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1.
The authors present a case of a healthy 55-year-old woman with a 1-year history of vaginal malodor and perineal dampness.
A pyridium (phenazopyridine) pad test revealed a well-defined stain area no greater than 3 cm. Cystoscopic examination revealed
multiple multilobulated polypoid neoplasms, which we feel probably represent pedunculated hemangiomas. Removal of the neoplasms
cured the dampness, malodor and recurrent vaginal infections. We submit this case as a unique cause of extraurethral incontinence. 相似文献
2.
The purpose of the study was to investigate the prevalence of urinary incontinence during pregnancy and the postpartum, and
to examine postpartum pelvic floor muscle strength. Eight weeks postpartum the prevalence of urinary incontinence and pelvic
floor muscle strength was registered. All women in a Norwegian community, delivering at the local hospital during a 1-year
period, were included in the study. The final study group consisted of 144 women (72%). Data concerning the prevalence of
urinary incontinence was collected by a structured interview and clinical assessment (pad test) 8 weeks postpartum. Pelvic
floor muscle strength was also measured. The prevalence of urinary incontinence during pregnancy was 42%. Eight weeks after
delivery the prevalence of self-reported urinary incontinence was 38%. There was a difference between self-reported symptoms
and urinary incontinence as assessed by the pad test. Symptoms of fecal incontinence postpartum were reported by 6 women (4.2%).
The prevalence of urinary incontinence was found to be nearly the same 8 weeks postpartum as during pregnancy. This documents
the need for a strategy to prevent and treat urinary incontinence during these periods. 相似文献
3.
Urinary incontinence is a common condition affecting up to 50% of the female population, but only a third seek medical help.
Although the majority of these are satisfactorily managed with conservative or conventional surgical treatment, 10%–15% continue
to remain incontinent despite intervention. Urinary diversion is a management option for this group. The different techniques
of urinary diversion, their results, complications and long-term sequelae are discussed, with a review of the literature. 相似文献
4.
D. Doddamani M. S. Ansari N. P. Gupta M. Aron I Singh S. Datta Gupta 《International urogynecology journal》2002,13(1):47-49
Mesonephric or mesonephroid adenocarcinoma of the bladder may be a malignant form of nephrogenic adenoma or nephroid metaplasia.
The lesion is rare, and to the best of our knowledge only 9 cases have been reported in the world literature. We report another
case of mesonephroid adenocarcinoma of the bladder and urethra which was treated with transurethral resection and subsequent
chemotherapy. 相似文献
5.
Many new serotonergic antidepressants have been introduced over the past decade. Although urinary incontinence is listed
as one side effect of these drugs in their package inserts there is only one report in the literature. This concerns 2 male
patients who experienced incontinence while taking venlafaxine. In the present paper the authors describe 2 female patients
who developed incontinence secondary to the selective serotonin reuptake inhibitors paroxetine and sertraline, as well as
a third who developed this side effect on venlafaxine. In 2 of the 3 cases the patients were also taking lithium carbonate
and β-blockers, both of which could have contributed to the incontinence. Animal studies suggest that incontinence secondary
to serotonergic antidepressants could be mediated by the 5HT4 receptors found on the bladder. Further research is needed to
delineate the frequency of this troubling side effect and how best to treat it. 相似文献
6.
Correlates of Urinary Incontinence in Pregnancy 总被引:6,自引:2,他引:4
L. Hvidman L. Hvidman A. Foldspang S. Mommsen J. Bugge Nielsen 《International urogynecology journal》2002,13(5):278-283
In a population sample, the period prevalence of urinary incontinence (UI) during pregnancy was found to be 19.9% and 24.1%
among 352 nulliparous and 290 primiparous women, respectively. The first UI episode ever was experienced by 16.7% and 7.0%
during the two last trimesters of the first and second pregnancies, respectively. None of the pregnancy-specific risk factors,
such as emesis and birthweight, was significantly associated with UI during pregnancy. Previous UI was a significant risk
factor for period prevalent UI during pregnancy, explaining 34% and 83% of pregnancy UI for the nulliparous and the primiparous,
respectively. The present data suggest pregnancy UI not to be provoked by the mere onset of pregnancy, but by increasing hormonal
concentrations or local tissue changes caused by hormones, whereas there was no support for a theory based on increasing pressure
on the bladder caused by the weight of the fetus. 相似文献
7.
