essential for the normal control and evacuation of stool. A variety of functional disturbances of the pelvic floor, including incontinence and constipation, are not life threatening, but can cause significant distress to affected patients. Understanding the normal anatomy and physiology of the pelvic floor is essential to understanding and treating these disorders of defecation. This article describes the nor...

  14. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-01

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

  15. Laparoscopic assisted percutaneous nephrolithotomy in chronic kidney disease patients with ectopic pelvic kidney

    Science.gov (United States)

    Patwardhan, Sujata K.; Shelke, Umesh Ravikant; Patil, Bhushan P.; Pamecha, Yash R.

    2017-01-01

    Purpose: Patients with deranged renal functions have a number of associated factors which can impair healing of wound and increase postoperative morbidity. This study was conducted to assess the problems while managing ectopic pelvic kidney calculi using laparoscopic approach for percutaneous nephrolithotomy (PCNL) in chronic kidney disease patients. Subjects and Methods: Patients with calculi in ectopic kidney with increased serum creatinine level secondary to obstruction were included in the study. Initially, obstruction was relieved. Patients later underwent laparoscopic-assisted PCNL. Patients were monitored postoperatively. Results: Three patients with large renal calculi in ectopic pelvic kidney had presented in 2 years. Laparoscopic-assisted PCNL was done to remove the stone. Patients had persistent urine leak post-operatively. Mean duration for removal of nephrostomy tube and drain removal were 4.67 days and 6.67 days, respectively. These patients also had paralytic ileus for prolonged duration. Conclusion: Although laparoscopic assisted PCNL is an option in the management of patients with stone disease in ectopic pelvic kidney, prolonged time for healing of tract may increase postoperative morbidity in these patients with impaired renal function. PMID:28794593

  16. Which Foetal-Pelvic Variables Are Useful for Predicting Caesarean Section and Instrumental Assistance?

    Science.gov (United States)

    Frémondière, P; Thollon, L; Adalian, P; Delotte, J; Marchal, F

    2017-01-01

    To assess the variables useful to predict caesarean delivery (CD) and instrumental assistance, through the analysis of a large number of foetal-pelvic variables, using discriminant analysis. One hundred and fourteen pregnant women were included in this single-centre prospective study. For each mother-foetus pair, 43 pelvic and 18 foetal variables were measured. Partial least squares-discriminant analysis was performed to identify foetal-pelvic variables that could statistically separate the 3 delivery modality groups: spontaneous vaginal delivery (SVD), CD, and instrument-assisted delivery (IAD). For the SVD versus CD model, voluminous foetuses and women with a narrow pelvic inlet had a greater risk for requiring CD. The most efficient variables for discrimination were the transverse diameter and foetal weight. The antero-posterior inlet and obstetric conjugate were considered in this model, with the former being a useful variable but not the latter. For the SVD versus IAD model, the most important variables were the foetal variables, particularly the bi-parietal diameter. Women with a reduced antero-posterior outlet diameter and a narrow pubic arch were more at risk of requiring an IAD. The antero-posterior inlet was an efficient variable unlike the obstetric conjugate. The obstetric conjugate diameter should no longer be considered a useful variable in estimating the arrest of labour. Antero-posterior inlet diameter was a sagittal variable that should be taken into account. The comparison of sub-pubic angle and bi-parietal and antero-posterior outlet diameters was useful in identifying a risk of requiring instrumental assistance. © 2017 S. Karger AG, Basel.

  17. Renal perfusion scintiscan

    Science.gov (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  18. Osteosarcoma of pelvic bones: imaging features.

    Science.gov (United States)

    Park, Se Kyoung; Lee, In Sook; Cho, Kil Ho; Lee, Young Hwan; Yi, Jae Hyuck; Choi, Kyung Un

    The metaphyseal locations of tubular bones with osteoid mineralization in young patients are important diagnostic radiologic features of osteosarcoma. The pelvic bones are an unusual location of osteosarcoma. Although osteosarcoma occurring in pelvic bones is not common, the osteoid matrix may be a critical finding for differentiating osteosarcoma from other common pelvic bone tumors. Therefore, the possibility of osteosarcoma in pelvic bones may be considered in the presence of osteoid matrix even in the old age group. Copyright © 2016. Published by Elsevier Inc.

  19. [Functional anatomy of the pelvic floor].

    Science.gov (United States)

    Yiou, René; Delmas, Vincent

    2013-01-01

    The pelvic floor is the support of the pelvic viscera. The levator ani muscle (LA) with its two bundles (pubo- and iliococcygeus) is the major component of this pelvic floor. LA is formed essentially by type I fibers (slow twitch, with high oxidative capability and presence of slow myosin) as in postural muscles. The aerobic metabolism makes LA fragile to excentric contraction and to mitochondrial dysfunction. The innervation of the pelvic floor comes from the 2nd, 3rd, 4th anterior sacral roots; denervation affects pelvic dynamism. Perineum includes the musculofascial structures under the LA: ventrally the striated sphincter of urethra and the ischiocavernosus and bulbospongiosus, caudally the fatty tissue filling the ischioanal fossa. Pelvic fascia covers the muscles ; it presents reinforcements : the uterosacral and cardinal ligaments, the arcus tendineus fascia pelvis (ATFP) and the arcus tendineus levator ani (ATLA). The pelvis statics is supported by the combined action of all this anatomical structures anteriorly forming the perineal "hammock," medially the uterosacral and cardinal ligaments, posteriorly the rectovaginal fascia and the perineal body. The angles formed by the pelvic viscera with their evacuation ducts participate to the pelvic statics. During the pelvic dynamics the modification of these angles expresses the action of the musculofascial structures.

  20. Emergency management of hemodynamically unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-gang

    2011-01-01

    Pelvic fractures are serious injuries.Death within 24 hours is most often a result of acute blood loss.The emergency management of these patients is challenging and controversial.The key issues in its management are identifying the site(s) of hemorrhage and then controlling the bleeding.Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team.The issues addressed in this management algorithm are diagnostic evaluation,damage control resuscitation,indications for noninvasive pelvic stabilization,preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography.This review article focuses on the recent body of knowledge on those determinations.

  1. 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.

  2. Testing of the Anorectal and Pelvic Floor Area

    Science.gov (United States)

    ... Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Personal Stories Contact About GI Motility ... Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Personal Stories Contact Anorectal and Pelvic ...

  3. Reconstructive options in pelvic tumours

    Directory of Open Access Journals (Sweden)

    Mayilvahanan N

    2005-01-01

    Full Text Available Background: Pelvic tumours present a complex problem. It is difficult to choose between limb salvage and hemipelvectomy. Method: Forty three patients of tumours of pelvis underwent limb salvage resection with reconstruction in 32 patients. The majority were chondrosarcomas (20 cases followed by Ewing sarcoma. Stage II B was the most common stage in malignant lesions and all the seven benign lesions were aggressive (B3. Surgical margins achieved were wide in 31 and marginal in 12 cases. Ilium was involved in 51% of cases and periacetabular involvement was seen in 12 patients. The resections done were mostly of types I &II of Enneking′s classification of pelvic resection. Arthrodesis was attempted in 24 patients. Customized Saddle prosthesis was used in seven patients and no reconstruction in 12 patients. Adjuvant chemotherapy was given to all high-grade malignant tumours, combined with radiotherapy in 7 patients. Results: With a mean follow up of 48.5 months and one patient lost to follow up, the recurrence rate among the evaluated cases was 16.6%. Oncologically, 30 patients were continuously disease free with 7 local recurrences and 4 deaths due to disseminated disease and 2 patients died of other causes. During the initial years, satisfactory functional results were achieved with prosthetic replacement. Long-term functional result of 36 patients who were alive at the time of latest follow up was satisfactory in 75% who underwent arthrodesis and in those where no reconstruction was used. We also describe a method of new classification of pelvic resections that clarifies certain shortcomings of the previous systems of classification. Conclusion: Selection of a procedure depends largely on the patient factors, the tumour grade, the resultant defect and the tissue factors. Resection with proper margins gives better functional and oncological results

  4. Imaging of male pelvic trauma.

    Science.gov (United States)

    Avery, Laura L; Scheinfeld, Meir H

    2012-11-01

    Prompt imaging plays an important role in the evaluation of male pelvic soft tissue trauma. Using appropriate imaging modalities, with optimization of contrast administration when appropriate, is essential for accurate diagnosis. Traumatic bladder rupture, either extraperitoneal or intraperitoneal, is diagnosed with high accuracy using computed tomography cystography. Suspicion of urethral injury warrants evaluation with retrograde urethrography to evaluate for the presence of injury and injury location. Early identification of laceration of the testicular tunica albuginea is essential. Understanding both normal penile anatomy and the imaging appearance of corpus rupture (as opposed to a hematoma) is imperative for proper diagnosis and management.

  5. 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...

  6. [Functional rehabilitation of the pelvic floor].

    Science.gov (United States)

    Minschaert, M

    2003-09-01

    Pelvic floor revalidation is devoted to conserve perineal functions as statics, urinary continence and sexual harmony. The therapeutics includes preventive and curative actions, and is based upon muscular and neuromuscular properties of pelvic floor. The different steps are: information, local muscular work, behavioral education, biofeedback, functional electrostimulation, intraabdominal pressure control. The therapeutics is only continued if clinical improvement is demonstrated after 10 sessions.

  7. Pelvic Inflammatory Disease (PID) Fact Sheet

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Pelvic Inflammatory Disease (PID) Note: Javascript is disabled or is not ... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Pelvic Inflammatory Disease (PID) - CDC Fact Sheet Language: English (US) Españ ...

  8. Laparoscopic Pelvic Floor Repair Using Polypropylene Mesh

    Directory of Open Access Journals (Sweden)

    Shih-Shien Weng

    2008-09-01

    Conclusion: Laparoscopic pelvic floor repair using a single piece of polypropylene mesh combined with uterosacral ligament suspension appears to be a feasible procedure for the treatment of advanced vaginal vault prolapse and enterocele. Fewer mesh erosions and postoperative pain syndromes were seen in patients who had no previous pelvic floor reconstructive surgery.

  9. Pelviureteral inhibitory reflex and ureteropelvic excitatory reflex: role of the two reflexes in regulation of urine flow from the renal pelvis to the ureter.

    Science.gov (United States)

    Shafik, A

    1997-01-01

    The mechanism by which the ureteropelvic junction (UPJ) regulates the passage of urine from the renal pelvis to the ureter, and prevents urinary backflow from the the ureter to the renal pelvis, is not completely understood. The current communication studies this mechanism in 18 dogs. With the dogs under anesthesia, nephrostomy was done through which two catheters (one pressure and one balloon-tipped) were introduced into the UPJ and the renal pelvis, respectively. Renal pelvis distension with a balloon filled with 1 ml of saline effected a rise of renal pelvic pressure from a mean basal pressure of 4.8 +/- 1.2 cm H2O to 6.9 +/- 2.3 cm H2O (P pelvic balloon (P > 0.05). Renal pelvic distension with 2, 3, and 4 ml caused a significant rise of renal pelvic pressure to 8.4 +/- 2.7 (P 0.05). In contrast, the UPJ showed no significant pressure change upon distension of the locally anesthetized renal pelvis or ureter, respectively. Likewise, the locally anesthetized UPJ exhibited no significant pressure response to renal pelvic or ureteric distension. The study demonstrates that urine might have to accumulate in the renal pelvis up to a certain volume and pressure so as to effect UPJ opening, which occurs at its maximum irrespective of the distending volume. UPJ opening upon renal pelvic distension postulates a reflex relationship which we call "pelviureteral inhibitory reflex." This reflex is believed to regulate the passage of urine from the renal pelvis to the ureter. Ureteric distension closes the UPJ; we call this reflex action the "ureteropelvic excitatory reflex" as it seems to prevent reflux of urine through the UPJ and thus protects the kidney. The concept that the UPJ acts as a physiologic sphincter is put forward.

  10. 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...

  11. 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.)

  12. Mortality in patients with pelvic fractures

    DEFF Research Database (Denmark)

    Hauschild, Oliver; Strohm, Peter C; Culemann, Ulf

    2008-01-01

    BACKGROUND: Pelvic and acetabular fractures are rare injuries and account for approximately 3% to 8% of all fractures. Often the result of high energy blunt trauma, most of the patients sustaining pelvic injuries are at high risk of associated injuries strongly influencing outcome and survival...... rates. Because of anatomic differences it has been suggested that pediatric pelvic fractures are different injuries as compared with that of adults. However, this has been controversially discussed. Aim of this multicenter register study was to identify similarities and differences between pediatric...... and adult pelvic trauma and evaluate the influence of changes in medical treatment by comparison of two treatment periods. METHODS: In this multicenter register study, data of 4,291 patients treated from 1991 to 1993 (n = 1,723) or 1998 to 2000 (n = 2,568) for pelvic fractures in one of the 23 participating...

  13. Laparoscopic trans-peritoneal pyelolithotomy in a pelvic kidney

    Directory of Open Access Journals (Sweden)

    Shahnawaz Ahangar

    2012-01-01

    Full Text Available Urinary lithiasis is one of the most common and the oldest known afflictions of the urinary tract. The management of renal stones has undergone radical changes in recent years, the latest being the minimally invasive procedures like extra-corporeal shock wave lithotripsy and percutaneous nephrolithotomy, making the open surgical procedures relatively obsolete. However, there are situations where the above-mentioned minimally invasive procedures prove to be lacking in achieving the cure; laparoscopic pyelolithotomy caters to such group of patients, e.g. the presence of calculi in malrotated or malpositioned kidneys. Herein, we report a case of pelvic kidney with a large calculus managed by laparoscopic trans-peritoneal pyelolithotomy.

  14. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2012-01-01

    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  15. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt

    1988-01-01

    lesion. Three cases of renal angiomyolipoma, 2 of which underwent perfusion-fixation, were studied by electron microscopy to clarify the cellular composition of this lesion. In the smooth muscle cells abundant accumulation of glycogen was found, whereas the lipocytes disclosed normal ultrastructural......-specific vesicular structures. These findings suggest a secondary vascular damage, i.e. the thickened vessels may not be a primary, integral part of renal angiomyolipoma. Evidence of a common precursor cell of renal angiomyolipoma was not disclosed. It is concluded that renal angiomyolipoma is a hamartoma composed...

  16. Total pelvic floor ultrasound for pelvic floor defaecatory dysfunction: a pictorial review.

    Science.gov (United States)

    Hainsworth, Alison J; Solanki, Deepa; Schizas, Alexis M P; Williams, Andrew B

    2015-01-01

    Total pelvic floor ultrasound is used for the dynamic assessment of pelvic floor dysfunction and allows multicompartmental anatomical and functional assessment. Pelvic floor dysfunction includes defaecatory, urinary and sexual dysfunction, pelvic organ prolapse and pain. It is common, increasingly recognized and associated with increasing age and multiparity. Other options for assessment include defaecation proctography and defaecation MRI. Total pelvic floor ultrasound is a cheap, safe, imaging tool, which may be performed as a first-line investigation in outpatients. It allows dynamic assessment of the entire pelvic floor, essential for treatment planning for females who often have multiple diagnoses where treatment should address all aspects of dysfunction to yield optimal results. Transvaginal scanning using a rotating single crystal probe provides sagittal views of bladder neck support anteriorly. Posterior transvaginal ultrasound may reveal rectocoele, enterocoele or intussusception whilst bearing down. The vaginal probe is also used to acquire a 360° cross-sectional image to allow anatomical visualization of the pelvic floor and provides information regarding levator plate integrity and pelvic organ alignment. Dynamic transperineal ultrasound using a conventional curved array probe provides a global view of the anterior, middle and posterior compartments and may show cystocoele, enterocoele, sigmoidocoele or rectocoele. This pictorial review provides an atlas of normal and pathological images required for global pelvic floor assessment in females presenting with defaecatory dysfunction. Total pelvic floor ultrasound may be used with complementary endoanal ultrasound to assess the sphincter complex, but this is beyond the scope of this review.

  17. Renal histology in polycystic kidney disease with incipient and advanced renal failure.

    Science.gov (United States)

    Zeier, M; Fehrenbach, P; Geberth, S; Möhring, K; Waldherr, R; Ritz, E

    1992-11-01

    Renal specimens were obtained at surgery or postmortem from patients with autosomal dominant polycystic kidney disease (ADPKD). Patients had either serum creatinine (SCr) below 350 mumol/liter (N = 12) or terminal renal failure (N = 50). Specimens were examined by two independent observers using a carefully validated score system. Mean glomerular diameters were similar in ADPKD patients with early renal failure (176 +/- 38 microns) and in victims of traffic accidents (177 +/- 23 microns), while they were significantly greater in diabetics with comparable renal function (205 +/- 16 microns). Glomerular diameters in ADPKD patients with terminal renal failure (191 +/- 45 microns) and with early renal failure were not significantly different. On average, 29% of glomeruli (17 to 62) were globally sclerosed in early renal failure, and 49% (19 to 93) in terminal renal failure. The proportion of glomeruli with segmental sclerosis was less than 4% in both groups. Marked vascular sclerosis, interstitial fibrosis, and tubular atrophy were present in early renal failure, and even more so in terminal renal failure. Interstitial infiltrates were scarce and consisted mainly of CD4 positive lymphocytes and CD68 positive macrophages. Immunestaining with monoclonal renin antibodies showed an increased juxtaglomerular index and expression of renin by arterioles adjacent to cysts, as well as by cyst wall epithelia. The data show more severe vascular and interstitial, but not glomerular, changes in ADPKD with advanced as compared to early renal failure.

  18. Current status of renal biopsy for small renal masses.

    Science.gov (United States)

    Ha, Seung Beom; Kwak, Cheol

    2014-09-01

    Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.

  19. Current Status of Renal Biopsy for Small Renal Masses

    Science.gov (United States)

    Ha, Seung Beom

    2014-01-01

    Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered. PMID:25237457

  20. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all acknowle

  1. Renal fallure

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920705 Endothelin and acute renal failure:study on their relationship and possiblemechanisms. LIN Shanyan(林善锬), et al.Renal Res Lab, Huashan Hosp, Shanghai MedUniv, Shanghai, 200040. Natl Med J China 1992;72(4): 201-205. In order to investigate the role of endothelin

  2. Renal cancer.

    NARCIS (Netherlands)

    Corgna, E.; Betti, M.; Gatta, G.; Roila, F.; Mulder, P.H.M. de

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  3. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  4. Traumatic pelvic fractures in children and adolescents.

    Science.gov (United States)

    DeFrancesco, Christopher J; Sankar, Wudbhav N

    2017-02-01

    Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma.(1-4) Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury. Unstable pelvic ring fractures should be acutely managed using an initial approach similar to that used in adult orthopedic traumatology. Although very few pediatric pelvic fractures will ultimately need surgical treatment, patients with these injuries must be followed over time to confirm proper healing, ensure normal pelvic growth, and address any potential complications. The trauma team suspecting a pelvic fracture in a child must understand the implication of such a finding, identify fracture patterns that increase suspicion of associated injuries, and involve pediatric or adult orthopedic specialists as appropriate during the management of the patient. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Outcome analysis of pelvic ring fractures

    Directory of Open Access Journals (Sweden)

    Sen Ramesh

    2010-01-01

    Full Text Available Background: The behavior of pelvic ring fractures in the long run has been very sparsely studied. The purpose of this study is to assess the long-term outcome of pelvic ring fractures. Materials and Methods: A total of 24 patients with pelvic ring fractures, not involving the acetabulum, were followed up for an average duration of 33 months (range 24-49 months. The clinicoradiological assessment was done using the pelvic scoring system adapted from Cole et al. Parameters assessed included sacroiliac (SI joint involvement and, among SI joint injuries, the presence of a fracture disruption and the degree of displacement. Results: Pain and limp were present in 13 patients (54.2% each and residual working disability in 9 patients (37.5%. The overall Cole′s pelvic score was 31.3 ± 7.02 of a total score of 40. The average pelvic score in patients with SI disruption was 29.2 ± 6.75; much lower than patients without SI disruption with an average score of 34.9 ± 6.25 reaching statistical significance. The pelvic score among patients with a displacement ≤10 mm was 33.0 ± 3.92 and with a displacement> 10 mm 25.88 ± 7.14. The difference was statistically significant. Conclusions: Pelvic ring injuries can lead to long term problems significantly. The involvement of the SI joint affects the long-term outcome adversely, more so if the residual displacement is> 10 mm. The pelvic scoring system is comprehensive and depicts subtle differences in the outcome, which the individual parameters of the assessment fail to show.

  6. 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.

  7. [Patients with hemodynamic unstable pelvic fractures in extremis: pelvic packing or angiography?].

    Science.gov (United States)

    Liñán-Padilla, A; Giráldez-Sánchez, M Á; Serrano-Toledano, D; Lázaro-Gonzálvez, A; Cano-Luís, P

    2013-01-01

    The multidisciplinary management of patients with pelvic trauma has improved prognosis, but mortality is still very high. The appropriate treatment strategy remains controversial, especially regarding the control of bleeding in patients whose clinical situation is extreme by using angiography or pelvic packing. We propose using a tool of evidence-based medicine (CAT) the benefit of the completion of pelvic packing in relation to a specific clinical question from a specific situation. What is best for the management of bleeding, extraperitoneal pelvic packing or angiography, in patients with hemodynamically unstable pelvic fracture in extremis? From this study we can conclude that angiography may improve control of bleeding in patients with arterial bleeding and hemodynamically stable but the packing has priority in patients with pelvic fractures and hemodynamic instability.

  8. 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.

  9. 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.

  10. Epidemiology and outcome of complex pelvic injury

    DEFF Research Database (Denmark)

    Schmal, Hagen; Markmiller, Max; Mehlhorn, Alexander T

    2005-01-01

    Soft tissue injuries associated with pelvic fractures are often responsible for compromised haemodynamics. The objective of this study was to clarify what parameters determine patient outcome. In a cohort study, all patients with a pelvic fracture treated between 1991 and 2001 at a Level I trauma...... center were analysed for associated intrapelvic injuries, classification, severity of trauma, type of intervention and outcome. Of 552 patients with a pelvic fracture who entered the study, 15.5% presented with associated intrapelvic injuries secondary to the fracture (group I). A subgroup of patients...

  11. Locally vascularized pelvic accessory spleen.

    Science.gov (United States)

    Iorio, F; Frantellizzi, V; Drudi, Francesco M; Maghella, F; Liberatore, M

    2016-01-01

    Polysplenism and accessory spleen are congenital, usually asymptomatic anomalies. A rare case of polysplenism with ectopic spleen in pelvis of a 67-year-old, Caucasian female is reported here. A transvaginal ultrasound found a soft well-defined homogeneous and vascularized mass in the left pelvis. Patient underwent MRI evaluation and contrast-CT abdominal scan: images with parenchymal aspect, similar to spleen were obtained. Abdominal scintigraphy with 99mTc-albumin nanocolloid was performed and pelvic region was studied with planar scans and SPECT. The results showed the presence of an uptake area of the radiopharmaceutical in the pelvis, while the spleen was normally visualized. These findings confirmed the presence of an accessory spleen with an artery originated from the aorta and a vein that joined with the superior mesenteric vein. To our knowledge, in the literature, there is just only one case of a true ectopic, locally vascularized spleen in the pelvis.

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

    Science.gov (United States)

    Pastore, Elizabeth A; Katzman, Wendy B

    2012-01-01

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

  13. The “Pelvic Harness”: a skeletonized mesh implant for safe pelvic floor reconstruction

    OpenAIRE

    Sumerova Natalia; Neuman Menahem; Krissi Haim; Pushkar Dmitri

    2016-01-01

    ABSTRACT Objectives To evaluate the feasibility, safety and surgical results of skeletonized mesh implants to form a pelvic harness for pelvic floor reconstruction surgery. Study design Patients with advanced pelvic floor prolapse were enrolled to this study. Study model was a kit mesh, reduced to 75% of the original surface area by cutting out mesh material from the central mesh body. Patients were evaluated at the end of the 1st and 6th post-operative months and interviewed at the study...

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

    Science.gov (United States)

    Scheiner, David; Betschart, Cornelia; Perucchini, Daniele

    2010-01-01

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

  15. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    OpenAIRE

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and ...

  16. Diameters of Triton and Pluto

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, D.; Cruikshank, D.P. (Hawaii Univ., Honolulu (USA). Inst. for Astronomy); Brown, R.H. (Hawaii Univ., Honolulu (USA). Dept. of Physics and Astronomy; Hawaii Univ., Honolulu (USA). Hawaii Inst. of Geophysics)

    1982-12-02

    Upper limits are reported to the thermal IR emission from Triton, the major satellite of Neptune, and Pluto, the outermost planet, that permit significant upper limits to be set on their diameters and also demonstrate that both are high albedo objects. These results exclude the possibility that Triton is the largest planetary satellite and are consistent with the small size of Pluto deduced from other data.

  17. Renal teratogens.

    Science.gov (United States)

    Morgan, Thomas M; Jones, Deborah P; Cooper, William O

    2014-09-01

    In utero exposure to certain drugs early in pregnancy may adversely affect nephrogenesis. Exposure to drugs later in pregnancy may affect the renin-angiotensin system, which could have an impact on fetal or neonatal renal function. Reduction in nephron number and renal function could have adverse consequences for the child several years later. Data are limited on the information needed to guide decisions for patients and providers regarding the use of certain drugs in pregnancy. The study of drug nephroteratogenicity has not been systematized, a large, standardized, global approach is needed to evaluate the renal risks of in utero drug exposures.

  18. Postoperative pelvic pain: An imaging approach.

    Science.gov (United States)

    Farah, H; Laurent, N; Phalippou, J; Bazot, M; Giraudet, G; Serb, T; Poncelet, E

    2015-10-01

    Postoperative pelvic pain after gynecological surgery is a readily detected but unspecific sign of complication. Imaging as a complement to physical examination helps establish the etiological diagnosis. In the context of emergency surgery, vascular, urinary and digestive injuries constitute the most frequent intraoperative complications. During the follow-up of patients who had undergone pelvic surgery, imaging should be performed to detect recurrent disease, postoperative fibrosis, adhesions and more specific complications related to prosthetic material. Current guidelines recommend using pelvic ultrasonography as the first line imaging modality whereas the use of pelvic computed tomography and/or magnetic resonance imaging should be restricted to specific situations, depending on local availability of equipment and suspected disease.

  19. Emergency management of hemodynamically unstable pelvic fractures

    Directory of Open Access Journals (Sweden)

    ZHAO Xiao-gang

    2012-02-01

    Full Text Available 【Abstract】Pelvic fractures are serious injuries. Death within 24 hours is most often a result of acute blood loss. The emergency management of these patients is challenging and controversial. The key issues in its management are identifying the site(s of hemorrhage and then controlling the bleeding. Management of hemodynamically unstable patients with pelvic fracture requires a multidisci- plinary team. The issues addressed in this management algorithm are diagnostic evaluation, damage control resuscitation, indications for noninvasive pelvic stabilization, preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography. This review article focuses on the recent body of know- ledge on those determinations. Key words: Pelvis; Hemodynamic; Emergencies; Practice management

  20. 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.

  1. Pelvic Gliomatosis within Foci of Endometriosis

    OpenAIRE

    Killeen, Vincent B.; Reich, Harry; McGlynn, Fran; Virgilio, Lawrence A.; Krawitz, Michael A.; Sekel, Lisa

    1997-01-01

    The third reported case of pelvic gliomatosis found within foci of endometriosis is documented 16 years after the removal of a benign cystic teratoma. Grossly at laparoscopy the lesions appear as typical deep fibrotic endometriotic implants.

