Efficacy of Maximal Electrical Stimulation for Treatment of Overactive Bladder

PURPOSE: To evaluate the efficacy of acute maximal functional electrical stimulation(AMFES) for the treatment of overactive bladder(OAB). MATERIALS AND METHODS: Twenty-eight patients(male 3, female 25) with OAB symptoms were treated with AMFES(10Hz biphasic alternating pulse, 20 min per session, 10 sessions) via intravaginal or anal electrode. They were divided into OAB symptoms with and without detrusor overactivity(DO) based on urodynamic study (n=15 vs. 13, respectively). DO-present group was subdivided into idiopathic DO subgroup (IDO, n=9) and neurogenic DO subgroup(NDO, n=6). The outcomes were assessed by 3-day frequency-volume chart and the Bristol Female Lower Urinary Tract Symptoms Questionnaire Changes in OAB symptoms at 1 and 3 months after discontinuing the stimulation were evaluated. RESULTS: Cure rates for urgency and urge incontinence at 1-month after stimulation were determined as 62.5% and 50% in IDO group, 66.7% and 66.7% in NDO group, respectively, which were higher compared to DO-absent group. At 3-month after treatment most patients in IDO and DO-absent group who achieved a cure at 1 month, maintained improvement, however three(75%) of 4 patients in NDO group recurred. There were no significant changes in urodynamic parameters. The detrusor overactivity was no longer observed in 5(55.6%) patients in IDO group and none in NDO group. CONCLUSION: AMFES has a beneficial effect on women with OAB. Our data suggest electrical stimulation may have a significant carry-over effect in well-selected OAB patients although further studies with large population are needed to establish long-term results.

A Case of Leiomyoma in the Female Urethra

Leiomyoma of the female urethra is exceedingly rare entity. Twenty-four year woman admitted to the hospital with a painless, gross hematuria and protruded mass outside the vaginal introitus. Vaginal examination revealed a mass arising from anterior urethral wall extending from meatus up to 1 cm proximally. Histopathological studies confirmed urethral leiomyoma. Surgery completely resolved the original symptoms and no evidence of complications after surgery. We report a case of leiomyoma of the female urethra and a review of the literature.

A Case of Skene's Duct Cyst in Adult Woman

Skene's duct cyst in the adult is rare lesion. A 40-year-old woman was referred with a chief complaint of dysuria. Examination of the external genitalia revealed a 1 cm cystic mass on the right side of the urethral orifice. VCUG, ultrasonography and cystourethroscopy showed no abnormal findings. A surgical excision was decided as it was considered that the most probable diagnosis was a Skene's duct cyst. The pathology report showed the cyst wall was lined by stratified squamous epithelium and confirmed the clinical diagnosis of Skene's duct cyst.

A Case of bladder stone after intravesical migration of Lippes IUD / 대한산부인과학회지

Migration of an intrauterine device into the bladder, together with secondary stone formation is an extremely rare complication. We have recently encountered the migration of a Lippes loop into the urinary bladder and an associated secondary stone formation. We report our findings together with a review of the literature.