Lichen planus with multiple system involvement including the mouth, vagina, urethra, and scalp: a case report

This is a case report of lichen planus (LP) with multiple system involvement. A 35-year-old female patient was admitted in November 2014 with a 5-year history of painful/difficult sexual intercourse and loss of oral mucosa, and an 8-year history of focal hair loss. Earlier, the patient had been unable to adhere to corticosteroid therapy because of severe adverse side effects. In September 2014, labia minora mucosa defects and stricture of the urethral orifice (with dysuria), vaginal orifice, and vagina were identified. Biopsy was performed and a diagnosis of erosive LP was made. The patient was treated with an oral immunosuppressant (cyclosporine A) and urethral/vaginal dilatation. Urine flow rate and sex life were improved after 6 months and she discontinued medication. Four years later, the patient reported a good overall treatment efficacy. LP can involve multiple systems and should be considered in patients with dyspareunia. Immunosuppressive agents can achieve a satisfactory effect in patients with contraindication to corticosteroid.

Application of dermoscopy image analysis technique in diagnosing urethral condylomata acuminata

Abstract: Background: In this study, cases with suspected urethral condylomata acuminata were examined by dermoscopy, in order to explore an effective method for clinical. Objective: To study the application of dermoscopy image analysis technique in clinical diagnosis of urethral condylomata acuminata. Methods: A total of 220 suspected urethral condylomata acuminata were clinically diagnosed first with the naked eyes, and then by using dermoscopy image analysis technique. Afterwards, a comparative analysis was made for the two diagnostic methods. Results: Among the 220 suspected urethral condylomata acuminata, there was a higher positive rate by dermoscopy examination than visual observation. Study limitations: Dermoscopy examination technique is still restricted by its inapplicability in deep urethral orifice and skin wrinkles, and concordance between different clinicians may also vary. Conclusion: Dermoscopy image analysis technique features a high sensitivity, quick and accurate diagnosis and is non-invasive, and we recommend its use.

A new material to prevent urethral damage after implantation of artificial devices: an experimental study

ABSTRACT Objective To validate the application of the bacterial cellulose (BC) membrane as a protecting barrier to the urethra. Materials and Methods Forty female Wistar rats (four groups of 10): Group 1 (sham), the urethra was dissected as in previous groups and nothing applied around; Group 2, received a 0.7cm strip of the BC applied around the urethra just below the bladder neck; Group 3, received a silicon strip with the same dimensions as in group 2; Group 4, had a combination of 2 and 3 groups being the silicon strip applied over the cellulosic material. Half of the animals in each group were killed at 4 and 8 months. Bladder and urethra were fixed in formalin for histological analysis. Results Inflammatory infiltrates were more intense at 4 months at lymphonodes (80% Grade 2), statistically different in the group 2 compared with groups 1 (p=0.0044) and 3 (p=0.0154). At 8 months, all samples were classified as grade 1 indicating a less intense inflammatory reaction in all groups. In group 2, at 8 months, there was a reduction in epithelial thickness (30±1μm) when com-pared to groups 1 (p=0.0001) and 3 (p<0.0001). Angiogenesis was present in groups 2 and 4 and absent in group 3. In BC implant, at 4 and 8 months, it was significant when comparing groups 4 with 1 (p=0.0159). Conclusion BC membrane was well integrated to the urethral wall promoting tissue remodeling and strengthening based on morphometric and histological results and may be a future option to prevent urethral damage.

Quiste de conducto de Skene en niñas: A propósito de 2 casos clínicos / Skene duct cyst in female newborns: Case reports

Introduction: The Skene duct cyst, classified as a paraurethral cyst, is a rare congenital abnormality in female neonates and it may manifest throughout the course of life. The incidence varies from 1 in 2000 to 3000 female births. Objective: To expose the characteristics and symptoms of a Skene duct cyst at different stages of child development in order to carry out a timely suspicion and diagnosis. Case report: The first case is a female newborn who presented a painless yellowish tumor adjacent to the urethral meatus, which drained spontaneously; the second case is a teenager who consulted due to leucorrhea for a year and a three-centimeter diameter paraurethral injury between the labia minora, which required surgical treatment and study of the paraurethral mass. Conclusions: Based on the literature review, we concluded that the frequency of Skene duct cyst is higher than the number of reported cases. Cyst removal, marsupialization, puncture and aspiration are all effective treatment methods. Spontaneous drainage is also appropriate in certain cases. We suggest the use of the least aggressive technique according to each case.