  2. Subclinical Pelvic Inflammatory Disease and Infertility

    National Research Council Canada - National Science Library

    Wiesenfeld, Harold C; Hillier, Sharon L; Meyn, Leslie A; Amortegui, Antonio J; Sweet, Richard L

    2012-01-01

    OBJECTIVE:The reported incidence of acute pelvic inflammatory disease (PID) has decreased but rates of tubal infertility have not, suggesting that a large proportion of PID leading to infertility may be undetected...

  3. [Pelvic actinomycosis and sub-acute abdomen].

    Science.gov (United States)

    Messalli, E M; Cobellis, L; Festa, B; Pecori, E; Stradella, L; Cobellis, G

    2002-12-01

    An interesting case of pelvic actinomycosis with paculiar clinical manifestation is presented. A 42 years-old patient came to our emergency service for an abdominal pelvic pain and fever. Past history showed IUD in situ for over 15 years. The patient was submitted to a ultrasonographic scan and a complete hematological screening was performed. The diagnosis was of subacute abdomen, and an exploratory laparotomy was carried out. During laparotomy an atypical reactive tissue and a suppurative cavity were found. The histological finding of tissue biopsy showed pelvic actinomycosis. On the basis of these findings the conclusion is drawn that a better prevention of pelvic actinomycosis is necessary of its diffusion in the last years due to sexual habit changes.

  4. Imaging findings in idiopathic pelvic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Bongartz, G. [Inst. of Diagnostic Radiology University Hospital Basel (Switzerland); Stoffel, F. [Inst. of Urology, University Hospital Basel (Switzerland)

    2001-04-01

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

  5. Normal differential renal function does not indicate a normal kidney after partial ureteropelvic obstruction and subsequent relief in 2-week-old piglets

    Energy Technology Data Exchange (ETDEWEB)

    Dissing, Thomas H.; Mikkelsen, Mette Marie; Pedersen, Michael; Froekiaer, Joergen; Djurhuus, Jens Christian [University of Aarhus, Institute of Clinical Medicine, Aarhus (Denmark); Eskild-Jensen, Anni [Aarhus University Hospital, Department of Nuclear Medicine, Aarhus Sygehus, Aarhus (Denmark); Gordon, Isky [University College London, Institute of Child Health, London (United Kingdom); University College London, Radiology and Physics Unit, Institute of Child Health, London (United Kingdom)

    2008-09-15

    We investigated the functional consequences of relieving ureteric obstruction in young pigs with experimental hydronephrosis (HN) induced by partial unilateral ureteropelvic obstruction. Three groups of animals were followed from the age of 2 weeks to the age of 14 weeks: Eight animals had severe or grades 3-4 HN throughout the study. Six animals had relief of the obstruction after 4 weeks. Six animals received sham operations at both ages. Morphological and functional examinations were performed at age 6 weeks and again at age 14 weeks and consisted of magnetic resonance imaging (MRI), technetium-diethylenetriaminepentaaceticacid ({sup 99m}Tc-DTPA) renography, renal technetium-dimercaptosuccinicacid ({sup 99m}Tc-DMSA) scintigraphy, and glomerular filtration rate (GFR) measurement. After relief of the partial obstruction, there was reduction of the pelvic diameter and improvement of urinary drainage. Global and relative kidney function was not significantly affected by either obstruction or its relief. Renal {sup 99m}Tc-DMSA scintigraphy showed a change in both the appearance of the kidney and a change in the distribution within kidneys even after relief of obstruction. This study shows that partial ureteric obstruction in young pigs may be associated with little effect on global and differential kidney function. However, even after relief of HN, the distribution of {sup 99m}Tc-DMSA in the kidney remains abnormal suggesting that a normal differential renal function may not represent a normal kidney. (orig.)

  6. Sarcomatoid carcinoma of the renal pelvis in duplex kidney

    Institute of Scientific and Technical Information of China (English)

    CHEN Ge-ming; CHEN Shan-wen; XIA Dan; LI Jun; YAN Sheng; JIN Bai-ye

    2011-01-01

    Sarcomatoid transitional cell carcinoma of the renal pelvis is a rare neoplasm with only 14 well-illustrated examples reported previously. Duplex kidney is the most common congenital abnormality of the urinary tract, with an incidence of around 2%. Neoplasia of the renal pelvis in duplex kidney is rare. We reported a case whose sarcomatoid carcinoma originated from the upper portion of the duplicated renal pelvis with hydronephrosis, and total nephroureterectomy with bladder cuff excision surgery of both renal units was carried out. Because of the rare nature of renal pelvic sarcomatoid carcinoma and its apparent lack of response to adjuvant therapy, it is essential to do early diagnosis and early radical surgery to improve survival. It is important to stress the need for frequent and diligent monitoring or treating complex duplex kidney with hydronephrosis of either moiety in case of a risk of having neoplasias.

  7. The grade of vesicoureteral reflux in voiding cystourethrography: comparison with ultrasonography and Tc99m-DMSA renal scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    To evaluate the prevalence of abnormalities seen on sonography and renal scintigraphy, according to the grade of vesicoureteral reflux (VUR) on in voiding cystourethrography(VCUG). One hundred and forty-nine patients (age range: 1 months-10 years) with urinary tract infection underwent sonography, VCUG, and renal scans, and 32 showed VUR on VCUG. We retrospectively evaluated the frequency and characteristic findings of sonographic abnormalities according to the grade of VUR, and also the frequency of cortical defects seen on renal scans of 32 patients with VUR. The remaining 117 patients without VUR were also evaluated for the frequency of abnormal findings seen on sonography and renal scans. Among 32 patients (49 kidneys) with VUR, abnormal findings were not detected in 17 (29 kidneys) on sonography; thus, findings were abnormal in 15 (20 kidneys, 41%). Among these 20 kidneys, renal calyceal and/or pelvic dilatation and dilatation of distal ureter were seen in 11, all of which were grade 4-5 VUR. Renal pelvic dilatation only was noted in eight kidneys; two were grade 1-3 and six were grade 4-5 VUR. Nineteen patients (24 kidneys, 49%) showed focal cortical defects on renal scintigraphy. Six kidneys were grade 1-3, and 18 kidneys were grade 4-5 VUR. Of 117 patients without VUR, 34 patients (29%) showed renal pelvic dilatation on sonography and in 14 patients (12%), cortical defects were seen on renal scintigraphy. Among 32 patients with VUR, 41% showed abnormal sonographic findings and in 49%, cortical defects were seen on renal scintigraphy. With a higher grade of VUR, the prevalence of abnormalities increased on both sonography and renal scintigraphy. Sonographic demonstration of renal caliceal and/or pelvic dilatation associated with ipsilateral distal ureteric dilatation was the characteristic finding in high grade VUR.=20.

  8. Vaginal parity and pelvic organ prolapse.

    Science.gov (United States)

    Quiroz, Lieschen H; Muñoz, Alvaro; Shippey, Stuart H; Gutman, Robert E; Handa, Victoria L

    2010-01-01

    To investigate whether the odds of pelvic organ prolapse vary significantly with the number of vaginal births and whether cesarean birth is associated with prolapse. In this cross-sectional study of women over the age of 40, pelvic organ prolapse was defined as descent to or beyond the hymen. Logistic regression was used to estimate the relative odds of pelvic organ prolapse for each vaginal birth or cesarean birth, controlling for confounders. Two hundred ninety women underwent a pelvic organ prolapse quantification POPQ examination, and 72 were found to have pelvic organ prolapse. A single vaginal birth significantly increased the odds of prolapse (OR 9.73, 95% CI 2.68-35.35). Additional vaginal births were not associated with a significant increase in the odds of prolapse. Cesarean births were not associated with prolapse (OR 1.31, 95% CI 0.49-3.54). The odds of pelvic organ prolapse were almost 10 times higher after a single vaginal birth. The marginal impact of additional births on this association was small.

  9. Preperitoneal pelvic packing: Technique and outcomes.

    Science.gov (United States)

    Filiberto, Dina M; Fox, Adam D

    2016-09-01

    Significant pelvic ring fractures are usually secondary to high-energy trauma, and when associated with other life-threatening injuries and hemodynamic instability, result in high mortality rates ranging from 40 to 60%. The major cause of death during the first 24 h after pelvic trauma is attributed to acute blood loss, with later mortality secondary to multisystem organ failure. In a majority of patients, the source of pelvic bleeding is from disruption of the presacral venous plexus and bony fracture sites, while arterial injury is present in only 10-15%. The optimal management algorithm for hemodynamically unstable patients with pelvic fractures remains controversial. The principles of care center on resuscitation, external stabilization of the pelvis, and hemorrhage control with angiography and embolization (AE) and/or preperitoneal pelvic packing (PPP). AE is effective in controlling arterial bleeding and its role in the management of hemodynamically unstable patients with pelvic fractures is supported by the EAST guidelines. However, since most patients suffer from venous bleeding, PPP can be an alternate life saving technique to control hemorrhage, especially if AE is not immediately available. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Pelvic floor and sexual male dysfunction

    Directory of Open Access Journals (Sweden)

    Antonella Pischedda

    2013-04-01

    Full Text Available The pelvic floor is a complex multifunctional structure that corresponds to the genito- urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.

  11. Seasonal trend of acute pelvic inflammatory disease.

    Science.gov (United States)

    Xholli, Anjeza; Cannoletta, Marianna; Cagnacci, Angelo

    2014-05-01

    Many infections follow a seasonal trend. Aim of our study was to check whether acute pelvic inflammatory disease (PID) follows a seasonal progress. In a retrospective study on 12,152 hospital records, 158 cases of acute pelvic inflammatory disease were identified. Periodogram analysis was applied to the date of pelvic inflammatory disease admission and to related environmental factors, such as temperature and photoperiod. Pelvic inflammatory disease follows a seasonal rhythm with mean to peak variation of 23 % and maximal values in September (±37.2 days). The rhythm, more evident in married women, is related to the rhythm of temperature advanced by 2 months and of photoperiod advanced by 3 months. Cases of pelvic inflammatory disease are more frequent than expected in unmarried (36 vs. 17.3/34,626, p = 0.015), particularly divorced women 30-40 years of age. Our study evidences a seasonal trend and confirms unmarried, particularly divorced status, as important risk factor for acute pelvic inflammatory disease.

  12. Sarcoidose renal

    Directory of Open Access Journals (Sweden)

    AQUINO MARIA ENEDINA CLAUDINO DE

    2001-01-01

    Full Text Available Em uma mulher de 62 anos, branca, em avaliação pré-operatória de facectomia, foram detectadas alterações urinárias, tendo sido firmados os diagnósticos de calculose renal esquerda e exclusão renal homolateral. No pré-operatório da nefrectomia foram evidenciados processo pulmonar intersticial bilateral e adenopatia torácica, cuja investigação foi adiada para após a cirurgia. No rim retirado foram detectados granulomas epitelióides não necrotizantes, o mesmo ocorrendo posteriormente em biópsia transbrônquica. A paciente foi tratada com metilprednisolona, com discreta melhora pulmonar, o que não ocorreu com a função renal. O diagnóstico final foi de sarcoidose com envolvimento pulmonar, ganglionar torácico e renal.

  13. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  14. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  15. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  16. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  17. Renal Hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    İbrahim Halil Bozkurt

    2015-03-01

    Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

  18. Treatment of pelvic inflammatory disease.

    Science.gov (United States)

    Cunha, B A

    1990-04-01

    The pathogenesis, risk factors, microbiology, sequelae, diagnosis, and treatment of pelvic inflammatory disease (PID) are reviewed, and factors associated with the selection of effective, safe, and economical drug therapy are discussed. PID is an acute clinical syndrome not related to surgery or pregnancy that is caused by the spread of microorganisms from the vagina and cervix to the endometrium, fallopian tubes, and other adnexal structures. Primary PID, the most common form of the disease, is the result of the ascent of sexually acquired or endogenous lower genital tract microorganisms to the upper genital tract. Presence of a sexually transmitted disease is the most common risk factor for PID, but a previous episode of PID, multiple sexual partners, intrauterine device use, and young age are also risk factors. PID is classified as gonococcal or nongonococcal (i.e., caused by anaerobic and aerobic pelvic organisms). The long-term consequences of PID are the most devastating aspects of the disease; infertility remains the most common sequela. Therapy of PID is aimed at preserving fertility, preventing long-term consequences, and relieving acute clinical symptoms. In areas in which penicillinase-producing Neisseria gonorrhoeae is endemic, therapy that is effective against penicillinase-producing N. gonorrhoeae is necessary. Gonococcal PID that is not penicillin resistant may be treated with a single intramuscular or oral dose of a penicillin; penicillin-resistant infection may be treated with a cephalosporin or ciprofloxacin. If chlamydia is a diagnostic consideration, a one- to two-week course of oral tetracycline or doxycycline (injectable-drug therapy is an alternative) should be added to the regimen. Single-agent therapy is a cost-effective alternative to combination regimens. Ampicillin-sulbactam is a cost-effective alternative to the more costly injectable cephalosporins or the combination regimens of an aminoglycoside plus clindamycin or metronidazole. With

  19. Direct pelvic access percutaneous nephrolithotomy in management of ectopic kidney stone: a case report and literature review.

    Science.gov (United States)

    Mehmet, Rifaioglu Murat; Rustu, Yalcinkaya Fatih; Hanefi, Bayarogullari; Mursel, Davarci; Fusun, Aydogan; Mehmet, Inci

    2013-01-01

    Percutaneous nephrolithotomy (PNL) is an effective procedure for the treatment of patients with large or complex stones. PNL is challenging in anomalous kidneys, certain patients, such as those with renal ectopia. It is unable to undergo PNL in conventional technique safely in these cases. We presented a case report of laparoscopic-assisted PNL via direct pelvic puncture in a pelvic kidney stone and discussed previous published literature. A 49-year-old man presented with right lower quadrant pain and hematuria. Intravenous pyelography and three-dimensional computerized tomography revealed an opaque 2.7 × 1.7 cm pelvis renalis stone in a right side ectopic pelvic kidney with grade III hydronephrosis. Laparoscopic-assisted tubeless PNL was performed to remove the calculus. Laparoscopic-assisted PNL as a minimally invasive therapy in ectopic kidney has many advantages. Our case showed that, in pelvic ectopic kidney with pelvic stones greater than 1.5 cm in size, laparoscopic-assisted PNL via direct pelvis puncture is a safe and effective technique.

  20. IgG4-related inflammatory pseudotumor of the renal pelvis involving renal parenchyma, mimicking malignancy.

    Science.gov (United States)

    Park, Ho Gyun; Kim, Kyoung Min

    2016-01-22

    IgG4-related disease is a recently recognized systemic disease characterized by storiform fibrosis with infiltration of IgG4-positive plasma cells. In rare incidences, IgG4-related renal disease can present as a solitary mass lesion at renal pelvis and can pose a diagnostic challenge since these lesions mimic malignancy. Herein, we present a rare case of IgG4-related disease presenting as inflammatory pseudotumor lesion, involving the renal pelvis and also neighboring renal parenchyma. A 75-year-old man with no history of IgG4-related disease underwent computed tomography (CT) scan for evaluation of prostatic cancer. The CT scan incidentally revealed a mass lesion located at the right renal pelvis. Radiologic findings were highly suggestive of malignancy. Therefore, the patient underwent right nephroureterectomy. Microscopically, the mass lesion showed storiform fibrosis with diffuse and intense inflammatory cell infiltration. Infiltrating cells were mainly histiocytes and plasma cells. Tubulointerstitium adjacent to the lesion also showed fibrosis with abundant plasmacytic infiltration. Immunohistochemical staining revealed the presence of IgG4-positive plasma cells in both the mass lesion and tubulointerstitium (mean of 94/HPF per field). Considering these findings, we diagnosed the mass lesion as IgG4-related inflammatory pseudotumor of the renal pelvis. In patients with renal pelvic masses, IgG4-related inflammatory pesudotumor should be considered in the differential diagnosis to avoid unnecessary surgical intervention.

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  3. 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...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

    M.C.P. Slieker-ten Hove (Marijke); A.L. Pool-Goudzwaard (Annelies); M.J.C. Eijkemans (René); R.P.M. Steegers-Theunissen (Régine); C.W. Burger (Curt); M.E. 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 pelv

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  7. Current treatment of pelvic organ prolapse correlated with chronic pelvic pain, bladder and bowel dysfunction.

    Science.gov (United States)

    Liedl, Bernhard; Goeschen, Klaus; Durner, Leopold

    2017-05-01

    The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years. Laxity in ligaments and/or vaginal membrane due to damaged connective tissue may prevent the normal opening and closure mechanism of urethra and anus, because muscles need finite lengths to contract properly. Hypermobility of the apex can irritate the pelvic plexus causing chronic pelvic pain. In consequence, dysfunctions as abnormal emptying of the bladder, urgency, pelvic pain, fecal incontinence and obstructed defecation can occur in women with different degrees of POP. In conclusion, it has to be recognized that women bothered by these symptoms should be examined for POP and appropriately advised for possibility of cure by pelvic floor surgery after careful selection. VIDEO ABSTRACT.

  8. Demonstration of Pelvic Anatomy by Modified Midline Transection that Maintains Intact Internal Pelvic Organs

    Science.gov (United States)

    Steinke, Hanno; Saito, Toshiyuki; Herrmann, Gudrun; Miyaki, Takayoshi; Hammer, Niels; Sandrock, Mara; Itoh, Masahiro; Spanel-Borowski, Katharina

    2010-01-01

    Gross dissection for demonstrating anatomy of the human pelvis has traditionally involved one of two approaches, each with advantages and disadvantages. Classic hemisection in the median plane through the pelvic ring transects the visceral organs but maintains two symmetric pelvic halves. An alternative paramedial transection compromises one side…

  9. Chronic prostatitis/chronic pelvic pain syndrome and pelvic floor spasm: can we diagnose and treat?

    Science.gov (United States)

    Westesson, Karin E; Shoskes, Daniel A

    2010-07-01

    National Institutes of Health category III prostatitis, also known as chronic prostatitis/chronic pelvic pain syndrome, is a common condition with significant impact on quality of life. This clinically defined syndrome has a multifactorial etiology and seems to respond best to multimodal therapy. At least half of these patients have pelvic floor spasm. There are several approaches to therapy including biofeedback, acupuncture, and myofascial release physical therapy. However, the only multicenter study of pelvic floor physical therapy for pelvic floor spasm in men failed to show an advantage over conventional Western massage. We have proposed a clinical phenotyping system called UPOINT to classify patients with urologic chronic pelvic pain and subsequently direct appropriate therapy. Here, we review the current approach to category III prostatitis and describe how clinical phenotyping with UPOINT may improve therapy outcomes.

  10. The truth about laser fiber diameters.

    Science.gov (United States)

    Kronenberg, Peter; Traxer, Olivier

    2014-12-01

    To measure the various diameters of laser fibers from various manufacturers and compare them with the advertised diameter. Fourteen different unused laser fibers from 6 leading manufacturers with advertised diameters of 200, 270, 272, 273, 365, and 400 μm were measured by light microscopy. The outer diameter (including the fiber coating, cladding, and core), cladding diameter (including the cladding and the fiber core), and core diameter were measured. Industry representatives of the manufacturers were interviewed about the diameter of their fibers. For all fibers, the outer and cladding diameters differed significantly from the advertised diameter (P cladding, and core diameters of fibers with equivalent advertised diameters differed by up to 180, 100, and 78 μm, respectively. Some 200-μm fibers had larger outer diameters than the 270- to 273-μm fibers. All packaging material and all laser fibers lacked clear and precise fiber diameter information labels. Of 12 representatives interviewed, 8, 3, and 1 considered the advertised diameter to be the outer, the cladding, and the core diameter, respectively. Representatives within the same company frequently gave different answers. This study suggests that, at present, there is a lack of uniformity between laser fiber manufacturers, and most of the information conveyed to urologists regarding laser fiber diameter may be incorrect. Because fibers larger than the advertised laser fibers are known to influence key interventional parameters, this misinformation can have surgical repercussions. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Physical activity and the pelvic floor.

    Science.gov (United States)

    Nygaard, Ingrid E; Shaw, Janet M

    2016-02-01

    Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially modifiable risk factor; the large number of girls and women participating in sport and strenuous training regimens increases the need to understand associated risks and benefits of these exposures. The aim of this review was to summarize studies reporting the association between physical activity and pelvic floor disorders. Most studies are cross-sectional and most include small numbers of participants. The primary findings of this review include that urinary incontinence during exercise is common and is more prevalent in women during high-impact sports. Mild to moderate physical activity, such as brisk walking, decreases both the odds of having and the risk of developing urinary incontinence. In older women, mild to moderate activity also decreases the odds of having fecal incontinence; however, young women participating in high-intensity activity are more likely to report anal incontinence than less active women. Scant data suggest that in middle-aged women, lifetime physical activity increases the odds of stress urinary incontinence slightly and does not increase the odds of pelvic organ prolapse. Women undergoing surgery for pelvic organ prolapse are more likely to report a history of heavy work than controls; however, women recruited from the community with pelvic organ prolapse on examination report similar lifetime levels of strenuous activity as women without this examination finding. Data are insufficient to determine whether strenuous activity while young predisposes to pelvic floor disorders later in life. The existing literature suggests that most physical activity does not harm the pelvic floor and does provide numerous health benefits for

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

    Science.gov (United States)

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

    2008-01-01

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

  13. The Surgical Treatment of Pelvic Bone Metastases

    Directory of Open Access Journals (Sweden)

    Daniel A. Müller

    2015-01-01

    Full Text Available Pelvic bone metastases are a growing concern in the field of orthopedic surgery. Patients with pelvic metastasis are individually different with different needs of treatment in order to attain the best possible quality of life despite the advanced stage of disease. A holistic collaboration among the oncologist, radiation therapist, and orthopedic surgeon is mandatory. Special attention has to be directed to osteolytic lesions in the periacetabular region as they can provoke pathological fractures and subsequent functional impairment. Different reconstruction techniques for the pelvis are available; the choice depends on the patient’s prognosis, size of the bone defect, and response of the tumor to adjuvant treatment. If all the conservative treatments are exhausted and the patient is not eligible for surgery, one of the various percutaneous ablation procedures can be considered. We propose a pelvic analogue to the treatment algorithm in long bone metastasis and a scoring system in pelvic metastasis. This algorithm aims to simplify the teamwork and to avoid under- or overtreatment of pelvic bone metastases.

  14. Renal Cell Carcinoma Metastasized to Pagetic Bone.

    Science.gov (United States)

    Ramirez, Ashley; Liu, Bo; Rop, Baiywo; Edison, Michelle; Valente, Michael; Burt, Jeremy

    2016-01-01

    Paget's disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent. Patients with Paget's disease of the bone are at increased risk for primary bone neoplasms, particularly osteosarcoma. Many cases of metastatic disease to pagetic bone have been reported. However, renal cell carcinoma metastasized to pagetic bone is extremely rare. A 94-year-old male presented to the emergency department complaining of abdominal pain. A computed tomography scan of the abdomen demonstrated a large mass in the right kidney compatible with renal cell carcinoma. The patient was also noted to have Paget's disease of the pelvic bones and sacrum. Within the pagetic bone of the sacrum, there was an enhancing mass compatible with renal cell carcinoma. A subsequent biopsy of the renal lesion confirmed renal cell carcinoma. Paget's disease of the bone places the patient at an increased risk for bone neoplasms. The most commonly reported sites for malignant transformation are the femur, pelvis, and humerus. In cases of malignant transformation, osteosarcoma is the most common diagnosis. Breast, lung, and prostate carcinomas are the most common to metastasize to pagetic bone. Renal cell carcinoma associated with Paget's disease of the bone is very rare, with only one prior reported case. Malignancy in Paget's disease of the bone is uncommon with metastatic disease to pagetic bone being extremely rare. We report a patient diagnosed with concomitant renal cell carcinoma and metastatic disease within Paget's disease of the sacrum. Further research is needed to assess the true incidence of renal cell carcinoma associated with pagetic bone.

  15. CROSS-SECTIONAL IMAGING EVALUATION OF RENAL REPLACEMENT LIPOMATOSIS (RRL

    Directory of Open Access Journals (Sweden)

    Deb Kumar Boruah

    2016-06-01

    Full Text Available BACKGROUND Renal replacement lipomatosis is an uncommon benign entity where abundance of fibrofatty tissue proliferation occurs in renal sinus with further extension of proliferated fatty tissues into renal hilum, perinephric and periureteric spaces. It is usually associated with renal atrophy and marked renal parenchymal destruction. Aim of our study was cross-sectional imaging evaluation of Renal Replacement Lipomatosis (RRL. METHODS A hospital based cross-sectional retrospective study was conducted. The study group comprised of 16 patients presenting to the Departments of Radio-diagnosis, Surgery and Urology in a tertiary care hospital from May 2014 to April 2016. All patients were initially evaluated clinically and ultrasonographically followed by cross-sectional imaging modality like Computed Tomography (CT, Magnetic Resonance Imaging (MRI or both. RESULTS Out of 16 patients of renal replacement lipomatosis, 15 patients (93.8% had associated renal pelvic or ureteric calculus while 1 patient (6.2% had left para-aortic mass without associated calculus. Out of fifteen patients of calculus related RRL, 8 patients (53.3% had calculus size more than 40 mm, followed by 4 patients (26.7% who had size from 20 to 40 mm and 3 patients (20% had size less than 20 mm. The mean CT HU value of calculus was 1334±84.5 in our study. Three patients (18.8% had only renal hilar fatty excessive deposition, 1 patient (6.2% had renal hilar and perinephric space fat depositions, 3 patients (18.8% had renal hilar, perinephric and periureteric spaces depositions and 9 patients (56.2% had renal hilar and periureteric excessive fatty depositions. Delayed renal functioning was noted in 9 patients (56%, followed by non-functioning in 5 patients (31.2% and 2 patients (12.5% had normally functioning kidneys. CONCLUSION Cross-sectional imaging like CT and MRI scan helps in diagnosing RRL and proper delineation of extensions of excessive fatty tissue proliferation.

  16. Laparoscopy and ultrasound examination in women with acute pelvic pain

    DEFF Research Database (Denmark)

    Mikkelsen, A L; Felding, C

    1990-01-01

    The results of preoperative pelvic examination and eventual ultrasound examination were correlated with the laparoscopic findings in 316 women with acute pelvic pain. The predictive values of normal and abnormal findings at pelvic examination were 46.9 and 82.1%, respectively. 42.1% of the women...... had ultrasound examination performed. This investigation showed to be helpful especially in patients with normal findings at pelvic examination. If ultrasonic findings were abnormal the results at laparoscopy were also abnormal in 90%. On the contrary, normal findings at ultrasound examination did...... not exclude abnormal pelvic findings. The predictive value of normal results at ultrasound examination was 50.0%. This discrepancy between ultrasonic and pelvic findings can be explained by the size of the pelvic masses. Ultrasound examination is a valuable tool in the evaluation of patients with acute pelvic...

  17. 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.

  18. A Rare Renal Epithelial Tumor: Mucinous Cystadenocarcinoma Case Report and Review of the Literature

    Science.gov (United States)

    Tepeler, Abdulkadir; Erdem, Mehmet Remzi; Kurt, Omer; Topaktas, Ramazan; Kilicaslan, Isin; Armağan, Abdullah; Önol, Şinasi Yavuz

    2011-01-01

    Primary renal mucinous cystadenocarcinoma is a very rare lesion of kidney which originates from the metaplasia of the renal pelvic uroepithelium. Only one case with primary mucinous cystadenocarcinoma has been reported in the English literature. We report second case of mucinous cystadenocarcinoma which was radiologically classified as type-IIF Bosniak cyst in peripheral localization. We aimed to present this extreme and unusual entity with its radiological, surgical, and pathologic aspects under the light of literature. PMID:22110514

  19. Evaluation of embolization for periuterine varices involving chronic pelvic pain secondary to pelvic congestion syndrome

    Directory of Open Access Journals (Sweden)

    Flavio Meirelles Siqueira

    Full Text Available OBJECTIVES: To evaluate the clinical response and success rate after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome and to report the safety of endovascular treatment and its rate of complications. METHODS: Retrospective cohort of patients undergoing endovascular treatment of pelvic congestion syndrome in our department from January 2012 to November 2015. Data were analyzed based on patient background, imaging findings, embolized veins, rate of complications, and clinical response as indicated by the visual analog pain scale. RESULTS: We performed periuterine varices embolization in 22 patients during the study, four of which required a second embolization. Seventeen patients reported a reduction in pelvic pain after the first embolization and three patients reported a reduction in pelvic pain after the second embolization. Minor complications were observed in our patients, such as postural hypotension, postoperative pain, and venous perforation during the procedure, without clinical repercussion. CONCLUSION: Periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome appears to be an effective and safe technique.

