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PubMedDate not supplied

Quantitative and qualitative assessment of milk production after pharmaceutical induction of lactation in the mare.

The induction of lactation is performed in ruminants by steroidogenic impregnation, followed by drugs intended to increase prolactin secretion. The aim of this study was to induce lactation in barren mares and to evaluate milk production. Five treated and 5 control mares were used in June and September in year 1, and 12 mares were used in year 2. Mares were administered a vaginal pessary (500 mg altrenogest and 50 mg estradiol benzoate) for 1 week. The 2nd week, another sponge with 100 mg estradiol benzoate was administered, together with 50 mg/100 kg body weight (BW) sulpiride in oil (IM q12h). All mares were milked by hand. Drug treatment was stopped after I L was obtained. Milk production and composition and plasma prolactin concentration were measured. In year 2, the same steroid treatment was applied, but mares received sulpiride (n = 6) or domperidone (1.1 mg/kg PO q12h) (n = 6). A milking machine and oxytocin injections 1 minute before the start of milking were used. In year 1, all treated mares started milking within 1-5 days after sulpiride treatment. Mean daily milk production was 0.88 +/- 0.52 L/500 kg BW. Milk immunoglobulin G (IgG) contents increased in all mares (IgG concentration range, 14-92 g/L). Plasma prolactin increased during sulpiride treatment (range. 27.7 +/- 2.9 to 43.7 +/- 6.7 ng/mL [before] to 289.0 +/- 7.8 ng/mL during treatment, P < .001). In year 2, results were similar to those in year 1, with peak IgG concentrations ranging from 4.2 to 106.7 g/L and a larger daily milk production (3.13 +/- 0.75 with sulpiride and 3.45 +/- 0.51 L/500 kg BW with domperidone). In conclusion, lactation can be induced in mares within 2 weeks, and some mares produce good-quality colostrum.

Administration, Intravaginal↗
PubMed2004

Urinary incontinence, pelvic floor dysfunction, exercise and sport.

Urinary incontinence is defined as "the complaint of any involuntary leakage of urine" and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as "involuntary leakage on effort or exertion, or on sneezing or coughing". The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women's participation in sport and fitness activities and, therefore, it may be a threat to women's health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A 'stiff' and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as <2g of leakage on pad tests, varied between 44% and 69%. Pelvic floor muscle training has no serious adverse effects and has been recommended as first-line treatment in the general population. Use of preventive devices such as vaginal tampons or pessaries can prevent leakage during high impact physical activity. The pelvic floor muscles need to be much stronger in elite athletes than in other women. There is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor muscle training in female elite athletes.

Exercise↗
PubMed1990

Effects of melatonin and progesterone administered to ewes in spring and summer.

Melatonin (MEL) was evaluated for effects on LH, prolactin (PRL) and fertility in spring (Exp. 1, 2) and summer (Exp. 3 to 5). In Exp. 1, 17 ovariectomized ewes bearing estradiol implants were fed 3 mg MEL or vehicle for 44 d beginning May 1. Melatonin decreased (P less than .001) PRL levels but had no effect on LH secretion and response to GnRH. In Exp. 2, 12 ewes each received a 40-d MEL ear implant or a sham implant on March 31. Progesterone-releasing pessaries (CIDR) were applied for 12 d and were withdrawn concomitant with ram joining on May 7. Neither treatment stimulated follicular development or induced estrus or ovulation. Exp. 3 and 4 were contemporary 2 x 2 factorial trials with 24 ewes at each of two locations. Melatonin implants were administered on June 29 and CIDR on July 22. The CIDR were removed and rams (Exp. 3, vasectomized; Exp. 4, fertile) were joined on August 3. Days from introduction of rams to estrus were reduced (P less than .05) by CIDR but not by MEL. All ewes lambed in Exp. 4, and days to estrus and conception were reduced (P less than .001) by CIDR but not by MEL. Exp. 5 was designed like Exp. 4 except that MEL implants were inserted June 20 and rams were joined August 8. Intervals from introduction of rams to estrus were reduced (P less than .01) by both MEL and CIDR treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

Anestrus↗
PubMed1992

Effects of various steroid milieus or physiological states on sexual behavior of Holstein cows.

