The transobturator tape (TOT) procedure is a relatively safer than tension-free vaginal tape (TVT) operation but it may cause vascular injury. Recently we experienced a case using uterine artery embolization for the patient with uterine artery bleeding after TOT.
Hemorrhage* ; Humans ; Suburethral Slings* ; Uterine Artery Embolization* ; Uterine Artery* ; Vascular System Injuries

Congenital renal arteriovenous malformations are rare. Moreover, rupture of congenital arteriovenous malformations in the unilateral renal agenesis with uterine malformation is more rare. We present a case of acute urinary retention due to large hematoma of spontaneously ruptured congenital arteriovenous malformation of unilateral renal agenesis in a 33-years-old woman.
Arteriovenous Malformations* ; Female ; Hematoma ; Humans ; Rupture ; Urinary Retention*

Residual urine can be erroneously estimated due to cystic pelvic pathology by portable ultrasound scanning. We report a case involving a false-positive elevated postvoid residual urine result using a bladder ultrasound caused by an ovarian cystadenoma unrelated to the urinary tract.
Cystadenoma* ; Ovarian Neoplasms ; Pathology ; Ultrasonography* ; Urinary Bladder ; Urinary Tract

Spontaneous intraperitoneal bladder rupture is a rare complication of radiation therapy. We report an unusual case of spontaneous intraperitoneal bladder rupture 17 years after pelvic radiotherapy for carcinoma of the cervix in a 59-year-old woman who underwent prompt surgical repair.
Cervix Uteri ; Female ; Humans ; Middle Aged ; Radiotherapy* ; Rupture* ; Urinary Bladder* ; Uterine Cervical Neoplasms*

Emphysematous cystitis is a rare infectious condition of the urinary bladder. Underlying diabetes mellitus is present in over half of reported cases with women being affected twice as often as men. It also occurs in alcoholism, undernutrition, radiating and immunosuppressive treatments. We present a case of postpartum emphysematous cystitis after Casarean section (C-sec) in a young female without underlying disease.
Alcoholism ; Cystitis* ; Diabetes Mellitus ; Female ; Humans ; Male ; Malnutrition ; Postpartum Period* ; Urinary Bladder

PURPOSE: We investigated the effect of oral or intravenous tolterodine on cystometric parameters in awake spontaneously hypertensive rats (SHRs) as a model of overactive bladder (OAB). The aim of our study was to observe the experimental conditions required to reproduce the clinical pharmacological effects of tolterodine, as seen in humans, to decrease bladder pressure or increase bladder capacity. MATERIALS AND METHODS: We studied the effects of the most widely used antimuscarinic drug, tolterodine, on cystometric parameters via two different administrations (oral and intravenous) in awake SHRs. RESULTS: Oral administration of tolterodine 10 mg/kg(-1) body weight in awake rats did not change any cystometric parameters significantly. Intravenous administration of tolterodine 0.3 mg/kg(-1) body weight significantly decreased basal pressure (BP) and micturition pressure (MP), but showed no effect on micturition interval (MI) or bladder capacity (BC). CONCLUSION: Despite a high dose of tolterodine via an oral or an intravenous route, a decrease in BP or MP was the only effect on cystometrographic parameters in awake rats, whereas MI and BC were not significantly affected. Therefore, it is difficult to reproduce in awake rats as an acute response the cystometric increase in the MI that is observed in humans after chronic administration of antimuscarinic agents.
Administration, Intravenous* ; Administration, Oral ; Animals ; Body Weight ; Humans ; Muscarinic Antagonists ; Rats ; Rats, Inbred SHR* ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urination ; Tolterodine Tartrate

PURPOSE: N-acetylcysteine (NAC) is a potent antioxidant, and a free radical scavenger. We investigated the possible effects of NAC after ischemia/reperfusion (I/R) of rat bladder. MATERIALS AND METHODS: I/R injury was induced by abdominal aorta clamping and ischemia for 60minutes, followed by 120minutes reperfusion. Twenty rats were divided into four groups: sham operation + saline group (S+S), sham operation + NAC group (S+NAC), I/R + saline group (I/R+S), I/R + NAC group (I/R+NAC). Blood levels of reactive oxygen species (ROS) were determined using the free oxygen radical tests (FORT). Superoxide generation was measured based on lucigenin-enhanced chemiluminescence. The level of malondialdehyde (MDA) was analyzed in order to measure lipid peroxidation. RESULTS: In I/R+S group, the isometric contractile responses to carbachol were significant lower than other groups and were reversed by the pretreatment with NAC. The level of FORT and MDA showed a marked increase in I/R+S group compared with S+S group. NADPH-stimulated superoxide production was also significantly increased. I/R+NAC decreased these parameters compared with I/R+S group. CONCLUSION: Our results suggest that treatment with NAC reversed the low contractile responses of rat bladder and prevented oxidative stress following I/R.
Acetylcysteine ; Animals ; Aorta, Abdominal ; Carbachol ; Constriction ; Ischemia ; Lipid Peroxidation ; Luminescence ; Malondialdehyde ; Oxidative Stress ; Oxygen ; Panax* ; Rats* ; Reactive Oxygen Species ; Reperfusion ; Superoxides ; Urinary Bladder*

