1/11. hematometra and extended vaginal haematoma after laser conization. A case report.A very rare case of haematometra and extended vaginal haematoma in a 53-year-old woman after laser conization is reported. The patient presented with amenorrhea and complete urinary retention. The possible pathogenesis of this complication is discussed. ultrasonography, combined with physical examination were very helpful in determining the diagnosis. Cervical dilation and protection of surrounding tissues from thermal damage is recommended during laser conization to avoid similar complications.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/11. Vaginal evisceration long after vaginal hysterectomy.BACKGROUND: Vaginal evisceration can take place many years after vaginal surgery. CASE: An 87-year-old woman presented with evisceration of small bowel through the vagina, 15 years after she underwent a vaginal hysterectomy. On physical examination, her vital signs were normal. Forty centimeters of small bowel was visible emerging from the vagina, appearing viable and nonedematous. Because of the high surgical risk, the bowel was replaced and the defect in the vaginal wall was repaired transvaginally. CONCLUSION: Vaginal evisceration can be treated by a transvaginal surgical approach. Factors such as the medical condition of the patient and the viability of the herniated viscus should dictate the optimal approach in each case.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/11. Multiple vaginal wall cysts: diagnosis and surgical management.BACKGROUND: Simple cysts of the female genital tract may become symptomatic and require surgical removal. CASE: A 20-year-old woman had complaints of a vaginal bulge, pelvic pressure, dyspareunia, and stress urinary incontinence. Two cystic masses were seen in the vagina. A magnetic resonance imaging scan revealed 2 additional larger cysts. Urodynamic evaluation was significant for stress incontinence at 200 mL and a Valsalva leak-point pressure of 51 cm H(2)0. The 2 smaller cysts were removed intact through a superficial incision. The larger cysts were intentionally ruptured and dissected out. Histologic examination revealed a low cuboidal or a ciliated columnar epithelium that stained positive with mucicarmine, consistent with mullerian origin. One year after surgical excision, the patient remained symptom free with no urinary incontinence and no recurrence of the cysts. CONCLUSION: magnetic resonance imaging was useful in delineating the course and anatomic arrangement of the vaginal cysts, but more importantly, identified another cyst that was not readily apparent at physical examination.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/11. Imperforate hymen complicated with pyocolpos and lobar nephronia.An imperforate hymen is not a rare condition in female newborns, but is often ignored in a genital examination by physicians. Lobar nephronia is a rare condition in pediatric patients that can be screened by ultrasound or computed tomography to distinguish it from a renal abscess. Treatment for lobar nephronia requires at least 14 days of antimicrobial therapy and a follow-up assessment by renal ultrasonography or dimercaptosuccinic acid scan. We report an unusual case of a 2-year-old girl with an imperforate hymen and pyocolpos. The pyocolpos compressed the left lower ureter to cause hydroureter, hydronephrosis, and nephronia. Partial hymenotomy was performed to drain the pus, and antibiotics were administered for a total of 3 weeks. There was a good outcome. This case demonstrates the need to perform a full physical examination, particularly a genital examination, in newborns. Further, if gynecologic pathology is suspected, then urologic screening studies are recommended to rule out potential associated anomalies.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
5/11. Obturator abscess after transobturator tape for stress urinary incontinence.BACKGROUND: A transobturator tape is a nonwoven, thermally bonded polypropylene tape recently approved in europe for minimally invasive treatment of stress urinary incontinence. CASE: Three cases of obturator abscess after transobturator tape procedures are reported. patients presented with groin pain and vaginal discharge, and physical examination showed vaginal erosions. magnetic resonance imaging confirmed the obturator abscess. All patients had complete sling removal and were treated with antibiotics. The organism responsible for the obturator abscess was bacteroides fragilis in all three cases, suggesting that the infection occurred through a vaginal erosion. CONCLUSION: Persistent painful or irritating symptoms after suburethral tape procedures may be due to a vaginal erosion that can be associated with an obturator abscess. Appropriate evaluation and treatment result in marked symptomatic improvement, although stress incontinence may recur.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
