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Female weak bladder dysfunction

Aroj Bhattarai, Manfred Staat
After menopause, decreased levels of estrogen and progesterone remodel the collagen of the soft tissues thereby reducing their stiffness. Stress urinary incontinence is associated with involuntary urine leakage due to pathological movement of the pelvic organs resulting from lax suspension system, fasciae, and ligaments. This study compares the changes in the orientation and position of the female pelvic organs due to weakened fasciae, ligaments, and their combined laxity. A mixture theory weighted by respective volume fraction of elastin-collagen fibre compound (5%), adipose tissue (85%), and smooth muscle (5%) is adopted to characterize the mechanical behaviour of the fascia...
2018: Computational and Mathematical Methods in Medicine
Guillermo Aldave, Daniel Hansen, Steven W Hwang, Amee Moreno, Valentina Briceño, Andrew Jea
OBJECTIVE Tethered cord syndrome is the clinical manifestation of an abnormal stretch on the spinal cord, presumably causing mechanical injury, a compromised blood supply, and altered spinal cord metabolism. Tethered cord release is the standard treatment for tethered cord syndrome. However, direct untethering of the spinal cord carries potential risks, such as new neurological deficits from spinal cord injury, a CSF leak from opening the dura, and retethering of the spinal cord from normal scar formation after surgery...
June 2017: Journal of Neurosurgery. Pediatrics
Anas Abdallah, Erhan Emel, Betül Güler Abdallah, Murad Asiltürk, Özden Erhan Sofuoğlu
This study aimed to find the factors that may affect the surgical outcomes of congenital tethered cord syndrome (TCS) in adults by evaluating the long-term surgical outcomes of 25 consecutive cases. Medical records of 79 TCS cases which underwent surgery in Bakırköy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry (BRSHH), during an 11-year period from 2005 to 2015, were retrospectively reviewed. All adult cases (patient age > 18 years) were selected as the core sample used for this study...
January 2018: Neurosurgical Review
Gouri Sreepati, Toyia James-Stevenson
BACKGROUND Fecal incontinence and constipation are common gastrointestinal complaints, but rarely occur concurrently. Management of these seemingly paradoxical processes is challenging, as treatment of one symptom may exacerbate the other. CASE REPORT A 51-year-old female with lifelong neurogenic bladder secondary to spina bifida occulta presented with progressive symptoms of daily urge fecal incontinence as well as hard bowel movements associated with straining and a sensation of incomplete evacuation requiring manual disimpaction...
March 7, 2017: American Journal of Case Reports
Zohreh Habibi, Sara Hanaei, Farideh Nejat
BACKGROUND CONTEXT: Split cord malformation (SCM) is a congenital disease that can be associated with other spinal anomalies. Few cases of concurrent intradural arachnoid cyst and SCM have been sporadically reported; however, sacral extradural arachnoid cyst (SEAC) with SCM is very rare. PURPOSE: The report describes our experience with simultaneous surgery in patients with concurrent SEAC and SCM in an effort to document the treatment of the rare spinal concomitant anomalies...
September 2016: Spine Journal: Official Journal of the North American Spine Society
Hsin-Hsiao S Wang, Jessica C Lloyd, John S Wiener, Jonathan C Routh
PURPOSE: Bladder dysfunction in patients with spina bifida can lead to significant morbidity due to renal insufficiency. Indications for surgery vary among institutions and the impact is unclear. We examined trends and variations in urological interventions and chronic renal insufficiency in patients with spina bifida. MATERIALS AND METHODS: We reviewed NIS (Nationwide Inpatient Sample) for all patients with spina bifida treated from 1998 to 2011. We used ICD-9-CM codes to identify urological surgery and chronic renal insufficiency...
April 2016: Journal of Urology
Margarida Rodrigues, Francisco Cabral, Fátima Pina
INTRODUCTION: HTLV-1 infection is endemic in Japan, Caribbean, Africa, and South America. It is transmitted from mother to child, sexual contact, blood transfusions, or sharing needles. Tropical Spastic paraparesis (TSP) is a chronic degenerative neurological disease associated with this infection. It results from a spinal cord symmetrical degeneration at the thoracic level and is characterized by progressive motor weakness in the lower limbs, hyperreflexia, sensitivity changes, urinary incontinence, and bladder dysfunction...