Introducción: El quiste del conducto de Skene, se describe dentro de los quistes parauretrales, siendo una rara anomalía congénita descrita en neonatos de sexo femenino, que se puede presentar en el transcurso de la vida. La incidencia varía de 1 cada 2.000-3.000 recién nacidos vivos femeninos. Objetivo: Dar a conocer las características y formas de presentación del quiste del conducto de Skene en distintas etapas del desarrollo del niño para su sospecha y diagnóstico oportuno. Casos clínicos: Se presenta una recién nacida con una lesión tumoral amarillenta, adyacente al meato uretral, no dolorosa, que drena espontáneamente y un segundo caso de una adolescente que consulto por leucorrea de un año de evolución, con una lesión parauretral de tres centímetros de diámetro entre labios menores, que requirió tratamiento quirúrgico y estudio de la masa parauretral. Conclusiones: Basado en la revisión de la literatura, concluimos que la frecuencia de los quistes de conducto de Skene es más alta que el número de casos informados. La extirpación, marsupialización, la punción y aspiración del quiste son todos métodos eficaces de tratamiento. El drenaje espontáneo también es una conducta apropiada en ciertos casos. Se sugiere utilizar la técnica menos agresiva acorde a cada caso.

Urethral dysfunction due to alloxan-induced diabetes. Urodynamic and morphological evaluation

PURPOSE: To evaluate the effect of short and long term alloxan-induced diabetes on bladder and urethral function of female rats, and also describing its correlated morphological alterations. METHODS: Thirty five female rats were divided into three groups: G1 (n=9), control group; G2 (n=17), six weeks alloxan-induced diabetic rats; G3 (n=9), 20 weeks alloxan-induced diabetic rats. Functional evaluation was performed by cystometry and simultaneous measurements of the urethral pressure during bladder filling and voiding. Morphological evaluation was also performed with measurement of bladder and urethral fibrosis and collagen content and thickness of lamina propria and smooth muscle layers. RESULTS: The peak bladder pressures and contraction amplitudes were decreased in 100% and 47% of the G3 and G2 groups respectively, when compared to control. Bladder overactivity was observed in 53% of the G2 group. CONCLUSION: Alloxan-induced diabetes urethropathty in female rat was associated to bladder morphological alterations as higher thicknesses of it lamina propria, detrusor and adventicea. .

Parameatal urethral cyst.

Cyst formation in the parameatal area of the urethra is an uncommon entity. It was first reported in two male cases as recently as 1956 by Thompson and Lantin. Further reports have been rare. Herein, we report a case of a 21 year-old male having a spherical, cystic swelling 1 cm in size at the external urethral meatus. The diagnosis of parameatal urethral cyst was made and the cyst was excised. Histopathological examination revealed a monolocular cyst lined with transitional cells. The postoperative period was uneventful.

A citologia uretral como ferramenta na detecção de efeito citopático do papilomavírus humano (HPV) em pacientes com peniscopia característica de infecção viral / The role of urethral cytophatology in detection of cytopatic features of Human Papillomavirus (HPV) in patients with peniscopy characteristic of viral infection

O objetivo deste trabalho foi avaliar a eficiência da citopatologia uretral na detecção de papilomavírus humano em 37 pacientes diagnosticados com lesões HPV-induzidas pela peniscopia, na Policlínica Santa Beatriz (São Luís - MA). Avaliou-se a ocorrência das diferentes faixas etárias, a positividade para efeito citopático por HPV pela citopatologia uretral comparado com a peniscopia e a associação dos resultados obtidos quando a parceira era portadora da virose. A faixa etária mais freqüente estava compreendidaentre 20 e 39 anos (86,5%) com média de idade de 31,2. A citopatologia uretral apresentou positividade para a virose de 13,5%. Todos os pacientes com citopatologia uretral com efeito citopático compatível para HPV tinham parceiras com história anterior de HPV,porém 40,6% dos pacientes com citopatologias uretrais negativas possuíam parceiras com história anterior de HPV.

The goal of this work was to assess the efficiency of urethral cytopathology in detection of human papillomavirus (HPV)carried out in 37 male patients attended at Clínica Santa Beatriz (São Luís-MA) with previous positive peniscopy for HPV. We evaluated the positiveness of urethral cytopathology compared with peniscopy in different band age and the influence of the partner in the transmission of the disease. The most frequent age was between 20 to 39 years (86.5%), with age average of 31.2%. Urethral cytopathology presented positiveness for cytopatic effects in 13.5% of the cases. All males evaluated with positive cytopatic effect for HPV had partner with previous HPV diagnosis, although 40.6% of the subjects presented negative urethral cytopathology.

Fibroepithelial polyp of the urethra

The fibroepithelial polyp of the urethra is rare in adults. Hematuria and obstructive urinary symptoms are the most common findings. The treatment of choice is endoscopic resection and the prognosis for these lesions is excellent. There is no previous report on recurrence. We describe 2 new cases, with 1 of them presenting recurrence following surgical resection.

Urethral diverticulum as a sequele of instrumentation for transurethral resection of prostate [TURP]

We present a case of acquired urethral diverticulum following transurethral resection of the prostate. He developed the symptoms of urinary incontinence, passing urine by straining and squeezing the scrotal swelling nine months after surgery. Diverticulectomy was done successfully.Acquired urethral diverticulum is a rare complication following transurethral resection of the p rostate. To our knowledge this is not mentioned as a complication in the literature