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Pain after vaginal prolapse repair surgery with mesh is generally attributed to the mesh fixation, particularly to mesh erosion, dislocation or the development of hematoma. However, once all the causes have been excluded, the urinary system, bladder and ureters should be accurately examined by means of endovaginal ultrasound. This report concerns the case of a 72-year-old woman who had undergone mesh-supported prolapse surgery 3 months prior, with no other relevant diseases, who visited the emergency department complaining of dull, right-sided colic pain. The endovaginal ultrasound examination revealed a prevesical ureteral calculus on the right side with consequent dilatation of the proximal ureter. Computed tomography of the abdomen and pelvis confirmed the calculus in the distal right ureter and revealed a right renal lower pole calculus. The patient underwent treatment via an operative ureterorenoscopy with removal of stones and placement of a double-J-stent. Two months later, a second ureterorenoscopy was performed with double-J-stent removal and concomitant stone extraction. It appears that no similar cases have been reported in the literature. This is why, during the urogynecological postoperative follow-up, it is of paramount importance to examine the entire urogenital system with endovaginal ultrasound. This case report highlights how, through a simple, non-invasive, radiation-free examination, like ultrasound, most of the post-operative complications of vaginal prolapse repair surgery using mesh, including urolithiasis, can be excluded., (© 2024 The Authors. Published by Elsevier B.V.)

Background: Provoked vestibulodynia is commonly associated with dyspareunia and affects 7% to 15% of women. This pathology has major implications on sexual function and quality of life, and several types of treatments are available for its management. However, a consensus has not been reached concerning the best treatment of vulvar pain. The aim of this study was to assess the efficacy and safety of a brand-new product, the vulvar emulgel Meclon ® Lenex, for the management of provoked vestibulodynia and non-infective vulvitis., Methods: This was a monocentric, prospective, randomized, double-blind and placebo-controlled study. We enrolled 40 women with provoked vestibulodynia; 20 patients received Meclon ® Lenex, whereas the remaining received a placebo. Each woman was assessed subjectively (through questionnaires) and objectively by evaluating vaginal and vulvar symptoms (Friedrichs criteria and Marinoff dyspareunia grade). We evaluated efficacy, safety, compliance and tolerability of the brand-new product vulvar gel Meclon ® Lenex in provoked vestibulodynia., Results: After administration of Meclon ® Lenex, we evaluated all parameters of the Friedrichs criteria (burning, dyspareunia, erythema, vulvar pain at the 5 o'clock position and 7 o'clock position), as well as the levels of Marinoff dyspareunia. The active treatment showed to be statistically significantly effective ( p value ≤ 0.05) in reducing all symptoms of Friedrichs criteria, vulvar pain and Marinoff dyspareunia., Conclusion: This prospective study showed that Meclon ® Lenex vulvar emulgel revealed an excellent tolerability and compliance, demonstrating to be a safe and effective option in the treatment of provoked vestibulodynia and non-infective vulvitis.

Background and Objectives: Early-onset colorectal cancer (eoCRC), defined as colorectal cancer (CRC) before the age of 50 is increasing in incidence. We evaluated exogenous and endogenous risk factors, and clinical features of eoCRC, compared to late-onset CRC (loCRC)., Methods: In this retrospective case-case study, patients were prospectively enrolled from 2015 to 2018. We collected clinical features (age, sex, time from symptom onset to diagnosis, symptoms, family history, smoking and alcohol habits, diabetes, BMI, and genetic analysis) and tumor characteristics. Independent risk factors for eoCRC and odds ratios (ORs) were identified., Results: Fifty-four eoCRCs and 494 loCRCs were enrolled. Patients with eoCRC experienced longer delay time from symptom onset to diagnosis: 40.7% were diagnosed within 6 months from symptoms onset, compared to 85.6% of patients with loCRC (P < 0.0001). They differed for sex, presence of symptoms, family history, smoking habit, alcohol intake, and BMI. Rectal localization was more closely associated with eoCRC (64.8%) than loCRC (34.5%, P < 0.0001). Family history of CRC was associated with eoCRC (OR = 8.8). When family history occurred with hereditary cancer syndromes, the OR for eoCRC increased to 21., Conclusion: In young adults with alarming symptoms, CRC must be suspected to avoid delay time from symptom onset to diagnosis and genetic risk assessment has to be evaluated. Smoking habits, alcohol intake, and BMI are not associated with eoCRC., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

A rare case of gangrenous cystitis is described. The questions of the incidence of this pathology are discussed, considering its rareness after the antibiotics age. The etiology of this disease is probably multifactorial and it is never possible to identify a unique cause. The gangrenous cystitis doesn't present with any typical symptomatology, out with urinary troubles common to many urologic diseases. Surgery is often performed in emergency without a preoperative defined diagnosis. Surgical treatment has changed with time from a simple bladder cavity draining to the resection of the necrotized bladder wall. In our case a total cystectomy with uretero-ileocutaneostomy, in two times, was performed. This procedure allowed the patient a good quality of life (1 year of follow-up).

The authors report three cases of mucocele of the appendix. They review the literature on this argument and discuss the hypotheses on etiology, pathologic and clinical classification, problems in diagnosis, principles of therapy and prognosis.

The study, conducted on 40 patients with pain resulting from "minor" general surgery, for the purpose of evaluating the efficacy and tolerability of ST-679 (administered in a single oral dose of 1200 mg in 20 patients) and to compare them with those of paracetamol (administered in a single oral dose of 1000 mg in 20 patients), demonstrated that the new drug was active on all recorded parameters and superior to the reference drug. The evaluation of the evolution of pain, performed using the Scott-Huskisson visual analog scale, evidenced that the maximum analgesic efficacy of ST-679 is reached after 1 hour and 15 minutes from assumption and remains unaltered until the final observation (6 hours). The paracetamol registers maximum analgesic efficacy after 30 minutes, but does not remain constant for the entire observation period. All the other parameters evaluated (variation in pain intensity, peak of analgesic activity and total remission of pain) are significantly favorable to ST-679. The tolerability of ST-679 was very good and better than the reference drug.

The Authors observed and report a case of Mondor's syndrome in a male. In the attempt to identify the real origin in this peculiar thrombophlebitis they reviewed the recent literature. It is apparently impossible to drawn definitive conclusions from the different studies on this subject. Anyway Mondor's syndrome looks suitable for inclusion in the group of jumping thrombophlebitis. Therefore the real cause of the venous accident should be a pathologic situation next to the venous branch where the thrombophlebitis has broken out.

The A. describe the essential traits of the "sinus pilonidalis" disease and report the results obtained by surgical therapy and compared their data with literature data. The A. underline the goodness of the "closed method" particularly if a few special tricks are employed.