PURPOSE: To explore the effect of bilateral oophorectomy on the several proteins of female rat bladder via a proteomic approach. MATERIALS AND METHODS: A total of 20 female Sprague-Dawley rats were obtained at 8 weeks of age and were divided randomly into 3 groups: a control groups underwent sham operation and bladders were excised 4 weeks and 8 weeks after operation each. Other two groups underwent bilateral oophorectomy and bladders were excised 4 weeks (group 1) and 8 weeks (group 2) after operation each, too. Each group has 5 rats. Conventional proteomics was conducted via high resolution 2-D gel electrophoresis, followed by image analysis and protein identification through mass spectrometry. RESULTS: Bladder weights were reduced significantly in group 2 as compared with the 8-week control group. A comparison of the bladders of the oophorectomy group subjects with those of the control group subjects demonstrated that the expressions of 11 proteins were altered Eukaryotic translation initiation factor 5A (elF-5A), chaperone grp 75 precursor, actin-depolymerizing factor, contrapsin-like inhibitor 1 precursor, guanine deaminase, actin, peroxiredoxin 2, phosphatidylethanolamine, putative protein kinase, Keratin complex 2 and Enol protein. CONCLUSION: The roles of 11 proteins are variable. A part of these proteins have a role of cellular apoptosis, acute inflammation, and muscle contraction. It seems that these changes of proteins have an influence on bladder functions and LUTS.
Actins ; Animals ; Apoptosis ; Electrophoresis, Gel, Two-Dimensional ; Female ; Guanine Deaminase ; Humans ; Inflammation ; Mass Spectrometry ; Muscle Contraction ; Ovariectomy* ; Peptide Initiation Factors ; Peroxiredoxins ; Protein Kinases ; Proteomics ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder* ; Weights and Measures

PURPOSE: To evaluate the effect of suprapubic magnetic stimulation (SMS) with the use of an arm-type magnetic stimulator for the treatment of patients with neurogenic detrusor overactivity. MATERIALS AND METHODS: Eleven patients with neurogenic detrusor overactivity were enrolled in this study. All patients underwent more than 16 SMS sessions, two times per week, with the use of an arm-type magnetic stimulator. Objective success was defined as a significant reduction (> or =50%) in the total number of leakage episodes per 24 hours, whereas subjective success was defined as the request to continue treatment. RESULTS: Five (71.4%) of 7 patients who had urinary incontinence before treatment reported objective success, and 3 patients showed no incontinence. A total of 6 (75.0%) of 8 patients showed increased average voiding volume. One patient showed an adverse effect of back pain after SMS and dropped out. Seven patients (70.0%) of 10 patients wanted to continue this treatment. They showed significant improvements in frequency/volume chart data, quality of life scores, and urodynamic data. CONCLUSIONS: SMS can be a safe, non-invasive and effective option for the treatment of neurogenic detrusor overactivity.
Back Pain ; Humans ; Quality of Life ; Urinary Bladder ; Urinary Incontinence ; Urodynamics

PURPOSE: To access the feasibility of Canal transobturator tape (Canal TOT) for stress urinary incontinence (SUI) in women over 65 year old. MATERIALS AND METHODS: From August 2006 to December 2008, we reviewed the medical records of 261 patients underwent Canal TOT in Division of Urogynecology, Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine in Seoul. This study is a retrospective analysis of the clinical characteristics (age, gravida, parity, body mass index), previous operation history, comorbidity, surgical procedure and operation outcomes. We performed stress test, one hour pad test, urodynamic study, postvoid residual assessment to all patients for diagnosis of SUI. All patients answered self assessment questionnaires (IIQ-7, UDI-6) at 6 months and 12 months after operation. RESULTS: 55 women over 65 years were underwent Canal TOT. Mean follow up was 11+/-4.5 months. Mean age of patients was 70.2+/-3.9 years, gravida 5.8+/-2.3 times, parity 3.9+/-1.5 times and body mass index (BMI) 25.6+/-3.1Kg/m2. 8 patients had got hysterectomy (14.5%). 16 patients (29%) had sling operation (Canal TOT alone), and 39 patients (71%) had Canal TOT combined with vaginal surgery for pelvic organ prolapse. The cure rate was 96.4% in 6 months follow up. Leakage after operation were reported by 2 patients (3.6%) and 3 patients (5.5%) transiently suffered from postoperative voiding difficulty. Of whom had incontinence complexed with overactive bladder symptoms (frequency, nocturia, and urgency) 12 patients complained of persistent symptoms after Canal TOT (12/33, 36.4%). The scores from self assessment questionnaires (IIQ-7, UDI-6) at6months after operation were improved significantly. CONCLUSION: Canal TOT is feasible and safe method for SUI in old age. The procedure also shows favorable results when combined with other operations for pelvic organ prolapse.
Body Mass Index ; Comorbidity ; Diagnosis ; Exercise Test ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Medical Records ; Nocturia ; Obstetrics ; Parity ; Pelvic Organ Prolapse ; Surveys and Questionnaires ; Retrospective Studies ; Self-Assessment ; Seoul ; Suburethral Slings* ; Urinary Bladder, Overactive ; Urinary Incontinence* ; Urodynamics