Introduction Intravesical instillation with a hyaluronic acid (HA) solution is an effective treatment for interstitial cystitis/bladder pain syndrome (IC/BPS), but its impact on sexual functioning of patients is not known. Aim The aim of this study was to evaluate the changes in sexual function of women with refractory IC/BPS who underwent a second-line intravesical HA therapy. Methods A total of 103 women diagnosed with refractory IC/BPS were enrolled in this prospective, multicenter study. Sexual function was evaluated using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-9). Bladder-related symptoms and bother were assessed by the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), and a pain visual analog scale (VAS), respectively. Data were analyzed with univariate methods or multivariate logistic regression analysis accordingly. Main Outcomes Measures Changes in PISQ-9, ICSI, ICPI, and pain VAS scores after treatment were assessed. Results Mean age and duration of symptoms was 43.6 ± 11.8 and 5.1 ± 5.0 years, respectively. ICSI, ICPI, and pain VAS scores were significantly (P < 0.001) improved after 1 month and 6 months of treatment. Of the 87 (84.5%) sexually active women evaluated, PISQ-9 total scores improved significantly (P < 0.001) from the baseline (mean 18.9 ± 6.4), after 1 month (20.4 ± 5.8), and 6-months (21.5 ± 5.6) of treatment. Significantly improved PISQ-9 items included “dyspareunia” (P < 0.001) and “negative reactions” (P = 0.015) during sexual intercourse, and “intensity” (P < 0.001) of sexual orgasms. After a logistic regression analysis, we found that a baseline PISQ-9 score was negatively correlated with the duration of IC/BPS symptoms (P = 0.022). Meanwhile, the changes in PISQ-9 scores were positively correlated with the reduction in ICSI scores after treatment (P = 0.045). Conclusions Intravesical HA is an effective treatment for refractory IC/BPS. A longer duration of IC/BPS symptoms may be a predictor of poor sexual function. However, intravesical HA may improve sexual function along with the reduction of IC/BPS symptoms.

Carcinoma of the uterine cervix is a common malignancy, and many affected women, have been found to exhibit loss of heterozygosity (LOH) in the chromosome 3p region. Recent studies have localized the FHIT (fragile histidine triad) gene in this region and also demonstrated a high frequency of abnormalities of this gene in various cancers. To determine the role of the FHIT gene in cervical and uterine carcinomas, 16 cases of cervical carcinoma and 7 cases of endometrial carcinoma, as well as nearby non-cancerous tissues in these patients, were analyzed by reverse transcription of the FHIT mRNA followed by polymerase chain reaction amplification and sequencing of the products. In this study, 13 of 16 cervical cancers and 4 of 7 endometrial cancers displayed abnormal FHIT transcripts, including a lack of 2 or more exons of the FHIT gene, the insertion of several bases in the deletion junctions, and a 282 bp deletion from cDNA 171 to 452, resulting in a frameshift. Moreover, 5 of 16 matched noncancerous tissues from the cervical cancer patients and 4 of 7 non-cancerous tissues from endometrial cancer patients also showed the presence of abnormal transcripts lacking 3 or more exons of the FHIT gene. Only 1 of 23 paired samples exhibited LOH. Our results suggest that the abnormal transcript of the FHIT gene is common in both normal and tumor tissues of the uterus and cervix. We also checked for HPV infection in these samples and found no definite relationship between the abnormal transcript and human papillomavirus infection. Int.

With the introduction of transvaginal probes, high resolution images of organs in the pelvis can now be obtained. We present two cases of vesicovaginal fistula with transvaginal sonographic findings. One was secondary to abdominal hysterectomy, the other was a sequela of radiotherapy. CASE REPORT Case 1A 27-year-old woman, G4P3, had an abdominal hysterectomy for symptomatic uterine myoma and developed a watery vaginal discharge on the 21st postoperative day. A methylene blue test was positive, and cystoscopy confirmed a vesicovaginal fistula. Five months later, repeat cystoscopy showed a bladder wall defect, about 0.5 cm in size, located near the orifice of the left ureter.A sonographic scan was performed with a Toshiba SSA-260A scanner (Tokyo, Japan) with a 5.0-MHz vaginal probe. It showed a fistula tract with an echogenic wall, located in the upper vaginal wall ( Figure 1A). The fistula tract was clearly delineated when the upper vagina and bladder were filled with urine. The diameter of the fistula tract diminished in size and the outline became obscure when the vagina and bladder were further distended with a greater amount of urine ( Figure 1B). However, a flow wave from the fistula into the urine of the bladder was inducible by coughing, helping to locate the site of fistula. The mucosa of the bladder wall was 3.2 mm thick. Urinalysis showed a leukocyte count of 8/HPF to 15/HPF. The patient had a Latzko operation and has been well since then.