Epidemiology and Natural History of Urinary Incontinence 总被引:6,自引:0,他引:6
S. Hunskaar E. P. Arnold K. Burgio A. C. Diokno A. R. Herzog V. T. Mallett 《International urogynecology journal》2000,11(5):301-319
This paper examines or current state of knowledge of the epidemiology of urinary incontinence. The population studied was
community-dwelling non-institutionalized persons. The review includes discussion of the prevalence, incidence, natural history
and presence of racial and ethnic differences in the epidemiology of urinary incontinence. We also review correlates and
potential risk factors that have been revealed in epidemiological studies. Differences between epidemiological and clinical
approaches to a health problem, help-seeking behavior and methodological issues for research are also discussed. We have reviewed
a large number of completed studies in the field of urinary incontinence, and have emphasized high-quality and population-based
studies. We also wished to present studies from a variety of countries. Because of the abundance of studies, only a small
fraction can be presented here. Other studies may have equal standards and useful information, but lack of space precludes
their inclusion. 相似文献
8.
F. Demirci S. Ozden Z. Alpay E. Tozkır Demirci S. Ayas 《International urogynecology journal》2001,12(2):129-133
We investigated the effects of vaginal delivery (VD) and cesarean section (CS) on bladder neck (BN) mobility and genuine
stress incontinence (GSI). Of the 230 patients included in the study, 95 had CS, 95 had VD and the remaining 40 continent
nulliparous women served as controls. In both the CS and the VD groups 40 women had delivered once, 35 women twice and 20
women three times. Perineal ultrasonography was performed in all patients. Vaginal delivery affects BN mobility and its position
more negatively than does CS, and increases its mobility in two directions. The CS group also has similar findings after the
third delivery. The GSI rate was not significantly different between the CS and the VD groups, but the VD group had a higher
percentage. Our study also shows that BN mobility is associated with GSI compared to the continent controls. 相似文献
9.
Incontinence surgery is rarely performed prior to the completion of a woman’s childbearing. The literature is sparse in regard
to women with prior incontinence surgery. There are no reports of pregnancy complicated by a sling procedure. A 26-year-old
gravida 3, para 2-0-0-2 with prior surgical history of a Pereyra urethropexy followed by a Vesica suburethral sling, was referred
at 18 weeks’ gestation for assessment of the sling. Her antenatal course was complicated by pyelonephritis and intermittent
urethral obstruction requiring Foley catheter placement. She delivered by scheduled cesarean section at 37 weeks’ gestation.
Three months following delivery she presented with pyelonephritis and recurrence of her incontinence. Pregnancy complicated
by prior suburethral sling procedure may result in urinary outlet obstruction, pyelonephritis and disruption of the surgical
repair. 相似文献
10.
K. Everaert D. De Ridder L. Baert W. Oosterlinck J. J. Wyndaele 《International urogynecology journal》2000,11(4):231-236
The aim of the study was to determine the success rate, the complications, the failures and the solutions found in troublesome
cases. A retrospective study was performed in three university centers in Belgium. Between March 1994 and April 1998, a quadripolar
electrode and a pulse generator were implanted in 53 patients (8 men, 45 women, 43 ± 12 years, mean follow-up 24 ± 8 months,
range 13–39 months). During the first few months, 45 (85%) of the 53 patients had an objective response. Eight late failures
occurred, with a mean failure delay of 9 ± 5 months. We performed 15 revisions in 12 patients. Major complications were pain
and current-related troubles. The outcome was significantly better (P= 0.001) in post-stress incontinence surgery patients. Device-related pain was found more frequently in patients with dysuria
and/or retention or perineal pain, and the test stimulation was less reliable (P= 0.025) in patients with a psychiatric history. Sacral nerve stimulation is efficient in treating patients with refractory
lower urinary tract symptoms and/or perineal pain. 相似文献
11.