  20. Epidemiology and outcome of complex pelvic injury

    DEFF Research Database (Denmark)

    Schmal, Hagen; Markmiller, Max; Mehlhorn, Alexander T

    2005-01-01

    Soft tissue injuries associated with pelvic fractures are often responsible for compromised haemodynamics. The objective of this study was to clarify what parameters determine patient outcome. In a cohort study, all patients with a pelvic fracture treated between 1991 and 2001 at a Level I trauma...... center were analysed for associated intrapelvic injuries, classification, severity of trauma, type of intervention and outcome. Of 552 patients with a pelvic fracture who entered the study, 15.5% presented with associated intrapelvic injuries secondary to the fracture (group I). A subgroup of patients...... haemorrhage (group II), the severity of injury, the proportion of multiple injured patients, the prevalence of unstable fractures and the incidence of sepsis were significantly increased. The only predictive factor for outcome was the amount of blood transfused, suggesting that fast elimination...

  1. 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.)

  2. Prevention and management of pelvic organ prolapse

    Science.gov (United States)

    Giarenis, Ilias

    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 currently changing due to the controversial issues surrounding the use of mesh and the increasing demand for uterine preservation. The evolution of laparoscopic and robotic surgery has increased the use of these techniques in pelvic floor surgery. PMID:25343034

  3. Knowledge of the pelvic floor in nulliparous women

    OpenAIRE

    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 dys...

  4. 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.)

  5. Complete Pelvic Floor Repair in Treating Fecal Incontinence

    OpenAIRE

    Lee, Patrick Y. H.; Steele, Scott R

    2005-01-01

    Fecal incontinence is associated with 20 to 40% of the patients with pelvic floor prolapse. Successful management of fecal incontinence requires not only an understanding of anorectal function but also a thorough understanding of pelvic floor anatomy and how pelvic floor prolapse affects fecal continence. Imaging techniques have been instrumental in visualizing pelvic floor prolapse and have helped correlate surgical findings. Stabilization of the perineal body appears to be a key component t...

  6. Anterior internal fixation to treat vertical unstable pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    王世松; 张鹏程; 杜敦进; 杨泗华

    2002-01-01

    With the Chinese development of industry, agriculture and communication, various traffic and work related accidents are increasing, leading to an increase in pelvic fractures. Among the different kinds of fractures, pelvic fracture is the third largest cause of death.1 The treatment of pelvic fractures is a “hot spot” and a difficult point in orthopedic surgery. Since 1998 we have treated 20 patients with vertical unstable pelvic fracture using anterior internal fixation. Satisfactory results have been obtained.

  7. 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.

  8. Laparoendoscopic single site in pelvic surgery.

    Science.gov (United States)

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

    2012-01-01

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

  9. Total Pelvic Exenteration for Gynecologic Malignancies

    Directory of Open Access Journals (Sweden)

    Elisabeth J. Diver

    2012-01-01

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

  10. Role of female pelvic anatomy in infertility.

    Science.gov (United States)

    Harris-Glocker, Miranda; McLaren, Janet F

    2013-01-01

    Infertility is defined as a couple's failure to achieve pregnancy after one year of regular, unprotected intercourse. The etiology of infertility can be due to female factors, male factors, combined male and female factors, or have an unknown etiology. This review focuses on the role of female pelvic anatomy in infertility. Normal anatomy and the physiology of reproduction will be discussed, as well as the anatomic and pathophysiologic processes that cause infertility including ovulatory disorders, endometriosis, pelvic adhesions, tubal blockage, mullerian anomalies, and abnormalities affecting the uterine cavity such as leiomyomata and endometrial polyps.

  11. Diagnosis and therapy of pelvic actinomycosis.

    Science.gov (United States)

    Taga, Shigeki

    2007-12-01

    Pelvic actinomycosis is difficult to diagnose. In most cases, it is not diagnosed until after surgery. If this condition is diagnosed preoperatively, it can be treated in many cases. Three cases of actinomycosis are reported here. Three women with intrauterine devices (IUD) each presented with lower abdominal pain and pelvic mass, and elevated white blood cell count and C-reactive protein. Left salpingo-oophorectomy was performed for one the women. The pathological diagnosis was actinomycosis. For the other two women, a Gram or Papanicolaou stain of the IUD sample showed actinomycetes. They were discharged after intravenous administration of penicillin without surgery.

  12. Pelvic floor function during and after first pregnancy

    NARCIS (Netherlands)

    Brummen, H.J. van

    2006-01-01

    This study evaluated the effects the first pregnancy and childbirth on the pelvic floor. Pregnancy and vaginal delivery can negatively affect pelvic floor function. Micturition symptoms, defecation symptoms and sexual dysfunction are all signs of an impaired pelvic floor function. These symptoms are

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

    NARCIS (Netherlands)

    D.M.J. Oom (Daniëlla)

    2009-01-01

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

  14. Pelvic musculoskeletal infection in infants -- diagnostic difficulties and radiological features.

    Science.gov (United States)

    Kearney, S E; Carty, H

    1997-10-01

    Musculoskeletal infection involving the pelvis has rarely been reported in infants. When such infections involve the pelvic muscles they are generally believed to result from secondary spread from adjacent structures. We report five cases of primary pelvic musculoskeletal infection affecting infants pelvic musculoskeletal infection in infants and the role of the various radiological investigations in its diagnosis is discussed.

  15. A case of pelvic actinomycosis presenting as cutaneous fistula.

    Science.gov (United States)

    Tedeschi, Amando; Di Mezza, Giovanni; D'Amico, Odette; Ermann, Alfredo; Montone, Luigi; Siciliano, Marcello; Cobellis, Giovanni

    2003-05-01

    Actinomycosis of the female genital tract has greatly increased over the last two decades. A pelvic form of the disease, associated with the use of Intra-uterine Devices (IUD), can severely damage pelvic organs and even can lead to death. We report a case of pelvic actinomycosis presenting as cutaneous fistula.

  16. Double pelvic osteotomy for the treatment of hip dysplasia in young dogs.

    Science.gov (United States)

    Vezzoni, A; Boiocchi, S; Vezzoni, L; Vanelli, A B; Bronzo, V

    2010-01-01

    The aim of this study was to evaluate the feasibility of the double pelvic osteotomy (DPO) (osteotomy of the ilium and pubis) to treat clinical cases of hip dyplasia in young dogs instead of performing a triple pelvic osteotomy (TPO) (osteotomy of the ilium, pubis, and ischium). Candidates for DPO were 4.5- to nine-month-old dogs with coxofemoral joint subluxation and laxity, indicative of susceptibility to future development of severe hip dysplasia. The angle of reduction (AR) and angle of subluxation (AS) with Ortolani's sign, Norberg angle (NA), percentage of femoral head (PC) covered by the acetabulum, and the pelvic diameters and their relationships were measured clinically and radiographically before and after surgery. The surgical technique was similar to the TPO technique, but excluded ischiatic osteotomy. A DPO was carried out in 53 joints of 34 dogs; AR and AS values immediately postoperatively and at the one- and two-month follow-up examinations were significantly lower than the preoperative values (p table (7.5%). Changes in PC and NA values obtained immediately after surgery and at the first and second follow-up examinations were significantly greater (p surgery. Sufficient acetabular ventroversion was achieved to counteract joint subluxation and the modifications of AR and AS. The NA and PC direct postoperative values reflected a significant improvement in the dorsal acetabular coverage. Restoration of normal joint congruity (PC from 50 to 72%) and maintenance of the pelvic geometry without pelvic narrowing were the most intriguing features of DPO. The complications observed were greatly reduced when using dedicated DPO plates. Based on our experience, the morbidity after unilateral and bilateral DPO was lower than after TPO because elimination of the ischiatic osteotomy allowed for increased stability of the pelvis. The surgical technique of DPO was a little more demanding than TPO because of the difficulty in handling and rotating the acetabular

  17. Renal Cysts

    Science.gov (United States)

    ... as “simple” cysts, meaning they have a thin wall and contain water-like fluid. Renal cysts are fairly common in ... simple kidney cysts, meaning they have a thin wall and only water-like fluid inside. They are fairly common in ...

  18. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  19. Drug-induced renal injury

    African Journals Online (AJOL)

    Drugs can cause acute renal failure by causing pre-renal, intrinsic or post-renal toxicity. Pre-renal ... incidence of drug dose adjustment in renal impairment in the SAMJ. ... Fever, haemolytic anaemia, thrombocytopenia, renal impairment and.

  20. Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Jacek Kadziela

    2016-05-01

    Full Text Available Introduction : Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. Aim : To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA versus conventional angiography. Material and methods: Forty patients (41 renal arteries, aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D and lesion length (CTA_LL were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D and lesion length (ANGIO_LL as well as proposed stent dimensions were obtained by visual estimation. Results: The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001. Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001. The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS, with significant correlation of these variables (r = 0.66, p < 0.0001. The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005 and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001. Conclusions : Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure.

  1. Simultaneous laparoscopic management of ureteropelvic junction obstruction and renal lithiasis: the combined experience of two academic centers and review of the literature

    Directory of Open Access Journals (Sweden)

    Stravodimos KG

    2014-05-01

    Full Text Available Konstantinos G Stravodimos,1 Stilianos Giannakopoulos,2 Stavros I Tyritzis,1 Aristeides Alevizopoulos,1 Stefanos Papadoukakis,1 Stavros Touloupidis,2 Constantinos A Constantinides11Department of Urology, Athens University Medical School, Laiko Hospital, Athens, 2Department of Urology, Democritus University of Thrace, Alexandroupolis, GreeceIntroduction: Approximately one out of five patients with ureteropelvic junction obstruction (UPJO present lithiasis in the same setting. We present our outcomes of simultaneous laparoscopic management of UPJO and pelvic or calyceal lithiasis and review the current literature.Methods: Thirteen patients, with a mean age of 42.8±13.3 years were diagnosed with UPJO and pelvic or calyceal lithiasis. All patients were subjected to laparoscopic dismembered Hynes–Anderson pyeloplasty along with removal of single or multiple stones, using a combination of laparoscopic graspers, irrigation, and flexible nephroscopy with nitinol baskets.Results: The mean operative time was 218.8±66 minutes. In two cases, transposition of the ureter due to crossing vessels was performed. The mean diameter of the largest stone was 0.87±0.25 cm and the mean number of stones retrieved was 8.2 (1–32. Eleven out of 13 patients (84.6% were rendered stone-free. Complications included prolonged urine output from the drain in one case (Clavien grade I and urinoma formation requiring drainage in another case (Clavien grade IIIa. The mean postoperative follow-up was 30.2 (7–51 months. No patient has experienced stone or UPJO recurrence.Conclusion: Laparoscopy for the management of UPJO along with renal stone removal seems a very appealing treatment, with all the advantages of minimally invasive surgery. Concomitant renal stones do not affect the outcome of laparoscopic pyeloplasty, at least in the midterm. According to our results and the latest literature data, we advocate laparoscopic management as the treatment of choice for these cases

  2. 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.

  3. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2011-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  4. Pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after pelvic exenterations.

    Science.gov (United States)

    Cibula, D; Zikan, M; Fischerova, D; Kocian, R; Germanova, A; Burgetova, A; Dusek, L; Fartáková, Z; Schneiderová, M; Nemejcová, K; Slama, J

    2017-03-01

    To describe the technique and report experiences with pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after extensive pelvic procedures. Surgical technique of MRAM harvest and transposition is carefully described. The patients in whom pelvic floor reconstruction with MRAM after either infralevator pelvic exenteration and/or extended lateral pelvic sidewall excision was carried out were enrolled into the study (MRAM group, n=16). Surgical data, post-operative morbidity, and disease status were retrospectively assessed. The results were compared with a historical cohort of patients, in whom an exenterative procedure without pelvic floor reconstruction was performed at the same institution (control group, n=24). Both groups were balanced in age, BMI, tumor types, and previous treatment. Substantially less patients from the MRAM group required reoperation within 60days of the surgery (25% vs. 50%) which was due to much lower rate of complications potentially related to empty pelvis syndrome (1 vs. 7 reoperations) (p=0.114). Late post-operative complication rate was substantially lower in the MRAM group (any grade: 79% vs. 44%; grade≥3: 37% vs. 6%) (p=0.041). The performance status 6months after the surgery was ≤1 in the majority of patients in MRAM (81%) while in only 38% of patients from the control group (p=0.027). There was one incisional hernia in MRAM group while three cases were reported in the controls. Pelvic floor reconstruction by MRAM in patients after pelvic exenterative procedures is associated with a substantial decrease in postoperative complications that are potentially related to empty pelvis syndrome. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Efficacy of extra-peritoneal pelvic packing in hemodynamically unstable pelvic fractures, a Propensity Score Analysis.

    Science.gov (United States)

    Chiara, Osvaldo; di Fratta, Emanuele; Mariani, Anna; Michaela, Bertuzzi; Prestini, Lucia; Sammartano, Fabrizio; Cimbanassi, Stefania

    2016-01-01

    An option for emergency control of pelvic hemorrhage is Extra-peritoneal Pelvic Packing (EPP), which addresses the retroperitoneal source of exsanguination in pelvic fractures. The aim of this study was to demonstrate the efficacy of early EPP in reducing mortality due to hemorrhage from pelvic fractures, and to evaluate the impact of packing on transfusion requirements within the first 24 h and ICU length of stay (ICU-LOS). All data pertaining trauma patients admitted from October 2002 and December 2103 with hemodynamic instability and pelvic fractures were selected from the Hospital Trauma Registry. Patients with severe brain injury and bleeding from extra-pelvic sources were excluded. Patient population was divided into two groups: EPP group, including patients admitted from 2009 to 2013, with EPP as part of the treatment algorithm, and NO-EPP group, from 2002 to 2008, without EPP as atherapeutic option. Descriptive statistical analysis was performed on allpatients. Twenty-five patients of each group with similar features were matched using Propensity Score Analysis (PSA). Six hundred eighty out of 4659 major trauma (14.6 %) presented a pelvic fracture. In 78 hemodynamically unstable patients (30 in EPP group,48 in NO-EPP group) the major source of bleeding was the pelvis. Among patients selected by PSA early mortality was significantly reduced in EPP group (20 vs 52 %, p = .03) compared to NO-EPP, notwithstanding similar hemodynamic impairment. No difference was observed in transfusion requirements and ICU-LOS. The EPP is a safe and quick procedure, able to improve hemodynamic stabilization and to reduce acute mortality due to hemorrhage in patients with pelvic fracture, in combination with optimized transfusion protocol. EPP may be useful as a bridge for time-consuming procedures, such as angio-embolization.

  6. Pelvic Inflammatory Disease: Diagnosis And Treatment In The Emergency Department.

    Science.gov (United States)

    Bugg, Charles Walter; Taira, Taku

    2016-12-01

    Pelvic inflammatory disease is a common disease that is associated with significant complications including infertility, chronic pelvic pain, ruptured tubo-ovarian abscess, and ectopic pregnancy. The diagnosis may be delayed when the presentation has nonspecific signs and symptoms. Even when it is properly identified, pelvic inflammatory disease is often treated suboptimally. This review provides evidence-based recommendations for the diagnosis, treatment, disposition, and follow-up of patients with pelvic inflammatory disease. Arranging follow-up of patients within 48 to 72 hours and providing clear patient education are fundamental to ensuring good patient outcomes. Emerging issues, including new pathogens and evolving resistance patterns among pelvic inflammatory disease pathogens are reviewed.

  7. Complete pelvic floor repair in treating fecal incontinence.

    Science.gov (United States)

    Lee, Patrick Y H; Steele, Scott R

    2005-02-01

    Fecal incontinence is associated with 20 to 40% of the patients with pelvic floor prolapse. Successful management of fecal incontinence requires not only an understanding of anorectal function but also a thorough understanding of pelvic floor anatomy and how pelvic floor prolapse affects fecal continence. Imaging techniques have been instrumental in visualizing pelvic floor prolapse and have helped correlate surgical findings. Stabilization of the perineal body appears to be a key component to the success of pelvic floor repair and fecal continence, but the optimal repair is far from being established.

  8. Pelvic organ prolapse and overactive bladder.

    NARCIS (Netherlands)

    Boer, T.A. de; Salvatore, S.; Cardozo, L.; Chapple, C.; Kelleher, C.; Kerrebroeck, P. van; Kirby, M.G.; Koelbl, H.; Espuna-Pons, M.; Milsom, I.; Tubaro, A.; Wagg, A.; Vierhout, M.E.

    2010-01-01

    AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms

  9. 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.

  10. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

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

    2010-01-01

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

  11. Magnetic resonance imaging of pelvic endometriosis.

    Science.gov (United States)

    Méndez Fernández, R; Barrera Ortega, J

    Endometriosis is common in women of reproductive age; it can cause pelvic pain and infertility. It is important to diagnose endometriosis and to thoroughly evaluate its extension, especially when surgical treatment is being considered. Magnetic resonance imaging (MRI) with careful examination technique and interpretation enables more accurate and complete diagnosis and staging than ultrasonography, especially in cases of deep pelvic endometriosis. Furthermore, MRI can identify implants in sites that can be difficult to access in endoscopic or laparoscopic explorations. In this article, we describe the appropriate MRI protocol for the study of pelvic endometriosis and the MRI signs of pelvic organ involvement. It is necessary to know the subtle findings and to look for them so we can ensure that they are not overlooked. We describe clinical grading systems for endometriosis and review the diagnostic efficacy of MRI in comparison with other imaging techniques and surgery. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Pelvic organ prolapse and overactive bladder.

    NARCIS (Netherlands)

    Boer, T.A. de; Salvatore, S.; Cardozo, L.; Chapple, C.; Kelleher, C.; Kerrebroeck, P. van; Kirby, M.G.; Koelbl, H.; Espuna-Pons, M.; Milsom, I.; Tubaro, A.; Wagg, A.; Vierhout, M.E.

    2010-01-01

    AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms d

  13. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

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

    2010-01-01

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

  14. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

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

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

  15. The “Pelvic Harness”: a skeletonized mesh implant for safe pelvic floor reconstruction

    Science.gov (United States)

    Natalia, Sumerova; Menahem, Neuman; Haim, Krissi; Dmitri, Pushkar

    2016-01-01

    ABSTRACT Objectives To evaluate the feasibility, safety and surgical results of skeletonized mesh implants to form a pelvic harness for pelvic floor reconstruction surgery. Study design Patients with advanced pelvic floor prolapse were enrolled to this study. Study model was a kit mesh, reduced to 75% of the original surface area by cutting out mesh material from the central mesh body. Patients were evaluated at the end of the 1st and 6th post-operative months and interviewed at the study conclusion. Results Ninety-five women with advanced pelvic floor prolapse had this implant. Mean follow-up duration was 9 months (6-12 months). The POP-Q point’s measurements showed marked and statistically significant improvements. Bladder over-activity symptoms, fecal incontinence, pelvic pain and constipation rates were all reduced as well. No adverse effects related to the dissection or mesh implantation were marked. The first and sixth post-operative month follow-up records as well as the study conclusion interview findings were satisfactory in terms of subjective and objective cure and adverse effects occurrence. Conclusion This study data proposes that skeletonizing meshes might be safely and successfully implanted for potentially improved pelvic floor reconstruction. PMID:27286114

  16. The “Pelvic Harness”: a skeletonized mesh implant for safe pelvic floor reconstruction

    Directory of Open Access Journals (Sweden)

    Sumerova Natalia

    2016-06-01

    Full Text Available ABSTRACT Objectives To evaluate the feasibility, safety and surgical results of skeletonized mesh implants to form a pelvic harness for pelvic floor reconstruction surgery. Study design Patients with advanced pelvic floor prolapse were enrolled to this study. Study model was a kit mesh, reduced to 75% of the original surface area by cutting out mesh material from the central mesh body. Patients were evaluated at the end of the 1st and 6th post-operative months and interviewed at the study conclusion. Results Ninety-five women with advanced pelvic floor prolapse had this implant. Mean follow-up duration was 9 months (6-12 months. The POP-Q point’s measurements showed marked and statistically significant improvements. Bladder over-activity symptoms, fecal incontinence, pelvic pain and constipation rates were all reduced as well. No adverse effects related to the dissection or mesh implantation were marked. The first and sixth post-operative month follow-up records as well as the study conclusion interview findings were satisfactory in terms of subjective and objective cure and adverse effects occurrence. Conclusion This study data proposes that skeletonizing meshes might be safely and successfully implanted for potentially improved pelvic floor reconstruction.

  17. Pelvic floor dysfunction in inflammatory bowel disease.

    Science.gov (United States)

    Bondurri, A; Maffioli, A; Danelli, P

    2015-12-01

    Advances in tailored medical therapy and introduction of biologic agents for inflammatory bowel disease (IBD) treatment have ensured long-term disease remission. Some patients, however, still report defecatory symptoms. Patients present with a wide spectrum of conditions - anal incontinence, obstructed defecation and pelvic pain among the most frequent - that have a great impact on their quality of life. Due to IBD diagnosis, little relevance is attributed to this type of symptoms and their epidemiologic distribution is unknown. Pathogenetic hypotheses are currently under investigation. Routine diagnostic workflow and therapeutic options in pelvic floor service are often underused. The evaluation of these disorders starts with an endoscopy to rule out ongoing disease; the following diagnostic workflow is the same as in patients without IBD. For fecal incontinence and obstructed defecation, simple conservative therapy with dietary modifications and appropriate fluid intake is effective in most cases. In non-responding patients, anorectal physiology tests and imaging are required to select patients for pelvic floor muscle training and biofeedback. These treatments have been proven effective in IBD patients. Some new minimally invasive alternative strategies are available for IBD patients, as sacral nerve and posterior tibial nerve stimulation; for other ones (e.g., bulking agent implantation) IBD still remains an exclusion criterion. In order to preserve anatomical areas that could be useful for future reconstructive techniques, surgical options to cure pelvic floor dysfunction are indicated only in a small group of IBD patients, due to the high risk of failure in wound healing and to the possible side effects of surgery, which can lead to anal incontinence or to a possible proctectomy. A particular issue among defecatory symptoms in patients with IBD is paradoxical puborectalis contraction after restorative proctocolectomy: if this disorder is properly diagnosed, a

  18. Renal morphology of Bradypus torquatus

    Directory of Open Access Journals (Sweden)

    Pedro Kastein Faria da Cunha Bianchi

    2012-11-01

    Full Text Available Among the Xenarthras, sloths present a hydric ingestion restricted to water from leaves, fruits, and vegetables. As a first approach to verify whether these animals have some morphophysiological difference which could justify or compensate this low hydric ingestion, the renal anatomy of these animals was investigated, particularly that of maned sloth (Bradypus torquatus. Kidneys from these animals were macroscopically analyzed, through light microscopy and scanning electron microscopy. The Bradypus torquatus kidneys are bean-shaped paired organs, located dorso-cranially to the pelvic girdle, between the peritoneum and the posterior abdominal wall. The use of histological techniques allowed us to identify, in the cortical region, the renal corpuscles and tubules, and, in the medullary region, a significant amount of interstitial tissue with a collecting duct. The results of this study showed that, although Bradypus torquatus doesn’t drink water directly, its kidneys doesn’t differ from that of most mammals, presenting the same anatomical structure, suggesting that these animals fully reach their hydric needs, basically by consuming leaves, fruits, and sprouts. Nevertheless, in order to confirm this hypothesis, studies on the effectiveness of water reabsorption, such as the renin-angiotensin-aldosterone system, must be carried out.

  19. MWD tool for deep, small diameter boreholes

    Energy Technology Data Exchange (ETDEWEB)

    Buytaert, J.P.R.; Duckworth, A.

    1992-03-17

    This patent describes an apparatus for measuring a drilling parameters while drilling a borehole in an earth formation, wherein the borehole includes a small diameter deep borehole portion and a large diameter upper borehole portion. It includes small diameter drillstring means for drilling the deep borehole portion; sensor means, disposed within the small diameter drillstring means, for measuring a drilling parameter characteristic of the deep portion of the borehole while drilling the deep portion of the borehole and for providing sensor output signals indicative of the measured parameter; an upper drillstring portion extending between the surface of the formation and the small diameter drillstring means, the upper drillstring portion including a large diameter drillstring portion; data transmission means disposed within the large diameter drillstring portion and responsive to the sensor output.

  20. Dynamic gadolinium-enhanced magnetic resonance urography for assessing drainage in dilated pelvicalyceal systems with moderate renal function: preliminary results and comparison with diuresis renography.

    Science.gov (United States)

    Chu, W C W; Lam, W W M; Chan, K W; Yeung, C K; Lee, K H; Sihoe, J D Y

    2004-04-01

    To evaluate the use of dynamic gadolinium diethylenetriaminepenta-acetic acid (DTPA)-enhanced magnetic resonance urography (Gd-MRU) for assessing kidneys with markedly dilated pelvicalyceal systems and impaired function. Eight children (mean age 30 months, sd 25) were assessed, diagnosed as having gross unilateral hydronephrosis with a mean (sd) anteroposterior renal pelvic diameter of 36 (7) mm and reduced (30-40%) renal function. Dynamic Gd-MRU was performed after the patients were pre-loaded with intravenous fluid and diuretics, and comprised a dynamic T1-weighted sequence after Gd-DTPA (0.1 mmol/kg body weight) was administered, with a time-intensity curve of each kidney produced. Drainage was diagnosed by a clearly declining time-intensity curve and direct visualization of contrast medium within the ureter in several frames. High-grade or complete obstruction was diagnosed when drainage of contrast medium could not be detected. Gd-MRU results were compared with diuresis radionuclide (mercapto-acetyltriglycine, MAG3) renography within the same week. Unobstructive units detected by Gd-MRU were treated conservatively with a close follow-up by ultrasonography and radionuclide studies. Diuresis MAG3 renography showed drainage in three dilated units and poor washout in five; in contrast, Gd-MRU showed drainage in seven dilated systems (three showed poor washout by MAG3), and obstruction in the remaining case. The unobstructed units detected by MRU under conservative treatment thus showed no further deterioration of renal function or progressive hydronephrosis in the subsequent follow-up (mean 18 months, range 15-23). These preliminary results suggest that dynamic Gd-MRU is a useful noninvasive imaging method in distinguishing obstructive from unobstructive dilated systems, particularly in patients with hydronephrosis and reduced renal function.

  1. 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

  2. Renale Osteopathie

    OpenAIRE

    Horn S

    2001-01-01

    Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Thera...

  3. Renale Knochenerkrankungen

    Directory of Open Access Journals (Sweden)

    Mayer G

    2008-01-01

    Full Text Available Störungen des Mineral- und Knochenstoffwechsels sind bei fast allen Patienten mit chronischen Nierenerkrankungen anzutreffen. Pathogenetisch spielt eine Neigung zur Phosphatretention bei einer Reduktion der glomerulären Filtrationsrate die zentrale Rolle. Neben typischen, aber sehr variablen Veränderungen der Knochenstruktur (renale Osteopathie besteht auch eine sehr enge Assoziation zwischen diesen Störungen und dem massiv erhöhten kardiovaskulären Risiko der Patienten.

