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Viorel Dragos R, Radu Cristian C, Mircea O, Corneliu M, Pavel O, Razvan Lucian B, Ingrid TV, Adina T, Dan P. A Rare Cause of Urinary Incontinence: Vesicouterine Fistula-A Case Report. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:3-7. [PMID: 38249937 PMCID: PMC10797169 DOI: 10.1089/whr.2023.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 01/23/2024]
Abstract
Vesicouterine fistula is a rare complication occurring mainly after cesarean sections. We present here a particular case of vesicouterine fistula (VUF) whose only symptom was urinary incontinence. We describe the diagnostic methods used and the surgical treatment used to resolve the case. A 30-year-old woman presented to the gynecology clinic with urinary incontinence that occurred 5 days postoperatively after a cesarean section. The diagnosis was made on the basis of computed tomography and cystoscopy. Treatment was surgical and consisted of excision of the fistula and suturing of the bladder and uterine wall, without interposition of the omentum. Postoperative evolution was uneventful. When the urethral catheter was removed on the 14th postoperative day, the patient presented spontaneous micturition without vaginal urine leakage. In the context of urinary incontinence after cesarean section, although it is a rare complication, we must consider the occurrence of a VUF.
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Affiliation(s)
- Radu Viorel Dragos
- Department of Urology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa,” Iasi, Romania
- Department of Urology and Renal Transplantation, “C.I. Parhon” University Hospital, Iasi, Romania
| | - Costache Radu Cristian
- Department of Urology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa,” Iasi, Romania
- Department of Urology and Renal Transplantation, “C.I. Parhon” University Hospital, Iasi, Romania
| | - Onofriescu Mircea
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa,” Iasi, Romania
- Obstetrics and Gynaecology Department, “Cuza Voda” Obstetrics and Gynecology University Hospital, Iasi, Romania
| | - Morosanu Corneliu
- Department of Urology and Renal Transplantation, “C.I. Parhon” University Hospital, Iasi, Romania
| | - Onofrei Pavel
- Department of Morphofunctional Sciences II, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa,” Iasi, Romania
- Department of Urology, Elytis Hospital, Iasi, Romania
| | - Bobeica Razvan Lucian
- Department of Urology and Renal Transplantation, “C.I. Parhon” University Hospital, Iasi, Romania
| | - Tanasa Vasilache Ingrid
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa,” Iasi, Romania
- Obstetrics and Gynaecology Department, “Cuza Voda” Obstetrics and Gynecology University Hospital, Iasi, Romania
| | - Tanase Adina
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa,” Iasi, Romania
- Obstetrics and Gynaecology Department, “Cuza Voda” Obstetrics and Gynecology University Hospital, Iasi, Romania
| | - Popescu Dan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa,” Iasi, Romania
- Obstetrics and Gynaecology Department, “Cuza Voda” Obstetrics and Gynecology University Hospital, Iasi, Romania
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Hammade M, Alhoulaiby S, Ahmed A. Isolated giant renal hydatid cyst with a simple renal cyst appearance: a case report. J Med Case Rep 2022; 16:386. [PMID: 36274149 PMCID: PMC9590224 DOI: 10.1186/s13256-022-03630-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background Isolated renal hydatid cysts of the kidney are a rare occurrence that account for about 2–3% of all hydatidoses. They can stay asymptomatic for years and could have a variable presentation on imaging techniques, which results in a challenging diagnostic process. Case presentation We report a 22-year-old Caucasian male with a large cyst on the upper pole of the left kidney that had no septations nor membrane calcifications on computed tomography, which led to mistakenly considering it a simple renal cyst. The true diagnosis was identified intraoperatively and proven postoperatively by pathology. Conclusions This case highlights the importance of keeping echinococcosis in mind when treating suspected renal cysts and tumors to avoid incorrect treatment and possible content spillage, anaphylaxis, and peritoneal dissemination.
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Symeonidis EN, Memmos D, Anastasiadis A, Mykoniatis I, Savvides E, Langas G, Baniotis P, Bouchalakis A, Tsiakaras S, Stefanidis P, Stratis M, Mutomba WF, Vakalopoulos I, Dimitriadis G. Jackstone: A Calculus “Toy” in the Bladder. A Case Report of Rare Entity and Comprehensive Review of the Literature. Acta Med Litu 2022; 29:149-156. [PMID: 36061940 PMCID: PMC9428641 DOI: 10.15388/amed.2021.29.1.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
Abstract
Background: An uncommon type of urinary calculus, Jackstone was named after its distinct resemblance to the children’s game “Jacks.” It typically involves the bladder and, to a lesser extent, the upper urinary tract.Case Presentation: Herein, we report a case of Jackstone vesical calculus in a 75-year-old male undergoing elective open prostate surgery for benign prostate hyperplasia refractory to medical treatment. Preoperative clinical examination revealed intermittent gross hematuria and symptoms suggestive of bladder outlet obstruction, while radiological investigation confirmed the presence of a solitary star-shaped spike-like bladder stone along with an overly enlarged prostate. Following open simple prostatectomy and concomitant intact stone removal, our patient made an uneventful postoperative recovery.Conclusion: This case highlights an infrequent subtype of bladder lithiasis and further expands upon the importance of promptly treating the underlying cause once this rare entity is detected. A comprehensive review of the literature on Jackstone calculi is further presented.