6/11. A simulated "acquired" imperforate hymen following the genital trauma of sexual abuse.Imperforate hymen, a condition in which the hymen has no aperture, usually occurs congenitally, secondary to failure of development of a lumen. A case of a documented simulated "acquired" imperforate hymen is presented in this article. The patient, a 5-year-old girl, was the victim of sexual abuse. Initial examination showed tears, scars, and distortion of the hymen, laceration of the perineal body, and loss of normal anal tone. Follow-up evaluations over the next year showed progressive healing. By 7 months after the injury, the hymen was replaced by a thick, opaque scar with no orifice. patients with an apparent imperforate hymen require a sensitive interview and careful visual inspection of the genital and anal areas to delineate signs of injury. The finding of an apparent imperforate hymen on physical examination does not eliminate the possibility of antecedent vaginal penetration and sexual abuse.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/11. Stenosis and fistulae with neglected vaginal foreign bodies. A case report.foreign bodies present in the vagina for long periods of time are infrequent but potentially serious findings in adult women. Significant injury can occur to bowel, bladder or other pelvic structures. Repair of fistulae is delayed following removal of the foreign bodies until the chronic inflammation produced by the objects has resolved. Coexisting psychiatric illness or physical abuse may complicate the evaluation and treatment of some women with long-standing vaginal foreign bodies.- - - - - - - - - - ranking = 0.098956301615645keywords = physical (Clic here for more details about this article) |
8/11. Xanthogranulomatous pseudotumor of the vagina: evidence of a local response to an unusual bacterium (mucoid escherichia coli).Utilization of nonconventional bacterial strains and electron microscopy occasionally may aid in the recognition of unusual microorganisms which fail to be demonstrated by more conventional bacterial stains. We report an unusual case of recurrent vaginal polyps, initially thought by physical examination to represent a malignant neoplasm and histologically to represent a granular cell tumor. The lesions were comprised microscopically of sheets of large, polygonal, histiocytic-like cells with abundant eosinophilic granular cytoplasm. With the Dieterle silver stain, the cytoplasm of these cells contained large numbers of intracellular rod-shaped bacilliform bodies thought to be microorganisms. These organisms stained not at all or very poorly with more conventional bacterial stains, such as Gram and Giemsa stains. Electron microscopy was employed to confirm the presence of intra- and extracellular bacilliform bodies and the absence of large numbers of cytosegresomes, the latter characteristically seen in typical granular cell tumors. Cultures of tissue from the biopsy documented a pure strain of a mucoid form of escherichia coli. We were unable to identify any prior report describing a similar recurrent inflammatory vaginal lesion in which mucoid E. coli was demonstrated. We discuss possible pathogenesis of this case, and relate it to morphologically similar diseases, such as Whipple's disease and malakoplakia, in which there appears to be defective clearance of bacteria from a variety of tissues.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
9/11. Vaginal bleeding as a presenting symptom of synovial sarcoma.A case is reported of a woman who presented with bleeding from a vaginal extension of a synovial sarcoma. The patient was unaware of the primary tumor in the left thigh and histologically, the tumor resembled a carcinosarcoma. awareness of the physical and radiologic findings allowed the correct pathologic diagnosis to be made. The manner of presentation of the tumor is believed to be unique.- - - - - - - - - - ranking = 0.098956301615645keywords = physical (Clic here for more details about this article) |
10/11. case reports. Intrauterine echovirus type II infection.The case described herein represents the first laboratory-confirmed case indicating intrauterine infection due to echovirus type II. The virus was recovered from the vagina of the mother and from the blood from the umbilical cord and nasopharynx of an apathetic newborn (all cultures were taken within 60 minutes of birth in the delivery room) with a generalized maculopapular exanthem. When the infant was 15 days of age, results of all laboratory tests and physical examinations were normal.- - - - - - - - - - ranking = 0.098956301615645keywords = physical (Clic here for more details about this article) |
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