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Vaginal Wall (vaginal + wall)
Kinds of Vaginal Wall Selected AbstractsVascular endothelial growth factor expressed by mast cells rather than tumour cells in angiomyofibroblastoma of the vaginal wallHISTOPATHOLOGY, Issue 4 2007T Kumasaka No abstract is available for this article. [source] Bladder-sparing surgery and continent urinary diversion using the appendix (Mitrofanoff procedure) for urethral cancerINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2005MIZUKI KOBAYASHI Abstract We performed bladder-sparing surgery and continent urinary diversion in two patients with urethral cancer. The first patient was a 58-year-old man with bulbomembranous urethral cancer (squamous cell carcinoma, cT2N0M0). The second patient was a 77-year-old woman with urethral cancer invading the vaginal wall (transitional cell carcinoma with squamous cell carcinoma, cT3N0M0). After bladder-sparing urethrectomy, continent urinary diversion with appendicovesicostomy (Mitrofanoff procedure) was performed in the both patients. More than 4 years after the surgery, both patients were continent, had no trouble with catheterization, and experienced no recurrence of cancer. Bladder-sparing surgery and urinary diversion based on the Mitrofanoff procedure can be considered for appropriately selected patients with urethral cancer. [source] Adenocarcinoma of the female urethral diverticulum treated by multimodality therapyINTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2003YASUO AWAKURA Abstract A 75-year-old female presented with a 7-month history of intermittent macrohematuria and urinary retention. Physical examination revealed a firm, round mass on the anterior vaginal wall. The diagnosis by urethroscopy and radiological evaluation was localized urethral diverticular tumor. Pathological examination of the biopsy specimen revealed adenocarcinoma. The patient received two courses of intra-arterial and systemic chemotherapy using cisplatin, 5-fluorouracil and leucovorin, followed by radiation to the urethra. The tumor shrunk markedly after chemotherapy. The patient underwent total urethrectomy and vesicostomy. Two years after the operation, she had no evidence of recurrence. Adenocarcinoma of the female urethral diverticulum is rare and has been treated by surgery and/or radiation. The present case is the first case of it being treated by multimodality therapy including chemotherapy. [source] Reality of the G-spot and its relation to female circumcision and vaginal surgeryJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2009Saeed Mohamad Ahmad Thabet Abstract Aim:, To clarify the reality of the G-spot anatomically, functionally and histologically, and to determine the possible effect of female circumcision and anterior vaginal wall surgery on the integrity and function of the G-spot. Methods:, A controlled descriptive and comparative cohort prospective study was conducted at Kasr El Aini School of Medicine, Cairo University, Cairo, Egypt, of 50 uncircumcised and 125 circumcised women with small to moderate anterior vaginal wall descent. Preoperative sexual examination was performed to map the site of the G-spot and other anatomical landmarks on the anterior vaginal wa11 and to verify the associated circumcision state. Pre- and postoperative sexual assessment and histological examination of different mapped sites in the anterior vagina were also conducted. Results:, Histological findings, results of the anatomical and sexual mapping of the anterior vaginal wall and sexual scores were recorded. The G-spot was proved functionally in 144 (82.3%) of women and anatomically in 95 (65.9%). The latter appeared as two small flaccid balloon-like masses on either side of the lower third of the urethra and were named ,the sexual bodies of the G-spot'. These bodies were significantly detected in all histo-positive cases in the circumcised women and in the uncircumcised women who had small or average clitorises. The G-spot was also proved histologically in 47.4% of all cases and was formed of epithelial, glandular and erectile tissue. Sex scores were significantly higher in the histo-positive cases with sexual bodies but significantly dropped after anterior vaginal wall surgery. In contrast, female circumcision rarely alters the scores. Conclusion:, The G-spot is functional reality in 82.3% of women, an anatomical reality in 54.3% and a histological reality in 47.4%. Anterior vaginal wall surgery usually affects the G-spot and female sexuality, but female circumcision rarely affects them. [source] Retroperitoneal schwannoma bearing at the right vaginal wallJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2004Takafumi Inoue Abstract Benign schwannoma commonly arises from schwann cells of the neural sheath. We report a rare case of retroperitoneal schwannoma bearing at the vaginal wall. The tumor was a 7 × 5 × 4-cm solid mass revealed using several image techniques and diagnosed to be a retroperitoneal tumor preoperatively. The tumor was tightly