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 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

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*

PURPOSE: The aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence. MATERIALS AND METHODS: A total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards. RESULTS: Both groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference. CONCLUSIONS: Our results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon's decision whether to treat asymptomatic UC.
Cystocele ; Female ; Humans ; Lower Urinary Tract Symptoms ; Physical Examination ; Stress, Psychological ; Urethra ; Urinary Incontinence ; Urination ; Urodynamics

PURPOSE: The use of synthetic mesh to reinforce the anterior vaginal wall support for cystocele repair has been proposed to prevent recurrence. We evaluated the efficacy and safety of cystocele repair using monofilament polypropylene mesh (Gynemesh PS(TM)). MATERIALS AND METHODS: This study was performed in 53 patents who underwent cystocele repair using monofilament polypropylene mesh between January 2006 and January 2009. According to the ICS (International Continence Society) stage classification, 33, 17 and 3 women had stage II, III and IV cystocele. The operation were performed through the vaginal approach. Patients were followed up for 9 to 36 months. We defined the cure of cystocele as stage 0, improvement as stage I, and failed as stage II or greater RESULTS: The mean follow-up was 23.8 months. At follow-up, 41 women were anatomically cured (77.4%), 12 women were improved as stage I (22.6%) and no one was failed. Six cases were previously ICS stage II, 5 cases were stage III and 1 case was stage IV in improved group. No significant intraoperative complications occurred. The postoperative complications were de novo urgency (4 cases, 7.6%), erosion of mesh (2 cases, 3.8%) and anterior vaginal wall hematoma (1 case, 1.9%). CONCLUSION: The use of polypropylene mesh for correction of cystocele by transvaginal route with tension free technique seems to be a safe and effective procedure.
Classification ; Cystocele* ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Intraoperative Complications ; Polypropylenes* ; Postoperative Complications ; Recurrence

A cystocele is present when the bladder base descends below the inferior ramus of the symphysis pubis either at rest or with straining. A severe cystocele can combined with voiding difficulty, back pain, hydronephrosis, and renal failure and it must be corrected surgically. We report a case of grade IV cystocele with unilateral hydronephrosis which was incidentally found in 67-year-old female. She was asymptomatic and underwent cystocele repair using prolene mesh and TVT (Tension-free Vaginal Tape). The left hydronephrosis and marked cystocele were normalized 3 months after operation.
Aged ; Back Pain ; Cystocele* ; Female ; Humans ; Hydronephrosis* ; Polypropylenes ; Renal Insufficiency ; Urinary Bladder

PURPOSE: Because of the disappointing long-term results of transvaginal bladder neck suspension surgery for anatomical incontinence (AI), a pubovaginal sling, which was formerly operated for sphincteric incontinence (SI), was used to treat AI. The results of the pubovaginal sling for treating AI and the risk factors that affect the result were evaluated. MATERIALS AND MTHODS: A total 39 women with AI underwent a pubovaginal fascial sling using a strip of autologous rectus muscle fascia. The urethral sphincteric function was assessed by measuring the Valsalva leak point pressure. Fifteen patients has type I and 24 patients type II stress incontinence. The results of the pubovaginal sling were compared with those of 51 women who received the Raz precedure. The risk factors for the pubovaginal fascial sling were evaluated. RESULTS: The success rate of an autologous pubovaginal sling (95.6%) at mean follow-up period of (21 months) was significantly higher than that of the Raz bladder neck suspension (80.4%) during the same follow-up period (p<0.05). The success rate of the Raz procedure - 80.4%, 70.8% and 60.7% at 21, 36, 72 months - was decreased after months. The predictive factors for the pubovaginal sling - the number of deliveries, history of hystectomy, the type of stress incontinence, cystocele, urge incontinence, and age - had no significant effect on the success rate of the pubovaginal sling (p<0.05). CONCLUSIONS: A pubovaginal fascial sling may be an effective surgical treatment not only for treating sphincteric incontinence but also anatomical incontinence.
Cystocele ; Fascia ; Female* ; Follow-Up Studies ; Humans ; Neck ; Risk Factors* ; Urethra ; Urinary Bladder ; Urinary Incontinence, Urge

PURPOSE: Because of the disappointing long-term results of transvaginal bladder neck suspension surgery for anatomical incontinence (AI), a pubovaginal sling, which was formerly operated for sphincteric incontinence (SI), was used to treat AI. The results of the pubovaginal sling for treating AI and the risk factors that affect the result were evaluated. MATERIALS AND MTHODS: A total 39 women with AI underwent a pubovaginal fascial sling using a strip of autologous rectus muscle fascia. The urethral sphincteric function was assessed by measuring the Valsalva leak point pressure. Fifteen patients has type I and 24 patients type II stress incontinence. The results of the pubovaginal sling were compared with those of 51 women who received the Raz precedure. The risk factors for the pubovaginal fascial sling were evaluated. RESULTS: The success rate of an autologous pubovaginal sling (95.6%) at mean follow-up period of (21 months) was significantly higher than that of the Raz bladder neck suspension (80.4%) during the same follow-up period (p<0.05). The success rate of the Raz procedure - 80.4%, 70.8% and 60.7% at 21, 36, 72 months - was decreased after months. The predictive factors for the pubovaginal sling - the number of deliveries, history of hystectomy, the type of stress incontinence, cystocele, urge incontinence, and age - had no significant effect on the success rate of the pubovaginal sling (p<0.05). CONCLUSIONS: A pubovaginal fascial sling may be an effective surgical treatment not only for treating sphincteric incontinence but also anatomical incontinence.
Cystocele ; Fascia ; Female* ; Follow-Up Studies ; Humans ; Neck ; Risk Factors* ; Urethra ; Urinary Bladder ; Urinary Incontinence, Urge