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Objective To discuss the correlation between female chronic pelvic pain and pelvic floor anatomy.Methods The female patiems of chronic pelvic pain 179 cases,age 28-67 years,average 49.4 years;pelvic pain history 8 months-9 years,average 2.8 years;167 cases has childbirth history,43 cases has surgery history,which gynecological surgery 31 cases,and urinary surgery 7 cases,and anus surgery 5 cases.Results High incidence of female pelvic pain were 30-60 age (incidence of 54.8%),93.3% has birth history,24% has operation history,the myofascial tissue pain higher than the organ,were 87.4% than 12.6% (P < 0.01),the front of pelvic pain higher than back,were 65.6% than 21.8% (P < 0.01).Conclusions Female chronic pelvic pain associated with the particularity of the pelvic anatomy and physiological,with the tissue of pelvic floor and urogenital diaphragm of primary injure and chronic inflammation is an important cause of chronic pelvic pain.
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Objective To observe the different effects caused by different injection sites in bladder ,in cases of female overac‐tive bladder cured by botulinum toxin type A injection .Methods Forty cases were divided into 2 groups randomly .Cases of group A accepted botulinum toxin type A injection only on detrusor .Cases of group B accepted botulinum toxin type A injection on detru‐sor and trigone of urinary bladder .The following parameters were recorded to evaluate the effects 4 weeks later :average daytime u‐rination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgency ,bladder capacity at first de‐sire ,maxima bladder capacity ,OABSS scores and QOL scores .Results After 4‐week treatment with botulinum toxin type A ,all pa‐rameters ,average daytime urination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgen‐cy ,bladder capacity at first desire ,maxima bladder capacity ,OABSS scores and QOL scores in cases of group A had a better im‐provment than those of cases of group B .Conclusion Botulinum toxin type A injection on bladder is a new effective method for fe‐male refractory overactive bladder .Injection on detrusor and trigone of urinary bladder is better than injection only on detrusor .
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Objective To analyze the risk factors of urolithiasis in pregnancy and the relationship between urolithiasis in pregnancy and pregnancy outcomes.Methods From January 2004 to December 2009,the clinical data of 162 pregnant women (Group A),diagnosed as upper urinary tract calculi,were reviewed,retrospectively.Their age ranged from 18 to 41 years (mean 24±5 years).Seven of them had history of urolithiasis before pregnant.At the same time,150 pregnant women without urinary stone (Group B) were also included in this study,whose mean age was 23±5 years.In addition,150 women without pregnant and urinary stone (Group C) were included in this study,whose mean age was 24±4 years.The blood and urine routine results,blood uric acid and electrolytes were recorded and compared among those groups.In group A,119 cases had symptomatic urolithiasis.Surgical intervention was performed in 24 cases and the conservative therapy was performed in 95 cases.The rates of abortion,premature delivery and cesarean delivery were compared between two groups.Results Compared group A with group B and group C,there were significant differences in the urine WBC (145.16±202.18 vs.46.00± 119.50 and 55.33 ± 145.36 per high power lens) and urine ketone body (2.41 ± 6.14 mmol/L vs.0.30± 1.75 mmol/L and 0.17± 1.26 mmol/L) (P<0.05).Meanwhile,there were significant differences in the blood leukocytes [(11.39±3.89)× 109/L,(10.78±2.98) ×109/L vs.(6.21±1.48) × 109/L],the blood uric acid (331.12±215.22 μmol/L,329.32± 88.50 μmol/L vs.280.01±69.88 μmol/L),the urine protein (0.29±2.00 mmol/L,0.10±0.19 mmol/L vs.0.02±0.09 mmol/L),urine glucose (2.50±8.44 mmoL/L,2.35±8.63 mmol/L vs.0.25± 1.97 mmol/L) and urine erythrocyte (76.60±98.11,77.43±71.00 vs.13.77±37.93 per high power lens) (P<0.05).In those patients with symptomatic urolithiasis,there was 1 case of abortion in the conservative treatment and surgery intervention groups,respectively.The premature delivery rate and cesarean delivery rate were 5.3% vs.0% and 17.9% vs.4.2%,respectively.Conclusions The blood leukocytes,blood uric acid,urine protein,urine glucose and urine erythrocytes are significantly high in pregnant women than those in non-pregnant women.However,the relationship between those abnormality and urolithiasis in pregnancy is still indefinite.Since the urine leukocytes and ketone increase obviously,it might suggest that the occurrence of the urine calculi is related with the metabolism of nourishment and electrolytes,urinary tract infection in pregnancy.The surgery intervention may be a risk of fetus miscarriage.
ABSTRACT
This study examined the association of pregnancy with urolithiasis and provided new insights into urolithiasis in pregnancy. A total of 462 subjects were studied from January 2004 to December 2009 in Foshan Maternal and Child Health Hospital, China. Among the 462 subjects, 162 cases of urolithiasis during pregnancy (UPG) were selected as the observation group, 150 cases of no urolithiasis during pregnancy (NUPG) served as pregnancy control group, and 150 cases of no pregnancy (NPG) at reproductive age who took part in physical examination were randomly assigned into non-pregnant control group. At the same time, the patients in observation group were divided into the following sub-groups: no symptomatic urinary calculus (NSUC) and symptomatic urinary calculus (SUC) groups; SUC group was further divided into surgical intervention (SI) and conservative management (CM) groups. The general information and the data of blood and urine were collected and compared among the groups. The results showed that the incidence of urinary calculi in pregnant women was lower than that in non-pregnant women, the formation of urinary stone was associated with the change of metabolism of protein and sugar in pregnant women, and the surgical intervention was a practicable alternative to treat the clinical intractable symptomatic urinary calculi in pregnancy.