attached to the vaginal submucosal tissue, so complete surgical resection was difficult. However, an almost complete resection was carried out macroscopically using laparotomy. Histologic and immunohistochemical studies confirmed the diagnosis. The patient has been followed for 18 months after the operation, but there is no evidence of recurrent tumor. [source] Urinary Bladder Herniation through a Vaginal Tear in a Rottweiller with DystociaJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2000DACVECC, Deborah C. Mandell VMD Summary A four-year old female Rottweiler presented with a 34-hour history of dystocia. Physical examination revealed a purple-black, fluid-filled sac protruding from vulva and suspended by a similar colored stalk. Digital vaginal examination indicated that the stalk of tissue extended up into the cervix and beyond. Due to the grossly necrotic appearance, the stalk of tissue was ligated, and the sac was removed. Three puppies were delivered vaginally, but a subsequent caesarian section was required due to uterine inertia likely secondary to exhaustion. Three more live puppies were delivered via the c-section. Further abdominal exploration revealed a tear in the left vaginal wall, one ligated ureter, and the second ureter free at its distal end and leaking urine into the abdomen. The surgical findings indicated that the bladder, ureters, and urethra had herniated through the vaginal tear and prolapsed through the vulva. [source] Methodology for biomechanical testing of fresh anterior wall vaginal samples from postmenopausal women undergoing cystocele repair,NEUROUROLOGY AND URODYNAMICS, Issue 4 2009Philippe E. Zimmern Abstract Goal To explore the methodological challenges of biomechanical testing of freshly harvested human anterior vaginal wall (HAVW) samples. Method Longitudinal full-thickness samples of HAVW were excised during cystocele repair in postmenopausal women and age-matched controls. Two methods of tissue storage during transport were compared. All samples were prepared for uniaxial testing within 2 hr of harvest and loaded at a rate of 0.5 mm/sec, until irreversible deformation was observed. Young's modulus and other parameters were extracted from the tensile stress,strain curves. Results Samples were obtained over 2 years from 42 patients. Significant differences in biomechanical parameters were noted based on the degree of hydration of the tissue, suggesting that the wetter samples were mechanically weaker. Conclusions This study reports on a new method for testing the biomechanical properties of freshly harvested HAVW tissues and the impact of tissue hydration during transport between the operating room and the testing lab. Neurourol. Urodynam. 28:325,329, 2009. © 2009 Wiley-Liss, Inc. [source] Direction sensitive sensor probe for the evaluation of voluntary and reflex pelvic floor contractions,NEUROUROLOGY AND URODYNAMICS, Issue 3 2007Christos E. Constantinou Abstract Aims The development of a vaginal probe for the evaluation of the dynamics of pelvic floor function is described. Fundamental criteria in the design of this probe involves the incorporation of a means of assessing whether the isotonic forces closing the vagina are equally distributed or whether they are greater in some directions than others. The aim of this study is to present the design of directionally sensitive multi-sensor probe, having circumferential spatial resolution, constructed to identify the distribution of anisotropic forces acting on the vagina following voluntary and reflex pelvic floor contractions. Materials and Methods Probe system consists of four pairs of force/displacement sensors mounted on leaf springs enabling isotonic measurements of voluntary and reflex contractions. Assembly is retractable to 23 mm for insertion, and expandable to 60 mm for measurement. Simultaneous measurements were made of force and displacement with the sensors oriented in the anterior/posterior and left/right orientation of the vagina. Using this probe, measurements were carried out to identify the temporal and spatial characteristic response of the vaginal wall. Data were analyzed with respect to voluntary pelvic floor and cough-induced contractions of nine subjects having a mean age of 64 years. Results A robust probe system was developed and measurements were successfully made. Initial results show that the maximum force and displacement occurs during reflex contractions in the anterior aspect of the vagina validating the anisotropic nature of the forces acting on the vaginal wall. The data also show that both the force and displacement produced by the cough-induced has a higher magnitude than voluntary pelvic floor contraction. Conclusions A directional multi-sensor vaginal probe has been developed to evaluate the force and displacement produced during isotonic pelvic floor contractions. Analysis of the results provided new biomechanical data demonstrating the anisotropic nature of vaginal closure as a consequence of pelvic floor contractions. Neurourol. Urodynam. 