1/21. Pelvic neurilemmoma.A case of a 37-year-old man admitted to our Department of internal medicine for medical evaluation of hypertension is reported. The patient had a 4-year history of oscillating hypertension prior to admission, however, with no major subjective complaints, except for pollakisuria. Clinical and biochemical assessment revealed no damage to target organs. Laboratory parameters showed normal values, except for hyperlipidemia. On routine ultrasonography of the pelvis confirmed a pelvic tumor of uncertain etiology, with no abdominal lymph node enlargement. No signs of metastasis were found. The patient was transferred to the Department of Surgery, where the tumor was removed in toto. Histopathologic analysis of the tumor, 11 x 8 x 8 cm in size, composed of cellular and mixoid areas with traces of collagenous connective tissue, necrosis, and tiny calcifications with scattered palisading nuclei and Verocay bodies, pointed to the diagnosis of a benign tumor, i.e. neurilemmoma. Postoperatively, the patient's subjective state was excellent, with normal blood pressure values, and without pollakisuria. A very large space-occupying lesion was responsible for compression of the neighboring organs, especially urinary bladder, resulting in pollakisuria. To our knowledge, pelvic localization of neurilemmoma, particularly a large one, is rare.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/21. pelvic pain without pelvic organs.We report on 4 patients with persistent, severe pelvic pain unresponsive to removal of the bladder, uterus, ovaries and fallopian tubes. Of the patients 3 had a diagnosis of interstitial cystitis and 1 had voiding dysfunction. We conclude that severe pelvic pain may not be responsive to the elimination of pelvic organs and alternative organ-preserving therapies should be considered.- - - - - - - - - - ranking = 3keywords = organ (Clic here for more details about this article) |
3/21. meningioma presenting with only urinary symptoms which is diagnosed by magnetic resonance imaging followed by urodynamic study.Neurological tumour processes when involving bladder organs or innervations may give rise to urological symptoms. Depending on the organ or nerve tract affected, and emptying capacity of the bladder, the clinical signs manifested may be extremely varied, simulating different pathological entities that may lead to unnecessary treatment.- - - - - - - - - - ranking = 5.7397173061933keywords = nerve, organ (Clic here for more details about this article) |
4/21. Polyglucosan body disease.adult polyglucosan disease has been described in 15 cases. All had signs of peripheral neuropathy, upper motor neuron signs, and 12 of the 15 had sphincter problems. dementia was prominent in 8 of 15 cases. We reported 2 cases that contained these clinical features. Electrophysiological studies showed axonal neuropathy. Somatosensory evoked potentials on the second patient were abnormal. sural nerve biopsy showed clusters of polyglucosan bodies. Although the presence of polyglucosan bodies in biopsy is nonspecific, the number as well as the clinical features are necessary to make the diagnosis. Branching enzyme activity in muscle extracts of the muscles were normal. Hence, a specific enzyme abnormality is not yet known.- - - - - - - - - - ranking = 4.7397173061933keywords = nerve (Clic here for more details about this article) |
5/21. Surgically confirmed cauda equina and nerve root injury following percutaneous discectomy at an outside institution: a case report.A 39-year-old woman sustained a permanent nerve root and cauda equina injury following a left-sided L5-S1 automated percutaneous discectomy (PERC) performed with the Nucleotome at an outside institution. Despite delayed surgery, which included excision of a sequestrated L5-S1 disc on the right and intradural exploration and resultant confirmation of a disrupted cauda equina, S1 radiculopathy, sacral numbness, and overflow incontinence persisted. Although PERC using the Nucleotome has been accepted by some as a safe alternative to the surgical management of disc disease, the paucity of similar complications reported in the literature may more closely reflect the medicolegal climate rather than the inherent safety of this technique.- - - - - - - - - - ranking = 23.698586530967keywords = nerve (Clic here for more details about this article) |