Two experiments were conducted to determine how steroid milieus and pregnancy affect sexual behavior. Experiment 1 was arranged as a Latin square with five ovariectomized cows and five steroid milieus: no steroid (N); progesterone (P4); estradiol benzoate (EB); P4 + EB; and P4 followed by EB (P4:EB). Progesterone was administered via pessary (2 g of P4) for 5 d and EB was injected (1 mg i.m.) on the day before a test day. On a test day, cows were exposed for four 30-min periods, twice each with a tied or a loose estrual test cow (prepared using P4:EB). Sexual behaviors recorded were attempted mounts, successful mounts, front mounts, stands, head butts, chin rests, and vulvar sniffs. Cows exhibited more (P less than .05) sexual behavior during periods with the loose estrual test cow than with the tied estrual test cow. Cows receiving P4 alone ranked lowest among treatments for each behavior, whereas cows receiving EB or P4:EB ranked highest or second-highest. Progesterone prevented stands in cows given P4 + EB, but these cows displayed mounting behaviors similar to those of cows given EB and P4:EB. Cows given P4 + EB were similar to those given N for most behaviors. In Exp. 2, 118 intact, lactating cows were observed in groups of four or five for mounting of estrual test cows during 24, 30-min observation periods on 8 d over 2 yr. The design was an incomplete block with physiological state, parity, estradiol, progesterone, and a calculated estrogen:progesterone ratio included in the model. Each block included one or two cows at 23 +/- .8 d after insemination, divided retrospectively into one pregnant and two non-pregnant groups (low [less than 1 ng/mL] vs high progesterone), and other cows at 89 +/- 1.0, 152 +/- 1.2, and 234 +/- 1.7 d of gestation (six physiological groups). Most cows were observed once, but 27 cows were included twice during 2 yr. Only 60% of the 118 cows made attempted or successful mounts even though estrual test cows were always receptive. Physiological state was not associated with amount of mounting because very active (greater than or equal to five attempts) and inactive cows were represented in all physiological groups. The estrogen:progesterone ratio on test day accounted for small, but significant, variation in mounting behavior. For cows observed on two different days, correlations between successive observations were .46 for attempted mounts, .78 for successful mounts, and .71 for total mounts.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1994

Influence of simulated photoperiod alteration and induced estrus on reproductive performance of spring-born Columbia and Targhee ewe lambs.

The objective of this study was to test the hypothesis that a combination of induced estrus (IE) and melatonin (MEL) would increase reproductive performance in breeds characterized by late maturity more than either IE or MEL alone. Spring-born Columbia (C; n = 161; 188 to 222 d range of age at breeding; 49 to 80 kg range of BW at breeding) and Targhee (T; n = 166; 183 to 210 d range of age at breeding; 40 to 68 kg range of BW at breeding) ewe lambs were stratified randomly by breed to treatments: ambient controls (AC); IE; MEL; and MEL+IE. Melatonin (18 mg of Regulin) was implanted on September 7. Estrus induction included medroxyprogesterone acetate (MAP) pessaries inserted for 12 d and pregnant mare's serum gonadotropin (PMSG; 500 IU i.m.) at time of MAP removal. Ewe lambs were placed into two pens with five rams per pen by breed. Targhee ewes lambed at an increased rate with IE vs no IE (84.5 vs 67.9%; P < .01) and tended to lamb at an increased rate with MEL vs no MEL (82.5 vs 70.6%; P = .07). The 92.7% lambing rate observed in the Targhee ewe lambs for the combined treatment (MEL+IE) was slightly higher than an additive effect but the interaction between IE and MEL was not significant (P = .24). By contrast, none of the treatments altered (P = .5) lambing rate, number of lambs born, or number born alive for Columbia ewe lambs.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Passive immunization of ewes against an inhibin-like peptide increases follicle-stimulating hormone concentrations, ovulation rate, and prolificacy in spring-mated ewes.

The objective of this experiment was to determine whether passive immunization against a synthetic inhibin-like peptide (alpha-IF) increases FSH secretion and reproductive performance of ewes bred in the spring. Crossbred ewes were assigned to three treatment groups of 10 ewes each. Progesterone-releasing pessaries (CIDR-G) were inserted and left in place for 12 d. The CIDR-G were removed on April 7 (0 h), and three rams were introduced. A single 1.8-mL i.m. injection containing 0, 315-, or 630-reference preparation-2 (RP-2) kU semipurified alpha-IF-antibody (Ab) was given at -48 h. Antibody solution was prepared by ammonium sulfate precipitation and concentration of ovine immune sera that had been generated against alpha-IF-human-alpha-globulin. After the alpha-IF-Ab injection, plasma alpha-IF-Ab titers and FSH concentrations increased within 6 h, peaked 12 to 24 h later, and then decreased. At 12 h after injection, FSH concentrations were increased (P = .05) 28 and 42% over control values in ewes injected with 315- and 630-RP-2 kU alpha-IF-Ab, respectively. All ewes expressed estrus and ovulated, except one control that did not ovulate. Ovulation rate (OR) was increased (P < .0001) by alpha-IF-Ab treatment. Mean OR was 1.0 in control ewes, 1.7 in ewes given 315-RP-2 kU, and 2.5 in ewes injected with 630-RP-2 kU. Fertility (ewes lambing/ewes exposed) from breeding at the induced-synchronized estrus tended (P = .09) to be greater for ewes injected with 630-RP-2 kU alpha-IF-Ab.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1999

