Case: Urethral prolapse (UP) is a rare condition with unknown etiology. We reported on an 86-year-old woman with a normal BMI and cystocele, presented with acute urinary retention and perineal pain. A residual urine of 950 mL was measured and released by an indwelling catheter. The physical examination revealed 2 × 3 cm severely sore and purple polyp around the urethral meatus with signs of necrosis. A diagnosis of a strangulated urethral prolapse was stated.Outcome: The patient was admitted to the Department of Urology, and treated with surgical excision using the four-quadrant excisional technique. The histopathological examination revealed a non-keratinized, inflammatory squamous epithelium. At a follow-up visit, the patient remained asymptomatic and a complete anatomical resolution was achieved.
Conclusion:UP is an uncommon, sometimes misdiagnosed condition. The management is controversial and to date no consensus exists. This clinical picture is sufficient for diagnosis and surgical excision of the prolapsed urethral mucosa is reasonable if there are signs of strangulation.
Summary
Amniotic fluid levels of total oestrogens, pregnanediol and creatinine were studied in samples obtained between 35 and 43 weeks of pregnancy. Amniotic fluid total oestrogen levels increased in the last weeks of pregnancy and dropped in patients who were overdue and gave birth to infants showing signs of postmaturity. Amniotic fluid pregnanediol levels were steady in the last weeks of pregnancy, but increased sharply when pregnancy lasted more than 40 weeks. Creatinine levels increased steadily throughout pregnancy. It was felt that high amniotic fluid levels of pregnanediol were in some way associated with a failure of processes responsible for the onset of uterine contractions at term.
Activities of L-leucyl-β-naphthylamidase
(aminoacyl-naphthylamide amidohydrolase EC 3.4.1.1),
and α-L-aspartyl-p-nitroanilide hydrolase of placenta and
related tissues were determined in 4 periods of the development
of human placenta. It was shown that both enzymes
were the most active in placentas originating from the
period of growth and differentiation, i.e., between the 14th
and 28th week of gestation. Three zones of L-leucyl-β-naphthylamidase
were demonstrated by polyacrylamide gel electrophoresis in extracts of
placenta, and four zones in membranes. Placenta was found to contain one zone of a-Laspartyl-
naphthylamidase, membranes were devoid of this activity.
Antitryptic, antichymotryptic and antipapain activities in maternal serum were
measured in the course of normal pregnancy. An increase in inhibitory capacity toward the
three examined proteases was demonstrated. The level of antipapain activity was highest
between the 13th and 24th weeks of gestation in contrast to antitrypsin and antichymotrypsin
activities which have shown the highest values between the 25th and 36th weeks of pregnancy.
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