INTRODUCTION AND HYPOTHESIS: Pregnancy and childbirth predispose to pelvic floor dysfunction (PFD), coinciding with functional and anatomical changes in the pelvic floor. To some extent, these can be assessed by transperineal ultrasound (TPUS), yet the correlation between ultrasound findings and symptoms has not been well elucidated. We hypothesised that pregnant women with PFD would show different findings at TPUS. METHODS: This is a planned secondary analysis of a prospective cohort study. Pregnant women were asked to fill out standardised questionnaires on PFD and undergo TPUS at 12-14 weeks and 28-32 weeks of gestation. We compared bladder neck descent, urethral rotation, retrovesical angle, pelvic organ descent, genital hiatus dimensions and the presence of anal sphincter defects between women with and those without PFD using t test and Fisher's exact test. Linear mixed-effects models were used to assess the correlation between TPUS findings and PFD severity. As this is a secondary subgroup analysis of participants who underwent TPUS, no sample size was determined upfront. RESULTS: At Valsalva, women with urinary incontinence had more pronounced bladder neck descent (p = 0.02) and urethral rotation (p < 0.01), as well as wider retrovesical angles (p = 0.04) and larger genital hiatus areas (p < 0.01). After controlling for age, BMI and parity, the retrovesical angle was the only persistent predictor of urinary incontinence. No correlation was observed between any TPUS marker and symptoms of either prolapse or anorectal dysfunction. CONCLUSIONS: In pregnant women, symptoms of urinary incontinence, but not of prolapse and anorectal dysfunction, are associated with differences in pelvic floor anatomy at TPUS.

• MeSH
• Anal Canal diagnostic imaging   MeSH
• Adult MeSH
• Urinary Incontinence diagnostic imaging   etiology   physiopathology   MeSH
• Pregnancy Complications * diagnostic imaging   physiopathology   MeSH
• Humans MeSH
• Pelvic Floor Disorders * diagnostic imaging   physiopathology   etiology   MeSH
• Pelvic Floor * diagnostic imaging   physiopathology   MeSH
• Prospective Studies MeSH
• Pregnancy MeSH
• Ultrasonography MeSH
• Urethra diagnostic imaging   physiopathology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Práce shrnuje současné znalosti o příčinách, diagnostice, léčbě a komplikacích poranění močové trubice. Tato poranění se mnohem více vyskytují u mužů než u žen a nejčastější příčinou je zavádění katétru do uretry a endoskopická vyšetření a výkony. Základní vyšetření zahrnuje anamnézu, klinické a radiologické vyšetření doplněné ve vybraných případech o endoskopii. Existuje celé spektrum léčebných možností od pouhého sledování, přes prosté zavedení drenáže (katétr, epicystostomie) až po komplikované rekonstrukční výkony. Správná prvotní péče a další kroky jsou klíčové pro celkové výsledky a následky pro pacienta. Kvůli jednodušší struktuře a menším rozměrům ženské uretry, je článek zaměřený na mužské pacienty, ale obsahuje důležité poznámky o rozdílech v diagnostice a léčbě mezi pohlavími.

This article summarizes the recent knowledge on the etiology, diagnosis, therapy and complications of urethral injuries. There is much higher overall incidence in males than in females and the most common cause is urethral catheterization and endoscopic examination and procedures. Basic evaluation comprises patient ́s history, clinical and radiological examination with endoscopy in selected cases. There is a wide scale of treatment options from clinical follow-up, through simple insertion of drainage (catheter, epicystostomy) up to complicated surgical reconstructions. Proper primary managment and further steps are crucial for the final results and consequences for the patient. Due to tiny structure and short course of the female urethra it is focused on male patients, but important comments about differences in the diagnosis and therapy between the genders are mentioned.

• MeSH
• Surgical Procedures, Operative methods   MeSH
• Diagnostic Imaging methods   MeSH
• Humans MeSH
• Wounds and Injuries surgery   etiology   classification   MeSH
• Urethra * surgery   diagnostic imaging   injuries   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Fraktura penisu se sdruženým poraněním uretry je vzácný akutní stav v urologii. Diagnostika se provádí převážně pomocí anamnézy, fyzikálního vyšetření, retrográdní uretrografie (v případě podezření na poranění uretry), případně magnetické rezonance (MRI). Při prokázané FP s poraněním uretry či při diagnostických pochybách je indikována operační revize se suturou tunica albuginea a uretry. Konzervativní terapie se nedoporučuje z důvodu rizika komplikací (erektilní dysfunkce, zakřivení penisu, striktura uretry).

Penile fracture with associated urethral injury is a rare acute condition in urology. The diagnosis is mainly based on medical history, physical examination, retrograde urethrography (in the case of suspected urethral injury), and/or magnetic resonance imaging (MRI). When penile fracture with urethral injury has been demonstrated or if there is diagnostic doubt, surgical revision with suture of the tunica albuginea and urethra is indicated. Conservative treatment is not recommended because of the risk of complications (erectile dysfunction, penile curvature, urethral stricture).

