Pelvic arteriovenous malformations (AVM) of the pelvis are rare diseases and difficult to treat due to complex pelvic anatomy and extensive feeding vessel. Diagnosis of pelvic AVM relies on transrectal ultrasound (TRUS) and digital rectal examination as initial survey and computed tomography (CT) as secondary evaluation. Treatment options include surgical resection and embolization. We reported as 41-year-old male patient with congenital pelvic AVM that presented as perineal pain. TRUS revealed hypoechoic lesion with turbulent blood flow. CT demonstrated engorged vessel and angiography suggested high flow AVM with feeding artery from the right internal pudendal artery. Congenital pelvic AVM was diagnosed, but the patient refused treatment and requested clinical follow-up.

IMPORTANCE Literature has suggested that trauma among pregnant women is associated with an increased risk of adverse pregnancy outcomes. However, limited research has investigated the association of trauma with adverse pregnancy outcomes by using a national data set.OBJECTIVE To investigate the association between traumatic injury and adverse pregnancy outcomes. DESIGN, SETTING, AND PARTICIPANTSThis population-based cohort study of pregnant women in Taiwan linked 3 data sets, the Taiwan Birth Registry, Household Registration Information, and

Objective Current evidence concerning the effect of aging on the treatment outcome of extracorporeal shock wave lithotripsy (ESWL) is still conflicting. We performed a retrospective analysis to investigate the effect of age on the treatment outcome of ESWL for ureteric stones. Materials and Methods Our study was a pair-matched analysis comparing the three month stone free rate (SFR) after primary ESWL. Between March 1 st , 2013 and December 31 st , 2015, a total of 1204 patients received ESWL in our facility. We recruited 131 patients who were above or equal to 65 years old, 72 of whom met our inclusion criteria. These patients were stratified into Group A. To compare differences in treatment outcome between age groups, patients in Group A were matched 1:1 to patients aged less than 65 years by their stone size, stone location and gender. These matched patients were sorted into Group B. We compared the three-month SFR and the effect of co-morbidities on the three-month SFR between the two groups using the Pearson's chi-square test and multivariate analysis. Results Seventy-two patients were included with a male-to-female ratio of 1:1 in each group. The average stone size was 6.74 mm (95% confidence interval, CI: 7.51-5.96) and 6.61 mm (95% CI: 7.25-5.96) in Group A and B, respectively (p=0.799). There were no differences in the three month SFR between Group A and B (63.9% vs. 66.7%, p=0.726). Univariate analysis suggested that stone location and diameter were related to SFR. However, multivariate analysis failed to show any statistically significant factors affecting SFR, including age. Conclusion In our study, age did not affect the three month SFR of ESWL. Therefore, ESWL could be an effective treatment modality for older patients. However, prospective studies with detailed data collection are required to validate these findings.

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