Posterior Wall Of Urinary Bladder Research Articles

Intraperitoneal metastatic malignant melanoma arising from small bowel…… A case report.

Small bowel tumors are very rare. Melanoma in small intestine can be primary or metastatic. Metastatic malignant melanoma in small intestine can arise from skin, eyes, oropharynx, esophagus or ano rectal mucosa. Primary malignant melanomas of small intestine are very rare. In this case report, we are going to present primary malignant melanoma of small intestine, which has already metastasized by the time of presentation. A 60 year old male, presented to us with abdominal pain, vomiting and absolute constipation. On exploration, black colored mass of 5x5cm in distal ileum which was attached to posterior wall of urinary bladder on right side and whole of the gut from stomach to rectum was involved. The patient was thoroughly examined and investigated for cutaneous melanoma, but there was no such tumor present. So it was concluded that this patient had primary malignant melanoma arising from distal ileum.

Asymptomatic Intravesical Migration of an Intrauterine Device Detected during Delivery

Intrauterine Contraceptive Devices (IUCD) are known to be associated with many complications; however, uterine perforation with migration into adjacent soft tissue is rarely observed. The authors report a rare case of a 31-year-old full-term pregnant female who presented in labour and was posted for a Lower Segment Caesarean Section (LSCS) in view of a history of LSCS. Dense adhesions were noticed between the posterior wall of urinary bladder and uterus. A foreign body was also palpable in the bladder. The limb of an IUCD (Copper T) was seen through a rent in the bladder wall, via which it was removed in its entirety. As asymptomatic cases missed by routine scans can occur, Magnetic Resonance Imaging (MRI) may have a role to play in dubious cases of pregnancy having a history of IUD insertion which wasn’t removed.

Late presentation of vesicouterine rupture following vaginal birth after caesarean

Vesicouterine rupture is one of the complications of vaginal birth after cesarean section. Late presentation of bladder along with uterine rupture is rarely reported in literature. A case of vaginal birth after cesarean got admitted on seventh postpartum day due to hematuria and urinary retention. On Per abdominal examination bladder was palpable. A large defect was noted in the dome of bladder on cystoscopy. The posterior wall and fundus of uterus was acting as posterior wall of urinary bladder on laparotomy. Total hysterectomy was done and bladder was repaired.

Vesico-vaginal fistula post Right radical nephroureterectomy with bladder cuff excision

Case: 61 years, female presented at KMH OPD with involuntary urinary leakage per vaginum for seven months following Right radical nephreureterectomy with bladder cuff excision for urinary bladder carcinoma at other centre. Dye test was positive. Cystoscopy revealed VVF defect around 2 cm (Goh’s stage 3biii) at right posterior wall of urinary bladder. Ureteric catheter was placed in left ureter and VVF repair was done. Dye test following 14 days of Foley’s catheterization was negative and patient went home dry. We present here a case of successful repair of VVF following Right radical nephreureterectomy with bladder cuff excision. 
 Key words: dye test, Goh’s stage, pelvic surgeries, urinary tract injuries, vesico-vaginal fistula

Primary Localized Amyloidosis of Urinary Bladder: A Case Report and Review of Literature

Amyloidosis is a disorder of protein metabolism characterized by extracellular deposition of abnormal protein fibrils. It may either be localized to any organ or systematically distributed throughout the body. The biochemical nature of proteins varies but the physical and tinctorial properties are shared by all the amyloidogenic proteins. In the West, it is mainly composed of amyloid light (AL) type immunoglobulin (Ig) light chains. Amyloidosis of the genitourinary tract is rare except for the kidney and isolated primary amyloidosis of the urinary bladder is even rarer. It mainly presents as intermittent painless gross hematuria. It mimics transitional cell carcinoma on imaging and endoscopic examination. We herein present a case of fifty six-years-old male with history of painless hematuria for three months. Cystoscopy revealed a 1 cm hyperemic area on the posterior wall of urinary bladder. The biopsy showed features of amyloidosis and amyloid A (AA) immunostaining was negative. Extensive workup was done to exclude other sites of involvement and a final diagnosis of primary localized amyloidosis of the urinary bladder was made. The patient is on regular follow-up.

Correlation between anterior compartment prolapse assessments by transperineal ultrasonography and pelvic organ prolapse quantification

Objective To explore the clinical value of sonographic quantification of anterior compartment organ prolapse by observing the anterior compartment of postpartum women by transperineal ultrasonography,and to compare the sonogrpahic findings against the pelvic organ prolapse quantification (POP-Q).Methods Transperineal ultrasonography was performed in 67 postpartum primiparae who were diagnosed to have anterior compartment organ prolapse according to POP-Q examination.Taking a horizontal line at the inferior margin of symphysis pubis as reference,the movements of urethra and posterior wall of urinary bladder when patients performing maximum Valsa[va maneuver were studied,and the distance from the lowest point of the posterior wall of urinary bladder to the reference line was measured.The sonographic findings were compared against that of the POP-Q assessment.Results Transperineal ultrasonographic assessment of anterior compartment organ prolapse showed great correlation to POP-Q examination (r =0.70).The criteria of anterior compartment organ prolapsed evaluation by transperineal ultrasonography were:1) When the maxima[descent of the posterior wall of urinary bladder was still above the reference line,it was defined as I-degree;2) If the lowest point of the posterior wall fell below the reference line but still less than 2 cm,it was defined as Ⅱ degree.Conclusions Transperineal ultrasonography can be used to evaluate anterior compartment organ prolapse and it has high correlation to POP-Q examination.Transperineal ultrasonography is a more objective method of quantification of anterior compartment organ prolapse in clinical practice. Key words: Ultrasonography ; Pelvic organ prolapse; Anterior compartment

Congenital pouch colon in female subjects

Over a period of 5-year (May 2000 to April 2005) 29 patients of congenital pouch colon (CPC) were managed by single pediatric surgeon in the Department of Pediatric Surgery of a tertiary hospital. Of these, 11 were girls (M: F: 1.6:1). Detailed anatomy could be studied in nine patients, were included in this study. Age of presentation in female subjects ranged 1 day to 8 years. On examination, eight of the nine patients had single perineal opening suggesting a very high incidence of association of cloaca in female subjects with CPC. Four had short urogenital sinus with colonic pouch opening in the posterior wall of urinary bladder. In other two patients, CPC terminated in short cloaca. Anomalies of mullerian structures such as uterus didelphus and septate vagina ware commonly encountered. Proximal diversion with or without pouch excision was done as the initial preliminary treatment for all those patients who presented in early life. Of the nine girls, two died after the preliminary surgery. Only five patients have undergone definitive surgery. Definitive surgery included abdomino-perineal pull-through of proximal normal colon (<i> n</i> =2), tubularization of pouch with abdomino- posterior sagittal- pull through (<i> n</i> =2) and abdomino-posterior sagittal urethra-vaginoanorectoplasty with pull through of tapered pouch colon in one patient. Two of these patients had concomitant bowel vaginoplasty. Three patients with tubularized pouches had constipation and spurious diarrhea. However, good pseudo-continence of bowel was achieved on regular bowel washes. The cosmetic appearance of perineum in all these three patients was acceptable. The patients in whom pouch excision was done had diarrhea and severe perineal excoriation resistant to conservative management.