Production and lambing rate of blastocysts derived from in vitro matured oocytes after gonadotropin treatment of prepubertal ewes.

The aim of this study was to evaluate the effect of gonadotropin treatment on the in vitro maturation, blastocyst production, and developmental potential to term of oocytes collected from Sardinian neonatal and prepubertal ewes at 4 to 6 wk of age. Cumulus-oocyte complexes were recovered at 24 h after withdrawal of a 1/6th size progestagenated pessary from the donors, of which each received 120 IU FSH/LH and 400 IU PMSG in a single dose 36 h before sponge removal. Treated donors produced a greater (P<.01) number of oocytes per animal (86.2 +/-7.9) compared with slaughterhouse (untreated) prepubertal ewes (55.5+/-6.1) of the same age or with treated neonatal ewes (6.1+/-0.7) 10 d old. During oocyte maturation, there were no differences in the percentage of germinal vesicle break-down (78.08 vs. 74.24), metaphase I (89.13 vs. 87.18), and metaphase II (77.91 vs. 76.38) when evaluated after 8, 14, and 24 h of maturation, respectively, between oocytes from treated and slaughterhouse (untreated) prepubertal ewes. The embryo cleavage (71.1 vs. 73.7) and blastocyst rates (22.2 vs. 19.8) were similar in the treated and the untreated prepubertal ewes after transfer of in vitro matured oocytes into ligated oviducts of temporary recipients. The in vitro viability rates of vitrified blastocysts (81.2 vs. 76.9) and the in vivo survival rates (46.1 vs. 50.0) of embryos derived from in vitro matured and in vivo fertilized oocytes showed no difference. The data suggest that gonadotropin treatment increases oocyte production per animal but has no effect on oocyte quality because embryo production and lambing rates of blastocysts derived from in vitro matured oocytes were not markedly different from those derived from untreated prepubertal ewes of the same age.

Animals↗
PubMed1981

Synchronization of ewes during anestrus: influence of time of year and interval to onset of estrus on conception rate.

The effects of progestogen-gonadotropin treatment on estrous response, ovulation rate and lambing response of crossbred ewes were examined at two times during the anestrous season (May-June and July-August). Each ewe group was treated with progestogen pessaries for 16 days and injected with 750 IU pregnant mare serum gonadotropin (PMSG) on days 17 and 32 to induce two consecutive estrous periods. Data accumulated from single-sire matings of 500 ewes indicated that estrous, ovulation and lambing responses did not differ (P less than .10) between ewes treated in May-June (92%, 2.5, 66%) and ewes treated in July-August (93%, 2.5, 67%). We concluded that there were no significant differences between reproductive responses of ewes synchronized during mid-anestrus (May-June) and those of ewes treated during late anestrus (July-August). For the May-June and July-August groups combined, estrous, ovulatory and lambing response were higher (P less than .05) during the first induced estrous period (76%, 3.0, 62%) than during the second (33%, 1.9, 43%). In both the first and second induced estrous periods, as interval from PMSG injection to onset of estrus increased, significant declines in ovulation rate, conception rate and ram marking activity were observed, particularly when onset of estrus occurred 72 hr or more after PMSG injection. These results indicate that the reduced lambing responses reported for ewes synchronized during anestrus may be due to increased asynchrony of reproductive events in the ewe, or decreased ram aggressiveness and fertility, or a combination thereof, as the interval from PMSG injection to the onset of estrus increases.

Animals↗
PubMed1985

Ovulation rate in sheep selected for weaning weight or litter size.

