Preoperative urodynamic evaluation of SUI and detrusor function was useful for predicting postoperative urinary conditions in POP patients. Its cost-effectiveness remains to be examined.
Based on UDS, an increase in detrusor or abdominal pressure may not be necessary in micturition in women. The present study suggests that relaxation of pelvic floor muscles including normal urethral function are important for micturition in women.
Congenital prepubic sinus is an extremely rare anomaly. The etiology is uncertain and the anatomical features often differ from each other. We report a 22-year-old woman with a congenital prepubic sinus accompanied by a prevesical abscess. She was admitted to our hospital with high-grade fever and low abdominal pain. Computed tomography revealed a prevesical abscess. After treatment of the prevesical abscess, we completely excised the congenital prepubic sinus. To our knowledge, this is the first reported case that accompanied by prevesical abscess on a congenital prepubic sinus. Moreover, this case represents the oldest reported age of a patient with a congenital prepubic sinus.
Tension-free vaginal mesh (TVM) surgery is a common and minimally invasive procedure for female pelvic organ prolapse. In 2004, this procedure was developed by a French group, and standardized surgical kits are now commercially available in many countries. Although it is less invasive, one of the shortcomings of this procedure is that it involves a single surgeon groping around with their fingers without any intraoperative monitoring. Therefore, using Intraoperative fluoroscopic monitoring during TVM surgery makes it safer, even for beginners. In this case, we performed TVM for the anterior vaginal wall. First, we used the c-arm of a fluoroscope to insert bilateral ureteral stents. A urethral catheter was then used for both urine drainage and contrast medium injection. In all procedures, we were able use fluoroscopic imaging whenever necessary. We were able to easily confirm the positions of the prolapsed bladder and the bilateral ureteral stents with fluoroscopic imaging, and the ischial spine was easy to locate before the procedure. We were also able to confirm the position of the top of the needle with fluoroscopic imaging whenever necessary. If a surgeon is worried about the risk of bladder injury during TVM surgery, they should inject contrast medium into the bladder at the start of the procedure. Intraoperative fluoroscopic monitoring during TVM surgery is easy and makes the procedure safer, even for beginners. Moreover, fluoroscopic imaging also allows intraoperative training. To avoid exposing the body to excess radiation, we must minimize the total length of the fluoroscopic examination
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