- MeSH
- incidence MeSH
- lacerace etiologie chirurgie MeSH
- lidé MeSH
- perineum * zranění chirurgie MeSH
- pooperační komplikace * etiologie epidemiologie MeSH
- prospektivní studie MeSH
- retence moči * etiologie epidemiologie MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- komentáře MeSH
- Geografické názvy
- Uganda epidemiologie MeSH
We present the case of a 47-year-old woman with a bulky, nascent necrotic myoma, which at first glance appeared to be a malignant process in the cervix. It caused significant retention of urine due to compression of the bladder and ureters, hydronephrosis and deterioration of renal function. A fully developed picture of the "bulge syndrome" dominated - lymphedema of the lower limbs and lower abdomen, pain in the lower abdomen, constipation, secondary secondary urinary infection, and paradoxical ischuria. During a gynecological examination in a specula, a strong-smelling, necrotic tumour was visualized reaching half of the vagina, which was causing a bloody discharge, which brought the patient to the examination. A biopsy was taken from the tumour. A permanent urinary catheter was inserted into the urinary bladder with gradual adjustment of renal functions. Due to the difficulties and the benign histological findings from the biopsy, a simple abdominal hysterectomy with bilateral salpingectomy from a lower midline incision was indicated. The operation was complicated by an extensive adhesive process and blood loss of 1,200 mL, with a decrease in hemoglobin in the blood count from 128 g/L to 79 g/L and the need for three blood transfusions. In the postoperative period, there is a prompt recovery of spontaneous micturition with normalization of bladder function, subsidence of lymphedema and subjective complaints of the patient.
- Klíčová slova
- Hysterectomy, bulky diseases, myoma, nascent uterine myoma, urinary retention,
- MeSH
- hysterektomie škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfedém * MeSH
- močový měchýř MeSH
- myom * komplikace chirurgie MeSH
- retence moči * komplikace chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Here we present the case of a 50-year-old woman with acute urinary retention who was treated by the insertion of a permanent catheter. For associated headaches, fever and muscle and joint pain, the patient underwent neurologic examination, including lumbar puncture and magnetic resonance of head and spine. The results confirmed aseptic meningitis. Subsequently, the patient was hospitalized at the infectious disease clinic, where the permanent catheter was extracted after 5 days, with spontaneous micturition recovery and no post-void residual volume. The combination of aseptic meningitis and urinary retention is called meningitis-retention syndrome. This is a rare disease, which has been described only a few times in the literature.
- MeSH
- katetrizace močového měchýře MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- meningitida aseptická komplikace diagnostické zobrazování MeSH
- mozek diagnostické zobrazování MeSH
- retence moči etiologie terapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Spinal epidermoid cysts are benign tumors. Syringomyelia secondary to intramedullary tumors are frequently observed. However, the association between syringomyelia and spinal intradural extramedullary epidermoid cyst in the conus medullaris region is extremely rare. We present the case of a 3-year-old male who was admitted with paraparesis and urinary retention. Magnetic resonance imaging (MRI) of the spine demonstrated intradural extramedullary lesion, compatible with epidermoid cyst, that at the conus medullaris level and a large syringomyelia extending from T4 to L1 vertebrae. Total microsurgical excision of the cyst was performed. No additional drainage was carried out for the syringomyelic cavity. Histopathological examination verified the diagnosis of the epidermoid cyst. Total excision of the cyst and disappearance of the syringomyelia were observed on MRI at 15 days postoperatively. We have clarified the etiology, clinical, histopathological and radiological features, differential diagnosis, and treatment modalities of spinal epidermoid cysts. In addition, we have discussed the possible mechanisms of syringomyelia formation in spinal intradural lesions.
