Application of translabial ultrasound in female periurethral benign solid lesions / 中华超声影像学杂志

Objective:To investigate the value of translabial ultrasound (TLUS) in female periurethral benign solid lesions (PBSL).Methods:Twenty-one female patients (21 lesions) with PBSL identified pathologically within the process of cystoscope or surgery from June 2017 to December 2020 were enrolled. All of them underwent urethral examination (UE) and TLUS. The detection rates of the lesions of UE and TLUS were compared, and the ultrasonic diagnostic accuracy and ultrasonic manifestations were analyzed.Results:Sixteen of the 21 patients showed lower urinary tract symptoms (76.19%). Among the 21 lesions, the detection rates of UE and TLUS were 52.38% (11/21) and 85.71% (18/21), respectively, the difference was statistically significant ( P=0.019). The length of 18 lesions detected by TLUS was (1.79±1.04)cm, and 13 lesions (72.22%) were shorter than 3 cm. Among 18 cases, urethral caruncle (13 cases) was the most common benign periurethral mass, the main ultrasonic manifestations of urethral caruncle showed hyperecho lesions in the middle and distal urethra, and the blood flow was mostly in a branch-like distribution. At the same time, there were 5 cases of urethral myoma and other solid lesions, the main ultrasonic manifestations of urethral myoma showed clear boundary, low echo and peripheral short strip blood flow. Using pathological results as the gold standard, the accuracy of ultrasonic diagnosis was 88.89% (16/18). Conclusions:TLUS is able to improve the detection rate of periurethral benign solid lesions, and the diagnostic concordant rate is acceptable.TLUS can provide more diagnostic and therapeutic information.

Septic shock caused by the under-recognized bacterium Eggerthella lenta in a 61-year-old male with a periurethral abscess: a case report

Abstract Eggerthella lenta is a gram-positive anaerobic bacillus that has been associated with life-threatening infections. Bacteremia is always clinically significant and is mostly but not always associated with gastrointestinal disease. We present a unique case of abrupt deterioration and rapid development of septic shock secondary to periurethral abscess caused by E. lenta infection. This case highlights the atypical clinical presentation, risk factors, uncommon source of infection, challenges in therapy, and outcome of this infrequent infection. There is still a gap in the understanding of E. lenta pathogenicity, and more literature is needed to establish clear management recommendations.

Imaging findings of female Skene gland disease / 中华放射学杂志

Objective To investigate the imaging characteristics of female Skene-gland (periurethral glands) disease. Methods A retrospective analysis of preoperative imaging findings was performed in 15 female patients with surgical-pathological proven Skene gland disease. MRI scans were performed in 8 cases, CT scans were performed in 5 cases, both CT and MRI were performed in 2 cases. Imaging characteristics were observed and summarized.Results There were 3 types of diseases,including:(1) Skene gland cyst (n=3), located in the distal and posterolateral urethra or close to the proximity of urethra, presenting as cystic lesions with teardrop shape on sagittal images, which appeared as hypo-attenuation on non-enhanced CT, and hypo-intensity on T1WI, hyper-intensity on T2WI, and without enhancement. One case complicated with infection presented as hyper-intensity on T1WI and gaseous intensity inside,with thickened cystic wall and enhancement.(2)Urethral diverticulum communicating with Skene gland (n=10), located in the middle or distal and posterolateral urethra, presented as a horseshoe shaped cystic lesion partially surrounding the urethral(n=3)or spoke wheel-like cystic lesion with multiple septum completely surrounding the urethra (n=7). They appeared as fluid attenuation on unenhanced CT, and hypo-intensity on T1WI, hyper-intensity on T2WI and without enhancement. Heterogenous signal or attenuation and enhanced septum or cystic wall were found in 6 cases complicated with infection. (3) Malignant tumor (n=2, one adenocarcinoma and one neuroendocrine carcinoma), presented as cystic-solid mass surrounding the urethral, showing heterogenous low attenuation on nonenhanced CT and iso-to hyper-intensity on T2WI and hypo-to iso-intensity on T1WI with significant enhancement.Conclusions Female Skene-gland disease has specific occurrence location and imaging characteristics.

The Efficacy of Periurethral Injection Therapy for Female Stress Urinary Incontinence

No abstract available in English.

Urethral Ultrasonographic Evaluation of the Urethral and Periurethral Tumor / 대한비뇨기과학회지

Tumors of the urethra and periurethra are rare lesions accounting for less than 1% of tumors arising from the genitourinary tract. Routine examinations of the urethra are X-ray study and endoscopic examination. X-ray and endoscopic examination have the risk of radiation exposure to the reproductive organs or pain at study and they have the limitation on outlining the periurethral environments. In the last few years, diagnosis of disease by ultrasound has made tremendous advances. Many investigations of ultrasound examinations on the male and female lower urinary tract using transrectal, transvaginal and transpubic approaches have been reported. But there has been no report of the ultrasound examination on the urethra and periurethral tumor. We report our experiences with sonourethrography of 6 cases of urethral and periurethral solid tumors. And we concluded that sonourethrography is less expensive, non-invasive and can accurately image the outline of the urethra and periurethral tumor.

Mucoid Cyst of Penile Skin: A case report

A rare case of mucoid cyst of the penile skin in a 23 year-old man is reported, which has been presented as a movable, superficial and no tender nodule, measuring 0.8 cm in maximum diameter at the periurethral meatus of the glans for 6 months. This nodule was removed by simple excision and proved to be a mucoid cyst of penile skin, which was lined by pseudostratified columnar epithelium with occasional mucous epithelium and glands, suggesting its origin is most likely from sequestrated periurethral glands.

An Experimental Study on the Changes of Ureter and Adjacent Tissue by Extravasation of Irrigation Fluid / 대한비뇨기과학회지

The study was designed to evaluate the radiological and pathological changes in the periureterally extravasated left ureter of rabbit following the irrigation with normal saline without dilatation and the effects of steroid in 30 rabbits. The rabbits were divided into two groups :the periureterally extravasated group without steroid administration( irrigation group) and the steroid administered group before and after ureteral irrigation( irrigation + steroid group). The results were as follows: 1. The frequency of ureteral peristalsis was decreased in both irrigation group and irrigation steroid group compared to the that of pre-irrigated one but with no significant difference between two groups. 2. The ureteric wall was easily liable to hydrostatic inflammatory reactions even with only periureteral extravasation in both irrigation group and irrigation +steroid group but with no significant difference between two groups. 3. The mechanism for the ureteral and periureteral fibrosis at an area where ureteroscope hasn't contacted is thought to be related to the microscopic or visible injury of transitional epithelium of ureter followed by extensive mucosal or periureteral extravasation of irrigation fluid resulted from high pressure of the irrigant within the ureteral lumen.