The Jikei University School of Medicine urology department


Urology disease

  • Man
  • Woman

Woman health care

1.Cystitis interstitial

Beginning, urine become near and bleed, and inflammation that is chronic in bladder is unidentified disease that there is ulcer (Hunner ulcer) in seriously ill intravesically by mucous membrane of bladder becoming thin with cystitis interstitial, and exfoliating. Neither diagnostic method nor cure is established for the moment, but is felt uneasy about when patients of cystitis interstitial doubt may increase recently (to a population of 100,000 people approximately 4,600). In addition, we are told that woman who is easy to repeat cystitis has many (woman: man = 1.5:1). We investigate bladder organization of patient thoroughly using various immunity stainings in order to establish objective diagnostic method for this intractable disease. In addition, in addition to pharmacotherapy and operation (bladder water pressure expansion) that are conventional cure, we perform search of new cure. Please consult about one with cystitis interstitial doubt by all means.

Question vote of cystitis interstitial is this

(more than six points: cystitis interstitial doubt)

2.Urinary incontinence of woman

Urinary incontinence that is often detected in woman attributable to the urethra attributable to "stress urinary incontinence (approximately 50%) and bladder "is greatly classified in two of impending urinary incontinence (approximately 10%). In addition, there is often (approximately 40%) when both mix. Generally, we perform individual guidance of pelvic floor muscle exercises for mild urinary incontinence in outpatient department. In addition, pharmacotherapy is effective for impending urinary incontinence. On the other hand, we perform operations using mesh (tape) for severe stress urinary incontinence. There is TOT (Trans-Obturator Tape) law to provide to TVT (Trans-Vaginal Tape) law and obturator foramen giving both ends of mesh on the pubic bones, but which operation is surgical method that is low aggression to be over transvaginally in (15-30 minutes) for short time, too. Please consult about trouble for urinary incontinence by all means.

3.Pelvic organ prolapse

With pelvic organ prolapse

By organ escaping for disease that organs such as a certain bladder, uterus, rectum are depressed in pelvis intravaginally, we call with cystocele (bokouryu), prolapse of uterus (shikyudatsu), rectocele (chokuchoryu). Because muscle, muscular fasciae, ligament supporting organ in pelvis becomes weak for aging, delivery, obesity, we are angry and are disease that there is many for woman. Symptom is pelvic pain or discomfort, dysuria, dyschezia.

(as for the bladder, as for yellow, the uterus, as for pinkness, the rectum, brown)

Uterine prolapse
Cure for pelvic organ prolapse

Cure except operation includes methods such as the ring (pessary) insertion in pelvic floor muscle exercises and vagina, but there is only operation to cure well. There are transvaginal expression mesh fixed operation and skill to insert mesh in as performed surgical method from vaginal wall in laparoscopic mesh fixation to insert mesh in from stomach using laparoscope now. Both surgical methods are said to have better treatment result than conventional method, but please understand enough the risk because surgical method of pelvic organ prolapse using mesh is relatively new.

With skill in transvaginal expression mesh fixation (TVM)

We cut anterior vaginal wall open for cystocele and detain mesh between bladder and vaginas. We cut posterior vaginal wall open for rectocele and detain mesh between rectum and vaginas. We detain mesh in front and behind vagina for uterine prolapse or pick out uterus itself from vagina. In addition, range of mesh to use by each condition is different as cystocele, uterine prolapse, rectocele often occurs at the same time.

Skill in previous vaginal wall mesh fixation for cystocele (as for the mesh, blue)

Skill in latter vaginal wall mesh fixation for rectocele (as for the mesh, blue)

With skill in laparoscopic mesh fixation (LSC)

As shown, we make entrance (port) to install camera and forceps in. Then, we detain mesh between intraabdominal close bladder and vagina, rectum and vaginas each after having extracted the uterus and the ovary of both sides. We pull this mesh to head side and fix to the spinal front. Therefore, person who extracted the uterus and the ovary can pull mesh well, but does not mean that you must necessarily take the uterus and the ovary. This operation is usually carried out for uterine prolapse and vaginal stump prolapse after hysterectomy.

Wound of stomach colposcope operation
Skill in laparoscopic mesh fixation for uterine prolapse

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