Transvaginal bladder neck suspension by Raz is an acceptable procedure for the treatment of stress urinary incontinence with high cure rate, operative simplicity, short hospitalization and little morbidity. Recently we experienced 8 cases of stress urinary incontinence treated with Raz's procedure and 2 cases with coexisting cystocele were treated with 4-corner operation. All cases have been assessed prior to and following operation and the results were satisfactory. Herein, we report 10 cases of stress urinary incontinence treated by Raz's procedure and 4-corner operation with review of literatures.
Cystocele ; Hospitalization ; Neck* ; Urinary Bladder* ; Urinary Incontinence*

A rare case of vaginal tuberculosis is reported. A 42-year-old woman referred to our hospital for surgical treatment of a cystocele presented with vaginal mass for 2 months. Pelvic examination revealed a cystic mass at anterior vagianl wall. Her initial diagnosis was urethral diverticulum. Surgical excision was performed and pathological analysis of the specimen revealed tuberculosis. She was treated with antituberculous drugs. We emphasize the need to maintain a high index of suspicion and to biopsy any suspicious vaginal lesion in the diagnosis of vaginal tuberculosis.
Adult ; Biopsy ; Cystocele ; Diagnosis ; Diverticulum ; Female ; Gynecological Examination ; Humans ; Tuberculosis*

A paraurethral cyst is a rare congenital or acquired abnormality in females that is characterized by a round, yellow or orange-colored cystic mass on either side of the urethral meatus. We report a patient who presented with frequent, postvoiding dribbling. The important differential diagnostic considerations in infants and adults are an ectopic ureterocele, urethral diverticulum, cystocele and paraurethral tumors. Intravenous pyelography, voiding cystourethrogram, cystourethroscopy are essential for differentiating these lesions. This case of a paraurethral cyst was treated with complete excision.
Adult ; Cystocele ; Diverticulum ; Female ; Humans ; Infant ; Ureterocele ; Urethra ; Urography

A rate com;lication of hysterectomy is complete prolapse and inversion of vagina. This can occur whether the hysterectomy was abdominal or vaginal and cystocele and/or enterocele is often associated with this condition. Traditionally, prolapse has been treated by surgery, the types of operation for prolapse are generally but not always, carried out through the vaginal rather than through the abdominal surgical route. We experienced five cases who had repair of posthysterectomy vaginal vault prolapse by transabdominal sacral colpopexy and report with brief review of literatures.
Cystocele ; Hernia ; Hysterectomy* ; Pelvic Organ Prolapse* ; Prolapse ; Vagina

Paraurethral cysts in female patients have distinctive histologic characteristics based upon their etiopathogenesis, which may be acquired or congenital. One patient is presented with discussion of the embryology of the lower genitourinary in the female subject. Important differential diagnostic considerations in infants and adults are ectopic ureterocele, urethral diverticula, cystocele and paraurethral tumors. IVP, VCUG, cystourethroscopy are necessary to differentiate these lesions. We have treated a case of paraurethral cyst with complete excision.
Adult ; Cystocele ; Diverticulum ; Embryology ; Female ; Humans ; Infant ; Ureterocele

Ever since Pereyra described needle suspension of the bladder neck as a form of surgical therapy for the treatment of stress urinary incontinence in women numerous modifications have been presented. Each of these modifications has helped to found healthy anatomical and surgical principles that ensure patient safety, decrease morbidity and improve effectiveness. We had treated 8 patients of stress urinary incontinence with or without cystocele by transvaginal Burch procedure. By fixing suspension sutures to the Cooper`s ligament we expected to achieve a static suspension independent of everyday patients` activities. The duration of follow up was 3 months to 6 months. Them were no serious operative complications. Incontinence was completely disappeared in 6 patients (75%) and significantly improved in 1 patient (12.5%), and failed in 1 patients (12.5%). Although the small number of patients and limited follow up, we believe that fixation of suspension sutures to the Cooper`s ligament can favorably influence long-term results of treatment for female stress urinary incontinence.
Cystocele ; Female* ; Follow-Up Studies ; Humans ; Ligaments ; Neck* ; Needles ; Patient Safety ; Sutures ; Urinary Bladder* ; Urinary Incontinence*

PURPOSE: Vaginal erosion is known complication of synthetic sling material, Most series report a relatively low erosion rate, ranging from 0 to 11%. but few report on management of only vaginal erosion after TVT procedure have been described. We estimated the incidence of vaginal erosion associated with the use of TVT and investigated clinical outcomes. MATERIALS AND METHODS: Between 1999~2002, 296 cases (mean age: 48.8 yrs; range: 31~67 yrs) of TVT performed by 2 university were retrospectively reviewed. Post-operative vaginal erosion as well as their management and surgcial outcomes were investigated. We performed only TVT on 173 patients with grade 1, 2 cystocele, and TVT combined cystocele repair on 123 patients with cystocele grade 3, 4. RESULTS: 11 women (3.72%) required secondary interventions due to vaginal erosion. The interval between insertion and removal varied from 1 to 14 months (mean 6.24), 6 patients developed before postoperative three months. Among 11 patients, 7 patients had TVT combined cystocele repair (one vertical incision), and the others had TVT only. A transvaginal approach was used for vaginal flap over TVT in 2 patients (secondary vaginal erosion developed after 2 months) and a vaginal flap in 1 patient (secondary vaginal erosion developed after 7 months), and TVT removal in 8 patients. Before and after secondary intervention, all patients were totally dry (mean FU period: 12.5 months). CONCLUSION: We suggest that vaginal erosion after TVT procedure should be treated with complete removal of the tape.
Cystocele ; Female ; Humans ; Incidence ; Polypropylenes ; Postoperative Complications ; Retrospective Studies ; Suburethral Slings* ; Urinary Incontinence ; Vagina

The modified supracervical hysterectomy with intrafascial cylindriform enucleation of cervix via endoscopy or vaginal approach enables to do an minimal invasive and organ preserving surgery. The pelvic floor support is maintained and sexual sensation is preserved, and there may be nearly little concern of cancer on cervix. The physical stress to the patient is minimized. But, Intrafascial Vaginal Hysterectomy is rarely performed in case of large uterus size. We performed Intrafascial Vaginal Hysterectomy in patient of adenomyosis with cystocele and rectocele and then report that with review of journal and text book.
Adenomyosis* ; Cervix Uteri ; Cystocele* ; Endoscopy ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Pelvic Floor ; Rectocele* ; Sensation ; Uterus

PURPOSE: The purpose of this study is to evaluate the efficacy of biofeedback 1 treatment and functional electrical stimulation in stress incontinence patients as a physiotherapy and to know which factors affect on the outcome. MATERIALS AND METHOD: A group of 65 patients with stress incontinence were treated with combined alternating biofeedback and intravaginal electrical stimulation during 12 sessions, each 21 minutes in length, during 6 weeks. All patients had type l or ll stress incontinence. RESULTS: At immediate post treatment, subjective cure(complete dryness) rate was 15% and improvement(recovery to avoid other forms of treatment) rate was 60% and failure rate was 25%. Thus, the overall success rate for this treatment was 75%. In 49 patients who had all scheduled sessions and good compliance, subjective cure rate was 14% and improvement rate was 71%, but in 16 patients not to have good compliance, cure rate was 19%, improvement rate was 25%. In compliant patients, the result of 3 months after treatment showed cure rate was 11%, improvement rate was 54%. Compliance with reatment was the most significant parameter predictive of a good outcome(p<0.01) and the degree of stress incontinence was also significant in compliant patients(p<0.05). No clinical correlation with outcome was found in age, type, severity of cystocele, pelvic muscle strength, initial degree of vaginal contraction. Intravaginal pressure increased by an average of 10cmH20. Increased vaginal pressure was found in 93% of the patients and at least 50%improvement was 61%. Urge incontinence and urgency were present in 10(15%) and 19(29%) of the patients and improvement including cure was found 90% in urge incontinence and 89% in urgency. CONCLUSIONS: Biofeedback treatment and functional electrical stimulation is more effective for the patients who have good compliance, low degree stress incontinence and combined bladder irritation symptoms. In order to attain and maintain good results, a well structured biofeedback and functional electrical stimulation program that teaches specific muscle exercise should be used and the patients should be followed by a maintenance program and reinforcement.
Biofeedback, Psychology* ; Compliance ; Cystocele ; Electric Stimulation* ; Humans ; Muscle Strength ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

PURPOSE: We retrospectively evaluated the 45 patients who underwent the original Raz procedure and anterior vaginal wall sling(AVWS) operation for stress urinary incontinence(SUI) with or without cystocele. MATERIALS AND METHODS: Transvaginal bladder neck suspension was performed in 14 patients, 4-corner bladder and bladder neck suspension in 16 patients, anterior vaginal wall sling in 14 patients, and 6-corner suspension in one patient. Of 16 patients who underwent 4-corner operation, 11 had grade 2 cystocele, and 5 had grade 3 cystocele. RESULTS: Mean age was 49 years and mean parity was 2.7. Duration of symptom was 58.5 months in average. Patients with grade l was 27%(12), grade ll was 69%(31) and grade lll was 4%(2). Mean operation times were 92. 1minutes in Raz bladder neck suspension, 90.9minutes in 4-corner bladder and bladder neck suspension, and 76.2minutes in anterior vaginal wall sling. The duration of follow up was 20 months in average. Urinary incontinence was completely disappeared in 40 patients(91%), and significantly improved in 3 patients(7%), but one patient(2%) underwent Raz BNS was recurred. Complications include a case of severe bleeding requiring intraoperative transfusion, 2 cases of prolonged retention, 2 cases of do novo urgency and 2 cases of persistent weak urinary stream. CONCLUSIONS: Our midterm result for Raz BNS and 4-corner operation was good(96.7%) and short term result for AVWS was excellent(100%). We think that original Raz BNS may be used in patients with mild SUI without ISD. And, long term follow-up for AVWS operation is required to determine persistence of the good results in patients with moderate to severe SUI.
Cystocele* ; Female* ; Follow-Up Studies ; Hemorrhage ; Humans ; Neck* ; Parity ; Retrospective Studies ; Rivers ; Urinary Bladder* ; Urinary Incontinence*