Our objective was to evaluate the symptom and sign of stress incontinence in predicting the presence of urodynamically diagnosed
genuine stress incontinence (GSI). The study was a computation of the sensitivity and predictive values from the published
literature (1975–1998), evaluating the history and/or physical examination for the diagnosis of GSI, with calculation of efficacy
variables. Results show that the isolated symptom of stress incontinence has a positive predictive value (PPV) of 56% for
the diagnosis of pure GSI and 79% for GSI with additional abnormalities. The PPV of stress incontinence in association with
other symptoms is 77% in detecting GSI (with or without additional abnormalities). A positive cough stress test has a PPV
of 55% for detecting pure GSI and 91% for the mixed condition (GSI plus additional diagnosis). When isolated, the symptom
or the sign of stress incontinence is a poor predictor of GSI. In combination, the prediction may be more promising. 相似文献
12.
Urodynamics in Climacteric Women with Urinary Incontinence: Correlation with Route of Delivery 总被引:1,自引:0,他引:1
T. Guarisi A. M. Pinto-Neto V. Herrmann A. Faúndes 《International urogynecology journal》2002,13(6):366-371
The aim of this study was to compare the urodynamic findings among climacteric women complaining of urinary incontinence
who had only vaginal deliveries with those who had only cesarean sections. The study group comprised 30 climacteric women
with complaints of urinary incontinence consulting at the Menopause Outpatient Clinic, State University of Campinas, submitted
to anamneses and complete urodynamic testing. Nineteen women had had only vaginal deliveries and 11 were delivered only by
cesarean section. Vaginal delivery was significantly associated with a reduced normal and strong desire to void and maximum
cystometric capacity compared to women who delivered only by Cesarean section. Detrusor instability was four to five times
more frequent among women who had had only vaginal deliveries. There was no difference between the two groups concerning uroflowmetry
parameters. Climacteric women with urinary incontinence who had had only vaginal deliveries are at a higher risk of urodynamic
abnormalities.
Correspondence and offprint requests to: Viviane Herrmann, Rua Alexandre Flemming 1001, Cidade Universitária ‘Zeferino Vaz’, Mailbox 6081, 13083-970 Campinas, Sao
Paulo, Brazil. Tel/Fax: +55 19 3788-9306; E-mail: vherrmann@hotmail.com 相似文献
13.
P. E. Papa Petros 《International urogynecology journal》1999,10(6):356-360
The aim was to prospectively follow a group of 25 patients (mean age 60.5 years) presenting with double incontinence, urinary
and fecal. Other than endoanal ultrasound, no allowance was made for fecal incontinence. All patients were treated exclusively
according to an anatomical classification used for the management of urinary incontinence. Initially, all patients underwent
surgical reconstruction of their pubourethral neoligaments with intravaginal slingplasty. All 25 patients reported complete
cure of their fecal incontinence for a minimum of 6 months (mean 26 months, range 6–48 months) after surgery, and 22 patients
of their urinary incontinence as well. The external anal sphincter was normal in all 25 patients (100%). The internal anal
sphincter (IAS) was normal in 18 patients (72%). In 3 patients fecal incontinence recurred simultaneously with the occurrence
of herniations in the posterior and middle parts of the vagina. Subsequent surgical repair of the uterosacral and arcus tendineus
fasciae pelvis ligaments cured the recurrence. The results appear to indicate that non-traumatic (‘idiopathic’) fecal incontinence
may have the same cause as urinary incontinence. As only connective tissue was repaired, it is suggested that connective tissue
damage may be an important cause of fecal as well as urinary incontinence. 相似文献
14.