  4. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

  5. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  6. Comparison of glomerular filtration rate measured between anterior and posterior image processing using Gates’ method in an ectopic pelvic kidney

    Science.gov (United States)

    Li, Na; Li, Baojun; Liang, Wenli

    2016-01-01

    Objective The aim of this study was to evaluate the difference in measured glomerular filtration rate (GFR) of an ectopic pelvic kidney between anterior and posterior image processing using Gates’ method of renal dynamic imaging. Methods A total of 10 patients were studied retrospectively, with a single ectopic kidney in the pelvic cavity and a contralateral kidney at its normal anatomical position confirmed by ultrasound, computed tomography, renal dynamic imaging, etc. All images of ectopic kidneys were processed, and GFRs were measured using anterior and posterior Gates’ method of renal dynamic imaging, respectively. The contralateral normal kidney was only processed on posterior imaging. The total GFRant of one patient, which was equal to the sum of the GFR of a normal kidney on posterior imaging and the GFR of an ectopic kidney on anterior imaging, was compared with the total GFRpost of two kidneys on posterior imaging, with the GFRtwo-sample from the two-sample method, and with the estimated GFR in the Chronic Kidney Disease Epidemiology Collaboration equation. All correlation analyses were carried out between GFRs obtained from three methods, and all patients were followed up. For statistical analysis, nonparametric rank tests were used, Bland-Altman graphs were plotted. Results The mean GFR of the ectopic kidney on anterior imaging was 27.48±12.24 ml/min/1.73 m2. It was higher than the GFR (10.71±4.74 ml/min/1.73 m2) on posterior imaging (t=−2.803, P0.05), but there were statistical differences in the accuracy within 10% of the total GFRant and that of the total GFRpost (Pectopic pelvic kidney in renal dynamic imaging. PMID:26867167

  7. 胎儿盆腔肾的产前超声诊断%Prenatal ultrasonic diagnosis of fetal pelvic kidney

    Institute of Scientific and Technical Information of China (English)

    鲁嘉; 孟华; 姜玉新; 刘欣燕; 袁岩; 张一休; 欧阳云淑

    2012-01-01

    Objective To discuss the ultrasound screening method and sonographic features of fetal pelvic kidney. Methods Prenatal sonographic characteristics of 8 fetal pelvic kidneys detected with prenatal ultrasound were retrospectively analyzed according to the autopsy after induction of labor or postnatal follow-up. Results Pelvic kidneys were detected in 8 fetuses with gestation of 22?6 weeks, 4 in left, 3 in right, while 1 was crossed fused kidney. Two fetuses had normal sized, shaped and structural pelvic kidneys, 1 had normal structural but crossed fused right pelvic kidney, 2 had severe hy-dronephrosis with pelvic kidneys, 3 had multicystic kidney dysplasia, 2 in the ipsilateral pelvic kidney and 1 in bilateral kidneys with other multiple abnormalities. Induction of labor was performed for 3 fetuses, and pelvic kidney was confirmed in 2 with histopathological examination. After birth, pelvic kidney was confirmed with follow-up in 3 of 4 newborns. One fetus was still in pregnancy. Conclusion In fetuses with unilateral empty renal fossa, attention should be paid to find the pelvic kidney. Color Doppler ultrasonic depiction of renal artery is important for the diagnosis of fetal pelvic kidney.%目的 探讨胎儿盆腔肾的超声筛查方法和声像图特点.方法 回顾性分析经产前超声诊断的8胎胎儿盆腔肾的声像图特征,并结合引产后尸体检查病理结果及出生后随访复查等进行分析.结果 盆腔肾胎儿8胎,胎龄22~36周;左肾4胎,右肾3胎,交叉融合肾1胎.2胎盆腔肾形态结构正常,1胎交叉融合肾结构正常;2胎盆腔肾合并肾积水;3胎盆腔肾合并多囊性肾发育不良,2胎为同侧,1胎为双侧并多发畸形.8胎中,引产3胎,2胎经病理检查证实;4胎出生,其中3胎经出生后复查证实,1胎失访;1胎尚在孕期随访中.结论 对于单侧肾窝肾缺失的胎儿,应注意寻找异位盆腔肾.彩超显示肾动脉对诊断胎儿盆腔肾有重要提示作用.

  8. CTU结合常规CT对2cm以下肾盂移行细胞癌诊断中价值%Diagnostic value of CTU combined with conventional CT shift in transitional cell carcinoma of renal pelvis in below 2 cm

    Institute of Scientific and Technical Information of China (English)

    吴枕戈; 刘绪明; 郑文龙; 郑汉朋; 邱乾德

    2014-01-01

    目的:探讨CTU结合常规CT在2.0cm以下肾盂移行细胞癌诊断中价值。方法回顾性分析经手术病理证实的2.0cm以下肾盂移行细胞癌31例常规CT和CTU表现,研究两种方法对本瘤检出率。结果肿瘤位于肾盂15例,肾盏9例,肾盂与输尿管交接部7例。肿瘤呈结节状充填肾盂或肾盏28例,沿肾盂表面浸润生长3例。肿瘤最大直径1.1~2.0cm ,其中1.5cm以下8例,1.6~2.0cm20例,仅见肾盂壁界限性结节状增厚3例。敏感度常规CT为80.6%,CTU为90.3%;准确度常规CT为54.8%,CTU为77.4%。结论本组研究显示CTU结合常规CT能提高诊断准确率。%Objective To study on CTU combined with conventional CT diagnostic value in transitional cell carcinoma of renal pelvis in below 2 .0 cm .Methods We retrospective analysed of below 2 .0 cm proved by operation and pathology fol-lowing renal pelvic transitional cell carcinoma in 31 cases of conventional CTU and CT manifestations ,studied of two methods in detection of the tumor .Results The tumors located in the renal pelvis in 15 cases ,renal pelvis in 9 cases ,re-nal pelvis and ureter in 7 cases .The tumor was nodular filling kidney or renal calices in 28 cases ,renal pelvis surface infil-tration growth in 3 cases .Maximum tumor diameter ranged from 1 .1 to 2 .0 cm ,in which below 1 .5 cm was 8 cases ,1.6~2 .0 cm 20 cases ,3 cases were nodular thickening of the pelvic wall boundaries .The sensitivity of the conventional CT was 80 .6% ,CTU 90 .3% .The accuracy of conventional CT was 54 .8% ,CTU 77 .4% .Conclusion The results showed that CTU combined with conventional CT significantly improved the accuracy of diagnosis .

  9. Renal atrophy after stereotactic body radiotherapy for renal cell carcinoma.

    Science.gov (United States)

    Yamamoto, Takaya; Kadoya, Noriyuki; Takeda, Ken; Matsushita, Haruo; Umezawa, Rei; Sato, Kiyokazu; Kubozono, Masaki; Ito, Kengo; Ishikawa, Yojiro; Kozumi, Maiko; Takahashi, Noriyoshi; Katagiri, Yu; Onishi, Hiroshi; Jingu, Keiichi

    2016-05-26

    Renal atrophy is observed in an irradiated kidney. The aim of this study was to determine dose-volume histogram parameters and other factors that predict renal atrophy after 10-fraction stereotactic body radiotherapy (SBRT) for primary renal cell carcinoma (RCC). A total of 14 patients (11 males, 3 females) who received SBRT for RCC at Tohoku University Hospital between April 2010 and February 2014 were analyzed. The median serum creatinine level was 1.1 mg/dl and two patients had a single kidney. Nine patients were implanted with fiducial markers. The median tumor diameter was 30 mm. SBRT was delivered at 70 Gy in 10 fractions for 7 tumors, at 60 Gy in 10 fractions for 2 tumors, and at 50 Gy in 10 fractions for 5 tumors with 6 and/or 15 MV X-ray using 5 to 8 multi-static beams. Renal atrophy was assessed using post-SBRT CT images after 12-24 months intervals. Correlations were examined by Spearman rank correlation analysis. Differences between two groups were evaluated by the Mann-Whitney test, and pairwise comparisons were made by the Wilcoxon signed-rank test. The median tumor volume shrunk from 14.8 cc to 10.6 cc (p = 0.12), and the median irradiated kidney volume changed from 160.4 cc to 137.1 cc (p atrophy (p = 0.02). Significant renal atrophic change was observed. Dose distribution of SBRT at 20-30 Gy had a strong correlation with renal atrophy when irradiation was performed in 10 fractions.

  10. 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

  11. Carcinoma of the renal pelvis and ureter

    Directory of Open Access Journals (Sweden)

    Fernando Korkes

    2006-12-01

    Full Text Available OBJECTIVE: To assess the occurrence of upper urinary tract urothelial tumors (UUTT in Brazil. MATERIALS AND METHODS: We performed a clinical and histopathologic study of 33 patients who were diagnosed with a malignant neoplasm in the renal pelvis or ureter in the period of 1994 to 2004, in a single institution. RESULTS: Among the patients with upper urinary tract carcinoma, 70% were males and 30% females, with mean age of 65 ± 16 years (ranging from 31 to 91 years. Nineteen patients presented renal pelvis tumor (58%, 9 ureteral tumor (27% and 5 synchronic pelvic and ureteral tumors (15%. Renal pelvis tumors represented 2.8% of all the urothelial neoplasms, and 11.4% of all renal neoplasms treated in the same period. Ureteral tumors represented 1.6% of all the urothelial malignancies surgically managed in these 11 years. Tobacco smoking was the most common risk factor, and analgesic abuse was not reported by those patients. Most carcinomas were high-grade and muscle-invasive. Mean time to diagnosis was 7 months, being hematuria the most common symptom. CONCLUSIONS: A high association was also found between UUTT and bladder urothelial carcinoma. UUTT were mostly seen in men in their seventies and related to a high overall and cancer-related mortality rate. The overall disease-specific survival was 40%, much lower than found in most of the reported series.

  12. [Pregnancy in patients with renal transplantation].

    Science.gov (United States)

    Chocair, P R; Ianhez, L E; de Paula, F J; Sabbaga, E; Arap, S

    1989-01-01

    From 1969 to 1987, 35 pregnancies occurred in 31 women with renal transplant. Four of them were still pregnant when this study was concluded. There was one ectopic pregnancy. All patients received azathioprine and prednisone. In the majority of patients the glomerular filtration rate increased in a way similar to normal pregnant women. In five cases there was a progressive loss in renal function. In four of them this was attributed to preexistent renal damage. No toxemia occurred. Anemia developed during 11 pregnancies and blood transfusion was required for five women. Four patients had urinary tract infection which was easily controlled with antibiotics. One patient had severe arterial hypertension, secondary to chronic rejection. One patient developed jaundice reverted with reduction in azathioprine doses. One woman died of septicemia secondary to fetal death, during the 6th month of pregnancy. Twenty children were born with no abnormalities, although many of them were underweighted. Two thirds of pregnancies were delivered by cesarean section. No harm to the pelvic allograft occurred in vaginal deliveries. There have been 4 abortions (2 of them were induced with no medical indication). Four pregnancies (26 to 39 gestational weeks) ended in stillborn babies: the mothers had impaired renal function associated with hypertension and proteinuria. One newborn died of pulmonary infection two days after delivery. Another was born with microcephaly and polydactilia and survived 6 years. No breast feeding was allowed.

  13. Bilateral Renal Mass-Renal Disorder: Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ozlem Tiryaki

    2013-01-01

    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  14. Distal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by a defect ...

  15. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  16. [Mixed epithelial and stromal tumor growing with polypoid pattern in the renal pelvis].

    Science.gov (United States)

    Yamasaki, Toshinari; Yagihashi, Yuusuke; Iwamura, Hiroshi; Shirahase, Toshiaki; Hashimura, Takayuki; Katsura, Yoshitaka

    2004-01-01

    A 68-year-old woman was found incidentally to have right hydronephrosis and a renal pelvic mass by abdominal ultrasonography. Radiographic examinations revealed a heterogeneous renal pelvic tumor, and right nephroureterectomy was performed. The tumor was well circumscribed yellow-whitish solid mass with scattered cysts. Histologically, the tumor was composed of both mesenchymal and epithelial components. The mesenchymal elements consisted of fibroblasts and smooth muscle cells, and the epithelial elements of cystic and tubular structures lined by cuboidal epithelium. Atypia and mitoses were not identified. The patient was free of recurrence 42 months postoperatively. Mixed epithelial and stromal tumor of the kidney is a recently recognized neoplasm that occurs almost exclusively in perimenopausal woman. Similar tumors have been reported previously under various names, including adult mesoblastic nephroma and cystic hamartoma of the renal pelvis. Histogenesis of the tumor is still controversial.

  17. Safety and efficacy of coronary drug eluting stent for atherosclerotic stenosis of the small renal artery

    Institute of Scientific and Technical Information of China (English)

    LI Chun-jie; WU Zheng; YAN Hong-bing; WANG Jian; ZHAO Han-jun

    2009-01-01

    @@ Small diameter renal artery refers to the renal artery with the cross-section diameter less than 5 mm, the incidence of which is approximately 8%.1 Small diameter renal artery is common in patients with congenital multi-branch renal arteries, diabetes and multi-coronary artery lesions. Renal artery bare-mental stent (BMS) implantation is the standard treatment for ostial renal artery stenosis.2,3 However, the restenosis rate4-6 is too high and becomes one of the relative contraindications for small diameter renal artery stent implantation. Clinical trials (e.g. RAVEL,7,8 SIRIUS9 and TAXUS-IV10) have proved that drug eluting stent (DES), compared with BMS, can reduce the restenosis rate after the percutanous coronary intervention (PCI). And Huda et al11 claimed that DES had the better results than BMS in the treatment of obstructive superficial femoral artery disease. However,there are few studies involved restenosis after the renal artery intervention. We hypothesized that coronary DES applied in renal artery stenosis might inhibit intimal proliferation effectively as in coronary artery disease;therefore we evaluated the results of 25 patients with atherosclerotic renal artery stenosis treated using coronary DES to assess the safety and efficacy of coronary DES in patients with small renal artery stenotic lesions.

  18. Renal tuberculosis

    Directory of Open Access Journals (Sweden)

    Džamić Zoran

    2016-01-01

    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  19. Renale Osteopathie

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    Horn S

    2001-01-01

    Full Text Available Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Therapiemöglichkeiten. Wir beeinflussen dadurch nicht nur die Morbidität und Lebensqualität, sondern auch die Mortalität unserer Patienten.

  20. Renal disease in pregnancy.

    Science.gov (United States)

    Thorsen, Martha S; Poole, Judith H

    2002-03-01

    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.

  1. Immunological Mechanisms Underlying Chronic Pelvic Pain and Prostate Inflammation in Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    María L. Breser

    2017-07-01

    Full Text Available Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS is the most common urologic morbidity in men younger than 50 years and is characterized by a diverse range of pain and inflammatory symptoms, both in type and severity, that involve the region of the pelvis, perineum, scrotum, rectum, testes, penis, and lower back. In most patients, pain is accompanied by inflammation in the absence of an invading infectious agent. Since CP/CPPS etiology is still not well established, available therapeutic options for patients are far from satisfactory for either physicians or patients. During the past two decades, chronic inflammation has been deeply explored as the cause of CP/CPPS. In this review article, we summarize the current knowledge regarding immunological mechanisms underlying chronic pelvic pain and prostate inflammation in CP/CPPS. Cumulative evidence obtained from both human disease and animal models indicate that several factors may trigger chronic inflammation in the form of autoimmunity against prostate, fostering chronic prostate recruitment of Th1 cells, and different other leukocytes, including mast cells, which might be the main actors in the consequent development of chronic pelvic pain. Thus, the local inflammatory milieu and the secretion of inflammatory mediators may induce neural sensitization leading to chronic pelvic pain development. Although scientific advances are encouraging, additional studies are urgently needed to establish the relationship between prostatitis development, mast cell recruitment to the prostate, and the precise mechanisms by which they would induce pelvic pain.

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

    Science.gov (United States)

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

    1997-01-01

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

  3. Immunological Mechanisms Underlying Chronic Pelvic Pain and Prostate Inflammation in Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    Breser, María L.; Salazar, Florencia C.; Rivero, Viginia E.; Motrich, Rubén D.

    2017-01-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common urologic morbidity in men younger than 50 years and is characterized by a diverse range of pain and inflammatory symptoms, both in type and severity, that involve the region of the pelvis, perineum, scrotum, rectum, testes, penis, and lower back. In most patients, pain is accompanied by inflammation in the absence of an invading infectious agent. Since CP/CPPS etiology is still not well established, available therapeutic options for patients are far from satisfactory for either physicians or patients. During the past two decades, chronic inflammation has been deeply explored as the cause of CP/CPPS. In this review article, we summarize the current knowledge regarding immunological mechanisms underlying chronic pelvic pain and prostate inflammation in CP/CPPS. Cumulative evidence obtained from both human disease and animal models indicate that several factors may trigger chronic inflammation in the form of autoimmunity against prostate, fostering chronic prostate recruitment of Th1 cells, and different other leukocytes, including mast cells, which might be the main actors in the consequent development of chronic pelvic pain. Thus, the local inflammatory milieu and the secretion of inflammatory mediators may induce neural sensitization leading to chronic pelvic pain development. Although scientific advances are encouraging, additional studies are urgently needed to establish the relationship between prostatitis development, mast cell recruitment to the prostate, and the precise mechanisms by which they would induce pelvic pain. PMID:28824626

  4. Leiomyosarcoma presenting as a spontaneously ruptured renal tumor-case report

    Directory of Open Access Journals (Sweden)

    Ather M

    2002-11-01

    Full Text Available Abstract Background Ruptured renal neoplasms can be a catastrophic clinical presentation. Angiomyolipoma is the commonest renal tumor which presents in this fashion. Renal sarcomas are rare renal neoplasms. Renal leiomyosarcomas are the most common histological subtype of renal sarcomas, accounting for approximately 50–60% of the reported cases. These tumors are usually peripherally located and appear to arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall. Case presentation A 70 years old male, with hypertension and ischemic disease, developed acute left flank pain. The general physician evaluated this using ultrasound, which showed a solid left renal mass. Two weeks later, he presented in the emergency room in a state of shock with a palpable flank mass. CT scan of the abdomen showed a large heterogeneous mass lesion in the left perinephric space with minimal post contrast enhancement. Per-operatively, large retroperitoneal hematoma was found within Gerota's fascia along with spleen plastered to the upper limit of hematoma. Nephrectomy and splenectomy were performed. Postoperative course was uneventful and patient was discharged on the 10th post-operative day. Histopathological evaluation of the specimen showed high-grade leiomyosarcoma Conclusions Spontaneous rupture of renal neoplasm is a rare clinical presentation. Angiomyolipoma is the commonest cause of spontaneous rupture of the kidney. Presentation of a leimyosarcoma as a ruptured renal neoplasm has not been previously reported in the English literature.

  5. [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

  6. Pelvic radiotherapy and sexual dysfunction in women

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine; Froeding, Ligita Paskeviciute

    2015-01-01

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

  7. Mechanical devices in pelvic organ prolapsed

    Directory of Open Access Journals (Sweden)

    Raja AM, Seema SR

    2013-07-01

    Full Text Available 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 of life of the patients and even can differ surgical management. As the aging population is increasing in developed and developing countries, pessaries can be of considerable help in managing the pelvic organ prolapse.

  8. MR imaging of the female pelvic region.

    Science.gov (United States)

    Olson, M C; Posniak, H V; Tempany, C M; Dudiak, C M

    1992-05-01

    Magnetic resonance (MR) imaging is a valuable technique for noninvasive evaluation of the female pelvic region. This article presents the normal anatomy and abnormalities of the female pelvis. MR imaging may be more useful than clinical evaluation or other imaging modalities in diagnosing or staging developmental anomalies, leiomyomas, adenomyosis, endometrial or cervical carcinoma, vaginal neoplasms, ovarian cysts, endometriosis, teratomas, polycystic ovaries, or other ovarian masses. It could potentially replace laparoscopy as a more useful tool in the diagnosis of uterine anomalies. MR imaging is generally capable of helping determine whether a pelvic mass is uterine or adnexal in origin and may be used to characterize some adnexal masses. In some cases, MR imaging is used to differentiate recurrent disease from posttreatment fibrosis, which aids in treatment planning.

  9. [Anatomy of the pelvic lymphatic system].

    Science.gov (United States)

    Wolfram-Gabel, R

    2013-10-01

    The lymphatic system of the pelvis collects the lymph of the genital and urinary organs and of the digestive tract. It is formed by lymphatic nodes and vessels situated inside the conjunctive tissue, near the organs (visceral lymphatic nodes) but especially along the external, internal and common iliac vessels (iliac lymphatic nodes). These nodes receive afferent vessels issued from the different pelvic organs. From the iliac lymphnodes arise efferent vessels running towards lymphatic collectors, situated above them, and which end in the lymphatic lombar duct. The lymphatic pathways represent the preferential way of scattering of cancerous cells. Therefore, the knowledge of the anatomy, of the situation and of the draining of the nodes is of the utmost importance in the evaluation of a cancer of a pelvic organ.

  10. [Pelvic actinomycosis abscess and intrauterine device].

    Science.gov (United States)

    Ko-Kivok-Yun, P; Charasson, T; Halasz, A; Fournié, A

    1997-03-01

    A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.

  11. [Urogenital trauma associated with pelvic ring fractures].

    Science.gov (United States)

    Pavelka, T; Houcek, P; Hora, M; Hlavácová, J; Linhart, M

    2010-02-01

    To evaluate, in a retrospective study, injuries to the urogenital tract in patients with pelvic ring fractures. MATERIAL In the years 1998-2007, a total of 308 patients with pelvic ring fractures were treated. The study did not comprise patients with low-energy fractures, such as apophyseolysis in children, osteoporotic bone fractures or pathologic fractures. It also did not include patients with multiple injuries who died within 6 hours of admission to the hospital. The group consisted of 186 men and 122 women with an average age of 34 (range, 6 to 76) years. The fractures sustained were classified as type A in 5 %, type B in 57 % and type C in 38 % of the patients. The average follow-up was 71 (range, 13 to 121) months. A primary injury to the urogenital tract was recorded in 50 (16 %) patients. Injury to the urethra was found in 23 (7.5%) and urinary bladder trauma in 18 (6%) patients, vaginal injury was in four women (1%), and penis injury in three (1%) and lacerated testicles in two men (1%). Injury to the urogenital tract was associated with a pelvic ring fracture type A in 5 %, type B in 34 % and type C in 61 % of the patients. Out of the 23 patients with urethral trauma, only six (26 %) were free from functional and subjective complaints; eight (35 %) continued to receive therapy for urethral stenosis seven (30 %) reported urinary incontinence, and seven men (30 %) had erection problems. In six patients (26%) the lasting sequelae were combined. The 18 patients with injury to the bladder reported no subjective complaints at a one-year follow-up. Two patients with penis root injury had erectile dysfunction. Two patients with the loss of both testicles were in the care of a psychiatrist. The patients' satisfaction was evaluated on a 0-to10-point scale. The average value for the whole group was 4.1 points. In the patients with erectile dysfunction, the value was 0.8, and in those with isolated injury to the urinary bladder it was 9.4 points. The increasing

  12. Transrectal Drainage of Deep Pelvic Abscesses Using a Combined Transrectal Sonographic and Fluoroscopic Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kyung Soon; Lee, Eun Jung; Ko, Ji Ho; Joh, Young Duk [Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of); Jung, Gyoo Sik [Ulsan Hospital, Ulsan (Korea, Republic of)

    2005-09-15

    To evaluate the feasibility and clinical efficacy of transrectal drainage of a deep pelvic abscess using combined transrectal sonographic and fluoroscopic guidance. From March 1995 and August 2004, 17 patients (9 men; 8 women; mean age, 39 years) suffering from pelvic pain, fever and leukocytosis were enrolled in this retrospective study. Ultrasound (US) or computed tomography (CT), which was obtained prior to the procedure, showed pelvic fluid collections that were deemed unapproachable by the percutaneous trans abdominal routes. Transrectal drainage of the pelvic abscess was performed under combined transrectal sonographic and fluoroscopic guidance. The causes of the deep pelvic abscess were postoperative complications (n=7), complications associated with radiation (n=3) and chemotherapy (n=1) as well as unknown causes (n=6). A 7.5-MHz end-firing transrectal US probe with a needle biopsy guide attachment was advanced into the rectum. Once the abscess was identified, a needle was advanced via the biopsy guide and the abscess was punctured. Under US guidance, either a 0.018'or 0.035' guide wire was passed through the needle in the abscess. Under fluoroscopic guidance, the tract was dilated to the appropriate diameter with sequential fascial dilators, and a catheter was placed over the guide wire within the abscess. Clinical success of drainage was determined by a combination closure of the cavity on the follow up images and diminished leukocytosis. The technical and clinical success rate, complications, and patient's discomfort were analyzed. Drainage was technically successful in all patients and there were no serious complications. Surgery was eventually performed in two cases due to fistular formation with the rectum and leakage of the anastomosis site. The procedure was well tolerated in all but one patient who complained of discomfort while the catheter was inserted . The catheter did not interfere with defecation and there was no incidence of

  13. 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

  14. Interstitial Cystitis: Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Fatih Atuğ

    2005-01-01

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

  15. Interstitial Cystitis: Chronic Pelvic Pain Syndrome

    OpenAIRE

    Fatih Atuğ; Naime Canoruç

    2005-01-01

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

  16. Foxd1-dependent signals control cellularity in the renal capsule, a structure required for normal renal development.

    Science.gov (United States)

    Levinson, Randy S; Batourina, Ekatherina; Choi, Christopher; Vorontchikhina, Marina; Kitajewski, Jan; Mendelsohn, Cathy L

    2005-02-01

    Development of the metanephric kidney involves the establishment of discrete zones of induction and differentiation that are crucial to the future radial patterning of the organ. Genetic deletion of the forkhead transcription factor, Foxd1, results in striking renal abnormalities, including the loss of these discrete zones and pelvic fused kidneys. We have investigated the molecular and cellular basis of the kidney phenotypes displayed by Foxd1-null embryos and report here that they are likely to be caused by a failure in the correct formation of the renal capsule. Unlike the single layer of Foxd1-positive stroma that comprises the normal renal capsule, the mutant capsule contains heterogeneous layers of cells, including Bmp4-expressing cells, which induce ectopic phospho-Smad1 signaling in nephron progenitors. This missignaling disrupts their early patterning, which, in turn, causes mispatterning of the ureteric tree, while delaying and disorganizing nephrogenesis. In addition, the defects in capsule formation prevent the kidneys from detaching from the body wall, thus explaining their fusion and pelvic location. For the first time, functions have been ascribed to the renal capsule that include delineation of the organ and acting as a barrier to inappropriate exogenous signals, while providing a source of endogenous signals that are crucial to the establishment of the correct zones of induction and differentiation.

  17. Patients with Pelvic Floor Muscle Spasm Have a Superior Response to Pelvic Floor Physical Therapy at Specialized Centers.