26:386,391, 2007. © 2007 Wiley-Liss, Inc. [source] Compliance of the bladder neck supporting structures: Importance of activity pattern of levator ani muscle and content of elastic fibers of endopelvic fasciaNEUROUROLOGY AND URODYNAMICS, Issue 4 2003Matija Barbi Abstract Aims Firm bladder neck support during cough, suggested to be needed for effective abdominal pressure transmission to the urethra, might depend on activity of the levator ani muscle and elasticity of endopelvic fascia. Methods The study group of 32 patients with stress urinary incontinence and hypermobile bladder neck, but without genitourinary prolapse, were compared with the control group of 28 continent women with stable bladder neck. The height of the bladder neck (HBN) and compliance of the bladder neck support (C) were assessed, the latter by the quotient of the bladder neck mobility during cough and the change in abdominal pressure. By using wire electrodes, the integrated full-wave rectified electromyographic (EMGave) signal of the levator ani muscle was recorded simultaneously with urethral and bladder pressures. The pressure transmission ratio (PTR), time interval between the onset of muscle activation and bladder pressure increment (,T), and area under the EMGave curve during cough (EMGcough) were calculated. From bioptic samples of endopelvic fascia connecting the vaginal wall and levator ani muscle, elastic fiber content was assessed by point counting method. Mann-Whitney test was used to compare all the variables. Correlations between the parameters were evaluated by using the Spearman correlation coefficient. Results In the study group, HBN was significantly lower (P,<,0.001), C was significantly greater (P,<,0.001), and PTR was significantly lower (P,<,0.001). In the study group, the muscular activation started later (median, ,Tl, ,0.147 second; ,Tr, ,0.150 second), and in the control group, it preceded (,Tl, 0.025 second; P,<,0.001; ,Tr, 0.050 second; P,<,0.001) the bladder pressure increment. EMGcough on the left side was significantly greater in the study group (P,<,0.046). Elastic fiber content showed no difference between the groups. The analysis of all patients revealed negative correlations between C and PTR (r,=,,0.546; P,<,0.001) and between C and ,Tl (r,=,,0.316; P,<,0.018). Conclusions Firm bladder neck support enables effective pressure transmission. Timely activation of the levator ani seems to be an important feature. Neurourol. Urodynam. 22:269,276, 2003. © 2003 Wiley-Liss, Inc. [source] Intraperitoneal Insemination in Mammals: A ReviewREPRODUCTION IN DOMESTIC ANIMALS, Issue 2 2002JL Yaniz Contents This review focuses on factors associated with the development of intraperitoneal insemination in mammals. Findings to date indicate that fertility improves as the sperm cell concentration rises, but that the optimal sperm number differs in each species. Sperm washing before intraperitoneal insemination favours fertility. Peritoneal fluid shows a variable effect on spermatozoa, depending on the hormonal status of the female. The optimal time for insemination appears to be just prior to ovulation. The technique may be performed either through the abdominal or the vaginal wall. Verification of sperm deposition in the proximity of the ovaries improves fertility rates. Although associated with some risk of infection and an immune reaction against spermatozoa, the intraperitoneal technique rarely gives rise to severe anaphylactic shock, peritonitis, adhesion formation and the production of anti-sperm antibodies and these complications may be prevented by adequate sperm pretreatment and antibiotic therapy. The success of intraperitoneal insemination in humans, with results comparable with those of intrauterine insemination in the treatment of infertility, suggest the potential use of this technique in domestic mammals, especially in those in which intrauterine insemination poses practical difficulties. Some of the methods applied in human intraperitoneal insemination, such as confirming the position of the needle in the peritoneal cavity, and sperm pre-treatments might also improve results in domestic species. Conversely, the use of the animal model should help to develop some aspects of this technique in humans. [source] Menopause Leading to Increased Vaginal Wall Thickness in Women with Genital Prolapse: Impact on Sexual ResponseTHE JOURNAL OF SEXUAL MEDICINE, Issue 11 2009Lúcia Alves Da Silva Lara MD ABSTRACT Introduction., Hypoestrogenism causes structural changes in the vaginal wall that can lead to sexual dysfunction. A reduction in vaginal wall thickness has been reported to occur after menopause, although without precise morphometry. Aim., To measure vaginal wall thickness in women with genital prolapse in normal and hypoestrogenic conditions and to correlate sexual dysfunction with vaginal wall thickness and estradiol levels. Methods., Surgical vaginal specimens from 18 normoestrogenic and 13 postmenopausal women submitted to surgery for genital prolapse grades I and II were