The patient was a 66-year-old woman who had a hysterectomy for myoma uteri 20 years before presenting to us, followed by vaginal stump prolapse about 10 years later. At the age of 64 years, she developed dysuria and vaginal stump prolapse and visited the urology clinic. An indwelling urethral catheter was inserted and surgical treatment was recommended. In January 2013, she underwent a complete transvaginal mesh operation for vaginal stump prolapse. Postoperatively, the prolapse was cured but stress urinary incontinence occurred. In June 2013, transobuturator tape was used to treat urinary incontinence. Three months later, transurethral inversion of the bladder became obvious associated with pain, and severe incontinence recurred. In November 2014, urethroplasty and a rectus muscle fascia sling procedure were performed. The transurethral inversion of the bladder was cured and the patient could void without urinary incontinence.

Animal models for the study of erectile function monitoring the changes in intracavernous pressure (ICP) during penile erection was reviewed. The development of new models using small commercially-available experimental animals, rats and mice, in the last decade facilitated in vivo investigation of erectile physiology. The technique enabled to evaluate even subtle erectile responses by analyzing ICP and systemic blood pressure. Moreover, the method has been well improved and studies using conscious animal models without the influence of any drug or anesthesia are more appropriate in exploring the precise physiological and pharmacological mechanisms in erection. Also, more natural and physiological sexual arousal instead of electrical or pharmacological stimulation is desirable in most of the studies. This article reviewed the development of ICP studies in rats and mice.
Animals ; Disease Models, Animal ; Erectile Dysfunction ; physiopathology ; Male ; Penile Erection ; physiology ; Penis ; blood supply ; physiopathology ; Regional Blood Flow ; physiology

Humans ; Male ; Parkinson Disease ; physiopathology ; Penile Erection ; physiology ; Receptors, Dopamine ; physiology ; Spinal Cord ; physiology ; physiopathology ; Urinary Bladder ; physiology

Background/Aims: The recovery room used after endoscopy has limited capacity, and an efficient flow of the endoscopy unit is desired. We investigated the duration of hospital stay after endoscopy and the risk factors for prolonged hospital stay among outpatients. Methods: We retrospectively studied consecutive patients who underwent esophagogastroduodenoscopy or colonoscopy at the Toyoshima Endoscopy Clinic. We collected data on age, sex, body weight, midazolam and pethidine dosage, respiratory depression during endoscopy, and duration of hospital stay after endoscopy (scope out to check out). Risk factors for prolonged hospital stay (>100 minutes) were identified using multiple logistic regression analysis. Results: We enrolled 3,898 patients, including 3,517 (90.2%) patients tested under sedation and 381 (9.8%) patients tested without sedation. Overall, 442 (11.3%) patients had prolonged stay (>100 min). The mean time difference between sedation group and non-sedation group was 44.2 minutes for esophagogastroduodenoscopy and 39.1 minutes for colonoscopy. Age (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.014−1.036), female sex (OR, 1.657; 95% CI, 1.220−2.249), and midazolam dose (OR, 1.019; 95% CI, 1.013−1.026) were independently associated with prolonged hospital stay after esophagogastroduodenoscopy, with similar results for colonoscopy. Conclusions Old age, female sex, and midazolam dose were independent risk factors for prolonged hospital stay after endoscopy.

No abstract available.

Pelvic organ prolapse (POP) is not regarded as life-threatening, and has been left undiagnosed on occasion. However, in some cases, the condition has resulted in hydronephrosis and renal failure. We have investigated the prevalence of hydronephrosis in patients with POP at the Female Pelvic Floor Medicine Center, and how it may be improved through surgery. Of the 555 patients examined between January 2016 and December 2017, 265 patients were diagnosed with POP. This study involved 192 of these cases diagnosed with POP as subjects. Using preoperative ultrasound scanning, hydronephrosis was classified into four categories depending on severity. At the time of surgery, the conditions of POP were classified into stages I to IV of the POP Quantification (POP-Q) system. Of these 192 patients, 20 (10.4%) had been evaluated as hydronephrosis (slight hydronephrosis 9, mild hydronephrosis 6, and severe hydronephrosis 5). It is known that as the staging of POP progresses, the likelihood of developing hydronephrosis also increases. In 20 cases with POP-Q stage IV, 7 were confirmed to have hydronephrosis; 3 of these were severe hydronephrosis. The 6 cases of mild, and 5 cases of severe hydronephrosis achieved cure after tension-free vaginal mesh TVM surgery. POP may cause hydronephrosis, so examination of the upper urinary tract is necessary. Ultrasound scans are useful in detecting hydronephrosis. There has been a case where it took 6 to 10 months for hydronephrosis to improve, so early diagnosis and management are crucial in order to prevent hydronephrosis. TVM surgery can be used for repair of not only anterior prolapse, but also uterine prolapse, which can be thus treated without hysterectomy, and this has the potential to improve hydronephrosis.