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Urethral duplication is a rare finding in females, with fewer than 40 cases published since 1970. We report a case of urethral duplication in a woman with uterovaginal and rectal prolapse but without other associated congenital anomalies. On urodynamic and cystoscopic evaluation, an accessory urethra was noted to emerge from beneath the clitoral hood. The patient underwent exploratory laparotomy and transabdominal excision of the rudimentary urethral orifice with concurrent transvaginal prolapse repair and rectopexy. At 5-year follow-up, the patient continued to be continent and without prolapse.

Uvular necrosis is a rare complication after endotracheal intubation and upper endoscopy. A 49-year-old woman underwent surgery for uterine prolapse, rectocele, and stress urinary incontinence under general anesthesia with

Objective The purpose of this study was to assess which preoperative and postoperative variables correlated with satisfaction after surgical treatment of urinary incontinence. Study Design We conducted a retrospective cohort study of 371 women who underwent rectus fascial or midurethral sling procedure. Satisfaction was defined as a questionnaire response of "completely satisfied." Incontinence symptoms were based on responses to validated questionnaires. Associations between preoperative and postoperative variables and satisfaction were assessed with the use of logistic regression models. Results Increasing patient age (odds ratio [OR], 0.8; P = .002), body mass index (OR, 0.8; P = .003), and an autologous rectus fascial sling (compared with a midurethral sling; OR, 0.5; P = .003) were associated with decreased odds of satisfaction in a multivariate model. Furthermore, patients who required urethrolysis or had severe lower-urinary tract symptoms were significantly less likely to report satisfaction. Conclusion Increasing age, body mass index, and type of operation were associated with decreased odds of satisfaction.

Background While pelvic floor dysfunction may manifest with bladder or bowel symptoms, the relationship between functional defecatory disorders and dysfunctional voiding is unclear. Our hypothesis was that patients with defecatory disorders have generalized pelvic floor dysfunction, manifesting as dysfunctional urinary voiding. Methods Voiding was assessed by a symptom questionnaire, a voiding diary, uroflowmetry, and by measuring the postvoid residual urine volume in this case-control study of 28 patients with a functional defecatory disorder (36 ± 2 years, mean ± SEM) and 30 healthy women (36 ± 2 years). Key Results Women with a defecatory disorder frequently reported urinary symptoms: urgency (61%), frequency (36%), straining to begin (21%), or finish (50%) voiding, and the sense of incomplete emptying (54%). Fluid intake and output, the minimum voided volume, and the shortest duration between voids measured by voiding diaries were higher (P

The purpose of this study was to describe health-related quality of life and satisfaction after global endometrial ablation in women with bleeding disorders and a systematic review of the literature.A follow-up survey was mailed to 36 patients with bleeding disorders and 110 reference patients (no coagulopathies) who underwent global endometrial ablation for menorrhagia. The survey included a generic (SF-12) and menorrhagia multi-attribute utility scale questionnaires.Ninety-six women (66%) responded. The total menorrhagia multiattribute utility scale score increased from 35-100 in bleeding disorder cohort (P = .03) and from 48-100 in the reference cohort (P.001). Although postablation SF-12 mental domain scores were comparable in both cohorts (55 vs 55; P = .67), physical domain scores were lower in the bleeding disorder cohort (50 vs 56; P.001). High satisfaction was reported by both cohorts (95% vs 84%; P = .60).Global endometrial ablation improved health-related quality of life for women with bleeding disorders and had high satisfaction rates.

Objective The purpose of this study was to compare complications from vaginal hysterectomy with abdominal hysterectomy in renal transplant recipients. Study Design Women who underwent renal transplantation then hysterectomy from 1966-2008 at Mayo Clinic, Rochester, MN, were identified. Data were collected about preoperative, intraoperative, and postoperative events. Main outcome measure was loss of allograft function; secondary outcomes included types of complications and treatment methods. Results Of 58 women with renal transplants, 42 women (72.4%) underwent abdominal hysterectomy. The most common indication for hysterectomy was menorrhagia (n = 20; 34.5%). Overall, 24 women (41.4%) had complications, the most common of which were infection (n = 15) and transfusion (n = 8). Women who underwent abdominal hysterectomy were no more likely to have perioperative complications than were women who underwent vaginal hysterectomy (odds ratio, 1.25; 95% confidence interval, 0.38–4.08). Conclusion Although patients with renal transplants had perioperative complications, none of these complications led to renal graft loss. Hysterectomy can be considered in these patients when accompanied by diligent postoperative care.