6/21. A romance with pain: a telephone perversion in a woman?The patient repeatedly and compulsively made stereotyped telephone calls to her mother and other female protective figures. She had a history of genito-urinary infections and operations consequent to urinary retention. These symptoms were relieved gradually in the course of analysis, in which this was interpreted as a sado-masochistic perversion based on a central fantasy of phallic intrusions on the mother. The fantasy was related to turning passive viewing into active exhibitionism, actively seeking to inflict pain on herself and others in an attempt to overcome early painful medical intrusions, misplaced identification with the father, complementary relationship with the passive, compliant mother, and consequent failed identification with the oedipal mother. In the analysis, she attained a gradual reorganization of adaptive functions which allowed identification with the father through her work, reconciliation with the rivalrous siblings, and enjoyment of her female sexuality in heterosexual intercourse with the use of a fetishistic requirement that the man be uncircumcised. The hypothesis was developed that whether called a symptom or a perversion, the treatment was the same so that it was most useful to think of it as a compromise formation rather than attempting to preserve a distinction largely based on moralistic considerations.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
7/21. pelvic pain and organic dysfunction in a patient with low back pain: response to distractive manipulation: a case presentation.Many patients with low back pain demonstrate pelvic symptomatology attributable to lower sacral nerve root compression. Lower sacral nerve root compression has been identified as a cause of pelvic pain and pelvic organ dysfunction. Pelvic symptomatology secondary to lower sacral nerve root compression is given. Lower sacral nerve root compression is most commonly the result of lumbosacral disc lesion. A case of low back pain accompanied with pelvic symptomatology is presented along with its response to distractive manipulation. chiropractic treatment may be an effective means of treating pelvic disorders secondary to lower sacral nerve root compression provided that the underlying disc lesion is dealt with, although further study is needed.- - - - - - - - - - ranking = 26.198586530967keywords = nerve, organ (Clic here for more details about this article) |
8/21. Achalasia like disorder of the oesophagus in von Recklinghausen's neurofibromatosis.The association of achalasia like disorder of the oesophagus with von Recklinghausen's neurofibromatosis to our knowledge not previously reported is described in a 56 year old man who also had bladder dysfunction. At necropsy the oesophageal myenteric plexus showed ganglion cell depletion with nerve fibre hyperplasia probably the result of Schwann cell hyperplasia. We suggest that the disturbances of oesophageal and bladder function were a consequence of involvement of the autonomic nervous system by neurofibromatosis.- - - - - - - - - - ranking = 4.7397173061933keywords = nerve (Clic here for more details about this article) |
9/21. Gram-negative endocarditis following cystoscopy.patients with bacteriuria are at risk for local and distant infectious complications at the time of urologic procedures. The american heart association recommends that penicillin and streptomycin be given prophylactically to patients with rheumatic or congenital heart disease without reference to the presence or absence of bacteriuria. A patient with unrecognized calcification of the mitral annulus who underwent cystoscopy for evaluation of urinary retention is reported. Although bacteriuria was present preoperatively antibiotics were not given. Subsequently, serratia marcescens and possibly proteus morgani mitral valve infection developed and the patient died. Calcification of the mitral valve annulus and an extensive urinary tract infection were identified at autopsy. This case suggests that calcification of the mitral annulus may be an endocarditis risk factor. The spectrum of prophylactic antibiotic coverage given at the time of urologic procedures to patients with congenital or aquired heart disease, including calcification of the mitral annulus, should include whatever organisms are present in the urine.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
10/21. Lower urinary tract dysfunction after radical hysterectomy for carcinoma of cervix.The charts of 22 consecutive patients who had undergone radical hysterectomy for carcinoma of the cervix were reviewed retrospectively. Uroflowmetry, gas cystometry, and postvoid residual measurements were performed pre- and postoperatively, and a questionnaire to evaluate urinary problems experienced postoperatively was mailed to all patients. Twenty responses were received and followed up by a telephone interview with the urologist. The number and kind of problems suggest that the cause of urinary dysfunction commonly reported after radical hysterectomy is disruption of nerve supplies to both bladder and urethra. Data on retention suggest that the characteristics of this dysfunction change with time but generally are stabilized by the end of the first postoperative year. It is noted that recurrent urinary tract infection may occur asymptomatically because of loss of bladder sensation. Because of the diversity of presentation, urodynamics played an important role in individualization of treatment and monitoring of progress.- - - - - - - - - - ranking = 4.7397173061933keywords = nerve (Clic here for more details about this article) |
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