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Ended Megaureter in a 23-Year-Old Woman Causing Chronic Pain
341 Central European Journal of Urology CASE REPORT URINARY TRACT INFECTIONS The remnant of a congenital, blind- ended megaureter in a 23-year-old woman causing chronic pain and urinary infections Tomislav Pejcic1, Biljana Markovic2, Zoran Dzamic1, Milan Radovanovic1, Jovan Hadzi-Djokic3 1Clinical Center of Serbia, Urological Clinic, Belgrade, Serbia 2Clinical Center of Serbia, Institute of Radiology, Belgrade, Serbia 3Serbian Academy of Sciences and Arts, Belgrade, Serbia Article history Multicystic dysplastic kidney (MCDK) is a congenital anomaly as the result of abnormal interaction be- Received: March 31, 2103 tween the ureteric bud and metanephric mesenchyme. Unilateral MCDK can be associated with other Accepted: May 19, 2013 anomalies of the genitourinary tract. Relatively rare associated anomaly is the presence of ipsilateral Correspondence refluxing blind megaureter. Tomislav Pejcic The patient reported herein is a 23–years–old woman with involuted MCDK and ipsilateral blind mega- 129/9, Bulevar Zorana ureter causing chronic urinary infection and chronic abdominal pain. Preoperative and intraoperative Djindjica 11070 Belgrade, Serbia examination failed to detect the communication between megaureter and the urinary bladder. phone: +38 111 212 1616 [email protected] Key Words: multicystic dysplastic kidney ‹› refluxing blind megaureter INTRODUCTION CASE REPORT Multicystic dysplastic kidney (MCDK) is a congeni- A 23–year–old woman from a small village was sent tal anomaly that is the result of abnormal interac- to the urologist from the gynecologist, due to solitary tion between the ureteric bud and metanephric right kidney, cystic mass on the left side of the uri- mesenchyme, early ureteral obstruction, or ureteral nary bladder and the presence of chronic pain and atresia. -
Effectiveness of Ureteric Reimplantation on Non-Refluxing Obstructive
EFFECTIVENESS OF URETERIC REIMPLANTATION ON NON-REFLUXING OBSTRUCTIVE CONGENITAL MEGAURETER SHAFIQUR RAHMAN1, MOHAMMAD ABDUL AZIZ1, MM HASAN1, NURUN NAHAR HAPPY2, TASNEEM MAHJABEEN3 1Department of Urology, BIRDEM General Hospital, Dhaka, 2Department of Plastic Surgery and 100 Bed Burn Unit, DMC & H, Dhaka, 3Department of Dermatology, BIRDEM General Hospital, Dhaka Abstract: Background: One in ten thousand children born with megaureter. A significant portion of this groups are of obstructed variety and the rest are refluxing ureter. It can cause obstructions and back pressure renal damage. Early diagnosis and treatment can stop deterioration of renal function and prevent complications like renal failure. Definitive treatment is uretero-neocystostomy with or without tailoring the ureter. Objective: Objective of this study was to observe the effectiveness of ureteric reimplantation on non-refluxing obstructive congenital megaureter. To achieve this objective we had observed serum creatinine level pre and postoperatively and assessed structural changes in kidney by ultrasonogram, IVU, MCU and RGP pre and postoperatively. We also observed the split renal function and split GFR of the affected kidney both pre and post operatively. Methods: This was a cross-sectional observational study. This study comprise of 35 cases of congenital non-refluxing obstructed megaureter, who were admitted in BIRDEM General Hospital and multiple other hospitals in Dhaka city from July 2013 to December 2014. Diagnosis was made by intravenous urography (IVU) reveling a dilated lower third or entire ureter with narrow tapering lower end. Obstruction was also confirmed by diuretic Tc99m DTPA scan. A voiding cystourethrogram was obtained to exclude VUR. Those with poor renal function were evaluated by ultrasonography, DTPA scan and retrograde ureteropyelography. -
NVA Research Update E- Newsletter September – October – November 2016
NVA Research Update E- Newsletter September – October – November 2016 www.nva.org __________________________ Vulvodynia The Vulvar Pain Assessment Questionnaire inventory. Dargie E, Holden RR, Pukall CF. Pain. 2016 Aug 1. https://www.ncbi.nlm.nih.gov/pubmed/27780177 Millions suffer from chronic vulvar pain (ie, vulvodynia). Vulvodynia represents the intersection of 2 difficult subjects for health care professionals to tackle: sexuality and chronic pain. Those with chronic vulvar pain are often uncomfortable seeking help, and many who do so fail to receive proper diagnoses. The current research developed a multidimensional assessment questionnaire, the Vulvar Pain Assessment Questionnaire (VPAQ) inventory, to assist in the assessment and diagnosis of those with vulvar pain. A large pool of items was created to capture pain characteristics, emotional/cognitive functioning, physical functioning, coping skills, and partner factors. The item pool was subsequently administered online to 288 participants with chronic vulvar pain. Of those, 248 participants also completed previously established questionnaires that were used to evaluate the convergent and discriminant validity of the VPAQ. Exploratory factor analyses of the item pool established 6 primary scales: Pain Severity, Emotional Response, Cognitive Response, and Interference with Life, Sexual Function, and Self-Stimulation/Penetration. A brief screening version accompanies a more detailed version. In addition, 3 supplementary scales address pain quality characteristics, coping skills, and the impact on one's romantic relationship. When relationships among VPAQ scales and previously researched scales were examined, evidence of convergent and discriminant validity was observed. These patterns of findings are consistent with the literature on the multidimensional nature of vulvodynia. The VPAQ can be used for assessment, diagnosis, treatment formulation, and treatment monitoring. -
Paper Sessions
8 Table of Contents BAUS Annual Meeting, 17–20 BJUI June 2013, Manchester Central Paper Sessions Tuesday 18 June Paper Session A 1400–1530 Charter 1 PROSTATE CANCER DIAGNOSIS Chairs: Professor Martin Gleave & Mr William Cross Papers A1–A9 Wednesday 19 June Paper Session B 1330–1430 Charter 1 GENERAL UROLOGY Chairmen: Mr Peter Malone & Mr Toby Page Papers B1–B7 © 2013 The Authors 8 BJU International © 2013 BJU International | 111, Supplement 3, 8 Papers Abstracts 9 Tuesday 18 June BJUI Paper Session A 1400–1530 Charter 1 PROSTATE CANCER DIAGNOSIS Chairs: Professor Martin Gleave & Mr William Cross Papers A1–A9 A1 We then compared cancer yield in 50 Conclusion : Visualisation of each biopsy 3 D Visualisation of biopsy consecutive cases of positive prostate trajectory signifi cantly increases cancer trajectory and its clinical impact biopsies in the 2D vs. the 3D group (Part 2 detection rates and allows for a more in routine diagnostic TRUS guided of the study) through sampling of the prostate. Not only prostate biopsy Results : Th e results are tabulated as does this have a role in targeted biopsies K Narahari, A Peltier, R Van Velthoven follows but also in routine diagnostic biopsies. University Hospital of Wales, United Kingdom Introduction and Aims : Transrectal ultrasound (TRUS) guided biopsy remains Part 1 the gold standard in prostate cancer Parameter 2D USS * 3D USS *** P value diagnosis however prostate remains n = 110 n = 110 Student ’s t test perhaps the only solid organ where biopsy Age in years 64 (46–90) 65 (46–84) NS is “blind”. Traditionally the surgeon would Mean (Range) prepare a “mental image” of the prostate PSA ng/ml 9 (0.5–70) 10 (0.5–59) NS and target his biopsy cores evenly to map Mean (Range) out the prostate as best as possible. -
Table of Contents
Society for Sex Therapy and Research SSTAR 2008: 33rd Annual Meeting Continuing Medical Education Credit is provided through joint sponsorship with The American College of Obstetricians and Gynecologists (ACOG). Intercontinental Hotel Chicago, Illinois USA March 13-15, 2008 TABLE OF CONTENTS President‘s Welcome ..........................................................................................................1 SSTAR 2009: 34th Annual Meeting – Arlington, Virginia, USA ........................................2 SSTAR 2008 Fall Clinical Meeting – New York, New York USA ....................................2 SSTAR Executive Council and Administrative Staff ..........................................................3 Continuing Education Accreditations & Approvals ............................................................5 Acknowledgements ..............................................................................................................6 Program Schedule ................................................................................................................7 2008 Award Recipients ....................................................................................................14 SSTAR Health Professional Book Award .............................................................14 Sex, Therapy, and Kids Recipient: Sharon Lamb, EdD SSTAR Service Award ..........................................................................................14 Recipient: Bill Maurice, MD SSTAR Student Research Award Abstract ............................................................15 -
Co™™I™™Ee Opinion
The American College of Obstetricians and Gynecologists WOMEN’S HEALTH CARE PHYSICIANS COMMITTEE OPINION Number 673 • September 2016 (Replaces Committee Opinion No. 345, October 2006) Committee on Gynecologic Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice and the American Society for Colposcopy and Cervical Pathology (ASCCP) in collaboration with committee member Ngozi Wexler, MD, MPH, and ASCCP members and experts Hope K. Haefner, MD, Herschel W. Lawson, MD, and Colleen K. Stockdale, MD, MS. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Persistent Vulvar Pain ABSTRACT: Persistent vulvar pain is a complex disorder that frequently is frustrating to the patient and the clinician. It can be difficult to treat and rapid resolution is unusual, even with appropriate therapy. Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. Although optimal treatment remains unclear, consider an individualized, multidisciplinary approach to address all physical and emotional aspects possibly attributable to vulvodynia. Specialists who may need to be involved include sexual counselors, clinical psychologists, physical therapists, and pain specialists. Patients may perceive this approach to mean the practitioner does not believe their pain is “real”; thus, it is important to begin any treatment approach with a detailed discussion, including an explanation of the diagnosis and determination of realistic treatment goals. Future research should aim at evaluating a multimodal approach in the treatment of vulvodynia, along with more research on the etiologies of vulvodynia. -
Prostate Cancer Early Detection, Diagnosis, and Staging Finding Prostate Cancer Early
cancer.org | 1.800.227.2345 Prostate Cancer Early Detection, Diagnosis, and Staging Finding Prostate Cancer Early Catching cancer early often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed, but that is not always the case. ● Can Prostate Cancer Be Found Early? ● Screening Tests for Prostate Cancer ● American Cancer Society Recommendations for Prostate Cancer Early Detection ● Insurance Coverage for Prostate Cancer Screening Diagnosis and Planning Treatment After a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment. ● Signs and Symptoms of Prostate Cancer ● Tests to Diagnose and Stage Prostate Cancer ● Prostate Pathology ● Prostate Cancer Stages and Other Ways to Assess Risk ● Survival Rates for Prostate Cancer ● Questions To Ask About Prostate Cancer 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Can Prostate Cancer Be Found Early? Screening is testing to find cancer in people before they have symptoms. For some types of cancer, screening can help find cancers at an early stage, when they are likely to be easier to treat. Prostate cancer can often be found early by testing for prostate-specific antigen (PSA) levels in a man’s blood. Another way to find prostate cancer is the digital rectal exam (DRE). For a DRE, the doctor puts a gloved, lubricated finger into the rectum to feel the prostate gland. These tests and the actual process of screening are described in more detail in Screening Tests for Prostate Cancer. If the results of either of these tests is abnormal, further testing (such as a prostate biopsy) is often done to see if a man has cancer. -
Evolving Concepts in Human Renal Dysplasia
DISEASE OF THE MONTH J Am Soc Nephrol 15: 998–1007, 2004 EBERHARD RITZ, FEATURE EDITOR Evolving Concepts in Human Renal Dysplasia ADRIAN S. WOOLF, KAREN L. PRICE, PETER J. SCAMBLER, and PAUL J.D. WINYARD Nephro-Urology and Molecular Medicine Units, Institute of Child Health, University College London, London, United Kingdom Abstract. Human renal dysplasia is a collection of disorders in correlating with perturbed cell turnover and maturation. Mu- which kidneys begin to form but then fail to differentiate into tations of nephrogenesis genes have been defined in multiorgan normal nephrons and collecting ducts. Dysplasia is the princi- dysmorphic disorders in which renal dysplasia can feature, pal cause of childhood end-stage renal failure. Two main including Fraser, renal cysts and diabetes, and Kallmann syn- theories have been considered in its pathogenesis: A primary dromes. Here, it is possible to begin to understand the normal failure of ureteric bud activity and a disruption produced by nephrogenic function of the wild-type proteins and understand fetal urinary flow impairment. Recent studies have docu- how mutations might cause aberrant organogenesis. mented deregulation of gene expression in human dysplasia, Congenital anomalies of the kidney and urinary tract and the main renal pathology is renal dysplasia (RD). In her (CAKUT) account for one third of all anomalies detected by landmark book Normal and Abnormal Development of the routine fetal ultrasonography (1). A recent UK audit of child- Kidney published in 1972 (7), Edith Potter emphasized that one hood end-stage renal failure reported that CAKUT was the must understand normal development to generate realistic hy- cause in ~40% of 882 individuals (2). -
Vulvar Pain Syndromes a Bounty of Treatments— but Not All of Them Are Proven
second of 3 parTs VulVar paIn syndroMes a bounty of treatments— but not all of them are proven Treatments for vulvodynia and vestibulodynia range from lifestyle adjustments and application of topical agents to tricyclic antidepressants and nerve blocks— but the data on their efficacy are not as bountiful neal M. lonky, Md, MpH, moderator; libby edwards, Md, Jennifer Gunter, Md, and Hope K. Haefner, Md, panelists s we discussed in the first installment vulva. Cool gel packs are sometimes helpful. of this three-part series in the Sep- In thIs When it comes to intercourse, I recom- Article A tember issue of OBG Management, mend adequate lubrication using any of a the causes of vulvar pain are many, and the number of effective products, such as olive Therapies discussed diagnosis of this common complaint can be oil, vitamin E oil, Replens, Slippery Stuff, As- by the panel difficult. Once the diagnosis of vulvodynia troglide, KY Liquid, and others. page 34 has been made, however, the challenge shifts There is an extensive list of lubricants at to finding an effective treatment. Here, our http://www.med.umich.edu/sexualhealth/ How to determine expert panel discusses the many options resources/guide.htm which treatments available, the data (or lack of it) behind each are best therapy, and what to do in refractory cases. In Part 3 of this series, in the November Topical agents might offer relief page 35 issue, the focus will be vestibulodynia. —but so might placebo Dr. Lonky: What is the role of topical medi- Is physical therapy cations, including anesthetics, for treating underrated? Management of vulvar pain vulvar pain syndromes? page 38 begins with simple measures Dr. -
The Clinical Role of LASER for Vulvar and Vaginal Treatments in Gynecology and Female Urology: an ICS/ISSVD Best Practice Consensus Document
Received: 30 November 2018 | Accepted: 3 January 2019 DOI: 10.1002/nau.23931 SOUNDING BOARD The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document Mario Preti MD1 | Pedro Vieira-Baptista MD2,3 | Giuseppe Alessandro Digesu PhD4 | Carol Emi Bretschneider MD5 | Margot Damaser PhD5,6,7 | Oktay Demirkesen MD8 | Debra S. Heller MD9 | Naside Mangir MD10,11 | Claudia Marchitelli MD12 | Sherif Mourad MD13 | Micheline Moyal-Barracco MD14 | Sol Peremateu MD12 | Visha Tailor MD4 | TufanTarcanMD15 | EliseJ.B.DeMD16 | Colleen K. Stockdale MD, MS17 1 Department of Obstetrics and Gynecology, University of Torino, Torino, Italy 2 Hospital Lusíadas Porto, Porto, Portugal 3 Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal 4 Department of Urogynaecology, Imperial College Healthcare, London, UK 5 Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio 6 Glickman Urological and Kidney Institute and Department of Biomedical Engineering Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 7 Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio 8 Faculty of Medicine, Department of Urology, Istanbul University Cerrahpaşa, Istanbul, Turkey 9 Department of Pathology and Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, New Jersey 10 Kroto Research Institute, Department of Material Science and Engineering, -
Irish Rare Kidney Disease Network (IRKDN)
Irish Rare kidney Disease Network (IRKDN) Others Cork University Mater, Waterford University Dr Liam Plant Hospital Galway Dr Abernathy University Hospital Renal imaging Dr M Morrin Prof Griffin Temple St and Crumlin Beaumont Hospital CHILDRENS Hospital Tallaght St Vincents Dr Atiff Awann Rare Kidney Disease Clinic Hospital University Hospital Prof Peter Conlon Dr Lavin Prof Dr Holian Little Renal pathology Lab Limerick University Dr Dorman and Hospital Dr Doyle Dr Casserly Patient Renal Council Genetics St James Laboratory Hospital RCSI Dr Griffin Prof Cavaller MISION Provision of care to patients with Rare Kidney Disease based on best available medical evidence through collaboration within Ireland and Europe Making available clinical trials for rare kidney disease to Irish patients where available Collaboration with other centres in Europe treating rare kidney disease Education of Irish nephrologists on rare Kidney Disease. Ensuring a seamless transition of children from children’s hospital with rare kidney disease to adult centres with sharing of knowledge of rare paediatric kidney disease with adult centres The provision of precise molecular diagnosis of patients with rare kidney disease The provision of therapeutic plan based on understanding of molecular diagnosis where available Development of rare disease specific registries within national renal It platform ( Emed) Structure Beaumont Hospital will act as National rare Kidney Disease Coordinating centre working in conjunction with a network of Renal unit across the country -
Supermicar Data Entry Instructions, 2007 363 Pp. Pdf Icon[PDF
SUPERMICAR TABLE OF CONTENTS Chapter I - Introduction to SuperMICAR ........................................... 1 A. History and Background .............................................. 1 Chapter II – The Death Certificate ..................................................... 3 Exercise 1 – Reading Death Certificate ........................... 7 Chapter III Basic Data Entry Instructions ....................................... 12 A. Creating a SuperMICAR File ....................................... 14 B. Entering and Saving Certificate Data........................... 18 C. Adding Certificates using SuperMICAR....................... 19 1. Opening a file........................................................ 19 2. Certificate.............................................................. 19 3. Sex........................................................................ 20 4. Date of Death........................................................ 20 5. Age: Number of Units ........................................... 20 6. Age: Unit............................................................... 20 7. Part I, Cause of Death .......................................... 21 8. Duration ................................................................ 22 9. Part II, Cause of Death ......................................... 22 10. Was Autopsy Performed....................................... 23 11. Were Autopsy Findings Available ......................... 23 12. Tobacco................................................................ 24 13. Pregnancy............................................................