Skene's duct cyst in the adult is rare lesion. A 40-year-old woman was referred with a chief complaint of dysuria. Examination of the external genitalia revealed a 1 cm cystic mass on the right side of the urethral orifice. VCUG, ultrasonography and cystourethroscopy showed no abnormal findings. A surgical excision was decided as it was considered that the most probable diagnosis was a Skene's duct cyst. The pathology report showed the cyst wall was lined by stratified squamous epithelium and confirmed the clinical diagnosis of Skene's duct cyst.
Adult* ; Diagnosis ; Dysuria ; Epithelium ; Female ; Genitalia ; Humans ; Pathology ; Ultrasonography

Midurethral slings are increasingly popular for the surgical treatment of stress urinary incontinence. They are relatively simple to implant and shorten operating time, hospital stay, and recovery time. Tension free vaginal tape (TVT) and Intravaginal slingplasty (IVS) mesh are both polypropylene mesh. TVT is a type I totally macroporous mesh which, because of pores larger than 75 microns, admits bacteria, macrophages, and fibroblasts into the pores. IVS is a type III mesh with microporous components which admits bacteria but not macrophages. So anterior IVS appear to be more at risk of infection or vaginal erosion than other monofilament mesh. We report our experience with a patient who underwent anterior IVS and developed erosion of the mesh through vagina, creating pelvic abscess.
Abscess* ; Bacteria ; Fibroblasts ; Humans ; Length of Stay ; Macrophages ; Polypropylenes ; Suburethral Slings ; Surgical Mesh ; Urinary Incontinence* ; Vagina

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*

PURPOSES: An overactive bladder is highly prevalent in middle-aged woman, especially during the postmenopausal period. We evaluated the relationship between detrusor overactivity and postmenopausal state and the effects of estrogen replacement for detrusor overactivity caused by the ovariectomy in rat. MATERIAL AND METHODS: Thirty female Sprague Dawley rats were divided into three groups: the control, the ovariectomy group and the estrogen replacement group after the ovariectomy. The ovariectomy and estrogen replacement groups had the bilateral ovariectomies at 12 weeks of age. After 2 weeks, the control and ovariectomy groups were injected weekly with saline, while the estrogen replacement group was injected with estradiol benzoate (500 migrogram/kg) weekly. After 12 weeks, the voiding frequency study was recorded and a cystometrogram was performed while awake. The harvested bladders were used in the carbachol-induced detrusor muscle contraction study and the distribution of estrogen, M2 and M3 muscarinic receptors in the rats' bladder. RESULTS: The ovariectomy group voided more frequently than the others (p=0.005). During the awake cystometrogram, the detrusor characteristics of the ovariectomy group were a higher mean intervoiding pressure and smaller bladder capacity than the others (p=0.000). There was no significant statistical difference between the control and estrogen replacement group. The other cystometric parameters were not statistically different either. The detrusor muscle contraction study showed no difference between three groups. There was a significant difference in the distribution of M2 and M3 receptors of bladder mucosa between the control and ovariectomy group. CONCLUSIONS: This study suggested that the detrusor overactivity resulted from increased connective tissue ratio and decreased M2, M3 receptor in the bladder mucosa. Moreover, estrogen replacement in the postmenopausal state had the effect of reversing the physiological and morphological changes caused by an estrogen deficiency in the bladder.
Animals ; Benzoates ; Connective Tissue ; Estradiol ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Mucous Membrane ; Muscle Contraction ; Ovariectomy* ; Physiology* ; Postmenopause ; Rats* ; Rats, Sprague-Dawley ; Receptors, Muscarinic ; Urinary Bladder* ; Urinary Bladder, Overactive

PURPOSE: This study is designed to explore the role of retrograde urethrography as a predictor of recovery of urinary continence after radical retropubic prostatectomy. MATERIALS AND METHODS: A total of 40 patients who underwent radical retropubic prostatectomy from January 2005 to April 2007 were investigated. Among them one neurogenic bladder patient and one follow up loss patient were excluded. Voiding pattern and urinary incontinence were investigated with voiding diary monthly after Foley catheter removal. Recovery of urinary continence was defined as usage of less than 1 diaper per day. Pericatheter urethrography was conducted 2 weeks after operation. If definite bladder-urethral extravasation was not detected, an retrograde urethrography was performed immediately. 30 patients with sufficient length of urethra, regular margin of urethra and beaky appearance were defined as Group A, and 8 patients without above mentioned characteristics were marked as Group B. Differences between two groups were compared in terms of age, prostate volume, prostate specific antigen, urodynamic parameters, and duration of urinary incontinence. RESULTS: No significant differences were found in age, prostate volume, PSA between two groups. In group A, recovery rates of urinary continence were 70% (21 persons), 100% (30 persons) at 1,3 months after removal of catheter, respectively. In group B, rates of urinary continence recovery were 16.6% (1 person), 37.5% (3 persons), 75% (6 persons) at 1,3,4 months, respectively and 1 person regained continence at 7 months. CONCLUSION: A catheter free retrograde urethrography can be easily added after confirmation of bladder urethra anastomosis site healing. It gives us some valuable informations about external sphincter. The characteristics of retrograde urethrography can be used as a predictor of early recovery of postoperative incontinence.
Catheters ; Follow-Up Studies ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Incontinence ; Urodynamics