• MeSH
• Cystostomy MeSH
• Adult MeSH
• Hematoma surgery   MeSH
• Humans MeSH
• Penis * surgery   diagnostic imaging   injuries   MeSH
• Rupture * surgery   etiology   MeSH
• Urethra surgery   diagnostic imaging   injuries   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

• Keywords
• leak point pressure, cystometrie, uroflowmetrie,
• MeSH
• Diagnostic Techniques, Urological * MeSH
• Electromyography methods   MeSH
• Humans MeSH
• Urinary Bladder diagnostic imaging   MeSH
• Urination Disorders diagnosis   MeSH
• Flowmeters MeSH
• Urinary Incontinence, Stress diagnosis   MeSH
• Lower Urinary Tract Symptoms diagnosis   MeSH
• Urethra diagnostic imaging   physiopathology   MeSH
• Urodynamics * MeSH
• Check Tag
• Humans MeSH

• MeSH
• Diagnostic Techniques, Obstetrical and Gynecological classification   MeSH
• Diagnostic Techniques, Urological classification   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Urinary Bladder * anatomy & histology   diagnostic imaging   MeSH
• Pelvic Floor diagnostic imaging   MeSH
• Radiography methods   MeSH
• Rectum diagnostic imaging   MeSH
• Ultrasonography methods   MeSH
• Urethra diagnostic imaging   MeSH
• Urogenital System * diagnostic imaging   MeSH
• Urologic Surgical Procedures MeSH
• Check Tag
• Humans MeSH

• Keywords
• cystometrie,
• MeSH
• Diagnostic Techniques, Urological * MeSH
• Urinary Bladder, Overactive diagnosis   MeSH
• Urinary Incontinence * diagnostic imaging   diagnosis   MeSH
• Humans MeSH
• Urinary Bladder diagnostic imaging   physiopathology   MeSH
• Urination Disorders diagnostic imaging   diagnosis   MeSH
• Surveys and Questionnaires MeSH
• Urinary Incontinence, Stress diagnostic imaging   therapy   MeSH
• Urethra diagnostic imaging   physiopathology   MeSH
• Urodynamics MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Publication type
• Review MeSH

• MeSH
• Endoscopy * MeSH
• Humans MeSH
• Young Adult MeSH
• Penis diagnostic imaging   injuries   MeSH
• Replantation methods   MeSH
• Self Mutilation diagnostic imaging   surgery   MeSH
• Amputation, Traumatic diagnostic imaging   surgery   MeSH
• Urethra diagnostic imaging   surgery   MeSH
• Check Tag
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Publication type
• Letter MeSH
• Case Reports MeSH

Endoskopie je minimálně invazivní diagnostická nebo terapeutická metoda. Umožňuje zjištění stavu tělních dutin nebo dutých orgánů za využití tělních otvorů nebo nepřímé cesty. Používají se speciálně upravené rigidní tubusy s optickým systémem tvořeným klasickými čočkami nebo ohebné (flexibilní) přístroje s optickými vlákny. Endoskopy umožňují diagnostiku a terapii různých patologických stavů močových cest, jako jsou nádory, cizí tělesa, obstrukce močových cest. Derivace moči znamená zajištění odtoku moči z organismu jinou než přirozenou cestou. Článek popisuje možnosti jednotlivých druhů endoskopie a derivací moči v urologii a je určen specialistům z jiných oborů a praktickým lékařům a neslouží k detailnímu popisu jednotlivých metod.

Endoscopy is a minimally invasive diagnostic or therapeutic method. It allows to examinate the status of a body cavity or holloworgans using the body openings. Endoscopes are specially modified rigid tubes with an optical system composed of conventionallenses or flexible devices with optical fibers, which allow the diagnosis and therapy of various pathologies of the urinary tract suchas tumors, foreign bodies and urinary tract obstruction. Urinary diversion means urine drainage from the body other than thenatural way. Article describes the different types of endoscopy and urinary diversion in urology and is intended for non-urologyspecialists and GPs and is not used for a detailed description of the methods.

• Keywords
• cystouretroskopie, ureterorenoskopie, epicystostomie,
• MeSH
• Cystectomy MeSH
• Cystoscopy MeSH
• Urinary Diversion methods   MeSH
• Endoscopy * methods   MeSH
• Prostatic Hyperplasia diagnostic imaging   surgery   MeSH
• Laser Therapy MeSH
• Kidney diagnostic imaging   MeSH
• Humans MeSH
• Urinary Bladder Neoplasms diagnostic imaging   surgery   MeSH
• Nephrostomy, Percutaneous MeSH
• Stents MeSH
• Ureteroscopy MeSH
• Urethra diagnostic imaging   MeSH
• Urologic Diseases * diagnostic imaging   surgery   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH