TL;DR: Knowledge of the various atypical mesenchymal cell proliferations that are encountered in the genitourinary tract may prevent the misdiagnosis of a malignant tumor.
Abstract: Three pseudosarcomatous lesions of the genitourinary tract are described. One that arose in the urinary bladder of a 59-year-old man was composed of atypical spindle cells admixed with inflammatory cells in an edematous stroma. The second lesion occurred in the stroma of a hyperplastic prostate gland of a 51-year-old man and was characterized by the presence of numerous atypical mesenchymal cells with large, hyperchromatic nuclei. The third case was that of a 57-year-old woman with a urethral caruncle that contained numerous atypical mesenchymal cells in its stroma. All three patients were treated conservatively, and follow-up for periods ranging from 18 months to eight years has revealed no evidence of recurrence. Knowledge of the various atypical mesenchymal cell proliferations that are encountered in the genitourinary tract may prevent the misdiagnosis of a malignant tumor.
TL;DR: Urethral caruncle is an uncommon lesion that may clinically mimic benign and malignant conditions and awareness of the spectrum of clinical and histologic differential diagnoses is important in dealing with this unusual disease.
TL;DR: The Anatomy of Pelvic Support and Stress Incontinence, Instrumentation for Vaginal Surgery, and Transvaginal Reconstruction of the Female Urethra are reviewed.
Abstract: * The Anatomy of Pelvic Support and Stress Incontinence * Instrumentation for Vaginal Surgery * Suprapubic Cystostomy Placement of a Foley Catheter Using the Lowsley Retractor * Complications of Vaginal Surgery * Surgical Therapy for Urinary Incontinence: A. Transvaginal Needle Bladder Neck Suspension . B. Four Corner Bladder and Urethral Suspension for Moderate Cystocele . C. Surgical Repair of Grade IV Cystourethrocele . D. Vaginal Wall Sling . Pubovaginal Sling . Polypropylene (Prolene) Sling . Cadaveric Fascial Sling Using Bone Anchors . Cadaveric Fascial Sling with Suprapubic Fixation * Transvaginal Uretholysis for Urethral Obstruction * Vaginal Prolapse: A. Transvaginal Repair of Enterocele and Culdosuspension . B. Posterior Vaginal Wall Repair . C. Repair of Perineal Hernia . D. Vagina Hysterectomy for Uterine Prolapse . E. Sacrospinous Ligament Fixation for Vaginal Vault Prolapse * Fistulas: A. Transvaginal Repair of Vesico-Vaginal Fistula and Urethro-Vaginal Fistula . B. Repair of Recto Vaginal Fistulas . C. Repair of Recto-Perineal Fistula * Excision of Urethral Diverticula * Transvaginal Reconstruction of the Female Urethra * Transvaginal Closure of the Bladder Neck * Vaginal Wall Cysts * Excision of Skene's Glands Diverticula * Excision of Urethral Caruncle * Construction of the Neovagina Index CD-ROM CONTENTS: VIDEOS: - Sling Procedure - Hysterectomy - Enterocele - Cystocele - Fistula - Diverticula - Martius Flap - Rectocele
TL;DR: A 75‐year‐old woman complained of a mass of the external meatus and underwent en block resection of urethra including bladder neck, uterus, adnexa, vagina, and vulva, and Y‐V graft for reconstruction of the vulva.
Abstract: The case is reported of amelanotic malignant melanoma of the female urethra mimicking urethral caruncle. A 75-year-old woman complained of a mass of the external meatus. Urethral carunclectomy was performed, but histological diagnosis was amelanotic malignant melanoma. Finally, she underwent en block resection of urethra including bladder neck, uterus, adnexa, vagina, and vulva. As urinary diversion, she underwent a continent cathererizable stoma with an appendicovesicostomy, according to the method described by Mitrofanoff, and Y-V graft for reconstruction of the vulva.
TL;DR: PMB is a symptom of varied aetiologies and the associated incidence of malignancy is high and a thorough diagnostic evaluation is mandatory.
Abstract: Objective To study the aetiology and pattern of Postmenopausal Bleeding (PMB) in the local population. Design A retrospective study Subjects 163 consecutive patients who presented with postmenopausal bleeding (PMB) SETTING: Kandang Kerbau Hospital, Singapore Results Malignant causes were found in 42 (25.7%) patients. Cervical carcinoma was the most common malignancy (12.9% of the patients) followed by endometrial carcinoma (11%). Important benign causes are cervicitis (12.9%), atrophic vaginitis (12.3%) and cervical polyp (6.7%). Other benign causes include endometrial hyperplasia (3.1%), urethral caruncle (2.5%) and estrogen replacement therapy (1.8%). Conclusion PMB is a symptom of varied aetiologies. The associated incidence of malignancy is high and a thorough diagnostic evaluation is mandatory.