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Zouari M, Ben Dhaou M, Ammar S, Jallouli M, Mhiri R. Laparoendoscopic Single-Site (LESS) Surgery in Pediatric Urology: A 4-Year Experience. Curr Urol 2019; 12:153-157. [PMID: 31316324 DOI: 10.1159/000489434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/12/2017] [Indexed: 11/19/2022] Open
Abstract
Objective The aim of the study was to assess the feasibility and outcomes of pediatric urological laparoendoscopic single-site (LESS) surgery. Materials and Methods We retrospectively collected charts of all patients who underwent LESS procedures in our department from January 2013 to December 2016. Data included demographic characteristics, type of procedures, intraoperative details, hospital stay, and complications. The umbilicus was used as the surgical site in all cases. All procedures were performed with a homemade glove port and standard straight 3- or 5-mm laparoscopic instruments. Results Seventy-three patients (55 males, 18 females) were identifed. Procedures included 46 orchidop-exies, 21 pyeloplasties, 8 varicocelectomies, 3 nephrecto-mies, 3 nephroureterectomies, 3 orchiectomies, and 1 renal hydatid cyst treatment. Median operative time for the entire cohort was 47 min (range 26-156 min). There was no signifcant intraoperative blood loss. No conversion to conventional laparoscopy or open surgery was needed. All patients required paracetamol postoperatively. The mean follow-up was 18 months. Two patients had testicular atrophy after a Fowler-Stephens procedure and 1 patient had testicular reascension. Cosmetic results were excellent. Forty-five (62.5%) patients were discharged on the day of surgery. Conclusion Our study demonstrated that LESS surgery using our glove port technique and conventional laparoscopic instruments is a feasible and safe technique for the surgical management of various pediatric urological conditions.
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Affiliation(s)
- Mohamed Zouari
- Department of Pediatric Surgery, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Mahdi Ben Dhaou
- Department of Pediatric Surgery, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Saloua Ammar
- Department of Pediatric Surgery, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Mohamed Jallouli
- Department of Pediatric Surgery, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Riadh Mhiri
- Department of Pediatric Surgery, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
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Vesicouterine Fistula (VUF) as a Rare Urogenital Complication Managed with Delayed Surgical Repair: A Case Report and Review of the Literature. Case Rep Obstet Gynecol 2018; 2018:2394896. [PMID: 30473897 PMCID: PMC6220400 DOI: 10.1155/2018/2394896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 10/14/2018] [Indexed: 01/08/2023] Open
Abstract
Vesicouterine fistula (VUF) represents a rare urogenital complication. It is considered to be the least common type of urogenital fistulas. Iatrogenic reasons have been shown to be the most prominent cause, with lower segment caesarean section accounting for approximately two-thirds of the cases. The highest incidence concerns young females of reproductive age. VUF can present with clinical symptoms varying from cyclic hematuria, amenorrhea, and vaginal leakage of urine to secondary infertility and first-trimester abortion. Quality of life (QoL) for patients having this pathology is strongly affected due to the psychological burden. Surgical excision of the fistula remains the mainstay of treatment, as less than 5% of patients respond to conservative therapy. Recently laparoscopic and robotic-assisted VUF repair started gaining ground with comparable results to open surgery. Herein, we presented the successful delayed surgical repair of VUF in a 32-year-old female patient. A review of the published literature was also performed, summarizing all the available evidence regarding this rare clinical entity.
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Abstract
As the frontiers of minimally invasive surgery (MIS) continue to expand, the availability and implementation of new technology in pediatric urology are increasing. MIS is already an integral part of pediatric urology, but there is still much more potential change to come as both recent and upcoming advances in laparoscopic and robotic surgery are surveyed.
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Abstract
PURPOSE OF REVIEW In this review, we summarize research that has evaluated the role of laparoendoscopic single-site (LESS) and robotic surgery in pediatric urology, highlighting new and/or controversial ideas. RECENT FINDINGS The newest research developments over the last several years are studies that address generalizability of these techniques, ideal patient factors, extrapolation to more complex surgeries, and comparative studies to more traditional techniques to define the associated costs and benefits, as well as patient-centered outcomes. Specifically in the field of LESS, addressing the limitations of suboptimal vision, instrument crowding, and loss of triangulation have been a focus. The literature is now replete with new applications for robotic surgery as well as descriptions of the specific technical challenges inherent to pediatrics. Robotic surgery and LESS are areas of growth in pediatric urology that allow continual innovation and expansion of technology within a surgeon's armamentarium.