    Science.gov (United States)

    Polackwich, Alan Scott; Li, Jianbo; Shoskes, Daniel A

    2015-10-01

    Chronic prostatitis/chronic pelvic pain syndrome is a common condition that often requires multimodal therapy. Patients with chronic pelvic pain syndrome have a high incidence of pelvic floor spasm, which can be treated with pelvic floor physical therapy. However, this is a specialized skill. We compared outcomes of pelvic floor physical therapy as part of multimodal therapy in patients with chronic pelvic pain syndrome between those treated at our institution and elsewhere. We identified patients from our chronic pelvic pain syndrome registry with pelvic floor spasm who were seen between 2010 and 2014 for more than 1 visit. Patient phenotype was assessed with the UPOINT system and symptom severity was determined by the National Institutes of Health CPSI. A 6-point decrease in CPSI was used to define patient improvement. A total of 82 patients fit the study criteria. Mean age was 41.6 years (range 19 to 75) and median symptom duration was 24 months (range 3 to 240). Mean CPSI was 26.8 (range 10 to 41), the median number of positive UPOINT domains was 3 (range 1 to 6) and 27 patients (32.9%) were treated locally. At followup 9 patients had refused pelvic floor physical therapy, and 24 and 48 had undergone pelvic floor physical therapy elsewhere and at CCF, respectively. The mean change in CPSI was 1.11 ± 4.1 in patients who refused, -3.46 ± 6.7 in those treated elsewhere and -11.3 ± 7.0 in those treated at CCF (p physical therapy at CCF (OR 4.23, p = 0.002) and symptom duration (OR 0.52, p = 0.03) predicted improvement. Pelvic floor physical therapy can be effective for chronic pelvic pain syndrome in patients with pelvic floor spasm. However, the outcome depends on specialty training and experience of therapists. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Small renal Oncocytomas: Differentiation with multiphase CT

    Energy Technology Data Exchange (ETDEWEB)

    Gakis, Georgios, E-mail: georgios.gakis@web.de [Department of Urology, University Hospital Tuebingen, Eberhard-Karls University, Hoppe-Seyler Strasse 3, Tuebingen (Germany); Kramer, Ulrich [Department of Radiology, University Hospital Tuebingen, Eberhard-Karls University, Tuebingen (Germany); Schilling, David; Kruck, Stephan; Stenzl, Arnulf [Department of Urology, University Hospital Tuebingen, Eberhard-Karls University, Hoppe-Seyler Strasse 3, Tuebingen (Germany); Schlemmer, Hans-Peter [Department of Radiology, University Hospital Tuebingen, Eberhard-Karls University, Tuebingen (Germany)

    2011-11-15

    Objectives: To evaluate characteristic imaging findings of tumor attenuation in multiphase computed tomography (CT) between renal oncocytomas and clear-cell renal cell carcinoma (ccRCC) of small tumor size ({<=}5 cm). Methods: We retrospectively identified 20 patients with complete four-phase CT with either histologically confirmed small renal oncocytoma (N = 10) or ccRCC (N = 10) who underwent subsequent total or partial nephrectomy. Exclusion criteria for RCC were non-clear-cell components in histology and a tumor diameter >5 cm. The relative attenuation of solid renal lesions and normal renal cortex was determined in the unenhanced, corticomedullary, nephrographic and excretory phase. Statistical comparison was carried out by Wilcoxon Rank Sum Test. Results: Mean tumor size of renal oncocytomas was 2.8 {+-} 0.4 cm (1.2-5) and of ccRCC 2.5 {+-} 0.2 cm (1.7-4.4; p = 0.57). All lesions were homogenous without extended areas of necroses. In the nephrographic phase, the difference of attenuation between renal cortex and tumor lesion was highest in both entities (oncocytoma, 48.1 {+-} 5.2 HU; ccRCC, 67.5 {+-} 12.1) but not between entities (p = 0.30). In the corticomedullary phase, renal oncocytomas showed greater isodensity to the normal renal cortex (13.9 {+-} 4.3 HU) compared to clear-cell RCC (51.5 {+-} 5.0 HU; p = 0.003). No further significant differences were found for the unenhanced and excretory phase. Conclusions: In this study, the maximum tumor-to-kidney contrast coincided with the nephrographic phase which was thus the most reliable for the detection of a renal lesion <5 cm. For lesion characterization, the corticomedullary phase was most useful for differentiating both entities. This finding is particularly important for the preoperative planning of a partial nephrectomy.

  19. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  20. 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.

  1. Tachykinin receptors in the equine pelvic flexure.

    Science.gov (United States)

    Sonea, I M; Wilson, D V; Bowker, R M; Robinson, N E

    1997-07-01

    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.

  2. CT findings of acute pelvic inflammatory disease.

    Science.gov (United States)

    Lee, Mi Hee; Moon, Min Hoan; Sung, Chang Kyu; Woo, Hyunsik; Oh, Sohee

    2014-12-01

    To determine the computed tomographic (CT) findings of acute pelvic inflammatory disease (PID). This retrospective, single-institution case-control study was approved by our institutional review board, and the informed consent was waived owing to the retrospective nature of the study. CT images of 32 women with clinically proven acute PID and 32 control subjects with other conditions of similar presentation were retrospectively reviewed. Analysis of CT findings included hepatic capsular enhancement, pelvic fat haziness, complicated ascites, uterine serosal enhancement, tubal thickening, endometritis, and oophoritis. Comparison of CT findings was performed with the Chi square test or the Fisher exact test and logistic regression analysis was used to determine significant CT findings in predicting PID. The CT findings that showed a statistically significant difference were hepatic capsular enhancement on late arterial phase (p = 0.003), pelvic fat haziness (p = 0.045), and tubal thickening (p = 0.001). Subsequent multivariate logistic regression analysis revealed that the presence of hepatic capsular enhancement on late arterial phase and tubal thickening were significant predictors of PID (hepatic capsular enhancement on late arterial phase, p = 0.015, odds ratio [OR] = 4.8; tubal thickening, p = 0.005, OR = 10.5). Diagnostic morphological CT findings in women with clinically proven PID and acute abdominal pain include hepatic capsular enhancement on late arterial phase and tubal thickening.

  3. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

    Science.gov (United States)

    Pusiol, Teresa; Morichetti, Doriana; Pedrazzani, Corrado; Ricci, Francesco

    2011-01-01

    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. PMID:21904441

  4. Pelvic radiation disease: Updates on treatment options

    Science.gov (United States)

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

    2015-01-01

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

  5. EAU guidelines on chronic pelvic pain.

    Science.gov (United States)

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

    2010-01-01

    These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. To revise guidelines for the diagnosis, therapy, and follow-up of CPP patients. Guidelines were compiled by a working group and based on a systematic review of current literature using the PubMed database, with important papers reviewed for the 2003 EAU guidelines as a background. A panel of experts weighted the references. The full text of the guidelines is available through the EAU Central Office and the EAU Web site (www.uroweb.org). This article is a short version of the full guidelines text and summarises the main conclusions from the guidelines on the management of CPP. A guidelines text is presented including chapters on chronic prostate pain and bladder pain syndromes, urethral pain, scrotal pain, pelvic pain in gynaecologic practice, neurogenic dysfunctions, the role of the pelvic floor and pudendal nerve, psychological factors, general treatment of CPP, nerve blocks, and neuromodulation. These guidelines have been drawn up to provide support in the management of the large and difficult group of patients suffering from CPP.

  6. 7 CFR 51.2850 - Diameter.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... Diameter. Diameter means the greatest dimension measured at right angles to a straight line running from...

  7. 7 CFR 51.712 - Diameter.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... § 51.712 Diameter. Diameter means the greatest dimension measured at right angles to a line from stem...

  8. 7 CFR 51.651 - Diameter.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946...) Definitions § 51.651 Diameter. Diameter means the greatest dimension measured at right angles to a line from...

  9. Measuring angular diameters of extended sources

    NARCIS (Netherlands)

    van Hoof, PAM

    2000-01-01

    When measuring diameters of partially resolved sources like planetary nebulae, H II regions or galaxies, often a technique called Gaussian deconvolution is used. This technique yields a Gaussian diameter, which subsequently has to be multiplied by a conversion factor to obtain the true angular

  10. 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...

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

    Science.gov (United States)

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

    2010-06-01

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

  12. 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.

  13. Medical Treatments for Endometriosis-Associated Pelvic Pain

    OpenAIRE

    2014-01-01

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

  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. Tactile Imaging Markers to Characterize Female Pelvic Floor Conditions.

    Science.gov (United States)

    van Raalte, Heather; Egorov, Vladimir

    2015-08-01

    The Vaginal Tactile Imager (VTI) records pressure patterns from vaginal walls under an applied tissue deformation and during pelvic floor muscle contractions. The objective of this study is to validate tactile imaging and muscle contraction parameters (markers) sensitive to the female pelvic floor conditions. Twenty-two women with normal and prolapse conditions were examined by a vaginal tactile imaging probe. We identified 9 parameters which were sensitive to prolapse conditions (p pelvic floor prolapse.

  17. Association between pelvic muscle mass and canine hip dysplasia.

    Science.gov (United States)

    Cardinet, G H; Kass, P H; Wallace, L J; Guffy, M M

    1997-05-15

    To investigate the relationship between pelvic muscle mass and development and expression of canine hip dysplasia (CHD). Prospective study. 5 Greyhounds with anatomically normal hip joints, 59 German Shepherd Dogs (23 with CHD, 24 with near-normal hip joints, and 12 with normal hip joints), and 18 German Shepherd Dog-Greyhound crossbreeds (7 with CHD, 6 with near-normal hip joints, and 5 with normal hip joints) between 12 and 47 months old in which pelvic muscle mass was evaluated. Pectineal muscle and hip joint development were evaluated in 25 German Shepherd Dogs at 8 and 16 or 24 weeks of age. For evaluation of pelvic muscle mass, individual pelvic muscles were weighed and hip joints were assigned a score on the basis of severity of degenerative changes. For evaluation of pectineal muscle development, muscle sections were stained and examined. Pelvic muscle mass was greatest in Greyhounds, intermediate in crossbred dogs, and smallest in German Shepherd Dogs. Differences in pelvic muscle mass among breeds were attributable to differences in weights of individual muscles. Hip score was negatively correlated with pelvic muscle mass and weights of selected pelvic muscles. Dogs with pectineal hypotrophy at 8 weeks of age had type-2 muscle fiber paucity or muscle fiber-type grouping at 16 or 24 weeks of age. At 8 weeks of age, hip joints were composed of multiple centers of ossification, and the acetabulum was largely cartilaginous. By 24 weeks of age, the pelvic bones were largely, although incompletely, fused. Diminished pelvic muscle mass in dogs with CHD and altered muscle fiber size and composition in 8-week-old dogs that subsequently develop CHD strongly suggest that abnormalities of pelvic musculature are associated with development of CHD. The complex development of the hip joint from multiple centers of ossification may make the joint susceptible to abnormal modeling forces that would result from abnormalities in pelvic muscle mass.

  18. Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

    Directory of Open Access Journals (Sweden)

    Murat Bozkurt

    2014-12-01

    Full Text Available Pelvic floor dysfunction (PFD, although seems to be simple, is a complex process that develops secondary to multifactorial factors. The incidence of PFD is increasing with increasing life expectancy. PFD is a term that refers to a broad range of clinical scenarios, including lower urinary tract excretory and defecation disorders, such as urinary and anal incontinence, overactive bladder, and pelvic organ prolapse, as well as sexual disorders. It is a financial burden on the health care system and disrupts women's quality of life. Strategies applied to decrease PFD are focused on the course of pregnancy, mode and management of delivery, and pelvic exercise methods. Many studies in the literature define traumatic birth, usage of forceps, length of the second stage of delivery, and sphincter damage as modifiable risk factors for PFD. Maternal age, fetal position, and fetal head circumference are nonmodifiable risk factors. Although numerous studies show that vaginal delivery affects pelvic floor structures and their functions in a negative way, there is not enough scientific evidence to recommend elective cesarean delivery in order to prevent development of PFD. PFD is a heterogeneous pathological condition, and the effects of pregnancy, vaginal delivery, cesarean delivery, and possible risk factors of PFD may be different from each other. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist; therefore, the isolated effects of these variables on the pelvic floor are difficult to study. The routine use of episiotomy for many years in order to prevent PFD is not recommended anymore; episiotomy should be used in selected cases, and the mediolateral procedures should be used if needed.

  19. Pelvic radiotherapy and sexual function in women

    Science.gov (United States)

    Froeding, Ligita Paskeviciute

    2015-01-01

    Background During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing 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 literature search revealed a few RCTs with FSD evaluated as a PRO and being a secondary outcome measure in endometrial and in rectal cancer patients. Very limited information could be extracted regarding FSD in bladder, vulva, and anal cancer patients. The literature before and after 2010 confirms that pelvic radiotherapy, independent on modality, increases the risk significantly for FSD both compared to data from age-matched healthy control women and compared to data on patients treated by surgery only. There was only very limited data available on modern radiotherapy modalities. These are awaited during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. Conclusions

  20. Modeling the pelvic region for non-invasive pelvic intraoperative neuromonitoring

    Directory of Open Access Journals (Sweden)

    Moszkowski Tomasz

    2016-09-01

    Full Text Available Finite element analysis (FEA of electric current distribution in the pelvis minor may help to assess the usability of non-invasive surface stimulation for continuous pelvic intraoperative neuromonitoring. FEA requires generation of quality volumetric tetrahedral mesh geometry. This study proposes the generation of a suitable mesh based on MRI data. The resulting volumetric mesh models the autonomous nerve structures at risk during total mesorectal excision. The model also contains the bone, cartilage, fat, skin, muscle tissues of the pelvic region, and a set of electrodes for surface stimulation. The model is ready for finite element analysis of the discrete Maxwell’s equations.

  1. Levator trauma is associated with pelvic organ prolapse

    National Research Council Canada - National Science Library

    Dietz; Simpson

    2008-01-01

    .... Design Retrospective observational study. Setting Tertiary urogynaecological unit. Sample A total of 934 women seen for interview, examination using the pelvic organ prolapse quantification (POP-Q...

  2. 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.

  3. Pelvic congestion syndrome masquerading as osteoarthritis of the hip

    Directory of Open Access Journals (Sweden)

    Scott J Dos Santos

    2016-12-01

    Full Text Available Objectives: Pelvic congestion syndrome (PCS is associated with pelvic vein reflux (PVR, occasionally secondary to venous compression. Its symptoms, usually intra-pelvic, are alleviated following the abolition of this reflux by pelvic vein embolisation (PVE. The objective of this report is to present two cases of left hip pain, erroneously diagnosed as osteoarthritis, which disappeared after successful PVE and abolition of PVR. Methods: Two females presented with lower limb varicose veins, and also had a history of left-sided hip pain. Both had previously been investigated for the hip pain and diagnosed as osteoarthritis despite minimal arthritic changes on pelvic X-rays. During investigation for lower limb varicose veins, both showed a pelvic origin for their leg veins and hence underwent transvaginal duplex ultrasound. This revealed PVR, and PVE was planned in both patients. Results: Both patients underwent PVE and reported ‘miraculous’ resolution of left hip pain and also PCS symptoms including pelvic pain, irritable bowel issues and the disappearance of pelvic dragging, with almost immediate disappearance of vulval and vaginal varicosities. One patient also noted reduced clitoral sensitivity. Conclusion: Manifestations of PCS may vary in terms of intra- or extra-pelvic signs. PCS and PVR should be considered in the differential diagnosis of patients with arthritic symptoms in the hip without evident radiographic evidence.

  4. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  5. TRANSPLANTE RENAL

    Directory of Open Access Journals (Sweden)

    Soraia Geraldo Rozza Lopes

    2014-01-01

    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  6. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  7. Traumatismo renal

    OpenAIRE

    Rocha, Sofia Rosa Moura Gomes da

    2009-01-01

    Introdução: A realização deste trabalho visa a elaboração de uma revisão sistematizada subordinada à temática da traumatologia renal. Objectivos: Os principais objectivos deste trabalho são: apurar a etiologia, definir a classificação, analisar o diagnóstico e expôr o tratamento e as complicações. Desenvolvimento: Os traumatismos são a principal causa de morte antes dos 40 anos. O rim é o órgão do aparelho génito-urinário mais frequentemente atingido. Os traumatismos renais são mais fre...

  8. An Unusual Course of Segmental Renal Artery Displays a Rare Case of Hilar Nutcracker Phenomenon

    Science.gov (United States)

    Sawant, Devendra A.; Moore, Thomas F.

    2015-01-01

    Nutcracker phenomenon or renal vein entrapment is classically seen as a compression of renal vein in between abdominal aorta and superior mesenteric artery with patients being asymptomatic or clinically manifested in the form of nutcracker syndrome as proteinuria, hematuria, flank pain, pelvic congestion in women, and varicocele in men. In this report, we are presenting a case of rare variant of nutcracker phenomenon along with brief review of anatomy, pathophysiology, public health, and clinical significance of nutcracker syndrome. On a routine dissection of an adult male cadaver, we noticed an unusual arrangement of the structures at the hilum of the left kidney showing entrapment of renal vein between left anterior inferior and posterior segmental renal arteries. The variation in the course of left anterior inferior segmental renal artery leads to compression of left renal vein at renal hilum. Therefore, we have named this rare abnormal anatomical entity as hilar nutcracker phenomenon. The structures in the right renal hilum are normal. The objective of this paper is to report an unusual but important variant of nutcracker phenomenon and also give collective knowledge of such anatomical variations in renal vasculature that will help in diagnosing and treating such rare renal disorder. PMID:26448765

  9. An Unusual Course of Segmental Renal Artery Displays a Rare Case of Hilar Nutcracker Phenomenon

    Directory of Open Access Journals (Sweden)

    Devendra A. Sawant

    2015-01-01

    Full Text Available Nutcracker phenomenon or renal vein entrapment is classically seen as a compression of renal vein in between abdominal aorta and superior mesenteric artery with patients being asymptomatic or clinically manifested in the form of nutcracker syndrome as proteinuria, hematuria, flank pain, pelvic congestion in women, and varicocele in men. In this report, we are presenting a case of rare variant of nutcracker phenomenon along with brief review of anatomy, pathophysiology, public health, and clinical significance of nutcracker syndrome. On a routine dissection of an adult male cadaver, we noticed an unusual arrangement of the structures at the hilum of the left kidney showing entrapment of renal vein between left anterior inferior and posterior segmental renal arteries. The variation in the course of left anterior inferior segmental renal artery leads to compression of left renal vein at renal hilum. Therefore, we have named this rare abnormal anatomical entity as hilar nutcracker phenomenon. The structures in the right renal hilum are normal. The objective of this paper is to report an unusual but important variant of nutcracker phenomenon and also give collective knowledge of such anatomical variations in renal vasculature that will help in diagnosing and treating such rare renal disorder.

  10. Impact Structures: What Does Crater Diameter Mean?

    Science.gov (United States)

    Turtle, E. P.; Pierazzo, E.; Collins, G. S.; Osinski, G. R.; Melosh, H. J.; Morgan, J. V.; Reimold, W. U.; Spray, J. G.

    2004-03-01

    Crater diameter is an important parameter in energy scaling and impact simulations. However, disparate types of data make the use of consistent metrics difficult. We suggest a consistent terminology and discuss it in the context of several examples.

  11. Assessment of the effect of pelvic floor exercises on pelvic floor muscle strength using ultrasonography in patients with urinary incontinence: a prospective randomized controlled trial

    OpenAIRE

    Tosun, Ozge Celiker; Solmaz, Ulas; Ekin, Atalay; Tosun, Gokhan; Gezer, Cenk; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Mat, Emre; Malkoc, Mehtap; Askar, Niyazi

    2016-01-01

    [Purpose] The aim of this study was to evaluate whether the effect of pelvic floor exercises on pelvic floor muscle strength could be detected via ultrasonography in patients with urinary incontinence. [Subjects and Methods] Of 282 incontinent patients, 116 participated in the study and were randomly divided into a pelvic floor muscle training (n=65) group or control group (n=51). The pelvic floor muscle training group was given pelvic floor exercise training for 12 weeks. Both groups were ev...

  12. Defining a Minimum End Mill Diameter

    Directory of Open Access Journals (Sweden)

    A. E. Dreval'

    2015-01-01

    Full Text Available Industrial observations show that the standard mill designs in many cases do not provide a complete diversity of manufacturing operations, and a lot of enterprises are forced to design and manufacture special (original designs of tools. The information search has revealed a lack of end mill diameter calculations in publications. There is a proposal to calculate the end mill diameter either by empirical formulas [2, 3], or by selection from the tables [4].To estimate a minimum diameter of the end mill to perform the specified manufacturing operations based on the mill body strength the formulas are obtained. The initial data for calculation are the flow sheet of milling operation and properties of processed and tool materials. The end mill is regarded, as a cantilevered beam of the circular cross section having Dс diameter (mill core diameter with overhang Lв from rigid fixing and loaded by the maximum bending force and torque.In deriving the formulas were used the following well-reasoned assumptions based on the analysed sizes of the structural elements of the standard mills: a diameter of mill core is linearly dependent on the mill diameter and the overhang; the 4τ 2 to σ 2 4τ2 ratio is constant and equal to 0.065 for contour milling and 0.17 for slot milling.The formulas for calculating the minimum diameter are as follows:  3 обр в 1 121 1.1  K S L L D m C z    for contour milling;  3 обр в 1 207 1.1  K S L L D m C z    for slot milling.Obtained dependences that allow defining a minimum diameter of the end mill in terms of ensuring its strength can be used to design mills for contour milling with radius transition sections, holes of different diameters in the body parts and other cases when for processing a singlemill is preferable.Using the proposed dependencies for calculating a feed of the maximum tolerable strength is reasonable in designing the mills for slots.Assumptions used in deriving

  13. Unit distances and diameters in Euclidean spaces

    CERN Document Server

    Swanepoel, Konrad J

    2007-01-01

    We show that the maximum number of unit distances or of diameters in a set of n points in d-dimensional Euclidean space is attained only by specific types of Lenz constructions, for all d >= 4 and n sufficiently large, depending on d. As a corollary we determine the exact maximum number of unit distances for all even d >= 6, and the exact maximum number of diameters for all d >= 4, for all $n$ sufficiently large, depending on d.

  14. Shaft Diameter Measurement Using Structured Light Vision

    OpenAIRE

    2015-01-01

    A method for measuring shaft diameters is presented using structured light vision measurement. After calibrating a model of the structured light measurement, a virtual plane is established perpendicular to the measured shaft axis and the image of the light stripe on the shaft is projected to the virtual plane. On the virtual plane, the center of the measured shaft is determined by fitting the projected image under the geometrical constraints of the light stripe, and the shaft diameter is meas...

  15. Appendiceal diameter: CT versus sonographic measurements

    Energy Technology Data Exchange (ETDEWEB)

    Orscheln, Emily S. [University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH (United States); Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2016-03-15

    Ultrasound and CT are the dominant imaging modalities for assessment of suspected pediatric appendicitis, and the most commonly applied diagnostic criterion for both modalities is appendiceal diameter. The classically described cut-off diameter for the diagnosis of appendicitis is 6 mm when using either imaging modality. To demonstrate the fallacy of using the same cut-off diameter for both CT and US in the diagnosis of appendicitis. We conducted a retrospective review of patients younger than 18 years who underwent both US and CT of the appendix within 24 h. The shortest transverse dimension of the appendix was measured at the level of the proximal, mid and distal appendix on US and CT images. We compared mean absolute difference in appendiceal diameter between US and CT, using the paired t-test. We reviewed exams of 155 children (58.7% female) with a mean age of 11.3 ± 4.2 years; 38 of the children (24.5%) were diagnosed with appendicitis. The average time interval between US and CT was 7.0 ± 5.4 h. Mean appendiceal diameter measured by CT was significantly larger than that measured by US in cases without appendicitis (5.3 ± 1.0 mm vs. 4.7 ± 1.1 mm, P < 0.0001) and in cases with appendicitis (8.3 ± 2.2 mm vs. 7.0 ± 2.0 mm, P < 0.0001). Mean absolute diameter difference at any location along the appendix was 1.3-1.4 mm in normal appendices and 2 mm in cases of appendicitis. Measured appendiceal diameter differs between US and CT by 1-2 mm, calling into question use of the same diameter cut-off (6 mm) for both modalities for the diagnosis of appendicitis. (orig.)

  16. 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.

  17. Condom Use and the Risk of Recurrent Pelvic Inflammatory Disease, Chronic Pelvic Pain, or Infertility Following an Episode of Pelvic Inflammatory Disease

    Science.gov (United States)

    Ness, Roberta B.; Randall, Hugh; Richter, Holly E.; Peipert, Jeffrey F.; Montagno, Andrea; Soper, David E.; Sweet, Richard L.; Nelson, Deborah B.; Schubeck, Diane; Hendrix, Susan L.; Bass, Debra C.; Kip, Kevin E.

    2004-01-01

    Among 684 sexually active women with pelvic inflammatory disease (PID) followed up for a mean of 35 months, we related contraceptive use to self-reported PID recurrence, chronic pelvic pain, and infertility. Persistent use of condoms during the study reduced the risk of recurrent PID, chronic pelvic pain, and infertility. Consistent condom use (about 60% of encounters) at baseline also reduced these risks, after adjustment for confounders, by 30% to 60%. Self-reported persistent and consistent condom use was associated with lower rates of PID sequelae. PMID:15284036

  18. 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

  19. Pelvic Incidence in Patients with Hip Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Ibrahim Raphael

    2016-04-01

    Full Text Available Background: Hip osteoarthritis (OA is a major cause of pain and disability that results in considerable social and medical costs. Mechanics such as posture, alignment and orientation of the hips and the spinal column and the relationship between these factors have been implicated in the development of both hip and spine pathologies. This study aims to test the hypothesis if pelvic incidence varies in patients with and without osteoarthritis. We assessed the relationship between spinopelvic alignment as measured by pelvic incidence (PI and the presence of hip OA. Methods: We collected supine pelvis CT scans of 1,012 consecutive patients not known to have hip OA. Our first group consisted of 95 patients with moderate to severe hip OA as per radiology reports. The second group included 87 patients with no evidence of hip OA. Power analysis revealed the need for 77 patients per group to find a mean difference in PI of 5º or less between both groups. Two trained physicians independently measured the PI to account for inter-observer reliability. Results: Patients with moderate to severe hip OA had a mean PI of 56.5º±12.8º. The mean PI for patients without hip OA was 57.2º±7.5º. An independent samples t-test revealed no significant difference between the PI values of the two groups. Spearman’s correlation coefficient of 0.754 demonstrated a high inter-observer reliability. Conclusion: There was no difference in PI angle of hip OA patients and "healthy" patients. Our measurements of patients without OA were almost identical to the reported normal PI values in the literature. It appears that hip OA is not associated with PI angle, refuting the hypothesis made in previous studies, stating that elevated PI contributes to the future development of hip arthritis. CT scan seems to be a reliable and accurate way of assessing pelvic incidence.

  20. Robotic single-site pelvic lymphadenectomy.

    Science.gov (United States)

    Tateo, Saverio; Nozza, Arrigo; Del Pezzo, Chiara; Mereu, Liliana

    2014-09-01

    To examine the feasibility of performing pelvic lymphadenectomy with robotic single site approach. Recent papers described the feasibility of robotic-single site hysterectomy [1-3] for benign and malign pathologies but only with the development of new single site 5mm instruments as the bipolar forceps, robotic single site platform can be safely utilized also for lymphadenectomy. A 65 year-old, multiparous patient with a body mass index of 22.5 and diagnosed with well differentiated adenocarcinoma of the endometrium underwent a robotic single-site peritoneal washing, total hysterectomy, bilateral adnexectomy and pelvic lymphadenectomy. The procedure was performed using the da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA) through a single 2,5 cm umbilical incision, with a multi-channel system and two single site robotic 5mm instruments. A 3-dimensional, HD 8.5mm endoscope and a 5mm accessory instrument were also utilized. Type I lymphonodes dissection for external iliac and obturator regions was performed [4]. Total operative time was 210 min; incision, trocar placement and docking time occurring in 12 min. Total console time was 183 min, estimated blood loss was 50 ml, no intra-operative or post-operative complications occurred. Hospital discharge occurred on post operative day 2 and total number of lymphnodes removed was 33. Difficulties in term of instrument's clashing and awkward motions have been encountered. Robotic single-site pelvic lymphadenectomy using bipolar forceps and monopolar hook is feasible. New developments are needed to improve surgical ergonomics and additional studies should be performed to explore possible benefits of this procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Pelvic Organ Prolapse-Associated Cystitis

    OpenAIRE

    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 UT...

