Online survey of genital and urinary symptoms among Japanese women aged between 40 and 90 years.

OBJECTIVE: The purpose of this survey was to assess the prevalence of genital and urinary tract symptoms among Japanese women with declining estrogen levels. METHODS: A health-related questionnaire survey was conducted among women in their 40s or older to inquire about their genital, intercourse-related, and urinary symptoms and concern over their symptoms. RESULTS: Of the consecutive 10,000 respondents recruited, 4488 (44.9%) reported having symptoms: 3546 (79.0%) expressed concern over their symptoms. Furthermore, 2173 women (21.7%) had incontinence, 1999 (20.0%) had urinary frequency, 1648 (16.5%) had itching, and 1560 (15.6%) reported odor; these were followed by looseness, dryness, and burning. Of the 2518 (25.2%) sexually active women, 518 (20.6%) reported having dyspareunia and more reported having urinary symptoms than genital symptoms. Of the symptomatic respondents, 33.1% had genital symptoms alone, 28.4% had urinary symptoms alone, and 38.4% had both. More sexually active women had genital symptoms, while more sexually inactive women had urinary symptoms. CONCLUSIONS: Genital and urinary symptoms were shown to be common and coexist in a considerable proportion of the respondents, highlighting the pathology of genitourinary syndrome of menopause. Again, dyspareunia and lower urinary tract symptoms were shown to be quite common among postmenopausal women.

A clinical sign of the Marcus Gunn phenomenon. Case Report.

We present a 33-year-old man with severe unilateral congenital blepharoptosis associated with the Marcus Gunn "jaw-winking" phenomenon. The most important factor in surgical treatment was elimination of the synkinetic reflex. We also thought that excision of as much of the levator muscle as possible was necessary. The result was both functionally and cosmetically satisfactory.

Giant mixed tumor of the face.

A 35-year-old Japanese man consulted our clinic with an eight year history of a 6 cm diameter subcutaneous tumor on the left cheek. Hematoxylin and eosin staining of the resected section showed histology corresponding to a benign chondroid syringoma. Keratin was positive in most of the constituent cells, and S-100 protein was positive in the cells distant from the lumens and in myxomatous cells. A benign chondroid syringoma of this size has only been very rarely reported in the literature.

Reconstruction of scalp and cranium defect utilizing latissimus dorsi musculocutaneous and serratus anterior muscle free flaps with interpositional anastomosis of T-shaped flap artery: case report.

The use of a combination musculocutaneous free flap, consisting of a latissimus dorsi flap and a serratus anterior flap, for reconstruction of a large scalp and cranium defect is described. The recipient artery, the superficial temporal artery (STA), was anastomosed to the flap artery, without sacrificing blood flow, by means of a special technique: forming the end of the flap artery into a T shape and interposing it between the two stumps of the transected STA, because the STA was crucial for tissue adjacent to the defect. The flap vein was anastomosed to the external jugular vein with a vein graft. The extensive defect was immediately closed with sutures, and there were no remarkable complications.

Transinterosseous transfer of a peroneal island flap for reconstruction of prepatellar skin defect: report of two patients.

We describe the use of a peroneal vascular transinterosseous island flap for the resurfacing of a prepatellar skin defect in 2 patients. Being a fasciocutaneous flap, the peroneal flap is thin, and the location of perforators is easily and safely detected with a Doppler flowmeter. When used as a vascular island flap, either a distal pedicle or a proximal pedicle can be used. The peroneal flap can be used as either a free flap or a vascularized fibular and fasciocutaneous flap. It may, therefore, be applied to compound skin, subcutaneous tissue, and bone defects in the lower extremities. A peroneal vascular transinterosseous island flap can reach a prepatellar skin defect, whereas the peroneal island flap with conventional proximal pedicle cannot.