[Acute urinary retention due to cervical myoma--a case report and a review of the literature]. / Ostre zatrzymanie odplywu moczu spowodowane miesniakiem szyjki macicy--opis przypadku i przeglad literatury.

CASE REPORT: A 48-year-old woman with acute urinary retention due to a big cervical leiomyoma pressing on the urethra was admitted to the Gynecologic Unit. A Foley catheterization was performed and 1500 mL of urine was drained. The gynecologic examination revealed a cervical tumor 10 cm in diameter. Acute urinary retention and intensifying abdominal pain were indications for emergency surgery. The presented case of obstructive urinary retention is a rare finding as the literature offers only single reports on the symptoms of cervical fibroids and the treatment methods. CONCLUSIONS: Cervical leiomyoma is a rare cause of acute urinary retention. The surgical procedure requires considerable experience to avoid intraoperative bleeding and bladder or bowel complications.

Postpartum endoanal ultrasound findings in primiparous women after vaginal delivery.

BACKGROUND: Natural childbirth is regarded as the most frequent cause of anal sphincter defects. The majority of obstetric injuries are detectable only by anal endosonography (AES), in from 6.8% to 35% of women after vaginal delivery. PURPOSE: To evaluate prospectively anal sphincters in primiparous women in the first days after delivery to estimate the prevalence of anal sphincter defects and to correlate selected risk factors with the recognized injuries. MATERIAL AND METHODS: A total of 112 consecutive primiparous women aged 19-40 years (mean 29.3 years) underwent three-dimensional (3D) AES with the use of a BK Medical scanner Profocus 2202 in the first weeks after delivery. RESULTS: Twelve tears (10.7%) in the perineum, including three extending to anal sphincters (2.6%) were found on AES. As many as 86 (76.8%) women had medio-lateral episiotomies due to the practice pattern in our hospital or as a consequence of obstetric factors. The statistical analysis did not prove a significant association between diagnosed injuries and episiotomy (P=0.73), nor a traumatic effect of epidural anesthesia, fetus head circumference > or =34 cm, or birth weight > or =3525 g. CONCLUSION: Anal sphincter tears following childbirth were found in only 2.6% of primiparous women, suggesting that vaginal delivery might not imply high risk of pelvic floor damage as has previously been assumed. The results do not confirm that medio-lateral episiotomy is conducive to obstetric anal sphincter defects.