  2. Pelvic girdle shape predicts locomotion and phylogeny in batoids.

    Science.gov (United States)

    Ekstrom, Laura J; Kajiura, Stephen M

    2014-01-01

    In terrestrial vertebrates, the pelvic girdle can reliably predict locomotor mode. Because of the diminished gravitational effects on positively buoyant bony fish, the same relationship does not appear to exist. However, within the negatively buoyant elasmobranch fishes, benthic batoids employ pelvic fin bottom-walking and punting as primary or supplementary forms of locomotion. Therefore, in this study, we employed geometric and linear morphometrics to investigate if their pelvic girdles exhibit shape characteristics similar to those of sprawling terrestrial vertebrates. We tested for correlates of pelvic girdle shape with 1) Order, 2) Family, 3) Swim Mode, and/or 4) Punt Mode. Landmarks and semilandmarks were placed along outlines of dorsal views of 61 batoid pelvic girdles (3/3 orders, 10/13 families, 35/72 genera). The first three relative warps explained 88.45% of the variation among individuals (P girdle, was significantly different among punt modes, whereas only pectoral fin oscillators had differently shaped pelvic girdles when compared with batoids that perform other swimming modes (P girdles of batoids vary greatly, and therefore, likely function in ways not previously described in teleost fishes. This study illustrates that pelvic girdle shape is a good predictor of punt mode, some forms of swimming mode, and a species' Order. Such correlation between locomotor style and pelvic girdle shape provides evidence for the convergent evolution of morphological features that support both sprawled-gait terrestrial walking and aquatic bottom-walking.

  3. Pelvic Organ Prolapse : Conservative treatments in primary care

    NARCIS (Netherlands)

    Panman, Chantal; Wiegersma, Marian

    2017-01-01

    Pelvic organ prolapse is defined as descent of the anterior or posterior vaginal wall, the uterus, or the vaginal vault (after hysterectomy). Pelvic floor muscle training (PFMT) and pessaries are commonly used in the conservative treatment of prolapse. Although both treatments could typically be

  4. CHRONIC PELVIC PAIN SYNDROME – MODERN LOOK TO THE PROBLEM

    Directory of Open Access Journals (Sweden)

    S. B. Izvozchikov

    2011-01-01

    Full Text Available The main causes of chronic pelvic pain syndrome (CPPS, and its pathogenetic mechanisms are described. The criteria of evaluation ofchronic pelvic stress pain are described .It is proposed to use ultidisciplinary approach for therapy CPPS with compulsory neurologists, chiropractic physicians, psychiatrists and therapists, urologists, gynecologists and proctologists involvement to improve diagnostic and quality of therapeutic measures.

  5. Understanding peripartum pelvic pain: Implications of a patient survey

    NARCIS (Netherlands)

    J.M.A. Mens (Jan); A. Vleeming (Andry); R. Stoeckart (Rob); H.J. Stam (Henk); C.J. Snijders (Chris)

    1996-01-01

    textabstractStudy Design. An analysis was made of the self-reported medical histories of patients with peripartum pelvic pain. Objectives. To compile an inventory of the disabilities of patients with peripartum pelvic pain, analyze factors associated with the risk for development of the disease, and

  6. CHRONIC PELVIC PAIN SYNDROME – MODERN LOOK TO THE PROBLEM

    Directory of Open Access Journals (Sweden)

    S. B. Izvozchikov

    2014-07-01

    Full Text Available The main causes of chronic pelvic pain syndrome (CPPS, and its pathogenetic mechanisms are described. The criteria of evaluation ofchronic pelvic stress pain are described .It is proposed to use ultidisciplinary approach for therapy CPPS with compulsory neurologists, chiropractic physicians, psychiatrists and therapists, urologists, gynecologists and proctologists involvement to improve diagnostic and quality of therapeutic measures.

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

    NARCIS (Netherlands)

    C.M.A. Zwienen

    2005-01-01

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

  8. 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)

  9. Gonad shielding in paediatric pelvic radiography: disadvantages prevail over benefit

    NARCIS (Netherlands)

    Frantzen, M.J.; Robben, S.; Postma, A.A.; Zoetelief, J.; Wildberger, J.E.; Kemerink, G.J.

    2012-01-01

    Objective To re-evaluate gonad shielding in paediatric pelvic radiography in terms of attainable radiation risk reduction and associated loss of diagnostic information. Methods A study on patient dose and the quality of gonad shielding was performed retrospectively using 500 pelvic radiographs of ch

  10. Labor Dystocia as First Presentation of Pelvic Malignancy

    Directory of Open Access Journals (Sweden)

    Dennis van Hamont

    2011-01-01

    Full Text Available The underlying causes of labor dystocia can be various. Lack of expulsive forces or fetal malpresentation are amongst the most common ones. However, pelvic masses are described as well. Here we describe two cases of labor dystocia as first presentation of pelvic malignancy.

  11. Labor Dystocia as First Presentation of Pelvic Malignancy

    OpenAIRE

    Dennis van Hamont; Zusterzeel, Petra L. M.

    2011-01-01

    The underlying causes of labor dystocia can be various. Lack of expulsive forces or fetal malpresentation are amongst the most common ones. However, pelvic masses are described as well. Here we describe two cases of labor dystocia as first presentation of pelvic malignancy.

  12. Comparative histology of mouse, rat, and human pelvic ligaments.

    Science.gov (United States)

    Iwanaga, Ritsuko; Orlicky, David J; Arnett, Jameson; Guess, Marsha K; Hurt, K Joseph; Connell, Kathleen A

    2016-11-01

    The uterosacral (USL) and cardinal ligaments (CL) provide support to the uterus and pelvic organs, and the round ligaments (RL) maintain their position in the pelvis. In women with pelvic organ prolapse (POP), the connective tissue, smooth muscle, vasculature, and innervation of the pelvic support structures are altered. Rodents are commonly used animal models for POP research. However, the pelvic ligaments have not been defined in these animals. In this study, we hypothesized that the gross anatomy and histological composition of pelvic ligaments in rodents and humans are similar. We performed an extensive literature search for anatomical and histological descriptions of the pelvic support ligaments in rodents. We also performed anatomical dissections of the pelvis to define anatomical landmarks in relation to the ligaments. In addition, we identified the histological components of the pelvic ligaments and performed quantitative analysis of the smooth muscle bundles and connective tissue of the USL and RL. The anatomy of the USL, CL, and RL and their anatomical landmarks are similar in mice, rats, and humans. All species contain the same cellular components and have similar histological architecture. However, the cervical portion of the mouse USL and RL contain more smooth muscle and less connective tissue compared with rat and human ligaments. The pelvic support structures of rats and mice are anatomically and histologically similar to those of humans. We propose that both mice and rats are appropriate, cost-effective models for directed studies in POP research.

  13. Diagnosis and treatment of rare complications of pelvic fractures

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

    M. de Groot (Mirthe)

    2005-01-01

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

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

    NARCIS (Netherlands)

    C.M.A. Zwienen

    2005-01-01

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

  16. Pathologic Malgaigne fracture following pelvic irradiation. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jones, A.R.; Lachiewicz, P.F.

    1987-08-01

    A 48-year-old woman developed symptomatic superior and inferior pubic rami fractures with a concomitant subluxation of the ipsilateral sacroiliac joint three years after pelvic irradiation for a gynecologic malignancy. Pathologic pelvic fractures (PPF) caused by irradiation may be difficult to distinguish from those caused by metastatic disease. PPF produce prolonged disability.

  17. Small bowel obstruction in percutaneous fixation of traumatic pelvic fractures

    Directory of Open Access Journals (Sweden)

    Roberto Bini

    2013-01-01

    Full Text Available The use of external fixation for the initial treatment of unstable, complex pelvic injuries with hemodynamic instability remains an effective treatment for multiply injured patients. Bowel entrapment within a pelvic fracture is a rarely reported, potentially fatal complication. Here, we report a polytrauma patient with pelvic fractures who developed an intestinal obstruction after an external fixation. At an explorative laparotomy, we found an ileum segment trapped in the sacral fracture. Reported cases of bowel entrapment in pelvic fractures, especially in sacral fractures, are exceedingly rare. The diagnosis is often delayed due to difficulty distinguishing entrapment from the more common adynamic ileus. In conclusion, clinicians and radiologists should be aware of this potentially lethal complication of pelvic fractures treatment. To exclude bowel entrapment, patients with persistent ileus or sepsis should undergo early investigations.

  18. Survival trends and predictors of mortality in severe pelvic trauma

    DEFF Research Database (Denmark)

    Pohlemann, Tim; Stengel, Dirk; Tosounidis, Georgios

    2011-01-01

    STUDY OBJECTIVE: To determine longitudinal trends in mortality, and the contribution of specific injury characteristics and treatment modalities to the risk of a fatal outcome after severe and complex pelvic trauma. METHODS: We studied 5048 patients with pelvic ring fractures enrolled in the German...... Pelvic Trauma Registry Initiative between 1991 and 1993, 1998 and 2000, and 2004 and 2006. Complete datasets were available for 5014 cases, including 508 complex injuries, defined as unstable fractures with severe peri-pelvic soft tissue and organ laceration. Multivariable mixed-effects logistic...... with this type of injury was 18% (95% CI 9-32%) in 2006. CONCLUSION: In contrast to an overall decline in trauma mortality, complex pelvic ring injuries remain associated with a significant risk of death. Awareness of this potentially life-threatening condition should be increased amongst trauma care...

  19. Effect of pelvic tilt on lumbar spine geometry.

    Science.gov (United States)

    Delisle, A; Gagnon, M; Sicard, C

    1997-12-01

    The purpose of this study was to use a noninvasive method to determine the effect of pelvic tilt on the lumbar spine geometry in the sagittal plane. Five healthy male subjects were instructed in performing active forward and backward pelvic tilt manoeuvres in the standing position. The lumbar spine geometry (severity of lordosis, pelvis and lumbar vertebrae orientations) was estimated with a lumbar spine geometric model. The voluntary backward pelvic tilt succeeded in reducing the depth of the lumbar spine curvature, but the forward tilt did not change it. Both pelvic tilt manoeuvres influenced the absolute orientations of the lower lumbar vertebrae and the relative orientations of some lumbar vertebrae. Interestingly, the L5/S1 joint showed was little affected by the pelvic tilt manoeuvres.

  20. Effect of pelvic floor muscle exercises on pulmonary function

    Science.gov (United States)

    Han, DongWook; Ha, Misook

    2015-01-01

    [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

  1. [Pelvic Health: Healthcare Needs From Medical and Women Perspectives].

    Science.gov (United States)

    Lyu, Ji-Yan; Chang, Lu-I; Tsai, Chuan-Hsiu

    2017-04-01

    The pelvis, one of the most important cavities in the human body, is involved in human reproduction health. The pelvis changes in females with age and reproduction-related changes in hormones. Women generally lack sufficient knowledge regarding their pelvic-health needs and feel embarrassed to seek pelvic-health-related medical advice. Conversely, medical care related to women's health focuses mainly on maternal health and cancer prevention. When facing the challenges of pelvic floor dysfunction, surgical procedures are the most common treatment modality. The present article aims to define pelvic health and to compare the differences in perspective on this issue between the medical and women. Lastly, suggestions for pelvic healthcare that focus on women's needs are made.

  2. Anatomy of the collecting system of lower pole of the kidney in patients with a single renal stone: a comparative study with individuals with normal kidneys

    Directory of Open Access Journals (Sweden)

    Zomorrodi Afshar

    2010-01-01

    Full Text Available At least 5% of women and 12% of men during their lives will experience renal colic, at least once. Many theories have been suggested for the etiology of renal stones and va-riations in the anatomy of the collecting system have been suggested to have a role in stone formation. This study was conducted to examine the role of variation of lower pole collecting system in patients with lower pole kidney stone and compared the same in normal persons (kidney donors. Investigation for the anatomy of the lower pole of the kidney (angle between lower infundibulum and pelvis, length and diameter of the infundibulum and number and pattern distribution of calyces was carried out using intravenous pyelogram (IVP in 100 cases with urinary stone (study cases and 400 persons with normal kidneys (control subjects. The study was a retrospective cross-sectional case control study. Results were analyzed by Mann-Whiteny and independent sample chi square tests. The mean infundibulum-pelvic angle (IPA in control subjects and in patients was 112.5 ± 10.7 and 96.6 ± 28.8, respectively. There was significant correlation between reduced angle and stone formation (P= < 0.001. The mean infundibulum-uretero-pelvic angle (IUPA in control subjects and study cases was 53.5 ± 12.7 and 42.6 ± 13.4, respectively. There was significant correlation between decreased angle and stone formation (P= < 0.001. The mean length of infundibulum of lower pole of kidney (IPIL in controls and study patients was 22.5 ± 4.1 and 27.5 ± 7.7, respectively, which was statistically significant (P< 0.001. The mean number of calyces in lower pole of the kidney (LPCN in controls and study patients was 2.6 ± 0.6 and 3 ± 0.9, respectively, which was statistically significant (P= < 0.002. There was no significant correlation between distribution of calyces and stone formation (P= 0.366. Our study suggests that abnormal renal anatomy was more common in patients with lower pole kidney stone and should

  3. Clinical assessment of the impact of pelvic pain on women.

    Science.gov (United States)

    Chalmers, K Jane; Catley, Mark J; Evans, Susan F; Moseley, G Lorimer

    2017-03-01

    We aimed to develop a questionnaire that assesses the impact of pelvic pain on women, regardless of diagnosis, that has high utility, sound psychometric performance, easy scoring, and high reliability. Two studies, with 3 separate cohorts, were undertaken. Both studies were completed online. Studies included women with self-reported pelvic pain. Women were eligible to participate regardless of whether their pelvic pain was undiagnosed, self-diagnosed, or diagnosed by a clinician. Study 1 used a 3-round "patient-as-expert" Delphi technique. These rounds defined the 10 aspects of life with the self-reported greatest impact on the lives of women with pelvic pain, which formed the questionnaire. Study 2 used Rasch analysis to assess the psychometric properties of the resultant 10-item questionnaire. To assess its reliability, a subgroup completed the questionnaire 3 times over a 3-week period. In study 1, 443 women with pelvic pain participated. The resultant 10-item questionnaire consisted of 8 Likert questions and 2 supplemental, nonscored questions. In study 2, 1203 women with pelvic pain completed the questionnaire. Rasch analysis showed that the questionnaire targeted the pelvic pain population well, had appropriate Likert categories, constituted a unidimensional scale, and showed internal consistency. Twenty-seven women with pelvic pain completed the reliability trial. Test-retest reliability was high (intraclass correlation coefficient 0.91, P Pelvic Pain Impact Questionnaire assesses the life impact of pelvic pain. It uses patient-generated language, is easily administered and scored, has very strong psychometric properties, and it is suitable for research and clinical settings across primary, secondary, and tertiary care.

  4. Factors predisposing women to chronic pelvic pain: systematic review

    Science.gov (United States)

    Latthe, Pallavi; Mignini, Luciano; Gray, Richard; Hills, Robert; Khan, Khalid

    2006-01-01

    Objective To evaluate factors predisposing women to chronic and recurrent pelvic pain. Design, data sources, and methods Systematic review of relevant studies without language restrictions identified through Medline, Embase, PsycINFO, Cochrane Library. SCISEARCH, conference papers, and bibliographies of retrieved primary and review articles. Two reviewers independently extracted data on study characteristics, quality, and results. Exposure to risk factors was compared between women with and without pelvic pain. Results were pooled within subgroups defined by type of pain and risk factors. Results There were 122 studies (in 111 articles) of which 63 (in 64 286 women) evaluated 54 risk factors for dysmenorrhoea, 19 (in 18 601 women) evaluated 14 risk factors for dyspareunia, and 40 (in 12 040 women) evaluated 48 factors for non-cyclical pelvic pain. Age < 30 years, low body mass index, smoking, earlier menarche (< 12 years), longer cycles, heavy menstrual flow, nulliparity, premenstrual syndrome, sterilisation, clinically suspected pelvic inflammatory disease, sexual abuse, and psychological symptoms were associated with dysmenorrhoea. Younger age at first childbirth, exercise, and oral contraceptives were negatively associated with dysmenorrhoea. Menopause, pelvic inflammatory disease, sexual abuse, anxiety, and depression were associated with dyspareunia. Drug or alcohol abuse, miscarriage, heavy menstrual flow, pelvic inflammatory disease, previous caesarean section, pelvic pathology, abuse, and psychological comorbidity were associated with an increased risk of non-cyclical pelvic pain. Conclusion Several gynaecological and psychosocial factors are strongly associated with chronic pelvic pain. Randomised controlled trials of interventions targeting these potentially modifiable factors are needed to assess their clinical relevance in chronic pelvic pain. PMID:16484239

  5. Collagen fibril diameter and leather strength.

    Science.gov (United States)

    Wells, Hannah C; Edmonds, Richard L; Kirby, Nigel; Hawley, Adrian; Mudie, Stephen T; Haverkamp, Richard G

    2013-11-27

    The main structural component of leather and skin is type I collagen in the form of strong fibrils. Strength is an important property of leather, and the way in which collagen contributes to the strength is not fully understood. Synchrotron-based small angle X-ray scattering (SAXS) is used to measure the collagen fibril diameter of leather from a range of animals, including sheep and cattle, that had a range of tear strengths. SAXS data were fit to a cylinder model. The collagen fibril diameter and tear strength were found to be correlated in bovine leather (r(2) = 0.59; P = 0.009), with stronger leather having thicker fibrils. There was no correlation between orientation index, i.e., fibril alignment, and fibril diameter for this data set. Ovine leather showed no correlation between tear strength and fibril diameter, nor was there a correlation across a selection of other animal leathers. The findings presented here suggest that there may be a different structural motif in skin compared with tendon, particularly ovine skin or leather, in which the diameter of the individual fibrils contributes less to strength than fibril alignment does.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  11. 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.

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

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Dehlendorff, Christian

    2013-01-01

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

  13. 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.

  14. Learning Pelvic Examination with Professional Patients

    Directory of Open Access Journals (Sweden)

    S Shrestha

    2010-03-01

    Full Text Available Performing pelvic examination is a vital skill to learn during gynecological and obstetrical training. It's a difficult maneuver to master as there is very little to see and more to feel and interpret. In addition, learning PE in usual clinical set-up has been found to induce lot of stress and anxiety among both the patients and the students. Students fear of hurting the patients and being judged inept, whereas patients feel embarrassed having to expose their most intimate body parts for learning purpose. This hampers effective learning. Learning PE on sedated women before surgery or on mannequins has been practiced as alternative learning models. But, they have been found to miss out on teaching the communication skills, which are as important as the palpation skills. However, there exists another model of learning PE--the professional patients, who are specially trained to act as patients and also guide the students on how to make a proper PE. They provide stress-free environment for the students to learn PE and at the same time, provide immediate feedback on each of their maneuvers. They form a complete learning model and help students to see patients as partner and not just a person seeking help. Keywords: learning model, pelvic examination, stress, students.

  15. Gluteal Compartment Syndrome Secondary to Pelvic Trauma

    Directory of Open Access Journals (Sweden)

    Fernando Diaz Dilernia

    2016-01-01

    Full Text Available Gluteal compartment syndrome (GCS is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

  16. Gluteal Compartment Syndrome Secondary to Pelvic Trauma.

    Science.gov (United States)

    Diaz Dilernia, Fernando; Zaidenberg, Ezequiel E; Gamsie, Sebastian; Taype Zamboni, Danilo E R; Carabelli, Guido S; Barla, Jorge D; Sancineto, Carlos F

    2016-01-01

    Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

  17. Percutaneous drainage of pelvic fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Young; Sohn, Cheol Ho [School of Medicine Keimyung University, Daegu (Korea, Republic of)

    1995-10-15

    To evaluate safe access route and success rate of percutaneous drainage of pelvic fluid collection. The 35 percutaneous drainages of pelvic fluid collection under the CT and fluorosocpic guidance were done in 32 patients. The anterior transabdominal approach was done in 20 patients, while the nine patients used the transgluteal approach through greater sciatic foramen. Three patients, who had septated or noncommunicating abscesses, underwent drainage using both approaches. The catheter was removed when the patient's symptom and laboratory data were improved or the amount of drainage and the size of fluid collection were markedly reduced. Success, partial success and failure were classified. The causes of fluid collection were complication of intraabdominal operation in 27 patient. The diagnosis after drainage included abscess (21), loculated ascites (6), and hematoma (4). The 27 cases (30 procedure) were treated successfully and the mean duration of catheter insertion was 10 days. The partial successes were two cases (2 procedures), which had palliative purpose. Three cases (3 procedures) were failed, which were multiple loculated ascites of pancreatic origin (2) and recurrent abscess (1). The significant complication during the procedure or drainage was not noted.

  18. [Risk factors associated with pelvic inflammatory disease].

    Science.gov (United States)

    Pelayo Vera, Salvador; Hernández Landa, Tomás; Rodríguez Guzmán, Leoncio Miguel; Hernández Cruz, Leticia

    2002-08-01

    To determine the socio-demographic and gynecological risk factors in pelvic inflammatory disease (EPI). A study of the cases and controls divided by the age and the medical attention unit was performed. Women with an active sex life, who chose to participate in the study, were included. The definition of a case were the women who presented at least four of the clinical manifestations identified as critical as the principal criteria for EPI. For both groups a questionnaire was applied which contained the socio-demographical, gynecological and obstetric variables. 50 cases and 50 controls were evaluated. The risk factors associated with EPI were: scholastic level below high school, RMp 2.22 (IC95% 1.03-5.13); low scholastic level of the couple, RMp 2.33 (0.91-6.6); working women, RMp 3.17 (IC95% 1.3-8.7); women with a low socioeconomic level, RMp 2.86 (IC95% 1.24-7.26); a history of infectious vaginitis in the previous three months, RMp 41 (IC95% 7.94-838). The history of a use of intrauterine devices (DIU) did not present any association (RMp 0.06). The presence of EPI was found to be associated to socio-demographic and previous infectious vaginitis variables. The use of oral hormones and IUD did not show any relation. A greater amount of sexual education is needed for women with an active sex life in order to avoid the pelvic inflammatory disease.

  19. Treatment of Acute Pelvic Inflammatory Disease

    Directory of Open Access Journals (Sweden)

    Richard L. Sweet

    2011-01-01

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

  20. Computed tomography in pelvic and acetabular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Born, H.; Schmidt, C.

    1988-06-01

    In a retrospective study we analyzed the results of 127 patients, who were examined not only by means of conventional radiography but also by means of computed tomography after a trauma of the pelvic. Our investigations were based upon such patients, to whom a definite diagnostic procedure of plain radiography had been performed. Therefore all polytraumatized patients were inapplicable. They were only examined by computed tomography because of other more important accompanying injuries of other body regions. We compared the results of 127 patients with pelvic trauma. The results of the CT were in accordance with the results of the plain radiography for 103 patients. The results of the CT concerning the availability and the localization of the fractures were basically coincident with the plain radiography for 22 patients, but the CT showed a higher degree of trauma and additional intraarticular fragments. Two isolated lesions of the sacroiliac joint could not be recognized by both methods. They could only be diagnosed by bone scintigraphy on the third day after trauma.

  1. Precise renal artery segmentation for estimation of renal vascular dominant regions

    Science.gov (United States)

    Wang, Chenglong; Kagajo, Mitsuru; Nakamura, Yoshihiko; Oda, Masahiro; Yoshino, Yasushi; Yamamoto, Tokunori; Mori, Kensaku

    2016-03-01

    This paper presents a novel renal artery segmentation method combining graph-cut and template-based tracking methods and its application to estimation of renal vascular dominant region. For the purpose of giving a computer assisted diagnose for kidney surgery planning, it is important to obtain the correct topological structures of renal artery for estimation of renal vascular dominant regions. Renal artery has a low contrast, and its precise extraction is a difficult task. Previous method utilizing vesselness measure based on Hessian analysis, still cannot extract the tiny blood vessels in low-contrast area. Although model-based methods including superellipsoid model or cylindrical intensity model are low-contrast sensitive to the tiny blood vessels, problems including over-segmentation and poor bifurcations detection still remain. In this paper, we propose a novel blood vessel segmentation method combining a new Hessian-based graph-cut and template modeling tracking method. Firstly, graph-cut algorithm is utilized to obtain the rough segmentation result. Then template model tracking method is utilized to improve the accuracy of tiny blood vessel segmentation result. Rough segmentation utilizing graph-cut solves the bifurcations detection problem effectively. Precise segmentation utilizing template model tracking focuses on the segmentation of tiny blood vessels. By combining these two approaches, our proposed method segmented 70% of the renal artery of 1mm in diameter or larger. In addition, we demonstrate such precise segmentation can contribute to divide renal regions into a set of blood vessel dominant regions utilizing Voronoi diagram method.

  2. End-stage renal disease due to delayed diagnosis of renal tuberculosis: a fatal case report

    Directory of Open Access Journals (Sweden)

    Elizabeth De Francesco Daher

    Full Text Available Renal TB is difficult to diagnose, because many patients present themselves with lower urinary symptoms which are typical of bacterial cystitis. We report a case of a young woman with renal TB and ESRD. She was admitted with complaints of adynamia, anorexia, fever, weight loss, dysuria and generalized edema for 10 months. At physical examination she was febrile (39ºC, and her abdomen had increased volume and was painful at palpation. Laboratorial tests showed serum urea=220mg/dL, creatinine=6.6mg/dL, hemoglobin=7.9g/dL, hematocrit=24.3%, leukocytes=33,600/mm³ and platelets=664,000/mm³. Urinalysis showed an acid urine (pH=5.0, leukocyturia (2+/4+ and mild proteinuria (1+/4+. She was also oliguric (urinary volume <400mL/day. Abdominal echography showed thick and contracted bladder walls and heterogeneous liquid collection in the left pelvic region. Two laparotomies were performed, in which abscess in pelvic region was found. Anti-peritoneal tuberculosis treatment with rifampin, isoniazid and pyrazinamide was started. During the follow-up, the urine culture was found to be positive for M. tuberculosis. Six months later the patient had complaints of abdominal pain and dysuria. New laboratorial tests showed serum urea=187mg/dL, creatinine=8.0mg/dL, potassium=6.5mEq/L. Hemodialysis was then started. The CT scan showed signs of chronic nephropathy, dilated calyces and thinning of renal cortex in both kidneys and severe dilation of ureter. The patient developed neurologic symptoms, suggesting tuberculous meningoencephalitis, and died despite of support measures adopted. The patient had ESRD due to secondary uropathy to prolonged tuberculosis of urinary tract that was caused by delayed clinical and laboratorial diagnosis, and probably also due to inadequate antituberculous drugs administration.

  3. Diameter Preserving Surjection on Alternate Matrices

    Institute of Scientific and Technical Information of China (English)

    Li Ping HUANG

    2009-01-01

    Let F be a field with |F| ≥ 3, Km be the set of all m × m (m ≥ 4) alternate matrices over F. The arithmetic distance of A, B ∈ Km is d(A, B) := rank(A- B). If d(A, B) = 2, then A and B are said to be adjacent. The diameter of Km is max{d(A, B) : A, B ∈ Km}. Assume that ψ : Km→ Km is a map. We prove the following are equivalent: (a) ψ is a diameter preserving surjection in both directions, (b) ψ is both an adjacency preserving surjection and a diameter preserving map, (c) ψ is a bijective map which preserves the arithmetic distance.

  4. The truth about small-diameter implants.

    Science.gov (United States)

    Christensen, Gordon J; Child, Paul L

    2010-05-01

    SDIs that are treatment planned correctly, placed and loaded properly, and are within a well-adjusted occlusion, are working in an excellent manner for the patients described in this article. It is time for those practitioners unfamiliar with SDIs and their uses to discontinue their discouragement of this technique. SDIs are easily placed, minimally invasive, and a true service to those patients described. They do not replace conventional diameter implants; however, they are a significant and important augmentation to the original root-form implant concept. There is obvious evidence of the growing acceptance of small-diameter implants by both general practitioners and specialists.