examined. Patients were evaluated for FSH, estradiol, prolactin, glycemia, and serum TSH levels. For histological analysis, samples were stained with Masson's trichrome and hematoxylin-eosin. Sexual function was assessed by the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Main Outcome Measures., GRISS questionnaire, histological analysis, morphometric methods, Masson's trichrome. Results., The vaginal wall was thicker in the postmenopausal than premenopausal group (2.72 ± 0.72 mm and 2.16 ± 0.43, P = 0.01, and 2.63 ± 0.71 mm and 2.07 ± 0.49 mm, P = 0.01, for the anterior and posterior walls, respectively). These thicknesses seem to be due to the muscular layer, which was also thicker in the postmenopausal group (1.54 ± 0.44 and 1.09 ± 0.3 mm, P = 0.02, and 1.45 ± 0.47 and 1.07 ± 0.44 mm, P = 0.03, for the anterior and posterior wall, respectively). The vaginal epithelium was thinner in the middle segment than in the proximal one in the posterior wall (0.17 ± 0.07 mm, 0.15 ± 0.05 mm, 0.24 ± 0.09 mm, P = 0.02). There was no correlation between coital pain, vaginal wall thickness, and estradiol levels in either group. Conclusion., The vaginal wall is thicker after menopause in women with genital prolapse. In this study, vaginal thickness and estrogen levels were not related to sexual dysfunction. da Silva Lara LA, Ribeiro-Silva A, Rosa-e-Silva JC, Chaud F, Silva-de-Sá MF, Meireles e Silva AR, and Rosa-e-Silva ACJS. Menopause leading to increased vaginal wall thickness in women with genital prolapse: impact on sexual response. J Sex Med 2009;6:3097,3110. [source] Prediction of findings at defecography in patients with genital prolapseBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2005Jan-Paul W.R. Roovers Objective Defecography may be useful in pre-operative assessment of patients with genital prolapse. Defecography is an invasive and embarrassing procedure for patients and little effort has been made to optimalise selection criteria for defecography. This study investigated whether discrimination of high and low probability of abnormal defecography is possible based on the quantified findings from patient history, pelvic examination and a validated questionnaire. Design Prospective observational study. Setting Three teaching hospitals in The Netherlands. Population Eighty-two patients undergoing surgical correction of uterine prolapse Stages 2,4. Methods A history and pelvic examination were obtained from all patients. A validated questionnaire was used to assess the presence of defecation and micturition symptoms. Using multivariate logistic regression analyses with receiver operating characteristic curves, a diagnostic model to predict the presence of an abnormal defecography was systematically constructed and validated. Main outcome measure Presence of abnormal finding at defecography. Results The most important predictors for abnormal defecography were prolapse of the posterior vaginal wall, history of abdominal or pelvic surgery and the presence of constipation. With these variables, a prediction rule could be constructed which predicted the prevalence of an abnormal defecography (area under curve = 0.73; 95% CI 0.61,0.83). Conclusions This study shows that a diagnostic model based on findings obtained from a non-invasive workup can accurately predict the presence of an abnormal defecography. Such a model provides the possibility to tailor the request for defecography to the individual patient. [source] Twenty years of experience with Krzeski's cystovaginoplasty for vaginal agenesis in Mayer-Rokitansky-Küster,Hauser syndrome: anatomical, histological, cytological and functional resultsBJU INTERNATIONAL, Issue 11 2008Andrzej Borkowski OBJECTIVE To evaluate the long-term anatomical results using the original method of vaginal reconstruction with a pedicled bladder flap (Krzeski's cystovaginoplasty, CVP) in women with Mayer-Rokitansky-Küster,Hauser syndrome (MRKHS) and the evaluation of radiological, histological, cytohormonal and functional results of CVP. PATIENTS AND METHODS Between 1981 and 2000, 38 patients (mean age 22.5 years, range 18,40) with MRKHS underwent CVP. A physical examination was used to evaluate the anatomical results, 27 patients had vaginography, and biopsies of the neovaginal wall and cytohormonal smears were taken in two. Functional sexual and urinary results, and opinions on CVP, were evaluated by an inventory mailed to 37 patients in 2000. RESULTS The anatomical result was good in 37 patients during a mean (range) follow-up of 9 (0.25,19) years; the result was good in 30 patients, but seven developed vaginal stenosis that was successfully repaired. There were two cases of post-coital vesicovaginal fistula (VVF) at 18 months after CVP. Vaginal biopsies showed epithelialization of the posterior vaginal wall and gradual metaplastic changes from urothelium to stratified nonsquamous epithelium. Cytological smears showed a normal biphasic pattern and neovaginal susceptibility to hormonal milieu. In all, 27 patients (73%) responded to the