Ovulation rate was measured by laparoscopy at two consecutive cycles on 366 ewes 2 yr old and over and 85 yearling ewes of five lines of Targhees from the base base population; 53 yearling linecross ewes were also included. The lines were two unselected controls (HCl and DC), two selected for 21 yr for increased 120-d weight (HW and DH) and one selected for 19 yr for multiple births (T). Ewes were synchronized in late July or early August at the start of the normal breeding season with intravaginal pessaries impregnated with 60 mg methylacetoxyprogesterone and examined at first and second estrus. Ovulation had occurred in both cycles in 327 (89%) and 177 (85%) of the mature and yearling ewes, respectively. Overall mean numbers of corpora lutea at first and second estrus were 1.42 and 1.63, respectively for ewes 2 yr and over and 1.20 and 1.44 for yearlings, indicating an effect of synchronizing treatment, season, flushing, or a combination of these. Among mature ewes, ovulation rate was higher (P less than .05) in DH (+.20), HW (+.19) and T (+.16) than in controls at first estrus, and in HW (+.29) and T (+.21) but not DH (-.04) at second estrus. Among yearlings, differences were significant only at second estrus (HW, +.40; T, +.35) and again not for DH (+.08). The failure of line DH to increase in ovulation rate from first to second estrus as did other lines was transmitted to linecross progeny. Body weight within line affected ovulation rate significantly, with a greater effect at second estrus, in both age groups. Adjustment for body weight removed the difference between HW and controls but not between T and controls. Repeatability of corpora lutea count was .27 and .25 for mature and yearling ewes, respectively.

Animals↗
PubMed1988

Influence of concentration, duration and route of administration of melatonin on reproductive performance of spring-mated polypay and polypay-cross ewes.

The effects of exogenous melatonin on reproductive performance of 737 Polypay and Polypay-cross ewes were evaluated during a late March and April breeding period. Different concentrations (2 or 10 mg) routes of administration (fed vs implanted) and durations of administration (20 or 40 d before breeding) were studied. Estrus was synchronized in all ewes using 60 mg medroxyprogesterone acetate (MAP) in a vaginal pessary. Number of mature ewes lambing/ewe present at lambing was increased (P less than .05) nearly 20% by implanting for 40 d with melatonin (75%) or by feeding either 2 (72%) or 10 mg (73%) melatonin for 40 d before spring breeding compared with untreated control ewes (54%) or ewes implanted for only 20 d before breeding (58%). Date of lambing, number of lambs born/ewes lambing and number of lambs born alive/ewe lambing were not altered significantly by treatments. Number of yearling ewes (n = 166 for ewes 1.5 yr old at lambing time) lambing/ewe present at lambing was lower (P less than .01; 26%) than that of mature ewes (n = 381, greater than or equal to 2.0 yr; 68%). We concluded that feeding 2 or 10 mg melatonin or implanting melatonin for 40 d enhanced reproductive performance and effectively overcame the restrictions of seasonality of breeding in mature ewes. In yearling ewes, 10 mg melatonin increased the number of ewes lambing.

Administration, Oral↗
PubMed1990

The effect of the anti-progestin mifepristone (RU 486) on plasma prostaglandin metabolite levels in early pregnancy and its influence on pregnancy termination.

The effect of a single dose of RU 486 (600mg) on prostaglandin metabolite levels has been studied over a 48 h period in 20 women undergoing medical termination of early pregnancy. The results were compared with controls of similar gestation who were treated surgically. The mean (SD) PGEM levels at 0 and 48 h in the RU 486 group were 13.7 (2.7) and 13.2 (2.2) pg/ml respectively, which was not significantly different from the values of 11.7 (1.1) and 11.3 (0.4) pg/ml measured in the control patients. Similarly the mean (SD) PGFM values of 22.3 (14.7) and 17.0 (7.2) pg/ml at 0 and 48 h were not significantly different from the corresponding control values of 21.9 (13.8) and 23.8 (7.2) pg/ml. In 10 of the study patients, there were no significant changes in PGEM and PGFM concentrations prior to and at 4, 24 and 48 h after RU 486 administration. Although all pregnancies were successfully terminated with the combination of RU 486 and subsequently a vaginal pessary containing PGE1, no stimulation of prostaglandin production could be demonstrated.

Abortion, Induced↗
PubMed1991

Open randomized comparison of prostaglandin E2 given by intracervical gel or vagitory for preinduction cervical ripening and induction of labor.