PURPOSE: We compared the treatment results and complications between retropubic route of IVS (intravaginal sling) & SPARC (suprapubic arc) and transobturator route of TOT (transobturator tape) & TVT-O (tension-free vaginal tape-obturator). MATERIALS AND METHODS: Targeting group was limited to 104 patients who were diagnosed with female stress urinary incontinence from January 2004 to July 2005. The preoperative evaluation included careful history taking, physical examination, stress and pad test. The postoperative evaluation included a questionnaire, stress test and complications. RESULTS: The numbers of the patients with IVS, SPARC, TOT and TVT-O were 16, 18, 53, 17, respectively. The success rates (cured+improved) were 93.8 (75+18.8)%, 94.4 (83.3+11.1)%, 98.2 (92.5+5.7)%, 100 (88.2+11.8)%, respectively (p>0.05). There was no serious complication. Although urinary tract infection, supurapubic pain, inguinal pain were reported, all the complications got better with conservative therapy. Transobturator route groups took a bit shorter than retropubic route groups as the operation of IVS, SPARC, TOT, TVT-O took 31.8 minutes, 30 minutes, 20 minutes and 21.2 minutes, respectively (p<0.05). CONCLUSIONS: There were no differences in complications and the results of treatment among IVS, SPARC, TOT and TVT-O. Consequently, if all the operation methods are regarded as the proper ones, transobturator route would be preferred to retropubic route, due to shorter operation time and unnecessary for cystoscopy.
Cystoscopy ; Exercise Test ; Female* ; Humans ; Physical Examination ; Surveys and Questionnaires ; Suburethral Slings ; Treatment Outcome ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Tract Infections

PURPOSE: We examined an occurrence of the lower urinary tract symptoms (LUTS) within the chronic kidney disease (CKD) comparatively analyzed implications with components of the CKD. MATERIALS AND METHODS: We surveyed eighty-two CKD patients who were over than 50-year-old, micturated upward of 1,000cc a day. The check list concerned with the LUTS consists of International Prostate Symptom Score (IPSS), quality of life, volume of prostate, maximal flow rate and residual urine volume and we evaluated GFR, serum creatinine, prevalence period, causative disease and diabetes. We analyzed correlations between the CKD and components of the LUTS and examined an aspect of LUTS concerned with the degree of CKD, prevalence period and diabetes. A control group composed of twenty-eight male adults who visited to the general medical examination center and they were examined by the same checklist. RESULTS: The group of CKD is significantly worse than the control group over the whole items of LUTS beside the volume of prostate; they were on the average 57.3+/-3.8 years old, 17.1+/-2.3 of IPSS, 3.8+/-1.2 of quality of life, 12.6+/-3.2ml/sec of maximal flow rate and 38.9+/-4.3ml of residual urine, 25.9+/-3.4g of prostate in the group of CKD. Furthermore, a group of patients who had suffered from the CKD for over than 3 years and combined with diabetes is significantly worse than control group. CONCLUSIONS: The study revealed that a number of CKD have LUTS and they seem to be influenced by prevalence period, stage and causative disease of CKD rather than the volume of prostate.
Adult ; Checklist ; Chronic Disease ; Creatinine ; Humans ; Kidney ; Lower Urinary Tract Symptoms ; Male* ; Middle Aged ; Prevalence ; Prostate ; Quality of Life ; Renal Insufficiency, Chronic* ; Urination Disorders

The transobturator tape surgery is the most recent minimally invasive midurethral sling procedure. This technique is introduced with the expect of decreasing some of the complications such as bladder, bowel and blood vessel injury that is associated with retropubic passage of needles. Reported is a 48-year-old woman who underwent a transobturator tape(TVT-O) procedure and who developed a retropubic hematoma at the pelvic cavity.
Blood Vessels ; Female ; Hematoma* ; Humans ; Middle Aged ; Needles ; Suburethral Slings ; Urinary Bladder ; Urinary Incontinence*

Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula. VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary leakage of urine into the vaginal canal. In addition to the medical sequelae from these fistulas, they often have a profound effect on the patient's emotional well-being. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are most commonly seen. In 1914, Latzko published his partial colpocleisis technique for repair of posthysterectomy VVF, in which he employed the resection of scarred vaginal mucosa and a layered horizontal closure. Latzko's procedure has been cited, with his 95-100% success rates noted. Recently we experienced a case of huge vesicovaginal fistula. The patient is a 67-year-old woman with a history of constant urine leakage. The problem began after she had undergone total abdominal hysterectomy 30 years ago for uterine ruture. We repaired it by Latzko partial colpocleisis.
Aged ; Cicatrix ; Female ; Fistula ; Humans ; Hysterectomy ; Mucous Membrane ; Urinary Bladder ; Vagina ; Vesicovaginal Fistula*

Pelvic inflammatory disease can induce tubo-ovarian abscess, peritonitis, perihepatitis as sequelae. It can result in an associated hydroureteronephrosis or ureteral obstruction. We experienced a case of ureteral obstruction with urinoma in a 22-year old woman who had tubo-ovarian abscess, presented with fever, chills and left flank pain. She was treated with ureteroureterostomy and urinoma excision.
Abscess* ; Chills ; Female ; Fever ; Flank Pain ; Humans ; Pelvic Inflammatory Disease ; Peritonitis ; Ureter* ; Ureteral Obstruction* ; Urinoma* ; Young Adult