- Klíčová slova
- conus medullaris, epidermoid cyst, spine, syringomyelia,
- MeSH
- epidermální cysta komplikace diagnostické zobrazování chirurgie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mícha diagnostické zobrazování patologie MeSH
- nemoci míchy komplikace patologie chirurgie MeSH
- paraparéza diagnostické zobrazování etiologie patologie MeSH
- předškolní dítě MeSH
- retence moči diagnostické zobrazování etiologie patologie MeSH
- syringomyelie diagnostické zobrazování patologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
BACKGROUND: The advent of robotics has facilitated new surgical techniques for radical prostatectomy. These allow adjustment of pelvic anatomical and functional relationships after removal of the prostate to ameliorate postprostatectomy incontinence (PPI) and reduce the time to complete continence. OBJECTIVES: To describe the results of a new surgical technique for reconstruction of vesicourethral anastomosis using the levator ani muscle for support during robot-assisted radical prostatectomy (RARP). DESIGN, SETTING, AND PARTICIPANTS: A prospective, randomised, single-blind study among 66 consecutive patients with localised prostate cancer (cT1-2N0M0) undergoing RARP from June to September 2014, 32 using the new technique and 34 using the standard posterior reconstruction according to Rocco. SURGICAL PROCEDURE: In the advanced reconstruction of vesicourethral support (ARVUS) intervention group, the fibres of the levator ani muscle, Denonvilliers fascia, retrotrigonal layer, and median dorsal raphe were used to form the dorsal support for the urethrovesical anastomosis. Suture of the arcus tendineus to the bladder neck served as the anterior fixation. MEASUREMENTS: We compared demographic data and preoperative and postoperative functional and oncologic results for the two groups. The primary endpoint was continence evaluated at different time points (24h, 2, 4, and 8 wk, and 6 and 12 mo). The secondary endpoints were perioperative and postoperative complications and erectile function. RESULTS AND LIMITATIONS: Using a continence definition of 0 pads/d, the continence rates for the ARVUS versus the control group were 21.9% versus 5.9% at 24h (p=0.079), 43.8% versus 11.8% at 2 wk (p=0.005), 62.5% versus 14.7% at 4 wk (p<0.001), 68.8% versus 20.6% at 8 wk (p<0.001), 75.0% versus 44.1% at 6 mo (p=0.013), and 86.66% versus 61.29% at 12 mo (p=0.04). International Index of Erectile Function questionnaire results at 6 and 12 mo after surgery showed similar potency rates for the control group (40.0% and 73.33%) and the ARVUS group (38.8% and 72.22%). There were four postoperative complications (2 in each group): three haematomas requiring transfusion and one lymphocele that needed drainage. No urinary retention, anastomosis leak, or perineal pain was observed. Limitations include the small sample size and the single-institution design. CONCLUSIONS: The ARVUS technique yielded better urinary continence results than standard posterior reconstruction, with no negative impact on erectile function, complication rate, or oncologic outcome. External validation is warranted before clear recommendations can be made. PATIENT SUMMARY: We showed that postprostatectomy incontinence can be assuaged using a new technique for vesicourethral anastomosis reconstruction during robot-assisted radical prostatectomy (RARP). This could significantly improve the quality of life of patients after RARP. More studies are needed to support our results.
- Klíčová slova
- Anastomosis, Continence, Erectile function, Functional reconstruction, Prostate cancer, Robot-assisted radical prostatectomy,
- MeSH
- anastomóza chirurgická metody MeSH
- inkontinence moči prevence a kontrola MeSH
- jednoduchá slepá metoda MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- močový měchýř chirurgie MeSH
- nádory prostaty chirurgie MeSH
- netěsnost anastomózy epidemiologie MeSH
- pánevní dno chirurgie MeSH
- pooperační komplikace epidemiologie prevence a kontrola MeSH
- prostatektomie metody MeSH
- retence moči epidemiologie MeSH
- roboticky asistované výkony metody MeSH
- senioři MeSH
- uretra chirurgie MeSH
- výsledek terapie MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