Intracervical application of prostaglandin E2 (PGE2) in a viscous gel was compared with conventional wax-based PGE2 vagitories (pessaries) for ripening of the cervix prior to induction of labor. A total of 226 healthy pregnant women at term were randomly allocated to receive intracervical gel with an effective dose of 0.5 mg (n = 116) or vagitories containing 2.5 mg PGE2 (n = 110). All women had a modified cervical score of less than or equal to 4. The numbers of cases contributed by each of the three centers were similar. There was no significant difference in parity, gestational length, maternal characteristics, indications for induction or preinduction cervical scores between the treatment groups. The rate of spontaneous birth was 71% in the gel group, compared with 69% in the vagitory group. Successful treatment was defined as active labor within 24 h or a change in cervical dilatation allowing artificial rupture of the membranes with subsequent progressive labor. The success rate was not significantly different in the gel group (82%) compared with the vagitory group (80%). There were no differences in the frequency of fetal distress, outcome of labor, assisted delivery rates or maternal side effects. The cervical scores were not different at 12 and 24 h after application. Intracervical gel and intravaginal application of PGE2 were similar in their efficacy and safety for ripening of the cervix and inducing labor at term.

Administration, Intravaginal↗
PubMed1994

An open prospective randomized study of dinoproston and gemeprost in second trimester legal abortions.

The aim of this open prospective randomized study was to compare two non-invasive methods for second trimester abortion using gemeprost pessaries (Cervagem) and dinoproston gel (Cerviprost) concerning effectiveness, time for abortion, consumption of analgesics, infection-rate and side-effects. Forty women admitted for second trimester legal abortion were allocated to treatment with either gemeprost (20) intravaginally or dinoproston (20) intracervically. All patients were pre-treated with a 3 mm in diameter Lamicel tent applied intracervically for about four hours. The success-rate was 95% for gemeprost and 75% for dinoproston within approximately 48 hours. The median abortion time calculated from the insertion of the Lamicel tent for the successful cases was 22 h 0 min for gemeprost and 24 h 5 min for dinoproston (not significant). The shortest abortion time was found among parous women in the Cervagem group. The difference between Cerviprost and Cervagem in parous women was statistically significant. For nonparous women there were no significant differences in abortion time between the two regimes. No significant difference was found in the demand of Pethidin and the infection-rate between the two groups. No major side effects of the treatment were found. Even if no significant difference in successful abortions was found, probably due to the small patient material, Cervagem seems to be the most appropriate of the two non-invasive methods, because of a 95 per cent success-rate within 48 hours, but also due to its simplicity in design.

Abortifacient Agents, Nonsteroidal↗
PubMed1994

Psychological responses following medical abortion (using mifepristone and gemeprost) and surgical vacuum aspiration. A patient-centered, partially randomised prospective study.

BACKGROUND: A substantial body of objective data now exists to support the consensus view that induced abortion results in a low incidence of psychiatric morbidity. However, these data do not include more recent advances in abortion technology. Medical abortion entails a participatory role on the part of the woman, who may perceive more pain or see products of conception. The physical and psychological events experienced by women undergoing this procedure may lead to differences in psychopathology. METHODS: 363 women undergoing legal induced abortion up to 63 days gestation were allocated by a prospective partially randomised design to undergo medical abortion (using mifepristone 600 mg followed 48 h later by gemeprost 1 mg vaginal pessary) or vacuum aspiration performed under general anesthesia. This study design allowed women with a preference for a particular method to undergo that method; women without preferences were allocated at random. Women completed sensitive and reliable psychometric instruments (the Hospital Anxiety and Depression Scale and a semantic differential rating scale designed to measure self-esteem) prior to abortion and 16 days later. RESULTS: There were no significant differences between women allocated at random to medical abortion or vacuum aspiration in post-abortal anxiety, depression or low self-esteem. Women with high levels of mood disturbance prior to abortion, who were smokers or who had medical complications following abortion were at highest risk of post-abortal mood disorder. CONCLUSIONS: Medical abortion is a psychologically safe as surgical vacuum aspiration. The quantitative findings of the study support the consensus view that abortion is associated with high incidence of psychological benefit, whichever method is used.

Abortifacient Agents, Nonsteroidal↗
PubMed2003

Acute renal failure from complete uterine prolapse: role of polycystic kidney disease.

A 48-year-old female developed acute renal failure from obstruction caused by a complete uterine prolapse. She had polycystic kidney disease (ADPKD) with previously stable mild renal impairment. She presented with rapidly declining renal function and oliguria which reversed following manual reduction of the prolapse and insertion of a ring pessary. None of the usual risk factors for uterine prolapse were present, however ADPKD may have contributed to the prolapse. Rapid deterioration of renal function in female patients with ADPKD should prompt gynecological examination to exclude a uterine prolapse as a cause.