A. Hirsch G. Weirauch B. Steimer K. Bihler U. Peschers F. Bergauer B. Leib T. Dimpfl 《International urogynecology journal》1999,10(1):7-10
The aim of the study was to evaluate the efficacy of pelvic floor training with EMG-controlled home biofeedback in the treatment
of stress and mixed incontinence in women. Subjects were recruited from the urodynamic outpatient clinic and performed pelvic
muscle training with an EMG-controlled biofeedback device for 20 minutes daily for 6 months. The number of pads used per day,
the number of incontinence and urgency episodes, voiding frequency, maximum urethral closure pressure, functional urethral
length and pressure/transmission ratio during stress were assessed before and after treatment. Thirty-three patients (13 with
stress and 20 with mixed incontinence) completed the study. There was a significant decrease in the number of pads used per
day, the number of incontinence and urgency episodes, and the voiding frequency. Twenty-eight patients (85%) reported that
they were cured or improved. Urodynamic parameters did not change significantly. It was concluded that home pelvic floor training
with EMG-controlled biofeedback is efficient in 85% of patients in alleviating the symptoms of genuine stress and mixed incontinence
without causing side effects. 相似文献
15.
Suture Injury to the Urinary Tract in Urethral Suspension Procedures for Stress Incontinence 总被引:2,自引:2,他引:2
The case histories of women attending the Urogynecology Department at the Royal Women’s Hospital and Mercy Hospital for Women
were reviewed between 1986 and 1998 to determine the incidence and postoperative morbidity caused by suture injury to the
urinary tract following urethral suspension surgery for stress incontinence. In our department 1103 Burch colposuspensions
and 61 Stamey urethral suspensions have been performed. Intraoperative cystourethroscopy was performed routinely for the early
detection and treatment of urinary tract injury. Intravesical sutures were found by routine intraoperative cystoscopy in 1
Stamey suspension, 1 open Burch colposuspension and 3 laparoscopic Burch colposuspensions. Ureteric suture ligation was diagnosed
in 2 women intraoperatively and 1 woman postoperatively after laparoscopic Burch colposuspension. Two women presented with
late complications from intravesical sutures following open Burch colposuspension. A further 7 women referred with urinary
symptoms were found to have intravesical sutures, 2 following Burch colposuspension, 4 following Stamey urethral suspension
and 1 following the Marshall–Marchetti–Kranz procedure. Seven of the 9 women diagnosed with intravesical sutures presented
with bladder or pelvic pain, frequency or urinary tract infection. Two women had recurrent stress incontinence and were found
to have a intravesical suture on routine cystoscopy at the time of stress incontinence surgery. Suture removal, with any accompanying
calculus, was achieved cystoscopically with almost immediate resolution of symptoms without loss of urinary control in all
cases. Non-absorbable intravesical sutures occurring as a result of suture misplacement or erosion is an infrequent but important
complication of stress incontinence surgery, but should be suspected if pain and irritative bladder symptoms or recurrent
urinary infection occur postoperatively. Cystourethroscopy performed intraoperatively or postoperatively is essential for
early diagnosis and treatment. 相似文献
16.
B. U. Tomlinson M. C. Dougherty J. F. Pendergast A. R. Boyington M. A. Coffman S. M. Pickens 《International urogynecology journal》1999,10(1):22-28
Forty-one women completed the first phase (self-monitoring) of the Behavioral Management for Continence (BMC) intervention,
while working with a nurse during home visits to reduce involuntary urine loss as part of the parent study involving older,
rural women living at home. A decrease in dietary caffeine intake and an increase in fluid intake were most frequently recommended.
