br Discussion Women face numerous major risk

Discussion Women face numerous major risk factors for developing UTIs, including inadequate fluid intake, infrequent urination, poor personal hygiene, and immunosuppressive status. When examining young women, an unusually active sex life, the use of a vaginal diaphragm, and infrequently changing menstrual pads during menstruation are additional factors that need to be considered; for older women, factors such as diabetes, urinary incontinence, and pelvic organ prolapse need to be considered. When considering recurrent UTIs, other unusual causes, such as a congenital anomaly or the presence of a foreign body, should also be considered. Sometimes urinary stones can develop because the foreign body serves as the initiating nidus within the bladder, thereby complicating the situation. Although UTIs respond well to a short course of empiric notch signaling in most cases, the special types of UTI mentioned above are always unresponsive unless the underlying causes are identified and corrected. As a result, when evaluating intractable and complicated UTIs, it is always helpful to be alert to the possibility of an underlying cause, rather than presuming that women are simply prone to the usual types of UTI. Sometimes a KUB X-ray or outpatient cystoscopic examination can yield important information that can be used to elucidate the underlying problem. Stress urinary incontinence, a condition often seen in postmenopausal women, is a consequence of pelvic floor weakness and insufficient support of the vesicourethral sphincteric unit. It can lead to unwanted urinary leakage, which is socially embarrassing and creates a hygiene problem. The basic goal of surgical correction is to realign the suspension of the vesicourethral sphincteric unit to its proper position. The operation can either be the classic retropubic sling surgery or the most up-to-date and minimally invasive tension-free procedure, such as the tension-free vaginal tape surgery. All of these anti-incontinence operations rely on sutures or slings, which consist of allographic or synthetic materials, to provide the necessary support. Complications are rare but mostly consist of perforations to the urinary bladder, which have been reported to occur following 4.9–9.0% of surgeries. In general, complications are either related to an improperly performed procedure or the failure to perform an intraoperative cystoscopic examination. If a bladder injury does occur, 95% of patients tend to present with hematuria shortly afterward; this complication will in turn alert the attending physician of the bladder injury. If a synthetic material is used in the procedure, it carries an extra risk of erosion into the urinary bladder or urethra. Erosion rates vary, but have been reported to occur following 0.3–23% of surgeries. Unfortunately, the process of erosion is often chronic and indolent, usually presenting as recurrent UTIs. Correct diagnosis depends on the complete and careful examination of the patient’s medical history by a highly attentive consulting physician. Encrustation usually occurs on the surface of the eroded foreign body following contact with urine. The inevitable result is the formation of urinary stones. Removal of the encrusted stones can be safely and effectively performed using various endoscopic approaches, such as using a laser, electrohydraulic, ultrasonic, or pneumatic lithotrites, or simple mechanical crushing devices. However, difficulties may be encountered when attempting to remove foreign bodies that are permanently embedded in the bladder wall. In uncomplicated cases, excision of the part exposed to the deep bladder mucosa is usually sufficient. Unfortunately, if simple endoscopic manipulation fails, a complete laparotomy may be necessary to completely remove the foreign body.
Conclusion
Introduction Epithelioid hemangioendothelioma (EHE) is a rare, well-differentiated vascular endothelial neoplasm. The clinical behavior of EHE is between hemangioma and angiosarcoma. Pulmonary involvement of EHE is even rarer. It was first reported by Dail and Liebow in 1975 as an intravascular bronchioloalveolar tumor. Four years later, Corrin et al demonstrated using immunohistochemistry that EHE was of endothelial origin. The tumor cells reacted to vascular markers such as CD31, CD34, factor VIII, and Friend leukemia integration-1 (FLI-1). Pulmonary EHE typically manifests as bilateral multiple pulmonary nodules in young or middle-aged women. Although many affected patients are asymptomatic, some present with pleuritic pain, dyspnea, and cough. We present a classic case of pulmonary EHE in which the patient’s pulmonary function was normal after operation.