BackgroundEndometriosis is the abnormal growth of uterine tissue outside the uterine cavity that can cause chronic pain, dysmenorrhea, and dyspareunia. Although the disease is common and nonmalignant in nature, the symptoms can severely impact function and quality of life. Treatment options for endometriosis are limited and not well understood despite a growing need.ObjectiveTo determine the effectiveness of pelvic‐floor musculature trigger‐point injections and peripheral nerve hydrodissection in treating endometriosis symptoms, associated pain, and pelvic functionality.DesignRetrospective longitudinal study case series.SettingPrivate practice.PatientsSixteen female patients with biopsy‐confirmed endometriosis.InterventionsUltrasound‐guided pelvic‐floor trigger‐point injections and peripheral nerve hydrodissection performed once a week for 6 weeks.Main Outcome MeasurementsPelvic pain intensity as measured pretreatment and posttreatment by the 0 to 10 Visual Analogue Scale (VAS) and the Functional Pelvic Pain Scale (FPPS).ResultsPretreatment, the mean VAS score was 6.0 (standard deviation [SD] 2.7), and posttreatment the mean VAS score was 2.9 (SD 2.6); P < .05, 95% confidence interval (CI) 1.16 to 4.97. The mean total FPPS score before treatment was 14.4 (SD 5.2) and posttreatment it was 9.1 (SD 5.8); P < .05, 95% CI 1.34 to 9.28. Analysis of the subcategories within the FPPS indicated that the improvement was statistically significant in the categories of intercourse, sleeping, and working. In the category of intercourse, the mean change in score after treatment was 1.3 (P < .05, 95% CI 0.26‐2.31). In the category of sleeping, the mean change in score after treatment was 1.2 (P < .05, 95% CI 0.32‐1.99). In the category of working, the mean change in score after treatment was 0.9 (P < .05, 95% CI 0.18‐1.53).ConclusionsAnalysis suggests that the treatment was effective at relieving pain related to endometriosis; it also reflected promise in improving overall pelvic function, particularly in relation to intercourse, working, and sleeping.

Altered DNA repair capacity may affect an individual's susceptibility to cancers due to compromised genomic integrity. This study was designed to elucidate the association of selected polymorphisms in DNA repair genes with urothelial bladder carcinoma (UBC). OGG1 rs1052133 and rs2304277, XRCC1 rs1799782 and rs25487, XRCC3 rs861539, XPC rs2228001, and XPD rs13181 were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 200 UBC cases and 200 controls. We found association of OGG1 rs2304277 [odds ratio (OR) = 3.55, 95% confidence interval (CI) = 1.79-7.06] and XPC rs2228001 (OR = 2.38, 95% CI = 1.43-3.94) with UBC. In stratified analysis with respect to smoking status, OGG1 rs2304277 and XPC rs2228001 exhibited increased risk in smokers [(rs2304277 OR = 4.96, 95% CI = 1.51-16.30) (rs2228001 OR = 2.19, 95% CI = 1.02-4.72)] as well as nonsmokers [(rs2304277 OR = 2.95, 95% CI = 1.26-6.90) (rs2228001 OR = 2.57, 95% CI = 1.31-5.04)]. These polymorphisms were also associated with both low-grade [(rs2304277 OR = 3.73, 95% CI = 1.72-8.09) (rs2228001 OR = 2.18, 95% CI = 1.21-3.92)] and high-grade tumors [(rs2304277 OR = 3.45, 95% CI = 1.52-7.80) (rs2228001 OR = 2.81, 95% CI = 1.48-5.33)] as well as with non-muscle-invasive bladder cancer [(rs2304277 OR = 4.03, 95% CI = 1.87-8.67) (rs2228001 OR = 2.14, 95% CI = 1.20-3.81)] and muscle-invasive bladder cancer [(rs2304277 OR = 3.06, 95%CI = 1.31-7.13) (rs2228001 OR = 2.95, 95%CI = 1.51-5.75)]. This is the first study on DNA repair gene polymorphisms and UBC in the Pakistani population. It identifies OGG1 rs2304277 and replicates XPC rs2228001 as significant modulators of UBC susceptibility.

Introduction: Urological chronic pelvic pain syndrome (UCPPS) represents a group of pain symptoms relating to patients with pelvic pain for which treatment is largely unsatisfactory. The objective of this study is to analyze the effects of a novel treatment strategy in males suffering from UCPPS.Methods: This retrospective, institutional review board-approved study analyzed eight male patients aged 24 to 61 with UCPPS. All the patients had a trial of antibiotic therapy, NSAIDs, and pelvic floor physical therapy before the study. The Visual Analog scale (VAS) and Functional Pelvic Pain scale (FPPS) were collected pretreatment. While continuing physical therapy, patients underwent weekly ultrasound-guided pelvic floor trigger point injections to the iliococcygeus, pubococcygeus, and puborectalis with lidocaine 1%. Concomitantly, patients received peripheral nerve hydrodissection performed on the pudendal nerve and the posterior femoral cutaneous nerve. The first two injections combined 1% lidocaine with dexamethasone, while the next four injections consisted of 1% lidocaine with traumeel (a homeopathic, plant-derived anti-inflammatory medication). At the 6-week follow-up, each patient retook the VAS and FPPS.Results: The mean age of our patients was 31.8 years and the average duration of symptoms of the UCPPS was 21 months. Pretreatment, the mean VAS was 3.3 (STD 1.7) and the mean VAS posttreatment was 1.8 (STD 1.4); P < .05; 95% CI, 0.73 to 2.27. The mean FPPS pretreatment was 11.0 Accepted Abstract and Oral Presentation for International Continence Society 2018, Philadelphia, PA.(STD 8.0) and the mean FPPS posttreatment was 6.3 (STD 5.3); P < .05; 95% CI, 0.03 to 9.22. Conclusion:Our results show promise for a novel, nonopioid-based treatment for UCPPS. K E Y W O R D Sbladder, collagen, cystometry, cystostomy, HE staining, Masson staining, rat