The relationship between a decrease in the amount of dietary caffeine consumed and fewer daytime episodes of involuntary urine
loss approached significance –P = 0.0744 – whereas an increase in the average amount of fluid intake was significantly related to an increase in the average
volume of urine voided –P = 0.0479 – and not to involuntary urine loss. 相似文献
17.
The Valsalva leak-point pressure has become an important urodynamic test in the evaluation of incontinent women. A review
of the history of the test, its methodology, and variables that can influence its performance is presented. Correlation with
clinical findings, reproducibility and comparison with other urodynamic tests are discussed. Although the test is still evolving
and several major variables have been recognized as affecting its results, it remains sound and reliable. It has excellent
correlation with the clinical severity of incontinence and a high degree of inter- and intraexaminer reproducibility. 相似文献
18.
Ando K Masumoto N Sakamoto M Teraoka K Suzuki T Kurihara T Abe S Tozaki M Fukuma E Hoshi K 《Breast care (Basel, Switzerland)》2011,6(6):471-473
BACKGROUND: Parotid gland metastasis in breast cancer is extremely rare, and only 14 cases have been reported between 1982 and 2010. CASE REPORT: A 67-year-old female patient was diagnosed with invasive lobular carcinoma of the left breast. Although clinical staging was T1N3M1 (stage IV), the tumor experienced a complete response to chemotherapy. We therefore performed a mastectomy followed by radiotherapy, and continued administration of trastuzumab. However, 11 months later, the patient complained of a swelling in the left parotid gland. Histology following a partial parotidectomy revealed a parotid gland metastasis from the breast. CONCLUSION: Treatment with capecitabine in addition to trastuzumab, which is one of the strategies applied in HER2-positive breast cancer, was effective in our patient. Analysis of the 14 cases of parotid gland metastasis from the breast reported between 1982 and 2010 revealed that the metastasis may occur not by direct lymphatic but by hematogenous spread. 相似文献
19.
The Prevalence and Determinants of Health Care-Seeking Behavior for Urinary Incontinence in United Arab Emirates Women 总被引:5,自引:2,他引:3
D. E. E. Rizk H. Shaheen L. Thomas E. Dunn M. Y. Hassan 《International urogynecology journal》1999,10(3):160-165
The aim of this study was to determine the prevalence and sociodemographics of urinary incontinence (UI) in women in the
United Arab Emirates (UAE). Women at risk, such as multiparous and climacteric women, were selected from the community (n= 200) and health-care centers (n= 200) and interviewed about inappropriate urine loss in the past 12 months, using a structured and pretested questionnaire.
Of these, 81 (20.3%) admitted UI; only 25 of these (30.9%) had sought medical advice. The reasons were embarrassment (38.2%),
choice of self-treatment because of low expectations from medical care (38.2%), and preferring to discuss the matter with
friends, assuming that UI is normal (23.3%). Sufferers were troubled by their inability to pray (90%) and to have sexual intercourse
(33.3%). Perceived causes of UI were paralysis (45%), childbirth (35.4%) and old age or menopause (33.7%). UI is common yet
underreported by UAE women because of cultural attitudes and inadequate public knowledge. 相似文献
20.
We describe our successful operative management of a solitary metastasis in the sternal body after modified left mastectomy.
Because the primary lesion was well controlled and the sternal metastasis was isolated, we performed a subtotal sternectomy,
with full-thickness resection of the anterior chest wall, including the sternal body and inferior part of the manubrium (14.5 cm
× 8.5 cm × 3.0 cm). A prosthesis was created to fill the defect, by sandwiching molded bone cement (methylmethacrylate) between
two layers of Prolene mesh. The prosthesis was fixed to the cut ends of the costal cartilages and the residual manubrium.
The patient had an uneventful course, and her respirations were normal without paradoxical movement of the thorax or hypoxemia.
The skin covering the prosthesis healed well. Thus, the creation of an artificial chest wall from methylmethacrylate and Prolene
mesh is a useful technique for repairing sternal defects. 相似文献