November 25, 2015: Revista Brasileira de Anestesiologia
Renato Mantegazza, Andreas Meisel, Joern P Sieb, Gwendal Le Masson, Claude Desnuelle, Mirko Essing
INTRODUCTION: Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder affecting the neuromuscular junction, clinically characterized by proximal muscle weakness and autonomic changes. LEMS is often associated with an underlying tumor (paraneoplastic form) but also occurs in the absence of cancer (idiopathic form). Treatment consists of immunomodulation (immunosuppression), anticancer treatment when carcinoma is present, and symptomatic treatment [acetylcholinesterase inhibitors and potassium channel blockers, e...
December 2015: Neurology and Therapy
Fumiaki Maruyama, Yasuharu Akasaki, Mitsuyoshi Watanabe, Takao Arai, Akira Isoshima, Hiroyasu Nagashima, Yuichi Murayama
Foix-Alajouanine syndrome (FAS), also known as congestive myelopathy due to spinal vascular malformations, presents with paraplegia, sensory disturbance of lower limbs, and dysfunction of the bladder and rectum. Although FAS is characterized by a subacute onset of neurological symptoms that may wax and wane over a few years, the progression mechanism remains unclear. We report a case of FAS due to an angiographically occult arteriovenous fistula (AVF) that was diagnosed by an open surgical biopsy and intraoperative indocyanine green (ICG) angiography...
August 2015: No Shinkei Geka. Neurological Surgery
A Kavallaris, D Zygouris, A Dafopoulos, I Kalogiannidis, E Terzakis
BACKGROUND: Cervical cancer is the second most common malignancy of the female genital tract worldwide. Radical hysterectomy with pelvic lymphadenectomy exemplifies the treatment of choice for early stage disease, whereas even if it is performed by gynaecologist-oncologist, still has the drawback of significant postoperative morbidity, especially for urinary bladder function. Nerve-sparing radical hysterectomy (NSRH) is a technique in which the neural part of the cardinal ligament which encloses the inferior hypogastric plexus, as well as the bladder branch (distal part of the plexus), remains intact...
2015: European Journal of Gynaecological Oncology
Andrea Winter, Alan Siu, Aria Jamshidi, Martin Malawer, Jonathan H Sherman
Spindle cell hemangioendothelioma is a rare benign vascular tumor that is not known to involve the sacrum. The authors describe the case of a 31-year-old woman presenting with low-back and radicular pain without weakness or bowel or bladder dysfunction. Admission CT and MRI studies revealed a large S1-3 lytic sacral lesion. The patient initially underwent a nondiagnostic percutaneous biopsy. She subsequently underwent an open biopsy, during which the lesion was found to be highly vascular. Histological investigation revealed a vasoformative lesion consistent with spindle cell hemangioendothelioma...
August 2014: Journal of Neurosurgery. Spine
Matthew J Schuchert, Kristen N McCormick, Ghulam Abbas, Arjun Pennathur, Joshua P Landreneau, James R Landreneau, Andre Pitanga, Jamilly Gomes, Felipè Franca, Matthew El-Kadi, Andrew B Peitzman, Peter F Ferson, James D Luketich, Rodney J Landreneau
BACKGROUND: Thoracic surgeons are commonly consulted to provide anterior thoracic exposure for infection and malignant neoplasms involving the thoracolumbar spine. These cases can present significant technical and management challenges secondary to the underlying pathology, associated anatomic inflammation, and impaired functional status. In this study, we review the perioperative outcomes in patients undergoing anterior spinal exposure for infection and neoplasm. METHODS: 130 consecutive patients (61 women, 69 men) undergoing corpectomy, debridement, or debulking for osteomyelitis (n=50) or neoplasms (n=80) with decompression/stabilization at a single institution were analyzed...
May 2014: Annals of Thoracic Surgery
Mohamad Bydon, Risheng Xu, David Santiago-Dieppa, Mohamed Macki, Daniel M Sciubba, Jean-Paul Wolinsky, Ali Bydon, Ziya L Gokaslan, Timothy F Witham
OBJECT: The aim of this study was to study the long-term outcomes of patients undergoing instrumented posterior fusion of the lumbar spine. METHODS: The authors present 511 patients who underwent instrumented arthrodesis for lumbar degenerative disease over a 23-year period at a single institution. Patients underwent follow-up for an average of 39.73 ± 46.52 months (± SD) after the index lumbar arthrodesis procedure. RESULTS: The average patient age was 59...