Acute Kidney Injury↗
PubMed2005

[Bladder stone caused by olive oil following TVT operation].

Tension-free vaginal tape (TVT), a less-invasive variation of the suburethral sling, has been rapidly gaining popularity worldwide in the treatment of female stress urinary incontinence. We report on two cases of bladder stones composed of fatty acid calcium following TVT operations. Case 1: A 76-year-old woman with a history of hysterectomy due to cervical cancer was suffering from vault prolapse. The insertion of a ring pessary lead to the development of stress urinary incontinence, and she was referred to our hospital. As she was frail, sexually inactive, and elderly, she underwent partial colpocleisis (Le Fort operation) combined with a TVT operation. One-month postoperative videourodynamics and chain cystourethrography (CUG) using olive oil as the lubricant showed cure of incontinence and mild support of the urethra. Her maximum flow rate was 18.8 ml/s and no residual urine was observed. Six months postoperatively she developed postmiction pain and pyuria that were not improved by antibiotics. Cystoscopy showed a small bladder stone, whose removal cured cystitis. Case 2: A 49-year-old woman, with a history of abdominal hysterectomy due to myoma uteri, visited our hospital complaining of stress urinary incontinence. A periurethral collagen injection was only temporarily effective, and she underwent a TVT operation. A 1-month postoperative evaluation including chain CUG using olive oil as the lubricant showed cure of incontinence, mild support of the urethra, a maximum flow rate of 28.8 ml/s, and no residual urine. Two months postoperatively she developed miction pain and pyuria that were solved by removing a small bladder stone. Anti-incontinence surgery increases the risk of developing bladder stones due to either foreign bodies (bladder erosion) or obstruction. However, neither of our cases had these conditions; instead, both bladder stones were composed of fatty acid calcium that appeared to be related to the olive oil used as the lubricant in chain CUG. Only four cases (including ours) of bladder stones composed of fatty acid calcium have been documented, but they may indicate that care is necessary when using olive oil as a contrast medium or lubricant in the urinary tract. When a woman with a history of anti-incontinence surgery has persisting or recurrent cystitis, cystoscopy should be performed to exclude bladder erosion and stones.

Aged↗
PubMed1999

[Genital actinomycosis. Diagnostic and therapeutic difficulties. Report of three cases].

Genital actinomycosis is a rare bacterial infection affecting women of child-bearing age, which is sometimes related to the use of an IUD or an intra-vaginal pessary. Nevertheless, this relationship is at best tenous and actinomycosis is not the only bacterial infection caused by IUD use. Genital actinomycosis often occurs as a pelvic tumour which is sometimes difficult to correctly diagnose and consequently treat accordingly. Rapid diagnosis is essential in order to avoid any irreparable tissue damage. Treatment of this condition consists of a combination of antibiotics and surgery to achieve complete recovery. Three cases are described.

Actinomycosis↗
PubMed2000

[Impact of genital prolapse on the upper urinary tract].

UNLABELLED: The authors reviewed five cases of genital prolapse affecting the upper urinary tract and causing renal failure. CLINICAL CASES: Five patients aged 55 to 75 years presented with genital prolapse, which was known by the patient in 3 cases for a period of 2 to 30 year, but left untreated. All cases had induced bilateral dilatation of the uretero-pyelocaliceal cavities with severe obstructive renal failure in 3 cases, moderate renal failure in 2 cases and associated with hypertension in 2 cases. Repair of prolapse, preceded by upper urinary tract diversion by ureteric and bladder catheters in 3 cases or pessary + bladder catheter because of the patient's age in 2 cases, cured or improved renal failure in 4 patients; only one patient had to be treated by dialysis because of the severity of the residual renal failure severity. DISCUSSION: The frequency (4%) of aetiopathogenic mechanisms (ureteric compression, progressive stretching of the ureter and posterior tilting of the trigone) are analysed. The delayed onset of sudden deterioration and the varying degrees of severity of renal failure demand emergency treatment of stage III prolapse with primary diversion of the upper urinary tract, currently by double J stents, until correction or improvement of renal function, after which surgical repair of the prolapse can be performed according to the usual surgical rules. Intravenous urography is still indicated in this situation. Palliative treatment is only indicated in elderly patients or patients with a high operative risk. The best treatment remains prevention by detection and treatment of prolapse before the development of this fortunately rare complication. CONCLUSION: This short clinical series emphasizes that undiagnosed prolapse can still be complicated by repercussions on the upper urinary tract with a risk of renal failure.

Aged↗