Leiomyoma of the female urethra is exceedingly rare entity. Twenty-four year woman admitted to the hospital with a painless, gross hematuria and protruded mass outside the vaginal introitus. Vaginal examination revealed a mass arising from anterior urethral wall extending from meatus up to 1 cm proximally. Histopathological studies confirmed urethral leiomyoma. Surgery completely resolved the original symptoms and no evidence of complications after surgery. We report a case of leiomyoma of the female urethra and a review of the literature.
Female* ; Gynecological Examination ; Hematuria ; Humans ; Leiomyoma* ; Urethra*

Intrauterine devices (IUDs) have a low complication rate and minimal side effects and are pervaded contraceptive method. Perforation of the uterus by an IUD is very rare. But perforation of the uterus is one of the most serious complications associated with insertion of IUD. During the puerperium when the uterus is small and the uterine wall is thin the risk of perforation increase. The frequency has been estimated between 0.05 and 13 per 1000 insertions. When the IUD strings are not visible during pelvic examination, physicians make efforts to locate the IUD. We experienced a laparosopic removal of perforated intrauterine device, which had been inserted on postpartum 5 th week, at posterior lower segment of uterus with intrauterine pregnancy. So we report a case with a brief review of the literature.
Contraception ; Gynecological Examination ; Intrauterine Devices ; Laparoscopy ; Postpartum Period ; Pregnancy ; Uterus

Leiomyoma arising primarily in the ovary is a rare tumor, accounting for only 1% of benign ovarian neoplasms. About 50 cases have been reported in the literature to date. Most cases are asymptomatic and this benign neoplasm is usually found incidentally on routine pelvic examination, at surgery, or at autopsy. We present a case of ovarian leiomyoma in 39-year-old woman which has been experienced in our hospital with brief review of literature.
Adult ; Autopsy ; Female ; Gynecological Examination ; Humans ; Leiomyoma* ; Ovarian Neoplasms ; Ovary*

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*

Hormone therapy for peri- and postmenopausal women is widely used for relieving vasomotor symptoms or preventing osteoporosis. Even though exogenous hormone is the most common cause of vaginal bleeding in postmenopausal women under hormone therapy, in clinical practice, physicians must never exclude the possibility of endometrial disorders, such as endometrial hyperplasia or cancer. Taking thorough medical history and performing physical and pelvic examinations are essential for the evaluation of abnormal uterine bleeding in menopausal hormone therapy. Transvaginal ultrasonography, endometrial aspiration biopsy, dilatation and curettage, and hysteroscopy are the options which physicians may use. This case is about a woman with continuous combined hormone therapy for 5 years who had experienced rather sudden onset of vaginal spotting lasting for several months and was finally diagnosed as having malignant mixed Mullerian tumor. Our purpose is to inquire into the proper approaching steps for vaginal bleeding in menopausal hormone therapy.
Biopsy, Needle ; Dilatation and Curettage ; Endometrial Hyperplasia ; Female ; Gynecological Examination ; Humans ; Hysteroscopy ; Metrorrhagia ; Osteoporosis ; Uterine Hemorrhage

Apeculiar case of choriocarcinoma of the left parietal lobe of the brain with intracerebral hemorrhge is presented. Pelvic findings by physical and radiological examination were negative postoperatively, a thorough radiological study that included chest PA, chest CT, abdominal CT, pelvic CT and pelvic ultrasonography were performed for the detection of its primary focus. The level of urine and serum beta-HCG was above 100.000mlU and of CSF was 1,600mlU. This case is thus metastatic in nature, yet the primay focus of the tumor could not be demonstrated.
Brain ; Choriocarcinoma* ; Female ; Gynecological Examination* ; Parietal Lobe ; Pregnancy ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography

Heterotopic pregnancy is defined as simultaneous intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has been increased. This increased incidence is explained by the rise in PID, pelvic surgery, IUD and assisted reproductive technologies-in vitro fertilization/gamate intrafallopian insemination/intrauterine insemination. Thus careful pelvic examination combined with serial beta-hCG determinations and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in ovulation induction and intrauterine insemination with a brief review of literature.
Early Diagnosis ; Female ; Gynecological Examination ; Incidence ; Insemination* ; Ovulation Induction* ; Ovulation* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic*