April 2014: Journal of Neurosurgery. Spine
Nitin Agarwal, Janki Shah, David R Hansberry, Antonios Mammis, Leroy R Sharer, Ira M Goldstein
BACKGROUND CONTEXT: Cauda equina syndrome is caused by compression or injury to the nerve roots distal to the level of the spinal cord. This syndrome presents as low back pain, motor and sensory deficits in the lower extremities, and bladder as well as bowel dysfunction. Although various etiologies of cauda equina syndrome have been reported, a less common cause is infection. PURPOSE: To report a case of cauda equina syndrome caused by infection of an intradural extramedullary abscess with Staphylococcus aureus...
February 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Marco Castori, Silvia Morlino, Marco Ritelli, Francesco Brancati, Carmelilia De Bernardo, Marina Colombi, Paola Grammatico
Lateral meningocele syndrome (LMS) is a rare hereditary connective tissue disorder characterized by pan-spinal meningoceles, specific facial dysmorphism, skeletal and soft tissue abnormalities, and hypotonia and/or muscle weakness. LMS has been observed in eleven patients with two instances of vertical transmission, and seven sporadic cases with an age at diagnosis ranging from 25 months to 33 years. We report on a further observation of LMS in a 55-year-old woman presenting with a long history of joint instability, chronic musculoskeletal pain, and iatrogenic bladder and anorectal dysfunction due to irreversible nerve damage after surgical excision of a meningeal cyst...
February 2014: American Journal of Medical Genetics. Part A
Mohamed Macki, Mohamad Bydon, Kyriakos Papademetriou, Ziya Gokaslan, Ali Bydon
Idiopathic extramedullary hematopoiesis (EMH) is the production of blood cells outside of the bone marrow without an underlying hematological pathology. This article examines the rare case of idiopathic EMH in the presacral area. A 65-year-old woman with a past medical history of a total abdominal hysterectomy and a negative hematological history presented with back and leg pain. MRI revealed a presacral mass. Fine needle aspiration revealed a diagnosis of EMH. The patient was managed conservatively with serial imaging...
December 2013: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Prathap Jacob Joseph, Maria Regina Reyes
UNLABELLED: OBJECTIVE/CONTEXT: To describe a distinctive clinical and radiographic pattern of myelopathy following intrathecal chemotherapy. Myelopathy is a rare complication of intrathecal chemotherapy used in the treatment of acute lymphoblastic leukemia (ALL). We present a 42-year-old female with T-cell ALL who developed a myelopathy primarily involving the dorsal columns. METHOD: Case report and literature review. FINDINGS: Within 24 hours of an injection of intrathecal methotrexate, cytarabine, and hydrocortisone, the patient developed ascending lower limb numbness and balance difficulties progressing to the inability to ambulate...
January 2014: Journal of Spinal Cord Medicine
Rakesh Redhu, Rajpal Poonia
A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs and bladder/bowel dysfunction. Imaging showed an osteolytic lesion at tenth dorsal (D10) vertebra with anterior compression on the spinal cord. Complete intralesional tumor excision with reconstruction was carried out using the anterolateral extrapleural approach. Histopathological examination was suggestive of giant cell tumor (GCT). Because of complete intralesional tumor excision and fear of post-radiation osteonecrosis of bone used for delayed bony union, a conservative approach was used, and radiation therapy was not given...
July 2012: Journal of Craniovertebral Junction and Spine
Muh-Shi Lin, Hsin-Ying Lin, Kuo-Sheng Hung, Tien-Jen Lin, Yao-Chin Wang, Wen-Ta Chiu, Woon-Man Kung
STUDY DESIGN: Case report. OBJECTIVE: To describe the surgical technique and outcome of 2 cases of lap-shoulder belt injury involving burst fracture at L5 and cauda equina syndrome (CES). SUMMARY OF BACKGROUND DATA: Lap-shoulder belts have largely replaced lap belts in the front seats of cars, and therefore the concept of seat belt injury needs re-evaluation. METHODS: Two adults, the driver and front seat passenger in the same car involved in a collision, sustained lap-shoulder belt injury...
December 1, 2013: Spine
Dong Ah Shin, Joong Won Yang, Seong Yi, Yoon Ha, Do Heum Yoon, Keung Nyun Kim
BACKGROUND: To identify clinical features, radiological findings and surgical outcomes of primary cauda equina tumours. METHODS: A consecutive series of 64 operations in 60 patients with primary cauda equina tumours from April 1999 to May 2009 at one institution comprised the study. The cases were divided into tumours of neural sheath origin (TNS, n = 48) and tumours of non-neural sheath origin (TNNS, n = 22). We analysed pain intensity, neurological abnormalities, MRI findings, surgical extent and functional outcome...
October 2013: Acta Neurochirurgica
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