questionnaire. All had sexual partners and started sexual intercourse at a mean of 14 months after CVP; 89% experience orgasms and in 48% the vagina was the source; 40% sometimes used lubricants and seven (26%) used vaginal dilators. Lower urinary tract symptoms (LUTS) after CVP were reported by 19 (66%) of the women and in six the LUTS were persistent. One patient was not satisfied with the functional and anatomical result of CVP, 89% declared that it improved sexual life, 93% would undergo CVP again and in 92% the quality of their sexual life was improved. All patients, when asked, stated that they would recommend CVP to another patient with MRKHS. CONCLUSIONS Vaginal reconstruction by CVP is characterized by good anatomical and functional results, sustained by long-term observation. The resultant epithelium is very similar to that of the native vagina in histology and function. All vaginas are functional and the level of patient satisfaction was high. The level of complications was acceptable, but in some patients LUTS can persist. [source] Colpo-wrap: a new continence procedureBJU INTERNATIONAL, Issue 7 2005Thomas M. Boemers OBJECTIVE To present a new surgical method to increase bladder outlet resistance for the treatment of urinary incontinence in girls and women. PATIENTS AND METHODS Six patients (mean age 9.6 years), with urinary incontinence were operated using the new technique within the last 3 years. The principle of the procedure is tightening of the bladder neck by mobilizing the anterior vaginal wall and wrapping it around the bladder neck and proximal urethra, in the sense of a vaginoplication (colpoplication). The underlying conditions and causes for urinary incontinence was neurogenic bladder-sphincter dysfunction caused by myelodysplasia in three girls and anorectal malformation combined with a tethered spinal cord in one. In one case incontinence was caused by a cloacal anomaly and one girl had intrinsic sphincter insufficiency after repetitive Otis urethrotomies. The colpo- wrap was combined with a bladder augmentation and Mitrofanoff in three patients, the three other girls undergoing isolated procedures. RESULTS The result of the method is a constant increase in outlet resistance and coaptation of the urethra, comparable with the effect of a vaginal sling procedure. Five patients are completely dry after surgery, one girl with cloaca needed an additional bladder neck injection with hyaluranon/dextranomer copolymer. Transurethral catheterization was possible after surgery with no problems in all patients who required intermittent catheterization. CONCLUSION Considering the feasibility of this technique the colpo-wrap is a reasonable alternative for treating urinary incontinence in females. [source] A clinicoanatomical study of the novel nerve fibers linked to stress urinary incontinence: The first morphological description of a nerve descending properly along the anterior vaginal wallCLINICAL ANATOMY, Issue 3 2007Susumu Yoshida Abstract When performing anterior colporrhaphy for cystocele, most pelvic surgeons have not considered the neuroanatomy that contributes to urethral function. The aim of the study was to anatomically identify nerve fibers located in the anterior vagina associated with the pathogenesis of incontinence and pelvic organ prolapse. Anterior vaginal specimens were obtained from 17 female cadavers and 33 cases of clinical cystocele by anterior vaginal resection. The specimens were step-sectioned and stained with hematoxylin-eosin, S100 antibody, and tyrosine hydroxylase antibody. As a result, descending nerves 50,200 ,m in thickness were identified between the urethra and vagina. They were located more than 10 mm medially from a cluster of nerves found almost along the lateral edge of the vagina and stained with S100 and tyrosine hydroxylase antibody, originated from the cranial part of the pelvic plexus, and appeared to terminate at the urethral smooth muscles. The authors classified the density of S100 positive nerve fibers in the anterior vaginal wall obtained from clinically operated cases of cystocele into three grades (Grade 1, nothing or a few thin nerves less than 20 ,m in diameter; Grade 2, thick nerves more than 50 ,m in diameter and thin nerves; Grade 3, more than 3 thick nerves in one field at an objective magnification of 40××). Mean urethral mobility (Q-tip) values (28.1° ±± 19.6°) observed in the Grade 3 cases was significantly lower than those (50.0° ±± 27.4° and 59.4° ±± 19.9°) in Grade 2 and Grade 1, respectively. In addition, the presence of preoperative or postoperative stress urinary incontinence in the cases of Grade 1 was significantly higher than those of the cases with S100 positive stained nerves. In conclusion, the novel nerve fibers immunohistochemically identified in the anterior vaginal wall are different from those of the common nervous system or the pelvic floor and are associated with the pathogenesis of urethral hypermobility. Clin. Anat. 20:300,306, 2007. © 2006 Wiley-Liss, Inc. [source] | |||||||||||||||||||