PURPOSE: Although the reported failure rate of the transobturator tape procedure(TOT) is low, recurrence after this procedure have been reported, and no standard treatment has yet been established for the recurrence. We compared a shortening of the previously implanted tape with a repeat tension-free vaginal tape(TVT) procedure after a failed TOT procedure. MATERIALS AND METHODS: We enrolled eighteen women(mean age: 54.38+/-9.15 years, range: 38-72) who underwent shortening of the previously implanted tape or they underwent a repeated TVT procedure due to persistent or recurrent SUI. Of the 18 women, 10 patients underwent shortening of implanted tape and the others underwent repeat TVT. All the patients were evaluated preoperatively with a detailed history, pelvic examination, urinalysis, voiding diary and urodynamic study that included the Valsalva leak point pressure(VLPP). The postoperative outcomes were assessed by a review of admissions and the medical charts. RESULTS: The mean interval from first surgery to recurrence was 6.88+/-2.61 months for Monarc, 12 months for TVT-O and 4.71+/-2.42 months for T-sling. Of the 10 patients who underwent shortening of the implanted tape, 7(70%) patients were cured and the others failed. Of the 8 patients who underwent repeat TVT, 7(87.5%) patients were cured and one was significantly improved. The success rate is significantly higher in the repeated TVT group(p<0.05). CONCLUSIONS: Both a shortening of the previously implanted tape and a repeated TVT procedure are safe, effective, viable options in the event of initial TOT sling failure. However, the success rate of the repeated TVT group is higher than that of the shortening of implanted tape group, especially for patients with an internal sphincteric deficiency. Therefore, a repeated TVT procedure is a first option in the event of initial TOT sling failure.
Female ; Gynecological Examination ; Humans ; Recurrence ; Suburethral Slings* ; Urethra ; Urinalysis ; Urinary Incontinence* ; Urodynamics

PURPOSE: This study was to evaluate the efficiency of routine performance of a batch of tests in the clinical staging work-up of cervical carcinoma. MATERIALS AND METHODS: The medical records were reviewed for 1,393 consecutive cervical carcinoma patients who underwent pretreatment staging work-up in Seoul National University Hospital from January 1988 to December 1997. The impression stage -which is designated ten tatively by the findings of pelvic examination and biopsy-, the results of staging work-up, and the finally allotted FIGO clinical stage were reviewed. The annual trend of stage distribution and the positive yields of tests were evaluated. RESULTS: Annual trend shows that Ia is increasing. The positive yield of chest x-ray was 0.22% (3/1, 379; Ib: 1, IIa: 1, IIb: 1), intravenous pyelography (IVP) 2.50% (31/1, 242; Ib: 2, IIa: 4, IIb: 17, IIIb: 8), cystoscopy 0.55% (6/1, 093; IIb: 4, IIIb: 2), and proctosigmoidoscopy 0.086% (1/1, 157; Ib: 1). After completing the staging work-up, 29 patients (2.08%) were upstaged. The routine performance of IVP in impression stage Ia and cystoscopy in impression stage IIa or less was considered inefficient. The routine performance of proctosigmoidoscopy was considered inefficient because of its very low yield. CONCLUSION: The selective performance of tests according to the impression stage during staging work-up is recommended to minimize the unnecessary treatment delay, cost, and patients' discomfort.
Cystoscopy ; Gynecological Examination ; Humans ; Medical Records ; Seoul ; Sigmoidoscopy ; Thorax ; Urography ; Uterine Cervical Neoplasms

We report a case of unrecognized uterine inversion was restored spontaneously without surgical intervention. Initially, the case was diagnosed as uterine atony and not uterine inversion and was managed successfully with uterine artery embolization. However, a partial uterine inversion was detected on a subsequent scheduled pelvic examination. Fortunately, her uterus was completely restored without any surgical intervention on eighth week after delivery.
Gynecological Examination ; Postpartum Hemorrhage ; Uterine Artery Embolization ; Uterine Inertia ; Uterine Inversion* ; Uterus