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Hallbeck MS, Lowndes BR, McCrory B, Morrow MM, Kaufman KR, LaGrange CA. Kinematic and ergonomic assessment of laparoendoscopic single-site surgical instruments during simulator training tasks. APPLIED ERGONOMICS 2017; 62:118-130. [PMID: 28411722 DOI: 10.1016/j.apergo.2017.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 12/22/2016] [Accepted: 02/02/2017] [Indexed: 06/07/2023]
Abstract
While laparoendoscopic single-site surgery (LESS) appears to be feasible and safe, instrument triangulation, tissue handling, and other bimanual tasks are difficult even for experienced surgeons. Novel technologies emerged to overcome LESS' procedural and ergonomic difficulties of "tunnel vision" and "instrument clashing." Surgeon kinematics, self-reported workload and upper body discomfort were used to compare straight, bent and two articulating instruments while performing two basic surgical tasks in a LESS simulator. All instruments resulted in bilateral elevation and rotation of the shoulders, excessive forearm motion and flexion and ulnar deviation of wrists. Surgeons' adopted non-neutral upper extremity postures and performed excessive joint excursions to compensate for reduced freedom of movement at the single insertion site and to operate the instrument mechanisms. LESS' cosmetic benefits continue to impact laparoscopic surgery and by enabling performance through improved instruments, ergonomic improvement for LESS can reduce negative impact on surgeon well-being and patient safety.
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Affiliation(s)
- M Susan Hallbeck
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Mayo Clinic, Rochester, MN 55905, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55905, USA; Department of Surgery, Mayo Clinic, Mayo Clinic, Rochester, MN 55905, USA; Department of Mechanical and Materials Engineering, College of Engineering, University of Nebraska, Lincoln, NE 68588, USA.
| | - Bethany R Lowndes
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Mayo Clinic, Rochester, MN 55905, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55905, USA; Department of Mechanical and Materials Engineering, College of Engineering, University of Nebraska, Lincoln, NE 68588, USA
| | - Bernadette McCrory
- Department of Mechanical and Materials Engineering, College of Engineering, University of Nebraska, Lincoln, NE 68588, USA; Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Melissa M Morrow
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Mayo Clinic, Rochester, MN 55905, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55905, USA
| | - Kenton R Kaufman
- Division of Orthopedic Research, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Chad A LaGrange
- Department of Surgery, Division of Urology, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Cullis PS, Gudlaugsdottir K, Andrews J. A systematic review of the quality of conduct and reporting of systematic reviews and meta-analyses in paediatric surgery. PLoS One 2017; 12:e0175213. [PMID: 28384296 PMCID: PMC5383307 DOI: 10.1371/journal.pone.0175213] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 03/22/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Our objective was to evaluate quality of conduct and reporting of published systematic reviews and meta-analyses in paediatric surgery. We also aimed to identify characteristics predictive of review quality. BACKGROUND Systematic reviews summarise evidence by combining sources, but are potentially prone to bias. To counter this, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was published to aid in reporting. Similarly, the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) measurement tool was designed to appraise methodology. The paediatric surgical literature has seen an increasing number of reviews over the past decade, but quality has not been evaluated. METHODS Adhering to PRISMA guidelines, we performed a systematic review with a priori design to identify systematic reviews and meta-analyses of interventions in paediatric surgery. From 01/2010 to 06/2016, we searched: MEDLINE, EMBASE, Cochrane, Centre for Reviews and Dissemination, Web of Science, Google Scholar, reference lists and journals. Two reviewers independently selected studies and extracted data. We assessed conduct and reporting using AMSTAR and PRISMA. Scores were calculated as the sum of reported items. We also extracted author, journal and article characteristics, and used them in exploratory analysis to determine which variables predict quality. RESULTS 112 articles fulfilled eligibility criteria (53 systematic reviews; 59 meta-analyses). Overall, 68% AMSTAR and 56.8% PRISMA items were reported adequately. Poorest scores were identified with regards a priori design, inclusion of structured summaries, including the grey literature, citing excluded articles and evaluating bias. 13 reviews were pre-registered and 6 in PRISMA-endorsing journals. The following predicted quality in univariate analysis:, word count, Cochrane review, journal h-index, impact factor, journal endorses PRISMA, PRISMA adherence suggested in author guidance, article mentions PRISMA, review includes comparison of interventions and review registration. The latter three variables were significant in multivariate regression. CONCLUSIONS There are gaps in the conduct and reporting of systematic reviews in paediatric surgery. More endorsement by journals of the PRISMA guideline may improve review quality, and the dissemination of reliable evidence to paediatric clinicians.
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Affiliation(s)
- Paul Stephen Cullis
- Department of Surgical Paediatrics, Royal Hospital for Children, Glasgow, United Kingdom
- School of Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Katrin Gudlaugsdottir
- Department of Surgical Paediatrics, Royal Hospital for Children, Glasgow, United Kingdom
| | - James Andrews
- Department of Surgical Paediatrics, Royal Hospital for Children, Glasgow, United Kingdom
- School of Medicine, University of Glasgow, Glasgow, United Kingdom
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