  5. THERMAL EVALUATION OF DIFFERENT DRIFT DIAMETER SIZES

    Energy Technology Data Exchange (ETDEWEB)

    H.M. Wade

    1999-01-04

    The purpose of this calculation is to estimate the thermal response of a repository-emplaced waste package and its corresponding drift wall surface temperature with different drift diameters. The case examined is that of a 21 pressurized water reactor (PWR) uncanistered fuel (UCF) waste package loaded with design basis spent nuclear fuel assemblies. This calculation evaluates a 3.5 meter to 6.5 meter drift diameter range in increments of 1.0 meters. The time-dependent temperatures of interest, as determined by this calculation, are the spent nuclear fuel cladding temperature, the waste package surface temperature, and the drift wall surface temperature.

  6. Shaft Diameter Measurement Using Structured Light Vision.

    Science.gov (United States)

    Liu, Siyuan; Tan, Qingchang; Zhang, Yachao

    2015-08-12

    A method for measuring shaft diameters is presented using structured light vision measurement. After calibrating a model of the structured light measurement, a virtual plane is established perpendicular to the measured shaft axis and the image of the light stripe on the shaft is projected to the virtual plane. On the virtual plane, the center of the measured shaft is determined by fitting the projected image under the geometrical constraints of the light stripe, and the shaft diameter is measured by the determined center and the projected image. Experiments evaluated the measuring accuracy of the method and the effects of some factors on the measurement are analyzed.

  7. Shaft Diameter Measurement Using Structured Light Vision

    Directory of Open Access Journals (Sweden)

    Siyuan Liu

    2015-08-01

    Full Text Available A method for measuring shaft diameters is presented using structured light vision measurement. After calibrating a model of the structured light measurement, a virtual plane is established perpendicular to the measured shaft axis and the image of the light stripe on the shaft is projected to the virtual plane. On the virtual plane, the center of the measured shaft is determined by fitting the projected image under the geometrical constraints of the light stripe, and the shaft diameter is measured by the determined center and the projected image. Experiments evaluated the measuring accuracy of the method and the effects of some factors on the measurement are analyzed.

  8. Successful accessory renal artery denervation in a patient with resistant hypertension

    Directory of Open Access Journals (Sweden)

    Halil Atas

    2014-01-01

    Full Text Available Renal sympathetic denervation is safe and effective in patients with resistant hypertension. In all of the studies of renal artery denervation, patients with accessory renal arteries are excluded. So there is not any data regarding renal sympathetic denervation applied to the accessory renal arteries. We present a young female patient with resistant hypertension despite use of five different antihypertensive drugs. The patient had a well developed (diameter >4 mm left renal accessory. We believe that if we omitted the well developed accessory renal artery, we would not have maintained adequate blood pressure control. Thus, we applied radiofrequency ablation to both renal arteries and left accessory artery. Immediately after the procedure, the patient′s blood pressure was reduced to 110/60 mmHg and this effect was continued during the first month of follow-up.

  9. Influence of tube's diameter on boiling heat transfer performance in small diameter tubes

    Science.gov (United States)

    Gan, Chengjun; Wang, Weicheng; Zhang, Lining

    1998-03-01

    This paper reports the experiments of evaporation study in 6 mm inner copper diameter tubes using HFC-134a, HCFC-22 and CFC-12 as working fluid. The results show that the evaporation heat transfer coefficient increases with the decreasing of inner diameter of tubes. A new concept of non-dimensional tube diameter U is proposed in this paper for correction of the influence of the tube diameter on the evaporation heat transfer coefficient. And further, a convenient empirical correction method is presented.

  10. Influence of Tube‘s Diameter on Boling Heat Transfer Performance in Small Diameter Tubes

    Institute of Scientific and Technical Information of China (English)

    GanChengjun; WangWeicheng; 等

    1998-01-01

    This paper reports the experiments of evaporation study in 6 mm inner copper diameter tubes using HFC-134a,HCFC-22 and CFC-12 as working fluid.The results show that the evaporation heat transfer cofeeicient increasese with the decreasing of inner diameter of tubes,A new concept of nondimensional tube diameter U is proposed in this paper for correction of the influence of the tube diameter on the evaporation heat transfer coefficient.And further,a conveinent empirical correction method is preseted.

  11. Kidney (Renal) Failure

    Science.gov (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  12. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  13. Paraparesis secondary to erratic migration of Dioctophyma renale in a dog

    Directory of Open Access Journals (Sweden)

    Fernando Swiech Bach

    2016-05-01

    Full Text Available ABSTRACT: A 4 years old mongrel stray bitch, weighing 16kg was submitted to physical examination to demonstrated inability of locomotion with the pelvic limbs. Extradural spinal cord compression was observed in myelotomography of the thoracolumbar segment. The patient was submitted to exploratory hemilaminectomy of T13-L1 and L1-L2, in an attempt to decompress the medullar segments. During the surgery was observed one adult parasite, identified as Dioctophyma renale , located in the extradural space and causing spinal cord compression. The patient was submitted to postoperative physical therapy, presenting clinical improvement 15 days after surgery, remaining on prone position and able to move the pelvic limbs, but not yet able to walk unassisted. It started walking naturally 60 days after the surgery. With the present clinical report, the erratic migration of the parasite Dioctophyma renale should be added to the list of differential diagnoses for patients with paraparesis and extramedullary lesion pattern, especially in endemic areas.

  14. Body image and sexuality in women with pelvic organ prolapse.

    Science.gov (United States)

    Zielinski, Ruth; Low, Lisa Kane; Tumbarello, Julie; Miller, Janis M

    2009-01-01

    The effect of physical changes associated with pelvic organ prolapse on a woman's body image and how that may influence sexuality has not been well studied. The goal of this study was to assess the implementation and utility of a body image questionnaire in women with pelvic organ prolapse. Two research questions were asked: (1) What is the impact of pelvic organ prolapse on women's body image and how does this affect their sexual health?, and (2) Does the Vaginal Changes Sexual and Body Esteem (VSBE) Scale show utility for use in assessing body image and sexual health in women with pelvic organ prolapse? A qualitative design was used for this study. Telephone interviews were conducted using a semi-structured questionnaire and an adapted body image and sexuality questionnaire specific to genital body image. Thirteen women with pelvic organ prolapse completed the study. Eight women were classified as sexually active, and 5 women were not sexually active. Data showed women with pelvic organ prolapse, classified as sexually active, scored significantly lower on the VSBE scale than women who were not sexually active. There was a positive correlation between severity of prolapse and VSBE scores. The VSBE scale questionnaire showed utility and potential for demonstrating change in body image in women with pelvic organ prolapse. This tool may assist clinicians in a more thorough assessment of body image and sexuality in this population of women.

  15. Interstitial Cystitis in Persistent Posthysterectomy Chronic Pelvic Pain

    Science.gov (United States)

    2004-01-01

    Objectives: Hysterectomies may be performed unnecessarily in women with chronic pelvic pain if the diagnosis of interstitial cystitis is not considered. The objectives of this study were to investigate the prevalence of interstitial cystitis in patients with posthysterectomy chronic pelvic pain and to evaluate the efficacy of various therapies for interstitial cystitis. Methods: A study was performed of 111 patients with chronic pelvic pain whose pain persisted after hysterectomy. Patients were screened with the Pelvic Pain and Urgency/Frequency symptom scale, and underwent Potassium Sensitivity Testing. Patients were treated with dietary changes alone or in combination with cystoscopic hydrodistention or oral pentosan polysulfate, or both of these, for 3 to 6 months. Results: Of the 111 patients enrolled, 79% (n=88) were diagnosed with bladder dysfunction consistent with interstitial cystitis. For patients treated with dietary modification alone (n=33), the mean score on the Pelvic Pain and Urgency/Frequency questionnaire improved 15.4%, from 13.18 at baseline to 11.15 at follow-up. For patients treated with pentosan polysulfate or cystoscopic hydrodistention, or both, plus diet changes (n=78), Pelvic Pain and Urgency/Frequency scores improved 34.2%, from 15.01 to 9.87. Conclusion: In this study, nonsurgical treatment for interstitial cystitis resulted in a marked improvement in symptoms that had not improved with surgery. Without determining the origin of bladder pain, gynecologists should not proceed to hysterectomy in patients with chronic pelvic pain. PMID:15554275

  16. Laparoscopy in the diagnosis of tuberculosis in chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Shalini Rajarama

    2016-01-01

    Full Text Available Background: To estimate the prevalence of genital tuberculosis in women with idiopathic chronic pelvic pain on laparoscopy, correlate laparoscopic findings with microbiological and histological diagnosis of tuberculosis and assess the response to anti tubercular treatment (ATT in these cases. Method: In a prospective cohort study, fifty women with idiopathic chronic pelvic pain were enrolled. Diagnostic laparoscopy was done in all women and fluid from pouch of Douglas and/or saline washings were sent for acid fast bacilli (AFB smear, conventional and rapid culture and DNA polymerase chain reaction (PCR analysis for diagnosis of genital TB. The results of these tests were analyzed and agreement with laparoscopy was assessed using Kappa statistics. Pain scores using visual analogue scale were compared before and after treatment. Results: Pelvic pathology was present in 44 (88% women of idiopathic chronic pelvic pain, with a 34% prevalence rate of genital tuberculosis. Pelvic inflammation was associated with positive peritoneal fluid PCR (n = 4 and AFB culture (n = 3. Acid fast bacilli PCR had substantial agreement (kappa statistics = 0.716 with visual findings at laparoscopy. There was a significant reduction in pain scores after treatment. Conclusion: Genital tuberculosis contributes to one-third cases of chronic pelvic pain. Pelvic inflammation is an early feature of genital TB and peritoneal fluid PCR has the best co-relation with laparoscopic findings of genital tuberculosis.

  17. [Establishement for regional pelvic trauma database in Hunan Province].

    Science.gov (United States)

    Cheng, Liang; Zhu, Yong; Long, Haitao; Yang, Junxiao; Sun, Buhua; Li, Kanghua

    2017-04-28

    To establish a database for pelvic trauma in Hunan Province, and to start the work of multicenter pelvic trauma registry.
 Methods: To establish the database, literatures relevant to pelvic trauma were screened, the experiences from the established trauma database in China and abroad were learned, and the actual situations for pelvic trauma rescue in Hunan Province were considered. The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.
 Results: The complex procedure for pelvic trauma rescue was described structurally. The contents for the database included general patient information, injurious condition, prehospital rescue, conditions in admission, treatment in hospital, status on discharge, diagnosis, classification, complication, trauma scoring and therapeutic effect. The database can be accessed through the internet by browser/servicer. The functions for the database include patient information management, data export, history query, progress report, video-image management and personal information management.
 Conclusion: The database with whole life cycle pelvic trauma is successfully established for the first time in China. It is scientific, functional, practical, and user-friendly.

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

    Science.gov (United States)

    Inovay, J; Szendei, G

    1997-10-05

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

  19. FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Luis Muñiz Luna

    2016-03-01

    Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

  20. 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.)

  1. Spanish language translation of pelvic floor disorders instruments.

    Science.gov (United States)

    Young, Amy E; Fine, Paul M; McCrery, Rebecca; Wren, Patricia A; Richter, Holly E; Brubaker, Linda; Brown, Morton B; Weber, Anne M

    2007-10-01

    The purpose of the study is to translate existing measures of pelvic symptoms and quality of life from English into Spanish, facilitating research participation of Hispanic/Latina women. The forward-backward translation protocol was applied then adjudicated by a concordance committee. The measures included the Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ), Medical, Epidemiological, and Social Aspects of Aging (MESA) Questionnaire, Hunskaar Severity Measure, Fecal Incontinence Severity Index and modified Manchester Questionnaire, Pelvic Organ Prolapse/Urinary Incontinence Sexual Functioning Questionnaire (PISQ), and the Life Orientation Test (LOT). English and Spanish versions were administered to 50 Hispanic/Latina women with pelvic symptoms. Kappa correlations of items and correlation coefficients for scales were computed. Psychometric testing for translations demonstrated good (0.80-0.89), very good (0.90-0.95), or excellent (>0.95) correlations for primary scales of the PFDI, PFIQ, MESA, Hunskaar, PISQ, and LOT. Strict translation techniques and testing yielded valid Spanish translations of instruments assessing pelvic symptoms/functional life impact in women with pelvic floor disorders.

  2. 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

    2016-05-01

    [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.

  3. Economics of pelvic organ prolapse surgery.

    Science.gov (United States)

    Cheon, Cecilia; Maher, Christopher

    2013-11-01

    The aim was to review the economic costs associated with pelvic organ prolapse surgery. Every 4 years and as part of the Fifth International Collaboration on Incontinence we reviewed the English-language scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] or systematic reviews), level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies) and level 4 (case reports). The highest level of evidence was utilised by the committee to make evidence based recommendations based upon the Oxford grading system. Grade A recommendation usually depends on consistent level 1 evidence. Grade B recommendation usually depends on consistent level 2 and/or 3 studies, or "majority evidence" from RCTs. Grade C recommendation usually depends on level 4 studies or "majority evidence" from level 2/3 studies or Delphi processed expert opinion. Grade D "no recommendation possible" would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without a formal analytical process, such as by Delphi. The annual economic costs of pelvic organ prolapse surgeries are significant and over the next decades will grow at twice the rate of population growth because of our aging population. In a single institution study vaginal reconstructive surgery and pessary use were more cost-effective than expectant management, traditional abdominal sacral colpopexy (ASC) or robot-assisted sacral colpopexy (RSC; grade C). Two studies have demonstrated that ASC incurs lower inpatient costs than LSC or RSC (grade C). Data from a single RCT demonstrated the LSC to incur lower inpatient costs than RSC specifically relating to shorter operating times in the LSC group (grade B). Data from a single RCT demonstrated LSC to be a more effective cost-minimising surgery

  4. Numerical Analysis of Large Diameter Butterfly Valve

    Science.gov (United States)

    Youngchul, Park; Xueguan, Song

    In this paper, a butterfly valve with the diameter of 1,800 mm was studied. Three-dimensional numerical technique by using commercial code CFX were conducted to observe the flow patterns and to measure flow coefficient, hydrodynamic torque coefficient and so on, when the large butterfly valve operated with various angles and uniform incoming velocity.

  5. Photoacoustic determination of blood vessel diameter.

    NARCIS (Netherlands)

    Kolkman, R.G.; Klaessens, J.H.G.M.; Hondebrink, E.; Hopman, J.C.W.; Mul, F.F. de; Steenbergen, W.; Thijssen, J.M.; Leeuwen, T.G. van

    2004-01-01

    A double-ring sensor was applied in photoacoustic tomographic imaging of artificial blood vessels as well as blood vessels in a rabbit ear. The peak-to-peak time (tau(pp)) of the laser (1064 nm) induced pressure transient was used to estimate the axial vessel diameter. Comparison with the actual ves

  6. Reduced artery diameters in Klinefelter syndrome.

    Science.gov (United States)

    Foresta, C; Caretta, N; Palego, P; Ferlin, A; Zuccarello, D; Lenzi, A; Selice, R

    2012-10-01

    Various epidemiological studies in relatively large cohorts of patients with Klinefelter syndrome (KS) described the increased morbidity and mortality in these subjects. Our aim was to study the structure and function of arteries in different districts to investigate in these subjects possible alterations. A total of 92 patients having non-mosaic KS, diagnosed in Centre for Human Reproduction Pathology at the University of Padova, and 50 age-matched healthy male controls were studied. Klinefelter syndrome subjects and controls evaluation included complete medical history, physical examination, measurement of concentrations of the reproductive hormones, lipidic and glycidic metabolism, AR function and sensitivity, ultrasound examinations (diameters, carotid intima-media thickness and brachial flow-mediated dilation) of brachial, common carotid and common femoral artery and abdominal aorta. Klinefelter syndrome patients showed significantly reduced artery diameters in all districts evaluated. On the contrary no statistically significant difference was found in cIMT and brachial FMD values between KS patients and controls. Furthermore, we found no statistically significant correlation of artery diameters with reproductive hormones, metabolic parameters, anthropometric measures and weighted CAG repeats. To our knowledge, this is the first study finding a reduced artery diameter in several districts in KS patients compared with that of normal male subjects and overlapping to that of female subjects. We have not an explanation for this phenomenon, even if a possible involvement of genes controlling the development of vascular system might be hypothesized, and further research is required to verify this hypothesis.

  7. [Renal leiomyoma. Case report].

    Science.gov (United States)

    Joual, A; Guessous, H; Rabii, R; Benjelloun, M; Benlemlih, A; Skali, K; el Mrini, M; Benjelloun, S

    1999-01-01

    The authors report a case of renal leiomyoma observed in a 56-year-old man. This cyst presented in the from of loin pain. Computed tomography revealed a homogeneous renal tumor. Treatment consisted of radical nephrectomy. Histological examination of the specimen showed benign renal leiomyoma.

  8. Renal inflammatory myofibroblastic tumor

    DEFF Research Database (Denmark)

    Heerwagen, S T; Jensen, C; Bagi, P

    2007-01-01

    Renal inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor of controversial etiology with a potential for local recurrence after incomplete surgical resection. The radiological findings in renal IMT are not well described. We report two cases in adults with a renal mass treated...

  9. Role of laparoscopy in evaluation of chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Hebbar Shripad

    2005-01-01

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

  10. Role of laparoscopy in evaluation of chronic pelvic pain

    Science.gov (United States)

    Hebbar, Shripad; Chawla, Chander

    2005-01-01

    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 × 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. PMID:21188008

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

    Science.gov (United States)

    Persu, C; Chapple, C R; 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 respond to all the requirements of the medical community, so the vast majority were seen coming and going, failing to become the single most useful system for staging in pelvic organ prolapse (POP).The latest addition to the group of staging systems is the POP-Q system, which is becoming increasingly popular with specialists all over the world, because, although is not very simple as a concept, it helps defining the features of a prolapse at a level of completeness not reached by any other system to date. In this vision, the POP-Q system may reach the importance and recognition of the TNM system use in oncology.This paper briefly describes the POP-Q system, by comparison with other staging systems, analyzing its main features and the concept behind it.

  12. CT and sonography of severe renal and perirenal infections

    Energy Technology Data Exchange (ETDEWEB)

    Hoddick, W. (Univ. of California, San Francisco); Jeffrey, R.B.; Goldberg, H.I.; Federle, M.P.; Laing, F.C.

    1983-03-01

    Twelve patients with urosepsis and severe renal or perirenal infections were evaluated with both computed tomography (CT) and sonograhy. Six patients had nine proven renal or perirenal abscesses larger than 2 cm in diameter. One patient had multiple microabscesses smaller than 1 cm. Five patients had CT or sonographic evidence of focal or multifocal bacterial nephritis. Computed tomography correctly diagnosed all renal (six) and perirenal (three) abscesses. Sonography was falsely negative in a patient with multiple microabscesses and in another patient with a gas-forming perinephric abscess. In one patient with four bilateral renal abscesses, sonography correctly diagnosed only one of the abscesses. In the five patients with focal or multifocal bacterial nephritis, CT demonstrated poorly defined, poorly enhancing lesions in all cases. Sonography was normal in three of these patients. Although this report is based on a limited experience, computed tomography seems to be the more sensitive method of evaluating severe renal and perirenal infections.

  13. Drug-eluting stents in renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Zaehringer, M. [Marienhospital Stuttgart, Department of Radiology, Stuttgart (Germany); Pattynama, P.M.T. [Erasmus MC-University Medical Center Rotterdam, Rotterdam (Netherlands); Talen, A. [genae associates nv, Antwerp (Belgium); Sapoval, M. [Hopital Europeen Georges Pompidou, Service de Radiologie Cardio-Vasculaire, Paris (France); Inserm U 780 epidemiologie Cardio Vasculaire, Paris (France)

    2008-04-15

    Because of higher acute and long-term success rates compared with balloon angioplasty alone, percutaneous stent implantation has become an accepted therapy for the treatment of atherosclerotic renal artery stenosis. Restenosis rates after successful renal stent placement vary from 6 up to 40%, depending on the definition of restenosis, the diameter of the treated vessel segment and comorbidities. The safety and efficacy of drug-eluting stents for the treatment of renal-artery stenosis is poorly defined. The recently published GREAT study is the only prospective study, comparing bare-metal and sirolimus-coated low profile stent systems in renal artery stenosis, showing a relative risk reduction of angiographic binary in-stent restenosis by 50%. This is an opinion paper on indications, current treatment options and restenosis rates following renal artery stenting and the potential use of drug-eluting stents for this indication. (orig.)

  14. Risk of pelvic injury from femoral neck guidewires.

    Science.gov (United States)

    Feeney, M; Masterson, E; Keogh, P; Quinlan, W

    1997-01-01

    Many of the devices used in the internal fixation of femoral neck fractures are cannulated and require the initial placement of one or more guidewires for accurate positioning. These wires are occasionally advanced inadvertently through the hip joint and the acetabulum. Pelvic visceral damage may follow. To assess this risk, we inserted three guidewires to a depth of 16 cm into each femoral neck of ten cadavers and explored the pelvis during autopsy. Thirty-two of the 60 guidewires had penetrated a pelvic organ. The literature on intrapelvic injuries associated with hip surgery is reviewed, and suggestions are offered on the avoidance of pelvic penetration during hip fracture fixation.

  15. Pelvic orientation and assessment of hip dysplasia in adults

    DEFF Research Database (Denmark)

    Jacobsen, S.; Holm, S.S.; Lund, B.

    2004-01-01

    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...... dysplasia in the longitudinal survey cohort of the Copenhagen City Heart Study (CCHS; Osteoarthrosis Sub-study). 1) Cadaver pelvises and proximal femurs from a male and a female donor were mounted anatomically in holding devices allowing independent inclination/reclination and rotation. An AP pelvic...

  16. Chlamydia trachomatis in pelvic inflammatory disease.

    Science.gov (United States)

    Shrikhande, S N; Joshi, S G; Zodpey, S P; Saoji, A M

    1995-04-01

    The prevalence of genital Chlamydia trachomatis infection and some epidemiologic factors associated with it were studied in 273 pelvic inflammatory disease (PID) patients attending Gynaecologic clinic, Government Medical College, Nagpur. For detection of chlamydial antigen Pharmacia Diagnostics Chlamydia EIA test was used. This study revealed an overall positivity rate of 33% for C. trachomatis infection in PID patients. Of the hypothesised risk factors low socioeconomic status, history of sexual contacts with multiple partners and use of intrauterine devices (IUD) were significantly associated with C. trachomatis infections. However, use of oral contraceptives, barrier contraceptives and increasing age were found to be protective factors for C. trachomatis infection. Thus considering the significant contribution of C. trachomatis in etiology of PID and its independent association with some epidemiologic risk factors, extensive epidemiologic measures are recommended for prevention of these infections.

  17. [Lithiasis and ectopic pelvic kidney. Therapeutic aspects].

    Science.gov (United States)

    Aboutaieb, R; Rabii, R; el Moussaoui, A; Joual, A; Sarf, I; el Mrini, M; Benjelloun, S

    1996-01-01

    Kidney in ectopic position is dysplasic, and associated to other malformations. The advent of a lithiasis in these conditions rises questions about therapeutic options. We report on five observations of pelvic ectopic kidney with urinary lithiasis. Patients were aged from 16 to 42 years. Kidney was non functional in two cases, or with normal appearance sized 10 to 12 cm. We performed total nephrectomy in two cases, pyelolithotomy in the other cases. Surgical approach was subperitoneal via iliac route. A dismembered pyeloplasty was associated in one case. All patients did well. Radiologic control at 6 and 12 months showed no recurrence in a well functioning kidney. Surgical lithotomy is advocated as a treatment in urinary lithiasis affecting ectopic kidney. It is an easy procedure which permits correction of other associated malformations.

  18. Pelvic alveolar rhabdomyosarcoma in a young adult

    Directory of Open Access Journals (Sweden)

    David Reisner, MD

    2014-01-01

    Full Text Available Rhabdomyosarcomas are soft-tissue tumors, rare in adults. Accounting for nearly 5% of childhood cancers, they represent less than 0.03% of adult malignancies (1, 2. Three different subtypes of rhabdomyosarcoma have been described (embryonal, alveolar and pleomorphic, making up approximately 50%, 30%, and 20% of the cases, respectively (3. Although the definitive diagnosis is made pathologically, some distinguishing features among these subtypes, and between rhabdomyosarcomas and other soft-tissue tumors, can be suggested on MRI and CT. We present an interesting case of a 20-year-old female with a locally aggressive pelvic alveolar rhabdomyosarcoma. While the prognosis has improved with newer treatment techniques, overall survival rates remain poor. Our case study presents typical features of a rare disease, which can often present a diagnostic dilemma for clinicians.

  19. Sciatica due to pelvic hematoma: case report

    Directory of Open Access Journals (Sweden)

    Kocaman Umit

    2016-12-01

    Full Text Available Sciatica is defined as pain in the sciatic nerve distribution. The most common reason of sciatica is radiculopathy due to lumbar disc hernia. Other causes can be congenital, acquired, infectious, neoplastic, or inflammatory. The piriformis syndrome is another cause. The pain starts in an insidious manner when the cause of sciatica is an extraspinal tumor. It is intermittent at first but a constant and progressive pain that does not decrease with position or rest gradually develops in all patients. The possibility of an intraabdominal or pelvic mass should always be considered and the relevant tests requested when the cause of the sciatica cannot be explained. We present an 83-year-old male who presented with non-traumatic and non-vascular lumbosacral plexopathy due to a large hematoma in the left adductor muscle following the use of warfarin sodium.

  20. Pelvic radiation therapy: Between delight and disaster

    Institute of Scientific and Technical Information of China (English)

    Kirsten; AL; Morris; Najib; Y; Haboubi

    2015-01-01

    In the last few decades radiotherapy was established as one of the best and most widely used treatmentmodalities for certain tumours. Unfortunately that came with a price. As more people with cancer survive longer an ever increasing number of patients are living with the complications of radiotherapy and have become, in certain cases, difficult to manage. Pelvic radiation disease(PRD) can result from ionising radiationinduced damage to surrounding non-cancerous tissues resulting in disruption of normal physiological functions and symptoms such as diarrhoea, tenesmus, incontinence and rectal bleeding. The burden of PRDrelated symptoms, which impact on a patient’s quality of life, has been under appreciated and sub-optimally managed. This article serves to promote awareness of PRD and the vast potential there is to improve current service provision and research activities.

  1. [Reconstructive surgery of female pelvic floor prolapse].

    Science.gov (United States)

    Schär, Gabriel

    2010-01-01

    It is recommended to perform pelvic floor prolapse surgery within a concept which bases on the women's symptoms, the expectations on life quality and functional aspects of the vagina, urinary bladder and rectum. Decisions on type of surgery must also be founded on the anatomical defect. An apical prolapse should either be fixed by sacrospinous ligament suspension or by sacrocolpopexy. In case of a cystocele the type of defect must be considered; a cystocele with a central defect can be corrected by anterior colporrhaphy whereas the cystocele caused by a paravaginal defect needs lateral fixation which today is increasingly done by vaginal mesh surgery. Rectocele repair is performed by posterior colporrhaphy. Knowledge of success and complication rates is essential for taking the right surgical decisions and for counselling the patient.

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

    Science.gov (United States)

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

    2003-10-01

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

  3. From interstitial cystitis to chronic pelvic pain.

    Science.gov (United States)

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

    2010-01-01

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

  4. What meralgia paresthetica can hide: renal tumor as an infrequent cause.

    Science.gov (United States)

    Ramírez Huaranga, Marco Aurelio; Ariza Hernández, Andrés; Ramos Rodríguez, Claudia Carolina; González García, Jesús

    2013-01-01

    Meralgia paresthetica is a mononeuropathy of the femoral cutaneous nerve with characteristic findings, usually secondary to injury or compression, being most common in the inguinal area. Exceptional cases associated with compressions caused by abdominal or pelvic tumors have been published, so it is always advisable to extend the study with imaging tests. We present a case associated with a renal tumor. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  5. Spontaneous rupture of renal pelvis secondary to ureteral obstruction by urothelial tumor

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Daniel Alvarenga; Palma, Ana Laura Gatti; Kido, Ricardo Yoshio Zanetti; Barros, Ricardo Hoelz de Oliveira; Martins, Daniel Lahan; Penachim, Thiago Jose; Caserta, Nelson Marcio Gomes, E-mail: daniel_alvafer@yahoo.com.br, E-mail: daniel_alvafer@icloud.com [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Fac. de Medicina. Dept. de Radiologia

    2014-09-15

    Partial spontaneous rupture of the upper urinary tract is rare and usually associated with nephrolithiasis. Other reported causes, apart from instrumentation and trauma, involve obstructive ureteral tumor in the pelvic cavity, retroperitoneal fibrosis, fluid overload, and pregnancy. We report a case of spontaneous rupture of renal pelvis secondary to ureteral obstruction caused by urothelial tumor, clinically suspected and evaluated by CT scans and MRIs, discussing the relevant findings for diagnosis.(author)

  6. Additional renal arteries: incidence and morphometry.

    Science.gov (United States)

    Satyapal, K S; Haffejee, A A; Singh, B; Ramsaroop, L; Robbs, J V; Kalideen, J M

    2001-01-01

    Advances in surgical and uro-radiological techniques dictate a reappraisal and definition of renal arterial variations. This retrospective study aimed at establishing the incidence of additional renal arteries. Two subsets were analysed viz.: a) Clinical series--130 renal angiograms performed on renal transplant donors, 32 cadaver kidneys used in renal transplantation b) Cadaveric series--74 en-bloc morphologically normal kidney pairs. The sex and race distribution was: males 140, females 96; African 84, Indian 91, White 43 and "Coloured" 18, respectively. Incidence of first and second additional arteries were respectively, 23.2% (R: 18.6%; L: 27.6%) and 4.5% (R: 4.7%; L: 4.4%). Additional arteries occurred more frequently on the left (L: 32.0%; R: 23.3%). The incidence bilaterally was 10.2% (first additional arteries, only). The sex and race incidence (first and second additional) was: males, 28.0%, 5.1%; females, 16.4%, 3.8% and African 31.1%, 5.4%; Indian 13.5%, 4.5%; White 30.9%, 4.4% and "Coloured" 18.5%, 0%; respectively. Significant differences in the incidence of first additional arteries were noted between sex and race. The morphometry of additional renal arteries were lengths (cm) of first and second additional renal arteries: 4.5 and 3.8 (right), 4.9 and 3.7 (left); diameters: 0.4 and 0.3 (right), 0.3 and 0.3 (left). Detailed morphometry of sex and race were also recorded. No statistically significant differences were noted. Our results of the incidence of additional renal arteries of 27.7% compared favourably to that reported in the literature (weighted mean 28.1%). The study is unique in recording detailed morphometry of these vessels. Careful techniques in the identification of this anatomical variation is important since it impacts on renal transplantation surgery, vascular operations for renal artery stenosis, reno-vascular hypertension, Takayasu's disease, renal trauma and uro-radiological procedures.

  7. Pelvic inflammatory diseases in perimenopause and menopause

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    Cabunac Petar

    2012-03-01

    Full Text Available Introduction: In the gynecological profession Pelvic Inflammatory Disease (PID has a significant role due to its frequency, many complications and high costs of treatment Aim: The aim of this study was to investigate frequency and complications caused by these diseases, and used methods of treatment. Methods: The research was conducted in Clinic of Obstetrics and Gynecology 'Narodni Front', Belgrade, and included all consecutive patients diagnosed with PID during the period from year 2007 to 2010. The diagnosis of PID was set on the basis of: gynecological examination, test analysis (leucocytes, sedimentation, platelets, CRP, CA125, and ultrasound examination. A clinical criterion is divided into minimal and additional. The study included 112 patients. There were 33.93% of women in perimenopause/menopause (experimental group, while the control group consisted of 66.07% female subjects. Results: The frequency of surgically treated patients in experimental and control group was: 44.74% : 39.19% (χ2 test; p > 0.05. Women in experimental group used Intrauterine Device (IUD more than other patients 57.89% : 13.15% (χ2 test; p = 0.0001. A link was established between the use of intrauterine devicela in (χ2 test; p = 0.0516, patients’ irregular control of IUD (χ2 test; p = 0.0114 and surgical treatments of women in experimental group. The conservative treatment usually applies dual antibiotic therapy. Costs of surgically treated patients are around 1300 and conservatively treated around 210 €. Conclusion: Women in perimenopause and menopause are not exposed to higher risks of contracting PID. Women in perimenopause and menopause which use intrauterine device and don’t have regular controls, have higher risk of surgical treatments in case of pelvic inflammatory disease. Costs of treatment are 6-7 times in lower with conservatively treated patients compared to operatively treated ones.

  8. Laparoscopic radical prostatectomy: omitting a pelvic drain

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    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.

  9. Biofeedback therapy for chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

  10. Severe osteolysis of the pelvic in association with acetabular replacement without cement.

    Science.gov (United States)

    Maloney, W J; Peters, P; Engh, C A; Chandler, H

    1993-11-01

    We reviewed the cases of fourteen patients (fifteen lesions) who had osteolysis following the replacement of the acetabulum without cement. Nine women and five men, seventeen to sixty-seven years old, were involved in the study. One woman had bilateral pelvic osteolysis. Eight of the fifteen index acetabular reconstructions were done with a titanium-alloy implant and seven, with a chromium-cobalt-alloy implant. Eleven of the fifteen acetabular components had holes in the metal shell that may have acted as a conduit through which wear debris could gain access to the implant-bone interface, but only two of the acetabular components had been fixed with screws. In these two acetabular components, all available screw holes were not filled. The polyethylene liner was eight millimeters thick or less in twelve of the fifteen acetabular components; all of the liners were ten millimeters thick or less. The diameter of the head of eleven of the fifteen femoral components was thirty-two millimeters. Fourteen of the fifteen femoral components were placed without cement, and all but one was radiographically stable. The duration from the index operation to the appearance of pelvic osteolysis ranged from fifty-three to eighty-four months (mean, sixty-five months). At the time of the diagnosis, the patients were functioning well clinically, and all but three had a Harris hip score of 90 points or better, despite extensive destruction of bone in some instances. Since these patients were functioning well, the pelvic osteolysis was diagnosed radiographically at a regular follow-up examination. Only one patient had evidence of migration of the acetabular component on serial radiographs.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bruno Teixeira Bernardes

    Full Text Available CONTEXT AND OBJECTIVE: Previous studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse. DESIGN AND SETTING: Prospective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI; a hypopressive exercise group (GII; and a control group (GIII. The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS: The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001, but not in relation to GIII (P = 0.816. CONCLUSIONS: The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.

  12. Comparison of volume and diameter measurement in assessing small abdominal aortic aneurysm expansion examined using computed tomographic angiography

    Energy Technology Data Exchange (ETDEWEB)

    Parr, Adam; Jayaratne, Chanaka; Buttner, Petra [Vascular Biology Unit, James Cook University, Townsville, Queensland 4811 (Australia); Golledge, Jonathan, E-mail: Jonathan.Golledge@jcu.edu.au [Vascular Biology Unit, James Cook University, Townsville, Queensland 4811 (Australia)

    2011-07-15

    Aim: First we aimed to assess the reproducibility of a computer tomography angiography (CTA) based technique for measuring infra-renal aortic volume and diameter. Second we sought to investigate whether changes in aortic volume and diameter were similar during follow-up. Materials and methods: A prospective series of 57 patients, with aortic diameter initially measuring between 25 and 55 mm, were assessed with 2 CTAs a median of 14 months apart. Aortic volume and maximum diameter (both axial and orthogonal) were measured by a semi-automated workstation protocol based on previously defined techniques. Intra- and inter-observer reproducibility were assessed by repeat assessment of the initial CTA images of the first 33 patients included in the study, in order to estimate the 95% limits of agreements. Changes in aortic dimensions between the first and follow-up CTA, were defined for volume and diameter separately as changes greater than their respective 95% limits of agreement. Results: Reproducibility of aortic volume and diameter was excellent with an average coefficient of variation <4%. The median (inter-quartile range) increases in total volume, orthogonal and axial diameters were 4.9 cm{sup 3} (0.01-14.18), 1.2 mm (0.40-3.50) and 1.4 mm (-0.15 to 3.55) respectively. Forty-two percent of patients who had increased aortic volume above the 95% limit of agreement did not display corresponding axial or orthogonal diameter changes. Conclusions: Infra-renal total aortic volume, axial and orthogonal diameter can all be measured reproducibly from CTA. Aortic volume changes are not always reflected by similar changes in diameter and therefore provide complementary information when assessing AAA expansion over time.

  13. A Case of Squamous Cell Carcinoma of the Renal Pelvis in association with Schistosoma hematobium

    Directory of Open Access Journals (Sweden)

    Muhammad A. A. Khan

    2012-01-01

    Full Text Available A 72-year-old man presented with painless frank haematuria. Investigations included intravenous urogram and abdominal/pelvic CT which revealed a marked focal thickening of the wall of the inferior aspect of the left renal pelvis extending into the lower pole calyx and into the pelviureteric junction resulting in left hydronephrosis. Urine cytology demonstrated clusters of malignant keratinised squamous cells and schistosome ova. He underwent left laparoscopic radical nephroureterectomy and histology revealed moderately differentiated keratinising squamous cell carcinoma in the renal pelvis.

  14. Primary squamous cell carcinoma of the renal parenchyma: A rare occurrence

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    Rina Mukherjee

    2014-01-01

    Full Text Available Primary squamous cell carcinoma (SCC of renal parenchyma is a very rare entity although renal pelvic SCC is common. We probably are reporting the third case in a 35 years female presenting with left lumbar pain and weight loss. Lower pole mass was found on contrast enhanced computed tomography (CECT study of abdomen for which left total nephrectomy was done. Histopathological examination revealed a well differentiated squamous cell carcinoma. Her physical condition did not permit for any adjuvant therapy. Two months after surgery she expired.

  15. Botryoid-type of embryonal rhabdomyosarcoma of renal pelvis in a young woman

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    A Kaabneh

    2014-01-01

    Full Text Available A 22-year-old woman presented with three weeks history of intermittent left loin pain, on radiological evaluation by U\\S and MRI revealed left renal pelvic mass, ureterorenoscopy and biopsy taken, but couldn′t reveal definitive diagnosis other than presence of a malignant process. Left nephroureterctomy was performed. Grossly there is a polypoid mass attached to the upper pole of the kidney by stalk. Light microscopic examination and immunohistochemical staining confirm a diagnosis of Botryoid-type of embryonal rhabdomyosarcoma. Treatment and follow up to 1 year is mentioned. Reviewing the literature the presented case is the second of this tumor in adult renal pelvis.

  16. 3D Models of Pelvic Floor Muscles Developed by Manual Segmentation to FEM

    OpenAIRE

    Cristina S Saleme; Renato N. Jorge; Marcos P Barbosa; Marco Parente; Agnaldo L S Filho; Thuane Roza; João Manuel RS Tavares; Teresa Mascarenhas

    2009-01-01

    The female pelvic floor is an understudied region of the body from the biomechanical perspective. MRI has been used in the diagnostic evaluation of the pelvic floor dysfunctions. Static images show their morphology while dynamic images show the functional changes that occur on straining and contraction of the pelvic floor. In the present work, MR images contribute to generate 3D solids of pelvic floor muscles through manual segmentation. To study the biomechanical behavior of pelvic floor mus...

  17. Rare calcium oxalate monohydrate calculus attached to the wall of the renal pelvis.

    Science.gov (United States)

    Grases, Felix; Costa-Bauza, Antonia; Prieto, Rafael M; Saus, Carlos; Servera, Antonio; García-Miralles, Reyes; Benejam, Joan

    2011-04-01

    Most renal calculi can be classified using well-established criteria in a manner that reflects both composition and fine structure under specific pathophysiological conditions. However, when a large patient population is considered, rare renal calculi invariably appear, some of which have never been classified; careful study is required to establish stone etiology in such cases. The patient in the present case report formed two types of calculi. One was attached on the wall of the renal pelvis near the ureter and part of the calculus was embedded inside pelvic renal tissue. The calculus developed on an ossified calcification located in the pelvis tissue. Current knowledge on the development of calcification in soft tissues suggests a pre-existing injury as an inducer of its development. A mechanism of calculus formation is proposed. The second stone was a typical jack-stone calculus.

  18. Effect of uranyl intoxication on renal corticomedullary gradient of orthoiodohippurate in laboratory rat

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    Vlcek, J.; Kvetina, J. (Karlova Univ., Hradec Kralove (Czechoslovakia). Farmaceuticka Fakulta)

    1983-08-05

    The assessment is attempted of the intrarenal distribution (by means of the cortico-medullary gradient and the cortico-pelvic gradient) of a model diagnostic substance (O-/sup 125/I-hippurate) for the analysis of mechanisms causing damage to the renal function during intoxication induced by uranyl ions (uranyl nitrate). The findings were correlated with other indicators of the renal lesion (creatinine and urea plasma levels). Relative shifts of different gradients, i.e. mutual shifts and shifts in relation to hippurate blood levels, make it possible to describe the stepwise character of functional changes in the damaged kidney. The method used is suitable for investigating the dynamics of substances transport during functional renal changes in particular when combined with the determination the intensity of the uptake of model substances by renal tissue slices.

  19. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  20. Renal infarction resulting from traumatic renal artery dissection.

    Science.gov (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang

    2008-06-01

    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  1. Empirical processes with bounded \\psi_1 diameter

    CERN Document Server

    Mendelson, Shahar

    2010-01-01

    We study the empirical process indexed by F^2=\\{f^2 : f \\in F\\}, where F is a class of mean-zero functions on a probability space. We present a sharp bound on the supremum of that process which depends on the \\psi_1 diameter of the class F (rather than on the \\psi_2 one) and on the complexity parameter \\gamma_2(F,\\psi_2). In addition, we present optimal bounds on the random diameters \\sup_{f \\in F} \\max_{|I|=m} (\\sum_{i \\in I} f^2(X_i))^{1/2} using the same parameters. As applications, we extend several well known results in Asymptotic Geometric Analysis to any isotropic, log-concave ensemble on R^n.

  2. Transfinite diameter of Bernstein sets in

    Directory of Open Access Journals (Sweden)

    Bialas-Cież Leokadia

    2002-01-01

    Full Text Available Let be a compact set in satisfying the following generalized Bernstein inequality: for each such that , for each polynomial of degree where is a constant independent of and , is an infinite set of natural numbers that is also independent of and . We give an estimate for the transfinite diameter of the set : For satisfying the usual Bernstein inequality (i.e., , we prove that

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

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    Giuseppe La Pera

    2014-06-01

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

  4. Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

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    Vanessa S. Pereira

    2014-10-01

    Full Text Available Background: The proper evaluation of the pelvic floor muscles (PFM is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05. Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90. In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively. Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment.

  5. Small pelvic varices as a cause of pathospermia and ways of its correction

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    A. Yu. Tsukanov

    2014-12-01

    Full Text Available Eighty patients (mean age 33.0 ± 6.2 years with idiopathic pathospermia were enrolled in the investigation. The infertility period averaged 18.8 ± 3.9 years. The patients were made up of two groups: 1 51 patients who had the signs of small pelvic varices (SPV (a study group and 2 29 patients with no signs of SPV (a comparison group, and 34 healthy volunteers also participated in the investigation. The study group was randomized to 2 subgroups: 1 phlebotropic therapy only (n = 26; 2 phlebotropic therapy in combination with AndroDoz (n = 25. The comparison group used AndroDoz only. The treatment cycle was 3 months. Analysis was made by the results of a spermogram, biochemical examination of the ejaculate, resistive index, pulsatility index, peak blood flow velocity in the intraprostatic arteries, diameter of small pelvic veins, and their reflux. Subgroup 1 of the study group showed statistically significant differences in all parameters, other than hemodynamic ones. The greatest changes were noted in subgroup 2 of the study group; there were significant changes in all the parameters.

  6. New Large Diameter RF Complex Plasma Device

    Science.gov (United States)

    Meyer, John; Nosenko, Volodymyr; Thomas, Hubertus

    2016-10-01

    The Complex Plasma Research Group at the German Aerospace Center (DLR) in Oberpfaffenhofen has built a new large diameter rf plasma setup for dusty plasma experiments. The vacuum chamber is a stainless steel cylinder 0.90 m in diameter and 0.34 m in height with ports for viewing and measurement. A 0.85 m diameter plate in about the center serves as a powered electrode (13.56 MHz) with the chamber walls as the ground. It is pumped on by one of two Oerlikon turbo pumps with a pumping rate of 1100 l/s or 270 l/s. Argon gas is admitted into the chamber by an MKS mass flow meter and pumping is regulated by a butterfly valve to set pressure for experiments. A manual dropper is used to insert dust into the plasma. The dust is illuminated horizontally by a 660 nm 100 mW laser sheet and viewed from above by a Photron FASTCAM 1024 PCI camera. A vertical laser sheet of 635 nm will be used for side imaging. So far, single-layer plasma crystals of up to 15000 particles have been suspended. The particle velocity fluctuation spectra were measured and from these, the particle charge and screening length were calculated. Future experiments will explore the system-size dependence of the plasma crystal properties.

  7. 29 mm Diameter Test Target Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Woloshun, Keith Albert [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dale, Gregory E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Olivas, Eric Richard [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Naranjo, Angela Carol [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Romero, Frank Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-08-15

    The Northstar target for Mo99 production is made up of Mo100 disks in a stack separated by coolant gaps for helium flow. A number of targets have been tested at ANL for both production of Mo99 and for thermal-hydraulic performance. These have all been with a 12 mm diameter target, even while the production goals have increased the diameter to now 29 mm. A 29 mm diameter target has been designed that is consistent with the ANL beam capabilities and the capabilities of the helium circulation system currently in use at ANL. This target is designed for 500 μA at 35 MeV electrons. While the plant design calls for 42 MeV, the chosen design point is more favorable and higher power given the limits of the ANL accelerator. The intended beam spot size is 12 mm FWHM, but the thermal analysis presented herein conservatively assumed a 10 mm FWHM beam, which results in a 44% higher beam current density at beam center.

  8. Classification of pelvic ring fractures in skeletonized human remains.

    Science.gov (United States)

    Báez-Molgado, Socorro; Bartelink, Eric J; Jellema, Lyman M; Spurlock, Linda; Sholts, Sabrina B

    2015-01-01

    Pelvic ring fractures are associated with high rates of mortality and thus can provide key information about circumstances surrounding death. These injuries can be particularly informative in skeletonized remains, yet difficult to diagnose and interpret. This study adapted a clinical system of classifying pelvic ring fractures according to their resultant degree of pelvic stability for application to gross human skeletal remains. The modified Tile criteria were applied to the skeletal remains of 22 individuals from the Cleveland Museum of Natural History and Universidad Nacional Autónoma de México that displayed evidence of pelvic injury. Because these categories are tied directly to clinical assessments concerning the severity and treatment of injuries, this approach can aid in the identification of manner and cause of death, as well as interpretations of possible mechanisms of injury, such as those typical in car-to-pedestrian and motor vehicle accidents. © 2014 American Academy of Forensic Sciences.

  9. Whole pelvic osteomyelitis: Unusual finding in staphylococcal sepsis

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-07-01

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

  10. A standard for terminology in chronic pelvic pain syndromes

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  11. Damage control for devastating pelvic and extremity injuries.

    Science.gov (United States)

    Henry, S M; Tornetta, P; Scalea, T M

    1997-08-01

    This article focuses on some general principles of care and then discusses devastating pelvic injury secondary to both blunt and penetrating trauma. The authors describe the current approach to the mangled extremity and discuss indications for primary amputation.

  12. Pelvic orientation and assessment of hip dysplasia in adults

    DEFF Research Database (Denmark)

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

    2004-01-01

    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...... 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...... dysplasia in the longitudinal survey cohort of the Copenhagen City Heart Study (CCHS; Osteoarthrosis Sub-study). 1) Cadaver pelvises and proximal femurs from a male and a female donor were mounted anatomically in holding devices allowing independent inclination/reclination and rotation. An AP pelvic...

  13. Assessment of spino-pelvic morphometry, a predictor of lumbosacral ...

    African Journals Online (AJOL)

    Design: Case-series radiographic study. ... and lateral radiographs of 197 symptomatic individuals (low back pain) were analyzed between ... Parameters measurements on the lateral plain films were lumbar lordosis, sacral slope, pelvic tilt, ...

  14. Can Surgery Be Avoided? Exclusive Antibiotic Treatment for Pelvic Actinomycosis

    Science.gov (United States)

    Williams, E. M.; Markey, C. M.; Johnson, A. M.; Morales-Ramirez, P. B.

    2017-01-01

    Pelvic actinomycosis is an uncommon, slowly progressing granulomatous infection that has been associated with the presence of intrauterine devices. Due to its unspecific clinical and radiologic findings, it can mimic pelvic or intra-abdominal malignancy leading to mutilating surgery of high morbidity. Rarely, diagnosis is made preoperatively and in most cases surgical intervention is necessary. The patient in our case is a 42-year-old female with an IUD for 15 years diagnosed with pelvic actinomycosis. Patient was uniquely diagnosed preoperatively through paracentesis and treated conservatively with prolonged antibiotic therapy and without any type of surgical intervention. Follow-up at 1 year showed almost complete radiologic resolution of the inflammatory mass, nutritional recovery, and absence of symptoms. Pelvic actinomycosis can be successfully diagnosed and treated medically without surgical interventions. PMID:28299218

  15. 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 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...

  16. Surgical Updates in the Treatment of Pelvic Organ Prolapse

    Directory of Open Access Journals (Sweden)

    Julia Geynisman-Tan

    2017-04-01

    Full Text Available Pelvic organ prolapse affects approximately 8% of women, and the demand for pelvic organ prolapse surgery is expected to increase by nearly 50% over the next 40 years. The surgical techniques used to correct pelvic organ prolapse have evolved over the last 10 years, with multiple well-designed studies addressing the risks, outcomes, reoperation rates, and optimal surgical approaches. Here we review the most recent evidence on the route of access, concomitant procedures, and synthetic materials for augmenting the repair. Ultimately, this review highlights that there is no optimal method for correcting pelvic organ prolapse and that the risks, benefits, and approaches should be discussed in a patient-centered, goal-oriented approach to decision-making.

  17. Surgical Updates in the Treatment of Pelvic Organ Prolapse

    Science.gov (United States)

    Geynisman-Tan, Julia; Kenton, Kimberly

    2017-01-01

    Pelvic organ prolapse affects approximately 8% of women, and the demand for pelvic organ prolapse surgery is expected to increase by nearly 50% over the next 40 years. The surgical techniques used to correct pelvic organ prolapse have evolved over the last 10 years, with multiple well-designed studies addressing the risks, outcomes, reoperation rates, and optimal surgical approaches. Here we review the most recent evidence on the route of access, concomitant procedures, and synthetic materials for augmenting the repair. Ultimately, this review highlights that there is no optimal method for correcting pelvic organ prolapse and that the risks, benefits, and approaches should be discussed in a patient-centered, goal-oriented approach to decision-making. PMID:28467763

  18. Age at menarche and pregnancy-related pelvic pain

    DEFF Research Database (Denmark)

    Kirkeby, Mette J; Biering, Karin; Olsen, Jørn

    2013-01-01

    AIM: Menarcheal age is a predictor of several complications related to pregnancy and diseases later in life. We aimed to study if menarcheal age is a risk factor for pregnancy-related pelvic pain. MATERIAL AND METHODS: A nested case-control study was conducted within the Danish National Birth...... Cohort, a cohort of pregnant women, recruited during 1996-2002, and their children. In the second trimester of pregnancy the women provided information about age at menarche and potential confounders. Selection of cases (n = 2227) was based on self-reported pelvic pain during pregnancy from an interview...... done 6 months post-partum. The controls (n = 2588) were randomly selected among women who did not report pelvic pain. We used logistic regression analysis to calculate odds ratios (OR) for pregnancy-related pelvic pain according to age at menarche. RESULTS: In the cohort, 18.5% of all pregnant women...

  19. Iliac renal ectopia explored by {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA scintigraphy. Report of one case; Ectopie renale iliaque exploree par scintigraphie au {sup 99m}Tc-DTPA et au {sup 99m}Tc-DMSA. A propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Ghfir, I.; Ben Rais, N. [Hopital Ibn Sina, CHU de Rabat, Service de Medecine Nucleaire de Rabat (Morocco)

    2008-11-15

    Introduction Renal ectopia is a malposition by anomaly of migration during the embryonic development. It can be high, low or crossed. Association with an obstructive malformation is rather frequent. The objective of this work is to highlight the interest of {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA scintigraphy in the exploration of this type of malformation through the observation of a patient presenting an iliac right renal ectopia associated with an ureteral-pelvic junction syndrome. Observation A 38-year-old patient with an ureteral-pelvic junction syndrome on a right iliac renal ectopia revealed by intravenous urography. The dynamic renal scintigraphy using {sup 99m}Tc-DTPA with furosemide test evidenced an organic obstruction in the right urinary tract with a right renal function estimated at 40% on the {sup 99m}Tc-DMSA scintigraphy. A right pyelo-plasty was carried out. The evolution was marked by the disappearance of pain and a remarkable improvement of the permeability of the right urinary tract on the follow-up scintigraphy. Discussion Renal ectopia is not an unfrequent urinary malformation. It is generally low, pelvic or iliac. Association with an ureteral-pelvic junction obstruction is rather frequent. In this purpose, renal scintigraphy intervenes as a means of functional exploration, with low ionizing radiation and non-invasive to assess the permeability of the urinary tracts of the ectopic kidney and to appreciate the relative renal function. This contributes to the orientation of diagnosis and the improvement of therapeutic strategy.

  20. How to differentiate acute pelvic inflammatory disease from acute appendicitis ? A decision tree based on CT findings.

    Science.gov (United States)

    El Hentour, Kim; Millet, Ingrid; Pages-Bouic, Emmanuelle; Curros-Doyon, Fernanda; Molinari, Nicolas; Taourel, Patrice

    2017-09-11

    To construct a decision tree based on CT findings to differentiate acute pelvic inflammatory disease (PID) from acute appendicitis (AA) in women with lower abdominal pain and inflammatory syndrome. This retrospective study was approved by our institutional review board and informed consent was waived. Contrast-enhanced CT studies of 109 women with acute PID and 218 age-matched women with AA were retrospectively and independently reviewed by two radiologists to identify CT findings predictive of PID or AA. Surgical and laboratory data were used for the PID and AA reference standard. Appropriate tests were performed to compare PID and AA and a CT decision tree using the classification and regression tree (CART) algorithm was generated. The median patient age was 28 years (interquartile range, 22-39 years). According to the decision tree, an appendiceal diameter ≥ 7 mm was the most discriminating criterion for differentiating acute PID and AA, followed by a left tubal diameter ≥ 10 mm, with a global accuracy of 98.2 % (95 % CI: 96-99.4). Appendiceal diameter and left tubal thickening are the most discriminating CT criteria for differentiating acute PID from AA. • Appendiceal diameter and marked left tubal thickening allow differentiating PID from AA. • PID should be considered if appendiceal diameter is < 7 mm. • Marked left tubal diameter indicates PID rather than AA when enlarged appendix. • No pathological CT findings were identified in 5 % of PID patients.