Urogynecology - Science topic

A 35 years old lady, a known case of Psoriasis is on Homeopathic treatment. She has been married for the last 2 years and has now reported for evaluation for infertility. She has normal menstrual periods. Her general, systemic and pelvic examinations are within normal limits except for psoriatic patches. Laboratory investigations are normal. On pelvic USG, uterus is normal size and endomyomtrial echotexture is normal. There are 2 small subserous fibroids, one small cyst in right adnexa adjacent to ovary (? parovarian cyst) and an endometrial polyp of 13 x 8 mm size. Planning for hysteroscopic polypectomy. Can one go ahead with laparohysteroscpic evaluation in this case along with polypectomy?

A 40 y.o. female had pelvic trauma with disruption of urethrovesical junction 10 yrs back. Cystoscopy reveals gap of about 2-3 cm between bladder neck and utethral margin. Urethra is as such competent on scopy but bladder neck is slightly rigid and patulous. Tried urethroplasty but failed 2 yrs back.

I am trying to find the main contributor to parity in pelvic floor damage by the collagen change of cardinal ligament.

A 23 years old girl has been having recurrent vaginitis for the last one year.She has been in relationship for the last few years. Barrier contraception is being used with the present partner. She used to have unprotected intercourse with the previous partner. The clinical picture is that of fungal vaginitis. Local antifungal agent, Clotrimazole (at times along with Clindamycin) have been administered few times. She was put on once a week Flucanozole tablet for 6 weeks. The couple had taken combination of Azithromycin, Flucanozole and Secnidazole few months back. GTT done recently is WNL. HIV and VDRL were done in February and repeated few days back. They are non reactive. High vaginal swab has been taken for culture. Vaginal secretions have been collected for cytology. Report is awaited. How to manage this case?

Is it possible to induce vaginal prolapse in dogs or in lab animals?

A Patient:

Sex: F

Age/Date of Birth: 1946

Diagnosis: Adipositas Permagna; COPD; Arterial Hypertension; Paroxysmal atrial fibrillation; Urinary Track Infection; Endogenic Depression; Massive Urinary Incontinence and Diabetes Mellitus II.

Patient was admitted with a body weight of ca. 107.0Kg

Patient is always agitating, becoming very difficult to approach and sometimes a behaviour that might affect her medical and care plan.

Patient lost two closed family members withing two years (husband and son) consecutively. Suffered these great loss and perhaps could not mourn enough.

Patient is often confronted with unpaid bills which also often makes her get wilder and very much difficult to attend to.

Patient requests almost double meals as well as late meals and fruits at night. When these requests are not met, her anger is triggered with scolding behaviour.

Patient continuously increasing in weight, her urinary incontinence almost out of management because she never followed the procedures to a better incontinence management. Hygiene sometimes very poor as a result of infectious urine dropping around in her room.

Patient´s weight was regularly weight and eventually found that she has amassed ca. 140.5Kg.

Patient was calmly, but seriously advised to check and reduce her weight, by taking more calories and stop taking late night meals.

What could be the possible cause of sudden and acute outburst of Aggression. quarrelsome and not wanting to cope with medical and care plans?

Are there any useful and applicable evidence based care plan that could be applied to care for this patient?

What are some reports in the literature about what the risk factors are for the recurrence for POP surgery? What is the most recurrent area in POP surgery? Little about ideal procedure for recurrent POP surgery.