INTRODUCTION AND HYPOTHESIS: Our purpose was to verify whether extensive dissection toward the sacrospinous ligament (SSL) needed for mesh fixation during anterior compartment repair increases the risk of postoperative voiding difficulties. METHODS: A total of 124 patients after anterior compartment mesh repair without simultaneous suburethral sling placement operated on in the period 2005-2012 were enrolled in this retrospective observational study. Patients with previous anti-incontinence surgery with normal urodynamics were not excluded; 30 patients with incomplete data, severe perioperative complications, and urinary retention before and after the surgery were excluded. Urinary retention was defined as post-void residual over 150 ml more than 48 h after permanent catheter removal. The rate of urinary retention after anterior compartment repair by mesh anchored to the SSL from an anterior approach (SSLS group) was compared to that following transobturator mesh repair often combined with SSL fixation from the posterior approach (TOT group). RESULTS: Of the 94 patients considered for statistical analysis, 62 were from the SLSS group and 32 from the TOT group. The groups were comparable in age (mean 65.5 vs 66.3), body mass index (24.8 vs 25.9), and parity (2.4 vs 2.9). Patients from the SSLS group had higher rates of prior vaginal reconstructive (27 vs 19 %) and anti-incontinence surgery (26 vs 19 %). Postoperative urinary retention was statistically significantly more frequent in the SSLS group compared to the TOT group [(17 (27 %) vs 2 (6.25 %), odds ratio 5.7, 95 % confidence interval 1.2-26.3, p = 0.027]. Hospital discharge with self-catheterization was statistically insignificantly more frequent in the SSLS group [8 % (5) vs 3 % (1)]. CONCLUSIONS: Extensive dissection needed for SSL suspension from an anterior approach may lead to more frequent postoperative voiding difficulties. This phenomenon could be explained by more considerable injury to pelvic splanchnic nerves during the dissection. A large prospective study is needed for validation of our results.
- MeSH
- chirurgické síťky škodlivé účinky MeSH
- cystokéla chirurgie MeSH
- gynekologické chirurgické výkony škodlivé účinky MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- ligamenta chirurgie MeSH
- poruchy močení epidemiologie MeSH
- retence moči epidemiologie MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
The continuance of collecting system dilatation after plastic repairing of the ureteropelvic junction in children progressed hydronefrosis may have two causes, the first one is a great progress of the process, that do not allow to repair the dilatation, the second one is to be a failure with the operation. Another treatment depends on differentiating there two causes. Authors used ultrasonography with furosemide test. By comparing sonogram before and after giving furosemide. They described whether the continuance of collecting system dilatation can be caused by a urodynamic obstruct. The result is that the ultrasonography with furosemide is a simple of orientation noninvasive method, which can be used several times without risks for the children. According to experience of the authors more precise is the method with oral furosemide application that the intravenous. It is a method of orientation which can be filled by dynamic scintigraphy in case of suspicion on bad evacuation with furosemide. Then if the obstruction is confirmed, we can indicate the excretory urography with furosemide.
- MeSH
- aplikace orální MeSH
- dítě MeSH
- furosemid * aplikace a dávkování MeSH
- hydronefróza chirurgie MeSH
- intravenózní infuze MeSH
- lidé MeSH
- mladiství MeSH
- obstrukce močovodu diagnostické zobrazování etiologie MeSH
- pooperační komplikace MeSH
- předškolní dítě MeSH
- retence moči etiologie MeSH
- ultrasonografie MeSH
- urografie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- furosemid * MeSH
- MeSH
- dospělí MeSH
- komplikace těhotenství * MeSH
- lidé MeSH
- nemoci močového měchýře etiologie MeSH
- retence moči etiologie MeSH
- spontánní ruptura MeSH
- těhotenství MeSH
- uterus patologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
As demonstrated in animal experiments and in five patients with atonic bladders, "vesical cap" surgery causally solves detrusor impairment by functionally reinforcing it with a vital muscle layer from an ileal seromuscular flap. All other genuine components of the bladder are kept intact, which is very beneficial for bladder function.
- MeSH
- chirurgické laloky MeSH
- ileum chirurgie MeSH
- lidé MeSH
- močový měchýř MeSH
- nemoci močového měchýře patologie patofyziologie chirurgie MeSH
- psi MeSH
- retence moči patologie patofyziologie chirurgie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- psi MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- GYNECOLOGIC DISEASES *, POSTOPERATIVE COMPLICATIONS *, URINATION DISORDERS *,
- MeSH
- gynekologická onemocnění * MeSH
- gynekologické chirurgické výkony * MeSH
- lidé MeSH
- pooperační komplikace * MeSH
- poruchy močení * MeSH
- retence moči * MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
