International Urogynecology Journal and Pelvic Floor Dysfunction

We report a rare case of vesical endometriosis in a 65-year-old postmenopausal woman. An abdominal hysterectomy had been performed 34 years previously, and exogenous estrogens had not been administered. The hormone levels were normal for a castrated female subject. The patient was treated surgically with transurethral resection and the following hormonal therapy. Endometriosis of the urinary tract can happen even in postmenopausal women.

INTRODUCTION AND HYPOTHESIS: A case of inadvertent self-introduction into the urethra of a folded contraceptive vaginal ring (NuvaRing) in a 22-year-old woman is reported. METHODS: The patient presented with lower urinary tract symptoms, including dysuria, urgency, and terminal hematuria, that appeared a few minutes after insertion of the device. RESULTS: The diagnosis was made by abdominal echography. The abdominal pelvic computed tomography scan confirmed the intravesical presence of the unfolded ring...

Ureterouterine fistulas are rare surgical complications with fewer than 30 reported cases in the literature to date. Rarer yet is a fistula between an ectopic ureter and the uterus, with only one case described previously (Shibata et al. in J Urol 153: 1208-1210, 1995). Herein, we present the first case, to our knowledge, of a fistula between an ectopic ureteral stump (from a prior nephroureterectomy) and the uterus.

Longitudinal vaginal septum is a rare mullerian anomaly and its association with pelvic organ prolapse (POP) is unusual. A case of longitudinal vaginal septum with stage IV POP in a 35-year-old multiparous woman is being reported. Examination revealed an incomplete longitudinal vaginal septum (9 x 6 x 2 cm) with stage IV POP. Vaginal hysterectomy with repair and reconstruction was done along with excision of the longitudinal vaginal septum which was technically challenging due to proximity to rectum. This is the only case report of stage IV pelvic organ prolapse associated with a thick longitudinal vaginal septum in a multiparous woman without any obstetric complications...

No abstract text is available yet for this article.

TVT-Secur is a new "less" invasive derivative of the tension-free vaginal tape (TVT). We report an unusual case of dyspareunia for both the patient and her husband resulting from a retained finger pad from the TVT-Secur introducer. The sling was also explanted because of malposition.

We report a case of vesicovaginal fistula associated to a vaginal foreign body. A 72-year-old woman consulted our clinic complaining of severe urinary incontinence. The leakage was continuous and significant and she was feeling a "vaginal mass". Pelvic examination was suspicious for an advanced vaginal cancer, but further investigations showed the presence of a retained vaginal foreign body complicated by perforation of the bladder.

A 32-year-old female with Crohn's disease experienced a rectovaginal fistula and abscess with rectal expulsion of posterior Prolift. She underwent diagnostic laparoscopy, transanal incision and drainage of abscess, transanal excision of mesh, and laparotomy with loop ileostomy. Weeks later, she underwent colectomy, near-total proctectomy, end ileostomy, and fistula repair.

Candida krusei is an uncommon cause of vaginitis and cystitis but is unique because of the management challenge it poses due to intrinsic resistance to fluconazole and flucytosine. We report a case of C. krusei vaginitis and cystitis successfully managed with topical vaginal and intravesical amphotericin B. The challenges in managing C. krusei cystitis and the role of amphotericin B bladder irrigation in the management of fungal urinary tract infections are discussed.

No abstract text is available yet for this article.

INTRODUCTION AND HYPOTHESIS: The use of vaginally implanted polypropylene meshes in the treatment of prolapse is becoming increasingly popular. We set out to detect how often bacterial colonisation of the mesh occurs and if the intraoperative sterility procedures that are applied matter. METHODS: In 64 consecutive women, bacterial colonisation was compared between two intraoperative sterility procedures. Culture swabs of the core mesh were taken during surgery, and the mesh arms removed at the end of surgery were cultured separately...

INTRODUCTION AND HYPOTHESIS: This study reports 1-year outcomes in women who underwent transvaginal pelvic organ prolapse (POP) surgery with Prolift transvaginal mesh. METHODS: Pre- and postoperative objective vaginal Pelvic Organ Prolapse Quantification (POP-Q) and subjective symptom and impact assessments (Pelvic Floor Distress Inventory (PFDI)-20 and Pelvic Floor Impact Questionnaire (PFIQ)-7, respectively) were performed. Postoperative vaginal tenderness, stricture, and patient satisfaction were also obtained...

INTRODUCTION AND HYPOTHESIS: The purpose of this study was to evaluate the safety and efficacy of a modified transobturator vaginal tape inside-out (TVT-O) procedure for stress urinary incontinence (SUI) using custom-tailored polypropylene mesh and helical needles. METHODS: A 1x15-cm mesh made from the Gynemesh is positioned without tension under the mid-urethra using custom-made helical needles through the obturator. RESULTS: The procedure was carried out in 80 consecutive patients (mean age 65...

INTRODUCTION AND HYPOTHESIS: The objective of this study is to evaluate cervical amputation with uterosacral ligament plication (modified Manchester) and compare it to vaginal hysterectomy with high uterosacral ligament plication procedure with special regard to the middle compartment. METHODS: Consecutive women with pelvic organ prolapse who underwent either vaginal hysterectomy or a modified Manchester procedure were included. Assessments were made preoperatively and at 1-year follow-up, including physical examination with pelvic organ prolapse quantification standardised questionnaires (incontinence impact questionnaire, urogenital distress inventory, and defaecatory distress inventory)...

INTRODUCTION: The purpose of this study was to generate normative data for perineal length for Caucasian and Asian women in labour. METHODS: The distance from the posterior fourchette to the centre of the anal orifice was measured in 1,000 women in the first stage of labour. Data on ethnicity, body mass index, delivery mode and perineal trauma were collected prospectively. RESULTS: The mean perineal length in Caucasian women was 3.7 +/- 0...

INTRODUCTION AND HYPOTHESIS: Nationwide use and costs of anticholinergic drug for overactive bladder are unknown. METHODS: We performed a nationwide study based on the Swedish Register on Prescribed Pharmaceuticals. RESULTS: From 2000 to 2007, there was a 68.8% increase in dispensed anticholinergic drugs in a population of 9 million. More than 93 million DDDs (calculated average maintenance dose per day) of anticholinergic drugs were dispensed corresponding to an overall DDD/TID (DDD per 1,000 inhabitants per day) of 3...

INTRODUCTION AND HYPOTHESIS: There is limited data on prevalence and risk factors for bothersome lower urinary tract symptoms (LUTS) in women with diabetes mellitus (DM). This study assesses prevalence and risk factors for bothersome LUTS and voiding dysfunction in women with DM. METHODS: Two hundred twenty women participated in this study. Participants completed the King's health questionnaire and the international consultation on incontinence-female lower urinary tract symptom questionnaire...

INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare outcome and quality of life of tension-free vaginal tape "inside-out" (TVT-O) and Monarc transobturator tapes after 2-4 years. METHODS: The method used was a prospective comparative study. Participants (n = 191) were assigned to either a TVT-O (n = 93) or a Monarc (n = 98) procedure. Cure of stress urinary incontinence (SUI) was defined as the statement of the woman of not experiencing any loss of urine upon physical exercise...

INTRODUCTION AND HYPOTHESIS: We examined how preoperative urodynamic findings are related to the urinary problems following surgical repair of pelvic organ prolapse (POP). METHODS: The clinical records of 87 women who underwent surgery for POP were reviewed retrospectively. Preoperatively, cough stress test and urodynamic testing, including pressure-flow study, were performed with prolapse reduction. Postoperative evaluation included uroflowmetry, postvoid residuals, and symptom assessment using questionnaires...

INTRODUCTION AND HYPOTHESIS: An anatomical study on fresh cadavers was done to determine the vulnerability of the dorsal nerve of the clitoris to injury during "outside-in" transobturator sling procedures. METHODS: The dorsal nerve of the clitoris was identified bilaterally in ten fresh cadavers. Transfixing needles marked the inferomedial border of the obturator foramen. The distance between the foramen border and the nerve was measured. RESULTS: The nerve ran medially in close approximation to the ischiopubic ramus and inferior to the obturator foramen in all specimens...